_Age of Renovation (continued).--Animal Magnetism: Mesmer, 1754-1815.
Braid.--Brunonianism: John Brown, 1735-1788.--Realism: Pinel, 17451826.
Bichat, 1771-1802. Avenbrugger, 1722-1809. Werlhof, 1699-1767. Frank,
1725-1801.--Surgery: Petit, 1674-1750. Desault, 1744-1795. Scarpa,
1772-1832. Gunbernat, 11790. Heister, 1683-1758. Von Siebold,
1736-1807. Richter, 1742-1812. Cheselden, 1688-1752. Monro (1st),
1697-1767. Pott, 1749-1787. John Hunter, 1728-1793. B. Bell,
1806; J. Bell, 1820; C. Bell, 1842. Smellie, 1680. Denman,
1753-1815.--Revival of Experimental Study: Haller, 1708-1777. Winslow,
16691760. Portal, 1742-1832. Vicq d'Azyr, 1748-1794. Morgagni,
1682-1772.--Inoculation against Small-pox: Lady Montagu, 1762. Edward
Jenner, 1749-1823._
During{204} the eighteenth century also arose the illusory doctrine of
Animal Magnetism, which obtained among all classes a following that
can be accounted for only by the attractiveness of the marvelous and
unexplained. Frank Mesmer, born near Lake Constance, in 1754, was early
a victim of romantic yearnings, and his graduating thesis, delivered in
Vienna, dealt with the influence of the planets upon man and the use
of the magnet. After traveling extensively he erected a private
institution, where he treated blind girls, fidgety old maids, and
simpletons, until his deceptive methods were unmasked by a commission
appointed by the Empress Maria Theresa, and he was compelled to leave
Vienna in twenty-four hours. This martyrdom recommended him in Paris,
where the so-called Mesmerism speedily became fashionable. He finally
undertook instructions in magnetizing, at the rate of 100 louis a head,
and founded the "Order of Harmony." His so-called _baquets_ were tubs
with magnetic ducts, partially filled with soft water and all kinds
of ingredients, and armed with iron conductors, with which his pupils,
joining hands, placed themselves in contact. At these _séances_ Mesmer
appeared in lilac-colored clothes and professed to reinforce the action
of the tubs by looks, gestures, playing upon the harmonica, and touching
the subjects with wand or fingers. "If any one,{200} particularly a
lady, had a crisis at this time, she was borne to the 'crisis-chamber'
by Mesmer himself, where he treated her alone, as only when alone, he
claimed, could he attain success." He speedily became wealthy; managed
to deceive even the Queen of France; and, when he threatened to deprive
the country of his presence, 20,000 francs were offered him to instruct
others in his art. This offer, however, the wily charlatan declined. In
1785 some fool penned an article extolling him as a worker of
miracles; this stimulated the authorities to organize a committee
of investigation, the adverse decision of which, along with some
contributory evidence, made Paris too warm for him. After the revolution
he returned, but his day had passed, and he figures no more in medical
history. He has had many imitators, and the mesmeric craze, at times,
has infested different portions of the civilized globe; even some
who were eminent in science have fallen into the snares of so-called
Mesmerism,--notably Olbers, the discoverer of a number of asteroids.
Mystic medical doctrines, founded upon Mesmer's views, still continue
in certain circles, though the majority have long since succumbed to the
advances of scientific psychology. In this connection it is proper
to speak of the revived interest in "animal magnetism" due to the
researches of Dr. James Braid, of Manchester, England. This gentleman,
in 1842, published a work which pretty thoroughly exposed the fallacies
of the doctrine of Mesmer, and expounded many of the truths that were
entangled therein. He was among the first, perhaps, to employ the phrase
"animal magnetism," and was the author of the term "hypnotism," though
in his day the popular title was _Braidism_.
[Illustration: 0225]
During the middle of the eighteenth century arose a doctrine that, in
its novelty, ease of practical application, and apparent consistency
(through the ingenious employment of certain vital phenomena), secured
such a hold that its influence continued even into the present century.
