MEDICINE
It is not surprising that there should have been a magnificent century
of achievement in medicine at this time because their standards of
medical education were at a high level and were well maintained. The
medieval requirements for medical education had been three years of
preliminary work at the university, four years in the medical schools,
special courses in surgery if practice was to be in that department,
and a year's experience with a physician before personal practice on
one's own responsibility was allowed. The laws of the Emperor
Frederick for the Two Sicilies in the thirteenth century were very
strict in this matter and they constituted the standard which came to
be very generally adopted. In the Italian universities the Papal
charters explicitly demanded these requirements. [Footnote 34]
[Footnote 34: For full details of this surprising, too little known
formal development of medicine, see Walsh, "The Popes and Science,"
Fordham University Press, N. Y., 1907, where all the documents will
be found.]
We have a series of re-enactments on this subject just about the
middle of the fifteenth century. Above all, clinical experience was
required before the license to practise would be issued. In 1449 the
medical Faculty of Paris required that graduates in medicine should
diligently visit the hospitals or accompany a skilful practitioner in
his visits to patients and refused to grant the license when this rule
was not observed. In Ingolstadt graduates in medicine, according to
the statutes of 1472, were obliged to take an oath that they would
practise only as the representatives of their teacher, or of some
other doctor of the faculty of that place, until they were considered
skilful enough to receive the license for practice on their own
responsibility.
In the hospitals of this time, which were large and well arranged,
thoroughly ventilated and capable of being well cleansed, {382} there
was ample opportunity for clinical teaching and we know that it was
taken. A manuscript of Galen of the fifteenth century which is
preserved at Dresden has a number of initial miniatures, in which
groups engaged in clinical instruction are noteworthy. In his "History
of Medical Education," [Footnote 35] Puschmann notes the details of
some of these. There is a picture of a patient suffering from some
wasting disease, near whose bed stand a doctor and two nurses, while
the doctor dictates a prescription to his pupils. There is a
demonstration of leg ulcers by a physician to a pupil and a surgical
operation on the leg performed by the pupil in the presence of his
teacher, as well as the opening of an abscess in the axilla. There
were hospitals in every town of 5,000 and this gave ample
opportunities for clinical experience. When hospitals are numerous and
well managed there must be physicians to attend on them and this
provides opportunities for thorough study of patients.
[Footnote 35: Translation by Hare, London, 1891.]
The influences that were at work to lift medical education to a higher
plane in practical efficiency may be judged from such expressions as
those of Rabelais, who, in his letter on education in "Gargantua,"
suggests as preparatory studies for medicine, Greek and Latin with
even a little Hebrew, for the sake of the Holy Scriptures, and natural
science, especially zoology, botany and mineralogy, and "then
carefully go over again the books of the Greek, Arabian and Latin
physicians, not despising the Talmudists and Cabalists; and by
frequent dissections acquire perfect knowledge of the outer world, the
microcosm, which is man." He himself has shown in a number of passages
that he had taken his own advice and even in his famous description of
the anatomy of Lent in which his comparisons were formerly thought
more or less fanciful, "they are extraordinarily apt and vivid and
show deep knowledge of anatomy," while his descriptions of wounds show
a competent familiarity with surgical anatomy. This might very well be
expected, for Rabelais invented two surgical instruments, one for the
reduction of fractures of the thigh bone and the other for operating
in cases of strangulated hernia. He has at least one passage in which
it is clear that he knew much more about the circulation of the blood
than is usually supposed to have {383} been known in his time and
which demonstrates that there had been a gradual accumulation of
knowledge on this subject before Harvey's time. (See chapter on
Biological Sciences.)
The interest in medicine can be best realized from the large number of
medical books that were printed almost immediately after the discovery
of printing. After theology medicine was the subject most occupying
the attention of printers. During Columbus' Century a whole series of
the classics of medicine was reprinted and made available for wide
reading. The patience and scholarship required for this can only be
properly appreciated by those who know the labor of reading the
crabbed handwriting of the old manuscripts and collating them and the
time required to elucidate erroneous readings that had crept in
through the negligence of copyists. The world owes an immense debt to
the Renaissance for this work. To a great extent these books have been
neglected for the last two centuries and we are only now coming to
realize how much the scholarly interest of that time meant for
subsequent generations. Many of these books are now being republished
to the great benefit of medicine. Not only were Hippocrates and Galen
and Celsus and the other classics republished, but also the writers of
the intermediate time, Aetius, Alexander of Tralles, the great Arabian
writers and then the important contributors to medicine and surgery in
the later Middle Ages. The value of the debt thus owed is growing in
estimation every year.
The publication of medical books, even during the score of years
immediately after printing began to be employed, shows the intense
interest in the subject. The first medical publication was a purgation
calendar, that is, a list of the days of the year on which purgations
should be practised. This was printed by Gutenberg, 1457. Heinrich von
Pfolspeundt's "Treatise on Surgery" was printed in 1460; in 1470
medical treatises by Valescus de Tarenta, Jacopo de Dondis and
Matthaeus Sylvaticus were printed. In 1471 treatises by Mesne and
Nicolaus Salernitanus were put in type. In 1472 the old _"Regimen
Sanitatis"_ was printed and Bellegardo's monograph on "Pediatrics." In
1473 Simon of Genoa's "Medical Dictionary" was set up and in 1476
William of Salicet's "Cyrurgia" was given {384} to the press. In 1478
the first edition of Celsus was printed, and the first printed edition
of Mondino's _"Anathomia"_ was ready for sale. In 1479 came the first
edition of "Avicenna." In spite of the great losses of books that have
taken place in the course of time because of fire, water, use and
other enemies, we still possess many medical books printed practically
in every year of the first quarter of a century after the discovery of
printing. Unfortunately the neglect of these old classics during the
eighteenth and early nineteenth centuries did more than all the other
inimical elements put together in reducing the number of medical
incunabula that we might have had.
The first great medical teacher of Columbus' period was Nicholas
Leonicenus, born in 1428, who studied medicine at Padua, lived for
some ninety-six years and was professor of medicine at Ferrara for
over sixty years. He translated the "Aphorisms" of Hippocrates and
some of Galen's works into Latin, and occupied himself with the
application of the principles laid down in these great classics in his
practice, and above all, in his teaching. He made it the business of
his life to oppose the Arabian over-medication and especially the use
of many drugs on general principles, and he insisted on natural modes
of cure, diet, water, exercise, fresh air and the correction of any
morbid habits that might have been formed. Probably more than anyone
else he influenced the medicine of the first half of Columbus' Century
and his work has come to be well recognized in recent years with the
growth of interest in the history of medicine.
