2. The physician shall not himself conduct an apothecary shop.

3. In each department of the kingdom two respectable men,

selected by the Faculty at Salerno, shall be assigned the duty

of furnishing sworn statements to the effect that all the

electuaries, syrups, and other preparations of drugs kept for

sale in a given apothecary shop, have been made according to the

established prescriptions and are offered for sale only in that

state.

4. In the case of those preparations which ordinarily do not

keep for a longer time than one year without spoiling, the price

at which they are to be sold shall be at the rate of 3 Tarreni

(about 30 cents) per ounce; while those which ordinarily remain

unchanged during a longer period, shall be valued at 6 Tarreni

per ounce.

At the time which we are now considering, it was not the custom, owing

largely to the expensiveness of writing paper, to deliver to the

pharmacist a written prescription. Instead, the physician first gave

his instructions in person, and then, after he had seen the mixing and

other steps of the apothecary’s work properly performed, he carried the

preparation to the patient’s house.

Long before the middle of the fifteenth century apothecaries had become

thoroughly well established throughout Central and Western Europe.

Among the statutes of the Medical Faculty of Erfurt, Germany, there has

been found one which dates back to the year 1412 and which says:--

The student of medicine, before he applies for the Bachelor’s

Degree, should spend one month in the spring of the year, in an

apothecary’s establishment, in order that he may familiarize

himself with the proper manner of preparing clysters,

suppositories, pessaries, syrups, electuaries and other things

necessary for a physician to know.

The first work which was really worthy of being termed a treatise on

materia medica was published in 1447. It bore the title, “Compendium

Aromatariorum,” and was written by Saladin of Ascolo, the private

physician of Prince Antonio de Balza Ossino of Tarentum. Berendes says

that it was a work of much practical value.

_The First Indications of the Beginning of Chemistry._--Up to a

comparatively recent date it has been customary to speak of Geber as

the first practical chemist and the first writer among the ancients

who appreciated the important part which chemistry was likely to take

in medicine and philosophy at no distant period of time. But to-day,

as appears from the researches made by M. Berthelot about 1893, we are

compelled to abandon the belief that such a person as Geber existed,

and shall have to adopt the more commonplace view that the science

of chemistry represents a gradual development from the much older

alchemy. We may define the latter branch of knowledge as the science

of transforming copper and brass into gold and silver. During the first

two or three centuries of the Christian era there existed a firm belief

that such a transformation had actually been accomplished, and in

confirmation of the correctness of this statement it may be said that

Zosimos of Panopolis, one of the leading philosophers of Alexandria

during the fourth century of the present era, and a man who was

considered by his contemporaries, as well as by all later alchemists,

to be perhaps the greatest authority in this branch of knowledge,

speaks in unmistakable terms in his cyclopaedic work on alchemy (28

volumes), of a certain tincture which possesses the power of changing

silver into gold, and also of a “divine water” or fluid which is

capable of effecting many different transmutations. There can therefore

be no reasonable doubt that in the earlier centuries of the Middle Ages

the learned men of Alexandria accepted alchemy as a well-established

agency of great power. From the sixth century to the thirteenth this

science was cultivated with great assiduity by the Arabs in the

academies which they established in Cordova and other cities of Spain;

and it was from the latter region that the belief in alchemy spread to

all the countries of Western Europe, gradually gaining strength up to

perhaps the fifteenth century.

It was during the thirteenth century that the so-called “philosophers’

stone” came to be considered the most effective agent in transmuting

the baser metals into silver and gold, and there were not a few who

even believed that this as yet non-existent stone possessed the power

to increase longevity, to confer health, and to give a prosperous

issue to one’s undertakings. It was not the rabble, but the very

best and most highly educated men in the community who, during the

thirteenth century, took the most active interest in alchemy and the

philosophers’ stone. Arnold of Villanova, Raymund Lullus, Roger Bacon,

Albertus Magnus, and, to a lesser degree, the famous theologian Thomas

Aquinas were all believers in the art of the magician. And even more

extraordinary than this is the fact that in Germany men of this stamp

continued for two or three centuries longer to cherish a belief in the

reality of alchemistic processes. Even Martin Luther (1483–1546), the

great reformer, did not hesitate to express his approval of “the black

art,” as is shown by the following quotation from one of his writings:--

The art of alchemy is commendable and belongs in truth to

the philosophy of the ancient wise men, a fact which pleases

me greatly, not merely because of the intrinsic merits and

usefulness of the art in the matter of distillations of

vegetables and oily fluids and sublimation of metals, but also

because it serves as such a noble and beautiful symbol of the

resurrection of the dead at the last day of judgment. (Berendes.)

Another celebrated character who dabbled in the black art was Johannes

Faust, who was born in 1485, obtained his degree of Bachelor of Arts at

the University of Heidelberg, and died in 1540 in Staufen in Breisgau.

Professor Scherer of Berlin says that “he was a great braggart, never

failed to create a sensation wherever he went, and had the conceit and

effrontery to pass himself off as a scientist among the learned men of

his day. He called himself the philosopher of philosophers, a second

Magus. He maintained that he was both a physician and an astrologer,

and claimed that he could restore the dead to life, and could predict

future events from a mere inspection of fire, air and water.”

But although the persistent and wonderfully energetic activities of

the alchemists failed to find the philosophers’ stone, or to transmute

the baser metals into silver and gold, they placed in the hands of man

the key to a knowledge of chemistry, that branch of science which was

destined in later years to play such an important part in pharmacy,

in agriculture and in other industries. Thus we owe to alchemists the

discovery of many processes and the invention of many apparatus which

serve as the groundwork of modern chemistry. Some of the more important

of these are the following: The use of the spirit lamp; the invention

of tubular retorts; the production of potash and soda by burning

the hard deposit which collects in wine casks as well as various

marine plants; the oxidizing of certain metals (iron, lead, copper,

quicksilver and antimony); the making of metallic arsenic, of wine of

antimony, of sulphate of iron, of chloride of silver, of acetic acid

and of many other chemical products; the purification of metals by the

use of lead, etc.

_Supplementary Data Relating to Balneotherapeutics._--I have

referred to this subject on several occasions in the course of the

earlier chapters of this history, but always without entering very much

into details. This policy was adopted, partly because the facts upon

which a satisfactory sketch of the growth of balneotherapeutics might

be based were not very numerous, and partly because of the necessity of

gaining space for more important matters.

The principal facts to which I made reference were: First, that before

the Christian era the employment of baths in a variety of different

ways for therapeutic purposes was universal in the East; and, second,

that in the city of Rome during the centuries immediately following the

birth of Christ, facilities for this kind of treatment were provided

on a most lavish scale--as in the baths of Agrippa (27 A. D.), of

Titus (79 A. D.), of Caracalla (211 A. D.), and of Diocletian (302 A.

D.). I may now add that the warm springs of Aachen (Aix-la-Chapelle),

Baden-Baden and Wiesbaden, in Central Europe, and Bath, in England,

were known to the ancient Romans, and were utilized by them to some

extent for therapeutic purposes; but it was not until a much later

period that they and the less well-known springs of Schwalbach,

Driburg, Warmbrunn, Goeppingen and Gastein began to be actively

frequented for remedial purposes. By the beginning of the sixteenth

century it had become a very popular thing for sufferers from all sorts

of ailments to resort to these and other European springs. The history

of the therapeutic employment of mineral waters belongs, however, to

the period of modern medicine rather than to that which I have been

considering in the present volume.

PART III

MEDICINE DURING THE RENAISSANCE

CHAPTER XXVI

IMPORTANT EVENTS THAT PRECEDED THE RENAISSANCE--EARLY ATTEMPTS

TO DISSECT THE HUMAN BODY

_Important Events Immediately Preceding the Renaissance._--Three

hundred years before the Christian era Erasistratus and Herophilus

made, at Alexandria, Egypt, an attempt to develop a correct knowledge

of anatomy by means of dissections of human corpses, but the political

and religious conditions at that time were not favorable to scientific

work, and therefore the success attained was of a very restricted

character. Then, during the succeeding three or four centuries, this

early movement gradually died out, and no further contributions to

our knowledge of human anatomy were made until toward the end of the

second century of the present era, at which time Claudius Galen, a

man of giant intellect and tireless energy, did his best to supply

the anatomical knowledge so urgently needed. But the deeply rooted

prejudices of that age against dissections of the human body lay like

an insurmountable barrier across his path and forced him to confine his

efforts to the dissection of those animals whose bodily construction

resembled more or less closely that of man. Galen believed that the

anatomy which he thus evolved for the guidance of his professional

brethren would satisfy all their legitimate wants of this nature,

and he proceeded to build upon this faulty and unstable foundation

an equally faulty physiology. History records the extraordinary fact

that Galen’s belief in the sufficiency of his anatomy and physiology

for all the reasonable needs of physicians and surgeons was so well

grounded that during the following thirteen or fourteen centuries

nobody dared to cast the slightest suspicion upon the trustworthiness

of these foundations of the science of medicine. Then followed, during

the fourteenth and fifteenth centuries, an awakening which seemed to

affect all departments of human activity. This movement, which is

commonly termed the “Renaissance,” developed at first very slowly, and

reached a noteworthy degree of momentum only toward the middle of the

fifteenth century, about which time there occurred several events that

contributed greatly to strengthen and perpetuate the movement. Such

were, for example, the employment of gunpowder in the wars of Western

Europe; the invention of a method of manufacturing paper--a discovery

which led to the abandonment of the much more expensive parchment, and

prepared the way for the invention of printing in its different forms;

the taking of Constantinople by the Turks in 1453; the discovery of

America in 1492; and, finally, the Reformation inaugurated by Martin

Luther. Let us pass in review very briefly each of these events, in

order that we may the better appreciate how the science of medicine,

in the short space of time represented by a couple of centuries, made

a greater advance than it had previously made in the course of several

hundred years.

The employment of gunpowder in warfare robbed the knight of the

protection which he had previously enjoyed from the wearing of metal

armor, and thenceforward his life was as much imperiled in battle

as was that of the foot-soldier, who was not permitted to protect

his person in this manner. Thus were the two upper classes of the

community, the nobles and the bourgeois, in any conflict which might

arise between them, placed more nearly upon a footing of equality. The

ultimate result showed itself in an increased importance, an increased

prosperity, of the middle class or _bourgeoisie_, from which the

physicians chiefly came. Indeed, feudalism from this time forward

rapidly ceased to exist.

The discovery of paper, an excellent and relatively cheap substitute

for parchment, facilitated wonderfully the spread of knowledge.

Parchment, the material upon which books were written, was expensive

and was at times difficult to obtain; both of which circumstances

rendered books so costly that only a few physicians were able to

become the owners of the important standard medical works of that

period--such, for example, as the Hippocratic writings, Galen’s

treatises, the surgical manuals of de Mondeville and Guy de Chauliac,

the pharmacopoeia of Dioscorides, and still other books of lesser

value. And, if a satisfactory method of manufacturing paper had not

first been discovered, the benefits growing out of the invention of

printing in 1467 would have been far less than they actually proved to

be. Some idea of the magnitude of these benefits may be formed from the

following statement of facts. The demand for books, after the invention

of printing, became so great that the presses were kept almost

constantly busy. At first, according to the record furnished by Haeser,

Venice and Rome took the lead in supplying this great demand for books;

the former city printing 2978 and the latter 972 volumes between the

years 1467 and 1560; but, during a later period (1500–1536), Paris

outstripped Venice with a total of 3056 volumes, and Strassburg

advanced to the second place with a showing of 1021 volumes printed

during the same period of time. Thanks to the great diminution in the

market price of books that resulted from the two inventions named--the

manufacture of paper and the introduction of printing--almost every

physician in fairly prosperous circumstances was able at that period

to purchase the relatively few medical treatises which issued from the

presses; and, besides, new authors were thenceforth stimulated to put

their experiences into print.

Among the very first medical books printed the following deserve to be

mentioned:--

(In Germany.) _Buch der Bündth-Erznei_, by Heinrich von

Volsprundt, 1460.--_Das buch der wund Artzeny. Handwirckung

der Cirurgia von Jyeronimo brunschwick_, 1508.--_Das

Feldtbuch der Wundtartzney_, by Hans von Gerssdorff, 1517.

(In Italy.) _Avicennae opera, arabice_, 1473.--_Guillelmi

de Saliceto cyrurgia_, 1475. (A French translation was

published at Lyons in 1492.)--_Celsi de medicina liber_,

etc., 1478.--_Guidonis de Cauliaco cyrurgia_, 1490. (A

French version was printed in Lyons in 1498.)

(In France.) _Christophori de Barzizus de febribum cognitione

et cura_, 1494.--_Bernard de Gourdon, traduction de son

“Lilium medicinae,”_ 1495.

When Constantinople fell into the hands of the Turks in 1453, many of

its Greek inhabitants, and particularly those belonging to the more

highly educated classes, fled to Western Europe in order to escape from

the tyranny of the invaders. Not a few of these refugees brought with

them to Italy and France copies of the works of the classical Greek

authors, and on this account, as well as because of their willingness

to give instruction in their native tongue, they met with a cordial

welcome wherever they took up their new abodes. Their arrival in

Italy happened at a most propitious time, for the interest in Greek

literature was at that period just beginning to develop among Italian

scholars. Previously, Greek had been an almost unknown tongue in Italy.

