You are on page 1of 543

loo

Centres
orJ-kstoric

J

nterestr'

'"*>
<* Afcfit

.^////

?H

A HISTORY OF MEDICINE

rights reserved

THOMAS NELSON & SONS LTD 3 HENRIETTA STREET. LONDON, W
CT.2

PARKSIDF WORKS, EI>INBUROH
2,5 31

RUE DBNFERT ROCHEREAU, PARIS
i FLINDERS STRFET,

MELBOUUNE WELLINGTON STREET \VEST, TORONTO 385 MADISON AVENUE, NEW YORK
First published June 1945

PREFACE
"

THE longer you can look back, the further you can look forward,"
appearance of
book.

said

Mr. Winston Churchill, when addressing the Royal College of Physicians in March 1944. This truth provides ample justificapast supplies the key forms the basis of all to the present and History avenue of a convenient approach to any subject knowledge and is
tion for the
this

The

the future.

therefore only natural to regard the evolution and from bygone times as an essential backprogress of medicine education. Unfortunately, however, medical ground to modern

of study.

It is

the rapid advances and new discoveries of recent years have tended to eclipse the work of the early pioneers, and although due reverence is still accorded to the memory of such great figures as Harvey, Hunter, and Lister, the history of medicine in general

has not received that recognition which the importance of the
subject
in

would appear to demand. There is at present no systematic teaching of medical any medical school in this country, nor is there any

history British

periodical devoted to this aspect of medicine, although the Section of the History of Medicine, Royal Society of Medicine, which has done so much to foster medical culture, has kept interest alive

Too often early medical by publication of its Proceedings. has been as practice regarded merely quaint and sometimes
amusing,

now

obsolete

and of
is

little

value to the modern world.

encouraging to note, especially in the a younger generation, growing appreciation of the true purport of history in medicine and of its bearing upon the medical science
it

On

the other

hand

of to-day.

The need
is

for

an

historical

background to modern medicine
those

who regard the practice of securing recognition among medicine as something more than a mere technical accomplishment. Since no British text-book has been produced in recent years to meet this need, an attempt has been made in the following pages to construct an outline of the progress of medicine from the days of Imhotep to those of Sir William Osier. An outline does not aim at finality, and many worthy names have been omitted in order that the not lose interest by being overweighted story may with detail.

A

history of medicine should not be simply a chaplet of

PREFACE
biographies nor yet a maze of dates and events, but rather a consecutive narrative, showing the progress of the healing art from the earliest times to the present day. The work of the leading

and practitioners, the fashions and sects in medicine throughout the ages, the geographical march of medicine from Greece to Salerno and Padua, and thence, by way of Leyden, to Britain and America, the epoch-making researches of Harvey and Claude Bernard, of Lister and of many another these are but a few of the topics which the historian must fit into his mosaic of medical history, each detail as it falls into place revealing a steady and natural sequence. It is a noble theme, and it is hoped
scientists

that the story,
in those

however imperfectly

told,

may

stimulate interest

achievements of the past which help us to solve the problems of the present, and which must constitute the foundation of all future progress in medical science. As a guide to the reader who desires to pursue the study more deeply, references have been added, giving the authorities from which the author has drawn his information, and there is also a classified bibliography of works dealing with various aspects of this many-sided theme. In selecting the illustrations an effort has been made to avoid the commonplace and to secure pictures

and portraits from original sources. Geography is so closely related to history that a map is an A simple outline, essential complement to a work such as this. in which some of the important centres of medical learning are
shown, has been regarded as sufficient. It is designed merely as a rough guide to the reader who may wish to pursue his investigations with the aid of a more detailed atlas. It is obvious that a work of this nature cannot be undertaken without assistance, and the writer would like to pay tribute to the many friends who have assisted him in his task It was the late Dr. John D. Comrie who first led the author
:

into the fascinating paths of early medicine, and it is only fitting to honour the memory of one who did so much by his lectures

and

writings to foster an interest in the subject students and others.

among Edinburgh

To Mr. Alexander
teacher, the author
original manuscript
is

Miles, LL.D., F.R.C.S., his friend and Mr. Miles read the greatly indebted.

and supplied much helpful criticism in the early stages of the work, and the aid of one so well-informed in history and so skilled in editorship proved invaluable.
vi

Librarian of the Royal Society of Medicine. February 1945 Vll .PREFACE Another generous collaborator was Mr. Grateful acknowledgement is also due to many friends and colleagues who have assisted by supplying and by reading the proofs. J. F. In conclusion. G. G. was secured for this part of the task. the author desires to thank the publishers most references cordially for their unfailing courtesy at a and enthusiastic support time when publishing is attended by so many difficulties and restrictions. who made many valuable suggestions and responded to numerous requests for books and references with his customary alacrity and good nature. and it was fortunate that the aid of one so skilled in indexing as Dr. Corson. Edinburgh University Library. Hunterian Library of Glasgow University. Others to whom sincere thanks must be accorded for their expert assistance are the librarians and staffs of the National Library of Scotland. 21 CLARENDON CRESCENT EDINBURGH. C. Home. D. Edinburgh University Library. In every work of reference a good index is indispensable. Signet Library of Edinburgh. and the libraries of the Royal Colleges of Physicians and of Surgeons of Edinburgh.

HAVE ADVANCED THE PROGRESS OF MEDICINE knows whether the best of men be known. or whether there be not more remarkable persons forgot. and rest in unvisited tombs. Who life.TO THE MEMORY OF MANY PRACTITIONERS WHO. is half owing to the number who lived faithfully a hidden . than any that stand remembered in the known account of time ? Sir Thomas Browne. Hydriotaphia For the growing good of the world is partly dependent on unhistonc acts and that things are not so ill with you and me as they might have been. THOUGH UNKNOWN. George Eliot. Middlemarch Vlll .

The Dawn of . . Mithndaticum and Party Politics in Medicine A Follower of Hippocrates Celsus. . Regimen Sanitatis Salernitatum. Famous Graduates . 17 . . and the School of JundiRhazes and Avicenna Arabian Surgery in Spain Monastic Medicine. . Trepanning . VI ARABIAN MEDICINE: THE SCHOOL OF SALERNO The Influence of Christianity upon Arabian Medicine The Nestorians . . but not in Experimental Physiologist Circulation Galen as Author The Byzantine Compilers Public Hygiene in Rome The State Medical Service of Ancient Rome . and the End of the Moslem Empire Patron Saints in Medicine St. Salerno . . . Amulets. Thcriac Galen the Medical Dictator Galen as Practitioner The First The Blood in Motion.. Prehistoric Trephining or II THE FIRST KNOWN MEDICAL MEN Influence of Writing and the Medical Ethics in Babylonia Calendar Sekhet'enanach and Imhotep The Medical Literature of Ancient Egypt Embalming and the Pathology of Mummies Ancient Medicine of India China's Medicine in the Bible Contribution to Medicine. 84 Medicine . The Motives for Trephining Domestic Medicine or Folk Medicine among Primitive Races The Powder of Sympathy . . III EARLY GREEK MEDICINE " 39 . Medical Botanists. . . . . . IV HIPPOCRATIC MEDICINE The Background to Hippocrates The Hippocratic Collection The Hippocratic Oath The Nature of Disease The Importance of Prognosis The Aphorisms Hippocrates on Treatment . Oracle of Delphi Medicine and Surgery and Phoebus sprung " Apollo. V ALEXANDRIAN AND ROMAN MEDICINE The Medical School Settlers in " et jucunde . The Roman Hospital System . Roman Etruscans and Early Greek Gibes at Greek Medicine. . " Cito. Hospitals. . 63 of Alexandria Rome . . Vitus's Dance and St. 51 . . Anthony's Fire The School of Salerno The Medical Curriculum at Shapur . and Talismans The Origin of Medical Practice. . Tools. . and the " " Incubation or Temple Sleep Homeric . ix . . Disease . . . .De re Medtcma . Charms. .. . The Fall of Rome. . Philosopher-Physicians of Ancient Greece. and Bones Primitive Man and His The Problem of Death The Riddle of . . Trephining as Practised by Modern Primitive Man . . Where Delos rose . : . i Concept of Disease .CONTENTS I THE GENESIS OF MEDICINE Prehistoric Drawings. . tuto. . . . . Aristotle and his Influence .

. Early English Medical Books . . X WILLIAM HARVEY AND MEDICINE . Early Scottish Physicians and Art and Anatomy. . . the Medical Centre. . . . Leyden. and Medicine A Consultation at Edinburgh The Versatile The Origin of Syphilis The Physician Syphilis in Poetry First The Early Physicians of England Epidemiologist Oxford v.134 . . 196 . . Pediatrics in England . Animism and Vitalism .CONTENTS VII MEDIAEVAL MEDICINE The . .. .. . De Alotu Cordu et Sangumu Lacteals.. . Restored . . Surgery also . . . The Byrth of Mankynde. Restoration of . . . REFORMERS AND REVOLUTIONARIES . IX PHYSICIANS OF THE RENAISSANCE The Enigma of Paracelsus Paracelsus as a Writer A Chemical View of Life The Mission of Paracelsus Astrology. Philosophers and Scientists XI SCIENCE AND SUPERSTITION. Andreas Vesalius and Eustachius Humane Surgery. Cambridge The Royal College of Physicians A Brevianc Sweating Sickness. Schools of Montpcllier and Bologna . . King's Evil and the Royal Touch . . . . Ambroise Fallopius " Pare in Divers Places I Dressed Him and Journeys " God Healed Him Ambroise Pare at Court Itinerant Lithotomists English Surgery Surgery in Italy and Germany in the Sixteenth Century. . XVII-CENTURY 176 of William Harvey . 156 . . . . . Anatomy . . . Religio Medici. . and Gregory . . Leonardo da Vinci The Truth about The Pulmonary Circulation Anatomy. . . Surgeons. . . . . and Capillaries The Early Microscopists Societies and Journals . . . Medicine in the Army and Navy. in . Englishmen at MontA Medical Pope Medicine and Surgery at Bologna pellicr Pans and Padua The Roger Bacon and Albertus Magnus " " . Whytt. . . The Genius . THE QUEST FOR A NEW BASIS The Human Body Machine or Test-tube ? Clinical Medicine in Thomas Sydenham The Return to Hippocrates England The History of Cinchona The Great Plague of London The . Algebra. and German Surgeons pitals The Black Death " Mediaeval HosMedical Illustrations The Herbal in Medical Literature. . of Health . HIS TIMES. 215 . Lymphatics. XII XVIII-CENTURY MEDICINE Clinical Doses Large and Small The Old Medicine under Boerhaave Pupils of Boerhaave Influence of the Vienna School Leyden and Edinburgh Monros Foundation of the Edinburgh School The Teaching of Surgery Home. . English VIII MEDICINE OF THE XV AND XVI CENTURIES. . . .

The Surgery of Modern Warfare . TROPICAL DISEASE . The Royal Army Medical Corps . Neurology . ..CONTENTS XIII XVIII-CENTURY MEDICINE The Man-Midwife. . XVIII MILITARY AND NAVAL SURGERY. . Why not Try the Experiment ? Surgery and Contemporaries of John Hunter Applied Pathology The Career of Edward Jcnner Inoculation and Vaccination The Gold-headed Cane Quaker and American Physicians Heberden and Withering . . . . xi . . (Continued) . .. Percussion and Auscultation . a Antiseptic System . XVI EARLY XIX-CENTURY SURGERY Three Great London Surgeons Antecedents of the Puerperal Fever. . . . W T . . Public Health and Hygiene Mesmerism. 307 Dupuytren. Psychiatry 363 Psychology Ophthalmology Otology and Laryngology Dermatology and Venereal Diseases Radiology. Preventive Medicine in the Army . British Military Surgery Military Surgery in Germany and Russia .. . . . .. Disorders of Metabolism . XIV THE DAWN OF SCIENTIFIC MEDICINE IN THE XIX CENTURY Sir Charles Bell . Medicine and Surgery in the Navy Medical Men as The Conquest of Tropical Disease. Phrenology. Diseases of Children . 235 Smellie and Hunter Eighteenth-Century " " Pupils Why Think. .. Medicine as a Career for Women The Growth of Preventive Medicine The Sanitary Idea Philosophy and Health Health as a National Problem Public Health in other Countries. . 321 The Antiseptic System Early Life in Edinburgh and Glasgow Lister Returns to Edinburgh His Work and Later Years in London Disciples of Lister . . Pathology and Bacteriology . . 266 The Tragedy of Robert Knox ork and his Physiology and Physics Anatomy under Henle and Hyrtl The Genius of Claude Bernard Pioneer British Physiologists The Birth of a New Science. XV XIX-CENTURY CLINICIANS Clinical Medicine in London and Edinburgh Physicians Medical Pioneers in Arneiica Dublin. and Quackery . and Medical . Diseases of the Heart . . The Teaching of Military Surgery . . . . 290 . . . . Abdominal Surgery Established Appendicitis Defined Surgery in America Specialism in Suigcry. . . . Pans. Born Teacher The Tragedy of . XIX THE RISE OF SPECIALISM AND OF PREVENTIVE MEDICINE Specialization in Medicine . Baron Larrey and the Military Surgeons of Early Times Practice of Military Surgery . CONQUEST OF 337 . . The Coming of Communal Medicine. . Explorers . and Vienna A Bold First Ovariotomist The History of Anaesthesia. XVII LISTER AND HIS DISCIPLES .

. Rise of Medical Journalism American Medical Journals and Medical History . 2 of Medical History. Conclusion. APPENDIX A Classified Bibliography 4.CONTENTS XX JOURNALISM. HISTORY The BIBLIOGRAPHY. 42I GENERAL INDEX Xll . AND MEDICAL 393 .

of VII THE FIRST KNOWN MEDICAL MAN By courtesy of the Wellcome Figs. 4 from Arab Medicine and Surgery by Hilton-Simpson. 1923 . M. 1914 (by courtesy Figs.. by W. 4 by courtesy of the Society of Antiquaries of Scotland V MEDICAL LITERATURE IN BABYLON AND EGYPT 20 Fig. i from The Antiquity of Disease. Fig. from : Museum . by from Studies in the Palaeopathology of Ancient Egypt. 5 Figs. Moodic. 1894 5 Fig. AND TALISMANS Fig.. Man IV CHARMS. T. ed. Constable) torical . 1922 (by courtesy of The Clarendon Pressj . 49 EARLY ROMAN SURGICAL INSTRUMENTS From Naples Museum . 1921 (by courtesy of the University of Chicago Press) 2 IX RELICS OF APOLLO. by J. .10 (by courtesy of the Carnegie Institute of Washington) . 84 XIV PUBLIC HEALTH IN THE and ROMAN EMPIRE .LIST OF PLATES I DISEASE IN ANCIENT TIMES Facing page 4 R. by Sir Armand Ruffer. by E. by Elliott Smith and W. . . 3. L. R. 10. . Museum Flinders Petrie. Figs. 1907 (by courtesy of Messrs. 2. IMHOTEP . Fig. TECHNIQUE OF PREHISTORIC TREPHINING to 4 12 by courtesy of Dr. 3 by courtesy of Royal Anthropological Institute . ^. . 85 Pont du Card (photograph by the Author) Imperial Baths of Caracalla. i 21 Fig. AMULETS. from The Architecture of Greece and Rome by Anderson Spiers. 6 from the Wellcome His. Batsford) xiii . II PREHISTORIC AND PRIMITIVE TREPHINING . Fig. 32 Photographs by the Author X EPIDAURUS. 13 of Messrs.. H. 1 92 1 (Figs. . i. 2 Museum . Wilson Parry and the Editor of . i . 2 from Pitliecanthropus Erectus. . i. Dawson. 1924 . i . 1930 (by courtesy of the University of Chicago Press) VI THE LIVER IN DIVINATION from the British Piacenza Fig. 28 29 Historical Medical Museum Mil DISEASE IN EGYPTIAN MUMMIES from Egyptian Mummies. 2 from The Edwin Smith Surgical Papyrus. GOD OF HEALING . 6 from National Museum oi Antiquities of Scotland . i from The Seal Cylinders of Western Asia. 5 from London Museum III Figs. i from Amulets by Medical W. 2 from Muniz Collection (by courtesy of Smithsonian Institution) . 4 from Studies in the Palaeopathology of Ancient Egypt by Sir Armand Ruffer. Fig. Hayes Ward. 3. Breasted. . 3 Fig. Fig. Figs.. A CENTRE OF AESCULAPIAN HEALING Photographs by the Author 33 XI XII XIII THE ISLAND OF COS Photographs by the Author 48 : THE FATHER OF MEDICINE Statue found at Cos HIPPOCRATES . Fig. Dubois. 3 by courtesy of the Chicago University Press) .

145 XXIX SIXTEENTH-CENTURY SURGERY From A 1654 Discourse of the Whole Art of Chyrurgery 148 by Peter Lowe. . (a I4th cent. Ambrose Party (Eng. at the HotelDieu. CAMBRIDGE HONOUR From THE GATE OF 157 . 2 from The Works of that famous chirurgeon.125 128 XXV ZODIAC MAN From Fasciculus Medicinae by Johannes Ketham. Paris Fig. Cambridge by John Steegman by permission of A. ANATOMY ... . . . 3. Title-page of Fabnca by Vesalius. Facing page 92 XVI CORDOVA. F. XXI THE LEGEND OF MANDRAGORA Figs. XXIV JOHN AT RHODES .. CENTRE OF ARABIAN CULTURE IN WEST 93 Spain by Albert F. i from Cirurgia by Brunschwig. J. . .SURGEONS RECEIVE THEIR 149 Painting in the Royal College of Surgeons of England (by courtesy of Professor A. XXVI MECHANICAL AIDS TO MEDICINE AND SURGERY Fig. J. Kersting (Batsford) photograph 176 XXXIII "THE BREVIARIE OF HEALTH" Title-page from a copy of the book (1557 edition) in the Hunterian Library.. Cave and the Royal College of Surgeons of England) XXXI MEDICINE From De AtfD MATHEMATICS : : JEROME CARDAN 156 Subtilitate by Cardan. XV EARLY ARABIAN SURGERY From From From Avicenna's Canon of Medicine (Latin ed. Photographs by the Author 124 . ... Woodcut from De Library of Turin) 113 Balneis. 1543 UNDER AMBROISE PAR from a miniature in a contemporary MS. ed. 1778) 96 97 112 XVIII THE PATRON SAINTS OF SURGERY: By courtesy of Professor Charles Singer . 1517 Fig... 1551 XXXII CAIUS COLLEGE.. Glasgow University xiv .LIST OF PLATES . 2 from 144 XXVII VESALIUS TEACHING XXVIII SURGERY Fig. Venice. 1497 Feldtbuch der Wundartzney by Gersdorff. 1678) . 1911 Chirurgta of Albucasis (Arabic XVII ARABIAN SURGICAL INSTRUMENTS and Latin . 1904 (Clarendon Press) Chirurgia Times XXII XXIII ANATOMY From IN MEDIEVAL TIMES Magna by Guy de Chauliac RHODES . XIX SURGICAL PRACTICE AT SALERNO From Sloane MS. XX A MEDIEVAL SPA Museum PLOMBlfiRES 1553 (from the National . XXX THE CHARTER BARBER . i . . F. 1608) . 1491 129 .116 by 117 ) 4 from English Medicine in Anglo-Saxon Payne. MS A MEDIEVAL HOSPITAL: Photograph by the Author THE KNIGHTS OF ST. 1977 in the British : . .. Calvert. trans.

1662 664 . 1 628 i XXXVII HARVEY AND THE KING From a painting by R. Physicians of London 188 in the Hannah Royal College of " XXXVIII EARLY MICROSCOPES Little Ammah Fig.. XXXV THE From PHYSICIAN'S VISIT the . . 1654 Certo in Phyncis Title-page of 1715 De Comparando by Boerhaave. From a THE WORK OF JOHN HUNTER THE MEDICAL SOCIETY OF LONDON .. : XLV THE FOUNDER OF THE GLASGOW SCHOOL WILLIAM CULLEN From an engraving by T. . 2. : SANCTORIUS From Medicwa Fig. 241 painting by Samuel Medley in the Society's house . i 193 Stattca by Sanctorius. 22^ in the National Portrait Gallery of Scotland of the painting by W.. . . Cochrane 229 XLVI THE FOUNDER OF THE EDINBURGH SCHOOL: ALEXANDER MONRO From engraving by J.... 1 665 ic )2 1 XXXIX DECORATIVE ANATOMY From Thesaurus Anatomicus by Ruysch. Bafire of the painting by Allan Ramsay 236 XLVII EDINBURGH CENTURY DOCTORS OF THE EIGHTEENTH 237 1733 From Kay's Edinburgh Portraits XLVIII ARTISTIC OSTEOLOGY From Osteographia by Cheselden. Homine by Descartes. 1666 224 225 Adenochotradelogia by John Browne.. 2 from by Clifford Dobell. i from Antony van Leeuwenhoek and fits Sons) . . ..LIST OF PLATES XXXIV BIRTH SCENE From a copy 1554. 1932 (John Bale '* 189 & Micrographia by Robert Hooke.180 181 Figs. from De Motu Cordis by Harvey. XLIV A MEDICAL LECTURE AT LEYDEN . 208 1 THE ANATOMY OF THE BRAIN ft om XLIII . . XLIX THE MASTER OF BRITISH MIDWIFERY: WILLIAM 240 SMELLIE From a painting in the Royal College of Surgeons of Edinburgh L EARLY PATTERNS OF OBSTETRIC FORCEPS LI LII . . . Fig. from De Vetiarum Osttolu by Fabricius. Edinburgh University Library .256 257 xv .. THE ROYAL GIFT OF HEALING .. . Fig. in IN THE SIXTEENTH CENTURY/ et Facing page 177 of De Conceptu Generation* Hommis by Rucff. Sommers . 3 Stephenson Clarke Collection (by courtesy of Colonel Stephenson Clarke) XXXVI THE VALVES OF THE VEINS Fig. 70 1 XL AN XLI EARLY EXPONENT OF METABOLISM . 1614. 2 LONDON 209 Loimotomia by George Thomson.. XLI I THE GREAT PLAGUE OF From From from De Cerebn Anatome by Thomas Willis. . 1603...

EARLY NINE261 . Balfour and the : By courtesy of Dr. by courtesy of Rhode 384 LXXX A NEW KIND OF RAY Radiogram taken by Roentgen 385 : LXXI THE EARLIEST MEDICAL JOURNAL IN ENGLISH Medical Museum LXXII OSLER WRITING HIS TEXT-BOOK 400 Medicina Curiosa. i. : 284 Reports of Medical Cases LX AMERICAN EPHRAIM 285 MCDOWELL LXI THE FIRST USE OF ETHER ANAESTHESIA IN BRITAIN From a painting in University College Hospital. Sidney Scott Mrs. 277 St. Cecil Shistcd Bartholomew's Hospital. by courtesy of the Wellcome Historical From The Life of Humphrey Milford (429) . by courtesy of LIX BRIGHT From AND BRIGHT'S DISEASE by Bright. W. 320 of 321 . by courtesy Messrs. Oliver & Boyd LXIV LISTER'S EXPERIMENT Facsimile page from . London LXIII LISTER AND HIS FELLOW HOUSE-SURGEONS From Looking Back by John Chiene (1907).. Dr. 1684. LXVII NAPOLEON'S CHIEF SURGEON BARON LARREY LXVIII A DIRECTOR-GENERAL OF MEDICAL SERVICES SIR JAMES McGaiGOR LXIX THE INVENTOR OF THE LARYNGOSCOPE MANUEL . by courtesy Fig. PATIENT AND DOCTOR IN THE NINETEENTH Rahere Ward... S.. BELL'S CLASS 268 269 Original in the Royal College of Surgeons of Edinburgh LVI LAENNEC'S STETHOSCOPE From Traite dt VAuscultation Mediate. Wilson. 1827 PIONEERS DANIEL DRAKE.. 332 : 333 : GARCIA From a painting by John Island School of Design F. Donald Mayo Foundation . 2. Anderson's notebook LXV AN OPERATION AT ABERDEEN LXVI THE IN LISTER'S DAY 324 325 Photograph supplied by Charles A.LIII From a LIST OF PLATES Facing pagt EIGHTEENTH-CENTURY PHYSICIANS AND QUACKS 260 . . of Mr.. 401 Sir William Oslery by permission of Sir xv i . : 304 305 LXII A LECTURE ON SURGERY JAMES SYME From a sketch in the Museum of the Royal College of Surgeons of Edinburgh . Sargent. cartoon by Hogarth LIV A TEENTH CENTURY LV CERTIFICATE OF SIR CHARLES STUDENT'S CLASS CARDS. Aberdeen MAYO CLINIC C. LVII LVIII 1818 THE CONQUEST OF RABIES Statue in courtyard of Pasteur Institute of Paris 276 CENTURY Fig. Joseph Bell.

" wrote Byron of Poetry. his limbs adorned with stripes of paint and his head with a pair of large antlers. Cambndgc. i. C. Prehistoric Age Drawings. 400 .000 B. p.C. A w Study of . a relatively recent date for the Stone Age epoch. Burkitt. is " Indeed. Artist and model are said to Magicians or medicine class in have been members of the Aurignacian race. p.Sollas. of course. and are. and even such prehistoric drawings as have survived represent a relatively late phase in the evolution of Stone man . 257 R. and his remark may be fitly applied to the History of Medicine.. of a " medicine man " or sorcerer. 1921." or. at best. W '. rather. no written records. Some of them may well have been as instruments. 1 On the wall of the Trois Freres Cave in the Pyrenees is a drawing which is probably the oldest known portrait of a " medical man. living about 15. Dates in prehistory can never be regarded as exact.000 years. which is said to have lasted for some 500. * S. Ancient Hunters. employed still just as the Australian aboriginal uses a surgical flint knife in ritual circumcision. 133 J. Textbook of European Archeology 1921. for it is no easy task to describe the means by which our primitive ancestors discovered and developed the art of healing. There are. Pre-history : Early Cultures Europe and the Mediterranean Basin. this terrifying personage closely resembles the African " witch doctor " of recent times. M. Macalister. moreover. . Tools. and Bones men constitute the oldest professional the evolution of society. vol. 1911. Numerous stone and flint implements have been found and described as the tools and weapons of prehistoric man.A HISTORY OF MEDICINE CHAPTER I THE GENESIS OF MEDICINE NOTHING more difficult than a beginning. merely rough estimates. they are liable to be misinterpreted. p. 2 Arrayed in the skin of some animal. the whole vast subject of beginnings in Medicine largely a matter of conjecture. A.

The age of such a pathological specimen must be measured in millions of years. 1894 . as Professor Roy Moodie has proved by his discovery in Wyoming of a dinosaur (Apatosaurus) with a in tumour the caudal vertebrae bony (Plate i). firstly. To this question the attitude of primitive man towards disease let us now turn our attention. to defer further reference to the subject until the motives which prompted its performance have been mentioned. It may be convenient. however. Boule. bears a large bony tumour or exostosis near its upper end (Plate i). even 1 less intelligent eine than his prehistoric ancestor. and which is still practised to-day in many parts of the world. still member of a very primitive race of ape-men which became extinct about 400. Nevertheless. while the femur of the ape-like Pithecanthropus 1 erectus. Bones of palaeolithic and of neolithic dates have shown definite evidence of rheumatoid arthritis and of tuberculosis. Man's evolution is not always in an upward direction. Primitive Man and His Concept of Disease Although historic it seems perfectly legitimate to argue that pre- man in ancient times behaved in the same manner as primitive man to-day. the beliefs and customs of primitive man as he canthropus was a exists. consequently primitive man of modern times may represent a dein such generate type. Chap. Prehistoric trephining was performed long before any other surgical procedure was contemplated. one must bear in mind two possible errors an argument. discovered in Java by Dr. Pithecanthropus Erectus^ menschenaenltche Batavia.A HISTORY OF MEDICINE More informative than any other relics are the skeletal remains of prehistoric man. Pithe- " " of modern times . We have seen that the direct sources of information on the prehistory of medicine are scanty. These are. Fossil Edinburgh. the folk medicine which has passed from generation to generation down the centuries. and it deserves special consideration.000 years ago. Still more remarkable are the numerous prehistoric skulls which bear unmistakable evidence of the operation of trephining. Uebtrgangsform tuts E. 2 . Dubois in iSgi. by J. Dubois. and the miscalled savage secondly. M. trans. 1923. there remain certain indirect lines of investigation which deserve careful study. Disease is much older than man himself. : Elements of Human Paleontology. IV Mm Java. Ritchie.

G. 95 VV. and there is therefore a limited field for anthropological research. one is justified in concluding that the manners and customs of primitive man to-day (or at all events until quite recently) closely resemble those of his prehistoric difficulties prototype. that man was at first destined to be immortal." Even a brief consideration of the innumerable beliefs connected with death would take us far from our present subject. 1930. 3 . that primitive man does not admit the existence of disease from what we call natural causes. much valuable information regarding primitive medicine has been collected during recent times. According to a Central African (Bantu) legend. Frazer. vol. 42-94 Sir J | 3 . The Problem of Death At a very early stage in his evolution prehistoric man must have sought a solution for the age-long problem of death. man was at one time capable of renewing his youth by casting his skin each time he grew old.communities to-day which have not reacted for better or worse to the impact of modern civilization. Codrington. and " little can be learned from the native races segregated in reof human zoo. One old man operation. The Golden Bough. there must be very few primitive native. p. in spite of the imposed by the march of time in a rapidly shrinking world. and. 1891. Besterman. but it was essential that the process should take place in secret. Dawson. "The Belief in Ke-birth among the Natives of Africa. 1 Death came as a punishment for man's disobedience. indiscreetly allowed his granddaughter to witness the and thus so aroused the wrath of the gods that the boon was for ever withdrawn. 260.THE GENESIS OF MEDICINE Again. Magician and Leech : a Study in the Beginnings of Medicine." Folk-lore. p." Nevertheless. pp. K. 1929. p. vol. 3rd cd. T. 2 The well-known Biblical version of the tradition is that the eating of the forbidden fruit in the Garden of Eden "brought Death into the world. namely. 1890-1915. Rather let us study the attitude of primitive man towards disease. The field is steadily narrowing. and all'our woe. H. xh. as does primitive man of modern times. 11. sort as in a serves. No doubt he believed. The Melanesia. by analogy. R. The Riddle of Disease In whatever part of the world we investigate the matter we shall find the same result.

Gillen. Howitt. which prevails Australia is to this day in Australia." which is used with malevolent intent. primitive man ascribes disease to two possible causes (a) the projection of some morbid material : or influence into the victim and (b) the abstraction of the soul from the body of the victim. and the aggressor awaits the illness of his enemy. Magic. disease is a magical or being. J. tells us that act which according to our ideas is natural to a venomous animal. They also seek retribution from the aggressor. of the patient search for the bone. W. this is carried out by the medicine man. and Religion. Rivers. being accompanied way pointed 8 The bone is then buried. 359 . vol. Sir Baldwin Spencer. The Native Tnbes of South-east Australia. and if they find it friends the is recovery rapid. Medicine. Needless to add. Spencer and F." . or it may even be held that the animal which has bitten the victim is no ordinary snake. In other cases. magico-religious rather than a natural phenomenon. but it is believed that the snake has been put in the path of the victim by a sorcerer. W. Rivers. 2 The "bone. R. and to this race the attention of many able anthropologists has been directed. H. 251 1 1 1 4 . and has been known even to die of sheer fright. the victim beholds in the palm of the doctor a small rock crystal. is a long slender stick marked with It is held in a special rings to indicate the number of victims.." * Reasoning in this fashion.A HISTORY OF MEDICINE Invariably disease exercised is viewed as the result of malevolent influence a by god or supernatural being or by another human In other words. " boned. The aboriginal of Central universally admitted to be the most primitive type of man in the world to-day. B. As for the actual treatment of the sick. p. 1924. R. The latter. the patient then sick W. who proceeds to extract the evil influence by suction. whose researches in Melanesia are well " a case of snake bite is not ascribed to the known. the onset of illness is the first indication to the man that a bone has been pointed at him. 1928. In any event. p. the cause of all his trouble. by a song appropriate to the occasion." is not slow to respond to learning that he has been the suggestion. 1904. The Native Tnbes of Central Australia. but the sorcerer himself by a in snake-like form. and lo. 10 W. who receives a severe mauling or may even be killed. p. or has been endowed with special powers sorcerer. 1899 A. Wanderings in Wild Australia. H. the and the ritual towards victim. As an example of the first cause " there may be mentioned the custom of pointing the bone. i. alive or dead. He then expectorates into his hand.

\patosamus I cm u oi l'itli< < anthiopus Lucius slioumt^a bon\ ouli^iou til 'ji'itjf J SpoMchhti* dcfoi mans in lumbar \crtebrae arc fused an ancient Nubian of pre-Dynasiu times. Several into a solid mass by ostco-ai thntis pai.PLU'L 1 DIsL\M IN ANC. tumour of caudal \trtcbrae of a laigc dinosaur.e 2()) .lLN'l I IM1.

probably of Neolithic Age. shoeing trephined Skull of in Bute EarK Bronze Age.PLATE II PREHISTORIC AND PRIMITIVE TREPHINING Ancient IViuvian skull .e8) Skull iiom Aures Mountains Alg<iin. multiple trephining at different dates Skull of modern Melnnesian tiepinned b\ native method (pii. Andfnt Peruvian cross-cut trephining (page 7) skull . trephined b} modem name sui^on (page yj 1 he " " '1 hatnes skull. found Opening may be result opening (page 7) of trephining (page 8) .

exhibits a pebble or bead containing the soul. is prevented from escaping again by tying a strip of The dayong also undertakes to palm-leaf round the wrist. W." or ghost-shooter. Medicine. and was. Prehistoric Trephining or Trepanning we Let us now consider this strange surgical operation of which find such definite evidence in skulls of prehistoric date from various parts of the world. and treated by methods resembling those employed by the psycho-therapist to-day. With closed eyes he chants an account of the journey in search of the soul. It cona weapon called the sists of a hollow bamboo containing fragments of a dead man's bones. a Record from Borneo. 1933. and to persuade it to return. restored to its habitat. 2 The ceremony is conducted by torch-light. the underlying principle has persisted through the centuries. G. attributed to supernatural causes. and the evil spirit leaps out upon the victim. disease is believed be produced in a manner very similar to bone-pointing. to tamatetikwa. Charles Hose has described the technique of soul-catching in his fascinating book. p. In Melanesia. and probably also in prehistoric times. This is rubbed on the head of the patient. where this idea prevails. man Such observations would appear to show that to primitive in modern times. The second widely held belief is that disease is caused by the separation of the soul from the body. 155 Rivers. 5 . 13 Charles Hose. and although the details vary. Frazer. circle of friends and onlookers. Truly there is nothing new under the sun. At last. R. the soul-catcher. Sir J. emerging from his hypnotic state. Dr. and which is still practised by certain primitive people. disease is. and then the soul. H. 1926. like the Australian medicine man. he produces small black pellets of wax to show that his efforts have been and soon recovers. Magic. in the true fashion of the conjurer. The Fear of the Dead tn Primitive Religion.THE GENESIS OF MEDICINE feds better. the open end of the tube * uncovered. pp. by " is successful. Natural Man. and sends out his own soul to find that of the patient. from which. 215. 1924. p. When the enemy is sighted. 239 1 . In Borneo. the patient lying in the centre of a large The dayong falls into a trance. the dayong or professional soul-catcher is called to treat the patient. extract pain from the human body by suction through a tube. and Religion.

he stated. when these individuals died. and had lived for some years afterwards." 3 there was applied the name not removed. showing that the patient . Indeed. " rondelles. Soc. usually of circular form and often pierced so as to be worn as a necklace. which appeared to have been cut from another He concluded that the skull had been perforated so that skull. 1874. the trephined skulls were all not a single trephined child's skull was ever those of adults It was also noted that the majority of them showed found. tTAnthrop. was a flint scraper. Dechelette. discovered in a dolmen at Aiguieres in Central France a skull bearing in the occipital region a large artificial opening with smooth edges. Paris. - A. a custom not uncommon in primitive races. as Broca had suggested. Broca suggested that those who survived this operation were endowed with mystical powers. and it soon became apparent that the operation had not been performed upon children only. were greatly in demand as charms or amulets against epilepsy or mental disease. a general practitioner interested in archaeology. " 6 . 476. it might be used as a drinking cup. was often performed upon the children of The instrument employed Furthermore. Manuel cT Archtologie Prthistorique. 1 Shortly afterwards a number of other holed skulls were found in Brittany and other parts of France. Prunires had been mistaken in his conclusions. and that. p. Sur les cranes artificiellement performs ct les rondelles craniennes dolmens. de Paris. and in Sufficient The entire in other words. the dolmen people (late neolithic). . dt Pans. Pruniferes of Marvejols. Prunieres. preferably including a part of the edge of the artificial opening. and Professor Paul Broca of Paris in 1876 2 showed that Dr. and to these pieces of bone.*' Bull. P. near the Gevennes. which. xi.A HISTORY OF MEDICINE In 1865 Dr. Soc. vo1 P. p. Along with the skull he found a number of rounded or irregular pieces of bone." Bull. 572 J. and that the openings in the skulls were the result of the operation of trepanning or trephining. the edges of unmistakable evidence of healing the opening were rounded and smooth. and one which might well have obtained in neolithic times. 1924. of the trephined aperture was for the needs of the owner of the skull in some cases the abstracted portions were replaced by pieces of bone from other skulls (Plate in). vol. Thus he explained the fragments of skull which Prunieres had found. d'Anthrop. Further discoveries followed. 1876.l &5 r^poque des " 1 Sur 1'age des sujets a la trepanation chirurgicale neolithique. Broca. had survived the 1 ordeal. margin was left the next world. portions of their skulls.

which is probably of neolithic period. only two authentic specimens had been found in Britain. who has given much attention to the subject. xvi. 46. may have failed. Muniz and W. Wilson Parry. 1897. who in 1894 examined comparatively recently. lately B. but the disc of bone is not separated. " 7 . In this skull the operation is incomplete a circular groove has been made in the frontal area. One of them. and Dr.. for some reason. Washington. probably with the aid of a flint saw or scraper. Hist. Paine.M. and Spain. A. though in smaller numbers. both found in Dorset. shows an opening in the centre of the vertex. the doubtful British specimens J. At this place. i.THE GENESIS OF MEDICINE In rare cases. p. and the subject of the trephining was indeed fortunate to escape death by injury to his superior longitudinal venous sinus (Plate n). Mtd. pre-Incan age. found that nineteen 1. Peruvian skulls the opening is not oval. " Soc." vol. Muniz. The Prehistoric Trephined Skulls of Great Britain. T.Times. W.. Two Prehistoric Skulls. distinct operations (Plate n)." Report Bureau Etfmol. Roy. " Wilson Parry. (Sect." Man. Since the publication of Broca's paper numerous specimens of trephined skulls of neolithic man have been found in France. Several other holed skulls have come to light in Britain. of skulls. 1894-95. 1923. vol. The patient may have died during the procedure or the surgeon .). Germany. vol.J. by Dr. p. i ." Proc. In some of the showed three. death had probably resulted from the From each operation 1 2 Among (Plate in). and the markings indicate that four interesting saw-cuts have been made. an unusual site. pp. there appears to have been a number of pile-dwellings. 1940. The skull. and one of them had been trephined. but quadrilateral. and also. H. 1-72 1 T. as the discovery of various objects of stone and bronze indicates. Poland. one for each side of the aperture. 457 . Trephination of the Living Skull in Pre" historic . an adult male skull. Until recently. Russia. No. has described two other specimens.000 probably l Three of these showed two. p. and a skull showing five distinct perforations was found in Peru Dr. xiv. McGee. skull a large disc of bone had been removed. more than one trephining has been performed. to complete his task. The second British specimen was found in 1863 in a dolmen near Bisley. was dredged from the bed of the Thames in 1864 close to the present Hammersmith Bridge. As the cut margin showed no sign of healing. excavated in the county of Dorset. 33 M. is the skull of a young Primitive Trephining in Peru. in Gloucestershire. in Austria.

and the wound was dressed with strips of banana stalk. It is uncertain whether the aperture (Plate n. an island and insanity north of New Guinea. Crump 4 stated that in New Britain the operation was practised solely in cases of fracture. Paris. 1 R. J. J. a with together jet necklace. surrounded by a dense thickened rim of bone. while it is stated that in New Ireland. vol. Caucasia. The Rev. i." Jour. The instru- ment employed was a piece of shell or obsidian (volcanic natural glass). L* Operation du Trtpan. " The I93&-39. F. Munro. Robert Munro in 1 1 89 1. 4 and Us Place in European Cixnlization (1899). Isle of Bute. The skull. " Trephining in the South Seas.) was produced by trephining or by disease of the bone. Crump. a large number of natives had undergone trephining in youth as an aid to longevity. and Algeria. New Britain.. 1895 Trephiners of Blanche Bay. but many deaths resulted from the original injury rather than from the operation (Plate u). p. xxvi. 2 From Melanesia many skulls have been collected which show perforations closely resembling those found in neolithic They have been found in New Guinea and the specimens. P. Jowrn. Prehistoric Scotland Temer and M. vol. p. a Our knowledge common occurrence in tribal fights. which is very absorbent. 1901. by primitive races in some widely separated parts of the world.. or was performed until very recent times. headache. which shows a hole in the left frontal bone an inch above the outer angle of the orbit. Trephining as Practised by Modern Primitive woman which was Man of prehistoric trephining would be very meagre indeed were it not for the fact that the operation is still performed.2I 3 P^rairc. an urn. London. Surg. 3 All the trephined openings show healed edges. such as the South Pacific Islands. A. In certain other islands of the South Pacific the operation is (or was until recently) performed to cure epilepsy. L Brodsky. 167 8 . A. The mortality was about twenty per cent. Anthrop.A HISTORY OF MEDICINE found in a cist at Mount Stuart. neighbouring Bismarck Archipelago. and a small fragment of bronze. was described by Dr. Inst. and also in New Caledonia and the adjoining islands of the Loyalty Group. suggesting that recovery from the operation was the rule. xxxi. and is now in the museum of the Society of Antiquaries of Scotland. The practice of trephining in Asia is described by a writer ." Brit.

Hilton-Simpson describes the use of drugs collected and prepared from various find a degenerate local plants. The operation consists in removing a circular portion of scalp with a cylindrical iron punch. always as a treatment of some form of head injury. Medicine and Surgery. and even the operations of bone grafting to The bone of a replace a bone destroyed by injury or disease. the result of a blow (Plate n). and the is results are very One is not surprised to learn that trephining also commonly performed by these people. are of various shapes. It might be argued that here we form of Greek or classical medicine. injuries. on four occasions. Splints are used for fractures. in his book on Arab medicine and surgery. the knowledge being passed on from father origin is obscure. is Its hereditary. all head employ it for " " to pay the surgeon and that the aggressor is obliged for his services. and such be denied. Hilton-Simpson. 1922 i. In operating. namely. and the dura mater must be carefully preserved from injury. W. although of course the argument cannot a possibility could not apply to the primitive medicine and surgery of Melanesia which so closely resembles that of North Africa.* who tells us that the inhabitants of the Caucasian province of Daghestan. north-east of Biskra in Algeria. bordering on the Caspian Sea. circumcisions and lithotomy are practised. the opening must not involve any of the sutures. heated red-hot. " M. which are hafted in wooden handles. dog or sheep is employed. he was able to study their One wishes that there had been more at first hand.* Hilton-Simpson's offer of a modern trephine was declined by those Arab surgeons.* 138 . who preferred to use their own 5 1 a Krivyakin.*' Lancet. as the literature on primitive medicine expeditions The art of medicine in the in modern times is far too scanty. two rules are carefully observed. 1888. p. of this nature. dislocations are reduced. 2 The author visited the Aures Mountains.THE GENESIS OF MEDICINE to The Lancet in 1888. Gaining the confidence of the native practitioners. and then cutting the opening in the bone by the confined use of a small drill and a metal saw. He also attributes to those Arab doctors a sound acquaintance with the principles of surgery. The instruments. usually a fracture. freshly killed successful. vol. The best recent account of trephining by primitive man in modern times is given by Hilton-Simpson. One of them closely resembles the more modern " Hey's saw. methods Aures to son. Arab Trephining in Daghestan.

cast by the Hilton-Simpson The results of the operation are said to be very Oxford. vol. what treatment could be more obvious than to make an opening in his head so that the evil spirit could escape ? It also seemed reasonable to attribute magical powers to those who survived the operation. mental disease. 1918. to one ignorant of neurology. cast out a demon which The absence of any sign of cranial injury in the holed skulls of neolithic origin lends support to this view. a logical explanation was that the youth was in the grip of a demon. The set acquired by local native jewellers. As time went on trephining was employed in cases of fracture of the cranial vault. p. Berlin. when at length the patients died from some other cause. F. xxii. Path. Further. Such cases of devil possession would to-day be diagnosed as epilepsy. " GeschtehU der Trepanation. and many theories have been advanced to explain the motives which induced neolithic man to practise this serious operation. satisfactory. etc. Trephining in its Ancient and Modern Aspect. 1875 . and it seems reasonable to accept the notion. 1894. that trephining was originally performed in order to had taken possession of the individual. Such a classification ignores the fact that no clear-cut distinction can be drawn between these two motives.. Mention has already been made of the concept of disease in the mind of prehistoric man. M. Die J. 1 Attempts have been made to classify the indications as (a) a ritual or magical rite. to which many authorities subscribe. cerebral tumour. in Museum at be seen the Pitt-Rivers may The Motives for Trephining among Primitive Races It is not surprising that the problem of primitive trephining has engaged the attention of many distinguished archaeologists. 90 1 '> IO ." Jour. A. All who have studied the early history of medicine have noted that the physician was at first a priest. and to use as charms or talismans pieces of bone (rondelles) cut from the edge of the trephined opening. No one can read in the New Testament the account of the epileptic boy without admitting that. Home. tic douloureux. Braunc.A HISTORY OF MEDICINE tools. Ruffer. Studies in Paleopathology : some recent researches on prehistoric trephining. and (b) a therapeutic measure. and that the religious and medical duties were intimately intermingled. and Boot. migraine. which must have been very common in the M.

sleight of hand. disease was caused by the evil influence disease. 1 E. as well as cranial injury. and that not until the days of Hippocrates did the healing art take its rightful place. In some cases it was deemed necessary to combine physical with psychical methods of this we have an excellent example . and thus reasons for trephining appear to have been headache.THE GENESIS OF MEDICINE we find evidence of fracture in many of the in discovered skulls Peru. In any case. La Trepanation crdnicnne chez Us Ndoliihiques et chez. and whose methods of treatment included exorcism. vertigo. Arab surgeons of Algeria only a few years ago still practised trephining solely for injury resulting from a blow on the head. another means of inducing the evil spirit to leave in trephining. a demon. Massage. namely. and all the tricks of the magician. early man may have attributed disease to a separation of soul and body. grimacing. incantations. dancing. Among the Melanesians of comparatively recent times the Stone Age. or even an animal. where the Inca civilization persisted as late as the sixteenth century. and which gradually became a method of treating fractures of the skull and various intracranial lesions. one cannot accept the view of Dr. and was no longer merely a branch of magic or of religion. 1930 II . of an enemy. while the epilepsy. injuries. " " which originated as a means of permitting the escape of an evil spirit from the head of the victim. and epilepsy. there doubtless arose a class of men who claimed skill in the art of healing. and was gradually neuralgia. Guiard that trephining was originally a treatment for head extended to cases of migraine. Its pnmitifs modcrnes. Domestic Medicine or Folk Medicine As has been already remarked. a god. the medicine of prehistoric man was probably based upon an animistic attitude towards In his view. Guiard. Paris. and it must accordingly be treated by means calculated to dislodge the malevolent cause from the body of the patient. and like disorders. Like the presentday native of Borneo. that medicine was at first in the hands 1 of the priests. Primitive trephining illustrates one of the leading facts of medical history. Considering those facts.

The Infancy of Medicine. and the fish was " then returned to the river. 41.A HISTORY OF MEDICINE the body. this time for whooping cough. A somewhat similar treatment. 1883.*45 D. 36. Folk Medicine (Folk-lore Society publication). and still in use to-day. The ceremony over. From all these examples it would appear that casting " " " was the dominant factor in the primitive out or transference 1 1 M. taking the whooping cough with it. and then drive somewhat similar belief may have of inhabitants those Selborne. 2 Not so very many years ago a touch from the hand of a corpse was regarded as a cure for many diseases. unpleasant taste and disgusting nature of many of the older may also indicate a determination to dislodge from the body of the patient the supernatural intruder causing the Another curious and ancient method of treating disease. consisting in holding a live frog in the mouth for a few moments. McKenzie. 1 Later. to an animal. was until lately practised in Cumberland. or even to a plant. was based on the belief that the disease might be transferred from the patient to another individual. 1927. A naked children suffering from rupture might be passed through the gap. Die Medi&n der Naturvftkcr. and massage changed The prescriptions disease. cleft young ash trees asunder in order that the nail into an oak tree. which the dead man then took with him on his long journey. as devil possession to more gave place enlightened pathology. the tree was bound together. p. Black. From Cheshire came a remedy for aphthous ulcers of the mouth. Bartels. and then allowing it to escape. 1893. so also did the child become cured " of rupture. and many a fee did the hangman receive for granting this boon one to the sick. Leipzig. according to a widespread belief. Whoever found the bag acquired the warts. it was merely necessary to scarify the gum with a nail. warts were treated by touching each wart with a pebble. who. Best of all was the touch of an executed criminal. according to Gilbert inspired White (Letter LXX). consisted in stroking the limbs in a centrifugal direction that is." To cure toothache. P. towards the extremities. G. The pebbles were then placed in a bag. and as it grew together and healed. which " as the patient proceeded on his way was intentionally " lost to church. In Lancashire. pp. 84 W. 100 12 . 8 The head of a freshly caught fish was introduced for a minute or so into the child's mouth. the direction of the was applied in a centripetal direction.

The other t\\o specimens (natural size) are " rondelles.38.) \n irregular fragment with margin of trephined hole in centre of the lower margin ( natural size. found in CMC hel Skull df Laih Bron/e A^< I)O\MI Doistt. in 10. 7} Cranial amulets from dolmens in Irance (/. 1 iq on ii^ht sliu\\s t\<is(d lx>n< K placid pagt 7) . i I \p<inii(nts to illustrate tit t\\o stacjt pinning b\ mt." one of them perforated for use as a charm (page 6j .PLATE III TECHNIQUE OF PREHISTORIC TREPHINING \\ith laiijr trephined opcnim*.uis of a of th( operation ipaqc * flint strajxi.

PIAIL 1\ (HARMS. used for (unnti a tooih used to cure toothache t .ui h\ Sn \\aln j Sr oil [>aij( (I ) \\art-Iikf stone*. \MULL1S. inin (r ) C)t((i\ Si uaits (pat*c rj) Stcn< KM iiihlinir NIai\. A\D r l \LISMAXS (/ ) Anc i< nl I I (rvptuin (r ) Arnuh mscnlwd /*/ in nam< c hai in i< pif sriiiini> tin <\< oi Hoi us pay< jo Richanl\f>n\ Ma^rii to-dnLrntu Jtattfn ami <u tlu r( \ M s >\ Sold as (Ui< lor i h< uniatisin iftHft I < 1 ' I he I* l'cni>\ M lalisin. i(>io. l)<\on.

and " known locally as The Deil's Needle. yet it worthy of study and forms an important part of medical history. : Charms. perforated by the action of the water. a treatment still employed by some country children to-day. Few persons to-day consult a doctor for a common so also did prehistoric man employ his witch doctor only cold when ordinary domestic remedies had proved unavailing. Stone in Scottish Folk-medicine. the nail of a coffin. 1935. No. poisonous and the harmless. the patella of a sheep. process. Rorie. and although his methods of treatment included much magic and superstition he evolved a system of domestic medicine *of which traces remain in every nation to To mention a very simple example early man." It was believed that to l crawl through the opening was a cure for sterility in women." Ann. and all manner of other charms have been. vii. found that this was relieved by applying the nearest cool broad leaf available. Elgood. p. ing that contact with a nettle caused itching and burning. The bezoar stone. 1911. is 1 vol. There were minor maladies which could be simply cured by homely remedies." Caledonian Med. the Bezoar Stone. and still are. some of them were worn or carried as charms or talismans.. Who has not met some friend who keeps his rheumatism in check by carrying in his pocket a raw potato. The discovery of these remedies must have been a very gradual . or the right forefoot of a hare ? Belief in such mascots is almost universal. findthis day. " A Treatise on 410 73 '3 . In the bed of the River Dee near Aberdeen there is a large stone. Nevertheless primitive man became gradually convinced that not all diseases were caused by supernatural agents. which happened to be a dock or sorrel leaf. Med. although unfortunately there is also much charlatanism. "The 9. The remedies were not always taken internally . The best remedies of folk medicine still form the basis of modern herbalism.THE GENESIS OF MEDICINE treatment of disease. and Talismans A study of folk medicine reveals many curious beliefs. 1 D. and there is a good deal of sound teaching in the art. Hut. Just as cats and dogs eat grasses as their medicines. Jour. vol.. so did primitive man discover the therapeutic value of certain By painful experience he distinguished between the plants. C. p. and in such cases it was unnecessary to call in the sorcerer or medicine man. viii. The skin of a snake. in daily use. Amulets.

Antiq.. borrowed this talisman. Black. depositing Church viewed The this with surety. Soc. was an poison. 1938. 477." The the familiar saying. Soc." Proc. Antiq. 54 . application of dog's hair to heal a dog bite is an ancient and . 199 1 W." Another curious aspect of folk medicine is the importance ascribed to colour. 112 G. 1 which it At one time it had great reputation. Red pills were used in ancient China. Dalyell. but green has recently been used as a distinctive mark. was closely associated with healing.. vol. "The Lee Penny. Edinburgh. 1872. have been said to endow the wearer with found in the intestine of a goat.000 as by an epidemic. G. Reid. Curses. Lucks. p. 2 Red. perpetuated by " Take a hair of the dog that bit you. Simpson. would prevent nose 3 bleeding. loc. as in it is called. p. Sir J. p. p. p. and since immunity from many ills. or small tablets or papers bearing words of the Koran or the Bible. . p. i. 1876. No 1 T.A HISTORY OF MEDICINE infallible proof against the introduction of writing and printing. Archaeological Essays. for example. G. and water had been dipped became highly curative for many I disorders. which was in the possession of the Lockharts of Lee. The Folk-lore of China. One of the most famous charms was the talisman from which Sir Walter Scott named his novel. attacked 6. vol. The Darker Superstitions of Scotland. xxvii. p. Ivii. phylacteries." Proc. 138 N. B. and admonished the Laird of Lee to " tak hcid that it [the may talisman] be used hereafter with the least scandal that possiblie be. 1934. and Talismans. vol. red hangings in the sick-room prevented marking in smallpox. The Powder of Sympathy some reference account of folk medicine* would be complete without to the so-called sympathy cure. The Lee Penny. Blue is a colour much less in favour than red. Y. F. 119. 1892-93. Black. " Scottish Charms and Amulets. Lockhart. cit. 1922-23. the colour of the blood. is a dark red stone set in a silver coin of Edward IV. Dennys. and tied in front with nine knots. G. 108 J.. red flannel is believed to ward off sore throats. and a red thread worn round the neck. Scot. proceeding disapproval. and indeed a red coating to pills and tablets is favoured by many modern pharmacists. J. In the reign of Charles the city of Newcastle. near Lanark (Plate iv). Scot. Mummies were painted with red ochre to restore a life-like appearance.

" Folk-lore has been called the archaeology of the mind. 1660. while the latter have been imposed upon him from without. The Origin of Medical Practice In seeking to learn how the healing art arose in prehistoric times. touching the cure of wounds by the powder of Sympathy. The whole Even in cities one may discover its existence. which was simply copper sulphate. the idea of the sympathy cure was no invention of his. based upon magical or religious beliefs. for Britain. charms. A late discourse made in a Solemn Assembly of Nobles and learned men 9 MontpeUier in France. Some of it dates from remote antiquity. Nevertheless. being simply bound up and allowed to heal. and proverbs than from politics. was warmly recommended by the courtly Sir Kenelm Digby.. and little of it has been transmitted by the printed word. It may be noted that folk medicine is not confined to remote country districts. 15 . because the former are innate in man. 1 who. which subject of folk medicine is full of quaint superbut perhaps enough has been said to illustrate the part which it has played in the evolution of medicine. Sir at Kenelm Digby. The as it is not unlikely that it originated in prehistoric times. Nevertheless. we can draw no positive conclusion from the scanty evidence at our disposal.THE GENESIS OF MEDICINE it is practised in China as well as in variation consists in the internal administration of the heart or liver of the dog. In studying the history of mankind one may gain more information from tales. The to depart. stition. The powder. religions. A weapon which caused it. usually in hereditary form by word of mouth. wound but to the or first-dressing. not to the world-wide method. it is not unreasonable to conclude that the cures of injuries or diseases followed two distinct lines. consisted " soul " of the in dealing with the patient or in persuading or forcing the evil spirit which had entered the body of the patient first. though not a medical man. superstitions." which was applied." and it is an important guide to man's intellectual history. reason for the success of the method of Sir Kenelm Digby lay probably in the fact that the wound was left to nature. or to some clothing had been in contact with the wound. ed. Perhaps the most fantastic remedy based upon this reasoning " was the powder of sympathy. was wont to dabble in the sciences. 3rd. and food habits.

1939. W. Jour. Magic. G. G. Arab Medicine and Surgery. Men of the Old Stone Age. L. 1930 BURKITT. and OtoL." Folk-lore. The operation of trephining. J. for example. and still later to many other intracranial It is noteworthy also. 2. J. vol. 1 The two methods became intermingled in course of time. M. G. The Golden Bough. 1936 FRAZKR. 1894 HOSE. 2nd ed. Folk-lore and Medicine/' West London Med. vol. liv. much of which has persisted to the present day even in civilized communities. R. Lucks. 1923 BUDGE. and other forms of magic. G. 1927 MOODIE. and KRONFELD. Berlin. Amulets and Superstitions. A. Man makes Himself. xxxiv. 1943. GORDON. 1926 HOVORKA. was ultimately applied to cases of depressed fractures. 1883 BOULE. 1916 RIVERS. 44 . Folk Medicine. 1908-9 KEITH. D. The Antiquity of Man. A. J. and Religion. The Antiquity of Disease.. was of the nature of domestic or folk medicine. originally practised to allow a demon to escape. M. H. many remedies. Cambridge.. Fossil Men. 1928 16 . p. Medicine. Sir ARTHUR. the GUIARD. and Talismans. W. 1921 CHILDE. M.History : A Study of Early Cultures in Europe and Mediterranean Basin. WALLIS. showing that the original conception of disease as a supernatural phenomenon has persisted throughout the centuries since Neolithic times. it is closely bound up with superstitions. J. 311 1 . D. F. " BOOKS FOR FURTHER READING The Art of the Cavc-dwclle^ 1928 BLACK. trans. 1921 LOCKHART. " The Folk-lore of Children's Diseases. R. Wanderings in 1911 Wild Australia. Textbook of European Archeology. V. vol. 1924 SOLLAS. G. W. Sir J. incantations.. Cursef. R. SPENCER. others most irrational. p. 1921 McKENziE. The Infancy of Medicine. Paris. 1911 BALDWIN BROWN. at first applied only to minor disorders. Sir B. Rollcston. Chicago. " " and " Laryngology and Folk-lore. Vergleichende Volksmedizin. Pre. E. W. H. 287 Otology and Folk-lore Laryng. La Trepanation cranienne. O. Trephining in its Ancient and Modern Aspect. 1922 HORNE. Ritchie. 1923 OSBORN. of p." Jour. Sir E. i<)42. No. S. Ancient Hunters. Edinburgh. J. F. G. some rational. 1930 HILTON-SIMPSON. Ivii. that while folk medicine includes lesions. Natural Man: a Record from Borneo. 1938 MACALISTER.A HISTORY OF MEDICINE The second.

" adjacent Egypt. Systems of irrigation and of transport by land and water had been evolved. and later as that of the kingdoms of Sumer and Akkad. Agriculture and cattle-breeding were the chief sources of revenue of the Sumerians. Ur of the Chaldtes. the of Between the northern land in the and kind. There is a similar seal of a Babylonian medical man. Sumerian culture. 1928 C.. which lasted for about two thousand years. 1 The greatness of the Sumerian civilization. of hardened copper have been found. at a very early period. and many of the houses at Ur were provided with bathrooms and drains. of which we have such shadowy and indefinite records. has only recently been revealed by the excavation of the ancient city of Ur. Early History of Assyria to 1000 B.. and tools and utensils of copper. probably from 4000 B. and are believed to be Museum 1 * (Plate v). as some of the tablets which have been discovered have a bearing on medicine. Leonard Woolley.C. There can be no doubt of the existence of a Sumerian medical profession. Art and crafts- A method of writing upon clay tablets in cuneiform signs had been invented.C. the establishment of the calendar. in the Louvre surgical instruments. manship attained a high standard. boundary of the Arabian Desert and the mountains of Asia Minor there lies a semi-circular belt of country well watered by the great rivers Euphrates and Tigris.CHAPTER II THE FIRST KNOWN MEDICAL MEN AFTER that long prehistoric epoch. 2 This magnificent capital was situated at the eastern end of the Fertile Crescent. dated about 2300 B.C. appears to Sidney Smith. and known as the Fertile Crescent. came the invention of writing. Here. and there is in the Wellcome Museum the seal of a Sumerian physician who lived about 3000 B. and about one hundred miles from the Persian Gulf. therefore. Wheeled vehicles were in A number of small knives use. 1929 <* 17 3 . on the Euphrates. and. cradle of manscene was laid in Mesopotamia. arose the The " great civilization known at first as Sumerian.C. the dawn of recorded history. in consequence.

1905 ** 1 Medicine among the Assyrians and Egyptians in 1500 B. J. The kingdom of Sumer and Akkad came to an end about 2000 B. Edinburgh. D. of criminal offences. now preserved in the Louvre. 162 Thf Oldest Code of Laws m the World. King of Babylon. yet there appears to have been a well-organized medical profession in those ancient times. Chicago. treats of property. King. 4 Reprisals such as these might well have deterred the ambitious surgeon of Babylon. who had their capital first at Assur and later at Nineveh. H.. New Series. 11. 1909. that "if the doctor shall treat a gentleman and shall open an abscess with a bronze knife and shall preserve the eye of the patient." Edm. and the lists of remedies which : : W. 1915. F. It is stated. passed into the hands of two great nations. Johns. If the patient is a slave. of laws relating to medical practice. p. and derived benefit from both neighbours. vol. 3 for example. he shall receive ten shekels of silver. 1 L. Jour. 101 * R. the oldest in existence.C. 18 . his master shall pay two shekels of silver. It is true that magic entered largely into the treatment. by C. and the north to the Assyrians. his hands shall be cut off. This code." That there might be a debit account for the un"If the doctor fortunate doctor is shown by the following rule shall open an abscess with a bronze knife and shall kill the patient or shall destroy the sight of the eye. Comrie. what is of great interest to us. A History of Babylon. Med. It is not unlikely that there was a commercial and cultural link between the two great nations. the south to the Babylonians. p. with its glorious civilization. Harper. of marriage laws.) He drew up a Code of Laws ] . The Code of Hammurabi.A HISTORY OF MEDICINE have rivalled and perhaps even to have preceded the better known culture of Egypt. and edition. wliile the intervening country of Palestine.C. the operator was to pay to the master half the value of the slave. and. acted as a buffer state.G. and the country." place If the eye of a slave was destroyed as a result of operation. which was engraved on a pillar of hard stone and set up in the 2 temple at Babylon. who built their renowned capital city of Babylon. Medical Ethics in Babylonia One of the earliest kings of Babylon was an able ruler named Hammurabi (1948-1905 B. W." " He shall reIn the case of a slave the penalty is less drastic the slave with another slave. trans. home of the Hebrews.

carefully mapped out in squares. 247 4 . Temki. 1 " M. Nevertheless. " M. Loeb Library..). iv. Jastrow. xxvii. vii. . 109 " 6 O. Thomson. vol. 1906.. 105 " 1942. 1914.. iv. B. Gordon. Jastrow. The physicians were probably of the priestly class. each with a hole for a wooden peg. i.. xix. (Sect. and trans A. Any alteration on the surface of the fresh specimen was carefully pegged out on the model.*' Proc. and forms a suitable introduction to the more familiar medicine of ancient Egypt. there was a wcllR. the background which we have attempted to sketch is an essential link in the chain of medical history. 21).. . i.. may give him advice . G. vol. who wrote his history about 430 B. and a deduction was drawn from the result (Plate vi).. \Ve may read cepts From of Babylonian medicine. 241 19 . found in Babylon. Godley. 86 (Book i. Med. 20.C.. as it was the " if custom to lay the sick in the street so that any passers-by they have ever had his disease themselves. Egypt Certain it is that in Egypt. p. was inspected along with the fresh liver of a sacrificed animal. xxi. 4 vols. : were dominated by primitive magical and religious ideas. p. 1848. model of the sheep's liver.. 1 2 Herodotus. Popular Medicine in Sasanian Babylonia. 4 Not a single name of a physician has survived. as early as 4000 B.C. 3rd Ser. p. Soc. Roy. p.. 1936. 1921." Proc Roy." Ann. to use divination. or have known of any who has suffered from it. 197). . Gary. " The Sipns and Names for the Liver in Babylonia. 1924. 29 Herodotus. Egyptian and Babylonian Medicine. D." ^eit^ch. The Medicine of the Babylonians and Assyrians. p. Bohn Library. 5 We know little Influence of Writing and the Calendar The is influence of the Sumerian civilization upon that of a debatable problem which need not concern us here. tells us that every Babylonian was an amateur physician. Med. Assyrian Medical Texts. 250 * M. Hist. trans. Bd. and 1926. p. Med (Sect Hist. he consulted " with images. Med. p. p. vol.). vol. and medical con- " of such divination in the Bible The King of Babylon stood at the parting of the ways .f A\syrwl . and no one is allowed to pass the sick man in silence. p. he looked in the liver (Ezckiel. Soc. vol.THE FIRST KNOWN MEDICAL MEN have been deciphered from clay tablets are liberally interspersed with incantations and charms." Yet the existence of a medical profession is implied in the Code Hammurabi. H. Hist. 3 The it has been shown that divination was widely practised. the appearance of clay models of the liver." Bull. Hist. vol.

Imhotep. 1904." The introduction of writing naturally exercised a profound effect on the progress of medicine. and it was placed on all objects associated with danger. such as ships. a system of pictorial writing from which the modern alphabet was evolved. Ancient Times. There were various 3 Ra was the Sun gods who presided over the arts and sciences. Writing materials. engaged in a fight with Set. New Scries. 514. god of health. As for the calendar. Ancient Times. Horus. 1 who was originally a mortal. ii. gave place to sign writing or hieratic. which. Picture writing. The eye of Horus formed the design for a charm or amulet which was second only to the scarab or sacred beetle as a mascot of ancient Egypt. D. It is said to be the origin of the 4 which medical preceded prescriptions. pp. Comric. According to Breasted history.. while the lion-headed Sekhmet was the deity of childbirth. The galaxy of gods to which reference has been made was later augmented by the addition of the famous god of medicine. god of Wisdom. 1935. p. Breasted. too.* that ing has had a greater influence in uplifting the human race than any other achievement in the life of man." a this " is the earliest dated event in human Unfortunately we know very little about the condition of medical practice in Egypt at this early date. H. or hieroglyphic.C. and lost an eye. i. Chicago. J./* Edin. p. 59 E. that the date of its introduction was the year 4236 B. the eye of Horus passed through various phases until it became conventionalized as something resembling a capital R. 525 " Medicine among the Assyrians and Egyptians in 1500 B. Breasted. 2O . god. Originally recipe (R) sign an elaborate design. 66 A History of the Early World. cit. chariots and prescriptions (Plate iv)..A HISTORY OF MEDICINE organized government for several millions of people.C. 1 1 H. Professor Breasted remarks in " the invention of writhis fascinating volume. however. J. and the earliest alphabet came into use about 3500 B. and ed. it has been computed. Gods of Egypt. 1909. were invented. 101 J. was said to be the author of treatises on medicine. was restored by miraculous means. . and a means of recording time which with very few alterations remains as our calendar to-day. the of a falcon with the head ibis-headed Thoth. A. vol. loc. by the aid of astronomy. Jour. Budge. Med. vol.C. t p. and papyrus was found more convenient than clay bricks. the demon of evil.

( ups.aI-Lflina.( lie L^ocl i 'J On i a \ma-tjan-sa-chi I i-Lni.ON VXD 1XJYPT n of a cas< lioin th( oi tetanus fi>Ilo\Mii(r a \\ound paqt 2(^1 oi tin head Lduin Smith Ptifryrm \ Ins( i iption on Sral Ldin.PLATE V MF.i-inu-i. and n'dl< s used b\ ttje ph\si(ian -pai( 171 lh< .i I lie nj< ss( nu.R \TURE IN IUBV1. th( pl)\sician Ins servant Sral of a Bain Ionian phxsuian Sonic of the sit^ns inav reprfsrnt kni\(s.DICAL LITT.

!. \loma about i j< in .. us* (1 in ]>.PLATE VI THE LIVER IN DIVINATION ( hn iuo(l(l ol shop's h\M.British Must inn pji^< nj) Bron/o model of liver found at Pjacen/a brarinj? inscription in Etruscan. B c probabK third ccntur\ page (>j) .

p. Hurry. 1885. It is true that for long after his death he was worshipped first as demigod. Withington. Imhotep : The Vizier and Physician of King %pser and afterward* the Egyptian God of Medicine. much better known to medical historians. Withington. Imhotep was better known as physician. two names which deserve to be mentioned. Berlin. her hand resting on his shoulder. The Evolution of Modern Medicine. W. Sekhet'enanach has established a claim to be the first physician of history.THE FIRST KNOWN MEDICAL MEN SekheC enanach and Imhotep We have so little definite information regarding the state of medicine in ancient Egypt that we cannot tell who the greatest physicians were. but the physician chose to have his patient fashioned in stone. and it is difficult to however. though it would be futile to discuss whether Sekhet'enanach or Imhotep has the better claim to be regarded as the first medical man known to us by name. Med. Geschichte des alien Aeqyptens. B. SEKHET'ENANACH was chief to one of the who In Pharaohs lived about 3000 B. and should afterwards mark his tomb." The royal patient was willing to mark this service by any desired reward. Guest. as Imonthes. T. 706 * M. ii. Of Sekhet'enanach it is briefly recorded that " he healed the king's nostrils. 1926. Meyer. 1928 3 ' 21 . The second name. and that. and eventually as the god of medicine. p.. Hurry 4 and others. and suggested that this should be set up in a prominent position in the palace. 1894. rather than Hippocrates. 1922 J. so far as our present knowledge goes. Medical History from the Earliest Times. together with a record of the case. " is that of IMHOTEP. Osier Imhotep was the first figure of a physician to emerge from the mists of antiquity. vol. " Ancient Egyptian Physicians. vol. E. J. 14 E. while behind him stands his wife. Jour." Bnt. B. should be regarded as the Father of Medicine. During his lifetime. a name which means he who cometh in 3 states that peace/' truly a good name for a physician. he was identified by the Greeks as identical with their own Aesculapius. however. or that he should supplant Aesculapius as the God of the Healing 1 E. 95 . vizier and as architect than as justify the suggestion which has been made by Dr. p. Yet we have even less evidence of' his prowess as a physician than we have of the rival claimant Sekhet'enanach. There are. i. that Imhotep.C. physician his tomb he is depicted dressed in a leopard skin and carrying two sceptres. until well on in the Christian era. 1 According to Dr. Osier. 2 By making this choice.

Sethe. Roy. "Imhotep. Numerous statuettes have been found.) as a full deity. 134 G. The British Museum possesses ten such statuettes and the Wellcome Historical Medical Museum has thirty-one. M. Cairo. Quibell. a familiar sight to Art." Proc. The Step-pyramid. the largest of the pyramids. p. ii. p.). notable as a success achieve did only politician. 1 vizier to King Zoser. loc. B. Not presided. Etudes de Mythologie et d'Archfologie Egyptiennes. loc. p. from the earliest example of stonemasonry to the Great Pyramid (begun about 2885 B. at first as demigod. der Asklepio* der Aegypter. 769. a solid mass of blocks.C. 1916 R. 1902. p. Firth and J. J. 6 medicine as in he was worshipped for many centuries after his death as the god of medicine.). Joseph. He designed the Step Pyramid of Sakkarah. and which culminated in the building of the Great Pyramid at Gizeh. a*. 1936. which Imhotep built for his royal master. C. Soc. xxxiii. 138 22 .. representing Imhotep seated. Imhotep. Three temples are known to have been built in honour of K. and eventually (about 500 B. The task of organizing the labour for such a building must have been enormous. and 2900 state various over the like departments. Jayne. was therefore a and consists of six gigantic steps. Imhotep was grand to B. 10 W. Med. Hurry. more than two millions of them. The Step Pyramid which Imhotep 5 built magnificent achievement.C. for two standing figures (Plate vn). but is interesting as a transition between the simple stonefronted tombs of earlier times and the conventional smooth-sided pyramids which followed. most of them of solid bronze. each weighing about 2 J tons. C. a vols. vol. Maspero. This magnificent tomb. "/. A. Pans. and the greatest stone edifice of ancient times. 1 13 J..A HISTORY OF MEDICINE from official. Berlin. who lived about 2980 The vizier was the leading 3 every tourist who ascends the Nile or visits Memphis. Hist. H. (Sect. reading a papyrus which rests on his knees. 1940. Forbes. the rapidity of the decline of barbarism and the growth of civilization in ancient Egypt was Less than a century and a quarter elapsed truly remarkable. 1925. As Professor Breasted 4 remarks. The Healing Gods of Ancient Civilization. It is 200 feet high. including least as distinguished in Yet he must have been at architecture and politics. he also Imhotep 2 distinguished himself as one of the greatest architects of all time.C. J. is not only the oldest surviving stone building in the world. Breasted. vol. p. It is unfortunate that we know nothing of Imhotep as physician.

43). All of them have been lost. The available papyri are mere fragments of a great literature which began with the so-called Hermetic books of the god Thoth. as these contain.THE FIRST KNOWN MEDICAL MEN 1 There and elsewhere Imhotep. were kept for reference in the temples and were carried in the sacred processions. It was a since the construction of the great dam at Assuan close fine specimen of Egyptian architecture. It is perhaps unfair to judge the condition of medicine in ancient Egypt from the papyri at our disposal. was followed practice in Egypt as in Greece. for the most part. p. of which six dealt with medicine. his own life was forfeited. Guide to the Antiquities of Upper Egypt. however. The Medical Literature of Ancient Egypt writing. in least the accredited departed the case ended fatally. the physician closely to their teaching. i. t 1933. merely a series of notes and abstracts from the lost Hermetic books. thirty-two in number. Such an expectation has not been fulfilled as yet. p. on the island of Philae. E. " Medicine and Surgery in Ancient Egypt. Thus the Egyptian code of medical ethics meted out punishments for malpractices even more severe than those of the Babylonian code. but his tomb has not yet been found. but this has been sub- merged by. Med. 1929-37 * H. at Memphis. 237 '* 1 . and Philae. temple-sleep (see p. far up the Nile. 23 . Hist. Ranke. Those books. and the claim for recognition of this great sage as " the first known medical man " may thus be substantiated. Thebes. article Papvrology in Ency Brit i4th ed. Nevertheless they contain much informa- and A.. from the methods of treatment. Of those three temples only one survived. although the medical papyri which are still available appear to have been compiled from those earlier So highly were the Hermetic books esteemed that lost works." Bull. Weigall. S. vol. Mention has been made of the invention of and of the use of papyrus in ancient Egypt. Hunt. 7. Imhotep of or incubation. Perhaps one day it may be discovered. 3 no blame was incurred if the patient died. Imhotep is buried near the city of Memphis. 1913. 2 so that it might be expected that a study of the existing papyri would yield full information regarding the medical knowledge of the time. 298 " " A. so long as the physicians adhered If. and was there is reason to believe that the worshipped.

and contains about 900 recipes or prescriptions. Irom German version. P. Sometimes merely a knotted cord was to be used. 6 The primitive idea of devil possession was still the keystone of Egyptian pathology. xlv. and 1061 * G. It consists of 1 10 pages. too. with its dosage and quantity. von Klein. Med. and often also the appropriate spell or incantation. usually seven. The Papyrus Ebers. 26 R. 1930.. The " directions for use " in these days were. Not only is it the oldest complete medical book in existence.A HISTORY OF MEDICINE tion of interest to the student of medical history.C. and is now preserved in the University of Leipzig. vol li. ii. Major. trans. pp. There is abundant evidence to show that much of it has been 4 copied from other works many centuries older. 1930 24 . das hermetische Buck uber die Ar^tneimittel der alten Acgypter in hierattscher Schnft." Journ. Med. which suggest that the remedies were given with the intention of driving out or banishing the demon of disease. a form of amulet which has survived in folk-lore ! come that dost drive in these my to this day. H. 1014. 347 C. Papyros Ebcri. Ebers. however. As it is in almost perfect condition. 3 it is said to be the most ancient existing book of any kind." 6 Like the other medical papyri to which we shall presently refer. 1893. giving. * * The Medical Features of the Ebers Papyrus. the remedy. The Papyrus Ebers> trans. Htst. vol. das attest* Buck uber Hedkunde. H. The greater part of the writing. Amulets. Among the drugs Ancient Egyptian Medicine. p. Jour ." or. " Good. while " Welcome. into German : Papyros Ebers. with a specified number of knots. and its value is enhanced by the marginal notes by its first owner. 1875 1 J. Joachim. remedy ! Weltaking the medicine. No. away that which is in this my heart and limbs. " I have often used it. in each case. Finlayson. such as. to be hung round the neck or tied to the foot or to the great toe. 1890 1 '* 1 " C. " Assn. and as a calendar has been written on the back of the manuscript. 1 The Ebers Papyrus is the best known of the medical papyri. Berlin. the date of writing may be fixed with in a tomb of Thebes in 1862 by Professor 2 fair accuracy at about 1 500 B. An excellent remedy. It was found Georg Ebers." Ann. J. Leipzig. 748. consisting of images of the gods or other objects. the Ebers Papyrus is plentifully sprinkled with spells and incantations. such words as. Med. Amer. vol. to repeat. are advised.* Bnt. the disease for which it is to be used." This is only one of the many magical spells recommended in the papyrus.< 1905. Bryan. consists of lists of prescriptions.

which was used as a purgative. cd. and the statement is made that enters by the right ear and the breath of death by the left ear. p. 65 (one of the best concise accounts) on Medicine in The Legacy of Egypt . 1 Apparently the pharmacist of those days was also a good hunter." This rather confused series of observations shows that at least some attempt was being made to understand the mechanism of the human body. W. from the papyrus. p. also as a fuel for lamps. 1929. the snake. R. some of them of disgusting nature. 2 There were synchronous with the heart beat. the diseases mentioned in the Among papyrus affections of the stomach and intestines figure prominently. which was regarded as the principal vital organ. four for the head. . There is very little reference to symptoms or to diagnosis in the Ebers Papyrus. fat of the hippopotamus. This hygienic measure was later applied in the treatment of disease. the brain being only of minor importance. article Magician and Leech. showing that there has probably been little change in the incidence of these maladies from those early times 1 1 W. the goose. We learn. were believed to be organs of respiration as well " the breath of life as of hearing. Dawson. and that it is four for the liver. the the crocodile." or used as a fumigation ternally " to expel demons. and the ibex. K. It is noted that the pulse may be felt in many parts of the body. too." One strange remedy was bile from various animals pig bile was applied to the eyes. that the Egyptian habitually employed enemata. R. One interesting section deals with the action of the heart. described three vessels for each arm and leg. It was applied ex" to drive out painful swellings. The seeds were chewed and swallowed with beer as an internal remedy. Dawson. 1942. Among the prescriptions for baldness was one consisting of equal parts of the lion.THE FIRST KNOWN MEDICAL MEN mentioned are castor oil. while the fat of various animals was greatly favoured. The heart was carefully left in position during the process of embalming. 189 25 . Glanville. S. The ears and four for the lungs. which has had a long career in pharmacy. Another drug was hartshorn. although the medicine of the period appears to have been mainly blind empiricism. and the oil was applied externally for septic wounds and for burns. although all the other viscera were removed. for three successive days each month. as also do fevers and diseases of the eyes. R. Other animal substances were used.

4 Wounds were treated by fresh flesh.A HISTORY OF MEDICINE until the present day. Unfortunately the 8 description ends with the thorax. kept in place by a bandage. 1933.. as the book is incomplete. Chicago. 258 J. commencing with those of the head. *s now *n tne University The contents are very similar to those of the of California. Krause. and afterwards dressings of fat and honey were used. - 26 . de Mtd. A. and it is of later date (1400 B. it remained the property of the private collector whose name it bears. i. This was the Edwin Smith Papyrus (Plate v). should you find his mouth open. 6 Ebers Papyrus. 1930. It is a sort of handbook on the treatment of wounds and bruises. de I' Hist." Bull. G.. Med. Jour. The following description of a case of dislocated jaw. Papyrus Hearst. The Edwin Smith Surgical Pajyrus. and his mouth cannot close for him. There is evidence to show that surgical instruments were used. Publ. vol. diseases. Archaeol." Brit. of Cat. J.49 " 4 G. H. *935> v l. the standard of Egyptian medicine was regarded as rather low. 2 vols. 2 slightly earlier date : Papyrus. G. an idea still favoured in some quarters. p. Hist Med. vol. i 1 p. ed.. vol. you should put your two thumbs upon the ends of the two rami of the mandible inside his mouth and your fingers under his chin and you should cause them to fall back so that they rest in their places. until at his death it was presented to the Historical Society of New York. 1 Copper sulphate was largely used for eye A study of the Ebers Papyrus alone would suggest that the medicine of ancient Egypt was of the empirical or magical variety. Another docuA. Recently it has been studied He has shown that it is of than the Ebers Papyrus. " Le verso de Papyrus Edwin Smith. Reisner. 732 Smith. 1903. Egypt. "Ancient Egyptian Ophthalmology/* Bull.). until a few years ago.C. Univ.xxix P.. The Hearst and described by Professor Breasted." The other medical papyri which have come to light are smaller and more fragmentary than those just mentioned. found in Upper Egypt in 1899. de Lint. for the first day. and passing downwards. when the translation of another papyrus revealed a more logical and scientific outlook. is surprisingly modern having a dislocation of his mandible. Soc. p. in comparison with the general cultural level. Breasted. and that fractures were treated with splints. from " If you examine a man the papyrus. v. i. Elliot The Most Ancient Splints. 1908. Discovered at the same time and place as the Ebers Papyrus. Indeed. C.

11. ii. trans.C. Godley. vol. 86. and that this would assist that physical survival As burial customs changed after death in which they believed. while there Embalming and the Pathology of Mummies No the plete without account of the medicine of ancient Egypt would be comsome reference to the strange custom of preserving after death. Embalming was in from about B. and for the treatment of diseases of children. trans. 600.C. may have suggested to the Egyptians that the natural preservation might be favoured by artificial means. Bohn Library. p. It is sometimes called the London Medical Papyrus. but the contents are similar to those of the Ebers Papyrus. all of them consisting of prescriptions and it is Many is preserved at Cairo a Coptic manuscript Like the older papyri. and consisting of prescriptions and incantations for the protection of mothers and babies. while the skull is cleared of the rest by rinsing with it they draw out 1 Htrodotus. H. 86. to A. and it is practised 4000 Egypt estimated that about seven hundred million bodies were so treated. other medical papyri have been found. with no reference to diagnosis. buried remained for many years in a remarkable state of preservation. 126 Sect.C. 27 . lists of drugs. because the corpse which was placed in a tomb chamber or pyramid cell was no longer subjected to the desiccating effect of the desert grave.. ii. this became the more necessary. In the British Museum there is another fragmentary papyrus.. thus getting rid of a portion. known as the Sir Flinders Petrie. and probably of very early date. One is a poor production. 1921. largely composed of incantations. in effect a textbook of gynaecology. Apparently ment. and with fact that human body The in the dry hot sands of the desert. There are two medical papyri in the Berlin Museum (Berlin Papyri).THE FIRST KNOWN MEDICAL MEN Kahun Papyrus. Sect. Bk.. but appears to deal with the treatment of vaginal and uterine disorders. dead bodies. 370 . : the brain through the nostrils. 1 He writes " They take first a crooked piece of metal. A. was discovered in 1889 by Written about 1850 B. it is in fragmentary condition. charms. written about 1450 B. Herodotus gives a graphic description of the process. Loeb Library. Cary. Bk. D. 4 vols. the oldest known work on pediatrics. mostly of much more recent date. The other is a short but interesting document.D. it is made up of of the tenth century. p. 1848.

After this they fill the cavity with myrrh. cassia. Cairo. Elliot * Magician and Leech. During this process of heating resin was freely applied.. 1910. shaped in the figure of a man.. and the body is placed in natron for seventy days. G. bandages were also soaked in heated resin. and gall-stones have been found. urinary calculi. E. or in the simple pickling of the cadaver in a salt bath. with its characteristic deformities. p. it is given back to the relations. treated by some preservative. which showed kyphosis of the thoracic region resulting from disease 1 W. and returned to Mr. that rheumatoid reported. The case is fastened and placed upright in the sepulchral chamber. were held in greater esteem. Derry. and wrapped from head to foot in fine linen bandages smeared with gum . has been seen in mummies dating as far back as 3400 B. and the ." Less expensive methods consisted in the injection of cedar oil into the body cavities. 1920. 5. It seems rather surprising that in spite of the post-mortem examination which was part of the process of embalming. Elliot Smith and Deny 2 have described the mummy of Nesperehan. and dental caries rare. No.A HISTORY OF MEDICINE drugs . R. of Archaeological Survey of Nubia. and paracentetes who. 43 Smith and D. 21 28 . for example. wrapped in parcels. as many mummies show signs of fire.C. p. who enclose it in a wooden case. indeed. a high civic dignitary of the 2ist Dynasty. Such is the most costly way of embalming the dead. Interesting facts have been It has been shown. Bull. arthritis was extremely common. next they make a cut along the flank with a sharp stone. The " taricheutcs " (raplxcvnqs) who removed the organs. Then it is washed.. and has also been depicted in tomb portraits. nor were they concerned to ascertain the cause of death. The incision in the abdomen was made by the " " (TrapaKcvnjrri^) who were much despised. Dawson. it has provided the modern investigator with a rich field for investigation into the pathology of mummies. and the existence of tuberculous disease of the spine. Gouty concretions. . and take out the whole contents of the abdomen. Warren Dawson l believes that the body was the body. the Egyptians showed no great interest in anatomy or physiology. and other spices. The heart was carefully preserved intact in its original position all other viscera were removed. were obliged to fly for their lives on completing the task. dried or desiccated by heat. Yet this curious custom of embalming has had this advantage.

PLATE VII THE FIRST KNOWN MEDICAL MAN Statuette of Imhotcp. ph>siciaii and vi/itr to Kint? Zos< r about 2980 nr. <'pagc 21) .

\xitb advanced osteo-aithntis oi knee-joint page 2qi ' ) I . IN IXA'PIIAX MLMMILS Murninv lh( ol the pncst \rs[x i< li.ngt psoas ahscrss on I!IL 2800 H. sho\\ni^ tulxrculai tlivast of light side ip.m (< 1000 n < ).iKeolaiis (page jt) end (r oi lemur of ancient Nubian.I'LAfM YJII 1)ISL\SI.C <>li<miiu. absorption of (/) Jaus of a CJi/< h pwamid builder (( I oxxrr aKrolar margin tansed b\ p\orrhtxa .igrs jf jc^j spine and a l.

but a number of statuettes and incised representations of achondro3 rickety dwarfs are figured in his work. 1921 C. " Note on the Presence of Bilharzia Haematobium in Egyptian Mummies. is of very ancient date. A. 4 Unfortunately the quest is disappointing. 142 and 7fo Surgery of Ancient Egypt (Address to University of Leeds Medical Society on Jan. pleural and even appendicitis has been recognized. I will put none of these diseases upon thee which I . 21). concerned. E. and wilt God give ear to his commandments. Bilharzia eggs have been discovered in the kidney of mummies." Bnt. 1936 M. J. No evidence of syphilis and collapse of the vertebrae and also In other mummies or of rickets was found in the skeletons examined by Ruffer. Jour. Studies in the Paleopathology of Ancient Egypt. still so common in Egypt. Chicago.THE FIRST KNOWN MEDICAL MEN a large psoas abscess * have been seen. He was the source of life and health. 25. vol. Medicine in the Bible. as far as mortals are must remain the Father of Medicine. u indeed he existed at all. and they may have been intimately associated (Plate vni). Med Jour . who came in peace and showed the way. He was the first medical man whose name we know. sending disease and disaster to mankind as a punishment for sin. p. dethroning Aesculapius from Medicine in the Bible As our search for the medical knowledge of ancient times proceeds. 29 . 1938) 1 M. to turn to the Bible for information.. because God alone was regarded as the healer. xxxiii. i. Ruffer. . The Evidence for the Incidence of Tuberculosis in Ancient Egypt. A. J. and keep all his statutes. place for the physician. July 1939." 8 4 Brit. as some writers have suggested (p. and healing it only if the sufferers were worthy of cure. Gave. we are inclined. of Tuberculosis . physician Imhotep. 16 Ruffer. 1910. adhesions (Plate vin). " 1 A. Also. The Egyptians do not appear to have possessed that spirit of inquiry and that thirst for knowledge which characterized the Greeks. vol. Two other diseases of widespread incidence in Ancient Egypt were chronic suppurative periodontitis (pyorrhoea alveolaris) and chronic osteoarthritis (rheumatoid arthritis). showing that this 2 disease. and in the light of the existing evidence we arc hardly plasic and (?) justified in as god of his time-honoured position Medicine and setting Imhotep in his place. p. Brim. very naturally. " If thou wilt diligently hearken unto the voice of the Lord thy . and In the Old Testament there is little for a very definite reason. Hippocrates let honour us the Nevertheless.

EcclesiastiCanon. from a boil (the exact diagnosis unto death is obscure). 6) speaks of wounds which have not been closed. xxx. a noble testimonial to the medical profession. . " Isaiah (i." which ye may have of him is from a book which. iv. and in every case the treatment is recommended by a " man of God. involving. the washing or burning of infected clothing. 15-20) (Plate xxxv). . neither mollified with ointment/ showing the Jews knew something about first aid." Naaman. Few remedies are mentioned in the Old Testament. the leper. and the disinfection of houses. i. and birth stools or were in use (Exod. 25). are all described in detail. obstetric chairs performing artificial respiration There were midwives in those days. to wash himself seven times in the River Jordan 10) King Hezekiah. if necessary. lest it should detract from a power which ought to belong to God alone. the Bible is a mine of information on personal and social hygiene. strangely enough. neither that bound up. 10-14 Exod. and might even be regarded as the first textbook The thirteenth and fourteenth chapters of of public health. is told by Elisha (2 Kings v. The only surgical operation mentioned is circumcision." It is He that sinneth before his Maker. or. 7) while Elijah restored to life the son of the widow sick " " . 26). although " and In spite of this disappointing absence of references to medicine surgery. Leviticus contain explicit instructions to be observed by the priest in cases of leprosy. The oft-quoted eulogy them commencing cus. Any human knowledge of healing was regarded with disfavour. xvii. and they could also 5 treat fractures (Ezek. " is of the hand the physician into capable of more than one interpretation. the son of Sirach. of Zarephath. xv. 21). 17-23). The isolation of the patient. If physicians did exist among the Jews when the Old Testalittle ment was in written. there is surprisingly reference to Honour a physician with the honour due to him for the uses for the Lord hath created him. performed by the priest as a ritual procedure (Gen. was not included in the " The Wisdom of Jesus. apparently by (i Kings xvii. let him fall the last verse. is bidden by Isaiah to apply a lump of figs (2 Kings xx. complete destruction.A HISTORY OF MEDICINE have brought upon the Egyptians thce " : for I am the Lord that healeth (Exod. : " the sacred writings. 30 .

and the belief is strengthened by the fact " " that the trespass offering which priests and the diviners recommended to stay the epidemic consisted of five golden emerods and five golden mice. " images of your emerods. vi. There appears to be little doubt that " " with which the Lord smote the Philistines were emerods the We the buboes of plague.' " N.THE FIRST KNOWN MEDICAL MEN 1 Plague is frequently mentioned in the Old Testament. and images of your mice that mar the land" (i Sam. and was not exploded until Vcsalius so startling! y disposed of this and many other anatomical myths. Record. p. and the Jews were the pioneers of public health. A social conscience had awakened. The Talmud refers to blood-letting. 5). showing that . 309. J." Med. This is probably the plague. No. and although " there was apparently no S. 1910. Berlin. Hagcmann. which. cupping.D. Human anatomy is described in considerable detail. Physical purity was complementary to moral purity and cleanliness was literally next to godliness. vol. 4..). but it contains some details regarding Jewish medicine which are not to be found in the Old Testament. are told that twenty and four thousand died of plague at Baalpeor (Numbers xxv. 1915. to personal every soldier was obliged to carry an implement to facilitate the disposal of " his excreta.Y. * 934 4 Zur Hygiene der alten Israeliten. and shalt turn back and cover that which cometh " from thee (Deut. For the first time in history the individual was subordinated to the community. xu pp. 13). Jour. Biblische-Talmudische Medt&n. 191 1 " F. Especially interesting is the reference to the bone Luz. 23. The Medicine " of the Old Testament. The Old Testament contains many references 2 One example may be given. p. situated in some ill-defined part of the vertebral column. Ixxxvii. The bone called * Luz. H. Garmon. 149 E. was the permanent nucleus of the 4 This belief held throughout body which persisted after death. 9). The Talmud is mainly a book of regulations and laws. and the use of first reference to the rat as a disseminator of bubonic hygiene. And thou shalt have a paddle upon thy weapon and it shall be. thou shalt dig therewith. xxiii. Med. Preuss. Personal comfort or convenience must be sacrificed if that is necessary for the good of the greater number. the Middle Ages. Not only in the Bible but also in the Talmud 3 (fifth century A. Blakely. vol. when thou wilt ease thyself abroad. B. 1903. 449 31 . there is to be found much information on personal and social hygiene. splints 1 and bandages." Janus.

>\ R.. 2 219 Sir B. also The Antiquity oj Hindu Mtdtcvte.C. A. Gordon.Veda. dated about 700 called the Ayur-Vcda. 1 therefore. which was known to be caused by mosquitoes on phthisis. Soc.D.A HISTORY OF MEDICINE " organized medical education. Hist. M. and Susruta 6 about the fifth century A. 177. 17 * * le Rig. A study of ancient Hebrew literature. the Rig. C. Lieiard. Studies in the Medicine of Ancient '" Die Medi/m der alten Hindus. . d. vol. 1845 . or series of works. India. Gesch. 1896 . 1912 Works of Susruta. B. which was also very common. 1928. . p. owing largely to the difficulty of The earliest separating fact from fiction in oriental writings. and fever Hindu medicine was smallpox. Muthu. Da&gupta. S. nor indeed any medical men at all. vol. 1942. trans. 80 * D. Works ofCharaka. trans. " La Doctrine humorale des Hindous et p. indicates that the treatment of disease at that time consisted mainly of spells and incantations. Kaviratna. A. viii. leads us to the conclusion that although no great physician appeared among the Jews. L. " Medicine among the Ancient Hebrews. 1 B. 1907 32 . Gharaka 4 lived at the beginning of the Christian era. The Hindu " Short Review of the History of Ancient System in Medicine. Sanskrit document. Some of the writing attributed SUSRUTA. Kunja-Lal. which followed when many dead rats were seen &nd on which showed itself by haemoptysis. A Short History of Aryan Medical Scienct.*' Janus. Roy. Med. T. they did nevertheless contribute very materially to the progress of medical science by promoting a social conscience among the people. 3rd.. malaria. f. Calcutta. Jee. p. 2 Our knowledge of Hindu medicine in ancient times is incomplete and inaccurate. 1907 . Hoernle." Arch. p.Veda 3 (about 1500 B. the standard of "domestic medicine was of fairly high standard. Calcutta.). A Med. The works of the latter He wrote on many subjects on are the more noteworthy. although the original Ayur-Veda is date than cither of those great Hindu physicians. C. vol. contains is information. ed." Proc. vi.C.. 1913. xx. 1930. B. N. Hindu Medicine.*' Ann. Med. Ancient Medicine of India No account of the first known medical men would be complete without some reference to the early medical practice of the East. S. and by instituting valuable measures for the prevention of epidemic disease and the promotion of the health of the community. Wise. D. : much medical to CHARAKA and of much earlier . A.. cough. A later work. on plague.

PL\II IX RI LIC s <)I \POLIO.MJV. i I Hi* I r Omphalos tin at I)< Ipln -id< leading to \\a\ Sac rtd 1 ihr mpk c>i ( \ polio pa<4< 41 ) . CrOH CM Hl.

PLATE X EPIDAURUS.ooo p< rsons i pai^( 45. near tlu \\ith mplt acconmioclation foi jo. A CENTRE OF AESCULAPIAX HEALING The situate Ilnatn on (1 1 < tin Btautifully hilKule . the story iDscnlxxl on one oi he btcU* at Lpidauiub ^pac:c 44) . 1 lu of i MOIU \\hnh oi is Hoi nioclikcN.

and places of encampment. Some. Hut 1931. army surgeon were indicated in the follow" When the l king goeth with ing terms." Ann. 3 This was their greatest contribution to the art of healing. 1937. and inhalations. so that the sick. (429) 33 4 . Medical History from the Earliest Tunes. Calcutta. must see to the food. . like a bird with one wing. or wounded may find him quickly. Sarma. J. ." It was in surgery above all that the ancient Hindus excelled. " The Anatomical Knowledge of the Ancient Hindus. specialist. It is not unlikely.THE FIRST KNOWN MEDICAL MEN and Susruta mentions seven hundred and sixty External applications were largely used. T." might well be pondered by the modern rich in drugs. Withington." Arch. 1894. Hist. If he find poison he must remove it. 325 " * P. sneezing powders. using as models for practice the hollow stems of plants. Hindu Medicine and its Antiquity. M. which originated in India. water. that some of it was of Greek origin. 4 Operative procedures were taught. 1913 R. and the work was bold and distinctive. Kunja-Lal. xxx. One " He who knows only one branch of his art is of the remarks. and many other anatomical facts were distorted and fanciful. quoted by Withington : his army . as well as leaves and gourds. p. " Indische chirurgische Instrumente. His tent shall be near the king's tent. and there shall be a flag over his tent. p. 27 B. Of peculiar interest and of very ancient date is the operation It was frequently of rhinoplasty. as medicinal plants. and was undertaken by native trained surgeons until recent times. The Surgical Instruments of the Hindus. duties of the 1 * The * E. the excision of tumours. This pioneer work in surgery is all the more remarkable because the knowledge of anatomy was so slight. p.. p.. 1929. ointments. and performed many operations including Caesarean section. i. 5 The nerves and blood-vessels were believed to originate from the umbilicus. wood. F. though difficult to prove.. Med. 91 4 F. poisoned. and so save the army from death and destruction. . The performance of the last-mentioned operation was continued through the ages. vol. G.f. state that the Greeks drew much of their knowledge from the Hindus.'* Ann. vol. baths.. he shall take with him a skilful physician who . indeed. Some of the general information is of great interest. tit. and lithotomy. Muller. d Mtd. 318 Med. Cesch. S. Nevertheless the Hindus treated fractures with bamboo splints. 2 Susruta described more than a hundred surgical instruments. vol. Hammett.

discovered a large number of This knowledge he set forth in Pen drugs and of poisons. K. yet none can have a better claim to the title. which contains descriptions of over a thousand drugs. Scientific investigation of certain old Chinese drugs has been undertaken in recent years and has already this day. as we shall presently seek to prove. as adulterers were punished by having their noses cut The leaf of a tree. and is still in use in China." Nevertheless. A. or Chinese Materia Medica). 1936) G. vii. experimenting upon himself for many years. chinesischt Mm Medium. arsenic. the Chinese have shown originality and enterprise 2 although. Die 1932. Shanghai. Chinese Drug Stores. . was used as a pattern. was sutured in position. to quote one of themselves. fashioned to form the new nose. 4 1 W. the history of Chinese medicine is well worthy of investigation. (2nd. croton : . 8 Five thousand years is truly a wonderful record of longevity for a medical work. but also. Tientsin.. but some. An English edition was published as recently as 191 1." than SHEN NUNG. Chi Chinese Medicine (Clio Medica). R.A HISTORY OF MEDICINE required.C. pp. 1934. such as opium. many are inert and useless. 4 A K. Medicine farther east. who lived about 3000 B. 1925. It is not accurately known who was the originator of Chinese " Father medicine. 1929 Wong and Lien-Teh Wu. Med. although they may have been re-invented in Europe at later dates. and a piece of skin from the cheek or forehead. Chi Min Wong (1932) ". In medicine. and sulphur were also used. Thus off. Let us now turn our thoughts still and seek to ascertain the scope and extent of China's contribution to Medicine. of Medicine. New York. Stuart. 103 34 . 1911 Hist. 4< Chinese Materia Medica. cut to the desired shape and size. Dr. Leipzig." Ann. 2. ed. are in use to to mention only a few examples aconite. There were many subsequent editions of this book. History of Chinese Medicine. Chen. were the Hindus the pioneers of modern China's Contribution to plastic surgery. vol. Morse. This Emperor of China was a man of great ability who not only devised methods of cultivation and of raising stock. l Many inventions have been attributed to China. Inorganic remedies such as iron. they have never pursued a single subject in a way calculated to lead them to final success. Many of the drugs described are now obsolete. rhubarb. Hubotter. Tsao (the Great Herbal.

2 Two fundamental These two opposing principles were involved. lung. heat and cold. which is the foundation of all Chinese medical literature. H. of which the human body was fire. and kidney).. life and death. organs climate. water. Chinese " Hume. . As time went on. and naturally the principle was applied to health and Another doctrine was that of the five elements earth. The Square Way in Medicine. and so on. the Chinese seldom practised dissection. male and female. and heavenly a harmonious theory was independently evolved in somewhat similar fashion by the Greeks. The blood current flows The statement is continuously in a circle and never stops. Yang and Yin. B. vol. the Book of Medicine. that of was ephedrine. 1 Health was believed to consist in This balance between the various elements. wood. (heart. HWANG Ti (2650 B. 547. It contains a statement which is often quoted in support of the contention that the Chinese discovered the circulation of the blood many centuries before Harvey. owing to religious scruples.C. or rather rediscovery. ii. when they attributed diseases to ill-balanced " humours. and a theory was evolved which served as a basis for all subsequent practices. spleen. Everything in the universe depended upon the adjustment of balance between the two forces. Med." Among the methods of treatment which have been used in China from very ancient times are massage and acupuncture. and it is not unlikely that other useful substances in the Chinese Herbal await discovery. p. and metal The magical figure five was also applied to the composed." Bull. sun and moon. Read.*' Ann. They were ebb and flow. Kettle. to colours. viii. Hist. Med.) is believed to be the author of Net Ching. and their ideas of anatomy and physiology were grossly inaccurate. forces were believed to dominate everything. 1934. medicine in China gradually escaped from the control of magic and sorcery.. strength and weakness. " All the blood in the body is under the control of the heart. liver. Ma At a slightly later date another noteworthy medical work was written by another Chinese emperor." the more remarkable when we remember that.THE FIRST KNOWN MEDICAL MEN 1 yielded valuable results. . 1926. way One an of the discoveries made in this alkaloid isolated from the Chinese herb Huang. disease. 1940 and The 35 . 1 6 p. E. E. vol. . Hist. 1 " Gleanings from old Chinese Medicine. bodies.