After him, one of the most important of the physicians of the time was
Thomas Linacre, who, after studying some ten years in Italy, returned
to England to become the attending physician to Henry VIII. His
translations of Galen's works attracted wide attention and Erasmus,
Linacre's friend, once declared that after Linacre's translation Galen
now spoke much better Latin than he had Greek before. Linacre was a
type of the learned physicians of the time and was one of the greatest
scholars of the period. That scholarship did not make men impractical,
Linacre's organization of the College of Physicians of England is
abundant evidence. He found the practice of medicine on his return to
England sadly degenerate, {385} because there was no competent
authority to maintain proper standards of medical education and
prosecute those who attempted to practise medicine without any proper
training and sometimes, indeed, without any knowledge of the subject.
Through the charter from the King, at first for London and
subsequently for England, the duty of caring for the protection of the
public against the illegal practice of medicine was committed to the
Royal College of Physicians. Linacre organized and endowed it, and it
continues to exist and exert an excellent influence over medical
practice in England under its original charter down to the present
time.
Another of the distinguished contributors to medical practice at this
time was John Caius, who also translated some of Galen's works and
especially the _"De Medendi Methodo,"_ his edition containing a series
of annotations from his teacher Montanus, and from his own
observations on patients. He is deservedly best known for his little
book on the Sweating Sickness, in which he exhibited his power of
observation and his ability to describe what he saw. Gesner, the great
European biologist of the time, who was on terms of intimate relation
by correspondence with Caius and knew his work on plants and animals
very well, styled him, in the preface to his _"Icones Animalium,"_ "a
man of consummate erudition, fidelity and diligence as well as
judgment," and in an epistle to Queen Elizabeth bestows upon him the
eulogium of "the most learned physician of his age." Caius has the
merit of introducing the regular practice of dissection into the
English teaching of medicine. As Linacre had done, Caius too, as he
grew older, used the money which he had accumulated as Royal physician
and in the lucrative practice of medicine in London for academic
foundations. Linacre founded chairs in Greek and medicine at Oxford
and Cambridge, as well as the College of Physicians, and Caius, after
having been the first president of Linacre's Royal College, founded
Caius College at Cambridge, where he died in 1572. His last year of
life had been disturbed by the looting of his rooms of a number of
pious articles connected with the old Church to which he faithfully
adhered, and Mr. Andrew Lang suggests that only Dr. Caius' timely,
though untimely, death (he was but 63 years of age) prevented {386}
him from sharing the fate of the pious articles associated with the
old faith which he had cherished as faithfully as the tenets of that
faith itself.
One of the important teachers of medicine at this time was Giovanni de
Monte, according to the custom of the time known by the Latinized name
of Montanus. He was distinguished for his application of the
humanities to medicine and his direct translations of Greek medical
books into Latin, so as to avoid the errors which had come from the
roundabout translation in the previous times of Greek into Arabian and
then into Latin. To him, almost more than any other, is due the
reputation that the medical school of Padua obtained at this time, for
he gave a series of clinical lectures on the patients in the Hospital
of St. Francis which were written down. They show how thorough were
his observations and how suggestive his teaching. No wonder that he
had pupils from all over Europe. His pupils thought of him as the
Americans did of Louis during the early part of the nineteenth
century. Many Germans went to hear him. It was a Polish student who
reported some of his lectures and Dr. John Caius was, as we have said,
one of his most ardent students. Montanus insisted on making careful
inspections of the dead bodies in order to control his diagnosis, and
the teaching at Padua under him was thoroughly practical and such as
we are likely to think of as modern.
[Illustration: TITIAN, PARACELSUS ]
Quite different from the line of learned physicians who drew their
inspiration from the Greek classics of medicine, was another of the
great physicians of Columbus' period who ran counter to all the old
medical traditions and dared to think for himself. This was
Paracelsus, whose motto _"qui suus esse potest, non sit alterius"_--he
who can form an opinion of his own should not borrow that of
others--shows the independent character of the man. He broke away from
the teachings of medicine in Latin and sought far and wide for
anything and everything that might help in the cure of disease. He has
been an extremely hard man for historians to estimate and
appreciations of him have differed very greatly. There is no doubt at
all that he did much to introduce chemical remedies of many kinds into
medicine, though he was a decided opponent of the polypharmacy of his
day, a heritage from the Arabian {387} physicians, who delighted in
giving a large number of drugs. There are expressions of his which
show how carefully he had thought out the problems of the practice of
medicine. He said: "to be a true alchemist is to understand the
chemistry of life." "Medicine is not merely a science but an art. It
does not consist in compounding pills and plasters and drugs of all
kinds, but it deals with the processes of life, which must be
understood before they can be guided."
Above all Paracelsus recognized that success in medicine depends on
the treatment of the patient rather than his disease, and he insisted
on the idea that nature was, as a rule, eminently curative of diseases
rather than prone to make the affection worse, as physicians at so
many times in the history of medicine seem to have thought. Paracelsus
declared that "the knowledge of nature is the foundation of the
science of medicine and a physician should be the servant of nature,
not her enemy; he should be able to guide and direct her in her
struggle for life and not by his unreasonable drugging throw fresh
obstacles in the way of recovery." He appreciated very clearly the
influence of the mind on the body and said "the powerful will may cure
where a doubt will end in failure. The character of the physician may
act more powerfully upon the patient than all the drugs employed." He
realized also the place of the conditions surrounding the patient as
helpful towards his cure. He said: "the physical surroundings of the
patient may have a great influence upon the cure of his disease. Diet
is an extremely important element of cure and the physician should
know how to regulate the diet of the patient." He called attention to
the fact that trained attendants sympathetic with the patient are far
better for him than relatives who may be over-solicitous and show it,
or neglectful because they wish the death of the patient.
Paracelsus was the first to write on occupation diseases and his
monograph on _"Bergsucht,"_ "miner's disease," is a monument to his
power of observation. His clinical acuity is further exemplified by
his recognition of the relation between cretinism and endemic goitre.
He also wrote a booklet on mineral baths and analyzed mineral waters
for bathing and drinking purposes, getting at the iron content of
chalybeate {388} waters by testing with gallic acid, and the resultant
ink reaction, and also demonstrating the presence of other salts. He
did more than anyone else to establish properly in medicine the use of
opium (as laudanum), mercury, lead, arsenic, and his chemical
experiments taught him much about copper sulphate and potassium
sulphate and he recognized zinc as an elementary substance.
