physiological science appears to me to lie in its antagonism
to animistic hypotheses and animistic phraseology. It offers
physical explanations of vital phenomena, or frankly confesses
that it has none to offer. And, so far as I know, the first
person who gave expression to this modern view of physiology,
who was bold enough to enunciate the proposition that vital
phenomena, like all the other phenomena of the physical world,
are, in ultimate analysis, resolvable into matter and motion
was René Descartes. The fifty-four years of life of this most
original and powerful thinker are widely overlapped, on both
sides, by the eighty of Harvey, who survived his younger
contemporary by seven years, and takes pleasure in
acknowledging the French philosopher's appreciation of his
great discovery.
{2135}
In fact, Descartes accepted the doctrine of the circulation as
propounded by 'Harvæus médecin d'Angleterre,' and gave a full
account of it in his first work, the famous 'Discours de la
Méthode,' which was published in 1637, only nine years after
the exercitation 'De motu cordis;' and, though differing from
Harvey on some important points (in which it may be noted, in
passing, Descartes was wrong and Harvey right), he always
speaks of him with great respect. And so important does the
subject seem to Descartes that he returns to it in the 'Traité
des Passions' and in the 'Traité de l'Homme.' It is easy to
see that Harvey's work must have had a peculiar significance
for the subtle thinker, to whom we owe both the spiritualistic
and the materialistic philosophies of modern times. It was in
the very year of its publication, 1628, that Descartes
withdrew into that life of solitary investigation and
meditation of which his philosophy was the fruit. …
Descartes uses 'thought' as the equivalent of our modern term
'consciousness.' Thought is the function of the soul, and its
only function. Our natural heat and all the movements of the
body, says he, do not depend on the soul. Death does not take
place from any fault of the soul, but only because some of the
principal parts of the body become corrupted. … Descartes'
'Treatise on Man' is a sketch of human physiology, in which a
bold attempt is made to explain all the phenomena of life,
except those of consciousness, by physical reasonings. To a
mind turned in this direction, Harvey's exposition of the
heart and vessels as a hydraulic mechanism must have been
supremely welcome. Descartes was not a mere philosophical
theorist, but a hardworking dissector and experimenter, and he
held the strongest opinion respecting the practical value of
the new conception which he was introducing. … 'It is true,'
says he, 'that as medicine is now practised, it contains
little that is very useful; but without any desire to
depreciate, I am sure that there is no one, even among
professional men, who will not declare that all we know is
very little as compared with that which remains to be known;
and that we might escape an infinity of diseases of the mind,
no less than of the body, and even perhaps from the weakness
of old age, if we had sufficient knowledge of their causes and
of all the remedies with which nature has provided us.' So
strongly impressed was Descartes with this, that he resolved
to spend the rest of his life in trying to acquire such a
knowledge of nature as would lead to the construction of a
better medical doctrine. The anti-Cartesians found material
for cheap ridicule in these aspirations of the philosopher;
and it is almost needless to say that, in the thirteen years
which elapsed between the publication of the 'Discours' and
the death of Descartes, he did not contribute much to their
realisation. But, for the next century, all progress in
physiology took place along the lines which Descartes laid
down. The greatest physiological and pathological work of the
seventeenth century, Borelli's treatise 'De Motu Animalium,'
is, to all intents and purposes, a development of Descartes'
fundamental conception; and the same may be said of the
physiology and pathology of Boerhaave, whose authority
dominated in the medical world of the first half of the
eighteenth century. With the origin of modern chemistry, and
of electrical science, in the latter half of the eighteenth
century, aids in the analysis of the phenomena of life, of
which Descartes could not have dreamed, were offered to the
physiologist. And the greater part of the gigantic progress
which has been made in the present century is a justification
of the prevision of Descartes. For it consists, essentially,
in a more and more complete resolution of the grosser organs
of the living body into physico-chemical mechanisms. 'I shall
try to explain our whole bodily machinery in such a way, that
it will be no more necessary for us to suppose that the soul
produces such movements as are not voluntary, than it is to
think that there is in a clock a soul which causes it to show
the hours.' These words of Descartes might be appropriately
taken as a motto by the author of any modern treatise on
physiology."
_T. H. Huxley,
Connection of the Biological Sciences with Medicine
(Science and Culture, etc., lecture 13)._
MEDICAL SCIENCE: 17th Century.