E. Regnault..A HISTORY OF MEDICINE Blind masseurs were there employed for the first time. Hist. as he indica. 7/trf. Med. Organotherapy was also practised in China." a small cone of combustible material which was applied at various It must have demanded considerable points and then ignited. 1 1 5-205) 3 was the most famous surgeon of anc icnt China. p. good. Acupuncture consisted of the introduction of long fine needles at various . Hua Tu had a which after continued his and even in death. Chen and A. He was one of those who made a profound study of the pulse. His book on fevers is one of the classics of Chinese medical literature. he was revered on account of his noble aims and high ideals. Paris. Ling." Ann. self-control on the part of the patient. CHANG CHUNGKING. 1 The procedure probably did more harm than Another therapeutic measure was the use of the " moxa. Chang Chung. 1926. 185 36 . vol.D. 195. Mtdecuif 1 K. believed attributed the discovery of anaesthesia. p. the pulse being 1 Several hours felt may be spent in the investiga- in many different places. H. Pharmacie chez Its Chinots. and it is believed that any internal disease may be diagnosed from the pulse alone. vol. great reputation. viii. S. recent times effigies of him might be seen in certain temples. tion. . Furthermore. He also inaugurated a study of disease which was based upon observations of the patient rather than upon theories. More than 300 such points are described. HUA Tu (A. 1921. as none of his books have survived. His operations included and excision the of laparotomy spleen. 301 * J. " Fragments of Chinese Medical History.." Ann. K. Cowdry.specified points in the body. a method of examination which is very prominent in Chinese medicine.King and Hua Tu. Two hundred varieties of pulse have been described. is sometimes called the Chinese Hippocrates. and he was probably the first to treat certain fevers by cold baths. "Taoist et Ideas of Human Anatomy. though it survives in the treatment of sciatica and fibro- thyroid gland. to be Cannabis before operating upon them. but we know nothing of his methods. Inoculation against smallpox was practised in China from ancient times dried crusts from a smallpox patient were insufflated into the nose.D. cretins being fed on sheep's sitis. iii. Early in the Christian era there appeared two famous Chinese 2 medical men. 1902 Med. the true Hippocratic outlook. W. who lived about A. To him is gave his patients a narcotic draught.

when the influence of Germany became prominent. conceived the idea of gathering together all the medical knowledge then available and publishing it as an encyclopaedia of medicine and surgery. 37 .THE FIRST KNOWN MEDICAL MEN The Chinese have always felt a profound reverence for the past. and their ancient medical classics are more highly regarded by them than are the more modern works. in forty volumes. a great patron of literature. in 1827. and The Golden Mirror of Medicine. a young surgeon in the service of the East India Company. PETER PARKER. In 1744 the Emperor Kien Lung. opened a hospital for diseases of the eye at Macao. Although some of the ancient ideas and methods still hold their own. was the result. who.' One of the " of this to educate Chinese youths in objects hospital was Western medicine. first President of the Chinese Republic. Originally staffed mainly by British and American doctors. all those institutions have now come under the management of the Chinese. COLLEDGE. Japan has made some noteworthy contributions to progress. Colledge collaborated with an American medical missionary. The pioneer work at Canton was followed by the foundation of hospitals and medical schools in many other parts of China. A few years later (1835)." Among those youths was SUN YAT SEN (1867-1925). who are well fitted for the task. The work was undertaken by a committee of experts. It is still regarded as a standard work. The first Chinese to study medicine abroad was WONG FOON. One of the first to introduce European medicine into the East was THOMAS R. who graduated at Edinburgh in 1855 and then practised at Canton until his death in 1878. a general hospital at Canton. who graduated at Hong-kong. China is gradually evolving a system of medical practice which follows Western teaching and yet retains all that is best in the old and venerated Chinese tradition. and German was adopted as the language of scientific periodicals. although the need for well-trained medical men is enormous. Shortly after this time the pioneers of modern medicine began to reach China and to influence the traditional beliefs. Medicine in Japan followed the adopted Chinese lines until recent years. Many of the leaders ofJapanese medicine were trained in Germany. but continued to take an active interest in the hospital and school at Canton which now bears in the establishment of main his name.

Chicago. Ancient Times. 359). Among those who led the men as Kitasato (p. of Herodotus. Studies in the Paleopathology of Egypt. The Chinese Way in Medicine. R. S. a History of the Early World. BRIM. and Wn. J. To sum up what The Hebrews BOOKS FOR FURTHER READING BREASTED. Tientsin. H. The Legacy of Egypt. B. Studies in the Medicine of Ancient India. Imhotep : the Vizier and Physician of King %oser. C. of The Papyrus Ebers : The Greatest Egyptian Medical EBBELL. 1932 WOOLI EY. New York.A HISTORY OF MEDICINE such especially in bacteriology. 1935 in the Bible.. S. B. A W. 1929 Trans. 1921 WONG. C. 1907 HUME. 1905 Pal<eopathology : An Introduction to the Study of Ancient Evidences of Disease. Baltimore. 1936 Magician and Leech. Document* Copenhagen. Trans. W. regulated by a strict code but not inspired by any deep spirit of inquiry into the causes of disease. Berlin. 287) and Nogouchi (p. 1940 HURRY. The Hindus contributed materially to the art of surgery. F. said that the Babylonians laid great stress on personal and social hygiene. Ed. R. GODLEY. R. Loeb Library. C. 4 vols. and were the founders of epidemiology and public health. E. Biblische-Talmudische Medizin. it may be and Egyptians practised an empirical and magical kind of medicine. H. 1911 RUFFER. H. JOHNS. Chicago. J. Illinois. J. A. Sir B. LIEN-TEH. Short History of Aryan Medical Science. Sir M. way were has been described in this chapter. J. L. Ur of the Chaldees. 1923 PREUSS. 1896 The Oldest Code of Law in the World. D. C. 1 929 MOODIE. 1942 Medicine DAWSON. K. 1928 JEE. L. A. R. 1907 GLANVILLE. . History of Chinese Medicine. 1921 HOERNLE. M. A. while the Chinese were the originators of many discoveries in medicine which came to full fruition at later dates.

" Ann. G. D. Philosophy and history. and even Persia and India. vol. J. history from of by difficulty separating we may trace through and from Nevertheless men. p 90 * C. Nixon. sculpture and architecture. A.. and J. remains unchallenged in to day. 72 8 A. Cask. Cawadias. legend. It is 1 interesting to study the manner it which Greek medicine progressed towards the golden a study we are confronted such In Hippocratic Age. has the importance of the Minoan Civilization been The Minoans. p. poetry and drama. iii. It Herodotus himself furnishes proof of this. Almost everything that contributes to the interest and happiness of life originated in Greece. had their established. mathematics and astronomy. G. the Father of Medicine. E. Medicine. handed on to Greece the torch of learning. whose leadership. science and medicine all had their roots there. separated from magic. 1939. Langdon-Brown. un. 1921. " From Epidauros to Galenos. Comrie. The Principal Currents of Greek Medical Thought. vol. ii. though dominated arose. " What Medicine owes to Greek Culture." Lancet. Only within comparatively recent times. and indeed attained in some instances a level of excellence which has never since been equalled. and the beautiful frescoes and statuary which adorned the Palace of Knossos show that their arts had 1 W. An Introduction to the History of Medicine. by empiricism and superstition. had already attained a high There can be no doubt that Babylonia and Egypt. thanks to the labours of Sir Arthur Evans and others. a race of obscure origin. gods the maze the thread of thought which led by devious ways to the foundation of medicine. headquarters in Crete. became inspired by the spirit of scientific inquiry which dominated all the work of Hippocrates. 1 926.CHAPTER III EARLY GREEK MEDICINE MODERN civilization owes an immense debt to Ancient Greece. was in the Greek Islands that this knowledge was collected and amplified in the pre-Hellenic period. Hist. 3 By this time the practice of medicine. 501 39 . pursuing fact the from fiction. p. Cumston. dimmed throughout this the centuries. P. Med. steps 2 and the by which standard.

is depicted on the statuary to light. where once men prayed. 1 Unfortunately we have no records of the con- dition of medicine at the epoch which extended from 4000 to 2000 B. was born. 4 vols.000 slaves were sold in a single day. was raised from the bed of the sea and anchored by Zeus to provide a resting-place for the goddess Leto. 2 The island of the was the in Delos. Delos. symbol of healing. was the birthplace of Apollo. Apollo (Phoebus) and Artemis (Diana). 1921 Hellas Revisited. that of Cos. This. There can be few lovelier spots in the ^Egean archipelago. near the summit. the desolate.A HISTORY OF MEDICINE progressed far. p.. still a lovely isle set in a clear azure sea. and sanitary arrangements have been brought future Many inscriptions remain undeciphered. is crowned by Mount Cyiithus. where 15. and baths. so that the may show the stage at which medicine had arrived in times. we are told. who there gave birth to the twins. through the Homeric heroes and the philosopher-physicians of Greece. but the serpent. One may still discern the floor of the market. god Apollo. on whose slope. because neither death nor birth was permitted on the holy ground of Delos. a great city and an international market. reputed birthplace of of whom from arose the current of medical the health. 51 40 . and even in the time of Ovid it had become " Delos. the master physician. where Hippocrates. there is a grotto. Close by is the little islet of Rhenia. Cyclades group. 1929. at Knossos. From Greek mythology we learn that Delos. Minoan " Where Delos rose and Phoebus sprung " On another ^Egean island we may still find records of the sources of the healing art in Ancient Greece. 1 Sir A. which on the oracle of Delphi and the through thought passed cult of Aesculapius. The Palace of Minos 1 W. Evans. Delos became not only a place of pilgrimage but the centre of government of the Deliaii league. which served both as cemetery and as maternity hospital for the community.." Only a few ruined pillars mark the place of the temple. Delos is now an uninhabited isle.C. consisting of a cleft in the rock roofed by a double row of huge stone slabs forming a primitive arch (Plate ix). to reach at last yet another island. only a few of the subterranean water cisterns show the position of the mansion-houses of the classic period. the chief merchandise being wheat and slaves. once a floating island. MacNeile Dixon.

there stands a circular platform. the most sacred Here arose the famous oracle which made spot in all Greece. 1891. 1 There is another This is preserved omphalos. because it was then that his umbilical cord separated. He must have been very young when he was transported to Delphi. twelve miles distant. who had released at opposite ends of the earth (as then known) two eagles. 2 High up on the side of Mount Parnassus. 4 Close by. 374 H. by which the tourist untenable. Gardner. A E. Studies * * Greek Scenery. a village which occupied the of Delphi and which was bodily transplanted half a mile eastwards by the French excavators before they unearthed the ruins which may now be seen. a fact commemorated by the " omphalos/' a large sugar-loaf stone which may still be seen near the temple (Plate ix). p. Over it was a tripod on which the priestess chewing laurel leaves. now ascends the hill towards the Temple of Apollo. was to slay a python or monster. p. and uttering her raving replies to questions. The first act of the infant Apollo. and met at Delphi. 1 938. 1931. According to another tradition the omphalos is said to have been set up to mark The exact position of had been determined by Zeus. 3 a word. Mythology. G. though it has long since disappeared. household Delphi Beside the marble-paved Sacred Way. however incoherent. 1 Sir William Smith. were cleverly transcribed sat. and History. A. * Sir J. W. the centre or navel of the earth. 1 1 6 41 . probably of more recent date. this spot site museum at Kastri. it Delphi thereupon leapt into fame. and the Oracle of Delphi Apollo. tradition tells us. A Classical Dictionary in of Biography. which had rendered the site one in may readily understand just as maps of Greece. Parkc. Frazer. Delphi is a most eerie and awesome place even to-day. Oxford 1939 Greece and the Mgean. 2 ist ed.EARLY GREEK MEDICINE Apollo. approached by a steep and winding road from the port of Itea on the Gulf of Corinth. and Geography. and in the local why it occupied the central point Jerusalem was placed in the centre in the later days of Christendom. Legend. and for centuries remained a shrine for the worship of Apollo. on his arrival at Delphi. which flew towards each other. did not long remain on Delos. there was a chasm or cleft in the rock from which issued intoxicating fumes. History of the Delphic Oracle. These.

and protected from failure by their non-committal answers. 105 42 . constituting a Ministry of Information. ruins or partially restored. and respected even to-day. its Early History. when a patient desires reassurance even more than he desires treatment. and the city was captured into ! 2 by an enemy advancing over the dried bed. is the life-size bronze figure of a charioteer. as one cannot imagine that the astute " " brains trust established there would neglect so obvious an of raising their prestige as that afforded by the opportunity treatment of disease. That empire turned out to be his own Again. ego.*' Janus. 1 inquiring of the oracle whether he should go to war against the Persians. The replied that Lake Camarina was better left undisturbed. became submerged. amazingly natural. but the oracle. discovered only a few years ago. The services of the oracle were well rewarded indeed. p." and a dissociated personality replied to inquirers. although its influence has been neglected by medical historians. p. D. and Fall. the inhabitants of Camarina wished to drain a lake near their city which they regarded as a source of malaria. on being consulted. The staff of interpreters was in close touch with all the events of the day. Yet therapeutic advice may have been given at Delphi. 1914. the lake was emptied. to-day adorn the sacred precinct. There can be no doubt that among the many problems submitted to the Delphian Oracle there were some concerned with health and sickness. 1 1 J. for example. 69 "The Medical Aspects of the Greek Anthology." under the influence of fumes spiritualistic " " " or laurel. performed the function of a " Her medium.A HISTORY OF MEDICINE hexameter verse which usually conveyed an ambiguous " " sibyl Clearly the meaning. Rolleston. xix. The Delphic Oracle. advice was flouted. King Croesus. T. and complete even to the painted ivory eyes and delicate bronze eyelashes. so numerous and so valuable were the gifts to Delphi that treasuries or safe deposits were built by the donors. Influence. Dcmpscy. The idea was doubtless correct. and some of these. a principle elaborated by Hippocrates. One of the finest of the offerings. in . Oxford. 1918. The Oracle of Delphi was almost certainly a centre for medical advice. well qualified to advise. In those days prognosis was quite as important as treatment. was told that if he did so he would destroy a mighty empire. vol.

327 " The Worship I. 1939. 1900 of Asklepios." or temple sleep. 1914* v l. 1927. or in certain cases performed an operation. The Temples and Ritual of Asklepios. Soc. the gifted centaur. Close to each temple was the tholos. it was at Delphi that he performed miracles of healing. or Asklepieia. D. enclosing a paved pit or well. Apollo taught the healing art to Chiron.P. and in the morning the patient departed cured. and many patient was expected to make a sacrificial offering. a small building consisting of two concentric walls of stone. who promptly slew Aesculapius with a thunderbolt." Ann. 2 Aesculapius (Asklepios) is a shadowy figure. S. 4 . 158 M." or Temple Sleep only a step from Apollo and the Delphic Oracle to " " Aesculapius and the cult of temple healing associated with his 1 name. Hist. p. Ser. 1906 E. 1 R. 1920.. During the night Aesculapius appeared in a dream and gave advice. other places. p. who is sometimes regarded as the god of Surgery. Caton. of these temples. or the Cure of Disease in Pagan Temples and Christian Churches. and it has been suggested that the snakes were housed there. Athens. may still be seen. 419 6 Mary Hamilton. appealed to the supreme god Zeus... vol. Then he lay down to sleep in the abaton. Nevertheless.v ". (Sect.EARLY GREEK MEDICINE " It is Incubation. fearing that the supply of souls might thereby be decreased. . 3rd. " Health Temples in Ancient Greece and the Work Carried on in Them. and Chiron in his turn instructed Jason. 43 . vol. Wile. and Aesculapius.C. i. the ruler of the Underworld. for he became a god and was 4 Ruins worshipped in hundreds of temples throughout Greece. even restoring the dead to life. p. So many patients did he cure that Plutos.'* Med. "Chiron and his Pupil Asclepius. who may have had a human existence about 1250 B. Aesculapius reaped his posthumous reward. Med. The significance of the serpent in medicine has never been satisfactorily explained. * " The Cult of Asklepios. Snakes.. Hist. the tholos may have been a sacrificial 1 Proc. ix. Andrews. Hist. Gilruth. arid to purify himself by bathing. Bick. vm." Ann. Roy." Ann. On the other hand. assisted in the treatment by licking the eyes or sores of the patient. R.57 J. Incubation. Caton. Achilles. One of the most famous was at Epidaurus there were others at Cos. To the Asklepieia came many sick persons for the healing " 6 On arrival the ritual known as incubation. Hist. Pergamos. of the harmless variety still found in Greece. a long colonnade open to the air at each side. Med. Med.). 3 At all events. vol. St.

who ordered him to bring to the temple as large a stone as he could. As soon as she left it and got outside the temple precincts she bore a son. or. Our knowledge of incubation is largely derived from inscriptions on the stone stela. He 44 . the temple priest who " bore the sacrificial fire to the boy's father and said. when he left the abaton. Forty-four cases are described. making came he departed cured. " I do. 12. taught him wrestling. which now lies before the abaton sleep (Plate x). When boy came as a suppliant to the temple to recover he had performed the sacrifices and fulfilled the rites. in other cases. only the voice of the god. Agestratos suffered from insomnia on account of headAs soon as he came to the abaton he fell asleep and had aches. the methods the adopted by Delphian apparently depended upon altar. or tablets. The man brought the stone. A dumb his voice. Hermodikes of Lampsakos was paralysed in body. 15. gave it cured. When day came Euippos departed and he held the spear-head in his hands. and among them are the following : i." His father was greatly astonished at this. and both phenomena could doubtless be explained as forms of psychotherapy. The boy repeated the words and so was cured. a dream. 5. you promise to obtain that for turned pay within cheek. In his he was healed by the god.A HISTORY OF MEDICINE The revelation which came to the sleeping patient in a consisted of a vision of Aesculapius surrounded by dazzling Incubation lights. and after a short time he competed at the Nemean games and was victor in wrestling. and told his son to speak again. dream Oracle. Klco was with child for five years. 29. if you which you have come ? " Suddenly the boy answered. When day and. After these five years of pregnancy she came as a suppliant to the god and slept in the abaton. Euippos had had for six years the point of a spear in his As he was sleeping the god extracted the spear-head and to him into his hands. Do a year the fres for the cure. which have been found at Epidaurus. thought that the god cured him of his headache him stand up. who immediately after birth washed himself at the fountain and walked about with his mother.

Another description of temple healing. Aristides. Pergamos the treatment was vigorous. Even in its present ruined state Epidaurus is a and in spring the abundant anemones and other lovely place. He tells us that " the god ordered him to rub strong himself over with mud. Marius that Aristides the Epicurean (1885). the patient sometimes remained for days or weeks taking the waters and baths. in a single night. and to run three times round the temple. bathing. Although in the early days of the cult of incubation the methods employed were mystical and supernatural. he describes how the blind Ploutos had his sight restored by two prodigous serpents which in the licked his eyelids while he slept. whatever the issue. One may also visit the stadium or sports ground. to wash in the well. The Asklepieia were usually in healthy places. describes in his his exAt periences as a patient at various temples of Aesculapius. Instead of being cured. yet he did as he was told. account of a night at the abaton." It was a north wind and a keen frost. and following a routine of diet and exercise as at any modern spa. from the patient's point of view. as we shall see. Incubation was practised as early as the eighth century B. and exercise. who faithfully recorded his observations. and may use the massive stone seats provided for patients in the temple grounds. but one must remember was a hypochondriac. and even to-day. played an increasingly important part in the cure. Amusements were provided flowers enhance gay The theatre at Epidaurus. comprising diet. It was continued far into the Christian era.EARLY GREEK MEDICINE In reading those records of temple treatment one is impressed by two facts. in 45 . as by a miracle. mentioned. seating about 20. with natural springs and fine scenery. were the records of Hippocrates. All cases without exception were cured. may be found in Chapter III of Walter Pater's romance. in a remarkably good state of preservation.D.000 persons (Plate x). Another source of information on incubation is to be found " Ploutos " of In an amusing and satirical Aristophanes. who lived in the " " Sacred Orations second century A.. is one of the finest in Greece. and would respond only to measures. and found himself in fine condition. its attractiveness. as many had been regarded as Failures were not recorded and deaths were never incurable. and the cure appeared to be miraculous. How different.C. for the patients and their friends. physical therapy.

1906 1 C. Kenntnisse in Ilias und Odyssee. in Asia Minor and in Italy. surmounted by two carved lions . or the Cure of Disease in Pagan Temples and Christian Churches. Die arztlichen 46 . Korncr. and between historical Dr. and Styria. did much to infuse As a result. Schliemann. Sardinia. by his exfact and poetic fancy in the narrative. which he returned victorious ten years 1 only to be murdered Mary Hamilton. Daremberg. and through later. and has been discussed at length by Mary Hamilton in a most interesting monograph. the modern traveller in Greece and adjacent lands may visualize the Trojan war and may follow the wanderings of Odysseus. a great religious festival is held twice a year. emerged at last as a subject of scientific study. cavations at Troy and at Mycenae. La MJdfcine dans Homere. and at many country churches on the mainland of Greece and in Asia Minor. In the churches of Palermo. W. Naples. . Munich. No description of the medicine of Ancient Greece is complete without some reference to her greatest poet. Andrews in 1906. in Rhodes.* Before we pass from the early Greek period to the Hippocratic era. Paris. Nor can he remain unmoved as he enters the citadel of Mycenae through the Lion Gate. shaking off the bonds of magic and of empiricism. in search of information bearing upon may well be bewildered by the difficulty of distinguish- ing between gods and men in the characters. about 1876. reality into the epic tales of the Iliad and the Odyssey. now because both illustrate how medicine. Incubation. reader of Homer. On the sacred island of Tenos. published at St. one of the most famous sights of Greece. Andrews. rather a rare book. two further sources of information must be examined. 1865 O. the custom survives to this day. Incubation is also still practised on a small scale in Cyprus. forth to aid his brother that gate through which Agamemnon marched Menelaos in the siege of Troy. Homeric Medicine and Surgery 2 The medicine.A HISTORY OF MEDICINE Greece and the ^Egean Islands. with its gigantic hundred-ton lintel stone. 1929 St. and many sick persons sleep in the church in expectation of a cure. and to the philosophers. traces of this ancient cult may still be found. Each year miracles are reported. close to Delos. The subject is worthy of careful study. who included medicine in their comprehensive survey of knowledge.

892. PP. 28). 1931. he sucked out the blood and cunningly spread one skilled in whom archery hath . There is this descrip" tion of a dressing station Wounded is Odysseus. : Hekamede of the fair tresses shall heat warm water for the " Two of the bath. and E. W. soldier is told on his : . 1 1 S. A wounded "Sit where thou art. the hero son of Asklepios. trans." Lancet. When wounded with a bow shot. his glory and our grief. . are described. . . The * history of the campaign is well known. For instance. The following suggests that the writer was familiar with the acetabulum. From the Iliad we learn that the army was supplied with surgeons. Clytemnestra. "Homer's Surgeons . and brake both sinews withal. Asklepios' two sons were leaders. imparted to his sire There are many descriptions of wounds in the Iliad. (iv. Lang. vol. such as Cheiron of his good will had " . i. the noble leech. spearman and smitten is Eurypylos on the renowned. Homer. and wash away the clotted blood (xiv. " Achilles. to The god-like hero came and drew forth the it was drawn forth the keen barbs were broken backwards and when he saw the wound where the arrow had lighted. We thirty hollow ships (ii. the generalissimo was wounded Agamemnon commanded his herald that he should " with all speed call Machaon hither. and this men call the cup bone. smiting the neck [of Deukalion] with his sword. till are introduced to them to have taken part in the fighting. 732). 6). And about them the leeches skilled in medicine are busy. the cunning leeches Podalarius and Machaon. 1883 Machaon and Podalarius. . Aineias on the hip where the thigh turneth in the hip joint. and drink the bright wine. arrow. . and the jagged stone tore apart the Then the hero stayed fallen upon his knees and the skin. by A. The Iliad. 190). . . " " " Then sinews he refers though it is uncertain to what therewith he smote Tydeides grasped in his hand a stone . and the marrow rose out of the backbone and the corpse lay stretched : thereon soothing drugs.EARLY GREEK MEDICINE bathroom floor by his unfaithful wife. . Myers. and as . . 947 47 . to see Menelaos. of are well known as sons and surgeons they appear Aesculapius. ' . 2 And with them were arrayed " : . 294). swept far both head and helm.' So he crushed his cup bone. Leaf. and Agamemnon thigh with an arrow. healing their wounds " (xvi. Wood. " wounds Other mortal darkness of night veiled his eyes (v. " Of them that possessed Trikke and that possessed thus Oichalia.

479). 260). where earth into the wine whereof they drank. Surgery naturally lends itself less readily to magical bloody dust " The methods of cure than does medicine. smote him with a spear in the throat below the chin and drove the point straight through. had given her. and many all human 'kind baneful. and each. . . Or again. We Odysseus had come on his swift ship to seek a deadly drug. Even in the days of Homer.. 387). pain and Medicines of sorrow. was probably quite independent of the other. but it is to infer. supplies interesting facts does not tell of bloody battles like the on the medical lore of the time. As we shall presently note. . of such virtue had the daughter of Zeus. " Idomeneus . many that are healing in the cup. being con- not unreasonable " by a different class of patient. that Greek medicine is indebted for that impetus which led men to refuse to be blindly guided by It is to the 1 8 Homer." that each practised his art at the same epoch. Early Greek Philosophy. There is also the famous " nepenthe " used by Helen. H. which Polydamna. there was a movement towards scientific sulted medicine guided by observation and reason rather than by magic and superstition.. Butcher and A. a woman of Egypt. medicine was not entirely in the hands of the priests. (xiii. There each 220). and bring forgetfulness every anger. man is a leech skilled beyond The Philosopher-Physicians of Ancient Greece work of the early Greek philosophers. regarding priestly physicians and lay leeches. in the army at least. The Odytsey. trans. groaning and clutching the . yields herbs in greatest plenty. and the hint that in medicine the Greeks may have learned from the " Then Helen.A HISTORY OF MEDICINE on the earth. Burnet. l The though it Iliad. that he might have wherewithal to smear his bronze" shod arrows (i. the medical work cf Hippocrates had little in common with that of the priests of the Asklepieia in his native island of Cos. and he fell as an oak falls. so he lay stretched out. or a tall pine tree ..C. " " existence of those military or surgeons shows leeches that. the wife of Thon. 2 however. Lang. about 1000 B. 1908 . " (iv. five hundred years after Homer's day. Odyssey." (xx. 1887 J. daughter of Zeus . cast a drug Egyptians read that : " . by S. a drug to lull all . .

It ts sun minded PJ. of an earlier dale than the more famous headquarters at Rhodes ^see Plates xxni and xxiv) . John. one of Hippoc i airs '$(> fa< oi \\luch be .MS ( ft in < ucumfi trme).PLATE XI THE ISEAXD OF COS The b\ a so-called " r l KC ' maiblc \\all.it* tin msrnpuon illnstiaKcl in xn Castle of the Knights of St.

*Ma I) i * **i WftftMI **< ' rAr*i. Modem " Trot* of Italian inscription at the hast. h-hc\cd to he tliat ot Hippccr.4 i null A i //'!*/. VII.ites o^tt. XII "I ML IVIHI.R Or MEDIC NX I n fl AIL'OMBRA Di QVfSTO PLATANO ^ CIOVANI 1STRVENDO tD EDVCANDO ALL'ARTE CD AL SACERDOJIO DCLLA MEI>ICU*A I5T1TVIVA QVESTO OIVRAMENTO NEl SETOLO IV % C I IPPOCRATE~pj JCOO ' > MO crrAi M.4.iiuc ii>und tn ilu- island ofC'*s.of the 111 Clos (M c Platt xi) HippociaUs " .rmc. St.PI.

indeed. The doctrine of numbers suggested to Hippocrates the idea of critical days in illness. a few fragments. whether such knowledge could yield immediate practical results or not." Ann. p. and of the four elements and humours. that disease was a discord or disharmony of the elements composing the body. for he described the optic nerves and the Eustachian tubes. We know that he dissected animals. . p. Wnght. 1914. though it is none the less important. 25). so that the story is soon told. and not the heart. and taught men to inquire into in the transmigration of souls. we know nothing of his life. vol. as they appeared empty when opened after death. Alcmaeon noted that the brain. causes for the sake of knowledge alone. One of the greatest was PYTHAGORAS (580498 B. was the seat of the senses and the intellect. who lived about 500 B. J. although he subscribed to the current view that the arteries contained air. 1 J. founded Arithmetic. He was the first to believe that the earth and was a sphere. Pythagoras and the school which he founded exercised a profound influence upon medicine their ideas were a stimulus to critical thought.C. 116.EARLY GREEK MEDICINE supernatural influences or by rule-6f-thumb. Save that he was a native of Samos and an extensive traveller. veins and arteries. too.C. and that he lived for many years at Croton in Southern Italy. Hist 1925. It may be sufficient for our purpose to mention one more EMPEDOCLES of Agriphilosopher of the Pythagorean school. and that health was dependent upon harmony. Med. " A Medical History on the Timaeus. vol. He stated. and impelled them rather to seek out for themselves the causes and reasons of all the phenomena of Nature. "The Medical Aspects of the Greek Anthology. We know little of the lives of those their writings. . Rolleston. viii. a pupil of Pythagoras.). The philosophers. More closely identified with medicine was ALGM^EON of Croton. D. wn 49 5 . He believed in immortality and and he contended that animals also possessed souls. 1 . His chief claim to fame was his He may be said to have discovery of the theory of numbers. xix. and that there was a numerical ratio between the lengths which gave forth the concordant notes of the octave." Janus. determined the course which Greek medicine was to take in the hands of Hippocrates and his followers. and he enunciated the strange theory that He distinguished between goats breathe by their ears (cf. He showed that the pitch of a note produced by a stretched string depended upon the length of the string. apart from philosophers have all perished.

and Fall. 1683 Odyssey. and History. by A. H. Munich. R. G. Various miracles were attributed to him. L>j3 234 * BOOKS FOR FURTHER READING BURNET. H. Sir J. Early Greek Philosophy. Legend. 1931 GARDNER. trans. The Delphic Oracle. Lang. p. A History of the Delphic Oracle. theory of humours which was to dominate medical practice for centuries. C. W. MARY. and he was said to have ended his days by leaping into the crater of Mt. 1908. Influence. air. A. Etna. Oxford.A HISTORY OF MEDICINE 1 His life was surgentum." he wrote. Greece and the sEgean. 1938 HAMILTON. throughout the body. The Iliad. p. 1929 PARKE. E. in Sicily. W. and E. rounded by an aura of mystery. Incubation. Paris. La Medecine dans Homere. T. trans. so that the blood remains within. 1 J. 2 have bloodless through the lungs. Ibid. 1906 The HOMER.C. Empedocles also held that the heart was the organ " by which the pneuma. Andrews. and at the openings of these the outer layers of the skin are pierced all over with close set ducts. earth. so that he might become a god. lived from 504 to 443 B." which was identified with life and was distributed breath. Die ar&lichen Kenntnisse in Ilia* und Odyssee. or the Cure of Disease in Pagan Temples and Christian Churches. St." The conceplater to find its way into the doctrines and his followers. O. its Early History. He regarded the universe and everything in it as composed of four elements In this idea we have the nucleus of the fire. tubes of flesh spread over the outside of the body. He believed that breathing took place through the pores of the skin. Leaf. and water. Lang. 1918 FRAZER. Bunu't. as well as " " All beings. while a facile opening is tion of the pneuma was cut for the air to pass through. 1908 The Temples and Ritual of Asklepios. 1939 . Early Creek Philosophy. J. Myers. 1887 KORNER. That Empedocles was a practical physician is shown by the report that he checked an epidemic in his town of Agrigentum by draining a swamp and fumigating of Galen the houses. 1900 DAREMBERG. Studies in Greek Scenery. . Oxford. Butcher and A. CATON. by S. 1865 DEMPSEY.

" Glas. close to the coast of Asia Minor. 1921. Pheidias was building the Parthenon. 192 51 . 8 The only relic of Hippocrates which remains in Cos is the gigantic tree. vo '. who had two daughters. xxxvii. Med.. Hygica and Panacea." Ann.C. notwithstanding the fact that the country was at war.CHAPTER IV HIPPOCRATIG MEDICINE THE age of Pericles. "Notes and Comments on Hippocrates. It was an opportune moment for the birth of scientific medicine. p 128.. H. whose names have become household words. Withington. was a period of unparalleled prosperity in Greece. vol. 1939. and have stated that the Aesculapian cult of temple healing did not reach Cos until after the death of Hippocrates. in drama Euripides. and for the entry upon the stage of history of the greatest physician Herodotus was writing his history. stand on a beautiful hillside some three miles inland from the town of Cos. within less than a century. Hist. He is said to have been a B. 1892. At no time in the history of mankind has one nation. In philosophy there was Socrates. 3rd Series. The Background to Hippocrates In the little HIPPOCRATES was born in 460 island of Cos. Bull. i. Hist. and 1940. p. Med. vol. . the ruins of which. as we have already remarked. partially reconstructed.. lovely statues. that the methods and the records of the Hippocratic school were entirely different from those of the priests of Aesculapius. Moreover." P. 2 Recent authorities have disproved this statement. and was in some way connected with the Asklepieioii. 383 E. produced so many brilliant pioneers in the arts and sciences. " Early Medical Schools ii. Gask." 8 G. Hippocrates." in Singer's and Method of Science. who ruled from 490 to 429 B. No. Jour. and in geography Strabo. in poetry Sophocles.'9 vol. Aristotle of all time. ' p. Sigcnst. it is obvious to the most casual inquirer. an Oriental also 1 " J. Studies in the History " The Asclepiadae and the Priests of Asclepios. vol.. u. It has been stated that Hippocrates was a member of a guild of Asklepeiads. T.C. Med the Cult of Aesculapius and the Origin of Hippocratic Medicine. E. Finlayson. and Praxiteles was creating and Plato were soon to follow. 1934. 4 . 1 direct descendant of Aesculapius.

Some of the works. to-day. and eventually died at Larissa. what were the ideas and ideals. and have been the subject of innumerable commentaries. the methods and procedures. and one can well imagine him as an inspiring teacher and an ideal physician (Plate xn). thoughtful. a between him and those events it is. Under the shade of its branches. but all depict a dignified. it was probably 355 B. vital link who learn from him even should be. Hippocrates lived a long life. he was a great traveller. five hundred years is a great age for a tree.C. or whether there was more than one physician and author trate. Hippocrates was not the sole author of the hundred or more books which make up the collection. notably the Aphorisms. and gracious figure. which of the works were genuinely those of Hippocrates. At all as it The Hippocratic Collection Although we know very little of the man himself. and his clarity in recording cases. named Hippocrates. now so carefully supported by props of wood and pillars of stone. and other places. In studying the works of Hippocrates no one can fail to remark his high standard of ethical conduct. or Corpus Hippocrattcum a complete exposition of his methods.A HISTORY OF MEDICINE which stands in the centre of the town of Cos (Plate xi). and although the date of his death is not known with accuracy. but y that does not detract from their value as he certainly inspired them all. his insistence on prognosis. It will be more profitable to illus- by quotation from the books which are generally acknowledged to be most truly Hippocratic. a place of pious pilgrimage for all physicians. and it is perhaps 52 . were used as textbooks until the beginning of the nineteenth century. It would serve no useful purpose to discuss. Hippocrates is reputed to have taught his pupils. his accuracy of observation. yet one would fain believe that this is a genuine living memento of the great teacher. we have in the Hippocratic Collection. as the works of Hippocrates have been translated into many languages. which inspired the Father of Medicine. Two thousand Plane. and he practised in Thessaly. like the other wise men of his day. as has so often been done. A knowledge of Greek is no longer essential for such a study. holding an open-air clinic. Although he lived mainly at Cos. None of the busts and statues of Hippocrates which still exist can be regarded as an authentic portrait. Athens.

Afed. by F." 719 Med . and of taking no mean advantage of the position of medical adviser. Francis Adams. vol. they also day. by E. Adams' translation of Hippocrates appeared in I849. was regarded as unworthy of the physician. S.. and who is the subject of a charming essay in Dr. Some controversy has arisen regard- and refraining from discovery.. and there is urged upon him the duty of respect for his school or university. '* A Great Country Doctor . and gives the original Greek 2 alongside the translations. S. Francis Adams of Banchory." The Hippocratic Oath The " Hippocratic Oath. Loeb Library. John Brown's Horae Subsecivae. 1 The Genuine Works of Hippocrates. 1 A more recent translation (1923). vti. 1849. which appeared in 1839-61. 1796C. Jones.HIPPOCRATIC MEDICINE unfortunate that they have not remained in use until the present Although they contain much that is obsolete. The most extensive translation is in French." Bull. A Latin edition had been issued from the press of Calvus in Rome during the previous year. 1942. T. Hist. H. in Aberdeenshire. in the Loeb Classical Library in four neat little volumes. imply. p. Littre (OEuvres completes (THippocrate). Hippocrates. Let us briefly glance at the contents of the works. the country practitioner and scholar who practised at Banchory. Hippocrates. p i by W. Withington. in certain cases. Of English translations the best known is that of Dr. of seeking above all the Whatever this may ing the promise not to perform lithotomy. Nittis. 1861. benefit of the patient.Jones and E. trans. of making freely available any new secrecy. Hist vols." has been adopted medical men throughout the ages. is by W. as a pattern by In this noble code of ethics the disciple or graduand is shown the dignity and responsibility of his calling. xii. Singer. of maintaining professional gossip. in ten volumes. 1923-31 S. Adams for Sydenham Society. 4 Bull. Even at that early date surgery was to be referred to a specialist class of craftsmen. 1 3 2 vols. H. trans. *939 vol. it is clear that surgery. embody a code of teaching and principles that are surprisingly modern. The first complete Greek edition of the works of Hippocrates was printed by Aldus of Venice in 1526. 53 . the first to separate for all who wished to follow Medicine from Philosophy. " The Hippocratic Oath in Reference to Lithotomy. set a high standard what he called " The Art.

1924 54 . luxurious The same writer is " 1 S. The Doctor's Oath. when he is in need of money to share mine with him. but to consider carefully your patient's means. Sometimes give your services for and if there be an opportunity of serving one who nothing : . if it be what should not be published abroad. p. is a stranger in financial straits. But I will keep pure and holy both my life and my art. by Panacea. but to nobody to stone. give full assistance to all such. and I will abstain from all intentional of man or wrongdoing and harm. I will use treatment to help the sick according and judgment. Similarly I will not give to a woman a pessary to cause abortion. H. gives the following " I advice urge you not to be too grasping. holding such things to be holy secrets. xii. will carry out according to my ability and judgment. Nittis. and by all the gods and goddesses. . I will not use the knife. if I carry out this oath. I will enter to help the sick. by Hygeia. making them my witnesses. vol. especially from abusing the bodies woman.) even more personal when he advises the " to avoid physician adopting. 336 . And whatsoever I shall see or hear in the course of my profession. verily.. may the opposite befall and for my art . but the work of one of his school. impart precept. but I soever houses will give place to such as are craftsmen therein. but never with a view to injury and wrongmy ability Neither will I administer a poison to anybody when asked to do doing. and all other instruction to my own 9 sons.A HISTORY OF MEDICINE The Oath is worth quoting numerous English renderings : in its entirety in one of the I swear by Apollo the Physician. without fee or indenture. me. not even." but if I transgress and forswear Various embellishments of the oath and hints on professional conduct are to be found in other Hippocratic writings. to consider his family as my own brothers. . I will never divulge. there is also love of the art. and break it not. Hist Med. 1942. 1 The book entitled Precepts. and to pupils who have taken the physicians to else. that 44 I this indenture. as well as outside my profession in my intercourse with men. in order to gain a patient. generally believed to be of later date than Hippocrates. on sufferers from Oath. so. Into whatI enter. by Aesculapius." Bull.Jones. oral instruction. Hippocratic Ethics and Present-day Trends in Medicine. bond or free. S. For where there is the love of man. vi. this oath and To hold my teacher in this art equal to my own parents. to make him partner in my livelihood. nor will I suggest such a course. if they want to learn it. and to teach them this art. the sons of my teacher." (Prec. may I gain for ever reputation among Now it all men for my life myself. W.

and. Moon. but nobody wonders at them. O. causes. which he aptly likened to the creaking of leather. . He had no patience with the idea that disease was a punishment sent by the gods. of climate in causing disease. and independent. and in war of more than average courage. the friction sound of pleurisy. scientific although he had no and his writings are full . from cold. seem to me to be no less sacred and god" sent than this disease. any more divine or more sacred than other diseases." he continues. Taylor. 277 55 . O. tertians." Every " has its own nature and arises from external disease." The writer is much impressed by the influence of climate " When the land is oppressed by winter's upon mind and body. storms and burned by the sun. He advises the physician set up practice in an unfamiliar town. of sound observation and logical reasoning. with more than average intelligence in the arts. from the sun. especially. 1 His book on The Sacred Disease (believed to be epilepsy 2 ) begins : " It is not in my opinion. achieve the greatest triumphs in the practice of his art. of occupation. origin is due to man's inexperience fevers. But apparatus. "The Doctrine of Epilepsy i. From this information will deduce what diseases are the most prevalent. men are hard." I do not Yet/' he adds. vol." to he be able and will thus " 1 H. Med. One of his most interesting books about to deals with Airs y Waters^ and Places. for example. Hist. Temkin. Greek Biology and Medicine." /fa//." Hippocrates noted the effect of food." The Nature of Disease Hippocrates knew little of anatomy or physiology. the water supply. p. Hippocrates .. 23 to . and quartans. for it is not unworthy of a physician's dignity. and its supposed divine . but has a natural cause. p. or from changing winds. stubborn. forbid your trying to please.HIPPOCRATIC MEDICINE " " headgear or elaborate perfume. placing his ear to the chest of the patient and describing. the prevailing winds. the nature of the soil and the habits of the people. 1922. in the Hippocratic Writings. he had scientific method. to observe the exposure. It is true that he employed auscultation. and 1 his Successors in Relation the Philosophy of their Times (Fitzpatrick Lectures) 1923 O. 1933. R. and he possessed neither clinical thermometer nor stethoscope.

A HISTORY OF MEDICINE The Importance of Prognosis From a study of the natural history of disease. Success and failure he recorded without partiality." Then follows the I have stated. excellent thing for the physician to practice he will carry out treatment best if he knows : " Hippocratic fades. They were not concerned with causes. and a' babbled of green fields. in the 42 cases described diseases. 1 For them diagnosis and treatment were everything. and to many other signs upon which prognosis may be based. For it is by the same symptoms in all cases that you will know the diseases that come to a crisis at the time classical description of the : beforehand from the present symptoms what will take place later. he must examine the face of the patient. W. was He knew how to record a case clearly essentially an observer. the mainland close to the island of Cos there was the school of Cnidos. temples shrunken." One of the greatest works of Hippocrates " I is entitled Prognostic. on the other hand." The school of Hippocrates was not without its rivals." The description is closely mirrored by Shakespeare in his account " of the death of FalstafT . Singer. Not for him were the boastful cures of the Aesculapian temples. His case mortality was high..." In Prognostic the physician's attention is also directed to the position assumed by the patient in bed. C. 56 . name of any disease. and whether a fatal issue was likely to result. the colour yellow or very dusky. eyes hollow. 60 per cent. Sir James Mackenzie " No doctor lives long enough to write a reliable used to remark. and concisely. and the Cnidian physicians classified all symptoms as and produced a remedy for each. Here is an extract from the preface : hold that forecasting it is an . ed. his nose was as sharp as a pen. 1921.. the skin of the face parched and tense. R. the appearance of the sputum. ears cold and with their lobes turned outward. the nature of the respirations." " The routine method of examination is described thus First." which denotes " death Nose impending sharp. Livingstone. The concluding paragraph " Do not regret the omission. " Medicine " in The Legacy of p. Hippocrates was able to forecast how the symptoms would develop. from my account. Perhaps his own long life was conducive to his study of prognosis.. nor with prognosis. 206 1 On Greece. book on prognosis. of the runs. Hippocrates.

" lessness followed . p. Soc. " On Its Collection. Malaria was very common and fatal. a beautiful maiden aged twenty. On the seventh day there issued from the right ear more than a cupful of foetid reddish pus. the But the fever returned. who struck her with the open hand on the top of the head. " We must refrain from meddlesome interference. and on getting home was taken with severe fever. 524 . About midday on the sixth day he died. so was dysentery. W. black urine. 1943 Infectious Diseases 57 ." natures. irrational talk. with headache. The " Philliscus lived by may be a case of blackwater fever. Hippocratic Medicine . and she seemed a little relieved. she became comatose and speechless tremor and breathright side of her face was drawn spasms describes what we now call One other case may "be . Roy. and His methods may be studied in his prescribed a simple diet. He took to his bed with acute fever on the first day and sweating night uncomfortable. A. . The breathing throughout. . and sometimes no other food was given. the principle of Vis Medicatrix Nature. quoted. This was no great 1 E. 1934. sweating. Spirit and Method. The daughter of Nerios. thirst. Yet he gave sound advice.HIPPOCRATIC MEDICINE in the books of Epidemics. Fifth day distressing night. a head injury followed by otitis and meningitis. Goodall. Cheyne-Stokes respiration. and redness of the face. she Hippocrates on Treatment Hippocrates made little use of drugs in treatment. was rare and large. Third day until midday he appeared to have lost the fever. employed baths and fomentations when indicated." he said. (Sect. . xxvii. her tongue and eyes became paralyzed died on the ninth day." Proc. dry tongue. but towards evening acute following the wall. The favourite diet was barley gruel. fever.)." . Regimen in Acute Diseases. Sleepless completely out of his mind. as though he were The last sentence recollecting to do it. " are the physicians of our diseases. Hist. 1 He knew that there was in most diseases a tendency to natural cure. W. was playing with a girl friend. vol. cold sweat. but one must remember that most of the cases were of acute and serious disease. . New York. and Epidemiology in the Hippocratic Med. black urine. She saw a blackness before her eyes and lost her breath. Heidel. He Our watched the course of the disease and did not interfere with nature.

d. Chance. The follow" The ing is an extract which might have been written to-day nails neither to exceed nor come short of the finger tips. and worst of all children. as they illustrate to his . Gesch. and he goes on to advise the doctor to be prepared to do the right thing at the " right time. attendants. 31 K. and even trephined the skull. set fractures. gether. Deichgrabcr. speed. l The first of these is almost hackneyed. If there be great thirst. with each hand and with both to. or even one meal only. ii. vol. and the Art long experiopportunity fleeting ment dangerous. I. is oxymel [vinegar and honey]. Old men endure fasting most easily. Hippocrates did not confine his practice to medicine." The "Aphorisms" of Hippocrates is complete without some reference famous Aphorisms. ** On Hippocrates and the Aphorisms. : Details are also given regarding the use of boiled water. in which patient. and external circumstances must co-operate. No account . In the Surgery. xxix.. honey. B. Hist. and judgment difficult. Med. with thumb well opposed to forefinger.A HISTORY OF MEDICINE hardship to the Greeks." Arch.. "Goethe und Hippocrates. On Wounds in the Head His use of tar for wounds is a surprising forerunner of the (xxi) Even more remarkable is the advice which antiseptic method.' 5 elegance." Ann. 13. especially those of a liveliness greater than the ordinary. and readiness. 1 p. 58 . He drained pus. the man of middle age. p. and " stress is laid upon the need for ability. " Life is short.f. taking two meals a day. " The drink to be employed should there be any pain. give hydromel [water and 55 At the present day glucose would take the place of honey]. and reduced dislocations (using a special bench or table)." A few of the other aphorisms may be quoted. vol. 1936. Med. Practice all the operations. 1930. Good formation of fingers. Honey was also favoured. who were simple livers. and the assistants. the position of the light. as he clearly describes in the work. so well the teaching of the great master I. He was a good surgeon. : 6. he gives in his short notebook entitled. 27 . the instruments. youths very badly." he writes. painlessness. For extreme diseases extreme strictness of treatment is most efficacious.

sore throat. apoplexy. 6. vomiting. When bubbles form in the urine it is a sign that the kidneys are affected. and nostrils. strangury diseases consumption. 34. In the different ages the following complaints occur to little children and babies. apoplexy. III. The diseases which generally arise in rainy weather are protracted fevers. watery discharges from the ears. V. hardness of hearing. 1 6. recover. pruritis. If diarrhoea attack a consumptive patient it is a fatal symptom. pains at the joints. sleeplessness. II. a bad sign. the opposite crisis. II. and angina. ears. but to omit treatment is to prolong life. thirty-five. Consumption occurs chiefly between the ages of eighteen and 14. 20. neither with purges nor with other irritants. III. and dysentery. dizziness. dullness of sight. In winter occur pleurisy. III. mortifications. II. 19. 59 . Old men suffer from accompanied by difficulty in breathing. 2. coughs. Those who are attacked by tetanus days. is Do II. terrors. VII. : protracted. dizziness. Old men generally have less illness than young men. When on starvation diet. III. but such complaints as become chronic in old men generally last until death. 39. and that the disease will be VI. watery discharges from the bowels.HIPPOCRATIG MEDICINE I. All diseases occur at all seasons. In every disease it is a good sign when the patient's intellect is sound and he enjoys his food . seasons. III. V. fluxes of the bowels. When sleep puts an end to delirium it is a good sign. a patient should not be fatigued. not disturb a patient either during or just after a and try no experiments. In dry weather occur epilepsy. It is better to give no treatment in cases of hidden cancer treatment causes speedy death. aphthae. pneumonia. 24. 31. difficult micturition. 33. they survive these. but some diseases are more apt to occur and to be aggravated at certain 1 6. but leave him alone. colds. 9. if V. catarrh coughing. apoplexy. of the joints. 38. 23. : headache. either die in four or. eye diseases.

laboratory to-day it is again engaging the attention of some of the best minds in medicine. Neo-Hippocratism in Everyday Practice. though not himself a physician. . vol. was of inestimable value to medicine. The idea of focusing full attention on the rather than on scientific theories of disease or elaborate patient. 2.A HISTORY OF MEDICINE VII." " Ann. ARISTOTLE (384-322 B. G. ii. 144 60 . "Aristotle the Naturalist. xxxi. Hist. . p.)." Proc. Wright. 1927. p. 1 The originals deserve to be read and re-read by every practitioner of medicine and surgery." field. as the first 4 His home great biologist.." Ann. exercised a profound influence upon the practice of medicine. Wright. but they may good sense and astute observation of the writer. A Short History of Biology. 1041. 1931. Those that fire does not cure must be considered incurable. Aschner.. 37 J. 72. whatever his fact that We of our diseases." in Science and the Classics. constitute disease. was revived by Sydenham and Boerhaave. vol. Roy. Alexander the Great. 1938. vol. Those diseases that medicines do not cure are cured by the knife. 87. " Neo-Hippocratism. where he was a pupil of Plato.) was 3 probably the greatest scientific genius the world has ever seen.C. 2 fully reminded of the cannot be too frequently or too force" our natures are the physicians The physician and the specialist. was in Athens. Med. p. P1 " Modern Commentaries on Hippocrates. 260 A. when beyond due measure. Med. and later he was tutor to the son of Philip of Macedon. Hist. his work. Hist. 9 p. 1940. and should view disease with the eye of the naturalist. Commentary is needless. x. VII. That is the message of Hippocrates. p. 27 D'Arcy W. Aristotle and His Influence Closely following Hippocrates in point of time was one who. (Sect. Those that the knife does not cure are cured by fire. The work of Hippocrates is not a mere matter of historic interest. Thompson. should study the entire patient and his environment. though hundreds of commentaries upon the aphorisms have been published. Cawadias. Med. 34 B. "The Evolution and Thought of Aristotle. vol. Soc. No. Hist. Singer. P." Bull. as fresh to-day as it was 2400 years ago. 1919. ix. who J. Med. He was not only a profound philosopher .. Both sleep and sleeplessness. suffice to illustrate the Only a few of the aphorisms have been quoted. and tests.

and build the comb. ii." in Studies and Method of Science. Singer. and many of his descriptions and classifications remain sound to-day. In his conception of the Ladder of Nature there may be seen the first faint glimmer of a theory of evolution. vol. 1921. C. De Histono **lantarum. but also their He explains how frankincense and myrrh were collected. and he noted how they swarm. 1 Theophrastus. He also described the process of germination of seeds. moist. Aristotle other biologist.). and he was the first to distinguish monocenturies. and that it was composed of four phlegm. gather honey. not knowing her sex. Disturbance of the relative human body fundamental predominance of the humours constituted disease. 1916 " " * C. of their " ruler " as he called the queen. 2 vols. in tht History in Relation to the Rise of Modern Biology. Singer. ed by Sir A. vol. and black bile. when it excited the interest and admiration of the great physiologist. of medical interest. " humours " blood. a botanist. To-day. His investigation of the development of the chick within the egg was the first of a vast series of embryological researches during sub- sequent ages. ii. anwho was. 1 was He especially interested in fishes dissected innumerable animals. above all. and and molluscs. Historia Plantarum. He followed Hippocrates and others of his predecessors in believing that the possessed four the hot the the and cold.C. is and only the morphology use in therapeutics. Hort. His account of the curious placental dog-fish was not confirmed until early in the nineteenth century. yellow bile. dry and the qualities. Johannes Mullen He also gave an accurate description of the life of bees. he laid the foundation of modern scientific 2 It was the standard botanical textbook for many botany. and of embryology. incisions being made in the stems of the plants in order to extract the gum. Aristotle encompassed the entire world of living things. 3 cotyledons 1 and dicotyledons. By his great work.HIPPOCRATIC MEDICINE in his brief meteoric career was destined to alter the world's Aristotle laid the foundations of comparative anatomy history. Medical Botanists was followed by THEOPHRASTUS (307-256 B. "Greek Biology P- 56 61 . this would be interpreted as a disturbance of endocrine balance. as the writer described not and natural history of plants. 1921. Greek Diology in Studies in the History and Method of Science. Loeb Library.

1 De universa medicina. Wootton. 1922 Historia Plantarum. Yet the torch of Greek medicine. Its Sp'nt and Method. 1943 . 1910. The Greek Herbal of Dioscondes. 1 1 A R. The Legacy of Greece (article on Medicine by C. A Short History of Biology. W. THEOPHRASTUS. T. R. lish the science of Materia Medica. T. 1849. a Greek surgeon to of Nero. Singer). The Works of Hippocrates. ed. Theophrastus was one of the last great scholars of the high Greece was no longer to be the centre of intellectual supremacy. R. W. A. which includes mineral remedies such as It remained the salts of lead and copper. 1940 62 . 1923 O to the Philosophy of their SINGER. Gunthrr. G. 4 vols. 7 he Greek Herbal of Dioscondes 1934 C. 1916 THOMPSON. Sir A. S. Adams. classical period. 60). 2 vols. A. and the Classics (chapter on Aristotle). 1896 DICKINSON... to estabarmy His work on the subject.D. vol. Sydenham Society. LOWES. GUNTHER. C. p. y i. Hippocrates and his Successors in Relation Times. Loeb Library. 1923-31 LIVINGSTONE. 1921 MOON. not only in the great empire of Alexander. New York. Hippocratic Medicine. was for centuries used as the standard 2 authority. was to be kept alight by other distinguished men. trans. 2 vols. H. The period of decline had begun. O. D'ARCY. Chronicles of Pharmacy. 1934 HEIDEL.. 2 vols. H. R. more than three hundred years later. Jones and E. 1931 TAYLOR. which burned so brightly in the hands of Hippocrates and his immediate followers. but for four centuries in the still greater Roman Empire. 206 BOOKS FOR FURTHER READING The Greek View of Life. The Genuine Works of Hippocrates. by F. trans. T. Science Hort. by W.A HISTORY OF MEDICINE for DIOSCORIDES (fl. Withington. Loeb Library. De Greek Biology and Medicine.

though Greek culture give place to other lands.CHAPTER V ALEXANDRIAN AND ROMAN MEDICINE THE brilliant epoch in Greece was now passing. let us round off the Hippoa ever. who by their work added greatly to the knowledge of the countries conquered. Athens was to give place to Alexandria.C. and the country which had produced so many scholars and artists was now to Nevertheless. Of course we know that Alexander the Great. was fading in the land of its birth. and here was established a home of learning and a vast library. for it was destined to exercise a far-reaching influence. and that their practice and teaching remained predominant throughout mediaeval times. The Medical School of Alexandria rise of Greek medicine in Rome.000 books. With a vision far ahead of his him he took with on his time. campaigns a number of scientists. but it is remarkable that all the great physicians of the Roman Empire were Greeks. but marched eastward over Persia as far as India. Its mission was not yet accomplished. Of the medical school at Alexandria all 63 ." was a disaster almost too great to realize. which might have been even larger but for his untimely death at the age of thirty-three years. at Alexandria. It was natural that. Unfortunately our sources of information are very small. The loss to posterity which resulted from the burning of the library by a mob of fanatics. which eventually contained some 700. and established a vast empire. it was by no means dying.. really began cratic period by a brief reference to the Medical School of Alexandria. Alexandria was founded in 332 B. sweeping Before considering the which before him in his astounding march of progress. medicine should remain in Greek hands. and then to Rome. a year before Alexander's death. who were intent on getting " rid of the past so as to found a New Order. and in some respects to attain further eminence. conquered not only Greece and Asia Minor and Egypt. hownew epoch. until the Renaissance brought new ideas and more enlightened teaching.

the heart. Roy. elaborated and altered by Galen. His treatise on anatomy was undoubtedly an amazing piece of work for its time.). "Herophilus of Alexandria. He regarded the nerves as hollow tubes filled with fluid. HEROPHILUS was essentially an anatomist. but we know some- thing of their work from the pages of Galen and other authors. Soc. method for attaining knowledge.C. 1927. Medical History from 1894. p. His experiments marked a new development in Greek medicine. Their writings have perished. which had begun while Greece was still the intellectual centre of the world. Instead. E. xviii. and then This idea was carried throughout the body by the arteries. (Sect. as we shall see. they " procured criminals from prison by royal permission. Med. 825 the Earliest Times. Soc. It is somewhat gruesome to record that both of those distinguished Alexandrians may have practised human vivisection. Hist." As time went on the fame of Alexandria declined and the empire of Alexander was superseded by that of Rome." Proc. but Galen severely criticized the ideas of Erasistratus. nor was the medical system of Rome with any haste. the the the noted cerebrum from and cerebellum. In science. Roy. and dis" was by far the best sected them alive. distinguished difference between sensory and motor nerves." Proc. Med. p. where it was changed into the Vital Spirit. the torcular Herophili (wine-press of Herophilus). or an excessive blood 3 He believed that the air entered the lungs and then supply. 1 His name survives in one of the venous sinuses of the brain. Hist. and he was the first to name the duodenum and to count the pulse. but rather by a gradual process of infiltration. This. According to Celsus. vol. p. xx. Withington. " Erasistratus. about 300 B. This opened a new field for Greek medicine. F. 2 ERASISTRATUS. Dobson. 1925* vol. and led him to reject the accepted view that disease was due to maladjusted humours. T. J. (Sect. as in Rome was Greece transferred to 1 J.A HISTORY OF MEDICINE we know save that work was established and led by two great men. and he may have been the first to practise public dissection of the human body. Herophilus and Erasistratus. 19 Dobson.). 63 64 ." adds Celsus. regarded by some as the founder of physiology. Etruscans and Early Greek Settlers in Rome not built in a day. both of whom were born little. F. he attributed disease to plethora.

" Rome. B. Medicine and Roman Medical Inscriptions Found in Barnes. Many of those early Greek physicians were slaves in Roman families. Histoire et Doctrines. Castiglioni. 1865 " On Roman * H. and they call : 4 A. ancient Roman doctored himself and doctored his household.C. 1929 1 * <*) 65 6 . 1914. Medicine as a proThe fession was beneath the dignity of the Roman citizen. who hated the Greeks and all their works." wrote in his maxims of advice to his son (Pr&cepta ad Filium) They have sworn to kill all barbarians with their drugs. foretelling the future by inspection of the liver of an animal slain for sacrifice. 19). viii. as we have noted Rough and ready (p. resembling the clay models which. the first Latin prose writer of any importance.C. Roman medicine did not exist as a separate entity. Krumbhaar. was an attractive field for the itinerant Greek practitioner. when Julius Gsesar accorded unless to physicians the full rights of Roman 3 citizenship. 189 C. Everyone was his own physician.). That the Greek immigrants had forsaken the noble precepts of Hippocrates. Bronze models of the liver. Hist. Clifford Allbutt. moreover. La Mddecine. Chicago. trans. but as time went on there was no appearance of a native system of medicine. and that they were not slow to exploit the wealthy Romans. but that were the founders of Rome we must admit. therefore. Soc. E. Daremberg. have been found. and Rome was.ALEXANDRIAN AND ROMAN MEDICINE The origin of the Etruscans is art. obscure. they 1 we prefer to accept the legend of Romulus and Remus. vol. and there were no physicians before the advent of the Greeks. the reference textbooks. mais non pas sans medecine." P*oc. methods of healing were doubtless practised. Roman gibes at Greek Medicine Apparently Greek medicine was of rather low standard in those early days of Rome. as Sicily and the southern half of Italy were still parts of Greece (Magna Graecia). Rome was a borrower. a near neighbour. Roy. Cato the Censor (234-149 B. were used in Babylon (Plate vi). and so it remained until 46 B. and it is known that they practised divination. The status of the profession was low. p. Britain. is obvious from many con- temporary writings. p. so to speak. 71 4 T. A History of Medicine. Greek Medicine in Rome (Fitz pa trick Lectures). Like other primitive peoples they had their folk-lore. 1941. Med. invoking the aid of the gods. they were "sans medecins. (Sect.).. As 2 Daremberg remarks.

Soc. with hands as cold as snow I had no fever. vol. Ixxiv. a man who at first a good name and was called Vulnarius ( Wound-curer) acquired Later. Crawfurd.) . (Sect. however. Paris. which shows the play on the words gladiator. Martial and Medicine. of the Latin poets." Pliny. : Fecisti Hoplomachus nunc cs fueras ophthalmicus ante medicus quod facis hoplomachus. too. 6tudts mtdicales sur Martial. Bohn's Library. and he was then named come to Rome . was Archagathus. This was his panacea for all ills. he fell from grace. hundred students following in the rear All paw my chest." us barbarians. Yet they learn by our suffering and they experiment by putting us to death. approached too closely to investigate the eruption of Vesuvius when it overwhelmed the town of Pompeii. vii. I send for Symmachus he's here. 1914. " R. Roy. always a close observer. Cato lived to the age of eighty-five years. found in the Greek physicians 1 One of the epigrams of Martial target for their taunts. Pliny the Elder (A.D. in which he dealt not only with unicorns and winged horses and other strange " It is unfortunate. and if we are to believe Horace.C. or eaten and washed down with good wine. 15 66 . Hist.A HISTORY OF MEDICINE Remember that I forbid physicians for you. his favourite prescription for himself and his household was cabbage. viii. : : (You are now a gladiator. p. applied externally. The translation runs : I'm ill." Proc.. To Pliny we are indebted for the information that the first Greek practitioner to in 219 B. M6niere. 1858 The Epigrams of Martial. but I have it now. " he remarks. as it shows that clinical teaching was practised in Rome.D. 23-79) wrote a monumental natural history in thirty-seven books. Bk." beasts. Another of Martial's epigrams is of interest. and thus he met his death. formerly you were an oculist As a medical man you did what you now do as a gladiator. and that capital punishment is never inflicted on them. * P. No. 40-102) relates to an eye specialist who had become a 2 It is best appreciated in the original. Some a good (A. A 1 . Mcd.). and many Romans followed his example. : : let poetes lattns. but also with the medicine of the day. 1881. that there is no law to punish ignorant physicians. Carnifex (Executioner). The prejudice against Greek doctors appears to have continued until the Christian era.

the " Prince of Physicians. Cumston. where his sagacity Although though his ability had already brought him success. he met a funeral The bearers had laid down the corpse and were procession. Playfair.C. It is said that one day while walking in Rome. History rf Medtcme. he was a worthy follower of the Father of Medicine." was elaborated by THEMISON (123-43 B. and has " The Hippocrates of chronic disease. on the southern Educated at Athens and at in Rome. p. Asclepiades did not lack patients. Methodism. p. he eventually settled and strong personality soon led him to become the fashionable physician of the day and the friend of Cicero and of Mark Antony." as he has been called. where after some manipulation by the physician they were astounded to see the dead restored to life. though he preferred dietetic and physical therapy (baths. tuto. News of the incident spread rapidly in Rome. which he stigmatized as merely a meditation on death. and there have even been semblances of it in modern days. known as tion.) to treatment by drugs." He believed in active measures by the physician." he did not been called follow the Hippocratic rules. safely. 1910. 1926. was born at Prusa in Bithynia shores of the Black Sea in 124 B. that disease should be treated speedily. 1 Alexandria.C. He " condition of the " which permeated sthenic and asthenic states). 201 67 . and agreeably 2 held that disease depended upon the all the tissues of the pores or too were too contracted If these relaxed. the result. 1 * C. massage. Health was the balance between tension and relaxa" This theory. It was he who originated the idea etc. resting. advanced by Broussais " theory of (theory of irritation) and by Brown (" Brunonian (Cito. et jucunde). 119 M. History of Medicine. G. when Asclepiades. ill-health was body. et " Jucunde who the first Greek physicians to arrive in Rome was one deserves to be remembered. as may be imagined. ASCLEPIADES.ALEXANDRIAN AND ROMAN MEDICINE " Cito. noticed signs of life in the dead man. the pupil of Asclepiades.). vol. trans. though the title is disputed Among by Avicenna. i. E. as he passed by. He persuaded the relatives to delay the funeral and to convey the body to a neighbouring house. and in much more recent times it formed the basis of similar ideas. who practised in Rome during the reign of Augustus. Tuto. and. Neuburger. and indeed he denied the healing " power of Nature.

and the Eclectics. (Includes 68 . and as for the remaining sect. the the Methodists. The Empirics were not concerned with causes. and their only mistake was that they erected a complete superstructure upon an insufficient foundation. and reducing medical practice to rule of thumb. but they are partly preserved for us in the quotations of other writers. but relied upon experience alone. and the mind governed all the organs of the body. who called it animism. Parties and sects similar to those outlined above. Mention has already been made of Themison as a Methodist. and German texts) . though it is not known whether he ever practised it. R. His works have for the most part disappeared. as Galen preferred to call them. or. The Dogmatists. and a similar vogue was introduced by Van Helmont. For the Pneumatists. Such a conception has ever been a favourite theme with poets and philosophers. was made to explain all pathological and an endeavour phenomena by fitting them into the given theory. von Welz. 1 Party Politics in Medicine It may so largely dominated medical practice in the post-Hippocratic era. which was detected by feeling the pulse. Asdepiades von Bithunia Greek. these were free lances who might adopt any or every theory to meet the current need. Empirics. " the Rationalists. all disease was due to disturbance of the airy spirit or pneuma." They believed that medicine must be founded in physiology.Roman Some of them have been mentioned . This pneuma or breath was the vehicle of the mind. times there arose the Dogmatists. the Pneumatists. Gcsundhcitsvorschriften. Latin. Medicine has suffered much at the hands of theorists. 1842. names which have puzzled many a student of medical history. Instead of following the master in his reliance upon Nature and his observation at the bedside. that of the Eclectics. 1 and often : difficult to define.A HISTORY OF MEDICINE Asclepiades is said to be the first writer to mention tracheotomy. In Graeco. especially when the theory is allowed to supplant clinical observation. Pneumatism was revived in the seventeenth century by Stahl. the others need not detain us long. labelling the disease and the corresponding remedy. the sects be convenient and cults which at this point to interpolate a note on various theories of disease were constructed. may R. were the truest sons of Hippocrates.

" he states that this should not be " the limbs may yield as the bones attempted too soon. An Essay on Mithridatium and TTunaka. because are not yet become firm. Heberden. who in an antidote to poisons. Only boiled water and honey should be given for two days. manner of vegetable The 217 . and he ordered it in the form of pills " 1 Die Gcburtshilfe des Soranus Ephesius. Meyer-Steinig and K. 2 The original mithridaticum contained about fifty ingredients. practised Rome because offered great scope for his activities. Jena." because he may almost be regarded as the founder of obstetrical science. A man of high status and a good clinician. Sudhoff. 78-1 it 1 7). claimed that he had thus discovered antidote for every venomous reptile and every poisonous substance. 1847. Pirroff. Before leaving unprofitable subject. which led to its expulsion from the various pharmacopoeias. Galen's prescription had no less than seventy-three ingredients. and advises bathing the eyes of the new-born child. SORANUS in (A. though a native of Asia Minor. in 1 745." Mithridaticum and Theriac In dealing with the epoch of medical history between the death of Hippocrates and the birth of Christ. shows how the umbilical cord should be ligated. J.D. gynaecology. Geschtchle der Mcdtzin. 256). engaged the attention of pharmacists until William Heberden (p. he must be regarded as the leading authority on obstetrics. and on the third day nursing should commence. vol. wrote a counterblast to its use. 1 His treatise remained the only authority on the subject for fourteen centuries. 1 745 p. was wont to amuse himself by making experiments upon un" an fortunate criminals. 174). recipe underwent modification in course of time. and became the chief source of information for Roesslin's Rosengarten (1513) and Raynalde's Byrth of Mankynde (1545) (p. Soranus is said to " How the be the first writer to refer to rickets. T. mention must be made of another " Methodist." This drug." Janus.ALEXANDRIAN AND ROMAN MEDICINE be found this at all epochs in the history of medicine. ii. known as mithridaticum or theriac. 121 * W. p. king of Pontus. Soranus describes podalic version and the obstetric chair. mention must be made of the king whose name was for many centuries perpetuated Mithridates VI. 1921. including vipers' flesh and all products. and pediatrics among the ancients. Dealing with child should practise walking. 69 .

dated mentions sixty-two ingredients. indeed." jtonu. in which case it was to be taken twice a day for seven years. a universal " Never has a medicine remedy.A HISTORY OF MEDICINE as large as grapes. they stared as white's their shirt it was their poison hurt. 2 The basis of theriac was Venice treacle. we must remember that it was he. 457 70 . He may have been contemporary with Galen. but also for numerous other diseases. 191 xvL pp. record of the work of Aretaeus is found in the writings of Aetius A known The methods of King pocm r A Shropshire Lad 1 : Mithridates are described in A. all that springs to birth . To give King Mithridates his due. 371. It was. not only for the bites of venomous animals. he died old. who discovered that he could immunize himself against certain poisons by gradually increasing doses. who probably preceded him. the Cappadocian. 1 Theriac was of different composition. we know nothing the save that he lived in Alexandria about the second century A. A It Follower of Hippocrates must not be inferred. the Pharmacopoeia of the Royal College of Physicians of London. yet neither writer mentions the other. 1. so it is said. Of ARETAEUS. although. Housman's well-known He gathered a little. and it seems strange that his classical descriptions of disease should have been so little or quoted during more than a thousand years. " Observations sur la TheViaque. Apparently theriac was widely used. even as late as the eighteenth century. vol. They poured strychnine in his cup And shook to see him drink it up. Aretaeus quotes no medical authority except HippoThe first crates. of which ten were to be taken before and after food. From -the many-venomed First He earth thence to more. as one writer has said. that all the physicians of Graeco-Roman era were of the class who relied upon theories and theriac. but it was also an example of polypharmacy . C. They Them * shook. Daniels. Mithndates. I tell the tale that I heard told. sampled all her killing store * * * : They put arsenic in his meat And stared aghast to watch him eat. certain mystery surrounds Aretaeus.D. . E. E. in fact. not even Celsus. however. although the two antidotes are often confused. containing so much cured so little. but for the effects of poisons." 1724.

and (2) chronic diseases. 79). A based upon two manuscripts. 1930. vol." Bull. and have narrow chests. and his word pictures of disease resemble those of Hippocrates. xxx. Aretaeus the Cappadocian and his Contribution to Diabetes Mellitus. Historical Facts in Diabetes. 1 J. 2 Aretaeus was a talented physician who wrote in a clear and attractive style. x. 100).. vol. Sydenham Soc. Didsbury. along with the Greek text. The Extant Works of Aretaeus the Cappadocian. 1909..." never satisfaction occurs . The former includes descriptions of pneumonia.D." consisted in " The kidneys and faction of the flesh and bones into urine. A. G." 4 diabetes Sta/J^r^s (" a passer through "). . Hist.. " E. ii. F.. Couch. decussating each other in the form of the It was Aretaeus who gave its name to the disease letter X. d'apres Aretee de Cappadoce.. those marrow. whose scapulae are like wings or who have those doors. and a more recent translation. H.. Hasp. although his work attracted little edition attention until comparatively recent times. folding prominent throats. 1928. tetanus. p. the parts homonymous with it are paralysed. Hist. " " a liqueThis disease. 1 beautiful by Wigan was published by the Clarendon Press in 1 723. . who are pale. who lived in the sixth century. "The Literary Illustrations of Aretaeus of Cappadocia. Med. pleurisy. the left side The cause of this of the body will be paralysed [and vice versa] each passes is the interchange in the origins of the nerves over to the other side. J. while among the latter are accounts of insanity. " Considerations sur la Migraine Assoc Jour. whose original works are lost. Aretaeus was a close follower of Hippocrates and an accurate observer. to phthisis are the slender. p. he cannot be stopped patient drinks. p. Med. Adams. p. 387 . 424 4 " 71* . . as though the aqueducts " No matter what quantity of fluid the were opened wide. vol. and phthisis.. 371 E. . Leopold. J. as he called it." Canad. 556 . was prepared for the Sydenham Society in 1858 by the scholarly Francis Adams. a" Hist. Cordell.. Bull. vol. and diphtheria. Barach." Ann. fortunately rather rare.ALEXANDRIAN AND ROMAN MEDICINE of Amida (p. Of phthisis he writes that " most prone paralysis. But if the head be primarily affected on the right side." Johns Hopk. trans." He was the first to distinguish between " If the affection be in the spinal spinal and cerebral paralysis.'' Ann. xxxni. 3 He divides his material into (i) acute diseases. .. in the Vatican Library and the Bodleian Library. 260 1 F. Med. 1860 " 8 Aretaeus the Cappadocian. and by the earlier historians he was regarded as a frank copyist who borrowed from the writings of one Archigenes (c." bladder do not cease emitting urine . H. Med. 1936. p. 1935. At all events Aretaeus' valuable contributions to medicine passed unnoticed.

857 * W. but the only part which has survived are the eight books entitled De re Medicina. and the most recent. Jour.D. Many editions have been printed. 1935. vol. trans. Med. 2 military strategy. eager to be of assistance to the patient." Although Aretaeus was a frank copyist. his work commanded the admiration of scholars . and his work is well worth reading even It reveals the true disciple of Hippocrates. For fluids do not remain but use the body only as a channel through which they may flow out." Med. good English translation by J. Spencer. Written in Latin. G. 30. xxxvii. in the body. . as a clear and unbiased description of the medical knowledge of his time. 1 Bull. . p. and indeed some acquaintance with the art of healing became part of the equipment of every well-educated gentleman. viii. was the author of a great encyclopaedia dealing with philosophy. Works of Celsus. it was overlooked. Castiglioni. 5. . excellent and elegant Latin. but even in the Middle Ages At last the manuscript was brought to light Nicholas by Pope (1397-1455).. medicine. 1892. It was written about A. 1940. the bedside to-day. Celsus" De re Medicina " We now come to a writer who although not a Greek and probably not even a medical man. " Aulus Cornelius Celsus as a Historian of Medicine. and above all.A HISTORY OF MEDICINE from drinking or from urinating. it is unequalled and may still be read with profit. in 1478. Hist.. 3 vols. a calling only fit for slaves and foreigners. CELSUS. p. 72 . G." Glas. he showed originality in his clinical descriptions. Loeb Library. Grieve appeared in 1 756. is that of W. V A ingeniously bridges the gap between his work on agriculture and that on medicine by the introductory sentence of the latter " Celsus. and the work of a Roman. but not very long. Celsus then Written in attained a long delayed but well-merited fame. Spencer. and probably other subjects. vol. 8 Celsus giving Latin and English. observer disdainful of theory and preconceived ideas. it was one of the first medical books to be printed. Although the Romans scorned to soil their hands in the practice of medicine. Life lasts only for a time. 321 A. a member of the noble family of the Cornelii. law. has imprinted his name 1 indelibly upon the pages of medical history. they were interested in the subject. 1 J.. it is not surprising that it was hardly noticed by the Greek practitioners. Finlavson. and at Florence.

ear The patient is bound to a from the is noted." He promises prefaces his treatise by an of account Greek medicine. Thus. A quaint means of removing a teeth. Milne. the drugs in common use were Mandrake and poppy were nitre. of cardiac disorders. 1907 73 . including couching for cataract. hydrocephalus. and it is an interesting exercise. " Tonsils. includes an account of drugs V and their uses. and the board is struck with " a hammer. and the " very easy to one who technique of blood-letting is described has experience. so medicine health to the sick. of consumption." The operation of tonsillectomy described by Celsus " is the modern " method of enucleation. saffron. and and abdomen. employed to relieve pain Book VI is devoted to the " special subjects " skin. for the Roman kept a good table with great variety of dishes. lithotomy. yet very difficult to one that is ignorant. Dietetic treatment is discussed. lying on the affected side. and various eye operations. the writer commencing with the head. of madness. thorax. and the two coats the until eye through then the cataract is pressed down so that it may settle in the lower part." The third book treats of fevers (evidently malarial). redness. of lethargy. foreign body board. of dropsy. : dolor heat." The two remaining books deal with surgery. The first two books deal impartial with the digestibility and effects of many forms of food and drink . which is of it meets resistance. eye. and to these the nerves. a lengthy list. S. ears. and of palsy. Among . operations for goitre and for hernia. such as the removal of arrow-heads. gout. of : " As agriculture promises food jaundice. and ending with the tioned is feet. passing to the throat. the treatment of wounds. Internal diseases form the subject of the fourth book. to conjecture what the modern diagnosis would have been. Book VII is concerned with operative procedures. and iris. what is within it drops out. swelling. the last. by shaking the ear.ALEXANDRIAN AND ROMAN MEDICINE work to the healthy. 1 The " inserted last-mentioned is accomplished with a needle. calor. Surgical Instruments in Greek and Roman Tunes. they were the earliest anaesthetics. In this book are mentioned the four cardinal signs of inflammation familiar to the medical student to-day rubor. For the vein lies close to the arteries. and venereal diseases. 1 J. Aberdeen." he writes. The first disease menand Book myrrh. tumor -. in reading the descriptions. pain.

and wisely refrains from indulging in theory or argument. 525. Moreover." Ann. The surgical instruments which he describes correspond to those found in the house of the surgeon at Pompeii (destroyed A." book that the attributes of the surgeon are defined. Walsh. p. 1937. vol.. should be youthful or in early middle age. 1939. and although he was not nearly so great a man as Hippocrates. but anyone who dared to differ was treated as a heretic. Galen regarded the body as the mere vehicle of the soul. It is easy to understand why this was so. believing. he acknowledged the authority of the Father of Medicine and incorporated much of his teaching in his own. 34. or cut less than is necessary. viii. 143 . Galen : the Medical Dictator The Grseco-Roman period reached its climax with the appearance of a man whose teaching dominated medicine for the next 1 1 200 years. a view which naturally met with the approval of Christian and Moslem alike in the new age of monotheism. p. Celsus states the facts. should be disengaged all round by the finger and pulled out. 65 . vol. //ttf. ix. The De re Medidna of Celsus is a medical classic with a modern flavour. vol." The eighth and last book gives precise direction for the treatment of fractures and dislocations. In principle he followed both Hippocrates and Aristotle. with a strong and steady hand. pp. vol. i. i. 1936. and were fixgd by bandages stiffened with starch. which are still on view in the Naples museum (Plate xm). It is in this He " . Sen. as expert with the left hand as with the right. and work 74 . p.D. Med. his teaching was imparted in so dogmatic a fashion as to carry conviction and disarm criticism. and it would be a good thing for medicine if its popularity could be revived. (A valuable and comprehensive study of the life " Galen's Writings. 79). yet is not moved by his cries to go too fast. like the 1 J. and spirit undaunted so far void of pity that while he wishes only to cure his patient.A HISTORY OF MEDICINE " that are indurated after an inflammation. vi. with vision sharp and clear. for Galen had an answer to every question and a solution to every problem. Splints were used. 3rd of Galen) 1934. since they are enclosed in a thin tunic. Throughout the dull-witted early Middle Ages his views were not only accepted without question. and the Influences Inspiring Them.

just.ALEXANDRIAN AND ROMAN MEDICINE former. 1927. Hist. 1 on 1 The Background to Galen's Life and Activities and its Influence J. his Achievement.*' Ann. a post which naturally gave him ample experience in the treatment of injuries. p. and was appointed surgeon to the school of gladiators. To Nicon it was revealed in a dream that his son would become a distinguished physician. 2 After some further study and wandering in Greece. and benevolent. Soc. he returned to Pergamos.D. was amiable. thirty years later. and was perpetually she temper . My mother. a commanding view. saying that have but one physician. first in philosophy at Pergamos and Smyrna. or God. GALEN This city. 132 75 . 1930. Apparently. His fame increased. and there he remained until his death. "Galen's Studies at the Alexandrian School. Waish. and four years later he determined to seek further fortune in Rome.). " we the Emperor. however. called Bergamum. where in the specially built " gamum Museum it became one of the greatest art treasures of Germany. Marcus Aurelius. xxiii. Later. p. a talented and wealthy " " architect. Med." he tells us. soon acquiring a large clientele and a vast reputation." So he was summoned back to Rome. (Sect. always working towards a definite end and leaving nothing to chance. temple was bodily removed by German archaeologists last century. but the lovely Smyrna (Izmir).. Med. but a more likely explanation is that his successes had so aroused the enmity of his colleagues that life in Rome was becoming unpleasant and even dangerous. Galen. " vol. and Palestine. 1 131 J. and the quarrelsome nature of his mother. then. vol. 131-200) was born at Pergamos in Asia Minor. There he practised. is some fifty miles north of and may be approached from that city by a road One may inspect. Galen returned to Pergamos at the age of twenty-eight. and like the latter. (c. needed him. 1 My father. which ranked next to that of Epidaurus in fame." brilliant intellect good education. " Perto be reconstructed at Berlin. S. in the purposive creative power of Nature. and he therefore gave him a shouting at my father." Proc. on a hillside with very rough (1939). on the other hand. had a very bad used to bite her serving maids. Hist. Italy. in the healing powerv of the <f>vms9 or Nature. and then in medicine at Alexandria. After a few years. and conducted experiments. It was said that he did so to escape the plague. Prendcrgast. ix. now A. Galen was the son of Nicon. the ruins of the theatre and of the Asklepieion. Galen inherited the of his father. Roy. taught.

and sists to. Galen ascertained that the patient had recently fallen from a chariot. the the brachial as of the seat the trouble. Galen recognized the exciting and He predisposing causes of disease. however. and his case records differ vastly from the plain and unboastful histories of Hippocrates. " coction. was based on a study of apes and pigs." Arch. 417 76 . moisture. a sharp his physiological knowledge. yellow bile. This man complained of a loss of sensation in the fourth and fifth fingers of one hand. which laid the foundation of 1 He recognized the value of anatomy experimental physiology. Galen employed also used diet. and exercises in treatmany drugs. thus perpetuating d. for he was a forceful and opinionative man. fire. not upon his clinical work but rather upon his investigations. This success is related by Galen in no modest fashion." an error which greatly retarded the progress of water. vi. ment. : . The First Experimental Physiologist The lasting fame of Galen is based. and he massage.A HISTORY OF MEDICINE Galen as Practitioner followed the Hippocratic method." That he was a clever diagnostician is shown by the case of Eudamus the philosopher. p. which other physicians had failed to cure by local treatment. There were four elements : air. and he unhesitatingly transferred his discoveries to 1 human anatomy. supported the theory of and applying this to the healing of wounds. earth. In mediaeval " " times the humours were changed to temperaments sanguine. and had struck his neck against surgery. Applying in achieving a cure. this day. Med. cold. melancholy. and a nomenclature which percholeric. f. and black bile. T. accepting Jn practice (S^len " the doctrine of tl^e humours. His anatomy. Gesch. t 1912. " Studien zur Physiologic des Galens." which regarded the body as com. in medicine. his simple vegetable products " still known as being galenicals. phlegmatic. and four qualities heat. posed of blood^ -pibJegin. vol. terms which are still used." introduced by Hippocrates . he regarded pus as " laudable. plexus physician regarded and by applying counter-irritants to the region he was successful stone. and dryness and treatment was based upon the preponderance and interaction of the elements and qualities. stating that a physician without anatomical knowledge was like an architect without a plan. Meyer-Steincg.

on reaching the heart. endowed with Natural Spirit. 1 He was familiar with all the gross st brain. but not in Cuculation " In the opinion of Galen the vital principle was the pneuma. xxxi. to endow the body with sensa1 C. 1896. 57 J. von Pergamon. and also to the lungs. passed through minute and invisible pores in the interventricular septum." Arch. but Gibraltar. Prendergast.** Lancet. (Sect. p. and the fifth the facial and auditory together. 4. Soc. The blood was formed in the liver from the foodstuff or chyle. Gesch. vol. Ray. xxi. E. One of the first to distinguish between the sensory and motor nerves. J. i pair being the optic nerves. Part of the venous blood. Med. Dissection of the human body and although he had studied the human skeletoij was founded upon investigation of the Barbaif many now found only Galen gives a good description of ape. The Evolution of Anatomy t 1925. vein. brought thence from the intestine by the portal In the liver the blood. The blood which reached the brain became charged with the pneuma of the soul. and he recognized seven pairs of cranial obtainable in Europe. 1839 . and he showed that loss of voice was produced by division of the recurrent laryngeal nerve. the Animal Spirit. conducted for the most part on pigs.f. The Blood in Motion. 1928. 1938. the Vital Spirit. His experiments. "The Relation of Harvey to his Predecessors and Especially to Galen. and was carried forth by the nerves. 2 passed to the right ventricle. From the heart it passed throughout the body. F. and mingling with the blood " " which arrived from the lungs by the arterial vein (as he calls the pulmonary artery).ALEXANDRIAN AND ROMAN ME errors. revealed the effects of division or of hemisection of the spinal cord at various levels. he also discovered the sympathetic nervous system.). Med. Payne. Singer. 1 136 1 77 .. Hist. d. believed to be hollow during life. the facts being supplemented from his di animals. 254 . p. Wenkebach. vol. p. in order that the impurities might be exhaled in the breath. became charged with a second variety of pneuma. "Galen's View of the Vascular System in Relation to that of Harvey. whence it was distributed to nourish all the tissues and organs. p." which entered the lung in the act of breathing and there mingled with the blood.'* " Galenos Proc. He also demonstrated the position of the ureters by animal experiment. to confer power upon the organs and tissues.

1856 4 A. one of the best-known and most characteristic of the works. " Galen. But he had no idea that the blood circulated he imagined that it ebbed and flowed in the vessels. Med. Brock for the Loeb Classical Library/ Additional interest has been focused on the anatomy of Galen by the work of Max Simon. CEuvrts anatomiques physiologiques et mtdicales de Galen. Hist. p. 3rd Ser. viii. he recognized that it was the heart that set the blood in motion. 3 and although no edition so comprehensive exists in English. was that edited by no less a person than Rabelais (1537). Paris. 2 Some of Galen's works have been translated into many languages. trans. vol. They were copied and many times during the Middle Ages. forceful. Galen : On tlu Natural Faculties. a book which is now extremely rare. Hist. Slaughter. That he remained for centuries the undisputed authority from whom none dared to differ was not his fault. was the chief guide of the mediaeval physician . dogmatic.. J. Malloch. Med. Furthermore." Ann. has been translated (1917) by A. Brock. and admitted the possibility of healing by first intention. 1939. J. 1 One of the earliest of the latter. i. Leipzig. and when Ambroise Pare used simple dressings in place of boiling oil. Galen recognized that the arteries contained blood. as had been believed before his day. 61 D. " Medicine in the Life of Francois Rabelais. More than five hundred books were attributed to him.A HISTORY OF MEDICINE and motion. 1906 78 . Galen as Author Galen was truly a voluminous writer." Ann. was blindly accepted and followed for centuries. 1926. 438 * C. Simon. 1 ' A.. 396. vol. 6 Galen's achievement was the highwater mark of Graeco-Roman medicine. Galen. pp. and only about eighty remain extant. stated with the conviction which characterizes all the teachings of Galen. but many of his manuscripts were destroyed by a fire at his house in Rome while others were lost. On the Natural Faculties. 1917 ' M. until the period when Paracelsus had the audacity to preface his lectures by publicly burning Galen's volumes. when Vesalius disposed of many anatomical myths by dissecting the human body and describing what he saw.. $tebcn Bucher Anatomic des Galens. and recopied infallible. Daremberg. tion . and not merely air. There is an excellent French edition by Daremberg (i856). and his idea of a porous septum in the heart was one of these fallacies which. and not Hippocrates. and there have been numerous printed editions. Loeb Library.

in six volumes. was AETIUS. : Marcus Aurelius delayed the period of decline and fall by fighting and by diplomacy. Although the noble and enlightened emperor lived. 1894. Oribasius was careful to quote the exact sources of his information. To Oribasius we are indebted for our knowledge of ANTYLLUS (second century). he was of the Christian This is reflected in his teaching. physician to the much-maligned Emperor Julian (the Apostate). and the Huns. 325-403). Oribasius. although possessed of little originality. and this gives his work a special value as the mirror of a literature which might easily have been lost. and who described tracheotomy. During the years which elapsed between the death of Galen and the collapse of Roman authority. a city on the River Tigris. containing medical advice and hints on first-aid. the Roman Empire was already heading for a fall. Barbarian invaders were appearing on every side the Goths. Julian was the last of the Roman emperors to oppose Christianity and to uphold the old world of Greek civilization. was a native of Pergamos. like two other authors to whom we shall presently refer. p. medicine was kept alive by a series of learned physicians who.D. as he did not hesitate to faith. of which These are well preserved in the French twenty-five remain. 1 E. Medical History from the Earliest Times. Another Byzantine writer. earned the gratitude of posterity by collecting and transcribing much of the work of their predecessors which might otherwise have been irretrievably lost. and although Constantine postponed the final dissolution of the empire by transferring his capital from Rome to Byzantium (Constantinople). Withington. the Euporista. He also prepared a synopsis for the use of his son. in which Galen was the most happy and prosperous period in the history of the world. the Vandals. after two centuries of peace. the final crash in the fifth century was inevitable. Nevertheless. An industrious scholar. and. T. 129 79 . and a popular treatise. translation of Daremberg (1860). who treated aneurysm by ligation above and below the lesion. 1 One of the first of these compilers was ORIBASIUS (A. who lived in the sixth century.ALEXANDRIAN AND ROMAN MEDICINE The Byzantine Compilers According to Gibbon the second century. like Galen. of Amida. he wrote a digest of medicine and surgery in seventy books.

" Janus. For example. come up or go down. consisted (A. and oxyuris which he treated with fern and pomegranate. it was highly esteemed by the physicians of the Renaissance and later by Boerhaave. preserved and perpetuated the knowledge of Greek medicine during the ensuing centuries. His are said to be the best classical descriptions of disease of the eyes. p. John Freind. vol. whose History of Physick is still worth reading. in order to remove a bone impacted in the throat. Particularly interesting and valuable is his account of poisons. 607-690)." The work of Aetius is in sixteen books named the Tetrabiblion. and he appears to have been the first to differentiate the intestinal parasites ascaris. i. 282 * * 1 548 . vol. as his work is often quoted by later writers. bone. 1907. ears. Adams. 120. 381.D. 24. 1 Alexander is said to have travelled widely. he is the only Byzantine author whose writings show some originality. The sixth book. and Jonah out of the whale. 153. xvi. was highly valued by the Arabs who. Sydenham Society. F. ALEXANDER OF TRALLES (A. 525-605) also deserves mention. which he called the Epitome. Berendcs. taenia. of seven books. from the grave. The in the teaching of Paul of ^Egina is available for English readers 3 by Francis Adams Sydenham Society translation. History of Physick. An experienced physician. xxin. A number of Greek and Latin editions have appeared. 210. 79 " Des Paulos von jEgina. pp. pp. and throat.D. 1844-47. A German translation by Puschmann was published in 1879. trans. nose.. Freind. and although less accurate than that of Oribasius. 492. also 1913. as we shall see. He was also the first to define the uses of rhubarb and colchicum. discusses at some length the writings of Alexander and of Aetius. The last physician of the classical tradition was PAUL OF jEciNA 2 His work. the patient's neck is " As Lazarus came forth grasped. vol. His works were largely used in the school of Salerno. and to have taught and practised in Rome. The Seven Books of Paulus sEgineta.A HISTORY OF MEDICINE employ incantations based upon the Bible. although the Latin yet complete version of the sixteenth century is available. devoted to surgery and still regarded as the best of his writings. J. 3 vols. and a French version in four volumes by Brunet in 1933-37. 80 . and the physician commands. There is as no modern of his edition work. His accurate clinical picture of pleurisy is regarded as a classic. 1725. J.

In the army. vol. teachers of medicine were provided at public expense. '* Roman Architectural Hygiene. no an allowance which has never been approached to this day by any other city. 2 By the beginning of the Greeks. The surrounding marshes were drained during Etruscan times. The State Medical Service of Ancient Rome Although the Romans were content to leave the practice of medicine and surgery to the Greeks. and those of Caracalla. medical practice was in the hands of wider survey be taken. probably in order to ensure a supply of doctors for the fighting services. or main sewer. ed. Hist. The Cloaca Maxima. hot and cold baths. h. Magnificent public baths were available. the baths of Diocletian. Under the Emperor Vespasian (A. Christian era. and swimming Many were built by various emperors and wealthy pools. tion and water supply is unequalled in history (Plate xiv). Natural healing springs were patronised in later times (Plate xx). as we have noted." Ann. with dressings rooms. because. conveying a liberal supply of pure water from sources many miles distant.). they were not slow to realize the value of organization of medical teaching and of medical poor and for the army and navy. but the construction of the famous aqueducts was then commenced. Roman houses were provided with plumbing and sanitation. D. 289 C..C. Medicine." The Legacy of Rome. 1 Until the third century the Tiber was the only source of water supply for the city of Rome. 135 8l 7 . of which a plan has survived. medical men services for the 1 * " C. being especially imposing (Plate xiv). was constructed only a little later in the age of the Tarquins (sixth century B. 1923. p. gymnasia. Med. citizens. less than fourteen aqueducts had been built.D. 1930. 69-79). Bailey. and the water supply of Rome amounted to more than 100 gallons per head. C. Measured in terms of the diagnosis and treatment of disease the Roman contribution was negligible. Singer. so as to include measures we must admit that Rome a The Roman system of sanitato world the gave great example. U29) p. when the empire was nearing its grandest phase. Leake. But if a likely to benefit the public health.ALEXANDRIAN AND ROMAN MEDICINE Public Hygiene in Rome Before passing on from the Gneco-Roman epoch of medical history let us turn back for a moment to consider what the Roman Empire did for medicine.

A HISTORY OF MEDICINE
were part of the establishment, and although they ranked only as non-commissioned officers, they were exempt from taxation and from combatant duty. 1 There were legionary surgeons and cohort surgeons, working in unison, and each ship of the line had its surgeon. On Trajan's column there is sculptured a scene showing the work of what might be called a first-aid dressing
station.

Early in the history of the empire, public physicians or were appointed to attend the poor, and to supervise medical practice within their area. They were well paid, and were distributed to various towns and districts in proportion to the population. Those of Rome, the court physicians, were invested with a special dignity and had a voice in the government. Among them was Andromachus, who invented the poison antidote, theriac, to which reference has been made.
archiatri

The Roman Hospital System
legend of the origin of the first hospital in Rome has Plague or some other pestilence having broken out in the city in 293 B.C., a mission was sent to seek help from sacred sequent was entrusted with the task of Epidaurus. healing, and as the ship sailed up the Tiber, the serpent swam ashore and landed on the island of St. Bartholomew. 2 The

The

often been told.

A

plague was stayed, and on the island, which is shaped like a ship, and bears a serpent and staff carved on the " prow," there was

came Rahere
London. 3

established the hospital from which, many years later (A.D. 1123), the monk, to found St. Bartholomew's Hospital in

To the island hospital of Rome, in the days of the Republic, men sent their sick slaves, so as to avoid the trouble of caring for them at home. Thus it became a haven for the sick Later, in the first and second centuries A.D., there is poor. mentioned by various writers the existence of valetudinaria which " nursing homes." appear to have been private hospitals or
They may have developed,
It

eventually, into public institutions.

be expected that in the well-organized Roman army there should be hospital accommodation for sick and

was only

to

1

Sir J. Y. Simpson,
**

"Was

the

Roman Army
',

Provided

\\ith

Medical Officers ?*

Archaeological Essays*
1

*

Edinburgh, 1872, vol. ii. p. 197 C. Singer, Medicine," The Legacy of Rome 1923, p. 304 Sir N. Moore, History of St. Bartholomew's Hospital, 1918, 2

vols.

82

ALEXANDRIAN AND ROMAN MEDICINU
wounded soldiers. These were established at points, and the sites of several of them have been
various strategic excavated. One

of the most perfect examples is at Novaesium near Diisseldorf. 1 It dates from about A.D. 100, and, constructed on the corridor
system,
is

strangely modern.

The Fall of Rome

In conclusion it may be said that while Rome, apart from Greek aid, contributed little to the advance of scientific medicine, she set a great example to the world by the inauguration of a system of public hygiene which in some of its aspects has never since been excelled. The causes of the collapse of the mighty Roman Empire were many and various, and the problem has exercised the minds of numerous historians. Undoubtedly it was the result of moral and political corruption, the decline of farming, and the burden of But there was also another factor of peculiar interest taxation. to the medical historian. A severe form of malaria was rampant. This disease destroyed many thousands of persons, and undermined the mental and physical condition of many others. It has been regarded by some authorities as one of the main factors which led to the final collapse of Rome. 2 As for the Byzantine Empire, the plague of A.D. 542, which wiped out more tlian
half the inhabitants of Constantinople,
results similar to those
1

produced

in

the East

caused by malaria in the West.

*

" G. Singer, Medicine," The Legacy of How, 10^3, p 204 W. H. S.Jones, Malaria and (>reck Hutory, Manchestt r, njof)

BOOKS FOR FURTHER READING
The E\tant Works of Aretaeus the Cappadocian, Sydenham Trans. The Seven Books of Paulus Algincta^ 3 vols., 1844-47 ALLBUTT, T. CLIFFORD. Greek Medicine in Romt (Fitzpatrick Lectures), 1929 BAILEY, C. Ed. of The Legacy of Rome, 1923. (" Medicine," by G. Singer) BROCK, A. J. Trans. Galen : On the Natural Faculties, Loeb Library, 1917 DAREMBERG, C. La Mddecine, Histoire et Doctrines, 1865. (Euvres analomiques, physiologiques et medicales de Galen, Paris, 1856 JONES, W. H. S. Malaria and Greek History, Manchester, 1909 MENIERE, P. Etudes medicales sur les poetes latins, Paris, 1858 MILNE, J. S. Surgical Instruments in Greek and Roman Times, Aberdeen, 1907 MOORE, Sir N. History of St. Bartholomew's Hospital, 2 vols., 1918 SPENCER, \V. G. Trans. Works of Celsus, 3 vols., Loeb Library, 1935

ADAMS,

F. Trans. Society, 1860.

83

CHAPTER VI

ARABIAN MEDICINE; THE SCHOOL OF SALERNO
THE
Byzantine copyists were, as we have seen, the last to contribute a few bricks to the immense edifice of Graeco-Roman
;

Faded was the glory that was Greece gone was the Rome. Ahead lay the Dark Ages, the thousand odd years during which learning was no longer held in high esteem, experiment was discouraged, and originality was a dangerous asset. Medicine entered a long period of bondage and slavish convention which continued until it was broken by those bold spirits of the Renaissance who dared to break away from
medicine.

grandeur that was

tradition.

sometimes said that the dogmatic assertions and forceful Galen actually retarded the progress of medicine. Galen, with his monotheistic outlook and his acceptsoul as more lasting and important than the body, Had his views favour by the Christian Church. been rejected, there is no doubt that the Dark Ages, so far as medicine is concerned, would have been even darker. But was this age so very dark after all ? If contrasted with the preceding and the succeeding eras it certainly had little of their brilliance, yet it not only preserved the accumulated store of Greek medicine for the benefit of succeeding generations, but it also made its
It
is

teaching of Nevertheless ance of the was held in

own

contribution.

Medicine now passed into the hands of two very different
classes of

mankind

the Christian

Church and the Arab

scholars.

Let us see what they

made

of it.

The
It

Influence

of Christianity upon Medicine

cannot be denied the early Christian Church retarded the 1 It is true that Christ bade his progress of medical science.
followers

"

heal the sick,"

and gave many

practical illustrations

healing power. Yet the early Christians interpreted this teaching too literally when they denied to physicians the power of healing. Nothing, they alleged, must detract from the

of His

own

1

J. R. Russell, History and Heroes of the Art of Medicine, 1861, p. 97

84

PLATE

XIII

i:\RLY

ROM VN SURGICAL INSTRUMENTS
\1

IOUN1)

POMPLI1

J

s< alp<

shaip hork

d doublf -cdi*< d bladr. 2. Spun^ t< IJ.K ultini loi<fptrnaculuni 4 Scissor-actum ffrfrps \\nli scuatrd lil.idi s natural si/< and an bt(in/( c \< pt Ml ar< SlittMi \\nii bpnn^ haiitll*
1

\\ith

It

af-iihapt

01

f

{

<

tlu

sialpc

1

blade, \shich

i>

sttcL;

(

I*ai;<

7^

i

PLATE XIV PUBLIC HEALTH IN THE

ROMAN EMPIRE

I*<irjt

flu

(j.utl,
r
j

tlir

Roman
1

.iqu<(!u<t
lx
\\cit<i
lit

spunks

J

rrnUs distant

c
i

\\huh (om<\td \\iito to .\irucs in. in haniif is abo\e tlit highest stru*s (;f
]

ar<

s

patijt'

Hi

)

Interior of the

Tepidarium cf the

Inipeiial Baths of Carat alia at (Reconstruction b> R. Phene Spiers)

Rome

ARABIAN MEDICINE; THE SCHOOL OF SALERNO
pre-eminence of the one Great Physician. Prayer and fasting" were above all other remedies. Medicine must give place to the Church. The Christian view of disease, too, was a retrograde Even St. Basil of Caesarea, 1 who in A.D. 372 established one step. of the first known hospitals, denied that all disease was of natural Many diseases, he alleged, were sent as punishments origin. for sin, and such chastening demanded only prayer and repentance. The sensible views of Hippocrates were denied ; men returned to ideas analogous to those which prevailed in the days of the ^Esculapian temples. Miracles of healing were witnessed in the churches, and doubtless took place, as they still do. But in the early days no other method of healing was admitted or permitted

by the bigoted
dissection

Christians.

human body was held sacred, and its was prohibited, a veto imposed also by the Moslems. Anatomy and physiology became dead sciences which might not be studied at first hand, but only in the pages of Galen. Such restrictions naturally deterred students from entering the medical profession, and the best brains were attracted to the Church, where an increasing mass of theological dogma afforded ample scope for many scholars. " The antagonism to " secular learning reached its climax in A.D. 391, when a mob of Christian fanatics set fire to the great library of Alexandria and destroyed many priceless treasures of Such, then, were the blows levelled at the science of learning. medicine by the early Christians such were the adverse influences of the Church. Nevertheless, when all the evidence is weighed, it must be admitted that Christianity has generally favoured the advance of medicine. 2 The infinite pity and patience expended by the Church upon the cure of the sick far outweighs any temporary intolerance shown towards medicine. In addition, it must not
Furthermore, the
;

be forgotten that we are indebted to the mediaeval monks for the very existence of those ancient works which influenced, and still influence, the trend of medicine. By day and night the monk in his cell engaged in the work of translation and transcription, until, eventually, the invention of printing ing available for all.
1

made

learn-

2

J J Walsh, Medieval Medicine 1920, p. 170 E. T. Withington, Medical History from the Earliest Times, 1894,
,

P-

"9

85

A HISTORY OF MEDICINE
The

Dawn

of Arabian Medicine

great reservoir of medical knowledge during the Middle Ages was provided by the Arabs. 1 Their influence was greater than that of the Christian Church, because Arabian physicians not only approved of the views of their predecessors, and indeed even revered them, but they added much original work of their own which has become incorporated into the medical science of to-day. 2 It must be explained at once that the words " Arab " and " Arabian " are applied solely in respect of the which these physicians spoke and wrote. All were not language natives of Arabia very few were genuine Arabs. Some were Syrian, some Persian, some, as the Moslem Empire extended, were Spaniards. Nor were all of them Mohammedan. Many were Christians some were Jews. In those early times the Moslem was as tolerant and favourable towards learning as the Christian was intolerant and antagonistic. Had not the Prophet himself " written because God hath O servant of God, use medicine, " not created a pain without a remedy for it There was then ? a brotherhood of scholars in the Moslem Empire wise men were The Arab was by no means an uncultured highly respected.
early
;

The second

;

:

;

savagr, and, as Dr. Withington remarks, a Byzantine emperor was astonished to find that the right of collecting Greek manuscripts was among the terms dictated by the victorious Arab, and
illustrated copy of Dioscorides was the most acceptable he could offer to a friendly chief. present The Arabs constructed their system of medicine in a logical and regular manner. They began by translating the works of the Greeks into Arabic. Later, they wrote commentaries on those,

that

an

and added

Many facts were original observations of their own. discovered regarding epidemic fevers. Diseases of the eye, so common in the East, also claimed their attention. The greatest contribution to medical science, however, was in pharmacology. Manv new drugs were introduced by the Arabs and their uses " described. The word " drug itself is of Arabic origin ; so are

the words " alcohol," " alkali," " syrup," "sugar," "jujube," and " spinach," to name only a few. As for the actual Arab drugs,
1

M. Mcyerhof,

"

Science and Medicine," The Legacy of Islam, ed. Sir T. Arnold
\ols.
;

and A. Guillaume, 1931
*

arabe,

D. Campbell, Arabian Medicine, 1926, 2 Pans, 1876, 2 vols.

L. Leclerc, Histmre de Ic Mtdecinc

86

ARABIAN MEDICINE; THE SCHOOL OF SALERNO
these include benzoin, camphor, saffron, myrrh, musk, laudanum, naphtha, senna, and many others. Intimately associated with pharmacology is chemistry, or alchemy, as it was called. The Arabs excelled in chemistry.
lization,

They invented methods of distillation, sublimation, and crystaland perfected many of the processes familiar to chemists

to-day. Although the science of alchemy was often misdirected " " into useless channels, such as the search for the potable gold,"

of life," and the influence of the stars upon the metals, much work was also done. The " Father of Arabic Alchemy " was Jabir ibn Hayyan, sometimes called Jebir or Geber, 1 who lived about the seventh century and wrote many books, some of which survive. Such, then, was the contribution of the Arab to medicine. Let us now glance at the lives and work of some of the
elixir

useful

Arabian physicians.