He did quite as much for medicine by his negative conclusions and his
opposition to medical practices that had been common up to his time as
by his positive observations. Indeed it might possibly be thought that
there was more to his credit from the negative side. He set himself up
in strenuous opposition to the silly uroscopy and uromancy by which
physicians had deceived others and very often deceived themselves.
Something of the value of the urine in medical diagnosis had been
recognized in the Middle Ages, and then, as practically always happens
in medicine, little-minded men had pretended to be able to learn much
more from it than could possibly be revealed by it. Every disease came
to have its specific urine and diagnosis and prognosis came to be
largely dependent on changes in the color and character of the urine
that were in themselves quite insignificant. Paracelsus brushed all
this ridiculous nonsense aside, but of course, in doing so, made a
great many enemies. Men are much more disturbed, as a rule, by having
their false knowledge corrected than their real knowledge amended.
Paracelsus also refused to accept the practically universal persuasion
that every disease was an indication for blood-letting. He was sure
that in a great many cases this practice did more harm than good. He
felt the same way with regard to the almost universal purgation that
was being practised for every form of ill. No one recognized better
than he that there were poisonous substances in the body which
produced serious affections. He was quite willing to be persuaded,
too, that these poisonous substances could be at least to some extent
removed from the body by purgatives. He feared, however, lest
purgation might carry off with it many materials more beneficial to
the body than the poisons it would drain were harmful. The idea of an
autotoxemia or an autointoxication {389} is constantly recurring in
medicine, and the supposed remedies for its cure prove subsequently
nearly always to have done more harm than good. Medicine owes much to
Paracelsus for his firm stand in this matter. Shakespeare's genius in
intuition was right when in "All's Well That Ends Well" he ranged the
modern German with one of the greatest of the ancients. "So say I,
both of Galen and Paracelsus."
Meyer in his "History of Chemistry" has summed up what Paracelsus
accomplished by the co-ordination of chemistry and medicine. As it is
not the purpose of the great German historian of chemistry to give a
panegyric of Paracelsus but simply to indicate his place in the
history of chemical evolution, that opinion must have great weight. He
said, page 71: [Footnote 36]
[Footnote 36: "A History of Chemistry, from Earliest Times to the
Present Day: Being also an Introduction to the Study of the
Science," by Ernst von Meyer, Professor of Chemistry in the
Technical High School, Dresden; translated, with the author's
sanction, by George McGowan, Ph.D.; third edition; London: Macmillan
and Co., 1906.]
"Paracelsus was the man who, in the first half of the sixteenth
century, opened out new paths for chemistry and medicine by joining
them together. To him is undoubtedly due the merit of freeing
chemistry from the restrictive fetters of alchemy, by a clear
definition of scientific aims. He taught that 'the object of chemistry
is not to make gold but to prepare medicines.' True chemical remedies
had been used now and again before his time, but Paracelsus differed
from his predecessors in the theoretical motives which led him to
employ them. He regarded the healthy human body as a combination of
certain chemical matters; when these underwent change in any way,
illness resulted, and the latter could therefore only be cured by
means of chemical medicines. The foregoing sentence contains the
quintessence of Paracelsus' doctrine; the principles of the old school
of Galen were quite incompatible with it, these having nothing to do
with chemistry."
His contributions to surgery are almost more important than those to
medicine, for he insisted on keeping wounds clean and deprecated the
meddlesome surgery of the time. Cutting loose from everything that had
been taught before his time, he {390} almost necessarily made many
mistakes. Besides, in spite of his insistence on scientific
demonstration, he accepted many things for which there was no good
reason. His works, most of which we owe not directly to himself but to
his students, contain many absurdities. There is no doubt at all,
however, that he was a great genius and that the medicine of this
century and of succeeding generations owes much to him. He well
deserves the name of the Father of Pharmaceutical Chemistry which has
sometimes been given to him. He represents one of the important links
in the tradition of medicine and is a man who is ever more appreciated
the more we have learned about him through recent studies of his
writings." [Footnote 37]
[Footnote 37: Even Paracelsus' mistakes have had something of genius
in them. Above all, his influence has lived on through the
generations. His doctrine of signatures and his study of the effects
of poisons on the human system had more to do than anything else
with the establishment of the therapeutic systems of Hahnemann and
Rademacher.]
We have some two score of books attributed to him, but probably less
than a score are really his. Probably no one has ever had a higher
view of medicine. He bases it on the relationship which man bears to
nature as a whole and anticipates the very modern idea that disease is
not a negation, but itself a phase of life. Magnetism represents a
great force for him and some form of it is supposed to emanate from
all bodies and place them in relation with each other. The influence
of the stars on human constitutions is only one phase of this
magnetism which binds all the world together. The superabundance of
vitality in certain men gave them a magnetic influence over other men
and this magnetic influence might even persist after death. Hence
mummies were supposed to contain a certain astral balsam and the
consumption of mummy substance gave wonderful vitality to ailing
persons. Like scientists at all times, Paracelsus had to have his
explanation for miracles. He suggested that saints were people with an
abundance of vitality and some of this remained in their bodies after
their deaths just in the same way as it remained in the bodies of
mummies. It was sufficient, then, to come within the sphere of the
influence of these bodies to be affected by it. Miracles, then, were
not exceptions to the laws of nature but merely {391} fulfilment of
laws that men were only just getting to understand. That has been the
favorite mode of explanation for miracles ever since, though a new set
of facts has always been adduced as the basis of the explanation.
Of course Paracelsus believed in many absurdities. He suggests, for
instance, that it is possible to transplant toothache into a tree
after the following fashion. Having taken away a portion of the bark,
a piece of the wood is cut and with it the gum is pricked until the
blood flows. Then the piece of wood stained with blood is set again in
its place in the tree and the bark is also replaced. He believed also
in the vulnerary ointment, which could cure wounds, not by application
to the wound itself but to the weapon. It was important, however, that
the weapon should be stained with the blood from the wound. He had the
feeling that the morbid elements of an affection or a wound were
contained in the blood and might be neutralized even outside the body.
The vulnerary ointment was composed of moss from the head of a dead
person, preferably one who had been put to death for murder, mummy,
human fat and human blood. It all seems so absurd to us now, but
behind such prescriptions was the theory that some of the vital force
of these human beings could be made over to the diseased person in
order to add to his vitality. Many absurd prescriptions have been made
on theories not nearly so reasonable as this of Paracelsus.
