sixteenth century--and, indeed, among authors generally--to utilize
the writings of their predecessors without giving them proper credit
for their work; and Paré, it appears, was not entirely free from this
fault. Von Gurlt mentions a few of the more glaring instances of such
sinning, and among them the following: Paré’s two chapters on tumors
are taken from the “_De institutione chirurgica_” of Jean Tagault
(Paris, 1543), who in turn is charged with having borrowed the data
from Guy de Chauliac’s treatise; in his chapter on wounds in general,
Paré has also borrowed largely from the same work; and the chapter
which he devotes to the subject of special wounds is taken from the
writings of Hippocrates; and, finally, he has transferred almost
bodily Philippe de Flesselle’s “_Introduction pour parvenir à la
vraie cognoissance de la chirurgie rationelle_.” Before we condemn
Paré for plagiarism, and although the facts as stated by von Gurlt are
undeniable, we should take several things into careful consideration.
It is fitting, for example, that we should make some sort of an
estimate of the value of the text thus appropriated, in order that we
may be able to measure the seriousness of Paré’s sinning; and, if we do
this, we cannot fail to be struck with its insignificance in comparison
with the admittedly valuable character of all the remaining text of
these three huge volumes--text which bears every mark of being the
product of Paré’s brain. Paré himself, in speaking of his borrowings
from other authors, says that his acts of this nature are “as harmless
as the lighting of one candle from the flame of another.” Then, again,
there are several of these borrowings which are evidently the handiwork
of a rather dull person, and this fact alone makes one bold to assert
that Paré, who was certainly not lacking in brains or in a desire
to follow the golden rule in his treatment of the property of such
writers, could scarcely have been guilty of such clumsily contrived
interpolations. Inasmuch, however, as many important facts bearing
upon the question at issue are not within my reach, I am obliged, in
my attempt to defend the memory of Paré, to fall back upon speculative
reasoning. The medical profession at large has long since heard this
charge of plagiarism and it refuses to attach any importance to it as
affecting the personal character of Paré. It prefers to believe that
he is guiltless and that somebody else--at a time, perhaps, when Paré,
being well advanced in years, was too ill to revise the manuscript of
the “Collection of his Writings” edited by Guillemeau--thoughtlessly
yielded to the impulse to remedy, by borrowing from other sources,
the trivial defects or omissions noted in the text. In any case,
whatever the actual truth may be, I am, I believe, justified in
maintaining that Paré is not rightly chargeable with the guilt of
plagiarism.
[Illustration: FIG. 25. AMBROISE PARÉ, THE FAMOUS FRENCH SURGEON
OF THE SIXTEENTH CENTURY.
(From von Gurlt’s reproduction of the portrait published by Le
Paulmier, Paris, 1885.)]
Strange as it might appear, if history did not furnish many examples
of the same character, Paré’s merits as a man and as a surgeon were
not as fully appreciated as they deserved to be until after the
lapse of nearly two centuries. In 1812 the _Société de Médecine de
Bordeaux_ offered a prize for the best eulogy of Ambroise Paré,
and it was awarded to Vimont. Finally, in 1840, a fine bust of the
distinguished surgeon was completed by the sculptor David of Angers,
and set up in bronze in Laval, Paré’s birthplace. The portrait here
reproduced from the engraving in von Gurlt’s work represents the bust
in question (Fig. 25).
A complete collection of the writings of Paré has been prepared by
J. F. Malgaigne, the distinguished French surgeon, and published in
three very large volumes (Paris, 1840–1841). This collection is based
on a careful comparison and collation of all the previously published
editions. The contents of these volumes cover very nearly the entire
range of surgery.
CHAPTER XLI
SURGERY IN GREAT BRITAIN DURING THE SIXTEENTH AND SEVENTEENTH CENTURIES
In Great Britain the cultivation of the science of medicine began at
a much later date than it did on the continent of Europe, and, so far
as may be judged from the facts within our reach, there were, in the
early part of the sixteenth century, very few Englishmen who could
justly lay claim to the possession of more than the rudiments of
the art of surgery. Two centuries earlier, as I have already stated
in a previous chapter, there were three men in England who gained
considerable fame in this department of medicine. They were Gilbert
“the Englishman” (1210), John of Gaddesden (1320), the author of the
famous book entitled “Rosa Anglica,” and John of Ardern (_circa_
1350); but afterward, for a period of nearly two hundred years, the
records fail to reveal to us a single surgeon of any note. Then during
the sixteenth century the only English surgeons whose names deserve to
be perpetuated are Gale, Clowes and Woodall, of whom I shall presently
give brief accounts. They were all at one time or another, as in the
case of the leading continental surgeons of that period, officially
connected with the army. Some idea of the unsatisfactory state of the
medical service in the English army of that period may be gathered from
the statements made by Gale regarding this matter. From his account it
appears that in 1544 the army was accompanied by a miscellaneous crowd
of men who were supposed to be in some measure physicians, but who in
reality were uneducated quacks, vendors of all sorts of dressings and
washes for wounds, of infallible cures for gunshot injuries, etc. The
mortality in the English camp was, as might readily be expected, very
heavy. The same state of things existed, at a somewhat later date, in
the fleet sent against the Spanish Armada. It is not to be wondered
at, therefore, that very few of the educated surgeons were willing to
accept service in the English army or the English fleet, especially as
the pay which they received was no greater than that of the drummers
and trumpeters. Toward the end of the century much greater attention
was paid to the care of the wounded and crippled, and, in corroboration
of this, it may be stated that Henry the Fourth, King of France,--who,
it may safely be assumed, was influenced to take this step by the
enlightened advice of Ambroise Paré,--ordered the establishment of
military hospitals for the use of the army which was at that time
besieging Amiens. And again, at a later date (1603), there was
established at Paris a retreat for old and infirm or mutilated officers
and soldiers.
It is an interesting fact that during the year 1544, while Henry the
Eighth of England, in alliance with the German Emperor Charles the
Fifth, was carrying on the war against Francis the First, King of
France, there were present, on the soil of the latter country, all the
leading European surgeons of that period--viz., Ambroise Paré, with
the French army which was laying siege to Boulogne-sur-Mer (captured
a few months earlier by the English troops); Thomas Gale, the most
famous surgeon of that day in England, with the army of the besieged;
and Vesalius and Daza Chacon with the troops of Charles the Fifth
at Landrecy (near the Belgian boundary, south of Brussels) and at
St. Didier (in the northeastern part of France). I have already, in
preceding chapters, given brief accounts of the lives and professional
accomplishments of all these surgeons with the exception of Gale, and
it only remains now to supply such information as may be obtainable
concerning the latter and also concerning his contemporaries, the
English surgeons Clowes and Woodall.
_Thomas Gale._--Thomas Gale was born in London in 1507, practiced
medicine for some years in that city, and then, in the capacity of
a surgeon, entered the service of the army under Henry the Eighth.
At a later date he joined the army of Philip the Second of Spain. In
1544 he was present at the battle of Montreuil in France, and he was
also present at the siege of St. Quentin, in 1557. Two years later he
returned to London and became a member of the Barber-Surgeons’ Company.
His death occurred in 1587.
Gale was the author of several books on surgical subjects, the most
important of these works being that which deals with gunshot wounds.
His views regarding wounds of this nature agree in the main with the
teachings of Ambroise Paré; and yet, according to von Gurlt, he appears
to have formed his opinions independently, for he does not once mention
that surgeon’s name. He was not only a skilful surgeon, but also a man
of scientific and literary tastes, as shown by his translations of some
of Galen’s writings and of Giovanni da Vigo’s treatise on surgery, and
also by his own published works. His book on gunshot wounds, to which
reference has already been made, is the one which reflects the greatest
credit upon the author. One of its chief merits is to be found in the
fact that it enabled the physicians of England to keep in some measure
abreast of their brethren on the continent, at least in the matter of
treatment by surgical means. In one part of the work he makes reference
to the belief, which was held at that time by many surgeons, that the
bullet not only scorched the flesh of the wound which it inflicted but
also introduced into it a poisonous element. I quote here one or two
extracts from the comments to which I have just referred:--
The usuall Gonnepouder is not venemous, nother the shotte
of such hoteness as is able to warme the fleshe, much lesse
to make an ascar.... Hange a bagge ful of Gonnepouder on a
place convenient: and then stand so far of as your peece wil
shote leavell, and shote at the same, and you shall see the
Gonnepouder to bee no more set on fyer with the heat of the
stone [used as a bullet] than if you caste a cold stone at it.
An English translation of Paré’s book, says von Haller, was not
published until 1577. It is therefore not strange that Gale, whose book
was printed fourteen years earlier (_i.e._, in 1563), should
have made no mention of that author’s method of applying ligatures
to the bleeding vessels of an amputation stump. The first reference
(in English) to this plan of preventing hemorrhage from the divided
blood-vessels in an amputation stump occurs--so far as I have been able
to discover--in the treatise published in London by William Clowes, in
1588, under the title “A prooved practise for all young chirurgians
etc.” Clowes, however, erroneously gives the credit for this important
procedure to Guillemeau, one of Paré’s pupils.
In one of his writings Gale states, after witnessing the surgical
practice at the Royal hospitals of St. Bartholomew and St. Thomas in
1562, “that it was saide that Carpinters, women, weuvers, coblers and
tinkers did cure more people than the chirurgians.” (South.)
_William Clowes._--William Clowes was born, about the year 1540,
at Kingsbury, in Warwickshire, and received his early training in
surgery under George Keble of London. In 1563 he accepted the position
of surgeon in the army which was under the command of Earl Ambrose
of Warwick and was stationed at that time in France. Six years later
he settled in London, and was made a member of the Barber-Surgeons’
Company. In 1575 he received an appointment on the Surgical Staff of
St. Bartholomew’s Hospital and six years later still he was promoted to
the rank of full surgeon, a position which he already held in Christ’s
Hospital. In 1585 he resigned his appointment at St. Bartholomew’s and
accepted an invitation to serve in the Earl of Leicester’s army, which
was at that time in the Netherlands. During this war Clowes acquired
a rich and varied experience in the treatment of wounds. Soon after
his return to London in 1588 he joined the fleet which vanquished the
Spanish Armada. Later, he was given the appointment of Surgeon to the
Queen. His death took place at Plaistow, County of Essex, in August,
1604. Von Gurlt does not hesitate to qualify him as one of the most
distinguished English surgeons of his day.
Of the four surgical treatises which were written by Clowes, and of
which several editions were published between the years 1575 and 1637,
there is only one to which I shall refer in this brief account, viz.,
that which, in the edition of 1637, bears the title: “A profitable and
necessarie Book of Observations, for all those that are burned with the
flame of Gun-Powder.” This book is full of brief histories of cases
which came under the author’s personal observation, and it therefore
furnishes an excellent and truthful picture of the kind of wounds which
the highwaymen and soldiers of that day inflicted, and of the treatment
which was employed by the best English surgeons. The following may
serve as sufficient examples:--
(1) A clothier, who had been assailed by robbers, received a dangerous
wound in the left thigh. It was about four inches long and of such a
depth that “the rotula or round bone of the knee did hang downe very
much.” Clowes first removed a clot of blood from the wound and then,
“with a sharp and square-pointed needle, armed with a strong, even and
smooth silke thred, well waxed, introduced five stitches, one good
inch distant betweene every stitch, leaving a decent place for the
wound to purge at.” He then applied a suitable bandage. The patient’s
friends were not at all pleased that Clowes, having pronounced the
wound dangerous, should not have been willing to state how much time
would elapse before it would be healed. So they called in a charlatan,
who on the following day removed the dressings and cut through all
the stitches. Seven days later, Clowes was once more asked to see
the case. He found the wound gaping widely and in a bad state. After
adopting such measures as were most urgently required, he brought
the edges of the wound together by the application of three strips
of sticking-plaster. In due time healing took place, “but the motion
perished: for the patient had the imperfection of a stiff knee, which
constrained him to use a leather strap, fastened unto the toe of his
shooe, and again made fast unto his body; and so he remaineth unto this
day.”