Petrarch, for example, is reported to have said in 1360 that he did

not know of ten educated men in that country who understood Greek; and

there is no evidence to show that the number of such men increased

between 1360 and the time when the refugees from Constantinople

arrived. Many of the works of greatest importance to physicians--such,

for example, as the writings of Hippocrates, of Galen, of Rufus

of Ephesus, of Oribasius, of Alexander of Tralles, and of several

other classical medical authors of antiquity--were accessible (in

the original) only to those who were familiar with the Greek tongue.

Consequently the arrival of these refugees from Constantinople

constituted a most important event in the history of European medicine.

The discovery of America by Christopher Columbus in 1492 owed its

origin in part to the restless spirit of adventure which was abroad

in Spain and Italy at that time, and also, in perhaps still larger

measure, to the hope of gain which might be expected to follow the

discovery of a shorter and more direct route to India. As regards the

attainment of the latter object, the great explorer failed, but his

discovery of a new continent resulted eventually in bringing great

wealth to the rulers of Spain, in stimulating maritime commerce, and in

broadening men’s views with regard to every phase of human activity.

The addition of a few new drugs to the pharmacopoeia was a further

result of some importance. Luther’s efforts to reform the government

and doctrines of the Church undoubtedly gave a great impetus to the

Renaissance and therefore to the growth of the science of medicine.

Men learned to use their reasoning powers with greater freedom, and as

a result our knowledge of the structure of the human body (anatomy)

and of the working of its complicated machinery, both in health

(physiology) and in disease (pathology), made astounding advances. And

it is to the consideration of these fundamental branches of medical

knowledge that we must now turn our attention.

_Early Attempts to Dissect the Human Body._--Already as early as

during the first half of the fourteenth century physicians began to

appreciate the fact that further progress in the knowledge of medicine

was not to be attained otherwise than by a more profound study of human

anatomy than had been made up to that time; and they realized that it

was only by means of actual dissections that this more profound study

might be made. Various influences, however, co-operated to hinder such

study. In the first place, the people at large were thoroughly imbued

with the idea that dissecting a human corpse was an act of desecration,

and consequently it was by no means safe for a physician to do any

work of this character except in the most secret manner. Then, in

addition, it was commonly believed-and this belief persisted even up to

a comparatively recent date--that the bull which Pope Boniface VIII.

issued in 1300--and which declared that whoever dared to cut up a

human body or to boil it, would fall under the ban of the church--was

intended to cover dissections for purposes of anatomical study. The

recent investigations of Corradi, however, show (Haeser, p. 736 of the

third edition) that this bull was not intended to apply to dissections

for scientific purposes, but simply to put an end to the practice of

cutting up human corpses and boiling the separate sections in order to

obtain the bony framework in a condition suitable for transportation

from Palestine to Europe,--a practice which had grown to be very common

among the Crusaders.

Mondinus’ “Anatomy,” which was published in 1314, reveals the fact

that, during the early part of the fourteenth century, several private

dissections were made. As might be expected, from the primitive

character of the illustrations that accompany the text of Mondinus’

work, these dissections were carried out in a very imperfect manner,

for--to mention only a single example--this author admits that he made

no attempt to investigate the deeper structures of the ear, as such

an examination would necessitate the employment of violent measures,

“which would be a sinful act.”

The archives of the Bolognese School of Medicine contain an item which

reveals the active interest taken in anatomy by the students of that

day. It reads as follows: “At Bologna, in 1319, several of the Masters

stole from a grave the corpse of a woman who had been buried two days

before, and then turned it over to Master Albertus to dissect in the

presence of a large number of students.” At the Medical School of

Montpellier, in the south of France, the Faculty obtained permission

in 1376 to dissect the corpse of an executed criminal once every

year; and the records show that the school actually availed itself of

this privilege in the years 1377, 1396 and 1446. Felix Platter, who

afterward became one of the most distinguished physicians of Basel,

Switzerland, pursued his early medical studies at the latter university

during the years 1552–1557; and, in the diary which he faithfully

kept during this period, he reveals in an interesting manner what

difficulties as well as dangers he experienced, first, in reaching

Montpellier from his home in the eastern part of Switzerland, and,

second, in obtaining greater opportunities for acquiring a genuine

knowledge of anatomy than the school itself afforded in its official

course. Although, owing to lack of space, I shall not be able to quote

in full the appropriate portions of this most interesting narrative, I

will furnish an abridged English translation of the story as it appears

in Platter’s journal or diary. In all its more important details the

account reads as follows:--

Our little party was composed of three persons, viz., Thomas

Schoepfius, the schoolmaster of St. Pierre; a Parisian by

the name of Robert who happened to be passing then through

Basel on his way to Geneva; and myself, a lad of sixteen. We

traveled on horseback and all three of us were armed with

rapiers. My outfit, which was handed to me by my father shortly

before our departure, consisted of two extra shirts and a few

pocket-handkerchiefs, wrapped up in a piece of waxed cloth.

In the matter of funds for the journey I received from my

father three crowns in silver and four gold pieces which,

for further security, he sewed into my vest. In addition,

he presented me with a rare piece of silver money which had

been issued by the Cardinal Mathieu Schiner, of the Canton de

Valais, who personally commanded the Swiss soldiers in their

successful combat with the troops of Louis the Twelfth, at

Marignan. It was a coin, therefore, which possessed considerable

historical value. My mother also bestowed upon me a gold coin (a

_couronne_). As a last injunction my father begged me not

to forget that, in order to procure the money which he had just

placed in my hands, as well as that which he had already paid

for my horse, he had been obliged to mortgage his property.

We left the city at nine o’clock on the morning of Oct. 10th,

1552, and at the same moment the news reached us that the Plague

had made its appearance in Basel. This was a most depressing

piece of intelligence, especially as we were already in great

fear that the army of the Emperor Charles the Fifth, which was

at that time on its way to the siege of Metz, would utterly

destroy our city.

We arrived at Berne early on the morning of Oct. 12th, and,

after leaving our horses at the inn, The Falcon, lost no time

in visiting the objects of interest in that ancient city, not

forgetting the bear pit, in which there were at that time six

of these creatures. In the afternoon we resumed our journey

toward Fribourg, and very soon overtook a newly married couple.

As they were traveling on horseback like ourselves, and were

following the same route for a certain distance, we all agreed

to keep together. While passing along a shady part of the road

the bride’s dress became so firmly entangled in the branches of

an apple tree that, failing to stop the horse, she was left

suspended in the air by her skirts. I immediately dismounted and

helped her to regain her feet, to adjust her disordered dress,

and to resume her seat in the saddle. On arriving at Fribourg

we put up at the inn called _La Croix Blanche_, and soon

discovered that almost everybody in the town spoke French, a

language with which Thomas and I, who were Germans, were not

familiar; but, thanks to our companion Robert, the Parisian, we

experienced no difficulty whatever in making all our wants known

and in securing all the information that we desired.

On the following day, Oct. 13th, it was raining hard when we

left Fribourg, and we were soon wet to the skin. After passing

through several small villages we stopped for refreshment at

an inn in the picturesque town of Romont, and at the same time

availed ourselves of the opportunity to have our clothes dried.

Then, having satisfied our appetites, we resumed our journey

in the direction of Lausanne; but we did not get very far on

our way before we discovered that Thomas had disappeared. We

were of course obliged to wait for him, and, by the time he had

rejoined the party, darkness and a thick fog combined to render

further progress very difficult, and we soon realized that we

had lost our way. We wandered up and down for some time without

encountering a barn or building of any kind in which we might

find shelter from the rain and secure a measure of protection

from the robbers who, according to common report, infested that

part of the country. Finally, however, we discovered a small

village; but, when we applied for a night’s lodging, not one

of the householders was willing to receive us. So we engaged

the services of a young peasant to act as our guide, and with

his assistance we finally reached a mean-looking inn in a

village called Mézières, which was composed of a few widely

scattered houses. We entered the tavern and found several

Savoyard peasants and some beggars seated at the long table of

the bar-room; they were engaged in eating roasted chestnuts and

black bread, which they washed down with copious draughts of a

liquor called _piquette_. They unceremoniously examined

our weapons and acted with great rudeness toward us in other

respects. The woman who kept the house said she had no other

room which she could place at our disposal, and our first

impulse therefore was to resume our journey immediately after we

had finished our meal of black bread and chestnuts; but, after

careful reflection, we came to the conclusion that such a course

might prove fraught with considerable danger. So we decided to

remain awake and watch for an opportunity to make our escape.

Very soon afterward these half-intoxicated men lay down on the

floor before the fire in the adjoining hall-way or vestibule

and fell into a sound sleep. Our guide then confessed to us

that, while at work in the stable, he had heard them planning

to waylay us on the highway at an early hour of the following

day. As soon, therefore, as we heard them all snoring lustily

we very quietly slipped out of the house. Our score having

already been paid earlier in the evening, and our horses having

been left saddled and bridled in the stable, we mounted and

took our departure by a road which led at first in a direction

different from that in which we were supposed to be traveling.

We experienced no further trouble on this part of our journey

and in due time reached Lausanne. When we told the people at the

inn about our experience at Mézières they replied that we might

consider ourselves most fortunate, as almost every day there

occurred, in the forest through which we had passed (_la Forêt

du Jorat_), a murder or some other deed of violence.[72] It

was plain, therefore, that we had had a narrow escape from death.

In the further course of our journey along the north shore

of the lake we reached the city of Geneva on Oct. 15th. When

I called upon John Calvin, to whom my father had given me a

letter of introduction, he said to me: “My Felix, you arrive at

the right moment, for I am now able to give you an excellent

traveling companion for the remainder of your journey--_to

wit_, Dr. Michel Heronard, a native of Montpellier.” This Dr.

Heronard, as I learned subsequently, was a Protestant who played

a prominent part in the religious disorders which, a few years

later, greatly disturbed the peace of that city.

On the 30th of October--just twenty days after we set out from

Basel--we entered the city of Montpellier, and I lost no time

in hunting up Laurent Catalan, the apothecary, at whose house I

expected to reside during my stay in that city.

Platter had now, after a long and dangerous journey, reached one of the

three greatest medical schools of that period, and it was his hope

and expectation that he would here be able to acquire a correct and

intimate knowledge of human anatomy. He was already aware that this

knowledge could be satisfactorily obtained in only one way--that is,

by dissecting the human body; and accordingly he availed himself of

every possible opportunity, during the five years which he spent at

Montpellier, to accomplish this purpose. From the somewhat superficial

examination which I have made of the record furnished by the diary,

it appears that only five or six official lessons or demonstrations

were given by the professor of anatomy during the period of time

named; but--as every student of medicine knows--instruction of this

character is of relatively small value; and Platter himself seems to

have realized fully the truth of this statement, for during the second

year of his stay at Montpellier he joined a secret band of nocturnal

grave-robbers who were determined at all hazards to obtain the material

needed for self-instruction. The following brief description of one of

the raids made by this band of eager searchers after knowledge will

convey a good idea of the manner in which the work was conducted:--

Our first excursion of this kind was made on Dec. 11th, 1554. As

soon as it was really dark our fellow student Gallotus guided

us, along the road that leads to Nîmes, to the Augustinian

Monastery, which is situated about half-way between Castelnau

and the Verdanson brook. Here we were received by a monk called

Brother Bernard, a bold and determined fellow, who had disguised

himself for the business in hand. At midnight, after we had

partaken of food and drink, we started out, sword in hand, for

the cemetery which is located close to the church of Saint

Denis. Here we dug up with our hands a corpse which had been

interred that very day; and, having lifted it out of the pit by

means of ropes, and wrapped our cloaks around it, we carried the

body on two canes as far as Montpellier. Then, having concealed

our load close to the postern, alongside the city gateway, we

summoned the keeper and begged him to get us some wine, as

we were dying of thirst and very tired. While he was absent

in search of the wine three of our party slipped in through

the passage and carried the corpse safely to Gallotus’ house,

which was only a short distance from the gate. The gate-keeper

returned in due time with the wine, and did not appear to have

the slightest suspicion of the trick that we had played upon

him. It was now three o’clock in the morning.

The control exercised by the authorities over the practice of

dissecting human corpses differed very appreciably at different dates

in different parts of Europe. Thus, for example, orders were issued to

the Italian bishops during the latter part of the fourteenth century to

put a stop to further dissections, and for a period of over one hundred

years these orders accomplished the purpose desired. On the other

hand, the Emperor Charles the Fourth adopted a more liberal course:

from the year 1348 on he permitted dissections of human corpses to be

made without hindrance in Prague, Bohemia, but his liberality in this

particular appears to have been of little use, for there is no evidence

to show that the knowledge of anatomy made any appreciable advance

anywhere in Europe until after the beginning of the sixteenth century.

Gabriel Zerbi of Verona (1468–1505) published at Venice in 1502 the

first modern treatise on human anatomy that deserves to receive special

mention. Pagel speaks of it as containing fairly good descriptions of

different parts of the body. Zerbi held the Chair of Medicine, Logic

and Philosophy in the University of Padua, and lectured first in that

city, next at Bologna, and finally at Rome. One incident in his career

may prove of interest to the reader as showing the fearful risks to

which a practicing physician in those days was sometimes exposed. The

incident was of this nature:--

A wealthy pacha in Constantinople, failing to obtain relief from

his malady at the hands of the native Turkish doctors, summoned

an Italian physician from Venice. Zerbi, whom the ruling

Doge invited to accept the summons, sailed immediately for

Constantinople in company with his two sons who were mere lads.