To this period also belongs the name of Basil Valentine, who has been
called the last of the alchemists and the first of the chemists. Just
now we are passing through a phase of historical criticism which
throws doubt on his real existence, though we have a series of books
under his name published at the end of the sixteenth century.
Tradition declares that he was a Benedictine monk living about the
middle of the fifteenth century, who tested many forms of drugs with
the idea of securing materials for the cure of human diseases. To him
is attributed the discovery of hydrochloric acid, which he called the
spirit of salt, sugar of lead, and a method of preparing sulphuric
acid and probably ammonia. He is best known for his work on antimony
and his book, "The Triumphant Chariot of Antimony," put that metal and
its salts into medical practice {392} for centuries. The indication
for it was that disease was largely due to a toxaemia or accumulation
of poisons in the system, the modern idea of auto-toxaemia, and that
these could be best removed by brisk purgation. The use of calomel
subsequently, the theory underlying venesection and a great many of
our modern surgical fads for the improvement of man's condition by
taking something out of him have the same notion for basis.
Basil Valentine's works are precious because they insist that
physicians must know the drugs they use and their effects, not merely
by reading about them, but by studying them on patients and on
animals. He himself is said to have tried the effect of antimony on
the swine belonging to the monastery in which he did his work, and
other materials are said to have been tested in the same way. He is
thus really a father of experimental medicine. He cannot say too much
in deprecation of physicians who give medicines which they know little
about for diseases about which they know less. In my sketch of him in
"Catholic Churchmen in Science" (Dolphin Press, Philadelphia, 1907) I
quote a passage from his "Triumphant Chariot of Antimony," in which he
bitterly condemns the practice of physicians who give remedies knowing
practically nothing about them, only that they have been recommended
by someone else. It read like a diatribe of the modern time against
allowing the manufacturing chemist to suggest drugs for medical
practice. The passage makes very clear what is the secret of the
mystery by which remedies come and go in medicine because of
insufficient testing. Valentine said:
"And whensoever I shall have occasion to contend in the school with
such a Doctor, who knows not how himself to prepare his own
medicines, but commits that business to another, I am sure I shall
obtain the palm from him; for indeed, that good man knows not what
medicines he prescribes to the sick; whether the color of them be
white, black, grey or blew, he cannot tell; nor doth this wretched
man know whether the medicine he gives be dry or hot, cold or humid;
but he only knows that he found it so written in his Books, and
thence pretends knowledge (or as it were, Possession) by
Prescription of a very long time; yet he desires to further
information. {393} Here again let it be lawful to exclaim, Good God,
to what a state is the matter brought! what goodness of minde is in
these men! what care do they take of the sick! Wo, wo to them! in
the day of judgment they will find the fruit of their ignorance and
rashness, then they will see Him Whom they pierced, when they
neglected their Neighbor, sought after money and nothing else;
whereas, were they cordial in their profession, they would spend
Nights and Days in Labour that they might become more learned in
their Art, whence more certain health would accrew to the sick with
their Estimation and greater Glory to themselves. But since Labour
is tedious to them, they commit the matter to Chance, and being
secure of their Honour and content with their Fame, they (like
Brawlers) defend themselves with a certain Garrulity, without any
respect to Confidence or Truth."
Another of the great physicians of the time was Cornelius Agrippa,
born in 1486, of the old family of Nettesheim. Cornelius was at first
the secretary of the Emperor Maximilian, then a warrior and finally a
student of both law and medicine, yet all was accomplished so
expeditiously that when he was but twenty-four the Parliament of Dole
came in a body to hear his lectures on the Cabalistic Books of
Reuchlin. He practised for a while as a physician at Geneva after
having been an advocate at Metz and, with the tendency to wander that
so many of the men of this time had, we find him afterwards at
Freiburg, at Lyons, then for a time the physician of Louise of Savoy,
but jealousy drove him from the Court and a little later we find him
starving in Antwerp, and then in prison at Brussels. He passed through
Cologne, was at Bonn for a time and is heard from in prison at Lyons.
He seems to have run the whole gamut of human suffering. It is hard to
know what he was imprisoned for, but he seems to have been a man who
easily made enemies, refused to think that anyone else knew much and
probably his necessities led him into the doing of things that were
suspicious at least, if not actually criminal.
Agrippa was very much interested in magnetism, quite taken with the
idea of human magnetism and above all very much persuaded of the
influence of the mind on the body. He felt {394} the place that
autosuggestion or strong persuasion has in enabling men to accomplish
anything and he said: "We must therefore in every work and application
of things affect vehemently, imagine, hope and believe strongly, for
that will be a great help." He was quite sure that the mind could
influence the body strongly for healing purposes and would doubtless
have been looked upon as an advocate of New Thought or Psychic Healing
or some of the other schools of mental therapeutics in our time,
though he believed also in the use of medicines and remedial measures.
Another phase of his anticipation of some modern ideas may be still
more interesting for our generation, though it only shows how prone
human thought is to run in cycles and how hard it is to find anything
new under the sun: it may be rather surprising to many to learn that
Agrippa seems to have had a definite persuasion that woman was
superior to man. He was what the French would have called "a feminist
of the most modern." A book of his on the subject recently appeared as
a bibliographic treasure in the London bookseller, Tregaskis'
catalogue (No. 736). The title was: "Female Pre-Eminence: or The
Dignity and Excellence of that Sex Above the Male." An Ingenious
Discourse: Written originally in Latine, by Henry Cornelius Agrippa,
Knight, Doctor of Physick, Doctor of Both Laws, and Privy-Counsellor
to the Emperour Charles V. Done into English with additional
advantages. By H. (Enry) C. (are) Printed by T. R. and M. D. and are
to be sold by Henry Milion, 1670. The catalogue contains the note:
"Strong arguments in favor of women's superiority. It is rendered into
English, well embroidered with poetic imagery and rich in furiously
entertaining passages."