(2) The history of the second case may be given here in the following
brief outlines. The patient, a ship’s gunner, was wounded in the lower
part of the abdomen by what was probably a partially spent ball. The
wound made by the missile was of such a nature that it permitted a
large portion of the “zirbus” (omentum), together with some of the
intestinal canal, to protrude from the opening. After making a careful
examination of the parts, Clowes was satisfied that the intestine was
still uninjured.
Then with a strong double thread I did tie fast the zirbus as
close unto the wound as possible wel I might, and within a
finger bredth or thereabouts I did cut off that part of the
zirb that hanged out of the wound, and so I cauterized it with
a hot iron almost to the knot; all this being done, I put again
into the body that part of the zirb which I had fast tied, and
I left the peece of thred hanging out of the wound: which,
within four or five days after, nature cast forth, the thred
as I say being fast tied; then presently I did take a needle
with a double strong silke thred waxed, wherewith I did thrust
thorow both mirach [skin, adipose layer and muscular tissue]
and ziphach [peritoneum] on the right side of the wound, but
on the left side of the wound I did put the needle but thorow
mirach only, and so tied these three fast together with a very
strong knot, and presently I did cut of the thred.... All which
is according to Weckers[94] and other learned men’s opinions
and practices, who also say that the stitches of the one side
must be higher than on the other side. [The usual dressings were
afterward applied and were renewed three days later. At the end
of twenty-one days the wound was found to be completely healed.]
In chapter 27 of the same work there is given a list of the medicaments
and instruments with which a field-or ship’s-surgeon should be equipped
before he engages in active service. From this list I select the
following items as showing--at least in some measure--in what respect
the tools employed by surgeons four hundred years ago differ from
the modern ones of a similar character: “Small and long waxe candles
to search the hollownesse or depth of a wound.” “Small buttons or
cauterizing irons meete to stay the flux of an artery or veine.” “A
trepan.” “Needles two or three, some eight inches, some ten or twelve
inches in length, having a decent eye in it guttered like a Spanish
needle, and point or end blunt or round, that it offend not in the
going in of it, made fit to draw a Flammula, or a pece of fine lawne
or linnen cloth through the body or member that is wounded.” “As for
stitching quils and other instruments, that a Surgeon ought always to
carry about him, I leave unspoken of.”
In praise of one of the plasters enumerated in the list, Clowes
narrates the following incident which occurred near Arnheim in the
Netherlands: “A horseman was wounded with a pike neere the middle of
his right thigh; the weapon so passing upwards that by good fortune it
rested upon the os pubis, otherwise he had been slaine.” As the first
step in the treatment, the copious bleeding was arrested; after which
warm _oleum hyperici_ [oil of St. John’s wort] was injected into
the wound, then a short tent was introduced, and the sticking plaster
was applied on the outside. “Thus he was cured in fourteene days, and
so was ready to serve in the field again.”
_John Woodall._--John Woodall or Woodhall was born in England
about 1569, and was sent as a military surgeon to France by Queen
Elizabeth with the troops which Her Majesty placed at the disposal
of the French King, Henry the Fourth. After his return to England,
Woodall was made a surgeon of St. Bartholomew’s Hospital and also
Surgeon-General of the East India Company. He was already at that time
a member of the Company of Barber-Surgeons of London. Woodall must have
had a very extensive experience in the practice of surgery, for he
states that he had performed the operation of amputation of a limb more
than one hundred times. The date of his death is not known.
Von Gurlt calls attention to the fact that the first notice printed
in English of Ambroise Paré’s method of ligating blood-vessels after
an amputation is to be found in the treatise written by John Woodall
and published in London in 1639, under the title: “The Surgeon’s Mate,
or Military and Domestic Surgery.” As the first edition of this book,
which was published in 1617, says nothing about Paré’s method, it seems
permissible to infer that the news of this improvement, one of the
most important made in surgery (1552), reached England from France only
after the lapse of eighty-seven years! There can be scarcely any doubt,
however, that individual English surgeons had already learned about
Paré’s improved method at a much earlier date.
_State of Surgery in England During the Seventeenth
Century._--Before I pass on to the consideration of the state of
surgery in England during the seventeenth century it seems desirable
that I should say a few words with regard to the relative standing of
the two branches of the medical profession--the physicians and the
surgeons--in the esteem of their fellow Englishmen at this period
of history. In France, it will be remembered, a surgeon was looked
upon, even as recently as during the first half of the sixteenth
century, as a man of inferior social standing, perhaps a shade better
than an apothecary, but certainly far below his more highly educated
associate--the physician. The favors extended by French Royalty to
Ambroise Paré and the very high esteem in which he was held by French
society in general effected a great change in the relative status of
the two classes of practitioners in France; and, as a result of this
change in public opinion, medical practitioners, subsequent to 1560 or
1570, were led to realize that a surgeon, if sufficiently educated,
if earnestly devoted to his professional work, and if intent upon
helping his fellow men rather than upon accumulating a fortune, might
confidently aspire to a position of equality with the best physicians
of the community in which he lived. In England a similar change of
opinion in regard to the honorableness of the career of surgeon
took place about this time, probably in consequence of the great
reputation gained by Gale, Clowes and Woodall. In both countries the
change occurred slowly, and in France what was gained during Paré’s
lifetime seemed afterward to be lost for a period of several years.
But eventually the prevailing opinion again became favorable to the
surgeons, and from that time to the present they have enjoyed an
ever-increasing esteem in public opinion. But there was a brief period,
early in the seventeenth century, when it must have been very galling
to the pride of an honorable and experienced surgeon to be placed as
it were under the tutelage of the physicians who were his official
associates in certain hospitals--as, for example, in St. Bartholomew’s,
London. The following extracts[95] from the “Orders” or “Articles” of
that institution (1633) explain more precisely what is meant by the use
of the word “tutelage”:--
9. That no surgeon or his man do trepan the head, pierce the
body, dismember or do any great operation on the body of any but
with the approbation and by the direction of the Doctor (when
conveniently it may be had) and the surgeons shall think it
needful to require.
13. That every surgeon shall follow the directions of the Doctor
in outward operations for inward causes, for recovery of every
patient under their several cures, and to this end shall once in
the week attend the Doctor, at the set hour he sitteth to give
directions for the poor.
(From St. Bartholomew’s Hospital Reports, Vol. XXII., 1886.)
Among the English surgeons of the seventeenth century there appears to
have been only one who attained some degree of eminence, viz., Richard
Wiseman, who is often spoken of as the Ambroise Paré of England.
Haeser mentions 1625 as the date of his birth, and at the same time
states that he was in the service of the Stuart Kings from Charles
the First to James the Second. It seems to me highly probable that
this statement regarding the date of Wiseman’s birth is erroneous; for
if it be accepted as correct, then he (Wiseman) must have been only
fifteen years of age when he first started out with the prince (in
1640) on the latter’s wanderings through France and the Low Countries.
On the other hand, if Wiseman was really born in 1625, then we shall be
justified in assuming that he traveled with the prince at first simply
as his companion and not in a professional capacity; and we shall be
further justified in assuming that he acquired his medical and surgical
training during his residence on the continent.
In 1650 Wiseman returned with the prince to Scotland. At the battle
of Worcester he was taken prisoner by the Parliamentary army under
Cromwell and did not regain his liberty until 1652, at which time he
settled permanently in London. After the Restoration in 1660, his
practice increased very greatly and, so far as one may judge from the
large number of cases which he reports in his work on surgery that
was first published in 1676, it must have been very extensive and of
a most varied character. I have read many of these reports of cases
that occurred in Wiseman’s practice, and have been much impressed with
the thoroughly practical character of the treatment which he adopted
in the majority of instances, and also with the very clear and concise
manner in which he narrates the attendant circumstances--the nature of
the malady or of the injuries received, the treatment which he adopted,
and the final results attained. In the belief that they may furnish
corroborative evidence of the statements which I have just made, I now
take the liberty of reproducing here two of these reports of cases:--
(1) Whilst I was a prisoner at Chester (1651), after the battel
of Worcester, I was carried by Colonel Duckinfield’s order to a
man that out of much zeal to the Cause, pursuing our scattered
forces, was shot through the joint of the elbow; the bullet
entering in at the external part of the _os humeri_, and
passing out between the _ulna_ and _radius_. He had
been afflicted with great pain the space of six weeks. I found
the wound undigested,[96] and full of a loose, soft, white
flesh, the bones fractured, and not likely to unite, many
shivers lying included within the joints, and incapable of
being drawn out. The lower part of the arm was oedematous to
the fingers’ ends as full as the skin could well contain, and
the upper part was inflamed; also about the _os humeri_
and _axilla_ a perfect phlegmon was formed. The patient
thus tired with pain, desired to be cured or have his arm cut
off. To which purpose he had procured the Governor’s leave for
my staying with him. But, while that phlegmon was upon the
upper parts, there was no hope of a prosperous amputation, nor
of cure while those shivers of bone lay pricking the nervous
parts within the joint. The phlegmon was too forward for
repercussion,[97] and yet not likely to suppurate in less than
a week’s time. Wherefore I endeavored by emollients and some
discutients to succour the grieved shoulder and parts thereabout
by hindering the increase of the phlegmon, and to give some
perspiration to the part. Then with good fomentations I
corroborated the weak and oedematous member below; in which end
I also raised his hand nearer to his breast. Also by detergents
and bandage I disposed the wounds and fractured part to a better
condition, made way for discharge of matter, and endeavored to
extract the shivers of bones; then applied medicaments to remove
the _caries_. After some days the abscess suppurated in
the upper part of the shoulder and in the armpit; and while the
matter discharged from thence, the tumour discussed, and that
upper orifice cured soon after. But the continual pain in the
fractured joint kept that opening in the axilla from healing.
The patient growing weaker, and without hopes of cure, I was
necessitated to proceed to amputation. To which purpose I sent
to Chester to Mr. Murry, a knowing chirurgeon (since Mayor of
that city), to come with instruments and other necessaries,
whereby I might the better do the work. He accordingly came, and
we prepared dressings ready; which were stupes or pledgits of
fine short tow well worked, some like _splenia_ [bandages],
others were round, and bigger or less. We wetted them all in
oxycrate [water and vinegar], and dried them; et cetera....
The apparatus thus made, and the patient some while before
refreshed with a good draught of caudle [a hot drink made of
spiced and sugared wine], his friends took him out of his bed,
and placed him in a chair toward the light. One of his servants
held his arm; another of his friends held his other hand. Then
Mr. Murry drew up the skin and museulous flesh of the arm
towards the shoulder, whilst I made a strong bandage, some three
or four fingers’ breadth, above the affected part. Then with a
good knife I cut off the flesh by a quick turn of my hand, Mr.
M. pulling up the flesh, whilst I bared the bones.[98] After
which, with as few motions of my saw [as possible], I separated
the bone[s], the patient not so much as whimpering the while.
After this Mr. Murry thrusting his hands downwards with the
museulous flesh and skin which he had drawn upwards, I passed
a strong needle and thread through the middle of the flesh and
skin on both sides, within half an inch of the edges, and
brought the lips close within a narrow compass; and having tied
that ligature fast, and cut off the string, I passed the needle
again through the two contrary sides, which I tied as close;
then loosened the ligature above, and applied the little round
stupes of tow spread with a quantity of Galen’s powder mixed
with egg albumen. The long pledgits were applied from the middle
of the stump each way upwards along the arm, over which I put on
a bladder and a cross cloth, then rowled up the stump, and made
the bandage [pass] under his other arm and over his neck.... He
being thus dressed up, we put him into his bed. The third day
we took off his dressings, and found the stump well digested,
and at least two spoonfuls of matter discharged.... During which
the bone exfoliated, and the stump soon after cicatrized. Then
having procured a pass to come to London, I hastened away.