The Nestorians and

the School

of Jundi-shapur

570, and the Moslem which he and which founded, eventually stretched from Empire to lasted from the seventh to the thirteenth Samarkand, Spain of i.e. from the lifetime the century, Prophet to the sack of Baghdad

The Prophet Mohammed was born in A.D.

by the Tartars.

Before the birth of

Mohammed,
;

however, the

roots of Arabian medicine

had been planted

by an unorthodox but liberal-minded patriarch of Jerusalem, was banished for heresy in A.D. 431. With a band of followers he fled to Edessa (now Urfa), in Asia Minor,

planted, moreover, Christian. Ncstorius,

and there

established

a school of medicine.

Thence, under

further persecution, he proceeded to Jundi-shapur (Gondisapor, Jondisabur) in south-west Persia, where the Sassanian king

Choroes, whose capital was at Ctesiphon, had founded a uni2 The Arch of Ctesiphon is still a familiar landmark, but of the great city of Jundi-shapur not a trace remains, although Rawlinson claimed to have located it in 1898, at what was then a native village midway between the towns of Dizful and Shustar There, for two centuries, the Nestorians laboured (see end map)
versity.
.

1 E. J. Holmyard, "Jabir ibn xxvi. p. 46

Hayyan,"

Proc.

Roy

Soc.

Med.

(Sect. Hist.), 1923, vol.

*

G. Elgood, "Jundi-shapur.

A

Sassanian University," Proc. Roy. Soc. Med. (Sect.

Hist.), 1939, vol. xxxii. p. 1033

87

A HISTORY OF MEDICINE
work of translating Greek medical texts into Arabic. 1 Sometimes the translation passed through the medium of Syriac, and Professor E. G. Browne states that some of the Syriac trans" so literal as to be quite devoid of sense.'* lations are If the translator did not understand the meaning of a Greek word, he transcribed it into Syriac characters and left the reader to con2 The direct Arabic translations, on the other jecture the sense. hand, were well rendered. Among the works translated were
at the

those of Hippocrates, Galen, Dioscorides, Oribasius, and Paul of ^Egina. The chief physician to the great hospital of Jundi-shapur was JuRjis BuKHT-Yisntf (George Bachtishua). He was the first of a still more dynasty of six generations of pre-eminent doctors. famous member of this family of Syrian Christians was Jibra-il or Gabriel, grandson of George and physician to the court of Haroun al Raschid, of Arabian Nights fame. He must have been one of the wealthiest medical men in history, as he accumulated a fortune from fees representing three million pounds in our r coinage. On one occasion he received fo curing a caliph a fee to be while his salary was 1,000 25,000, equivalent computed to per month, with a present of 1,250 each New Year's Day. Another Christian physician of Jundi-shapur was HUNAYN IBN IsX^, better known as Honain or Johannitus, who lived early in He was responsible for many translations the ninth century. 3 of the Greek masters, and so excellent was his work that he is said to have received for his manuscripts their weight in gold. That he showed some originality is evident from his original work, Questions on Medicine, and from his Ten Treatises on the Eye, which is probably the earliest known textbook of ophthalmology. By this time papyrus and parchment had been supplanted by paper invented in China, and a paper factory had been established

A

in

Baghdad

(A.D. 794).

Rhazes and Avicenna

Arabic
activity,

medicine now entered upon a period of intense and there appeared one of the greatest, if not the

1 A. O. Whipple, " Role of the Nestorians as the Connecting Link between Greek and Arabic Medicine," Ann. Med. //u/., 1936, vol. viii. p. 313 E. G. Browne, Arabian Medicine (Fitzpatrick Lectures), 1921, p. 28. (Probably the best and most concise account of the subject by an acknowledged authority.) L. M. Sa'di, "A Bio-bibliographical Study of Hunayn Ibn Is-Haq Al-Ibadi (Johannitus), A.D. 809-877," Bull. Hist. Med., 1934, vol. ii. p. 409

88

ARABIAN MEDICINE; THE SCHOOL OF SALERNO Abu Bakr Muhammad ibn greatest, of Moslem physicians.
Zakariyya (A.D. 860-932) was born at Rai, in Persia, near modern Teheran, and is therefore commonly known as RHAZES. l Originally a philosopher and musician, he did not commence the study of medicine until he was forty years of age, but that he made good use of the remainder of his long life is evident from the volume of his work. The folio edition, in Latin, dated 1486, of his Liber Continent, is said to weigh twenty-two Ibs. Rhazes
the
is

practised in the town of his birth and afterwards at Baghdad. It said that when he was asked to choose a site for the hospital there, he hung pieces of meat at various points in the city, and
selected the place at
this hospital

which putrefaction was longest delayed. To he became chief physician. At an early stage of his career he unfortunately quarrelled with the ruler of Bokhara, who ordered him to be struck on the head with his own book until either his head or his book was broken. The head was the first to give way, and the injury is said to have caused blindness in later life. When in old age it was suggested to him that his sight might be improved by operation, he declined on the grounds that he had seen enough of this world's sorrow and misery. Yet Rhazes did not allow physical infirmity to interfere with his life mission. He was the author of about a hundred and fifty works, some of which have been lost. His most famous book deals with his most noteworthy contribution to medicine, the distinction between smallpox and measles. Apparently these were the only two endemic infectious diseases known to the Arabs. Rhazes gives a clear picture of each, in a passage which must be regarded " Exciteas a medical classic. Only one sentence need be quoted ment, nausea, and unrest are more prominent in measles than in smallpox, whilst the aching in the back is more severe in smallpox than in measles." An English translation of the volume, On Smallpox and Measles, undertaken for the Sydenham Society by Green2 The most important of Rhazes' works, hill, appeared in i848. however, is the encyclopaedia of medicine known as El Hdwi, or in Latin Liber Continens. The Latin version, published in 1486 at Brescia, is extremely rare, and no complete manuscript ofthe original
: 1

P.

Mn6trier,
"

"

Le Miltenaire de Razes,"

L.
1

Sa'di, 1935. vol vn

M.

The Milleruum
p 62

Bull. d'Hist. Mid., 1931. vol. xxv. p. 191 ; of Ar-Razi (Rhazes), A.D. 850-932, Ann. Med. Hist.,

W. A.

Grernhill, trans, of A Treatise on the Smallpox and Measles, by Rhazes,

Sydenham

Society, 1848

89

845-*:." and Advice on Slave-buying. 48 E. cit 90 . Browne. Much smaller. for like many other sages Rhazes was a man of wide interests. astronomy. T." he " but I say. loc. doubts if more this immense work exists at all at the present day. but no less interesting. Treating the sick and the is like boring holes in physician must act with pearls. for being cured the patient will surely " : A forget what thou didst for him. 146 E." 1 A 1 9 E. ISAAC JUDJEUS (A. 1894. 3 For example sickness is at its height. was the author of books 011 diet. for Rhazes was a close follower of Hippocratic methods. On the subject of asthma writes. on simple drugs. Arabian Medicine.D. dedicated " to the ruler Mansiir ibn Ishaq. but also philosophy. then so often affirmed. p. I say that owls' blood is not to be given. 940). p. " Ask thy reward when the Guide for Physicians. caution lest he destroy the pearl committed to his charge." mouth to condemn. were greatly in demand as late as the seventeenth century. and he was strongly opposed to all magic and quackery. Browne. Medical History from the Earliest Times ." for I " Bites of Venomous Beasts. on fevers. G. and it was useless. with " Medical Hints for Travellers.' Galen said that many cure asthma with owls' than half of ' blood given in wine." El Hdwi contains many case histories. His encyclopaedia comprises not only medicine. well recorded. 1 who has traaslated such fragments of " as are still in the Bodleian Library. c. that disease could be diagnosed simply by inspection of the urine. is the small textbook of medicine. open not thy third runs thus for each hath his hour. and called Mansuri or Liber " Almansoris. G. His collected works." Another maxim " : is : Should adversity befall a physician. and he is quoted by Robert Burton (1577-1640) in the Anatomy A number of pithy aphorisms are included in his of Melancholy.A HISTORY OF MEDICINE exists. and on the urine. have seen it administered. He discountenanced the claim." etc. an Egyptian Jew and physician to the rulers of Tunisia. Let persons troubled with asthma take two drachms of dried and powdered fox lung in their drink. the work Professor Browne. printed in 1515. 1921. and finally " he tells us that Ben Mesue said. Withington." contemporary of Rhazes who lived in another part of the Moslem Empire deserves mention as a writer of note. and mathematics." Rhazes adopts the characteristically Arabic method of prefacing " his own views by those of other writers." It deals with such subjects as Physiognomy. 2 So-and-so says.

ed. he soon achieved a great reputation. 1 93 1 91 . but his literary output was great. was never highly esteemed in Persia as a poet. " Avicenna and Arabian Medicine. or Q.. One stanza may well apply to Avicenna : from Earth's Centre through the Seventh Gate and on the Throne of Saturn sate. THE SCHOOL OF SALERNO The summit of excellence in Arabian medicine was reached by Abu Ali al Hussein ibn Abdallah ibn Sina. 157 M. at Jurjan. his influence still lives. which contained many priceless manuscripts. This reputation has led certain writers to identify him with the poet Omar Khayyam. Chatard. and was popularized only in England by Edward Fitzgerald in his classic translation. vol. with some justification. xix. The perquisite of this office which he most highly prized was free access to the royal library. A. Omar. Meyerhof. Arnold. and his work exercised a profound effect upon European medicine. Avicenna appears to have been a wanderer . the Koran by heart before he was ten years old. It is a lengthy work. and probably on that 1 J. His tomb is still a place of pilgrimage. p. and is still in current use in the East. where he died after many vicissitudes. " the Canon of Medicine. a name which has fortunately been contracted into AVIGENNA (A. to have been knew he of an as infant appears something prodigy. It may be that alcohol shortened his life.dnun 9 Avicenna endeavours to reconcile the teaching of Galen with that of Aristotle. Professor Browne ranks him as equal to Dr. however. he took little count of his own health." Johns Hopk." In the five books which compose his Canon. As a philosopher. at Isfahan. 980-1037). Probably no medical work ever written has been so much studied. Up I rose. the Prince of Physicians. he was at one time renowned . he was a Persian. Like Rhazes. Engaged in the care of others.D. Sir T. and at Hamadan.ARABIAN MEDICINE. Max Meyerhof 2 writes of Avicenna's great book. and he has been 1 He called. born near Bokhara. Hosp. for he died at the age of fifty-eight. 1908. as a physician. But not the Master-knot of Human Fate. and though he worked hard he also loved wine and minstrelsy. as is evident from his appointment as Court Physician at the age of eighteen years. " Science and Medicine The Legacy of Islam. Turning his attention to medicine. Certainly the personality of Avicenna resembled that of Omar. Aristotle. " in Bull. And many a knot unravelled by the Road. we find him at Khiva.

He notes the effect upon health of water supply. was undertaken by O. regarded as authoritative for many years after his death. It was accepted as the most authoritative text up to the time of the Renaissance (Plate xv). the seasons. An English translation of Book I. to be in a healthy state. and there is a chapter on the care of the aged. sleep." Bull. p. dc M4d. Book " I. in 1921." Nevertheless. p.A HISTORY OF MEDICINE was regarded by Arnold of Villanova as " scribblings " and by Avenzoar as " wastepaper. The Canon of Avicenna supplied a great deal of information outside the scope of the modern textbook of medicine. Gruner. The Canon of Avicenna. xxix. H. until recent times. Soc. was used as a textbook in many medical schools. C. Arabian Surgery in Spain 2 the time of the The Arabs were not well versed in the art of surgery. even in that of Montpellier as late as 1650. Gruner. climate. 1921 1 92 . Mid. and the bones dry." Bull. vol. xxvi. tTHtst. the Canon was highly prized in the later Middle Ages. 1935.. The fifth book of the Canon is devoted to drugs. 1 Avicenna " introduced many aphorisms into his work. the nerves cold. like that of Galen. to the methods of preparing them. In his confident and dogmatic method of expressing himself he resembles Galen. Advice to travellers is included." " Extreme pain in the abdomen. " If a is serious. Avicenna gives valuable hints which may still apply. with fever. 236. During Moslem Empire. and emotional disturbance." In the Canon. J. and he makes some interesting remarks on the therapeutic value of music.. and indeed throughout all history was regarded as inferior to medicine. vol. 1932. "Les Ongines de la Medecme arabe en Espagne. and it is perhaps largely on that account that his teaching was. Discussing the choice of a residence. de I Hist. account it pulmonary tuberculosis is for the first time regarded as a contagious disease. Renaud. must have the heart warm. P. The body. was eventually printed in numerous editions." patient makes movements with his hands as if picking things off himself. and to their action. the neglect of anatomy and 1 Zaki Aly. 321 1 O. Chirurgie arabe en Espagne. surgery and its practice was relegated to craftsmen rather than to scholars. it is a sign of death. C. and was the subject of many commentaries. At the time of which we speak there existed a still more powerful drag upon surgical progress. bathing..

Lower. Upper.PLATE XV EARLY ARABIAN SURGERY Treating a fracture-dislocation ( ? tuberculosis) of the spinal column (from Canon of Avicenna). combined with local manipulation (page 92) . Extension above and below or pounding \\ith a heavy instrument. Centre Direct pressure the operator throwing his weight on the other end. Direct pressure by a board hinged on the v^all. the seat of injury.

foriJH tlh Mosq'K (lh.ikMinah.tmtuai\ th< Hull .PLXIh X\ I CORDON A. toi all\ s. ( LVI KL OI 11IL \\LS1 \R\HI\\ CULTURE J\ 1 ov t r 1 of the 1\ ( athfdral.ip/1 i>i thr a M.

vol.Simpson's work (cf. 2 The facts that the library contained 200. he tells " had passed into the hands of vulgar and uncultivated minds us. and was a complete account of surgery and medicine. The second book is virtually a compilation from Paul of ^Egina. those two great sciences which were the first to revive at the Renaissance. as described in Hilton. but his treatise. while the third book is devoted to fractures and dislocations.D. was the first illustrated work on surgery (Plate xvn). 653 * J. an Arab surgeon did appear with . History of the Intellectual Development of Europe. and had fallen into contempt. 3 " " are of two kinds. c. S. Med. in medicine at least. with a population of over a million. 9). Draper.).000 volumes. Sudhoff. 29 T. Pa ii. that there were fifty hospitals in the city. (Sect. W. 1937. p. THE SCHOOL OF SALERNO physiology. Cordova stood high as a seat of medical learning. The centre of interest. The work contains many illustrations of surgical instruments and appliances." Proc Roy Soc. Hist.(A. had shifted by this time to the Western Cordova Caliphate. and deals with lithotomy and other operations. and to its use the first book is devoted. vol. The cautery was the favourite instrument. xxx. one of the earliest translations being that of Guy de Chauliac. the great mediaeval surgeon. 161 93 . It is therefore all the more interesting to find that towards the end of the period under discussion. Cordova. 1072-1162). Spink. 1921. Geschichte der Medizm. a large and important city. Spain was the home of several other Arabian physicians of the twelfth century." remarks Albucasis. Albucasis did much to raise the status of surgery which. p. It is interesting to compare the surgical methods of Albucasis with those of the Arabian surgeons of to-day. entitled Thesir (or "Assistance") had a far-reaching influence in Europe. Meyer-Stemeg and K. 1864. Surgical operations. had become a centre of commerce and of culture..D." with which he begins and ends his book. 1 ALBUCASIS 936-1013) (sometimes written Abulcasis) was born in (or Cordoba) (Plate xvi). The surgical portion. suggest that during the lifetime of Albucasis. ideas ahead of his time. Jena." His chief work was called the Collection. It was repeatedly translated into Latin. 2 vols. Little is known of the life of AVENZOAR (A. and that the university was founded in the eighth century. produced separately. or Tasrif.ARABIAN MEDICINE. p. and exists in many 1 M. those which benefit the patient and those which usually kill him. "Arabian Gynaecological and Obstetrical Practice Illustrated from Albucasis." That he was a conservative surgeon is evident from the motto " Caution.

It includes a talk on the worthlessness of riches and the importance of character. R.D. 1 1 35-1 204). Averrhcnsm. p." Avenzoar is said to have been the first to suggest that a patient suffering from oesophageal stricture might be fed by nutrient enemata. M. 250 W. 3 He was born in Cordova. for he died in 1 prison in Morocco after spending most of his life at Cordova. 1932. his influence was mainly that of a philosopher. xxvhi. 1935* vol. a Twelfth-century Phvsician. who figures in Sir Walter Scott's Talisman* For the benefit of the eldest son of Saladin he wrote a guide to personal health. vol. Hist. x. p. Med." Studies w Proc. 1544 4 G. p. Hist. Med. Coulton. Feldman. He is credited with having discovered the itch mite (acarus scabei).. 2 Another distinguished philosopher was the Jew. p. " a very small beast. and grew up at a time when the sun of Arabic culture was setting. scorpions. Roy. Med. he wandered to Morocco. the Saraeen leader who so frequently met the Crusaders in battle. 1938. Avenzoar records a number of interesting " I cases. 80 94 .A HISTORY OF MEDICINE Latin versions. He got perfectly well." Ann. Hist. 121 G. True happiness was to be found only in things of the spirit. 190 " Medieval Thought. iv. or MAIMONIDES (A. 318 * H. and. p. so that he could not even say his prayers. or Book oj Counsel. as.. v. I. AVERROES (A. whose unorthodox opinions involved him in trouble. . W.thinking philosopher of the Aristotelian school. Savitz." Ann. " Universals ") was Although his medical work. " The Character of El Hakim in The Talisman. 1 C. Singer. so small that he is hardly visible. despite his religion. The Legacy of Israel. for example. save in his heart. E. and C. Tallmadge. (Sect. 1 126-1 198) was a friend and pupil of Avenzoar." 1923. Doomed to banishment because he would not accept the Moslem faith. and then to Cairo. " Maimonides' Hygiene of the Soul. including those introduced 1 by the bites of snakes. vol." Ann. told him to eat nothing but baked bread and boiled sparrows and to rest quietly on his back for two months. Hist. Moses ben Maimon. Abraham. He is said to have been the original of the physician El Hakim. A. " The Life and Medical Work of Maimonides." A careful observer. K. vol. It is said that Richard Coeur dc Lion also desired Maimonides as personal physician but that he declined this offer. a case of rupture cured by rest. Med. 1927. " Maimomdrs. Mendelson. he was appointed physician to Saladin. dogs. Bevan.. p. the Colhget (or translated into Latin. 1940.D. where laws were more lenient and where he acquired so great a reputation that. a free. Soc. 6 Another work dealt with poisons.).

The Aphorisms is carefully annotated. Aphorisms according to Galen is the title of his most valued work. In the 1. there is embodied all that was best in Galen's 1 To the busy practeaching. Maimonides had a very large practice in Cairo. THE SCHOOL OF SALERNO worst of all. iii. and showed how each might assist the other. he was a talented philosopher. 585 : 95 . this synopsis must have been invaluable. scarification. cauterization. the End of the Moslem Empire pitals at Mention has already been made of the great teaching hosJundi-shapur and at Baghdad. which is A fifteenth and sixteenth and centuries. Med. for example. and his belief in the close relationship between mental and physical health. not merely a case. Hist. cupping. Even more magnificent were the hospitals of Damascus. stated with praiseworthy brevity. Physician and Scientist Hebrew Medicine. This search for causes suggests that he was far ahead of his time. if situated in a In this limb. as also in the work. Not only was Maimonides a distinguished physician. vol." he tells us. and the application of a tight bandage above the wound. and the fact that his literary output was of such high quality reveals him as a keen scholar and a tireless worker. of Medieval Arabic and " Moses The William Osier Maimonides. but no English translation is available. Treatment should consist in keeping the wound open. For him the patient was always a is still a place of pilgrimnot surprising. and abstracting the poison by sucking. All his works were written in few were translated and printed in Latin in the Arabic. had male and female 1 D J. human being. On Causes and Nature of Disease. the bite of a fasting man. p. Maimonides shows his wisdom by advising simple drugs rather than complicated mixtures and by his opposition to all forms of magic and astrology. work.500 aphorisms. of Cordova. and of Cairo. The Mansur hospital at Cairo." Bull.. The tomb of Maimonides at Tiberias age. 1935. Hospitals. arranged under twentyfive " headings.ARABIAN MEDICINE. titioner who had no time to search for information in the immense labyrinth of Galen's original works. as he was held in great esteem by his colleagues and is still regarded as one of the greatest of the many great Jewish physicians. as does also his advocacy of fresh air. Macht. The long incubation period of rabies is noted. In his Guide for the Perplexed he reconciled religion with medicine. and the source of every statement is quoted.

A wards for general HISTORY OF MEDICINE cases. p. That it was a great contribution is certain. 166 M. which went ways 1 E. the last-mentioned being cooled by fountains. and a library with six librarians. Further research may show that the Arabs have contributed to medical progress a share even greater than can at present be claimed. Baghdad was sacked by the Mongols in 1 258. and the moon and stars alike faded at the dawn of the Renaissance. and for fevers." Monastic Medicine After the downfall of the Roman Empire. Loiterers in the street. until he should be * fit to resume work. in The legacy of Islam. for eye diseases. Arnold. insomuch that most people avoided going that way. tells us that this Withington was in Masons and carpenters A.D. and shone like a moon in the Dark Ages." When this great hospital was opened the day of Arabian medicine was already far spent. were obliged to assist in " the holy work. ed. medicine followed their separate two * distinct and divergent paths. The lands of Islam had become too unsettled to provide a suitable field of learning for scholars. and there were storytellers to amuse all. and passers-by. but they also added much of their " Islamic medicine reflected own. Sir T. Fifty speakers recited the Koran day and night without ceasing. p. To quote Dr. T. 1894. 1931. for not only did they preserve the Greek learning. 354 96 . Europe was once again to provide the intellectual centre to the known world. The Moslem Empire had been subjected to hard blows from the east and from the west. though Granada resisted conquest for 200 years longer. Withington. while at night soft music was played to lull the sleepless. though their influence remains to this day. Meyerhof. Cordova had fallen in 1236. a botanical (or herbal) garden. also wards reserved for wounds. a dispensary. when its day had fled. Meyerhof 2 : the light of the Hellenic sun. Medical History from the Earliest Times. on departure. whatever their rank. Each patient. Some bright stars lent their own light. So ended the bright epoch of Arabian medicine. There were courtyards for lectures. were brought from all parts of Egypt. sufficient to tide him over convalescence. was giveti a sum of money. hospital completed 1284. and in any case the famous medical school of Salerno was already well established.

..PLATE XVII ARABIAN SURGICAL INSTRUMENTS v~ r it.^ Pa gt from cl thi 1778 Oxford thtion of Albucasis' /> Cfarurqia (Tasnf) The text is illustrated bv \arious patterns printed in \rahir and Latin a fasountr instrumciit \\ith the earh Arabian cautcr>.^^. surgeons (page 93 j < .. J "L A^.

'1 he amputate d Miniatinc painting c i Damian.ioup around the cofhn <f the (i a chinch i p.is i< < I 1 he tlu otlx'i l>lac k. Cosmas and aninir thin insti uni< nts ali<i ha\in(r amputated a cancel ous leg and liaxiiiir Dialled in its place (lie. nou ha\int. anothei i.PLATE XVIII THE PATRON SAIXTS OF SURGERY asc ilxd to Manic giia. sho\Miitr the t\Mii saints. lus in Ix d ii^ht th< S|H ctatoi 11 In the panel on max at lx* sr< dead Mooi the dom patient. limb is Ic on tlu ildtu the- at then . one leg \\hitt* and s i regard the inn ac It* \\ith annzcme nl.it^e 97) .ICLJ ol a Mocu ic couth deceased.

The mcaas of healing adopted by the Church were strangely like those of the Aesculapian temples. 1 It was no path of progress. and the quiet retreat from the world's to those of scholarly bent. death by drowning. when burning and stoning had failed to disrupt body and soul. sickness Any it as a discipline to be patiently investigation into the natural causes of was out of the question. in which the sick were nursed back to health. 1923-41. if they did not actually view disease as a punishment for sin. The relapse of medicine into the hands of a One of the fiist principles of priestly class is not surprising. who travelled far and wide. preaching Condemned to Christianity and curing the sick (Plate xvm). 481. after which. they were beheaded in A. hidden in cell and cloister. were places of pilgrimage for the sick. which the monastery offered was attractive The manuscript works of the Greek masters of medicine were now safe in the keeping of the Church. and paternosters took precedence over drugs. is not so easy to follow. Christianity was the healing of the sick. litanies. History of Magic and Experimental pp. New York. They became the patron saints of surgery. <*) 97 8 . 303. Adjoining the monastery there was often a herb garden. Many an unknown monk toiled for years copying. THE SCHOOL OF SALERNO hundred years later in the school of Salerno. They were Arabian physicians. i. path. at least regarded borne and endured. Among the earliest Christian saints to be associated with the healing art were the twin brothers COSMAS and DAMIAN. and miracles such as they performed during life were continued after their death in churches at Byzantium and 1 L. although now in Christian churches in place of pagan temples.D. and on that account sometimes called monastic medicine. 616 Science. The early Christians. and so was temple-sleep or incubation. Thorndike. The other. vol. illuminating. yet it served a useful function ^ in transmitting to the more enlightened time which followed part until they fused five One of the great heritage of Greek medicine which might otherwise have been lost. where simple vegetable remedies were grown. and another adjunct was the hospice. as did their pagan ancestors. Votive offerings were revived. Prayers. and the churches dedicated to certain saints and martyrs. Nevertheless the physical means of healing were regarded as a mere adjunct to the spiritual cure.ARABIAN MEDICINE. they were rescued by an angel. strife and translating the classic authors. that of Arabian medicine. we have just traced in its long journey.

H Garrison. 2 Theie still exists a plan of his monastery and of the garden.cs Images de la L. cumin." Amer. an effort was made to replace the signs of the zodiac. H)2(). in the History of Medicine* trans F. a Spanish monk. in. and it is not surprising to learn that Priscillian.D. Holmes. Saint Blaise or Blasius dominated the throat Saint Beriiardine the lungs . illustrated manuscript of the twelfth century. Saint Columba landed in the little Scottish island of lona in A. was burned alive in A.Damian and Cyrus-John.18. the Patron Saints of the Confraternity of the Surgeons of France. : mint. 42 98 . Among his followers were Saint Columba. and D. 385 for suggesting that the signs of the zodiac might preside over the various organs of the body. the latter showing fields devoted to various medicinal plants lily. Confrerie des Bienheurcux Martyrs Saint Cosnie et Saint Damien. An. . A/A/. whose iiumcs were associated with the art of healing. Roy. describes many of his miraculous cures. New York.A HISTORY OF MEDICINE elsewhere. p 19. a view which became widely adopted at a later date. ^." Bull d*Hist " C G Cumston. Soc 1906$ 1 . 10. A Note on St. K. As the Christian Church of early times became more powerful. 635) was associated with Lindisfarne on the Northumbrian roast. which included a herb garden and a hospice. Med. rue.D. sage. of an Operation bv Cosmas and Singer. vol. Thus." Proc. E. who had carried the work of evangelization as far as Ireland. established there a centre of missionary enterprise. Patron Saints in Medicine In the Middle Ages there were many saints. A D. vol. allotted to organs and members of the human body. xxiu. . Neu York. pennyroyal. Saint Cuthbert (b. Saint Gall. p. vol. Damian. Saint Gall (A. Patron Saints " of Surgery. Ne\v York. 1 . "Cosmas and Damian." Essays C. xxx. p. who were believed to dominate the various parts. M. and other herbs. 1926. Cosmas and St. where one of the cantons still bears his name. 614) travelled as far as Switzerland. there to establish a monastery. Surg. Roy. in the Bodleian Library. The Story of Medirinr in the A fiddle Axes.. 1919. 184 Damian. 219 " On a Miniature ascrilx'd to Mantcgna. rosemary. 1936. . Jour." Jour.. M . SudhofT." Contributions to Medical and Biological Research. 166 L. ** Horticulture in Relation to Medicine. p 70 D Riesman. Zimmerman. by patron saints. Saint Patrick. Oliver. 563. besides Saint Cosmas and Saint Damian and the others just mentioned. fennel. " Healing Miracles of SS Cosmas. xxxin p 160 I. 1 In those days the unorthodox were liable to suffer at the hands of their fellow Christians. p.D. vol. Osier's yotli Birthday volume. Soc. and Saint Cuthbert. xi. Hort.. p.

1 Sometimes more than one saint held sway over the part. vol " xin p 116. apparently common in mediaeval times. according to the country. Jour. " Les Saints gueVisseurs. Augenheilkunde. a martyr was one of the saints : 1 M. Gordon-Taylor. Edinburgh. One of the best known of the patron saints.. 1914. sue h as haemorrhoids or fistula. 127 . Monatsbl f. vol.. Erasmus) " 1 R. 'life of the saint. THE SCHOOL OF SALERNO Saint Apollonia the teeth . Bortarel. i. D. although the well house had been removed from its original site (Restalrig) to another well about a mile distant. Frequently the association arose during the For example. History of Scottish Medicine. he devoted his energy and his wealth to the care of the stricken people while the Black Death was devastating Europe. Sur%. Plague and Pestilence in Literature and Art. G. xxvi. Oxford. Santa Lucia. 1932. is said to have plucked them out and presented them to her lover impaled on a skewer. none knew from whence. and Saint Erasmus the abdomen. die Schutzheihge Hilferm und Retterm der Augcnkranken. vol. Pictures of Saint Triduana illustrate this incident. p. Then an angel appeared one night. 45 4 Raymond Crawford. After he had visited many cities on his mission of mercy. 105 99 . Returning to his native Montpcllier.. or Saint Lucia. leaving this message "All certain diseases. according to Comrie. Each day his dog brought him a loaf of bread. 1938. to signify a horse cab. 1921." Pans Mid. were healed by the intervention of Saint Fiacre. while diseases of the rectum. 1922. Saint Triduana. 2 vols. Montpellicr. a circumstance which led to the introduction of the French word fiacre. teenth century. of about the of fournoble the beginning parents. Saint Triduana of Scotland. The effigy of this saint adorned the inn at Paris where carriages were first offered for hire. Saint Dymplma. he was himself a victim of plague at Piacenza. vol.ARABIAN MEDICINE. persons with eye disorders still visited Saint Triduana's well at Holyrood. who presided over plague. c p. To other saints was accredited the power to cause or to cure of the seventh cenin cases of invoked tury. Saint Lawrence the back ." Kim. he was not recognized. In vertigo and epilepsy prayers were offered to Saint Avertiii. the patron saints of the 2 eyes were Saint Bridget. and healed his sore so that he recovered. 97 3 J. Comrie. Abdominal Injuries. vol. That belief in tradition dies hard is proved by the fact that as 3 recently as 1927. 217 ("contains reference to St. insanity. admired by a Pictish chief on account of her eyes. Greff. where he died. but was arrested as a spy and cast into prison. was Saint Roch. 1938. as might be ex4 Born in pected. where he crawled outside the walls to die. xiv. p. For example." Bnt. p. p.

Kerler. In Italy. especially in Apulia. Other saints associated with plague are Saint Sebastian and those stricken for by plague who pray and intercession of Saint Roch shall Saint Cyprian. p." Bristol Med. Fletcher. Jour. some of which have been preserved. St. usually associated with the name of the latter saint. long after the St. Hecker. Tarantism was at its height in Italy in the seventeenth century. There have been various interpretations of Anthony. Vitus's Dance of Germany had disappeared. held a similar view regarding Another saint whose name was linked with a disease was Saint " 3 St. Vitus's Dance and St. G. Some Diseases Bearing Names of Saints. just before he suffered martyrdom under the Emperor Diocletian in A. when his effigy was often carried in processions in order to check an epidemic. Babington. prayed to God that all who should commemorate the day of his death might be protected from the dancing mania. by B. was characterized by a complete loss of control of the persons affected. Although the last known epidemic of this nature occurred in Germany and the Netherlands in the fourteenth century. the Tarantellas. Ulm. Hippocrates. Vitus's Dance. the tarantula. the mania dated from the tenth century or and it appeared at intervals during the Middle Ages. 289 J. xxx. as all could be ascribed to natural causes. Diseases. The Epidemics of the Middle Ages. Saint Vitus was a Sicilian A youth who. Anthony's Fire Certain saints have given their names to diseases. " the sacred disease. it was attributed to the bite of a venomous spider. The dancing mania of Germany was regarded as the work of the devil. 2 R.'* The cult of Saint Roch did not appear immediately. The dance of Saint John or Saint Vitus.-Chir. earlier. chorea. who continued to dance in wild delirium until they fell to the ground exhausted. curable only by the Church. or chorea. but it became widespread during the fifteenth century. should not be named after saints. Sydenham Society. p. Paracelsus affirmed. 1 familiar example is St.D. Die Patronate der Heiligen. y 1912. F.A HISTORY OF MEDICINE and through the merit be healed. It was said to be relieved by music of a lively and impassioned nature. H. it will be remembered." epilepsy. K. 303. 1905 1 " 100 . 93 D. following close upon the Black Death. vol. trans. 1844. until Paracelsus attempted to prove that it was really a disease. and was accordingly called tarantism.

Associated with Theodoric in his work of charity was St. and above all to master the writings of Dioscorides on the nature and uses of herbs. throughout the Middle Ages. who regarded the care of the sick as one of the leading objects of the order he founded. The rules of the Benedictine monks were less stringent and more hygienic than those of other orders. the other two were synonyms for St. 1902 F. His chief minister. 163 ' > IOI . feu sacre. Cassiodorus (490-585). bearing a staff with bells attached. a task favoured by those in authority. Anthony's Fire with ergotism. Benedict of Nursia (480-543). Thcodoric. The disease was particularly severe in France during the tenth and eleventh centuries. The hours of sleep and exercise were reasonable. represented in art as a tall man. or even epidemics. The lastmentioned is now believed to have been bubonic plague. arising from the use of bread prepared from grain infected by claviceps purpurea or 1 The victims suffered from severe burning pain and rye disease. to read the works of Hippocrates and Galen and the Byzantine commentators. On the summit of Monte Cassino. 1 * E. Clcmow. but the accepted explanation identifies St. G. when it was also termed ignis sacer. Ehlers. 1903. The Geography of Disease Cambridge. and encouraged the monks to undertake the care of the sick poor. a duty which had previously devolved upon the Roman archiatri. Saint Anthony was born in Egypt in A. The monks were encouraged to study Greek. cramp in the limbs. Some cases. and mat des ardents. and encouraged the collection and copying of medical manuscripts. and accompanied by a hog with a bell fastened to one ear. Paris. near Salerno. pursuit of learning by the monks of those dark ages was encouraged by a number of wise and influential rulers. the " toe " of Italy. The king of the Ostrogoths (A.D. Anthony's Fire." a name sometimes applied to erysipelas even in modern times. THE SCHOOL OF SALERNO Anthony's Fire. followed by a long and painful stage of gangrene and separation. and there was ample time for study and for the copying of manuscripts. and in the nineteenth century 2 Saint Anthony is epidemics of ergotism appeared in Russia. founded two monasteries at his ancestral home of Squillace in Calabria. p. fostered the cultural life of the countries he had conquered. 454-526).ARABIAN MEDICINE. 251. UErgotisme. may have been erysipelas. but many epidemics have been reported since then.D. in epidemic form. The disease to which his name was applied was common.

that some of them show a series of fortification lines has suggested to Dr. 3 She made no serious contribution to medicine. 871). 1 It is a strange mixture of charms and incantations.. C. some thirty-five miles south of Naples. The School of Salerno The charming seaside town of Salerno. Engbrmg. Med. F. 39 " G. the Leech Book of Bald. that of HILDEGARD OF BINGEN (A. Among the the great rulers who favoured the literary efforts of monks were Charlemagne (A. This clever and learned woman. vi. 1864-66. and J. and the most interesting of her works are those in which she describes her visions. 4 Hildegard's Physica contained some curious remedies. spent most of her long life as abbess of a Benedictine nunnery at Bingen on the Rhine. who is credited with many miraculous cures. which revealed to her the structure of the universe and the nature of the soul. 1940. 1921. M." in From Magic to Science. 770 " The Visions of Hildegard of Bingen. Studies in the History and Method of Science. Leechdoms. p. vol. 1928." Bull. though she was never canonized. English Medicine in Anglo-Saxon Times (Fitzpa trick Lectures). viii. Wortcunmng. Cockayne. resembling the drawings of William Blake. 1098-1180. 2 Before leaving the rather arid subject of monastic medicine one other name must be mentioned. Hist. five centuries of comparative stagnation in the widely scattered monasteries of Christendom and in the cities of the vast Moslem 1 T. Saint Hildegard. 768) and Alfred the Great The earliest surviving Saxon medical manuscript is (A. which was written in the tenth century. Starcraft of Early England. vol. and she even tells her readers how to capture a unicorn. which was destined to take an important part in the foundation of that famous first school of medicine. Charles Singer that Hildegard was a victim of migraine. " The Scientific Views and Visions of Saint Hildegard. Twelfth-century Physician." in chap. after first organized medical school in Europe. 1098-1179). with the names of many herbal remedies and indications for their use. The Scivias is illustrated by most curious illumiThe fact nations. i. O. sometimes called Saint Hildegard. p. 1 IO2 .D. will ever be remembered as the seat of the At Salerno. 1904. using a young woman as the bait. p. Singer.D. 3 vols.A HISTORY OF MEDICINE Benedict founded his monastery. For leprosy she recommended an ointment made from unicorn's liver and white of egg.D. I 8 * . Payne.

1937. however. THE SCHOOL OF SALERNO 1 Empire. Emden. 1926. the period of the Crusades Regarding the origin of the school. It was the it was these influences which brought about its fall. and it is close to the Greek-speaking lands of Sicily and southern Italy. Powicke and A. trans by F. vol. " a meeting place 2 The flowering time of Salerno covered (1096-1270). Pontus the Greek. easy of access from all directions. Some contend that the school was founded by Charlemagne . 75 1 G. a Medieval Health Resort and Medical School " in Essays in the History of Medicine. no accurate for physicians of every race According to legend it was founded by " four masters Elinus the Jew. between the Benedictine monks and the Salernitans. it may at least be claimed that here was planted the seed which was to come to full fruition in the brilliant epoch of the Renaissance a few centuries later. new ed." " and creed. Corner." obscure fashion about the ninth century. and that it was a lay foundation. the School of Salerno no brilliant nor Although produced genius. which destroyed the popularity of the more conservative Civitas of Monte existed 3 The only certain facts are that it came into Hippocratica. The Universities of Europe in the Middle Ages. combined with the growth of medical faculties elsewhere. p. M. Such a legend at least points to details are available. Indeed. so far from the rise of the fame of Salerno having been due to Oriental influences. that friendly relations Cassino. and there can be little doubt that the valuable collection of medical manuscripts at Monte Cassino were available to the physicians of Salerno. medical learning became established on a sound basis. Adale the Arab. Sudhoff. to quote again from Rash" dall's famous work on mediaeval universities. 3 vols. a product of the adjacent monastery : It is known. and not.. but there is no strong evidence that either view is correct. that in the thirteenth century it gave way to the adjoinin the Twelfth Century. not surprising that Salerno was chosen as a Civitas Hippo- cratica. as some have supposed. B. A famous health Vesort since early Roman times. irrespective of language or nationality. Mayo Foundation. Salerno. any startling discovery." in of Medicine. p 245 * H. p 371 * K. " The Rise of Medicine at Salerno " Lectures on the History 103 . i. It is now generally accepted that Salernitan medicine bears little or no trace of Arab influence. two conclusions that the school was open to all. and Salernus the Latin. by F. Garrison. H. 1936. increasing popularity of the Arabic medicine in the thirteenth century. in a somewhat being that it reached the zenith of its fame in the tenth or eleventh century.ARABIAN MEDICINE. others that it was a direct outcome of Arabian medicine. Rashdall. W.

Medieval Lore from Bartholomaeus Anglicus. Rebecca. 1050).A HISTORY OF MEDICINE ing school of Naples and to the newly established universities of Montpellier and Bologna." Proc. which was a widely read book of popular information during the Middle Ages. ed. 471 . and which gives a clear picture of the life and learning of the time (thirteenth 8 It was translated into English by John of century) (Plate xxi). which appeared in 1495." in La MJdecvie. King's Classics. enjoyed a wide vogue. tk Trotula and the Ladies of Salerno. "De l'6cole de Salerne. p. " " were anything ladies of Salerno as it is not certain whether the more than nurses and midwives. For our scanty knowledge of the teachers of Salerno we are indebted to the researches of De Renzi. Medieval Medicine. Walsh. but he quotes freely from Hippocrates. The edition edited by Wynkyn de Worde. History of Women in Medicine. A subsequent edition by Berthelet (1535).. Histoire et Doctrines. is well known Of to bibliophiles. trace of its existence is to be found in Salerno to-day. K. 2 One of the earliest Salernitan masters was GARIOPONTUS (d. 1 Salerno owed much to Duke Robert Guiscard. xxxiii. Daremberg.. 1907 * H. Hurd Mead. His Passionarius. Dr Rcnzi. p. " Rashdall calls it a compilation with an earlier tradition behind it. BARTHOLOMEW the Englishman was the author of a popular encyclopaedia. although it lingered on. C. Hist. who published all the available information and manuscripts. in name at Not a least. vol. 1920. 1075. (Sect. * 5 vols. and who made it his capital and a great centre of trade and of culture. Conthis progressive school. 6 Of them we know little more than their attractive names Trotula. p. whom he highly revered. J. 192 * R. Steele. and upon venesection and diet as means of treatment. Med. Trevisa in 1397. J. Roy. p. 127 104 . and. Haddan. was one of the finest and earliest books to be printed in England.). of whose life little is known. a fter a siege of eight' months. until it was finally closed by Napoleon in 1811. a textbook of medicine. the Norman knight who captured the town in A.D. : 1 C. 1938. 123 1 S. Bavon. Abella. though it was mainly derived from Greek writings. 1865. De Proprietatibus Rerum. 1875. in which stress was laid upon the pulse and the urine in diagnosis. A Conn. P. Soc. Another textbook was the Practica of BARTHOLOMEUS ANGLICUS. 4 greater interest are the women doctors who taught in Here again we enter the realm of legend. 1940. Storia documentata delta Scuola Medico di Salerno." Gariopontus disregarded mystical medicine.

ARABIAN MEDICINE; THE SCHOOL OF SALERNO
TROTULA is said to be the author of a work on about A.D. 1050, and she is still better known " as the original of the Dame Trot " of modern fairy tales. Anatomy was taught, not from human dissection, but from the pig, whose organs were believed to resemble closely those of man. A treatise on the anatomy of the pig, Anatomia Porci, by KOPHO 1 (or Copho), is of great interest as the first textbook of anatomy. linked the school of of with Salerno is the name CONUsually STANTINE THE AFRICAN (1010-1087), who translated many Arabic works into Latin, and thus linked together the medicine of East and West. Born in Carthage, Constantine visited Persia and India, wandering and studying medicine for over thirty years. On his return to Carthage he was regarded with disfavour, as apparently he knew too much, and he was obliged to flee for his He sought refuge at Salerno, where his learning was recoglife. nized, and where he was made welcome at the Court of Robert Guiscard. Whether he taught in the school of Salerno is very 2 He soon doubtful, but his residence in the town was not long. retired to Monte Cassino, becoming a monk and devoting himself to translating into Latin the works of the Arabic physicians and the classical Greek medical writings which had been preserved 3 It is said that Constantine passed through the Arabian route. those as his of works off many own, and that he seldom acknowhis of the source information. His Pantegni, the " Whole ledged Art," is largely a compilation. Singer is of opinion that Constantine has been greatly overrated. 4 Be that as it may, he deserves credit for his assiduous work in making available for Latin readers the rich resources of Arabian medicine. Although it is agreed that Constantine did not confer an Arabian flavour " upon Salerno, he had, according to Thorndike, as good a right to be called Salernitan as most of the authors in De Renzi's
stanza,

and

others.

obstetrics written

collection."

6

Surgery was not neglected at Salerno. Its principal exponent was ROGER OF PALERMO who in A.D. 1080 wrote his Ckirurgia, or,
1

R. Creutz, " Der Magister Copho und seine Stellung im Hoch-Salerno," Arch.

Gesch.f. Med., 1938, vol. xxxi. p 51 * P. Capparom, Magtstn Salernitam Nondum Cogmti, 1923, p. 39 (English trans. ) " * Reflection of Arabian Medicine at Salerno and Montpelher," Ann. L. M. Sa'di,

Med. Hist., 1933, vol. v. p. 215 " * The School of Salerno and its C. Singer, From Magic to Science, 1928, chap, vii., Legends," p. 240 L. Thorndike, A History of Magic and Experimental Science* New York, 1923-41, voL L p. 742
fc

105

A HISTORY OF MEDICINE
sometimes called from its opening phrase, Post fabricam This work, which was for centuries regarded as a classic, was revised by ROLAND OF PARMA, a pupil of Roger. The surgery of Roger is, in the main, conservative and non-operative x (Plate xix). He regarded suppuration as an essential process in the history of wounds, though he employed ligatures as well as styptics to check haemorrhage. Skin diseases were included in the surgery of that day, and were treated for the most part with mercurial ointment.
as
it is

mundi.

Another interesting contribution

to Salernitan literature

was

made by MusANDiNUS, 2 who wrote De
infirmorum
;

modo praeparandi cibos et potus in other words, a textbook of sickroom cookery.
still
is

More
in
1

interesting

the

work on Medical Ethics

entitled

De

Adventu Medici, or
140.

The
3

Doctor's Visit," written by ARGHIMATHEUS following quotation gives some idea of the nature

"

The

When called to a patient commend yourself God and to the angel who guided Tobias. On the way, learn as much as possible from the messenger, so that, if you discover nothing from the patient's pulse, you may still astonish
of the advice
to
:

"

confidence by your knowledge of the case. On whether the patient has confessed, for if him do so the examination you will frighten him. after bid you Then sit down, take a drink, and praise the beauty of the country and the house, if they deserve it, or extol the liberality of the family. Do not be in a hurry to give an opinion, for the friends will be more grateful for your judgment if they have to wait for it. If asked to dinner, do not hasten to take the first place unless is is offered to you. Send often to inquire for the patient, that he may see you do not neglect him for the pleasures of the table, and on leaving, express your thanks for the attentions shown you."

him and gain

his

arrival ask the friends

The Medical Curriculum

at Salerno

The study of medicine at Salerno was no haphazard affair. Early in the twelfth century medical practice had been brought under official jurisdiction by King Roger II of Sicily, and later, the Emperor Frederick II, most able and enlightened of the
vol. vi. p.
s

The School of Salerno (Work of Roger)," A. Castigliom, 883 G. Daremberg, La MMecine, Histoire et Doctrines, 1865, p. 154
Ibid., p.

"

Bull.

Hut. Med., 1938,

148

106

ARABIAN MEDICINE; THE SCHOOL OF SALERNO
House of Hohenstaufen, decreed in 1221 that no one should practise medicine until he had been publicly examined and " in order that the king's approved by the masters of Salerno,
subjects should not incur danger through the inexperience of their physicians." Furthermore, no one could proceed to the

study of medicine until he had attained the age of twenty-one

had proved his legitimacy, and had studied logic for three years. The medical course lasted for five years, with an additional year of practice under the supervision of an older
years,

The candidate, having passed the examinations, took the oath to uphold the school, to attend the poor gratis, to administer no noxious drug, to teach nothing false, and not to keep an apothecary's shop. He then received a ring, a laurel wreath, a book, and the kiss of peace, after which he was entitled to call himself Magister or Doctor, and to practise medicine. 1 " It was at Salerno that the medical man was first called Doctor." The School of Salerno was also the first attempt to co-ordinate the teaching of medicine without any restriction as to religion or
practitioner.

and also the first to grant degrees after a definite course of study and examinations.
nationality,

Famous Graduates

The fame of the Salerno school spread who came to study was GILLES DE CORBEIL
(c.

far,

and among

those

(^Egidus Corboliensis) 2 a celebrated French physician who subsequently I2OO), taught in the University of Paris, and who wrote, after the fashion

of the time, two long poems in hexameter, De Pulsibus and De Urinis, which became widely known. Another famous pupil of Salerno was MICHAEL SCOT (A.D. H75), 3 who had a great reputation as a practitioner, not only of medicine, but also of the magical art of astrology. One of Michael Scot's prescriptions

an interesting light upon the early history of anaesthesia. Take of opium, mandragora, and henbane equal parts, pound and mix them with water. When you want to saw or cut a man, dip a rag in this and put it to his nostrils. He will soon sleep
casts

"

1

1

L. Thorndike, History of Magic and Experimental Science, New York, 1934-41, vol. ii " S. D'Irsay, The Life and Works of Gilles de Corbeil," Ann. Med. Hist., 1923,
vii. p.

vol
'

362

Life and Legend of Michael Scot, Edinburgh, 1897. best-known work, De Phiswnomie, had a wide and long reputation.)

J.

W. Brown, The

(Michael Scot's

107

A HISTORY OF MEDICINE
wish." It is not easy to undernon-volatile substances were absorbed, but that they were used as anaesthetics appears certain. The spongia somnifera (or soponfera) are mentioned by Nicolas of Salerno in his
so deep that

you

may do what you

stand

how such

Antidotarium, a large collection of formulae, probably compiled in the eleventh century, and printed in Venice in I47I. 1 This
it

work is sometimes called the Antidotarium parvum, to distinguish from a later and more elaborate work, the Antidotarium magnum, which was compiled by another Nicolas, a Byzantine
physician

maker),

named who lived

Nicolas Myrepsos (Nicolas the ointmentin the second half of the thirteenth century. 2

A special study of spongia somnifera and of mediaeval methods of surgical anaesthesia was made by Husemann some years ago. 3
Regimen Sanitatis Salernitanum
is complete without some account most famous literary product of the was the which poem " 4 constituted the school, and which, as Castiglioni remarks, backbone of all practical medical literature up to the time of the Renaissance." The Regimen Sanitatis Salernitanum* is a work of composite authorship and uncertain date, probably of the thirteenth century, according to Sudhoff. 6 It exists in innumerable manuscripts, and was printed in almost three hundred different editions up to the year 1 846. The most authentic manuscript, given in a commentary by ARNOLD OF VILLANOVA (1235-1312), contains 352 verses, but in subsequent editions this number has been multiplied at least ten times. It has been translated into many languages, and some of the phrases have become proverbs in common use. Indeed, it remains the most popular medical work ever written. The Regimen is a sort of handbook of domestic

No

reference to Salerno

of the

1

G. Sarton,

Introduction to the History

of Science, Washington, 1931, vol.

ii.

Pt.

I,

pp.

loc. at, vol. ii. Pt. 2, p. 1094 " T. Husemann, Die Schlafschwamme und andere Methoden der allgemeinen und ortlichen Anasthesie im Mittelalter," Dcutsch. %nt. f. Chir., Leipzig, 1896, vol. xlii. " Weitere Beitrage zur chirurgischen Anasthesie im Mittelalter," pp. 517-596, and
1

1

I35 239 G. Sarton,

Deutsch. %nt.f. C/r., Leipzig, 1900, vol. liv. pp. 503-550 4 A. Castiglioni, A History of Medicine trans. E. Krumbhaar, Chicago, 1942, p. 309 * F. R. Packard, The School of Salerno, with Sir John Harington's trans, of Regimen
-,

Sanitatis Salernitanum (1607),

K. Sudhoff, " Salerno,"
1926

Oxford, 1922

in Essays vi the History of Medicine, trans. F.
1

H. Garrison,

New York,

08

ARABIAN MEDICINE; THE SCHOOL OF SALERNO
medicine, and is said to have been written for Robert, Duke of Normandy, son of William the Conqueror, who in returning from a crusade stayed at Salerno (c: noo) for the treatment of his wound. 1 It was at Salerno that he met Sybilla, grand-niece of Robert Guiscard, who is said to have saved his life by sucking the *wound while he slept, and who afterwards became his wife. Robert's absence at the crusades lost for him the throne of England and led him, through the treachery of his brother, to a long term of imprisonment which lasted until his death. Others allege that the poem was dedicated to the king of France. One of the earliest English editions is the translation made for Queen Elizabeth by Sir John Harington and eventually published in 1607. More recent versions are by Sir Alexander 2 Croke, 1830, and by Professor John Ordronaux, iSyo. " " health hints The nature of the given in the Regimen from be the following extracts from Sir A. may appreciated Croke's version, but it is needless to add that the entire poem is worthy of study, and may be read with profit by every medical man. The dedication runs thus
:

The

Salcrnc School doth by these lines impart

All health to England's king, and doth advise From care his head to keep, from wrath his heart.

Drink not much wine, sup

light

and soon

arise.

Diet occupies a central place in the poem, for

A

King

that cannot rule

Will hardly rule his

him in his diet, Realm in peace and

quiet.

On milk, duck, and cheese, to select three foods at random, the following opinions are expressed
:

Cow's milk and Sheep's do well, but yet an Is best of all, and all the other passes.
* *
to see a

Ass's

*
fill'd.

Good

sport

it is

But with

their flesh

Mallard killed, your flesh should not be

* For healthy men may cheese be wholesome food But for the weak and sickly 'tis not good.

*

*

1 P. Capparoni, Magtstri Salemitam Nondum Cogniti. A contribution to the history of the Medical School of Salerno, 1923, p. 13 Sir A. Croke, trans, of Regimen Sanitate Salermtanum 1830 ; J. Ordronaux, The Code of Health of the School ofSalernum, Philadelphia, 1870
t

109

A HISTORY OF MEDICINE
There
is

some quaint advice on the care of the eyes

:

Three things preserve the sight, glass, grass, and At even springs, at morning vjsit mountains.

fountains.

A number of herbal
Some affirm tnat The pain of gout

remedies are mentioned, thus

:

they have found by trial is cured by Penny-royal.
as flegme
it

White pepper helps the cough,

riddeth,

And

Ague's

fit

to

come

it

oft forbiddeth.
is

The

doctrine of
still

Humours

replaced by that of Elements, or
:

as they aie

called,

Temperaments

Four Humours reign within our body wholly, And these compared to four Elements, The Sanguin, Choller, Flegme and Melancholy.

The technique of venesection is fully described, the time for the operation depending upon the moon Three special months, September, April, May There are in which 'tis good to ope a vein. In these three months the moon bears greatest sway.
:

The poem

appropriately concludes as follows
:

:

And here I cease to write, but will not cease To wish you live in health, and die in peace And ye our Physic rules that friendly read, God grant that Physic you may never need.

BOOKS FOR FURTHER READING
Sir T. and GHILLAUME, A., Ed. of The Legacy of Islam. (" Medicine,' Meycrhof), 1931 BROWN, J. W. The Life and Legend of Michael Scot, Edinburgh, 1897 BROWNE, E. R. G. Arabian Medicine, (Fitzpatnck Lectures,) 1921 CAMPBELL, D. Arabian Medicine, 2 vols., 1926

ARNOLD,

M.

CAPPARONI,

P.

Magirtri Salermtani

COCKAYNE, T. O.

Nondum Cogmti, English trans., 1923 Leechdoms, Wortcunnmg, and Slarcraft of Early England, 3 vols.,
Medica
di Salerno*

DE

1864-66 RENZI, S. cd. 1875

Storia Documentata della Scuola

5 vols., 2nd.

GREENHILL, W. A.

A

Treatise on the Smallpox

and Measles* by Rhazes.

Trans.

Sydenham ORDRONAUX, J.

Society, 1848 The Code of Health of the School of Salernum, Philadelphia, 1870 PACKARD, F. R. The School of Salerno. With Sir John Harington's trans, of Regimen Sanitatis Salernitanum (1607), Oxford, 1922
to Science

From Magic SUDHOFF, K. Eswvs in Garrison, 1926
SINGER, C.

(chap, vi Hildegard of Bingen "), 1928 u Trans. F. the History of Medicine ( Salerno").

"

H.

JIO

CHAPTER VII

MEDIAEVAL MEDICINE
To
write of the mediaeval period imposes a severe test upon the of the historian. It is usually regarded as an age " " of decadence and of stagnation, and the very name mediaeval
critical faculties

implies

the negation of progress,

and

suggests

backwardness,

superstition,

and

sloth. 1

It is true that at this stage of history medicine had sunk to a very low level indeed. The prevailing conception of disease was archaic ; diagnosis and prognosis were based on the state of the stars and on inspection of the urine ; treatment consisted of blood-letting and the use of herbs whose nature was ill under-

animal dissection

anatomy was taught from ancient texts or at best from alchemy was directed towards the discovery of an elixir of life and surgery was of the meddlesome type. 2 Under such circumstances, it does not surprise us to learn that in 1250 when a nobleman of Bologna had sustained an injury no one could be found to undertake the case for fear of latal consequences. Eventually Hugh of Lucca treated him, but only after thirty of the friends and relations had taken an oath that in event of the patient's death no harm would befall the surgeon. Fortunately he recovered, and all ended happily. Nevertheless, mediaeval medicine does not present a picture of unrelieved gloom. Here and there a shaft of light appears to herald the coming brightness of the revival of learning. Schools of medicine were opening and methods of teaching improved. Anatomy, though still full of Galenic misconceptions, was recognized as the foundation of surgery, and some bold spirits even
stood
;

;

;

dared to hint that Galen might not be entirely reliable. In surgery some new methods were devised, and it was even suggested
that suppuration was not an essential stage in the healing of wounds. Preventive measures, if somewhat crude, were introduced to prevent the spread of plague. Thus, the mediaeval period
small, yet important, contribution to medical science. Taylor, The Medieval Aftnd, 2nd ed., 2 vols., 1914 a C Singer, From Magic to Science (The Dark At^es and the Dawn of Science). 1928 H. E. Sigenst, " The Medieval Literature of the Early Middle Ages," Bull. Hist.
its
1

made H. O

;

Med. 9 1934,

11.

p.

26

III

A HISTORY OF MEDICINE
Although the available information is scanty, the lives and works of the physicians and surgeons of the Middle Ages fill an important page in medical history.

The Schools of Montpellier and Bologna

The medical
1

pellier.

As Rashdall

school of Salerno gave place to that of Montstates, it "may have been an offshoot

of Salerno." 2 Somewhat later, Bologna, where there was a famous school of law, became well known also as a school of anatomy

and

district

It was a famous for its intellectual interests, and including a large Greek element. Furthermore, it was easily accessible from Spain and Italy, so that the appearance of a medical school in

surgery. Montpellier, like Salerno, was a health resort.

such a centre is not surprising. The date of the foundation of the school of Montpellier is uncertain ; probably it was during the twelfth century. It was renowned during the thirteenth and fourteenth centuries, when it was frequented by a number of

famous men,

With to some of whom we shall presently refer. the rise of the medical schools of Padua and of Paris and the
Yet
it

departure of the

Popes from Avignon, Montpellier was less did not share the fate of Salerno ; as a centre frequented. of medical learning it remains to this day, and in 1890 the sexcentenary of the university was celebrated. During the early days of the school of Montpellier the most distinguished teacher was ARNOLD OF VILLANOVA, whose name has already been mentioned as the writer of a commentary on the Regimen of Salerno. Arnold was born in Spain, but spent most of his "life at Mont8 A graduate in theology and law as well as in medicine, he was highly esteemed at court, and among his patients were included two kings and three popes. \Vhen his unorthodox views brought him into conflict with the Church he sought the pro-

pellier.

tection of Pope Boniface VIII, who advised him to leave theology alone and to stick to medicine. Fortunately, it was not until
after his
1

death that Arnold was regarded as a heretic in league

*' The Medical School of Montpellier in the Fourteenth Century," S. Cooper, Ann. Med. Hist., 1930, vol. ii. p. 164 * H. Rashdall, Universities of Europe in the Middle Ages, 1936, vol. ii. p. 1 19 3 L. Thorndike, A History of Magic and Experimental Science, 6 vols., New >fork, 1923-41 , vol. ii. p. 841 ; vol. ni. p. 52

112

PLATE XIX SURGICAL PRACTICE AT SALERNO

Illustration

from a thirteenth-century

MS
(p.

of Roger's Ctrurgia in th^ British

Museum, shoeing the treatment of a dislocated shoulder. Above are three figures from Our Lord's Passion, a reminder of the homage due to religion by
surgery
106)

PLATE

XX A MEDIEVAL

SPA: PLOMBIERES

~^- ^ggf

,

\Yoodcut from De Balneti, \ finer, tfi^, slum ing a public bath in a health resort. Sonic of the patients, including a man in the centre of the bath, are using crutches. Another is being assisted do\\n the steps into the \\ater, \\hile a \\oman bather, inimeised \\aist-deep, is drinking troin a flask. Ni^ns on the surrounding
buildings

may

indicate that the) are inns

" Arnold must be credited with the desire to escape from dogma and empiricism. including a number of enterprising Englishmen. J. Englishmen at Montpellier Montpellier attracted students from many countries. : women. Walsh. and with a reliance on his own His was a spirit of investigation unusual at that observations. That Arnold practised surgery ^as well as medicine is obvious from the following selections from his " ous. fox. he did not hesitate to criticize Galen and the Arabists. fumigate with For example pomegranate. and stuff him with cucumber. E." As a physician and scientist.MEDIAEVAL MEDICINE with the devil. 1910-25." aphorisms " The : bite of a To postpone opening an abscess is dangermad dog should be enlarged and encouraged : He also gave advice not usually found in modern text" To drive away mice. Med." In the couise of this investigation he found that the virtues of herbs could be extracted by alcohol. and some of his works were publicly burned. " Skin a fat puppy. and he was thus the inventor of the modern " tincture. pellitory." Ann.R vol. 283 (429) . "John of Gaddesden on i. 1 Of the medical portion of his writings the best known is the Breviarium Practice. with God's help. apply to the brandy. Lennox. Then boil him and add wax an ointment. Medieval Medicine. and bear. juniper. '( V. Playfair. and shells of shrimps. who wrote a compendium of medicine which contained nothing new. There was GILBERTUS ANGLICUS (d. to make more distinguished English student at Montpe^fcf-^as JOHN OF GADDESDEN (1280-1361). sulphur. to consider diseases of to bleed. equal parts. afstofyff * if Medicine. which he made and prescribed. W." to the grease that floats on the top. in fact. IK p." " In this book I propose. and he did. 2 who became Wof$bq& -at J. p. M. The mice His book on poisons begins will flee and never come back. G. I shall then treat of the bites of venomous beasts. p. 1250). Epilepsy. though the recipe for Gilbert's ointment for gout is worth quoting as an example of mediaeval pharmacy. Ncuburger. time. he was one of those who spent much time in the search for the Elixir of Life. since women are poisonous creatures. and fat of goose. hellebore. which was printed in a number of editions during the sixteenth century. 1920. vol." books. rue. 75 * 1 A ^"* 66 . the name "aqua vitse. trans.

and temperament. ii. He could dissolve the Stone." It is believed that Chaucer. of cold or hete or moyst or drye. Wootton. : : of Gaddesden. that Bernard was a Scot. 4 1 BERNARD DE GORDON E. to whom we shall shortly refer. Freind. 4 Gaddesden. New York. though at first I thought it was an inflammaIt was generated from milk foods. and by having all the bed hangings and window curtains of red colour. vol." treated the son of Edward II for smallpox by wrapping him in a red cloth. and whose book bears the curious title.. C. and this " is how he describes the case I saw a stone in my father's mouth under the tongue. p. and of what humour. A History of Magic and Experimental Science. without any vestiges " of scarring. History ofPhystck. vol. p. 1285). I extracted it with a fine knife." as the him " " Well coude he gesse the ascending of the star Wherein his paticntes fortunes settled were. the Lilium Medicinae. Thorndike. and on the pathology of " humours. 2 vols. which still exists in rare manuscript form." Nevertheless. very fond. 1725. Oxford. ii. another student of medicine contributed to the by writing garden Montpellier. but it is now generally believed that he was a native of the French town of Gourdon. T. 1910. the length of half a little finger. 287) p.A HISTORY OF MEDICINE Merton College. 399 J. on account of his name. (Full account of John A. who was a contemporary of John Rosa Anglica. Some historians have presumed. the Rosa Anglica 3 contains little that is new. said that there had been sent to him " a foolish English rose which contained no sweetness but only a few old fables. i. 134 L. Freind 2 writes of John of Gaddesden Nothing came amiss to him. and which had congealed by the heat of his choleric * John acquired a fashionable practice. He treated his father for salivary calculus. Chronicles of Pharmacy. the course of every maladye.. Medical History from the Earliest Times. He knew Were it or teacher of (c. of which my father was tion. 6 vols. Thus he cured him. And where they engendered. conquer Epileptic fits with a necklace.. 1894. depicted Doctor of Physick in The The picture shows his reliance on astrology Canterbury Tales. 488 114 . and cure a Palsy with Aqua Vitae. vol. It contains the first description of a truss and the first mention of spectacles. which I now carry about with me and exhibit in the schools. and Guy de Chauliac. He was a very parfit practisour. Withington. draw out the humour of Gout with an ointment. p. 1923- 1941.

His son Theodoric (1205-98). 4 G. Franchini. "Theodoric. p. Riesman. p." Consilia are essentially mediaeval in by 4 character. He D." so the story goes. he was elected to the papal chair as John XXI. 6 All his works have been lost. after his birthplace. 1935. et sa Chirurgie. " The Origin of the University of Bologna. iv. The Story of Medicine in the Middle Ages. owing to a series of unexpected events. Taddeo attracted many students. his chief claim to fame lies in his introduction of a new form of medical literature. became " Chyrurgia. giving a description of the symptoms and full details of treatment. HUGH OF LUCCA (Ugo Borgognoni). little is known save that he was the leading surgeon of his day. Med.. Hist. " Treasury of the Poor. i. and Dante is said to have attended his lectures." which reveals Bishop of Cervia. who deservedly acquired high reputations. There were also at Bologna two surgeons. xxiii. 285 D. " A Physician in the Papal Chair. vol. was appointed physician to Pope Gregory X.MEDIEVAL MEDICINE A Our list Medical Pope of distinguished Montpellier students may approa brief mention of a physician who became PETRUS HISPANUS Pope. Of the father. father and son. He met a violent death when the ceiling of his palace fell on him " as he was priately close with admiring himself." was very popular. de 1'Ordre des Prcheurs. 347 L. 3 Although he wrote many commentaries." These were discussions of clinical cases. combining theology with medicine in the fashion of the day.. New York. Riesman. vol. Karl." Bull. p. v. 1 His best known work. Sometimes these " " notes were sent to unseen patients. p. Med. 1277) was born at Lisbon. vol. d'Hist. Yet he was the only Pope Medicine and Surgery at Bologna 2 One of the earliest teachers of medicine TADDEO ALDEROTTI (1223-1303). 1936. vol. (c. 1923. and reflect the scholastic type of medical philosophy. called "consilia." Ann. H. "Ann. p. 189 Universities of Europe in the Middle Ages. 140 "5 . Mtd. Thesaurus pauperum. who died in 1252. or supplied to practitioners " " " consultants. whom Dante met in Paradise. A little later. and after a brilliant career as a student of theology and medicine. Hist. t 1929. sometimes at Bologna was called Thaddeus Florcntinus. Rashdall. 1932. and wrote a him as one of the most original surgeons of all time.

The root was therefore The Greek Herbal of Dioscorides ed. as the plant when uprooted uttered a shriek. 1934." This is probably the earliest reference to 1 Mandrake was also regarded as a cure surgical anaesthesia. 76 . iii. Dioscorides (first century A. IV. p. That living mortals hearing them. one of the most ancient of herbal remedies. Book IV. 47 The last-mentioned quotation refers to the widely shared belief that the gathering of the mandrake was not without danger. has a long tap-root. It may be convenient at this point to interpolate a note regarding mandragora. for sterility (Gen. and are depicted in many herbals. 4 Or have we eaten on the insane root takes the reason prisoner? That Macbeth. v. Romeo and Juliet.A HISTORY OF MEDICINE was one of the first to state that the formation of pus in wounds was unnecessary and undesirable. imings dipped in wine. . and soaked in hot water pregnated before being inhaled by the patient. male and female. III. Gunther. who heard it." and he notes " that do not apprehend the pain because they are overborne they with dead sleep. This plant. shi ieks like And iii. I. and bearing some resemblance to the human figure Indeed. with mandragora and opium.) (Plate xxvi). . 14). tinguished by As for its use in medicine. I. 85 mandrakes' torn out of the earth. or mandrake. were disthe ancients. great gap of time Antony and Cleopatra. which has already been mentioned as an ingredient of the so-called anaesthetic sponge (page 108). which caused the death or insanity of those 1 .D. iii. still common in the Mediterranean area. Shall ever medicine thee to that sweet sleep Which thou ow'dst Give yesterday. xxx. T. Oxford. and he favoured simple dressHe also used an anaesthetic sponge. run mad. writes in his herbal that to " the wine of the bark of the root " is be given to such as shall be cut or cauterised. often bifid. That I might sleep out My Antony is away. Othello. R. two varieties. Shakespeare refers repeatedly to mandragora and its effects. nor mandragora. as the following quotations " show : Not poppv. Nor all the drowsy syrups of the world. 331 me to drink mandragora this .

' kM ) Mandiagoia. as n pit s< ntccl in <ail\ luibals. slum ing (pii*(_s the fancied j^lant to the human imjurt 116-17) of the Mandragora. (r b> an Anglo-baxon artist of the thirteenth ctntury.PLATE XXI THE LEGEND OF MANDRAGORA %$4 >0. (MS in British Museum) (/ ) ) . \Mth the dog used in gathering the root (Tiorn an early edition Herbal of Apuleius A more fanciful version of the mandragora Itgend. or Mancliakf rest mhlance oi th< .

PLATE XXII ANATOMY IN MEDI. 1 he hones are depicted according to pie-\ tsalian ideas Mnuature ironi a inaiuistnpt of Ciu\ de Clhauluu \ Chiruri>ia. copied Irs Jtan Tourtur for tlie Duke of Bedford (pai^e 123) .-EVAL TIMES \ ttachei of anatomy in the fourteenth rrntur\ demonstiatmc: tlie skeleton to his pupil.

" it is to adopt new operations because. indicated the need for anatomical know- 3 He advised the dry treatment of wounds. He distinguished between venous and arterial haemorrhage. 1925 Anglo-Saxon Times (Fitz pa trick Lectures). quiet. Another great teacher at Bologna was WILLIAM OF SALICET (Gugliemo Saliceti. and with downcast countenance. Hist." and he said that there should be little conversation with the patients' friends and relatives. to quote his own words.D. practised medicine for the sake of gain.MEDIEVAL MEDICINE merely loosened by the digger. . and then fell down dead. and he contributed to both. and J. but also of anaesthesia. Take the other end. vi. to operate ia any method in common use. "European Anatomy 448 C. thus anticipating a muchneeded reform. not only of antisepsis. association of dropsy with nephritis. William aimed at the reunion of medicine and surgery. he preferred the knife to the cautery. which completed the process of uprooting.) who writes. He noted the Unlike the Arabs. 117 . way By this Some of the monks. F. Thus do we find in Theodoric of Bologna a pioneer. so that he may not reach it. pp. The Evolution of Anatomy. finding that supernatural cures were sometimes unavailing. and tie it to a dog's neck. and treated it by copious HENRI DE MONDEVILLE (1260-1320) was an advanced surgeon who. dangerous for a surgeon. like his master. Med. he advised them to be " reflective. 1934. Explicit directions to be followed by the mandrakegatherer are given in the Herbarium of Apuleius (fifth century A. William of Salicet had two distinguished pupils.. " When thou seest its hands and its feet." Ann. Payne. 1904. p." * Mediaeval . but he hesitated ledge. 307. 2 In his sound words to physicians. and he emphasized the importance of a knowledge of anatomy. T. Henry de Mondeville and Lanfranc of Milan. and then attached to a dog." time the Church was losing its hold upon medicine. 1210-77). vol. illustrations often represent the dog tethered to the mandrake root (Plate xxvi). 72 before Vesahus. draughts of oxymel and barley water. English Medicine in 1 W. Dempster. so that the hound be hungry next cast meat before him. except he jerk up the wort with him. giving an impression of wisdom. the two great adjuncts to surgery which did not meet with general acceptance until six centuries later. then tie thou it up. Singer. 1 different to that who is not of repute.

p. namely.. 1935* vol.*' Like the monks against whom he railed. to " solace him by playing on a tenstringed psaltery. translated into French by Nicaise. he states that no surgeon can be expert who does not know medicine. Although some amusing sayings of Henry de Mondeville have been quoted. Castiglioni.A HISTORY OF MEDICINE it was against such that Henri de Mondeville took his stand." is One final quotation reveals Henry. the friends should be excluded as they may faint and cause a disturbance . so I advise you to call in a surgeon." Obviously the rivalry between physicians and surgeons was keen. His surgical works. or Henricus as he literature. he should be told that the and that he is elected. 1894. Nevertheless. " false letters if may be written telling of the death of his enemies. Nicaise. La Chintrgie de Mattrt Henri de Mondeville. he should say. His progres" God did not sive outlook is indicated by his caustic remark that exhaust all his creative power in making Galen. just as no one can be a good physician if he is ignorant of surgery. Paris 1 Montpellier did not long remain the most important medical Other centres of learning were coming into and Padua s were about to take leading places E. were published in an elegant edition in 1893. he himself did not fulfil the highest ethical rules when he suggested that in order to sustain the spirits of a patient.* Paris and Padua school of Europe. prevents me from attending you any longer. a canon of the Church. he may have been merely indulging his sense of humour. even in the Middle Ages. He certainly was doing so when he suggested that if a physician were " My business attending a patient without result. Speaking of the need for a close relationship between medicine and surgery. 214 . Med. ." Perhaps it is best not to take Henri de Mondeville too seriously . he or he is He tells us that expected to be well paid for his services. A. Medical History from the Earliest Times." He adds a more reputable is dead bishop means of cheer. " when treating an accident. Hist. the picture. Paris. vii.2I 4 . as the far-seeing often called in and broad-minded scholar. he must be regarded as a sound surgeon and anatomist. Withington. P. T. 1893 " The Medical School at Padua/* Ann. nevertheless sometimes a higher fee may be obtained from persons fainting and 1 breaking their heads than from the principal patient.

iii. white of egg. he was obliged to flee from Italy to France. so that he may be able to state his views clearly and give good reasons for his beliefs. an unusual accomplishment at that time. A History of Magic and Experimental Science. Lanfranc held his finger to the spot for an hour. while an assistant fetched a styptic of frankincense. Introduction to the History of Science y 3 vols. 874 1 J J. 6 vols. Coulton. 1894 G. and minor surgery were still in the Lanfranc was a popular teacher. and he deplored hands of barbers. he regarded pressure as the best means of arresting haemorrhage. vol. 1 It was Lanfranc. already mentioned became the leader of French surgery at Milan. Lanfranc (St. no G.. Medieval Medicine. 1931. but had also acquired a familiarity with Greek. and he was a cautious surgeon who did not operate for stone or for hernia. "9 . at the University of Padua a university which was destined to play so large a part in the renaissance of medical learning there was a teacher whose advanced ideas helped to prepare the ground for that great movement. he was well received in Paris.J- . He had a high ideal of his calling. aloes. and in 1295 he became a member of the surgical school of St. a procedure which had been neglected by other the fact that venesection surgeons. 3 Meantime. vol. Come Gumo Unlike his teacher. as a pupil of Salicet. and hare's fur. Washington. including the importance of careful suture of the ends of divided nerves. favoured the cautery. 69 4 L. ii. 1920. Thorndikc. ii. but 9 LANFRANCHI (d. Salicet of Bologna. p. 1079 Lanfrank's Science of Cirurgie... No. Lift in the Middle Ages. New York.MEDIEVAL MEDICINE in the history of medicine. p. vol. He held that a surgeon ought to be well versed in philosophy and logic.. and it is recorded of him that when a child fell with a knife in his hand and wounded a vein in the neck. Already a distinguished surgeon. PETER OF ABANO 4 1 1 had not only travelled far in search of knowledge ( 250-1 3 5) before settling in Padua. 4 vols. Cosmas). he treats of many things. 1315) spent the early part of his life becoming involved in the Guelph and Ghibelline 2 controversy. p. 1396. In his Chirurgia Magna. Walsh. Sarton. Part 2. G. 102. Early English Text Soc. p. 1 923-41. 1928-29. who in those early days. who added largely to the reputation of Paris as a medical school. He was thus in a position to read the classic writings in the original tongue. written in 1296 and printed in French in 1490. Though he was acquainted with the ligature.

thus difficult to estimate his influence According to Neuburger. The problem of pain. and on which side should one sleep. and that Lazarus might have been in a trance. and as many have tried to do since. how many meals a day should be eaten. in order to preserve the chrono- mention two great scholars.. and he Nevertheless. indeed. ii. English whom exercised an influence upon the intellectual life of his time. 1 Roger Bacon and Albertus Magnus It is convenient at to this point. so long as the light of scientific freedom shall shine. 1 8 D. Indeed. place was not appreciated until many years after his death. The Story of Medicine in the Middle Ages. 616. and to interpret them to his students. Thorndikc. vol. p. 1935. had an enormous therefore burned in effigy. and his fortune was confiscated by the Church. are among the matters he debated." Like so many other pioneers. and when eventually he dared to suggest that certain miracles could be naturally explained. 2 It is of his time . (Full discussion of work of Roger Bacon) I2O . 75 L. his life was no longer safe. It is for this reason that his principal book. Riesman. as many had attempted before him. and his friends were obliged to hide his body. he incurred the displeasure of the Church. His services were greatly in demand. It does not surprise us to learn that one of so inquiring a turn of mind should have found himself at variance with the Church. ROGER BACON (1214-94) was a scholar with ideas far ahead so much so. Thus was the search for truth requited in the Middle Ages.A HISTORY OF MEDICINE unaltered by the process of translation. His views were those of Aristotle and Averroes. it was only his death from illness that saved him from being burned He was alive. is known as the " Conciliator. which deals with medicine and much else besides. foe. the one an logical sequence. p." His discussions of fantastic problems and curious questions resemble those of Sir Thomas Browne. time to the study of philosophy. one whose name can never be erased from the annals of the intellectual development of man- kind. that he seems a little out of a as mediaeval The full significance of his work figure. and he sought to reconcile philosophy and medicine. n/. New York. he is " upon current thought. he devoted much practice. the other a German Dominican. each of Franciscan.

earning there the title of a of he man was to able means. one of the most learned men of the Middle Ages. Redgrove. 1922. regards this work as " a primarily compilation. with the invention of the telescope." ^Paris for a time. Medicine had strayed back into the paths of Aristotelian philosophy. containing as it did many original botanical observations. Singer. and with the foretelling of aviation and mechanical transport." in Singer's Studies tn History and Method of Science. n. Scholasticism. 1921. De Vegetabilibus. p. an active observer and tireless experimenter. but rather a physicist. and he has been credited. 1921. he was a close follower man of encyclopaedic knowledge. effect of the experiment. try centuries the famous dictum of John Hunter. His book on this subject. Roger Bacon and the State of Science in the Thirteenth Century. Paris. This could only be supplied by one such as Roger Bacon.MEDIAEVAL MEDICINE and was imprisoned for fourteen years towards the end of his career. and philosopher." in ii. 2 Unlike Bacon. life and reality. rightly or wrongly. Ancient and Modern. a Dominican monk who taught at Paris and at Cologne. ALBERTUS MAGNUS (1192-1280). Steele. Daremberg. however. p. Being spend large sums of money on experiments. spectacles. " Albert le Grand et THistoire des Sciences au Moyen Age. his writings include not only philosophy and theology but all the A natural sciences. who appears to have anticipated by many " Don't think. Many of his writings still remain unpublished. and gunpowder." in La Mtdecine : Histotre et Doctrine. vol. Singer. vol. remained an authority for many years. and the salutary a new outlook was sorely needed.). written about 1250. the diving bell. and interpreter of Aristotle. C. A student of Oxford. p. 73 121 . mathematician. 121 C." Associated with Roger Bacon in Paris was Albert von Bolls tad t of Swabia.C. with its futile discussions that had no bearing on was the philosophy of that day." based on the work on plants by Nicolas of * Damascus " (first century B. " Greek Biology. he taught in " Doctor Mirabilis. 1865 H. 44 Studies in the History and Method of Science. and though he dealt in magic and astrology he was also an authority on the healing virtues of plants.* 1 R. which naturally limited his work. and the first edition of his Opus Majus was not printed until 1 733. he must have influenced medicine by his continual insistence on the value of experiment as opposed to argument. the microscope. Alchemy. 1 Although he was not a physician.

trans. Tht Evolution of Anatomy. pointed out from afar the various scholars and professional students. and lasted for only a few days." part was made by Mondino de Luzzio. as well as to physicians and a perfunctory examination of the contents of the abdomen and thorax. the teaching of the subject remained theoretical owing to the prevalent antipathy to dissection of the human body. 1 Interested in public Under affairs. he also took part in the government of the city. or MUNDINUS (ca. took executed criminal. describing in his book the natural members or parts associated with digestion. for judicial issued reasons. Singer. nerves. It consisted in which had been exposed. At the University of once year. In 1300 Pope Boniface VIII had a Bull forbidding the boiling and dismemberment of the bodies of dead Crusaders so that their bones might be sent back to their native lands.A HISTORY OF MEDICINE The Restoration of Anatomy Although the value of anatomy as the foundation of medicine gained recognition in the later Middle Ages. while the professor. was occasionally practised. a or even less frequently. by part. The first attempt to remedy this condition of affairs and to " " " introduce the systematic teaching of anatomy. The stomach is described as spheroid. The cranium was seldom there was no systematic dissection of the muscles." The dissection was open to men. 1995. and opened. who was born and who taught at Bologna. the liver as 1 * C. 74 G. is the first practical manual of anatomy. 1275-1326). it was decreed that All who take part the body of a criminal shall be dissected. place " for every three years Tubingen. His Anatomia^ written in 1316. Post-mortem examination. 1275-1326). his guidance anatomy became recognized as the essential basis structures of the medical curriculum. and it is not easy to differentiate between such autopsies and public dissections. The actual work was performed by a menial. Singer. and the animal members or parts within the head. seated on an elevated platform. the spiritual members or thoracic contents. of Anathomia of Mundinus (Mondino dt Luttt. p. 2 It is true that he perbe called the petuated the errors of Galen. and he is therefore entitled to " " restorer of anatomy. and vessels of the limbs. example. But it gradually became permissible to dissect in public the body of an This procedure. the anatomia publica. shall attend a mass for the subject's soul and shall afterwards attend the remains to the grave. 1925 122 .

the peritoneum is Siphac. and of casting aside his dignity in order to become his own demonstrator. " 1 C. A Study in Early Renaissance Anatomy " in Studies in the History and Method of Science. 2 vols. The abdominal wall is called Mirach. but to do so would be sinful. 8 It was in his later years that he wrote the book which perpetuated his fame. Walsh. gives as for the bones. He was a scholar of wide learning. New York.MEDIAEVAL MEDICINE possessing five lobes. the heart as having three ventricles. GUY DE CHAULIAG (1300-67). until replaced by words of Greek or Latin origin. p. Surgery also "Restored" The most famous surgeon of later mediaeval times was a pupil of Mundinus. Classic Descriptions of Disease t 1932. 258 . Yet. Alexandra Galiani. vol. and the brain as under the control of a red worm (known to us now as the choroid plexus). D. H. Major. the first step in this direction. though he fortunately recovered." Many He To crown all. Arabic nomenclature remained in use for many years. 1914. p. 1920. uterus.. and Guy was himself a victim. 4 Guy was well qualified to write the Chirurgia Magna. Crawford. Plague and Pestilence in Literature and Art (Fitzpatrick Lectures). the Anatomy of Mundinus remained the standard textbook for two hundred years or more. but he took editions. Petrarch's Laura died then of plague. 118 1 R. 1917. and there were forty subsequent Mundinus did not revolutionize anatomy. Medieval Medicine. He was wont to carry out the work of dissection with his own hand. Clement VI. The Story of Medicine in the Middle Ages. the son of a French peasant. 115 and 120 R. where he gave devoted service during the terrible plague epidemic of 1348. the omentum Airbus. Singer. he depicted a seven-chambered a most superficial account of the extremities and of his anatomical terms are Arabic. Riesman. J. 123 . he remarks that these might be better studied " if cleaned by boiling. and to two of his successors. in spite of all its imper" " fections. 73 . p. pp. 2 Most of his life was spent at Avignon. 1 It was eventually published in Padua in 1478. 79 * J. i. that of leaving the professorial chair. Perhaps the time was not yet ripe for that complete reorganization of anatomical knowledge which was to be carried to a logical conclusion by the scalpel of Andreas Vesalius. studied medicine and theology at Montpellier and " " to physician and chaplain Bologna. . 1 93 5 p. and eventually became the Pope at Avignon. assisted by his brilliant young girl pupil.

Speaking of fractures of " After the application of splints. vol. 1898. It is not surprising that his treatise was the authoritative text. sober. GcschichU der Chirvrgie. in place of simple dressings. and that Malgaigne wrote of it that never since Hippocrates had there been a surgical work so clearly written in so few words. as. the first work of this kind since the time of Celsus. 77 L. stone. p. Berlin." 2 He was interested in the radical cure of hernia." " His noble ideal of his calling is shown in his remark.. not greedy of gain. a contrivance for which many thousands of patients have since been grateful. Bd. He may have been the first to employ extension in the treatment of fractures. 1923-41. A History of Magic and Experimental Science. He reproaches " his immediate predecessors for following each other like cranes. When he did operate. In this classic text Guy gives an account of medical history. he writes to the foot a mass of lead as a weight. in French. for he based his writing upon observation and experience. in surgery" (Plate xxn). 3 vols. though By his and forceful method of he dogmatic expression perpetuated certain surgical methods which ought rather to have been improved. The original manuscript was in Latin it was first printed. and no mere copyist. and cataract were still in the hands of the itinerant quack. though he did not advise operation in every case.A HISTORY OF MEDICINE a good physician as well as a surgeon. I attach the thigh. and he criticized the prevailing method of sacrificing the testicle in order to A obliterate the canal. taking care to pass the cord which supports the weight over a small pulley in such a manner that it shall pull on the leg in a horizontal direction. and was largely used until the sixteenth century. Gurlt. in other respects he was a reformer." himself he rather closely followed Albucasis. Thorndike. p." He also suspended a rope above the bed of the patient so as to facilitate changes of position. 518 124 . pious. . and with a sense of his own dignity. he placed the patient in what we now call the Trendelenberg position. Guy insisted on " without which one can do nothing the importance of anatomy. ii. and merciful. preferring the use of a truss whenever possible. good surgeon should be courteous. giving rules for the care and cleansing of the teeth so as to prevent : > E. He deplored the fact that operations for hernia. iii. for example. and he well deserved the title of " The Restorer of Surgery. 1 Nevertheless. in 1478. New York. He also made a noteworthy contribution to dentistry. the use of salves and plasters and of the cautery.

Just the opposite the pedestrian figure hospital. which is also illustrated in Plate xxiv (page 128 .PLATE XXIII A MEDLEV\L HOSPITAL The gateway of the Street of the Knights at Rhodes.

formeil) guarded b\ the Clolobsus .PLATE XXIV THE KNIGHTS OF ST. JOHN AT RHODES (iatev\ay ol the hospital (sec Plato x\in) Court \ard oi the hospital (pasro 1281 Lntiame to the harbour of Rhodes.

which consisted in boldly incising the wall and checking He was careful to recognize the bleeding by sponge pressure." as a cure for epilepsy. as for instance. travelling long distances to operate. continuing as long as the patient lived. and advising the replacement of lost teeth by other made of bone. The patient was to wear for a month a sheet of paper bearing and was to say daily three Paternosters and three Ave Marias. counselling them to cultivate modesty. that no operation should be time. and he was present at the battle of Cre^y. Apparently his practice was large. who wrote an illustrated treatise on fistula in ano (edited in 1910 by Sir D'Arcy Power). Haemorrhoidst and Clysters . 1412. Early English Text Society. of Fistula in Ano. " the words Melchoir. No attempted. he removed to London. most of the work of John of Arderne is still in manuscript form. charitableness. noting that treatment can only be palliative. " De Arte Phistcale 1922 Sir John Arderne. Jasper. always with clean hands and well-trimmed nails. D'Arcy Power. cancer of the rectum. he remained for some time in France as an army On his surgeon. John appears to have been an itinerant surgeon.MEDIAEVAL MEDICINE teeth or by artificial teeth decay. 1 Sir : D'Arcy Power. 1 Educated at Montpellier. and clysters. return he practised at Newark. by " 125 . and Balthazar to be written in blood from the little finger of the patient. which reveals him as a scholar and an expert surgeon. John of Arderne was a specialist in what is now called proctology. and studious habits. haemorrhoids. then an important centre and a meeting-place of Parliament later. but the only one of . of which he gave a clear description. and charging proportionately large fees. and included many persons of rank and distinction. and he showed his originality by inventing a new operation for fistula. He set a high moral standard for surgeons. Apart from the edition just mentioned of the treatises on fistula in ano. these words. human English and German Surgeons doubt there were many surgeons in England about this whom we have any clear record was JOHN OF ARDERNE (1307-90). which were paid cither at the time or in the form of an annuity. It is merely a sign of the times in which he lived that John mentioned the use of charms. ed. and to be scrupulously clean in dress and in person. 1910 Treatises et De Cirurgia of Master John Arderne. and that friends should be warned of the fatal issue.

1924. Brunschwig. Allyn. p. " the According to Garrison. H. F. consecrated Pope drifted helplessly in the North Sea and the without crews Ships and Mediterranean. 194 " The Black Death and the Medieval Universities. causing the death of about a quarter of the 4 Half the people of London died. t 1925. a manuscript on bandaging and the treatment of wounds. His Feldtbuch der Wundtartzney extracted bullets with special instruments.. Geschichte der Chirurgie.A HISTORY OF MEDICINE to Although their work was of later date. but not boiling. 2 He wrote the Buck own one of the der Cirurgia Hantwirckung der Wundartzny in 1497. i. the Biindth-Ertznei. 640. E. though his work is interesting in containing a first brief reference to the extraction of bullets. the Black Death. Hist. "Hieronymus Brunschwig of Strassburg. aao . H. in 1460. HEINRICH VON PFOLSPEUNDT x was a Bavarian army surgeon who wrote. 3rd ed." Ann." Ann. Med. Hist. 226 126 . vol. M. An vol. contains some unique illustrations (Plate xxvi). Med. Med. (Brunschwig's Cirurgia was reprinted in facsimile in 191 1. Gurlt.) Introduction to the History of Medicine. He checking the haemorrhage by pressure and styptics. who had for forty years in appeared in 1517... and to plastic surgery of the face. which devastated the civilized world in the fourteenth century. 1925. and dressed the wound with warm. " The Black Death. it is here convenient mention three German surgeons whose works. vii. after served various campaigns. ii. noteworthy as first illustrated medical works. Hist. D'Irsay. p. The Black Death some reference account of mediaeval medicine would be complete without to the terrible and widespread epidemic of plague. like Brunschwig's. Central in Asia. 187 A. oil. indicate how war promotes the art of surgery. Garrison. S. Amputation stumps he enclosed in the bladder of an animal. Brunschwig gave first detailed account of gunshot wounds in medical literature. and now a rich prize for collectors. 1939. His main concern was with arrow wounds. p. the plague spread along the trade Commencing 1 No Often misprinted Pfolsprundt. His book. the Rhone so that bodies might be cast into it. vol. vii. vol. which was discovered and printed as recently as 1868." 3 A still more extensive account of military surgery was given a little later by HANS VON GERSDORFF." Ann. an Alsatian named HIERONYMUS BRUNSCHWic. 1898. spread the infection when driven ashore. written in their tongue. About the same time there lived another army surgeon. p. At Avignon the population.

how many lair Ships arriving from the Levant and Egypt were isolated at special ports. which were heaped by the hundred in vast trenches. 2 was pitiable to behold they sickened by the thousands daily and died unattended and unsuccourcd. p. Crawfurd." Proc. ladies. Religious fanatics went about scourging themselves for This law was It is first easy to understand their sins. Roy. 4 D. as did the black patches on the skin which followed the appearance of the swellings in bodies. although the " plague tracts. 169 " Hist. . or quarantine. 115 " in Essays in the History of Epidemiological Rules from the Past trans. groin or armpit. Boccaccio has given in his Decameron (1353) a dramatic " The condition of the people account of the plague in Italy. Singer. SudhofF. advised blood-letting and the 4 It is interesting to note that a tract of this drinking of vinegar. " Some Plague Tractates (Fourteenth and Fifteenth Centuries)." Treatment was unavailing and measures for prevention were adopted too late. p.. 159 R.3 how Europe was thrown into panic and demoralization by such a dreadful visitation. 1914. Many died in the open street . D'Irsay. p. H. and later for forty. hence the name quaranta giorni. and flocks and herds wandered at large. Treatment was of little avail. Med. Germany. p. Jews were accused of poisoning the wells. 152 Medicine. days .MEDIEVAL MEDICINE raged with great violence in the year spread through Italy and France to England and I348. Med. enforced at Ragusa on the Adriatic in I377. Fields were left untilled. F. others dying in their houses made it known that they were dead by the stench of their rotting bodies. Garrison. * ' Pestilence in Literature and Art. eventually reaching Russia in 1 352. and travellers were detained at port for thirty. 127 . and then at intervals up to the end of the seventeenth century." proceeds Boccaccio. 1927. "Defense Reactions against the Black Death. 1926. . and many of them were burned alive. by which time the epidemic abated. ix.. like The Black aboard goods ship. Haemoptysis betokened inevitable death. vol. ix. 1916. Plague and K. 1 S." written for popular enlightenment. 1348-49. New York." Ann. How many " valiant men. and covered with a little earth. vol. W. which had brought such punishment upon mankind. " breakfasted with their kinsfolk and that same night supped with their ancestors in the other world. Consecrated ground did not suffice for the burial of the vast multitude of routes to Europe. Soc. 1 where it It . though it returned in less violent form a few years later." Death showed itself in both pneumonic and bubonic forms. Of the latter the most important was quarantine.

others for of earlier date throughout the country. their spacious wards having tiled floors. then at Rhodes at Malta ( 1 530) The organization. Med. 3rd ed. public to flee far and quickly. Jerusalem. An E. History of Saint Bartholomew's Hospital. 23. and it is easy to understand how the first were of ecclesiastical foundation.* as Sir Norman Moore remarks. 1918 (cf p. Writers of the plague tracts advised the cloves. p. and were under the control of the Church (1311) and eventually . 1938. and by the fourteenth century many of them were lay institutions.A HISTORY OF MEDICINE nature the first medical book to be printed in Preventive measures consisted in fumigating the house by burning juniper and other aromatic substances. Church to the municipalities. some of them for the pilgrims and travellers or for the aged. E. Whatever obstacles Church may have placed in the path of scientific medicine. and a dress which covered him com" " nose bag pletely. advice which Medieval Hospitals from the hospitals The care of the sick poor was a duty incumbent upon Christians earliest times. and to return slowly. though there were varipus hospitals mew's in 1 1 and St. Hist. in the provision of housing and nursing for sick and wounded persons. 1924. and cinnamon. 1 England The physician wore gloves. retained has vastly changed. naturally spread the disease. 1 F." Sir Bull. Graduadministration of hospitals passed from the the ally. 495. vol. there was no hindrance. sick. 2 vols. may have been (in 148s). where it was established during the Crusades by the Knights of St. 195 of the Knights Hospitaller of Saint John of vi. with a containing a sponge soaked in vinegar. H. : Thomas's in 1215. Bartholotime. 398. Moore.. Some of the great hospitals of London were founded at the St. 677 N.. 1 Hume.. St. and Each had an ample water cubicles with beds for the patients. 82) 128 . John 2 (Plates xxii and xxm). arrangements supply. can claim to be the oldest British hospital of any great size. " The Medical Introduction to the History Work of Medicine. The Knights established themselves first at Jerusalem. however. Many fine hospitals were built during the later Middle Ages. large windows. for the and disposal of sewage. though its ideal and exists to this day. Bartholomew's. the One of the first examples of those mediaeval hospitals may still be seen on the island of Rhodes. but rather encouragement. Garrison. pp.

was printed at Milan in 1924 (Cf "\\ound Man. translated by Sudhoff and Singer and edited b> Sis?iTist." Plate xxwn) . of v\hirli a magnificent edition.PLATE XX\ ZODIAC MAX 6( t injnpiHma munDt ofti to r vg\ tmc cfr tr Ijr cvditm t Illustration fiom Faicuulut Medicma of Johannes Kttliarn. 14^1.

PLATE XXVI MECHANICAL AIDS TO MEDICINE AND SURGERY \ppluaiion of pusinglv i modem \tensioii apparatus to afiartured arm 'J ho procedurt in pimciple. dtsdilx-d and illustintrd b\ BiunB\ mrans of a \\inch thr patirnt i^ suspended (. \\ondcul horn (tirsdoifFs beldthuch der ! sur- \\*wid- scluMc: in his of expelling a \\orni from thr both.tritrg?a. 1407 head do\\m\nids o\er a basm of hot Boat's milk As the \\orni en ic rues to drink the milk tlie \\mch is \\onnd up until the rntnt \\onii is dislodged (page i->6) Method .

MEDIEVAL MEDICINE Besides hospitals there were institutions in which lepers could be segregated and nursed. The Evolution of Anatomy. ed. 1907. medicines or for drawing blood was ascertained by a study of those constellations and of the moon." in which the structures were shown in a very imperfect and unnatural fashion. the five-figure series. A. <42) 190 ' C. 1914 I2 g 10 . Tradition und Naturbeobachtung in den Illustrationen Medizwischer Handschnften und Fruhdrucke vornehmlich des 15 Jahrhunderts. 3 The of Abano. the constellation Taurus controlled the neck and throat." a full-length human figure showing the muscles Another very common illustration was the " zodiac dissected. and was the subject of a work by Dr. xx.. Capricornus The best time for giving to the knees. Jama. 170 K. already mentioned. Sudhoff. and viscera in a series of frog-like figures. When he walked abroad each leper was obliged to wear a distinctive dress. contains the first representation of a " muscle man. Leipzig. 4 443 Introduction to the History of Medicine. of lepers steadily declined. Medical Illustrations Much may be learned from the miniature paintings which adorn medical manuscripts and early printed books. Astrology Medicine (Fitzpatrick Lectures). or houses. 6 Indeed.. Scorpio was related to the genital organs. C. Sudhoff. Leper Houses and Medieval Hospitals (Fitzpatrick Lectures. and to carry a bell or clapper to announce his presence. Only crude efforts at anatomical illustration were made about the time of Mundinus. man" (Plate xxv). 1925. p. Singer. H. showing the relation of the various heavenly bodies to the human frame. p. vessels. Leprosy was a common disease in " " lazar the Middle Ages. 3rd. 2 Our knowledge of those illustrations has been greatly extended by the " " of Peter Conciliator researches of Professor K. Mercier. 1924. a belief widely held in the Middle 4 Ages and still further developed during the sixteenth century. the influence of the moon upon disease was a belief which held sway as late as the eighteenth century. A. when it was customary to depict the bones. 1915 C. * * 1 vol. p. Mcrcier. and Pisces to the feet. find F. 1 existed in Britain and throughout Europe. and numerous leper houses. For example. nerves. Gamson. muscles. and thus wani all number After the fourteenth century the persons to avoid him. and by the seventeenth century the disease had almost disappeared in Europe. usually " five in number.

8 As already noted." showing the position of various wounds and the " Another familiar illustration was the vein man/' showing some twenty-eight veins from which blood could be taken withthe object of removing the materia peccans. the source of infection. The physician. on the same side. was to be preferred. \ol. while the mother of the sufferer stands by." It was PIERRE BRISSOT (1478-1522). p. and feeling the pulse at the same time. Mcd. H. as we now call The Arabs taught that blood should it. or water casting. subject persisted in more recent paintof was the disease ings. is shown holding up to the light the flask containing the patient's urine. who " derivation. as History of Anatomic Illustration. consisting sites for ligation of arteries 1 (Plate xxvin). 1927 M. and having his fingers adorned with rings. vol." used by pointed out that the contrary method of in the lesion. Frank 130 . Many We 1 Ci. J P. Gesch. xxx. how operations were conducted. Coiner. Volksmedizin in den Wandmalereien des deutschen Mittelalters. and many another Thus may one learn history without the interesting scene. 1852. another common which also of illustration. Surgical works of mediaeval times often illustrate a " wound man. bv 1936. Med. be taken from a vein at a distance from the diseased part. trans. 271 * L. 1920 F. Washington. anxiously awaiting the verdict (Plate xxxv).A HISTORY OF MEDICINE Richard Mead. Finally. 1902 The Historical Aspect of Art and Medicine. t 1937-38. trouble of reading or translating. Chicago. diagnosis by uroscopy. iv. sometimes clad in his blue ermine cloak and velvet cap. of Paris. Sigerist. Richer. Leipzig. Arch. and near blood-letting Hippocrates. or. f. the early drawings show that the actual work of dissection was not 4 performed by the anatomist himself." Bull. d. the so-called method of " revulsion. VArt et la Mtdecuie. other miniature paintings and early woodcuts inform are shown what a pharmacy us of the medical life of the time. Wcindler. Ghoul ant. p. E. 5 looked like. and from the opposite side of the body. W. Hist. from which much may be learned regarding mediaeval medicine. ' t und Bibliographie der anutomische Abbildung. Geschichte M. 78. In books and manuscripts of the period there are numerous other illustrations. 2 Representations of the anatomist engaged in dissecting and demonstrating were a favourite subject with the Dutch artists of the eighteenth century. Anatomical Texts of the Earlier Middle Ages. L.

written about A. it is said. The name of Fuchs is commemorated in the " fuchsia. 117). whose He? ball (1525) was very popular. was also signalized by the appearance of the Flemish edition of LEONHARD FUGHS'S De historia stirpium (Basel. Turner was followed by JOHN GERARD. was made in A. published in 1597. In his Herball.D. of uncertain authorship. although neither work has any claim to A : originality. sometimes called the Father of British Botany.D. printed in Germany in 1491 and conThe earliest English printed taining many quaint woodcuts. until recently. James I. at Monte Cassino. The most beautifully illustrated herbals of the sixteenth century were printed in Germany. herbals are those of RYCHARDE BANGKES. with its accurate descriptions and fine coloured woodcuts. while the year 1543. Wortcunning and Starcrajl Rolls Series). 1000. Gerard writes of bugloss growing '3* . now in the Imperial Library at Vienna. A new and high standard of accuracy was set by OTTO BRUNFELS in his Herbarium vivae eicones (1530).MEDIEVAL MEDICINE The Herbal in Medical Literature plants used in medicine was days prior to the development A descriptive account of the essential to the physician in the ef synthetic pharmacy. which was transcribed in Modern English by T. 102) " to flying venom or elf shot. London. in which Vesalius and Copernicus published their epochal works. 572 for Juliana Anica. Mention has already been made of Early England of Leech the Book of Bald. and usually known by her name. Cockayne in 1864 (Leeckdoms. Among the earliest " herbals " is that of materia medica libri quinque. of which the only surviving manuscript. author of The Golden Ass. in which infection is attributed (p." The pioneer of English herbalists is WILLIAM plant " TURNER." a current belief in Saxon times. daughter of a Byzantine De emperor. who cultivated more than a thousand different herbs in his garden at Holborn. to be distinguished from Apuleius. who called his book The grete herball (1526). manuscript version of the ninth century was preserved. the potato. Of printed herbals. and in the British Museum there is a Saxon translation. Of later date was the Herbarium of APULEIUS PLATONICUS (p. Dioscorides (p. including. 1542). one of the earliest was the Ortus sanitatis. 62)." whose New Herball appeared in 1551 and was dedicated to Queen Eliza" " to herbalist beth. and of PETER TREVERIS. which had been recently introduced from Virginia. O.

Paradisus Terrestris (1629). and the reader who the study will find complete information in pursue list is the recent works by Agnes Arber a and by Eleanour Sinclair 3 Rhode.. No longer a subject of scientific study. Cambridge. sponsored by * A. 2nd. During the following century there appeared the well-known work ofJOHN PARKINSON. 1649. herbalism was kept alive. The Old English Herbds. or " " and using them to prepare medicines is now compound . from which the present writer has derived most of the above data. The strange myth was believed for several centuries. " that 1 This first Pharmacopoeia in Britain was published in 1618 . editions of both publications appeared until supplanted by the British Pharmacopoeia the Medical Council in General 1864. Even in our own day the latest phase of the subject may be studied in A Modern Herbal by M. S. 1656. published in . Herbalism was becoming divorced from medicine and the rift was widened when NICHOLAS CULPEPER incurred the wrath of the * College of Physicians by incorporating their Pharmacopoeia in his Physical Directory. attached to a stalk. died. 1938 * . during the same year. who wrote A Curious Herbal in 1737 of JAMES NEWTON. fed upon the surrounding foliage. and of a number of other herbalists of repute." simpling collecting plants. and when that was consumed the plant.A HISTORY OF MEDICINE in the ditches of Piccadilly and of marigolds in the marshes of Paddington. and animal. and. Parkinson was the last of the great English herbalists. the College of Many subsequent Physicians of Edinburgh issued its own Pharmacopoeia in 1699. ed. the title including an ingenious word-play upon his owr name. simples. nevertheless. The above desires to by no means complete. Many of the remedies formerly derived from plants are now by chemical processes produced synthetically " art of consequently the " of is. GRIEVE. through the more genuine efforts of WILLIAM COLES. Rhode. of ELIZABETH BLACKWELL. author of The Art of Simpling. The elaborate tide-page of the Paradisus " " includes an illustration of the which was Vegetable Lamb believed to combine animal and vegetable in strange fashion. . in The English Physician Enlarged. Their Origin and Evolution. 1922 132 . whose Compleat Herbal is dated 1 752. London. Arber. the latter being a treatise on astrological botany which had a wide circulation and numerous editions. Park-in-sun. The lamb. Herbals. The first-mentioned contains a number of beautiful woodcuts from some of the early herbals. entitled Parodist in sole.