The treatment which he inaugurated proved promptly successful,

and Zerbi, having been handsomely remunerated for his services,

was already on his way back to Venice when his ship was

overhauled by a swift-sailing caique on board of which were

the sons of his recent patient, who--as the story goes--had

celebrated his recovery by eating and drinking to excess.

This debauch promptly caused his death--probably by cerebral

apoplexy; but the sons were convinced that it was the result of

poison administered by Zerbi, and accordingly they lost no time

in starting out to capture the supposed murderer. Their first

act, on reaching the vessel which they were pursuing, was to

kill the younger of the two sons, in the presence of the father,

by sawing his body in two lengthwise. Then they killed Zerbi

himself in the same manner.

Tiraboschi, the first historian of Italian literature (1731–1794), is

mentioned by Dezeimeris as his authority for this terrible tale. The

events here narrated occurred in 1505.

At the beginning of the sixteenth century--the period with which our

history now has to deal--the only available knowledge of anatomy

was that which had been supplied by Galen in the third century of

the Christian era, and which had been handed down through all the

intervening centuries as something absolutely correct and not to be

challenged. But the time had arrived when men were no longer willing

to accept as truth the teachings of any individual until they had

subjected them afresh to the most searching investigations; and thus

it came about that a group of remarkably able men devoted all their

energies, during the greater part of the sixteenth century, to a very

critical study of human anatomy. As the work accomplished by these

men constitutes a very important chapter--perhaps the most important

chapter--in the history of medicine, I may be pardoned if I devote a

disproportionately large amount of space to the consideration of the

careers of the more prominent of these founders of modern anatomy, and

to an enumeration of the details of the work which they accomplished,

and which furnished the most complete verification of the truth stated

by Francis Bacon, Lord Verulam (1561–1626), in the following words

(_translation_):--

Man has no other means of getting at and revealing the truth

than by induction coupled with a never-tiring, unprejudiced

observation of nature and an imitation of her operations.

Actual facts must first be collected, and not created by a

process of speculation.

One of the earliest and most thorough students of human anatomy was

Marc Antonio della Torre (1473–1506), who belonged to an honorable

family of Verona, several members of which had attained distinction

as physicians. He planned to publish a treatise on anatomy, and, with

this object in view, secured the assistance of Leonardo da Vinci

(1452–1515), the celebrated painter, architect and civil engineer, to

make life-size pictures of the parts which he had dissected with such

care. But, after the latter had completed many of the drawings which

were intended to serve as illustrations for the projected treatise,

Della Torre unexpectedly died, and the book was never finished. Quite

a number of the drawings, however, found their way to England, and for

many years past they have been carefully treasured at Windsor Castle

and in certain private collections. If Della Torre’s life had been

spared it is highly probable that his treatise on anatomy, equipped

with illustrations copied from this great artist’s drawings, would have

constituted a formidable rival of Vesalius’ famous work.

Not long after this event it became the rule, among the leading

painters and sculptors of the Renaissance period, to pay a great deal

of attention to the study of human anatomy. The museums of Central and

Southern Italy contain quite a large number of anatomical drawings that

were made by Michael Angelo, by Raphael and by other great masters

of that period. Doubtless many of my readers recall seeing, in the

Cathedral of Milan, Marco Agrate’s (1562) extraordinary masterpiece,

in the form of a life-size black marble statue which represents Saint

Bartholomew standing erect, and carrying on one arm the folded skin of

his entire body. In this statue all the muscles and bony prominences

are modeled with perfect accuracy. It is a remarkable work of art.

CHAPTER XXVII

THE FOUNDERS OF HUMAN ANATOMY AND PHYSIOLOGY

Among the earliest physicians of this period to inculcate the

importance of substituting a correct knowledge of anatomy for the

frequently incorrect descriptions that had been prepared by Galen and

handed down through the succeeding centuries, were the following:

Jacques DuBois of Paris (1478–1555), who was perhaps better known by

his latinized name of “Sylvius”; Guido Guidi (died in 1569), who was

also known as “Vidus Vidius”; and Winther of Andernach, a small city

on the Rhine. These three men, all of whom taught anatomy at Paris,

were commonly considered the best anatomists of that early period.

DuBois was further entitled to the credit of having been the first

physician to inject blood-vessels with a material that renders them

more easily visible, and also the first person in Paris to dissect a

human corpse. It was from these men that Vesalius, who afterward became

such a famous anatomist, received his first practical instruction in

this branch of medical science. Nothing further need be said here of

DuBois, but brief sketches of Guido Guidi and of Berengarius of Carpi,

another contemporary anatomist of considerable distinction, deserve to

find places in our history of this period. Vesalius’ facetious remark

that “Winther of Andernach never used a knife except for the purpose

of dissecting his food” absolves us from the duty of saying anything

further about his career as an anatomist.

In 1542 Francis the First, King of France, gave a great impulse to the

study of medicine by calling Guido Guidi from Florence, Italy, to teach

that science in the _Collége de France_, an institution which

he had founded at Paris in 1530. Guidi, upon his arrival in Paris,

was at once most cordially received, both by those who were to be his

colleagues and by the King. Francis bestowed upon him a suitable gift,

appointed him to the position of First Physician (Archiater) at his

Court, and assured him that he would receive an ample salary during

his residence in the French metropolis. In 1547, after the death of

Francis the First, Guidi returned to his home in Florence, where Cosimo

dei Medici, at that time the head of the Florentine Republic and a

little later Grand Duke of Tuscany (Cosimo III.), made him his First

Physician and gave him the appointment of Professor of Philosophy in

the University of Pisa. Not long afterward Guidi was transferred to the

Chair of Medicine. He retained this position almost up to the time of

his death (May 26, 1569), and during this long period Cosimo bestowed

upon him various ecclesiastic honors, which not only increased his

social rank but added materially to his financial resources.

Dezeimeris says that, while Guidi does not deserve to be placed, as

an anatomist, in the same rank with Vesalius and Fallopius,[73] he

merits full credit for the very important service which he rendered the

physicians of his day by placing within their reach translations of

certain Greek treatises relating to surgical topics--such treatises,

for example, as those of Hippocrates on ulcers, on wounds of the

head, on the joints and on fractures (with Galen’s comments), Galen’s

treatise on fasciae, and that of Oribasius on ligatures and other

surgical contrivances.

Apart from his merits as a worker in the field of medical science,

Guidi occupies a creditable place in the history of medicine as a

fine type of the well-educated and kindly disposed physician, as the

following testimony given by Benvenuto Cellini, the distinguished

Florentine sculptor, shows:--

On the occasion of my visit to Paris I made the acquaintance

of Messer Guidi, and I wish to state in what a very friendly

manner I was received by that noble citizen of Florence and

excellent physician, the most virtuous, the most lovable, and

the most domestic man whom I have ever met.

Guidi’s treatise on anatomy was first published at Venice (under the

editorship of his nephew) in 1611--_i.e._, forty-two years after

his death. His translations from the Greek treatises of Hippocrates,

Galen and Oribasius will be found in the work which bears the title

“_Collectio Chirurgica Parisina_,” Paris, 1544.

Berengarius of Carpi (a small town in Northern Italy), who died in

1530, is pronounced by Kurt Sprengel a worthy predecessor of Vesalius.

He was Professor of Anatomy, first at Pavia and then at Bologna (from

1502 to 1527), and he is reported to have dissected more than one

hundred(!) cadavers during that period. Fallopius and Eustachius were

among his pupils, and it was their opinion that he did more than

anybody else to revive the interest in anatomical work. The famous

sculptor, Benvenuto Cellini (1500–1571), is authority for the statement

that Berengarius was not only an experienced anatomist and practicing

physician, but also a very skilful draughtsman; the three works which

he published being illustrated with a certain number of original

woodcuts that are not without interest both to the anatomist and to the

lover of art.

Andreas Vesalius (1514–1564) was born at Brussels, of German parents

whose home was located at Wessels on the Rhine,--whence the name

“Vesalius.” His father was the apothecary of the Princess Margaretha,

Charles the Fifth’s aunt, and several of his ancestors had been

physicians of considerable distinction. At Louvain he received, in

early youth, a thorough training in the Latin, Greek and Arabic

languages and also in mathematics. When he was about eighteen years

of age, he visited Montpellier and afterward Paris, at which latter

city he received practical instruction in anatomy from the three

men whose names I have mentioned in the preceding paragraph--viz.,

Guido Guidi, Jacques DuBois and Winther of Andernach. The instruction

in anatomy given in Paris at that period (about 1533) consisted

in interpretations of Galen’s teachings, in dissections of a few

animals, and in occasional demonstrations--which never lasted longer

than three days--of the easily accessible parts of a human cadaver.

Scanty as were these sources of information, Vesalius cultivated

them with the greatest zest. From time to time his teacher, DuBois,

noting the interest which his pupil took in anatomy, and recognizing

his fitness for imparting instruction, assigned to him the special

duty of rehearsing, in the auditorium, before his fellow students,

the essential facts of the day’s lecture. After war had been declared

between the Emperor Charles the Fifth and Francis the First, King of

France, Vesalius left Paris and returned to Louvain, where he began

lecturing on anatomy. These lectures constituted the very first attempt

at anything like systematic instruction in anatomy that is known

to have been made at that ancient university. It was while he was

engaged in this work that Vesalius, in order to become the possessor

of an entire human skeleton,--a thing of which he felt a very great

need,--ventured to remove from the gallows, outside the city, the

cadaver of a criminal. This, as Haeser declares, was an act of great

boldness and full of peril.

The life of a military surgeon attached to the army of Charles the

Fifth, which was the life that Vesalius led during the following year

or two, was not sufficiently attractive to divert his mind seriously

from his favorite study; and it is therefore not surprising that

we find him, at the age of twenty-three, accepting from the Senate

at Venice the appointment of the professorship of anatomy at the

University of Padua. When he entered upon this new work Vesalius felt

considerable uncertainty as to the correctness of the anatomy which

he was then teaching, and it is therefore easy to understand why his

first three lectures were based entirely upon the teachings of Galen;

but, before he had finished the third one of the series, he made up his

mind that he would cut loose from the anatomy of the ape and confine

himself to that of the human subject, as was then being revealed to

him more and more perfectly from his own dissections. The stock of

knowledge which he had thus begun to accumulate, increased steadily

until, after seven years of teaching at Padua, Bologna and Pisa, at

each of which schools of medicine he gave courses in anatomy of seven

weeks’ duration, and after conducting the most painstaking dissections

of a number of human cadavers, he finally declared that he was ready to

publish his great treatise on anatomy. Some of his friends, foreseeing

clearly what a storm of protest the new book would arouse among the

followers of Galen, urged him to postpone for a time its publication;

but a few others agreed with him that it should be issued without

further delay. Accordingly Vesalius sent the manuscript of his work at

once to the printers at Basel, and the book was finally published in

June, 1543, before its author had attained his twenty-ninth year. Its

title was “_De corporis humani fabrica_,” and it was provided with

exceptionally fine pictorial illustrations, most of which were drawn,

as is generally believed, by John de Calcar, one of Titian’s pupils. A

second edition, superior in every respect to the first, was published

in 1555. In comparison with this great work the few treatises written

by Vesalius in later years are of minor importance.

Vesalius may rightly be considered the founder of modern anatomy,

for he was the first to furnish correct information, based on actual

dissections of the human cadaver, respecting quite a large number of

the more important anatomical relations; and by this very act he won

the further credit of having dealt the first effective blow toward the

dethronement of Galen, the man who, next to Hippocrates,--probably even

more than Hippocrates,--had exercised, by his teachings in nearly every

department of medical science, almost despotic sway over physicians

for considerably more than one thousand years. At this distance of

time, it is hard to realize what a startling effect was produced by the

announcement of the discovery of so many errors in Galen’s scheme of

anatomy. Albert von Haller, the great authority on medical literature,

speaks of Vesalius’ book as an “immortal work”; and, although its title

would lead one to suppose that it deals only with the construction of

the human body, an examination of its contents reveals the fact that

it contains in addition quite full information regarding physiology and

pathological anatomy, as well as many details relating to comparative

anatomy. Perhaps the most marvelous thing about this book is the

fact that its author completed his work before he had reached his

twenty-eighth year. It may also interest the reader to learn that,

prior to 1914, the University of Louvain possessed a copy of Vesalius’

great work printed on vellum and illustrated with many drawings in

colors; but I am unable to say whether this beautiful volume did or did

not escape destruction at the hands of the ruthless men who invaded

Belgium during the summer of that memorable year.

[Illustration: FIG. 14. ANDREAS VESALIUS.

(After the portrait by Van Calcar in the Royal College of

Surgeons, London.)

Copied from the reproduction published in the _Nederlandsch

Tijdschrift voor Geneeskunde_, Jan. 2, 1915.]