This was{205} the "Brunonian doctrine," promulgated and upheld by
the great foe and rival of Cullen,--Doctor John Brown. In youth very
precocious, though of most humble birth, Doctor Brown had mastered the
Latin language at the early age of seven years, and three years later
essayed to learn a trade. At the age of twenty he left his native
village of Dunse for Edinburgh, seeking employment as a tutor and
intending to study theology. Poverty soon compelled him, however, to
take a rural school, but he returned a few years later (in 1759) to
the Scottish Athens and began the study of medicine, supporting himself
meantime by rendering theses into Latin and by teaching, translating,
and quizzing. Finally, he attracted the attention of Cullen, to whom he
became useful through his knowledge of the classics; but, ultimately, a
foolish quarrel made bitter enemies of the former friends. In 1770, in
private lectures, Brown{206} began to advance the theory to which he had
been led by one of his own attacks of gout that disappeared under the
use of stimulants, the disease having previously always been aggravated
by the treatment prescribed and that was held to be orthodox,--viz.,
antiphlogistic. He had now become somewhat dissolute, and the students
he gathered about him were of very much the same character; but they
formed the nidus of a great following opposed to Cullen, and quarreled
on all occasions with the adherents of the latter. Finally, Doctor Brown
removed to London, where fortune seemed to smile upon him, as he gained
rapidly in reputation and practice; indeed, he barely missed a call to
Berlin and another to Padua as a teacher, the scale being turned against
him by his dissolute habits. Though possessed of the highest mental
gifts, Brown was unfortunate in lack of mental stamina. He taught that
life is not a natural condition, but an artificial and necessary result
of constant irritations; all living beings, therefore, tend toward
death. Health is an intermediate grade of excitement; diseases, which
are either sthenic or asthenic, represent either too high or too low a
grade of excitement. It has been said that Brown's teachings slaughtered
more human beings than the French Révolution and the wars of Napoleon
combined. In England this system found no important followers, but
in America Benjamin Rush, of Philadelphia (1745-1815), distinguished
himself as an adherent. In Spain and France it found little place; but
in Italy, and later in Germany, it secured a numerous and important
following, which numbered, among others, Scarpa, Massini, and Girtanner.
[Illustration: 0227]
Another system which attained influential development, extending even
into the present century, was the so-called _Realism_, originated by
Pin el (1745-1836). Born in poverty, and designed for the Roman
Catholic Church, Pin el did not turn his attention to medicine until his
thirtieth year,{207} but on completing his studies he rapidly rose to
positions of importance. Led to the investigation of mental diseases
by the fate of one of his particular friends, who had become insane,
escaped into the forest, and was there devoured by wolves, Pinel
speedily developed a great interest in this class of sufferers. The
lot of the insane at this time was most pitiable: they were imprisoned,
chained, and treated worse than wild beasts. In his efforts to improve
their lot, Pinel acquired the title of conservative and aristocrat,
either of which was almost equivalent to a death-sentence. Unterrified,
however, he appeared before the Paris Council and urged the adoption
of reformatory measures, replying to the challenges of skeptical and
selfregardful opponents by liberating a number of insane patients who
were in his charge. The courage thus exhibited receives appreciation in
our time, if never before. Not the least{208} of Pinel's services was
the substitution of analytical for synthetical methods; he also sought
to determine disease by a diagnosis carefully constructed from symptoms,
but unfortunately he made pathology and anatomy subordinate factors. He
was a pupil of Barthez, but he placed his preceptor's vitalism far in
the background.
[Illustration: 0229]
Francois Bichat, born in 1771, earned high rank both as a clinician and
an anatomist. His education was begun in Nantes, but he studied surgery
and anatomy in Lyons and Montpellier, subsequently going to Paris, where
he became a member of Desault's family. After the death of his patron he
lectured on surgery, and from 1797 on anatomy. Possessed of a feverish
scientific activity, he became a member of the Société d'Emulation.
Death overtook him in 1802 as the sequel of consumption and an injury
received through a fall. He was the most capable physician of France
in his time, and, brief as w>as his span of life, he was author of nine
important volumes, the chief of which were a _Treatise on Membranes_
and works on general and pathological anatomy. From the latter a new
tendency in study took origin. He it was who gave utterance to the
aphorism: "Take away some fevers and nervous troubles, and all else
falls to the kingdom of pathological anatomy." As an evidence of his
energy, it is related that he in one winter examined seven hundred
bodies. He taught how to discriminate between disease processes,
and notably subdivided peripneumonia into pleurisy, pneumonia, and
bronchitis, these having been previously confounded. He once remarked:
"You may observe disease of the heart, lungs, abdominal viscera, etc.,
night and morning by the sick-bed for twenty years, yet the whole
furnishes merely a jumble of phenomena which unite in nothing complete;
but if you open a few bodies, you will see the obscurity speedily give
way,--a result never accomplished by observation if we do not know the
seat of the disease." To Bichat is also due our modern recognition of
cellular,{209} osseous, fibrous, and other tissues, as such, wherever
they appear throughout the body. He differentiated, without the aid
of the microscope, twenty-one different tissues as simple and similar
elements of the body, enumerating them as one does the chemical
elements; he described the stomach as composed of mucous, serous, and
muscular layers; overthrew the speculative tendency of medicine, and
placed facts in the front rank; and so conspicuous were his services
that he has been termed the "Napoleon of Medicine." He supplemented
the influence of Pinel upon the side of pathological anatomy; called
sensibility and contractility vital properties, whose alterations
constitute disease, claiming, however, that the vital properties of
individual tissues differed among themselves. His life and works are
revelations to young men and show what can be accomplished at a very
early age{210} by sufficiently active and harmoniously developed brains.