Introduction of Peruvian Bark.
"The aborigines of South America appear, except perhaps in one
locality, to have been ignorant of the virtues of Peruvian
bark. This sovereign remedy is absent in the wallets of
itinerant doctors, whose materia medica has been handed down
from father to son, since the days of the Yncas. It is
mentioned neither by the Ynca Garcilasso de la Vega, nor by
Acosta, in their lists of Indian medicines. It seems probable,
nevertheless, that the Indians were aware of the virtues of
Peruvian bark in the neighborhood of Loxa, 230 miles south of
Quito, where its use was first made known to Europeans; and
the local name for the tree quina-quina, 'bark of bark,'
indicates that it was believed to possess some special
medicinal properties. … In 1638 the wife of Don Luis
Geronimo Fernandez de Cabrera Bobadilla y Mendoza, fourth
Count of Chinchon, and Viceroy of Peru, lay sick of an
intermittent fever in the palace of Lima. … The news of her
illness at Lima reached Don Francisco Lopez de Canizares, the
Corregidor of Loxa, who had become acquainted with the
febrifuge virtues of the bark. He sent a parcel of it to the
Vice-Queen, and the new remedy, administered by her physician,
Dr. Don Juan de Vega, effected a rapid and complete cure. …
The Countess of Chinchon returned to Spain in the spring of
1640, bringing with her a supply of that precious quina bark
which had worked so wonderful a cure upon herself, and the
healing virtues of which she intended to distribute amongst
the sick on her husband's estates. It thus gradually became
known in Europe, and was most appropriately called Countess's
powder (Pulvis Comitissæ). By this name it was long known to
druggists and in commerce. … In memory of the great service
to humanity performed by the Countess of Chinchon, Linnæus
named the genus which yields Peruvian bark, Chinchona.
Unfortunately the great botanist was misinformed as to the
name of her whom he desired to honour. This is to be accounted
for by his having received his knowledge of the Countess
through a foreign and not a Spanish source. Thus misled,
Linnæus spelt the word Cinchona … and Cinhona, … omitting
one or two letters. … After the cure of the Countess of
Chinchon the Jesuits were the great promoters of the
introduction of bark into Europe. In 1670 these fathers sent
parcels of the powdered bark to Rome, whence it was
distributed to members of the fraternity throughout Europe, by
Cardinal de Lugo, and used for the cure of agues with great
success. Hence the name of 'Jesuits' bark,' and 'Cardinal's
bark;' and it was a ludicrous result of its patronage by the
Jesuits that its use should have been for a long time opposed
by Protestants, and favoured by Roman Catholics. In 1679 Louis
XIV. bought the secret of preparing quinquina from Sir Robert
Talbor, an English doctor, for 2,000 louis-d'or, a large
pension, and a title. From that time Peruvian bark seems to
have been recognised as the most efficacious remedy for
intermittent fevers."
_C. R. Markham,
Peruvian Bark,
chapters 2-4._
{2136}
MEDICAL SCIENCE: 17th Century.
Sydenham, the Father of Rational Medicine.
"Sydenham [Thomas Sydenham, 1624-1689], the prince of
practical physicians, whose character is as beautiful and as
genuinely English as his name, did for his art what Locke did
for the philosophy of mind—he made it, in the main,
observational; he made knowledge a means, not an end. It would
not be easy to over-estimate our obligations as a nation to these
two men, in regard to all that is involved in the promotion of
health of body and soundness of mind. They were among the
first in their respective regions to show their faith in the
inductive method, by their works. They both professed to be
more of guides than critics, and were the interpreters and
servants of Nature, not her diviners and tormentors." Of
Sydenham, "we must remember in the midst of what a mass of
errors and prejudices, of theories actively mischievous, he
was placed, at a time when the mania of hypothesis was at its
height, and when the practical part of his art was overrun and
stultified by vile and silly nostrums. We must have all this
in our mind, or we shall fail in estimating the amount of
independent thought, of courage and uprightness, and of all
that deserves to be called magnanimity and virtue, which was
involved in his thinking and writing and acting as he did.