When the human mind has adjusted itself, in the course of years, to

consider certain beliefs and ideas as settled truths, it comes as a

painful shock to be told that these beliefs are erroneous and that

new ones must take their places. This is precisely what happened when

Vesalius’ book was first published. From one end of Europe to the

other there was a very great stir among the well-educated physicians;

the more liberal-minded being ready to accept at once the genuineness

of the new anatomy, whereas others,--and possibly they represented

the larger number,--acting under the influence of personal jealousy

or perhaps blinded by the belief that it was impious not to accept

without questioning the descriptions made by Galen, were scandalized

by the boldness of Vesalius in asserting that many of the statements

made by this great medical authority were incorrect. Jacques DuBois,

whose name has been mentioned by me on a previous page, was one of the

most bitter of Vesalius’ assailants. In a pamphlet which he published

in Paris in 1551 he even went so far as to speak of his late pupil as

“a crazy fool who is poisoning the air of Europe with his vaporings.”

On account of their former pleasant relations, and also because DuBois

was at that time an old man, Vesalius made no reply to these attacks;

but when Bartholomaeus Eustachius, Professor of Anatomy at Rome, one

of the most celebrated anatomists of that period, and a man of his own

age, entered the lists as the champion of Galen, Vesalius took up the

challenge, left the work upon which he was then engaged, and began a

tour of visits to the universities of Padua, Bologna and Pisa, for the

express purpose of disproving, by the aid of numerous dissections,

the statements made by his antagonists. Throughout this tour he was

received everywhere with enthusiasm, the older men among the teachers

of anatomy vying with the younger in manifesting the strength of their

approval. The entire journey, says Haeser, was from beginning to end

a series of the most brilliant triumphs. But, notwithstanding this

vindication, which most men would have accepted with the greatest

satisfaction, Vesalius returned to his home in Brussels only to find

that the bitter attacks made by his enemies had not ceased. This

depressed him greatly, for he was not philosophical enough to recognize

the facts that jealousy was at the bottom of this ill feeling toward

him, and also that sufficient time had not yet elapsed for the news

of his triumphant vindication to travel from Italy to Belgium. While

suffering from this fit of the blues he committed to the flames all his

books and manuscripts. These latter, it appears, contained not only

the fruits of many years of laborious anatomical and physiological

research, but also a large number of memoranda relating to pathological

anatomy.

In 1556, complaints having reached the ears of Charles the Fifth to

the effect that the sin of dissecting human corpses was greatly on the

increase, this monarch decided to refer the question to the Theological

Faculty of the University of Salamanca, in the northwestern part of

Spain, for an authoritative opinion. The reply which these broad-minded

theologians sent to the Emperor was most satisfactory. It is reported

to have been expressed in the following words: “The dissection of

human cadavers serves a useful purpose and is therefore permissible to

Christians of the Catholic Church.” This decision did not of course

put an immediate end to the harsh criticisms and petty persecutions of

the bigots; but, as the years went by, it was noted that the work of

scientific research in human anatomy and physiology acquired greater

freedom of action, and it is fair to assume that this result was

largely due to the famous decision to which I have just referred.

Shortly after Vesalius had retired, as stated above, from active

participation in anatomical research work, he was called by Charles the

Fifth to serve him in the capacity of private physician. During this

service, which lasted for several years, he visited, in company with

the Emperor, many of the principal cities of Europe; and then, when the

latter abdicated the throne of Spain,--for Charles was not only Emperor

of the Holy Roman Empire but also King of Spain,--Vesalius became the

private physician of Philip the Second, Charles’ son and successor on

the Spanish throne. This long period is largely a blank in the history

of Vesalius. Toward the end he got into trouble with the Inquisition

and was obliged, as a means of escaping the punishment of death, to

undertake a voyage to the Holy Sepulchre in Jerusalem. While he was

in that city he received an official invitation from the Senate at

Venice to fill the Chair of Anatomy at Padua. He then at once turned

his steps toward Italy, doubtless very happy over the prospect of once

more engaging in anatomical work; but he was shipwrecked on the coast

of the Island of Zante, October 2, 1564. Thirteen days later, before he

had completed his fiftieth year, he died from starvation and exposure.

A memorial tablet was placed in one of the neighboring churches on the

island, and in 1847 his Belgian compatriots erected a suitable monument

to his memory in the city of Brussels.

Admirable as was Vesalius’ treatise on human anatomy, it was soon

discovered that it was deficient in certain particulars. Not a few of

the descriptions, for example, were incomplete, and there were also a

number of parts or organs for which no descriptions whatever had been

provided. Many of these deficiencies were supplied by contemporary

anatomists, nearly all of whom were Italians. First and foremost among

this secondary but yet very important group of laborers in the field of

original research work, the names of Fallopius and Eustachius deserve

to be mentioned.

Gabriele Fallopius, who was born in Modena in 1523, was appointed to

the Chair of Anatomy at Ferrara when he was only twenty-four years

of age. Subsequently he taught at the University of Pisa. At the

time of his death in 1563 he was Professor of Anatomy, Surgery and

Botany at Padua. He made many important discoveries in anatomy, more

particularly in relation to foetal osteology and the distribution

of the blood-vessels. His work in the latter department is all the

more remarkable from the fact that it was accomplished at a time when

the art of injecting blood-vessels with some opaque material was

unknown in Italy. His name has been perpetuated in connection with

the Fallopian tube. As a man Fallopius was much liked because of his

kindly disposition and absence of conceit. The only treatise which he

published was that entitled “_Observationes anatomicae_,” Venice,

1561.

Bartholomaeus Eustachius, born at San Severino, in the Marches of

Ancona, in the early part of the sixteenth century, was one of the most

distinguished physicians of his day. He taught anatomy at the famous

University of Sapienza at Rome, and devoted a great deal of time and

thought to the preparation of a large work which was to bear the title

“On the Dissensions and Controversies Relating to Anatomy”; but death

overtook him before he had completed this undertaking. It appears,

however, that in 1564--that is, ten years before he died--he published

a smaller work containing separate chapters on the kidneys, the organ

of hearing, the movements of the head, the vena azygos, the vena

profunda of the arm, and on certain questions relating to osteology;

and he introduced, as illustrations for the text, eight plates of

octavo size. These plates and thirty-eight others, which were to have

served as illustrations for the great work, were all completed as early

as during the year 1552. The artist Pini, who made the drawings that

served as the originals from which the plates were made, was related in

some degree to Eustachius, and upon the latter’s death the metal plates

became his property by inheritance. But nothing further was heard of

them until they were discovered, early in the eighteenth century, by

Lancisi, the Pope’s attending physician, in the possession of Pini’s

descendants. They were published for the first time in 1714. Haeser

says that these pictures are true to nature, but that in artistic merit

they are not equal to those which belong to the treatise published by

Vesalius. The name Eustachius is permanently connected with the channel

which leads from the tympanum to the nasal cavities--the Eustachian

tube.

Only the briefest possible mention may here be made of those anatomists

who, following immediately in the footsteps of the three great leaders

mentioned above, played parts of greater or less importance in building

up the science of anatomy. Each one of them did creditable work in

correcting the errors made by their predecessors or in supplying

descriptions of structures or structural relations which these pioneers

had overlooked. Thus, long before the sixteenth century came to an end,

the gross anatomy of the human being had attained a large measure of

the completeness which it possesses to-day. The names of some of the

more prominent men among those to whom I have just referred are the

following: Giovanni Filippo Ingrassia, Matthaeus Realdus Columbus,

Julius Caesar Arantius, Constantius Varolius, Volcher Koyter and

Hieronymus Fabricius ab Acquapendente.

Ingrassia (1510–1580), a Sicilian physician, cultivated osteology

assiduously, and is entitled to special credit for having first

described the stapes, the third one of the ossicles of hearing, and

for having made valuable contributions to our knowledge of epidemic

diseases. He was a professor in the University of Naples, and, after

the year 1563, held the position of Archiater in Palermo, Sicily. His

descriptions of the different bones of the skeleton were made with such

care and thoroughness that later anatomists found very little for them

to discover or to alter.

Matthaeus Realdus Columbus (or simply Realdus Columbus), who died in

1559, was born in Cremona, Northern Italy. He served for some time as

Prosector to Vesalius at Padua, and then succeeded him in the Chair

of Anatomy, first at Padua and afterward at Pisa. The last teaching

position which he held was that of Professor of Anatomy in Rome, in

which city he counted Michael Angelo among his intimate friends.

The discoveries which he made in anatomy were quite numerous and of

considerable importance, and his descriptions were distinguished by

an unusual degree of accuracy and clearness. Unfortunately, he did

not hesitate, at the same time, to exalt the value of his own work by

disparaging that of his famous teacher.

Arantius, who also was one of the pupils of Vesalius, occupied the

Chair of Anatomy in his native city of Bologna during the latter half

of the century. His death occurred in 1589. The particular department

in which he gained considerable fame was that of the foetus, the

placenta, the uterus, etc. His descriptions of these structures are

written with very great care. Blumenbach gives him credit for having

been the first anatomist to furnish a description of the pregnant

uterus in its different stages. His earliest published work bears the

title “_De humano foetu opusculum_” Rome, 1564.

Constantinus Varolius, whose name is imperishably connected with that

part of the brain which is known as the “Pons Varolii,” was born in

Bologna in 1543. He was appointed Professor of Anatomy in the Academy

of his native city at an early age, and soon distinguished himself by

the careful studies which he made of the human brain and nervous system

in general. Before his untimely death at the age of thirty-two he was

chosen the attending physician of Pope Gregory the Thirteenth. His

earliest published work bears the title “_De nervis opticis, etc.,

epistola_,” Padua, 1573.

Volcher Koyter, who was born at Groningen, North Holland, in 1534,

studied under Fallopius and Guillaume Rondelet (1507–1566), to whom

the University of Montpellier was indebted for its anatomical theatre,

and to whom (rather than to Gaspard Bauhin of Basel) is due the honor

of discovering the ileo-caecal valve. Koyter was one of the earliest

workers in the field of comparative anatomy--a department of knowledge

to which Vesalius had already made some creditable additions; and

his two most important published treatises bear these titles: “_De

ossibus et cartilaginibus corporis humani tabulae_” (Bologna, 1566),

and “_Externarum et internarum principalium humani corporis partium

tabulae_” (Nuremberg, 1573). He died in 1600.

Hieronymus Fabricius was born in 1537 at Acquapendente, a small city

of Etruria, about fifty miles northwest of Rome. He studied anatomy

at Padua under Fallopius, and, after the latter’s death, was assigned

to the duty of making the necessary dissections and anatomical

demonstrations before the class. In 1565 he was appointed Professor

of Surgery, with the understanding that he was to continue giving his

demonstrations in anatomy. The salary which he received for this double

work was 100 ducats, but it was increased from time to time until

finally he was paid 1100 ducats yearly. At the end of thirty-six years

he was retired upon a pension of 1000 ducats for the remainder of his

life, and was allowed the privilege of appointing his successor in the

Chair of Surgery. He gave the place to Julius Casserius in 1609. To

distinguish him from another Fabricius, who gained great distinction in

the field of surgery, it has always been customary for later historical

writers to speak of him as “Fabricius ab Acquapendente.” His namesake

is known as “Fabricius Hildanus.”

As a teacher of anatomy, especially in its relations to physiology,

Fabricius was held in the highest esteem. Albert von Haller speaks of

him as being one of the glories of the Italian school of medicine.

Pupils came in flocks from all parts of Europe to attend his lectures,

and among them were some who, like William Harvey of England, afterward

attained great celebrity for the effective work which they did in

advancing the science of medicine. One of the attractive features of

Fabricius’ teaching was to be found in his practice--something quite

new at that period--of showing to the students, not only the particular

organ (human) upon which he happened then to be lecturing, but also

the corresponding organ in one or several of the animals; thus enabling

them to learn what were the features possessed in common by all the

species, and what were those in respect of which the species differed.

As time went on, the number of those who came to witness his anatomical

demonstrations increased so greatly that he felt impelled to build,

at his own expense, a new and larger amphitheatre. But even this, in

a short time, proved to be too small, and then the Senate at Venice,

which exercised a governing control over the University of Padua,

erected (in 1593) a much larger and more complete amphitheatre, upon

the walls of which there was placed an inscription stating that it had

been built in honor of Fabricius. Among the other distinctions which

were conferred upon him at this time he was raised to the rank of

Knight of the Order of Saint Mark and made an honorary citizen of Padua.

Fabricius ab Acquapendente added to our stock of anatomical knowledge

by his researches on the structure of the oesophagus, stomach and

intestines, the eye, ear, larynx and foetus. One of his chief claims to

distinction, however, rests upon the fact that he wrote an elaborate

monograph on the valves of the veins. Although these structures had

been seen and described at an earlier date by Charles Estienne,

Berengarius, Vesalius, Cannani and others (Fra Paolo Sarpi, for

example), nobody had yet offered a satisfactory explanation of their

probable use or had traced them through the venous system at large.

In 1574 Fabricius demonstrated their presence in all the veins of the

extremities.

But Fabricius ab Acquapendente was not merely a good anatomist and

physiologist; he was also a most distinguished surgeon and general

practitioner. From far and from near patients came to consult him

about their ailments, and he appears to have been immensely popular

among all classes of the community. His home, situated on the River

Brenta, just outside the city of Padua, was most attractive, and it was

there that he dispensed hospitality in a princely fashion. One of his

peculiarities was that in many cases he was unwilling to accept a fee

for his services. As a natural result, gifts of all sorts, many of them

of considerable value, were showered upon him. He devoted one of the

rooms of his residence to the purposes of a cabinet or museum, in which

all those gifts which were suited to such display might be properly

exposed to view, and over the doorway of the room he placed this

inscription, “_Lucri neglecti lucrum_,” which I venture to render

into English by the following, “Costly gifts representing unproductive

wealth.”[74]

Fabricius remained a bachelor all his life, and at the time of his

death (May 21, 1619, at the age of eighty-two) his fortune, which he

bequeathed to his brother’s daughter, amounted to 200,000 ducats--a

very large sum in those days.