C. Indeed. J. 1932 PAYNE. Astrology and Medicine (Fitzpatnck Lectures). of Master John 1922 Arderne* RASHDALL. The History of St.. G. by M. and medical botany has assumed a position of minor importance. as it offers to the research worker a field which has not yet been compounding of drugs. The Medieval Mind. New York. Sir D'ARCY.. 191 8 PARSONS. but is also of practical value to the pharmacologist. COULTON. 1886 TAYLOR.. 1928-29 MERCIER. L. 935 SINGER. D. fully explored.. 3 vols. 6 vols. L. O. J. 2nd cd. A. J. Studies in the History and Method of Science.. G.. Herbs have come to occupy a sort of between nevertheless. H. F. 1915 MERCIER. History of Saint Bartholomew's Hospital. H. 2 vols. the drugs and foods nondescript position lore of herbalism is not only of great interest to the medical historian. The Craft of Surgery in England. 4 vols. The Story of Medicine in the Middle Ages. Frank. 1 1923-41 WALSH. F. although we still speak of the .J. F. BOOKS FOR FURTHER READING CHOULANT.. 1921 SOUTH. Sir N. . 1904 " De Arte " Phisicale et De Cirurgia POWER. Thomas's Hospital. Leper Houses and Medieval Hospitals.. G. 2 vols. 1914 THORNDIKE. 1920 133 . 1920 History of Anatomic Illustration. G. A History of Magic and Experimental Science. 2 vols. Medieval Medicine. Life in the Middle Ages. G. The Universities of Europe in the Middle Ages. trans. Chicago. the word " "simpling has become obsolete. 1914 MOORE. 3 vols. 1936 RIESMAN.MEDIAEVAL MEDICINE practised only by a few herbalists. English Medicine in Anglo-Saxon Times.

and from the traditional limitations imposed by the Church. and it affect all mankind generally. a feeling of dissatisfaction with the for . 1910 134 . and by his brother Lorenzo. It was also a change in the entire outlook of thinking men. especially Florence. But more important than any discovery was the change of heart in the people. It would be difficult to assign a definite date to a movement which began so quietly during the Middle Ages. Attainment of the Renaissance ideal was facilitated by various discoveries. where it coincided with that noble period known as the Elizabethan Age. who sought to escape from the tyranny of dogmatic scholasticism. the expansion of the known world by the discovery of America and of routes to the Indies. the alteration in methods of warfare which followed the invention of gunpowder each exercised a profound influence upon the awakening and renewal of culture implied in the Renaissance. 1 From Italy the enlightenment spread to other countries of Europe. ancient learning. Young. The invention of printing. and a humanism in place of the dry and decadent philosophy of living scholasticism of the Middle Ages. G. 1 Nevertheless it is generally agreed that the year Col. Of course the change was not sudden.CHAPTER VIII MEDICINE OF THE XV AND XVI CENTURIES: REFORMERS AND REVOLUTIONARIES THE wonderful phenomenon of the Renaissance. and eventually to England. Cosimo de' Medici. did not consist merely in a revival of the ancient classic culture of Greece and Rome. nor did A hard battle was to be fought. The Mtdicis. which began about the end of the fourteenth century and reached its climax some two hundred years later. F. where a renewed appreciation of art and literature had been fostered by the powerful and wealthy ruler. a new standard of human dignity. here and there. At first there arose a demand freedom of thought. the city of Dante and of Petrarch. the appearance of a receptive and unbiased attitude towards innovations. the fight was to last for many years.. We have already noted that in the field of medicine there was. Italy was the birthplace of the movement. 2 vols.

and he pursued his investigation of the deeper parts. eager for information. Hemmetcr. that to turn from the writings of Galen. Ball corporis fabrica. who visualized aviation and modern methods of warfare. gifted in original ideas. Med. less these restrictions were gradually being overcome. Classical ideals were returning. They looked to the anatomists for guidance. and their work was rendered Neverthedifficult by the restrictions imposed upon dissection. 6 vols. the viscera. such as the maxillary sinus and the moderator band of the heart. 1921. M." Ann. 135 . 1910 " Leonardo da Vmci as a Scientist. Thorndik". v. Andreas Vesalius. and the artists were the first heralds of the new age. Mundinus. but his interest grew. to and Andreas Vesalius rendered a his similar service Dr. No longer was the body regarded as a sinful instrument which must be hidden. This Greatest of all was LEONARDO DA VINCI (1452-1519). Raphael. in that Nicolaus because year Copernicus revolutionized astronomy by the publication of his treatise entitled. De revolutionibus orbium coelestium. vol. and others to the beauties of Vesalius' work is " like passing from darkness into sunlight. Med. History of Maqic and Experimented Science. He was the first to demonstrate the ventricles of the brain by 3 injections. wax 1 * J. also made discoveries in anatomy. medicine with De humani Art and Anatomy. 155 "Leonardo da Vinci as a Physiologist. he set out to study the bones and muscles in their relation to art. 1941. a time man centuries ahead of his and versatile artist.REFORMERS AND REVOLUTIONARIES 1 1543 marks a peak in the history of medicine and of science. ui. or as something so sacred that it must not even be investigated. and to depict correctly the foetus and its membranes within the uterus. vol. Louis. 4 Originally.. L. and Albrecht Durer. Leonardo da Vinci One of the results of the new outlook was an appreciation of the beauty of the human body. but the anatomists were still slaves of tradition. iv. p.. 1932. J. 4 26 E. remarks. the Reformer of Anatomy 9 St." Ann. vol. and who discussed many problems of engineering which were later put into practice. did not hesitate to use the scalpel so as to satisfy themselves regarding the structure of the human frame. Ball. Among the great artists who engaged in dissection were Michael Angelo.. and some of the bolder artists. C. in his biography of Vesalius. 406 M. Baumgartcn. < p. Hist.'* 2 Vesalius is chief among the great medical men of the Renaissance. Hist. p. J.

New York. an approach to medicine which has been adopted by many a boy since then. and especially the heart. Berlin. Leonardo da Vinci the Anatomist. vol. 1930. Spielmami. and other small animals. MacCurdy. Harvey Gushing. 1938 1 M. Ball. Singer.A HISTORY OF MEDICINE the brain. and have only recently appeared in print. but another parts of anatomy from his lectures. G. He received a good education at the University of Louvain. he alleged that the human body must have become changed since Galen's time. 1943 136 . dissected dogs. ed. Louis. great-grandfather. "Les Portraits de Vesale. 1478-1555). J." in Studies in the History and Method of Science. excellent teacher. C. Cardan tells us that Sylvius taught " from fragments of dog's limbs." Janus. 2 vols. H. 1910 . It is only within recent years that the value of Leonardo's contribution to anatomy has been fully appreciated. the blood vessels. learning not only Greek and Latin but also some Hebrew and Arabic. standing. 151 Leonardo as Anatomist.. Baltimore. J. The Truth about Anatomy. M. 4 Young Andreas. mice. He made hundreds of sketches and manuscript notes. although an was so close a follower of Galen that when he found any anatomical structure which did not conform to Galen's description. 3 A native of Brussels. Among his teachers there were Sylvius and Guinther. Thence he proceeded to Paris to study medicine. Andreas Vesalius foremost anatomist of the Renaissance. professor at Leyden a century later. P. 1914. and his grandfather. Hopstock." and that he omitted the difficult (It was not he. Roth. he belonged to a medical family. Andreas Vesalius. of the same name. who first tion. anatomists of the old school. and indeed of was ANDREAS VESALIUS (15 14-64). This apostle of naturalism in art must also be regarded as a leading pioneer in anatomy. we are told. McMurrich. but this project was abandoned owing to the death of his co-worker. p. The Notebooks of Leonardo da Vinci. 1 He intended to publish a great work on anatomy in collaboration with Marco Antonio della Torre of Pavia. many of which are preserved in the Royal 2 Library at Windsor. De Lint. xix. . 1892 . A Bio-bibliography of Andreas Vesalius. J. Reformer of Anatomy t St. " 4 M. The Iconography of Andreas Vesalius f 1925 . 1921. 416 1 H. the Andreas Vesalius Bruxellensis. each with a great reputaJACOBUS SYLVIUS (Jacques Dubois. (The most complete work on the subject) 1 E. p. His father was apothecary to the Emperor Charles V. and great-great-grandfather had all been medical men of good all The time.

Vesalius pursued his studies at Paris with great energy and enthusiasm. where he attained eminence in practice and in teaching. P-435 137 . 1914. xix. and when owing to the outbreak of war he was obliged to return for a time to Louvain. vol. and even spoke of him. Guinther made no great contribution to anatomy. named Jan Stephan van Calcar. His search for material led him. Vesalius travelled to Italy. which proved of great value in his studies. to whose career let us now return. 5 " the Ninth Book of Rhazes Almansor. who was so poor a student that he was obliged to beg in the streets. M. but now he concentrated his attention on anatomy. at great personal " " risk. almost complete and with ligaments intact. but as Vesanus (madman). he secretly bore home his trophy. On In Padua he lectured to a held courses of instruction there. Vesalius. "Die Schriften des Andreas Vesalius/' Janus. not as Vesalius. was appointed Professor of Anatomy in Paris. seated for 500. and busied himself with the 1 Already he had translated preparation of his great Anatomy. a man of humble birth. Vesalius now entered the most strenuous and productive two occasions he visited Bologna and years of his career. He strongly disapproved of the anatomical discoveries of his pupil." a compendium of treatment which became a valuable textbook. Appointed Professor of Surgery and Anatomy at Padua in 1537. but he was one of those who recognized and encouraged the work of the young Vesalius. whence he had retired. On the completion of his course at Paris. 44 whose pestilential breath poisons Europe. that the current teaching was full of errors 1 F. to undertake various body-snatching expeditions. but who nevertheless became Professor of Greek at Louvain. as he continually found. Fcyfcr. he found on a gallows outside the city walls the skeleton of a criminal.REFORMERS AND REVOLUTIONARIES described the fissure of Sylvius in the brain. a student of art and pupil of Titian. crowded classroom. Aided by a friend. in the course of his dissections. who later drew the wonderful wood engravings which adorn the works of Vesalius." Very different was JOHANNES GUINTHER (sometimes written Gunter or Winter) of Andernach (1487-1574). At the age of thirty-eight he turned to medicine as a career. and so rose in repute that he eventually became a nobleman of Strassburg. and at Venice he met another Belgian.) Sylvius of Paris was not liberal in his judgments of the work of others. G.

was produced at the same time. Vesalius also helped to found the science of anthropology when he noted that the Germans had round heads. mechanism " or " working. for the author sought to depict the body in action. entitled Tabula Anatomicae. but in the second he states emphatically that there are no such openings. showing cherubs engaged in dissection and other activities." which Vesalius was twenty-eight years of June 1543. was only an introduction to the magnificent volume. and that the sternum was composed of only three parts. and that blood cannot possibly pass direct from one ventricle to the other. and to teach physiology as well as anatomy. Vesalius corrected Galen in showing that the lower jaw consisted of a single bone.A HISTORY OF MEDICINE that Galen could no longer be regarded as the final authority. their significance. The frontispiece to the Fabrica shows Vesalius dissecting and demonstrating to a crowd of interested spectators (Plate xxvn). of which only and two copies still exist. while the Belgian heads were long. The description and delineation of the structures marks a great advance upon any previous work. published in 1555. generally known as the Fabrica. a word " when He noted the existence of valves in the veins. Even the initial letters are works of art. however. and Vesalius went to Basel in order to superintend the production. although the main interest centres in the plates. Epitome age. The Fabrica was printed in Basel by Joannes Oporinus." arrangement for the In the first edition of his work he admitted the existence of pores in the interventricular edition. which was carried out with the utmost care. a satirical representation of his 338 . No finer anatomical plates have ever been seen than those which adorn the Fabrica. It is no dead anatomy that is here represented. and one of the fundamental data on which Harvey based his discovery of the circulation of the blood. and not seven. extremely rare. The figures of the skeleton and of the muscles are of particularly high artistic merit. This. The subjects are full of life and expression. but did not appreciate was accompanied " mutual flux and reflux of materials. An of the now work. and have served as models for many generations of artists. he deduced that this was simply an septum of the heart. Observing that each artery supplying a viscus by a vein. After a year at Padua he published a series of six large plates for the use of students. appeared in Fabric of the best rendered in English as De Humani Corporis Fabrica (On the Human Body). This was the first stage towards a complete denial of Galen's doctrine. There are seven chapters or books in the volume.

His ideas were strongly opposed in certain quarters. K. " goes through the vena arteriosa to the lungs then." to the through the arteria venosa Re Anatomica. Rosenkranz. at the entrance to the Gulf of Corinth. whose chief claim to fame rests in his discovery of the pulmonary. circulation. island of Zante. 1941. Vesalius was succeeded at Padua by REALDUS COLUMBUS (Realdo Colombo. Little known of his life in Spain. History of Mtdtcin Anatomie. and there. Castiglioni. Padua 1 for Rome. which appeared in 1557. Vesalius died. 2 He demonstrated by experiment that blood passed from the lung " into the pulmonary vein. His epochmaking work had been crowded into three short years. action is uncertain. as their names are familiar to every student of anatomy. f. and his services were highly esteemed. The physician was pardoned only on condition that he would expiate his crime by a visit to On the return journey his ship w as wrecked on the Jerusalem. at the age of thirty. or lesser. but a few of them deserve mention. Gesch. in October 1564. De left heart. 1 With the publication of the Fabrica and the Epitome. mixed with air. which he In 1564 he Madrid The consequences were disastrous.. d. he was is finished." he said. revisited. Vesalius was in the act of performing a post-mortem examination when the subject showed signs of life. Med. 1510-99). New York. But anatomy knew him no longer. From both he received respect and honour. . the brilliant career of Vesalius was virtually completed. One who to revolutionize anatomy and to expose the mistakes of the ancients could not hope to escape criticism.REFORMERS AND REVOLUTIONARIES students. It is said that a nobleman whom he was attending having died. The Pulmonary Circulation The immediate successors and contemporaries of Vesalius were overshadowed by his greatness. " Die Initialen i 937-3 8 V <>1. of Cremona. and now. Columbus published in Vesals - these observations. xxx P. it goes In his book.35 : A. The blood. p. left or in the Netherlands. long after he had left . as might well be imagined in those days of the Inquisition. 435 139 . to proceed on a The reason for such an pilgrimage to the Holy Sepulchre. and he found himself the subject of heated and bitter controversy. and went to Madrid Emperor Charles V and then to his son Philip II. Perhaps it was on that had dared account that he resigned as physician to his chair at Padua." Arch.

xxi." 3 There is. another anahad made the same discovery. at The passage in the Restitutio dealParis. p. Med. rather than to any " Much stronger evidence than circulation. Physician and Heretic. 2 Only three imperfect copies are preserved. Osier. " Michael Servetus. Willis. this point mention may be made of one for whom it is claimed. vol. Nevertheless One these anatomists did much to pave the way for Harvey. It is true that Ccsalpino affirmed that the blood-vessels originated from the heart. though on slender grounds.A HISTORY OF MEDICINE Six years previously. unknown to Columbus. Vienna. vol." Johns Hopk." Ann. Although he also stated that the blood passed from the heart to all parts of the body.. though i W. He was a distinguished anatomist and embryologist. Hosp. of any systemic circulation. and among his pupils was William Harvey. and was also a great botanist and mineralogist." conception of a that at present available would be required to remove Harvey from his accepted place as the great discoverer. pub-lished his account of the pulmonary circulation in a theological work. Condemned by Calvin for heresy. unfortunate Spaniard. he believed that it coursed At through veins and arteries alike. though both observers retained the Galenic idea of spiritus. 287 and Calvin y 1877 140 . and his works with him. 1 The main effect of the book was to focus upon the author the wrath of the Church. ANDREA CESALPINO (1519-1603) taught anatomy at Pisa and Rome. and Edinburgh.. 1928. " transmitted from ing with the circulation states that the blood is the pulmonary artery to the pulmonary vein. x. Restitutio Christianismi. G. 1553. Fabricius made a special study of valves in the veins. 1910. and it appears as though he still " " ebb and flow adhered to the old idea. by a lengthened passage through the lungs. R. p. Williams. nor is the word " tion used. and on that account it attracted little attention. no suggestion in the " circulaargument. that he anticipated Harvey's discovery. H. however. in the course of which it becomes of " crimson colour. Servetus Hist. i " Michael Servetus." and is freed from fuliginous vapours by the act of expiration. and not from the liver as Galen and his followers had affirmed. of the successors of Vesalius at Padua was FABRJCIUS AB ACQUAPENDENTE (1533-1619). and neither appears to have tomist had any The true conception of the general circulation of the blood. MICHAEL SERVETUS (1509-53). Bull. he was burned alive at Geneva on October 27.

emerged many new facts in pathology . the Tabulae Anatomicae did not appear in the lifetime of Eustachius. Withington. Fabricius was these structures He not only an anatomist. and also differentiated measles from scarlet fever. and his work in all these subjects was " in the of outstanding merit. 135 E. Fallopius and Eustackius other great anatomists lived and worked during this period. He took up the work of reconstruction where Vesalius had left it. Withington has claimed that beauty of his personal character as well as in the amount and ideas. his anatomical discoveries were many. p.2I 4 Then they C. During his short life discoveries of the " excellence of his work. 1894. His fame rests chiefly upon the atlas of excellent copperplate illustrations which were completed only a few years after the Owing to financial or other publication of Vesalius's Fabrica. Plater (15361614). Fallopius stands first of Italian anatomists. appreciate. and Ingrassia (1510-80). He held the combined professorship of anatomy. of Naples. order to complete the picture. T. Medical History from the Earliest Tinxs. that such valves were effective only in a one-way current. Casserius (1552-1616). 1 The plates* were lost for 138 years. who made numerous dissections out of which Many brilliant and busy . two men must still be mentioned. Although he was a follower of Galen. of Groningen. but also a leading surgeon who devoted part of his fortune to the building of a magnificent anatomical theatre at Padua. who discovered the stapes and the tensor tympani In muscle. * GABRIEL FALLOPIUS (1523-62) succeeded Vesalius at Padua after the brief interregnum of Columbus.REFORMERS AND REVOLUTIONARIES had been known to anatomists before him (Plate believed that they served to regulate the flow of xxxvr). The Evolution of Anatomy. who gave a complete account of the anatomy of the ear . Singer. 1925. surgery. their names being household words in anatomy. and botany at Padua. was a pioneer in comparative anatomy of earlier dates were Goiter (? 1534-90). as Harvey did. difficulties. who succeeded Fabricius at Padua. P." 2 While Vesalius was at Padua the Chair of Anatomy at Rome was held by BARTOLOMEUS EUSTACHIUS (1520-74). and he was even more forceful than his predecessor in his criticism of the Galenic he accomplished much besides his " and " tubes " which bear his aqueduct name. . of Basel. but he failed to blood.

but it is described in the Epistola de auditus organis. The number of new facts elucidated by Vesalius and his associates was so enormous not surprising that the practical significance of the was anatomy only gradually appreciated. level. led by Paracelsus. The real renais- sance of surgery did not take place until the nineteenth century. the larynx. with dire con- sequences. as of other periods. The text was never found. which was printed in 1563 and is probably the first complete book on the anatomy of the ear. and his zeal raised surgery to title of the Father PARE This was AMBROISE (1510-90). John of Arderne. advance had been taking place during the years which are so The ground had been well often regarded as sterile of ideas. while the first plate of the series is an engraving of the sympathetic nervous system. greatest surgeon a higher and well earned for himself the Modern 142 . and details of the facial muscles. the kidney. or the forceful and intolerant revolt from tradition in medicine. and the leading surgeons of this. to whose work reference will be made presently. that it is new Humane It Surgery. good surgical work had been done steady by Guy de Chauliac. in mediaeval times. the name of Eustachius would have stood beside that of Vesalius as the joint-founder of modern* anatomy. of the greatest of the and one Renaissance. though less artistic than the plates of Vesalius. were army surgeons. prepared for a great surgical reformer. the ciliary muscle. Curiously enough. Those illustrations. Already. Among them may be mentioned the thoracic duct. are in some respects more accurate.A HISTORY OF MEDICINE were discovered in the papal library at Rome. Ambroise Pare all its was the invention of gunpowder. and were published by Lancisi. Professor Charles Singer is of opinion that had the plates appeared when completed. in 1744. and constitute a record of numerous discoveries. the Eustachian tube is not shown in the Tabulae. his courage. and other structures. During the epoch under review no such spectacular change took Surgery showed no sudden upheaval comparable to the place. his humanity. the _pf Surgery. who by his noble person- A ality. and others. revolutionary and dramatic alteration of anatomy by Vesalius. ever been a great teacher of surgery. War has that drew surgery into the Renaissance movement. the Pope's physician. rather than the application of new anatomical facts.

Nevertheless he rose to great eminence.REFORMERS AND REVOLUTIONARIES 1 surgeons of all time. a hideous sore on his body. Ambroise Pare joined the Forces. he tells . France was engaged in many against Italy. he concentrated on surgery. his home. At all events. " A 8 Medieval Picture of the Hotel-Dieu of Pans. he engaged in many campaigns. Ambroise Pare" and his Times (75/0-90). and his country a worthy model for all modern surgeons. who loved his profession. in "Journeys Divers Places" During the wars : lifetime of Pare. (The biography by Stephen Paget gives a vivid picture of the great surgeon and contains many quotations from his autobio- graphical Journeys. 1 1 . The Life and Times of Ambroise Part. and he trusted to observation rather than to books. and England. Stephen Paget. t 1942. So let us approach him a little . Med. p. which he passed off as his own another. and. Withal. vol. with a practice at Vitr^ his father Of humble Ambroise may have been apprenticed to this brother. The surgeon accompanied 1 F. from some accounts. brilliant career 2 (Plate xxvm). 2nd ed. Germany. or. was clever in unmasking the tricks of street One impostor had acquired the arm of a hanged beggars. in the civil war so disastrous to the Huguenots. and eventually. xi i. with a foothold in Paris in the intervals of fighting. for his own benefit. and for the next thirty years. R. he knew no Latin or Greek. and was successful in obtaining a resident appointment at the great hospital. M. criminal. There was no organ- ized medical corps in those days. 1926 . and became surgeon to four kings of France in succession. Hist. he was a man of shrewd judgment and of simple piety. he was born at Laval in Moyenne. Yet he eventually reached Paris. had modelled. 1897. a barber surgeon of Paris.} * D. where he remained for three years. who. the Hotel-Dieu. laying a sound foundation to a in Brittany. at home. the early training of the young apprentice was by no means academic. barber and valet to the Comte de Laval. by means of coloured wax. It was natural that so keen a surgeon should seek scope for his talents in service with the army. Packard. was a cabinetmaker. us. Essentially humanist rather than scholastic. parentage.'* Bull. freeing himself from the hair-cutting part of his work.. more where closely. and his brother Jean became a barber surgeon. Quynn. His sister Catherine married Gaspard Martin.

a book worthy to stand beside the diary of Pepys or the reminiscences of Cellini. Come. who were but with plague and other diseases. We can never be too grateful to the Dean for his annoyance. 30 144 . thinking themselves superior to both. p. and not in dignified Latin. and to show *%We entered and in a stable where we thought to lodge our horses. He to tell of his first sight of Turin." would have nothing to do with the barber surgeons. in I537. sometimes pathetic. a most attractive journal.A HISTORY OF MEDICINE the troops. against the wall. Fare's first taste of active service was in the attack on Turin by the great king. mon petit maitre. and three propped . found four dead soldiers. in his "Journeys in Divers Places (Voyages fails eh divers lieux). and often ironical. heard. as when he calls his " mon petit maitre. learn the art of surgery. bitterly reproached any surgeon who dared to dabble in physic. this upstart author had written in his mother tongue. the rage of Dean Gourmelen against a barber surgeon who wished to publish a book which dealt. . with his own graphic and inimit" able touch. As . Par6 was an old reply to man when he wrote these reminiscences in an attack upon him by Gourmelen. Dean of the Faculty of Physicians of Paris. . They neither saw. as the college of St. It was often a triangular contest. consisting " of surgeons of the long robe. There was much rivalry and wordy warfare between physicians and surgeons at that period. attended them when required. as it called forth from the pen of Ambroise Pare one of the most delightful journals in literature. 1 Stephen Paget. The reply to is direct. You."' . and giving a clear picture. The regarded as altogether inferior. 1897. with obstetrics." proceeds how he " found a way to pell-mell into the city . of the life of an army surgeon in the sixteenth century. and received such rewards as they were willing to give. burned with gunpowder. therefore.1 He tells the story. you who have never come out of your study ? Surgery is learned by the eye and by the hands. full of adventure and good stories. Francis I. and with the folly of the physicians in employing such remedies as powdered mummy and unicorn's horn. nor spoke. and their clothes were still smouldering. physicians. not only with surgery." yet it is free from bitterness. sometimes amusing. but always interesting. " Dare accuser you teach me Surgery. Ambroise Part and his Times (75/0-90). Moreover. Imagine. know nothing else but how to chatter in a Gourmelen Chair.

d/ffomsc* frrwtdr* fane B A S 1 L E AEIhisuork I'jtt) a^< f>i tin I abnca of\\ salms publish* d in -.43 lud UK foundation of srif nlific anatoinv pa.* t'nn ryfnmlrgio < . c i r .PLATE XXVII VESALIUS TEACHING ANATOMY \ MvA GJUr+i FUf> ti* tt Srm*.

(r ) Type of illus(page 130. for the renioxal of darts ** tration kno\\n as Works oj that and arrowheads. in a u ' >nt< \'\ > mpoi St \ i al tht IK ds aic r urul< iL on<' littlt iiuiniisc npt at \ i nim\ f>l loti 1-1 pam i (/ ) Iiistrumenti. i unit th( . From The famous chtrurgeon Ambrose Parev (English translation of 1678) \\ound Man" .ihK t f Most . cf Plate xxv).l In.in c <)(<n])K(l h\ hann( Ixiott hint* IIO\K<S t\\> ]). ic Hc>ul-l>iu of Pans about to IM I ilu thntdiiih sishis .ici pioh.iiniits tin hou 'Ilu I'art I ih< hospital )j< |>uls< h.PLATE XXVIII SURGERY UNDER AMBROISE PARE A \\aicl in \\u tt.

(sambucus) scalding supply and he was then forced to apply " a digestive of eggs." " Mon petit maitre." adds our hero in experience " his naive way. there was plenty of surgical work as a result of the wrestling bouts then so Pare describes in detail a particularly savage contest popular. he answered he prayed God. or. No. with great pain. gently and without I told him he was a villain ill will. " do not partake of any venenate quality. which ended fatally." Then he discovered that gunshot wounds were not poisoned. he might find someone tojdo the same for him. needed no such drastic treatment. Then he went up to them and cut their throats. when he should be in such a plight. It was made by boiling together " a oil of lilies. that he should not linger in : misery. young whelps. while those to whom boiling oil had been applied were " feverish. and Ambroise. " Thou hast a surgeon young in age but old in knowledge and " take good care of him. and turpentine. and swelling of their wounds. not out of books. at Boulogne. He rose early. who had discovered a balm for wounds which gave wonderful results." and as he put it. See how I learned to treat gunshot wounds.'! j in Turin. if you had been there I should not have been Pare found many wounded treat them as . and earthworms in turpentine. " Then I resolved never more to burn thus cruelly poor men with gunshot wounds." But." His next journey was to Brittany. and to his great surprise found that those who had been dressed " " with the had little pain and that their wounds were digestive not inflamed." That night he could not sleep. and he proceeded to " de had with oil of ciders advised. oil of roses. A few years later. I said. under fire for the first time. "ducked his head low" as he felt the moved air. afraid all alone." > 145 ii . and though this never took place. where a landing of the English was expected. " though the ball was already far away. fearing that he should find those patients dead in the morning. the good man did not know that I had lived three years with the patients at the Hotel-Dieu in Paris.REFORMERS AND REVOLUTIONARIES I was looking at them with pity there came an old soldier who asked me if there were any way to cure them." One day Pare heard a nobleman remark to his general." In Turin he met another surgeon." But his of oil was soon finished. remedy like that which I had obtained by chance. contact was made with the English army. John Vigo hot.

and Pare to gain victuals from the peasants by force. He had become a barber surgeon in 1541. had married. tions." The book of journeys continues. He said he had got off cheap. relates how after the battle of St. Ambroise Pare at Court 1559. in Park's descriptions. after numerous formalities. and Ambroise Pare after telling of his adventures at the siege of Metz and of his attendance on the king of Navarre. Gome. there they infested the air and brought the plague with them. and had acquired the house in Paris close to the Pont St. Dieu le guarit" as it is written in Old French. and God healed him. 1932. " The camp was dispersed referring to another patient. he resided permanently in Paris. and Latin ligature and he or no Latin. and the surgeon proved equal to the task. surgeon. the office of physician. I wish you had been there. in his career as an army surgeon Pare had entered the Early service of the king. Quentin the ground was covered with dead men and horses. he writes and I returned to Paris with gentleman whose leg I had cut : " my off. be he barber surgeon or no. was a favourite expression which occurs many times. might supplant the cautery as a haemostatic in amputatells many a good story in his own intimate fashion. and God healed him. attempting of another campaign. which was forced to recognize so distinguished a man.A HISTORY OF MEDICINE "/ dressed him and God healed him " tells Germany was the seat how a soldier. with variaAt the end of the German war. 83 146 . 1 Mon petit maitre. Michel. It has been mentioned that Pare was After surgeon to four kings of France. returned so mutilated that his fellows had already dug a grave for him. you write in your book. his campaigning days being over. apothecary. Classic Descriptions of Disease. and cook. had been admitted to the close fraternity of the College of St. I dressed him. not counting the king of Navarre. H. and " so many blue and green flies rose from them that they hid the sun where they settled. 1 R. and thirteen years later. not to have been miserably burned to stop the blood. p. Here was a case to test the utmost skill of the I did him surgeon. Major. where he lived and died." He describes how he found that the as . mon petit maitre." " Je le pansait . I dressed him to the end of his case. mortally wounded. tions.

Even if he did saints. and Vesalius came from Brussels by the order of Philip of Spain. and in the 1 believe in evil spirits. to carry on his work. he invented artery forceps and many another instrument. 1898. the Huguenot general. and he knew all that was wounds. leaving a widow. he suggested dislocations. the right eye. Bd. and even purchased the recipes of charlatans so that they might be generto ally available. husband of Mary Stuart. and then under Henry III." Whether Ambroise was Huguenot or Catholic has often been argued. 688 147 . 1559. In the terrible massacre of St. as he agreed that " it was not reasonable that one who was worth a whole world of men should be thus murdered. probably meningitis of otitic origin. He be known about sick nursing. the notorious Catherine of Medici. Henry II was grievously wounded while in a friendly tournament with Count Montgomery. Geschichte der Chirurgie. sheltered Pare in own room. and three weakly and worthless sons. engaged of the Scottish Guard. Queen of Scots. Charles IX. survived his father by only eighteen months. who two days previously had attended Admiral Coligny. he investigated old wives' cures. E. Pare was suspected of having put poison in his ear by command of the Queen Mother. in the power of the influence of the stars. though in favour of the slaughter. August 22. services to surgery' did not merely concern gunshot discussed in detail the treatment of fractures and he abolished castration in herniotomy. Certainly his two marriages were celebrated with Catholic rites. They dissected the heads of four criminals. 1 Keenly interested in all aspects of medicine. as he was believed to be a Huguenot. who was assassinated a year before Par^ died. Despite this malicious accusation.REFORMERS AND REVOLUTIONARIES 29. Gurlt. to ascertain what direction the lance may have taken. The lance struck him above captain On June Pare and several other surgeons attended him. was himself in great danger. The eldest. 1572. but to no purpose. who died of phthisis fourteen years later. Pare retained his Court appointment under Charles IX. mortally wounded by an assassin. and all his nine children were baptized into the his Roman His Church. Bartholomew. Ambroise Pare. At the age of seventeen he died from disease of the ear. that syphilis was a cause of aneurysm. his works are still 11. p. The king died on the eleventh day. Francis II. with severe headache. Berlin.

vol. even the symptoms point to a fatal issue.. Like John Hunter. He did not approve the idea. One of the best known of this class was PIERRE FRANCO (1505-70). 204 148 . removing a large stone which lie had failed to extract by the perineal route. Itinerant Lithotomists Of the many good surgeons of the Renaissance period. Cataract was another condition for which he operated. He wrote a treatise on hernia. it was not until 1718 that John Douglas of London. if always wise to hold out hope to the patient. then prevalent. Rules : Here are a few of his Surgical Canons and He who becomes a surgeon for the sake of money will accomplish nothing. we must run the for our lives. Mere knowledge without experience does not give the surgeon self-confidence. but if we lithotomists have a mishap. despite his success. revived the operation. p. brother of James Douglas the anatomist. a very common complaint. claiming success in the great majority of his cases. xxvi. a native of Provence. and later at Lausanne. tTHist. only a few need be mentioned to illustrate the trends of the time. surgical genius. According to a Franco was He was the first to Malgaigne. That his lot was not always a happy one. and he was first to describe the operation for strangulated hernia. so that the fragments might more easily pass through the wound." 1 D. Indeed. Many of them possessed great skill and experience. is shown by his remark. Un Chirurgien urologiste au XV I e Siecle : Pierre Franco. 1932. Franco invented strong forceps for crushing a stone. Ambroise Pare was one of the master surgeons of history. and some undertook other operations as well.A HISTORY OF MEDICINE well worth reading. " Bail. but he did not advise the routine adoption of this new method. who made his 1 headquarters at Berne. perform suprapubic lithotomy. " The physicians and surgeons can defend themselves when unfortunate. to itinerant lithotomists. that a stone might be dissolved by remedies given by the mouth. A It remedy thoroughly is tested is better than one recently invented." Bull. . with whom he has often been compared. It was the custom to entrust the care of cases of stone in the bladder.

run .PLATE XXIX SIXTEENTH-CENTURY SURGERY Dental fonops 01 "Instruments to pull out. 1654 ^pa^e 154) . foi c\tiipahon Both illustrations from A Discourse of the Whole Art of Chyrurqery. s< t 01 k " In- and Claut<rs actuals.iiul filt Supriflumis trt t Amputating stiuriunts. 4th edition. by Peter Lowe.

a: U. rn o w O ~ gn PQ H i c 3 .

Buck. made it a rule only to operate in the . Frere Jacques and Frre Jean. p. of Encycloptdie Franfaise d'Urologie. condemned by the Church. In the following century FRiRE JEAN DE SAINT COME ( 1 803-8 ) a professional and ecclesiastical brother of Frerc Jacques. until the 8 This procedure was strongly grafted part had established itself. p. 1 . 1914. associated with his which came into general use.REFORMERS AND REVOLUTIONARIES Two later practitioners of this class were the French monks. of cures in over 1. practised lithotomy with such creditable results that he was able to maintain a private hospital in Paris. 1 66 E. Withington. and his operation consisted in the transplantation of a flap of skin from the arm. Reference has already been made to German surgery of the A. ed. and so had GUIDO GUIDI. whose name is familiar to anatomists. or restoration of loss of the nose by a plastic operation. He was GASPARE TAGLIACOZZI (1546-99) of Bologna. must be made of the inventor of rhinoplasty. 2 vols. which discountenanced any attempt to improve upon the handiwork of the Almighty. H. the limb being bandaged in contact with the nose. 1917. invented a lithotome with a concealed knife. 285 1 P- H9 . or Vidius. and he charged no fees but merely took what was offered. Desnos. the Italian anatomists of the Renaissance were also surgeons. In 1697 he visited Paris. It is said that Vesalius met Pare in consultation at the deathbed of Henry II. 549 1 A. Pousson and E. retaining only just sufficient money for living expenses and giving the surplus to the poor. 1894. He practised the operation of lateral lithotomy. Surgery in Italy and Germany As has been mentioned. Fabricius of Acquapendente had a large surgical practice.000 cases. i. and was often name. 1 FRERE JACQUES DE BEAULIEU (1651-1719). as he was called.presence of a physician or surgeon. of Pisa (d. 1569). and the operation was not revived until the nineteenth century. where his success aroused the jealousy of the surgeons to such an extent that he was obliged to resume his wanderings through Europe. The Growth of Medicine from the Earliest Times to About i8oo t Yale. a native of Central France who travelled widely in order to practise his art. however.. Special mention. vol. He was able to claim 90 per cent. 2 Frere Come. Medical History from the Earliest Times. T. and like him a Franciscan monk. which ensured greater accuracy of incision.

p. becoming chief surgeon to the king. Geschichte der Chtrurgtf. 1898. 1931 1 1 Of the 150 . It was said that he used a red hot knife for amputation in order to check bleeding. was one of the few John English surgeons who wrote on his subject and gave to posterity some idea of the prevailing practice. English Surgery in the Sixteenth Century As early as the fourteenth century the barber surgeons of " England were organized in groups or gilds. He was the author of the first textbook of anatomy to be written in English.. 2 The name of THOMAS VICARY (1495-1561) is memorable for two reasons. and he was the first Master of the United 3 Originally a practitioner in Company of Barber Surgeons. Bd. iii. p. i. Berlin. Yet it is not until the sixteenth century that the picture becomes more clear. and rapidly to London as he went Maidstone. near Diisseldorf. Lecture). pub- ^ lished in 1653. after his death. vol. in Selected Writings. Med. or FABRIGIUS HILDANUS (1560Fabry 1 e acquired much experience during the Thirty Years I624J. although most of the records are lost. contains many interesting illustrations. It was reprinted in 1577. Rolleston. have appeared in 1548. but one name which must be added is that of Wilhelm of Hilden. 107 " The Early History of the Teaching of Anatomy. of Arderne. Another ingenious German inventor of surgical instruments was JOHANN SCULTETUS. 3rd " " 1 The Education of a Surgeon under Thomas Vicary (Vicary D'Arcy Power. but no trace of this first edition can be found. 1939. Hist. whose work we have noted. A Treasure for 535' It is said to Englishmen^ containing the Anatomie of Man's Body. individual members we know little beyond a few names. Despite the severity of his methods he had a private hospital at Berne." Every town of importance had its gild." Ann. *n X His work on anatomy bore the title. Henry VIII. War when he introduced the tourniquet. Gurlt. and he worked hard to raise the surgeon to a position of dignity equal to that of the physician. Sir H. by his colE. and it is estimated that there were twenty or thirty of them. whose Armamentarium Ckirurgium.A HISTORY OF MEDICINE period. rose to fame. a barber surgeon. and proved the necessity of amputating through healthy tissue in cases of gangrene. 203 Series. In his Observations Medico-Ckirurgiae may be found many illustrations of the instruments he invented.

In his own " Some of late have fondly affirmed that the chirurgeon words. and later in London. and there was at this time a military surgeon whose quaint writings " visceral 5 also a give St. One of the earliest teachers of anatomy under the new scheme was JOHN BANESTER (1533-1610). 3 His works include a treatise on venereal in 1 repulse of the disease (1565). 101 * G. and that barbers should restrict their surgery to dentistry. nor friendship . 1943-44. the who became Bartholomew's practice. and . The new Company was empowered to impose fines upon unlicensed practitioners in London. 1886.. Parker. 1920. 90 H. would be to the benefit of both. which he dwells on the importance of writing in the vernacular J. Jour. South. vol. distinguished himself on service with army army in Flanders. p. The Early History of Surgery in Great Bntatn. some interesting details of (1540-1604). who succeeded Vesalius at Padua. F. as in France. p. p. Memorials of the Craft of Surgery in England. the other practise without the aid of both. open book beside him is the book of Columbus. who had a great reputation both as a physician and surgeon. Small courtesy it is to break faithful for the one cannot work without the other. 1 He strove hard to reunite surgery and medicine. . and with the navy in the Armada. The Act of 1540 declared that surgeons should no longer be barbers. despite that the author had studied at Padua. Bartholomew's Hospital. he stated. Thus it is evident that Banester was following the new knowledge of anatomy. xxxi. In England. Surg. at Nottingham. WILLIAM CLOWES to Queen Elizabeth and to surgeon Hospital. which union. Vicary was instrumental in securing in 1540 the Royal Assent to a union of the gilds of barber surgeons and surgeons. The occasion is commemorated in a well-known picture by Holbein in the possession of the Royal College of Surgeons (Plate xxx)." In the Huntcrian Museum of Glasgow his anatomical figures are preserved. war was a teacher of surgery. Lett. contained in it is of the mediaeval the fact anatomy type. hath not to deal in physic.REFORMERS AND REVOLUTIONARIES leagues on the staff of St. and it held its place as a textbook until the seventeenth The century. contemporary painting showing Banester delivering the " lecture at the Barber Surgeons Hall of London in 2 The 1581. " Anatomy at the Barber Surgeons' Hall. 74 * . and was entitled to have two bodies of executed criminals each year for the study of anatomy." Bnt.

and might well carry poison into a wound. He gives some liis THOMAS GALE interesting accounts of the surgical instruments then in use. for curing of wounds made with Musket and Caliver shot and other weapons of wane commonly used at this day both by Sea and observations. " The name of MICHAEL SCOT 1175-? 1232) has been already mentioned (p. The Surgeon's Mate and Viaticum. both afloat and ashore. and an important work on gunshot wounds. 1569-1643. oil of vitriol." Early Scottish Physicians and Surgeons Only scanty (? 1 records exist of the practice of medicine and surgery in Scotland in early times. who had an extensive experience. though now rather a rare book. information which cannot be found elsewhere) Surgeon. Major. 107 .A HISTORY OF MEDICINE rather than in Latin. the bullet could not be purified by heat.1 643). (1507-86) was another army surgeon who. therefore. in the service of the East India Company." Jour. H. A profitable and necessarie book of etc. long before James Lind published his treatise on the subject (1753). for and also Land (isgi). Biographical Memoirs of Medicine in Great Britain. 1940.. and where none of these can be had. 1780. Woodall commends " the juice of vegetables and fruits. all those that are burned with the flame of gunpowder. i 1 J. Aikin. proves that. 1 Clowes makes many interesting observations. Roy. xxvi. the bullet does not acquire such heat in its motion as to render the wound similar to cautery. vol. in Treatise of Wounds with Gonneshot (1563). (Aikin's Memoirs. Another of Queen Elizabeth's surgeons was JOHN WOODALL 2 1 ( 569. vol. Jenkinson. 93 (Gale). Clearly. Med. and details R. and his ethical rules for surgeons must have exercised a salutary influence at a time when the field of surgery was invaded by many charlatans. as he had conducted experiments on the vexed question of whether or no gunshot wounds were poisoned. Service. Hist. Woodall is sometimes credited with the discovery of lime or lemon juice as a cure for scurvy. supplies interesting S. p. "John Woodall.. The Pathway to the Surgeon's Chest (1639) g* ve details of the necessary instruments and equipment. p." Gale was a man of high principle. or the Continent. as well as on His books. 238 (Woodall). William Clowes and his Profitable and Necessarie Booke of Observations" Ami. Naval Med. a short book with the long title. and describe how they are to be used. he argued. 107). contrary " to the prevailing idea. iv. 152 . He noted that when arrows were fired from a musket the feathers were not singed. Royal Navy. p. 1932. p.

" Further. Edinburgh. are described in Comrie's History of Scottish Medicine. 83 (Historical Notes from 153 . Comrie mentions several pioneers. Every prospective surgeon must be able to read and write. and of examining candidates who desired to The examination was to include " the anatomy. Andrews. 1932. i. This gild was to have the sole right of practising within the burgh. Creswell. Schevez was a renowned scholar who had studied at Louvain. elected Deacon. C. and complexion of man's body. History of Scottish Medicine. and again in 1602. the gild was entitled to claim each " ane condampnit man efter he be deid to mak anatomca year. including one WILLIAM SCHEVEZ (1428-97). and being as well versed in theology as in medicine. Andrews. Comrie. p. the gild was to have the monopoly of making and selling aqua vitae (whisky) within the burgh. who was. 1926. " of quhairthrow we may haif experience in other words. save that he was the best-known practitioner of Scotland in the fifteenth century and physician to King James III at a 20 per annum. in response to a petition from the two crafts. 2 vols. and in 1505 an important event took place at " " Seal of Cause was granted by King Edinburgh when a James IV. and to entertain to dinner the existing members of the craft. ! PRIMROSE. D. nature. join them. 2 This royal decree conferred certain rights and privileges on the new body. or as the document has it. H. The Royal College of Surgeons of Edinburgh 1505 to /ooj). 1 Little is known of his medical work. Surgery in Scotland. became Archbishop or Primate of Scotland in 1487. as elsewhere. 4 J. Lastly. who practised at St. vol.REFORMERS AND REVOLUTIONARIES of a number of Gaelic medical manuscripts dating from the twelfth century to the fourteenth century. 1 1 p. At this date the business was in the capable hands of GILBERT salary of . the Incorporation of Barber Surgeons. and the signs of the zodiac and facts governed by them. Unfortunately no record of the meetings was kept until 1581." the position of the veins so that phlebotomy might be performed. which later became the Royal College of Surgeons of Edinburgh. and founded a valuable library at St. one executed criminal might be claimed for dissection purposes. " baithc wryte and reid. as the President was then called. or Prymross (1535-1616). and most strange of all. that enlightened monarch.. a It may be privilege which apparently has been allowed to lapse added that each candidate for admission was to pay a fee of 5. in 1581-82. was in the hands of surgeons and barbers.

was dedicated to his friend Gilbert Primrose. but in 1826 the Faculty raised another action with a view to it in . resenting such interference with their rights. a charter for the Faculty of Physicians and Surgeons of Glasgow. in 1599. although all entitled to practise medicine. 1 His chief work. Lowe was a native of Glasgow who had spent more than twenty years in France and Flanders as a student and army surgeon. Primrose appears to have compounded his own drugs. did not rest until he had obtained from King James VI. noting the prevalence of ignorant practitioners and the lack of organization within the profession. 2 He was an apostle of medical reform who. it being decided that the offenders. was PETER LOWE of Glasgow (I55O-I6I2). A Discourse on the Whole Art of Chirurgerie. and not merely the surgeons and barber surgeons. were not legally qualified to practise surgery in or near Glasgow until they had passed an examination by the Faculty.A HISTORY OF MEDICINE Unfortunately he left no writings. 1596. and it is said to be the first textbook of surgery to be written in English (Plate xxix). a member of the well-known family of which Lord Rosebery is now the chief representative. The Faculty was empowered to examine candidates. The repiica is now He was preserved in the College Museum. the prefix Royal being added in 1909. The view of the Faculty was upheld. It was unquestioned until early in the nineteenth century. and to control practice in Glasgow and the south-west of Scotland. with a view to having them interdicted from the practice of surgery. as in Scottish surgeon. as well as medicine. bearing the name of Gilbert Primrose. which still exists. The Faculty. which had been found in a field near Hawick. This authority remciined in the hands of the Faculty until the Medical Register was established. and had then returned to practise in his native city. and we know little of his career. although did not then grant a surgical degree. graduates of the four Scottish Universities. In 1904 Lord Rosebery presented to the Royal College of Surgeons of Edinburgh a replica of a mortar. The University then introduced the degree of Master of Surgery. when the University of Glasgow. The purpose of this body was to unite all who practised medicine or surgery. claimed for its graduates medicine the privilege of practising surgery. raised an action in the Court of Session in 1815 against four general practitioners of Glasgow. better A London and Edinburgh. known on account contemporary of his authorship. within the area.

H. 1896. R. 1910 BUCK. during One of the original functions of this Faculty of Glasgow established by Peter Lowe was the provision of free treatment " for the poor. Glasgow. although only after a law suit lasting fourteen which the University was obliged to meet heavy on behalf of its graduates. Thought and Expression in the Sixteenth Century. G. Glasgow." This practice continued for two centuries. R. STEPHEN. 1925 SOUTH. 192^ TAYLOR. All those polemics were soon expenses forgotten. H. Again judgment was given in their favour. Yale. New York. H. from Maister Peter Lowe to Sir William Gairdner. 2 vols. as hospitals became available. SINGER. or. 1920 . free vaccination took the of free treatment. P. 1892 The Evolution of Anatomy. Edinburgh. if not actually in deed. Glasgow. is kept alive in word.REFORMERS AND REVOLUTION \RI RS interdicting those holding this degree. F.. M. 155 . Memorials of the Faculty of Physicians and Surgeon* of Glasgow (1599 '850). A F. Andreas Vesalim* the Reformer of Anatomy. and this was provided throughout the place nineteenth century. 1938 McMuRRicii. A. 1930 PACKARD. p.) Berlin. 1 877 ROTH. F. Ambroise Pare and his Times (75/0-7590). The Early History of Surgery in Great Britain. Duncan.. Fergus. Memorials of the Craft of Surgery in England. The Life and Times of Ambroise Part. as the Medical Act of 1858 changed the entire outlook by transferring to the General Medical Council the responsibility of deciding who should be permitted to practise. to give counscll to puir disaisit folk gratis. The poor were treated gratis. i()i MACCURDY. as the Charter states. 1930 WILLIS. E. The Iconography of Andieas Vesalius. O. M. M. H. 21 1 Peter BOOKS FOR FURTHER READING BALL. and the Faculty adjourned. J. J. Louis. The Growth of Medicine Jrom the Earliest Times to 1800. F." A. Andreas Vesahus BruxeUensis. Leonardo da Vinci the Anatomist. 1926 The Origin and Development of the Glasgow School of Medicine FERGUS. The Origin and Development of the Glasgow School of A1edit me from Maister Lowe to Sir William T Gairdner. The Notebooks of Leonardo da Vinci. St. 1926 PAGET. 1897 PARKER. Even to this day the spirit of the foundation Then. G. as the minutes of " each meeting conclude with the phrase. 2nd ed. 1886 SPIELMANN. years. J. The Royal College of Surgeons of Edinburgh (Historical Motes from 7505 to 1905). Servetus and Calvin. 1917 GRESWELT C. 1911 * A. I (In German. Baltimore.

The Enigma of Paracelsus true value the influence of He had many of medicine." which is praise indeed. History and Heroes of the Art of Medicine. 1911 Anna M. New 1936 York. vol. 1941 Paracelsus : J K. but the comno fact and the that of his theories. on the other hand. R. and tends to perpetuate this 4 unpopularity." in March of Medicine. Withington. in which he discusses the greatness of a reformer who had been misunder" the Luther of Medicine." are by no means easy to understand. however. 353 Stoddart. 156 . 1 upon progress his and for after his death centuries lifetime. 1936. while the more kindly critics said that he was of unsound mind. " regards him as a mere trumpet blower. Russell. 1891.. Sigerist. Hist. Paracelsus " : ein deutsches Lebensbild aus den Tagen der Renaissance. a mere drunken quack and disreputable braggart. 5 was born at Einsiedeln. let us turn back and attempt to follow the progress of Renaissance medicine. notably by Sudhoff. 1 J. 12 vols. 157 H. Philippus Aureolus Theophrastus Bombastus von Hohenheim. K. complete English plexity It is difficult to assess at its Paracelsus the translation is available. Sudhoff. 2 In the nineteenth century." Osier designates Paracelsus stood. Samtliche Werke. p. opponents during the prevailing opinion classed him as a charlatan. ed. iv. p. better known as PARACELSUS (i4go-i54i). 1926-32 The Scientific Significance of Paracelsus. " Paracelsus in the Light of Four Hundred Years. F. Med. Sudhoff. The leader in the revolt against the past and the search for new and better methods was that strange man known as Paracelsus. They are highly appraised 3 by German medical historians. vastly inferior to Vesalius It must that be admitted the writings of Paracelsus or Harvey. " and Garrison calls him the most original thinker of the sixteenth century. Leipzig. places Paracelsus beyond the compre- hension of the average student. Robert Browning wrote a poem on Paracelsus. Medicus. Jena. E." Bull.CHAPTER IX PHYSICIANS OF THE RENAISSANCE HAVING now traced the spread of Renaissance surgery from the days of Ambroise Pare to those of Peter Lowe. L\fe of Paracelsus.

F<. Hoioscopc dra\\n b\ \rrhhishopHamilton Caidan during his \isit of of St Anclr<\\s.} ) 1512 Dir *.PLATE XXXI MEDICINE AND MATHEMATICS Jerome.fcor lo.Caidaii oi Milan (paints i(>i (>.Mtfffctt* Poll At f r HA E4mrgi. to Scotland in .

PLATE XXXII CAIUS COLLEGE. CAMBRIDGE The Gate of Honour (page 168) .

Then he travelled far and wide throughout Europe. except the sick whom I healed. mineralogy and chemistry. Roy." Experience must be added to experiment. My beard knows more than you and my shoe-buckles are more learned than Galen or your writers Avicenna." He prefixed his lectures by publicly burning the works of Galen and Avicenna. 1 CS&e^V'not sur.PHYSICIANS OF THE RENAISSANCE near Zurich. town physician at There. and incurred the grave displeasure of the authorities by lecturing in German instead of Latin. ix. and Lecturer on Medicine in the University. and at the Italian centres of learning. Near this place were the Fuger lead mines. What we do know is that at the age of twenty-three he set out on the long wanderings which were to last for twelve " The doctor must be a traveller. he saw military service in the Netherlands. he visited the tin mines of Cornwall. and journeyed as far east as Turkey and Russia. by compounding his own medicines. and on his return to Switzerland in 1526 he was appointed. he must inquire of the world. Proc. 157 . The Portrait of Parcelsus at the Med. and by his vehement condemnation not only of the ancient writers but " I of the methods of his colleagues and contemporaries. and he carried a swor is said. G. During those years he was busily in and teaching when he could. He spent some time in Montpellier. He visited France and Spain. assisting in the laboratory and laying the foundation of his later work. but we have no record of his student days." he wrote. allowed his intolerance to outweigh his discretion. " because years. he Basel. where Paracelsus was first attracted to . he was wont to brandish in the privacy. and which appears in several of his portraits. 1 13 impetuous and fordpiif ffconocla&m Museum at 4i." Paracelsus did not favour the velvet robe of the but chose simple garments. p. explored the mineral wealth of Sweden. When the boy was twelve years old. Cumiton. so that he became engaged writing well known. prised to learn that 1 by his " C. the son of a studious and well-educated country doctor who had married the matron of the local pilgrim hospital. his father was appointed town physician of Villach in Garinthia. pleased " no one." he writes. through the influence of Erasmus. 1916. Bologna and Padua. vol. He is said to have attended the University of Basel. Soc.&*$. holding that a complete break from the past was " essential to progress.

Garrison. a European reputation. now known to be a fictitious person. Medicine. regarding the character and influence of Paracelsus. Basil Valentine. ROBERT FLUDD (1574-1637). Sudhofif. lyio. The Life and Writings of Robert Fludd. worn out with strenuous work in the search. although but little of his work was published during his He himself predicted that he would not be understood lifetime. 1 He was a voluminous writer. and he died there on September 24. and at other places. Wootton. Eventually in 1541 he reached Salzburg. 1902 . for the edition of his works. 3 1 The Literary Remains of Paracelsus. trans. 224. England or more. The Rosicrucians ^ " Their Rites and Mysteries 9 1887 i. and that within two years. in each of which he practised with great success. Huser of Basel. despite much opposition. twenty years after his death. find him at Colmar.. Gallen. F. Many of those were members of that curious sect known as Rosicrucians.Jennings. p 275 * J." in Essays in the History of K. 376 158 . did not appear until 1591. 2 voK. His travels were ended. pp. was written by the Paracelsists. edited by J. until at least first Much Some of that he did not write has been attributed to him. which resulted in a vogue for that metal as a medicament. C. H. and it was so. Craven. the contention having culminated in a dispute regarding fees. but for knowledge and truth. 2 A book entitled The Triumphal Chariot of Antimony (1604). notably in on his teaching for a century carried and Germany. acquiring. but is now acknowledged to be the work of Paracelsus. We Paracelsus as a Writer still Whatever side one takes in the controversy. was said to have been written in the fourteenth century by a monk. one is bound to admit that he was one of the most interesting figures in the medicine of the Renaissance. 1926. B. The leading exponent in England was an alchemist. New York. H. Chronicles oj Pharmacy. A. he was obliged to leave Basel and to resume his wanderings. said to have been founded by a monk it " called Rosenkreuz. which con- tinues. at Zurich. rank." who. at St.A HISTORY OF MEDICINE he made many enemies. vol. not for gold or.

By the pillar of philosophy Paracelsus implied knowledge of natural phenomena. He despised anatomy." Every action of the body depends upon the proportions and actions of these principles. he did not agree that they controlled the destiny of individuals. 1 D. and was virtue.PHYSICIANS OF THE RENAISSANCE A It is Chemical View of Life not easy to epitomize the teaching of Paracelsus. the ashes are salt. 1935. the path to true therapy was in the heavens. In his principal work. Virtue was the most important of all. all who entered Philosophy by other ways were thieves or murderers. but at must be admitted that Paracelsus simplified prescribing. the gate of medicine . the natural renovating and reparative mechanism of the human body. To it our modern ears sounds nonsensical. mercury. alchemy. therefore. but it must be remembered that some years were to elapse before Vesalius changed the outlook and made of anatomy a living science. from his pen. which he called the " Paramirum. Ricsman. to prepare the essential remedies for disease. p. though it was given to only a few : physicians to understand the ways of Providence. and he gave the name 55 " the heart of the elements. and may be cured by one of them or by its derivatives. there were only three diseases all this and three least remedies. what smokes is mercury." he stated that man was com" What 1 posed of three elements sulphur. nor did he believe in horoscopes. and in no useful purpose would be served by discussing at any length the obscure and now completely obsolete ideas that flowed brief outline will suffice. was not the astrology of the time. The Story of Medicine tn the Middle Ages. Alchemy was needful. Astronomy was essential . 338 159 . and all disease is the result of maladjustment of the three. While there is no need to elaborate the doctrine of the three principles. as he was a true follower of Hippocrates in his insistence " " to archaeus fond of coining words. New York. Although he admitted that life upon this earth was influenced by the stars. his second pillar. and failed to see how any knowledge could be gained from the dead body. and salt. reference must be made to another important foundation of Paracelsian teaching. He was The astronomy of Paracelsus. He alleged that all medicines rested upon four pillars or columns philosophy. burns is sulphur. case A Basically. astronomy. upon observation as opposed to theorizing.

he alleged. 2 vols. It was sometimes a dangerous theory Van Helmont suffered imprisonment for stating that this was the reason for the cures wrought by relics of the saints.. l He stated that the aim of the alchemist was to separate poison from food. Rcdgrove. vol. which he practised. Alchemy. that of alchemy. But those ideas played no great part in his system of treatment. save that it was not the 2 His surgery was sound as far opium preparation known to us. Surely the man who could write thus was more than " a mere drunken sot. E. To this deposit he applied the name tartar and he held that it was the cause of gout and of stone. as 1 it went. Hist. 14). There has been much controversy regarding the " laudanum " which was one of his favourite remedies. and no definite conclusion has been reached. 1910. Ancient and Modern. As for the fourth pillar. but rather an attempt to explain health and disease in terms of chemistry. p. 2nd ed. The lungs of foxes were used for lung diseases. so does the invisible body send forth its healing influence. was not a search for the philosopher's stone. Reference has already been made to this curious mode of treatment (p. i." Bull. " It is said that he believed in the weapon salve. virtue. and other inorganic substances into therapeutics. extolled later by Sir Kenelm Digby. Wootton." that strange practice.." diseases because the leaf resembles the human ear. and "just as the lily produces invisible perfume. . could prevent such influence from being evil. vol. antimony. p. 243 Laudanum in the Works of Paracelsus. The physician must be a God-fearing man." Only faith in God.A HISTORY OF MEDICINE The third pillar. this was the most potent healing factor of all. or active principles quintessence now call them. Med. ix. of applying certains drugs to the weapon that caused a wound rather than to the wound direct. He sought out the " " " " as we of his remedies. There was a spiritual side of healing. Medicine is indebted to him for the introduction of iron. Sigerist. Chrorticles of Pharmacy. 191 1. 530 . " " or in the organs. and although to his mind lithotomy was the only * " H. C. for medicine was more than a collection of facts. " " Paracelsus also believed in the doctrine of or signatures " For example. the poison became deposited upon the teeth. mineral salts. the plant cyclamen was used for ear similars. for if this was not accomplished. and so on. 1 60 . or powder of sympathy. 1941. 58 H. a yellow remedy was the treatment for jaundice. p.." as Paracelsus is termed by one of his opponents. A.

1501-76). and according to his horoscope. was the most popular philosopher and the most fashionable physician of the sixteenth century. soon or late. as has been stated. * : by Mrs. He certainly was boastful. intolerant. put into his mouth by Robert Browning . and injudicious. His motto. he pointed out Nature's method " " of healing wounds by sealing the edges with a natural balsam manufactured by the body. A mystic and an enigma. and even pious in his own way. I press God's lamp Close to my breast its splendour. though now almost forgotten. He may have suffered from congenital syphilis. : If I stoop Into a dark tremendous sea of cloud. and Medicine While Paracelsus was blowing the trumpet of criticism and brandishing the sword of reform in Switzerland. was the following : Eins andern Knecht soil Der or. Paracelsus was not a Vesalius nor yet a Harvey. (429) Stoddart. as translated fur sich bleyben niemand seyn kann alleyn. I shall emerge one day. which is inscribed beneath many of his portraits. he has been misinterpreted nevertheless he will always remain one of and misunderstood the great figures of medical history. and he exemplified the Philistine in medicine. Yet he was sincere and honest. The Mission of Paracelsus Whatever view one may take regarding the personal character of Paracelsus and his contribution to medical progress. Our account of Paracelsus may fitly conclude with the words. Stoddart in her excellent work That man no other man shall own Who to himself belongs alone. for he was nothing if not original. (Plate xxxi). and he may have been addicted to alcohol. one is bound to admit that he must have given a powerful stimulus to original thought. Life of Paracelsus. there lived in Italy a versatile scholar who. was born in Milan. JEROME CARDAN (Hieronymus Cardanus.PHYSICIANS OF THE RENAISSANCE operation which was justified. Algebra. : Astrology. It is but for a time . to 1 Anna M. Will pierce the gloom . 1911 jgi 12 .

G. was virtually the ruler. but." His unhappy childhood and youth. W. Liber. l62 . finally his death in Rome as a pensioner of the Pope . Astrology was only one of the many interests of this paradoxical character. whose views represent a mixture of mediaeval " His life. the unfortunate archbishop was ultimately executed for treason (Plate xxxi)." wrote Morley. De Vita Propria translated by Jean Stoner. i. and his health was an affair of national 2 It is a commentary upon the backwardness of importance.. 1931 J. and Sylvius persons : conducting the treatment of this case of asthma H. and alongside the better known life story of Cardan's compatriot 1575. an unlucky star ruled his nativity. vol. of self-revelation. 1932. Waters. The Book of My Lye (De Vita Propria Liber]. 1 absurdity and Renaissance wisdom. his mathematical achievements. several months in Edinburgh and at Monimail. The archbishop was not only Primate of Scotland. a Spaniard named Cassanate. Morley. the most wonderful sense and the wildest nonsense. is a unique document A Consultation at Edinburgh The most interesting episode in the tragic career of Jerome Cardan was his journey to Scotland in 1552 in order to attend Archibald Hamilton. as well as in Cardan's autobiography. 179 1 . Jerome Cardan. History of Scottish Medicine. which has been which well deserves to stand It and contemporary. trans. Benvenuto Cellini. Comrie. 1898 Jerome Cardan.A HISTORY OF MEDICINE which he attached great importance. his eventual and astonishing rise from this level to that of Professor of Medicine at Padua and Pavia. D. Jerome Cardan spent in Fife. Jean Stoner. full of extremes and contradictions. Regent of Scotland during the minority of Mary Stuart. with a highly successful result. Jean Fernel the leading physician. all these details of his eventful career are recorded in the biographies of Morley and of Waters. British medicine at that time that the archbishop's personal physician. During his journey Cardan met a number of distinguished in Paris. on surprisingly modern lines. as his brother's adviser. was obliged to summon a consulting physician from Italy. his fame as a physician. 1854. his gambling for a livelihood. following the execution of his son as a murderer. The Ltfe of Girolamo Cardano of Milan. Although he survived for twenty years. his struggle with poverty as a country practitioner. a Biographical Study. his broken-hearted old age. p. brother of the Earl of Arran. " was one of the most curious on record. Physician* 2 vols.

although now altoVita Prcpria Liber is still worth reading. especially his observations on things supernatural. Hist. The little book of precepts which he wrote " Never associate with a stranger on a sound advice. About one-third of the material is of medical interest. Though this was really discovered by a rival mathematician named Tartaglia. Smith. 1917. or your wife. Sir Walter Scott mentions it in his novel. which remained unpublished until 1658. such as the marking of household linen. His collected works. Besides the autobiography." or the significance of lines on the forehead." joint. it is still known as Cardan's rule. the origin of mountains. the identification of mushrooms." Cardan's most popular work was De Subtilitate (1551). comprise ten large closely printed folios.. contained an account of" metoposcopy. as one of the quaintest literary relics of that fruitful age. " " When road you talk with a bad or dishonest man. signalling by torches. The . not at his face . The " His learned face stooping until a Abbot." 1 D. the great naturalist London. a study analogous to palmistry. vol. in the Sixteenth Century. he wrote a treatise on algebra which he called The Book of the Great Art (1545). of yourself. and in which he propounds the rule for solving cubic equations. now known as the De Subtilitate gether obsolete. contains "Do not talk to other people look at his hands. E. the boy king Edward VI Conrad Gesner.PH\SICIANS OF THE RENAISSANCE the anatomist . Medicine and Mathematics p. the twinkling of stars. chapter xxxii. Cardan's chief claim to fame probably rests upon his contribution to mathematics. your children. Praeceptorum Filiis Liber. * A book of very different nature. such as. " i. the raising of sunken ships. and surely one of the most absurd and fantastic subjects of investigation. dealing with all manner of subjects. thus : physiognomist might have practised the metoposcopial science upon it. in Zurich. and the universal " Cardan shaft." Ann. public " . Med. and in Versatile Physician Jerome was an industrious author. which was his last work. 125 163 . published by Spon of Paris a hundred years after his death. De was Cardan's masterpiece. for he attached great weight to dreams and omens. for the benefit of his children. a sort of household encyclopaedia.

consisting of widespread skin eruptions and ulceration. where it at once assumed epidemic proportions and a severity which has never since been equalled. K. Thomas Browne acknowledges in medicine. disease. Fracastorius The Spaniards. it writers. collection of facts and he was an John Hunter. The translation. It was said to have been brought to the Spanish occupants of Naples by the sailors of Christopher Columbus. by his clarifying of ideas. writings have attracted the attention of Robert Burton quotes from Cardan repeatedly in his Anatomy of Melancholy. in turn. De Consolatione. there broke out in the city a new and dreadful disease. and Sir his great intellectual influence. while named it Spaniards was the first to apply to it the name "syphilis. one fully acknowledged and The Origin of Syphilis History is punctuated by the appearance from time to time of plagues and epidemics which. Sudhoff. when Charles VIII of France laid siege to Naples. " The Origin of Syphilis. however disastrous in their The Black effects. with great destruction of all the tissues. Whether syphilis was known before that date is still open to certainly there is no mention of it by the ancient argument In any case. 257 in Essays in //. acted as a stimulus to the medical profession. New York. Garrison. causing many deaths. 1 which it retains to this day. Jerome Cardan's many scholars. was the only book by Cardan which was translated into English during his lifetime.A HISTORY OF MEDICINE Another small work. he made the path of easier for others. was either reactivated or introduced at the siege of Naples. and he well deserves to be more investigation as of the great Renaissance doctors. was another. . Nevertheless. 1 F. passed it on The French called it the Neapolitan the French disease. the Sweating Sickness. and persisting for years in those who survived the initial illness.*' H. 1926. by Thomas Bedingfeld. trans." Indies. who had acquired it in the West the to the French invaders. like Cardan made no great discovery empiric physician. and if it did exist it was in a mild form. by 164 . In 1495. is entitled Cardanus Comforte (1573). History of Medicine. Death was one such visitation . as we shall see. p.

and adding to those serious studies the lighter pursuits of music and poetry. 1 First Epidemiologist much more than merely describe and name He became keenly interested in epidemic diseases. The neighbouring shepherds catch'd the spreading Flame. and entitled Syphilis.. p. 1932. vol." written in 1521. He was a student at Padua It centrated medicine. W. Henrickson. The Fracastorius did syphilis. who incurred the anger of the gods by some act of impiety and was smitten with a loathsome and contagious disease. first He First felt strange pains. i. Major. a remedy of American origin which had accompanied the disease to Europe. or Holy Wood. practising medicine." Bull. he spent most of his life at his villa there. and D. ii. studying mathematics. sive morbus Gallicus. himself a sufferer from the disease. Hieronymus Fracastorius. HIERONYMUS FRACASTORIUS (1483-1553) was of noble family. 2 Born at Verona. H. vol. along with his friend Copernicus. Fracastorius was attracted chiefly to The poem on syphilis was his first and best known work. and being thus favoured by fortune was able to devote himself to a life of study. Singer. p. ii. The Scientific Position of Girolamo Fracastoro (?I478" Med. and of the treatment by mercury and guaiacum." Ann. D. Classic Descriptions of Disease. Hist.. and sleepless passed the From him the malady received its name. 3 In elegant verse modelled upon the style of Virgil. night. I 1553) ' R. p. " 406 . Hist. Syphilus was merely the patient on whom the poet grafted his description of syphilis. 1917. 37 * 165 . 1934. Ann. p. In 1519. ULRICH VON HUTTEN of Tubingen. extolled the virtue of this drug in a treatise which was translated into English twenty years later under the title. and astronomy. he tells of a mythical young shepherd named Syphilus. There is no story in the poem. Of the wood called guaiacum that healeth the French pockes and also helpeth the goute in thefeete. geology. 1930. L. wore Buboes dreadful to the sight. Med. Med. but while Copernicus conupon astronomy. Montgomery. C.PHYSICIANS OF THE RENAISSANCE Syphilis in Poetry was in 1530 that Fracastorius published " that Divine 1 poem. and "The " * G.. vol. 515 ' Syphilis of Girolamo Fracastoro. Hist.

1932. as in smallpox or plague. and it was not until the Elizabethan age that men like Francis Bacon. step by step." a " Early Physicians of England The new learning. word which he was the first to apply to infected clothing." Centuries elapsed before any practical use was made of such enlightened views. p. His death was much lamented. but they remained followers of Galen. It needed the genius of William Harvey to integrate the knowledge of the past. de AM/. the seeds of disease which multiply rapidly and propagate their like. etc. p. infection by first : was the " of imperceptible particles or seminaria. They certainly revived an interest in the classics. Biographical Memoirs of in Great Britain. 2 de la and At A. grew slowly. son Iconographie Medicme 1 et les Traitds Contagion. " Sur Fracastor. men who raised the level of surgery in England and in Scotland Now we must turn to to a status worthy of royal recognition. his contribution to medicine was entirely positive. 1 780. a monument which still adorns one of the principal squares of Verona. and Galileo pointed the way to the inductive method of reasoning. de rHist. vol. and infection at a distance. Soc.. utensils. and a few years later there was erected a statue to his memory. Aikin. physicians whose names will be mentioned presently were direct products of the Renaissance. in which he described the three methods of infection infection by direct contact. Terson. 1 the great work. Oxford went to travel in Italy. 28 66 .. and to fashion. the wonderful idea of the cirMention has already been made of the culation of the blood. xxvi. and although bacteria were as yet unknown. 171 1 J. Some years It is doubtful whether the elapsed before it reached England. De Contagione. A more genial and friendly character than either Paracelsus or Cardan. those who performed a similar service for medicine.A HISTORY OF MEDICINE In 1546 he published to recognize typhus fever. and so guided science into fruitful fields. The description is wonderfully modern. Descartes. Fracastorius presumes the existence fomites. The Royal College of Physicians THOMAS LINACRE (1460-1524) was born after taking his degree in 1 in Canterbury." Bull. nevertheless Fracastorius must be regarded as the founder of modern epidemiology. born in Italy.

which later (1551) became the Royal College of Physicians of London. it is said. Paul's Cathedral." died of stone. of Browning's Grammarian but his skill in practice was widely recognized. upon those who broke the laws. At Rome. often with the connivance of their bishops. Not only was he the leading classical scholar of his day the original. p. 61 the Revival o! Learning. and also to examine and license practitioners throughout the kingdom. The Graduates of Oxford and Cambridge were exempted. and of charlatans and empirics. "John Cams and (Sect. The wellknown portrait by Holbein may be seen in All Soul's College. of which Linacre was a Fellow. Thomas Linacre. and he included Erasmus among his patients. son of Henry VII. He practised medicine for a time at Norwich. 1 Sir W. Oxford. 167 . The sister university of Cambridge may also claim a distin1 JOHN CAIUS. sincerely faithful to his He friends. Med. where he lodged in the same house as Vesalius. Linacre's greatest achievement. Roy. and was buried in St. Cambridge. This body was empowered to decide who should practise within the city or within a radius of seven miles around it. where he studied medicine. xxxv. apart from his translations of Greek classics. college also had authority to examine prescriptions and drugs in apothecaries' shops. guished and scholarly physician of this period. and well beloved of all ranks and degrees of men. He therefore obtained from the king. On his return to Oxford he taught Greek in the university. letters patent for a body of regular physicians. His appointment as court physician was continued during the three successive reigns. The first President of the new college was the learned Dr. He had noted with concern that medicine was engaging the attention of illiterate monks. Soc. 1941. Hist. a native of Norwich. and he was responsible for the health and education of Prince Arthur. Langdon-Brown. who permitted him to share a tutor with his own son. sometimes written Kaye or Keys (1510-73). and then studied medicine at Padua. in 1518.). he is said to have been the first Englishman who understood Aristotle and Galen in the original Greek." Proc. vol. became at an early age a Fellow of Gonville Hall. and to inflict fines and even imprisonment .PHYSICIANS OF THE RENAISSANCE " " at Florence Bologna he was recognized as an elegant Latinist he was fortunate in meeting Lorenzo de' Medici. Henry VIII. was the establishment of an authoritative body to control the practice of medicine. Linacre was " a hater of fraudulent dealings.

Cambridge found her champion in our John Caius (apparently no relation). 1 68 . Over the gates of " ville and Caius college he caused to be inscribed the words. the 1564. and in the chapel of which he was buried. His works include Latin versions of Galen. which he wrote at the request of his friend Conrad " Gesner of Zurich. De Ephemera Britannica. The later years of his life were spent as master of the college which perpetuates his name. Virtue.D. VI. on the antiquity of Cambridge. rather unwisely. and this was accomplished " Gonlargely through his own benefactions. public orator. with such success that and During the reign of Mary. he obtained permission to rebuild Gonville Hall as a college (1557)..C. who sought to prove that Cambridge had been a seat of learning since the days of a Spanish Prince named Cantaber in 394 B. the brief epitaph. This called forth a spirited challenge from one Thomas Caius of Oxford who stated that his Alma Mater was founded by Alfred the Great in A. Cambridge was his contribution to a wordy contest with the rival University of Oxford regarding priority When Queen Elizabeth visited Cambridge in of foundation. and therefore antedated Oxford by more than a thousand years. and Honour (Plate xxxn). as President of the College of Physicians. Oxford Cambridge Caius was a diligent author. and a quaint volume on British dogs. the German Pliny. claimed superior antiquity for Cambridge." who died of plague in of The history 1565. Mary physician succeeded Linacre." A few bears. and these articles were burned in public. The arguments of both sides are now regarded as completely mythical. v.A HISTORY OF MEDICINE during the reign of he was called to court and he remained as court Henry VIII. 870. as he had directed. years before his death he was subjected to some indignity when it was found that he possessed certain vestments worn in Roman Catholic ritual. treatises on the pronunciation of Greek and Latin. on rare plants of Britain. for whom he had a high regard. Humility. It is said that his life was shortened by this demonstration of religious intolerance. He Tudor. at Shrewsbury. His tomb " Fui Caius. which office he held for nine years. to and Edward Elizabeth. De Canibus Britannicis.

or Scotland to Ireland. guaiacum. many fever. because other physicians. nor to the Continent. Oxford University was closed. the illness as a corruption of the humours. Two Lord Mayors and six Aldermen died within a week. 1552. v. Earl of Richmond. and even theriac. vol. The outbreak observed by Caius at Shrewsbury was the fifth and last of a series of epidemics. in The epidemic spread so rapidly that it was at its height London by the middle of September. A Short History of the Sweating Sickness.PHYSICIANS OF THE RENAISSANCE The Sweating Sickness to medical literature is the account of that remarkable disease. and profuse perspiraIt lasted only for twenty-four hours. and to attack the higher classes more severely than the poor. but did not as quickly as it came. had viewed it with 2 Caius. Within a few weeks. for the disease spared none indeed it appeared to be more severe among robust young men. wrote a direct and popular book. H. but many died within Shaw. one of which occurred in 1551 while Caius was 1 It is greatly to his credit that he practising at Shrewsbury. though mentioning China root. Classic Descriptions of Disease 1932. abdominal pain. and was about to ascend the throne of England. which ravaged the country in a series of severe epidemics. It is said that not one in a hundred escaped the death-rate was terrifying. the force of the epidemic was spent . Thousands of them while walking in the streets. lethargy. Business to be postponed. died. The Sweating Sickness originally broke out among the soldiers of Henry VII. 246 R. Med. which is the only good contemporary account of He blamed the gross and unhygienic mode of life the Sweat. or Sweating Sickness. p. . finding no mention of the disease by the Greek writers. Hist. 149 169 .. 1485. and he gave sound advice. " M. claiming no specific remedy as his own. of the time." Ann. tion. the English Sweat. wrote A Boke of Conseill against the Disease commonly called the Sweat or Sweating Sickness. it vanished It swept through England. 1 headache. thus to inaugurate the prosperous Tudor classical Cams' principal contribution dynasty. however.. B. who. p. '. and the coronation had . although he also strove to explain singular hopelessness. landing from France at Milford Haven. secured a great victory at the Battle of Bosworth on August 22. Major. spread The disease began very suddenly with shivering and violent was at a standstill. 1933.

" in that town within a few days . C. F. Creighton. women filled the streets with lamentations and loud " The disease prayers. at all times of the day. p. 1517. but in 1517 there was again a violent outbreak which claimed many victims all over England. the drinking of cider. 2 Epidemics occurred again in 1508. beginning in July. 1528. and had lost none of its old malignity. with redness of the face and body. B. excess of clothing and especially the thick cloth caps worn by men. were excess of meat in the diet. each time during the summer months. No immunity followed. and sometimes a vesicular rash. The Epidemics of the Middle Ages. so that many died within an hour or two. A History of Epidemics in Britain. 1551. it was soon found that the only hope for the patient was to take to bed at once. and probably the most potent factor dirty personal habits and the scarcity of soap. The epidemic of 1508 was not severe. it was on this occasion accompanied by other epidemic took heavy toll The plague." 1 Among the circumstances favouring the disease. Moreover. and funeral bells tolled day and night. 2 vols. measles. in order to favour the perspiration. most severe epidemic of all appeared in May 1528. and diseases . There was a characteristic stench. G. From Hamburg it spread through Germany to the Netherlands and to the Scandinavian countries. 1 J. quotes a contemporary de- scription of the " symptoms as a grete swetyng and stynkyng. and fatal cases were not numerous. Creighton in his History of Epidemics in Britain. was also a severe pestilence. and many persons suffered from two or three or even more attacks. 181 170 .A HISTORY OF MEDICINE the day. on journeys. and a contynued thurst. trans. As for treatment. He was on no account to be permitted to sleep until the twenty-four hours had elapsed. Babmgton.. and some within the first hours of the attack." final The visitation. . Hccker. of those who not only did it spread rapidly with a very high mortality. which began in Shrewsbury in April Nine hundred persons died No one thought of his daily occupations. and diphtheria survived the sweating sickness. lack of fresh vegetables." came completely without warning at table. Once again it vanished as quickly as it came. and to avoid chill or the least exertion. 1844. with a grete hete and hedeche because of the fumes and venoms. and 1551. and which. 1891-94 K. Sydenham Society. according to various historians. but contrary to its usual habit it spread to Northern Europe during 1529 with severe malignity. lasted until the end of the year.

Long after the sweating sickness disappeared from England. it commences boke the whiche traytied necessaries for the infirmite a grete sekeness called Pestilence the has no titlepage. The copy and litil in the John Rylands Library. and desquamation longer. 1 remarks that the first medical work to be printed in England was a little plague tract entitled. the nature of which has often been discussed. p. there broke out in Northern France an epidemic of what was known as the Picardy Sweat. who in turn had copied it from Johannes Jacobi of Montpellier (1364). which were among the first medical books printed in English and in England. probably of the virus infections. but never satisfactorily explained. History of Medicine. 195 . consists of ten pages. Had it occurred it would as one have classed been to-day. in his well-known history. reproduced in the following in facsimile in 1910." Appearing first in 1718. followed about a week later. Here begynneth a and reherced many gode thinges It manner " : whiche often times enfecteth us made by the most expert Doctour in phisike Bisshop of Arusiens in the realme of Denmark. Although none of them bears the stamp of originality. the last outbreak of a strange disease. In some respects it resembled was no sign of throat infection. but lasted A rash appeared within two days." It is believed to have been printed in London in 1485 1 by F. It was not influenza.. 128). but there scarlet fever. Garrison. H. 3rd ed. Manchester. or " Suette des Picards." allied to rheumatic fever. The symptoms resembled those of English Sweat. all are of interest as examples of current medical practice. A Passing Code Lityll Boke Necessarye and It was a translation Behovefull Against the Pestilence (cf. nor was it a modified form of typhus. Garrison. Sweden (1461). from Bishop Kanutus of Vasternas. and they appear to demonstrate clearly that not until the time of William Harvey did the renaissance of medicine exercise much influence in Britain. it returned almost every year for the next century.PHYSICIANS OF THE RENAISSANCE This was the epidemic described by John Caius in his famous pamphlet. 1924. p. malignant " It is now generally conceded that both diseases were miliary fevers. Early English Medical Books Our brief study of Renaissance medicine may be suitably concluded by a brief account of a few contemporary works.

The Introduction of Knowledge. Dutch. just after Sweden had been devastated by plague. dealing with each of the countries he visited " also with the naturall disposycion of the people and theyr " As one of the objects of the book is to teach a man to speche. and sometime Carthusian monk. by Andrew Boorde. vol. His writings. and " * Some regard this that he was the original Merry Andrew. It was said that during his travels he was wont to make humorous speeches at fairs and markets. The Dyetary of Health. are also wise. In the opinion of some authorities.." Proc. dated 1494. He studied medicine at Montpellier. the Latin name of Vasteras. ANDREW BOORDE (1490-1549). xi. Roy. The work was originally written about 1461-63. traveller.) There is a Latin edition of the little book. Soc. Bishop of Arusiens or Arosias. and Romany Gipsy (this is the first printed example of the Gipsy language). vol. and show that he was a man of considerable learning." in truly modern fashion he appends lists of phrases in many tongues. Welsh. He spent a year in R. " which he designated the noblest university of the world for physicians and surgeons. The first-named is a most interesting treatise. ' * ' 172 . (Arusiens was wrongly identified as Aarhuus in Denmark." so he tells us.) i i. he was educated at " in and through and around all Oxford. in the Royal College of Physicians of London. the first original English medical book to be printed was The Breviarie of Health. Hist.A HISTORY OF MEDICINE Willelmus de Machlina (or Malines. " The ' Breviarie and Dyetary of Andrew Boorde. These works include. near Stockholm. Dec. 1943 1 " . or Andreas Perforatus (bored) he called himself." Ceded. who had set up a printing press in Holborn." and he visited many other places on the continent and in Britain. and The Breviarie of Health. ." in any case. including Cornish. C. in Brabant). Buist. speake parte of all maner of languages. and led a roving life Christendom. was rather an odd character. Andrew Boorde. and the author was Knutsson. Med. and further English editions appeared in 1510 and in 1536. which appeared in 1547 (? 1542) (Plate xxxm). Only two other copies are known . Castilian." as . Hebrew. it would be a capital mistake to class as a myth Andrew Boorde as a buffoon. p. the other in Cambridge University Library. one is in the British Museum. Physician. Jour. It is now known that no Bishop of Aarhuus bore a name at all resembling Knutsson. though witty. (Sect. 292 Douglas Guthrie. xxxvii. As one of the physicians to Henry VIII he had a good standing at court. Med.

and it doth make a man to bee mery and to laughe. neither of Lord of love nor of Printer nor of no man living." which begins." said he. This by F." " " The Breviarie of Health From interesting work. named body lyce. Woman. impediment doth come by unclene kepynge or lyenge with lousy persons or in a lousy bedde or the not changynge of a mannes sherte. Music. Writing on " is the Greek in Latin it is Liena. although melancholy resteth in the as long as I do live. J. a spongious substance lienge under the ribbes on the left side." The Breviarie also has chapters on Drunkenness. and nits. be joconde. and not to study upon " Let him be bloud of a veyne any supernatural thynges. " if I should write all my mynde. Trust no Skott. for. and such aspects of personal hygiene as clothing. nor will I never have none . the best use of one's income. and many another subject. splene let if him Cfc lacio or is Morbus pediculorum be In Englysche it is the Latin wordes. Tears. If any man be splenitike use mery company. 173 . author of this little household medical dictionary." " he wrote. crabbe lyce. Furnivall (1870).PHYSICIANS OF THE RENAISSANCE lityle unyuersyte named Glasco. to sleep on the right side with the head high." " PedicuThere is a chapter on Lowsiness." Boorde " did never look for no reward. Pestilence." but " it is evident that he did not love the Scots. In Greek it and there be lowsiness. the Breviarie is Boorde's most Brevity was the keynote in the mind of the " " (Plate xxxm). word. head lyce. They have been excellently edited for the Early English Text Society foure kyndes." he gathered from the following extracts." The Dyetary deals not only with food and drink. and to wear " a skarlet nyght-cap. God : there be impedimentcs in it." named Basilica on the left side. everie bongler would practise The writing of it was a labour Phisicke uppon my booke. in health and Scotland. at " a in sickness. exercise. but with the choice of a house. Spleen proceeds thus In Englysche it is named a man's splene. the medical standpoint. and sleep. Andrew Boorde's works are still well worth reading. Phthiriasis. helping me Some idea of the contents of this quaint volume may be " Spleen. where I study and practyse physyk for the gustentacyion off my lyvyng. He counsels his readers to keep their bedroom windows closed. they youse flatteryng wordes and all ys falshode.

F. states that it was a translation from the French. annoint the gummes with the braynes of a hare mixed " with capon's grece and hony. 216 1 J.. was the work of Richard Jonas. Aikin. Still. by A. biographies. Hist.R. Cutter." The cause of terrible dreames " " and feare in the slepc is the arysyng of the stynking vapours out of the stomake into the fantasye and sences of the brayne. It was from the Latin version of Roesslin's book. S. The first edition of The Byrth of Mankynde. 1919. which had appeared in 1532 under the title De Partu Hominis." 1 G. of which the British Museum possesses the only copy known to exist. and marked. Der schwangeren frawen und hebammen roszgarten. Historical Chapter in Obstetrics and Gynaecology. It appeared in 1513. but it is a good Here compilation of all that was known of the subject. p. 1933. save that he was originally a lawyer in London before he took to medicine. p. Philadelphia. and his book was the first separate work on midwifery to be printed. 108 . It shows no originality. enwas published in 1554 by Jacob RuefF. and that he wrote The Boke of Children. or Rhodion. A History of Pediatrics. are fragments of Phaer's advice "To procure easy breding of teeth." and the treatment consists in giving " honey and powdered seeds of peony. Med.. was a medical man who practised in Worms and then in Frankforton-Main." after which one must not rock or move the infant too " much. entitled The Byrth of Mankynde. One of the woodcuts is reproduced in Plate xxxiv. "Ancient Poems on Infant Hygiene. 1931. and was the first English work on Pediatrics 2 his in medical (see page 367). which was * published in 1 545. vol. p 78 8 I. of whom we know little. or Phayre (1510-60). It " is dated 1540. Biographical Memoirs of Medicine in Great Britain. for overmuch shaking maketh the chylde to vomyte.A HISTORY OF MEDICINE Pediatrics in England About the same time as Boorde there lived a physician named THOMAS PHAER. by E. Rhodion. J. p." : " The Byrth of Mankynde " The first English printed book on midwifery was a translation of Eucharius Roesslin's Rosengarten. Imprynted at London by T. a work which enjoyed a very wide circulation and was translated into many languages. that the English translation. An improved version." Ann. H. ii. Footc. Aikin. Carter. ed. titled De conceptu et generatione hominis. 3 Roesslin. was prepared by THOMAS RAYNALDE in 1545. 1700. 5 174 .

all bear the name of Thomas Raynalde. J. and (The Woman's Stoole). We shall have occasion to note in the next chapter that William Harvey not only solved the problem of the circulation of the blood. and Contents. W. GREIGHTON. a Biographical Study. 1906 and 1907. 2 vols. C. L. 1830 Physician. The Epidemics of the Middle Ages. to Ballantyne. K. H.. 1854 STOOD ART. Life of Paracelsus. but also made the first original contribution to It depicting the various positions by a woodcut showing a birth British midwifery (p. F. according fourteen in who made a careful bibliographical study of the work. of the child in the uterus. 1911 Paracelsus . A. The book is physician. Subsequent editions. WOOTTON. F. J. 2 vols 1891-94 FURNIVALL. Its Author. Ed. STILL. A History of Epidemics in Britain. 1936 WATERS. 1844 MAcMiCHAEL. Philadelphia. Leipzig. Early English Text Society. MAJOR. trans B. G. Lives of British Physicians.) W BOOKS FOR FURTHER READING CARDAN. " Renaissance Midwifery. 1907. H. The Book of My Life (De Vita Propna Liber). The Byrth of Mankynde maintained its place as a textbook of midwifery until the eighteenth century. 183). 1910 175 . 1898 Chronicles of Pharmacy. and Gynaecol of the British Empire. SUDHOFF. between 1545 and 1676. K. J. although it is uncertain whether there were two men of this name. 2 illustrated by a stool series by anatomical drawings from the Fabrica of " of Byrth Fygures " Vesalius.. . em deutsihe^ Lebembild aus den Tagtn der Renaissance. the other a All the editions are now very rare. 1932 MORLEY. 2 vols. Classic Descriptions of Disease. Ballantyne. one a printer. J. JEROME. trans." in I933* Mayo The Evolution of Modern Obstetrics Foundation Lectures on the Hutory of Medicine. Renaissance to Britain. G. G. Stoner.PHYSICIANS OF THE RENAISSANCE 1 presumably Thomas Raynalde. Jerome Cardan. C. R. F. 1931 ANNA M. The Life ofGirolamo Cardano of Milan. 1 was he who really brought the J. 1870 HECKER. The Byrth of Mankynde (Reprinted from Journ of Ob si. Miller. A History of Pediatrics. W. of The Introduction and Dyetary of Andrew Boorde. (1500-1700). number. Editions. Babington. Sydenham Society.

the Galenic pathology of the still believing in witches. Among the unbiased investigators of the seventeenth century there stands forth the noble figure of William Harvey. it at the philosophical and scientific during the early part of this be interesting to glance background which existed great century of medical progress. as every student of " " humours Shakespeare knows. methods and concepts persisted. however. far outnumbered by the seekers after new truths. Each stated views with caution. New ideas took root and flourished. Before referring to Harvey's achievement." which in turn became obsolete. and both were actuated by The Seventeenth-Century Background. conservative worshippers of Galen and his school were. yet each made a valuable contribution to the sum of human 1 knowledge. discoveries were made and adopted. XVII-CENTURY MEDICINE THE it seventeenth century was a period of intense intellectual 1 In the realm of medicine activity in all the arts and sciences. still making use of theriac and of a decoction of earthworms. during the period of transition old knowledge. and a thirst for fresh Nevertheless. who by his genius and insight revolutionized medical science. 176 . may Philosophers and Scientists The reform discovery. his of philosophy was a necessary prelude to scientific Bacon and Descartes were the reformers.CHAPTER X WILLIAM HARVEY AND HIS TIMES. Basil Willcy. some The of whom in their eagerness to find something to replace antiquated " notions constructed systems. new was indeed a golden age. 1934 utilitarian motives. so that we find Sir Theodore Turquet of Mayerne. and. having no desire to become a martyr for truth. the great Sir Thomas Browne still guished practitioners in the control of health and diseases. There was a general feeling of dissatisfaction with the past. many distinregarding the stars as potent influences still holding its own. the most fashionable physician of his day.

tottfolofte t&cobroitt tccmet of Titlc-pa^c of the copv in the i *)j7 Huntcnan edition of \ndrc\\ Boordt s liresiaue nf Health. .PLAIT XXXIII -THE BREYIARIE OF HEALTH" bt tnmanateMUUi. From tht Librar\ of Glasgow L"rn\< r>it> pages 172-73.

1 J. rittfuum <juoqut/emcn ittiadmtjcct* A i it* vtcx \\'<><>dcnt from Ructf's De CnnceMu ft Grntratwnt Hormnis. From the copy in Edinburgh Unuersity Library (page 174. seated on a birth stool. Atttem rttrtu > quod gcrittAlcfcminetfcxus wemlrum eft. D* mixtura vtriufque focus femims. .PLATi: XXXIV BIR'IH S(ENE IN THE SIXTEENTH CENTURY PRIM C A P V T V S. At the \\mdow in the background an astrologer is casting the horoscope of the child about to be born.eiiuqj fubftatuia & forma. attended b\ three mid\vi\es. shoxving the patient.

too. the way and to leave scientific verification to others." Far different in personal character was the austere yet kindly . his ideas were not generally adopted until the following century. (429) Descartes. for not only did leaving college joined the army in order to see the world. In his " " Novum Organum (1620) he urged men to abandon the four idols accepted authority. Roger was a scientist as well as a philosopher Francis was content to point . as Descartes did." Proc Roy R. calling indeed for a philosopher. J. both favoured experiment as opposed to argument. (Sect Hist ). 2 vols." Nor did he found any new school of philosophy." as Isaak Walton called him. 76 in the . his Life and Tuiw. Richardson. Writings of Francis Bacon. legal bias. French philosopher. 1913. Consequently " Francis Bacon was well content merely to ring the bell which called the wits together. l philosopher and statesman. but he wrote the first textbook of physiology. G. and both spurred men on to think for themselves. Truth. ?7 . p. 120). to whom he makes no reference in his Both were antagonistic to the current methods of writings. whom Pope. De Homine. however. and personal " " method of inductive prejudice and to replace them by the 2 Naturally. 1905 . 1 Soc. was not derived from authority but from experience. Nevertheless he was a man of great wisdom and learning who expressed the new spirit ol the age. Greater. 402 (*' Francis Bacon") 1 E. a strange 3 The main part of his life. " Medical Allusions Med. deemed meanest of mankind. and to hold fast to facts. popular opinion. He simply revived the Platonic method of reasoning. His immediate influence was not great indeed. secretary of nature. Disciple* of Aesculapius.WILLIAM HARVEY AND HIS TIMES FRANCIS BACON. S. vol. which. Russell. " the noblest. 1896. but science and medicine must have been influenced to some extent by this philosopher. they argued.. to make experiments. vol. 177 1 Sir B W. Descartes. apparently with mixed feelings. Haldaae. The legal training of a Lord Chancellor. History and Heroes of the Art oj i Medicine. Roger Bacon (p.3 . which admitted of no imagination. scholarship. 1861. p. was not published until some years after his death. has often been compared with his greater namesake. was not the best preparation for a scientist. RENE DESCARTES (1596-1650) was a brilliant student who after influence. Lord Verulam ( 1 561-1 626). this "great reasoning based upon experience. was bound to affect the march of scientific endeavour. W. Steevens. p. was his immediate he found a new school of thought. wisest.

p. in the period under discussion. A Discourse on Method (Everyman's Library. 1912. who was " the first to teach that there are small passages at the extremity of the arteries through which the blood passes into the vein and " returns to the heart." so also Just as the progress of medicine was influenced by philosophy. 1 The central idea in his philosophy was that mind and matter constituted the universe. Then." wrote Descartes. For Descartes the body was of better than the hand God by any machine of incomparably human invention. and he died of pneumonia within eighteen months. devoting himself to the elaboration of his ideas. but that there was no connection between them. " there is absolutely nothing in our power. The kernel of his : ." Animals did not possess minds and souls they were. No. was it guided by science. Eventually he accepted an invitation from Queen Christina of Sweden to join her court. although by some strange reasoning he located the soul in the pineal gland of the human " a machine made brain (Plate XLI). ." Thought could be no illusion indeed. At the commencement of his mental pilgrimage. 21 178 . Furthermore Descartes commanded the respect of medical men by his interest in physiology and in the work of Harvey. I think. which up to the time of the Renaissance had been diverted into astrological channels.A HISTORY OF MEDICINE however. although he likewise was a machine. 570). mere automata. " and it was peculiarly attractive to the school of latro-physicists. had acted as a distraction and a hindrance. in fact. Except our own thoughts. but the rigour of the climate proved too severe for him. where he lived in seclusion for over twenty years. Man. was possessed of a mind which acted upon the body. The proof of the existence of mind was con" scious thought. therefore I am. Descartes. on the other hand." who regarded the human body as a mechanical contrivance. in order that he might base his opinions on a foundation wholly his own. nothing else was certain. was spent in Holland. Astronomy. there 1 R. which Descartes so delightfully describes in his Discours de la Methode (1637). Tycho Brahe and his pupil Kepler had made wonderful discoveries without the aid of any telescope. Such a conception could not fail to influence medical progress. ne endeavoured to rid his mind of all that he had previously learned. Copernicus had established this science on a sound basis. The effect of " Cartesian " philosophy upon medical science was considerable." philosophy was his famous dictum.

p." article in Studies in the J. practised in London. 1935. Hist. that there were mountains on the moon's surface. Castighom. 248 " Galileo Galilei and his Influence on the Evolution of Medical A. compared it with the beat of his own pulse. p. Singer. and that there were spots on the sun which moved as that orbit rotated. 1921. upon mechanics and measurement in science accelerated the discovery of various methods of diagnosis in medicine.. 206 " 1 L." The stress which laid Galileo theless. xii." Bull. * " Galileo Galilei/' Ann " Med 7/n/. and Galileo was forced to deny them on oath. becoming physician to Elizabeth and to James I. The vScientific Personality of Galileo. he showed that the Milky Way was formed of stars. noticing that amber could be electrified by friction. 226 " * Sir B Richardson. though " Neverthere is a legend that after his recantation he murmured.. i." Bull. for amber. 1896. vol. by WILLIAM GILBERT Gilbert was born in Colchester.WILLIAM HARVEY AND HIS TIMES appeared a versatile Italian who by his discoveries made a valuable contribution to medicine. vol. 5 His work on magnetism entitles him to be regarded as the Father of Electrical Science indeed. p 372 W 179 . vii. 2 Thus he discovered the principle of the pendulum. The Scientific Works of Galileo (1564-1642). educated at (1540-1603). 33 (" Gilbert ) p. He perfected. GALILEO GALILEI (1564-1642) did indeed study medicine. made his first great discovery before he was twenty. and also President of the College Queen of Physicians. Vaccaro. Thus did the philosophers and scientists of the seventeenth century supplant the theorizing of the Schoolmen by the practice of observation and experiment. by G. the telescope. ed. J Fahie. Hist. 1942. In the cathedral he watched the movement of a swinging lamp. if he did not actually invent. History and Method of Science. 11. Disciples of Aesculapius. This was De Magnete (1600). it was he who. 4 At the very beginning of the seventeenth century there appeared the first book on physical science to be published in England. and although his instrument magnified only thirtytwo diameters. and he avoided mathematics. Med. it does move. Olsrhki." derived from at this period . Thought. p. 1 * L.. and Cambridge. introduced " " the word elektron/' the Greek name electricity. 3 Sucb heretical discoveries could not escape the censure of the Church. as he felt that the two 1 Born in Pisa and educated there. vol. \ol xn. and realized that it might be used in the recording of time. he subjects might conflict. vol. 1942. Med.

the Folkestone in 1600." or and Harvey's stemma. 347. 1932. (Almost every phase of William Harvey's life and work has been discussed by many generations of Harveian 1 1 orators) Sir W. WILLIAM HARVEY (1578-1657) was born eldest of the seven sons of at Folkestone. D'Arcy Power. in the hall of the university. 109. Fabricius did not grasp the true significance of the valves of the veins. B." Ann. and it was left to Harvey to show their true 2 significance as part of his proof of the circulation of the blood On his return to London Harvey engaged in practice. Hist. vol. 1578-1657.. Among his teachers coat of arms. and within a few years he became a Fellow of the College of Physicians and physician to St. iv. William received a good education at the Thomas Harvey. which was heated by a great fireplace stoked with wood from the Royal forest at Windsor. serpents 892. The facts of his life and labours are so well known through the medium of many biographies and hundreds of Harveian orations that only a brief synopsis need be given. " the little doors of the veins. pp. Representing his " " nation as a councillor. graduating with high honours as Doctor of Medicine in 1602. 1924.A HISTORY OF MEDICINE The Genius of William Harvey There now entered upon the scene one who was to revolutionize medical science. Hemngham. 491. seen in the parish church. then at the height of its fame as a centre of medical 1 learning. Next he proceeded to the renowned University of Padua. William Harvey (Masters of Medicine Series). William Harvey. whose tomb may still be Grammar School of Canterbury and at Caius College. Mid. and to lay the foundation of modern practice. at Padua was the who had De successor of Vesalius. William Harvey. Hervey Wyatt. (Plate xxxvi). 8 Under the terms " one of the latter appointment he was obliged to attend the poor day in the week through the year. " The Life and Times of Dr. Five of the sons became well-known men of business in London. who was Mayor of and his wife Joan. Bartholomew's Hospital. Harvey spent four years at Padua. 1897 R. 575 180 . to change the centre of outlook. He thought that they simply prevented over-distension." he was entitled to a stemma. Hieronymus Fabricius. a a hand around which two candle showing grasping lighted was in 1 are discovered entwined." and this he did in the hall of the hospital. 249. Cambridge." published a work on venarum ostiolis.

s an < \ 1< in < x.is i<s orisiH< for h rnlidfd I h< Plixs MII\ \isii * .PLATL XXXV THE PHVSK.it paintings ot \ar\mu: clr MI^II from tht St( ph< n-son (laik< J\dn .s \ISIF Jan Siren. \\ork Coll<cnon.nnplc oi Ins .I VV. \\. l< ' ctst t\\*nt\ / IK- ah<i\. \\lio \\a>. horn .tf < in ih h.

i bn-^. i(>j8 \\herc tlie\ arc used bv sujiport his proof ol the circulation of the blood (pa^e Har\ t*v 180) to .< Woodcuts lioui DC motu con/n. b> Fabric 141) ins. at Padua Harxey's teacher (pat.PLATE XXXVI THE VALVES OF THE VEINS Woodcut horn He iwunum o\fjr>fi\.

under the date February 27. and in a curious mixture of Latin and English. was that of Lumleian Lecturer on Anatomy and Surgery. throughout the end of six years. whose son Charles I made him Physician in " 1 William Harvey's Knowledge of Literature Classical.). Notes of his first course are still preserved in the British Museum. at year." The " anatomies " were open to the and Mr." According to the fashion of the time Harvey made his rounds on horseback. Mcd.WILLIAM HARVEY AND HIS TIMES The appointment which brought him greatest renown. James I. Medieval. In 1618 he was appointed Physician Extraordinary to the king. xxvii. Renaissance. Terne. p. and with a habit of fingering nervously the small dagger which he wore." Yet it was not until twelve years later. the entire course was recommenced. Written in the very illegible hand which is favoured by so many medical men. of dark complexion. his man following him on foot. rapid in speech and given to gesture. however much they may condone such views in a " quack. Frascr-Hams. Pepys. 1616. At the outset of his career. Exercitatio Anatomica De Motu Cordis et Sanguinit in Animalibus." he the circulation of the blood. F. that he published the full results of his great work in the little book of public. D. and Contemporary. 1934. Patients fell away greatly when he announced his great discovery. Hist. Although Harvey was not distinguished as a clinician. a successor of Harvey. for five days if the bodies may last together. the notes show that even then Harvey had reached a conclusion regarding " The movement of the blood. (Sect. as well before as after dinner so long without annoy. he had a good practice which. the The subjects differed each year until. how1 ever. which was printed in Frankfort in 1628. gives a spirited account of his attendance to view a dissection by Dr. 1662. seventy-two pages. Each Caldwell. 1099 181 . The lectureship was founded in 1581 by Lord Lumley and Dr. Harvey has been described by one who knew him as a man of short stature." Proc. vol. Roy. a week before the death of Shakespeare. Soc. however. provided for a series of lectures. Harvey delivered his first lecture on April 16. and he held the appointment for the next forty years. It year the lecturer was " to dissect all the body of man . twice a week. and with keen dark eyes and hair black and curling. do not favour unorthodox views in a regular practitioner. " is constantly in a circle. having meantime carefully verified each proof of his discovery. of the heart. and is brought about by the beat writes.

complaining of the lack of anatomical material. and fishes. and it was recorded by one of the gentlemen" little Dr. during which he wrote to Lord Dorchester. or gannets. P. that the movement of the heart could be observed more readily in cold-blooded animals such as frogs and He ranged the entire animal kingdom for his material. for he " could scarce see a dog. 2 vols. MacMichael. many of his writings on comparative anatomy visit have been Shortly after the Scottish he was commanded by the king to conduct a post-mortem examination of Thomas Parr. and in his treatise on Development he describes the solan geese.37 J. Aikin. for he allowed him to make observations on the deer in the royal parks 2 (Plate xxxvii). 290 dissects (Harvey Old Parr) . or any other bird or thing to anatomise.A HISTORY OF MEDICINE Ordinary. Harvey would be in-waiting that during the journey. p. 3 A few years later King Charles was faced with the troubles of the civil war. which led to his own tragic end. who had died at the alleged age of 153 years." and "came so near to being lost that he incurred the ambassador's displeasure. had he not come to London as a member of the household of the Earl of Arundel. cow. Fortunately the king was interested in Harvey's researches. Timbs. 41 J." Some years later he accompanied the Earl of Arundel to Germany. brought on by the impure London atmosphere. Parr was a countryman of Shropshire. which congregate there in such numbers. 1 Harvey was then in attendance on the king when His Majesty journeyed to Scotland to be crowned in the Abbey Church of Holyrood and to hold court there. Harvey observed. kite. p. Harvey was closely associated with the He attended the Duke of Lennox on Court of King a mission to France and Spain. and the sudden adoption of a high mode of living and rich diet. The study of comparative anatomy was highly regarded by Harvey. Harvey was 1 s W. 1873. making observations of strange trees and plants. Biographical Memoirs of Medicine in Great Britain. v l182 \ 780. as it also was by John Hunter more than a century later. it is A unfortunate that lost. Doctors and Patients. and who. Secretary of State. who had enjoyed perfect health. Harvey found that his death was due to pleuropneumonia. for example. had married twice. 1830. and again at 1 20. Charles. might have lived still longer. During the visit to Edinburgh Harvey found time to visit the Bass Rock. Lives of British Physicians. much more important duty was undertaken in I633.. first at the age of 88.