'The improvement of physic [he wrote] in my opinion, depends,
1st, Upon collecting as genuine and natural a description or
history of diseases as can be procured; and, 2d, Upon laying
down a fixed and complete method of cure. With regard to the
history of diseases, whoever considers the undertaking
deliberately will perceive that a few such particulars must be
attended to: 1st, All diseases should be described as objects
of natural history, with the same exactness as is done by
botanists, for there are many diseases that come under the
same genus, and bear the same name, that, being specifically
different, require a different treatment. The word carduus or
thistle, is applied to several herbs, and yet a botanist would
be inaccurate and imperfect who would content himself with a
generic description. Furthermore, when this distribution of
distempers into genera has been attempted, it has been to fit
into some hypothesis, and hence this distribution is made to
suit the bent of the author rather than the real nature of the
disorder. How much this has obstructed the improvement of
physic any man may know. In writing, therefore, such a natural
history of diseases, every merely philosophical hypothesis
should be set aside, and the manifest and natural phenomena,
however minute, should be noted with the utmost exactness. The
usefulness of this procedure cannot be easily overrated, as
compared with the subtle inquiries and trifling notions of
modern writers. … If only one person in every age had
accurately described, and consistently cured, but a single
disease, and made known his secret, physic would not be where
it now is; but we have long since forsook the ancient method
of cure, founded upon the knowledge of conjunct causes,
insomuch that the art, as at this day practised, is rather the
art of talking about diseases than of curing them.' … His
friend Locke could not have stated the case more clearly or
sensibly. It is this doctrine of 'conjunct causes,' this
necessity for watching the action of compound and often
opposing forces, and the having to do all this not in a
machine, of which if you have seen one, you have seen all, but
where each organism has often much that is different from, as
well as common with, all others. … It is this which takes
medicine out of the category of exact sciences, and puts it
into that which includes politics, ethics, navigation and
practical engineering, in all of which, though there are
principles, and those principles quite within the scope of
human reason, yet the application of these principles must, in
the main, be left to each man's skill, presence of mind, and
judgment, as to the case in hand. … It would not be easy to
over-estimate the permanent impression for good, which the
writings, the character, and the practice of Sydenham have
made on the art of healing in England, and on the Continent
generally. In the writings of Boerhaave, Stahl, Gaubius,
Pinel, Bordeu, Haller, and many others, he is spoken of as the
father of rational medicine; as the first man who applied to
his profession the Baconian principles of interpreting and
serving nature, and who never forgot the master's rule, 'Non
fingendum aut excogitandum, sed inveniendum, quid natura aut
faciat aut ferat.' … Like all men of a large practical
nature, he could not have been what he was, or done what he
did, without possessing and often exercising the true
philosophizing faculty. He was a man of the same quality of
mind in this respect with Watt, Franklin, and John Hunter, in
whom speculation was not the less genuine that it was with
them a means rather than an end."
_Dr. John Brown,
Locke and Sydenham and other Papers,
pages 54-90._
ALSO IN:
_T. Sydenham,
Works;
translated by R. G, Latham._
MEDICAL SCIENCE: 17th Century.
Closing period of the Humoral Pathology.
The Doctrines of Hoffmann, Stahl and Boerhaave.
"If we take a general survey of medical opinions, we shall
find that they are all either subordinate to, or coincident
with, two grand theories. The one of these considers the solid
constituents of the animal economy as the elementary vehicle
of life, and consequently places in them the primary seat of
disease. The other, on the contrary, sees in the humors the
original realization of vitality; and these, as they determine
the existence and quality of the secondary parts, or solids,
contain, therefore, within themselves, the ultimate principle
of the morbid affection. By relation to these theories, the
history of medicine is divided into three great periods.
During the first, the two theories, still crude, are not yet
disentangled from each other; this period extends from the
origin of medicine to the time of Galen. The second
comprehends the reign of Humoral Pathology—the interval
between Galen and Frederic Hoffmann. In the last the doctrine
of the Living Solid is predominant; from Hoffmann it reaches
to the present day. … By Galen, Humorism was first formally
expounded, and reduced to a regular code of doctrine.