In reviewing the theories and lives of those mentioned as medical
luminaries of the eighteenth century, one experiences a feeling of
mingled respect and disappointment--respect for the devoted way in which
they worked and sought for the truth, and disappointment at so much
waste of intellectual power and labor. The lesson is also taught, and
should be impressed, that in all so-called new systems old principles
for the most part reappear, and that the labors of the past are rarely
so deliberately consulted as to guard against repetition and revamping
of theories that had long before been proved futile.
Let me now mention a few other of the physicians of the last century who
have left more or less of an impress upon their successors and upon our
science. One man, in particular, historians are wont to remember with
the honor that was denied him by his colleagues and contemporaries. I
refer to Leopold Avenbrugger, who was born in Graz in 1722, and who,
after pursuing his philosophical and professional studies in his native
city, obtained, at the age of twenty-nine, charge of a Spanish military
hospital; while thus employed lie invented the art of percussion as
applied to diagnosis. This he gave the test of experience during seven
long years before making it known to the profession, and even then it
was not appreciated, but remained practically unnoticed until after his
death, which occurred in 1809. He did receive a patent of nobility from
the Emperor Joseph II, but this hardly compensated him for the contumely
heaped upon him by his colleagues. Paulus Ægineta employed sounds and
specula; Santoro used the balance, counted the pulse, and resorted to
the use of the thermometer; Boerhaave employed the thermometer and the
simple lens; Floyer, and after him Haller, utilized the watch in marking
seconds; a Salernian practitioner utilized auscultation and percussion
in tympanites and ascites; but the{211} diagnosis of diseases of the
great viscera by percussion was never known before Avenbrugger. His
booklet of twenty-two pages, unsalable in his time, is to-day held worth
far more than its weight in gold. His famous colleague, de Haën, wrote
fifteen volumes without a word on percussion; Van Swieten did it no
greater justice; in his great treatise the _History of Medicine_,
Sprengel barely alludes to it; yet the contents of Avenbrugger's booklet
were of more practical value than all that these other men ever wrote,
or all the results of the vast and bloody campaigns during which it
slept. In 1808 this volume was rescued from oblivion by Corvisart, who
translated it into French and proclaimed its undying value.
During the earlier part of this century lived Werlhof, of Helmstâdt
(1699-1767), a far-famed observer, author, and practitioner, who
declined a professorship, and especially distinguished himself as a
writer of German poetry. Though possessed of an exceptional knowledge of
modern tongues, he wrote only in Latin,--the scientific language of
the day. In 1734 he was appointed physician to King George II, in which
position he attained world-wide fame, while indefatigable in his
efforts to elevate science. He first described the disease known by his
name,--_morbus maculosus Werlhofii_,--and struggled hard to establish in
Germany the use of cinchona.
From 1740 to 1802 flourished Wichman, of Hanover, highly esteemed as a
writer and practitioner. He is especially known for his pleas in favor
of more scientific diagnosés, and his demonstration of how to make them.
The rôle of the itch-mite in the transmission of scabies he demonstrated
upon himself; to be sure, Bonomo, a hundred years before, had called
attention thereto, but with little avail.
Another eminent Hanoverian was the fickle, stubborn, and misanthropic
Zimmerman, born in 1728, in Berne, upon whom misfortune and disease
played many shabby tricks.{212} He was, however, a man of ingenious
endowments, and merits especial regard, because he sought to free
medical science from the charge of being a secret art.
Another of the prodigies of medical history was J. P. Frank, born (1725)
in the Bavarian Palatinate, of pauper parents, and, while an infant,
abandoned by a cruel father. His early life was passed in a religious
school; at twenty-five he became a court and garrison physician, and
later a professor in Gottingen; finally he went to Vienna, where he died
in 1801. He was greatly beloved by his pupils, and Walther, the famous
surgeon, said of him: "No one ever made so elevating and permanent an
impression on me." He published an extensive work on forensic medicine
and sanitation,--wherein he took up the hygiene of the individual, of
the family, and of the school,--which constituted an effort far ahead of
anything of the kind previously known. He is also memorable for
efforts toward increasing the population, for the Thirty Years' War had
depopulated extensive districts--to such a degree, indeed that in
1750 bigamy was legalized in Nuremberg and many other towns. Frank was
distinguished for a keen and even caustic humor, whose subject was not
infrequently himself.