(2) A lady coming to town with a swelling in her left breast,
consulted some of our Profession, and at last me. She said she
had some years since kernels in her breast, which were judged
the “King’s Evil”; upon consideration of which she was presented
to His Majesty, and touched. In progress of time they swelled,
and her breast being extremely painful, she desired my judgment
of it. The swelling was large and round, and greatly inflamed,
under which it was soft and seemed to have matter in it. The
parts more distant were hard, and several tubercles lying
under the skin made it unequal; yet the breast was not fixed.
She urged me instantly to deliver my thoughts of it; which to
decline I turned from her, and told her friend it was a cancer,
and that I saw no hopes to save her life but by cutting it off.
He wished me to consider how I delivered such judgment of it,
two chirurgeons having lately assured her the contrary, they
taking it for a phlegmon. But I, not being used to guide my
judgment by what others delivered, confirmed to him what I had
before said by a sad prediction, which befel her in few weeks
after. And indeed there was no way then to deal with it but by
cutting off her breast.
One is not a little startled, after reading a number of case-histories
like the two which I have just reproduced, to discover other portions
of text (Vol. I., pp. 384 and 385) which show clearly that Wiseman,
although a surgeon of the most practical character and a man equipped
with excellent reasoning powers when he was placed in the presence
of most of the problems which are constantly being submitted to
physicians for solution, was nevertheless the victim of a belief that
supernatural powers may reside in certain human beings. Speaking
of the cure of the “King’s Evil”--also called by him “struma” and
“scrofula”--Wiseman, in the chapter which he devotes to this subject,
makes the following statement:--
But when upon trial he (the chirurgeon) shall find the
contumaciousness of the disease, which frequently deluded his
best care and industry, he will find reason of acknowledging the
goodness of God; who hath dealt so bountifully with this Nation
in giving the Kings of it, at least from Edward the Confessor
downwards (if not for a longer time), an extraordinary power in
the miraculous cure thereof.... I myself have been a frequent
eye-witness of many hundreds of cures performed by his Majesty’s
touch alone, without any assistance of chirurgery; and those,
many of them, such as had tired out the endeavors of able
chirurgeons before they came thither.
Some years before his death, which occurred in 1686, Wiseman was given
the title of Serjeant-Chirurgeon to King Charles the Second.
CHAPTER XLII
REFORMS INSTITUTED BY THE ITALIAN SURGEON MAGATI IN THE
TREATMENT OF WOUNDS.--FINAL ENDING OF THE FEUD BETWEEN THE
SURGEONS AND THE PHYSICIANS OF PARIS.--REVIVAL OF INTEREST IN
THE SCIENCE OF OBSTETRICS
_Reforms Instituted by Magati._--Cesare Magati, who was born in
1579 at Scandiano, in the Duchy of Règgio, studied medicine at the
University of Bologna and received the degree of Doctor of Medicine
from that institution in 1597. Immediately afterward he went to Rome
and devoted himself particularly to the study of anatomy and surgery.
Then, upon his return to his native land, he quickly acquired so great
a reputation as a surgeon that the Duke of Bentivoglio, who was a man
of enlightened views and ambitious to promote in every possible way the
best interests of the University of Ferrara, offered Magati the Chair
of Surgery in that institution. The offer was accepted in 1612, and
Magati continued to hold the position for several years, his services
being highly appreciated both by the authorities of the university and
by the students. But, when his health began to break down,--he was
affected with stone in the bladder,--he decided that his best course
was to resign his professorship, retire from active practice, and
become a Capuchin monk. When he took this step he obtained permission
from the head of the Chapter to which he belonged, to resume in a
limited measure the surgical work which he was so well fitted to do.
But in the year 1647 his sufferings became so acute that he was obliged
to visit Bologna in the hope of obtaining relief through operative
interference. The operation, however, did not prove successful, and
death occurred shortly afterward.
Magati effected, in a quiet and unostentatious manner, a number of
desirable reforms in surgical procedures. Thus, for example, he pointed
out how undesirable it is, in most cases, to change the dressings of
a wound so frequently as was, at that period, the common practice.
The process of cicatrization, he insisted, is not effected by the
efforts of the surgeon, but is fundamentally the work of Nature. Then,
in addition, he protested against the practice of introducing wicks
and pledgets of lint into wounds. These criticisms and this advice,
says von Gurlt, had been given many times before by different ancient
authors, but they undoubtedly had to be repeated from time to time.
The treatise in which Magati has written these things bears the
following title: “_De rara medicatione vulnerum, seu de vulneribus
raro tractandis, libri duo_,” Venice, 1616 and 1676; also Nuremberg,
1733.
_Final Extinguishment of the Long-standing Feud between the Surgeons
and the Physicians in Paris._--At several points in the course of
this sketch of the history of medicine, I have called attention to the
fact that, during the centuries preceding those which are reckoned by
certain authors as belonging to modern times, surgeons as a class were
generally looked upon, especially in the larger cities of France, as
decidedly inferior to physicians. The first attempt at something like
systematic instruction in surgery was made by the Brotherhood of Saint
Cosmas and Saint Damian at Paris. This organization, which was founded
by Jean Pitard about the middle of the thirteenth century, was composed
of a group of barbers who felt a strong desire to secure for themselves
a better training than was obtainable by the generality of barbers in
those days. The latter were known as “surgeons of the short gown,”
while the more ambitious men, who belonged to the group mentioned
above, were known as “surgeons of the long gown.” With the progress of
time this smaller group of barbers really succeeded in making better
surgeons of themselves, but in accomplishing this they intensified
at the same time the jealousy which the physicians as a class felt
toward them, a jealousy which repeatedly manifested itself in the form
of downright persecution. The data for a complete account of this
persecution, that persisted through centuries, are lacking, and even
if I possessed them I should not care to devote the time that would
be required for a proper presentation of the subject. It is pleasant,
however, to be able to record the fact that these plucky barbers
never entirely lost courage, but fought on, year after year, until
they eventually succeeded--with the help of a strongly sympathetic
public--in making the St. Côme Medical School the nursery of some
of the best surgeons in France during the sixteenth and seventeenth
centuries. It was here, for example, that Paré, Guillemeau, Thierry
de Héry and other men of distinction obtained their early training,
and it was doubtless through their influence that some of the wealthy
patients whom they had treated successfully, were induced to contribute
liberally to the support of the school. The final event in the history
of this institution was the complete overthrow of the opposing
physicians and the merging of the two surgical schools--that of the
regular Faculty and the St. Côme School--into one, under the direction
of de Lapeyronie, of whom I shall now furnish a brief sketch.
_François de Lapeyronie._--François de Lapeyronie was born at
Montpellier on January 15, 1678, and he enjoyed the privilege of
receiving a most careful preliminary education. He was only seventeen
years of age when the academic degree which corresponds to our Master
of Arts was bestowed upon him. As the next step he visited Paris for
the purpose of perfecting his knowledge of surgery, the branch of
science in which he was specially interested; and upon his return
to Montpellier he began giving instruction in anatomy and surgery.
In a short time he was chosen Surgeon-in-Chief of the Montpellier
Hôtel-Dieu. In 1714 he was called to Paris to take charge of the Duc
de Chaulnes, whose malady had not yielded to the treatment adopted
by the surgeons of that city; and in this case the measures which he
employed proved so efficacious that de Lapeyronie decided to settle
permanently in the metropolis. He taught anatomy in the Collège de
Saint-Côme, and in a short time was chosen Head Surgeon of the Charité,
one of the largest hospitals of Paris. In 1731 he became one of the
founders of the Royal Academy of Surgery, and he took a most prominent
part in the struggle which was then actively going on between the
physicians and surgeons of Paris,--one of the last and most serious
of the attempts made by the former to render the surgeons subordinate
to the physicians. The surgeons won the battle (April 23, 1743), and
Dezeimeris says that the part taken by de Lapeyronie in this struggle
may be looked upon as one of the most honorable achievements recorded
in the history of medicine. De Lapeyronie died on April 25, 1747, after
a long and painful illness. In his will he made most liberal provision
for the promotion of medical science; establishing funds for the giving
of annual prizes, for the founding of a medical library, for the
building of an anatomical amphitheatre, etc. In his treatise on anatomy
Hyrtl, the distinguished professor at the University of Vienna, makes
the following brief statement with reference to a certain dissecting
room in Paris, but he does not state in what part of the city the
room in question is located, nor does he mention any other facts that
might enable his readers to fix its location. In the absence of more
precise information concerning this matter, I shall take the liberty of
suggesting that Hyrtl’s discovery was made in the Anatomical Institute
which de Lapeyronie founded. Hyrtl’s statement reads as follows:--
Over the entrance doorway of a dissecting room in Paris I read
this inscription: _Hic locus est ubi mors gaudet succurrere
vitae._ [Here is the spot where Death rejoices to render
assistance to Life.] No more beautiful or fitting words could
be employed for inspiring the student, upon his first entrance
into the room, with respect for the work in which he is about to
engage.
And yet, a few pages beyond that on which the above statement is
printed, Hyrtl quotes Vicq d’Azyr as saying: “Among all the sciences
anatomy is perhaps the one the usefulness of which has been most
highly lauded, but at the same time the one for which the least has
been done to favor its advancement.”
_The Revival of Interest in Obstetrics._--With Soranus, the
early Greek writer on obstetrics, this science seemed to come to
a standstill, and during all the intervening centuries, up to the
sixteenth, not a single work of any special value was published on
this subject; for it is safe to say that nobody would claim for the
one or two obstetrical treatises that were written by teachers in
the Medical School of Salerno during the ninth or tenth century,
that they contributed materially to advance our knowledge in regard
to this branch of medicine. It therefore seems fitting, as suggested
by Haeser, that during the century which gave birth to such immortal
works as those of Vesalius and Paré, there should appear somebody who
possessed the inclination to stir once more into life the dying embers
of the science of midwifery; and such a man was found in the person of
Eucharius Roesslin, the elder, more commonly known--says Dezeimeris--by
the Greek name of “Rhodion.” He lived during the first half of the
sixteenth century, his death occurring about the year 1526, and his
was the first modern treatise especially devoted to obstetrics. He
began the practice of medicine in the city of Worms, in the central
part of Germany, and then moved to Frankfort-on-the-Main, where he
filled the salaried office of City Physician. Midwifery, at that time,
was left entirely in the hands of ignorant old women; and it was only
in response to the wishes of Catherine, the Duchess of Brunswick and
Lüneberg, that Rhodion undertook to prepare a manual from which these
ignorant and careless women might learn to conduct their midwifery work
in a more efficient, safe and acceptable manner. This little treatise,
which was first published at Worms in 1513, passed through a number
of editions and was translated into Latin, French, Dutch and English.
Von Siebold says that Rhodion compiled its text from various ancient
sources, and added practically nothing from his own experience. The
woodcuts, which are supposed to represent the different positions of
the foetus in the uterus, are not at all in accordance with the truth,
and show the most marvelous products of the artist’s fancy. Von Siebold
states, however, that the prejudices which at that time existed in the
minds of the people against the slightest participation of males in the
operations of midwifery were so strong that Rhodion would not have been
permitted to do anything toward learning the truth by the employment of
direct observation and careful examination--the only possible way in
which the actual facts might have been learned.
Rhodion’s book, notwithstanding the defects to which I have just
referred, accomplished much good. It also restored the operation of
podalic version to the position which it deserved, and it improved
the service of the midwives,--which was what the Duchess chiefly
desired,--and it undoubtedly emphasized the fact that the time had
arrived when obstetrics should receive the same degree of scientific
study that was being bestowed on all the other departments of medicine.