{2137}
Four elementary fluids, their relations and changes, sufficed
to explain the varieties of natural temperament, and the
causes of disease; while the genius, eloquence, and unbounded
learning with which he illustrated this theory, mainly
bestowed on it the ascendency, which, without essential
alteration, it retained from the conclusion of the second to
the beginning of the eighteenth century. Galenism and Humorism
are, in fact, convertible expressions. Not that this
hypothesis during that long interval encountered no
opposition. It met, certainly, with some partial contradiction
among the Greek and Arabian physicians. After the restoration
of learning Fernelius and Brissot, Argenterius and Joubert,
attacked it in different ways. … Until the epoch we have
stated, the prevalence of the Humoral Pathology was, however,
all but universal. Nor was this doctrine merely an erroneous
speculation; it exerted the most decisive, the most pernicious
influence on practice.—The various diseased affections were
denominated in accommodation to the theory. In place of saying
that a malady affected the liver, the peritonæum, or the
organs of circulation, its seat was assumed in the blood, the
bile, or the lymph. The morbific causes acted exclusively on
the fluids; the food digested in the stomach, and converted
into chyle, determined the qualities of the blood; and poisons
operated through the corruption they thus effected in the
vital humors. All symptoms were interpreted in blind
subservience to the hypothesis; and those only attracted
attention which the hypothesis seemed calculated to explain.
The color and consistence of the blood, mucus, feces, urine,
and pus, were carefully studied. On the other hand the
phenomena of the solids, if not wholly overlooked, as mere
accidents, were slumped together under some collective name,
and attached to the theory through a subsidiary hypothesis. By
supposed changes in the humors, they explained the association
and consecution of symptoms. Under the terms, crudity,
coction, and evacuation, were designated the three principal
periods of diseases, as dependent on an alteration of the
morbific matter. In the first, this matter, in all its
deleterious energy, had not yet undergone any change on the
part of the organs; it was still crude. In the second, nature
gradually resumed the ascendant; coction took place. In the
third, the peccant matter, now rendered mobile, was evacuated
by urine, perspiration, dejection, &c., and æquilibrium
restored. When no critical discharge was apparent, the
morbific matter, it was supposed, had, after a suitable
elaboration, been assimilated to the humors, and its
deleterious character neutralized. Coction might be perfect or
imperfect; and the transformation of one disease into another
was lightly solved by the transport or emigration of the
noxious humor. … Examinations of the dead body confirmed
them in their notions. In the redness and tumefaction of
inflamed parts, they beheld only a congestion of blood; and in
dropsies, merely the dissolution of that fluid; tubercles were
simply coagula of lymph; and other organic alterations, in
general, naught but obstructions from an increased viscosity
of the humors. The plan of cure was in unison with the rest of
the hypothesis. Venesection was copiously employed to renew
the blood, to attenuate its consistency, or to remove a part
of the morbific matter with which it was impregnated; and
cathartics, sudorifics, diuretics, were largely administered,
with a similar intent. In a word, as plethora or cacochymia
were the two great causes of disease, their whole therapeutic
was directed to change the quantity or quality of the fluids.
Nor was this murderous treatment limited to the actual period
of disease. Seven or eight annual bloodings, and as many
purgations—such was the common regimen the theory prescribed
to insure continuance of health; and the twofold depletion,
still customary, at spring and fall, among the peasantry of
many European countries, is a remnant of the once universal
practice. In Spain, every village has even now its Sangrador,
whose only cast of surgery is blood-letting; and he is rarely
idle. The medical treatment of Lewis XIII, may be quoted as a
specimen of the humoral therapeutic, Within a single year this
theory inflicted on that unfortunate monarch above a hundred
cathartics, and more than forty bloodings.—During the fifteen
centuries of Humorism, how many millions of lives did medicine
cost mankind? The establishment of a system founded on the
correcter doctrine of Solidism, and purified from the
crudities of the Iatro-mathematical and Iatro-chemical
hypotheses was reserved for three celebrated physicians toward
the commencement of the eighteenth century—Frederic
Hoffmann—George Ernest Stahl—and Hermann Boerhaave. The
first and second of this triumvirate were born in the same
year, were both pupils of Wedelius of Jena, and both
professors, and rival professors, in the University of Halle;
the third was eight years younger than his contemporaries, and
long an ornament of the University of Leyden."