From 1707 to 1782 there lived in England one Sir John Pringle, chief
of the Army Medical Department, known to this day as an author upon
military hygiene. John Huxliam (1794-1868) advanced our knowledge
of putrid dissolution of the blood. John Howard (1766-1790) rendered
eminent service in prison reform. Heberden (1710-1801) was the first to
describe varicella, and also angina pectoris--which was long known as
Heberden's asthma. John Fothergil (1712-1780), a Quaker, acquired fame
by his observations on chronic angina, neuralgia, and hydrocephalus;
was likewise a benefactor of the poor, regarding them as "bridges to the
pockets of the rich"; indeed, a large part of what he gained from the
latter class{213} he bestowed in charity, and at his death left £200,000
for the same purpose. Radcliffe (1750-1814) was an eminent, witty,
successful practitioner of London, who was wont to declare that, as a
young practitioner, he possessed twenty remedies for every disease, but
at the close of his career had found twenty diseases for which he had
not one remedy. Richard Mead (1673-1754) was a prolific writer, and
the author of the first quarantine regulations adopted in England.
Contemporary with Mead was Lettsom,--the busiest, most philanthropic,
and most successful physician of his day,--whose practice, although a
large part of it was gratuitous, brought him sixty thousand dollars
a year, and who gave away immense sums for charitable purposes; also,
Thomas Dover, who invented the sedative known by his name and who died
in 1741. Akenside, physician and poet (1721-1770), wrote on dysentery.
Baillie, of Edinburgh, was the first to accurately describe the morbid
anatomy of gastric ulcer.
Among the French surgeons must be mentioned la Peyronie, of Montpellier,
born in 1668, who ultimately became director of the Academy of Surgery
and surgeon to the king. His wealth was employed for the elevation
of the craft, and he founded no less than ten different surgical
professorships at his own expense. In 1743 he effected the separation of
the surgeons from the barbers. He died in 1747, dedicating his estate
to the purpose for which he had lived. The most famous of the earlier
surgeons of this century was J. L. Petit (16741750), inventor of the
screw tourniquet, and who was called to treat Augustus the Strong,
of Poland; indeed, several other crowned heads became his patients.
Garen-geot (1688-1759), a professor in the College of St. Come,
published a work on operative surgery. Morand (1697-1773) and le Dran
were distinguished surgeons of Paris, the former especially noted for
the number of times{214} he performed paracentesis. Famous lithotomists
were le Cat and Frère Come,--whose real name was Baseilhac, and who
operated by means of the lithotome caché, Astruc (1685-1766) was a
syphilographer of extensive attainments; Quesnay (1694-1774), an eminent
and undaunted surgeon of Louis XV, who wrote on the history and progress
of surgery in France; Brasdor (1721-1776) was best known for his method
of distal ligation in aneurism; Sabatier (1732-1811) wrote a famous
treatise on operations, in which he recommended resection of the head of
the humerus.
One of the most celebrated surgeons was P, J. Desault (1744-1795), the
son of a poor farmer, originally designed for the priesthood, but who,
after obtaining a thorough mathematical education, began the study of
surgery with an ignorant master of his native town. Subsequently he went
to Paris, and here supported himself by teaching, gradually rising, step
by step, until, without collegiate education, he became professor and
chief-surgeon at the Hôtel-Dieu, where he established the first surgical
clinic. He opposed violently the prevalent abuse of the trephine, and
was also a champion of healing by first intention. A trusted friend of
Desault was Ghopart, well known because of the amputation of the foot
that bears his name. Another well-known surgeon, likewise a friend
of Desault, was Doublet; and it is somewhat remarkable that Desault,
Ghopart, and Doublet suffered persecution and perhaps martyrdom in
connection with the supposed death of the Dauphin of France,--properly
Louis XVII,--in 1795. There is evidence that the child who died in the
temple was not the dauphin, but a substitute, and these three surgeons,
who examined the corpse, had the hardihood to express their doubts.
The same day that Desault reported upon the evidence he was invited to
dinner by some members of the Convention, was taken ill at the table,
and died almost immediately after his return home, A few days{215} later
Chopart and Doublet died, also under mysterious circumstances.
Daviel (1796-1862) is remembered among French surgeons chiefly for
extraction of the lens as an independent method of treating cataract;
Tenon (172-4-1816), for his writings on the anatomy and diseases of the
eye; and Anel for originating the operation for aneurism, mistakenly
attributed to Hunter. There were also many others, of lesser note, who
distinguished themselves through special services to surgery or some of
its branches.
Among the Italians of this century may be mentioned Scarpa (1772-1832),
of Motta, professor successively in Modena and Pavia, and who advanced
our knowledge of hernia, diseases of the eyes, aneurism, and general
anatomy.
The most famous Spanish surgeon was Gimbernat, of Madrid (1742-1790),
for a time professor in Barcelona, who also became distinguished through
anatomical researches.