The writings of Fabricius were published at Leipzig in a single volume

in 1687, but Johann Bohn, who edited the collection, omitted the

different prefaces which Fabricius had written. In the Leyden edition

of 1737 this defect has been remedied.

To furnish here even a much abbreviated account of the important

discoveries made in anatomy and physiology during the sixteenth century

would call for a much larger amount of space than can possibly be given

to these two branches of medical science. Our modern text books on the

subject of anatomy alone are, in a certain sense, catalogues of these

very discoveries, and every physician knows what a vast amount of space

they occupy. I have already made mention of a few of these discoveries,

and, when I come to consider the splendid work done by William Harvey

in the early part of the seventeenth century, I shall have occasion

to recapitulate briefly the more important discoveries made by his

predecessors in this particular field. In this way I shall be able to

supply information regarding several of the discoveries which I am now

obliged to pass over in silence, but which, under other circumstances,

would more properly receive consideration in the present chapter.

CHAPTER XXVIII

FURTHER DETAILS CONCERNING THE ADVANCE IN OUR KNOWLEDGE OF

ANATOMY--DISSECTING MADE A PART OF THE REGULAR TRAINING OF

A MEDICAL STUDENT--IATROCHEMISTS AND IATROPHYSICISTS--THE

EMPLOYMENT OF LATIN IN LECTURING AND WRITING ON MEDICAL TOPICS

_Further Details Concerning the Advance in Our Knowledge of Gross

Anatomy._--In the preceding chapter I have given some account of

the efforts made during the sixteenth century by certain physicians

to lay solidly the foundations of a gross anatomy of the human body.

The time was ripe for such a movement, and the right sort of men took

charge of it and pushed it forward to such a stage of successful

accomplishment that we physicians of to-day are able to continue in

the direction indicated, and under the impulse communicated, by these

master builders. These men, it should be remembered, did something more

than merely to lay solid and durable foundations in the form of an

accurate anatomy, they also taught the correct methods of procedure for

the erection of the superstructure of the science of medicine.

Up to the end of the sixteenth century almost all the work done in

anatomy was effected with the aid of the scalpel alone, the object

being to isolate and expose clearly to view the larger tissues and

organs, such as muscles, arteries, veins, nerves, etc. In a very few

instances more elaborate methods were devised, even as early as during

the fifteenth century, by men of exceptional cleverness. Thus, for

example, in 1490, Alexander Benedetti, Professor of Anatomy at Padua,

invented a method of preserving muscles, nerves and blood-vessels as

permanent dry specimens, and it is said that he sold such preparations

for large sums of money. As already stated on a previous page, the

injection of blood-vessels with certain fluids was also employed to a

very limited extent at this early period as a means of distinguishing

them more easily from the surrounding structures; but this practice

gave place, during the seventeenth century, to the better method of

employing, as an injecting material, a semi-fluid preparation which

became quite solid soon after it had penetrated well into the interior

of the vessels, and to which any desired opaque color might be given.

This method was invented by the Hollander, John Swammerdam (1627–1680)

and perfected by Van Horne. It was largely by the employment of this

procedure that Friedrich Ruysch of Amsterdam (1638–1731), Professor

of Anatomy and Botany in the university of his native city, gained

such celebrity throughout Europe for the great beauty of his permanent

anatomical preparations. Hyrtl mentions the fact that Peter the Great

of Russia, who resided for a certain length of time at Zaandam, near

Amsterdam, in order that he might familiarize himself with the art of

ship-building, was in the habit of visiting Ruysch from time to time

in his museum and laboratory; and finally (in 1717) bought from him,

for the sum of 30,000 florins, his entire collection of specimens,

together with the formula of the mixture which he employed in making

his injections. The collection itself, it should be stated, contained

not only specimens illustrative of normal human anatomy (_e.g._,

the various solid and hollow organs, the organs of special sense,

and objects belonging to the vascular, muscular, nervous and osseous

systems), but also many specimens illustrating pathological and

comparative anatomy, and a great variety of monstrosities.

Ruysch also attained remarkable success in restoring the rosy color

and soft flexibility of the skin and the natural facial expression

in certain dead bodies by the employment of a preservative fluid

widely known as “_Liquor balsamicus_.” Tradition says that in one

instance, that of a child whose corpse had been treated in this manner

by Ruysch, the face presented such a perfectly life-like appearance

that the Czar, as he passed near the object, thought he was looking

upon a sleeping child and gave it a kiss.

The aged professor lived to be ninety-three, and continued giving his

lectures on anatomy almost up to the day of his death, which resulted

from accidental injuries. When it became clear that these were of so

serious a nature that he could not possibly recover, he asked to be

carried on a stretcher into the assembly room in order that he might

say a farewell to the students who had been attending his lectures.

Although some critics have intimated that Ruysch should be ranked

merely as a very clever mechanic in the domain of anatomy, there are

certain well-established facts which show that this estimate of the man

is unfair. It is known, for example, that he was the first anatomist

to call attention to the features which distinguish the male from the

female skeleton (_e.g._, the differences in the form of the pelvis

and of the thorax). Ruysch also advanced our knowledge of the vascular

system by means of the improvements which he effected in the method of

injecting blood-vessels. His skill in this special work was so great

that people were wont to say of him that he possessed the fingers of

a fairy and the eyes of a lynx. It was Ruysch too who furnished the

first descriptions of the bronchial blood-vessels and of the vascular

plexuses of the heart. Finally, the term “_membrana Ruyschiana_,”

in connection with the choroid of the eye, bears testimony to the fact

that he was also an original worker in this very difficult corner of

the field of human anatomy.

The crowning event in the life of Ruysch--an event which shows

how wasteful many of us men are of our productive powers when we

deliberately retire from all participation in active work, physical or

mental, at the comparatively early age of sixty-five--occurred in 1717,

when he had attained the age of seventy-nine. Peter the Great had

hardly left the premises with the great collection of specimens for

which he had paid such a fabulous price, when Ruysch began the making

of a new collection; and at this task he worked so diligently that in

less than ten years he was able to deliver to John Sobieski, King of

Poland, the greater part of the new collection (for which he received

the sum of 20,000 florins). Then followed a period of about three years

during which he continued active work as a teacher of anatomy, death

alone seeming to possess the power to arrest his extraordinary energy.

Ruysch’s only published works are the following: Catalogue of the

Specimens contained in his Museum, Amsterdam, 1691; and a _Thesaurus

Anatomicus_, in 10 volumes, Amsterdam, 1701–1715.

In reading over the account which I have given of the discoveries

made in gross anatomy and in physiology during the sixteenth and

seventeenth centuries, I find that I have omitted some that may just as

appropriately be mentioned in this section as in that which I intend to

devote to work done in the domain of minute anatomy. I shall therefore

refer to them briefly now, and then pass on to the consideration of the

latter branch of my subject.

Eustachius, the famous Italian anatomist, deserves special credit

for the experimental methods which he devised and employed in his

efforts to gain a better knowledge of the anatomy and physiology of

the kidneys. Moritz Hofmann of Fürstenwald discovered in 1641, in the

turkey gobbler, the outlet duct of the pancreas, and a short time

afterward George Wirsung, a Bavarian, discovered the same structure in

the human being. Then, in 1651, Olaus Rudbeck, Professor of Anatomy

in the University of Upsala, Sweden, discovered the lymphatics of

the intestines, and established (at a later date) the fact that they

are a separate system from that of the chyle ducts. Francis Glisson

(1597–1677) of Cambridge University, England, one of Harvey’s pupils,

made two series of anatomical investigations of a most creditable

character--the first concerning the relationship which exists

between the intestinal lymphatics and the alimentary canal, and the

second regarding the internal construction of the liver (“capsule of

Glisson”). Thomas Wharton (1610–1673), a native of Yorkshire, England,

and a London practitioner of medicine, discovered the outlet channel

of the submaxillary salivary gland, now known as “Wharton’s duct,”

and he also published the first exhaustive treatise on the structure

of glands in general (thymus, pancreas, submaxillary, etc.). About

the middle of the seventeenth century Nathanael Highmore of Oxford,

England (1613–1685), discovered and adequately described the cavity

in the superior maxilla which bears his name (“antrum of Highmore”),

and which in comparatively recent years has assumed such importance

from the viewpoint of the practical surgeon. A Danish anatomist,

who is known to us English-speaking physicians as Nicholas Steno

(1638–1686), but to his own countrymen as Niels Stensen, discovered

the outlet duct of the parotid gland (“Steno’s duct”). Stephen

Blancaard (1650–1702), a practicing physician of Amsterdam, made the

first successful injections of capillary blood-vessels; and Domenico

de Marchettis (1626–1688), Professor in the University of Padua,

employing Blancaard’s technique, succeeded in proving that the finest

ramifications of both veins and arteries communicate the one with the

other. To Conrad Victor Schneider, a professor at the University of

Wittenberg, Germany (1614–1680), we are indebted for putting an end

forever to the erroneous doctrine that the nasal mucus is produced

in the brain. He did not, however, have the good fortune to discover

the glands from which this mucus actually comes; the credit for

this discovery being due to Niels Stensen. Among the host of other

successful discoverers in the domain of anatomy during the seventeenth

century the following men deserve at least to be mentioned by name:

Johann Conrad Peyer (1653–1712) of Schaffhausen, Switzerland; Johann

Conrad Brunner (1653–1727), also a native of Switzerland; Theodor

Kerckring (1640–1693) of Hamburg, Germany; Anton Nuck (1650–1692),

Professor of Anatomy at the University of Leyden, Holland; Reignier

de Graaf (1641–1673), a native of the Netherlands; and Thomas Willis

(1622–1675) and William Cowper (1666–1709), both of them Englishmen.

And, finally, it may be stated that all the leading anatomists of the

sixteenth century devoted a great deal of time to the study of the

manner in which the nerves are distributed throughout the body and

to ascertaining the arrangement of the intracranial and intraspinal

nervous structures. To give even the most superficial account of what

these men accomplished would occupy far more space than can well be

spared for this purpose. Kurt Sprengel is my authority for saying

that, of all the workers in this particular field during the period in

question, Fallopius is entitled to receive the greatest credit for what

he accomplished.

_The First Beginnings of Minute or Microscopic Anatomy._--The

anatomy of the tissues--microscopic anatomy--begins with Marcello

Malpighi (1628–1694), a native of Crevalcuore, near Bologna, Italy.

It is not positively known who was the inventor of the compound

microscope. First employed about the year 1620, the instruments of this

type came into fairly general use toward the middle of the seventeenth

century. But the early compound microscopes were not very satisfactory,

and consequently preference was given, for a long time, to those of

the simple type. Achromatic instruments were not purchasable until

1780, when the famous German physicist, Leonhard Euler, succeeded in

overcoming the obstacles which had up to that time stood in the way of

their successful manufacture.

In 1661 Malpighi, who was in the habit of manufacturing his own

microscopes, was able, by aid of one of these instruments, to exhibit

the blood, loaded with its corpuscular bodies, passing rapidly from

one capillary vessel to another in the frog’s lung. Then in 1683

Guillaume Molyneux, in 1690 Anton van Leeuwenhoek, and in 1697 William

Cowper, witnessed the same phenomenon in warm-blooded animals. Among

the other anatomists of this period who contributed in varying degrees

to our knowledge of the minute anatomy of the different tissues and

organs the following deserve to be mentioned: J. Riolan (1577–1657),

Boselli of Naples (1608–1679), Lower of Oxford, England (1631–1691),

Vesling of Minden, Germany (1598–1649), Regnier de Graaf of Delft,

Holland (1641–1673), who gained so great distinction by his accurate

description of the ovarian follicles (“Graafian follicles”); and

James Douglas (1676–1742), the English anatomist, who ascertained and

described the precise limits of the peritoneum.

Of all the men whom I have mentioned above, Malpighi and Leeuwenhoek

are probably the best known to our readers for the large number

and important character of the contributions which they made to

microscopic anatomy. The list of Malpighi’s achievements, for example,

includes the following, in addition to the demonstration of the blood

in actual circulation, as already mentioned: contributions to our

knowledge of the finer structure of plants; the demonstration of

the minute anatomy of the skin (“_rete mucosum_” or “_rete

Malpighi_”); the amplification of our knowledge of the structure

of the teeth; the discovery that the lungs are composed to a large

extent of terminal vesicles, the walls of which are richly supplied

with blood-channels.; the demonstration that certain glands possess

an acinous structure (_i.e._, an outlet channel springing from

numerous small sacs, the whole group resembling a cluster of grapes);

more complete details regarding the structure of the spleen and

the kidneys (“Malpighian bodies or corpuscles”); additions to our

knowledge of the structure of the white and the gray substances of

the brain and the demonstration that fibres from the spinal cord pass

on into the brain; the declaration that the papillae of the tongue

are organs of taste and the papillae of the skin are organs of the

sense of touch; and not a few other contributions of greater or less

importance. During his long life Anton Leeuwenhoek (1632–1723) of

Delft, Holland, made a great many additions to microscopic anatomy,

some of the more important of which are the following: he was the

first to discover and to describe the many varieties of Infusoria

(the animalcules found in stagnant collections of water); to him is

also due the credit of first observing the faceted arrangement in

the eyes of insects; he made original investigations into the origin

and mode of development of several species of the lower organisms; he

was the first to observe the canaliculated mode of construction in

bone, and he also noted the existence of the so-called bone-corpuscles

(afterward rediscovered and more accurately described by Purkinje); he

discovered the striated condition of the bundles of muscular fibres,

and was also the first person to teach the doctrine that the growth

of muscles is effected by an enlargement of the primitive bundles of

fibres and not by a multiplication of these structures; he taught

further that muscle-substance consists of numberless small spheres; he

was the first to describe the crystalline lens as a structure composed

of fibres which are arranged in layers or sheets; in association with

Guillaume Molyneux he studied, under the microscope, the speed with

which the blood-current travels in the blood-vessels; he made valuable

observations on the nature of the spermatozoa; and, finally, the very

first studies in bacteriology appear to have been made by Leeuwenhoek.