_Sir W. Hamilton,
Discussions on Philosophy and Literature,
pages 246-249._
"The great and permanent merits of Hoffmann [1660-1742] as a
medical philosopher, undoubtedly consisted in his having
perceived and pointed out more clearly than any of his
predecessors, the extensive and powerful influence of the
Nervous System, in modifying and regulating at least, if not
in producing, all the phenomena of the organic as well as of
the animal functions in the human economy, and more
particularly in his application of this doctrine to the
explanation of diseases. … It was reserved for Hoffmann …
to take a comprehensive view of the Nervous System, not only
as the organ of sense and motion, but also as the common
centre by which all the different parts of the animal economy
are connected together, and through which they mutually
influence each other. He was, accordingly, led to regard all
those alterations in the structure and functions of this
economy, which constitute the state of disease, as having
their primary origin in affections of the nervous system, and
as depending, therefore, upon a deranged state of the
imperceptible and contractile motions in the solids, rather
than upon changes induced in the chemical composition of the
fluid parts of the body."
_J. Thomson,
Account of the Life, Lectures and Writings of William Cullen,
pages 195-196._
{2138}
"George Ernest Stahl (1660-1734), chemist, was professor of
medicine at Halle (1694) and physician to the King of Prussia
(1716). He opposed materialism, and substituted 'animism,'
explaining the symptoms of disease as efforts of the soul to
get rid of morbid influences. Stahl's 'anima' corresponds to
Sydenham's 'nature' in a measure, and has some relationship to
the Archeus of Paracelsus and Van Helmont. Stahl was the author
of the 'phlogiston' theory in chemistry, which in its time has
had important influence on medicine. Phlogiston was a
substance which he supposed to exist in all combustible
matters, and the escape of this principle from any compound
was held to account for the phenomenon of fire. According to
Stahl, diseases arise from the direct action of noxious powers
upon the body; and from the reaction of the system itself
endeavouring to oppose and counteract the effects of the
noxious powers, and so preserve and repair itself. He did not
consider diseases, therefore, pernicious in themselves, though
he admitted that they might become so from mistakes made by
the soul in the choice, or proportion of the motions excited
to remove them, or the time when these efforts are made.
Death, according to this theory, is due to the indolence of
the soul, leading it to desist from its vital motions, and
refusing to continue longer the struggle against the
derangements of the body. Here we have the 'expectant
treatment' so much in vogue with many medical men. 'Trusting
to the constant attention and wisdom of nature,' they
administered inert medicines as placebos, while they left to
nature the cure of the disease. But they neglected the use of
invaluable remedies such as opium and Peruvian bark, for which
error it must be admitted they atoned by discountenancing
bleeding, vomiting, etc. Stahl's remedies were chiefly of the
class known as 'Antiphlogistic,' or anti-febrile."
_E. Berdoe,
The Origin and Growth of the Healing Art,
book 5, chapter 7._
"The influence of Boerhaave [1668-1738] was immense while it
lasted—it was world-wide; but it was like a ripple on the
ocean—it had no depth. He knew everything and did everything
better than any of his contemporaries, except those who made
one thing, not everything, their study. He was familiar with
the researches of the great anatomists, of the chemists, of
the botanists, of historians, of men of learning, but he was
not a great anatomist, chemist, or historian. As to his
practice, we cannot pronounce a very decided opinion, except
that he was a man of judgment and independence. Here his
reputation made his success: a prescription of his would no
doubt effect many a cure, although the patient had taken the
remedy he prescribed fifty times without any benefit. His
greatness depended upon his inexhaustible activity. He had the
energy of a dozen ordinary men, and so he was twelve times as
powerful as one. He mentions quite incidentally how he was in
the habit of frequently spending whole nights in botanical
excursions on foot; and we know he had no time to sleep in the
day. He took an interest in everything, was always on the
alert, had a prodigious memory, and indefatigable industry. On
these great homely qualities, added to a kind disposition and
an unaffected piety, his popularity was founded. It was all
fairly won and nobly worn. It is startling, however, to find
that a man whose name one hundred years ago was familiar to
the ear as household words, and of whom historians predicted
that he would always be regarded as one of the greatest as
well as best of men, an example to his race, should be already
almost forgotten. An example is of no use unless it is known;
Boerhaave is now unknown. The reason is plain;—he was not the
founder of any system, nor did he make any discovery. He
simply used with supreme success the thoughts and discoveries
of others; as soon as he ceased to live, his influence began
therefore to decline; and before his generation had passed
away, his star had waned before the genius of Cullen, who
succeeded in fixing the attention of Europe, and who, in his
turn, was soon to be displaced by others."