WILLIAM HARVEY AND HIS TIMES present at the battle of Edgehill in 1642. Spencer. The honour of Presidency was offered to him this. Curtis. of Derby and a manuscript on Observations in Midwifery which was printed for private circulation so recently as 1863." was June 1657. and it is said that he had charge of the two young princes and was reading a book not far from the battlefield. 9 Flourens." is devoted of Harvey's book on Generation. uncoffined but lapped in lead. Philadelphia. entitled to obstetrics. it obstetrician. ending " All my arguments could not remove that with the remark. His generosity is shown by his gift at this time of a library and museum to the College of Physicians. p." After the defeat of the Royalists Harvey retired to Oxford. Histovre de la dicouvtrte de la circulation du sang y Paris. One chapter " DC Partu. buried at Hempstead in Essex. 1934. A H." Harvey was now over seventy years of age. he was obliged to decline on account of He died in his eightieth year on the 3rd of and infirmity. A History of Embryology. left PERCIVALL WILLOUGHBY (1560-1631). however. p. -. till at the last all her from her. is probably quote It is dedicated to the greatest book in medical literature. hopes vanished into persuasion and fatness. 3 Charles I. * D. flatulency . the centre The Anatomical Treatise on in Animals. De Generatione Animalium^ in 1 65 1. History of British Midwifery 1927. some fifty miles from London. to 1 J. but although he was a martyr to gout his brain was active as ever. 1933. R. London. ed. of Obstetrics and Gynaecology. i . 1 Needham. and Harvey compares the king to the heart. He also described a case of spurious pregnancy. p. so that he was obliged to remove his station. may 2 A contemporary to be wifery published by an English author. " De Motu Cordis " et Sanguinis the Movement of the Heart and Blood the English title of De Motu Cordis. 1857 183 . 1 12 H. which he compared to that of the chick emerging from the egg or the butterfly from the chrysalis. when his studies were interrupted " by a stray cannon shot. He advanced the view that the foetus assisted its own delivery by active movement. ^nd there continued his studies in embryology which led to the publication of his second great work. age " his and body. 1 Although the main theme of the work also is indicated in its be regarded as the first original book on midtitle.

was the motive power which drew the blood along." Ann. he built up his great discovery. as it were." but he still believed in the to-and-fro movement. He compared the sequence of movements to a flint-lock the flint. p. nor are the arteries ruptured. Where does all the blood come from and where does . and ejects the bullet." attacks another Proceeding. Servetus certainly discovered the pulmonary. 323 Harvey's Predecessors and Contemporaries. in a circle. though his view was not at once accepted. vol." In those words Harvey first introduced a new conception of the functions of the human body. or lesser." Ann. Hist. The genius of Harvey led him far beyond his predecessors. x." Before Harvey's time was known that the blood moved. 2 He altered the entire conception of the blood system. just as Vesalius had given a it as : 1 J. causes the explosion. and as a " result of all this careful thought and experiment he began to think whether there might not be a motion. and confirming each advance by experimental proof. striking the steel.A HISTORY OF of it MEDICINE all strength and power.. ignites " the powder. Maclcod. go ? The veins are not drained. passed from the arteries to the veins during sleep. Step by step. Harvey problem. Furthermore. p." not the blood. Med. ' 338 Sir H. It is true that Cesalpino described " a perpetual movement from the vena cava through the heart to the aorta. and that the blood. Rolleston. impelled into the arteries. Med. vol. adding that " the knowledge of his own Heart cannot be unprofitable to a King. circulation. R. but a to-and-fro motion was 1 The dilatation or diastole of the heart and arteries envisaged. might be expected. J. and it was* believed that blood could pass from the right to the left ventricle through pores in the septum. gave rise to the pulse. Harvey ligated arteries and veins at various he calculated the amount of blood points. " " Harvey's Experiments on Circulation. 184 . x. the liver was regarded as the central blood organ. and noted the effect expelled at each heart-beat so as to show that the entire volume of the blood would be used up within a short time. He showed that the heart was indeed a hollow muscle. and proved the heart to be the central motive force. and alleged that " the native heat. all in the twinkling of an eye.. 1928. 1928. Vesalius had shown that there were no pores in the septum between the ventricles. so that every objection to the new idea might be met with irrefutable argument. Hist. but he did not by analogy suggest that there might be a systemic circulation.

discovered the lymph vessels in 1657. 1922. in which he attributed the presence of chyle in the lacteals to " too ample a supply of nourishment. Hut. the whitish vessels spread over the mesentery and intestine of a dog which he was dissecting.. Med. p.. p. Med. 1902. Withington. Riolan was Professor of Anatomy in Paris." Ann. for the He wrote that whether for the sake of nourishment or is communication of heat.W. 1923. 1 This is shown in a letter written by Harvey a year after the latter discovery. 251." Lacteals. 137. and distinguished them from completed lacteals. vol. nor the demonstration. 1924. the lacteals. Donley. by JEAN PECQUET in 1647. and like his friend GUY PATIN. pp. JEAN RIOLAN of Paris.. appeared in 1627. p. published in 1649. and Capillaries Apparently Harvey did not accept the discovery of the lacteals. Century. outnumbered his opponents and he lived to see his views accepted and applied. T. 357 (reprinted in book form. i 185 . 13 E. not certain. v. De Circulatione Sanguinis. Aselli's book. His discovery of the circulation was indeed an W." Nevertheless these two works had added greatly to the significance of Harvey's researches. which had been made by GASPARE ASELLI of Cremona (1581-1625). vi. 1 * 8 Hist. did he reply in any detail. the first anatomical work to have coloured illustrations. Lymphatics. J. One is not surprised to learn that the publication of De Motu Cordis gave rise to much heated controversy. Hist. " * F. who also questioned Harvey's work. The Multiple Personality of Dr. 1894. Stirling. Med. Medical History from the Earliest Times. of their connection with the blood-stream. Harvey advanced no dogmatic view to the reason " why the blood circulated. vol. Aselli's discovery by tracing the entire course of the and OLAF RUDBECK. Guy Patm and the Medical Profession in Paris in the Seventeenth Ann. Harvey treated his critics with patience and with dignity. Courtney. Some Apostles of Physiology. he was an ardent 4 Nevertheless Harvey's supporters soon supporter of Galen. This he did in a small book. 400 " Riolan and Harvey. Guy Patin. the Professor of Medicine and author of the well-known Letters. while still a student. 26 J. Pecquet. a Swedish student at Padua. Packard. iv.WILLIAM HARVEY AND HIS TIMES new view of as its structure. De lactibus sive lacteis venis. the year before 2 The author describes how he noted Harvey's De Motu Cordis. vol. 3 Only to one. p." Ann." " ! 9 2 4) . R.

the supply of air was renewed in time. 1925. and the glomeruli of the kidney. who devoted his wealth and talent to the service of science. Experimenting with his air pump. Harvey gave no explanation of the reason why the blood circulated. Harvey makes a brief reference to the matter in stating that he did not know whether " " or not the heart added to the blood. Harvey knew that there was some sort of channel between the smallest arteries and the smallest veins along which the blood must pass so as to complete the circulation." The problem was solved. whose contributions to the anatomy and physiology of the ear. and the method by which the results were secured was as admirable as the work itself. He was succeeded by his pupil ANTONIO VALSALVA (1666-1723). which then became cooled down as it coursed through the vessels. Each of them was responsible for a definite contribution to the physiology of respiration. Hayman. nor would a candle burn. heat. Malpighi's Concerning the Structure of the Kidneys" Ann. " 1 J. p. Although he demonstrated so clearly and conclusively the course and mechanism of the circulation. step by step. he showed that in a vacuum a mouse or a small bird could not live. The circulation of the blood was now completely demonstrated. or perfection " nor whether the movement of circulation was for the purpose of cooling or for nutrition. however. by the genius of four young Oxford scientists. M. 244). He was the first to describe the layers of the skin. in De Aure Humana (1704) established his fame (p. ROBERT BOYLE (1627-91). It has served as a model for all research scholars since that day. 242 1 86 . vol. 1 Investigating the entire world of plant and animal life. There was only one link in Harvey's remarkable chain of evidence which awaited the strengthening touch of visual confirmation. a he a saw network of blood-vessels examining frog's lung tiny which connected the venules with the arterioles. Hist. If.. the lymph nodes of the spleen. The introduction of the microscope enabled MARGELLO MALPIGHI In (1628-94) of Bologna to furnish the necessary evidence. First came the Hon. Malpighi made other discoveries with his primitive microscope. vii.A HISTORY OF MEDICINE immense achievement. spirit. he was a tireless worker who may well be honoured as the founder of microscopic anatomy. The prevailing view was that the heart heated the blood. Mfd. son of the Earl of Cork. already mentioned among the founders of the Royal Society.

so that the air escaped through the openings. De Corde" Ann. The conclusion to be drawn from those experi- became dark and venous. also. Some BiiU. Med. W. x. air . 113 4 M. we could breathe as well in the most filthy prison as in the most delightful pastures. xxv. the first demonstration of artificial respiration. 599 3 K." Ann. p. This aspect of the problem of respiration was RICHARD by two Cornishmen. M. 1902. noting that it then acquired the bright red hue of arterial blood. Stirling. Richard Lower. Hist. p." Lower was the first to perform blood transfusion from one animal This led to attempts to transfuse blood from an to another. he took some dark blood from the vena cava and " perfused " it through the lungs. 1936. Htst. LovyER (1631-91) tells us in his Tractatus de Corde (1669) that the surface of a fresh blood clot becomes bright red when turned round and exposed to air. p.. J. the blood also as in the lungs that it became bright the respiration was resumed. p 39 P. Franklin. iv. therefore. (Sect. 190). ROBERT HOOKE. Hist. because 4 nothing was then known of haemolysis or of blood grouping. Then. " Blood Transfusion by Richard Lower in 1665.). J. to whose work miscroscopist the air. lungs were no longer to be regarded as bellows which cooled the After removing the greater part of the chest wall in fiery heart. vol. 1631-91. 3 " Were it not so. proved that it was which sustained life. and not merely the movement. Roy. Did this change in colour take place solved blood circulated through the lungs ? 2 Lower repeated the experiment of Hooke and found that it was indeed so. in fact. p. "The Work of Richard Lower. Life and Times of Med. the results were not encouraging. vol." Proc. essential for life Clearly. animal into man as a means of resuscitation after haemorrhage.WILLIAM HARVEY AND HIS TIMES the bird or animal would recover. Med. Hooke made some openings in the surfaces of the lungs. Hist. The a dog. Lower and Mayow. Hoff. 1631-91.. 517 . Soc. by blowing into the windpipe. we shall presently refer (p. vol. Further. vol. 213 187 ." "The " Richard Lower and his Med. C. 1931. and red again when for the ments was that the entrance of fresh air into the blood was essential maintenance of life. As might be expected. medicine is indebted for the proof that the 1 W. Hoff and Apostles of Physiology. This was. 1932.y 1928. The interaction between the air and the blood was not yet understood. He noted that when the artificial respiration was stopped. was as a and for combustion 1 Then Boyle's assistant. Franklin. Hollingsworth. To Lower. iii. K. he was able to keep the animal alive. E.

Now the substance which was attracting the attention of chemists of that day was nitre. his own contribution. p. and death particles followed. so argued Mayow. In the above experiment the candle. The Early Microscopists The microscope. adding mechanism passive the inspiratory movement accomplished by the diaphragm and the movement it respiration. the heart-beat ceased. discovered oxygen. was intercostal muscles. though it did not acquire that name until it had been re-discovered by Mayow's great Joseph Priestley more than a century later. in fact. who achieved much during his short of thirty-six years. which enabled Malpighi to complete the work of Harvey. although the air remained. In its earliest form it consisted of 1 Sir M. that constituent of gunpowder which was not by itself inflammable but which burned fiercely even in a vacuum when mixed with sulphur. although the evidence is inconclusive. a fact which may partly account for the precision and He reviewed the entire knowledge of clarity of his writing. . was probably known to the ancients." It was essential to life and when breathing stopped. 1 His description of the respiration." It was not the entire air. There was something in the air which was necessary to enable the candle to burn and the animal to live. and not from " purging of the " brain as was previously imagined. Mayow had.A HISTORY OF MEDICINE increased flow of nasal mucus which accompanies a cold arises from the nasal mucous membrane. was supplied by the air which contained " igneo-aerial particles " or " nitro-aerial spirit. 185 (" 1 Mayow") 88 . Lectures on the History of Physiology. and whose Tractatus Qyinque is a medical classic. Mayow was a lawyer before he turned his attention to medicine. Combustion and breathing were identical. represented the sulphur. Yet his is a name which deserves a high place in the annals of medical research. or the animal. the expiratory phase a holds good to this day. The last of this brilliant school of Oxford physiologists was JOHN MAYOW life (1643-79). Foster. The nitre. As for the object of " obvious to Mayow that some constitutent of the air necessary to life enters into the blood in the apt of breathing. the nitrous were not supplied. 1901. services to physiology are apt to be forgotten. for when a small animal or a lighted candle were sealed up in the same vessel the candle went out and the animal died.

PLATE XXXVII HARVEY AND THE KING \\illiam Har\i\ dt monstialjiiuj his rcs<*ar(hs on the dftr to C'harlrs bo\ Prince" (pacje itiz) Paintinc. London. in I and the Ro\al Clollccjo of Ph>si(ians. by R Hannah .

1665. inav be mo\ed in t\\o diitctions bv scrn\ adjustments so as to biing it \\ithm locus of the small kns B.at fixed distance from the e\e Hooke often dispensed is \\ith this (page 190* . mounted on Leeuvvenhoek's mirrosc opt*. \\huh is firmh fixed between two perforated biass plates (page 189) Robeit Hooke's microscope.PLATE XXX VI 11 EARLY MICROSCOPES M he object to be examined. The objective a tmv double convex lens of short focus. from his Aficrografthti. A v idei field might be secured b\ a plano-convex lens \\ithm the tutx. holder A. mounted in a cell close to a pinhole diaphragm.

The first to apply the microscope to the study of disease was ATHANASIUS KIRGHER (i 602-80). p. he discovered red blood corpuscles. as the writer knew no language but his own Dutch. Major. vol. and usually of much less. 1 Roger Bacon first suggested the use of lenses as spectacles. ground more than two hundred of them." It is generally agreed that what Kircher really saw were masses of red blood corpuscles. and many of the animalculae so familiar to students of stagnant ponds. contagious minute living organisms. invisible to the naked eye. He amplified the work of Malpighi by finding capillaries in the tail of the tadpole . Hist. i. Singer. Yet his inference was for he stated that were conveyed diseases correct. p.WILLIAM HARVEY AND HIS TIMES a simple biconvex lens. It was ZAGHARIAS JANSEN. i. a spectacle' in Holland. H. Med Hist. was able to devote his long life of 4 ninety years to microscopical study (Plate xxxvm) Leeuwenhoek his own lenses and constructed his own microscopes. who. about the year 1609." Proc. and a simple lens was used by Malpighi and also by Leeuwenhoek. p. Roy. 3rd Series. some of which were translated and published by the Royal Society. Med. vol.).. vol. and round in men and mammals. and although he used a simple lens and obtained a magnification of only 160 at most. 30 " * Notes on the History of Early Microscopy. vii. C. the 1 first to see and describe bacteria and also protozoa. One of the greatest of the early microscopists was that remarkable man ANTONY VAN LEEUWENHOEK (1632-1723). 1914. No. this invention to practical use. 3 Professor of Physiology at Wurzburg. accidentally discovered the principle of the telescope and micro2 Galileo turned scope by placing two lenses together in a tube. the compound eyes of insects. a merchant of Delft. Haden. the greatest achievement of this energetic amateur was that he was . Hist. as he could not have seen plague bacilli with lenses of such low power. i. Athanasius Kircher. but the instrument remained maker of Middleburg merely a toy for some years. Soc. Med. He also described the striation of muscle fibres. 247 " R. Antony van Leeuwenhoek and his 1932 189 . by Fracastorius had advanced a similar idea but had produced no evidence to support it. H. From the medical standpoint. 1939. The Origin of the Microscope. Examin- " R. he made many valuable observations. who in examining the blood of plague-stricken patients found " countless masses of small worms.. noting that these were oval in fishes and amphibians." Ann. who. blessed with leisure. 105 " Little Animals" 4 Clifford Dobell. (Sect." Am.

He showed that the point of a needle. Another pioneer of microscopy. ix. Bhgh. the Royal Society made him a Fellow in 1680. who crowded into his life a vast deal of original work. 135 A." he was the ing a section of cork. and he made some wonderful dissections of the internal organs of bees. was JAN SWAMMERDAM (1637-80) of Amsterdam. S.'59 W. i. 2 His Micrographia (1665) is a classic work. Swammerdam's " Bible of Nature " is the greatest collection of microscopical observations ever made by a single worker. Grew was a London physician. arid moving about in the most delightful manner. 343 190 . sponsored the appearance of some of them under the title. 1902. he saw animals. 1931. P. and secretary of the Royal Society. C. Some Apostles of Physiology. 1 His manuscripts. and the most brilliant. 4 In his Anatomy of Plants (1682). in the The illustrations (Plate xxxvm). when another great Dutchman. G B Stubbs and " E. pp.. 1910." edge sharp razor was his of and furrows.A HISTORY OF MEDICINE " little ing the white film which collected on his teeth." thus anticipating the cell theory of Virchow by many years." Ann. adorn his work. he traced the vascular structure. was ROBERT HOOKE (1635-1703).. Bybel der Natuur. showing how plants resemble animals and In the field noting the presence of sex in plants. " first to use the word cell. 34. 8 vol." Although Leeuwenhoek never visited London. 1 Many beautiful drawings S. " a multitude of holes and under the microscope. short England. were not published until years after his death. more numerous than all the people in the Netherlands. vol. p. p. dragonflies." full of field. a man of intense energy but indifferent health. other microscopists were blazing earliest. 227 W. Hist. also a Dutch- man. of microscopic botany NEHEMIAH GREW (16411712) led the way. 4 The Medical Aspect of Robert Hooke. W. 1927. Wootton. " much like a honeycomb. Boerhaave. 2 vols. Sixty Centuries of Health and Physwk. and many other types. Chronicles of Pharmacy. revealed " like a plowed a the of that and scratches. who acted as Curator to the Royal Society. illustrated by excellent drawings. Middleton. His discoveries mainly concern the structure of insects. biological drawings Many ridges of plants and insects have since been reproduced as standard Meanwhile. trail. the beauty of the draw3 In describings being equalled only by those of Swammerdam. Med. Stirling.

Robert Boyle. then in Gresham College. all great men who " fulfilled the object of the Royal Society. T. The Royal Society of London 1660-1940. Hist. commenced the publication of its Philosophical Transactions two The Royal Society became responsible for many publications. not without some risk of ecclesiastical censure. 1 C. the Accademia dei Lincei was founded in Rome by an enlightened aristocrat. famous Samuel Pepys was president. when a group of scientists formed " the Invisible College. the greatest of all works on physical science. Duke Federigo Cesi. 1 ." 1939. the Collegium Naturae Curiosorum was inaugurated at Halle in 1652. and Christopher Wren. and was accorded royal patronage by Louis XIV in 1666. . vii. It was at one time believed that the mace of the Royal " " which had incurred Crombauble Society was the identical well's contempt in Parliament. 970 Wren. 1848 . Musser and J. Cambridge." which held meetings for discussion. the Academic des Sciences came into being. 3rd cd. John Mayow. mostly physiologists. Most renowned of all was the Royal Society. now well established. C. Sir Henry Lyons. Krantz. A few years later a number of scientists in Oxford. p. A History of the Royal Society. In Paris. viz. at first in each other's rooms. through the influence of his minister." At last a royal charter was granted by Charles II. 1944 1 . Weld. 2 vols. Sprat. In Germany. which appeared in 1687 when the 3 years later. the improvement of natural knowledge. which began in a small way about 1645.. Med vol. one of a . Robert 2 Hooke.group of scientific societies which arose during the seventeenth century. 1 They included Thomas Francis Glisson. The History of the Royal Society of London. Colbert. The Friendship of Robert Boyle and Christopher Bull.. and the Royal Society. including Newton's Principia. Willis. instituted meetings for the advancement of their interests. Italy led the movement when. in 1663. but this pretty story has since been disproved. in 1603. 1722 " P. This academy of " lynx-eyed " scientists applied their penetrating vision to the solution of many problems. Richard Lower. The society published many important scientific works. R.WILLIAM HARVEY AND HIS TIMES Societies and Journals Mention has been made of the Royal Society. and included Galileo among their early members.

too. p. D. Sir Hans Sloane had a garden at Chelsea. Nicholas de Blegny and the First Medical Periodical. 1939. C. in this time. 3 also French. also a short-lived periodical. 1938. Medicina Curiosa (1684). Later. Hist. there was added the large accumulation of plants and animals brought from the West Indies by Sir HANS SLOANE (1668-1753). Drewitt. 393). 1924 B. founded in 1626 by Cardinal Richelieu ." Ann. and also to lay out a physic garden at Holyrood. 225). Chance. Johnston-Saint. The Romance of the Apothecaries' Garden at Chelsea. still exists. and who gave his name to more than one London He succeeded Sir Isaac Newton as president of the Street. 1870. Med. Nicholls. The nucleus of the British Museum was the collection of specimens belonging to the Royal Society. Assoc. preceded by the Journal des Sgavans (savants) was the first scientific journal to be published in which (1665) The first medical journal. 198 " The First 4 P. Jour. designed for the purpose by the redoubtable Robert Hooke." Med. vol. Med. p.. 390 " A. 117 192 . publication contained contributions from scientists of all Royal Society it but was countries. The leading physicians of Edinburgh.^ 1934. Nouvelles Descouvertes sur toutes les Parties de la Medecine (1679-81). Another scientific and 4 F. 1 and which (p. xxxi p. who attended Queen Anne. the best museums and botanical gardens became known was the Jardin des Plantes Paris. but every medical school had its physic garden for the cultivation of medi- cinal plants. 2 activity of the seventeenth century was the of The Philosophical Transactions of the journals. J. surgeon to Louis XIV It was followed by an English medical journal. Jeaffreson. edited by Nicolas de Blegny (1652-1722). 225). p.. x. his queen. The rise of medical journalism will be discussed more fully in a later chapter (p.A HISTORY OF MEDICINE About popular. of which only two numbers were issued. Of the latter. English Medical Journal. which was the first of a series of such gardens in or near the city (p. Royal Society. cci. 30 (" Sir Hans Sloane ") " Sir Hans Sloane. was the vernacular. This was transferred in 1676 to Montague House. 1 . vol. led by Sir Robert Sibbald determined to establish the Royal College of Physicians of Edinburgh (1681). In London. Press and Circ. which he presented to the Apothecaries' Company in I722. vol. a well-known physician who lived in Bloomsbury Square and later in Chelsea. A Book about Doctors. G.'* Canad.

.

seated in his balance. entitled Medicina Statica* 1614 ^page 197) . determines the variations of his " " in\isible perspiration The illustration forms the frontispiece of his \\ork.PLATE XL AN EARLY EXPONENT OF METABOLISM Sanctorius.

By Papal decree all non-Catholics had been excluded from the Italian universities. was to be open to all students Protestants. Swammerdam and Leeuwenhoek. to whom further reference will be made. came students from numbers. Catholics. 1935. 2 One 1 of the most versatile professors at Leyden was PETER at the University R. from England. Anatomists. in increasing to become established at Leyden. or SYLVIUS (1614-72). By this time the Reformation had lessened the popularity of the Italian and French centres of learning. then from Salerno to Montpellier. P. and To Leyden. a popular : whom had teacher. John James. and Jews alike. F. 1932 1 Beekman. "3 . English-speaking Student* of Medicine of Leyden. W. the Medical Centre Reference has been in made to the work of two Dutch pioneers neither microscopy. vii. discoverer of the fissure of Sylvius in the brain. was now to shift still farther north. of any medical training. Ireland. Nevertheless the great medical school of Leyden had come into being before that time. even Scotland. Innes-Smith. Leyden (Lugdunum Batavorum) was able to acquire an international reputation. There was Francis de la Boe. although of Protestant foundation. 1 As Latin was the academic language.WILLIAM HARVEY AND HIS TIMES Leyden. which was now The educational centre of medicine which had fading fast. afterwards a distinguished London physician. Med. such an action could not revive the glory of the Italian Renaissance. and eventually to Padua. In 1575 William of Orange desired to reward the town of Leyden for its valiant and successful defence against the Spaniards in the inhabitants He asked the to choose between a previous year.." Ann. passed from Greece to Salerno. and the University of Leyden. and it was a happy choice. Hist. who published a magnificent atlas of anatomy which was unfortunately plagiarized by the English anatomist William Cowper. and GOVERT BIDLOO (16491713). vol. Among the many learned medical teachers at Leyden there were well-known anatomists. and although Padua had evaded the edict by establishing a separate university for non-Catholics. (429) " Bidloo and Cowper. remission of taxes for ten years and the establishment of a university. They wisely chose the latter. student to matriculate was an Englishman. many lands The first medical and from America.

Bull. vol. Meige. 1929. Brunner. and he wrote an account of the disease. Wirsung. who devised a method of preserving anatomical specimens by injecting the blood-vessels with a material which solidified on 2 Of these specimens he had a large number. Cole. The Lesson in Anatomy" was NICOLAS TULP (1593-1674) of Amsterdam. p. who was also a physician and the first to describe the disease beri-beri from East Indian cases. Stensen. He was a pioneer in anthropology. vol. " the central figure in Rembrandt's painting. d'Hist.." Bull. Regnault. and it is said that during his twenty-two years as occupant of the Chair he dissected sixty bodies. Med. "Frans Hals vu par un Medecin. Peyer." Johns Hopk. vii. de Mid. J. Dictionnaire encycloptdiquc des Sciences mtdicales. Wharton. Most familiar of all Dutch anatomists as . showing much zeal and courage during a plague epidemic. ii 8 F. He also practised medicine. "Johnson's Life of Frcdenc Ruysch. He was largely responsible for the foundation of the Anatomical School of Leyden. Physician's Visit Anatomy flourished exceedingly in other countries during The names of Bartholin." in Singer's Studies in the p. describing in his treatise on osteology the cranial differences to be found in the various races of mankind. vol. xxiii. Meibom. which was published after his death. 324 History and Method of Science 1921. in fantastic style and arranged in cabinets.A HISTORY OF MEDICINE PAAW and ( 1 also at Paris. Hist. -. Dentist the heads of their victims. Hahn. " The Physician in the Paintings of Jan Steen. xxiii." Bull. 480 p. such as itinerant tooth-drawers and blood-letters and the quacks who removed fictitious stones from " " is an example. Jan Steen's " " as is his (Plate xxxv). mounted cooling. 1907. Vieussens. Paris. " Les Medecins de Jan Steen.. vol. 1900. T. Dutch artists were fond of painting anatomical scenes. vol. 194 . and Schneider will recall to the mind of the reader who knows his anatomy a 1 L. 187. W. The History of Anatomical Injections. 28 4 H. xix. Hosp. 1 . Pacchioni.. this century. 617 N. He deserves to be remembered as one of the great figures of the Leyden School. 217 . Hazen. 564-1 6 1 7). Janus. vol. pp. 1939. " F. v. Another anatomist of Leyden was FREDERIK RUYSGH (16381731). Churchman. J. p. decorated by dried The collection was eventually sold plants and corals (Plate xxxix) to Czar Peter the Great. 3 and they also included among their models the less reputable practitioners. director x He had studied under Fabricius at Padua and on his return home had been appointed of the Botanical Garden as well as Professor of Anatomy. 1884. a remarkable achievement for that time.

F. English-speaking Students of Medicine at the University of NEEDHAM. T. D. 1 The Dutch physiology was who leading obstetrician was HENDRIK VAN DE VENTER (1657-1724). B. 425. pp. 1924 HALDANE. SPRAT. Catchpole. S. A History of Embryology." Bull Hut Mcd. and made observations on the secretion of saliva and bile. 1905 HERVEY WYATT. Descartes." Janus. S. HIS TIMES duct. 1261 2 Kouwer. D'ARCY. The Seventeenth-Century Background.. 1932 W. 3rd cd. or some other anatomical structure named from well represented by REGNIER de GRAAF discovered the Graafian follicles of the ovary (1641-73). Century. William Harvey (Masters of Medicine). xvii. B. 1932 DOBELL. Leyden. and COURT. R. R. 506 BOOKS FOR FURTHER READING CLAY. 1897 WILLEY. 1934 PACKARD. E. 2 The relationship of the school of Leyden to that of Edinburgh will be discussed in a later chapter. his Life and Times. R. vol. 1940. T. vui. 1931- 195 . p. CLIFFORD. a gland. Guy Palm and York. J. who 1 H. " Hendnk van Deventer.WILLIAM HARVEY AND the discoverer. Antony van Leeuwenhoek and his "Little Animals" 1932 DREWITT. vol. 1925 the Medical Profession in Paris in the Seventeenth New POWER. practised at The Hague and was the first to make a study of the variations of the female pelvis and their effect upon labour. William Harvey (1578-1657). " Regnicr de Graaf (1641-73). History of the Royal Society of London. R. 1722 B\SIL.. 1924 INNES-SMITH. R. The History of the Microscope. F. 1912. J. The Romance of the Apothecaries' Garden at Chehea. S.

1934 196 . believed in the efficacy of the Royal Touch in cases of scrofula. iatro-physical " " view to school Another iatro-mechanical theory.CHAPTER XI SCIENCE AND SUPERSTITION : A NEW THE QUEST FOR BASIS IN addition to the wonderful work of Harvey. of the pioneer microscopists. theorizings appeared in the teaching of Thomas counselled a return to Hippocratic methods. and even the learned Sir Thomas Browne affirmed that witches did exist. and when pushed period. science but only physicians There still remained a substratum of superstition in the medicine of the time. About the middle of the century. as served yet they stepping-stones to greater wisdom. and to replace obsolete Some of the ideas were faropinions by new and fresh ideas. The seventeenth century produced a series of brilliant investigators. as physical " " or This was the or mechanical in nature. 1 There was at that time a general desire to discard the past. who and reminded that was not a medicine also an art. preferred 1 Basil Willey. of the Dutch anatomists. a salutary corrective to such Sydenham. the leading surgeon of his time. The Human Body : Machine or Test-tube ? In the early years of the seventeenth century two curious trends in medicine made their appearance. and of the young Oxford physiologists. Richard Wiseman. and therefore deserve to appear in any account of the medicine of the fetched. and sought to explain all its workings. One school regarded the body as a machine. The Seventeenth Century Background. Let us now examine a little more closely each of the above movements. whether in health or disease. some of whom sought to explain all the phenomena of health and disease on a materialistic basis. to extreme limits were even absurd. the period under review is noteworthy for certain other traits which may now be considered briefly.

who applied his mechanical skill to the service of medicine by designing a number of ingenious instruments. Hist. as he went further than Sanctorius in his application of mechanical principles to the solution of problems of health and disease. the watch of Sir John Floyer. Sanctorius tells us. This theory was designated " iatro-chemical.. Major. R. however. a trocar and cannula for the performance of tracheotomy." upon which he laid great weight of the The results of this pioneer work in what we stress (Plate XL). he estimated the " invisible perspiration. 197 . 1 He invented the first clinical thermometer. p. and a pulsilogium. 369 145 (" Sanctorius ") H. but Descartes was primarily a philosopher. Another Italian of the iatro-physical school is often regarded as its founder. his aphorisms contain much sound wisdom. Sigerist. E. H. 150 Sir M.THE QUEST FOR A NEW BASIS life as a series of chemical processes or reactions. 257). * Santorio Santorio." than in and has been found to be hours. and a token of health . Foster. and which was translated into English in the following century by John Quincy. which he described in his book " The Physician's Pulse Watch (1707). was the weighing machine or balahce in which he literally passed a great part of his life. and his book is one of the most interesting of medical classics. 1 GIOVANNI ALPHONSO BORELLI (1608-79) was Professor " . eating and even sleeping in it. now call metabolisrji he embodied in a collection of aphorisms. p. which antedated by a century a similar invention. x. 1901. assuming that the body was a sort of test tube. vol. is natural. and only incidentally a physiologist. published in 1614 under the title Medicina Statica. Perspiration. The first of the iatro-physicists was SANCTORIUS SANCTORIUS (1561-1636) of Padua." Although Sanctorius was obviously obsessed by his idea. off with sweat. Great Doctors^ 1933. Seated in this balance. Descartes (p." As already mentioned." is insensible." Ann. Med. which Perspiration. 1938. 177) upheld the iatrophysical view of Fhomme-machine.* The most famous (p. Lectures on the History of Physiology. p." Imperceptible perspiration lightens the body more than all the sensible evacuations together. " Insensible perspiration is greater but Sweat is the contrary. waking during sleep " about forty ounces. creation of Sanctorius. but that insensible steam which exhales to the " The quantity of about fifty ounces in the space of one day. must be distinguished from " The perspiration which is beneficial is not what goes sweating. or pulse clock.

was not published until after his death. vol. and placed the patient in the centre of the " The two chief pillars of Physick. and that his early death was much deplored. He believed that all muscles increased in bulk during contraction. vessels.." he wrote in his De picture." Ann. best book of medical knowledge was the narrative of the sick man. waterworks a grinding mill. GIORGIO BAGLIVI (1668-1706) was not only a clever physicist but also a brilliant clinician and a popular teacher.A HISTORY OF MEDICINE of Mathematics at Pisa. when he undertook his researches on animal movement and wrote his great work. 3rd Ser. 1 M. iii." For Borelli this " " substance was succus nervens which circulated through the nerves. however. Med. The teeth were scissors . p. Baglivi soon discovered that all could not be explained in terms of Dissatisfied with current views. We are not surprised to learn that Baglivi had a large practice. Having surveyed the human body from the standpoint of the . the the stomach. Borelli busied himself with the mechanics and statics of the body. healing art could be learned only by a study of the patient himself. Hist. heart and bellows the thorax. calculating with mathematical accuracy the force expended by the muscles and the physical laws involved in animal locomotion and bird flight. 1941. in Rome. Giorgio Baglivi. All the theories of Borelli are now merely of historic interest. 2 As Professor of Anatomy at Rome. . p. Foster." be transmitted along the nerves to the muscles. just as the blood circulated through the arteries and veins. and was held in high esteem. But when he became Professor of Medicine. and that Nature was the best physician. he compared the human body to a collection of mechanical contrivances. Lectures on the History of Physiology." Here was a true praxi medica. " must from without. He also showed that the action of the heart was like that of any other muscle.. 55 (" Borelli ") " F. who then resided. 1 It soon became evident. 1901. he was indebted to the patronage of Queen Christina of Sweden. however. he discovered that the physics. are that the of who held disciple Hippocrates. " Reason and Observation. De Motu Animalium. Stenn. 183 Sir 198 . This was evident to the third member of our group of Italian iatro-physicists. and a close personal friend of Malpighi. which. He discarded theory." he alleged. and that the hardening and tension " inflation of the muscular substance by something were due to " Some corporeal substance. that the working of the body did not strictly conform to mathematical rules. Like Descartes.

E. G. which presided over nutrition. 1932." was produced during the fermentation of wine. He discovered that a gas. Roy. and indeed over all vital functions. or Francis de la Boe." dominated all the bodily processes. Redgrove. let us now turn to that of the iatro-chemist. pancreatic juice. but it was often too energetic and required to be pacified by treat" " Bias has been long since forgotten. remained. but which he called gas sylvestre. It was a professor at Leyden who placed chemical physiology upon a sounder basis. 257 p. The founder of the iatro-chemical school was JEAN BAPTISTE VAN HELMONT (15771 This follower of Paracelsus refused the M. which renders his writings rather obscure. In choosing a profession. a knowledge of acids and alkalis furnished not only a key to the problems of life. 4 was on surer ground when he introduced the word " Gas. Sylvius studied the nature of the juices of the body saliva. for whom he had a great regard. which we now know to be " carbon dioxide. 6 He showed that fermentation. and Mystic.THE QUEST FOR A NEW BASIS iatro-physicist. 23 . and during combustion. the last hope. 75 H. and to Medicine he devoted his life. Ancient and Modern. but also an index of the appropriate treatment. Lecture* on the History of Physiology.. Yet Sylvius was not merely a chemist and physio1 R. because his livelihood would be derived from the sins of the people. Medicine. digestion. vol. xxv. Wootton. Sigerist. was only one of the many chemical changes which took place in the body. with the escape of gas. 1910. would not accept the speculations of the alchemists. FRANGISGUS SYLVIUS (1614-72). 147 (" Sylvius ") 199 . For him. 1922. . Chemist. Alchemy. fever.. Proc. 3 Like Paracelsus. Van Helmont's chemistry was largely tinged with the mysticism of the alchemist. 157 Sir M.A. Philosopher. cough. in an effort to get rid of harmful products. bile. regarded life as a collection of chemical experiments. H. Law he also rejected. Soc. C. Med. Great Doctors. and drew his deductions therefrom. Cumston. Chronicles of Pharmacy." which he alleged was a ferment or a number of ferments. 1926. etc. 1901. Physician. but Van Helmont ment. p. he declined to take Holy Orders. 1933. which he " called It produced Bias. Foster. "Van Helmont. and who who compared the human body to a test tube. O. Moon. vol. 2 He set himself to develop the views of Paracelsus. etc. p. i. as it was not always based on truth and justice." C. 1 ' 4 * 279 (" Van Helmont ") A. he believed that a life force or archaeus. degree of Louvain because he did not feel that he was Master of any Arts.. p.1644) of Brussels. movement. p. History of Medicine. p.

A HISTORY OF MEDICINE legist first he was a truly great clinician. first accurate description of the capsule of the liver his De Rachitide (1650) is well known as a classical " irriaccount of infantile rickets. ready to correct or prevent any irregularity. Medical History from the Earliest Tunes. 4 In his Anatomia A (1597-1677). Med. Dow. and are children not delighted like other children." Willis is also credited with the discovery of the presence of sugar in diabetic urine. who not only designed St. who afterwards became a fashionable physician in London. 3rd Ser. 387 J. was the first to suggest intravenous medication (Plate XLI). Soc. with the agitation of their bodies. one of the first descriptions of the brain. 303 R. S. x. Barach. This Professor of Natural Philosophy at Oxford. Med. and he attracted the excellence of his teaching.* 1928. p. Med. The History of the Study of Medicine in the British hies. The name of Willis is still familiar in its application to the arrangement of arteries at the base " of the brain. vol. p. is perhaps best known for his researches on the nervous system. 1 1 1 (" Glisson ") 1 200 . Moore. Hist. p. p." Ann.. Withington." The rickety E. H. he wrote that the affected " do not shake and brandish their little Joynts. was illustrated by no less a person than many students by Sir Christopher Wren (1632-1723). 1 It is said that he was the . a staunch Royalist during the Civil War. watching the fermentations of the body. " 4 Sir W. THOMAS WILLIS (1621-75) said that the physician." Proc. T. Langdon-Brown. 2 His Cerebri Anatome (1664).. being pleased only with gentle usage and quiet rest." also to the phenomenon of hear" ing better in a noise. the circle of Willis. p. Paul's Cathedral but assisted to found the Royal Society . 17 . Of rickets. Roy. 1894. to introduce clinical instructions at Leyden. 181 " 8 Historical Facts on Diabetes. Sir N. tability borated by Von Haller. vol. might be compared with a brewer or vintner. ii. 1908. Hist. 3 Clinical Medicine in England distinguished contemporary of Willis was FRANCIS GLISSON who succeeded Harvey as Lumleian Lecturer." Ann. and although he was not a medical man. paracusis of Willis. 1940. Hepatis (1654) he gave the . and he described the inherent " was elalater tissues of an of the the idea which body. xxxvi. "Thomas Willis (1621-75) as a Comparative Neurologist. and became Professor of Physic at Cambridge.. Francis Glisson and the Insurgent Century. 1942. there was in England another great clinician who developed the ideas of the iatro-chemical school. vol. Contemporary with Sylvius.

" Mayerne goes on to describe the king's former illnesses. declares physicians to be of very little use and hardly necessary." 1937. now aged fifty-seven years. p. noting everything. Hist. and although some of his prescriptions contain such ingredients as powdered human skull. or the Breast of a Hen or Capon. Sir at of clinical medicine in England. vol. and " balsam of bats. He writes " that the king. Med. 4 The king cared little about the causes of illness. or by " " in He a coach. v. near Geneva. 2OI ." he was responsible for the introduction of calomel and of the mercurial " black wash. who usually called. the blood of weasels. the other two being Those were the pioneers of the study is " . 3rd Ser. 1827. and practised for a time in Paris. 2 He became a physician soon a Fellow of the Royal College of Physicians and Physician to King James I.. ix. T. The History of the Study of Medicine in the British Isles." Ann." and observer still water and all watery drinks. T. Memorabilia. " A Sketch of the Career of Theodore Turquet de Mayerne. Hist." The above quotations are from the translation by Sir Norman Moore. He edited the first edition (1618) of the Pharmacopoeia of the College of Physicians. p.. 288 8 W. " The Iconography of Sir Theodore Turquet de Mayerne. 193 (" Biographical Notes ") 4 Sir N. 1908. has a very steadfast never which was disturbed the brain." Glisson was one of the three great clinical physicians of the seventeenth century. Moore. his skill as In 1611 he settled in London. sea.Mayerne and Sydenham. Hist. simply.. who writes that.. Gibson. Theodore Turquet de Mayerne. preserved in the British Museum (Sloane MS. vol. Med. by drinking wine. p. where won for him an immense reputation. 1933. Wadd. p. hi. Med. THEODORE TUR^UET OF MAYERNE.). but demanded relief to from pain." is bolts affected easily by driving by cold. and producing a record which might well serve as a pattern of case-taking." " has the strongest antipathy his food owing to want of teeth. Gibson. who honoured him with knighthood.THE QUEST FOR A NEW chest he BASIS compared to the Keel of a Ship inverted." Ann. 315 " 1 Letters of Dr. 401 Ann. Mayerne (1573-1655)." 3 That Mayerne was a careful lotion known as is shown by his record of the medical history of James I. and he must have caused a good deal of trouble to " The King laughs at medicine and Mayerne. p. studied medicine 1 Heidelberg and Montpellier. vol. the 1 original manuscript being in Latin. for the middle riseth to a point and the sides are pressed down. 97 .

well named "the English Hippocrates.D. James's Park on his way home. p." and when Sloane at a later date mooted his project of collecting plants in Jamaica. who of course was on the side of the Royalists. Sydenham continued 1 his medical * 8 " John Brown.. 3 Among his friends at Oxford were Robert Boyle the 4 It is chemist. Riesman. go to the bedside . demonstrated that common sense was better than ! asked him to recommend a textbook of medicine. at an opportune time in the history of medicine. Anatomy. Clinician. and John Locke. and little respect for the fundamental sciences. nonsense No. is obvious from the wellknown tales of his retorts to two of his pupils. physician and philosopher. 2 To Sir Richard . ii. Graduating at Oxford. but studies at little is known of his early life. Sydenham told him that he had better drown himself in the pond in St." Ann. 656 J. which must have given him that sympathy and insight into human nature. 1900. ist ed. (One of the best of this charming collection of essays. Sydenham came of a wellto-do Puritan family. I read it Read Don Quixote. young Thomas also enlisted." Such a man was needed to shake medicine. a very good book myself still. 1925. " As a clinician Sydenham was unrivalled his word pictures are unsurpassable. Disciples of Aesctdapius. 202 . p. there alone can you learn disease. vol. Locke and Sydenham. Med. and served for four years as captain of a troop of horse. free from the bonds of such schools and systems as had been introduced in place of the mediaeval scholasticism. so clearly shown in his later life. unlikely that he ever met Harvey. Such were the opinions of the physician who. vague theory.) 4 Hist. vol. As his father and four of his brothers were already serving in Cromwell's army. D. 192). 174 Richardson." in Hora Subseciv*. with a Short Biography. young man.. M." His rejoinder to Sir Hans Sloane (p. he replied who " : .A HISTORY OF MEDICINE The Return to Hippocrates clinical : Thomas Sydenham By far the greatest physician of the seventeenth * century was THOMAS SYDENHAM (i 624-89). D. ist Ser." That he had no patience with book-learning in medicine. Comrie. whose testimonial described him as "a good botanist and a skilful Blackmore.. 1858. 1922 Sir. botany. " " anatomist was.. though less famous than Rab and his Fnends in the 2nd Ser. vii. Selected Works of Thomas Sydenham. His Oxford were interrupted by the Civil War. W. " Thomas Sydenham. In his works he makes no reference to his military experiences. B. Born at Wynford Eagle in Dorset.

who had was suffered mentioning the name of Sydenham. p. MacMichael. A. a white tongue. Of " The measles generally attack children. form. p. 8 The value of his work was not fully recognized until after larity. T. in later years much troubled with stone. W. viii. 1660-1742. 1827. the windows constantly open. Owing to his political views. James's Church. when lecturing at Leyden. in abridged A Treatise on the Gout. 1942. The Ancient Physician's Legacy to His Country (1732). Dover's famous powder is still in use. 1941. " vol. Yet he had many admirers in his day. His best-known works are Medical Observations. quaintly entitled.. His portraits reveal Sydenham as a robust man. whose reason was much superior to mine. ship surgeon and 4 buccaneer. where the College of Physicians." and relates how Sydenham treated him during an attack of smallpox.. ii. in which he discusses fevers. Sydenham. On measles he writes : the first day they have cold and shivers. p. 774 203 . from gout since early manhood. will show how clear and concise were his descriptions." Lancet. The nose H. fascinating to read.Although he was not a Court physician. xlix. Osier. .THE QUEST FOR A NEW BASIS studies at Montpellier." Ann. xlvx. and his book." 6 Sydenham. 84 Portraits of Thomas Sydenham. Med. 259. 213 (" Sydenham ") " Pirate and Buccaneer Doctors. 266 p. 1926. he never became a Fellow of the Royal College of Physicians. He was not a voluminous writer. and short extract from each. 1830. always raised his hat on 1 One of them was his ardent pupil. Nixon. Hist. Jour. P. vol. he disliked popugrave but kindly. M. p. in 1810. ii. vol. Wadd.. Hist. in spite of difficulties and opposition. A W. "Thomas Dover. and was buried in St. THOMAS DOVER (1660-1742). when his books became very popular." in An Alabama Student and Other Essays. Piccadilly." Edm. Russell. his expression 2 Benevolent and modest. 45 W. On the second they have the fever in full. It is greatly to his credit that he accomplished so much. the rescuer of Alexander Selkirk (Robinson Crusoe). vol. Howell. and it is said that Boerhaave. is 6 He refers to " the honest and good Dr. L. p. 3rd 265 " Dover's Legacy. p. Thomas Dover. the bedclothes no higher than the patient's waist and " twelve bottles of Small Beer every twentyfour hours. and on his return he practised in London. H. his extensive practice included many distinguished persons. Jones. 1942. J." Edm. He died at his house in Pall Mall. vol.. his death. Med. Jour. thirst and somnolence. with no fire in the room. Lives of British Physicians. Med. " Salt-water Surgeons. Memorabilia. Med. his hair worn long." Ann. W. Eloesser. erected a tablet to his memory. 1940. " The Ser.. 1908 .

Wootton. Sydenham rendered to medicine was to divert men's minds from speculation. which increase and cluster together so as to mark the face with large blotches. The pain becomes intense. however. Then there appear like flea-bites The symptoms increase until the fourth on the face and forehead small red spots . and he had the greatest veneration for the Hippocratic outlook. . and in vain effort by change of posture to obtain an abatement of .. so serious and so prevalent a disease in England during the seventeenth century. Schnitker. iv. ii. G. 1936 Physick. About two o'clock in the morning he is awakened by a severe pain in the Then follow chills and shivers and a little fever." Bull.. remained popular remedy for many years. The spots spread to the trunk. Med.A HISTORY OF MEDICINE and eyes run continually. Bligh. Chronicles of Pharmacy. he At last the patient has a respite. p. p. rather than the mercury. In treatment. day. cloves. On the eighth day they disappear. 175 vol. " and cinnamon. . for there only could the art be studied. and to lead them back to the bedside." as it was a called. in the form of a tincture to wiiich were added saffron.. . C. great toe. Fevers he treated . W. . he popularized the use of the quinine-yielding cinchona bark. Sixty Centuries of Health and A. . by cooling methods phthisis by open air exercise on horseback. On the ninth. 93 204 . 1910. Blood-letting he practised with circumspection. swells and suffers the same pains. he rejected entirely the the pain. . 1931. Sydenham's laudanum. A. One of his favourite drugs was opium. 3 Syphilis he treated by mercurial inunctions until free salivation occurred. and he believed that it was the salivation." Sydenham was essentially a clinician . he preferred simple remedies. The night is passed in torture . . 89 S. 1 " The victim goes to bed and sleeps in good health. . 2 His method consisted in the careful observation and recording of the phenomena of disease. vol. . there are none anywhere. now it is a gnawing pain and now a . In the morning few days after the other foot finds the part swollen. ." Of gout Sydenham could speak from intimate experience. Now it is a violent stretching and tearing of the ligaments. Sydenham was one of the first to prescribe iron for anaemia . Stubbs 3 and E. The greatest which service. Hist.. lately introduced from Peru.. pressure or tightening. " A History of the Treatment of Gout. p. 1 M. in the treatment of ague or malaria. which wrought the cure. A ideas of iatro-physics or iatro-chemistry.

his He states that the exposure of the errors relating Indian name Quina-quina (literally. 417 205 . and was repeated by Sir Clements Markham in his Memoir of Lady Ana de Osorino. A. and was supplanted by cinchona bark. and is said to have afterwards introduced the drug into Spain. results. she distributed large quantities to the citizens of Lima. Moreover. plentiful The deception passed unnoticed for the barks two being used indiscriminately and many years. nor did she introduce . and thus the two products or barks were often confused. fell into disuse.THE QUEST FOR A NEW The History of Cinchona BASIS Mention has been made of Sydenham's use of " the bark " in cases of ague. p. a powder (quinine) prepared from the bark of a tree. Haggis has gone further in to cinchona. it into Europe. has proved that the Countess died in Spain before her husband was sent to Peru and. conflicting naturally or Jesuit's bark. further. the Countess of Chinchon. 1941. from 1 A W. the pretty legend has recently received a rude shock from the researches of Mr. Med. Haggis. it. which came to be known as Countess's Powder. vol. 1 who. came to be used also to designate the plant Cinchona. Haggis. with Eventually Peruvian bark. London. 1874. Peruvian bark was in such great demand in and the Europe that adequate supplies were not available cargoes were sometimes fraudulently adulterated with the more ." Bull. To this statement. a further note may be added.. Early in the seventeenth century. as it was called. that his second wife. x. Hist.The romantic tale of the discovery of cinchona is familiar to every student of medical history. led a remarkably healthy life. and eventually by quinine prepared cinchona bark. after a study of the original diary of the Count of Chinchon. . originally applied to the tree Myroxlyon which yielded Peruvian balsam. and never returned to Spain at all. bark of bark). " Fundamental Errors in the Early History of Cinchona. who accompanied him. wife of the Viceroy of Peru. The story was first recorded by Sebastian Bado in 1663. As a thank-offering for her recovery. was miraculously cured of a fever by the use of a remedy suggested by a local governor. Countess of Chinchon. W. Unfortunately. so that she was neither cured by cinchona.

commenced slums. Journal of the Plague Tear. which was seldom. Med. for. and needless to say. the words. and light neither water supply nor sanitation. There had been previous outbreaks of plague in London. Crawfurd. the very physicians were seized with it. or the old women who " performed the gruesome task of searchers. p. Owen. locked and guarded. with their preservatives in their tion of death 1 viii. Plague and Pestilence in Literature and Art. as most of his patients had fled to the country. Many escaped from infected dwellings and spread the Of those who remained. where the wooden houses. 249 R.. vol. but " The Poore's Plague as it " of 1665 eclipsed in the or air. indeed whole streets of families. said he. with little the plague. " The Poore's Plague and Mr. and can hardly be regarded as an eye-witness." and that the plague defied all medicines. save the physician. Defoe. 1926. evaded. which had appeared shortly " " tokens or God's before death. 206 ." which were the only index of the extent of The law was often the plague. with his family." Ann. R. records his feelings when he saw several marked houses in Drury Lane.A HISTORY OF MEDICINE The Great Plague of London Among the diseases described by Sydenham was plague. in whose diary there arc many references to all in fury. of infected houses. p. 2 Almost invariably the tokens foretold a fatal issue. feared how a man can escape. us. them It was well named. which he had ample opportunity of observing in London during 1665. he had deemed it prudent to follow. and which were known as marks. Pepys. the " Bills of Mortality. 187 Hist. in his disease." Samuel Pepys." No one might enter or leave the sealed house. were marked with " Lord have mercy on a red cross and. were by no means accurate. in large letters. 1914. G. which. The bodies often showed dark red patches. when available. tells us " whole families. Notificawas not then compulsory." their duty being to view the dead bodies in order to report the cause of death. for which the Lord God bless me or make me fitted to receive it. few survived. although. favoured the spread of any 1 Conditions were made worse by the enforced closure epidemic. and his natural fear that he might be a " the season is so sickly that it is much to be victim. were swept that " away altogether. though he was only six years old in that year. while the epidemic was at its height.

The first edition. 105 (" Hodges ") 8 Nathaniel Hodges. Mcd." he drinking to cheerfulness of " concluded the evening at home." by way of fumigation. and visited the sick at their homes. Hodges tells us that he rose early. 1940." couraged sleep On two occasions he felt ill and feared he might be smitten with plague. though based on reliable information. After a further round of visits. Memorabilia. and tokens were upon them and they dropped down dead. vol." Then he breakhours. albeit with such imperfect weapons. which contained twenty-one ingredients. until my old favourite liquor.THE QUEST FOR A NEW 5* BASIS " men went about prescribing to others till the mouths. 1722. and promoting perspiration by serpentarium. for two or three " crowds of citizens.. London. and dried toad powder. 79 . 3rd ed. dated 1672. saw 3 On the threshold of fasted. cinnamon. $rd Ser. in the city to fight the plague 2 One of the physicians who stayed was Dr. Meanwhile he sucked lozenges containing myrrh. 1927. He tells us that he tried bezoar stone. he drank a glass of sack " before and after the meal. H. (Entirely a work of fiction. and angelica root. Hist. Describing his daily round while the plague was raging.. Wadd. " " the Greek word loimos meaning pestilence. He " " Plague water quotes a number of prescriptions. Evan. including the of the Pharmacopoeia of the College of Physicians. is now a rare book.) 2 G. p. and Sir Theodore Mayerne's cordial with its twenty-nine component drugs. unicorn's horn. his favourite remedy. destroyed by the very enemy they directed others to oppose. A Journal of the Plague Tear. and he took care to recover his breath and coolness before entering the sickroom." * All honour to those brave physicians who remained in London to fight the . by Hodges treated rest.pestilence. Loimologia. or Virginian snake root. John Quincy. eight or nine at night. " each dwelling he immediately had burnt some proper thing upon coals. which enand an easy breathing through the pores all night. The book is of great interest as a first- W. complete 1 Daniel Defoe. Recognizing that the infection was air-borne. (English editions of this work are still occasionally obtainable. NATHANIEL HODGES (i 629-88). Hodges noted the benefit of fresh air. his plague patients very sensibly. " Nathaniel Hodges. ed.. took a dose of antipestilential electuary and then. entitled Loimologia. as in a hospital. hand account of the plague. ii. 1772. to whom we are indebted for the best contemporary account. insisting on with light diet." Ann.) 207 . but that these much vaunted cures were of no value. p. On returning home to dinner. but a glass of sack proved a sure antidote.

The bills of mortality showed a steadily rising death rate." Hodges mounted " " my states that during that third week of September 12. the epidemic gradually declined.A HISTORY OF MEDICINE miasmata/ exhale a fetid and and of fumigation. the air was polluted by the corpses. (The most complete and reliable 1 Us.000. reception stench of bodies buried too near the surface in a summer which was unusually hot and sultry. which throw suffocating sulphur. commencing in June. and the cry of " Bring out your dead. when the plague reached not thus escape the streets were broken only by the tolling of bells. It was believed that dogs carried the infection. Salisbury. The Great Plague in London in 1665. Nevertheless the plague on in the country during the following year. Plague On (A well-documented history of plague. coffins became unobtainable. made a praiseworthy though futile effort to discover the cause of the disease by post-mortem examination as he records in his book entitled " Loimotomia (Plate XLII). so that three. to Oxford. and 1 Then great pits were dug for the churchyards were soon filled. five thousand died in a week. is probably more correct than the official figure.297. the trouble. were in dreadful plight. and by the month of December people were flocking back to the city. lest it should please God to take me. with 208 . Thereafter. real source of the which were the rats." wrote Pepys." Funerals were forbidden. house and all things in the grievous Settling best order I can. Bell. an appalling climax in September. reaching " brisk winds which help to dissipate the poisonous 5 gradually abating until by his court fled to Salisbury. G. the death rate became steadily less. fear was replaced by hope. when the entire population of London was some In the third week of September the mortality had 500. shops re-opened and his estimate resumed its normal course. the deserted. The king and and thence. and they were No war was waged therefore slaughtered in great numbers.) Geddes Smith. of the and even so. The poor people who could Trade stood still . which " resinous woods. special reference to America. 1941." A contemporary physician. against The plague raged throughout the summer of 1665. 1924. and then November it was gone. GEORGE THOMSON.* The biggest Bill yet." but with out a clear and unctious smell.000 perished. silence was to 8. four. not with coals. so that dragged life 1 and W. which is very to us all.) modern account. The rumble of the dead carts.

ilkistiated by (Sn) Christopher \\uii. marked in the abo\e figure from his book De Horrnne (page 177) H .is "the circle ol \\ilhs" (page i>oo. . Descartfs regarded the human lx>dy as a machine controlled by the soul. which was located in the pineal gland.md tht above represents tin arrangement ol blood-\ t ss< Is kiio\\n .PLATE XLI THE ANATOMY OF THE BRAIN In 1664 1 homas \\ilhs of Oxford published Ins (Icichrt Analome.

PLATE XLII THE GREAT PLAGUE OF LONDON * Loimotomia." I'lontispu'cr from by Qcorjj< 1 liomson. en J IK Pest Anatomised. in \\hich lit t^i\ t-s an account of his Hhi is t<j avctitmn the cause of plague tiy post-mortem k examination (page 208) .

and it helped to raise the status of the surgeon. (d. was the greatest work on the . The Early History of Surgery in Great more. Wiseman army of Charles I until the final defeat by Cromwell at Worcester in 1651 Next came a period of service with the Spanish Navy. Britain has never again been visited by plague.500 deaths. 113. which had previously been altogether subservient to that of the physician. Meanwhile. and thus ended the plague which had killed more than a fifth of the inhabitants. there was PIERRE 1718) of Paris. After the Restoration Wiseman returned to London. and JOHANN SGULTETUS of Ulm (1595-1645). 1920. Long1 209 5 . In France.THE QUEST FOR A NEW many BASIS Norwich. The name of RICHARD WISEMAN Father of English Surgery. For a time he was a surgeon in the Dutch Navy. who gave courses of operative surgery on the cadaver. whom we have mentioned. 1 G. DIONIS England was represented by one who accomplished for British surgery a work similar to that achieved by Thomas Sydenham for British medicine. and Sydenham as Roundhead. published in the year of his death. Wiseman made excellent use of the years of experience in naval and military surgery. surgery in England which had appeared up to that time. and military indeed we have scant knowledge of his adventurous life. Apart from slight sporadic outbreaks. career of Wiseman need not detain us long. and other towns suffered likewise. Richard Wiseman a Biographical Study. 1891 < 4 ^) . a post which he faithfully occupied until his death sixteen years later. had 2. whose Armamentarium Chirurgium contains illustrations of many instruments of his devising. modestly entitled Severall Chirurgicall Treatises. writings were highly esteemed. His book. GOTTFRIED PURMANN (1649-1711) was a German army surgeon whose advance in surgery. p. Parker. The King's Evil and Royal Touch the The seventeenth century was not marked by any great Germany produced such men as Fabry of Hilden. Sir T. London was purified by the Great Fire. The as Cavalier. Then he served with Civil War. then the second city of England. although they served on opposite sides during the the " ( 1 622-76) 1 . publishing a textbook with illustrations of the instruments required for each operation." is worthy to stand beside that of Sydenham. and was appointed Surgeon to Charles II. Britain.

" 2 The custom reached its zenith during the Stuart period. 39 . xiii. witness of hundreds of cures performed by His Majestie's Touch Nevertheless he alone. Riesman. chiefly affecting the lymph surgical language. 101 . Numismatic Jour. without any assistance of Chirurgery. glands of the neck. p. 4. pieces vol. and the and as time went on the cure was attended with great ceremony and was incorporated in the liturgy. 247 1911.500 persons. " Touchfor the King's Evil.000 persons every year" (Plate XLHI). The King's Evil " ceremony and of touch-pieces.A HISTORY OF MEDICINE Perhaps the most interesting of the treatises is that devoted to King's Evil. he being then about two years old. 1827. God grant you better health and more sense. " states that Charles II actually touched. Dr. or KingsEvil-Swellings (1654)." Brit. vol. the name applied to struma or scrofula. 496).") (Fitzpatrick Lectures).. " " to treat the evil was Edward the Confessor. 2IO . which his royal master claimed to cure on so lavish a scale. . In 1660. from then to the end of his reign. it is not surprising that he chose to write on King's Evil. saying." but Queen Anne restored the 3 One of the custom. Wiseman gave an excellent account of scrofula. Each patient received a gold coin." In France this divine attribute of kings dated back to Clovis the Frank (A. 173 (Well documented and illustrated.725 persons. and the grand total. xv. To return to Richard Wiseman. though she was the last of the royal healers. p. It was called King's Evil. vol. some were cured of the king's evil. xiv. The Story of Medicine in the Middle Ages." 1 The practice continued in France until I775. Wadd. " Louis XIV is said to have " touched 2. p. p. and John Browne. Samuel a than touched was less her no patients by person Johnson. is the standard authority on the subject. as it was believed " to be curable by the Royal Touch.D. vol.107. (Contains . for he touched but few. or in modern " " tuberculosis. Memorabilia. was sceptical King William " of the royal power. whose work entitled Adenochoiradelogia. as Wadd quaintly remarks in his Memo" rabilia (1827). 134 Raymond Grawfurd. the year of his restoration. p. xii. on an average. 1 first English king D. 1 8 Helen Farquhar. which brought more patients and more fame to those royal practitioners than they deserved. Even during his exile in Holland he was so besieged by sufferers seeking relief that on one occasion six persons were trampled to death. or " touchpiece. was 92. who never had any other evil than that of poverty." and thus. 1935. p.) illustrations of the W. 205. and that he believed in the miracle performed by the " I have myself been an eye king is evident from his statement. he touched 6. New York.

Muscles. In Norwich he conducted a large and extensive practice." " Bones are frequently affected . vol. he settled in Norwich. Wiseman gave a graphic account of gunshot wounds. yet the inward juices are all putrid and rotten. H.THE QUEST FOR A NEW BASIS . A Divers Parts of Europe. may fitly close with a reference to a medical man and philosopher who made an immortal contribution to English literature. so that Wiseman had ample clinical Here are a few . " sentences from the treatise The parts usually affected are either : Glandules.. 11 Religio Medici " This chapter. Sir Thomas Browne (English Brief Account of some Travel in Men of Letters) . 1 905 ii. "Sir Thomas Browne. Viscera. Med. he was educated at Oxford and later at the then leading medical schools of the Continent Montpellier. 1 Born in London. shows what chirurgery can do when the king is not available " in his own words. Shortly after his return from abroad. Sir THOMAS BROWNE of Norwich (1605-82). for such as had not the opportunity of receiving the benefit of that stupendous power. and described many cases from his vast experience. 1930. I 8 Edward Browne. and was well known . He married Dorothy Mileham. or Bones. 3 attained eminence in medicine. Membranes. and became President of the Royal Thomas Browne was a Royalist. . Hist. Tendons. and the Bone swells and the outward shell thereof appears hard.D.." Ann.material upon which to base his description. who bore him ten children the eldest boy. Edward." Scrofula was very common at that time. where he lived and worked for forty-six years. and Leyden. M. which opened with an account of some philosophers who influenced medicine. p. wrote a notable book of travel. as is better known an author than as a physician." In another of his treatises.. I do not remember ever to have seen the Nerves or Brain affected. 2 Padua. but in College of Physicians. . Rolleston. his works he preserved a discreet silence on politics. He was basis." " Glandules are a very notorious seat of this Distemper insomuch that authors generally have confined it to them as its Subject. 1685 211 . 1 * Sir Sir Edmund Gossc. 2nd ed. and his writings deserve the attention of every medical man. yet he fills an important place in medical history. on a sound and well qualified to establish British surgery right well did he perform this task.

Moore. conferred on King Charles II. in manuscript. despite its unorthodox views." great Moses burnt the Golden Calf. or anything." Whence it came he could not tell. what tender filaments that Fabrick hangs." Thus we are men and we know not how there is something in us that can be without us and will be after us. in visiting Browne the honour of knight- hood. loyal son of the Church of England.) 1 Sir 1 W. which had a great reception in England and on the Continent. and thus hastened the appearance of the authorized edition of 1643. all airs. he was no slave to creed. who wrote his Observations on it. for that mystical metal consumeth " he could not dream " that there should be at the not in fire . which he wrote at the age of thirty. (Reprinted in An Alabama Student and Other Essays. Religio Medici was written at a time when the new thought had separated science and medicine from the Church. Twenty editions appeared during the author's lifetime. for he had " no antipathy in dyet. and there have been innumerable editions since then." and for him last day any Judicial proceeding or A Countrey. 69 " Sir Thomas Browne. humour. 212 . I must confess a scriptures. January 1906." His training as a physician induced him to remark upon the intricacy of human anatomy. make one air. " all places. among his friends. " he wrote of would gladly know how deal he obscurity. but was circulated. the town in 1671. just after his return from his three years of continental study (i635). do wonder that we are " not always sick. Osier. The History of the Study of Medicine in the British Isles. as it was inconceivable that a medical man could be a Browne seeks to reconcile faith and reason. although he recognizes that " many things are true in Divinity which are neither inducible by reason nor confirmable by sense." The Library." But he found in the Fabrick no Organ or " Instrument for the rational Soul. . The very title was a paradox. a copy reached the notorious Sir Kenelm Digby. Printed by one of them without permission. and to marvel how health was pre" I that have examined the parts of a man and know upon served. p. 2 ^ was not intended for publication. 1908. religious man." His scientific mind would not accept a literal interpretation of the " For the first chapters of Genesis. It is : N. 1 His best known work is Religio Medici.A HISTORY OF MEDICINE as a naturalist and antiquary. calling to the bar as indeed the Scripture seems to imply." as the idea of Hell was inconceivable to him.

W. Francis. so modern in his outlook. 1 A 1912. from a copy in the possession of Sir William Osier. Francis. or Hydriotaphia (1658). convicted of witchcraft. not surprised to learn that . 1906. or Enquiries into Vulgar and Common Errors (1646). death and immortality. it suggests more than its words express. Lamb. Browne was for Osier a hero and example whose writings he was wont to recommend to students of medicine in " such words as the following Not only does the charm of high clad in beautiful thoughts language win readers to a love of good is One (Urn Burial). in modern times. W. p. L. which contains observations on every department of knowledge. should have believed in witches. Sir Thomas Browns.. 92. vol. i. Portraits. a kindred : literature. although these can convey no idea of the symphonic nature of the work. 1 924 8 W. and Ancestry. : gleaned from the writings of Sir of counsels of perfection which Mastery of self. 1908). who were convicted of witchcraft before Sir Matthew Hale at Bury in 1664.THE QUEST FOR A NEW to multiply quotations BASIS tempting Religio. even adding his evidence in the condemnation of two old women. deep interest in human beings Student. Quaintest of all is Pseudodoxia Epidemica. Johnson. Strange indeed that Browne. though he confessed We are but embryon philosophers." Lancet. W. 1 Like It stimulates music.. The Garden of Cyrus (1658) treats of ancient gardens and of much else besides. 3 who drew attention to two Sir Thomas Browne. Everyman's Library. Rehgio Medtci and Other Works. a and man a sane outlook on the "gives thought complex probJems of life. his Skull. That this view is erroneous has been shown by Dr. Browne discourses with 2 great eloquence on his favourite theme. that illustrious and versatile physician Sir William Osier. (This is a handy edition and readily obtainable. Lowell. A dialogue between two infants in the womb concerning the state of this world might handsomely illustrate our ignorance of the next from the " many have found in Browne them among Coleridge. but some of the earlier editions facsimile of the first edition was published in Oxford in 1909 are very attractive. . spirit and. No. but the Religio is full appeal to the mind of youth." The mystery of death ever intrigued Sir Thomas " Browne. Tildesley. and is a plea for the use of the Baconian principle in research.) 1 M. these best of all lessons may be " Thomas Browne (An Alabama In Urn Burial. It has been widely believed that Sir Thomas Browne was responsible for the hanging of Amy Duny and Rose Cullender. " Sir Thomas Browne and the Witch-Trials : a Vindication. devotion to duty. 158 213 .

D. some of Browne's biographers have perpetuated a statement so damaging to the high reputation of one whose character was so Belief in the supernatural retained this gentle and saintly. H. Selected Works of Thomas Sydenham. Lectures on the History of Physiology. W. M. Ancient and Modern. 1905 LONOMORE. 1931 . Sir T.D. The Early History of Surgery in Great Britain.. 1924 COMRIE. E. Richard Wiseman. and need not detract from the homage due to the Sage of Norwich. 1920 REDC. J. 1891 PARKER. Malcolm Letts after a study t BOOKS FOR FURTHER READING BELL. The Great Plague in London in 1665.ROVE. STT nns. 1922 CRAWFITRD. 1914 FOSTER. G. D. RAYMOND. 1901 GOSSF. 1935 RIESMAN. Sir EDMUND. S. articles in the Norfolk Chronicle of Mr. Alchemy. written by of the contemporary official Sir Thomas Browne was present in court. G. a view shared by the great majority of his learned contemporaries. G. Sir Thomas Browne (English Men of Letters). W. New York. report of the trial. witchcraft. Plague and Pestilence in Literature and Art. and at an early stage in the trial the judge asked him to state He thereupon expressed his belief in the reality of his opinion. 1922 The Story of Medicine in the Middle Ages.A HISTORY OF MEDICINE December 1911. Sir M.. but he took no part in the condemnation of the accused. It is highly probable that the witches were convicted on the evidence adduced by the prosecution without reference to It is indeed unfortunate that Sir Thomas Browne's opinion. medieval flavour long after the Renaissance. a Biographical Study. Sixty Centuries of Health and Physick. and BLIGH.

vol. Hist. and then there came a time when it was mass of new necessary to pause and take stock of the situation. could be applied with advantage in the daily age. Larsson. Physician and Botanist. H. many other systems about 1 this time. B. round of medical practice. known as LINNAEUS (1707-78). t 1938. Linnaeus The Story oj His Life. all the sciences. not only all things on the earth. 1923 215 . each having its genus and its species. but also all the heavenly bodies. was bound to exercise a profound effect upon 1687. in fact the entire universe. Med. Linnaeus. whose garden may still be seen at Upsala. SIR ISAAC NEWTON (1642-1727) was not directly concerned with medicine. Newton's Principia. Jackson. x." Ann. " Carolus . and Linnaeus brought order. extended to animals as well as plants. and the method. and thus gave science a means of classification which brought order and uniformity in place of confusion. one of the most eminent physicians of all MANY A time. New facts had accumulated without being assimilated. In addition to the general principles laid down by Newton and " " and theories were evolved at Linnaeus. 197 B. p. Most of them are now obsolete and : forgotten. Nevertheless his proof that certain laws governed not only the human body. if some semblance of law and order was to be achieved.CHAPTER XII XVIII-CENTURY MEDICINE years elapsed before the brilliant discoveries of the new or Renaissance. published in " has been called the greatest triumph of the kuman mind." slightly later date Carl von Linne. D. included as its leading representative Homo sapiens. In medicine the outstanding figure was that of Boerhaave. introduced the binomial method of classifying plants. when two great scientists supplied the need of the age. To the apparent chaos Newton applied law. This was the condition of affairs at about the beginning of the eighteenth century. knowledge awaited arrangement and classification. The Systema Naturae was published in 1735.! a successful physician as well as one of the greatest At a botanists of all time. and that there was one set of laws for all.

all vital movement was the soul or anima. Stahl strove to reconcile the views of physicians and theologians. It was true that the body did eventually die. Stahl was not gifted with an engaging convincing. on the other hand. to whose life and work we shall afterwards direct the reader's attention. like Descartes. animism was simply so much nonsense.A HISTORY OF MEDICINE but as they played an important part in the evolution of modern medicine. and each advanced along a separate path. Nevertheless there were those who thought otherwise. 2 His anima" had been described blended. Withinpton. the defence being often ineffective." The soul he alleged. Medical History from the Earliest Timer. and it involved a policy of undue simplicity in the treatment of disease. In the age under discussion a wide gulf had formed between them. archaeus. and he even denied that anatomy was essential to the physician. or pneuma. had become so materialistic that the functions of the human body in health and disease were simply questions of physics and chemistry. resented the apparent degradation of the soul into a kind of defender of the body against death and disease. and in modern times as the subconscious or unconscious mind. p. To the physicians.y 1926. p. Professor of Medicine in the newly constituted University of Halle. " Stahl 's idea was not new. f. 334 " Richard Koch. 1894. 20 2l6 . This was GEORG ERNST STAHL (16601734). as we have noted. Gcsch. devoid of proof. Nor would he admit. prevented the putrefaction which takes place after death in the soulless body. Stahl discarded chemistry or physics. vol. The theologians. that soul and body each went their In Stahl 's opinion soul and body were closely separate ways. Medicine. if only to emphasize the far greater importance of Boerhaave. some reference must be made to the theories and to their sponsors. 1 1 E. and the source of " * previously as nature. and at this stage we encounter a medical prophet who dared to reaffirm the existence and importance of man's immortal soul. xviii. but he satisfied neither party. Thus Stahl's views were open to question and were not very Moreover. T. Med. War Georg Ernst Stahl cm sclbstandiger Deiiker ? " Arch. but that was only when it no longer provided a suitable habitation for the soul. Animism and Vitalism The action and reaction between medicine and religion throughout the ages is one of the most interesting aspects of medical history.

" while lack of it. and appears to have deserved the criticism of Boerhaave. as this was a not need remedies mann's anodyne his extensive The One of his preparations. as it was obvious that this was merely another name for the life " " force which had eluded so many inquirers. He was intolerant of criticism. and urbane temperament." The idea made little progress. 1 Aetheris Co) still survives. Medicina rationalis systematic^ in nine volumes.. and by suggesting that the psychical aspect of disease personality. 1910 217 . blunt in manner. C. caused acute disease. tonus. JOSEPH BARTHEZ of Montpellier (1734-1806). who called should not be neglected. and tonics for the latter.XVIII-CENTURY MEDICINE him " the sour metaphysician. Vitalism presented no advantage over animism." and that this subtle something maintained the body in a state of tonic equilibrium. His system of medicine was based upon the belief that the universe was pervaded by a finer than all other matter. Hoffmann had all the of the successful physician.materialism. soul. disease resulted from excess or deficiency of " Excess of tonus. who was born in the year of Stahl's death. Hoffuniversal practice at the time. vital substance. 1718-40. In Hoffmann's view. qualities Nevertheless Stahl and A man of kindly Hoffmann had little in common. Often associated with the name of Stahl in medical history is that of his fellow-professor at Halle. A. Chronicles 1 of Pharmacy. has long since been forgotten." Nevertheless he served his generation well by provoking some degree of reaction against . he would probably have become a distinguished psychiatrist. This " he called the vital principle. Had he lived to-day. although (Spiritus work. Even the modern fact that patient still demands " a tonic " from his doctor. consisted for the most part in the administration of sedatives for the former condition. caused chronic disease. but he also gained a great reputation as a teacher. or spasm." introduced a dominant which he alleged was neither the one nor the other. but not exactly spirit. or atony. FRIEDRIGH HOFFMANN (1660force 1742). therefore. Treatment. or mind. Hoffmann employed and sold certain secret detract from his good name. Not only did he conduct a " large practice. recognizing the difficulty of champion" " " soul or of ing the claim of body. 2 vols. Wootton.

Medical Portraits. between the students of Brown and those of Cullen. became the subject of much controversy. p. while his boastful manner made him unpopular with his colleagues. the two teachers having come into open enmity. Richardson. his record did not improve. Withington.. and had even been in prison for debt. vol.' The Brunonian system was really very simple. according to Brown. as Brown was an excellent Latin scholar. 1 4 T. vol. to 5 1 M. but achieving no success in either he turned his attention to medicine. alas. indeed. food. 1894. i. H* Garrison. One result of the quarrel was that Brown could not hope to graduate at Edinburgh. intellectual energy. who employed him as secretary and tutor to his family. He was at war with all his colleagues. and he died in poverty two years later. Sir B. although popular with his students. He devoted himself to education and to theology in turn. Life. Continuing his medical studies. in 1786. 351 2l8 . 245 -F. and to publish his work Success attended those entitled. which closely followed those of Hoffmann. p. 1838-40. 2 vols. so violent. W. Andrews for his News of the Brunonian doctrine reached the degree. p. History of Medicine* 3rd ed. J. Consequently. of which Brown was twice President.. Large and Small While Hoffmann was approaching the end of his life. 319 E. 2 Unfortunately for himself. 4 Yet in his own city the prophet was without honour. muscular movement. where it gave rise to violent controversy. Medical History from the Earliest Times. Continent. T. he determined remove to London. 1896. JOHN BROWN ( 1 735-88). 221). He was at first befriended by Cullen (p. he was of fickle temperament and of convivial habits. Pcttigrew. There. Brown even ventured to give extra-academical lectures in medicine. depended upon continuous stimulation. * a child of poor parents in a Berwickshire village. and was obliged to proceed to St. was educated at the grammar school of Duns and at Edinburgh University. Such is the brief history of" the Paracelsus of Scotland. there was born in Scotland a man whose views.A HISTORY OF MEDICINE Doses. " views in the so-called Brunonian the and activities. Disciples of Aesculafnus. expressed " 8 his students. iv. Elementa Medicinae (1780). that at the University of Gottingen it became necessary to call out the military to quell the disturbance.D. 1924. The stimulants were warmth. were warmly espoused by System Stormy debates raged in the Royal Medical Society.

1845. the greater was the potency. p." In other words. Guttcntag. the new idea was strenuously opposed by the 1 * H. cause certain symptoms. defect of stimulation. provided that the correct remedy had been chosen. in large and even No lating drugs. and that a second dose should not be given until the first had ceased to act. who spent most of his life in Leipzig. His views were in a work entitled Organon der rationellen Heilkunde. Little Brunonian methods tion killed wonder that it has been remarked that the more persons than the French Revolu- and the Napoleonic wars taken together. was the originator of homoeopathy. drugs which. as a rule. p.XVIII-CENTURY MEDICINE emotion. 1172 2IQ . E. cures like. The third principle of homoeopathy was that the dose should be so small that it would act only upon the disease. and whose influence is still felt to-day. Similar reasoning determined the use of cinchona for ague and ipecacuanha for asthma. There can be no doubt that. 682 O. vol. a system of medical treatment which is usually associated in our minds with the B use of drugs in infinitesimal doses. diluted and rediluted many times. and he defended his use of solution of a drug. therefore it was used in scarlet fever. assumption. frequently. At the opposite extreme. other diagnosis was required. etc. are to be given in illness when such symptoms are present. or. much more Disease was the result of excess of stimulation. Acting upon this . viii. Hahnemann argues that the smaller the dose. Hahnemann succeeded in 2 Belladonna classifying the drugs which served his purpose. Past and |fresfpt&7 amt. 1940. 1 The chief principle of homoeopathy. when administered to healthy persons. lies not in the absurdly small dose but " like in the selection of the drug. who likewise moulded medical thought in less drastic but more permanent fashion. SAMUEL HAHNEMANN (1755-1843). Similia similibus curantur. setting aside the value of his deductions. and the treatment was obvious. Med. " " heroic doses of stimuconsisting. "Trends Towards Homoeopathy. Hacser. Gfschwhte der Medn'm. As a result of numerous experiments on himself and his friends. Another rule of his system was that only one remedy should be used at a time.. however. stands a contemporary of Brown. Hahnemann added greatly to our knowledge of the action of drugs. by stating that disease produced an abnormal sensitiveness to the given -drug. causes symptoms resembling those of scarlet fever. Brown classified all diseases as sthenic or asthenic. as regards dosage.

vol. 1 A How did Boerhaave Speak?" Janus. was HERMANN BOERHAAVE 668-1 738). Proc. This silenced the critic. Instead. who had just startled Europe by affirming that God was everywhere. notebook of a Carlisle physician). History of Medicine. The Life and " Boerhaave Pilgrimage Writings of Hermann Boerhaave. the young divine determined to his and to adopt the calling to which he was change profession. Hist. Mrd. ( greatest of all time." of the birth of J<wy. H. his younger brother James would enter medicine. Roy. xi. It may have been his attendance at lectures on anatomy." Hermann distinguished lymself as a student by the ease with which he acquired a sound knowledge of mathematics and of classical and modern languages. H. far the greatest clinical teacher of the eighteenth century. "Hermann Boerhaave. 3rd ed. C. " in Holland. Success came rapidly. vol. and to devise methods of teaching which would yield the best It is a relief to By medical practice. who was poor in money but pure in spirit. vol. Young Hermann was travelling in a packet boat when a discussion arose among the passengers regarding Spinoza. E. x The son of a country pastor. p. I 22O . 257 . Sigerist. and one of the of Leyden " 1 Eventually it was James who became the minister and Hermann it is said. and when first introduced served a useful purpose in checking the dangerously excessive drugging which was then prevalent. xvii. 2nd ed. 1924. condemnation of such heresy. p. Boerhaave found that there had arrived before him the rumour that he was a follower of Spinoza. Garrison. of the following encounter. On reaching Leyden. p. Hist. p. Soc. W. 1939. (Sect. It was useless to protest. which first Yet his father felt that so clever a attracted him to medicine.). 1917. but he had his revenge." Bull.. attracted. 320 . xxin. One speaker was the doctor. vii. As a junior already strongly particularly severe in his F.. Med. 145. (Oration on the 2501*1 anniversary " On Consultations with Boerhaave " (extracts from the Boerhaave) . vol. Burton. H. E.A HISTORY OF MEDICINE were likely to be deprived of their profits. 193. Hermann would study theology . youth must not be lost to the Church. Drones. Clinical Medicine under Boerhaave who were results in turn from these theorists and extremists to those content to make the best use of the existing knowledge. Yet homoeopathy has it had many followers. 1918. 1912. then regarded as an essential part of a liberal education.. 1746 . until Boerhaave asked him whether he had ever read the works which he so hotly attacked. van Leersum. the result. p.

Europe. in his later years. vol.. J. Only second in importance to Boerhaave as an eighteenthL Cullen was century teacher was WILLIAM CULLEN (i 710-90). Boerhaave is still an Leyden by elegant statue by the Boerhaave Kwartier. 1710. centre of the picture. possessed also. 1879 Century Consultant. I ife of Dr. so that it is of a^ letter from China. Beloved and honoured during at . and gifted with a keen memory and a wide knowledge of affairs. he accepted the Chair of Chemistry in 1718.. 17 *' An Eighteenth- 221 . and Aphorismi. p. lecturing extempore in well phrased Latin. that of Like Hippocrates." which was delivered without delay. of a sound physique. and on his appointment to the Chair of Botany and Medicine at Leyden in 1 709 his fame spread so widely that students from all over Europe. 1 J. once the seat of such intense activity by his lovely country house. commemorated his lifetime. and in 1731 he published Elementa Chemiae. Comrie. qualities of great value to the popular teacher and fashionable physician which he was (Plate XLIV). and even from America. he placed the patient in the Hippocrates. both of which passed through many editions and were the The Index Plantarum. and adopting any theory or system which might serve his purpose. he made excellent use of this scanty material. .twenty years he was the central figure of European medicine. . . Med. . is subject of various commentaries. no doubt. a catalogue of the Botanical Gardens of Leyden. for Boerhaave was a partisan of no special method except. 1 709. 1 708. His chief works are the Institutiones Medicae. perhaps. in manner.XVIII-CENTURY MEDICINE Lecturer on Medicine he attracted many students. 1925. xxxii. Not content with his reputation as a leading physician and botanist. as the Medical Buildings are called by his town house. Jour. His enormous private practice drew patients from the entire civilized world. a present from a grateful patient and by the botanical gardens which he so greatly loved. which had engaged his attention for some years. and favoured observation rather than argument. Thomson. though he suffered greatly from gout He was dignified. born at Hamilton. in Lanarkshire. Boerhaave. Needless to say. 2 vols. William Cullen." Edm. D. where his father was a lawyer. which he classified and enlarged. Although only twelve beds were allotted to him. For over . though kindly. came to attend his classes. he was a man of intense activity and boundless energy. addressed easy to believe the well-known tale " to Dr.

Ramsay. About this time he formed a friendship with William Hunter. Cullen became sole professor. MacMichael. materia medica. From the Grammar School of Hamilton young Cullen proceeded to Glasgow University. 1911. p. he arranged with JOHN GREGORY (1724-73). he became ProMedicine in Glasgow.A HISTORY OF MEDICINE and factor to the Duke of Hamilton. Fergus. Cullen given in the vernacular instead of Latin. not practice. of Chemistry in Edinburgh. his plate in his native town. on his favourite subject. and the two determined to practise in partnership. which the distinction he had conferred brought upon Glasgow. especially as he enjoyed the patronage of the Duke. M. Next year Hunter went to London. for in 1766 he added the Chair of Institutes or Theory of Medicine. alternately. his versatility was apparent. He also undertook a voyage to the West Indies as. and who achieved great distinction in his subject. In Edinburgh. History of Medicine\ yd ed.. when he was forty-one years of age. Glasgow conducting a large with the and lecturing. he delivered lectures on clinical medicine in the Royal Infirmary. 368 Sir W. was friendly consent the partnership was dissolved. or Physiology as we now call it. Live* of British Physicians. and the practice of physic. and he continued to lecture on this on chemistry. also a native of Lanarkshire. 261). each releasing the other. p. Nor was that all. that he and Gregory should lecture on this subject alternately. 234 * H. until 1755. also. 1924. 1 He may indeed be regarded as the founder of the Glasgow School of Medicine (Plate XLV). who had been his pupil in Glasgow. After this training he felt justified in setting up ship's surgeon. The Life and Letters of Joseph Black. and later to an apothecary in London. who had come from Aberdeen to be Professor of the Practice of Medicine. p. Garrison. only chemistry. ii 1 1 W.D. for further study of medicine. 2 His lectures were the first to be 3 To Edinburgh. F. 1918 222 . The Origin and Development of the Glasgow School of Medicine. approval of the authorities. F. Not content with chemistry alone. but as there was as yet no organized Medical Faculty he became apprenticed to a surgeon in Glasgow. Cullen was fessor of 1 A. which had become vacant by the death of Robert Whytt. but also on botany. when he obtained the Chair and subject. find in we next him and ambitious. to become engrossed in anatomical work. too. 1830. In 1751. When Gregory died. and by mutual and Cullen. Finally. At the same time he resigned from the Chair of Chemistry in favour of Joseph Black 4 (p..

Pupils of Boerhaave Bocrhaave and Cullen were two great teachers of Clinical Medicine in the eighteenth century. the former at the beginning. as well as with an attempt to classify diseases. Lectures on the History of Physiology. His monograph. . who. 2 vols. and he was no slave " There must be a tub to amuse the whale. " Albrecht von Hallrr (1708-77). he placed at their disposal his house. and there he died two years later. Foster. and although he is credited with having drawn attention to the importance of the nervous as system in disease. Among South American physician and patriot HIPOLITO UNANUE (1755the methods of Leyden 1833). would say. Sir M. took himself so seriously and pursued his "system" like a fanatic. would have been well advised to imitate the philosophic calm of his master. his Cullen's students was the library. History of Scottish Medicine. Great Doctors. We shall secure a better underthe latter towards the end. as we have seen. 1936. vol." Ann. 191 223 . His gifts of infinite patience and of unruffled temper added to his success. 1 Although Cullen was the author of a successful textbook. of Gregory's Powder fame. Sigenst. Both were members of the distinguished Aberdeen family which produced no fewer than sixteen professors within five generations.XVIH-CENTURY MEDICINE now sixty-three years old. 383 Hist. Med. p. Boerhaave had attracted students who subsequently became famous that it is only possible to mention a few of them. son of the Dr. First Lines of the Practice of Physic. E. lives medical of the history of the time if we survey the standing and work of a few of the colleagues and pupils of those two disto Leyden so many tinguished men. Comne. 2 He was a precocious 1 J. 10 . His pupil and secretary. 205 . One of the most eminent was ALBRECHT VON HALLER (1708-77). who transferred to Lima in Peru de Lima (1806)... when he retired to his country seat at Kirknewton near Edinburgh. O. more to be deserves a medical classic which widely known. p. Klotz. Linnaeus classified plants. D. John Gregory just mentioned. and even his purse. Nevertheless he continued to teach for other fifteen years. H. 1777. vol viii. 1932. is Clima El and Edinburgh. p. i." he to systems. p. " " Cullen's successor was James Gregory. a native of Berne. Taking a keen personal interest in his students. 1933. The fact that Cullen taught in the vernacular added interest to his lectures. John Brown. 1901. Theories he only used to illustrate his remarks. he cannot be regarded as a discoverer.

so well. Introduction to the History of Medicine. His Elementa Physiologiae> in eight volumes. unlike many other infant prodigies. 1926. above all. then he returned to his native Berne. J. studying at Leyden under Boerhaavc. inherent in the irritability muscle itself. and added many facts of his own discovery. as the founder of modern physiology. His greatest achievement was his demonstration of the irritability He proved that of muscles and of the sensibility of nerves. 1838-40. His as a possible successor to Boerhaave. he worked hard for seventeen years . Medical science owes much to this brilliant scholar. It was Haller who originated the myogenic theory of the action of the heart. Medical Portraits. The Old Vienna School HARD VAN SWIETEN at Another of Boerhaavc's pupils who achieved fame was GER(1700-72) who. however. and was only a fraction of his work. Pcttigrew. After adult life . his achievements hi fulfil the promise of his early years." descriptive of the Swiss mountains he loved In botany his work on The Flora of Switzerland earned high fame. Fortunately. as a botanist and. where he continued his researches and writing until the date of his death. with good reason. Cumston. and not dependent upon the nerve supplying the muscle.A HISTORY OF MEDICINE child. 1933. 2 Especially eminent in physiology. 376 224 . he has been acclaimed. vol. Glisson had already suggested the hypothesis. especially " the poem Die Alpen. He wrote Latin verse at the age often. The Empress name was even mentioned 1 1 C. but. i. 340 T. As he was a Roman Catholic. was an immense undertaking. he had won the confidence of the Empress Maria Theresa by his skilful treatment of her sister. 8 was of an attribute muscular tissue. as a great pioneer physiologist. he visited Paris and London. but Haller proved it by a scries of experiments upon excised muscle tissue. p. Classic Descriptions of Disease. p. 1 759-66. His name did really lives in history as a poet. (*' Haller") R. acted as a lecturer there with great success. He is one of the most imposing figures in medical history. and had commenced practice in Berne when he was called to be l There professor at the newly established University of Gottingen. for he collected and arranged all the work on that subject which had been done prior to his time. His poetry was of high standard. G. Major. this post was closed to him. and composed scientific lectures before he was fifteen years old. H. after completing his studies Leyden.

. King's E\il. 1654 Illustration from John 210.PLATE XLIII THE ROYAL GIFT OF HEALING Charles II "touching" Broun< 's to curr AiJcnochoiradel(ti>ia.

unc. ^as tin t^n al< st ph\suian a nnif 'Jhrabo\e title -p.ii> of oiu oi his \\oiks rt addicsMiig a large audience at Le\drn (pages ijao-Ji linn .PLATE XLIV A MEDICAL LECTURE AT LEYDEN tcaclici oi Ins Hrtmanii llncih. i(hi> 173*^.

1932 (429) . Leyden and Edinburgh Many British students found their way school enjoyed world-wide fame. who was also a Dutchman. the first Professor of Medicine in the Town's College (later University) of Edinburgh. but not content to be a mere courtier. and Van Swieten was appointed principal. 2 He was one of a of professors of medicine appointed by the town (1685). British Medicine and the Vienna School. JAMES HALKET. he determined to reconstruct the medical school in Vienna. 1943. P. ed. p. Among Browne.XVIII -CENTURY MEDICINE persuaded Van Swieten to come to Vienna as her physician. This he did. who graduated there in 1633. and supported the expectant or Hippocratic method. this innovation was severely criticized. As early as 1660. Recognizing the and of observation bedside teaching. and then returned to Edinburgh. was a hard worker and an excellent clinician. then to Leyden. The university was brought under the control of the State. Sir ROBERT SIBBALD (1641-1722) spent a year and a half at Leyden under Sylvius and other teachers. Ncuburger. and he did so with characteristic skill and energy. Yet Van Swieten's masterly handling of the situation overcame all difficulties. followed by detailed notes of progress or changes from day to day. He was the author of a treatise on therapeutics. he inaugurated importance able administration the Medical School of Vienna L a system of careful case-taking. to become famous as the founder of the Royal College of Physicians of Edinburgh (1681). of The Memoirs of Sir Robert Sibbald (1641-1722). and the author of a number of works on history and archaeology. then to Montpellier and Padua. Hett. to Lcydcn while that them was Sir Thomas The torch of learning which had been lit in Greece had passed to Salerno. Geographer Royal for Scotland. and under his (the Old Vienna School) took root and flourished. Other members of the faculty resented the intrusion of a Dutchman and the limitation of their authority. the others being Dr. though an austere and arrogant man. another Leyden student. Naturally enough. which then became the centre of medical learning. ANTON DE HAEN (1704-76). in which he condemned the excessive drugging which was then prevalent. and early in the eighteenth century it was handed on to Edinburgh. and continued to do so under his successor. and trio 1 1 M. De Haen. 15 F.

Pitcairne adopted the views of the iatro-physical school of thought.. ARCHIBALD PITGAIRNE (1652-1 7 is). may be traced the origin of the Edinburgh Medical School. the youngest to receive this distinction. which. Pitcairne. at Rheims in 1680. a claim which was then by no means universally accepted. About this time he wrote an able defence of Harvey's claim to the discovery of the circulation of the blood. xxxv. Edinburgh. Pitcairne died at the age of sixty-one and was buried in Greyfriars churchyard. published under the title Dissertationes Fifeshire family. 1932. 2 had graduated in divinity and in law before turning to medicine. Accordingly the tomb was restored. History of Scottish Medicine. and the memory of the deceased duly honoured with the men who had contents of the Jeroboam. Yet his is a name worthy to be revered in the annals of medicine. Comrie. and to that of ALEXANDER MONRO. Med. decided that the restoration of the tomb of Pitcairne might well fulfil the terms of his will. The History of the Fife Pitcatrns." Edm. 368 vol. He studied in Edinburgh and Paris. Gregory as Professor of the Institutes of Medicine. 1928. other bequests he it left a "Jeroboam" of wine. and in 1800 a number of medical in Edinburgh. 1 Pitcairne was only of when thirty-three years age appointed professor. 2 vols. and the celebrated London physician. A year later he was made a Fellow of the Royal College of Physicians of Edinburgh. 1652-1713. led by ANDREW DUNCAN (1744succeeded 1828). explained all the activities of the body on a mechanical basis. with in- structions that was to be drunk on the restoration of the Stuart That event was not forthcoming. 8 1 a * J. To his influence. D. was a man of strong personality. p. Among his pupils in Leyden were his successor. a member of a well- known and became M. 1905 R. who was to to his become so famous. 277 Constance Pitcairne. and when we learn was a Jacobite and an Episcopalian we may readily understand why he was not universally popular. Dr. that he Among kings. Medicae. "Archibald Pitcairne. he was obliged to return to Edinburgh at the end of his first year in Holland. Jour. Richard Pitcairne Mead (p. vol.D. 254). i. as we have noted. for family reasons. 226 . and he became the most celebrated Scottish physician of his day.A HISTORY OF MEDICINE Dr. Boerhaave. At Leyden he enhanced the reputation of the medical school although.. increased his reputation and led appointment as Professor of Medicine at Leyden in 1692. His writings. Thin. p.

and the number rose steadily each year. but he rapidly recovered his composure.XVIII -CENTURY MEDICINE Influence of the Monros Among Pitcairne's students at Leyden was JOHN MONRO in the army of William of Orange. progress had been made by the appointment of Sibbald. p. 1927. Simon. surgeon of high standing in his profession. a man of (d. Meanwhile his father had done everything possible to smooth his path and promote his success. called PRIMUS. and Drummond in the anatomical theatre of the Royal College " of Surgeons. In any case he emerged creditably from At first Monro taught in the Surgeons' Hall. seizing the opportunity. and on returning to Edinburgh ALEXANDER MONRO (1697-1767). Edinburgh. an army surgeon. and delivered an extemporaneous lecture with great success. and the subjects of botany and chemistry had been taught. In 1703 Robert Eliot had been appointed public " " dissector in the Town's College. A. W. After studying in Edinburgh. His first course was attended by fifty-seven students. and John Monro. 244 227 ." he was obliged to seek sanctuary within the university. 191 1 " The Influence of the Monros on the Practice of Medicine. specially educated his son Alexander for the post of Professor of Anatomy. in consequence of a public demonstration against snatching. and Pitcairne as Professors of Medicine. was appointed Professor of 2 Anatomy. Alexander continued his studies in Leyden under Boerhaave and in London under Cheselden. McGill. 1737). then only twenty-two years of age. ix. It is reported that at the first lecture the presence of the Lord Provost and Magistrates and the leading physicians and surgeons of Edinburgh so disconcerted the young professor that he entirely forgot his discourse. As we have some already noted. the ordeal. The time was now ripe for a further step." Ann." as the university was then called.. Med. Accordingly he set out to interest the physicians and surgeons in this project. vol. Inglis. 1 and sound education His 9 great ambition was to establish a Medical School in Edinburgh on the lines of the Leyden School. The Monros of Auchinbowie. Among other incidents. there had been a fight between the students and the 1 relatives of the deceased for the possession of the body of a 1 J. Eliot. while classes in anatomy had been held by Monteith. Hist. Halket. but in " body 1725. to distinguish him from his son and grandson of the same name. According to another account he had left his notes at home. S. at a salary of 15 per annum.

Of him " Struthers wrote. the came to life. Plummer. While the fight " " in progress. and this was done in 1726. independently of the Infirmary. 1726. 1 J. . thirty-eight years. and it was through the exertions of Young's successor. four leading Fellows of the College of Physicians. Systematic lectures on the subject were not given. and He was active in his attendance upon the wounded after the battle of Prestonpans in 1745. Drs. that the corpse revived. The Edinburgh Medical School was then securely founded. for taught surgery as well as anatomy. St. in 1793. Rutherford. petitioned the Town Council to be appointed professors in the university. was its occupant. ALEXANDER HAMILTON (1739-1802) that a maternity hospital was established. ANDREW ST. he well earned the title of father of the Edinburgh Medical School 51 (Plate XLVI). who practised in Leith. with great acceptance. This was about a century before the days of the terrible Burke and Hare murders." According to another account. Maggie Dickson was a native of MuSselburgh. at first on a small scale in a " hired house. while the funeral procession resting at Peffermill. . being Half-hangit Maggie Dickson. and lived for many body " known as years. He died in 1 739. Historical Sketch of the Edinburgh Anatomical School. and Innes. GLAIR taught the Institutes of Medicine (Physiology) JOHN RUTHERFORD.A HISTORY OF MEDICINE criminal who had just been executed. until THOMAS YOUNG was elected professor in 1 756. woman was and was it was on the journey thither. Each of the new professors had studied in Leyden under Boerhaave. and JOSEPH GIBSON. Glair. Monro continued to teach. another Chair was founded. however. He conducted a large practice. and indeed was the first Professor of Midwifery to hold office in any university." and eventually by the opening of an infirmary in 1741. Naturally a great impetus had been given to the clinical teaching by the provision of hospital beds. a great and good man. that of Midwifery. to the conster- nation of the bearers and the delight of the mourners. ' Foundation of the Edinburgh School Stimulated by Monro's success. 1867 228 . In the same year. as also had the Professors of Chemistry (JAMES CRAWFORD) and of Botany (CHARLES PRESTON). Struthers. the maternal grandfather of Sir Walter Scott. dealt with the Practice of Medicine while ANDREW PLUMMER and JOHN INNES shared between them the subjects of Chemistry and Materia Medica.

e 221) Sornrrurs. of a painting by W. Cochrane .PLATE XLV THE FOUNDER OF THE GLASGOW SCHOOL From an engraxin^ by T \\IJIIAM CULT TN. 1710 go (paq. in the National Portrait Gallery of Scotland.

M F f).NT. Bafire of the painting by Allan Ramsay) . . 1697-1767 (page 227) b> J. MONRO (From an engraving (primus). unil K.S.PLATE XLVI THE FOUNDER OF THE EDINBURGH SCHOOL ALEXANDRA Ml C> N K O .S K .

and he was the first person in Edinburgh to carry an umbrella. The surgeons of the time were general practioners. and in Leyden under Albinus. 54 J. he did not even trouble to delete the remark. 1877 229 . during a period of one hundred and twenty-six years. to ALEXANDER MONRO. he was recognized as the leading surgeon of Edinburgh. 1925-26. i. ii. familiarly " who was known as Lang Sandy Wood. such as ALEXANDER WOOD (1725-1807). achieve greatness. Thus anatomy was taught in Edinburgh by three generations of Monros. Miles." who was often accompanied on rounds by a tame raven and a sheep. he was the leading age. History of Scottish Medicine.000 students attended his classes. bursae mucosae None of his great work was published until he was fifty years of Besides being a famous anatomist. "The Dynasty of the Monros. He added to the reputation of the Infirmary by his his professional 1 vol. 1 He had studied in London under William Hunter. Among his discoveries was the foramen of Monro.. p." 2 Nevertheless he occupied the Chair for thirty-eight years. intellectually and socially. and like his father he spoke without notes. among the great men of his period. During the early part of the eighteenth century surgery was taught by the professor of anatomy as a mere appendage to his subject. Monro secundus was even more brilliant than his distinguished father. his father " was obliged to " from father to son. yet Monro held his place. Unfortunately the high standard was not maintained in the next generation. and he was also consulted regarding surgical He certainly deserved cases. familiar to every student of anatomy. Again the Professorship of Anatomy passed his successes .. It is estimated that during his fifty years' tenure of the Chair about 40. and he published original " " observations on the and on the lymphatics. p. content to read to his students his a lectures. Kay. 1932. striking figure. 3 Despite such eccentricities. 493 J. this time. vol." University of Edinburgh Jour. SECUNDUS (1733-1817). D. physician of his time. Edinburgh Portraits. Edinburgh. in 1798. and although he had never been to Leyden. grandfather's century old. TERTIUS (17731859). though he did not himself operate.XVI II -CENTURY MEDICINE Alexander Monro was succeeded in 1 758 by his son ALEXANDER MONRO. 2 vols. "When I was a student at Leyden in I7ig. in Berlin under Meckel. a tall. He was a clear and eloquent lecturer." It is often unfortunate but 'Monro secundus was to be the son of a distinguished father." born great. Comne. 8 8 A.