German surgeons did not rank high during the earlier half of the last
century, owing to the contempt engendered by the church for this branch
of the medical art. The fashion of imitating the French, however, led
to some surgical development. The first German surgeon of scientific
education was Heister (1683-1758), of Frankfort-on-the-Main, who,
unable to obtain honorable employment in the military service of his own
country, entered that of Holland, where he remained until the experience
of his own nation had brought about a healthy reaction. In 1720 he came
to Helmstâdt, where he developed great activity in anatomy, surgery,
and botany; also distinguished himself as a dentist and oculist, and
discussed the whole range of surgical topics from the least to the
greatest.
Bilguer (1720-1796), of Chur, became surgeon-general in Berlin, and
performed the first resection of the wrist in 1762;{216} he was an
opponent of amputation, which at that time was altogether too frequently
practiced.
Von Siebold (1736-1807) was the founder of an institution for surgical
instruction, where, for the first time in Germany, surgery was taught
clinically. He became one of the most famous teachers, and was first in
his native land to perform the operation of symphysiotomy, so recently
revived.
The greatest German surgeon of the eighteenth century, however,--one
eminent both as writer and operator,--was August Gottlieb Richter
(1742-1812), of Zorbig, a descendant of a ministerial family, who wrote
a famous work on hernia, and greatly improved all branches of surgery;
he it was that enunciated the principle of dressing wounds "quickly,
easily, and rarely."
Among English surgeons of the century must be mentioned, first of
all, Cheselden (1688-1752). wrhose name is inseparably connected with
anatomy and pathology as well as surgery At first a warm advocate of the
high operation for stone, his dexterity in lithotomy excited the wonder
of his contemporaries. He published a treatise on anatomy, and one on
the suprapubic section.
Alexander Monro, Sr. (1697-1767), of Edinburgh, was also eminent in both
anatomy and surgery, and contributed more than any other one man to
the success and reputation of the Scottish medical school. His sons,
Alexander and Donald, and his grandson, Alexander (3d), w'ere equally
celebrated in anatomy.
Charles White, of Manchester, is generally credited with having
performed, in 1768, the first subperiosteal resection of the head of the
humerus, although, as a matter of fact, this was not done until 1774,
and then by Bent, of Newcastle. He also performed resection of the
hip-joint upon the cadaver--another of the same name, Anthony White,
having done the operation on the living subject in 1721. He invented the
method of reducing dislocation of the{217} humerus with the foot in the
axilla,--a procedure that is ordinarily ascribed to Sir Astley Cooper;
also operations for false joint by the removal of the involved surfaces
of the bone.
It will be seen that the excision of the joints was peculiarly an
English method, the elbow-joint having been first excised in 1758,
by Wainman, and the knee-joint by Filkin, of Northwich. The man who
permanently attracted the attention of surgeons to these new operations
was Henry Park, a bold surgeon, who wrote in 1782. The merits of these
methods were then soon forgotten, however, and were revived in the
present century by Liston and Syme.
One of the best-known London surgeons was Percival Pott (1749-1787), who
became especially eminent through his{218} studies upon hernia, spinal
disease, and diseases of the bones and joints; his complete chirurgical
works appeared in London in 1771.
[Illustration: 0237]
William Hunter (1718-1783), of Scotch parentage, originally a
theological student, and a pupil of Cullen, went to London in 1741,
began to lecture on anatomy and surgery in 1746, and soon acquired a
great reputation as a surgeon, obstetrician, and anatomist. He achieved
enormous success in practice, and spent £100,000 upon his house,
library, and private collections. The latter now form the Hunterian
Museum in the University of Glasgow. His magnificent plates illustrating
the gravid uterus required the labors of twenty years and appeared in
1774.
[Illustration: 0239]
John Hunter (1728-1793), younger brother of William, enjoyed even
greater reputation than the latter. He was a pupil not only of his
brother, but also of Cheselden and Pott. Beginning the practice of
surgery in 1763, he became surgeon to St. George's Hospital in 1768,
and Surgeon-general of the English forces in 1790. So memorable were the
labors and services of this man that at the Royal College of Surgeons,
of London, there is given annually an "Hunterian Oration," intended in
some way to commemorate his labors or to draw some lesson from his life
and work, To do justice to John Hunter would require a volume, hence we
must at present dismiss the subject with this brief reference.
Almost equally famous as a surgeon, though by no means such an
omnivorous student as Hunter, was Benjamin Bell, of Edinburgh, who
died in 1806. He employed tubes of lead and silver for the purpose of
drainage. Sir Charles and John Bell, also of Edinburgh, are eminent
names pertaining to the latter part of the eighteenth and first part of
the nineteenth century. The latter was Professor of Anatomy, Surgery,
and Obstetrics, a busy practitioner, a fertile writer, and not only one
of the most successful operators of his day, but an excellent classical
scholar;{219} his _Principles of Surgery_ appeared from 1801 to 1807.