The most important scientific development for medicine came from
pathological anatomy. This science is supposed as a rule to be of much
later origin than the period we are occupied with, but the interest in
the history of medicine in recent years has shown us how much of
attention there was given to pathology and how many observations were
accumulating in the published books of the Renaissance time. There was
much more of such scientific observation in the Middle Ages than is
usually thought. Three men at the beginning of {395} Columbus'
Century, Professor Montagnana of Padua, Professor Savonarola of
Ferrara, the grandfather of the martyred Dominican, and Professor
Arcolani of Bologna, described a number of different lesions which
they had noted in the many bodies that were being dissected at this
time. In the next few years these observations multiply. Benedetti,
the Professor of Anatomy at Padua and the founder of the anatomical
theatre at that university, made reports on gall-stones and
apoplexies. Benivieni, a simple practising physician at Florence, was
probably the first to describe gall-stones and he has a very large
number of pathological observations. He is the first that we know who
made a number of autopsies with the definite idea of finding out the
cause of death and he has come deservedly to be called, as a
consequence, the Father of Pathological Anatomy. Allbutt, the Regius
Professor of Medicine at the University of Cambridge, says of him:
"Before Vesalius, before Eustachius, he opened the bodies of the dead
as deliberately and clear-sightedly as any pathologist in the spacious
times of Baillie, Bright and Addison," and Malgaigne has described his
book as "the only work on pathology which owes nothing to anyone."
It became the custom then to collect observations of this kind and
Berengar of Carpi, the discoverer of the appendix, who had dissected a
great many bodies, described a number of pathological changes. Aranzi,
the professor of medicine and of anatomy in Bologna, has many
observations of pathological finds in his book and paid special
attention to tumors. Ingrassias, professor of anatomy at Naples, was
also interested in pathology and, as specializing had become the
fashion, his observations were mainly with regard to bones.
Eustachius, the professor of anatomy in Rome, declares in the preface
to his anatomical tables that he was the first to make autopsies for
pathological purposes in Rome, and that he had collected an abundant
amount of material. The publication of Eustachius' anatomy was delayed
until long after his death and his pathological observations were
never published. Columbus in Rome made a series of autopsies even on
high ecclesiastics for the purpose of determining the cause of death
and evidently the science of pathology was gradually coming into
existence. Vesalius made a large number of pathological observations
{396} and promised in his book on normal anatomy to publish them.
Unfortunately he never did so, and his notes seem lost, though it is
not impossible that the manuscript or some portion of it may yet be
found in Spain.
In many other countries besides Italy, however, pathological anatomy
attracted much attention. Joost van Lom, often known by his Latin name
of Jodocus Lommius, a physician in Brussels, who was royal physician
to King Philip II, published three books of medical observations at
Antwerp just after the close of Columbus' Century (1560) in which
notes of all diseases and problems of prognosis are set forth. Johann
Kentmann, a physician of Torgau, devoted a great deal of attention to
the study of the formation of all kinds of calculi in human beings,
biliary, salivary and intestinal. Francisco Valles, Professor of
Medicine at the University of Alcala in Spain, published a volume of
Galen's _"De Locis Affectis,"_ in which he incorporated many notes of
his own pathological observations. Jacques Houillier (Hollerius)
published about the same time at Paris, where he was professor of
medicine, a book on "Internal Diseases" with many pathological notes.
Johann Weyer (Wierus) also added valuable pathological annotations to
his writings.
At the end of the century pathological anatomy as a definite
department of medicine had been firmly established. Dodoens
(Dodonaeus), Royal physician to the Emperor Maximilian II and Rudolph
II, made a large number of valuable observations at autopsies and
described cases of pneumonia, ulcers of the stomach, inflammation of
the abdominal organs, aneurisms of the coronary arteries and of the
arteries of the stomach, stony concretions in the lungs, purulent
conditions of the ureters and kidney, and ergotism. Even more
important for the science was the work of Schenck von Graffenberg,
official physician at Freiburg in Breisgau, who gathered together a
larger collection of observations on the diseases of separate organs
than had ever been made since Hippocrates' time. He paid special
attention to the pathological anatomy of these cases and while many of
the observations were his own, a great many of them had been collected
from friends. His work was done after the close of Columbus' Century,
but he {397} himself was over twenty before the century closed and he
was only carrying out the inspiration that had been given by workers
in that tune. Pieter van Foreest (Petrus Forestus), a practising
physician in Delft, deserves almost as much credit as Schenck von
Graffenberg and much more than many of the professors in medicine and
anatomy of this tune. He made a special study of the pathological
conditions of the ordinary diseases and was indefatigable in
collecting information. His own observations include more than 100
cases with autopsies. With this spirit abroad the future of scientific
medicine was assured.
A good idea of the accomplishment of the medical teachers of the time
may be judged very well from the life of Fracastorius. Prof. Osler in
his sketch of him published in his book, "An Alabama Student,"
[Footnote 38] says: "The scientific reputation of Fracastorius rests
upon the work _'De Contagione.'_ It contains among other things three
contributions of the first importance--a clear statement of the
problems of contagion and infection, a recognition of typhus fever and
a remarkable pronouncement on the contagiousness of phthisis." In the
same sketch Osler adds: "Fracastorius draws a remarkable parallel
between the processes of contagion and the fermentation of wine. It is
not the same as putrefaction, which differs in the absence of any new
generation and is accompanied with an abominable smell. Certain
poisons resemble contagion in their action, but they differ
essentially in not producing in the individual the principle or germ
capable of acting on another poison." This discussion is wonderfully
complete and thorough, yet conservative. Later Boyle declared that a
time would come when someone would discover the cause of fermentation
and probably at the same time throw light on the origin of contagious
disease. That prophecy was fulfilled when Pasteur made his studies in
the fermentation of wine and beer and then went on to lay the
foundation of bacteriology. Fracastorius' thoroughly scientific spirit
will be appreciated from the fact that, like Leonardo, he saw fossils
in their true light and has the first reference in the history of
science to the magnetic poles of the earth.
[Footnote 38: Oxford Press, 1908.]
{398}
Men whose names are usually associated with surgery often manifested
successful interest, and above all, power of observation in pure
medicine. A single example may be taken in illustration. Anyone who
thinks that observation and theory and investigation of arthritism is
new or that we have occupied ourselves much more with the study of its
symptoms than they did in the olden time should read Pare's chapters
on Gout. He says that the word gout, which appealed to him as French,
was probably used because the humors distil drop by drop, _goutte a
goutte_ over the joints. Or perhaps because sometimes a single drop
(goutte) of the humor of this disease causes very great pain. He
describes the deposits of gypsum-like material, or stony matter like
chalk, which occur in the affection. The severe pains which occur in
connection with the disease Pare does not hesitate to attribute to
alteration of the humors by a poison which he calls _"virus
arthritique"_ He notes that the pains are distinctly influenced by
atmospheric fluctuations, so that one may well say of the gouty that
they carry with them an almanac which may serve them as a weather
indicator all their lives. Serious complications can arise in gout if
the humors of the disease involve other organs than the joints. He
attributed inflammations of the liver, of the pleura, colicky
disturbances of the intestines, to this cause. Continuous fevers
represented for him the effect of the gouty toxin upon the large
vessels, while paralyses might occur if the gouty toxin involved the
"porosities" of the nerves.