The title of Rhodion’s (or Roesslin’s) little book reveals the fact
that he possessed no small degree of humor. It reads: “Garden of Roses
for Pregnant Women and for Midwives,” Worms, 1513.
_The Operation Known as Caesarian Section._--The following
statements relating to the operation known as “Caesarian section”
have been compiled from Haeser’s _Geschichte der Medizin_:--This
operation, which owes its name to the erroneous idea that Caesar
was brought into the world by its aid, is commonly believed to have
been practiced on different occasions throughout antiquity, but
there has not yet been found in the records of history any account
which shows clearly that the operation was performed upon a living
woman, and also that the incision extended not merely through the
abdominal integuments, but also through the actual uterine wall. At
Siegershausen, in Switzerland,--according to the report of Caspar
Bauhin in the treatise (“_Gynaecia_”) which he published at Basel
in 1586,--a man named Jacob Nufer performed (about 1500) what was
believed to be a Caesarian section on his own wife, and delivered a
living child. Both mother and child did well; the child growing up
to the age of seventy-seven and the mother giving birth to living
children, _per vias naturales_, several times afterward. In this
instance it is generally believed that the case was one of abdominal
pregnancy and that the wall of the uterus had not been incised.
The first separate treatise on Caesarian section was written by
François Rousset, and in it are reported several cases in which the
operation was said to have been performed successfully. But both von
Siebold and Kurt Sprengel do not seem willing to accept these reports
as genuine, and we are therefore compelled to assume that the first
trustworthy account of a Caesarian section successfully performed by
a Dr. Trautmann of Wittenberg (in 1610) is that given by Sennert in a
communication which was printed early in the seventeenth century.
_Invention of the Obstetrical Forceps._--After the publication of
Roesslin’s “Garden of Roses,” the book of which I gave a brief sketch
on a previous page, nothing worthy of special note was done for a
period of several years to advance the existing knowledge of midwifery
or even to systematize that which had already accumulated. Then there
began to appear evidences of an awakening among those physicians who
recognized the importance of this department of medical science, and as
a result there were soon placed upon record accounts of two or three
advances of real and permanent value. One of the first of these gains,
for example, was the revival and general acceptance of the practice of
podalic version, or version by internal manipulations,--that is, the
operation of changing the faulty position of the foetus _in utero_
in such a manner that the feet shall be the parts which protrude into
the vagina. Podalic version--as it appears from the account given by
von Siebold--was known to the ancients, both Celsus and Aëtius having
described it in their treatises, but it was afterward forgotten or
neglected until Ambroise Paré, in 1550, again recommended it in one of
his writings. At the same time Paré states, at the very beginning of
his monograph on this subject, that his colleagues, Thierry de Héry
and Nicole Lambert, had both of them already carried out the method in
certain cases. This fact, however, does not detract from the credit due
Paré for having been the first, after the lapse of several centuries,
to bring the operation to the knowledge of the medical profession; and
from that day to the present it has held a fixed place in the science
of obstetrics. As will be readily understood, this is not the proper
place in which to furnish details with regard to the operation itself.
When Paré was asked whether it would be permissible for the midwives
to undertake this operation of podalic version, he replied that it
would be, provided the individual who assumed this responsibility
felt convinced that she possessed the requisite degree of skill
and experience in work of this nature, and provided also that--as
soon as she began to suspect her inability to finish the operation
successfully--she would promptly call to her aid a skilful surgeon, one
who had acquired considerable experience in obstetrical operations.
Paré’s favorite pupil, Jacques Guillemeau (1550–1630), a native of
Orleans, France, made several important additions to our knowledge of
the operation of podalic version, and he was also in other respects an
important promoter of the science of operative obstetrics. His treatise
on this branch of practical medicine, which was originally written in
French and published at Paris in 1609, was soon translated into English
(“Childbirth, the Happy Deliverance of Women,” London, 1612). In the
opinion of von Siebold, podalic version may justly be considered the
most important contribution that was made to obstetrical science during
the sixteenth century.
One of the French midwives of this period, Louise Bourgeois (or
Boursier), attained considerable celebrity by the excellence of the
treatise which she wrote on obstetrics. She was born at Paris about
the year 1564. In 1588 she began to fit herself for the career of
midwife, and in the course of a few years, after passing successfully
the required examinations, she was admitted by the authorities as a
“sworn midwife” of the city of Paris. She gained steadily in experience
and public favor, and the record states that already as early as 1601
she had the good fortune to officiate at the delivery of Henry the
Fourth’s wife (Marie de Medicis) of a son--the Dauphin (later, Louis
the Thirteenth). Her royal patrons were much pleased with the services
which she rendered on this occasion, and, as a further evidence of
the confidence which she inspired, they asked her--as each of these
occasions approached--to preside at the births of five other children.
One of the meritorious features of the treatise which Louise Bourgeois
wrote,[99] says von Siebold, is to be found in the fact that she
championed most earnestly podalic version. The book was translated into
both German (1644) and Dutch (1658).
François Mauriceau (1637–1709), who was indisputably the most
distinguished writer on obstetrics of the seventeenth century, was
born in Paris. During the early part of his career he was simply a
general surgeon, but, after the lapse of a few years, he gave up all
his other work and confined himself strictly to midwifery. For quite a
long period he held the position of Chief Obstetrician at Hôtel-Dieu,
and at the same time he conducted an extensive private practice in
cases of confinement. Worn out by the excessive amount of work which he
performed during the most active period of his career, he was finally
obliged to retire from practice several years before his death.
Mauriceau did not invent any remarkable obstetric instruments or
procedures, but he was the first to set forth in clear and precise
terms the principles of this science and art and to expound the rules
required for putting them into practice. The titles of his two most
celebrated treatises are the following: “_Traité des maladies des
femmes grosses_,” Paris, 1668; and “_Observations sur la grossesse
et l’accouchement_,” Paris, 1695. In 1706, three years before his
death, he also published “_Dernières observations sur les maladies
des femmes grosses_.”
The first of the three books mentioned passed through five editions
during Mauriceau’s lifetime, and there were two reprintings after his
death. A noticeable feature of the work, says von Siebold, is the care
which the author takes to preface all his lectures with a detailed
exposition of the anatomical relations of the region concerning which
he is about to speak; and this custom, which he was the first to
introduce, has since then been followed by the great majority of those
who have written on the subject of midwifery.
In the book which hears the title “_Observations sur la grossesse,
etc._,” Mauriceau gives an account of his first and only interview
with the English obstetrician, Hugh Chamberlen, to whom is commonly
accorded the credit of having invented the first pattern of the
obstetric forceps. From this account it appears that on August 19,
1670, Mauriceau was called to see a primiparous woman, thirty-eight
years old, who had already been in labor for several days, but
who had not yet been able, owing to the extreme narrowness of her
pelvis, to give birth to her child. (The case was one of head
presentation.) As Mauriceau was not at all willing to perform a
Caesarian section,--which alone, as he believed, promised a way out
of the difficulty,--Chamberlen, who happened to be in Paris at that
moment, was asked to see the patient. He came at once, made a hasty
examination, and declared that he needed only six or seven minutes for
effecting, by means of the method which he had invented, the delivery.
The patient was placed under his charge and he proceeded to apply his
method. Instead of a few minutes, he spent three hours in the attempt
to accomplish this purpose, but without success; and then admitted
that it was impossible, in this particular case, to effect delivery.
At the end of twenty-four hours the woman was dead. A postmortem
examination revealed the fact that the uterus was torn in several
places and perforated at one spot, all of which lesions had evidently
been produced by the instrument or instruments employed by Chamberlen.
“To complete this story,” adds Mauriceau, “it should be remembered
that, six months before the occurrence of the events just narrated,
this physician had come to Paris from England, and boasted that he
possessed a secret method by means of which he could, even in the most
desperate cases of labor, promptly effect the delivery of the child,
and had told the King’s Physician-in-Ordinary that he would sell the
knowledge of this secret for the sum of 10,000 Thalers (about $7500).”
One naturally hesitates about giving any measure of credit to a
physician whose professional conduct, as revealed in his relations to
Mauriceau’s patient, is clearly that of a charlatan. At the same time
we are obliged to bear in mind that in 1670 it was still possible for
a physician or surgeon to own a secret method of treatment and yet not
forfeit all consideration on the part of his professional brethren.
But at no time in the history of medicine has such conduct as that
attributed to Hugh Chamberlen (apart from the question of ownership
of a secret process) been considered otherwise than reprehensible.
However, as there does not appear to have been an earlier claimant for
the honor of having invented the obstetric forceps,--crude as it must
have been in its first form,--it seems only fair that Chamberlen should
be granted undisputed possession of this honor. During the eighteenth
century--a period with which the present volume has no concern--the
obstetric forceps underwent many alterations, and finally was given, by
Levret and Baudelocque in France, by Smellie in England, and possibly
also by Palfyn in Holland, practically the form which it possesses
to-day.
Before I finally dismiss the allied topics of obstetrics and
gynaecology, it seems desirable that I should add a few remarks
concerning two French surgeons who attained considerable eminence in
this special field, viz., Portal and Dionis.
_Paul Portal._--Paul Portal, a native of Montpellier, France, was
a contemporary of Mauriceau and an excellent obstetrician. He received
his training under the best teachers at Paris, and more particularly
under the guidance of René Moreau, Dean of the Paris Faculty of
Medicine (1630 and 1631) and Royal Professor of Medicine and Surgery.
He died in 1703. In the treatise which he published at Paris in 1685
(“_La pratique des accouchements, etc._”) he lays down very
strongly the maxim that the surgeon or the midwife who has charge of
a case of labor should make no attempt to accelerate the efforts of
Nature until it becomes plainly evident that artificial assistance is
absolutely necessary. Portal cultivated the art of digital exploration
to a very high degree of excellence. In Chapter VI., according to von
Siebold, he expounds with great clearness the dangers which result from
a prolapse of the umbilical cord. When this condition is discovered, no
time should be lost in delivering the child. “In narrating some of his
most remarkable cases Portal uses very simple and clear language, and
he puts on record many things which in later years have been published
as entirely new discoveries. But, unfortunately, his immediate
successors were not disposed to profit from Portal’s admirable
teachings.” (Von Siebold.) The only translations of his treatise into
foreign languages that have been published are one in Dutch (1690) and
another in Swedish by Van Hoorn (1723).
_Pierre Dionis._--Pierre Dionis, who was born at Paris in the
early part of the seventeenth century, was in some degree related to
Mauriceau, the famous Parisian accoucheur. In 1673 he was appointed
Royal Demonstrator of Anatomy and Surgery at the institution known
as the “_Jardin-du-Roi_,” and from this date onward, up to
the year 1680, he gave instruction regularly in these branches of
medical knowledge to large classes of students. He was particularly
distinguished for the clear and methodical manner in which he handled
the subjects upon which he lectured. In the year last mentioned he was
called to Vienna to fill the position of Physician-in-Ordinary to Maria
Theresa, Empress of Austria, but von Siebold, who is my authority for
the present sketch, does not say for what length of time he continued
to hold this position. His death occurred in 1718.
The earliest work published by Dionis bears the title: “_Histoire
anatomique d’une matrice extraordinaire_,” Paris, 1685. (Description
of a case of extra-uterine pregnancy.) Five years later he published
the treatise on human anatomy (“_L’anatomie de l’homme, etc._,”
Paris, 1690) upon which his celebrity largely rests. This book passed
through numerous editions and was translated into Latin, Dutch and
English (1723), and also Chinese; this last piece of work being
done by the Jesuit missionary, Father Parrenin, at the request of
Cam-Hi, Emperor of China, who died in 1723. Another treatise, which
perhaps contributed, even more than did his Anatomy, to render Dionis
celebrated, is that which bears the title: “_Cours d’opérations de
chirurgie démontrées au Jardin-du-Roi_,” Paris, 1707; and later
translations into German, Dutch and English. This book covers the
entire field of operative surgery, and its subject-matter is most
methodically arranged. It contains a large number of precepts which
are as sound to-day as they were two hundred years ago. From the
frequent mention which Dionis makes of the diseases to which the teeth
are liable, and from his descriptions of the operations that may be
performed for the cure or relief of these disorders, one is justified
in drawing the conclusion that, at that early period, this branch of
surgery was not, as many suppose, abandoned entirely to charlatans.