Sir Charles, who died in 1842, belongs more to the present century, but
was equally distinguished as an operator, surgeon, and writer, and best
known, perhaps, lor his _Bridgewater Treatise on the Hand_.
Among the Dutch an eminent surgeon was Peter Camper (1722-1789), who,
in order to acquire manual dexterity, learned to use various mechanical
tools. He was a fruitful author, and did not consider it beneath his
dignity to write a treatise about the best form of shoes, published in
Vienna in 1782, but recently translated and republished in England as
something new. Sandifort, of Leyden, discussed ruptures, dislocations,
etc., and reported the first observation of downward dislocation of the
femur.
As already noted, the surgeons of the eighteenth century were often
obstetricians,--William Hunter conspicuously. The{220} most important
obstetrician of his time was William Smellie (1680-1763), of London, who
invented numerous instruments, wrote a large treatise on the theory and
practice of midwifery, and greatly advanced our knowledge of deformed
pelves. He was the first to distinguish one diameter from the other,
and to point out the importance of cephalic version and version of the
breech. Parenthetically, it may be remarked that William Hunter, great
as he was, was the uncompromising foe of instrumental midwifery, and was
in the habit of showing his forceps, covered with rust, as evidence that
he never resorted to such aids. A rival of Smellie and Hunter was Thomas
Denman (1753-1815), best known, perhaps, because of his demonstration of
the portability of puerperal infection.
The researches of anatomists during the eighteenth century were, for the
most part, directed toward the minute, more difficult, and less striking
parts, and to increased thoroughness and accuracy of description.
Microscopical anatomy suffered a relative quiescence. Pathological and
general anatomy, which were destined to control the medicine of the
succeeding century, were newly created and not yet regarded as sciences
by themselves, but merely as special branches. The most important
feature was the revival and more accurate study of experimental
physiology, which had been scarcely resorted to since the time of Galen,
except for Harvey's discoveries. This revival, which really seemed
an epoch in the history of medicine, was effected by the great Haller
(1708-1777), of Berne,--a man who really deserved the title of "Great,"
as he was a universal and indefatigable _savant_, possessed of thorough
conscientiousness, marvelous capacity for work, great ingenuity, natural
endowments, and an inextinguishable love for art and science; he was
certainly one of the most versatile scholars and thinkers of any
time, distinguished not only in his chosen field of medicine, but as
a poet,{221} botanist, and statesman. Like all Swiss poets, he never
passed beyond the didactic and the homely in his versification. From his
tenth year he wrote poems in Latin and German, and even when eight years
old had made most extensive compilations from Bayle's dictionary. At
fifteen he went to the University of Tubingen, where, in the second year
of his sojourn, he disputed with one of his teachers. In 1725 he went
to Leyden, where Boerhaave and Albinus found in him a most indefatigable
follower. At nineteen he received the degree of doctor. In the excess of
his zeal for anatomy he purchased for a considerable sum, from Albinus,
half of a corpse, the other half of which his teacher had dissected;
and, while in Paris, he even engaged in grave-robbing, and, being
betrayed by his own carelessness, was compelled to save himself by
flight. In many other States, and in more than one country, he studied
with the best of teachers, lecturing at times himself. At the age of
twenty-six he became professor and hospital director at Berne, and in
1752 published his famous researches on irritability. Three years
later he accepted a call to Gottingen as Professor of Anatomy, Surgery,
Chemistry, and Botany. He was the founder of a botanical garden; for
many years was so busy that he slept and lived in his library; and, in
spite of his enormous and unique correspondence with the _savants_
of the world, he never left a letter unanswered. Strange to say, his
permanent influence upon the practice of medicine was only indirect;
and, although he was professor of surgery, and performed many
vivisections, he was never able to persuade himself to perform a
single surgical operation upon the living human being. He it was that
introduced into Germany the use of the watch in counting the pulse. Like
Hunter, Haller demands a special historian, and it is possible here to
outline only a few of the services he rendered to medicine. He enriched
the anatomy of the heart, of the brain and dura, and pointed out the
venous nature of the{222} sinuses; taught that the uterus should be
regarded as a muscle: advanced the knowledge of the lymphatic system,
and believed in and taught a developmental theory that every individual
is descended or derived from a preceding one. In the mechanism of the
heart his doctrine of irritability especially maintained itself. He
administered the death-blow to the doctrine of vital spirits, and
was, in fact, the father of modern nerve-physiology. His doctrine
of irritability moved the minds of his century in a way that has no
parallel, unless we compare it with the doctrine of Darwin. Glisson had
established the general principles of irritability, and Haller followed,
teaching it by the inductive method, and proving its existence by
experiments,--proving, moreover, that it is a peculiarity of the
muscular substance and not governed by ordinary sensation. His
researches deserve the more credit because he lacked modern aids to
physiological study. The first physiological institute was founded
in Breslau by Purkinje, some fifty years ago. Haller had no such
opportunity; even his successor, the great Müller, possessed no such
advantages. The profound impression made by Haller's teachings may be
measured by the number of his supporters and opponents; he was a great
man, second only in wide-spread influence to Boerhaave, and one who left
a more lasting impress upon the world than even the latter.