W. Miles. Home. A. 1896. Richardson. 2 vols. he found himself excluded from the Royal Infirmary. vol. the Scottish Military Surgeon Who First Described Diphtheria as a Clinical Entity. Hist. while serving (1719-1813) became its first occupant.D. ac(Plate XLVII). i." 3 (Plate Lvm). S.. portrayed him as " Sherlock Holmes. He was a clever surgeon and had a large practice. fi.. CHARLES ALSTON. Comrie. 1932. 1918. of the same name. He wrote a System of Surgery. succeeded to the Chair of Botany. 31 1 " Gonan Doyle. Materia Medica was made a separate Chair in 1 768. also a well-known surgeon. he soon became the first surgeon in Scotland. Another pupil of Boerhaave. 482 J. slightly later date was BENJAMIN BELL (1749-1806). to whom we shall refer later (p. in six volumes. and Gregory Meanwhile the teaching of other subjects was passing on from the original occupants of the Chairs to capable successors. xi. which was translated into French and German. Disciples of Aesculapius. p. had ordered his dragoons to drink only boiled water. 2 vols. 1 Appointed as surgeon to the Royal Infirmary at the of age twenty-four. 1935. 48 230 . 60 E. but no relation to Benjamin. Conan Doyle. Med.. was JOHN BELL (1763-1820)." Bull. although as a result of a malicious attack by -the irritable Professor James Gregory. when FRANCIS HOME 6 Home. B. who been acclaimed as " the first of the Edinburgh scientific BELL (1837-1911). MacNalty. in 1738." Ann. p. surgeons a of quiring knowledge surgery such as could not then be obtained in Scotland. Another eminent Edinburgh surgeon. p. to which was added Materia Medica. The Teaching of Surgery Of has " He studied in London and Paris. Med. and was for many years a standard 2 Benjamin Bell was an ancestor of Dr. E. vii. 532 Sir A. 1719-1813. vol. While on the Continent he had taken the opporSir B. vol. Whytt. 1942. p.. p. M. Hist. "Francis Home. with the army in Flanders. 266).A HISTORY OF MEDICINE while by his genial and friendly manner he promoted the harmony of his profession (Plate XLVII). JOSEPH authority. 4 His younger brother was Sir Charles Bell. Hume. The Edinburgh School of Surgery before Lister. skill. History of Scottish Medicine.. and doubtless he had thus saved many lives (Plate XLVII). to which he replied with dignity. who became still more widely famous when his pupil. vol.

and his original descriptions of tuberculous meningitis and of diphtheria are medical classics. Med. vol. xxxii. 1839). but also in a violent quarrel with a colleague of similar temperament to his own. 1885. Another great professor was ROBERT WHYTT (1714-66). 755 2 * 1 " An Eighteenth-century Neurologist. and his It was textbook. 4 Unfortunately he was rather contentious. Jour. who followed Cullen. and to show that it was independent of the brain. His work on diseases of the nervous system was of high standard. 383 Life of Robert Christison. History of Scottish Medicine. 137 J. JAMES GREGORY (1753-1821). vol. Wootton. at. Comrie. p. vol. p. 2 vols. It is interesting to note that Professor James Hamilton was the last person in Edinburgh to visit his patients in a sedan chair. 485 J. which conveyance he used as late as 1830. He achieved great success in practice and as a teacher. 2 vols. i.XVIII-GENTURY MEDICINE tunity to attend Boerhaave's lectures . of whose work some account has been given. Comrie. D. and made extensive research on the possibility of dissolving stones in the bladder by the injection of lime-water and soap. C. 228)." Edin. rhubarb. As has been 2 already mentioned. served Edinburgh well in those early days. He taught both the theory and the practice of medicine. JAMES HAMILTON (d. Alexander Hamilton (p. J. Comrie. p. although by that time the death of Boerhaave had deprived that school of its chief ornament. loc.. vol. as Professor of Midwifery. by his sons. 1910. 231 . had a large circulation. Such were the polemics of eighteenth-century Edinburgh.. 1925 4 * D." 8 His regarded as powder containing magnesia. He was the first to localize the seat of reflex action in the spinal cord.. vol. D. still another Leyden student to become an Edinburgh professor. The stamp of Leyden. and became involved not only in an altercation with the surgeon John Bell. Whytt was succeeded in the Chair of Practice of Medicine by John Gregory. 1 One of the most brilliant of the early Edinburgh professors. ii. and in that of the Institutes of Medicine by William Cullen. 5 The difference of opinion led to blows and ended in court. as already mentioned. Gregory is said to have remarked that the pleasure of beating Hamilton was worth the money. " a model of exactness and classical elegance. 80 A. i. 1932. 2 vols. ii. and ginger is still well known. where Hamilton was awarded 100 of damages. and especially the tradition of Boerhaave. ed. p. Conspectus Medicae. Gregory was a member of a famous family. Chronicles of Pharmacy. had studied at Leyden. who had succeeded his father.. p..

232 . at which international agreement was reached regarding the protection of the sick and wounded and In the following year the Conof those who attended them. He combined the duties of this Chair with the practice of medicine. he graduate became M. There he encountered. led eventually to the development of the 2 Actually it was the publication organization in modern warfare. which was rigidly " Red Cross " observed. Disease. MacMichael. of his impressions of the horrors of the battlefield. which prepared the way for the Geneva Convention of October 1863.. p. 172. and Leyden. 1 After a brilliant undercareer at St. R. and returned to settle in Edinburgh. Jean Henry Dunam. Sir JOHN PRINGLE (1707-82) was the son of Sir John Pringle. bled much at first. it is fitting to pay a brief tribute to two Edinburgh graduates who distinguished themselves by their services to the army and navy respectively. At the battle of Dettingen (1743). Edinburgh. when he returned to England he served. then in command of the British Army on the Continent. 16 92 .D. and he was present at the battle of Culloden. To complete our story of Pringle. The British Red Cross. of Stitchel. Lives of British Physicians. of the last-mentioned university in 1730. Andrews. which men." The Chief Medical Officer to the army of Prince Charles 1 W. under the Duke of Cumberland. There he was appointed Professor of Moral Philosophy.A HISTORY OF MEDICINE Medicine in the Army and Navy As a conclusion to this sketch of the rise of the Edinburgh Medical School. H. War and 1944. p. but easily healed. vention reassembled and resolved that neutral status should be accorded to all persons in attendance on the wounded. This arrangement. the Red Crescent) Bart. by the Swiss banker. a new type of wound. Roxburghshire. fields. and the emblem of the Red Cross (in Moslem countries. in the army sent to quell the Jacobite Rebellion of 1 745. p. was adopted as their distinguishing mark. it was on Pringle's suggestion that arrangements were made with the French commander that military hospitals on both sides should be considered as sanctuaries and be mutually protected. Major. among 270 wounded " cuts with the broadsword. Dermot Morrah. and attained eminence in both In 1 742 he was appointed physician to the Earl of Stair. 1944. 1830. in a little book entitled Un Souvenir de SolferinOy 1862.

most of the time in tropical seas." wrote James Lind in his book. Nav. and bad water. Oliver of Bath. vol.XVII I -CENTURY MEDICINE Stuart was another baronet. . xxxvii. from whose healing virtues relief only can be had. Roy. and hospitals. E. Med. vol. i. he practised in Edinburgh for ten years. in which the word " " is used for the first time. Retiring from the sea in 1 748. 2 The cabins were " " cold. and which was translated into French. 329 H." Edm. 233 . rancid pork. A Treatise on the Scurvy.. and Italian. a graduate of Edinburgh University and an ardent Jacobite. Physician to King George III. Sir STUART THREIPLAND. with the most craving anxiety. " In such a situation. p. vol. Pringle became a Fellow of the Royal College of Physicians. damp. who Edward afterwards settled in Edinburgh and Royal College of Physicians. p. became President of the In 1752 Pringle published Observations on the Diseases of the Army." the diet consisted of putrid beef. for green vegetables and the fresh fruits of the So earth. Krumbhaar. About the same period there lived a surgeon who rendered to the navy a service similar to that which Sir John Pringle had given to the army. Med. JAMES LIND (1716-94). i. and was then appointed physician to Haslar Hospital. 1926. "James Lind and Scurvy. Hist. Service.. the physician whose name 1 strangely survives in a biscuit. 181 R. and President of the Royal Society. a famous work which passed through many editions. Jour. one of the most interesting and important works in medical literature 3 . and certain other recommendations which contributed to the comfort and health of the troops." Ann." so that scurvy was rampant on every voyage. In it he made suggestions for the better ventilation of barracks. 1929. entered the navy at the age of twenty-three and served for nine years. 1753.'* Jour. a post which he held for twenty-five years. Pioneer of Naval Hygiene. B. the ignorant sailor and the learned physician will equally long. 1915. Stockman. p. James Lind. Often it was " said of him that few physicians have rendered more definite services to humanity. German. read before the Royal Society (1750-52). Those papers are included antiseptic as an Appendix to the Observations mentioned above. Med. jails. born and educated in Edinburgh. mouldy biscuit. 253 " * Sir 1 " Bath Olivers Doctor and Biscuit. and unwholesome. 8 Rolleston. He married a daughter of Dr. When he joined the navy he found the conditions most unfavourable to health." Among his other works was a series of short papers on Experiments upon Septic and Antiseptic Substances.

in 1750. but he recommended the use of lemon juice. William Cullen. Gray. 285 in the British Fleet BOOKS FOR FURTHER READING CHRISTISON. who wrote a Treatise on Fever. p. recommended the use of cider and vegetable diet as a means of 2 The Devonshire colic studied by Huxham preventing scurvy. and papers on malignant sore throat and on Devonshire colic. 1838-40 The History of the Fife Pitcairns. Classic Descriptions of Disease. J. A. Surgeon's Mate : The Diary of John Knyveton. John Woodall mentioned it in The Surgeon's Mate a century earlier (p. T. 1867 THOMSON. Surgeon the Seven Years' War. Medical Portraits. H. scurvy disappeared as if by magic. 2 vols. H. 1923 MILES. 1932. STRUTHERS. 1 942 F. though he did not live to see the full result of his efforts. History of Scottish Medicine. Ed. 152). 1910 234 . 1756-1762. 2 vols. Garrison. writes in his During * 8 E. to suggest the use of lime juice or lemon juice for scurvy. J. 1885 COMRIE. P. 2 vols. 1918 PETTIGREW. J. C. a well-known physician of Plymouth. D. Historical Sketch of the Edinburgh Anatomical School. was proved by Sir GEORGE BAKER (1722-1809) to be lead poison3 ing arising from the lead pipes of cider presses. 1905 PITCAIRNE. History of Medicine. Linnaeus : The Story of his Life.A HISTORY OF MEDICINE John Knyveton. Life of Sir Robert Christison by His Sons. Lind was not the first. of his ship's company from scurvy during his voyage round the world. p. and Lind often had three hundred to four hundred cases in his wards at Haslar.. 2 vols. 1879 G. He knew nothing of vitamins. F. A. 2 vols. B. It was the scourge of the navy. 373 R." x Lord Anson had lost seventy-five per cent. Major. 3rd ed. Life of Dr. WOOTTON.. another naval surgeon of this " scores of poor wights lying helpless with swollen diary of the discoloured limbs and bleeding mouths. 1 time. Chronicles of Pharmacy. The Edinburgh School of Surgery before Lister . 1924. 1932 JACKSON. 1932 HETT. and did not claim to be the first. Thanks to his efforts.. J. Edinburgh. and made other suggestions to improve the health of seamen. D. of The Memoirs of Sir Robert Sibbald (1641-1722). and JOHN HUXHAM (1692-1768).

Spencer. 30 235 . was now to be established on a scientific basis. P-453 * It was Sir Richard Manningham who. the first to illustrate and describe the forceps (1733). The Man-Midwife." Ann. Fothergill and Lettsom. was sent to Godalming in Surrey who claimed to by King George I to investigate the strange case of Mary Toft. * A. after the Chamberlens. Med. The master of British midwifery was WILLIAM SMELLIE (16971763). have given birth to seventeen rabbits.' P. 1933. p. and Heberden. the first. Baillie.CHAPTER XIII XVIII-CENTURY MEDICINE (Continued) IN the medical world of London early in this eventful century surgery was in the capable hands of Cheselden and Pott. vol. Curtis.. 4 I 739)> 3 . he studied medicine in Glasgow. iv. " The Rabbit Woman " provided the sensation of London for a season.*6 * H. and since then Sir RICHARD MANNiNGHAM. above all. 2 the first to institute " lying-in " wards ( WILLIAM GIFFARD. We have noted that William Harvey was the first Englishman to write on the subject (1651). until the hoax was exposed. Menjer. v l. of Obstetrics and Gynaecology." x He was unpopular with some of his colleagues. Philadelphia. 1927. and. 1932. History of British Midwifery. who held that the assistance of a A for obvious reasons surgeon was demanded only in exceptional obstetric cases. and there came on the scene a new type of specialist who was appropriately called the " man-midwife. and 1 W. Smellie and Hunter Prior to this time the practice of obstetrics had remained for the most part in the hands of midwives. EDMUND CHAPMAN. obstetrics. 1710) helped to found the famous Dublin School of Midwifery. F. and other " " man-midwives had contributed to the knowledge of obstetrics while in Ireland Sir FIELDING OULD (b. to use the forceps or "extractor" (1726). The third great branch of medical science. H. Born at Lanark. and many others. In medicine the leaders were Radcliffe and Mead. " The Origin of the Male Midwife. R. of John Hunter. ed. A number of distinguished men had already specialized in obstetrics. and he was even more unpopular with the midwives. Withering. change was now imminent. in 1726. Hist.

peared in 1752. his retirement in 1 759 he returned to Lanark. had the honour of being called to attend Henrietta Maria. and he also corrected many errors and laid down sensible rules for obstetrical practice. Aveling. So great was the prejudice against forceps on the part of patients and midwives that it was customary to apply them without the either. 1929 (An excellent and comprehensive account. The Chamberlens and : Forceps Its History Glasgow. He On His library. J. where he had acquired the small estate of Smyllum. it now leather (Plate XLIX). Dr. as is sometimes stated.) 236 . the inventor of the forceps. each of whom doubtless inherited the secret of the forceps. after the midwife in charge had " on entering the queen's chamber. 1882 .A HISTORY OF MEDICINE 1 Then after a short practised in his native town for sixteen years. with 878 illustrations. lived in Pall Mall. Obstetric and Evolution. preserved there. proved handles were a later invention by Tarnier (1828-97). Glaister. and there he died. 2 This Peter Chamberlen. of which. which he bequeathed to the town of Lanark. wife of " swooned Charles I. Calcutta. in Paris he in settled London in 1 He soon became the stay 739. 1 J. in 1628. Das. and later in Wardour Street. the first of his dynasty.150 cases of labour. is still . but it is now agreed that the inventor was PETER CHAMBERLEN (the elder) (1560-1631). and along with these pupils he attended 1. and his portrait. now an orphanage. In it he gave a clear account of the mechanism of labour. im" " and added the pelvic curves. said to have been painted by himself. H. though he was one of the first to use this instrument. and at a later stage in his practice he had the blades covered with He modified the shape of the forceps. During his ten years in London 900 students attended his classes. Never- theless he made it a rule to employ forceps as seldom as possible. 1894 the Midwifery Forceps. He was not. The axis traction the look. is in the Royal College of Surgeons of Edinburgh Smellie's well-known Treatise on Midwifery ap(Plate XLIX). William Smellie and His Contemporaries. and as a teacher he was also very successful. with fear In four generations of Chamberlens there were seven medical men (including three Peters and two Hughs). leading obstetrician. The history of obstetric forceps has been a subject of much discussion. and that the invention was held as a secret by the Chambcrlen family for one hundred and twentyfive years. K. a Hugenot refugee. knowledge of Smellie at first employed wooden forceps in order to avoid the clinking noise of the metal blades.

PLATE XLVII EDINBURGH DOCTORS OF THE EIGHTEENTH CENTURY ^ / 229) ALEXANDER WOOD (page FRANCIS HOME (page 230) BENJAMIN BELL (page 230) JOHN SHIELDS as John Shields. and although he charged only a shilling per visit he amassed a considerable fortune. (From Kay's Edinburgh Portraits} . was the custom He kept an apothcc ary's shop in Nieolson Street. made his rounds on horseback. a typical general practitioner of the time.

OSTEOLOGY Illustration of child graspfrom Cheseldon's Osteographia.PLATE XLVIII ARTISTIC. I733< showing skeleton ing an adult humcius (page 239) .

2 As already noted (p. consisting of two steel spoons. wrote in 1753 of his long forceps with double curve. they were contrived some years ago by " myself as well as other practitioners.most distinguished member of the family. who followed him to the metropolis a few years later. seven miles from Glasgow. The pelvic curve seems to have been independently introduced by Pugh. and many other patterns of forceps were introduced (Plate L). in 1747. and he is usually credited with this invention. in 1744-45. Hugh . added flanges to the grooves and so contrived the English lock. Peter Chamberlen (1601-83). to reside with him and to act as tutor to his son. as still used. 1893 237 .' William Smellie had been in London for three years when he was joined by a young fellow-countryman who was destined to become famous as an anatomist and obstetrician. Peter the Elder was the inventor. William Cullen. Essex. who writes in 1 754 of the forceps I invented upwards of fourteen years ago. p. a Belgian surgeon practising in Paris. Chamberlen died in 1728. It was Smellie who. 1933. 1 The writer is indebted to Professor Miles Phillips.' by Levret who. Obstetrics and Gynaecology. Philadelphia. and known as Mains de Palfyn.' and by Smellie who. whose interest in the subject is well known. WILLIAM HUNTER (1718-83). near Maldon. devised a form of forceps or tire-tete. Mather. nephew of the inventor and the When Dr. for the following notes on " " " lock and the " pelvic curve " the Chapman did not invent the English lock. Two Great Scotsmen : The Brothers William and John Hunter. JEAN PALFYN (1650-1730). H. Soon after his arrival in London William Hunter accepted the invitation of Dr. James Douglas. vol i. The secret instrument gradually became known. East Kilbride. a house which had once belonged to Dr. was born at the farm of Long Calderwood. though his fame was eclipsed by that of his younger brother. The inventor published no description of his instrument.XVIII -CENTURY MEDICINE In 1818. like his brother John. After the death of this patron Hunter commenced to teach : ' 5 : * * ' ' c ' ' 1 1 A. 56 G. his forceps with with characteristic honesty. exhibited to the Paris Academy la nouvelle courboure. R. For example. along with Dr. he practised for a short time in the town of Hamilton. though some authors think so he certainly did away with the screw (a French idea) and used a simple groove on each blade. the anatomist. Curtis. 222). several pairs of forceps were found at Woodham Mortimer Hall. he left no son to carry on the tradition. appears certain.

and worked hard to the end. His greatest work was an atlas of The Anatomy of the Human Gravid Uterus (1774). along with young Dr.A HISTORY OF MEDICINE anatomy. p. John Hunter. G. he was wont to exhibit his own rusty pair seldom used as proof of this fact. G. The History of St. famous.." Bull. and he became the leading obstetrician of London. now forms the Hunterian Museum of Glasgow. Tliis honour he shared at first with Smellie. vol. 2 vols. became surgeon to St. a student under William Cowper the anatomist. He led an austere life.. Forceps he in fact. Med. i. 1927. the centre of anatomical 1 He accumulated a learning in London during many years. xii. but his career was Moreover. and one of the best known men of his time. never married. John FothergilPs collection. collection of anatomical and other specimens which. Disciples of Aescula/nus. 1896. Med.. vol. 128 . In his obstetrical practice he was conservative. Cheselden was one of the first to perform iridotomy.." Ann. and saw the work of the great anatomist Albinus. then at the height of his fame. William Hunter founded the Windmill Street School of Anatomy. as a lithotomist. W. although his later years were clouded by an unfortunate controversy with his brother. 533 Parsons. his 'rule being to leave the case to Nature whenever possible. dress and refined in manner. F. for stone though (lithotomy) operations 1 S. x. . R. Thomas's Hospital* 3 vols. keep those limbs and to preserve those eyes. 238 . Hist. p. in contrast to Smellie who was somewhat uncouth. vol. restoring In sight to a blind boy by constructing an artificial pupil. Thomas's Hospital. Douglas. WILLIAM CHESELDEN (1688-1752). 2 He attended Sir Isaac Newton and Alexander Pope. William Cheselden. Packard. Hunter was elegant in longer than that of Smellie. 3 Incredible he excelled. he visited Leyden. Eighteenth-Century Surgery The two leading surgeons of the early years of the eighteenth century were William Cheselden and Percivall Pott. "The Great Windmill Street School. Richardson. 1932 Sir B. although their work was perhaps overshadowed by that of their brilliant pupil. Thomson. both of them able and distinguished men. The latter referred to his medical attendants in the couplet : I'll To do what Mead and Cheselden advise. 1942. p. along with Dr. Hist. and a few years later. 377 " 9 F.

Naturally the recovery was slow. St. M. another well-known London surgeon. surgeon to St. From his house in Bow Lane he conducted a large surgical practice.. and on this " he was carried home. " The Life and Works of Percivall Pott. Accordingly a door and two chair poles. he how serious it and how on the realized was. Repts. Ixvi p. in down the Old Kent Road. chief. He improved the technique of the operation. and it was said that his record time was fifty-four seconds. at first adopting the suprapubic route. vol. was built to his design in 1 729. PERCIVALL POTT (1714-88). Lateral lithotomy had been already preferred to median lithotomy by Frere Jacques. riding 1756 personal he was thrown from his horse and sustained a compound fracture His injury was not. no small achievement at a time when amputation was the treatment for almost every compound fracture. Earth's Hasp. which was Pott's fracture. as is sometimes stated. as there was no retiring age in those days. as it was safer and easier. 1933.CENTURY MEDICINE it may seem. a of the tibia." 1 G. he was popular with all ranks of society. he frequently completed the operation in one minute. nature when. ground just lay he sent for it might be aggravated by movement. a surprising figure in pre-anaesthetic days. attending such distinguished patients as Samuel Johnson and David Garrick. Chesclden modified this operation and reduced the mortality to seventeen per cent. " As he but something much more serious. are as amusing as they are elaborate (Plate XLVIII).. Bartholomew's Hospital until his death at the age of seventy-four. but later abandoning this in favour of the perineal route. Chesclden was a good draughtsman. Lloyd. and of the fracture just above the ankle." Edward Fortunately his old Nourse. 291 239 . was able to save the limb. which had been advised by John Douglas. a wooden structure spanning the Thames. gave classical descriptions of the tuberculous disease of the spine. but Pott improved the time by writing a treatise on hernia. Like many other anatomists and surgeons. to make a stretcher. His chief literary work was a beautifully illustrated monograph on the bones of man and animals. r It is said that every surgeon ought to experience operation Pott acquired experience of this or injury in his own person. Fulham Bridge. entitled Osteographia ( 1 733) Some of the illustrations .XVI II. still known Pott was respectively as Pott's disease and Pott's fracture. " 1714-^8 (Wix Prize Essay). A lively and sociable man.

" later known as "fibrinogen. 1790 1 Scotsmen 1 4 * Memoir of William and John Hunter 1924 G. Med. William. the Author. Mather.4 . vol. Life and Work. 2 John had no inclination for scholarship but had an insatiable curiosity regarding " " birds and bees and grasses and all the works of Nature. 3 vols. C. The Chirurgical Works of Percivall Pott . Peachey. Earle. p.*' Brit Jour.. his brother William was assisted by WILLIAM HEWSON (1739-74). to join his brother William in London.. not to a solidification of the corpuscles. John also commenced the study of surgery under the two great surgeons. Surg. John Hunter. Why Think? Why not Try the Experiment? In 1748. although he was never . John Hunter. 1897 G.. 1 Although less Pott did it much to place surgery great than his pupil. p. 209 240 . E. 1936-37. The Brothers William and John Hist. he was advised to seek rest in a warmer climate. youngest of the family of eleven children. "John Hunter in Portugal. " William Hewson. and the excellence of his work as an anatomist was immediately apparent. ten years his senior. 5 When John Hunter returned from Portugal he commenced those vast researches in comparative anatomy and physiology to which the remainder of his life was to be devoted. but to a " substance in the plasma which he called coagulable lymph. Bailey. JOHN HUNTER (1728-93). on a rational basis and to bring in physiology into line with the new thought and medicine. xxiv.. Two Great Hunter. H. 1728-93. 1923. and this advice he followed by enlisting in the army and serving as a staff surgeon in Belle Isle and Portugal for four years. R.. Man of Science and Surgeon. and on one occasion he asked the porter to bring in the skeleton so that he 1 Sir J.a good lecturer. set out on horseback from his home at Long Calderwood. With a Short Life of . a brilliant young man who demonstrated the existence and function of the lymph vessels in animals. He taught anatomy. 1739-74. and reached his destination in about a fortnight. FJR. set him to dissect the upper limb. G. and established the fact that the coagulation of the blood was due. The life story of John Hunter has been so often narrated by numerous " Hunterian " Orators that it need only be briefly sketched. 3 Threatened by tuberculosis.A HISTORY OF MEDICINE his best work. Gask. Cheselden and Pott. near Glasgow. : . 4 During John's absence on military service." Ann.S. 1893 Stephen Paget. Hii. 640 G. Glasgow." Hewson died from septicaemia following a dissection wound at the age of thirty-six.

PLATE XLIX THE MASTER OF BRITISH MIDWIFERY 1697-1703 Simlhc's long blades strips fore c-ps. the bound uitL pagf -'3^) leather .

easily detachable (page 235) 6 Burton's forceps. 1745. (All figures are \ natural s^e) . and retained as a family secret for many years (page 236) 2 Palfsn's forceps (Mains de Palf>n. Slop of Tristram Shandy . two spoons. 1733 . the blades united by a simple groove. 1751 slender blades controlled by screw handle. Burton. \\ith handles 3 Sniellie's short \\ooden forceps. the " French " Jock instrument by means of the 5 Chapman's forceps. of York. \\ith the "English" lock (see page 235 and Plate XLIX) first attempt to articulate Palf>n's 4 Dus6e's foiceps. 1733 .PLATE L EARLY PATTERNS OF OBSTETRIC FORCEPS 1 Forceps invented bv Peter Chamberlen (the elder) about 1630. \\ as the original Dr. clamped together (page 237) I 720^ .

With a Life by Drewry Ottley. As John Hunter prospered in surgical practice he removed from Golden Square to his brother's house in Jcrmyn Street. 2 vols. The Sir B. the life history of eels. of Naturalists' Library. Sir W. of Aesculapius .. London. vol. " " The experiment Why think ? Why not try the experiment ? related to the temperature of hibernating hedgehogs. vol. " Memoir of John Hunter. Palmer. and one of them contains the oft-quoted advice. as well as numerous Hunterian Orations including those by Sir James Paget (1877). (429) . and the feet appear in the famous portrait of John Hunter by Sir Joshua Reynolds. p. 1885. 1835 . Home. Many tales are told of his quest for material and of his dissections ranging from bees to whales. and Edward Jenner. G. In addition to this town establishment Hunter had a country house and grounds at Earl's Court. and among the more recent accounts that of Stephen Paget holds a high place.600 specimens which the museum eventually contained (Plate LI). Doctors. Physick of Pennsylvania. ii. J F. x. the Irish giant. Richardson. one of many problems investigated by Hunter and Jenner. 2 The skeleton of Bryne.XVIII-CENTURY MEDICINE " the word Gentlemen. which are especially noteworthy. 1817. Medical Portraits. the country doctor whose great invention saved innumerable lives..S. 1896. and then to a large establishment in Leicester Square. i. F. Adams. and his museum. ii There are many shorter biographical notices of John Hunter. 1794 . Peachey have each added to the attraction of their works by including both the Hunter brothers. For many years he worked incessantly to study and collect the 13. Eminent . Mather and G. 2 vols. 1 G. 133 T. Bettany. Pettigrew. 4 vols . 1 Among his pupils were Abernethy and Astley Cooper oi . W. of The Works of John Hunter. and here also were his consulting rooms." vol. which Hunter long coveted during the lifetime of its owner. There he kept all kinds of J. Disciples . T. A. . 501 I 83^-40.R. and Mr." and he certainly raised surgery from the level of a technical accomplishment to that of a definite science. was one of the treasures of the museum. The Life of John Hunter. vol. p. Life and Doctrines of the the Late John Hunter. Perhaps the best of the earlier biographies is the work of Drcwry Ottiey. This was his home. 1843 Jardine. Sir William MacCormack (1899). 1794 Jesse Foot. Life of John Hunter. the habits of the cuckoo. ed. Vaccination did not engage the attention of Jenner until after Hunter's death. They also studied the plumage of nestlings. The letters written by John Hunter to Jenner have fortunately been preserved. Wilfred Trotter (1932). and at last secured for 500. and many other interesting matters." Later might preface his remarks with " the whole circle of the sciences in his career he lectured on around surgery. his lecture rooms. John Hunter was the founder of surgical pathology. J. 1 Sir E.

A HISTORY OF MEDICINE animals. Another patient. iv. 3 His great collection in the Royal College of Surgeons' Museum has recently been destroyed by enemy action. "John Hunter. In practice. p. John Hunter. Martin's Church until 1859. when it was re-interred in Westminster Abbey at the instance of Frank Buckland." in Selected Writings. D'Arcy Power. Richardson. 2 vols. There can be no doubt that he also suffered from cerebral syphilis. Press and Cure. birds. to which institution he had been surgeon for some years. vol. vol. 1931 Frank Buckland.. and teacher. p. lomew's Hospital. contracted as the result of a foolhardy inoculation of himself in order to ascertain whether syphilis and gonorrhoea were the same disease. 1896.. Abernethy and Astley Cooper. 1866. His writings are full of fresh observations which pointed the way for other pioneers. Barthofell heir to much of the practice of his He was a clear and dramatic lecturer. George's Hospital. and there he conducted In 1773 there occurred the many first experiattack of angina pectoris. succeeded Pott as surgeon to St. 1 He died suddenly at a meeting of the governors of St. Scots-Irish parentage. 1 4 Sir B. 786 242 . and earn it. he sent Fear of the to consult a fictitious Dr. a hypochondriac. and fishes. 159 * Morley Roberts." was his advice to a luxurious alderman. W. Disciples of Aesculapius.. His body rested in St. Philip Syng Physick. a Martyr to Science. "John Hunter and Evolution. he adopted a brusque and even rough manner with his patients.* who was born in London of . ments and dissections. May 29 and June 5 and 12 1 told to illustrate this peculiarity. made the patient forget his ills and completed the cure. 11. very popular with his students." Med. from which disease John Hunter died twenty years later. 1909. unknown verdict on the northward journey. 4 vols. and the first great American surgeon. JOHN ABERNETHY (1764-1 831). and many stories are " Live on sixpence a day. Curiosities of Natural History. Robertson of Inverness. Pupils and Contemporaries of John Hunter among John Hunter had many pupils who achieved fame them were the distinguished London surgeons. combined with anger against Abernethy as he returned. but the name of John Hunter will always remain one of the greatest in the history of surgery. yet in a sense he was the originator of many discoveries. 2 John Hunter made no great discovery.

1861. breast. 1933. J.. i. vol. . 2 vols. 1 1 1 Sir D'Arcy Power. D. pill. 361 W. i. who has been called the Father of American Sur4 Hunter pressed him to remain in London as his assistant. Father of American Surgery. Fortunately he recovered. vol. His most famous operation was the removal of a sebaceous cyst from the head of King George IV. Surg. 1843 A Book about Doctors. S. a successful achievement rewarded by a baronetcy. and was appointed and Professor of Surgery Bransby B. being the Nevertheless he was a bold to ligate the external iliac artery for aneurysm. was said to make 600 a year by showing in patients out of their turn.XVI11-CENTURY MEDICINE Abernethy alleged that all diseases whkh were and external were due and skilful not surgical his favourite to digestive disturbance. p. T. Eminent Doctors.. 3 Among his many hernia. although he never regained his original vigour.. Handsome and dignified in appearance." Brit. Bcttany. 1870. which give so intimate a l picture of domestic life in the fifteenth century. Physick gave faithful service to many patients until he was himself attacked by the fever. He was also the first to amputate at the hip joint. For some years his annual " " His servant Charles income was never less than 15. first and remedies were calomel and blue surgeon. 562 * S. G.000. Hist. he inspired the confidence of his patients and the admiration of his students. 2 Astley Cooper's boldest operation was ligation of the aorta in a case of aneurysm. 1 for his excellence as a surgeon. Gross. Bell) 243 . of Lives of Eminent American Physicians and Surgeons.*' Ann. Jeaffreson. p. 6 Nevertheless he soon became noted 1 surgeon to the Pennsylvania Hospital. C. Astley Cooper was a man of strong personality. Philadelphia. p. 1921. Life of Sir Astley Cooper. p. but he preferred to return to America. and he soon acquired an enormous practice.. gery. Middleton. courteous and agreeable in manner. 2 vols. 351 (" Life of Physick. Med. 1885. p. vol." by J. Cooper. xx. contributions to surgical literature were his treatises on on fractures and dislocations. 202 " The Removal of a Sebaceous Cyst from King George IV. and on diseases of the Another of John Hunter's pupils was PHILIP SYNG PHYSIGK (1768-1837). Sir ASTLEY PASTON COOPER (1768-1841) was the son of a Norfolk clergyman and a descendant of the family of Paston made famous by The Paston Letters. " Philip Syng Physick. ed. No sooner had he settled in practice than a violent epidemic of yellow fever broke out. Jour. He was a brilliant and careful operator.

he was a conand his operative work was for the most part limited to lithotomy and the extraction of cataract. was an In France the best-known surgeon was JEAN Louis PETIT (1674-1750) of Paris. 186) De Aure Humana in 1704. 1768-1837. 2 On the Continent there were a number of distinguished Italy was represented by ANTONIO SGARPA of Pavia surgeons. Ballancc." 5 The a made Petit's of the patient rapid recovery. Soc. 2 vols.A HISTORY OF MEDICINE at the University. p. 1935. Livinson." Ann. Geschichte der Medizin. A contemporary Italian was DOMENICO COTUGNO of Naples (1736-1822). * : Hist. He used " a trephine. 1 G. Philip Syng Physick's Last Major Operation." " Proc. I . viii.*' Bull. 145 * 1 A. Sudhoff. p. ix. enunciated a theory of hearing. servative surgeon. 1936. p. whose name survives in various anatomical descriptions. H. and the first to perform a successful operation for mastoiditis. description procedure was not published until after his death it therefore attracted little attention.. 1940. 1921. John Hunter. vol. and wrote a famous 8 Another name familiar to every otolomonograph on sciatica. p. (P. p. (1752-1832). 379 The Surgery of the Temporal Bone. " Philip Syng Physick. 133 " A. vol. Victs.379)- Other Parisian surgeons of the time were FRANJOIS CHOP ART (1743-95). who devised better methods of treating fractures. Like his master. whose LORENZ ing surgeon is that of ANTONIO who his Tractatus Ckirurgie. Med. ni. who discovered the cerebro-spinal and labyrinthine fluids. but who was also famous as a surgeon and ophthalmologist. Hist. 937. (p. published in 1718. i. Edwards. Domenico Gotugno. inventor of the screw tourniquet.*' Ann. Randall.. he was in every respect a worthy leader of the many great Americans who have advanced the profession of surgery since then. 701 4 * Sir G. a good lecturer. 1919. and a man of sterling character. p. xxxiii. vol. Med. The leadpublished German was HEISTER (1683-1758). gist VALSALVA of Bologna (1666-1723). and had scarcely got through the outer table when there escaped a quantity of foul-smelling exudation. and 1 DESAULT PIERRE-JOSEPH ( 744-95). " Domenico Cotugno His Description of the Cerebro-spmal Fluid. Med. 35 244 .. Hist. vol. Meycr-Steineg and K. About a century later the mastoid operation was established on a sound basis by Schwartze . A hard worker. w h improved the technique of amputations. vol.. T. treatise which became very interesting and well-illustrated 4 popular as a textbook. R. Med. 1 He modified and improved the treatment of fractures.. Roy.

p. p. Throughout his long life he strenuously pursued his search for the causes of disease. His views were the pathology. 283 T. 1896. muscular. Pcttigrew. Withington. p. of case histories and pathological appearances in no less than seven hundred cases. vol. sites and causes of diseases). including cirrhosis of the liver. During the later years of the century pathological anatomy was enriched by the work of another gifted observer. his fame spread. Krumbhaar. fibrous. Sigcnst. and already an anatomist of repute. He did not publish his results until he had reached the age of 2 The masterpiece which he then wrote gives details seventy-nine. 229 * Sir B. vol. osseous. 1933. appeared in 1761. Many were the discoveries he described. De sedibus et causis morborum (On the otitis. Castiglioni. the founder of pathological anatomy. 245 . MORGAGNI A. and who showed how important to the physician was a knowledge of The leader of the movement was GIOVANNI BATTISTA " a master (1682-1771). in fact.. twenty-one in all. MARIE pRANgois XAVIER BICHAT (1771-1802). in five volumes. 1941. 1894. His great achievement was the union which he effected between anatomy and pathology on the Post-mortem one hand. by E.CENTURY MEDICINE Applied Pathology During the eighteenth century there appeared the pioneers who demonstrated the importance of morbid anatomy. Great Doctors. Morgagni findings became correlated with clinical symptoms. An ardent student of the classics. whom Castiglioni refers to as in the best sense of the word and a tireless investigator. A History of Medicine trans. i. 1928 . E. the pupil and assistant of Desault in Paris. R. New York. pneumonic consolidation of the lung. Long." * He studied under Valsalva at Bologna and then returned to practise in his native town of Forli. p. J. was. 2 vols. 3 He it was who founded the science of histology. " the study of tissues or membranes. He was the first to show that cerebral abscess was a result rather than a cause of suppurative This great work. i .XVII I. E. and clinical medicine on the other. E. H. 602 . and other tissues. Richardson. 1838-40. Medical Portraits. and many forms of tumour." by directing attention to the pathological changes in cellular. and for the changes which are found on post-mortem examination. T. A History of Pathology. B. 358 1 . a poet and archaeologist. W. a position which he held with distinction for fifty-six years. Medical History from the Earliest Times. Disciples of Aesculapius. nervous. so that at the age of twenty-nine he was called to be Professor of Anatomy at Padua.

was the publication of his Morbid Anatomy in 1 793. famous pathologist was our own MATTHEW BAILLIE (1761-1823). wife of the British " " Ambassador in Turkey. His greatest achievement. 546 " The Historic Evolution of Variolation. to affected tissues rather than Bichat. In China. 69 1 246 . xxiv.A HISTORY OF MEDICINE Pathosubject of his Traitf des Membranes. R. and to draw through it a It in * W. where he taught anatomy Inoculation and Vaccination Smallpox. several members of the Royal House were inoculated. settled in A London. Any relief from such a plague was welcome. and among the survivors there were The mortality was high. 1827 (chap. "Bailhe"). the method had been tried successfully upon six condemned criminals. published in 1800. v. vol. and this naturally increased the popularity of the procedure. however. his is one of the names of medical third history. Major.. The method employed in England was to make a superficial incision in the arm. George's Hospital. Classic Descriptions of Disease. Klebs. 3 has been long in use in the East. and it is interesting to note that the figure illustrating 2 emphysema of the lung depicts the lung of Dr. faces many pock-marked and cases of blindness. p. Johns Hopk. 1932. Oxford. 1913. now a comparatively rare disease. and President of the Royal College of Physicians. physician to King George III. introduced inoculation into England After in 1717. was very pre- valent during the eighteenth century. physician to St. and when Lady Mary Wortley Montagu. whom he attended during his last illness. 1 Educated at Baliol College. logical changes. H. he for twenty years and a fortune a as He was eventually acquired large physician. it was eagerly welcomed and widely practised. was illustrated by a series of excellent engravings. This complete work. This view marked a great advance. Mac Michael. according organs. which held its own until the further discoveries of disease to the cells Virchow transferred the seat of of which tissues and organs are composed. the first of the kind. The Gold-headed Cane. Hasp. Samuel Johnson. it consisted blowing or sniffing into the nose the powdered dried crusts from a case of smallpox. (The emblem of office of Presidents of the Royal College of Physicians of London relates its advenSee p. 253) tures in the hands of a succession of masters. the nephew of the Hunters and son of the Professor of Divinity at Glasgow. p. at the Although Bichat died great age of thirty-one. A." Bull.

Baron. Hist..R. Bishop." which appear in 1 E. Dr. His method was to use a minute incision or a mere scratch.000. " " inoculation houses for . his arrangements to escape should any disaster attend his efforts. and the rank of Baron. though beneficial to individuals. titioners throughout the country became specialists in inoculation. ! he frequently inoculated children while they were asleep.XVIII-CENTURY MEDICINE thread soaked in the fluid from a smallpox pustule. ix. inoculation. p. is over other persons in St. his complete success. It was a perilous mission. and the 1 Medical pracpatient was safe-guarded from future infection. History and Pathology of Vaccination.. The Life of Edward Jenner.. 1932. St.. and 247 .. 321 R. John Pothergill and His Friends. 1838 1 M. 4 We have already " dear man. form one of the most romantic episodes in the history of medicine. M. and reference has been made to the researches in physiology and natural history which Jenner carried out in collaboration with his great teacher. vol. 2 vols. 2 News of his fame reached the Empress Catherine of Russia. Kingston Fox." chap. " She has had the smallpox in the most desirable manner which " He inoculated almost two hundred now. Petersburg and in Moscow. By those means there was produced a mild form of the disease.) 4 J. Med. iv. 2 vols. one of the greatest benefactors to mankind.S." as his intimates affecmentioned this pupil of the tionately termed John Hunter. None the less. " " Address to a Robin. did not check the spread of the disease nor reduce the mortality. 3 What relief Dimsdale must have felt as he wrote in his journal. 1919 (" Baron Dimsdale. who forthwith sent for him to inoculate herself and Dimsdale's journey to her son. and his great reward of 10." and Signs of Rain. F.D. J. " Thomas Dimsdale. Petersburg. and . The Career of Edwwd Jenner Such was the state of affairs when there came upon the scene a country practitioner named EDWARD JENNER (1749-1823). 1712-1800." Ann. One of the most successful virus inoculators was THOMAS DIMSDALE (1712-1800). a Quaker physician who practised at Hertford. the Inoculation of Catherine the Great of Russia. 1889 W. Crookshank. thank God. That he was a lover of Nature and a keen observer is shown by his verses. and all did well.and maintained isolation hospitals or the purpose. a pension of 500.

And what is Fame ? A with the arrows of malignancy. a Disease discovered in some of the Western Counties of England. with the long title. " I can't take smallpox. at home and abroad. For more than twenty years he considered the problem. with pus from the hand of a dairymaid. Sarah Nelmes. and no The proof was now complete. " My fortune is sufficient to gratify my . and even bored his medical friends with his views to such an extent that he was threatened with expulsion from the Gonvivio-Medical Club.A HISTORY OF MEDICINE in The son of the vicar of Berkeley. he practised in his and he there made his great discovery. as the local medical society was last.000 a year. he was urged to come to London. for I have already had cowpox. City life birthplace. he declined this prospect and wrote to a friend. Eight weeks later Jenner inoculated the boy with smallpox. who had become infected with cowpox.. and Jenner recorded his views and observations in a little book of seventy-five pages." Now cowpox was a relatively mild disease. wishes. to try the crucial experiment. never appealed to him nor indeed did fortune. He had even suffered financial loss. and consisting of a pustular eruption. Gloucestershire. 1830. 1 W. particularly Gloucestershire y and known by the name of " The Cow Pox" The advantage of vaccination was everywhere confirmed. At on I4th a boy of eight years. An Inquiry into the Causes and Effects of the Variolae Vaccinae. at the height of his fame. Mac Michael. Honours and congratulations showered upon Jenner. Rev. With true scientific generosity he had freely proclaimed his discovery. sufficient courage May 1796. 1 every biography of Jenner. 252 248 . and it was only fair that the Government should recompense a discoverer who had conferred so great a benefit disease appeared. Lives of British Physicians. Had he been selfish enough to keep his method secret he would have made a large fortune. accompanied by transient general malaise. called. for when.*' died. for ever pierced So in Berkeley he lived and The idea of vaccination was conveyed to Jenner by the chance remark of a dairymaid. assured of an income of 10. p. It was generally known in Gloucestershire that the dairymaid's statement was true. transmitted from the udder of the cow to the hands of the milker. and was. Jenner felt that such know- ledge might be put to practical use. he summoned He " vaccinated " James Phipps. Stephen Jenner. gilded butt.

John Fothergill and His Friends. Pettigrew. he planted a large botanical garden of five G. ever noted for its wide sympathies and love of justice. but soon returned to be the village doctor of Berkeley. perhaps it So wrote Dr.XVIII-CENTURY MEDICINE upon humanity. 169 T. p. as well as by WILLIAM TUKE. ii S. he used to vaccinate the poor in an arbour of his garden . Eminent Doctors. and distinguished himself in other subjects. 338 249 . The Society of Friends. p. 1932. 6 As his status and wealth increased he became in the introduction of in botany. of vaccination had been proved. and a principle had against typhoid. or even. exhibited like menagerie animals (p. Bhgh. W. brought him into prominence. there. augurated a humane treatment of the insane. during Monro in his work on osteology. 4 JOHN FOTHERGILL (1712-80) was born at Wensleydale. 2 vols. 372). he soon acquired a large " climbing on the backs of the poor to the pockets practice by His Account of the Sore Throat. in 1762." . Qiiaker and American Physicians " Let us preserve the memory of the deserving .000. vol. 1931. Sixty Centimes of Health and Physick. The Retreat. Bettany. and new greatly interested plants into England. Yorkand his a career as student in Edinburgh he assisted shire. Major. Classic Descriptions of Disease. Accordingly in 1802 he was voted and a further sum of 20. John Fothergill in 1 769. 1 10. There. Stubbs and E. Settling in London.. Dr. T. vol. i. was well represented in medicine during the eighteenth century by such versatile and great-hearted practitioners as Fothergill and Lettsom. and none is more deserving of remembrance than he. who before that time had been imprisoned and chained in a merciless fashion. For a short time he practised in London. as at Bedlam. as he advocated a milder treatment than had hitherto been adopted. J. the result of the rich. 99 p.000 was added in iSoy. R. H. 1885." of his observations during a violent epidemic of what was probably a malignant form of scarlatina. who at his mental hospital. 1919 R. 1838-40. he interviewed his many visitors and dealt with a correspondence now voluminous. at York (i794) 3 in- may prompt others likewise to deserve. Medical Portraits. Kingston Fox. cholera. To this end. 2 Meantime The value tion of the incidence and mortality of smallpox fell steadily. G. been established which was eventually to lead to the immuniza- man and other diseases. 1748.

" consisting of monthly records " Observaduring a period of four years. His garden. now incorporated in the West Ham public park. and promoted the cultivation the use popularized of the plant in the West Indies. along with his close friend. FothergnTs efforts were further directed towards the abolition of slavery. from 1751 to 1754. THOMAS CADWALADER . One of the most interesting of his papers deals with the " History and Use of Coffee. though unsuccessful. BENJAMIN FRANKLIN (1706-90). 250 . 1 Sir Hist. His tions on recovering a man dead in appearance. were his untiring efforts in 1774. is a forecast of artificial respiration. turned their attenForetion to hospital organization and medical education. him by whom as kino. while giving good service to the army. in promoting a scheme for prison reform. and the supply of cheaper fish for the poor. and he even grew a cinchona tree in his garden. 1 He advised hemlock (conium) for neuralgia. " The History of Cinchona and 111. An authority on materia medica. ranked next to Kew in importance. he extended the use of cinchona bark. Joseph he accumulated collected for in Essex (later the birthplace of another famous Lister). 1931. vol. (See also page 205) its Therapeutics. p.A HISTORY OF MEDICINE acres at Upton Quaker.." Ann. the use of maize or potato to augment the supply of wheaten flour. and other subjects. and there. introduced the friends. in hothouses and in the open. to prevent rupture between England and her American colonies. angina pectoris." Another noteworthy work was his account of* Weather and Disease. and his style is always precise and readable." 1744. and revived the use of antimony. many thousands of exotic plants which were by sea captains. One of the effects of the War of the Revolution was to bring into prominence a number of American physicians and surgeons who. by distending the lungs with air. the registration of births and deaths (although this did not become compulsory until 1837). sick headache. He wrote on epilepsy. 261. In the garden at Upton there astringent gum known He was a coffee shrub fifteen feet in height. He collaborated with his friend. JOHN HOWARD (1726-90). of coffee. Most important of all. most among them were Morgan and Shippen before them was Cadwalader and after them came Rush. and by collectors he employed. H. Med. that great philosopher and statesman. hydrophobia. the widening of certain London streets. Rollcston.

he was succeeded by another Quaker physician. Morgan was afterwards acquitted and restored to favour. the first American to confine his was called to be Director-General to the army medical department on the outbreak of war. Father of Medical Education in North America. a famous Quaker physician who succeeded Morgan as Professor of Medicine in Philadelphia. 1927. exerted his influence with William Penn on their behalf.XVIII-CENTURY MEDICINE (1708-79) was a colonial pioneer who had studied medicine in London. who had befriended Morgan and Shippen during their studies in Europe. he had also visited Morgagni at Padua. p. and the death penalty led to some decline in his practice." Ann. under Monro . he native city. Appointed to the Chair of Medicine in his practice to medicine. Life of Benjamin Rush. and he helped to found the hospital and library.. 13 " a S. and thus indirectly assisted to found this new medical school. alcohol. was BENJAMIN RUSH (1745-1813). p. 2 There. but he never recovered from the blow. another American who had studied at Edinburgh. and acquired a great reputation as of America/' although his active opposition to war. His name is perpetuated in Rush Medical College. Political squabbles led to his unjust dismissal in 1777. He was the first to teach anatomy in Philadelphia. Shippen was the first teacher of obstetrics in America. when WILLIAM SHIPPEN (1736-1808). 17 251 . Med. Jackson.D. "John Morgan. Middleton. he taught medicine for forty" the Sydenham four years. S. D. was appointed to succeed him. by S. 1861. Lettsom. When John Fothergill died of a prostatic tumour at the age of sixty-eight. slavery.. cd. The founder of the School of Medicine in the University of Pennsylvania and indeed of all medical education in America. although his professional Chair was that of anatomy and surgery. Hist. who came to London with an introduction to Fothergill. ix. a native of Philadelphia. at Edinburgh in 1768. 1 W. etc. was JOHN MORGAN (1735-89). Another student from Philadelphia. whose name is even more familiar than that of Fothergill. and had then gone to Pennsylvania with William Penn. There is little doubt that Fothergill. spending altogether five years in Europe. and an 1 While in Edinburgh he had studied Edinburgh graduate. Gross. His best known work was an ssqy on West-India Dry-Gripes (lead poisoning) which was printed by Benjamin Franklin in 1 745." in Lives of Eminent American Physicians. vol. and who proceeded to graduate M.

Friends. his face yellow and lined since his residence in the West Indies . which limited to thirty was the foundation of the Medical Society flourishes. fortune. . and after attending school in Lancashire. One of his earliest benefactions. and Leyden.) 8 Sir St.000. the son of a cotton Indies. of London. the most delightful of medical biographies. Aided by Fothergill. pairs close to the Guildhall. In time he built for himself and his wife a country residence at Camberwell. he commenced practice in the island of Tortola.000. Times. It is said to have risen as 12. John Coakley Lettsom and the Medical Society of London (Presidential Address to the Society). and thus " began the world without without person and without address. he was an ardent botanist. stood in pleasant grounds. tempered and genial in manner and moderate in all his habits. for like his predecessor Fothergill. he soon prospered. and Descendants. For many years he enjoyed an annual income of 5. in 1773. as had ever been his ambition. Lettsom was a tall spare man. was one of the seventh set of twins. house. was apprenticed to a surgeon-apothecary at Settle in Yorkshire. Abraham. he returned to his birthplace to claim his heritage. 2 The membership at first was physicians. His great popularity arose from his genuine kindness and liberality. and indeed his success was phenomenal. thirty surgeons. and soon saved sufficient money to enable him to return to Europe. a day. and that in 1795 he actually attended 82. and the only pair to survive.A HISTORY OF MEDICINE JOHN COAKLEY LETTSOM planter in the (1744-1813). He was sent to England to be' educated. and thirty apothestill 1 (One of J. then a Grove Hill. Lettsom : His Life. of horses Lettsom's house in Lanebrook Court. he promptly set them all free. It was he who introduced the mangold wurzcl into England. defending Jenner against the fight was most fierce. he commenced practice in London. without a friend. After a period of study at Edinburgh. J. who had moved farther west. Meanwhile his father had died and his mother had married again. his dress " " but not with strictness he was goodwas the Quaker attire. with an apiary of sixty-four hives and a well-stocked garden. As soon as he came of age. He championed his critics when the cause of vaccination." 1 Nothing daunted. has long since gone. Paris. Clair Thomson. as he named the village four miles from the city. 1933. West so that the only property accruing to young Lettsom consisted of a number of Negro slaves. 1917 252 .000 high as It is also said that on his long rounds he wore out three patients. Although this was his sole patrimony.

was the Royal Humane Society . bleeds. It was the forerunner of modern sanatoria. when no a meeting-place (Plate LII)." and the system was adopted in many towns throughout the country. his wig and three-cornered hat. This was before the days of hospital " out-patient departments. Such a cane. He also inaugurated in London a system of dispensaries which enabled poor patients to be treated as out-patients. open-air driving down from London during the night by coach. is no longer its principal object. well known to many who know naught else of Lettsom. with a gold or silver top. The Gold-headed Cane The fashionable doctor of the eighteenth century was some- what of a dandy. having a gold-mounted 253 cross-piece as handle . established in 1796. and still is. and said to have been written by himself : When any I sick to me apply. Still another institution owing its inception to Lettsom was. . Lettsom visited this hospital once a year. or stockings and buckled shoes. Lettsom. and which he assisted to establish in 1774. Another society to which Lettsom gave ardent support. I. he worked hard to ensure the success of the society. and even to be attended in their own homes by physicians of high rank. his gloves. perforated and hollow so as to contain some aromatic compound which was believed to prevent infection. What's that to me. and even his muff. of which many versions exist. the provision of sea-bathing facilities for weakly and tuberculous children. although the original reason for its existence.XVIII-CENTURY MEDICINE During the early days Lettsom contributed many papers material was forthcoming . his velvet or satin coat with gilt buttons. the Royal Sea-bathing Hospital at Margate. he thus followed up the work of Fothergill in his advocacy of artificial respiration. This tireless and energetic physician is commemorated in the following lines. with his buckskin breeches and top boots. and sweats 'em If after that they choose to die. and even presented to it a good house as caries. a practice he 'was wont to follow in visiting patients in the country. physicks. Another essential part of the physician's equipment was a cane.

112 A 69 . and It in her last illness Mary his queen. and a few bottles of drugs. a distinguished Fellow of the college and physician to the king. He attended King William. Jeaffreson. It was handed him his to in successor Richard and was passed office.A HISTORY OF MEDICINE instead of the usual knob. whom he offended by his curtness. in 1884. purporting to be the reminiscences of the relic itself. a skeleton. preserved in a glass case in the library. was a physician who JOHN RADCLIFFE ( 1 x owed common more to his natural sagacity and sound sense than to scholarship. MacMichael. p. although they flourished during a slightly earlier is period. he pointed to a corner of the room where lay a his great success herbal. by Mead. Halford deposited the cane in the college. and when the new college building . that "as a young practitioner he possessed twenty remedies for every disease. p. the RadclifFe Observatory. the work of WILLIAM MACMICHAEL (1784-1839). RadclifTe and Mead. when asked where his library was. who practised in Oxford. W. and a third. since attributed to others. and the Radcliffe Library. the RadclifFe Infirmary. and at the close of his career he found twenty diseases for which he had not one died of smallpox. use and I'll give you an infallible recipe 1 Book about Doctors. An account of some of the Presidents who carried the cane contained in a charming volume. the learned and courtly RICHARD MEAD " I love you. down to each successive occupant of the chair until it came to Matthew Baillie (p. Physicians. the next President. Yet he built up such a large and remunerative practice that he left funds sufficient to endow in Oxford the institutions which still bear his name. edited by William Munk. The earlier editions contain quaint illustrations." To his successor. 1870. and later in London. A second and enlarged edition appeared in 1828. It is entitled The Gold-headed Cane. who was Radcliffe who first made the remark. 1830. present a striking analogy to Fothergill and Lettsom. Lives of British 254 . The first two bearers of the cane. in Pall Mall East was opened in 1825. 650-1 729). and was first published in 1827. There it remains to this day. Mead. Indeed. 246) Baillie's widow presented it to Sir Henry Halford. J. where he had been educated. remedy. (1673-1754). was carried by John Radcliffe as President of the Royal College of Physicians. C. he gave the following advice : for success in practice .

.as the physician of Alexander Pope. who came to him with their problems. i. Mac Michael. which he had received from patients during his absence. 2 who was imprisoned for some months for his advocacy of the Stuart cause. life moved in a slow and there was time to cultivate the arts and and and collector." Dictatorial methods may be of use at times in medical practice. as it indicates that even at that date astrology held a place in medical practice. Disciples of Aesculapius. which he sought to solve without seeing the For this kind of practice. 1896. Mead was not a voluminous writer. and finally to BailJie. and When he moved into . His name has been already mentioned as a student at Leyden under Pitcairne. His services were greatly sought by the apothecaries. In the placid days of Queen Anne." 3 Of the many other century it may suffice honoured place 1 distinguished physicians of the eighteenth to mention two. Tradition has it that when Freind was released. p. Radcliffe's house in Bloomsbury Square he achieved success which eclipsed that of his predecessor. 412). vol. Richardson.XVIII-CENTURY MEDICINE all mankind ill. each of whom holds an in medical history." From Mead the gold-headed cane passed to Askew. 1827 vols. which must still be regarded as authoritative (p. * T. then to " it ceased to Pitcairne. J. not only as a physician but He possessed one of the best libraries in the country. Among his many friends was JOHN FREIND ( 1675-1 728). vol. Pcttigrcw. 362 255 . sciences. the Sun and Moon on Human Bodies. 1 Mead his principal patient. 2 VV. was well known. Richard Mead " lived more in the that Samuel Johnson remarked that he broad sunshine of life than almost any other man. besides a magnificent museum which became a Mecca for every distinguished visitor to London. Still more interesting is A Treatise concerning the Influence of as a scholar leisurely fashion. i. and Mead resolved to adopt gentler tactics. The Gold-headed Cane. W. In A Mechanical Account of Poisons he records some original observations on snake venom. It was of Dr. Medical Portraits. and who during his incarceration in the Tower wrote a History of Physick (1726). Sir B. 1838-40. day at Tom's Coffee House in Coven t Garden. but Radcliffe had carried them too far. still Mead paid him several thousand pounds. which occupied part of his patients. his fee was half a guinea. after whose death be considered any longer as a necessary appendage of the profession.

1932. Johnson called him the last of the faculties to the last. H. Rolleston. and who added 1 considerably to our knowledge. graduate of Cambridge. may make it not improperly be called Angina Pectoris. published until the year after his death.R." Ann. B. considerable for the danger belonging to it. Medical Portraits. F. as.> 1940. was not 2 It is a remarkable book. Davidson. he fell down dead. p. William Heberden the Elder." Bull. though he was not the first to describe this disease. vol.. " The Friendship of William Withering and Erasmus Darwin. Med. Samuel Johnson was another of his patients. P. Heberden lived to the age of ninety-one. vol. without the least motion of any limb. Krantz. 1767-1845. doctor in Shropshire." : A w : Another important service to medicine was rendered by Heberden when he published early in his career his Essay on Mithridatium and Theriaca. He made careful notes of all his cases. which gave the death-blow to this fantastic antidote. angina pectoris.S. Heberden. J. and perish almost immediately. viii. for example. vol. The termination is remarkable. 336 " The Two Heberdens Sir H. and at the age of seventy-two he wrote. Med. Pettigrew. Hi . retaining his mental " Dr. Romans. Hist. The 3 patients all suddenly fall down. 4 " William 1 T. Major. Musser and J. as it contains many excellent descriptions of disease." WILLIAM WITHERING (1741-79) was the son of a country He graduated at Edinburgh in 1766. which may still be read with profit. and led to its expulsion from the Pharmacopoeia." The first mention of such a tragic end was not recorded by a medical man. Htst. v. vol. C. iv. Dr.. by h* s son > ^ t ^lus describes the death of his father " The pain in his arm seizing upon him.D. 389 4 R. Earl of Clarendon (1609-74). 1838-40. p. 1922. M. and the sense of strangling and anxiety with which it is attended. Hist. according to his wishes. 1933. * 256 . 844 p.. Heberden writes " There is a disorder of the heart marked with strong and peculiar symptoms. It occurs in the Life of Edward. Classic Descriptions of Disease." Ann. William Heberden the Younger. he a in conducted London for many years and was large practice physician to King George III. and not extremely rare. p. 17101801 . his single volume of Commentaries which. Med. : t 409 R. for the benefit of his son. The seat of it.A HISTORY OF MEDICINE Heberden and Withering well upheld the dignity WILLIAM HEBERDEN the Elder (1710-1801) was a man who and honour of medicine.

PLATE LI THE WORK OF JOHN HUNTER Spur gro\\ifir cainccl out maii\ Huntti on cockscomb after transplantation txp<rim<ms in tissue transplantation (page 241) Dissection by John Hunter of the Olfactory Nerves (paige 241) .

8 d .

Gunn. Pearson. 3 His views were stated in An Account of the Foxglove. Jacobs. vol. " William Withering His Work. Doctor Darwin. p. too.XVIII-CENTURY MEDICINE practised for a time at Stafford. H. 1785. . 2 Like Jenner. "William Withering. Med. Roy. the inspiration for his great discovery came from folk medicine. with caution given. and that digitalis. p. Med. 1922 vol. and he was a member of the A Lunar Society of Birmingham. The century. Cushny. . vin." Proc. Med. 1942. S. May give a lengthened day. which ran for one minute. viii. 1930. and then. R." Ann.. John Floyer (1649-1734)." Ann. R odd is. (9> 257 1 8 . if carefully used and stopped if any nausea was caused. which held its meetings at full like moon. His Health. 189. 97 J. Hist. Percussion and Auscultation There were few century. p. 1 good botanist. 1915." Med. but it was not accurately timed until Sir JOHN FLOYER of Lichfield (1649-1734) introduced his Physician's Pulsewatch. Rosenbloom " Sir A. 1 clinical thermometer was hardly used until the end of the practised when JAMES CURRIE (1756-1805). The aids to physical diagnosis before the eighteenth physician. iv. had felt the pulse. " The History of Digitalis Therapy.). he was a provincial practitioner Jenner. at the suggestion of Dr. 1936 vol. 95 C. since the earliest days of his existence. Hist.. 1936. Soc. viii. hectic flush can blest moderate will is And. He showed that the dropsy might be due to cardiac disease. Hist. Moorman. 492 " * The History of Pulse Timing. xii. 297 J.. as watches did not then record seconds on their dials. a medical classic now The new drug was mentioned in a very rare and valuable.. vol. (Sect. Med. had to be invented. a Scot who H. was an excellent remedy. Hist. J." Bull. Press andCirc. contemporary rhyme : The Foxglove leaves. p 355 " * L. Med. Withering was aware that the country folk of Shrop. A special watch. he published a British Flora which became very popular. pp. His Friends. shire used a decoction of foxglove leaves (foxglove tea) as a cure for dropsy. he settled in Birmingham. William Withering and the Introduction of Digitalis into Medical " Ann. Another proof of favouring Heaven The The Will happily display. by Him Whose fate. 107 * A. Erasmus Darwin (grandfather of Charles Darwin). 197). rapid pulse it can abate. vol. . 1934. . p. Hist. p. and wrote his book with this title in 1707* (p. vol. 93 and 185 Practice M.

an opera entitled The Chimney-sweep. vol i. . an l The opinion is formed of the internal state of that cavity. I^jennec. Med." 374. and according full credit to the discoverer. Samtignon. and that he had composed. Rend Thdophile xi. 471. pp. translated it into French a year before he applied to the Auenbruggcr died. Born at Quimper. ii. it is convenient to mention here the discoverer of the stethoscope. McDonald. It is interesting to note that Auenbrugger was musical. in Vienna. p. and while treating typhoid fever with cold baths. 297 . 3 Next. 2 personal physician and friend of Napoleon Bonaparte. L. 27 Hyacmthe Laennec. Webb.. Foibcs. although unfortunately to the detriment of his health. 243. where his statue may still be seen. JEAN NICHOLAS CORVISART (1775-1821) of Paris. p 373 " * B. he proceeded to Paris where he studied under Corvisart and Dupuytren. RENE THEOPHILE HYACINTHE LAENNEC (1781-1826). popularizing the method. Ann. Med 1936. Corvisarl. sa vif ft son aruvre* Pans. " I here present the reader with a new sign which I have discovered for detecting disease of the chest. Hist. Meanwhile. and he had often used percussion to ascertain the level of wine in his father's casks. 1761. " A. It consists in percussion of the human thorax. 5^6 * . menced and 1940. and bore the lengthy title. he comhis medical career by assisting his uncle. This principle the human chest when he became physician to The Inventum Novum comMilitary Hospital of Vienna." work attracted little notice for twenty years. LEOPOLD AUENBRUGGER (1722-1809) was the son of an innkeeper of Graz. Although he really belongs to the following century. by thermometry. \ol. in Brittany. Hist . 1930. 1937. \ol iv. Inventum Novum ex percussione thoracis humani ut signo abstrusos interni pectoris morbos detegendi. 1904 G B.. vol. p. a physician at Nantes. vol. Then." Bull Hist. whereby . y 258 . ii.A HISTORV OF MEDICINE took up the idea inaugurated by Sanctorius. he had occasion to examine a patient whose stoutness made it difficult for the phy" 1 On Percussion of the Chest . acquitting himself with great distinction. 1939. 64 " H. Shortly after his appointment as physician to the Necker Hospital in 1816. A 'Iranslation of Auenbrugger's Original ]. mences with the words. at the request of Maria Theresa. His Life and Works/' Ann Med. there had been published a monograph of ninety-five pages which contained the first account of percussion as an aid to diagnosis. Treatise. The Aphorisms of Corvisart. Med. Hist." Ann. for he was attacked by tuberculosis which eventually caused his death at the age of forty-five years. checked his results in Liverpool. .. p. B Beeson.

Public Health and Hygiene The eighteenth century witnessed an awakening of interest in matters pertaining to the health of communities." which is audible in pleurisy. The work created a sensation in Paris. making his book of permanent value. it is sician to hear the heart sounds. Traite de mediate (1818). as Laennec stated. one tapping or scraping it while the other listened by holding his ear against the sawn end. and. Hale. and by the irony of fate he died four years later of the disease. more clear and distinct than I had ever been able to do by the immediate application of the ear. 1923 Translation of Selected Passages from " De I* Auscultation 259 . in hospitals. crepitations. 1 Sir W. said. indelicate.XVI 1 1 -CENTURY MEDICINE Inspired. perforated by a bore three lines " wide and hollowed out into funnel shape at one of its extremities (Plate LVI). pulmonary tuberculosis." * Auscultation by the direct application of the ear to the chest of the patient had been long known in medicine. " the older method was not only ineffective but inconvenient. placing one end on the patient's chest and the other to his own " in a manner ear. aegophony. which he had done so much to elucidate. example. and even Hippocrates had described the " creaking. by having noticed two children playing with a log of wood. mentioning. as of leather. discovered that he could hear the heart's action." The V Auscultation stethoscope described by Laennec in his book. and. and the prevention of disease by various hygienic measures. as Laennec not only described the sounds heard by the stethoscope. but in the second edition he added a detailed account of the diseases of the chest as then He liberally known. Laennec mtdiatt" with a Biography. Laennec rolled a quire of paper into a cylinder. but the strain was too great for him. But." covered to accept the Chair of Medicine in the College of France. even disgusting. rhonchi. of for the labours others. The labour compose his treatise was nearly necessary to perfect his discovery and to fatal to the author. and was well received in other countries. was "a cylinder of wood an inch and a half in diameter and a foot long. coining new terms such as pectoriloquy.White. and he was obliged to retire to Brittany to recuperate. acknowledges " that the employment of the new method must not make us In 1822 he had sufficiently reforget that of Auenbrugger.

or medical police as it was sometimes called. M. His views are embodied in an extensive work. " Ramazzini's : Med. tobacconists. but his main contention was that the government of a country should be responsible for the public health. p. Baumgarten and E. washerwomen.. System einer voll8 This stdndingen medizinischen Polizey. H. must be taught to keep their subjects healthy. Frank must be regarded as a great pioneer of sanitary rulers. legislation. E. Med. mercurial poisoning of surgeons who treat patients by inunction. 1930. Burget. gilders. Hist.. ix. vol. sewage disposal. not only in the people but in their rulers. One of its early was buildings Beginning advocates was Rev. ." Bull. Sigenst. p. vii. p. and later at Vienna. vintners. 109 260 .A HISTORY OF MEDICINE 1700 BERNARDINO RAMAZZINI (1633-1714). which by their In Modena and Padua. Johann Peter Frank and his System" Ann. in nine volumes (17 79. R. fishermen. . he said. 1677-1761. a versatile clergyman who had been the first to demonstrate and measure blood pressure by inserting a glass tube into the artery of a horse. 81 " * L. and the diseases of midwives. On the Diseases of Artificers. vol. 1933. Med. STEPHEN HALES of Teddington. 529 H. p. M. " The People's Misery Mother of Diseases. Ramazzini describes the lung diseases of miners and stonemasons. One feels that the unemployed arc at kast healthy. P. particular Callings they are most liable to." Ann. 525 1934. J.. tanners. It was not until the end of the century that JOHANN PETER FRANK (1745-1821) evolved his great scheme for public health legislation. He made it his mission in life to awaken a hygienic 2 The conscience. Frank. bearers of corpses. Hist. 1942. 1925. Major. 1941. vol. bearing the rather clumsy title. Hist. . v. vol. P. Hist. the eye diseases of black" cleansers of the jakes. Med. p.." the lead poisoning smiths.1 82 7) complete system of medical policy. "Stephen Hales. Middlesex (1677-1761). professor at published the first book to be written on diseases of occupation. Ramazzini's work is one of the most interest1 ing books in the medical literature of his period. 47 G. included water supplies. and even school hygiene. vol. Frank was a poor boy who by his own efforts climbed the ladder of fame. Hist. p. xu. Med. vi. E. becoming professor at Pavia. 69 " The History of Taking the Blood-pressure.. vol.." Ann. ventilation for houses and for public to attract attention. ii. in the English translation. An Address by J. and even learned men. Ramsey. 1 The importance of good J. and of printers and potters. 4 He it was who designed a Dissertation on Rinderpest." Bull. McDonald.

-jf>3 . . Mrs Mapp. Oornpam ol \\liorn r< ol I nd< i - ar< r sniffinir ( insjx tint. and Sf>ot \\artl tast< it . unm r The thrtn \\ith his fin^< i of th< puiun an fit^urts in tin upper part Fa\lor. rrpusrnts " cntitlrci.PLATE LIII EIGHTEENTH-CENTURY PHYSICIANS AND QUACKS Hofjaith\ caitoon tak< rs. sorrir the \inut(r< tt<*s in tht in a flask and on< is ahrnit \o " \niis of tin HonoinabU I h of the plnsinans of tin da\ most I\\o oi lln in aru s IK ads of thtir . Chcvali* ()j. from pai^fs It ft t'> niht.

C'aids of admission to medical classes and top centre) to library of Edinburgh Urmtrsitv. Barclay. suggests that Mr. ft. Grcijorx. AXATOMYJL Si RGKRY ^ <^ >/^yx /VXXVW ' HfUTAKY .*. EARLY NINETEENTH CENTURY MVJWIX \ Af'AtlKMI \ I'll M TIC 'A KlHXKVf ''.Sl*RC. /sft / // ////<//"/ l/J}.PLATE LIV \ STUDENT'S CLASS CARDS.. John McLaren spent fourteen veais in complt ing his course of stud). and the latest 823.. Thoi ison. Hamilton. and Duncan the earliest card is dated 1809. The\ aie The fact that Monro. Each of the teachers is mentioned in the present \\ork. .

Thorpe. and was accused of sympathy with the French Republicans. and he " " dephlogistigated air actually prepared oxygen which he called (1774). while expired Lavoisier was a great chemist. for appar" " idea. E. or when it was treated with an acid. acquiring the mysterious sub" staijce phlogiston. served as a minister there. a Nonconformist minister whose life was a long struggle with ill2 Born near Leeds. poverty. 222). Glasgow. Yet he did not completely solve the problem. which reduced the death rate from gaol fever ventilator considerably. p. 244 (" Lavoisier ") 26l . " " able to restore air which had been were growing plants vitiated by the products of combustion or of respiration. and he The was obliged to flee to America. Previously it had been imagined that the lime gained in weight. The need for fresh air was recognized all the more when the part played by oxygen was demonstrated by Lavoisier." Van Helmont had called it He expired air. Joseph Priestley (English Men of Science). air contained carbon dioxide. l JOSEPH BLACK (i 728-99). 1906 Foster. showed that when mild lime was burned into quick lime. he health. and this was fitted to the roof of Newgate prison. and that " it was present in named It is it fixed air. and disappointment. His house and chapel were burned." Black disproved this idea. Life of Joseph Black. noting also that the gas which he had discovered was a product of combustion and of fermentation. where he died. 1904 T. already mentioned as Cullen's and in Chair successor the of Chemistry at Glasgow and later pupil at Edinburgh (p. That Priestley was able to carry out his great chemical researches in the face He showed that of so much distraction is indeed surprising. and who proved that inspired air contained oxygen. Ramsay. M. Before mentioning his work." familiar to us as carbon dioxide. phlogiston ently he could not rid himself of the mythical It was ANTOINE LAURENT LAVOISIER (1743-94) who really discovered the nature of oxygen and its importance in respiration. 3 1 1 Sir Sir W.XVIII -CENTURY MEDICINE on the windmill principle. one of the first large-scale experiments in ventilation. Towards the end of his life he became involved in religious controversy. reference must be made to two other chemists who sought to solve the problem of respiration. it lost in weight by yielding up a gas. 1901. and subsequently at Warrington and Birmingham. Lectures on the History of Physiology. " gas sylvestrc. next step was taken by JOSEPH PRIESTLEY (1733-1804).

the cure of scrofula " " by the royal touch had been very popular during the previous century. and it ended tragically. had studied medicine in Vienna.A HISTORY OF MEDICINE not only replaced the phlogiston theory by definite facts but inaugurated schemes for street lighting. especially in Paris. the first during respiration for a definite air space for and to demonstrate the chemical changes occurring to show the necessity in inhabited buildings each individual. application He achieved great similar results by the use of his hands. 342 vol. He appears to have practised hypnotism by this means. where he was consulted by many eminent persons. Henry. he was a pioneer of hygiene. for example. he did attempt to establish his ideas upon a scientific basis. had taken upon himself the royal prerogative. " Iconoejraphie frangaise de Lavoisier. So passed Lavoisier. and he perished by the guillotine. Although not a physician. could cure by touching. 262 . Most of his life was spent in Paris. and Quackery credulity of mankind appears to have been especially developed during the eighteenth century. Zilboorg and G. d'Hist. asserting that the " animal magnetism. 2. Lavoisier and the History of Respiration. xxviii. xxxvii." Bull. introduced improvements in agriculture." loc. Some of those unorthodox methods of healing were sponsored by medical The well men. and investigated the value of different kinds of food. Hist. April 1944 1 G. 156 ." Proc." To give Mesmer secret of the success lay in his due. a/. Phrenology. D. notoriety.). p. 146. Soc.. No. His views were not acceptable to the revolutionaries. New York. too. So now Mesmer claimed that he. Mesmer had his imitators. and he must be looked upon as one of the earliest exponents of psychotherapy. when Valentine Greatrakes.> 1934} and " Les Habitations de Lavoisier. his great also scientific services who were forgotten. de Md. History of Medical Psychology. and had achieved a great reputation for casting out evil spirits by the laying on of hands. Lcmay. most of them untrained in medicine. Roy. Quacks and cults flourished as never before or since. and 1 likewise unscrupulous. Originally his treatment consisted in the until he found that he could achieve of magnets. W. the greatest reformer of chemistry since the 1 days of Paracelsus. E. 2 As has been mentioned. vol. Mesmerism. 1941. an Irishman. Med. Ashworth *" Underwood. FRANZ ANTON MESMER (1734-1815). (Sect. p. p.

yd ed. p. p. Ward's grown a famed physician by a Perhaps most notorious of all was Mrs. 401 vol. 100 263 . with liveried atten- For a time she dants.* It was a house sumptuously furnished. Imperial. ELISHA PERKINS of Connecticut deluded the public " his metallic tractors. achieved great success." Proc. for . "Joshua p. and electrical apparatus. Bennct.. fitted with immense mirrors. Soc. MAPP. dragons breathing flames. London. History of Scottish Mcdicwe. Of late. 336 . 1 H. to consult at the Grecian Coffee house. known as Spot Ward from the birthmark on his face.about this time the scientific work of Galvani and of Volta was attracting attention. but not Dr. Crazy Sally Mapp. Pt. charging his hearers two " " Emma guineas per lecture. and it is said that he became insane and died in poverty. with consulting fees in proportion. who established a " Temple of Health in Pall Mall. Although he made a fortune. Roy.XV II I -CENTURY MEDICINE There was JAMES GRAHAM. S. Another famous charlatan was JOSHUA WARD. 2 His " drops " and " pills " were sold in enormous quantities. the bonesetter who was actually paid by the town of Epsom to reside there. 1 J. of like quality was the CHEVALIER TAYLOR.. Mapp are depicted by specialist A he styled himself. Ward. In the Temple he lectured. until gradually she lost favour and died in obscurity. as He travelled about the country. of Edinburgh. ix. and Royal. without the least pretence to skill." He duped many. H. History of Medicine. i. Med. who called him " the most ignorant man I ever knew. In America. 1924. he soon lost it. Johnson. i. 1685-1761. pill. lecturing on " the eye. who later became Lady Hamilton and Lord Nelson's friend. From Epsom she drove twice a week to London in a magnificent coach and four. D. Spot Ward. with the assistance of Lyon. in 1780." which sold for five guineas a pair. and the charlatan Graham was quick to " exploit this interest to serve his own ends. James' Park. Garrison. and Mrs. and practising as Ophthalmiater Pontifical. and he was even asked to prescribe for the king. 1016. and by when applied to the skin with a stroking movement were said to " draw out " any disease. 1932." Chevalier Taylor. globes of glass. F. vol. Comric. receiving as part of his reward the privilege of driving his carriage through St.

Jeaffreson. C. did much to promote popular interest in healthy living as well as in phrenology. 1909 Elliot Smith. Nevertheless. 1 who were A at least genuine in their beliefs. An on before the Medical read essay Society Royal Phrenology. due credit must be given to its founders. was followed by a discussion lasting until four o'clock the next morning." p. 1870 ("Ward. and that those areas cause prominences on the surface of the skull. 2 Gall. originally a subject of serious study. 113 " . who later went to America. and were p. who with George Combe. however absurd this pseudoscience may appear to us to-day. GALL (1758-1828). The essayist was ANDREW COMBE his brother (1797-1847). SPURZHEIM. According to his theory.A HISTORY OF MEDICINE " The Arms of the Hogarth in his famous cartoon. " x Honourable Company of Undertakers (Plate LHI). though so uneducated that he wa^ unable to read or write. Since that time various attempts have been made to reestablish phrenology among the accredited sciences. who took to treating eye diseases with such good effect that he was knighted by his royal patroness. The Story of the Brain (Henderson Trust G. 187. Gall travelled through Europe with his pupil. 1924 264 ." "Taylor. a leading Edinburgh physician. and to prove the close relationship between the size and shape of the head and the mental attainments and proclivities of the individual. C." 1 B. J. Although Gall was no impostor. 191) Book about Doctors. Edinburgh). The Old Phrenology and the New (Henderson Trust Lecture. the founder of the pseudo-science of phrenology. was exploited by quacks and fell into disrepute. Hollander. Crich ton-Browne. Queen Anne's ophthalmologist was WILLIAM READ. a tailor. a Writer to the Signet. Phrenology cannot be said to have realized the ambitions of Gall and Spurzheim. Lecture. In quite a different category from those irregular and even fraudulent practitioners was F. entitled. 1923 . Edinburgh). Map. p. Francis Joseph Gall. Sir J. Unfortunately phrenology. The Unknown Life and Works of Dr. it was possible to ascertain the mental and moral peculiarities of any person by the 8 inspection or palpation of his head. J. of Edinburgh in 1823. who had been a student under Van Swieten in Vienna. maintained that certain areas in the brain presided over the various mental characteristics of the individual. J. his new science became a subject of lively controversy.

Hollander. Scientific Phrenology 1902 BOOKS FOR FURTHER READING : His Life. 1933 The Chamberlens and the Midwifery Forceps. Lacnnec. W. B. T. 1843 Fox. 1 870 MACMICHAEL. J. B. J. 1927 THORPE. History of British Midwifiry. The Life of'Edward Jenner. Joseph Priestley (English Men of Science). C. 1896 SAINTIGNON. J. H. R. Times. W. 1 '. 1897 PEACHEY. 1904 SPENCER. The Gold-headed Cane. AVELING. John Fothergill and His Friends. 1 924 RICHARDSON. B. R. 1827 MATHER. A Book about Doctors. sa vie et son cntvre. years elapsed ere the subject was placed on a more and scientific basis. JEAFFRESON. STEPHEN. Two Great Scotsmen : the Brothers William and John Hunter. G. 2 vols. R. Disciples of Aesculapius. John Hunter. ABRAHAM.XVI II -CENTURY MEDICINE the first to draw although rational 1 many attention to the localization of cerebral function. Life of Sir Astley Cooper. Paris. Man of Science and Surgeon. J. A Memoir of William and John Hunter. H. J. J. 1728-93. 2 vols. Lettsom PAGET. BRANSBY. H. 1 894 GLAISTER. KINGSTON. Glasgow. 1838 COOPER. 1906 265 . 1919 William Smellie and His Contemporaries. Dr. 1882 BARON. Friends and Descendants. G. C.

challenges no such comparison. considerable in bulk. modern medical We find ourselves constantly comparing why it is not easy to write the present-day condition of medicine and surgery with that of The history of more remote periods fifty or a hundred years ago. and the facts have been studied so fully and so frequently that they have settled down to an accepted place and value in the light of the present day. another reason history. There is. and one " whose name must be placed in the front rank among those who 266 . by glancing Sir Charles Bell and His Work At the gate of the century stands Sir CHARLES BELL (17741842). however. The facts are available. and to leave criticism to subsequent generations.CHAPTER XIV THE DAWN OF SCIENTIFIC MEDICINE IN THE XIX CENTURY PARADOXICAL as it may seem. The modern history of medicine is a matter of common knowledge. they are available in such profusion of detail that a selection must be made if one's work is to be contained within a single volume. and at the lives of a few of the distinguished medical men of that time. the greatest medical discoverer since Harvey. . it is advisable at this stage to abandon the analytic in favour of the synthetic method. Consequently. to set down the main facts briefly and concisely. There has been a tendency in recent histories of medicine to lay stress on the modern period. the portrayal of medical history becomes more difficult as one approaches modern times. In Garrison's well-known in Castiglio|ii's history this period occupies half the book history about one-third. instead of trying to evaluate recent discoveries. and the literature dealing with it is already very . to be sure indeed. This survey of medical history will accordingly be completed at some of the great medical advances of the nineteenth century. and to set forth the facts in their true perspective.

although it did not secure for him the Anatomical Chair in the Royal Academy. p." While still a boy he assisted his brother John in his class of anatomy. Wm. Nevertheless he contrived to give a good education to three of his sons. in a book intended for artists. There he lived and practised and taught anatomy. My mother was my only teacher. 1870. History of the Edinburgh Anatomical School. a Writer to the Signet John. and which remained a private school until it was closed in 1826. P. and later of Edinburgh. as brother John was deeply involved in medical polemics. he decided to remove to London. The youngest son. Struthers. which the Hunters had made famous. 2 " ruinous house in Leicester Square. who all became eminent men Robert. I obtained it. 1885. he had a hard struggle to In 1807 he acquired a " large achieve success in London. employing with advantage the great artistic skill with which he wa$ endowed. which was published 1806. A few years later Charles Bell married Marion Shaw of Ayr. Like many others before and since. On the Anatomy of Expression. and which added so largely to the success of his Nevertheless the association was not altogether later work. Bell of Doune.SCIENTIFIC MEDICINE IN THE XIX CENTURY . (Selected from his correspondence Bell. 3 In 1812 he acquired the \Y indmill Street School of Anatomy." " was the example set me by my brothers. and the prejudice against him was extended to Charles. in 1804. Rev. T. was only five years old when his father died. the surgeon (see p. ed. taking with him : . and *' finances became more straitened than ever. 1 happy. the Edinburgh Professor of Law. r There 1 Bell dissected and taught and pondered on the functions 1 8 Sir J. which give so intimate an account of his life. i. who saw little prospect of success under such circumstances. and writer of a well-known textbook." His father. imitation. 230) and Professor of Conveyancing and George Joseph. to whom he was deeply attached. the manuscript of his first great work. Perthshire. Bettany. 242 Lady Bell. Charles. have contributed to the progress of science and to the relief of human suffering. Professor of Scots Law. Accordingly. and once established his reputation. 1867. was an Episcopalian clergyman with an income of 25 a year. That he was confident of his own success at which during those early days is shown by his letters to his brother George. the younger sister of George's wife. and it was she who edited the Letters of Sir Charles Bell. Emmtnt Doctors. by he wrote. vol. . My education. George Joseph 267 .) with his brother. of Letters of Sir Charles Bell.44 G. and.

" he wrote to George in 1814." " and his arms powerless with the exertion of using the knife. He had now married and lived at 34 Soho Square. until his clothes were stiff with blood.000 paid to him by the Royal College of Surgeons of Edinburgh for his museum. " Already silence dwells here. Among its interesting contents are the oil of wounds which he made after Waterloo. cover the whole ground. excited much interest." That same year he was appointed surgeon to Middlesex Hospital. pack-saddles. nothing but a few wretched old men gathering but there are marks of struggle. and probably he was badly in need of the 3. an institution to which he brought a high reputation. and in 1810 " he described how he opened the spine of an animal and pricked the posterior filaments of the nerves. each subserving its own function. Letters. which . Without hesitation he left for Brussels. and discovered many other facts regarding nerves. etc. but he was too deeply devoted to science to acquire a large practice. and his lectures. Now you " what I hope to prove is. his masterpiece still in embryo (Plate LV). almost outmanned although at first he was At the field of Waterloo he wrote in his diary. that there are two great classes of nerves. Then he mediately the parts were convulsed." Thus was the function of the spinal nerve roots demonstrated. In 1807 he wrote to his brother George of his new ideas of the anatomy of the brain." noting that no motion " touched the anterior filaments. using " the galvanic stimulus from a zinc and a silver fork. He operated " each day for a week. left it to Magendie of Bordeaux to confirm his results. and to lend his assistance. He visited Haslar Hospital to see the wounded arrive from Gorunna. sensory and motor. . In 1815 the Battle of Waterloo gave him a further opportunity for treating gunshot wounds. . know. carefully prepared and well-delivered. when imfollowed. Yet he did some further experiments. His researches on the nerves culminated in his great discovery that there were two kinds of nerve. 268 . as every student knows when he dissects the long thoracic or external is still their property.A HISTORY OF MEDICINE of the nerves. where his sensitive nature was deeply affected by the picture of human misery. and of horses' cannon balls hoofs in all directions." " " for such a duty.. although Charles Bell. who disliked animal experimentation. caps." This he did indeed prove. gunshot paintings In 1824 ne was appointed Professor of Anatomy and Surgery by the Royal College of Surgeons of England.

but also as an artist.PLATE LV CERTIFICATE OF SIR CHARLES BELL'S CLASS Sir Charles Bell displayed great skill not only as a surgeon and anatomist. Original in Royal College of Surgeons of Edinburgh (pages 266-269. as is shown in the above certificate designed by him. .

\\hile the end \ie\\ (Fie: iiatuial si7ei. illustiates the relatixe si/e of the boie (page and 3 sho\\ sections of the > . 'I j mstiumeiil \vith and \\ithout the funnel.PLATE LVI LAENNEC'S STETHOSCOPE l^aeiviec \ \\ood< his 11 st ft hose ope Fief \\as ck signed ol sxibstitvite foi madt fiiniu 1 111 oiigmal roll UNO pieces. sereued paptr fitted into one end i tot^etlu i Pit^s 4} r*s a rnoie ptimaiient he (\hnder \l'i^ i\ \\ as \Mth a df tac liable \lif* '>).

and busied himself with the revision of his former work on the nervous system. began at the age of thirty-eight to teach anatomy on his own account. who had been educated for the Church. 1827 Bndgcwater Treatises." In 1835 the Chair of Surgery at Edinburgh became vacant. after assisting John Bell for 1 a time. All those discoveries. Professor Roux dismissed his class with the words " C'est assez. p. as he " considered that London was a good place to live in but not to die in. and he died two years later whilst visiting a friend at Hallow. his brother John continued to practise surgery. "Sir Charles Bell and the 1942. and in the following year Bell received the honour of knighthood. Sketching was another passion which had attracted him since boyhood. sketching and studying art. Med. and the first text-book of modern neurology. a muscle which raises the ribs in inspiration. near Worcester. are set forth in his volume on The Nervous System of the Human Body. Hist. especially on the Continent. vous avez vu Charles Bell. which supplies the serratus magnus." Nevertheless. and was thus enabled. Ballmgall. together with careful notes of forty clinical cases and a number of beautiful drawings by the author. He was the first anatomist " who did B. or when he meets with a case of Bell's paralysis. Spector. published a book on surgery.SCIENTIFIC MEDICINE IN THE XIX CENTURY respiratory nerve of Bell. which was a common result of surgical interference until Bell proved that division of the facial nerve "would not cure neuralgia. so violent a dislocation at the age of sixtytwo could not fail to have its repercussions. 314 1 G. and it was offered to Sir Charles Bell. Messieurs. Bull. In 1840 he spent two months in Italy. When Charles Bell left Edinburgh in 1804. But long ere this his merit had been recognized. but the leading teacher of anatomy y was JOHN BARCLAY (1758-1826). 269 . where he ranked even greater than Harvey. xii.. Naturally. When he visited Paris. vol. Life of John Barclay. It appeared in 1830. and his Bridgewater treatise on The Hand Its Mechanism and Vital Endowments as Evincing Design. to pursue his favourite sport of fly fishing. 1 He acquired considerable practice among the nobility of Scotland. he found " many changes in Edinburgh ." Yet he filled the Chair with acceptance. 2 Barclay. which had a great vogue and passed through many editions. a classic of medicine. and even encouraged. he seemed to walk in a city of tombs. He accepted it. But he was already in failing health.

p. Struthers. J. was an Irishman. and he greatly advanced the subject of comparative anatomy. p. His papers on those researches. like himself. and the increasing demand for subjects. xxvi. 1867. 1926 270 . The Tragedy of Robert Knox In 1826 Barclay was succeeded by ROBERT KNOX (1791-1862). 2 Within a few years his class numbered five hundred. Knox had already played a leading part in securing for this museum the collection of Sir Charles Bell. 39 Ball. vol. 1 So intent was he on times continue to lecture to empty benches his subject that he would someafter the dismissal bell had sounded. 1933. regarded as the most popular anatomist of Edinburgh. artists. Med. Scientist. 1870 8 A. Knox had who was tended the wounded at Waterloo. *' and Martyr. 3 Since the early days of the eighteenth century there had been a traffic in dead bodies for dissection. Roy. During five years as a military surgeon. He was a born orator and an inspiring teacher. obtained for him the post of Conservator to the Museum of the Royal College of Surgeons. Hist. Lonsdale. Gurrie. and even as far afield as Dublin and London. lawyers. but also noblemen. especially in Edinburgh. The Life of Dr. Robert Knox. and Barclay was obliged to lecture twice a day in order to accommodate his many students. (Sect. Alexander Monro (tertius) gave no opposition to such an energetic teacher. and had spent three years in South Africa. S. Historical Sketch of the Edinburgh Anatomical School. M. 4 In 1829 there died in William Hare's lodging-house in the West Port of Edinburgh an old man who had failed to pay his bill." who robbed recent graves. He had taken full advantage of his residence at the studies in anthropology and in natural history. Hare conceived the idea of clearing Cape by pursuing 1 Sir J. Anatomist. When Robert Knox was at the height of his fame as a teacher of anatomy. 56 H. another of his lodgers who. Soc.). Assisted by Thomas Burke. had stimulated the nefarious activities of the "Resurrectionists. in order to sell their gruesome spoils to the anatomists. The " Sack-em-up " Men. but in Glasgow. his career suffered a rude shock from the repercussions " " of the Burke and Hare murders. and included not only medical students." Proc. Robert Knox.A HISTORY OF MEDICINE not also practise medicine or surgery. not only in Edinburgh and neighbourhood. communicated to various learned societies in Edinburgh. and men of letters.

31 1 . Knox for 7. however. Meanwhile. as the last of the bodies were found in Dr.R. The Anatomical Memoirs of John Goodsir. ed. plying them with drink and then suffocating them.SCIENTIFIC MEDICINE IN THE XIX the debt series CENTURY by Encouraged by the sale of the debtor's this success. los. 395 W. p. and supported his contentions by publishing the report of the committee which had been set up by his friends to make impartial inquiry into the matter. He wrote papers for the Royal Society on whales. Anatomy under Henle and Hyrtl We have already noted the rise of anatomical teaching in America under such pioneers as Rush and Morgan and Shippen. and continued his work as a teacher of anatomy.S. al" our though. Memorial* of His Time. 271 . anatomists were spotlessly correct. 1921 * H.. whose discoveries in microscopic anatomy entitle him to a high place in medical history. 4 It is. both unfinally dying in obscurity in London. By this time his pupil. 1884 of Burke and Hare. Knox conducted himself with bravery and dignity. that fortunate and unfair Robert Knox should be remembered mainly in relation to the Burke and Hare murders. there was strong feeling against him. Dr. The Trial G. luring their victims into the house. JOHN GOODSIR (1814-69) 3 had succeeded Monro (tertius) as Professor of Anatomy. 1872. for he was an eminent anatomist and a great teacher. and. 1885. JACOB HENLE (1809-85). He weathered the storm. F. which had been so feebly held by his predecessor. so that the body showed no trace of violence. held professorships of anatomy successively at Zurich. and had revived the prestige of the chair. two ruffians embarked upon a of murders. and in the face of considerable personal danger." 2 In the trying circumstances. 1868 4 Life of Sir Robert Christison. before the miscreants were brought to justice. Turner. as Lord Cockburn tells us in Memorials of His Time. ever a topic of interest to anatomists. and 1 W. MacGregor. p. Knox's rooms.. The History of Burke and Hare. 3 vols. Cockburn. on the Continent. replied to his accusers in restrained terms. and Knox the most correct of them all. Knox gradually lost power and position. by one of his sons. the 1 body to Dr. and their bodies sold for dissection. vol. i. Thirty-two persons were done to death. Roughead. and eventually when he could no longer remain silent. Heidelberg. Whatever the reason. a number of great anatomists had appeared. Edinburgh. Edinburgh.

as Henle. and then the other tissues dissolved away by acid. Henle discovered the tubules of the kidney. Hyrtl was especially devoted to osteology. and first described the epithelial coverings and linings of the surfaces of the body. History of Medicine. interesting lecturer. to whose encouragement he owed much. The simile is appropriate. thus prophesying the dawn of bacteriology. H. and in later years he learned the 'cello and viola. p. Although his textbook was devoid of illustrations. 2 The son of years the a Hungarian musician employed by Haydn. 490 272 . Bichat had laid the foundation of histology. for he was a well-read scholar. p. 1937. Henle proceeded to build the edifice. E. H. and various structures in the brain. Sigerist. In his work on miasmata and contagions he states his conviction that infectious and contagious diseases are caused by living organisms. whose histological discoveries rank alongside the anatomical discoveries of Vesalius." Bull. and he possessed a wonderful collection of skeletons. was JOSEF HYRTL (i8io-94). both animal and human. in his excellent Handbook of Systematic Anatomy (1866-71). Another eminent anatomist. Great Doctors. Garrison. The lovely play his violin. 347 * F. " Some Aspects of Jacob Henle's Medical Thought. so that all the vessels remained clearly revealed. His friendliness and generosity endeared him to generations of students. for he was a clever artist. the muscular coat of the arteries. whose ability lay in teaching rather than research. he attracted students from all faculties. Hist. of Johannes Miiller.. 1933. 1 G. 1924. vol. viewed the work. Amid all this intense intellectual activity he found time to illustrations are his human body from an own architectural standpoint. it was so clearly and simply written that it passed through twenty editions within forty years. p. the minute anatomy of the eye. he describes the macroscopic and microscopic structure of the entire body. Yet he did not confine his attention to histology.. Med. 3rd ed. for he was an accomplished musician. Rosen." also developed the technique of making the blood-vessels of an organ or part being injected. 509 . He " corrosion preparations. Garrison regards Henle as one of the greatest anatomists of all time. In the three volumes which constitute this handbook.A HISTORY OF MEDICINE 1 As a student in Berlin he had come under the spell Gottingen. v. and while he pursued the familiar paths of anatomy he captivated his hearers by embellishing his subject with all manner of other information. he occupied for thirty A popular and first Chair of Anatomy at Vienna.

d.. Physiology and Physics was in the early part of the nineteenth century that physiology became established as a distinct science. " "A Summary of Von Baer's Commentar. A tireless and energetic worker. p. and Muller which established physiology as a separate science. he was keenly interested in comparative anatomy. 6). 1 His discovery of the mammalian ovum in 1827 was Petersburg. Anthropology owed much to PAUL BROCA (1824-80). 24 (429) Anatomic des Johannes Muller." Arch. Hist. 2 In his handbook of physiology he included the subject which we now call psychology. he contributed numerous papers to the Archiv fiir Anatomic und Physiologic. Med. In 1833 he was appointed professor of anatomy and physiology at Berlin. a post which he held until his sudden death at the age of fifty-seven. 273 jg . and later of St. xxii. His masterly account of the nature of mind may still 1 A. and who thus inaugurated the localization of cerebral functions.f. 1938. commenced his academic career as a teacher of anatomy and physiology at Bonn. tumours according to their microscopic appearances. and he quoted freely from the aphorisms of Spinoza. Meyer. Broca discovered methods of measuring and delineating the skull.SCIENTIFIC MEDICINE IN THE XIX at this time received its CENTURY chief stimulus from CARL Embryology ERNST VON BAER (1792-1876) of Konigsberg. Die Pathologische 1929. which des achievement was the publication of many years. Med. It rose to be a great pioneer of physiology." Bull. He made discoveries in embryology (Miillerian ducts) . the Parisian surgeon who discovered the motor speech centre. vol. and he was one of the first to classify . he enunciated he edited for he investigated the production the law of specific nerve energies of sound by the vocal cords . he confirmed the findings of Sir Charles Bell regarding the spinal nerve roots and their position . One of its first and greatest exponents was JOHANNES MULLER (1801-58). for his father was a shoemaker of Coblenz. W. p.. vi. and he contributed to the knowledge of prehistoric trephining (p. 1031 2 R. vol. Like John Hunter. which is full of original observations. but his greatest his Handbuch der Physiologic Menschen (1833-40). his one of numerous contributions to our knowledge of only growth in its earliest germinal stages. Ross le. Gesch. where he was assisted by Jacob Henle. who from a humble origin.

(p. him into brought prominence. as he wrote. the anatomist. G. (A complete and interesting biography. the assist : founder of Pennsylvania. and in 1829 he was appointed Professor of Physiology at Konigsberg University. hence arose In the well-known Young-Helmholtz theory of colour vision. L. as it was ever one of his chief traits to encourage his juniors and to them by every means in his power. attending " British Association at Hull. vision. Hermann von Helmholtz. a teacher of philosophy. 271). Henle. THOMAS YOUNG (1773-1829)." Although this instrument has proved its immense value in medical diagnosis. some papers were 1 J. has already been mentioned Virchow. the pathologist. he was worshipped by his students and assistants. where. Next. but Hermann was much more devoted to physics and chemistry. by electrical means. belongs to a later period (p. at the very outset of thq investigations which led to the publication of his great work on Physiological Optics (1856-67). therefore the boy was sent to study medicine. McKendrick. All his spare time was devoted to science. 282). and in due course he became a surgeon in the army. sought to interest his son in classical learning. On the Mechanics of the Eye (see p. had written a treatise. Virchow." published in Muller's Archiv. He established. His father. 1906. Among his disciples were many who became famous Henle. Welby. Perhaps the greatest of all Miiller's pupils was Helmholtz. R. trans. This gave him the opportunity to indulge his passion for original research. His paper. HERMANN VON HELMHOLTZ (1821-94) was born in Potsdam. 374). and had the great joy of being the first to see a living human retina.) 274 . Hermann von Helmholtz (Masters of Medicine).A HISTORY OF MEDICINE be read with profit. 1899 . 1 On his mother's side he was a descendant of William Penn. and others. Koenigsberger. by F. Those researches concerned the mechanism of accommodation and the problem of colour In 1801. a pioneer British ophthalmologist practising in London. it was at first regarded as a toy. that master of physics and physiology to whom the world owes so great a debt. " On the Conservation of Energy. and even Helmholtz himself regarded the discovery as a mere incident in the course of his researches. Helmholtz confirmed and elaborated Young's conclusion . Little or no livelihood was to be gained from science at that time. " he invented the ophthalmoscope. the his first to Helmholtz made visit 1856 England. the rate of transmission of nerve impulses. An impressive figure and an inspiring teacher. Helmholtz.

but he was already in failing health and he died soon after his return. bridging the gap between the science of acoustics and the art of music. which resulted in a mass of new facts and ideas. not only because he was one of the greatest scientists of all time. He showed that mathe" matics and music. where he could concentrate once more upon physioIn physiological acoustics he opened up a new field. Having completed his researches on the physiology of the eye." Two years later he visited Scotland at the invitation of Sir William Thomson. which appear so different. and was assisted by HEINRIGH HERTZ. On account of the delicate health of his wife. in logy. The two eminent men remained the closest friends until death separated them. and remains a classic. a brilliant scientist who died young. He now turned his attention to electro-dynamics. but finding the teaching of anatomy irksome. who made numerous experiments 275 . which still meets with general acceptance. This subject had a peculiar attraction for one so keenly devoted to music. was EMIL DU Bois REYMOND (1818-96). afterwards Lord Kelvin. three years later. he had accepted a Chair of Anatomy and Physiology at Bonn. In 1871 Helmholtz was appointed Professor of Physics in Berlin. and whose discovery of " " Hertzian waves made modern wireless transmission possible. and how physiology was enriched from physics. He fulfilled a cherished ambition in 1893 when he visited America. A close friend of Helmholtz. We have dealt at some length upon the achievements of Helmholtz. to Heidelberg. but also because his work showed how one science can assist another. appeals to lovers of music as well as to scientists." His brilliant work on Sensations of Tone. he was glad to be transferred. forty years later. Helmholtz resigned his chair in 1885 in order to become President of the great Physico-Technical Institute which had been set up by the Government. His output of scientific work was undiminishcd despite his seventy years. where he spent the rest of his life. Helmholtz turned his attention to the sense of hearing. also a pupil of Muller. he elaborated the Resonance Theory of Hearing. Amid many other discoveries. which he made many discoveries as admirable as those he had already made in physiological optics. are yet interrelated and mutually helpful. and some the tomfoolery of crackbrained persons.SCIENTIFIC MEDICINE IN THE XIX CENTURY important scientific contributions. written in clear and simple language.

. Medical Portraits. Some Apostles of Physiology. and Leipzig. he contrived to teenth century. 1936. AUGUSTUS WALLER (1816-70). v. A meat extract still bears his name. iv. was CARL LUDWIG ( 1816-95). vol." Bull. A.A HISTORY OF MEDICINE with muscle-nerve preparations. Rosen. Crile. he did much to advance our knowledge of always assigning to him the credit for any successful result. in England. Pettigrew. p. He attracted many pupils of all nationalities. vol. 840-191 1). discovering many new facts and founding the science of electro-physiology." About this time another branch of physiology. 107 Charlotte Hall. T. Much really his own was then published in the name of " one of his assistants or pupils. 428 G. " Henry Ingersoll Bowditch. 1932. blood pressure and of the function of the kidney. His contemporaries in the same field of work were. Hist. that of physiological chemistry. whose name is known to every medical student as an inventor of various forms of America. Life of Marshall Hall. " Carl Ludwig and his American Students. vol. Pioneer British Physiologists Among British physiologists MARSHALL HALL (1790-1857) exemplifies the trend of physiology in the early part of the nineversatile and energetic man. Med. 609 . Stirling. later perfected by G. 3 conduct an extensive medical practice while making the important A investigations in physiology which brought him lasting fame. After qualifying at Edinburgh and continuing his studies at Paris A." Ann. HENRY BOWDITCH ( 1 1 apparatus. 1861 . but his claim to fame rests upon his writings. and when he found a keen student he would give him a problem to work out. Hist. p. 1 1 276 . 2 While he was Pro- Vienna. iv. whose experiments in nerve blocking were the foundation of one method of producing local anaesthesia. Med. 1838-40. Another contemporary of Helmholtz. was founded by JUSTUS VON LIEBIG (1803-73) of work which was Giessen. 1902.. W. who showed that degenerative and in changes occur in the distal portion of a severed nerve . J. and fessor of Physiology successively at Zurich. often working along with him. By many he was regarded as the greatest teacher of physiology who ever lived. although he went too far when he denied that fermentation and putrefaction were due to vital agency. Walking. p. and especially his conception of metabolism. He made numerous contributions to organic chemistry.