As a result of his discovery of “round, rod-shaped, thread-like and

corkscrew-shaped bacteria” between the teeth of a human being, the

theory was set forth that probably many diseases owe their origin to

such “little animals.”[75]

The same idea, as will be shown farther on, occurred to the

distinguished medical practitioner of Verona, Italy,--viz.,

Fracastoro,--one hundred years earlier (1546). Leeuwenhoek, it should

here be stated, possessed a very great advantage over his rivals in

the field of minute anatomy, for he was in the habit of using, in

his investigations, microscopes which he himself had made, and which

magnified from 160 to 270 diameters, whereas those utilized by the

others were capable of magnifying, at the maximum, only 143 diameters.

While a large part of the work which he performed shows plainly that

he was a skilful and careful anatomist and endowed with good mental

powers, Leeuwenhoek nevertheless manifested certain mean traits of

character. Daremberg says that these “consisted in his disposition

to conceal his technical methods from his associates, and in his

jealousy of others--as manifested, for example, toward Leibnitz, who

had established a similar laboratory for research work in minute

anatomy. These traits of character showed that fundamentally he was

not a true lover of science, but rather an artisan. And yet, with all

these faults, he does not appear to have placed an inordinately high

value upon his discoveries or to have been unreasonably sure of the

correctness of his conclusions.” The first monograph published by

Leeuwenhoek bears the date 1673. It is a study of the minute anatomy

of the bee’s sting. He was the first to declare that the blood is the

nutritive fluid _par excellence_, and that it is to be found in

the entire series of organisms belonging to the animal kingdom. He

divided blood into two parts--the red, or the solid portion, and the

serum. The corpuscles which float in the serum and give to the whole

fluid its red color, are called by him “particles,” in the case of

blood from birds, reptiles and fishes, and “globules” in that from

quadrupeds. He employed this term “globules” because he believed that

these bodies were exactly spherical in shape. According to Daremberg,

Leeuwenhoek’s studies cover the entire field of human histology, and

his findings are for the most part correct.

_The Founding of Organizations for the Advancement of Medical

Science._--During the seventeenth century there were formed a number

of associations which had for their object the promotion of scientific

knowledge, and these organizations contributed greatly to stimulate

original researches in anatomy and physiology and to secure accuracy in

the published results. Perhaps the most important institution of this

kind was the French _Académie des sciences_, which was founded in

1666, and which deserves the credit of having taken a very important

part in the perfecting of our knowledge of anatomy and physiology.

The Royal Society of London, founded in 1645, possesses a splendid

record of valuable work accomplished. The following organizations also

deserve to be honorably mentioned in this place: the _Accademia dei

Lincei_ at Rome, founded in 1603; the _Académie des Curieux de

la Nature_, 1652; and the _Accademia del Cimento_, founded at

Florence in 1657. New universities were also founded in Germany.

During the second half of the seventeenth century there were three

French physicians who deserve credit for the excellence of the work

which they did in the departments of anatomy and physiology, viz.,

Vieussens, du Verney and Dionis.

Raymond Vieussens (1641–1716), a native of Rovergue, was Professor of

Anatomy at the University of Montpellier, in Southern France. Some idea

of the extraordinary industry displayed by this anatomist may be gained

from the fact that he is credited with having dissected more than five

hundred bodies. His more important published works relate to the heart,

the nervous system and the structures of the organ of hearing. Pagel

speaks of him as being entitled to the name of founder of the pathology

of diseases of the heart.

Jean Guichard du Verney (1648–1730), who held the Chair of Anatomy

in the University of Paris, gained a large part of his fame as

an anatomist from the excellence of his investigations into the

complicated structures of the internal ear.

Pierre Dionis, who died in 1718, was Demonstrator of Anatomy and

Surgery at the Jardin du Roi in Paris during the latter part of the

seventeenth century and early part of the eighteenth. In 1690 he

published a treatise on anatomy which remained the standard book on

this subject for a number of years. In course of time it was translated

into the Latin, English, German and Chinese languages.

_Dissecting Made a Part of the Regular Training of a Medical

Student._--The opportunities for dissecting human bodies varied

greatly in different parts of Europe during the period of which I am

now treating. Vieussens, as we have just seen, dissected no fewer than

five hundred bodies during his long professorship at Montpellier;

and Joseph Lieutaud, Professor of Anatomy at Paris, dissected more

than twelve hundred bodies during the continuance of his connection

with that institution. So far as I have been able to learn from my

examination of the literature, the professors and their immediate

official assistants were the only persons who had, up to this time,

derived the principal benefits that flow from work of this nature; the

students merely listened to the instructor’s remarks upon the objects

which had previously been exposed to view by dissection. But toward

the end of the period--a little before or shortly after the beginning

of the eighteenth century--facilities were provided in some of the

medical schools, and before long in all of the leading ones, for the

students themselves to participate in this highly important part of a

physician’s education. The value of such training was emphasized by

the statement made by the English philosopher, John Locke (1632–1704),

toward the end of his life, viz., that all human understanding is based

upon experience. He wrote that at birth the human soul is like a clean

sheet of paper upon which all the objects perceived by the senses are

recorded as experiences, and there they remain until by the aid of

reflexion--_i.e._, by the aid of the understanding, which Locke

calls the inner sense--they are combined into conceptions or ideas.

Locke, it should be remembered, was educated as a physician, but he

never took his degree, nor did he ever practice medicine.

The first stimulating effects of the Renaissance upon the devotees

of the science of medicine were felt in Italy toward the end of the

fifteenth century, and these effects rapidly gained in intensity

during the following century. First France and afterward Switzerland,

Belgium, Holland and England were almost simultaneously brought under

the same influence; and in all these countries the students manifested

a remarkable eagerness to acquire all the knowledge they possibly

could. In Germany, however, the influence of the Renaissance did not

make itself felt until a much later date, and the thirst for knowledge

was very much slower in developing than was the case in any of the

other countries mentioned. Thus Puschmann, in his “History of Medical

Education,” makes the following statement which shows clearly that in

Germany the university students of that period must have been a very

rough set of men: “In 1625 the Senate of the University of Leipzig was

obliged to warn its students that they must cease disturbing wedding

festivals and handling the guests roughly, that they must no longer

make obscene remarks to married women and maidens, etc. And in 1631 a

physician named Lotichius, in writing to a friend, made the statement

that ‘in our German high schools the students seem to prefer strife to

the reading of books, daggers to copy-books, swords to pens, bloody

encounters to learned discussions, incessant boozing and noisy reveling

to the quiet pursuit of their studies, and public-houses and brothels

to students’ work-rooms and libraries.’” In 1660 the students at Jena,

on one occasion, carried on a regular battle with the police, and as

a result of this encounter several persons were killed. In the light

of this evidence, therefore, it is not surprising that the science of

medicine made comparatively little advance in Germany until after the

eighteenth century was reached.

_Iatrochemists and Iatrophysicists._--During the seventeenth

century there was a great deal of disputing among physiologists about

the nature of certain processes like assimilation and retrograde

metamorphosis, about the manner in which blood is formed, about

digestion, and about the rôle played by the lymph vessels. According to

Haeser a large proportion of the physicians of that day were confident

that chemistry was entirely competent to solve these riddles, and

yet, on the other hand, there were not a few who believed that the

science of physics, which was then much further advanced than that

of chemistry, was quite as competent to explain all the phenomena.

At first the split into these two factions was confined to men who

were interested in questions of a purely physiological nature, but in

a short time the practitioners of medicine were also drawn into the

controversy; and from that time onward it became customary to employ

the terms, “iatrochemists” and “iatrophysicists” in speaking of the

partisans of the two schools of medicine (the iatrochemical and

the iatrophysical or iatromechanical). The iatrochemists described

digestion as an act that is essentially chemical in character, a form

of fermentation; and by the latter term the more advanced members of

this school--François Deleboë Sylvius (1614–1672), who was born in

Hanau, Prussia, of Dutch parents, and who took his doctor’s degree in

Basel in 1637, and Thomas Willis of London (1622–1675)--understood

something quite different from our modern conception of fermentation.

Their interpretation was as follows: “An internal chemical movement

of matter which is set agoing and continued in action in the stomach

and intestinal canal through the agency of certain chemical reagents.”

(Haeser.) They attributed an important influence to the saliva, the

pancreatic juice and the bile in effecting the changes mentioned. The

iatrophysicists, on the other hand, and more particularly Archibald

Pitcairn of Edinburgh, Scotland (1652–1713), and Giorgio Baglivi of

Ragusa, Italy (1668–1707), described digestion as a purely mechanical

breaking up of the elements of the food partaken--a “trituration.” As

to the further fate of the resulting chyle (its mode of reaching the

blood, for example) the two schools were in perfect accord.

Sprengel mentions it as an actual fact that, during the seventeenth

century, there were several physicians who combined the two careers

of teacher of medicine and hydraulic engineer (iatrophysicists or

iatromathematicians).[76] Several events conduced to the formation,

in Italy and in Great Britain, of a distinct iatromathematical

school. Among them may be mentioned, first and foremost, Harvey’s

discovery of the circulation of the blood; second, the spread of the

doctrines taught by Descartes favored in a marked degree the union

of medicine and mathematics (physiology, the iatromathematicians

claimed, was only a branch of applied mathematics); and, third, the

formation at Florence, in the middle of the seventeenth century,

of an association of the pupils of Galileo. The objects of this

association were to cultivate their master’s philosophy, to carry on

the work of experimental physics, and to apply its principles in every

department of natural science. Alphonso Borelli (1608–1679), Professor

of Mathematics first at Messina and afterward at Pisa, the author of

the famous treatise on “The Movements of Animals,” and the founder

of the iatromathematical school, was a member of the association. In

this connection it is important to mention another zealous worker

in the field of iatromathematics, viz., Sanctorius Sanctorinus, of

Capo d’Istria (1561–1636). His work was done quite independently of

any general movement among scientific investigators and at a much

earlier period than that during which the school flourished. He was

quite successful, for example, in his attempts to measure the actual

amount of imperceptible evaporation, and to determine the influence

which this process exerts upon health and disease. In the course of

these investigations in what he called “static medicine,” Sanctorinus

invented a number of unusual instruments.

The phenomenon of the formation of schools or sects, the members of

which were keenly interested in the maintenance and promulgation

of certain physiological, pathological, or therapeutic doctrines,

manifested itself anew, as I have shown above, in the seventeenth

century. In the early years of the Christian era the partisans of

different medical doctrines formed schools of this nature which

flourished for a certain period of time and then died out completely.

Such, for example, were the sects of the Dogmatists, the Methodists,

the Pneumatists, etc. The mere fact of the existence of these different

schools or sects showed unmistakably that the science of medicine

was alive at that time and that its devotees were making vigorous

efforts to increase their stock of knowledge. Then followed the long

period of the Middle Ages, a series of many centuries, during which

medicine made only slight gains; but at last came the Renaissance,--the

fifteenth, sixteenth and seventeenth centuries,--and here again we have

a recurrence of the same phenomenon of sects in medicine; but note the

great difference between the earlier manifestations and those which

I have just outlined. The present group, it is proper to remark, is

merely the forerunner of several similar movements that are to occur

during the eighteenth and nineteenth centuries, movements that are all

based, in varying degrees, upon the truth.