The two best known of Haller's opponents were: Wolf (1733-179-4), of
St. Petersburg, who regarded each generation as an actual new creation,
and was the first to teach the doctrine of the blastodermic membranes;
and Blumenbach (1752-1840), of Gotha, who did great service by
investigations in general anthropology, of which he was, in fact, the
founder, and whose researches in comparative anatomy and the history of
development have rendered him famous.
Of the famous anatomists of the century may be mentioned Sommerring
(1755-1830), of Frankfort,--the first to{223} distinguish the facial
and auditory nerves from eacli other, and whose published works are
well known, because of the beautiful illustrations furnished him by the
well-known artist, Koeck.
The ablest French anatomist of the century was Winslow (1669-1760),--a
man of Danish birth, but who became a professor in Paris, and is
best known by the foramen named for him. There were, also, Portal
(1742-1832), physician to Louis XVIII, who wrote a famous history of
anatomy and surgery; and Vicq d'Azyr (1748-1794), known equally well
for his labors in the department of anatomy, especially of the brain,
nervous system,{224} and the vocal organs. Bichat (already mentioned)
would deserve to be placed at the head of French anatomists were it not
for his superior rank in clinical medicine.
[Illustration: 0243]
The founder of pathological anatomy as a science was Morgagni, born
in 1682, in Forli, Italy,--a pupil of Valsalva, and, at the age
of nineteen, the assistant of the latter. It was not until his
seventy-ninth year, after he had published several works, that he
allowed his famous work on pathological anatomy to appear. This is the
historical classic, De Seclibus et Causis Morborum, published in Venice
in 1761. Its famous author did not cease work, even when he became
blind, and to him we owe the maxim that observations should be "weighed,
not counted." He was very versatile, and well informed in all branches
of science and literature, and possessed a remarkable memory; likewise
was the first to devote attention extensively and thoroughly to the
anatomical products of common diseases, since, before his time, little
had been regarded but rare discoveries in the body. He also called
attention to the important bearing which the history of the disease has
toward its products, and found his discoveries of advantage, even when
they were unable to promote the cure of disease, because of the light
which they threw upon physiology and normal anatomy, and because they
prevented incurable patients from being continually tormented with drugs
intended to cure them; also because pathological investigations
alone could settle disputes in diagnosis and matters of honor among
physicians. He died in 1772.
Morgagni's legitimate successors in Great Britain were Baillie
( 1761-1823), a son of John Hunter's sister, and Sir Everard
Home,--Hunter's brother-in-law,--who became professor in the Royal
College of Surgeons, and was intrusted by Hunter with the work of
describing his collection. Home, however, in a most discreditable
way, burned several volumes of Hunter's own descriptions, in order to
appropriate to himself the sole credit of the work. He has{225} gone
down to fame especially because of his book on the prostate.
One of the most notable events in the history of medicine was the
introduction of the systematic practice of _preventive inoculation
against small-pox_. It is so generally taught that this is entirely due
to the efforts of Jenner--or, rather, we are so often allowed to
think it, without being taught otherwise--that the measure deserves
an historical sketch. The communication of the natural disease to
the healthy, in order to afford protection,--or, in other words, the
communication of small-pox to prevent the same,--reaches back into
antiquity. It is mentioned in the Sanscrit Yedas as performed by
Brahmins, who employed pus procured from small-pox vesicles a year
before. They rubbed the place selected for operation until the skin was
red, then scratched with a sharp instrument, and laid upon it cotton
soaked in the variolous pus, moistened with water from the sacred
Ganges. Along with this measure they insisted upon careful hygienic
regulations, to which, in large measure, their good results were due.