He described a sanguineous gout frequent in the springtime, especially
among young people with acutely inflamed joints, the pain being most
severe in the mornings and the urine red and dense. This is evidently
acute rheumatic arthritis. Bilious gout occurred more among the
middle-aged and the involved joints were yellow rather than red and
the pain attained its maximum intensity in the early afternoons. The
urine was lemon yellow in color but often cloudy. The third form was
pituitary gout which occurred particularly in the winter, having as a
main symptom coryza, affecting the old rather than the young, but
usually without acute pain. The affected area is cold rather than hot
to the touch and the discomfort is most noted during the night. The
urine was pale in color and thick. {399} Melancholy gout, the fourth
form of the disease, was also an affection of old age, producing a
livid color in the joints and making them cold to the touch. The
patients' pains were worse at intervals of three or four days and the
urine had a deep cloudy color. Sanguineous gout was the most curable
of these four and usually lasted two to three weeks; bilious gout was
much more serious and often ended in death. Pituitary and melancholy
gout were chronic diseases of long duration. It is rather easy to see
Pare's powers of observation in all this. He jumped to conclusions and
over-generalized, as men have always done and thus made mistakes. Down
even to the present day, however, physicians have never quite got away
from the tendency to group these acute and chronic painful conditions
of joints under a single word, and rheumatism for many represents the
key to a puzzle that still exists.
An important development in medicine was the publication early in the
sixteenth century of regulations by the Bishop of Bamberg and the
Elector of Brandenburg, by which physicians or midwives were
authorized to be summoned as experts in medico-legal cases.
Medico-legal autopsies are on record long before this, though there
was always serious objection to their performance because of the
natural feeling of deterrence men have toward the destruction of the
human body. In general, however, the basis of our legal medicine and
the status of the physician in court as an expert was determined at
this time.
Probably nothing shows so well the great interest of this time in the
development of medicine and particularly therapeutics, as the number
of drugs imported from America and the East Indies, the many
experiments and careful observations made with them and the books
written about them. As a matter of fact no century has given us more
new drugs of enduring value. Schaer in the chapter on the history of
pharmacology and toxicology in modern times in Puschmann's "Handbook
of the History of Medicine" has summed up the work of this period.
Three well-known books of the time containing interesting scientific
material were written by Gonzalo Fernandez, a personal friend of
Columbus who, from his birthplace, is often known as Oviedo, Nicolas
Monardes and Francisco Hernandez. Fernandez was the superintendent of
the {400} government gold mines in South America, but after his return
he wrote his great work, _"Historia General y Natural de las Indias."_
The second of these, Monardes, deserves well of pharmacology and all
that relates to drugs through his famous collection of the natural
products of America which became widely known through his description
of them. [Footnote 39] Hernandez wrote on Mexican and Central American
plants and his _"Historia Plantarum Novae Hispaniae"_ is an important
source of information. Besides these, Pasi and Conti, Italians who had
travelled in the East Indies, wrote books containing valuable
observations on Oriental drugs and plants, and the Frenchman Bellonius
(Pierre Belon) (See chapter on Biological Sciences) described Arabian,
Persian and Indian products, while the Spaniard, Christobel Acosta,
and the Portuguese, Garcia da Orta and Duarte Barbosa, visited various
parts of the East and East African Malabar and wrote books which,
while not specifically medical, had much to say with regard to the
indigenous plants, especially such as either had been used by the
natives for medical purposes or promised to be of significance in this
way. The Portuguese apothecary Pirez directed a special letter with
regard to Hindustan and Farther India and what might be expected for
pharmacology from these regions to the king of Portugal which is of
great importance.
[Footnote 39: Monardes proved of so much interest that he was
translated into English before the end of the sixteenth century, and
his book was widely read.]
The Belgian, Charles de l'Esclus, better known as a rule under his
Latin name of Carolus Clusius, as professor of botany, director of the
botanical garden and superintendent of the Museum in Vienna and later
in Leyden, gathered together an immense amount of information, was in
correspondence with all who were interested in botany and in
pharmacology. He succeeded in making an encyclopedia of information
with regard to these subjects that has ever since been considered one
of the most important fundamental works in the history of this
department of science.
The spirit of the physicians of the time as regards scientific methods
in clinical medicine and their attitude towards {401} observation as
by far the most important means of obtaining medical truth is very
well brought out by some passages written by John Hall, a poet and
medical writer who wrote a translation of Lanfranc's _"Chirurgia
Parva"_ published shortly after the close of Columbus' Century. To
this was appended "A very Frutefull and Necessary Briefe Worke of
Anatomie" and "An Historiall Expostulation: against the beastlye
Abusers, both of Chyrurgerie and Physyke in our Tyme: with a Goodlye
Doctrine and Instruction Necessarye to be marked & folowed of all
Chirurgiens." In the Expostulation, which may be found in the Percy
Society's republication of old texts for 1844, Dr. Hall said: "Galen
also hath freely admonished that we ought not if we will be perfectly
cunning to trust only to doctrine written in books, but rather to our
proper eyes which are to be trusted above all other authors, yea!
before Hippocrates and Galen."
It is this trusting to observation rather than books that is, of
course, the key-note of clinical medicine and of medical progress. The
men of this time are often blamed for not having trusted to their
observation more and to their books too much. There is no doubt that
some of them erred rather seriously in this matter. Yet at all times
in the history of medicine the great majority of physicians have not
observed for themselves, but have taken their observation at second
hand from others. Hall has insisted over and over again that as
regards surgery the necessity for observation was extremely important.
In the chapter on Surgery a quotation from his Expostulation on this
matter will be found.
Even in the department of mental diseases there were distinct
contributions to the problems of this intricate specialty of great
value. This is not so surprising, for above all the men of the
Renaissance could see things for themselves and describe what they
saw. Shakespeare represents the Renaissance in England and no one has
ever succeeded so well as he in describing forms of the milder mental
diseases as they occur in characters like Ophelia or King Lear.