_J. R. Russell,
History and Heroes of the Art of Medicine,
pages 297-298._
MEDICAL SCIENCE: 17-18th Centuries.
Introduction of the Microscope in Medicine.
First glimmerings of the Germ Theory of Disease.
"Since Athanasius Kircher [1601-1680] mistook blood and pus
corpuscles for small worms, and built up on his mistake a new
theory of disease and putrefaction, and since Christian Lange,
the Professor of Pathological Anatomy in Leipzig, in the
preface to Kircher's book (1671) expressed his opinion that
the purpura of lying-in-women, measles, and other fevers were
the result of putrefaction caused by worms or animalculæ, a
'Pathologia Animata' has, from time to time, been put forward
to explain the causation of disease. … Remarkable as were
Kircher's observations, still more wonderful were those of
Anthony van Leeuwenhoek, a native of Delft in Holland, who in
his youth had learned the art of polishing lenses, and who was
able, ultimately, to produce the first really good microscope
that had yet been constructed. Not only did Leeuwenhoek make
his microscope, but he used it to such good purpose that he
was able to place before the Royal Society of London a series
of most interesting and valuable letters giving the result of
his researches on minute specks of living protoplasm. … The
world that Leeuwenhoek … opened up so thoroughly was rapidly
invaded by other observers and theorists. The thoughtful
physicians of the time believed that at last they had found
the 'fons et origo mali,' and Nicolas Andry, reviewing
Kircher's' Contagium Animatum,' replaced his worms by these
newly-described animalculæ or germs, and pushing the theory to
its legitimate and logical conclusion, he also evolved a germ
theory of putrefaction and fermentation. He maintained that
air, water, vinegar, fermenting wine, old beer, and sour milk
were all full of germs; that the blood and pustules of
smallpox also contained them, and that other diseases, very
rife about this period, were the result of the activity of
these organisms. Such headway did he make, and such conviction
did his arguments carry with them, that the mercurial
treatment much in vogue at that time was actually based on the
supposition that these organisms, the 'causæ causantes' of
disease, were killed by the action of mercury and mercurial
salts. With a kind of prophetic instinct, and certainly as the
result of keen observation, Varro and Lancisi ascribed the
dangerous character of marsh or swamp air to the action of
invisible animalculæ; in fact the theory was so freely and
forcibly propagated that even where no micro-organisms could
be found their presence was inferred with the inevitable
result, as Löffler points out, that these 'inconceivable'
worms became the legitimate butts for the shafts of ridicule;
and in 1726 there appeared in Paris a satirical work, in which
these small organisms received the name of 'fainter,'
'body-pincher,' 'ulcerator,' 'weeping fistula,' 'sensualist';
the whole system was thus laughingly held up to satire, and
the germ theory of disease completely discredited.
{2139}
Linnæus [1707-1778], however, with his wonderful powers of
observation and deduction, considered that it was possible
that there might be rescued from this 'chaos' small living
beings which were as yet insufficiently separated and
examined, but in which he firmly believed might lie not only
the actual contagium of certain eruptive diseases, and of
acute fevers, but also the exciting causes of both
fermentation and putrefaction. The man, however, who of all
workers earliest recognized the importance of Linnæus'
observations was a Viennese doctor, Marcus Antonius Plenciz.
… He it was who, at this time, insisted upon the specific
character of the infective agent in every case of disease; for
scarlet fever there was a scarlet fever seed or germ—a seed
which could never give rise to smallpox. He showed that it was
possible for this organism to become disseminated through the
air, and for it to multiply in the body; and he explained the
incubation stage of a febrile disease as dependent on the
growth of a germ within the body during the period after its
introduction, when its presence had not yet been made
manifest. … As regards putrefaction, having corroborated
Linnæus' observations and found countless animalculæ in
putrefying matter, he came to the conclusion that this process
was the result of the development, multiplication, and
carrying on of the functions of nutrition and excretion by
these germs; the products of fermentation being the volatile
salts set free by the organisms, which, multiplying rapidly by
forming seeds or eggs, rendered the fluid in which they
developed thick, turbid, and foul. This theory, admirable as
it was, and accurate as it has since been proved to be, could
not then be based on any very extensive or detailed
observation, and we find that some of the most prominent and
brilliant men of the period did not feel justified in
accepting the explanation that Plenciz had offered as to the
causes of disease and fermentation processes."