CHAPTER XLIII
THE FIRST APPEARANCE OF SYPHILIS IN EUROPE AS AN EPIDEMIC
DISEASE.--MEDICAL JOURNALISM.--THE BEGINNINGS OF A MODERN
PHARMACOPOEIA.--ITINERANT LITHOTOMISTS
Toward the end of the fifteenth and during the early part of the
sixteenth centuries accounts concerning syphilis began to be published
in the medical literature of Spain, Italy and France. The word
“syphilis,” it is true, does not appear in any of these records, for
it had not yet been coined; but the accounts themselves leave no room
for doubt that this was the disease to which the authors of these
records referred. The prevailing views with regard to the origin and
nature of syphilis differed somewhat in the three countries named. In
Spain, for example, it was a common belief that the disease originated
in an unfavorable conjunction of the stars[100] and yet at the same
time it was generally admitted that it was a disease which belonged
in the category of luxuries and might be avoided if one were careful
not to have intercourse with dissolute women. For a brief period of
time there were physicians in all three of the Latin countries who
maintained that syphilis had been imported, in the first instance,
from America by the men who made the voyage with Columbus and by the
earliest Spanish explorers of South America; but it was soon shown
that this theory was not compatible with certain known facts--such,
for example, as the published reports made by the Spanish physicians
Pintor and Torrella,[101] who describe cases of syphilis which they had
treated prior to 1493 (the year in which the first discoverers returned
from America). In Italy, according to Giovanni da Vigo, the author
of an excellent treatise on surgery (“_Practica in arte chirurgica
copiosa_,” Rome, 1514), the disease was first observed in Europe in
December, 1494, soon after the arrival of Charles the Eighth’s (France)
army at Naples; and only a short time elapsed before there developed,
as a result of this great accession of French soldiers, a veritable
epidemic of what then began to be known quite generally as “_morbus
gallicus_” or “the French disease.” The King himself, it is stated,
was among the number of those who contracted the infection.
So far as I am able to discover, the term “syphilis” was first
introduced into medical literature by Fracastoro, the distinguished
physician of Verona, who published in 1530 a Latin poem bearing the
title: “_Syphilis sive morbus gallicus_.” These verses were
received everywhere with great favor, were translated into several
modern languages, and speedily put an end forever to the employment of
the insulting term “_morbus gallicus_.”
A few more words with reference to the origin and distribution of
syphilis throughout the world may not seem inappropriate in this
place. J. K. Proksch, the author of the most recent history of this
disease,[102] says it has been fully proved that syphilis existed among
the inhabitants of India as long ago as during the Middle Ages, and he
adds that the evidence thus far collected justifies the further belief
that it was not an uncommon malady among the ancient Greeks and Romans,
and even among the Babylonians and Assyrians. Doubtless a good deal
of what was called “leprosy” in early times was in reality syphilis.
Another syphilographer--Raphael Finckenstein--makes the following
sensible remarks about the efforts that have been made to ascertain
the precise date when this disease first appeared in Europe:--[103]
It is just as foolish to suppose that the date of the first
appearance of syphilis may be discovered as it is to hope
that the disease will ever entirely disappear. As long as
wealth and idleness continue to exist, as long as there are
men who remain unmarried and women whose moral character is of
a yielding nature, and as long as it is not possible for the
police to creep into every nook and corner, just so long will
licentiousness and indulgence in fleshly lusts continue to
disturb the peace of the community. These are the conditions
necessary to the development and spread of syphilis.
Some account of the treatment of this form of venereal disease comes
next in order. It is commonly believed, says the author just quoted,
that it was from the Spanish physicians of the sixteenth century
that we learned how to treat syphilis by the methodical employment
of mercurial preparations. (See footnote at the bottom of page 542.)
He adds that there was published by Juan Almenar at Venice, in 1502,
a book which bears the title: “A treatise on the Morbus Gallicus,
in which it is demonstrated how the patient may be treated in such
a successful manner that the disease will never return, nor will
any objectionable lesions develop in the mouth; and yet, during the
progress of the treatment, the patient is not required to remain
in bed.” The author of this book, who was a resident of Valencia,
Spain, was a man of noble birth. His treatise passed through eight
successive editions, the last of which was printed at Basel in 1536.
Almenar’s plan of treatment was to employ mercurial inunctions in such
moderate doses as not to induce salivation. If, at the end of a few
days, he saw evidences of an approach of this symptom, he substituted
baths and evacuant remedies (rhubarb and senna) for a short time,
and also prescribed a more nourishing diet and the taking of various
internal remedies. Then, later, the inunctions were resumed. The
exact duration of such a course of treatment is not stated. So far as
I am able to judge from the account given by Finckenstein, Almenar
found it necessary in some cases to repeat the series of mercurial
inunctions as many as four times. His aim, in other words, was to
accomplish a radical cure of the disease, whereas his contemporaries,
who were mainly ignorant and uneducated physicians, were satisfied to
carry out a purely symptomatic treatment. Morejon, the historian of
Spanish medicine, expresses the belief that Almenar was the first to
use steam baths in the treatment of syphilis. Both Hensler and Simon,
the best modern authorities with regard to the history of syphilis,
agree that Almenar’s inunction method of treating this disease forms,
notwithstanding its crudeness in certain respects, the basis of all
modern methods of the same general character. Unfortunately, the
physicians of a later period did not follow the relatively mild and
safe inunction method advocated by Almenar, but so modified it for the
worse that it became a common thing for men to say that the cure was
worse than the disease.
_A Few Special Advances Worthy of Note._--The beginnings of
medical journalism belong to the second half of the seventeenth
century. In 1665, for example, there appeared for the first time,
a medical article in the “_Journal des Scavans_,” and during
the same year similar articles were printed in the “Philosophical
Transactions of the Royal Society of London.” According to August
Hirsch the earliest periodical that was devoted entirely to the
interests of the medical profession was the “_Journal des découvertes
en médecine_,” which was first published in 1679 and continued,
in 1680, under the title of “_Le Temple d’Esculape_.” Then
followed soon afterward: “_Le Journal des Nouvelles Découvertes en
Médecine_” (1681–1683); “_Le Mercure Savant_” (1684); “_Le
Zodiacus Medico-Gallicus_” (1680–1685), which was published in Latin
in Geneva, by Bonet; etc.
In addition to the more important advances in anatomy and physiology
that have already been mentioned on previous pages, the following
deserve to receive at least a passing notice: In the department
of anatomy and physiology, William Briggs (1642–1704), one of the
physicians of St. Thomas’ Hospital, London, published at Cambridge in
1676, under the title of “_Ophthalmographia_,” a most important
contribution to the anatomy and physiology of the eye; and there were
four other English anatomists who, during the seventeenth century,
gained well-merited credit by the original work which they did in the
fields of anatomy and physiology--viz., Thomas Willis (1622–1675),
Francis Glisson (1597–1677), Thomas Wharton (1610–1673), and Nathaniel
Highmore (1613–1684). The part played by Germany in these gains in
anatomy and physiology, during the period now under consideration, was
chiefly that of a sympathetic recipient; for the political conditions
at that time were entirely unfavorable to any active participation on
the part of the physicians of that country. Early in the eighteenth
century, however, they began in earnest to do their share of work in
advancing the science of medicine.
The relationship of the physical sciences to the theory and practice
of medicine is not of an intimate nature, and it will therefore not
be necessary for me to do more than briefly to enumerate the more
important of the discoveries of this character which occurred during
the sixteenth and seventeenth centuries.
Galileo (1564–1642), a native of Pisa, Italy, was the creator of the
science of motion, and he gave the first satisfactory demonstration
of equilibrium on an inclined plane. He devised an imperfect
species of thermometer, a proportional compass, and the refracting
telescope, by means of which latter instrument he made a number of
other important discoveries in the domain of astronomy. His pupil,
Evangelista Torricelli (1608–1647), also a native of Italy, discovered
the barometer, and in addition arrived at many fundamental truths
in mechanics and hydrostatics. Otto von Guericke (1602–1686), a
native of Magdeburg, Germany, invented the air pump. Sir Isaac Newton
(1642–1727), born at Woolsthorpe, Lincolnshire, one of the world’s
greatest authorities in natural philosophy, was the first to formulate
clearly the law of gravitation. Edme Mariotte (1620–1684), a native
of Burgundy, France, was the discoverer of what is commonly known as
“Mariotte’s law”--_i.e._, a law of elastic fluids, according to
which the elastic force is exactly in the inverse proportion of the
space which the mass of fluid occupies. He also discovered that the
part of the retina at which it meets the optic nerve is not capable of
conveying the impression of sight. Finally, Denis Papin (1647–1710),
a Frenchman, invented the first steam engine, of an embryonic and not
very practical type; for in this apparatus the piston floated on the
water in a separate cylinder.
The inventions which I have here briefly enumerated represent the more
important discoveries that were made in physical science during the
sixteenth and seventeenth centuries.
_The Beginnings of a Modern Pharmacopoeia, and One of the Last
Attempts of the Disciples of Galen to Maintain Their Ascendancy in
Therapeutics._--In the domain of pharmacology the first attempt in
modern times to organize this department of practical medicine was
made by an apothecary in Barcelona in 1497, and was published by him
in printed form in 1521. (Von Gurlt.) This pharmacopoeia was doubtless
wholly unknown beyond the borders of Spain. Not far from one hundred
years later,--_i.e._, in the early part of the seventeenth
century,--Theodore Turquet de Mayerne, who was born in 1573, in a
small village near the city of Geneva, made the second attempt in
modern times to organize the pharmacological department of practical
medicine. After showing quite early in life a fondness for the study
of chemistry, he devoted himself particularly to the investigation
of the remedies that are produced in the chemist’s laboratory; the
preparations of antimony attracting his especial interest. A little
before this time the physicians of Paris were split up into two
strongly antagonistic parties as regards the propriety of administering
this metal in any form as a remedy; but those who opposed its
therapeutic employment finally managed to secure from Parliament, in
1566, a decree prohibiting its use. While this quarrel was in progress,
de Mayerne visited Paris (1602) and established himself in that city
as an independent lecturer on chemistry. As the regular faculty still
held the belief that the teachings of Galen were the only safe guide
for physicians to follow, de Mayerne’s action must have appeared to
them like an impudent challenge. In one of his writings he strongly
recommended the employment of antimonial preparations,--remedies
introduced originally by the much-hated Paracelsus,--and he even
went so far as to offer some for sale. This was too much for the
disciples of Galen to bear without a protest, and consequently in
1603 the Parliament issued a new decree, in accordance with which de
Mayerne was prohibited from practicing medicine in Paris. This measure
appears to have proved successful in putting a stop effectively to
his obnoxious teachings, for we learn that shortly afterward he was
known to be living in London, where, in 1611, he was appointed the
Physician-in-Ordinary to King James the First, and later to Charles the
First. He died in 1655.