Among the Chinese was practiced what was known as "pock-sowing," and
ten centuries before Christ the Celestials introduced into the nasal
cavities of young children pledgets of cotton saturated with variolous
pus. The Arabians inoculated with needles, and so did the Circassians,
while in North Africa incisions were made between the fingers, and among
some of the negroes inoculation was performed in or upon the nose. In
Constantinople, under the Greeks, the custom had long been naturalized,
and was practiced by old women, instructed in the art, who regarded it
as a revelation of Saint Mary. The first accounts of this practice were
given to the Royal Society by Timoni, a physician of Constantinople, in
1714. The actual introduction of the practice into the West, however,
was due to Lady Mary Wortley Montagu, who died in 1762, and who was wife
of the English Ambassador to the Porte in 1717. She had{226} her son
inoculated in Constantinople, by Maitland, and on her return to London,
in 1721, her daughter also was inoculated. During the same years
experiments were undertaken by Maitland upon criminals, and, as
these turned out favorably, the Prince of Wales and his sisters were
inoculated by Mead. The practice was then more or less speedily adopted
on this side of the Atlantic, but suffered occasional severe blows,
because of unfortunate cases here and there, such as never can be
avoided. The clergy, especially, using the Scripture, as designing men
can always do, became warm opponents of the practice, and stigmatized
it as an atrocious invasion of the divine prerogative. Nevertheless, in
1746 the Bishop of Worcester recommended it from the pulpit, established
houses for inoculation, and thus made it again popular. In Germany it
was generally favored, and a little later came into vogue in France
and Italy. In 1757 Robert Sutton, near London, professed to have made
fifteen thousand inoculations without a single fatal case; he kept
his patients on a strict diet for nine days, then inoculated with the
smallest possible quantity of virus. The operation was not prohibited in
England until the year 1840, although it involved much greater dangers
than vaccination with cow-pox.
The first inoculation with cow-pox seems to have been performed in
1774: by a farmer of Gloucester, named Jesty, though the pioneer in
the extensive and general introduction of this method was Edward
Jenner (1749-1823), of Berkeley, in Gloucestershire, who, therefore, is
generally known as the "Father of Vaccination." The son of a clergyman,
he began early the study of medicine and surgery, and during his
apprenticeship received from a milkmaid information of the protective
power of cow-pox against variola, as established by popular observation.
(Sutton and others had proved that inoculation of _sheep_-pox was not
efficient.) This communication so struck Jenner as a means of affording
protection to the whole human race{227} that the subject never
afterward left his mind. In 1770 he became a pupil of John Hunter, and
when he communicated to him this idea the great surgeon said: "Do not
think; investigate!" Accordingly he went to Berkeley and performed the
little operation which has made him famous; and from 1778 until 1788 he
communicated to Sir Everard Home such observations as he had made. But
the first vaccination was performed in 1796, upon a boy, with matter
from the hand of a maid who had contracted cow-pox in milking.
[Illustration: 0247]
In 1798 he published his memorable work, and afterward removed
to London. He died full of fame and honor, in his native place,
having-received rewards from the government amounting to one hundred and
fifty thousand dollars, besides being made an honorary citizen of the
city of London. The subsequent wide-spread practice of the method, and
the formation of societies{228} for the promotion of vaccination are
matters of recent history.
The first vaccinations in the United States were performed by Doctor
Waterhouse, Professor of Medicine in Harvard College, in 1800, upon four
of his own children. The transmission of humanized virus through the
system of the cow, and its subsequent employment in vaccination of human
beings, was first practiced by Troja (1747-1827), of Naples, shortly
after the introduction of human vaccination; but in 1810 this was
prohibited in Italy. Compulsory vaccination was first extensively
introduced in Germany in 1807; in England it was first legalized in
1827. The occasional temporary character of the protection thus afforded
was first taught by Elsâsser in 1814. Schoenlein was the first to call
attention to the distinction between variola and varioloid.
Another matter in which the eighteenth century witnessed great reform
was the _treatment of the insane_, which continued in very bad condition
until toward the close of the century, when a movement for improvement
began. From and after this lunatics were liberated from their fetters
and from the hands of brutal keepers, and regarded as actually ill,
while so-called schools of psychiatry were founded. While the first
impulse in this direction was given by Lorry, the true reformer was
Pinel, already mentioned, who did away with corporeal punishment and
abuse, separated the insane from convicts, limited the employment of
drugs and especially venesection, placed the unfortunates in special
institutions under the charge of physicians, and classified patients
according to their symptoms. Yet, in spite of his humane teachings,
lunatics were found incarcerated in cages in some of the French cities
as late as 1834. Pinel was followed by Esquirol (1772-1840), who in 1818
established the first clinic for mental diseases.
It is well known what a conspicuous part _public baths_ played in the
social life of the ancient Greeks and Romans, but{229} the first
public resort for sea-bathing was established in Germany in 1794. The
cold-water epoch of this century, however, began with the researches
of Hahn (16961773), a Silesian, who introduced a systematic and almost
exclusive hydrotherapeutic method. The modern method of using cold
water as an antipyretic agent was first employed in England, in 1797,
by Currie, who originally was an American merchant. In France the method
found little sympathy, but it made its way even to Spain later, where it
was adopted by the famous Sangrado, who is well known to readers of _Gil
Blas_.