_G. S. Woodhead,
Bacteria and their Products,
chapter 3._
MEDICAL SCIENCE: 17-18th Centuries.
Hahnemann and the origin of the System of Homœopathy.
Samuel Hahnemann, originator of the system of medicine called
"Homœopathy," was born in 1755, at Meissen, in Saxony. He
studied medicine at Leipsic, and afterwards at Vienna. In 1784
he settled in Dresden, but returned to Leipsic in 1789. "In
the following year, while translating Cullen's Materia Medica
out of English into German, his attention was arrested by the
insufficient explanation's advanced in that work of the cure
of ague by cinchona bark. By way of experiment, he took a
large dose of that substance to ascertain its action on the
healthy body. In the course of a few days he experienced the
symptoms of ague; and it thus occurred to him that perhaps the
reason why cinchona cures ague is because it has the power to
produce symptoms in a healthy person similar to those of ague.
To ascertain the truth of this conjecture, he ransacked the
records of medicine for well-attested cures effected by single
remedies; and finding sufficient evidences of this fact, he
advanced a step further, and proposed, in an article published
in Hufeland's Journal, in the year 1797, to apply this new
principle to the discovery of proper medicines for every form
of disease. Soon afterwards he published a case to illustrate
his method. It was one of a severe kind of colic cured by a
strong dose of veratrum album. Before this substance gave
relief to the patient it excited a severe aggravation of his
symptoms. This induced Hahnemann, instead of drops or grains,
to give the fraction of a drop or grain, and he thus
introduced infinitesimal doses. Some years later he applied
his new principle in the treatment of scarlet fever; and
finding that belladonna cured the peculiar type of that
disease, which then prevailed in Germany, he proposed to give
this medicine as a prophylactic, or preventive against scarlet
fever; from that time it has been extensively employed for
this purpose. In the year 1810 he published his great work,
entitled Organon of Medicine, which has been translated into
all the European languages, as well as into Arabic. In this
book he fully expounded his new system, which he called
Homœopathy. His next publication was a Materia Medica,
consisting of a description of the effects of medicines upon
persons in health. These works were published between the
years 1810 and 1821, at Leipsic, where he founded a school,
and was surrounded by disciples. As his system involved the
administration of medicines, each separately by itself, and in
doses infinitely minute, there was no longer any need of the
apothecaries' intervention between their physician and the
patient. In consequence of this the Apothecaries Company
brought to bear upon Hahnemann an act forbidding physicians to
dispense their own medicines, and with such effect that he was
obliged to leave Leipsic. The Grand Duke of Anhalt Köthen,
appointed him his physician, and invited him to live at
Köthen. Thither, accordingly, he removed in the year 1821, and
there he prepared various new editions of his Organon, and new
volumes of his Materia Medica for publication. In 1835 he
married a second time; his wife was a French lady of
considerable position; and in the same year he left Köthen,
and settled in Paris, where he enjoyed a great reputation till
his death, which took place in the year 1843."
_W. Bayes,
Origin and Present Status of Homœopathy
(Translation of the Homœopathic Medical Society
of the State of New York, 1869, article 21)._
ALSO IN:
_W. Aneke,
History of Homœopathy._
_J. C. Burnett,
Ecce Medicus;
or Hahnemann as a man and as a physician._
MEDICAL SCIENCE: 18th Century.
The work of John Hunter in surgery and anatomy.
"John Hunter [born 1728, died 1793] was not only one of the
most profound anatomists of the age in which he lived, but he
is by the common consent of his successors allowed to be one
of the greatest men that ever practised surgery. One of the
most striking discoveries in this part of his profession—
indeed one of the most brilliant in surgery of his
century—was the operation for the cure of popliteal aneurism
by tying the femoral artery above the tumour in the ham, and
without interfering with it. He improved the treatment of the
rupture of the tendo achillis, in consequence of having
experienced the accident himself when dancing. He invented the
method of curing fistula lacrymalis by perforating the os
unguis, and curing hydrocele radically by injection. His
anatomical discoveries were numerous and important—amongst
others the distribution of the blood-vessels of the uterus,
which he traced till their disappearance in the placenta.