Jean Astruc, the distinguished French medical author of the eighteenth
century, speaks rather disparagingly of de Mayerne’s attempt to
organize a pharmacopoeia. An earlier, more successful, and much
more creditable attempt of this nature was made by Valerius Cordus,
whose “_Dispensatorium pharmacorum omnium_” was first published
at Nürnberg in 1535. This work, which subsequently bore the title
“_Pharmacopoeia Augustana_,” up to the year 1627 passed through
at least seven editions and was utilized to a greater or less extent
by the authors or editors of nearly all later pharmacopoeias. To
go still further back, the most ancient pharmacopoeia of which we
have any knowledge is that which bears the title of “_Antidotarium
Nicolai_,” the author of which work was Nicolaus, the President or
Dean of the Medical School at Salerno. The book was written originally
during the first half of the twelfth century, but it did not appear in
print, at Venice, until the year 1471, and then only in an incomplete
form. Quite recently a French translation of the book has been
made and published (1896) by Paul Dorveaux, of the Paris School of
Pharmacy. Most of the preparations there described have long since been
abandoned, but a few of them--such, for example, as citrine ointment,
honey of roses, oxymel, and oil of roses--are still to be found in the
pharmacopoeias of some nations.
_Itinerant Lithotomists._--For an unknown number of years
preceding the sixteenth century it had been a well-established custom
for members of the medical profession in France, and also, doubtless,
in neighboring countries, to intrust--as the Hippocratic oath
enjoined--all cases of stone in the bladder to expert lithotomists.
Such special knowledge and skill were not easily acquired, and so it
came about that there were very few individuals who were acknowledged
to be experts and who were really capable of teaching the art, and
these few guarded most carefully the knowledge which they had gained.
During the period of time which we are now considering, certain
members of the Collot and Pineau families were the most distinguished
lithotomists in France, and the records show that in the year 1600
Jehan Paradis and Nicolas Serre petitioned the Government for official
recognition of their special rights to enjoy a monopoly of operative
work of this character. “We ask that you give orders that all poor
patients who may apply to Hôtel-Dieu (the great city hospital of Paris)
or to the Bureau-of-the-Poor for relief from stone in the bladder, be
turned over to our care for proper treatment. The poor will receive
this treatment gratis, and those who can afford to pay will be charged
a very reasonable fee. And you will do well if you prohibit all other
persons from meddling with such cases in any manner.” In a document
bearing the date 1646 mention is made of four lithotomists--Philippe
and Charles Collot, Jacques Girault and Antoine Ruffin--who had erected
in the Faubourg Saint-Antoine, Paris, a building which was intended
to serve as a hospital “in which, at any time during the entire year,
those who are afflicted with stone in the bladder may be lodged, fed,
nursed and subjected to proper treatment,--the poor without charge of
any kind, and the well-to-do at a proper rate of remuneration.”
In Franco’s time (middle of the sixteenth century) cutting for stone
in the bladder was by no means an uncommon operation, and was almost
always performed by itinerant lithotomists (“_inciseurs_”). The
Collots had, for many years, possessed almost a monopoly of this
business. Laurent Collot, who was the first one of the family to engage
in the work, was Royal Lithotomist in 1556, and handed down to his son
all the knowledge on this subject which he had acquired through long
experience. François Tolet was another of these popular lithotomists
who flourished in Paris during the sixteenth and seventeenth centuries.
He died in 1724 at the age of seventy-seven. His treatise on lithotomy,
which was published in Paris in 1681, and subsequently passed through
several editions, is said by Dezeimeris to contain the records of a
large number of his own cases and to show clearly that he was a surgeon
of sound judgment. No better treatise on this subject, he adds, was
published during that period of the history of medicine.
In addition to those whom I have just mentioned there were two French
monks who gained wide celebrity as operators for stone in the bladder,
viz., Frère Jacques de Beaulieu and Frère Côme. The last-named belongs
to the early part of the eighteenth century, and should therefore--in
accordance with the plan which I have been following--not receive
consideration in the present account; but, in view of the fact that
these are the only two monks who, during the Renaissance and the period
immediately following, gained conspicuous credit for the honorable and
efficient service which they rendered, not merely to the science of
medicine but also to the cause of humanity, I believe that I cannot do
better than to place the two sketches together as if they both belonged
strictly to one and the same period of time.
[Illustration: FIG. 26. FRÈRE JACQUES DE BEAULIEU.
Born in 1651 in the village of Létendonne, Franche-Comté, France.
(From the steel engraving in the treatise _De la Taille
Latérale par le Périnée_, etc., by Pascal Baseilhac, nephew
of Frère Côme, Paris, 1804.)]
(_a_) Frère Jacques--or Brother James, who was born in 1561 at the
village of Létendonne, near Lons-le-Saulnier, Central France,--learned
the art of operating for stone in the bladder from an Italian surgeon
named Paulony, and acted as his assistant or associate up to the time
when he became a monk of the Order of Saint Francis--that is, of that
branch of the Order which had its chapter house at Feuillants in
Languedoc. He traveled about the country offering to treat gratuitously
all persons affected with stone in the bladder who were willing to
trust him, and he made it a rule, whenever such a thing was possible,
always to operate in the presence of one or more physicians or
surgeons. He was also ready at all times to give instruction to those
who wished to learn his method of procedure. He never asked to be
remunerated, but was always pleased to receive from his patients a
written testimonial of what he had done for them. Out of the moneys
which he received from the rich he retained only that which he required
for his own support and for the purchase of such instruments as he from
time to time required; the balance he distributed among the poor. He
was very faithful in performing his religious duties, and he succeeded
in gaining the good will and esteem of everybody with whom he had any
dealings.
For a long time it was customary in France to credit Frère Jacques
(Fig. 26) with the invention of the lateral method of operating for
stone in the bladder. This, however, was an error, for Franco, on page
95 of E. Nicaise’s reproduction of the 1561 edition, describes this
operation clearly. It must therefore have been invented a long time
before Frère Jacques was born. The text (rendered into English) reads
as follows: “... the incision should be made between the anus and the
testicles, two or three finger-breadths to one side of the commissure
or perinaeum [median line of the perinaeum].” This is said to be the
earliest clear description of the first step of the lateral operation
of which we have any knowledge.
In 1697, when Frère Jacques visited Paris, he had already attained
wide celebrity as a lithotomist; the number of his successful
operations--all of which had been performed according to the lateral
method of procedure--having reached a grand total of several thousand.
He therefore had a right to suppose that his visit would prove
acceptable to the physicians of that metropolis; but the published
account of this visit reveals plainly the fact that the surgeons of
that city were not at all pleased that an itinerant lithotomist from
one of the provinces should have the effrontery to request permission
of the authorities to exhibit his method before the Medical Faculty of
Paris. His request, however, was granted, and he was allowed to operate
on a man, forty years old, at Hôtel-Dieu. He performed the operation
before a large assembly of physicians, and, after the stone had been
successfully extracted, the patient made a prompt recovery. A short
time afterward he operated upon another patient at Fontainebleau in the
presence of several physicians, one of whom was Monsieur Félix, the
First Surgeon of the King, Louis the Fourteenth. In this case also, as
well as in several later cases, Frère Jacques was entirely successful,
and he now began to be treated by the public with marked consideration.
But, in a short time, owing to the jealousy exhibited by a large clique
of Paris surgeons, who were encouraged to pursue this course by Mery,
the Head Surgeon of Hôtel-Dieu, Frère Jacques was finally forced to
leave Paris. I cannot follow him on his further wanderings throughout
Europe, from the leading cities of Holland, Belgium and Switzerland to
Vienna and Rome. In 1716 he retired to Besançon and lived there quietly
up to the time of his death in 1719. But even then his enemies--men to
whom he had never done the slightest harm--did their best to destroy
the last traces of his existence. A visit made to Besançon by one of
his acquaintances not long after our Franciscan monk’s death, revealed
the fact that his name had been erased from the church registry of
deaths. The lateral method of operating for stone, which had been
revived and thoroughly developed by him, still finds favor among the
best surgeons of our own day; and the names of those mean-spirited men
who tried so hard to injure him have long since passed into complete
oblivion.
[Illustration: FIG. 27. JEAN BASEILHAC, COMMONLY KNOWN IN FRANCE AS
FRÈRE CÔME.
(From the steel engraving in Pascal Baseilhac’s treatise.)]
[Illustration: FIG. 28. CONCEALED LITHOTOME INVENTED BY FRÈRE CÔME IN
1748.
(From the steel engraving in Pascal Baseilhac’s treatise.)]
(_b_) Frère Jean de Saint-Côme,--or Brother John of Saint
Cosmas,--whose real name was Jean Baseilhac, was born in 1703 at
Poyestruc, Department of Hautes-Pyrenées, France. He received his
instruction in the principles of medicine from his father and his
grandfather, both of whom were regularly enrolled Masters in Surgery.
In 1722, when there could no longer be any doubt about young
Baseilhac’s settled purpose to fit himself for the practice of
medicine, his father sent him to Lyons, where his uncle, who was
himself a surgeon, would be able to superintend the boy’s further
training. Through the latter’s influence, young Baseilhac was allowed
to enter the Hôtel-Dieu of that city as one of its regular pupils.
At the end of two years--_i.e._, in 1724--he left Lyons and
went to Paris, where he hoped to add materially to his stock of
professional knowledge. His first step, after reaching the metropolis,
was to enter the service of a surgeon in active practice; and then,
aided by the latter’s influence, he succeeded (in 1726) in entering
the Paris Hôtel-Dieu as one of the regular pupils. Soon after he
had completed his term of service at the hospital, he was appointed
Physician-in-Ordinary to the Prince-Bishop of Bayeux, in Normandy. The
death of the latter in 1728, less than two years after Baseilhac had
entered his service, came as a great blow to the young surgeon, for he
had learned to esteem him very highly. In his will the Bishop left a
small legacy to Baseilhac--that is, a sum of money sufficient to pay
for the regular course of instruction at the Medical School of Saint
Cosmas in Paris, and also to procure a complete outfit of surgical
instruments. In 1740 he became a member of the Feuillants Branch of
the Franciscan monks, it being understood, however, that he was to be
allowed the special privilege of practicing surgery among the poorer
classes. Through accidental circumstances he was led gradually to drop
general surgery and to confine his work to operations for stone. His
official name at this time was “Frère Jean de Saint-Côme,” or simply
“Frère Côme.” (Fig. 27.) As he gained in experience as a lithotomist,
he became convinced that the method which his predecessor, Frère
Jacques, had practiced with such great success, was preferable to the
more complicated and more dangerous plan commonly pursued by surgeons
at that time, and thereafter he adopted it in all his cases. But he
modified the procedure to a certain extent; that is, he invented an
instrument by means of which the actual cutting of the perinaeum was
accomplished with a concealed knife (see Fig. 28). The chief advantage
to be gained by the employment of this instrument consisted--as was
claimed by Frère Jean and his nephew, Pascal Baseilhac,--in the fact
that in this way the danger of making the incision in the wrong place,
or of too great length, was materially diminished.
The first patient upon whom the new instrument was tried (October 8,
1748), was a dealer in lime, sixty years of age and in rather delicate
health. In less than three weeks after the operation, he was entirely
cured. Subsequently the instrument was employed in a large number of
instances, and the method was found to be most satisfactory; successful
results being obtained--on the average--in twelve out of thirteen
cases, whereas the best results previously obtained by the method
commonly employed at that period was 50 per cent of cures. At a still
later date the statistics showed even better results--viz., 96 cures in
one group of 100 cases, and 316 cures in a second group of 330 cases.
Owing to the rapidly increasing number of patients affected with stone
in the bladder who wished to be operated upon by Frère Jean himself, he
established in Paris in 1753, near the Saint Honoré gateway, a special
hospital for lithotomy cases, and kept it in active service up to the
time of his death. The laboring classes, and the poor in general, were
not expected to pay any fees, and indeed money was often bestowed
upon these people when they left the hospital, to enable them to
return comfortably to their villages; those in moderate circumstances
were asked to pay only the expenses that had been incurred in their
behalf; and the well-to-do made such voluntary contributions as they
thought proper toward the support of the hospital. The registers of the
institution showed that, first and last, over one thousand operations
had been performed there, either by Frère Jean or by his nephew, Pascal
Baseilhac. Our monk’s death occurred on July 8, 1781.