Pasteur's second patient.PLATE LVII THE C-ON'QUESr OF R \BIES Tht* lad Jupillc. cjiapplint? \Mtli tin Statue in courtvard ol Immut Pastt ur oi J^aris (page dog mad 2^4) .

u h in possession of thr hospital A contemporary Dr. Joseph Bell of Edinburgh in his " victoria " (page 230) .PLATE LVIII PATIENT AND DOCTOR IN THE NINETEENTH CENTURY l 'I hr Rahrrc Ward of Si sk< Hartholomrw's Hospital in 1832.

he he resembled Sir Charles of whom of character Bell. This important discovery was attacked. Probably the work of Marshall Hall has not received full recognition even " In yet.. He found time. Thomas's Hospital on accepted. 124 277 . and had a wide circulation." His reputation was increased by his appointment as physician to Nottingham Hospital. which originated from the observation that a headless newt moved when the skin was pricked. embittered by these reverses. At his house in Manchester a he of animals for his experiments. and highly praised. Though now superseded by other methods. and many other acts. too. although on the Continent it was Marshall Hall never became accepted. and in his visit to the United Two years States in order to study conditions of slave labour. " a prevalent practice of blood-letting. " William Sharpey. ix. he never held a hospital appointment in London." Ann. The integrity of the sensory and motor nerves and of the segment of the spinal cord from which they originated was " reflex noted by him to be essential. 1802-1880. C. was action 1 " J. beauty was the true successor. Matthew He also denounced the Baillie. 1927. so that in 1826 he removed to London. the first breath of a new-born child. Brougher.SCIENTIFIC MEDICINE IN THE XIX CENTURY and Gottingen. He was certainly one of the greatest men of his time. and eventually had the satisfaction of finding his views universally Although he lectured at St. vol. regarding the lancet as minute instrument of mighty mischief. which was commended by Dr. he studied hibernation." The first physiologist in Britain to devote his entire attention to the subject was WILLIAM SHARPEY (i 802-80) * He. he commenced practice in his native city of Nottingham. p. and even stigmatized as an absurd theory. His philanthropy is shown in his successful campaign to stop the practice of flogging in the army. Hist. Marshall Hall showed how explained the act of coughing. however. He continued his researches. kept regular menagerie Square Like John Hunter. making many long journeys on horseback. and the Royal Society refused to publish the work. Med. nervous diseases. the involuntary closure of the eyes when threatened. and actually earned 800 in fees during his first year there. it has been the means of saving many lives. before his death he introduced the method of artificial respiration which bears his name. to write a book on The Diagnosis of Diseases (1817). as was the custom. but his greatest achievement was his discovery of reflex action.

Descriptions of Disease. he assisted Allen Thomson by lecturing extra-murally on anatomy. 209 D. This he described in a paper. Sharpey. p. 1 In 1836 he was appointed Professor of Physiology at University College. During the next three years he visited Germany. where. On a Peculiar Motion excited in Fluids by the Surfaces of Certain Animals. who succeeded Allen Thomson as professor " of the Institutes of Medicine.A HISTORY OF MEDICINE an Edinburgh graduate who afterwards studied in Paris. and others. The holder of the chair was a physician in the Royal Infirmary. and he resolved to devote himself to physiology. An early pioneer of the subject in Edinburgh was JOHN HUGHES BENNETT (1812-75). For a short time he joined his stepfather. Major. p. 1932. 608 . an arrangement which had the advantage of linking physiology with clinical medicine. he discovered the medicinal value of cod liver oil. but science attracted him more strongly. History of Scottish Medicine. Eminent Doctors. Sharpey occupied He this Chair with great acceptance for thirty-eight years. xxxiv. Michael Foster. travelling on foot and learning much. 465 * - J. Med. vol. Stirling. Some Apostles of Physiology. He also rendered valuable service as secretary to the Royal Society for almost twenty years. Dr. H. and Italy. at the clinic of the famous Dupuytren.. . Jour. 120 vol. in practice at Arbroath. Physiology had been a mere appendage of anatomy and of physics until Sharpey gave it a place among the sciences. 1 W. " On a Peculiar Motion. Comrie. Classic 278 . collaborated with Quain by writing the sections on microscopic anatomy for the well-known Elements of Anatomyy which is still used as a work of reference. vol. and he pursued the research which resulted in his discovery of ciliary activity. Sharpey was an inspiring teacher who held the same position in Britain as Muller did in Germany. A man of kindly nature and ready wit. 1932. and he was the first to describe the blood disease known as his pupils who leucocythemia (i845). Bettany. G.. he formed a lifelong friendship with James Syme. At the same time RICHARD QUAIN was appointed Professor of Anatomy. 2 Hughes Bennett inaugurated the practical study of histology. p. 1885. Returning to Edinburgh. R. Arnott. T. p. 1902. ii. London. and W. France. Among were Burdon Sanderson. etc." Edin. 1830." as physiology was called. did much to advance physiology during the latter part of the century. ii. 8 Surg. the two subjects having been previously taught together by Quain's father.

as had been believed. Bernard did not know how the animal had been obtained for the laboratory. parentage. not far from Lyons. Olmsted. the incident ending happily for all concerned. All his spare time was devoted to the writing of poetry and drama. but he wisely advised the author to study medicine. The next important discovery. D. It was during this series of experiments that one of his dogs. By a series of carefully planned experiments. Claude Bernard (Masters of Medicine). he showed that digestion was not completed in the stomach. he said. As a youth he was apprenticed to a local pharmacist. and who was kind enough to read it. Foster. CLAUDE BERNARD (I8I3-78). but he soon pacified the owner and restored the dog to health. in the province of Beaujolais. p. vol. however. The dramatic critic to whom he submitted his work. His first work related to digestion. Hist." 2 which. M. the leading physiologist of France and an ardent apostle of physiological experiment. 253 vii. Magendie seemed.. was also the . and he devoted himself to research with a definite object in view. to substitute experiment for thought. and prodding in all directions in the hope of finding some new truth. 279 . as his father was a vine grower at St. Sir J. Bernard began his brilliant career by assisting Magendie. that of glycogen. until at the age of twenty-one he determined to seek his fortune in Paris." Ann. in the intestine. Med. an inspector of police. but the work did not attract him. escaped from the laboratory.SCIENTIFIC MEDICINE IN THE XIX The Genius of Claude Bernard CENTURY Another name which cannot be omitted from any account of nineteenth-century physiology is that of the great French 1 He was of humble scientist. recognized that it had merit. will After completing his student training. through the action of the pancreatic juice or secretion. " Claude Bernard as a Dramatist. 1935. that the liver did not merely secrete bile 1 1 it also Bernard proved produced sugar. having a cannula fixed in its pancreatic duct. " much more surely gain you a livelihood. and was brought back by the irate owner. Claude Bernard had the good sense to recognize the defects of his master's method. thrusting his knife here and there to see what would come of it. outcome of systematic and planned experiments. Julien. 1899 M. but that gastric Digestion was continued digestion was only a preparatory act.

Bernard was working at the subject of animal heat when he noted that division of the cervical sympathetic nerve in a rabbit raised its the temperature on that side of the head and neck. A third discovery was that of the vasomotor mechanism. 1 noteworthy described the principles upon which research should be conHis Introduction to the Study of Experimental Medicine. but made every lecture a new exposition rather than Sorbonne. and in was. in fact. H. an giving it this name Bernard paved the way for the discovery of " " the numerous hormones which we now recognize. Claude Bernard pursued his discovery of the glycogen function of the liver to its logical conclusion. t 1936. a repetition. iv. C. With characteristic insight he saw the significance of this side issue.A HISTORY OF MEDICINE and this function was independent of sugar in the diet. " The Philosophy of Claude Bernard. the production of sugar by the liver showed that the animal body could build up substances as well as destroy them. 280 . and he left little to be added by subsequent investigators. 1927 the Study of Experimental Medicine. vol. 1865. An Introduction by H. trans. each having separate function. . Success did not spoil him." 15 to Med. Moreover. which appeared in 1865. as it showed. further- more. p. The merit of Claude Bernard's work was recognized in 1854. and main quest to ascertain how the nerve could While investigating the function of the submandibular gland. Hist. is one of the greatest of medical classics which ought to be read by everyone who undertakes medical Towards the end of his contribution life to the research. he showed that the sympathetic nerve was the constrictor of the blood vessels the chorda tympani was the dilator. Descartes and from the path of scientific research in order Bull." or milieu inttrieur. stepped aside 1 two great Frenchmen. to improve his subject. ducted. There " internal secretion. Greene. 2 It is significant that Bernard. Thus were the fundamental facts of vasomotor physiology made known. 1 Claude Bernard. that the body was not simply a bundle of organs. nor did he relax his efforts He never repeated a routine course of lectures. Bergson. At the time his discovery had a far-reaching effect. New York. he made what is perhaps his most He advance of medicine. when a special Chair of Physiology was created for him at the turned aside from his influence temperature.

" what we know may only in men's minds." To Bernard. Menne. " words. and from this huge material he wrote those descriptions of disease which are models of clear and logical writing. and put it on again on leaving. in marked degree. Carl Rokitansky the Pathologist. One must shed one's imagination.SCIENTIFIC MEDICINE IN THE XIX CENTURY to survey the principles upon which research should be conducted. The two greatest exponents of pathology in the early nineteenth century The were Rokitansky and Virchow. impotent nothing. Perhaps the poet in him helped him to frame his hypotheses.. he disliked accepted formulae. Such was the philosophy of Claude Bernard. p." he affirmed. Baillie. Hist." Ann. by experiment. 1925. Sigerist. many thousands of post-mortem examinations. Bernard explained." Pathology and Bacteriology discovery of a bacterial cause in many forms of disease changed the whole face of pathology. vol." He also stated that " interfere with our learning what we do not know in other . 291 . well worthy to rank alongside those of his predecessors in this work. Claude Bernard stated that there was no place in experimental medicine (the name he gave to physiology) for " doctrines " or " " do not exist in Nature but systems. Ncuburger. R. 40 M. and to plan his experiments with such He also possessed great technical skill. and from those facts he framed a Then. E. had no place in the experiment itself. on entering the laboratory. the Vienna School. Great Doctors. " is an without a hand. like one's overcoat. of the fallacy Imagination. He " regarded pathology as the foundation of clinical F. p. the independence and freedom of mind so essential to the progress of humanity. and accordingly he set out to establish a good experimental standard. though essential before hypothesis. That change did not take place until the latter part of the nineteenth century. and after experiment. 1936. The true scientist." Systems." he wrote. belonged that attribute mentioned " in the last sentence of his treatise. the latter being often regarded as the leading pathologist of all time. CARL ROKITANSKY (1804-78) was a Czech who was Professor of 1 It is said that he performed Pathology at Vienna for thirty years. British Medicine and 28l . P1 379 H. He studied Nature. " A head success. Med. had no fixed starting-point. he observed facts. he tested the accuracy or hypothesis. 1943. 2 1 Morgagni and Matthew vii.

on which he wrote a large treatise defects of the heart. p. which was the subject of another work . and a few years later he was recalled to a similar post in Berlin. 454 1 906 Sketch of and Virchow's Life Bartlett." Ann. he was sent to investigate an history. " Rudolf Virchow and the Franco-Prussian War." in Lectures on the History of Medicine (Mayo Foundation). as pathologist that Virchow is known in medical While still in his twenties. A Med. he remarked of his sons. 1924. epidemic of typhus in Silesia. An apostle of democracy and freedom. Virchow was eminent as anthropologist. tattooing. 2 He was one of those exceptional individuals who have encompassed several careers within a lifetime. Schliemann to Troy 1879. He was largely 3rd ed. adding lustre to each of them. the healers and the howlers "Die Einen heilen. 1839-64. G. " Rudolf Virchow Hist. two of whom were physicians and two musicians. p. Time. and 3 politician. His political career 4 For many years he was by far the most less noteworthy. influential medical man in Germany. Among the subjects of his researches were diseases of the arteries.. It is. Numerous were his contributions to pathology. die Andern heulen. Leipzig. and one of the most famous medical men of the century under review. pathologist.. vol. He accompanied Dr. iv. G.. Garrison. he was strongly opposed to the policy of Bismarck." ibid. Schlumberger. Introduction to the History of Medicine.. which he named thus. and in allied subjects. Briefe an seine Eltern. By far the most distinguished pathologist. acute yellow A atrophy.A HISTORY OF MEDICINE knowledge. fields In the first of those wide tion into the physical anthropology of he conducted a vast investigaGerman children. and it was was no owing to his efforts that the drainage system and the water supply of Berlin were reconstructed on modern lines. Revolutionist. and many other diseases. 1942. that the responsible authorities banished him from Berlin. Fortunately he was appointed Professor of Pathology at Wiirzburg. however. that they were of two classes. 3 W. 3rd Ser. genial and kindly man. : His handbook of pathological anatomy had a wide circulation.. H. which came to be known as Virchow's Archiv. Schlumberger. 147 282 . 253 H. * p. 6 From 1880-93 he was a member of the Reichstag. 1933 4 H. and he investigated lake dwellings. His report revealed such deplorable social conditions. Early in his career he had founded the journal Archiv fur pathologische Anatomic. 1 1 F. and wrote an account of the wonderful discoveries there." l . Philadelphia. and his recommendations were so revolutionary. was RUDOLF VIRGHOW (182 1-1902). Virchow. " R.

Since Virchow's day it has been necessary to modify his views considerably. but at the time they marked a great advance. a little town in the Jura. In the Virchow Institute he personally collected and mounted some in achievement was his conception of the " 23. to whom he was indebted for the idea of cell domination. Pasteur was Professor of Chemistry at Strassburg. 1932 283 . Compton. Diseases of wine. The Genius of Louis Pasteur. Then commenced that systematic and strenuous life. The Birth of a New Science Contemporary with Virchow was a Frenchman who. 1 which had been built in his honour in 1888. morbid structure of cells derived from consisted Every The motto.. of domestic animals. He dedicated the book to Professor John Goodsir of Edinburgh (p. " Omnis cellula e cellula " was pre-existent cells. and his many years of hard work in the interests of social reform and public hygiene were suitably rewarded when his eightieth birthday was celebrated as a national holiday.900 specimens. Pasteur. P. L. of insects. with results which have proved of immense value to mankind. which appeared 1858. devoted to the solution of one problem after another. the foundation of his work on Cellular Pathology. leontiasis ossea. 1 born at Dole. 271). cell as the centre of pathoFor him there no were logical changes. Young Pasteur showed some aptitude for drawing portraits. Descour. where his father. a soldier of Napoleon's army. 1922 .SCIENTIFIC MEDICINE IN THE XIX the to record leucocytosis. Vallery-Radot. and eventually for over twenty years in The last six years of his life were spent in the Institut Paris. The Life of Pasteur. specific cells in diseased tissue. He was the recipient of many honours. though not a medical graduate. 2 vols. and of man were in turn investigated and elucidated. was one of the outstanding figures of medical The details of the life of Louis PASTEUR (1822-95) are history. and first CENTURY knowledge of His greatest and many to enlarge the other diseases. 1902 . but his scientific ability did not become apparent until his student days in Paris. He was so well known that they need only be recalled briefly. at Lille. Pasteur and Work. trichinosis. and when a magnificent new municipal hospital was named after him. and which destroyed at a blow the old-fashioned humoral " pathology. had returned to ply his trade as a tanner. and where his R. Virchow led a life of intense activity.

A HISTORY OF MEDICINE he worked in almost monastic simplicity. or splenic fever. His first researches concerned crystallography. assisted by his devoted wife. when he treated an Alsatian few boy. an old culture of low virulence. when he inoculated a shepherd lad from the Jura named Jupille. he discovered that it was the action of organisms which caused wine and milk to become sour. Pasteur was still engaged in this investigation when he was asked to go to the south of France to study the silkworm disease which threatened to wreck the industry. and which threatened to wipe out the sheep and cattle. a disease which had also caused heavy losses. His revived energy was now devoted to the prevention of anthrax. who was ever his best collaborator. which had assumed epidemic form in France. when injected into an animal. or "pasteurizaas it was called. Following the lines laid down by Jenner. At this point of his career ( 1 868) he was stricken with cerebral haemorrhage. After many experiments Pasteur had reached 284 A . to tion ' proof of the existence of atmospheric germs that led Lister to apply the principle to surgery. who had been bitten severely by a rabid dog while he grappled with it in an effort to protect his comrades. He showed that fermentawas not merely a chemical reaction. Pasteur prepared a weak form of virus. although he fortunately recovered from the paralysis after a long and tedious illness. who had been bitten by a mad dog. There. By this time he was no longer a chemist. but rather a bacteriologist. and he recommended measures for their prevention which saved the prosperity of the silk industry. Jupille's brave action is commemorated by a statue in the grounds of the Institut Pasteur of Paris (Plate Lvn). Pasteur's most famous discovery. but that it was due to micro-organisms. which. micro-organisms which caused the fermentation were spontanIt was Pasteur's eously generated. was made on July 6. however. caused a mild attack and conferred immunity. with amazing results (p. and that this could be prevented by the application of heat. 1 885. and as he noted how fermentation occurred in his solutions he was led to that vast study of the causes of putrefaction and fermentation which was engage his attention for many years. 323). months later Pasteur had a second successful case. Joseph Meister. or were present in the air. He next set out to ascertain whether the tion. After three years' work he discovered two distinct diseases. His appointment at Lille placed him in a winegrowing district. A similar means was devised for the prevention of chicken cholera.

17891858 The Hospital. a sailor who died of nephritis in Ouy's It \\as the study of this and other cases which led Bright The illustration is to associate dropsy with disease of the kidney from Bright "s Reports of Medical Cases. 1827 (page 29 1.PLATE LIX BRIGHT AND BRIGHT'S DISEASE RICHARD BRIGHT. kidneys of John Kine^. .

23 .PLATE PIOXEERS ^ (17^3 1852) (pat>.

and it was while working at the marine laboratory of Messina that his investigations of digestive processes in larval starfish and planarian worms led him to formulate the doctrine of phagocytosis.SCIENTIFIC MEDICINE IN THE XIX CENTURY the conclusion that the virus which causes rabies in animals and hydrophobia in man had its seat in the nerve centres. as a trained scientist. he was born near Kharkoff. the destruction of bacteria by white blood corpuscles. assisted him in his work. One of the most eminent was METCHNIKOFF (1845-1916). like John Hunter. It was this historic meeting which marked the beginning of a new era in medicine and surgery. the Russian scientist to whom the Nobel Prize was awarded in 1908. showing that keen curiosity which eventually led him to discover so much. Olga Metchnikoff. Among the pupils of Pasteur LIE were many famous men. and that the future will belong to those who have done most for sufferThen I refer to you. that nations will unite not to destroy but to instruct one another. and humanity in general are eternally indebted to this illustrious and devoted scientist. l Metchnikoff cared nothing for position or fortune. who entered leaning on the arm of President Carnot. Olga MetchnikofT 2 In later life who. then he pursued researches in Sicily. and to the marrow he produced an attenuated and the reduction of the mortality to less than i per cent. and of the researches which led him to fame. From the spinal virus for inoculation. 1921 . Pasteur and Lister met and embraced each other amid shouts of "Vive Pasteur"). For a time he taught zoology at Odessa. he was eager to know everything. believing as he did that " science and peace must triumph over ignorance and war. industry. Of humble parentage. . 1845-1916. my dear Lister. 1 W. Lord Lister said. p. 259 Life of lie Metchnikoff." Pasteur. Truly there Thus does not exist in the wide world an individual to whom medical science owes more than to you. is well told in a biography by his wife. and as a boy. Bulloch. success of his bold experiments led to the establishment of Pasteur Institutes in many parts of the world. The History of Bacteriology. expressed in his reply the joy he felt from the presence of foreign delegates. medicine. Metchnikoff devoted much attention to the question of intestinal . 1938." ing humanity. and in 1888 he gave up his post in Russia in order to work under Pasteur in Paris. agriculture. . Addressing Pasteur at the great and enthusiastic gathering in " Paris on his seventieth birthday. The story of Pasteur's kindness to him.

Pasteur was succeeded by his assistant MILE Roux (1853who ranks to next him as French the 1933). must be capable of cultivation outside the body. 1943. This study of anthrax suggested that this very infectious disease might be caused by its special micro-organism. . known as Koch's postulates. 1936. Med. vol. and showed how it was transmuted by drinking water. then so prevalent in animals The title and man. had served in the Franco-German war. who must share with Pasteur the of the founder of bacteriology. p. 684 Robert Koch. F. the sero-diagnostic test for typhoid fever. iv. He showed that anthrax. 1935. pp. vol. Sigerist. and to Java to examine the cause of malaria. discovered the virus of cholera (1884). was ROBERT KOCH (18431 Koch. Great Doctors. bacteriologist. p.. 3 One disease which specially interested Koch was tuberculosis. which bears his name. H. vii. 509 " L. in 1896. He perfected the preparation of anti-diphtheritic serum. who had studied at Gottingen under Henle and 19 lo).'* Nature. 2 In Koch's opinion proof of the specificity of an organism could be accepted only when certain facts. p." Ann. great German pioneer. " Robert Koch Founder of Modern Bacteriology. Brown. 286 ." He published his vague causes as results in 1876. greatest Roux made many remarkable discoveries. 1 clii. Robert Koch 1843-1910. and was not the result of such " " " miasmata or contagia. B. and therefore how it might be prevented. Another well-known bacteriologist of Paris was GEORGES WIDAL (1862-1929). The germ must be invariably present. was due to the large bacillus which had been discovered by Pollender in 1849.. Leipzig. He travelled to South Africa to study rinderpest. Webb. Hist. were established (1881). to India to investigate plague. consisting of a glycerine extract 1 G. Robert Koch (1843-1910). reproduce the disease. 385 . and in 1890 he suggested a new remedy. Med. : " vol. Heymann. E. and to the possibility of prolonging life by the ingestion of lactic acid bacilli. Hist. who discovered. 366 1 G. 292. and which has proved so valuable. 1932. 1932 B. if Koch injected into a healthy animal. His term of office as director of the Pasteur Institute was marked by many important discoveries. and must.A HISTORY OF MEDICINE sepsis. Petrie. and he showed that monkeys could be inoculated with syphilis. was a country practitioner at a village in Wollstein when he commenced his important researches." Ann. In 1882 he announced the discovery of the tubercle bacillus. 99.

Among his discoveries were the bacilli of diphtheria and of glanders he also devised new methods of staining and cultibacteria. There he continued his work until he retired in 1904. 1938. but honours. Bulloch. ALBERT NEISSER (1855-1916). and of diphtheria antitoxin. and there his ashes were deposited after his death six years later. He was the recipient of many and so beneficial to humanity. The successor of Gaffky was FRIEDRICH LOEFFLER (1852-1915). . as a scientist. which caused a spectacular fall in the death rate. one of the greatest of bacteriologists and an excellent writer and teacher. Collaborating with Von Behring was SHIBASABURO KITASATO (1852-1931). on Christmas night. so rich in its results. p. The History of Bacteriology. A principle of serum treatment. 1863). at the close of a laborious and fruitful life. 384) still further elaborated the antitoxin idea. including the Nobel Prize in 1905. He discovered the bacillus of plague in 1894. professor His discoveries were of great importance. that of tetanus. who worked under Koch for six years and then returned to his native Japan where he founded the Institute for Infectious Diseases. Yet another of Koch's disciples was RICHARD vating PFEIFFER (1858at Breslau from 1909 to 1926. and he made many other contributions to bacteriology. of which he became director in 1891. a dermatologist as well 1 W. whom he had accompanied to Egypt and India on the German Cholera Commission. GEORG GAFFKY (1850-1918) was appointed successor to Koch. which he called tuberculin. Gaffky was highly esteemed as a man and He was the discoverer of the bacillus of typhoid. 261 287 . including the influenza It was another physician bacillus and micrococcus catarrhalis. of the burg. then became professor. The first patient to be treated by the new method was a child in Von Bergmann's clinic in Berlin. antitoxin which yielded remarkable results. few of the distinguished bacteriologists who were trained by Koch may now be briefly mentioned. and worked out a system for standardizing the dosage. his expectations.SCIENTIFIC MEDICINE IN THE XIX of tubercle fulfil CENTURY which did not bacilli. 1891. of Breslau. An Institute for Infectious Diseases was built for him in Berlin in 1891. Ehrlich (p. EMIL VON BEHRING (1854-1917) spent some years in Koch's Institute. ). a discovery which was also made independently at Hong Kong by the French bacteriologist ALEXANDRE YERSIN Von Behring and Kitasato together discovered another (b. in 1890. first at Halle and later at Mar1 His great achievement was his discovery.

and 1 Ogston became Professor of Surgery in the streptococcus. vol. WILLIAM HENRY WELCH (1850-1934) was another distinguished American bacteriologist. while working at Aber- deen on the bacteriology of suppuration and named the staphylococcus. and in many cases effective methods of treatment were devised. the causal organisms of fectious diseases many in- were discovered. made many contributions to bacteriology. for thirty-four years. the new science of bacteriology was studied with Sir Almroth Wright.A HISTORY OF MEDICINE as a bacteriologist. History of Scottish Medicine. a physician of Berlin the chest. to whom we He was shall again refer in noted especially for his work on Texas fever of cattle. and Sir William Boog Leishman. New York. In America one of the most eminent bacteriologists was THEOBALD SMITH (1859-1934). evident from his Reminiscences of Three Campaigns. The pneumococcus was the discovery of ALBERT FRAENKEL (1848-1916). his col2 In league in the Chair of Medicine being William Osier. who discovered the gonococcus. vols. * S. Sir GERMAN SIMS WOODHEAD (1855-1921). 1919. Baltimore. Flexner.. a later chapter (p. Professor of Pathology at Cambridge. The leprosy bacillus was first identified in Norway. Many other British bacteriologists whose original work is familiar to every student are happily still with us. by ARMAUER HANSEN of Bergen (1841-1912). Comrie. and Senior Surgeon to Aberdeen Royal University in 1882. J. who specialized in diseases of Thus. ii. 1941 288 . Sir ALEXANDER OGSTON (1844-1929). a and J. in rapid succession. 391). anaphylaxis. first identified differentiated it from the His considerable experience of military surgery is Infirmary. and who occupied the Chair of Pathology at Johns Hopkins University. of Aberdeen. where the disease was endemic. and was the founder and editor of the Journal of Pathology and Bacteriology. F. and the differentiation of human from bovine tuberculosis. In Britain. the leading authority on leprosy of his time. 1 D. 555 William Henry Welch and the Heroic Age of American Medicine. the pioneer of energy and enthusiasm. p. who studied for a time in Germany. will be mentioned in the chapter on military medicine (Chapter XVIII). vaccine therapy and of anti-typhoid inoculation. 1932.

ZINSSER. Moll. H. Greene. Life ofEhe Metchmkoff. 400). who died of typhus fever in Mexico City. Welchii. p 224 A. Hermann von Helmholtz. include trench fever (conveyed by the louse). A. and History. Life of John Barclay 1827 BELL. New BULLOCH. and History. G. Robert Knox. 1921 ROUGHEAD. had shown that this disease was caused by minute organisms which were neither This group. C. The man William H. Others who enriched the science of bacteriology might be it may suffice to name two who were victims of the mentioned HOWARD TAYLOR RIGKETTS (1871-1910). Lady.SCIENTIFIC MEDICINE IN THE XIX 1892 Welch discovered aerogenes capsulatus. F. Japan river fever (by the harvest mite). 1902 280 20 . Philadelphia. p. CLAUDE. 1861 KOENIGSBERGER. Welch Library and Institute of Medical History at Baltimore is a fitting memorial of this great teacher and scholar (p. Aesculapius in Latin America. now known as Rickettsia bacilli nor protozoa. An Introduction to the Study English translation by H. CENTURY gangrene. The History of Bacteriology. 443 BOOKS FOR FURTHER READING BALLJNGALL. diseases they studied. CHARLOTTE. Life of Marshall Hall. 2 Some of the other workers who devoted their lives to the conquest of tropical diseases will be mentioned in Chapter XVIII). Some VALLERY-RADOT. English translation by Weiby. R. 1899 1870 of Experimental Medicine. The Life of Pasteur. New York. 1865. 1870 METCHNIKOFF. Lice. His keen interest in the history of medicine led him in later life to relinquish his work in Pathology and Public Health in order to accept the post of Professor of Medical History. 1944. being felt throughout the United States. OLGA. Claude Bernard. 1845-1916. 1927 the Heroic Age of American HALL. bacillus the bacillus of gas bacillus sometimes named He was a his influence of wide culture. 1941 FOSTER. 1935 (429) Apostles of Physiology. F. Rats. and an outstanding success as a teacher. infections. Medicine. and Rocky Mountain fever (by a tick). The Trial of Burke and Hare. 1 * H. 1 . W. The Life of Dr. Zinsser. 1906 LONSDALE. 1921 STIRLING. 1938 William Henry Welch and FLEXNER. R. L. Lice. Sir M. BERNARD. H. York. Bell. Editor of Letters of Sir Charles . W. S. 1902 2 vols. and J. DANIEL CARRION died at Lima in 1885 after selfinoculation with verruga pcruana. Rats. 1935. W.

Recollections of Past Life. Med. Bright drew the illusHe also contributed his return he studied for After graduation he spent some months on the Continent. 1927. 1872 vni. 1927. vol. . p. Thaver. the notes on Botany and Zoology. rather than a mere collection of medical biographies. While still a student he and his friend Holland." Guv's Hospital Reports. B. Richard Bright. Ixxvii. and becoming 1 Bright settled in London. which contains much information and some original observations on geology. On a time at Guy's Hospital before completing the medical course in Edinburgh. 1940. 909 W. let us now turn to the more purely clinical aspect.CHAPTER XV XIX-CENTURY CLINICIANS HAVING noted the advances in the scientific basis of medicine and surgery during the nineteenth century. 2 trations for Mackenzie's Travels in Iceland. Holland. ix.. Richard Bright. One of the best known for that reason. a journey which led to the publication of his Travels through Lower Hungary. Med. B. It is difficult to choose from the galaxy of masters of that time a select few in whose lives the history may be unfolded.. names therefore still familiar. and study the trend of medical thought and practice as exemplified in the lives and work of some of the great leaders. afterwards Sir Henry Holland. p. practising in Assistant Physician to Guy's . Hist. 253 " Chance. Sir H.D. Chance. and certainly the most renowned physician of his time." Bull. p. Hist." Ann. accompanied Sir George Mackenzie on an expedition to Iceland. in 1813. vol. vol. " S. graduating M. Bloomsbury Square. 290 . 1 The son of a wealthy banker of Bristol. a well-written and beautifully illustrated work. was RICHARD BRIGHT ( 1 789-1 858). London and Edinburgh Physicians Early in the century there appeared a number of physicians whose names became attached to various diseases and symptoms. he received his medical education at Edinburgh. Dr. Many worthy names are omitted in order that this outline may fulfil its mission as a history of medicine. 332 " 1 Richard Bright. Traveller and Artist.

was born near Newcastle-on-Tyne. at Edinburgh in 1815. Twenty-three cases of renal disease. Great Doctors of the Nineteenth Century. his aim being " to connect accurate and faithful observation after death with symptoms dis" second volume of Reports ( 1 83 1 ) played during life (Plate LIX) dealt mainly with nervous diseases. near Carlisle. Major. 1926. Addison spent many a holiday at Lanercost. not from his own disease.White. Rep. 1932. . was the result of kidney disease. regularly spending six hours a day at the hospital during many years. He graduated M.D.White. Bright was an amiable and kindly man and was in high repute as a consultant." Gvfs Hosp. but from aortic valvular disease of the heart. which unfortunately was never completed. 63 Classic Descriptions of Disease. are described in 2 detail. and Physician four years later. P-253 291 . as his family had long been associated with Lanercost. vol. Thomas Addison.D. together with post-mortem reports of all the fatal cases. He was an able writer. 1839). Sir W. I. and there he lies buried in the parish churchyard. and to glycosuria. He died at the age " of sixty-nine. THOMAS ADDISON ( 1 7953 Although Addison 1860). R. Bright was the first to point out that dropsy.. London. A distinguished contemporary of Richard Bright was his colleague on the staff of Guy's Hospital. and his father still owned Banks House. and he collaborated with Addison in lecturing on materia medica and in producing a work on The Elements of the Practice of Medicine (Vol. with dropsy and albuminuria. p. He was not content to study only one disease. M. A Other papers from his pen related to abdominal tumours. he was wont to consider himself a Cumberland man. By this means Bright's original observations were confirmed and new facts were revealed. p. The reports are illustrated by many coloured plates of high artistic merit. In 1842 two wards were set aside for his renal cases in Guy's Hospital. who also gave his name to a disease. with albuminous urine.XIX-CENTURY CLINICIANS He applied Hospiral in 1820.. to jaundice. 1 Sir W. Ixxvi. himself to the work with great energy. 1935. H. and shortly afterwards commenced practice in Hatton Garden. so that an intensive investigation might be made over a six months' period. His observations appeared in the first volume of his well-known Reports of Medical Cases Selected with a View to Illustrating the Symptoms and Cure of Disease 1 by a Reference to Morbid Anatomy (1827). near the fine old Priory of Lanercost. 493 " Hale. Hale." as is sometimes stated.

A HISTORY OF MEDICINE
a bold step for an unknown doctor from the North. Details of his early life are scanty, but his ability was soon recognized, and in 1824 he became Assistant Physician at Guy's Hospital, and in due course Physician. 1 For over forty years he was the leading teacher at Guy's, where he was revered by the students despite his rather haughty and reserved manner. His language

was well chosen,

his delivery eloquent

and dogmatic.

Owing
"

to

his retiring nature, however, he was hardly known in his day outside his own circle. The textbook of medicine which he wrote

along with Bright contained a good clinical account of Inflammation of the Appendix Vermiformis," many years before appendicitis became a household word. Addison devoted much attention to diseases of the chest. He greatly admired the work of Laennec, although he differed from him in certain matters. In his paper, On the Pathology of Phthisis (1845), he expressed the opinion that most of the changes seen in the tuberculous lung were the result of pneumonic inflammation. While it is now admitted that this statement is not entirely correct, the conception of two processes at work was in itself a great advance. " In 1849 Addison gave the first description of a remarkable form of anaemia." In the fatal cases he found a diseased condition of the suprarenal capsules. Continuing his researches, he
collected cases,

and

of forty pages, On
Suprarenal Capsules.

the Constitutional

eventually, in 1855, published his little quarto and Local Effects of Disease of the

He distinguished two separate maladies
became generally known
as

:

pernicious," in which no organic lesion could be discovered ; the other, an anaemia associated with bronzed skin and with diseased supra-

the anaemia which

"

one,

renal capsules. Disease.

The

latter

has since

been called Addison's

mainly posthumous.

Addison did not acquire a large practice, and his fame was Yet he was one of the greatest physicians

of the early part of last century. In the latter part of the century, the leading London physician was Sir WILLIAM WITHEY GULL (iSiG-go). 2 He exemplified all that was best in clinical medicine, combining a strong personality with sound wisdom. Born at Colchester, he was only ten years
S. Wilks and G. T. Bettany, A Biographical History of Guy's Hospital, 1892, p. 221 T. D. Acland, Memoir and Writings of Sir William Gull, Sydenham Society, 1896 Sir W. Hale- White, Great Doctors of the Nineteenth Century, 1935, p. 208
1

;

292

XIX-CENTURY CLINICIANS
old when his father died of cholera, leaving a widow and six children of whom William was the youngest. In later life Sir William Gull attributed his success to the training given to him by his mother, who instilled into her children habits of industry and perseverance. Young Gull showed ability at school, taught himself Greek and was then encouraged by the schoolmaster to " teach others, for, said he, Directly you begin to teach you will a time William cherished a desire to go to begin to learn." For sea, but at the age of thirteen he fortunately met Mr. Harrison, Treasurer of Guy's Hospital, who had already befriended Addison and Bright, and who was visiting his nephew, the rector of the parish in which the Gulls lived. Mr. Harrison invited William Gull to come to Guy's Hospital as an apprentice, offering him accommodation and a small salary. " I can help you if you will help yourself," was his wise remark. William acted upon the advice and took his M.B. degree with honours a few years later 1 He was now appointed medical tutor, and he taught (I84I). materia medica and natural philosophy, for there was as yet no He continued to live at Guy's until his marstrict specialization. in That 1848. year he joined the hospital staff, acting first riage as Assistant Physician, then as Physician until his retirement twenty years later. Gull soon acquired an enormous practice, and although money-making was not one of his ambitions, he left a large fortune. A baronetcy was conferred on him after his attendance on the Prince of Wales (King Edward VII), who was

from typhoid fever at Sandringham in 1871. One " his striking presence, William Gull has described his minute examination of every case, and the few slowly uttered words in which he delivered his judgment, often with encouragement and never without sympathy. His manner was the same in a hospital ward as in a palace." Nothing which concerned the well-being of the patient was too minute for his attention. The " Not a typhoid patient was never a case or a disease to him. " There fever but a typhoid man." Of a hysterical lady, he said X. is herself is Mrs. multiplied by nothing really wrong
seriously
ill

who knew

Sir

;

four."

Among

his other

aphorisms were the following
;

"
:

Cannot

is

a word for the idle and self-satisfied it is inadmissible in science." " The young, the aged, and the sick must always be helped." 1 S. Wilks and G. T. Bcttany, A Biographical History of Guy's Hospital, 1892,
p. 261

293

A
"

HISTORY OF MEDICINE
are,

However clever you syphilis, and itch."

you are sure to overlook

phthisis,

Sir William Gull used few drugs, and often none at all. One of his papers dealt with Acute Rheumatism treated by Mint Water, that is to say, the disease had been allowed to run a natural In reality his treatment was most thorough and his course. directions explicit. His prescriptions were always simple, and he distrusted polypharmacy. He took a deep interest in the training and welfare of nurses. " Nursing," he said, " sometimes a trade, sometimes a profession, ought to be a religion."

Although Gull wrote little, he made many original observations, noting that locomotor ataxia was a lesion of posterior spinal

myxoedema, differentiating varieties of and advising male fern in the treatment of tapeworm. He was a good linguist, a lover of poetry, and a keen Even the habits of the London sparrows observer of Nature. attracted the attention of this great-hearted man. Closely associated with Sir William Gull was Sir SAMUEL WILKS (1824-191 1), a charming and kindly man and an excellent 1 writer, while his chief rival was his friend Sir WILLIAM JENNER (1815-98), who also made a fortune by practice, and whose fame
columns,
describing
Blight's disease,
lies

more recent times were Sir WILLIAM OSLER, whose work is described in a later chapter (p. 408), Sir CLIFFORD ALLBUTT (p. 407), and many others who
elected to specialize in one of the many branches of clinical medicine which were beginning to appear. In Edinburgh, clinical medicine was upheld by ANDREW DUNCAN, whose work has been already noted (p. 226) and by JOHN HUGHES BENNETT (p. 278). There was also that eminent man, Sir ROBERT CHRISTISON (1797-1882), the son of the Professor

chiefly in his contribution to the Among the great clinicians of

knowledge of fevers.

of Latin, who, after graduating in Edinburgh, studied toxicology under Orfila of Paris, and on his return was appointed Professor of Medical Jurisprudence (i822). 2 His famous Treatise on Poisons

enhanced

his reputation,

and he excelled

as

an expert

witness,

He made valuable representing the Crown on many occasions. contributions to pharmacology, and for many years he was the leading consulting physician in Scotland.
1

1

Sir S. Wilks, Biographical Reminiscences, 191 1 Life qfSir Robert Christison, ed. by one of his sons, 2 vols.,

Edinburgh, 1885

294

XIX-CENTURY CLINICIANS
Clinical Medicine in Dublin, Paris,

and Vienna

The two most eminent physicians of the Irish Medical School were Robert Graves and William Stokes. Both were the sons of Dublin professors, and both graduated in medicine at Edinburgh. 1 ROBERT GRAVES (1796-1853), whose father was Professor of
Divinity at Trinity College, Dublin, spent several years in postgraduate study on the Continent. In Italy he enjoyed the friendand in Austria he ship of J. M. W. Turner, the famous painter had the unpleasant experience of being imprisoned as a German spy, so complete was his mastery of that language. On returning to Dublin he was elected Physician to Meath Hospital, where he introduced the system of clinical instruction which had impressed him on the Continent, namely, that of assigning patients to the charge of senior students, who were responsible to the physician, and who reaped the benefit of his criticism and advice. Graves was subsequently appointed Professor of the Institutes of Medicine (Physiology). He contributed a number of papers to the Dublin Journal of Medical Science, of which he was editor, but his chief
;

literary

(1843). translated into French, with an introduction by Trousseau, who " regarded Graves as a perfect clinical teacher." The name of

work was his Clinical Lectures on the Practice of Medicine The book had a deservedly high reputation. It was

Graves is sometimes associated with exophthalmic goitre, which he so clearly described. One of his reforms was the elimination of starvation, purgation, and bleeding from the treatment of fevers. Instead, Graves advised that plenty of good food be he even suggested as an epitaph for himself the words, given " He fed fevers." " Nothing," writes Sir William Hale-White, " has done more to improve the treatment of disease than Graves's
:

Clinical Lectures."

Meath Hospital and his lifewas WILLIAM STOKES (i 804-78). 2 He was the son of Whitley Stokes, Professor of Medicine at Trinity College, and a well-known member of Dublin society. William took his degree
Graves's colleague on the staff of

long friend

in Edinburgh in 1825, anc^ that Y ear whilst still only twenty-one years old, he published a small treatise on the stethoscope, in>

1

G. T. Bcttany, Eminent
Sir
;

1

W.

1898

Doctors, 2 vols., 1885, vol. ii. p. 202 Stokes (his son), William Stokes, his Life and Work (Masters of Medicine), T. G. Moorhead, " William Stokes, 1804-78,'* Med. Press and Circ., 1935,

vol. 191, p. 130

295

A HISTORY OF MEDICINE
spired

by a study of Laennec's book, which had appeared

six

years earlier.
Hospital,

He

succeeded

his father as Physician to

and he

closely collaborated with

Graves in

Meath the new

system of clinical instruction, which brought fame to the school and supplanted the old fetish of " walking the hospital." Stokes, like Graves, was a great teacher and a hard worker. He had a large practice, and he rendered valuable service during the epidemics of cholera and typhus which devastated Ireland at the time. His book on The Diagnosis and Treatment of Diseases of

appeared in 1837, and added greatly to his reputation as a clinician. A companion volume on Diseases of the Heart and Aorta appeared some years later. In 1845 he was appointed Regius Professor of Medicine in Dublin University, a post which he held up to the time of his death. Stokes noted, as his experience
the Chest

increased, that too much stress was laid upon physical signs, especially in valvular disease of the heart, and that the condition

of the heart muscle was of more importance than the state of the valves, a fact emphasized by Sir James Mackenzie fifty years later. Along with JOHN CHEYNE, a Scotsman practising in Dublin, Stokes " described the type of breathing known as Cheyne-Stokes resnoted its serious import. also and He recorded, along piration," with ROBERT ADAMS, a number of cases of slow pulse, accompanied " * by syncopial attacks the Stokes- Adams syndrome." Stokes was a man of wide learning and of many interests. He inaugurated the first British Diploma in Public Health, and he greatly improved the status of the medical profession in Ireland. lover of art and letters, he had many friends, and his house was a Mecca for distinguished visitors to Dublin. Another eminent Irish physician of slightly later date was Sir DOMINIC CORRIGAN ( 1 802-80). 2 After graduating in Edinburgh, Corrigan settled in his native Dublin, and soon acquired a leading position and a large practice. He is chiefly remembered for his work on aortic disease, which, he claimed, was the cause of " angina pectoris. Trousseau, indeed, spoke of it as the maladie

A

de Corrigan." 3 On the Continent Paris led the way in medicine during the first half of the century then German medicine became
;

prominent.
1

1 '

R. H. Major, Classic Descriptions of Disease, 1932, p. 301 ("Stokes-Adams") " R. T. Williamson, Sir Dominic Corrigan," Ann. Med. Hist., 1925, vol. vii. R. H. Major, Classic Descriptions of Disease, 1932, p. 323 (*' Corrigan")

p.

354

296

XtX-CENTURY CLINICIANS
Reference has already been made to the immortal work of Laennec (p. 258). Another Breton physician of the time who practised in Paris, though a man of much less account in medical history than Laennec, was FRANOIS JOSEPH VICTOR BROUSSAIS l Broussais, who had been a sergeant and then a (i 772-1838).

surgeon in Napoleon's army, appears to have adopted military tactics in his civilian medical practice, as he was a sort of Paracelsus of France, vigorous and dictatorial, who affirmed that there were no diseases, only symptoms, that gastro-enteritis caused most of the troubles of humanity, that the healing power of Nature did not exist, and that starvation and the application of leeches would cure every ill. 2 He caused a boom in the leech industry ; it is said that forty million leeches were imported into France in 1833. " Broussais has been called the most sanguinary physician in
history."

'A much sounder clinician was PIERRE CHARLES ALEXANDRE Louis (1787-1872), well known for his observation of phthisis, based upon a study of about two thousand cases and many postmortems. 3 He noted the predilection of the disease for the apex of the lung. He made a similar extensive study of typhoid fever, and he proved the value of statistics in medical work. As a teacher, Louis was held in high esteem, especially by his numerous

American pupils. 4 Another distinguished French clinician was PIERRE BRETONNEAU (1771-1862) of Tours, who described diphtheria, and was He also introduced tracheotomy for the first to use that name. 6
laryngeal diphtheria (1825). One of Bretonneau's pupils was ARMAND TROUSSEAU (1801-67), who became an eminent physician of Paris, where he was the 6 The procedure was improved first to apirate the pleural cavity.

GEORGES DIEULAFOY (1839-1911), an excellent " le beau a and gifted teacher, affectionately known as physician
by
his

pupil,

1 F. J. V. Broussais, 1772-1838: His Life and Doctrines," Proc. J. D. Rolleston, Roy. Soc. Med., 1939, vol. xxxh. p. 405 1 F. H. Garrison, History of Medicine, ed., 1924, p. 426 1 W. R. Steiner, " Dr. Pierre-Charles- Alexandre Louis," Ann. Med. Hist., 1940, 3rd

"

yd

" The Influence of Louis on American Medicine," Johns Hopk. Hosp. Bull., 1897, Nos. 77 and 78 " * His Life and Work," Proc. Roy. Soc. Med. (Sect. Bretonneau J. D. Rolleston,
4

Ser., vol.

ii.

p.

451

W.

Osier,

:

Hist.), 1925, vol. xviii. p.

I
;

A. H. Buck, The Dawn of Modem Medicine, 1920, p. 265 Trousseau," Internal. Clinics, 1916, p. 284

F.

H. Garrison, " Armand

297

A HISTORY OF MEDICINE
Dieulafoy."

Dieulafoy perfected the aspirator which Trousseau

had invented.

The leading exponent of clinical medicine in Vienna was 1 The son of a blacksmith of Pilsen, JOSEF SKODA ( 1 805-8 1). Bohemia, his genius was recognized by the wife of a wealthy manufacturer, who offered to assist him if he came to study medicine in Vienna. Skoda accepted the offer, walked all the
Vienna, a six days journey, and proved in every way worthy of the confidence of his benefactress. After graduation he devoted his attention to diseases of the chest, and wrote an im-

way

to

1

portant work on auscultation and percussion, attempting to assign to each of the sounds its musical pitch. He did much to lay the foundations of modern physical diagnosis, although he made no contribution to therapeutics. 2 He was the first to lecture in German in the Vienna School. In Germany one of the soundest clinicians was CARL WUNDERLICH (1815-77), to whom we are indebted for the temperature chart which has been in regular use since his day. 8 Clinical thermometers were at that time almost a foot in length, and took It was said of twenty minutes to register the temperature. " Professor of Medicine at he then Wunderlich, Leipzig, that 4 found fever a disease and left it a symptom."

FRIEDRIGH THEODOR VON FRERICHS (1819-85) was perhaps the leading exponent of clinical medicine in Germany in the An excellent lecturer and latter part of the nineteenth century.
a sound diagnostician, he was professor at Breslau, and then at Berlin, where for many years he conducted a large practice. His chief interest was the biochemical aspect of medicine, to which he contributed original observations dealing with digestion, It was he who discovered diseases of the liver, and diabetes. leucin and tyrosin in the urine, and acute yellow atrophy of the
liver.

Frerichs was succeeded at Berlin
1910),

by ERNST VON LEYDEN (1832-

who

carried

on the high

tradition as a clinical teacher in

the Charitd hospital. He also rendered useful public service by his advocacy of sanatorium treatment in tuberculosis. Two other German clinicians of this fertile period, each with
1

M.

NeubuiTger, British Medicine and the Vienna School, 1943, p. 38

4

R. H. Major, Classic Descriptions of Disease, 1932, p. 38 H. E. Sigerist, Great Doctors, 1936, p. 520 H. A. McGuigan, " Medical Thcrmomctry," Ann. Med.

Hist., 1937, vol. ix. p.

148

298

XIX-CENTURY CLINICIANS
an interest in neurology, although that branch of medicine had not then become differentiated, were Kussmaul and Nothnagel, both men of high culture and wide knowledge. ADOLF KUSSMAUL (1822-1902), who eventually occupied the jChair at Strassburg, was the first to describe progressive bulbar He contributed to our knowparalysis and also diabetic coma. ledge of disorders of speech, and made pioneer attempts in
oesophagoscopy and gastroscopy.

HERMANN NOTHNAGEL (1841-1905), the leader of clinical medicine in Vienna, was highly respected by his colleagues and students as one of the most popular figures of the time. Like Von Leyden, whom he assisted for a time, he was interested in His chief title to neurology, and contributed to the subject.
fame, from the literary standpoint, was his editorship of the comprehensive Handbuch der speziellen Pathologic und Therapie, in twenty-four volumes, which was completed in the year of his death

and was
of his

translated into English.
pectoris, leaving a written record
1 very hour of his death. clinical medicine, which time, will be noted in Chapter XIX.

Nothnagel died of angina

own painful sensations up to the The trend towards specialism in
this

became manifest about

Medical Pioneers

in

America

of the Medical School of Philadelphia in the has already been noted (p. 251). Among century eighteenth the graduates of that famous school were a number of men who did much to advance medicine. One of the greatest was DANIEL DRAKE (i 785-1852), 2 who has been called " the most picturesque " (Plate LX). Born in poverty, he figure in American medicine rose by his own industry and ability to a position of eminence, although he never visited Europe. He led a roving life, practising in seven different localities, and thus showing how even the peripatetic physician can collect wisdom. The story of his work He founded medical is described in his Pioneer Life in Kentucky.
schools at

The foundation

Ohio and Cincinnati, and he edited the
3

Western Journal
the

of Medical Science. His most notable book, however, dealt with Diseases of
1

Nothnagel, Wien, 1922, p. 352 Life of Daniel Drake," in Lives of Eminent American Physicians and Surgeons of the Nineteenth Century, Philadelphia, 1861, p. 614 1 O. Juettner, Daniel Drake and his Followers, Cincinnati, 1909
*

S.

M. Neuburger, Hermann "
D. Gross,

299

A HISTORY OF MEDICINE
of North America (1850-54), and was the result of of observation and travel. It is one of the greatest thirty years studies of the geography of disease. The conditions of life in the Mississippi Valley are described under the headings of climate, flora and fauna, diet, occupations, housing, etc. The second volume did not appear until after the author's death. It deals with the fevers and other prevalent diseases, arranged according to geographical distribution. Drake was a tall, handsome man, gentle and dignified in manner, and deservedly popular with
Interior Valley

his colleagues.

Exactly contemporary with Drake lived WILLIAM BEAUMONT (1785- 1 853),* an army surgeon who treated the Canadian Alexis St. Martin for gunshot wound of the stomach. The pa*tient recovered with a large gastric fistula, which Beaumont recognized as providing a unique opportunity for the study of digestion. At considerable personal inconvenience and expense he followed his patient in order to complete his investigations on the rate of digestion of various foods and on the composition of the gastric 2 His Experiments and Observations on Gastric Juice and the juice. Physiology of Digestion (1833) recorded a fine piece of research in the face of unusual difficulties.

A
Another

Bold Ovariotomist

time in surgery, was EPHRAIM (1771-1830), a native of Virginia, who had studied under John Bell in Edinburgh, and who practised in the remote town of Danville, Kentucky 3 (Plate LX). In December 1809 he performed ovariotomy, a bold venture indeed under primitive conditions and before the days of antiseptics or anaesthetics. The patient was the wife of a farmer, Mrs. Jane Todd Crawford, and McDowell took her to his home at Danville, sixty miles journey on horseback from her log cabin for the operation. She made her own bed on the fifth day, returning home on the twentybrilliant pioneer, this

McDowELL

Jifth
1

day,
Osier,

W.

"
;

and living for other thirty-five A Backwood Physiologist," in An Alabama

years.
Student,

McDowell
and Other Essays,

1908, p. 159

Jesse S. Meyer, Life and Letters of Dr. William Beaumont, St. Louis, 1912
;

"William Beaumont, M.D. (1785-1853)," Ann. Med. Hist., 1933, A. B. Luckhardt, " The Dr. William Beaumont Collection of the 28 University of Chicago," Bull. Hist. Med., 1939, vol. vii. p. 535 " * S. D. Gross, Life of Ephraim McDowell," in Lives of Eminent American Physicians " *' Father of Ovariotomy and Surgeons, 1861, p. 207 ; A. Schachner, Ephraim McDowell, and Founder of Abdominal Surgery, Philadelphia, 1921
S. Miller,
vol. v. p.

W.

30

XIX-CENTURY CLINICIANS
reported the case, with two others, in 1817. During his career he performed thirteen ovariotomies ; eight of the patients recovered. Although his celebrated operation on Mrs. Crawford

was the
deserves

first

ovariotomy to be performed in America, and he

and dressed the abdominal wound with " a large napkin dipped in warm French brandy." The patient, Margaret 1 Millar, survived in good health for thirteen years. According to some authorities Houston's operation was not an ovariotomy, but the incision and drainage of a cyst. Nevertheless it was a bold procedure, worthy of record, and in no way detracting from the later work of McDowell.
ovarian
cyst,

praise for this and for his subsequent* successes, priority of a century is often accorded to Robert Houston ot Glasgow who, in 1701, undertook the removal of an enormous
all

century JAMES MARION SIMS (1813-83) did original work in gynaecology and acquired a high reputation, in Europe as well as in America, for his successful operative treatment of vesico-vagirial fistula. 8 Many women who would otherwise have been invalids were by this procedure restored to health. America has produced many an eminent surgeon, but few more distinguished than VALENTINE MOTT (1785-1865), a pupil of Sir

In the

latter part of the

2

4 He was the Astley Cooper, who excelled in arterial surgery. first to ligate the innominate artery for aneurysm, and he performed many other operations which were then considered to be daring feats of skill. To him the New York Medical School owes

its

foundation.

was SAMUEL DAVID GROSS (1805-84) of Philaa scholarly and versatile man and an able surgeon, who delphia, wrote on pathology, on surgery, and on the history of American medicine. 5
later date

Of

The History of Anaesthesia

An account of early medical work in America inevitably leads one to recall the story of general anaesthesia, and the controversy which continued for years regarding the priority of its dig
1

A. Duncan, Memorials of
J.

the Faculty

of Physicians and Surgeons of

1896, p. 114

Marion Sims, The Story of My Life, New York, 1889 " Chassar Moir, J. Marion Sims and the Vesico-vaginal Fistul Brit. Med. Jour., 1940, vol. ii. p. 773 4 Samuel D. Gross, Memoir of Valentine Molt, M.D., LL.D.,
* 1

Samuel D. Gross,

Autobiography, 1887

301

Taylor. the Pioneer ix. vol. Sir HUMPHRY DAVY. mandragora. but felt no pain. during the visit of GARDNER COLTON. as also had the production of syncope by compression of the carotid arteries. " Historical Notes on Horace Wells. in 1 799. he did not publish his discovery until 1849. 1 H. and their doings form an interesting if also an intricate story. Shropshire. Mesmerism and hypnotism had 262) and his followers with uncertain results. He therefore administered ether to a boy. it is said.A HISTORY OF MEDICINE Various drugs." MICHAEL FARADAY. 191 (22 illustrations) . 267. importance. or remoteness from civilization. used ether in other failure to grasp its cases. Among his experiments was one with "laughing gas. The scene now shifts to America. vol. a lecturer on chemistry." as it came to be called. such as opium. Long (1815-78) l of Jefferson. but whether from lack of enterprise.. and he died broken-hearted. Meanwhile. which is said to date from been employed by Mesmer Assyrian times. and cannabis indica. and he suggested that this might prove useful in surgery. No-one would listen to Hickman. Next day Wells requested in Ether Anaesthesia. Long. Soifer. He was regarded as a crank. p." HORACE WELLS (i8i5~48). It began at Hartford (Conn." Bull. where in 1842 a country practitioner named CRAWFORD LONG " ether frolics. p. H. in 1815. Young. James Venable.y 1942.) in 1844. 101 3O2 . alleging that unconsciousness and insensibility to pain could be produced by the inhalation of carbon dioxide and nitrous oxide gases. xii. " Crawford Williamson Med. other pioneers had been at work. 1941. E. and within a few years " ether frolics " became quite a popular amusement. Hist." Bull. and painlessly excised a tumour of the neck. and " he wrote that it seemed capable of destroying pain and might probably be used with advantage in surgical operations." pp. Ann.. HENRY HICKMAN of Ludlow. and various attempts had been made to render patients unconscious during surgical operations (p. F. had been used to relieve pain since very early times. 116). Med. at the age of twenty-nine. had participated in bruises or minor injuries sustained at the time were unaccompanied by pain. L. vol. Hist. 394 M. (p. vii. noted that ether had a similar effect. " Crawford W. 1925. or laughing gas. Hist." and had noted that Georgia. noticed that the victim who inhaled the gas injured his leg in his excitement. published the results of some experiments on animals. Med. Long. 2 a local dentist. In 1824 Dr. observed the intoxicating effect " of nitrous oxide.

The operation appears to have involved an incision in the neck of a young man. But who was he ? Long. he coloured he even it and disguised the odour so as to elude discovery " Letheon. 249). to allow him to demonstrate the method to a number of medical men at Massachusetts General Hospital. . where he continued his Like he found nitrous oxide a capricious Wells." the name universally lauded proposed by Oliver Wendell Holmes. Morton persuaded a surgeon. CHARLES drug.000 by the British Government (p. now deceased. and he next tried ether on the suggestion of Dr. Horace Wells it The partner. . The argument continued for years. and as " this is ." But there was trouble in store for Morton. of the suitability of the drug. but ruined its discoverer. along with Jackson. Clover recommended To had a following year. and the relatives of Wells. who eventually abandoned dentistry and became a picture dealer. Morton removed Gilbert Abbott." patented it. return to the sequence of events in America. in exploiting his discovery for the sake of gain. Jackson. Now there arose " the great ether controversy. As Wells regained consciousness he exclaimed. satisfied. 1846. " A new era in tooth-pulling. Morton. naturally aroused the antipathy of the medical profession. Riggs extracted a molar tooth. on October 16. Being by experiments on himself and then on JACKSON. and the failure not only discredited the drug.XIX-CENTURY CLINICIANS Colton to administer the gas. was regarded as worthy of the highest praise. humbug." After a further successful trial of nitrous oxide in his practice. 303 . It was not until 1869 that Colton re-introduced nitrous oxide as a dental anaesthetic. Warren announced.Unfortunately this was not so satisfactory. and he probably saw no harm Such conduct. and the true nature of ether was soon revealed. Congress. while his friend Dr.000 dollars offered to the inventor by U.S. in London. WILLIAM THOMAS MORTON (1819-68) with whom he discussed the use of nitrous oxide. He never recovered from his disappointment and eventually he took his own life. it was painlessly made." Ether was " the discoverer of anaesthesia. JOHN COLLINS WARREN. experiments. He kept the nature of the drug secret. however. Eben Frost. Wells gave a public demonstration. under the name Morton was not a medical man. who recollected that Jenner had been voted 30. dissolved When the partnership was to Boston. were all claimants for the 100. Joseph as a preliminary to ether anaesthesia. no Gentlemen. a dental patient.

J. xxii. 98 Duns. Boston. Some writers have constructed a strong case in favour of Morton. had sent a sample of chloroform to Professor Simpson. London. by Robert Liston (p. xlviii. Jour. J. Amer. David Waldie. JAMES (1811-70). 1 but it is now acknowledged that the strongest claim to the title is that of Crawford Long. 1900 First Major Operation under Ether in England. Bd. he decided. The Anaesthesia. In the public gardens of Boston " there is a monument to commemorate the discovery that the inhaling of ether causes insensibility to pain. News of the Britain. 41 . 2 Joseph then a student. p. J. d. Surgical " F. Sci. Discovered Chloroform for Anaesthesia of Anaesth. Flockhart and Co. Meantime self the Professor of Midwifery in Edinburgh. 64. xii. first 1 and named " " H. 113 " Uber die Verbindungen welche durch die Einwirkung des Chlors J. 304 . 1935." Amer. recently described. and more 4 chloroform by Truly there is no lack of claimants for priority where anaesthetics are concerned. Edinburgh. 4 S. J. 1831. Soubeiran. vol. 105 " 8 E. a substance which had been discovered by YOUNG SIMPSON and his friends Guthrie. 1832. Dumas of Paris in 1835. 1873 " New Mode of Preparing a Spirituous Solution of Chloric Ether.. 3 He had tried ether. was one of those who witnessed the an amputation through the thigh. O'Leary. Simpson. Addresses and other Papers. Cock. and vol. In operation under ether was performed at . Heidelberg. xxix. Bigelow." but the name of the discoverer is not mentioned. On the evening in question the new drug rapidly took effect.. of Edinburgh prepared further supplies for him. auf Alkohol." Guthrie. 1831-32. Lister. prepared. p. de Chimie. July 1915. on December 21. but none of those chemists dreamed that the substance would be of practical use. " it Was " Simpson or Waldie ? Who Was the Person Who Brtt." Ann. and as Simpson recovered consciousness and saw his colleagues lying " This is far stronger than helpless under the table. Recherches sur quelques combinaisons du chlore. New Haven. p.A HISTORY OF MEDICINE and the award was never made.. p. a butler. aged thirty-six (Plate LXI). Peter Squire administering the anaesthetic. had been experimenting upon himwith a view to discovering a general anaesthetic." Ann. Duncan. 7 and Messrs. Bart.. von Liebig. vol. p. but had decided that it was unsuitable for use in midwifery. i. p.Univer- College Hospital. One evening the coterie of investigators tried chloroform. and Arts. xxi.1 846. a New York chemist. The patient was operation Frederick Churchill. a chemist of Liverpool. Jour. 6 Soubeiran 5 and by Liebig in 1831. M. Memoir of Sir Janus T. Surg. olbildenes Gas und Essiggeist entstehen. also independently by at about the same time. vol. Journ. vol. Aether. W. the sity first discovery of anaesthesia now reached Europe. 307). 182 7 A. Pharm.

.

one of Ins "j. a lilrloni? trirnd of l)i John Hio\\n. author oi Rah and /ti\ I'ne?t(h a skt tih in ilu muhc'um of the Roxal College of Surgeons uf Edinburgh 'page 310' . skctclicci hv Alt \andrr Ptddii'. 'From studints. cm siimci\.PLATE LXII A LECTURE ON SURGERY lints S\nu* hduniit.

1 Snow administered chloroform to Queen Victoria on two occasions. i." while Professor James Miller removed part of the For the next fifty years chloroform radius for osteomyelitis. He was obliged to defend chloroform against its antagonists who opposed it. Syme. vol. which he held for thirty years. not on medical but on moral grounds. deep earnest cries Simpson's energies were also directed to a method of haemostasis by the use of " long needles." Proc. he was not He was the only the discoverer of chloroform anaesthesia. 1872. On Chloroform and Other Anaesthetics. and credit is due to Dr." Agent to the use. JOHN SNOW (1813-58) for his researches on the best method of ether. writing. 388). specialist was JOSEPH CLOVER who advised the use of nitrous oxide and ether in sequence. Disciples of Aesculapius. Simpson was created a baronet in 1866." Army provided with Medical " 8 Officers ? The son of a baker in Bathgate. 1941. Y. 1847. papers on " Leper Hospitals in " Was the Roman and Scotland. Simpson. most eminent obstetrician of his day. p. he so distinguished himself that at the age of twenty-nine he was appointed to the Chair of Midwifery. alleging that it would " rob God of the " of women in labour. p. Med. and.. known as acupressure. vol. Soc. 227 (" Dr. ether inhaler he devised is surprisingly modern in design. He was the first British anaesthetist. 21 305 1 * < .. now a very rare work. upon whose domain displeasure he had thus encroached. 279 J. as described in his book. Marston. Richardson. was the anaesthetic of choice in Britain. W. 197. which endeared him to his patients. other works. 1858. 2 wa also a pioneer of preventive medicine (p. xxxv. and during the last ten years of his short life he The administered over four hundred anaesthetics each year. Snow Another London anaesthetic (1825-82). To return to our account of Sir J. D. and although he appeared to love practice. Y. p. among Sir B. at the Royal Infirmary. despite his enormous found time to distinguish himself as an archaeologist. He had a kindly manner and magnetic personality.XIX-CENTURY CLINICIANS Simpson communicated his Account of a New Anaesthetic Edinburgh Medico-Chirurgical Society on November 10. he " administered chloroform to a Highland boy who spoke only Gaelic. The Centenary of the First Anaesthetic Use of Ether. Simpson. Archaeological Essays. eighteen miles west of Edinburgh. Roy. John Snow ") " A. 2 vols. h. and five days later. vol." which incurred the his of surgical colleague.

1911 WILKS.. Biographical Reminiscences. T. Simpson. G. S. in many other respects he showed himself to be ahead of his time. he usually proved that his The was the correct view. Philadelphia. 1932 The Story of My Life. 1873 GORDON. his family declined the offer of a grave in bust of him stands there.. this of versatile and forceful man is one of the life-story most dramatic in medical history. Sir James Toung Simpson. R. Classic Descriptions of Disease. and BETTANY.A HISTORY OF MEDICINE controversy. Autobiography. Lives of Eminent American Physicians and Surgeons of the Nineteenth Century. Philadelphia. H. A Biographical History of Guy's Hospital. MARION. 1898 STOKES.. which he improved. S. 1861 . S. 2 vols. Bart. Edinburgh." When he died. Sir W. 1896 DUNS. J. Recollections of Past Life. 1897 GROSS. Although Simpson was among those who attacked the Listerian system of antisepsis. WILKS. New York. T. 1872 MAJOR. He made notable advances in the technique of ovariotomy and in the use of obstetric forceps. H. Memoir and Writings of Sir William Gull. and he even prophesied the discovery of " X-rays when he said that the day would come when by electrical and other lights we may render the body sufficiently diaphanous for the inspection of the practised eye of the physician or surgeon. Sir H. 1887 HOLLAND. J. is the BOOKS FOR FURTHER READING ACLAND. C. William Stokes : His Life and Work. but his chief Westminster Abbey. A monument as Simpson Maternity Hospital. 1889 SIMS. D. 1892 306 . Memoir of Sir James T. J. now incorporated part of the Edinburgh Royal Infirmary.

Compound fractures were treated by amputation. These were the days in which hospital gangrene assumed epidemic proportions. By a fortunate coincidence Lister's discovery was made only a few years after the discovery of anaesthesia. and his heart was in his work. p. when at University College Hospital. was still obliged least to face the pains and dangers of a septic wound. His dexterity as an operator has probably never been surpassed. let us examine the methods of a few of the surgeons who immediately preceded the time of Lister. The Edinburgh School of Surgery before Lister." the spectators that 1 A. with a mortality of at least twenty-five per cent. He was a tall. iqi8. that a considerable degree of heroism was demanded from the unfortunate patient who. he required not only of a giant. London. the strength surgeon. The stench of the surgical wards. and the hand of a lady. while the surgeon wore an old blood-stained coat with a bunch of silk ligatures threaded through one of the buttonholes. a gift of satire. and sepsis was an inevitable sequence of operations. powerful man.. 304) that he was the first in Britain to employ ether anaesthesia. an uncertain temper. EVERY medical two methods has been truly incalculable. may be readily imagined. During the slow process of " " laudable pus. which dripped healing. and kind to his patients. having endured the tortures of operation without anaesthesia.CHAPTER XVI EARLY XIX-CENTURY SURGERY discovery of the nineteenth century fades into who by his introduction of the antiseptic method completely revolutionized the practice of surgery. As for the " the eye of an eagle. rich and poor. He told " this Yankee dodge beats mesmerism hollow. 146 307 . In order to throw into relief the vast change wrought by the antiseptic system. then. Miles. We have already noted (p. and the benefit to humanity which followed the introduction of those insignificance beside that of Lister. with a commanding presence. a zinc tray contained the from the wound. ready for use. ROBERT LISTON (1794-1847) l had all the attributes of a great surgeon. perhaps the of the evils." but also a degree of dexterity and agility with which few men are favoured. Small wonder.

His list included the ligation of large vessels. visited Syme in Edinburgh. lithotomy which " " should not occupy more than two or three minutes at most and the removal of a tumour of the scrotum. reconciliation eventually took place. As assistant to John Barclay (p. 24 D. 1885. his junior by only a few years. Macfarlane of R. At 1 last. T. faring great care upon his education. This alleged conduct led the managers. shortly before his death. in 1822. a feat which added greatly to Liston's reputation. They assisted each other in teaching and in operating for some years. and the friends of each surgeon joined in the polemics when both applied for the Professorship of Clinical Surgery.. weighing forty-four pounds. in 1827. His father. Then relations became strained and eventually there was a complete those days when anatomical " material was scarce. Bettany. during which he steadily worked and overcame the opposition of many his contemporaries. He might well have been the original rupture. a vacancy occurred to which he was duly ^ ' J. L. a in West minister dissuaded him from the seaLothian. 2 vols. p. amputations. ii. he laid a sound foundation for his surgical career." Although he completely exonerated himself in an open letter to the Lord Provost. and Liston. the unfortunate incident delayed his appointment to the staff for other five years. 269) the anatomist. Close friendship and co2 operation then existed between Liston and Syme. and he was even accused of diverting Infirmary patients into his own clientele. A quarrel with Barclay led him in 1818 to undertake the teaching of anatomy for himself. vol. vol. assisted by James Syme.A HISTORY OF MEDICINE Listen spent his early years in Edinburgh. He treated ahd cured many cases which had been discharged from the Royal Infirmary as incurable. The co-operation in teaching and in practice came to an end. When Liston devoted his attention entirely to surgery five years later. ii.* " " Various tales are told of his escapades as a in resurrectionist " Dr.. and hibiting Liston from entering the Infirmary on any pretence whatever. 593 308 . Stevenson's The Body Snatcher. 1932. Syme took charge of the class which had been so successful. History of Scottish Medicine 2 vols. A In the early years of his surgical practice Liston performed operations in the homes of his patients. p. country career which was his first and bestowed fancy. to pass a resolution pro" at any time. Comrie. G. In 1 833 the quarrel grew more bitter. Eminent Doctors. to which Syme was appointed.

It was natural. p. age of sixteen he discovered a method of waterproofing cloth. C. which was subsequently adopted and patented by a Glasgow manufacturer named Macintosh. made him essentially an Edinburgh type of man. that his father was a Writer to the Signet. which was ruptured. when it was unexpectedly offered to him in 1835. The Royal College of Surgeons of Edinburgh. As a medical student Syme was a disciple of Barclay and a close associate of Liston. soon acquired a large practice. as we have noted (p. in Listen's genius lay in his operative skill rather than any literary ability. 1 On the death of Liston in London Syme was 1 appointed to ditions his chair at University College. therefore. 1874 1 309 . A Memorial of the Life of James Syme. Paterson. 1918. Dr. 1926. by teaching anatomy and practising surgery along with Liston. 316) with a pair of in still that instrument which is cutting forceps. and became eminent as a teacher. Syme remained in Edinburgh throughout his strenuous career. 250 1 R. but finding the conunsatisfactory he resigned and returned to Edinburgh within six months. by a blow from the boom of his yacht. London. and that he attended the " 2 High School. it is said. Creswell. Miles. he found time to indulge his favourite sports of yachting and hunting. com- mencing his career. indispensible daily use in many hospitals. While waiting for practice he visited the Continent on two occasions in order to study surgery at the leading hospitals of France and Germany. John Brown said of him that A. where he was reinstated in his former position. He died suddenly at the age of fifty-three of aortic aneurysm. Nevertheless. H. spend Indeed at the his spare time in studying botany and chemistry. In London he was well received. Miles tells us that. Edinburgh. that he should accept the Chair of Surgery at University College.EARLY XIX-CENTURY SURGERY appointed. Apart from this brief and unsuccessful venture in London. The Edinburgh School of Surgery before Lister. 277) Syme " " boneListon's presented Dupuytren (p. 1505-1905.870). Even more distinguished in the world of surgery was JAMES SYME ( 1 799." a to a he was not but loved As boy sportsman like Liston. p. while in Paris with his friend Sharpey (p. Liston remained a surgeon to the Royal Infirmary after Syme had been appointed professor. although he published a number of papers and a textbook of surgery. 174. but he was a disappointed man. Syme had a clear and concise " he never wasted literary style. Edinburgh. and the facts that he was born in Princes Street. 308). which had not been filled.

vol. however. immortalized by Dr. to Further. Four years later Professor Russell. declined. the opposition of the Liston faction appoint Syme. for a vacancy on the surgical staff of the Royal Infirmary. Syme was accustomed to operate in private houses.A HISTORY OF MEDICINE a drop of blood. He secured a large house and refitted it at his own expense. was a plea for the conservative treatment of tuberculous joints at a time when the routine remedy was amputation. He knew that he had ability. with an sarcoma enormous of the lower success. as he had as yet no hospital appointment. he applied inoperable. p. or On the Excision of Diseased Joints was very popular and passed through five editions. surgeons had regarded as In then 1829. Syme. he successfully performed amputation at the hip joint. being thirty years of age. The appointment was a great success. Subsecivae. however." * His treatise. that his successor should pay him an annuity of 300. Liston had been appointed in 1827. Syme's clinical clerk. The textbook which he entitled Principles of a word." 2 sketch. in that poignant " Rab and his Friends. JOHN LIZARS (1794-1860). All that he required was a hospital. There he continued to teach. or a drop of ink. 360 * Ibid. agreed to it. Horae ii. Minto House was opened on May 8. to which his less eminent colleague. fifteen inches in which several other circumference. Liston declined to consider such a bargain. James Syme. after open and honourable negotiation. an operation never before attempted in Scotland. and having knocked in vain at the door of the Royal Infirmary. and to develop those improvements in surgery with which the name of Syme is still associated. He stipulated. he determined to establish a hospital of his own. p. assisted to some extent by public contributions and the fees of students. was Surgery (1831) appointed. He also removed. and the managers. was undaunted by his failure. John Brown. and his services were greatly in demand. \ol. 3 vols. to practise. having reached the age of eighty-one. decided to retire. and was appointed. 1882. Like Liston. viewing with disapproval the feud between the two surgeons. With Liston's aid.. 363 310 . 1829. the veteran occupant of the Chair of Clinical Surgery. i. accounted for Syme's failure to secure the Chair of Surgery. and during the next forty odd years Syme was one of 1 J.. One of the most famous operations performed there by Syme was that of removal of the breast. Brown. jaw.

vol. He was appointed surgeon to the Queen and to the Prince Consort. p. 11. which had been offered to him at the Fergusson strongly supported suggestion of Sir Astley Cooper. The passing of Syme. originated an operation for hare-lip which met with great Although he excelled in lithotomy. now part of the Astley Ainslie Institution. his skill and dexterity as an operator contributed while popularity. Knox. splendid. 1885. The brilliant work of his famous son-in-law was just beginning " to yield the first results. devising his own lithotrite for the purpose." writes Mr. a baronetcy was conferred on him in 1866. Sir WILLIAM FERGUSSON (1808-77). T." it He success in his hands. to his success in practice. and became the most eminent surgeon in London. he must be regarded as one of the chief architects of surgery. generous. A tall handsome man. and various other instruments which are still employed in surgery. 2 vols. and also because he forms a link between the Edinburgh School and that of London. Miles. In 1839 ^ e succeeded Listen as surgeon to the Royal Infirmary. of surgery the advent of Joseph Lister opened one still more his glass-houses . he pre- ferred to crush the stone.. These qualities naturally increased his and kindly. born at Prestonpans and educated at Edinburgh. and in the following year he accepted the Chair in London. Despite his unfortunate tendency towards controversy. and he became President of the Royal College of Surgeons 1 A. he had been an enthusiastic anatomist. he was quiet and unassuming. He died in 1870 at his lovely house of Millbank." * Three Great London Surgeons Another Scottish surgeon may now be mentioned because his wort illustrates the trend of the surgery of the time towards conservatism. The Edinburgh School of Surgery before Lister. was appointed Professor of Surgery at King's College Hospital at the age of thirty-two. Eminent Doctors. " marked the close of a brilliant period in the history Miles. Syme in his advocacy of excision of joints as opposed to amputaHe would take endless trouble to save a limb. 71 G. 211 p. and deemed tion. " a grand thing when even the tip of a thumb could be saved. 3" . where and some of his fruit trees may still be seen. Bcttany.EARLY XIX-CENTURV SURGERY the foremost surgeons of Europe. although the house has been replaced by a modern structure. 2 As demonstrator to Dr. 1918.

but it arose from his industrious habits and his devotion to duty " rather than from any desire to make money. how he was apprenticed to an apothecary whose stock-in-trade consisted of five large bottles of" Misturae. but do nothing more. impressed upon " that he would do his utmost to give us a him and his brothers good education. Brodie led a very strenuous itself in and his physiologist." To Paget now let us turn. thirteen hours by coach from Salisbury. younger days he distinguished himself as an experimental physiologist when he published papers on animal heat. and how he fell heir to much of the surthat he could gical practice of Sir Astley Cooper. rector of Wintcrslow. Practical Surgery (1842). and four directions as as administrator. That he had is obvious from the fact that for some years 10. on the In his nervous control of the heart's action.. Sir BENJAMIN COLLINS BRODIE (1783-1862) stands first in the 1 From the brief autobiography of this chronological order.A HISTORY OF MEDICINE of England in 1870." All three sons did well. His chief literary work was his System of One of his contemporaries. Let it never be an enormous practice yielded it him 1 Timothy Holmes. Fergusson time. and on vegetable poisons. Baillie and Sir Joseph Banks. and Brodie represent all that was best in London surgery just before the time of Lister. Sir Benjamin Brodie. 1898 312 . For years he took no holiday. as philosopher. eminent surgeon we learn that his grandfather came to London that his father. One can easily understand how a surgeon whose tastes were aesthetic shrank from the mutilating operations and from the septic horrors which followed. Wilts. and mainly from guinea fees. Brodie's chief surgical work was. Paget. No doubt he regretted the delay.. life." how he was befriended by Dr. which was a valuable contribution to a difficult subject. how he assisted and eventually succeeded Sir Everard Home as surgeon to St. and to yet another great surgeon of slightly earlier date. His surgical work showed the tendency towards conservatism which was at that time manifest. Sir Benjamin Collins Brodie (Masters of Medicine).000 a year. and he paid his first visit to the Continent at the age of fifty-four. Those eminent men Fergusson. but Benjamin surpassed the others. He tells us how he came to London. On the Diseases of the Joints (1819). Sir James " called the greatest practical surgeon of our Paget. how he attended Abernethy's lectures. who was from Banffshire as a Jacobite refugee . versatility expressed as surgeon. George's Hospital.

of Memoirs and Letters of Sir James Paget. undertaken in later years. was The as noteworthy as his physiological and surgical work. Propria (p. At last. perhaps. 1 Stephen Paget (one of his sons). Fortunately he wrote an autobiography. Psychological Inquiries are not " intended to supply a complete system of philosophy. to William IV. baronetcy was con. of professional success. we have a few excellent examples such as Cardan's De Vita Ambrose Fare's Journeys in Divers Places. the right to practise within the British Isles had become limited to those medical men whose names were enrolled in the Medical Register. and no better choice could have been made. 1901 313 .EARLY XIX-CENTURY SURGERY that it [money] forms but a part. a small part. Brodie was thirty-one years of age when another great surgeon " was born. Autobiographies of medical men are all too rare. after many years of wrangling and of ineffective local laws. the " greatest of the century." His contribution to philosophy. if we apply that overwrought word in its widest Sir JAMES PAGET (1814-99) is one of the most inspiring sense. 301). his on him in 1834. Nevertheless. and his charm of manner entitled him to the position. holds first James Paget. and forgotten. His eminence in his profession. that man's problem cannot be " solved by reference to only one department of knowledge. A fer^ed Perhaps his greatest honour came in 1858. of and should be read and re-read by every medical man. It was natural that so versatile a man as Benjamin Brodie should have been the first president of the council empowered to control medical practice. The passage of the Medical Act of 1858 was a most important event in the history of British medicine. especially at the beginning of his career. with the exception of Lister. and Memoirs and Letters Autobiography of 1 Sir The last-mentioned. and he became President of the Royal College to Queen Victoria of Surgeons and of the Royal Society. 163)." and " how to a secondly." he writes. Sir Benjamin Brodie received many honours. the Samuel D. but to show. Gross (p. great extent we can improve our present The facts he discusses are now matters of common faculties. ed. figures in medical history. probably." knowledge. place. first. but Brodie's work must have attracted many readers when it appeared in 1854. administrative ability. He was surgeon to George IV. when he was chosen to preside over the newly formed General Medical Council.

He earned about 50 a year from hack journalfor the Penny Encyclopaedia. writing as of curator the acting hospital museum." and is now in its 3yth edition (1942). even to creditors who did not press their claims. reported lectures for the medical press. which sold at half a crown and attracted a good deal of notice. Bartholomew's price. and the practical experience thus gained added greatly to the interest of his subsequent studies. to all in the dissecting rooms. devoting much time and care to the preparation of every lecture. Among his students was one named William Senhouse Kirkes." Hospital. and he taught himself German in order to translate medical work. a task which occupied part He wrote reviews and of almost every day for seven years." and the materials of Paget's lectures formed the basis of Kirkes' " Handbook of Physiology. the discipline of acquiring it was beyond In his twentieth year he entered St. Charles Costerton. At the same time he was appointed Lecturer on Physiology. but Paget revealed that each was a little worm in its capsule. had acquired wealth and position. a brewer and shipowner of Yarmouth. James then paid off all the debts. " I cannot estimate too highly the influence of botany upon the course of my life. The apprenticeAt this ship system might be revived to-day with advantage. and for the next seven years he resided in the hospital. As a first-year student he discovered Trichina The " little specks " were familiar spiralis in human muscle. although in later life he suffered much financial loss. His father. Paget was devoted to botany and sketching. which was to be the main centre of his life work. 3M . and at. which later became Halliburton's.A HISTORY OF MEDICINE James Paget was the youngest of nine surviving children in a family of fifteen. The extent of his early struggles can only be appreciated by a perusal of his Memoirs. a time when he could least afford to do so. and the medical articles ism. William Clift. " one of my best pupils. He also rewrote the catalogue of the him 40 brought Royal College of Surgeons museum. noting in his memoirs. After qualification he decided to settle in London. an appointment which more. The knowledge was useless . To this work he applied himself with great energy and industry. continuing the work of John Hunter's assistant. he his Charles in collaborated with brother period publishing a Natural History of Yarmouth. In 1843 he was appointed students' warden. Early in life James Paget served for five years as apprentice to a local practitioner.

in 1842. true success without work. but his income from this source. 315 . and he was an eloquent orator." Paget was intolerant of those who separated the art from the some years. and during the same year he nearly lost his life from septicaemia contracted at a postmortem examination. and it was said that one should " go to Paget to find out what was the matter." clear observation and careful classification is shown in his writings. His life was a noble record of achievement. and full Surgeon in 1861. many eminent a worthy pattern for all surgeons. Paget was in practice as a surgeon. Bartholomew's Hospital in 1847. and then to Fergusson to have it cut out." he said. Sir James and Lady Paget had a very happy home life. persons Browning. and was followed by Clinical Lectures and Essays in He 1875. Eventually he had the most before he made 4ucrative practice in London. Pasteur and Virchow." and that His passion for to try to do some good bit of original work. In 1871 Paget was made a baronet. as that " might be obtained by the most ignorant through self-assertion. Darwin. Gladstone. and his own success was the fruit of incessant toil. beginning at 5. Diagnosis was his speciality. He used to say that he was the only person who had recovered after being attended by ten doctors. His name is associated with at least two diseases which he described. science of medicine. is. he dealt with the careers of a thousand of his old pupils at St. which are still admirable to read. Lectures on Surgical Pathology (1853) was at once recognized as a masterly work. or mere impudence. for the year 1836. but in the evenings after a busy day he would sit writing letters and preparing papers. for when he earned 10. Sir James " There is no Paget worked hard right to the end of his long life. had risen 15. with his family around him." Although he was made Assistant Surgeon to St. he never shone as an operator.000 a year though he scorned a reputation which could be measured only by money. and he had been sixteen years in practice only to 100 a year in fees. In an essay on What Becomes of Medical Students. 4s. self-advertisement. Bar- tholomew's.EARLY XIX-CENTURY SURGERY Meantime. while they talked and played and sang Among his friends were apparently without disturbing him. Ruskin. Tennyson. He did not retire to his study to work. " held that the roughest country practice " every man ought might be made a way of science.

Dupuytren wrote little." his defects. Langenbeck of Berlin. vol. and by making the scene of his activity. " for he was cynical. in the period just before Lister. edited by his sons. part of which was applied to the endowment of a museum." He was " a man whom all admired. Dupuytren^ Limoges. illustrious l in his time the most (i 777-1835). all of Paris. 1 * L. and none understood. intolerant. and on occasions more intolerably brutal than even the cunning Abernethy. Dupuytren. p. The offer was accepted. On this occasion he was rescued by his parents. and Velpeau. a centre of surgical teaching of wider repute than any other hospital of Paris. He may well represent Continental surgery early in the nineteenth century. but again at the age of twelve he was coveted by a cavalry officer. and their colleague. like Larrey (page 338). there were excellent surgeons Dieffenbach of Konigsberg. as Sir Robert Christison (p. since at the was attracted to reserved. Malgaigne. He left a fortune. which were very popular. A Born Teacher the Continent. 294). Delhoume. i. His personal qualities did not attract. which still exists. 229 316 . who noted that the solution to the problem of intestinal suture lay in securing union of the serous surfaces. Nelaton. few loved. he must have been an attractive age of four he was carried off by a rich lady who him. a threadbare coat. 1935 Life of Sir Robert Chnstison." Perhaps he has been misjudged. he became a Baron. wrote that " nothing could surpass the humanity and kindliness of the reputedly rough and 2 An eccentricity in dress accentuated ill-natured-looking man. and carpet slippers. perhaps the On many : greatest of them all. who offered to take him to Paris for his education. yet he exercised a vast influence through his clinical lectures. Although in man- GUILLAUME DUPUYTREN hood he was austere and child. 1885. the Musee Dupuytren. Nevertheless he had a large practice and. the Hotel-Dieu. a green cloth cap. the well-known Lembert suture. and thus commenced the career of one who greatly furthered the progress of surgery by inventing many new instruments and operations.A HISTORY OF MEDICINE Dupuytren. was born of humble parents in an obscure village. Middeldorpf of Breslau. Among the many distinguished pupils of Dupuytren was ANTOINE LEMBERT (1802-51). of and a France surgeon great clinical teacher. for he wore a dirty white apron. who saw him perform lithotomy on a child.

the son of a blacksmith. and who wrote a comprehensive work on operative surgery. the argument was transferred from maggots to microbes by another Italian. Physician. Gesch. p. Centenaire de la Facultt de Mtdtcme de Paris (1794-1894). 1 Antecedents of the Antiseptic System do full justice to the achievement of Lister. he said. p. Omne vivum ex ovo. p. have already described the dangers of surgery before the Lister. and that if meat is left covered to keep out the flies no maggots are seen. There had indeed been some groping towards the antiseptic principle before Lister's day. About the same time. Poet. Life alone produces spontaneous generation must have a parent. and we have recalled some of the giants of surgery who faced heavy odds. was making im2 The fruit of his observations is contained portant observations. Med. " Francesco Redi (1626-98).EARLY XIX-CENTURY SURGERY Of slightly later date than Dupuytren was ALFRED ARMAND Louis MARIE VELPEAU (1795-1867). vol. Htst.." 1938. though they could not explain what they saw through their primitive microscopes. Cole. Solla. 1896. dcr Naturforscher. 1 317 . (p. Med. A. the Italian poet and parasitologist. in his book of Osservazioni intorno agli animali viventi the si trovano negli animali viventi (Observations on living animals which are to be found within other living animals) (1684). just " " as there were glimmerings of a idea before the circulation " " advent of Harvey. d. LAZARO SPALLANZANI (1729-99). xxx. Even the name had been used antiseptic We coming of if not The hoek Sir John Pringle in the eighteenth century. which no one had thought of trying before. 1926. 352 Ann. viii. life. vol. Corlieu." to which we have already referred actually coined by He and Kircher were really the first bacteriologists.. the pioneer work on In the course of his researches he noted that animal parasites. 189). maggots do not appear spontaneously in putrefying material. f. R. From this crude experiment. Everything A century later. Naturalist. Paris. story really begins another century earlier with Lceuwenand his " little animals." Arch. 417 R. 347 . the facts of his life and work are already so well Fortunately known that the events which led to his discovery need only be It is difficult to briefly outlined. " Francesco Redi. who became Professor of Clinical Surgery in the Paris Faculty. FRANCESCO REDI (1626-98). Redi agreed that the widely held doctrine of " " was incorrect.

Cutter. ed. The Tragedy of Puerperal Fever A tireless While scientists were gradually moving nearer a solution of the cause of septic infections. 1933 318 . Another whose work is almost forgotten was ALEXANDER GORDON (1752-99) of Aberdeen. Peckham. Cullingworth. S. historical chapter Jn Obstetrics and Gynaecology. but tradition died hard and progress was slow. 187 " 8 Charles White of Manchester (1728-1813) and the Arrest of PuerJ. 284). who in 1795 published a Treatise on the Epidemic Puerperal Fever of Aberdeen.." He also insisted on strict cleanliness and adequate ventilation of the lying-in chamber. H. though they could -not The ghastly nature of fully explain the reason for their success. an enlightened surgeon and man-midwife of Manchester. 2 8 728-181 3).A HISTORY OF MEDICINE and ardent scientist. Adami. F. an English Catholic priest named Needham. A. from whom Lister derived his chief inspiration. wrote A Treatise on the Management of Pregnant and Lying-in Women. p. Med. Obst.S. H. p. Gastigliom. vol. Although he has never received sufficient notice from medical historians. 1903. Curtis. History of Medicine. 1922. and Gytiaec. 1941. J. Jour. : A Philadelphia. i vincial Surgeon of the Eighteenth Century. xxix. in which he recommended " the use of emollient and antiseptic injections into the uterus in cases when the lochia have become foetid. . 1935. surgeons and obstetricians were discovering a means of avoiding sepsis. n. Fever" peral (Lloyd Roberts Lecture. 9 " Great ProCharles White. G. trans. he was certainly a surgeon who practised methods far ahead of his time. Emp." Lancet." 1 A." Bull. vol. 111. 1 enable him to answer his chief critic. in the manner already described (p. generation The next notable worker in this field was none other than the famous Pasteur. C. 1921). vol. who continued to uphold " spontaneous " until Spallanzani finally disposed of the idea. 612 * 4 C. p. E Krumbhaar. he proved that micro-organisms do not develop in fluids contained in flasks which have been exposed Numerous experiments were necessary to to heat and sealed. in which he " nurses and the physicians who have attended advised that the affected with puerperal fever ought carefully to wash patients In 1773 CHARLES WHITE (i themselves and to get their apparel properly fumigated. Hist. 1071 I. p. of Brit. " A Brief History of Puerperal Infection. puerperal fever stimulated every thinking obstetrician to devise means for its prevention.R.

" 2 later the tragic Semmelweiss of Vienna made his contribution to the problem. i. to three per cent. H. which he read in 1843 to the Boston Society of Medical Improvement. through insisted that students coming from the dissecting rooms or postmortem theatre should wash their hands in a solution of chloride of lime. Morse. Hist. 1930. p. Professor of Medical Jurisprudence.. " my position." Ignaz Phillip British Medicine and the Vienna School. Semmelweiss noted that the symptoms. p. Hist. " " is caused by conveyance Puerperal fever. 45 1 8 " Semmelweiss. Wiese. While Semmelweiss sought to explain this disparity in death rates. closely resembled those of puerperal fever. Neuburgcr. 74 M. Ann. raised a storm of hostile argument by a paper. Immediately the mortality in the wards under his care fell from eighteen per cent. Knox." He organisms. 80 . Semmelweiss. . of putrid particles derived from living the agency of the examining fingers. observing certain old-fashioned practitioners. vol. Med. Life and Letters of Oliver Wendell Holmes. and he advised washing the hands and changing the clothes before attending a confinement. As First Assistant in the Maternity Hospital. T." Ann. 1943. 8 The Four years patients also noticed this and pleaded to be treated by the midwives. Holmes answered his critics with dignity. Others had Fifty years later he wrote of it. medical logic does not appear to be taught or practised our schools. M. On the Contagiousness of Puerperal Fever. 1 The improvement on this occasion was regarded as an insult by secting Holmes regarded the disroom as a source of infection. p. as well as the lesions found on postmortem examination. Edgar. and then to one to the pregnant 1 woman J." Bull. Hosp. . I. vol. " The Medical Life of Oliver Wendell Holmes.. 74 J. T. fell ill and died of a dissection wound. his friend Kolletschka. IGNAZ PHILLIP SEMMELWEISS (1818-65) observed that there was a much higher mortality in the wards open to students than in the wards to which only mid wives were admitted. criejl out against the terrible evil before I did.EARLY XIX-CENTURY SURGERY OLIVER WENDELL HOLMES (1809-94). Johns Hopk. better known in literary than in medical circles. but I think I shrieked my warning louder and longer than any of them before the little army of microbes was marched up to support that in .. R." He was probably more proud of this medical work than of any of his better-known publications of the " Break" " fast Table series. t 1907. The simple suggestion met with nothing but opposition and abuse. p." he wrote in 1847. 2 vols. xviii. 1939. .. . vol. ii. Med. 1896 " E.

in 1861. vol. One of the most successful was Sir THOMAS SPENCER WELLS (i8i8-97). 1943. he published his great work. and the persecution he endured led him to resign from his position and remove to Buda1 There. cleanliness. 2 vols. p. R. 1505-1905. and died from a septic wound on the finger. Edinburgh. Ncu burger. 1882 CRESSWELL. On the pest. Eminent Doctors. who commenced his career by seven years of service as a surgeon in the navy. 105 74 BOOKS FOR FURTHER READING BETTANY. G. in the pre-Listerian era There were surgeons strict who insisted on cleanliness of the hands. C." Yet he could not explain why cleanlinees was so important.. although they could not clearly explain the reason for such precautions. Wells was particularly successful in ovariotomy. and he was in high repute as a " the most scrupusurgeon.A HISTORY OF MEDICINE per cent. 1885 BROWN.. Memoirs and Letters of Sir James Paget. in his theatre. T. Sir Benjamin Collins Brodie (Masters of Medicine). Eminent and the Vienna School. 1 M. Eventually.. His success lay in his insistence upon lous cleanliness.. T. STEPHEN. 2 vols. H. J. ii. Life and Letters of Oliver Wendell Holmes. but with great care and strict attention to Complete silence during the operation was the rule During thirty years of active practice Spencer Wells operated upon a thousand cases of ovarian tumour with an " " safe astonishingly low mortality. 1943 PAGET. Horae Subsecivac 3 vols. 2 an eminent surgeon and gynaecologist of London. and the field of operation. an operation which he conducted with simple technique. Cause and Prevention of Puerperal Fever. JOHN. 1883. Bcttany. Doctors. A Memorial of the Life of James Syme. the instruments. 1896 NEUBURGER. the victim of the very disease he had done so much to prevent. British Medicine and the Vienna School. which was then merely a dispensary. 2 vols. Edin. 1898 MORSE. The Royal College of Surgeons of Edinburgh. M. 1874 320 . 1901 PATERSON. p. burgh. T. and became attached to the Royal Samaritan Hospital. he became insane. He afterwards settled in practice in London. TIMOTHY. but he never convinced his critics. His arguments and even his results did not convince the conservative obstetricians of Vienna. British Medicine * G. 1926 HOLMES. and he did not possess that genius for detached investigation which led Lister to the summit of success.

X r* w C 7" .

'J sinult pm< iioin Kctuit notfN I taken b\ U i s stiuli ills in CjKisii'm istti dfsdihis antiscpta puncipk Snilmi.PL\TE LXIV LISTER'S EXPERIMENT f . OIK la ^uppoit i-f ^pagc 3-^' \\iiluun lu> of tin t\p<inmnt .^VT>^-^W^^ ^M-^Lut S<Mt^ ^y^yVi* ~ f f . AncKistm. . .

degree of London before entering UniIn his early student days versity College Hospital as a student. John Fothergill." which is simply another name. His technique was misunderstood and mis-applied. were Quakers." operating table So said Sir James Y. who devoted his spare time to science. The patient on the " faced danger equal to that of the battlefield. overlooking West Ham Public Park. Lord Lister . the first medical peer. and " it has since been largely superseded by asepsis. The park was the property of Samuel Gurney. and of destroying them when already present. Lister took the B. was born at Upton House. before Lister and after Lister. 1918 (an excellent biography by his nephew) . G. another means of achieving the same end. Wrench. 249). inherited that simplicity and placidity which characterized the Society of Friends. and who had achieved a wide reputation for his improvements in microscopic technique. 1913 .A. Lord Lister. T. and Joseph referred (p. Watson Cheyne. 1 JOSEPH LISTER (182 7-1 9 is).CHAPTER XVII LISTER AND HIS DISCIPLES IT is customary and logical to divide the history of surgery into two epochs. Lord his Achievement. a leading Quaker. His Life and Work. Surgery had been rendered painless by the introduction of anaesthesia. Simpson when he advised that old hospitals should be pulled down and replaced by groups of small pavilions. In Lister's day Upton was a country village. but those facts in no way detract from Lister's discoveries. another famous Quaker to whom we have The Listers. 1 Sir Rickman Godlee. The dramatic change wrought by Lister is now universally acknowledged. 1 924 : 2I 22 . was a prosperous wine-merchant. Peter's Vicarage. His father. too. Lister attacked sepsis by a more direct method. but the terrible scourge of sepsis remained. who became Lord Lister. W. 1 925 (4-9) Lister. which also earned for him the Fellowship of the Royal Society. and during the previous century it had been the country estate of Dr. Lister and Cuthbert Dukes. With infinite he to his of system sought patience perfect preventing the entrance of germs into a wound. near Plaistow in Essex. The district is now absorbed into the great East End of London and the house is St. James Joseph Lister.

an experience which doubtless deeply impressed him. A second paper by 1 published in the Quarterly Journal of Microscopical Science (1853). on which he had set his heart. writing to his dictation for many hours at a stretch. vol.. died of cholera while on service in the Crimea. William Sharpey (p. Mackenzie.. Baron Lister." Early Life in Edinburgh and Glasgow His Professor of Physiology. 307). She acted as his secreShe tary." Lister. ii. performed by Liston (p.Mural School. wrote to his father. So Lister went to spend a month in Edinburgh ." year later R. surgery that he could not important as anything. he married Syme's eldest daughter Agnes. Lister owed much to the devotion and assistance of his wife. a brilliant young Edinburgh 2 Lister surgeon. J. I more and am honest more and and a lover of truth. " His paper. 2 vols.. He graduated M..B. was appointed to succeed him as Assistant Surgeon to the Royal Infirmary and as Lecturer on Surgery in the Extra. who praised Lister's work. The Collected Papers of Joseph. 1919 D. in 1852 and also became a Fellow of the Royal College of Surgeons." confirmed and extended the observations of Professor Kolliker of Wurzburg. the pilomotor " fibres which cause goose skin. History of Scottish Medicine. Physiology. At this time he was keenly interested in physiology. important to the surgeon than to the physician. 2 TO!S. then the leading surgeon of Europe. dealt with the muscular tissue of the skin. he actually stayed In 1853 he became Syme's house surgeon." he (Plate LXIII). " Certain it is that I love still I shall get on. . 277) suggested do better than continue his surgical studies in and he Edinburgh. although in doing so he was obliged to sever his connection with the Quaker community. 309). 599 322 . though he did not refer to it in his letters. is which as A He now established himself in practice in Rutland Street. 1 J. p. with for seven years. twelve dressers under him who affectionately regarded him as " The Chief. 1856.A HISTORY OF MEDICINE he witnessed the first operation under ether in this country." a name which he retained throughout his career " I must not expect to be a Liston or a Syme. also Nevertheless he regarded physiology as the introduction to a " career of surgery. On the Contractile Tissue of the Iris. supplied a letter of introduction to Professor James Syme (p. Comrie. 1932." " is even more he wrote. and on April 23. During the next thirty-nine years.

LISTER AND HIS DISCIPLES attended to his instruments and assisted in his experiments. evil The Antiseptic System His researches on inflammation had led Lister to suspect that decomposition. His wards in the Glasgow Royal Infirmary. Lister spoke of " Poor Joseph and his one Lister's election to the Chair of Clinical Surgery in patient. which was to years. in the foot of a frog gaged " at Duddingston Loch. as we have already noted (p. It offered a wide field for Glasgow a and to his freedom own ideas without the supersurgery develop vision of his father-in-law. but something carried by the air. were some of the most in the in London and Sir Erichsen unhealthy kingdom. but rather the reverse. and pyaemia which then " decimated this At his attention. valuable as that had been in the early So in 1860 Lister removed to Glasgow. for he so deeply absorbed in his work that he was prone to forget next appointment. Simpson in Edinburgh had each attributed the sources of the hospital gangrene. however. who drew Lister's attention to the work of Pasteur." John Sir J." was therefore opportune." an then much greater in hospitals than in private houses. and she tried to cure his unfortunate habit of unpunctuality. Pasteur's discoveries 323 . It was the professor of chemistry in Glasgow. Agnes Syme deserves the highest praise for the part she played in advancing the success of her famous became his husband. 284) had shown that putrefaction was a fermentation. as it was sometimes called. and that the cause was not merely the gases of the air. was the cause of suppuration and infection of wounds. The Early Stages of Inflammacaptured tion. become the scene of his epoch-making discovery. Pasteur. Y. and greatest of all in the largest hospitals. was slow to appear." Practice. erysipelas. Next year he wrote a paper on " The Coagulation of the Blood. the scientific side of surgery enand he investigated. a defect which implied no lack of diligence. caused by microscopic organisms which could be transmitted by air. period in his career. surgical wards to what was called hospitalism. as we gather from the fact that Mrs." communicating the results in a paper to the Royal Society in 1857. Thomas Anderson. built upon the site of an old burial ground crammed with the coffins of the " victims of the cholera epidemic of 1849. or putrefaction. To Lister.

instruments. he insisted that everything which touched the wound." containing carbolic acid that weaker applications. results in The Lancet under the " title. and various forms of putty or plaster." which contained the ually he favoured of mercury and zinc. Lister never claimed to have discovered carbolic acid or any other antiseptic. On a New Method of Treat- 324 .A HISTORY OF MEDICINE a revelation. or fingers should be treated with the antiseptic. What he did discover was the principle involving the prevention and cure of sepsis in wounds. as the condition could hardly be made worse. Event" double cyanide gauze. The antiseptic system was first used by Lister in March 1865 in a case of compound fracture of the leg." and finally by a steam apparatus. which were made in 1866. although Lister was unaware of came as work until two years after his own preliminary trials. If Lister had applied the word " aseptic " to his method of treatment he might have obviated the misunderstanding of those who imagined that he had merely discovered an antiseptic. and for this purpose he selected carbolic acid. Carbolic acid had also been employed as an antiseptic by a Parisian chemist. at first corrosive sublimate and then cyanides. and was dyed a heliotrope colour cyanides for identification. and if the treatment was successful In 1867 Lister published his first the limb would be saved. The spray was abandoned in the late eighties. then by a pump. At first he used crude carbolic acid. a mere application to the wound. He even produced an antiseptic atmosphere by means of a spray of carbolic lotion. From a study of Pasteur's work he deduced that infection in wounds must be analogous to Lister therefore sought for a means of putrefaction in wine. at first worked by hand. would answer the purpose. such " lac as the later. which had been prepared by a Manchester chemist named Calvert. remained for over twenty years an essential part of the antiseptic equipment (Plate LXV). By this time Lister had modified his views and was using a yellow gauze impregnated with carbolic acid. and had been used to deodorize and to disinfect sewage at Carlisle. At a later stage he tried various salts of this . Jules Lemaire. he found plaster. and he repeatedly. acknowledged his debt to Pasteur. The spray. mercury. the " donkey engine. in speech and in writing." such as tinfoil or oiled silk. whether dressings. Such a case was peculiarly suitable for a trial of the new method. destroying the organisms. such as i in 20 or i in 40 lotion. To minimize the irritant action he used <c a Not content with protective.

n a small plush-c .im s jH!> and jj . and ^Imts liad not daxxntd p. d talih spiax as us* d In Lisi< cia ol I.. <iili nds j t( Hit ulu. masks.PLATE LXV AN OPERATION AT ABLRDEEN IX LISII:R\S DAY The hguit the (ar)oli( loin h I hum hit i^ (Sn i .O\MIS caps.\ i.issist<mt . \n . Al \and< i ( )i^ston.h stands ..

uss Ir 'I \\illiani In and Chailrs Ma\o.i. illustrated atxne. LXVI THE MAVO CLINIC '1 oi hr clnrn founded siugual pi(ii. \\as opt IK d ^rwne 332- in . \\oild-lamous as ci pie^cnt ic)j8 building.

with nine and limb. The sinus forceps and the probe-pointed scissors which he invented are still used in every hospital. recoveries of life British " On the Medical Journal. while Sir William Jenner." put yourself In addition to his work on antiseptics. nursed From carefully on their knees in cabs and railway carriages. and Lister succeeded him in the Chair of Clinical Surgery at Edinburgh. and showed how it might be rendered safe by He also popularized the rubber storing it in carbolized oil. and the patient was Queen Victoria." and There is only one rule of practice in the patient's place. Two of his favourite aphorisms were " Success depends upon " attention to detail." declaring his preference for carbolic acid and describing his methods. which had been introduced by Chassaignac a few years earlier. drainage tube. No detail of treatment escaped his supervision. and noting that the fluid remained clear (Plate LXIV). Lister introduced the catgut ligature. and it was at this time that he introduced the spray. He stated that by the use of his method blood clotted instead of liquefying and becoming putrid. The first occasion on which he used it was in 1871. The case was one of abscess of the axilla. remained intact.LISTER AND HIS DISCIPLES ing Compound Fractures. and thus commenced a life-long friendship between two scientists. These famous flasks were used to illustrate his lectures. being conveyed to various medical meetings in London and elsewhere by Lister and his wife." He described eleven cases. who was also in attendance. Antiseptic System of Treatment in Surgery. from which he died a year later. open to the air but with necks drawn out and twisted. Lister went to Balmoral to open the abscess. Edinburgh Lister corresponded with Pasteur. Lister's scrupulous attention to detail is exemplified by his recommendation of black safety pins for securing bandages. and one death. In Edinburgh Lister continued his investigations. each of whom had a high personal regard for the other. worked : : 325 . Lister Returns to Edinburgh In 1869 Professor Syme was smitten with paralysis. He confirmed Pasteur's findings by keeping boiled urine in flasks. and A year later he wrote in the ultimately became organized. one amputation. as they are more easily seen. and he further notes that they should be inserted parallel to the line of strain. so that dust could not enter.