_The Employment of Latin in Lecturing and Writing on Medical

Topics._--In all the countries of Europe, but more particularly

in Germany, there existed during the sixteenth and seventeenth

centuries--and for a long time subsequently--the practice of delivering

all the lectures on medical topics in the Latin tongue--_i.e._,

in a language which at best could not be easily understood by more

than a small proportion of the students. Even the lecturers themselves

must have been hampered in the full expression of their thoughts by

this rule, which was practically compulsory. Paracelsus (1493–1534),

the famous Swiss physician, tried--a full century earlier, as will be

shown farther on--to break up this seemingly harmless but in reality

objectionable custom; his example, however, was not followed, and the

practice was continued without interruption for at least two centuries

longer. The use of Latin as the language in which all medical knowledge

was to be taught was undoubtedly based upon the idea that it was

necessary for the educated physician to be reasonably familiar with

that particular tongue, for the simple reason that it was the only

one in which, in those early days in Western Europe, the writings of

Galen were accessible, for nobody but a few expert scholars had yet

acquired any useful knowledge of Greek, the language in which all of

Galen’s works were originally written. But it is quite likely that

with this motive, which certainly was intended to produce good and

useful fruit, there was coupled the further idea that the great mass

of irregular practitioners--the quacks, the early barber-surgeons

(_Wundaerzte_), and the peripatetic physicians--would in this

way be debarred from entering the ranks of the regularly trained

physicians. It was only after the custom of using the Latin for

lecturing and writing purposes had become thoroughly rooted in the

minds of medical men as something right and proper, that it began to

dawn upon the minds of some of the brighter men that this practice was

harmful to the advance of medicine beyond the standards established

by Galen. Vesalius, who was a contemporary of Paracelsus, fully

appreciated how serious an obstacle to further progress in anatomical

knowledge the teachings of Galen were, and it was he who made the first

really successful attack on this great hindrance to further progress;

but there is no evidence to show that he had the slightest idea that

lecturing and writing about medical topics in Latin played any part in

the perpetuation of the evil which he was fighting. To Paracelsus alone

belongs the credit, so far as I know, of endeavoring, through the force

of example and by spoken arguments, to break up the practice which we

are here considering. I may be mistaken in the view which I have here

expressed, but it is difficult for me not to believe that the habitual

use of Latin as the proper vehicle for the transmission of facts and

ideas belonging to the domain of medicine must have materially hindered

the advancement of that science; for such use certainly tended to keep

men’s minds moving in fixed ruts, and those ruts all led straight

toward the faulty teachings of Galen.

CHAPTER XXIX

THE CONTRIBUTIONS MADE BY DIFFERENT MEN DURING THE RENAISSANCE,

AND MORE PARTICULARLY BY WILLIAM HARVEY OF ENGLAND, TO OUR

KNOWLEDGE OF THE CIRCULATION OF THE BLOOD, LYMPH AND CHYLE

Among the earliest known doctrines relating to the nature of the blood

and its mode of distribution throughout the body are those attributed

to Erasistratus and Galen; for the still more ancient ones, of which

Diogenes of Apollonia, Aristotle and the Hippocratic writers are

reputed to be the authors, are too incomplete to call for serious

consideration in this place.

_(a) The Doctrine Taught by Erasistratus._--Erasistratus, who

was born at Julis in the Island of Ceos (Aegean Sea) during the third

century before Christ, held the belief that the arteries contain

only air, which is drawn into the lungs by way of the trachea and

bronchi, whence it enters the pulmonary vein (called by him the “venous

artery”). In its further course this air passes from the pulmonary

vein into the left ventricle of the heart, and is then conveyed from

that organ through the arteries to the different tissues of the body.

Erasistratus further taught that the smallest subdivisions of both the

arteries and the veins lie side by side in the tissues, and that, in

certain abnormal bodily conditions, they communicate the one with the

other through anastomoses; but that, in a normal condition of the body,

no communication takes place between the two. In common with all other

physicians of that time, he believed that only the veins carry blood.

Here, then, we find the first glimmering of the truth with regard

to the nature of the circulating medium and also with regard to the

course which it pursues in one part of its circuit--that part, namely,

where the two kinds of vessels become capillary in character. His

substitution of air for blood in the arteries is plainly the principal

error in his scheme.

_(b) The Teaching of Galen and of Caesalpinus with Regard to the

Nature of the Blood and Its Mode of Distribution._--Galen, in the

second century of the present era, disputed the correctness of the

doctrine taught by Erasistratus. His objections are thus stated:

“Inasmuch as blood flows from an artery when it is wounded, one of two

things must be the truth. Either blood was already contained in the

vessel before it was wounded, or it must have found its way in from the

outside. But, if the blood comes from the outside into a vessel which

contains only air, then air must necessarily escape from that vessel

(when wounded) before blood does--which is contrary to the fact, as

blood alone flows out. Therefore arteries contain only blood.” As a

further proof of the correctness of his statement Galen carried out the

following experiment: In a living animal he placed two ligatures around

an artery at points situated not far apart, and then made an opening

in the vessel between the two ligatures. The intervening section of

the artery, it was thus found, contained only blood. This experiment,

it might reasonably be supposed, would have definitely settled the

question; but such was not the case. The followers of Erasistratus

immediately raised this objection: If the arteries contain blood, how

may the air which is drawn into the lungs find its way to all parts

of the body? Galen replied that the inhaled air does not pass through

the lungs, but is rejected by them after it has cooled the blood. This

refrigerating process, he claimed, constitutes the sole purpose of the

respiratory act.

Although Galen’s idea regarding the true function of respiration is

not in harmony with the doctrine taught by modern physiologists, it

nevertheless represents a marked advance over the belief previously

maintained. Even as recently as in the time of Albert von Haller

(approximately 1760–1780) physicians still continued to believe that

it was the function of respiration to cool the blood; and indeed it

was scarcely possible before 1800 to offer a more correct physiology

of the act of breathing, for it was not until after the lapse of many

centuries that the advance in our knowledge of chemistry reached a

point at which it became possible to find a satisfactory solution of so

complicated a problem.

As to the nature of the blood itself Galen believed, as I have already

stated more fully in Part I. (“Ancient Medicine”), that there are two

kinds--spirituous blood (or spirit) and venous blood. He gave the name

of spirituous blood to that which is found circulating in the arteries,

and which is appreciably brighter in color than that which fills the

veins. According to Flourens, the distinguished French physiologist

of the nineteenth century, Galen was the first among the ancient

anatomists to make this distinction of two different kinds of blood. To

the spirituous variety Galen ascribed the function of nourishing the

more delicately constructed organs like the lungs, while he claimed

that the venous blood is suited to nourish only the coarser ones, like

the liver, spleen, etc.

In his further development of a physiology of the circulation of the

blood Galen, who as a rule expresses his ideas with great clearness,

makes statements which I find it extremely difficult to comprehend.

I am therefore tempted to assume that the copyists, to whom we are

indebted for handing down his actual words from age to age, are the

persons upon whom should be cast the blame for the obscurity of which

I complain. However this may be, it is an unquestionable fact that

the ablest physiologists, were they to be confronted to-day with the

duty of solving this problem of the circulation under the conditions

of knowledge which existed during the third century of our era, would

surely not be able to provide a more correct solution than that which

is credited to Galen. The problem was attacked repeatedly by some

of the brightest and best-equipped minds of the Renaissance period,

but not one of these exceptionally clever men was able to offer an

entirely acceptable solution. Harvey alone, as will appear farther on

in this account, solved the riddle once and for all.

The “spirit”--the purest part of the blood--is lodged, according to

Galen, in the left ventricle; and, inasmuch as even the venous blood,

if it is to fulfil in some degree the function of a nourishing fluid,

must possess a certain proportion of “spirit,” it is clear that the

two ventricles should communicate the one with the other; for how

otherwise--thought Galen--is it possible for a certain amount of

“spirit” to commingle with the venous blood? The locality at which

this communication was assumed to exist was the interventricular

septum; and, as nobody was able to find anything like a foramen in this

membrane, it was asserted that the communication is effected through

an infinite number of pores. For over one thousand years physicians

accepted this porous character of the interventricular septum as an

established fact. In his commentaries on Mondino’s “Anatomy” (1521),

Berengarius of Carpi timidly ventured the statement that the openings

of communication are not distinctly visible, and this apparently was

the first feeble expression of doubt concerning the correctness of the

prevailing doctrine. Vesalius, on the other hand, boldly denied their

existence altogether.

According to Galen’s teaching the liver is the source of origin of all

the veins, just as the heart is the starting-point of all the arteries.

It is quite remarkable, says Flourens, that physicians who performed

almost daily the operation of venesection should, during a long series

of years, have failed to observe that this doctrine of blood flowing

through the veins from the liver to the different parts of the body,

could not possibly be true, inasmuch as at each such operation the

vein always became distended with blood _below_ (_i.e._, on

the distal side of) the ligature which they applied to the part (arm,

for example) before opening the vessel. This phenomenon, of course,

indicated clearly that the blood in the veins flowed _toward the

heart_, and not from any centrally located spot or organ _toward

the extremities_. And yet--he adds--even so bright and thoughtful

a man as Vesalius does not appear to have noticed this fact. Andreas

Caesalpinus (1519–1603), on the other hand, did observe and correctly

interpret the phenomenon; and he made the further observation that

physicians were habitually applying the ligature _above_ the

spot which they expected to bleed, regardless of the fact that in so

doing they were not acting in harmony with their belief concerning the

circulation of blood in the veins. Caesalpinus also states, in one part

of his writings, that “the blood, carried to the heart by the veins,

receives in that organ its last transformation toward perfection,

and is then--in this perfected state--transported by the arteries to

the remotest parts of the body.” So far as it relates to the general

movement of the blood this statement is correct, but it errs, as will

be shown presently, in mentioning the heart as the locality where the

perfecting process takes place. In his final remarks regarding the

anatomical relations which exist in the two chambers of the heart

Caesalpinus makes the following statement:--

Each ventricle possesses two vessels--one through which the

blood reaches that chamber, and a second one which serves to

carry it out of the ventricle. The vessel through which the

blood enters the right ventricle is called the _vena cava_,

and that by which it leaves this same chamber is called the

pulmonary artery. The vessel through which the blood arrives

in the left ventricle is called the pulmonary vein, and that

through which it leaves this left chamber of the heart is known

as the aorta.

_The Circulation of the Blood as Elucidated by Michael

Servetus._--Michael Servetus, a native of Villanueva, Spain,

who in 1553 was burned alive at the stake near the city of Geneva,

Switzerland, because of his heretical teachings, is not infrequently

mentioned as the individual to whom credit is due for having furnished

the first description of the lesser or pulmonary circulation. There

is no question whatever regarding the justice of according to him

at least a part of this honor, but one should be careful to specify

that Servetus is entitled only to the credit of having been the first

to teach that the blood, in its journey from the right to the left

side of the heart, must pass entirely through the lungs. So far, his

doctrine is correct; but he also taught at the same time that the

fluid which enters the aorta from the left ventricle is not blood but

perfected “vital spirit” (Galen), and that it becomes genuine blood

only after it has tarried for a few brief instants in the ventricular

chamber and has there been subjected to some unknown influence

exerted by the heart itself. This second erroneous part of Servetus’

description seems to me to diminish very materially the credit to which

he is otherwise entitled; and I cannot help feeling that Dezeimeris is

right when he claims that Realdus Columbus, whose more perfect account

of the lesser circulation was written only a little later than that of

Servetus, is perhaps better entitled to the honor in question.

It is an interesting fact that Servetus introduces his disquisition

on the circulation of the blood in the very midst of a treatise which

bears the title “Restitution of Christianity,”--in other words, in a

treatise which would never, under ordinary circumstances, be consulted

by physicians in their search for information regarding an important

problem in physiology like that of the circulation of the blood. In

this physiologico-theological treatise Servetus, who--as I omitted to

state--was a theologian as well as a physiologist, used the following

expressions:--

The soul, says Holy Writ, is in the blood; as a matter of fact,

the soul is the blood. And since the soul is in the blood, one

should--if one wishes to learn how the soul is formed--endeavor

to learn how the blood is formed; and, in order to learn how

the blood is formed, it is necessary to ascertain how it moves.

(Flourens.)

I am unable to state whether it was this particular chapter, or

the work taken as a whole, which appeared to the ecclesiastical

authorities--first those of France and afterward those of Geneva--to

warrant the author’s condemnation as a heretic. And, when we are

disposed to blame severely those bigots who, in the fifteenth and

sixteenth centuries, manifested such a keen desire to destroy

“heretics,” let us remember, with a proper sense of shame, that

we still have in our midst, in this twentieth century and in this

“land of freedom,” men of high social standing who are as virulent

heresy-hunters as ever were the enemies of Servetus.

_Experiments of Realdus Columbus._--Matthaeus Realdus Columbus,

who was born at Cremona, Northern Italy, in the early part of the

sixteenth century, acted for some time as Vesalius’ prosector, and

must therefore have had ample opportunities for acquiring a thorough

knowledge of the experimental method of studying questions in

physiology. He wrote a description of the pulmonary circulation which

was more lucid and nearer to the truth than any which his predecessors

had furnished. This description, which will be found in his treatise

on anatomy (Venice, 1559), was based largely upon experiments that he

carried out upon living dogs. As rendered into English from the French

version supplied by Dezeimeris, it reads as follows:--

When the heart dilates the blood passes from the vena cava into

the right ventricle; from the latter chamber it is pushed into

the arterial vein (the pulmonary artery), along which channel

it is carried to the lung, there to be properly thinned and

mixed with air. Ultimately the blood passes on into the venous

artery (= the pulmonary vein), the function of which vessel is

to carry this fluid, now charged with air through the action of

the lung, into the left ventricle of the heart. Then follows

the contraction (systole) of this organ, as a result of which

action the tricuspid valves rise up into position and form a dam

that prevents the return of the blood into the vena cava and

the pulmonary veins. Simultaneously with this action the valves

placed at the opening which represents the commencement of the

aorta (left ventricle), and those placed at the opening which

corresponds to the beginning of the pulmonary artery (right

ventricle), yield and thus open the way for the distribution of

the blood throughout the rest of the body.

The reader will, I believe, admit that this description, while perhaps

not faultless, is distinctly superior to that given by Servetus.