THE END
LIST OF THE MORE IMPORTANT AUTHORITIES CONSULTED
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London, 1902.
ASCHOFF, L.: KURZE UEBERSICHTSTABELLE ZUR GESCHICHTE DER
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BAAS-HANDERSON: HISTORY OF MEDICINE, New York, 1910.
BASEILHAC, PASCAL: DE LA TAILLE LATÉRALE PAR LA PÉRINÉE, ET
CELLE DE L’HYPOGASTRE, OU HAUT APPAREIL, Paris, 1804. (Includes
an account of the career of Frère Côme.)
BERENDES, J.: DAS APOTHEKENWESEN, Stuttgart, 1907.
BOERHAAVE: A NEW METHOD OF CHEMISTRY, translated by Peter Shaw,
M.D., London, 1741; APHORISMS, etc., English translation,
London, 1742.
BOTTEY, F.: TRAITÉ THÉORIQUE ET PRATIQUE D’HYDROTHÉRAPIE
MÉDICALE, Paris, 1895.
BROUSSAIS, F. J. V.: EXAMEN DES DOCTRINES MÉDICALES,
troisième edition (4 vols.), Paris, 1829–1834.
CABANÈS: PARACELSE--L’HOMME ET L’ŒUVRE, article in _La Revue
Scientifique_, Paris, May 19, 1894.
CASALIS: DE PROFANIS ROMANORUM RITIBUS; Chapter VII., DE
AESCULAPIO, Rome, 1644.
CELSE, A. C.: TRAITÉ DE MÉDECINE; traduction par le Dr. A.
Védrènes, Paris, 1876.
CHEREAU: LES ANCIENNES ÉCOLES DE MÉDECINE DE LA RUE DE LA
BUCHERIE, Paris, 1866.
CULLEN, WILLIAM: FIRST LINES OF THE PRACTICE OF MEDICINE,
Edinburgh, 1802. (2 vols.)
DAREMBERG, CHARLES: ŒUVRES ANATOMIQUES, PHYSIOLOGIQUES ET
MÉDICALES DE GALIEN, 2 vols., Paris, 1854–1856; ÉTAT DE LA
MÉDECINE ENTRE HOMÈRE ET HIPPOCRATE, Paris, 1869; HISTOIRE DES
SCIENCES MÉDICALES, 2 vols., Paris, 1870.
DEZEIMERIS, OLLIVIER ET RAIGE-DELORME: DICTIONNAIRE HIST. DE LA
MÉD. ANC. ET MOD., 3 vols., Paris, 1828–1837.
DIOSKURIDES, PEDANIOS: ARZNEIMITTELLEHRE, Uebersetzung von Dr.
J. Berendes, Stuttgart, 1902.
DORVEAUX, PAUL: L’ANTIDOTAIRE NICOLAI (NICOLAUS PRAEPOSITUS),
Paris, 1896.
FALK: GALEN’S LEHRE VOM GESUNDEN UND KRANKEN NERVENSYSTEME,
Leipzig, 1871.
FINCKENSTEIN: ZUR GESCHICHTE DER SYPHILIS, Breslau, 1870.
FOSSEL, VIKTOR: HIERONYMUS FRACASTORO; DREI BUECHER VON DEN
CONTAGIEN, DEN KONTAGIOESEN KRANKHEITEN UND DEREN BEHANDLUNG
(1546), Leipzig, 1910.
FRANCO, PIERRE: CHIRURGIE, Nouvelle édition par E. Nicaise,
Paris, 1895.
FREIND, J.: THE HISTORY OF PHYSICK, 2d edition, London, 1727. (2
vols.)
FRIEDLAENDER, L. H.: VORLESUNGEN UEBER DIE GESCHICHTE DER
HEILKUNDE, Leipzig, 1839.
FROELICH, H.: GALEN UEBER KRANKHEITSVORTAEUSCHUNGEN, in
Friedrich’s Blaetter fuer Gerichtliche Medicin, I. Heft,
vierzigster Jahrgang, Nuernberg, 1889.
GERMAIN, A.: L’ÉCOLE DE MÉDECINE DE MONTPELLIER, Montpellier,
1880.
GUERINI: A HISTORY OF DENTISTRY, etc., Philadelphia and New
York, 1909.
VON GURLT: GESCHICHTE DER CHIRURGIE, Berlin, 1898. (3 vols.)
GUY DE CHAULIAC: LA GRANDE CHIRURGIE, edited by Edouard Nicaise,
Paris, 1890.
HAESER, H.: LEHRBUCH DER GESCHICHTE DER MEDICIN, zweite Ausgabe,
Jena, 1868. (3d edition, 1875.)
VON HALLER, ALBERT: BIBLIOTHECA MEDICINAE PRACTICAE, Basel,
1776. (4 vols.)
HERODOTUS: HISTORY, translated by George Rawlinson, M.A. (2
vols.)
HIPPOCRATES: SAEMMTLICHE WERKE, translated into German by Dr.
Robert Fuchs (3 vols.), Munich, 1895–1900.
HIRSCH, AUGUST: GESCHICHTE DER MED. WISSENSCHAFTEN IN
DEUTSCHLAND, Muenchen und Leipzig, 1893.
HOLLAENDER, EUGEN: DIE MEDIZIN IN DER KLASSISCHEN MALEREI,
Stuttgart, 1903; PLASTIK UND MEDIZIN, Stuttgart, 1912.
HOMER: THE ILIAD AND THE ODYSSEY, published by Dent & Sons,
London. (2 vols.)
HYRTL, JOSEPH: LEHRBUCH DER ANATOMIE DES MENSCHEN, Vienna, 1846.
JUSSERAND, J. J.: ENGLISH WAYFARING LIFE IN THE MIDDLE AGES
(14th century), G. P. Putnam’s Sons, New York and London, 1889.
LABOULBÈNE, M. A.: SYNDENHAM ET SON OEUVRE, article in the
_Revue Scientifique_, Tome XLVIII, November 28, 1891.
LE CLERC, DANIEL: HISTOIRE DE LA MÉDECINE, Amsterdam, 1723.
LE CLERC, LUCIEN: HISTOIRE DE LA MÉDECINE ARABE (2 vols.),
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MALGAIGNE: OEUVRES COMPLÈTES D’AMBROISE PARÉ, 1840–1841, (3
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MEYER-STEINEG: CORNELIUS CELSUS UEBER GRUNDFRAGEN DER MEDIZIN,
Leipzig, 1912; KRANKEN-ANSTALTEN IM GRIECHISCHROEMISCHEN
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VON MEYER, E.: GESCHICHTE DER CHEMIE, 3d edition, Leipzig, 1905.
MOMMSEN, THEODORE: THE HISTORY OF ROME, translated from the
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MUENZ, ISAAC: UEBER DIE JUEDISCHEN AERZTE IM MITTELALTER,
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NEUBURGER, MAX: GESCHICHTE DER MEDIZIN, Vol. I. and Vol. II.,
zweiter Theil, 1906–1911.
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KRANKEN, Prag, 1859.
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PUSCHMANN, THEODOR: THE ORIGINAL GREEK TEXT AND A GERMAN
TRANSLATION OF ALEXANDER OF TRALLES, Vienna, 1878; and
GESCHICHTE DES MEDICINISCHEN UNTERRICHTS, Leipzig, 1889.
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SALICET, GUILLAUME DE: CHIRURGIE, traduction par Paul Pifteau,
Toulouse, 1898.
SCHWALBE, ERNST: VORLESUNGEN UEBER GESCHICHTE DER MEDIZIN, 2te
Auflage, Jena, 1909.
SIEBOLD, E. VON: VERSUCH EINER GESCHICHTE DER GEBURTSHUELFE (2
vols.), Berlin, 1839.
SOUTH, JOHN FLINT: MEMORIALS OF THE CRAFT OF SURGERY IN ENGLAND,
edited by D’Arcy Power, M.A. Oxon., F.R.C.S. Eng., 1886.
SPIESS, G. A.: J. B. VAN HELMONT’S SYSTEM DER MEDICIN, Frankfort
am Main, 1840.
SPRENGEL, KURT: VERSUCH EINER PRAGMATISCHEN GESCHICHTE DER
ARZNEIKUNDE (5 vols.), Halle, 1821–1828.
TACITUS: THE ANNALS, edited by E. H. Blankeney, Dent & Sons,
London.
TSINTSIROPOULOS, CONSTANTIN: LA MÉDECINE GRECQUE DEPUIS
ASCLÉPIADE JUSQU’ À GALIEN, Paris, 1892.
WELLMANN, MAX: DIE PNEUMATISCHE SCHULE, Berlin, 1895.
WISEMAN, RICHARD: EIGHT SURGICAL TREATISES, 5th edition, London,
1719.