Paracelsus even attempted what has not been achieved yet, a definition
of the insane person. "The person is sick in mind in whom the
reasonable and unreasonable spirit are not present in proper {402}
proportion and strength." He distinguished fools "who are animals
without any sense" from the imbeciles and idiots "who are deranged
beasts." His contemporary, Montanus, who was professor at Padua, and
has been called the second Galen, treated of melancholy in his medical
consultations and ascribed its etiology to _intemperies cerebri._ He
recommended treatment by water, by venesection and by hellebore. Jean
Fernel divided melancholy into what we now know as melancholy in the
proper sense of the word and mania. He considered that both affections
were due to disturbances of the fluids of the brain. Jodocus Lommius
differentiated between delirium, phrenitis, melancholia and mania and
described a particular variety of this last form as hydrophobia.
William Rondelet, Professor at Montpellier, frankly abandoned all
metaphysics in this subject and considered that melancholia was due
either to a defect of the brain or to some disturbance of the body
which brought about a sympathetic derangement of the brain, the
stomach particularly being likely to do this. He gave a rather
striking picture of the fixed ideas that take possession of those
suffering from melancholia. He differentiated mania from melancholia
by saying that the melancholia was due to a frigid humor, while mania
was due to the malignity of the thin and bilious humors of the body.
His contemporary, Francis Varreliora, described cases in which
insanity had occurred as a consequence of love troubles and in which
the cure of melancholy came about through the successful treatment of
an affection such as haemorrhoids that had been disturbing the patient
for a good while. It was a good many generations before medicine
advanced very far beyond the ideas that were put forward by these
physicians of the Renaissance in discussing their mental cases.
The extent to which balneotherapy was appreciated in this century may
be realized very well from the fact that just after the close of it
Winternach mentions some seventy-five places in Europe where there
were bathing establishments. About the same time Dr. Ruland of
Regensburg, published a monograph of twenty-eight pages containing an
alphabetically arranged list of diseases with the indication of the
particular watering place that would do them good. Indeed just after
{403} the close of Columbus' Century there is abundant evidence of the
very great revival of interest in the old hydrotherapeutic methods
which had taken place during the Renaissance.
One of the most interesting things about the medicine of this century,
that is often not appreciated, is that it did not go to that excess in
the employment of certain means of treatment to which some of the
succeeding centuries unfortunately did. Columbus' medical
contemporaries corrected the Arabian abuse of polypharmacy, which had
a tendency to manifest itself over and over again during the later
Middle Ages in spite of the well directed efforts of thoughtful
physicians to suppress it. The diffusion of a knowledge of the classic
authors in medicine did more than anything else to secure its
eradication at this time. Physicians used bleeding, but not in every
case, as came to be the custom later, and not to the excess in which
it was employed at the end of the eighteenth and the beginning of the
nineteenth century. Poor Mirabeau, the orator of the French
Revolution, under the best French skilled care a century ago, was bled
some eighty ounces in the course of forty-eight hours. Under the
impetus given by Basil Valentine's "Triumphant Chariot of Antimony"
they used antimony frequently, but not at all to the extent that it
was employed in the eighteenth century. Purgatives were much more
abused in the later seventeenth and eighteenth centuries than during
Columbus' Century. Under the immediate influence of the Greeks the
physicians of this time were thoroughly conservative, and there is as
little of regrettable therapeutics to be chronicled as at any time in
the world's history.
Jerome Cardan of this time is one of the geniuses of the history of
science whose career is extremely difficult to understand. His mixture
of credulity with a genuine scientific temper of mind that tests
everything by experiment, combined with his wonderful ability in
mathematics, adds to the difficulty of understanding him. He was a
great believer in dreams but then that was because he was sure that so
many of his own dreams had come true. He was a serious student of all
the borderland subjects between spirit and matter and constituted a
Psychic Research Society in himself, but with the tendency to accept
the marvellous on general principles. He {404} heard that instruments
which had been magnetized could be used for surgical operations
without producing pain and having tried some experiments in the matter
he announced this as a great discovery. He was sure that he had the
power to magnetize others in such a way as to prevent pain, but, after
all, it must not be forgotten that in these he only imitated what has
attracted much attention at many times in the history of medicine and
electricity. As the publisher of the formula for cubic equations he
has a distinguished place in mathematics, and he was looked upon as
one of the great thinkers of his time. His contributions to medicine,
and the estimation he secured for the profession by his popularity
among the great ones of Europe at this time, have made his life most
interesting to our generation.
Cardan's almost infantile absurdities have sometimes been cited as
indicating a lack of the critical scientific spirit at this time.
Anyone who recalls, however, the attitude of mind of some of the most
prominent scientists of our time towards certain questions, as, for
instance, vaccination, spiritism, and even phrenology and other
psychic subjects, will not be likely to accept any criterion of lack
of the critical faculty that might be set up arbitrarily, because a
scientist exhibited a tendency to accept some things without as
absolute proof as other men demand. Nearly all the great scientists
had certain peculiarities in this regard and Cardan is only an
exaggeration of this tendency. His absurdities have sometimes been
quoted as if they represented common opinions of the learned men of
this time and exhibited their lack of critical judgment, but no one
has scored Cardan's absurd opinions more severely, nor called
attention more emphatically to the fact that this great scientific
genius accepted some childish trivialities, than his contemporary,
Scaliger, who so often entered into controversies with him.
An instructive contrast to some of Cardan's absurdities is a little
book that has been a classic ever since in popular medicine, Louis
Cornaro's "Means of Obtaining a Long and Healthy Life," which was
published at this time (Padua, 1558). Editions of it have been issued
in nearly every generation since. Cornaro, to give a sentence or two
from Addison's essay {405} on the volume "was of an infirm
constitution till about forty, when by obstinately persisting in the
Rules recommended in this Book, he recovered a perfect state of
health, insomuch, that at four-score he published this Treatise. He
lived to give a fourth edition of it, and after having passed his
hundredth year, died without pain or agony, like one who falls asleep.
This Book is highly extolled by many eminent authors, and is written
with such a spirit of cheerfulness and good sense, as are the natural
concomitants of temperance and virtue."
The little book insists very much on temperance in eating and drinking
and is quite as sensible in its way as any popular book on medicine
ever written. It is a living proof that in spite of the popular
medical delusions of many kinds so frequent in this period, though not
more frequent than they are in our own, men of sense could view the
question of right living from the proper standpoint and give good
advice with regard to it. In the preface to the latest American
edition (New York, 1912) the publisher said: "The methods followed by
Cornaro and the recommendations and suggestions submitted by him can
be compared to advantage with the teachings of authorities of the
present day, such as Metchnikoff. The book is now presented to the
American public, not only as a literary and scientific curiosity, but
as a manual of practical instruction." [Footnote 40]
[Footnote 40: The first American edition, annotated by Mason L.