Columbus’ experimental studies threw considerable light upon other

matters relating to the physiology of the heart. He demonstrated,

for example, that the fluid which enters the left ventricle from the

lungs is genuine blood, and he also learned by the same method of

investigation the true nature of the systole and diastole of the heart

and the relations of these acts to the pulse and to the changes in the

position of the heart. The discovery of all these facts constituted

a material advance in our knowledge of the physiology of that organ;

but, from this time onward, for a period of nearly three-quarters of a

century, no further advance was made until William Harvey of England

appeared on the scene. The explanation of the failure of such able

investigators as Realdus Columbus, Vesalius, Servetus and others to

push their researches still further is to be found largely in the fact

that they were all still in bondage to the doctrines taught by Galen

centuries earlier, and probably more particularly to that dogma which

maintains that blood--if it is to be accepted as genuine or fully

formed blood--must first have been elaborated in the depths of the

liver. The impossibility of harmonizing such a dogma with the facts

which by that time were well established, is too plainly evident to

warrant further discussion in these pages.

_Discovery of Valves in the Larger Veins by Fabricius ab

Acquapendente._--The discovery of the presence of valves in the

interior of the larger veins is credited by some to Cannani (1546)

and by others to Fabricius ab Acquapendente (1574), but the best

authorities appear to favor the claim of Fabricius to this honor.

There are also a few authorities who maintain that Fra Sarpi, the

celebrated monk and scientist of Venice, is entitled to be considered

the discoverer of the valves in veins, but Tiraboschi, the historian of

Italian literature, makes it clear that this claim is unfounded.

Although it was known to Fabricius that these valves are inclined

toward the heart, he does not appear to have appreciated the fact that

this arrangement is entirely incompatible with Galen’s doctrine that

the flow of venous blood is from the liver toward the extremities; nor

did any other anatomist, so far as I am able to learn, discover this

incompatibility before it was pointed out by Harvey nearly fifty years

later.

_William Harvey, Who is Universally Acknowledged to be the Real

Discoverer of the Circulation of the Blood._--William Harvey was

born at Folkstone, England, in 1578, received his academic education at

Caius College, Cambridge, and became a doctor of medicine in 1602, at

the age of twenty-four. Four or five years before this event he went

to Padua, Italy, to study medicine under Fabricius ab Acquapendente,

who was considered at that period to be the ablest and most inspiring

teacher of anatomy and physiology in Europe. It was from him, it may

safely be assumed, that Harvey learned the importance of studying

Nature herself, rather than books, when one is desirous of learning her

secrets. Equipped with a thorough knowledge of the methods that may

best be employed in making studies of this character, Harvey returned

to England at the end of his long stay at Padua. He was soon afterward

made a member of the College of Physicians of London, and in 1615 was

elected to the Chair of Anatomy and Surgery in that institution. Later

still, he was appointed one of the physicians of St. Bartholomew’s

Hospital. He also held for several years the position of Court

Physician, first to James the First and then to Charles the First. It

was during this period of his professional career that he began working

in earnest upon the problem of the circulation of the blood, and he

kept steadily at this work throughout a period of several years. Among

the manuscripts preserved in the British Museum there is one bearing

the date of 1616 which shows that Harvey had already at this time

reached conclusions which, in all essential respects, agree with those

which appear in his final treatise published in 1628. The title of the

latter work is, “_Exercitatio anatomica de motu cordis et sanguinis

in animalibus_” (Frankfort, 1628).

Although, as I have shown above, several of the links in the chain

of proofs bearing upon this question of the circulation had already

been discovered before Harvey began his researches, he was not

willing to accept them as proven facts until he had himself tested

them thoroughly by the experimental method. Furthermore, they were

often disconnected, and this lack of continuity obliged him to supply

missing links at several points; in other words, nobody had as yet

demonstrated the important fact that the blood travels regularly in an

unbroken circuit, and it was to this great task that Harvey devoted

himself at the period which we are now considering. He carried out

all these investigations with the most painstaking care and made

public announcement of his discoveries only after the lapse of an

extraordinary length of time; his chief object being that ample

opportunity might thereby be afforded for complete verification. The

following are among the more important questions which he investigated

and to which he furnished satisfactory solutions. He learned, for

example, that the auricle and ventricle of each side of the heart do

not contract simultaneously but in succession. When the right auricle

contracts the blood which it then contains passes into the right

ventricle; and when the right ventricle contracts the blood is driven

into the pulmonary artery. From this vessel it passes ultimately into

the pulmonary vein, and from the latter into the left auricle, which

then contracts and drives the blood into the left ventricle. The

latter chamber next contracts and forces the blood into the aorta,

whence it is carried into all the arteries of the body. From these, in

turn, it passes into the veins and thence back to the right auricle

of the heart--the point from which it started. He corroborated the

finding--by other anatomists who had preceded him--of membranous valves

at the spots where the blood passes from one chamber to the other;

and he compared these valves to little doors which open to permit the

passage of the blood in one direction, but which close when there is

any tendency for it to pass in the opposite direction. The valves

of the right auricle, for example, allow the blood to pass into the

right ventricle, but prevent it from returning into the auricle. Then,

further, the valves of the right ventricle permit the blood to pass

into the pulmonary artery, but prevent it from returning into the

ventricle. The valves of the left auricle permit the blood to pass

into the left ventricle, but do not permit it to return into the left

auricle. Finally, the valves of the left ventricle allow the blood to

pass into the aorta, but prevent it from regurgitating into the same

ventricle. The valves with which the veins are equipped permit the

blood to travel onward toward the heart, but do not permit it to back

up into the arteries.

[Illustration: FIG. 15. WILLIAM HARVEY.

(After the portrait by Cornelius Jonson.)]

Galen taught that the arteries pulsated by reason of a “pulsific power”

which they derive in direct continuity from the tunics of the heart.

He tried to prove the correctness of his doctrine by experimental

methods, but in this he failed. Harvey was convinced that the arteries

do not pulsate by reason of their own inherent power, but by a force

of impulsion communicated to the blood at the heart. He refers to this

question in the following terms: “When an artery is opened the blood

escapes in jets of unequal force; the alternate jets being stronger

than the intermediate, and the stronger jets corresponding in time of

occurrence, not with the systoles but with the diastoles of the artery.

The artery, therefore, must be distended by impulsion, by the shock of

the blood. If the artery dilates by reason of its own inherent power,

the blood would not be expelled with the maximum force at the very

moment when this dilatation occurs.” As evidence of the non-existence

of Galen’s assumed “pulsific power,” Harvey mentions the fact that, in

the case of a patch-shaped calcification of the crural artery which

came under his observation, the pulsation took place as usual, but at a

point below (distal to) the edge of the patch. The intervening patch of

rigid calcareous matter was not able to prevent the traveling onward of

the propelling power.

Harvey next takes up the consideration of the veins, and, after

showing that they permit a flow of the contained blood in only one

direction,--viz., that from the extremities toward the heart,--he

calls attention to certain experiences which he has had: (1) When a

cord is tied lightly around a limb the flow of blood is arrested _only

in the veins_, because these vessels are located near the surface of

the skin; but, if the cord is tied more tightly, the flow of blood

is also arrested in the arteries, which lie at a relatively great

depth. (2) When a vein is tied the resulting distension manifests

itself _only below_ (_i.e._, on the distal side of) the ligature;

whereas, when an artery is similarly tied, the distension takes place

_above_ (_i.e._, on the proximal side of) the ligature. It is therefore

plain that in the veins the blood flows from the individual parts

toward the heart, but that in the arteries the flow is in the reverse

direction--_i.e._, from the heart toward the individual parts. “If one

reflects upon the nature of the movement of the blood,” says Flourens,

“one will promptly realize how speedy it is. Scarcely has the blood

entered the heart before it is hurried into the arteries; and then

from these vessels it passes in an instant into the veins, from which,

with almost equal speed, it finally travels back to the heart again.

It is this never-ending movement from one channel into another, and

then eventually back to the starting-point, which constitutes the

circulation of the blood.... Modern physiology dates from the discovery

of the circulation of the blood. Up to the time of this discovery

physiologists followed the ancients; they did not dare to walk alone.

Harvey had discovered the most beautiful phenomenon in the animal

economy.... From this time forward, instead of swearing by Galen and by

Aristotle, one had to swear by Harvey!”

Despite the great care which Harvey took to back up his scheme of the

circulation of the blood with unimpeachable proofs of its correctness,

he was obliged to pass through the same sort of experience as that to

which Vesalius and scores of other pioneers in the field of scientific

inquiry had been subjected. Two hostile forces stood constantly

ready, during that fruitful period of the Renaissance, to attack with

merciless bitterness all those who ventured to add new facts to our

stock of knowledge in the domain of medicine. On the one side were the

many men of small calibre, men filled with jealousy over the successes

gained by co-workers in the same field; and on the other was marshaled

the host of those who honestly believed that all medical wisdom ended

with Galen. Before his death, however (hardly thirty years later),

Harvey had the satisfaction of witnessing the almost unanimous

acceptance of his dogma concerning the circulation of the blood. Louis

the Fourteenth, King of France at this period, was so appreciative of

the importance of Harvey’s discoveries that he appointed Dionis, the

distinguished French anatomist, to demonstrate to the students of the

Medical School of the Jardin des Plantes at Paris the circulation of

the blood and other recent discoveries. Descartes (1596–1650), the

celebrated French philosopher, paid an even greater compliment to the

high character of the work accomplished by Harvey. His words, as quoted

by Flourens, are as follows:--

If I am asked why the supply of venous blood does not become

exhausted in flowing thus unceasingly into the heart, and why

the arteries--since all the blood that passes through the

heart must travel along these vessels--do not become filled to

overflowing, I can see no good reason why I should not give

to this question the very same answer that William Harvey, an

English physician, to whom praise is due for having taught ...,

has already given. [Then follows the text of Harvey’s reply.]

Our readers have doubtless noted the fact that, while Harvey, as I have

endeavored to show in the preceding account, has clearly established

his right to be considered the discoverer of the circulation of the

blood in all its most essential features, his scheme fails to furnish

any information concerning the composition of the blood and the manner

in which it is built up into a life-giving fluid. In the minds of some

this may seem to be an omission. A moment’s reflection, however, will

satisfy any reasonable person that questions of this nature do not form

a legitimate part of the problem which Harvey was engaged in solving,

and that they therefore should receive separate consideration. Thus,

for example, Harvey’s scheme fails to furnish satisfactory information

concerning those portions of the circuit where the blood is obliged

to travel through a system of communicating capillary channels, as

happens in the lungs and in the tissues generally throughout the body.

But Harvey had no means at his command for investigating a question

of this nature. Capillary blood-vessels are invisible to the naked

eye, and may be studied only with the aid of a microscope; but this

instrument was not available until long after the time (1605–1616)

when Harvey was engaged in carrying out his investigations into the

circulation of the blood.

_Other Discoveries Relating to the Vascular System._--To Vesalius

is due the credit of having discovered the fact that anastomoses exist

between the carotids and the vertebral arteries, thus explaining how a

man may continue to live even after both carotids have been severed or

ligated. His great rival, Fallopius, described these anastomoses in the

most detailed manner, and he noted the further fact that an anastomosis

with the basilar artery exists.

By the end of the sixteenth century a certain amount of progress had

been made toward a correct knowledge of the lymphatics. Bartholomaeus

Eustachius, for example, discovered the existence (in horses) of the

thoracic duct, but he supposed it to be a vein. His description of this

vessel reads as follows:--

In these animals there is a large vessel which extends downward

from the inner aspect of the clavicular vein (= left subclavian

vein). At the point where it joins the vein it is closed by

means of a semicircular valve. This vessel is of a whitish

color and it contains a scanty watery fluid. Not far from its

starting-point it divides into two branches which very soon,

however, join together again, and then, as a single trunk from

which no further branches are given off, it passes down along

the left side of the spinal column, penetrates the diaphragm,

spreads itself out over the aorta, and ends in a manner unknown

to me.

About one hundred years later (1647), Jean Pecquet of Dieppe, France,

professor in the Medical School of Montpellier, rediscovered (in a

dog) this same duct, with its tributary chyle ducts and also its point

of entrance into the left subclavian vein; and, as he had rightly

interpreted its nature, anatomists by common agreement accorded him the

rights of discoverer.

At a still earlier date (1622) Caspar Aselli of Cremona, Northern

Italy, professor in the Medical School of Pavia, discovered the chyle

ducts. This discovery was made under the following circumstances, which

reveal the fact that good luck sometimes plays an important part in

the work of the searcher after truth in the departments of anatomy and

physiology:--

Aselli was studying the distribution of the recurrent nerves and

the movements of the diaphragm in a well-nourished living dog,

when his attention was drawn to the presence of a large number

of delicate white threads coursing as it were over the surface

of the mesentery. Following the accidental injuring of one of

these threads there escaped from the wounded structure quite

a large quantity of chyle. Aselli, who instantly appreciated

the full significance of what had happened, exclaimed, in the

presence of the bystanders, “Eureka!” At the time he supposed

that these chyle vessels terminated in the liver and contributed

in some manner to the elaboration of the blood (in harmony with

Galen’s universally accepted theory of sanguification); but

later, after he had carried out a carefully conducted series

of experiments, he was able to rectify this erroneous belief.

(Haeser.)