GENERAL INDEX
A
ABDOMEN, penetrating wounds of, 469
ABELLA, teacher of medicine at Salerno, 245
ABOU BEKR, distinguished Arab physician in Spain, 232
ABOU SAHL EL MESSIHY, distinguished Persian physician, 223
ABSCESS, mediastinal, 229
ABULCASIS, famous Arab surgeon, 226
ABULPHARAGIUS, 184
ACADÉMIE DE CHIRURGIE, Paris (1731), 450
ACADÉMIE DES CURIEUX DA LA NATURE, 364
ACADÉMIE DES SCIENCES, 363
ACCADEMIA DEI LINCEI, Rome, 364
ACCADEMIA DEL CIMENTO, Florence, 364
ACRABADIN KEBIR, 209
ACUPRESSURE, 143
ADAMS, FREDERICK, 89
AEGIDIUS CORBOLIENSIS, 255
AENEAS, wounded in groin, 49
AESCULAPIUS, 47, 49
symbol of, 315
temple of, at Cos, 514
AËTIUS, 194, 318
AFFLACIUS, JOHN, 245, 248
AGATHINUS, 142
AGRATE, MARCO, 339
AIGLE, daughter of Aesculapius, 50
ALAE NASI, Galen’s comments on movements of, 173
ALBERT VON BOLLSTEDT (Albertus Magnus), 269
ALCMAEON, 73, 79
ALDEROTTI, THADDEUS, 272
ALEXANDER OF TRALLES, 195
ALEXANDER PHILALETHES, 115
ALEXANDER THE GREAT, 100
ALEXANDRIA, EGYPT, 100, 116
ALHAZEN, researches in optics, 233
ALKALOIDS (quintessences of Paracelsus), 405
ALMANSUR, Caliph of Bagdad, 184, 203
ALMENAR, JUAN, 544
ALPHANUS II., Abbot of Monte Cassino, 239
ALSAHARAVIUS, 227
ALU, 13
AMATUS LUSITANUS, 484, 487
AMBROSIA, antidote for poisons, 112
AMPUTATION OF LEG (Fig.), 463
AMROU, 116, 185
AMULETS and other magical remedies, 197
ANAESTHESIA, SURGICAL, from employment of soporific sponges, 253,
462
ANATOMICAL DEMONSTRATIONS at Salerno, 253
ANATOMICAL SPECIMENS, preservation of, 356
ANATOMY AND PHYSIOLOGY, important discoveries during 16th century,
353
ANATOMY, importance of study of, 312
ANATOMY, MICROSCOPIC, 360
ANAXIMANDER, 72
ANAXIMENES, 72
ANDREAS OF CARYSTUS, 114
ANIMISM, 405, 432
ANTIDOTARIUM, early name for pharmacopoeia, 319
ANTIDOTARIUM NICOLAI, 548
ANTIMONY, curative action of, 158, 548
ANTIOCHUS, cured by Erasistratus, 106
ANTONINUS PIUS, 57
ANTRUM OF HIGHMORE, 359
ANTYLLUS, 143, 201
APES, dissection of, 164
APOLLO, the god of medicine, 18, 50
APOLLONIUS MUS, 111
APOTHECARY, 316, 319
APPARATUS MAGNUS (operation for stone in the bladder), 474
APULEIUS, LUCIUS, 120, 126
AQUA VITAE, how prepared, 313
ARABIAN PHYSICIANS, dogmatism of, 412
ARAB RENAISSANCE, 203, 217, 233, 259
ARANTIAN OPERATION, a substitute for Tagliacotian operation, 481
ARANZIO or ARANTIUS, 349, 481
ARCEO, FRANCISCO, 484, 486
ARCHAEUS INFLUUS and ARCHAEUS INSITUS, 399
ARCHAGATHUS, 119
ARCHIGENES, 142, 174
on ligation of larger blood-vessels before amputation of a limb,
470
ARCHIMATHAEUS, 248
ARDERNE, JOHN, 307
ARETAEUS, 144
ARISTOPHANES, 58
ARISTOTLE, 73, 102, 433
commentary by Averroes, 229
ARNOLD, of Villanova, 292–296
ARROW, EXTRACTION OF, from chest during battle (Fig.), 461
ARS PARVA, of Galen, 248
ARTERIES, ligaturing of divided, after an amputation, 289
ARTERIOTOMY, for relief of hemicrania, 470
ARTERY FORCEPS devised by Ambroise Paré, 512
ASAKKU, the demon who produces fever in the head, 13
ASCLEPIADES, founder of a new sect at Rome, 116, 119, 122
ASCLEPIEIA, 50, 52, 57
ASCLEPIEION at Cos (Figs.), 53
at Epidaurus, 52
ASELLI, CASPAR, 385
ASSYRIAN MEDICINE, 11
ASTRINGENTS, 133
ASTROLOGER, a typical, 12
ASTROLOGERS in Babylonia, 14
ASTRUC, JEAN, 548
ATHENAEUS, founder of sect of Pneumatists, 141
ATHENS, a great medical centre, 96
epidemic of the Plague at, 96
ATHLETIC EXERCISES as a therapeutic measure, 69
ATHOTIS, 17
AUGUSTUS, Roman Emperor, cured of gout by hydrotherapy, 129
AURICLES OF THE HEART, comments on, by H. de Mondeville, 290
AUSCULTATION of the chest, 20, 159
AUSTRICHILDIS, King Guntram’s wife, 240, 241
AUTHORS, numerous in Cordova in 12th century, 232
AVERROES, pupil of Avenzoar, 229
AVERROISM, 267
AVENZOAR, 228
AVICENNA, 221
B
BABYLONIA, genuine remedial agents employed in, 13
BABYLONIAN ASTROLOGERS, 14
BABYLONIANS, strange beliefs held by, in regard to human anatomy
and physiology, 13
BACON, FRANCIS, 338
BACON, ROGER, 271
BACTERIOLOGY, first studies in, 362
BAGDAD, a second great hospital founded at, in A. D. 914, 219
BAIN, CHRISTOPHER, 396
BAKHTICHOU BEN DJORDIS, 205, 207
BAKHTICHOU, GEORGE, 205
BARBARIC LATIN, 262
BARBERS, the earliest surgeons in France, 530
BARBERS AND BARBER-SURGEONS, 282, 369, 449, 464
BARBER-SURGEONS’ COMPANY, of London, 519
BARTHOLOMAEUS, 245
BASEILHAC, JEAN, 552
BASEILHAC, PASCAL, 496
BASEL, public dissection of human body at, 455
visited by Vesalius in 1542, 455
BATHS extensively used by ancients, 157, 323
BAUDELOCQUE, 539
BEDE, THE VENERABLE, believed in cures by supernatural means, 241
BELLADONNA, when first used for dilating the pupils, 157
BENEDICTINE MONASTERY on Monte Cassino, 238
BENIVENI, ANTONIO, 389, 498
BENVENUTO CELLINI, 341
BERENDES, 159, 317, 322, 426
BERENGARIUS OF CARPI, 342, 374
BERNARDO DI RAPALLO, 472
BERTHARIUS, abbot of Monte Cassino, 239
BERTHELOT, on Geber, 320
BERTRUCIUS, 310
BILE, black and yellow, 86
manner of production, 109
BLADDER, tuberculous ulceration of, 200
BLANCAARD, STEPHEN, 359
BLOOD, inflammation of (Sydenham), 423
production of, according to Erasistratus, 109
spirituous, 373
transfusion of, 408
BLOODLETTING, comments on, by Celsus, 152
from a vein, technique, 152
how practice first originated, 6
rule of Hippocrates regarding, 411
under what circumstances advisable, 133
BLOOD-VESSELS, CAPILLARY, circulation in, 383
when first injected artificially, 356, 359
BOERHAAVE, HERMANN, 144, 438, 441
gives clinical instruction at Leyden, 430
treatise on chemistry the standard for many years, 440
BOILING OF DRINKING WATER practiced by ancient Persians, 26
BOLOGNA MEDICAL SCHOOL, 272, 281, 332
BONIFACE VIII., POPE, successfully treated for stone in the
bladder, 293
BOOKS, great demand for, in 15th century, 329
BORELLI, ALPHONSO, 368
BOTALLO, LEONARDO, 413
BOTANICAL GARDENS, 17, 392, 393
BOUGIES, URETHRAL, 495
BOURGEOIS, LOUISE, 536
BOYLE, ROBERT, a distinguished chemist, 406
BRANCA, father and son, skilled in rhinoplasty, 459
BRASSAVOLA, experimental pharmacologist, 398
BREVIARIUM, ARNOLD’S, 294
BRIGGS, WILLIAM, 545
BRISSOT, PIERRE, 411
BRONZE SURGICAL KNIVES, 16
BROWNE, ANDREW, the friend of Sydenham, 422, 424
BRUNNER, JOHANN CONRAD, 359
BRUNSCHWIG, HIERONYMUS, 456
BRUNUS, 277
BULLETS not hot when they enter the flesh, 513
BURINNA, name of spring on the Island of Cos, 54
BYZANTIUM, the new capital of the Roman Empire, 180
C
CABANÈS, 402
CACAO, 395
CAELIUS AURELIANUS, 132, 159
CAESAR, JULIUS, liberality of, toward foreign physicians settled
in Rome, 119
CAESALPINUS, ANDREAS, 372, 375, 394
CAESARIAN SECTION, 396, 534
CAIRO PHYSICIANS distinguished ophthalmologists, 225
CALCAR, Vesalius’ draughtsman, 344
CALCULUS in the bladder may not be dissolved by internal remedies,
498
CALLIDUM INNATUM of Hippocrates, 415
CALVIN, JOHN, visited by Felix Platter, 335
CANCER OF BREAST, sculptured in marble (Fig.), 68
CANCER, ULCERATED, not to be cauterized, 285
CANNANI, 378
CANON, THE, of Avicenna, 222
CAPSICUM, 395
CARAKA, East Indian medical author, 31
CARBONIC ACID, nature of, expounded by Van Helmont, 400
CARBONOUS OXIDE, 434
CARCANO LEONE, 475, 476
CASE HISTORIES recorded on tablets, 67
CASSIODORUS, 238
CASTOR OIL, perfected by Apollonius Mus, 111
CATARACT OPERATIONS of Pierre Franco, 494
CATO, MARCUS PORCIUS, 117, 235
CAUSTICS, too freely used as haemostatics, 466
CAUTERIZATION of ulcerated cancer not approved by Lanfranchi, 285
CAUTERIZING INSTRUMENTS, 279
CELSUS, AULUS CORNELIUS, 150, 151, 155
CEREBRAL NERVES, crossing of, in relation to paralysis of one side
of the body, 144
CERMISONE, ANTONIO, 313
CHAMBERLEN, HUGH, 538
CHALDEAN DOCTRINE OF NUMBERS, 74
CHARCOAL, fumes of burning, 435
CHAUCER’S ACCOUNT of a clever physician, 308
CHEMICAL ELEMENT defined, 407
CHEMISTRY in ancient Egypt, 17
modern, developed gradually from alchemy, 320
CHICORY an effective remedy in abdominal diseases, 109
CHINESE CONCEPTIONS concerning human physiology, 41
CHINESE MEDICINE, 38, 39
CHIRON, 48
CHRISTIANITY, influence of, upon evolution of medicine, 179
CHRYSIPPUS, 141
CHYLE, distribution of, after it leaves the stomach, 109
CHYLE DUCTS, discovery of, 385
CICERO’S INTERPRETATION of the expression “gods” as employed by
the ancients, 18
CINCHONA, discovery of, 408
CIRCA INSTANS, the title commonly given to treatise of Matthew
Platearius, 253
CIRCULATION OF BLOOD, Galen’s physiology of, 373
de Mondeville’s comments, 289
CITIZENSHIP, rights of, bestowed by Julius Caesar on all foreign
physicians practicing in Rome, 119, 130
CIVITAS HIPPOCRATICA, 243
CLAUDIUS, Roman Emperor, merciful action of, toward slaves, 235
CLEMENS, of Alexandria, Egypt, 17
CLEMENT IV., POPE, protects Roger Bacon, 272
CLEMENT V., POPE, removes papal seat from Rome to Avignon, 293
CLINICAL INSTRUCTION at Leyden Hospital, 429
CLOWES, William, 519
CNIDIAN SCHOOL OF MEDICINE, 81
CNIDUS, in Caria, Asia Minor, 51
COCA, 395
COLD, exposure to, unusual treatment of, 489
COLLEGE OF PHYSICIANS, London, 417
COLLEGE OF SAINT COSMAS, Paris, 283, 284, 448
COLLIGET, title of treatise written by Averroes, 229
COLOT, LAURENT, famous French lithotomist, 474
COLUMBUS, REALDUS, 349
experiments relating to physiology of heart, 377
CÔME, FRÈRE, 550
COMMUNITIES, term employed by the Methodists for designating the
two conditions “laxum” and “strictum,” 130
COMPENDIUM AROMATARIORUM, the first modern treatise on materia
medica, 320
COMPENDIUM SALERNITANUM, 246
CONCILIATOR, title of one of Pietro d’Abano’s great works, 266, 267
CONSTANTINOPLE, taking of, by the Turks, an important aid to the
advance of medicine, 328
CONSTANTINUS THE AFRICAN, 239, 248, 260
CONTAGION, INNATE, 220
CONTAGIOUS DISEASES, Fracastoro’s classification of, 390
CONTINENS, title of Rhazes’ great work, 220, 262
CONTRARIA CONTRARIIS, principle of, in therapeutics, 132
COSMAS AND DAMIAN, 282, 449
COPAIVA, BALSAM OF, 395
COPHON, teacher of medicine at Salerno, 245
CORDOVA, SPAIN, centre of great intellectual activity, 218, 232
CORPSE, the touching of a, believed by the Persians to produce a
special contamination, 25
COS, ISLAND OF (Figs.), 53
COSTA BEN LUCA, 215, 216
COSTANZA CALENDA, 245
COWPER, WILLIAM, 360
CROKE, A., 250
CRONOS, 19
CROTONA, ITALY, 51
CULLEN, WILLIAM, 432
CURTIS, JOHN G., 72, 140
CYRENE, in Lybia, Africa, 51
CYSTOTOMY, HYPOGASTRIC, 495
D
DAMASCUS, an active medical centre in the 13th century, 225, 232
DAREMBERG, 50, 75, 240, 420
DARIUS I., King of the Persians, 26, 75
DAVID’S HARP-PLAYING, effect of, on King Saul’s melancholia, 27
DA VINCI, LEONARDO, 339
DAZA CHACON, 484
DE LE BOË, FRANZ, 427