Weems (Philadelphia, 1809), had with what might be thought
characteristic American enterprise Benjamin Franklin's "Way to
Wealth" as an Appendix.]
It is interesting to bring together some of the sanitary regulations
of this period because it is often presumed that it is only in our
time that public care of the health has come to be recognized as a
duty of the civil authorities. Wickersheimer in his "Medicine and
Physicians in France, at the Time of the Renaissance," [Footnote 41]
has gathered a number of the details. It was forbidden butchers in
Paris to keep meat for sale more than two days in winter or thirty-six
hours in summer. Hotel keepers were not allowed to kill their own meat
because, as {406} they could cook it before selling it, it was easy
for them to "dissimulate bad meats." Restaurateurs were forbidden to
serve meat which had been warmed over or warmed-over soup or
vegetables. Fish was guarded particularly by detailed regulations and
heavy fines were inflicted for its sale, except under conditions that
must have assured its absolute freshness. Butter and fish could not be
sold in the same shop. It was forbidden to put coloring matter in
butter, no matter what the form of color material used, and also to
mix old butter with new. The sellers of spices were required by Louis
XII to watch over the absolute cleanness of their mustard mills and to
employ as workmen only those who were clean and in good health.
Similar regulations existed for the bakers. In a word, they
anticipated in many ways the pure food laws of our time. Unfortunately
these regulations were allowed to fall into abeyance during the
neglect of social order that characterized the notable degeneration of
the eighteenth and earlier nineteenth centuries.
[Footnote 41: _"La Medicine et Les Medecins en France a l'Epoque de
la Renaissance,"_ Paris: Thesis 1905.]
Some of the popular hygiene of the time is very interesting and
distinctly foreshadows practices of our own time. Erasmus gave
directions to students for cleanliness. The hands were to be washed
after each meal; a practice rendered necessary by the absence of forks
and the nails were to be cut and cleaned every week. Gums and teeth
were to be rubbed with a rough towel every day according to Montaigne,
and various tooth powders were commonly employed. The feet and the
hair ought to be washed at least once a week. Among foods, sea-fish
were preferred to river fish and the livelier the fish the better it
was liked. Shellfish were recommended by some and deprecated by
others. Lobsters were usually counted difficult of digestion, and
oysters and other shellfish shared in this prejudice. Popular
traditions as to food were quite like our own. Peas were very much
praised as an article of diet, spinach was considered to be good for
torpid liver, water cress was said to have a favorable action on the
bowels and lettuce as well as most of the material for green salads
was declared to be sedative in action. Cucumbers were indigestible
unless cooked, melons must be ripe and soft and without any spots in
them or they were dangerous, and cabbage and onions were {407} praised
or blamed as articles of food according to the particular part of the
country from which one came.
Even in the matter of drinks opinions were not so different from those
which are held at the present time, though there was just as much
disagreement as regards their effects as we are accustomed to. In
Normandy, where apples were common and cider a familiar drink, cider
was considered to be much better for men than wine. In the middle and
South of France, however, wine was considered of the greatest value
for health, and white wine was considered to be diuretic while red
wine was recommended for diarrheic conditions. Wine was declared to be
much more wholesome as a drink than water and there is no doubt at all
that in this our colleagues of that time were eminently justified by
their observations. Any water in the neighborhood of cities or
considerable centres of population was almost sure to be contaminated
by sewage of some description and to be distinctly dangerous. Wine was
ever so much less likely to be followed by disease than water. There
were many who recognized how much of evil was done by the abuse of
wine however, and Renou declared that in that century wine had killed
many more people than the sword. He declared that the abuse of wine
led to degenerations of the brain and the liver, disturbances of the
nerves, brought on tremors, convulsions, even paralysis, and was
active in the production of dyspnoea and other serious conditions.
Dr. Cramer calls attention [Footnote 42] to the fact that in 1481 the
republic of Lucca in Italy elected three citizens to serve as a board
of health. They were given plenary powers to act in case of epidemics.
Their main purpose was to prevent the spread of infectious diseases.
For this purpose they kept in touch with other countries, so as to be
forewarned of places where epidemics were raging, and they had the
right to forbid entrance into Lucca of persons, animals or goods until
after a sufficient delay to insure the absence of infection or
thorough disinfection. The word quarantine of course is very old,
though often the idea is supposed to be new, and there seems no doubt
that in most of the Italian cities health boards and health
regulations anticipating many supposedly modern developments were in
existence. There is even question of {408} the contagiousness of
tuberculosis having been recognized at this time, and measures taken
to prevent its spread. We know that scarcely more than a century after
Columbus' period every principality in Italy has laws declaring
tuberculosis contagious and regulating it.
[Footnote 42: _Revue Medicale de la Suisse Romaine._
1914, XXIX, No. I.]
Sir Thomas More in his "Utopia" has a very curiously interesting
paragraph with regard to the status of physicians in his ideal
Republic, which shows what his own idea of the place of medicine in
the world is. His long friendship with Linacre might very well have
been expected to give him such a high estimation of the physician. It
is all the more interesting because he expresses depreciation of his
own profession of the law in "Utopia." What is striking in this
passage is his recognition of the lofty place that medicine deserves
to hold in the intellectual world as a department of philosophy and
science. He emphasizes the fact that the less people need physicians
the more they appreciate them, thus anticipating the modern idea that
prevention rather than cure is the great basis for prestige in medical
science. His fine tribute to the honor that medicine should have in
the estimation of men will make his words a fitting close to this
chapter on medicine in Columbus' Century.
"One of my companions, Thricius Apinatus, happened to carry with him
some of Hippocrates' works and Galen's 'Microtechne,' which they
hold in great estimation, for though there is no nation in the world
that need physic so little as they do, yet there is not any that
honors it so much; they reckon the knowledge of it one of the most
pleasantest and profitable parts of philosophy, by which as they
search into the secrets of nature, so they not only find this study
highly agreeable, but think that such inquiries are very acceptable
to the Author of nature; and imagine, that as He, like the inventors
of curious engines amongst mankind, has exposed this great machine of
the universe to the view of the only creatures capable of
contemplating it, so an exact and curious observer, who admires His
workmanship, is much more acceptable to Him than one of the herd,
who, like a beast incapable of reason, looks on this glorious scene
with the eyes of a dull and unconcerned spectator."
{409}