When the Edinburgh students heard of this. So to London he went. accepted in almost every part of the world. 1892. however. 326 . His antiseptic doctrine. and system was adopted. and was received with enthusiasm in a country which was then eager to adopt new ideas. while his clinic attracted many distinguished foreign visitors. The Jenner Institute." which was then the subject of a Royal Commission. Sir William Fergusson died. London. Lister and reached the chair his retiring age. He was now at the summit of his fame. when he attended an international congress at Philadelphia in September 1876. taking with him as his assistants Watson Cheyne and John Stewart. colleagues critical or disinterested.A HISTORY OF MEDICINE A few years later Lister was placed in an awkward position when the queen asked him to make a public " statement opposing vivisection. yet they could not but admire his results. had made little headway in London. Gradually the critics were disarmed. popular with his students. 285). and Lister was invited to fill the vacant Chair of Clinical Surgery at King's College. The second Edinburgh period was probably the happiest part of Lister's life. as it was called at first. nevertheless this incident. year. Surgeons were even horrified when he opened the knee joint to wire a fractured patella. delayed his honour of a baronetcy by several years. An equally warm welcome awaited him in America. Students were apathetic. embracing as it did the study and treatment of all infective diseases. and also the famous meeting at That the Sorbonne on Pasteur's seventieth birthday (p. opened in 1897. was a man petition imploring him to remain. Lister's friendship with Pasteur has been mentioned. had a much wider scope than that of a Pasteur Institute. In 1875 he visited Germany. the Year f Lister's fiftieth birthday. and very the bellows of the spray. it is said. seven hundred of them signed a Lister. The reception was somewhat chilly. In 1903 it became the Lister Institute of Preventive Medicine. In a tactful reply he explained why he could not do so . with a mission. resigned Lister's He and hospital appointment. nurses even hostile. His Work and Later Tears in London In 1877. took a keen interest in the foundation of a British Pasteur Institute for the treatment of hydrophobia.

and who rendered . By this time he had retreated to Walmer in Kent. 327 . 1912. of the Order members of Merit. and when he became a peer in 1897 he rendered good service by his support of the VaccinaIn 1902 he became one of the tion Bill in the House of Lords. tolerance of hostile criticism." . by his practice and by writing a short work entitled Chirurgie antiseptique (1876). who was one of the first to employ spinal anaesthesia. perturbable temper.LISTER AND HIS DISCIPLES In 1893 Lady Lister died while they were on holiday in Italy. owing to increasing infirmity. at the age of eighty-five. and he gradually withdrew from public life. Championntere is also remembered for his advocacy of early massage and movement in the treat- ment of fractures. Kelvin as President of the Royal Society in 1895. Lister's health now began to fail. a leading gynaecologist of Paris and admirer of Lister. and the first in France to perform ovariotomy by PAUL RECLUS (1874-1914). will Disciples of Lister Immense advances have been made in surgery and all its branches during the short period since Lister's day. but none more aptly worded than that which appeared in the His gentle nature. was the first to introduce into France. Many were the eulogies which appeared at the time of his death. he was President of the British Association in 1896. instituted at the coronaoriginal tion of King Edward VII. by MARIN THEODORE TUFFIER (1857-1929). although he came strongly into prominence on the occasion of his eightieth birthday (1907). There he died on February 10. In more recent times French surgery has been well represented by JULES PEAN (1830-1898). which was celebrated with enthusiasm throughout the world. his views were accepted and their value was recognized abroad sooner than at home. imresolute indifference to ridicule. combined to make him one of the : Royal College of Surgeons' report " noblest of bless men. As so frequently happens. Lister did not allow his great grief to interfere with the public He succeeded Lord duties which now engaged his attention. and will. JUST LUCAS CHAMPIONNIERE (1843-1913). a pioneer of local (1864) anaesthesia. His work will last for all time humanity him evermore and his fame will be immortal. who had studied " " Listerism under Lister in Glasgow.

the time of healing shorter. In Germany Lister had many disciples. feats which had been rendered possible by his early adoption of Lister's methods. was E. the English translation : mentioned on p. was one of the first to adopt He described." Stromeyer of Hanover. 1928. Med. Wiese. " Theodore Billroth. and by many others whose names are familiar. a famous teacher of surgery in the Vienna School. JOHANN VON MIKULICZ-RADECKI (1850-1905). Halle. Another of still further extended the field of abdominal surgery. Neuburger. Hist." he wrote. professor 1 at Berlin. who devised the method of skingrafting named after him .. a Polish pupil of Billroth. Billroth's pupils. Professor of Clinical Surgery at Copenhagen. who taught at Vienna and there introduced many new operations. in a letter antiseptic surgery on the Continent. MATHIAS HIERONYMUS SAXTORPH (1822-1900). Our results. 343. British Medicine and the Vienna School. and even supplied looks grateful now on thec For what thou did'st in Surgery And Death must often go amiss. There was KARL THIERSCH (1822-95) of Leipzig. especially in the surgery of the abdomen. Billroth was the first to excise cancer of the stomach. to Lister in 1870. 278 . Mankind By smelling antiseptic bliss. Scholar. vol. Musician. is ERNST VON BERGMANN (1836-1907). was ANTON VON EISELBERG (1860-1939). an able surgeon and a prolific writer.A HISTORY OF MEDICINE important services in many branches of surgery and in the treatment -of wounds during the Great War . 1943. Abdominal Surgery Established One of the most brilliant German surgeons of Lister's time was THEODORE BILLROTH (1829-1894). P- "3 328 . whose work is crystallized his opinion of Lister in light verse. " become better and better. how he had banished pyaemia from his hospital. R. and the first to perform laryngectomy. Several of Nussbaum's letters " to Lister have been preserved. and Master Surgeon. of which he 1 regarded sometimes as the founder. p. and pyaemia and erysipelas completely disappeared. x. In Breslau." Ann. ever associated in the tractures . RICHARD VOLKMANN (1830-89) of minds of students with fascial con- and JOHANN VON NUSSBAUM (1829-90) of Munich. M.

In Russia we find an important link in the chain of modern surgery in the person of IVAN PETROVIGH PAVLOV (1849-1936). 1920. and his elabora" " tion of conditioned reflexes have had an important bearing upon many problems of surgery and medicine. As a representative of the Italian surgery of modern times. Sir JONATHAN HUTCHINSON (18281913). surgeon to the London Hospital. PAUL KRASKE (1857-1930). In his clinic at Rome. To return to British surgery. He was succeeded in the Chair of Surgery by AUGUST BIER (1861. there may be mentioned at this stage in our story the name of one of Lister's contemporaries who deserves to be honoured. Although not a practising surgeon. a monograph on his method of excision of the rectum for carcinoma. Bassini evolved the technique of the operation for inguinal hernia associated with his name. who pointed out the <e advantage of elevating the pelvis in certain operations. the name of EDUARDO BASSINI (1844-1924) may be selected for mention. and he was the leading surgeon of Italy in his day. Berlin. English trans. He had an outlook similar to that of John Hunter. was a man of encyclopaedic knowledge and of wide experience. achieving world-wide fame. It was Von Bergmann introduced sterilization by steam and improved the design of operating theatres.) so well known for his treatment of in- who flammatory lesions by passive congestion. he was perhaps the greatest experimental surgeon of modern times." Another Berlin surgeon bearing a name familiar in surgery was FRIEDRICH TRENDELENBURG (1844-1924). Were Good Days. BesonnU Vergangenheit. He made important contributions to other branches of surgery. chief of the surgical clinic at Freiburg for thirty-six years. trans. and performed two thousand thyroidectomies with a mortality rate of five per cent. which was simply another means of applying aseptic the principles so clearly stated by Lister. 1 He introduced what he called the " " method. foremost Swiss surgeon of his time was THEODORE (1841-1917) who in his clinic at Berne revolutionized the surgery of the thyroid gland. Miall. L. His researches on syphilis and leprosy are well 1 The KOCHER C.) 329 ." by B. His researches on the psychic factor in the secretion of digestive juices. Schleich. entitled. while he was still a junior assistant. wrote. (Recollections of a surgeon whose " Those name is associated with local anaesthesia.LISTER AND HIS DISCIPLES another follower of Lister. with whom he has often been compared.

Bett. He was the first name " apply the appendicitis." knowledge of York (1845-1913). 3 Another early exponent of abdominal surgery was a Swiss. who had come to Chicago at an early age. and by ROBERT LAWSON TAIT (1845-99). Professor of Surgery at Philadelphia. 2 His Sir Edward VII Perforating Inflammation of its the Vermiform Appendix. W. McKay. NICHOLAS SENN (18441908)..A HISTORY OF MEDICINE his Archives of Surgery (1889-99) was a mine of information. Lawson '* 330 . History of Surgery. 1943. The leading gynaecological surgeon of America was HOWARD KELLY of Baltimore (1858-1943). R. Senn performed intestinal anastomosis by means of bone plates. who operated upon King for appendicitis in 1902. a pupil of Simpson known. in addition to other important work. and JOHN BLAIR DEAVER (1855-1931). The pathologist who established appendicitis as a definite lesion was REGINALD HEBER Frrz (1843-1913) of Boston." Brit. 1922 Treves* First Appendix Operation. was a leader of abdominal surgery. Nevertheless. in fact. in which great advances were being made. Tait: His Ltfe and Work. of The History of Some Common Diseases. pp. vol. 168 R. 1934. a brilliant surgeon who wrote a monograph on appendicitis (1896). Surg. Leonardo. Appendicitis Defined FREDERICK TREVES (1853-1923). Jour. later. xxiii. which ful" " filled the same function as did Murphy's button a few years surgeons to the Among American who added appendicitis were CHARLES McBuRNEY of New who devised the so-called gridiron incision. p. 1935. which had preto understood. and who was an authority on the use of radium. surgical At this period gynaecological surgery was represented by Sir Spencer Wells (p. i . on asepsis. 323 1 Stewart Sir D'Arcy Power. ed. 318. and this was no doubt in 1 the cause of the remarkable success of his operations. p. and he denied the bacterial nature of sepsis. he always insisted on absolute cleanliness. A. 320) who achieved wonderful results in ovariotomy. and Edinburgh who built up a large practice in Birmingham. with Special Reference to its Early Diagnosis and Treatment. Lawson Tait was strongly opposed to Lister's views. focused attention upon the disease and viously been ill upon relation to peritonitis. who introduced many new operative procedures.

Surgeon. Details of his interesting career have lately been set forth in a biography entitled Surgeon Extra1 prdinary. Surgeon Extraordinary : The Life ofj.LISTER AND HIS DISCIPLES JOHN BENJAMIN MURPHY (1857-1916). also of Chicago. Surgery in America General surgery in the United States was considerably advanced the labours of GEORGE WASHINGTON CRILE of Cleveland ( 1 864by His researches were chiefly concerned with the causes of 1943). Professor of Surgery in the University of Edinburgh. especially in operations for toxic goitre. and Kelly Halstead was a worthy disciple of Lister. William Sttwart HalsUad. 1 * the surgical member of the great team. and (gynaecology). had rendered possible. 1938 Donald Bateman. Berkeley Moynihan. 8 Facile alike as operator as author. and Great Sir War he was created a Baron. in the teaching of medicine at the Johns " Loyal Davis. who used to unite the fractured patella by wire. MacCallum. one of those who endeavoured to secure a sterile field in operating. B. and he perfected operations for hernia and for removal of the breast. was unrivalled as a surgical teacher. Murphy. who achieved distinction for his work on the surgery of the gall bladder. he made many contributions to the knowledge of For his services during the gall stones and of duodenal ulcer. 1930 331 ." engaged Hopkins University. WILLIAM STEWART HALSTEAD (1852-1922) 8 was the big four. surgical shock and the best means of avoiding shock. ARBUTHNOT LANE (1856-1943) introduced an " " A Sir more recent worker in the field of abdominal surgery was DAVID PERCIVAL DALBRECK WILKIE (1882-1939). Lane had his own views on chronic intestinal stasis. He achieved success and fame in the face of much opposition. for which he advised a method of short-circuiting the bowel. from its inception in 1889. G. An eminent British exponent of abdominal surgery was BERKELEY GEORGE ANDREW MOYNIHAN (LORD MOYNIHAN) (1865!93 6 )> Professor of Surgery at Leeds. which marked a great surgical advance. The others were Welch (pathology). Osier (medicine). operative technique of plating fractures by uniting the bones with metal plates. Baltimore. 1940 W. To this end he introduced the use of rubber gloves. a procedure which the method of Lister.

placed it on 1 H. The Mayo Clinic soon became the surgical focus of the United States and a centre of study for surgeons the world over . was another ideal successfully attained by the brothers. Reference has already been made to the rapid growth of abdominal surgery. content with nothing but the best in their immense " They were born at the right time.A HISTORY OF MEDICINE A by crowning triumph of American surgery was the foundation. early to ride the wave of advance that followed upon the work of Pasteur and Lister. The rise of specialism in the fields of medical science will form the theme of a subsequent chapter. Mr. when Lister's nephew and biographer. neither too undertaking. nor too late to reap the advantages of the old school at its soundest and best. Will turned his attention largely to abdominal surgery. (1861-1939) and CHARLES HORACE MAYO (1865-1939) achieved their rise to fame almost as one man. The fascinating story of the two brothers. This was in 1884. Charlie. Charlie was WILLIAM JAMES MAYO an authority on thyroid surgery. Meanwhile a few words may be said regarding the rise and progress of various branches of surgery. of perfection. its Trotter. Minnesota. Clapesattle. Wilfred Neurological Surgery. is well told in the recent biography by Helen Clapesattle. University of Minnesota. 1941 33 2 . ." Every surgeon admired and a more the subtle and criterion of their greatness Mayos. Even more spectacular was the surgery of the central nervous system. and in commemorating the operation fifty years later. which bears their name (Plate LXVI). The Doctors Mayo. respected was shown in the affectionate regard of the town folk of Rochester. had which has now reached such a high degree beginnings in London. to advance the teaching of surgery." as they were familiarly 1 called. " " My brother and I was the phrase used constantly by each of them. the brothers Mayo. who regretted that in such great events of medical history the name of the patient is so seldom mentioned. was the first to remove successfully a tumour of the brain. of the clinic at Rochester. " Dr. and the Mayo Foundation. who were Specialism in Surgery The trend of surgery towards specialism was already evident towards the end of the nineteenth century. Sir RIGKMAN GODLEE (1859-1925). Will and Dr. Both were inspiring teachers.

i 7(>G -i Larrcy's " Flying Ambulance " (pas$e 338) .PLATE LXYII NAPOLEON'S CHIEF SURGEON Han m LARRIY.

Mortality* and Invaliding among to unpioxc the health of the arm\ and the efficiency of the medical ser\ices ^pagc 341) . 7V00/U did so much \\hose Reports on Sickness.PLATE LXVII1 A DIRECTOR-GENERAL OF MEDICAL SERVICLS Sir the James McGngor.

who. 1893) is a medical classic.In America the pioneer was WILLIAM WILLIAMS KEEN (18371932) of Philadelphia. p. He served in France during the Great War. 1207 1 s * A. a highly skilled neurologist and pathologist. and on tumours of the literature. like Godlee. was the first." Lancet. in 1887.LISTER AND HIS DISCIPLES this young man's record that he was a native of Dumfries. was the surgery of the genitourinary system. 1942 Stephen Paget. Bowman. and wrote an account of his 4 His Bio-bibliography of Andreas Vesalius was not pubexperiences. and by some authorities he is regarded of diagnosis as the founder of modern neuro-surgery. "A Landmark in Modern Neurology. 1919 Harvey Gushing. and PAUL BROCA (1824-80) of Paris. Life of Sir Victor Horsley. twenty-three recoveries) remains unequalled. who evolved a technique of his own. Early workers in the field of neuro-surgery in Europe include FRANCESCO DURANTE (1844-1934) of Rome. Sir William Macewen : A Chapter in the History of Surgery. . whose achievements as an anthropologist (p." * " name was Henderson. His Pyogenic Diseases of the Brain and Spinal Cord (Glasgow. first Another highly specialized field which at this time became from general surgery. was surgeon to University College Hospital. Horsley died of sunstroke while on 3 military service in Mesopotamia during the Great War. vol. who introduced the osteoplastic flap in brain surgery. greatest neurological surgeon of America was HARVEY GUSHING (1869-1939). and that ARTHUR BARKER (1850-1916) was the first in this country to drain successfully an otitic brain abscess in 1886. Sir to operate successfully for the removal of an accurately localized tumour of the spinal cord. and who successfully The nervus acusticus (1917). 1936 333 . and who published classic monographs on the pituitary body (1912). lished until 1943. 6) are equalled by his skill as a surgeon and anatomist.closely followed by Sir WILLIAM MACEWEN (1848-1924) of 2 Glasgow. whose series of early successes in the treatment of brain abscess (twenty-four operations. ii. His biography of his friend Sir William Osier (1926) is a gem of medical biography. briefly called Urology. who made notable contributions to surgical removed a brain tumour in 1888. From a Surgeon's Journal. A great impetus was given differentiated 1 Wilfred Trotter. 1915-18. He was one of the to apply his knowledge of cerebral localization to the brain tumours. 1934. and he was . VICTOR HORSLEY (1857-1916). K.

LOYAL. 1919 William Stewart Halstead. R. WATSON. The MACCALLUM.A HISTORY OF MEDICINE DAVIS. B. 1920 Collected Papers LISTER.. T. WRENCH. History of Surgery. Besonnte Vergangenheit. The Life of Sir Robert Jones. Sir RICKMAN. Lord Lister. Surgeon Extraordinary : The Life of J. Baron Listery 2 vols. 1922 PAGET. L. 1913 336 . W. Murphy9 1938 GODLEE. A. F. Lawson Tail: His Life and Work. G. C. G. STEPHEN. Berlin. 1934 Lord Lister: His Life and Work. 1930 McKAY. 1919 SCHLEICH. 1943 of Joseph. 1918 LEONARDO. Life of Sir Victor Horsley. Baron. STEWART.

The battlefield has always been a training ground for surgeons.A. as we have noted (p.*' Jour. and whose investigations. Thomas Gale. Ixvii. although the German surgeon Hieronymus Brunschwig had given the first account of gunshot wounds in his illustrated (p. R. (429) 337 23 . 1934. and in recent years war has provided opportunities for vast experiments in public hygiene and national health which could not have been carried out during the years of peace. is nevertheless not without its compensations. was the first English surgeon to publish An Excellent Treatise of Wounds made with Gonneshot y 1563. who so closely followed " What Medicine Owes to War and War Owes to Maj. The great surgeon of the Civil War was Richard Wiseman. E. who saw service in the navy as well as in the army. " The Influence of Wars on the Graft of Surgery. H..C. were concerned with the burns produced by gunpowder. Fare's prototype and contemporary. William Clowes. p. the Roman Army appears to have had its medical officers.CHAPTER XVIII MILITARY AND NAVAL SURGERY.C. Stephens. Downes. 1 Military Surgeons of Early Times The first surgeons in history were doubtless military surgeons. vol. detailed to tend the casualties resulting from single combat or from tribal fighting. work. 209). becoming more and more dreadful on each occasion. 40 1 . and so it went until the time of Ambroise Pare*. and in that war we find a still greater campaigner in the person of William Harvey.A.-Capt. Medicine. vol." Jour. Homer sang of the bold surgeons Machaon and Podalarius. 381 Surg. M.M. 151).M. whose career has been noted (p. R. p. CONQUEST OF TROPICAL DISEASES WAR. R. Cirurgia Hantwirckung der Wundartzny. 1497 Gale was closely followed by another Elizabethan surgeon. the Knights Hospitallers treated wounded Crusaders. when the invention of gunpowder added so greatly to the problems confronting the military on surgeon.. 1936. which brings sorrow and suffering. 126). but.-Gen. R.

DOMINIQUE JEAN LARREY (1766-1842) was a native of Baudean When he was a boy his father died and he in the Pyrenees. Mention has ako been made of the pioneer work of Sir John Pringle in the interests of military hygiene." Ann. 1939.A HISTORY OF MEDICINE the fortunes of his tragic royal master. and won the emperor's admiration and friendship. and afforded the young surgeon the opportunity of studying mal de mer and scurvy. 1937.. who took part in all Napoleon's campaigns. vol. ix.. p. and then. P- 435 338 . Dominique Jean Larrey. the birds and animals. 428 " E. C. he narrowly escaped shipwreck off the stormy coast of Newfoundland. the climate. E. The Hospitals and Surgeons of Paris. Now another great French military surgeon The war which marked appeared on the scene and achieved immortal fame. 309 " P. was brought up by an uncle. Wiese. of which he was an eye-witness. Larrcy. and 3 it was thus possible to collect and deal with the wounded rapidly. and Larrey at once entered the army. as well as the scenery." These were light. Hist. acted The century strong had of the battlefield made little since the time surgery progress of Ambroise Pare. centre of warfare. 1843. Bechet. where no heavy ambulance could be taken. such as John Hunter and Charles Bell. 2 It was at this early stage of his career. that he introduced his ambulances volantes. when he was with the " army of the Rhine. each drawn by two horses (Plate LXVII). p. medicine. Baron Larrey and the Practice of Military Surgery the opening.years of the nineteenth a as stimulus to surgical advance. and of certain distinguished surgeons. Stewart. well sprung vehicles. vol. two-wheeled. The voyage lasted seven months. 1 Among his patients were some of the victims of the Revolution. acted as chief surgeon to the army. an army surgeon in charge of the There Larrey engaged in the study of hospital at Toulouse. and the native customs of this part of the New World. who added to their civilian experience by a period of military service or by a visit to some. i. In 1792 war broke out. Hist. On his return to France he studied in Paris at the Hotel-Dieu. This was Baron Larrey. and commenced the work for which he was so admirably fitted. entering the navy as surgeon to a frigate Vigilante." Ann. 1 1 8 F. Med. Med. R. Napoleon's Chief Surgeon. They could readily be rushed up to the front line.

afterwards inscribed.MILITARY AND NAVAL SURGERY Larrey's flying ambulances brought him into prominence. He wrote his great work on military surgery. Ten years later. 3 vols. Memoires de Chirurgie militaire et Campagnet. He was present at many battles. when " the cold was more deadly than the enemy. whose leg was removed " under the enemy's fire and amid thickly falling snow. Details of his adventurous life with the army of Napoleon are given in his Memoires de Chirurgie 1 Campagnes." The general lived for fourteen years more. on December 1 He Baron Larrey. will make you Baron of the kill officers' " when he died. although on one occasion. Larrey was compelled to face the poverty and trials which were the lot of Napoleon's followers. Larrey treated Napoleon for an injury to the foot caused by the kick of a horse. Napoleon affected displeasure and sent officers for Larrey. Among the troops he was enormously popular." This he did. 1812 339 . Empire. Paris." For his valour he received from the hands of his general a valuable sword of honour. Hearing of this.900 wounded. Larrey became Inspector-General of the army in He was present during the fateful retreat from Moscow." said Larrey simply. he incurred the displeasure of his fellow militaire et by slaughtering some of their horses in order to make bouillon for his wounded men at a time when provisions were scarce. He had never lost the high esteem of his countrymen. the only wound which he e'ver received. and in 1830 he was appointed Surgeon-inChief at the Hotel des Invalides.. 1805." His campaigning days ending at Waterloo. " Aboukir et Larrey. visited England in 1826. and was Viceroy of Poland " horses in order to Yes. " " I Well. by order of the emperor. Yet he was not idle. and " many amputations were performed in the field of battle amid a shower of bullets. in Egypt. Larrey showed a devotion to duty which was almost fanatical. Larrey himself was wounded on two occasions. in Egypt and at Waterloo. and in those days amputation was the rule for compound fractures or severe injuries. At Aboukir there were 1." At the battle of Borodino he performed two hundred amputations. and was well received by Sir Astley Cooper and other surgeons. feed your Have you dared to wounded ? " he asked." retorted Napoleon. One of his patients during the Russian campaign was General Zayochek. Larrey was a strong advocate of prompt amputation by the circular method when the limb could not be saved. iSia. but this was by no means his only achievement.

to recall that the name of N&aton was associated with his invention of a porcelain-tipped 1 vol. Paris. Corlicu.A HISTORY OF MEDICINE 15. edition of the works of Ambroise Par (1840)." His colleague at the Hopital Saint-Louis was AUGUSTE NELATON (180773). a modest and kindly man who declined to involve himHe was a careful operator and a popular self in controversy. JOSEPH FRAN9OIS MALGAIGNE (1806-1865). * * 4 E. 192 L. p. Le Baron DcsgcnttUs. Paris. 2 experiment had no Among others who influenced the trend of French military surgery during the early part of the century. Fortunately the foolhardy yet heroic ill effects.000 francs to Baron Larrey. 1762-1837. Becclard." in J. Htstotre des membres de VAcadirme royale de Me'decine. Paris. although neither adopted the army as a career. RENE NICOLAS DUFRIGHE DESGENETTES (1762-1837) entered the army after completing his studies at Montpellier. Gazrl. p." my my from a bubonic paigns. " Napoleon bequeathed the sum of 100. 1878. was distinguished. teacher of surgery. 2 vols. 1840. Another man of sterling quality was Napoleon's chief physician. as a sign of the times. 344 " Notice historique sur la vie ct les travaux d'Auguste N^laton. He followed all Napoleon's Camand carried out such measures as were available in his day for the promotion of the health and well-being of the troops. two men were preeminent." Napoleon was indeed fortunate in retaining in his service a surgeon so efficient as Baron Larrey. He published an excellent All his writing was of high quality." " has heart been more distressed by memories. including a treatise on fractures and dislocations in which he advised fixation of the " fractured patella by Malgaigne's hooks. the fact a that by during plague epidemic in Egypt. nettes deliberated inoculated himself in their presence with pus abscess.. 1896. and made valuable contributions of his own to surgical literature. the most virtuous man I have ever known. Paris. 4 It is interesting. 289 340 . and like Larrey became a Baron of France. 1845. Pariset. not only as a 3 surgeon. but also as a clear writer and as a medical historian. p. and by his ability and devotion to duty 1 That he possessed courage is shown rapidly rose to eminence. when the soldiers were terror-stricken by the spread of the disease. ii. "Never. Desgenettes was the recipient of many honours. Notices et Portraits. surgeon to the H6pital Saint-Louis of Paris. Desge- he wrote. Centenaire de la Facultf de Mtdecine de Paris ( 1794-1894} . 1912 A. he attended the funeral of his emperor.

a surgeon in Pall Mall. information.C. the porcelain becoming marked when it rubbed against the leaden bullet. and who fully earned his title of British Larrey. 86 1 1 T. wounded at E. then in the " for six years. which was used to locate bullets. While still a youth of sixteen years he entered the Among mate " at York Hospital. Guthrie at once submitted his name. at first five years in Canada. (" McGrigor ") Ibid. vol. Phillips. especially of in and of interesting India are full the health troops Egypt. Medical Portrait Gallery.MILITARY AND NAVAL SURGERY probe. the British army was likewise very fortunate. the officers who served under Sir James McGrigor was one who was his great friend. although he had been placed sula on half pay and had commenced practice in London. 1893. B. and passed the M.R. p. Aberdeen Doctors. 1838-40. ("Guthrie ") 1 341 . Rodger. British Military Surgery While the medical services of Napoleon's army were under the able leadership of Larrey. Chelsea. he began his medical career as apprentice to Dr.S. which was largely responsible for the l development of the medical school in that city (Plate LXVIII). J. iv. The first patient whose wound was probed with this instrument was Garibaldi. The Director General of Medical Services at the time was Sir JAMES McGRiGOR (1771-1858). and who founded the Aberdeen Medical Society. and those which deal with the McGrigor's reports. and he originated a fund for their widows and orphans. iv. whose fame became even greater " The than that of his chief. vol. an Inverness-shire man who studied at Aberdeen and Edinburgh. he resumed military duties in order to assist in treating the 1 . 8 Hardly had he commenced work there when an order was issued obliging army as " hospital all hospital mates to obtain a medical qualification. examination with ease. Born in London of Scottish ancestry. There now commenced for him a long period of " Peninmilitary service. No one did more than he to raise the standard of the medical department of the army so that it might attract the best class of surgeon. who may be regarded as the most distinguished British army surgeon in history. after which. 2 He inaugurated at Chatham a museum and a library for army medical officers.. H. Pcttigrew. 125 Autobiography of Str James McGrigor.*' This was GEORGE JAMES GUTHRIE (1785-1856).

S. greatly amused His monograph on Gunshot Wounds (1815) is still worth reading. The rule appears to have been. iii.C. and in 1855 there appeared his Commentaries on the Surgery of War. 1841. was twice wounded. mortality amputate. and 1854.C. and he preferred the circular method " in most cases. R.S.A HISTORY OF MEDICINE 1 At the age of twenty-six he had three Brussels.A. three occasions he was President of the On Royal College of Surgeons. and he was one of the first to lay stress on the need for medical representation in Parliament. 145 1 342 . Howell.R. cated the extraction. and even distinguished himself by capturing a French " " a his general. A. 1910. He was a small. xiv. was The about In 1816. in 1833. Military Surgery in Germany and Russia Other nations besides Great Britain and France possessed their military surgeons. Guthrie served on the staff of this institution. and his services were so appreciated that the students presented him with a silver cup. with a brusque military manner which concealed his kindly nature. he advised that when amputation was essential it should be performed as soon as possible after the injury. George James Guthrie. Ophthalm. He organized courses of instruction for medical officers of the navy and army. thousand wounded under his care after the Battle of Albuera. Founder of the Royal Westminster Ophthalmic Hospital. and he was also appointed surgeon to Westminster Hospital." of declined the honour he an infirfounded having knighthood. fifty per cent. L. " whom Garrison has designated " the H.M. 1919. Like Larrey. F. vol." Bnt. "George James Guthrie. certainly within twenty-four hours. respect opening There was KARL FERDINAND VON GRAEFE (1787-1840). In his treatise on The Operative Surgery of the Eye (1823) he advo" " of cataract. Royal Ophthalmic Hospital. Yet he did not forget the army. where he won the admiration of Wellington for his skill and devotion to duty. as opposed to the couching In 1830 Guthrie published an important work on Diseases and Injuries of Arteries. 1785-1856." Jour. Grixnsdale.. for of diseases the the Westminster mary eye. He was present at many engagements. vol. feat which gun single-handed. active man..R. 577 H.. Jour. 2 He was as successful in civil surgery as he had been in military surgery. F. Professor of 1 Surgery in Berlin. p. after Waterloo. Germany set a high standard in this the at the of nineteenth century. When in doubt. His services to military surgery were great. p..

and who advised the Esmarch elastic bandage for securing haemostasis. Med. (Date of birth should have been 1768) * 343 . and he founded the German Society of Surgery as well as the influential surgical journal. 247) of Thomas Dimsdale of Hertford. Doctors from other lands went to seek their fortunes in Russia. In addition to his prowess as a strictly military surgeon lie was a pioneer of oVthopaedic surgery. 1758-1854. His rise to fame was rapid. The story of his successful treatment of a courtier for an abscess of the throat reached the ears of the Tsar. who had seen active ^military service as a combatant and also as a surgeon." in civil as in military For forty-two years he held the Chair of Surgery at Kiel. The founder of modern military surgery in Germany. 1406.D. 1 far in the royal service. however. England. He devised many new operations. who was summoned to inoculate Catherine the Great against smallpox. Notice has been taken (p. Sir JAMES WYLIE ( 1 768-1 854). Stromeyer. (Sect. G.. and took part in every He was said to be a good surgeon.. Pt. Biographical Note on Sir James Wylie. a post which throughout the reigns of the two succeeding Tsars." Proc. xxi. though 1847 by not specifi- may be mentioned at this stage as the most famous operator and teacher of his time in Germany. Hanover.. JOHANN FRIEDRICH DIEFFENBACH (1792-1847).. One of the adventurers who sought practice in Russia was an Aberdeen 2 Young Wylie went to graduate. p. Hist. the On his death he was succeeded in the Chair by another eminent pioneer of plastic surgery. Archivfiir klinische Chirurgie. life. Soc. at Berlin in BERNHARD VON LANGENBECK (1810-87) who. vol. 2 vols. Roy. Russia at the age of twenty-two. applying the operation of subcutaneous 1 tenotomy to the relief of various deformities of the limbs. L. Bart.)." He was in close touch with army throughout his career. 1874 " Sir R. Hutchison. Dieffenbach was in turn succeeded cally a military surgeon. M. who introduced the first field dressing during the Franco-Prussian War. him he retained Wylie travelled Russian campaign of the time. 1928.MILITARY AND NAVAL SURGERY founder of modern plastic surgery. F. A Medical Adventurer. was GEORG FRIEDRICH Louis STROMEYER (1804-76). Towards the end of the century the most outstanding military surgeon was FRIEDRICH VON ESMARCH (1823-1908). He was a strong advocate of " first aid. 2. In Russia there was no organized medical profession until well on in the nineteenth century. who promptly raised to the office of court physician. Envurungen eines deutschen Aretes.

An Introduction to the History 1 A. and serving for over a year in the Crimea. Edinburgh. At the age of thirty he became Professor of Surgery at St. and he was the recipient of * many other honours. with over 200 plates depicting the numerous frozen sections which he had prepared. His Treatise on Military Surgery appeared in 1 864. and London. 231). A military hospital to his memory was. The Teaching of Military Surgery Early in the nineteenth century there arose a vogue for the teaching of military surgery as a special subject. Thomson 1 F. 108 yd 532 344 . His application was unsuccessful. introducing female nursing and insisting upon a more adequate supply of medical comforts. and was already Professor of Surgery at the Royal College of Surgeons and surgeon to the Royal Infirmary when the military Chair was instituted. thereby raising his prestige considerably. Petersburg. of Medicine. accordingly he published an Atlas of Anatomy (1851-54). H. a Chair was established incumbent was JOHN THOMSON (1765-1846). a chair which he held for forty-five years. opened in 1873 in the city now known as Leningrad.A HISTORY OF MEDICINE and he certainly was a capable administrator. taking part in many campaigns. At Edinburgh. and his name is associated with a method of amputating the foot. p. who saw much active military service. Garrison. l Pirogoff adopted ether anaesthesia as early as 1847. 1924. both civil and military. ing the wounded. When he accompanied Tsar Alexander to England in 1814 he was made a baronet by the Prince Regent. He certainly endeavoured to atone for his lack of military experience by visiting the field of Waterloo and attendin i8o3. He had studied at Glasgow. Educated at Berlin and Gottingen. 1918. School of Surgery Before Lister. who did much to found and to organize medical schools. then the centre of British medical learning. 2 The first the son of a Paisley weaver. The greatest of Russian military surgeons was NIKOLAI PIROGOFF (1810-81). The Edinburgh ed. This appointment he held for sixteen years. where on the Russian side he acted as Florence Nightingale did on the British side. rendered vacant by the death of James Gregory (p. he came to the conclusion that anatomy as then taught was insufficient for surgical needs . resigned from the Chair of Military Surgery in order to apply for the Chair of Medicine. Miles. p. although he lent no great distinction to the Chair.

and named the " closed " method. which had been founded at his suggestion. It is obvious from his career that he was no advocate of specialism and that he even viewed He with disfavour the separation of medicine from surgery. It is not surprising that Dr. Sir GEORGE BALLINGALL (1780-1855) was a good teacher. popular with his students. Ballingall had " a very high opinion of the beneficial effects of large and repeated leeching. Tetanus was common. 1932. who had subjects. It would greatly add to the comfort of the soldier. Thomson was succeeded in the Chair of Military Surgery by one whose military experience at home and in the East well fitted for his new duties. as inaugurated and occupied Chairs in three different " the old chair maker. Miles. although occasionally In gunshot wounds. compelled to travel with a broken leg. and was him believed to be the result of injury to a nerve. The practice of swinging or suspending fractured legs in a sort of cradle. D. The Edinburgh School of Surgery Before History of Scottish Medicine. Lister. Of fractures " which has been recently re-discovered. That extreme degree of wound infection. which 1 A. was very prevalent. vol. Comric. and highly esteemed 1 His Outlines of Military Surgery (1832). especially in Egypt and India.. 1 15 . He also writes of a method of treatment of compound fracture hospitals. might well be extended. and in Ballingairs opinion was best treated by the cautery. gives a clear picture of the state of the subject prior to the time of Lister." In 1813 Thomson published a book which had a wide circula- It was entitled Lectures on Inflammations. The usual dressing for wounds was the cold water compress. A p. treated plaster compound fractures with cushions or compresses of straw. Exhibiting a View tion. surprisingly modern in design. especially seen even after slight wounds." and he advised that an ample supply of leeches should be available in military he writes. therefore approached the subject of inflammation from the medical as well as the surgical point of view. First. 506 345 . J. ii. which by his colleagues. known as hospital gangrene. went through five editions. he recalls that Larrey.MILITARY AND NAVAL SURGERY but ten years later he became the first professor to occupy the Chair of Pathology. as I have seen practised in many Continental hospitals." He gives an illustration of the apparatus. in Egypt. 2 vols. p. 1918. Robert Knox referred to Thomson. wounds of joints. of the Doctrines of Medical Surgery.

but they remained subsidiary to the fighting . and not the ranks. I was preparing to amputate the limb when the parents came and carried him away to a potter who enveloped the limb in clay and finally cured the were left " patient. ii. Nevertheless. but later rose in prestige in spite of it. beri-beri. p. Besides Sir James McGrigor.. an ^ Professor to the Secretary of State for War expressing the opinion that the duties of a military or naval surgeon could only be taught by actual demonstration. suffered a term of imprisonment for his rashness. 746 i. fever. to whose work reference has been surgery. vol. and that a Chair of Military " Surgery was a useless encumbrance. having sustained a compound fracture of the leg. Boys only fill the hospitals. 1 Discipline. George Ballingall died suddenly in 1855. 2 vols. Scott. Sir and guinea-worm. 346 . 1939. vol. J. an indomitable Scot who. vigorous efforts to raise the status of medical service in the British Army were made by such men as ROBERT JACKSON (1750-1827). having literally fought with a Surgeon-General who was opposed to any reform. when the Crimean War broke out in 1854. there was no organized medical corps. Nevertheless. and drew pay from both appointments." This interesting volume concludes with an account of diseases of troops on foreign stations. Then he relates a small boy was brought to my tent in India." It was therefore abolished Syme wrote in 1856. 43 . and Economy of Armies (1804) became a military classic. 1932." In the chapter on the selection of recruits the author expresses " the opinion that the most eligible time for enlistment is from twenty to twenty-five years of age. there were other administrators who saw the need for improvement in the medical department of the army. namely.A HISTORY OF MEDICINE how undisturbed until cure was complete.. Indeed his Systematic View of the Formation. p. Comrie. Each medical officer wore the uniform of the regiment to which he was attached. 1 H. History of Scottish Medicine. there made. Some purchased their commissions some also purchased combatant commissions. 2 vols. D. H. The Royal Army Medical Corps In spite of this burst of enthusiasm for the teaching of military was comparatively little scope for the development of the subject during the peaceful years of the nineteenth century. A History of Tropical Medicine. dysentery. A few were posted for duty in general hospitals.

and the corps became consolidated under its own officers. but who had been detailed for this duty from various regiments. medical men. the former name of " Medical Staff being revived. in 1898.'s and men. 1932 . Seymer. The orderlies were many of whom were unfit to bear " Medical Staff Corps. The were still civil organizations. in charge of medical stores and equipment. T." of her victorious return story of to England. Notes on Nursing. Cook. and her little handbook. and even the Director-General could exercise little authority.MILITARY AND NAVAL SURGERY ranks. It was at this stage that FLORENCE NIGHTINGALE (1820-1910) took the law into her own hands and introduced women nurses into* the hospital at Scutari. until after the To return to the main theme. was the important decision that the corps should be commanded by medical officers. There were no army ^hospitals nurses most of the orderlies were pensioners employed for this duty. 2 Although Florence Nightingale did her great work before the antiseptic era. 1913 L. 1907-12 Col. no of their own.o. War in 1857 that there came " it was not Crimean Hospital into being an "Army of specially trained n. " There were also Apothecaries to the Forces. E. 2 vols. came the red-letter day. 1 All the world is familiar with the " The Lady with the Lamp.. A further step. a stretcher. Fred Smith. was therefore doomed to failure from the first. and its own uniform. and it was followed by many other similar schools." having all the usual army ranks and titles. . " In arduis fidelis. with officers. This was opened in 1860.. New York. Dock. however. is still well worth reading. History of Nursing. in 1884. Eventually. In the Crimea. R. 4 vols. however. they had received no were." who had been chemists in civil life. The Life of Florence Nightingale. The scheme and had officers special training. The first attempt to improve matters consisted in recruiting strong men for the work in place of the feeble old pensioners. A Short History of the Royal Army Medical Corps. M.c. Aldershot. 1929 * 1 347 . with the badge bearing the motto. A General History of Nursing. and of the fund raised in her honour to endow a school for nurses at St. royal warrant of Queen Victoria inaugurated the " Royal Army Medical Corps. Nutting and L. In 1873 this regimental system was abolished. who Corps were not. the need for reform became more clamant. Thomas's Hospital." a " Corps when a Sir E. she revolutionized nursing as a profession. A." They formed into what was called the of scant men education.

). as never before. a medical graduate of Glasgow.000. vol. In the Great War typhoid fever was relatively rare. that of Gallipoli. was opened in 1902. who preceded him as Professor of Pathology in the Lt. During the South African War of 1899-1902 typhoid fever was a more formidable foe than the enemy.M.. 1058 1 1 348 . 89 H.C. The Great War and the R. This happy result may be traced to the labours of one man. 1939. for the first time in history. the supreme importance of a fully trained and efficient medical service was proved on many occasions.-Col. or is infinitely dum-dum fever.A HISTORY OF MEDICINE The Royal Army Medical College.130 other ranks of the R. 1 In that war. Then.M. the strength of the R. 2 vols. H. Hist. Ray. in all ranks was 9.C. 2 Nevertheless. Preventive Medicine in the It Army has been truly said that in war the prevention of disease more important than the actual treatment of the sick and wounded.. the five-year period 1907-1 1 showed an average mortality rate of only six per thousand. so that by the end of the war in 1918 the total strength of the corps had increased to 133. and he simple method also made original investigations into the cause of kala-azar. gave their lives in the Great War. 2. ii. which was associated with a heavy death rate. " The Rate of Mortality in the British Army a Hundred Years Ago. and even in the most unhealthy centre. and in the same year the auxiliary medical services were included in the corps. 1919 Arnold Chaplin. No less than 743 officers and 6. 1916. When the Great War broke out in 1914. now known as Leishmaniasis. Sir WILLIAM BOOG LEISHMAN (18658 Early in his career he 1926).000. (Sect. Med. Scott. Much was accomplished by improved hygiene." Proc. for the special instruction of officers of the corps.A.M.C.. Soc. F. A History of Tropical Medicine. the entire medical profession of the country was placed at the disposal of the army. Pt.A. and accounted for twice as many deaths as his weapons. the incidence was very small and the enormous improvement was almost entirely due to the success of anti-typhoid inoculation. and there was little or no reduction of this figure during the greater part of the nineteenth century. vol. p. S. and by increased knowledge of the causes of disease. ix. Brcreton. In 1817 the mortality rate in the British Army in India was as high as eighty-seven per thousand. p.A. Along with Sir ALMROTH WRIGHT (1861-1932). a of devised staining the malarial parasite.

The writings of Larrey." 2 War. a G. 1897 Surgical Experiences in South Africa. The Surgery of Modern Warfare It is interesting to read the accounts of various campaigns which have been written by military surgeons who took part in them. Makins. which proved highly satisfactory in the Great War.MILITARY AND NAVAL SURGERY Army Medical College at Netley. preventing any serious epidemic. who saw much active In 1870 he published the first volume of his Medical service. in Sir GEORGE MAKINS (1853-1934). together with the earlier " " field hospitals in the South African treatment afforded by " " in the Great War. and whose name is closely linked with the discovery of vaccine therapy (p. Sir W. and he eventually prepared a vaccine from a triple source. his book being mainly a clinical study of the effects nature and On 1 the outbreak of the Great of injuries produced by bullets of small calibre. wrote an excellent work on Gun-shot Injuries in 1877. I* *s interesting to note that a large part of the volume is devoted to a description of various instruments for the location and removal of bullets. related his surgical experiences " South Africa. and by casualty clearing stations considerably lessened the suffering of the wounded. Three contemporary accounts of this new era in military surgery may now be mentioned. Even during the South African War the rifle remained the chief lethal weapon. and paratyphoid B. 1901 349 . however. 288). Leishman became Director-General two years before his untimely death at the age of sixty-one. surgeon Thomas's Hospital. a Deputy Director-General. and of Ballingall show clearly how dreadful must have been the terror of the battlefield in those early days. potent against the organisms of typhoid. Wounds in War. the Army Col. as they arc well worth reading. Leishman set himself to devise a system of inoculation against typhoid. war. and a third after the death of the writer. The introduction of antiseptics and anaesthetics. Stevenson. A second volume appeared in 1876. of Guthrie. 1 to St. paratyphoid A. Sir THOMAS LONGMORE (1816-95). London. Wholesale amputation was no longer practised. and saving many lives. F. and Surgical History of the War of the Rebellion. The American Civil War produced a historian in the person of GEORGE ALEXANDER OTIS (1830-81). The graphic descriptions by Ambroise Pare5 show clearly the nature of gun-shot wounds in his day.

the closed plaster method of treating compound fractures. as also was the procedure of excising wounds or removing the " bruised and torn edges by debridement. so that at the commencement of the greatest conflict in history mankind was confronted with " a form of warfare not only highly mechanized. The possibility that noxious gases New might be used led to a study of suitable defensive measures. while a similar procedure reduced to a minimum the danger of " " trench warfare in France typhoid fever. " " and more deadly explosives in aerial bombs gave rise to blast injuries of a nature previously unknown. Deaths from wounds now exceeded those from sickness. and trench foot." in the sense that every man. and which it is hoped will soon be adapted to the needs of peace. and taxed to the utmost the resources of the medical profession. but other new methods of destroying human life were also invented. which caused many thousands of deaths.A HISTORY OF MEDICINE Medical Department was faced with new and difficult problems new weapons and new methods of warfare. and the menace of tetanus and gas gangrene was met by preventive inoculation." Team work and had which of value in civilian practice. New modes of treatment were devised to meet the demand. the application of psychological tests in the assessment of fitness for service. The end of the Great War in 1918 was marked by a world. such as trench nephritis. and the injuries produced by shell-fire were much more dreadful than those caused by bullets. medical and surgical. Facilities for blood transfusion were organized on a large scale. were tried. were specialism. The issue of steel helmets reduced the proportion of head injuries. " During the period between the wars/' medicine and surgery continued to advance. proved occasioned by now adopted in military hospitals.wide epidemic of influenza. these are only a few of the advances in medical science which have appeared in time of war. and continuous irrigation of wounds with sodium hyposulphite solution by the Carrel-Dakin technique was introduced. New antiseptics. while vast developments in aviation created new problems relating to the health and efficiency of Air Force personnel. woman. The sulphonamide treatment of septic infections. 35<> . although the last-mentioned had been previously described by Larrey. such as flavine and various dyes. the discovery of penicillin . and child was potentially in the front line of battle. The new type of brought its own peculiar afflictions. trench fever. but also total.

most of them needless and preventible. he returned to London in 1783. 1 TOBIAS SMOLLETT (1721-71) had been a surgeon's mate. through the influence of William Hunter. Roy. Sir GILBERT BLANE (1749-1834). and then." 25 . Gilbert Blane and Thomas Trotter. ii. 72 351 . Nevertheless. 233) to the trying conditions under which seafaring men lived and worked in those early days. Drinker. Proc.. was appointed to the staff of St. graduated M. R. and the voice of the medical reformer was " that of one crying in the wilderness. p. Soc. Ser.D. he had now so high a reputation in the navy that throughout his life he was frequently consulted by the Government on matters concerning public health. and knew his topic from sad personal experience. vii. are now so many medical problems of to-day apply In the days of sailing ships the navy was confronted with of its own. 233) advised the use of fresh fruit and vegetables for the prevention of scurvy.. Ann. a native of Ayrshire and of difficulties . One need only read the vivid descriptions of life in the navy in the pages of Roderick Random to be convinced of the hardships. Roy.. as the two ^services. vol.. Med. Blane so distin- guished himself that he was appointed Physician to the Fleet.. F." Jour. p. Sir Humphry D. Hist. and in particular the health of the navy. p. vol. 31 1 " Medicine and Science in the Writings of Smollett. Although James Lind had in 1753 (p. the system was not officially adopted until Blane was in a position to enforce 1 E. Rolleston. After further active service in the West Indies.MILITARY AND NAVAL SURGERY Medicine and Surgery in the Navy Much of what has been said regarding the evolution of military medicine and surgery may be applied to the navy. which shortened the career of many a sailor. with the more modern Air Force. 1916. Med." Attention has already been drawn (p.R. 1925. studied in Edinburgh. Two of his immediate followers are worthy of attention. Med. vol. " Sir Gilbert Blane. Nav. Thomas's Hospital. 1937." " Doctor Smollett. together closely associated that to all three services.S. whose lectures he attended in London. Accompanying the Admiral to raise the siege of Gibraltar in 1779.D. at Glasgow. and setting up in practice as a physician. xxx. M. C. was appointed personal 2 physician to Admiral Sir George Rodney. well-to-do parentage. It is true that James Lind had already brought about some improvement his name must remain pre-eminent in the annals of naval medicine. Ashworth Underwood.

192 " Sir Humphry D. He advised. vol. a sort of encyclopaedia of naval medicine. Serv. 1785. manner as tobacco and slops. v. 1943." and that drugs and medical stores. Roy. gradually rising to become Physician to the Channel Fleet in 1 794. Trotter was a prolific writer on many subjects. Allison. which up to that time had been provided by the surgeon himself. he studied at Edinburgh. but have not attained success as ordinarily estimated. and other complaints. or the diluted rum. Nav. Rolleston." Jour. a fellow Scot. When the new came : fluxes. and in doing so he gave Lind full credit for his efforts. 1 R. of that time (1781) showed a sickness rate of one man in and a death rate of one in seven among the sick. in three volumes. the use of wine " " in place of rum. S. according to Sir Humphry Rolleston. The Story of a Great Natural Experiment in Preventive Medicine in the * Royal Navy. Previous to that date. scurvy. the appeared diseases of seamen appeared to fall into four categories fever. Sea Diseases. and practised in Newcastle until a few years before his death. although. known as grog he . " in the same urged that soap should be supplied to the men. Blane was made a baronet in 1812.1 834). Med. In dealing with scurvy Trotter took the view that crystallized citric acid was better than preserved lemon juice. entered the navy as surgeon's mate in 1779. into force. whose energy in promoting reform was no less energetic than his own. besides fruit and vegetables." His best known work is Medicina Nautica^ 17911803.. 412 352 . He retired from the navy in 1802. Gilbert Blanc's Observations on the Diseases Incident to Seamen." justly termed Blane had a colleague and contemporary. to take the place of shore hospitals. which were apt to be dreadfully overcrowded. a view which has been shared by others since his time.D. should be supplied at public charge. p. he was one of those "who have striven and deserved. and he received many other honours for his public services.A HISTORY OF MEDICINE it in 1 796. which accounted for his nickname of " Chilblain " among flippant colleagues. He urged that the war against scurvy. t 1919. He has been " The Father of Naval Medical Science. scurvy at once disregulation 1 from official the returns. Thomas Trotter. He also favoured the use of hospital ships. Blane outlined a plan for the better ventilation and cleansing of ships. No meteoric rise to power marked the career of THOMAS TROTTER 2 1 Born at Melrose. and he was a far-seeing and clear-headed reformer. and ( 760. p. His manner was somewhat austere. This we learn from Sir The navy fifteen. M.

he became sole Medical Commissioner to the Admiralty. It is a book. Medical Men as Explorers Since early times a number of naval surgeons have distinguished themselves as naturalists and explorers.) On the introduction of vaccination in 1798 he urged its advantages to the navy. vol. who was also the first American writer on naval medicine. which was used on a large scale even in recent years. including the Battle of Trafalgar. An able administrator. The first Medical Director-General of the Royal Navy was another Scotsman. " Sir 1 Sir Humphry D. New York. to Director-General of the Medical Department of the Navy. Roy.*' Jour. Serv. Rolleston. although his advice was not taken until 1858. Roddis. useful even to the naval surgeon to-day. in 1844. a fever which he regarded as miasmic in origin. Med. William Burnett.. Sir WILLIAM BURNETT ( 1 779-1 86 1). writing. After having been knighted in 1831. Trotter's advocacy of better hygienic conditions. He insistently demanded that the pay of seamen should be raised to a posed that level corresponding to that of soldiers. 181 (429) . as he did. p. 1 Joining the navy at an early age. Hisf efficiency and zeal led to rapid promotion. His chief contribution to medical literature was A Practical Account of the Mediterranean Fever (1814). and he pro(This was ' not done until 1857. i' L. The First Medical DirectorGeneral of the Royal Navy. he founded the libraries and museums at the two great naval hospitals. Nav. higher pay. Haslar and Plymouth.MILITARY AND NAVAL SURGERY so successful in the navy. 2 His Observations on the Means of Preserving the Health of Soldiers and Sailors compact and common-sense . A Short History of Nautical Medicine. seamen should be supplied with uniform. 1922. of which zinc chloride was the main ingredient. long before the discovery of Micrococcus Melitensis. The greatest medical pioneer of the American Navy was EDWARD CUTBUSH (1772-1843). 1941. and in 1801 he inspired a number of naval surgeons to present Edward Jenner with a gold medal. p. little appeared in 1808. H. Burnett's name is also associated with a disinfecting fluid. he served with distinction in a series of naval engagements. should be extended to the mercantile marine. and better food for seamen should ever be remembered in the annals of naval medicine. viii. later he was appointed Physician-General. a title which was changed to Inspector-General of Hospitals and Fleets. and finally.

Ainsworth Davis. the anatomist (p. Nov.M.. who commenced his distinguished career as a zoologist by acting as surgeon and naturalist aboard H. especially of the polar regions. p. Life of " Sir Rollcston.M. C..S. Rev.D. and then in the futile search for Franklin. Julian Huxley. Beagle.S. ed.A HISTORY OF MEDICINE Sir JOHN RICHARDSON (1787-1865)..S. Among his pupils at Haslar were many distinguished men.S.. Beagle (Captain Fitzroy. 1924. Cam- bridge. steadily engaged in literary work and in scientific study. Fauna BorealiAmericana. 1859. In 1848 he led the expedition which spent almost two years in a fruitless quest for Franklin. Huxley's Diary of the Voyage of HM. Incidentally. Roy.D. but the chief interest of his career was in his close association with Sir John Franklin. on a three years' survey of the sea between Australia and the Great Barrier Reef. 161 J.D. LL.) 3 other naval surgeons have distinguished themselves as ELISHA KENT KANE explorers." Jour. 1907 .M. 1933 354 . Barlow.. it is of interest to note that CHARLES DARWIN HENRY HUXLEY (1809-82). Richardson passed the last ten years of his life in retirement at Grasmere. LL. H. C.S. the Arctic explorer. J. a brother of John Goodsir. From 1838 to 1855 he was physician to Haslar Hospital. Rattlesnake.B. also inaugurated his life work by a voyage of five years in southern waters as naturalist to the expedition of H.B. and who. Sir John Richardson. who was born at Dumfries and who died at Grasmere. 271). R. x. profoundly influenced the trend of medicine by his work. 1935 1 N. whose views were strongly supported by Huxley. (1820-57). as Director of the Royal Gardens at Kew. Serv. Mcllraith. who succeeded his father. F. including Sir JOSEPH DALTON HOOKER (1817-1911). Many 1 Humphry D. As surgeon and naturalist he took part in three Arctic expeditions. of Charles Darwin's Diary of the Voyage of H.R. F. Sir William Hooker. ed.. of T. The Origin of Species. Thomas H. Huxley (English Men of Science). served in the naval medical service for forty-eight years. twice with Franklin.. and THOMAS 2 (i8i5~95). set sail in the Advance an naval American surgeon. though not himself a medical man.R.. The assistant surgeon who had accompanied Franklin on his last voyage was Harry Goodsir. vol. Sir John Richardson. Med. 1 He saw a good deal of active service afloat.S. The zoological collections of the first two voyages formed the subject of Richardson's great four-volume work. 1868 . M. Rattlesnake (Captain Owen Stanley).

to find Franklin. Tom Thumb. " Medical 875 G. son of the famous neurologist. sailed to Australia aboard H. surgeon. but was separated by the strait now known as Bass Strait. 2 Wilson was a noble and A few words may here be added regarding a few of the many medical men who have explored on land. A name both British naval surgeon. every part explorers nearly MUNGO PARK (1771-1806). 1 In a later voyage Bass and Flinders circumnavigated Tasmania. 933 355 ." the list be extended to include medical widely although might of of the world. naturalist. Accompanied 1 saintly figure.M. became the leader of two expeditions to the Antarctic. on the last voyage his vessel. and proving that Tasmania was not part of Australia. and himself a neurologist for a time. Jour. after a voyage to Sumatra as ship's surgeon. Seaver. Bass then set off on a voyage to South America in a trading ship of his own. which disappeared with Reliance. hailing from Lincolnshire. He explored North Polar regions as well . and in the Terra Nova in 1910. which ranks high among medical biographies of modern times. is a fascinating work. although only a small selection has been made from the long list. In more recent times JEAN CHARCOT (1867-1936). xxv. who accompanied Captain Scott in the Discovery in 1901. 1 Laurence Duncan. New South Wales in the and then extended his survey southwards in a whale boat with a crew of six. Edward Wilson of the Antarctic. offered his services to the African Association. The epic story of the second and last expedition is familiar to everyone.. by George Seaver. the scene of whose labours was The Dark Continent.S. Edward Wilson of the Men as Explorers. p." 1 Med. which had been formed to develop trade in West Africa. A final naval surgeon to be honoured as an explorer. 1938. and artist. Antarctic. is EDWARD all ADRIAN WILSON (1872-1912). of Austral. whose closely linked with that of his friend Matthew Flinders. vol. mapping six hundred miles of coast. returning thirty months Kane had been farther north than any previous explorer. a hands. explored part of the coast of tiny eight-foot craft.CONQUEST OF TROPICAL DISEASES in 1853 in an attempt later after terrible hardships. the Pourquoi Pas ? sank near Iceland and all were drowned. is GEORGE BASS (1763-1803). and had charted a thousand miles of new sea coast. It must suffice to " select two.

His exploration of the Zambesi. his disappearance for years in the heart of Africa. 2 Being determined to become a medical missionary. Blaikie. 1880 1 . Nevertheless. his meeting with H. who commenced his working life as a mill worker in Blantyre. and he may have been the prototype of Gideon Gray in The Surgeon's Daughter. Only five of the party remained alive when the river was reached. and in 1805 he sailed again for Africa with other forty-four Europeans in order to continue the exploration of the Niger. 1934 W. remedy No and work hard. his discovery of the Victoria Falls. Niger : Joseph Thomson. and in 1 799 he published an account of his travels. 1 35 6 . although as yet the trypanosome carried by the fly was undiscovered. M. Livingstone gives an account of the tsetse fly. Mungo Park and the Niger. almost worshipped by natives. Stanley. near Glasgow. 1 Although he did not attain this object. his death at Chitambo's village. but he was greater than any of them." Lewis Grassic Gibbon. news of the disaster reaching England some five years later. and of the diseases of horses and cattle. who had been sent to find him. The Personal Life of David Livingstone. 1890 The Life of Mungo Park. wonderful record inspired other explorers. On his return he practised medicine for seven years at Peebles. he collected much valuable information. and respected " Fear God even by Arab slave traders. resulting from its bite. Livingstone was the first to administer arsenic to horses as a " for the disease known as nagana." one has done more for African geography than this His missionary explorer during his thirty years of service. he spent over two years in searching for the source of the River Niger.A HISTORY OF MEDICINE only by two natives. where he was the friend of Sir Walter Scott. His simple motto was. he qualified in 1840 and offered his services to the London Missionary Society. and all were drowned in the rapids while escaping from hostile natives. are facts which build up a familiar and inspiring In his Missionary Travels and Researches in South Africa story. and his burial in Westminster Abbey. his efforts to track the sources of the Nile. G. (1857). Another medical explorer of undying fame was DAVID LIVINGSTONE (1813-73). the life of a country practitioner did not attract him.

" which expressed the same idea. Manson-Bahr and A. first in Formosa and Amoy. 1939. vol. where he demonstrated. 1 For centuries like flagellae. thread" " as he called them. The name " malaria " is derived from the view of its origin which was held for centuries. and was once much more widespread than it is to-day. and then in Hong Kong. and even in the nineteenth cen" " tury marsh fever was still to be found in the fens of Cambridgeshire and Lincolnshire. to sketch in broad outline the main discoveries. 151 P. now familiar to were then unknown. It is. Scott. that the disease was caused by noxious air Various observers had noted " particles of pigment " in the blood of patients suffering from malaria. p. i. The first definite proof of a relationship between insects and tropical disease was supplied 2 by Sir PATRICK MANSON (1844-1922). and the all. in 1877. fully proving the con- and it must suffice. The Life and Work of Sir Patrick Manson.. however. A History of Tropical Medicine. discovered the parasite in the blood corpuscles. were taken at night from human blood by the culex mosquito. the cause of elephantiasis and other lesions. A synonym was " paludism. H. It was prevalent in England in Sydenham's day. the increase of pigment. namely. and noted. 83). and in certain other districts. Malaria has been known since ancient times (p. the little circular body. then. The story of the gradual tropical diseases is tention that truth is stranger than fiction. It to confine our attention to three of the tropics may also be advisable main scourges of the malaria. yellow fever. for the purposes of the present work. first. and finally. a young medical officer of the French Army stationed in Algeria. 1927 357 .CONQUEST OF TROPICAL DISEASES The Conquest of Tropical Disease A century ago life diseases peculiar to warm in the tropics was full of danger. a lengthy and intricate tale. the extrusion of wavy. but it was not until 1880 that ALPHONSE LAVERAN (1845-1922). discovery of the cause and cure of certain curious and romantic. The countries were ill understood. how the embryos of the minute worm known as filaria. 2 vols. and sleeping sickness. and to glance at the lives of a few of the distinguished men who blazed the trail. means of preventing them. who spent twenty-four years in China. Alcock. a graduate of Aberdeen arising from marshy land. or oscillaria there had been a vague idea that insects played some part in transmitting malaria and other diseases. developed within the body University 1 2 H.

where he was employed as Medical Adviser to the Colonial Office. Ronald Ross. Hale. when infected mosquitoes sent from Italy to London were allowed to bite a healthy young man. p. Manson believed that the extrusion of flagellae. GIOVANNI GRASSI of Rome (1854-1925). 290 358 .White. Discoverer and Creator. Ross discovered the malarial parasite in the stomach of the spotted-winged mosquito. who was also celebrated for his studies in the histology of the nervous system. and there he worked almost to the end of his life. It was in 1894 that Manson met the young Indian army doctor who became Sir RONALD Ross (1857-1932). Megroz. and when three-of Manson's assistants lived in perfect health throughout the malaria season in a 2 Since that day. Gradually. and had observed that the stage bitten. was the only genus capable of transmitting malaria. on August 20. 1931 Sir W. notably in Italy. He founded the London School of Tropical Medicine in 1897. and were transmitted when another human subject Manson's paper on the subject." He explained his views to Ross. which. as proved in the following year by another ardent worker. and the conclusive evidence was supplied by Manson in 1900. has achieved wonderful results. the drainage of marshes. published in the Transactions of the Linnean Society in 1879. Great Doctors of the Nineteenth Century. who attacked the problem with enthusiasm. the screening of dwellings. but on his retirement from practice in Hong Kong a few years later he resumed his researches in London. L. had noted the difference between the parasites of tertian fever and those of quartan fever. was " a natural organic process in the life history of the parasite. then on leave from India. had confirmed Laveran's discovery. was received with incredulity. mosquito control. 1 1 R. mosquito-proof hut in the Roman Campagna. by the destruction of mosquitoes and mosquito larvae. 1897. 371). the life cycle of the parasite in man and mosquito was clearly traced. was of sporulation corresponded to that of the malarial rigor (p. with a view to its further development in some suctorial insect. and the distribution of quinine and specific synthetic drugs. which took place after the blood had been withdrawn from the human body. 1 Eventually. anopheles. 1935.A HISTORY OF MEDICINE of the insect. and showed him the parasite of malaria in the blood. By this time a number of observers. who developed malaria. Manson's son. although the problem of malaria is by no means fully solved. CAMILLO GOLGI (1844-1926).

the commission set to work with the co-operation of Carlos Finlay. i. former times it was confused with malaria.. YOUNG. Dominguez. like Lazear. 3 Reed was a young army surgeon with a keen interest in bacteriology who had studied under Professor William H. 4 as also did his colleagues. the rural form by other mosquitoes. H. New York. describes a ship smitten by the disease. Carroll acquired yellow fever after allowing himself to be bitten by an infected mosquito. G. 1 Coleridge. in his Ancient Mariner. Yellow fever is caused by an ultra-microscopic virus. 1906 A. when he succumbed. In 1 88 1 CARLOS FINLAY of Cuba (1833-1915). who was also bitten by a stegomyia mosquito. was studying yellow fever at Accra. Welch of Baltimore. JAMES CARROLL (1854-1907). who had already been working in Cuba. A. 1943 359 . Kelly. Scott. Docteur Carlos J. Eckstein. 2 vols. Walter Reed and Yellow Fever. Another name to be remembered in the story of the campaign against yellow fever is that of HIDEYO NOGOUCHI (1876-1928). 1 935 Howard H. 1931 New York. Thus it became proved that that of infected mosquitoes could transmit yellow fever. 2 Another noteworthy name in the history of yellow fever is WALTER REED (1851-1902). New York. who. fell a victim to the disease. t history.CONQUEST OF TROPICAL DISEASES Yellow Fever. 1939. Reed continued the work. and South America. a tale often paralleled in actual and many epidemics of past times have been recorded. in the West Indies. expressed his belief that yellow fever was transmitted by the stegomyia mosquito. . p. another deadly disease of the tropics. ADRIAN STOKES and W. although he was unable to produce definite evidence in support of his theory. vol. This brilliant investigator. No reference to the history of yellow fever 1 is complete with- 1 H. of Japanese birth and a pupil of Kitasato. He recovered. of which the urban form is transmitted by the striped or tiger mosquito known In as stegomyia or aedes. Truby. who was second in command under Reed. E. but Lazear. who had already done good work at the Rockefeller Institute. and who was sent to Havana in 1 900 as director of a Yellow Fever Commission. Memoir of Walter Reed : The Yellow Fever Episode. died of yellow fever after a few days' illness. and JESSE LAZEAR (1866-1900). West Africa. Nogouchi. Finlay. Paris. was at one time very prevalent in West Africa. A History of Tropical Medicine. and recommended preventive measures which were so successful that Havana was free from the scourge within a year. 279 F. Along with two other bacteriologists from Baltimore.

920). as compared with fourteen per thousand in the United States. the work was abandoned. but the mosquito. Malaria and yellow fever had produced a death rate of 1 76 per thousand. 1939. Wilson. 979 360 Philadelphia. Scott. who had so successfully completed the Suez Canal. The last fatal case of yellow fever occurred in 1906. with Colonel Gorgas in 2 Even then Gorgas had a charge of the medical department. after eight years. and even in 1920. largely on account of the unhealthy conditions which prevailed. William Crawford Gorgas : His Life and Work. when the canal was completed. A History of Tropical Medicine. Within a few years the death rate was greatly reduced. He became chief sanitary officer in Havana. and died after a few days' illness. for his in rendering habitable the deadly work membered. vol. . addressed himself to a similar task of canal construction at Panama in 1880. H. the great French engineer. D. Hcndrick. the Panama Canal Zone showed a general death rate of only six per thousand. Part of the plan adopted by Gorgas was to isolate every case of yellow fever in a mosquito-proof room. where it was his duty to apply the means of prevention which had been recommended by Walter Reed. hard fight to convince the authorities that it was not filth.A HISTORY OF MEDICINE out some mention of the work of WILLIAM CRAWFORD GORGAS l 1 His introduction to yellow fever was personal. and by 1914. sanitary brigades were organized on Support was forthcoming a large scale. 8 Gorgas did splendid work in organizing the army medical service of America during the Great War. In 1904 the Americans assumed control. 1 M. he applied the measures which had proved so effective in Cuba. Ferdinand de Lesscps. and fifteen per thousand in London. p. a vols.. 1942 (a history of the conquest of tropical disease and especially yellow fever) 8 H. and to institute a very thorough The name of Gorgas is chiefly reanti-stegomyia campaign. 1 ( 854. and which proved so highly successful. at the age of sixty-six. Ambassadors in White. however. Undeterred. Gorgas and B. He retained his energy to the end of his life. when he attended an International Congress of Hygiene in London. he was preparing to sail for the Congo to investigate a yellow fever epidemic when he was taken ill. as he was himself attacked by the disease while acting as an army surgeon in Texas in the early days of his career. New York. which spread most of the disease. Nevertheless. Panama Canal zone. M. 1924 1 C. J. . ii.

1 Assisted in all his researches tribute. and by checking the movements of infected natives. W. investigating on the Congo. A History of Tropical Medicine. to this JOHN EVERETT BUTTON (1874-1905). human blood in 1901 by by his Bruce showed that whose work he paid high trypanosome was conveyed by Next. which he was To return to the story of Bruce. that Europeans as well as natives are susceptible to sleeping sickness. refers to a fly called tsetse (Glossina morsitans) which was very "fatal to horses and cattle. he and his wife arrived in Uganda in 1903 in order to assist in the solution of the sleeping sickness problem. was also well known and widespread. and others. The fly disease of cattle. Subsequently Bruce found trypanosomes also in the blood. Together with Aldo Castellani. an army medical officer and an Edinburgh graduate who had already won a reputation for his investigations on Malta or Mediterranean fever. and towards the end of the nineteenth century it reached epidemic proportions. B. discoveries Into the further history of sleeping sickness. arrived in Natal to investigate nagana. Greig. the bite of the tsetse fly. Scott.CONQUEST OF TROPICAL DISEASES or Trypanosomiasis. 1018 361 . in his Travels. and who named the parasite Button unfortunately died in the folTrypanosoma gambiense. B. ii. and a barrier to " progress (p. 1939. The fly. p. he concluded. Gambia. and discovered in the blood of all the affected animals a protozoal parasite or trypanosome. In 1894 Sir DAVID BRUCE (1855-1931). mentioned. and there was no complex life cycle of the parasite as in malaria. or nagana. the means ol 1 H. E. Profiting by his studies and on nagana. Thanks to the labours of Bruce and his followers. of tick-borne relapsing fever. was a simple carrier. 356). LivingSleeping Sickness. lowing year. sleeping sickness is no longer a major scourge in Africa. H.. he showed that the tsetse fly was the carrier. Nabarro. apparently as the result of the extension of trade routes and increased facilities of travel. need only be briefly had been known in Africa for many years. The disease ' stone. Bruce con- who was working in firmed Castellani's discovery of trypanosomes in the cerebro-spinal fluid of sleeping sickness patients. 2 vols. This view was modified later by the work of Klein. and that the spread of the disease might be limited by the destruction of flies and their breeding places. a trypanosome was found in wife. which came to be known as Trypanosoma brucei. vol.

Sir GEORGE. 1890 362 . The in South Africa. F.A. 1929 THOMSON. 1924 1913 of Science). 1907 William Crawford Gorgas : His Life and vols. A Short History of the Royal Army Medical Corps. and ALCOCK. Ronald Ross. AINSWORTH. J. Lt. 1939 SEAVER. Mungo Park and the Niger.. H. B.A HISTORY OF MEDICINE reservoir for treatment.. T. M. Aldershot. BRERETON. Philadelphia. DAVIS. H. it is not proposed to enter. The Great War and the R. Medicine in the Royal Navy. The Life of Florence Nightingale. 1 906 LARREY. Sir E. S. A. HOWARD H.. Edward Wilson of the Antarctic. 1812 Paris. 1 943 The Personal Life of David Livingstone. Sir H. Col. MAKINS.M. R. FRED. GORGAS. New York. Work.. L. the possibility of big game acting as a the parasites. 2 Thomas H.. Discoverer and Creator. G. 1901 Patrick Life and Work of Sir Manson 9 1927 MEGROZ. A Short History of Nautical Medicine. S. B. and HENDRICK. 1 880 BLAIKIE. JOSEPH. A History of Tropical Medicine. Mdmoires de Chirurgie militaire et Campagnes. R. New York. Men KELLY. W. as sufficient has been said to indicate its place in medical history. Walter Reed and Yellow Fever.C. D. Surgical Experiences MANSON-BAHR. Nor need the story of tropical pathology be pursued further. 1941 SCOTT. P. and other problems still unsolved. COOK. 1933 SMITH. L. 3 vols. Huxley (English J.. its " " importance and BOOKS FOR FURTHER READING The Story of a Great Natural Experiment in PreSea Diseases. 1919 ventive ALLISON. 1931 RODDIS.-Col. BARON. 2 vols.

viruses. however distinguished. preventive medicine is itself a special branch of medicine. who is fortunately still with us. The need of rendering available to the public the benefits of specialized medicine has brought about an enlargement of all that is implied in the term. insulin. which important to-day. along which modern medicine has advanced and is still advancing. yet forgotten to-morrow. Some are ephemeral. Those two lines. one of the difficulties of presenting history is that of deciding at what point the narrative should cease. which will be read by our children and our grandchildren. penicillin. perhaps Others. or rather should be allowed to merge into what may field Deeds and be termed present-day knowledge. Thus. and indeed all events within living memory. as biography is concerned. of hormones. Nevertheless the events of to-day. do not immediately fall into their places in the epic of history. are not divergent branches of progress. and it is now in the hands of specialists. not yet written. and a host of other familiar discoveries must be told in the future. still less sanitation. our narrative of the march of medicine down the ages must include two important trends of recent years Specialism and Preventive Medicine. Conversely. "preventive medicine." which is no longer merely story The public hygiene. sulphonamides. may prove appear vahle to the next generation. when their integration into the general concept of medical science is complete. however. Perhaps the most logical solution of the problem. who have accepted the enormous responsibility of guiding and directing the entire medical profession in its efforts to serve the community. As for the spectacular medical discoveries of recent times. though it passed through those phases. so far. vitamins. discoveries of our time will be found in works on history. 363 . no in our to of to be of supreme be moment eyes.CHAPTER XIX THE RISE OF SPECIALISM AND OF PREVENTIVE MEDICINE THE of the historian steadily extends from day to day. at least. these are so well known that it would be superfluous to include them in this history. In the meantime. is to refrain from mentioning the name of anyone.

276) and others in what was called the by chemical physiology. the general practitioner remains the backbone of the medical profession. In this chapter. 71).A HISTORY OF MEDICINE Specialization in Medicine " general physician or general surgeon may hardly be said to exist. . who eventually succeeded Kussmaul at Strassburg (p. . it appeared among some of the greatest physicians during that period of intense activity about the middle of the nineteenth century. and published Der Diabetes 1898 in an important monograph. and advise a return to Hippocratic methods. There are some who deplore it as a decadent trait. One of the pioneers on the clinical side was BERNARD NAUNYN (1839-1925). 299). He was the 364 . and to Thomas Willis (p. of course. Applying the new chemical knowledge. 200). In medicine this tendency was probably more gradual and less obvious. although. Disorders of Metabolism The special study of Diseases of Metabolism was greatly assisted researches of Liebig (p. Medicine and surgery have become so highly specialized in years that recent the old-fashioned " . Naunyn carried the work a stage further. who first named the disease. with the patient more definitely in the centre of the picture. it is proposed merely to record the appearance of specialism in the nineteenth century. as it was a specialty from the first and remains so. diseases of psychology metabolism were elucidated by the growth of bio-chemistry pediatrics became no longer a mere side-line of general medicine. taking as examples a few of the lines which it has followed. Obstetrics pursues its even way. The history of diabetes may be traced back to the time of Aretaeus (p. in 1906. an assistant of Frerichs at Berlin. and its growth up to the present time. first. Nevertheless. to note the formation of acid in diabetic coma. however. Whether the subdivisions of medicine and surgery are a sign of advance and evidence of progress need not be discussed here. It was then that neurology became a distinct branch of medicine psychiatry received a powerful stimulus from the development of the new cardiology arose out of physiology . The dividing of surgery into various sections has already been discussed in a previous chapter. who noted the presence of sugar in the urine. to which he applied the term his results in mellitus.

the science of cardiology.. devoted much attention to the study of diabetes to the influence of diet on the condition. who recorded the electrical impulses of the heart. death. " Walter Holbrook Gaskell. In England the leading authority in the field was FREDERICK WILLIAM PAVY (1829-1911). Bartholomew's Hospital. the distinguished embryologist of Basel.SPECIALISM AND PREVENTIVE MEDICINE "acidosis. Garrison. was largely the outcome of various researches in physiology and in pharmacology. who noted the effect of nitrites in producing vaso-dilatation and in relieving the pain of angina This discovery he made while he was a young house pectoris. 279). Bernard Naunyn. 559 F. und Mrinungen. 1925 H. vol. 2 The development of cardiology was facilitated also by the work of Sir LAUDER BRUNTON (1844-1916). p. in conjunction with CHARLES HERBERT BEST (1899) and JOHN JAMES RICKARD MACLEOD (1876-1935). who became professor at Leipzig. an observation which led to the introduction of the electro-cardiograph and WALTER HOLBROOK GASKELL of Cambridge (1847-1914). Gedanken. of Guy's Hospital. 1914. . London. Munich." a attractive word now so widely used. Recently the entire outlook in diabetes has been altered by the discovery of insulin in 1922 by Sir FREDERICK BANTING of Toronto (1891-1941). who studied the " heartnerves of the heart. 1 CARL VON NOORDEN ' who succeeded Nothnagel and at Vienna. 1847-1914. ii. 365 . . Diseases of the Heart Our modern knowledge of diseases of the heart. Erinnerungen. who had been a pupil of Claude Bernard (p. he sought to show that the excess of sugar obtained by Bernard from the liver was a post-mortem change. a general practitioner of Kensington. Med." and who laid the foundation of our modern knowledge of the autonomic nervous system." Brit. Naunyn wrote an his autobiography which appeared in the year of (1858). 1 Jour. Among the physiologists may be mentioned WILHELM His (1863-1934). and that the part played by the liver in producing sugar from glycogen might be questioned. who was the first to apply the term block. Following the researches of his teacher. Pavy devoted his life to the study of this problem. physician to St. and who noted the myogenic nature of the heart beat AUGUSTUS WALLER (1816-70).

Perthshire. The introduction of percussion by Auenbrugger in 1761. and edited a System of Medicine. 258). studied the action of many drugs. lectures Brunton wrote in an attractive style. patrick Lectures on also made Sir William Osier at Oxford. with the aid of the sphygmomanometer. Accurate instrumental methods of recording the pulse. were gradually applied to clinical practice.A HISTORY OF MEDICINE physician (1867). In 1902 Mackenzie invented his polygraph. 8 1 For many Life years he was engaged in general of Sir Clifford Allbutt. 105 1 R. Sir Sir Humphry D. The Humphry D. which he preferred to digitalis as a cardiac stimulant. Rollcston. tended to focus attention upon such physical aids to diagnosis (p. who succeeded Christison as Professor of Materia Medica in Edinburgh. having been mere laboratory apparatus for years. and recording by its aid the brought order out of cardiac chaos of the irregularities. (p. He was. ARTHUR ROBERTSON CUSHNY of drugs upon use of digitalis. moreover. 1926 366 . 408). adding greatly to our knowledge of the sphygmograph. In this country the method was introduced by Sir THOMAS CLIFFORD ALLBUTT (1836-1926). and his Action of Medicines (1897) are still worth reading. 1928. 1929 since Cardiovascular : Diseases Harvey's Discovery (Harveian Oration). also the action studied (1866-1926). while others betokened grave disease of the heart. contemporary original observations on cardiology. many original contributions to the subject. as was shown by his Fitz" " His Greek Medicine in Rome (p. 407). a medical historian of distinction. and studied medicine arterial and jugular " pulses simultaneously in Edinburgh. on The Sir THOMAS RICHARD FRASER (1841-1920). p. an authority on cardio-vascular disease. was undertaken as a routine procedure by PIERRE CARL POTAIN of Paris (1825-1901). as he always sought to apply the lessons of the laboratory to clinical practice. A further step was taken when estimation of the blood pressure. Regius Professor of Medicine at 1 He made Cambridge. 2 Sir JAMES MACKENZIE (1853-1925). McNair Wilson. was born at Scone. Rollcston. such as the after Eraser's successor. The Great Physician The Life of Sir James Mackenzie. founder of a new era in cardiology. which enjoyed a wide circulation. including strophanthus." showing that certain forms were of little significance. the heart. and of auscultation with the stethoscope by Laennec in 1816.

J. Lancashire. which he continued to practise. which included the diseases of children who were no longer infants. for Mackenzie was fifty-four years of age when he left Burnley London. 2 He was one of the first to use the binaural stethoscope in the diagnosis of cardiac and pulmonary disease. Diseases of Children a special branch of medicine. he having approached the subject by the gateway of obstetrics. 1942. Another American physician who. Herrick. Springfield. and it was there that he applied himself to such problems as the mechanism of pain and the significance of irregularities of the pulse. 1 James Mackenzie. a disease which he had Hospital. digitalis. arose from two which comprised diseases of the new-born child. and he was the author of a number of valuable mono- graphs. p. during the Civil War. vol. 3 as sources obstetrics. 8 A Short History of Cardiology. he submitted. the condition of the myocardium should be the main guide in framing an opinion as to He also laid down definite rules for the use of the outlook. B. One of the first to devote his attention to pediatrics in London was CHARLES WEST (18161898). Diseases of the Heart > 1 908 111..SPECIALISM AND PREVENTIVE MEDICINE practice in the industrial town of Burnley. done much to elucidate. as well as appointment to the staff of the London He died of angina pectoris. neither of which. made a special study of functional disease of the heart in soldiers (a condition very common in the Great War) was JACOB DA COSTA of Philadelphia (1833-1900). and the Hospital for Pediatrics. In America one of the pioneers in cardiology was AUSTIN FLINT (1812-86) of New York. iii. who had been a student under Trousseau in Paris. need be viewed with alarm. One of the results of his investigations was to alter the attitude towards ^abnormal heart sounds (murmurs) and abnormalities of the heart's action. and general medicine. and his treatise on diagnosis was widely appreciated. Da Costa was recognized as one of the best teachers of his time. but such was his reputation that he soon acquired a large practice. 102 * Or paediatrics 367 . 1 The important factor in prognosis was the ability of the heart to react to increased effort . His Lectures on Diseases of Children (1847) became a standard work.

F. D. who published a Treatise on the Diseases of Childhood (1869) based on his original observations. who rendered valuable public service by his advocacy of a pure milk supply. was THOMAS MORGAN ROTCH (1849-1914). although. 685 1919. and his enthusiasm for his subject. l He greatly advanced the subject by his researches. H. In Germany the subject of children's diseases was developed by EDUARD HEINRICH HENOCH of Berlin (1820-1910)..A HISTORY OF MEDICINE Sick Children in Great Ormond Street was founded in 1852. 1 1 J. made him a popular figure with colleagues and students alike. 1830-1919. his textbook being widely read in Britain and America . vol. Hist. a German who settled there in 1853. Comric. vol. ii. and James Parkinson of London gave an account of paralysis agitans in 1817. P. By his work and writings he rendered noteworthy service to American medicine as also did his contemporary.. Another pediatrician of world-wide fame was JOHN THOMSON of Edinburgh ( 1 856-1 926). The first to occupy the Chair of Pediatrics at Harvard (1888). largely as a result of his labours. His quiet and kindly manner. History of Scottish Medicine. p. "Abraham Jacobi." Ann. whose work on infant feeding became the basis of all subsequent trics. and by his successor in the chair. researches. Garrison. Domenico Cotugno of Naples wrote a treatise on sciatica in 1770. ii. by ABRAHAM JAGOBI Neurology The study of nervous diseases became a specialized branch of medicine largely through the teaching and writings of the French school. 1932. who made many valuable contributions to pediaincluding a history of the subject as far as the eighteenth century (The History of Pediatrics .'94 368 . 1931). In more recent times an eminent physician to that institution was Sir GEORGE FREDERICK STILL (1868-1941). as already noted. an d w h continued to teach the subject for 2 forty-two years. Med. the subject had long engaged the attention of physicians. JOB LEWIS SMITH (1827-97). 2 vols. the French and Spanish translations were also in great demand. In America the study of diseases of children was promoted of New York (1830-1919). Robert Whytt of Edinburgh described tuberculous meningitis in 1 768. LEONHARD HEUBNER (1843-191^6).

diseases was the Lehrbuch (1840-46). including locomotor ataxia. good-humouredly. It is based on personal observation. 91 g 2 . and gives the first clear account of the ataxies. often at great Some of the physicians resented the personal inconvenience. to this study he devoted himself with great patience and energy. This branch of medical science owes much to GUILLAUME BENJAMIN ARMAND DUCHENNE (18061875). he studied medicine in Paris and returned to practise in his native town. Romberg's clinic at The first modern treatise der Nerven-Krankheiten t Berlin attracted many neurologist of later date Heidelberg (1840-1921). 1919. others. Menders of the (429) Maimed. then something of a novelty.SPECIALISM AND PREVENTIVE MEDICINE on nervous. There was thus revealed to him a new means of studying muscular action." l Born in Boulogne. Keith. Sir Arthur Keith one of the most remarkable figures which has ever appeared on the medical stage. He observed and described many diseases not then known to medical science. and he addressed himself to the self-appointed task. p. progressive muscular 1 Sir A. or at least viewed him with suspicion . regarded him as a harmless crank. intrusion of this unknown practitioner from the country. noting the significance of tendon reflexes. in treating the victims of chronic rheumatism who so frequently consult the youngest practitioner. however. and recording their progress. and refers to him as " . with no thought of self-advancement. to the subject. His tact and perseverance won the day. which he continued almost to the date of his death. and perfecting the technique of electro-diagnosis. but seeking only to extend the knowledge of neurology. that Another eminent German WILHELM HEINRIGH ERB of who made many original contributions students. studying the relation of syphilis to tabes. He had occasion to use the Faradic current. the son of a sea captain. He discovered that there was no need to puncture all that was necessary the skin in order to stimulate the muscles was to place a wet sponge on the terminals. he set out for Paris at the age of thirty-six. the work of MORITZ HEINRIGH ROMBERG (1795-1873). following up the patients. It is to France. After twelve years in Boulogne. who was content to wander for over thirty years in the history of hospitals of Paris. carrying with him the beloved battery which was to bring him fame. was we must turn for the early modern neurology. having acquired a modest competence. From that time until his death he haunted the hospitals.

1935. He showed how muscles never act singly.MARTIN CHARCOT (1825-93) served. but perhaps his greatest achievement was his great work. and studied peripheral nerve injuries during the Great War. Exper. contributed to the knowledge of aphasia. His fame has grown steadily since his death. and how the same muscle may subserve different functions. In Britain the pioneer of modern neurology was JOHN HUGHLINGS JACKSON ( 1 834-1 91 1 ). and bulbar paralysis. 268 " 370 . entered the field in more orthodox fashion and became one of the most famous teachers of the time. in a house which bears a tablet to his memory. his writings were precise and logical. and an inspiring leader.f. i . Charcot and the Salptottre. p. Duchenne did not attain fame during his lifetime . which appeared in 1867. Who described many new diseases of the nervous system. Although he was never a successful lecturer. One MARIE eventually becoming physician to that institution. Allen Starr. Pathol. " Memorial of Professor Jean-Martin Charcot. Queen Square) was founded in 1859 he became a member of the staff. studied medicine in London. 4th series. at the London Hospital. H.A HISTORY OF MEDICINE atrophy. vol. vol. but always in groups. JEAN. 1894. p. indeed.White. He explained the cause of acromegaly.T. 3 Born near York. and he in high esteem by his contemporaries. Physiologic des Mouvements. and when the National Hospital for the Paralysed and Epileptic (now National Hospital. His M. Early in his career he turned his attention to neurology. 1 Charcot's clinic at the Sal2 He was petri&re was the Mecca of neurologists the world over. vol. he spent his boyhood there. "Jean Martin Charcot. Other pupils of Charcot were JOSEPH JULES D&JERINE (18491917). a gifted orator. 81 Sir W. was held Jackson rendered great service to neurology. F.." Internal. of Charcot's most distinguished disciples was PIERRE (1853-1940). Hale. 1926. i ii.. N. some years elapsed before his views received the recognition they deHis contemporary. Garrison. Clinics. Med. and later on Physiology." Bull. known for his work on hysteria and for the reflex sign of toe movement which bears his name. Bernard Naunyn. and JOSEPH BABINSKI (1857-1922). For forty years he conducted a large consulting practice at 3 Manchester Square. who wrote an important work on the anatomy of the central nervous system as well as many clinical studies." Arch. a clear writer. Acad. and became lecturer on Pathology. Great Doctors of the Nineteenth Century. and he is still regarded as the ultimate authority 1 on many neurological problems. p. xxxiii. 1893.

His textbook on medical ophthalmology is illustrated by himself. and the syndrome known by his name. Jackson movements with lesions of the motor area of the A third matter to which he devoted much cerebral cortex. Weir Mitchell. and who devised improved methods of staining nerve cells and fibres. He confirmed the discoveries of Broca (p.D.D. The pioneer neurologist of the United States was SILAS WEIR MITCHELL of Philadelphia (1829-1914). and the Spanish researches * W. W. who investigated the finer microscopic details of the nervous system.S. Among his best novels are Hugh Wynne and Westwqys. and wrote a semi-popular treatise.. The clinical study of neurology was greatly assisted by the <i of laboratory workers. he had written an account of injuries to nerves. Memorial Addresses. Weir Mitchell also attained distinction as a poet and as a novelist. Keen and others. Sir WILLIAM RICHARD GOWERS (1845-1915). who described the tract in the spinal cord. S. Gowers was one of the first to recognize the importance of the ophthalmoscope in neurology. 1829-1914. F. Earlier in his career. 1914 371 . according to the level of the epileptic correlated such Hughlings Jackson was no mere theorist . the seat of the trouble was in the left cerebral hemisphere.SPECIALISM AND PREVENTIVE MEDICINE first researches concerned speech defects associated with lesions of the brain.. Fat and Blood large circle of readers and was translated into (1877) which had several languages. during the Civil War.R. M. and who submitted to division of his own radial nerve in order that he might observe the resulting phenomena. 333). Scarcely less renowned was Jackson's contemporary. whose name has been mentioned in connection with malaria. and low. now known as Jacksonian epilepsy. he illustrated his deductions by records of numerous cases. by showing how. Philadelphia. LL.. who introduced the "Weir Mitchell treatment" of certain types of nervous disease by rest in bed and strict isolation. who made notable studies of aphasia. More recently British neurology has been well upheld causative lesion in the central nervous system. in right-handed persons. most carefully observed. by Sir HENRY HEAD (1861-1940). The leaders of the movement were CAMILLO GOLOI (1844-1926). middle. * He made valuable contributions to neurology. Another problem which he solved was that of the localized movements. attention was the classification of pathological muscular movements as high.

enterprise did adoption of 1 much to alter public opinion. another for thirty-six years. was conducting an energetic campaign in favour of non-restraint. Philadelphia. and the success of the argument in all circles of society. SANTIAGO RAMON v CAJAL of Madrid (1852-1934). to Golgi and Ramon y Cajal in 1906. as it gives a picture of the medical life of Spain. who much to the knowledge of the histology of the central nervous system. trans. The new outlook upon " insanity " and " madness " was but slowly adopted. The Nobel Prize was awarded. Ramon y Cajal is the author of an interesting autobiography which is of special interest. H. He introduced the idea of the mental hospital. jointly. New York. and even in 1830 JOHN CONOLLY (1794-1866). 1 added so Among his other works is a collection of charming essays entitled Charlas de Cafe (Cafe Gossip). who accused him of harbouring refugees. It became a subject of heated While Pinel was still at work William Tuke. Craigic. Henry. and in which casehistories would be recorded and scientific investigations conducted. Pinel was a bold man to advise such reforms during the years of Revolution. who was not a medical man. and to hasten the humane treatment. at the Bicetre hospital of Paris. in which mental disease would be treated like other forms of disease. Zilboorg and G.3*9 A History of Medical Psychology. Madrid. W. 1937 G. for forty years. P. Psychiatry and Medical Psychology Nothing is more impressive in medical history than the change of attitude towards mental disease which has taken place within the past hundred and fifty years. 1941. formed the Retreat at York. and was rescued only by the intervention of a patient whom he had liberated. by E. Cajal. in Paris in 1792. a Quaker philanthropist. William Tuke's great-grandson. an institution designed to mitigate the unhappy fate of mental patients. Here there was no restraint and no chains. Recollections Santiago Ramon y of My Life. Pinel affirmed that the mentally sick should not be treated as criminals. 1921.A HISTORY OF MEDICINE scientist. physician to Hanwell Asylum. It was in 1798 that the noble-minded PHILIPPE PINEL (17451826) boldly advised removal of the chains which restrained insane 2 One had been chained persons. so little known and appreciated in other countries. 372 . and it is recorded that he was attacked by a mob.

p. Bettany. 1924 Sigmund Freud." 5 1 p. 1941 F. 1941. he did much to raise (p. "In Germany the leading exponent of psychiatry was EMIL KRAEPELIN (1855-1926). 3 His monumental textbook describes the two major groups of mental diseases the manic-depressive psychoses and dementia praecox. W. most of whose work was done at Munich. lived Vienna. Henry. the former usually curable.SPECIALISM AND PREVENTIVE MEDICINE DANIEL HACK TUKE (1827-95). and also a Yorkshireman. A History of Medical Psychology. An enlightened and scholarly man. An Autobiographical Study (Eng. and foreshadowed the present-day vogue for popular expositions of psychology. and discussed the connection of insanity with crime. W. and gave a salutary check to the materialistic tendencies of the age of SIGMUND FREUD (1856-1939). Strachey). New York. In like manner Freud. was an excellent teacher of psychiatry. Kraepelin's system is no longer adopted. 249). 450 : 373 . specialism. Zilboorg and G. His Textbook of Mental Diseases was widely used. altered the trend of medicine. 1 * * * G. Wittels. T. 422 G. New York. while his work on The Hygiene of Mind is full of salutary advice. 4 " In his who revolutionized his life most of in autobiography he tells us that in 1889 he realized that there could be powerful mental processes which nevertheless remained hidden from the consciousness of men. like many other diseases. ii. by viewing man from a zoological standpoint. had profoundly influenced the current of medical thought. Zilboorg and G. His many contributions to the subject Science. vol. trans. A History of Medical Psychology. the entire field of psycho-pathology. the status of his specialty in Britain and America. p. Eminent Doctors Their Lives and Work. 232 G. by his discovery of the unconscious mind. Sigmund Freud : His Personality. there was working in Charcot's clinic in Paris a young man who was destined to revolutionize psychiatry. studied medicine and became a He also was associated with the York Retreat * psychiatrist. 2 He wrote extensively on the mutual relationships of body and mind. the latter incurable. Sir THOMAS SMITH GLOUSTON (1840-1915) of Edinburgh. by J. was HENRY MAUDSLEY (1835-1918). Meanwhile. Darwin and Huxley. His Teaching. were published in the Journal of Mental of which he was editor. Henry. but he rendered good service by showing that mental disease follows a definite course. in 1885 to be precise. and His School. 1885. Another editor of this journal. 1935. and indeed to change the outlook in the whole field of medicine. who practised in London.

that there was no clear borderline between From this normal and abnormal psychology.S. 1 The G. as a refugee. Despite the opposition. p. were only slowly adopted. and of Quaker parentage. Gottingen. Somerset. F.. Freud's principles. Freud lived long enough to see his views widely accepted. 1 It was during his student days at St. The Young-Helmholtz theory of colour vision is well known. moreover. 1855 78 374 . and Cambridge. Previous to this time it had been believed that accommodation was effected by an elongation of the entire eyeball. THOMAS YOUNG (1773-1829) was undoubtedly the most versatile and learned physician of his day. Ophthalmology Although diseases of the eye had provided a field for specialism since the earliest days of medicine. although the end of his life was clouded.R. discovery of the ophthalmoscope by Helmholtz in 1851 was a strong impetus to the study of the eye. A native of Taunton. Life of 1 W. the nineteenth century witnessed an immense advance in our knowledge of this branch of medicine. and he died in London importance of the Freudian revolution is not To-day. The work of Helmholtz has been already described. and his ideas have assumed importance in almost every field of human activity. 2 After a further period of study at Edinburgh.A HISTORY OF MEDICINE " " idea Freud evolved his system of psycho-analysis and found that he could dispense with hypnotism.. Stirling. Somt Apostles of Physiology. he succeeded his uncle. 1902. whose name is often linked with that of Helmholtz. medical psychology is permeating all branches of medicine. and at first he was severely criticized on account of his preoccupation with sex psychology. Peacock. Thomas Toungt M. he was a precocious child with an insatiable thirst for knowledge. Young's communication on the subject secured for him the Fellowship of the Royal Society at the early age of twenty-one. and it may prove to be the activating factor of a new era in medical science. which he had been employing. his discovery of the unconscious mind was more important than any other in the whole history of mental disorders. The yet fully realized. and we may therefore turn to another distinguished pioneer. He showed.D. Bartholomew's Hospital that he discovered the effect of the ciliary muscle upon the shape of the lens of the eye. now so familiar.

His researches on the mechanism of the eye were followed by a series of lectures . vol. 1929. In 1846 he joined the staff of the Royal Ophthalmic Hospital at Moorfields.." Ann. He took up the study of optics where Newton had left it. 274). P-94 375 . 4 For many years he was the leader of ophthalF. 2 vols. in a fashionable London practice. 1924. while he part of King's College. The History and Traditions of the Moorfields Eye Hospital. Sir Michael Foster called him physiology of the kidney " the Father of the Kidney. and indicated how they might be corrected. 1935.on Natural Philosophy at the Royal Institution. Bonders devoted all his time to the practice and study of ophthalmology. Oldham. and Ophthalmologist. A man of great energy and diligence.SPECIALISM AND PREVENTIVE MEDICINE Dr. p. Thomas Toting. Sir William Bowman. Chance. 260 1 1 4 E." so greatly did he extend the knowledge . Philosopher and Phys ician. Eminent Doctors : Their Lives and Work. Young was a student of many subjects.. which occupied the later years of his life. a block of basalt discovered in Egypt in 1 799 which was transferred to the British Museum after the French capitulation (cf. In this work he differentiated the various errors of refraction. George's Hospital. was his interpretation of the hieroglyphic inscriptions of the Rosetta Stone. Buring the early his was Bemonstrator of Anatomy at career. p. vol. Worthy to stand beside Helmholtz and Young as a pioneer of ophthalmology was FRANZ CORNELIUS BONDERS (1818-89). 3 He also discovered the basement membrane of the cornea. and became physician to St. and contributed a number of papers on the subject to the Royal Society. F. The Anomalies of Refraction and Accommodation. He also wrote a number of articles on physics for the Encyclopaedia Britannica.S. which contained 1 many original ideas and afterwards appeared in print. Another of Thomas Young's achievements.White. ii. 177 . From 1862 until his death. of the microscopic structure of that organ. and from that time devoted all his attention to diseases of the eye. Physiologist. which bears his name. Anatomist. Hist. Bettany. 1885. T. whose great work. was published in English in 1864 and is the foundation of all subsequent studies. London. G. p. Brocklesby. the Professor of Physiology at Utrecht. and acquired an international reputation. Treacher Collins. Hale. 143 9 Sir W. p.R. 1933 " B. Med. Another physiologist who turned his attention to ophthal2 mology was Sir WILLIAM BOWMAN (i8i6-g2). vi.. he made a number of important discoveries relating to the minute structure of muscle and to the indeed. Great Doctors of the Nineteenth Century.

Archiv fur Ophthalmologie. and he perfected the operations of iridectomy and of removal of cataract. who made careful notes of his cases. 531. which did so much to raise the status of the specialty.762 ) " Von Graefe sign " in exophthalmic goitre and student in the the Von Graefe cataract knife. although the pioneer of the latter operation was JACQUES DAVIEL of Paris 1 1 The name of Von Graefe is familiar to every medical ( 696. there was an ophthalmologist of world-wide reputation. Comrie. becoming professor two years before his death from tuberculosis at the age of forty-two. Von Graefe founded the scopic findings. Bowman A contemporary British ophthalmologist was WILLIAM MACKENZIE of Glasgow (1791-1868)." The modern surgery of the eye was largely developed by ALBERT VON GRAEFE (1828-70) 2 son of the surgeon (p. Von Graefe spent all his short life at Berlin. 708 R.. 244 376 . where he was one of the first to employ A baronetcy was conferred on him in 1884. London. who devised many operations. and he was the first to recognize the importance of the ophthalmoscope and to describe ophthalmoAlong with Donders. He had an friends 1 and patients. including iridectomy for glaucoma and the linear extraction of the lens for cataract. the first to be appointed Lecturer on Diseases of the the introduced the treatment of lachrymal obstruction by the use of graduated probes. Major. and who wrote an important . Classic Descriptions of Disease. and was a great and America on several occasions. and wrote a Practical Treatise on the Diseases of Eye in 1830. H. In Edinburgh. at a slightly later period. Eye at the University of Edinburgh. DOUGLAS ARGYLL ROBERTSON (1837-1909). History of Scottish* Medicine. He made many original name is commemorated by the pupil reaction international practice. a keen observer. J. 1932. 2 vols. 342). 1932. As a teacher he acquired an international reputation. and his known as " Argyll Robertson pupil.A HISTORY OF MEDICINE mic practice in the ophthalmoscope. 1 D. visiting attractive personality and charm of manner attracted many textbook. His Britain traveller. 1 observations. to whose clinic came medical men from all countries. pp. Later in the century the greatest teacher of ophthalmology was ERNST FUCHS of Vienna (1851-1930). p.

who also " London practised ophthalmology. p. It to every otologist is that of whose Tractatus de aure humana ANTONIO VALSALVA (1666-1723). Treacher Collins. who deserves mention as the discoverer of tho artificial tympanum.SPECIALISM AND PREVENTIVE MEDICINE Otology and Laryngology Although otology has been recognized as a separate branch of medicine for little more than a century. 1845. and founded in 1805 the Dispensary for Curing Diseases of the Eye and Ears. 1874. basis Various efforts were made to