{2140}
He was the first who demonstrated the existence of lymphatic
vessels in birds; described the distribution of the branches
of the olfactory nerve, as well as those of the fifth pair;
and to him we owe the best and most faithful account of the
descent of the testicle in the human subject, from the abdomen
into the scrotum. Physiology is also indebted to him for many
new views and ingenious suggestions. … 'Before his time
surgery had been little more than a mechanical art, somewhat
dignified by the material on which it was employed. Hunter
first made it a science; and by pointing out its peculiar
excellence as affording visible examples of the effects and
progress of disease, induced men of far higher attainments
than those who had before practised it to make it their
study.' The best monument of his genius and talents, however,
is the splendid museum which he formed by his sole efforts,
and which he made, too, when labouring under every
disadvantage of deficient education and limited means. It
shows that as an anatomist and physiologist he had no
superior."
_W. Baird,
Hunter (The Imperial dictionary of universal biography)._
ALSO IN:
_S. D. Gross,
John Hunter and his Pupils._
MEDICAL SCIENCE: 18th Century.
Preventive Inoculation against Smallpox.
"One of the most notable events of the 18th century, or for
that matter, in the history of medicine, was the introduction
of the systematic practice of preventive inoculation against
small-pox. We are 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 necessarily taught
otherwise, that the measure deserves a historical sketch. The
communication of the natural disease to the healthy in order
to protect them from the same natural disease, in other words,
the communication of small-pox to prevent the same, reaches
back into antiquity. It is mentioned in the Sanskrit Vedas as
then performed, always 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 the place cotton soaked
in the variolous pus, moistened with water from the sacred
Ganges. Along with this measure they insisted upon most
hygienic regulations, to which in a large measure their good
results were due. Among the Chinese was practised what was
known as 'Pock-sowing,' and as long ago as 1000 years before
Christ they introduced into the nasal cavities of young
children pledgets of cotton saturated with variolous pus. The
Arabians inoculated the same disease with needles, and so did
the Circassians, while in the states of 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 practised by old women instructed in the
art, who regarded it as a revelation of St. 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
her son inoculated in Constantinople by her surgeon Maitland,
and after her return to London, in 1721, it was also performed
upon her daughter. 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 ocean as well as on that, but suffered
occasional severe blows because of unfortunate cases here and
there, such as never can be avoided. The clergy, especially,
using the Bible, as designing men always can use it, to back
up any view or practice, became warm opponents of vaccination,
and stigmatized it as a very atrocious invasion of the Divine
prerogative of punishment. But in 1746 the Bishop of Worcester
recommended it from the pulpit, and established houses for
inoculation, and thus made it again popular. In Germany the
operation was generally favored, and in France and Italy a
little later came into vogue."
_Roswell Park,
Lectures on the History of Medicine (in MS.)._
MEDICAL SCIENCE: 18th Century.
Jenner and the discovery of Vaccination.
Many before the English physician, Dr. Jenner, "had witnessed
the cow-pox, and had heard of the report current among the
milkmaids in Gloucestershire, that whoever had taken that
disease was secure against smallpox. It was a trifling, vulgar
rumor, supposed to have no significance whatever; and no one
had thought it worthy of investigation, until it was
accidentally brought under the notice of Jenner. He was a
youth, pursuing his studies at Sodbury, when his attention was
arrested by the casual observation made by a country girl who
came to his master's shop for advice. The smallpox was
mentioned, when the girl said, 'I can't take that disease, for
I have had cow-pox.' The observation immediately riveted
Jenner's attention, and he forthwith set about inquiring and
making observations on the subject. His professional friends,
to whom he mentioned his views as to the prophylactic virtues
of cow-pox, laughed at him, and even threatened to expel him
from their society, if he persisted in harassing them with the
subject. In London he was so fortunate as to study under John
Hunter [1770-1773] to whom he communicated his views. The
advice of the great anatomist was thoroughly characteristic:
'Don't think, but try; be patient, be accurate.' Jenner's
courage was greatly supported by the advice, which conveyed to
him the true art of philosophical investigation. He went back
to the country to practise his profession, and carefully to
make observations and experiments, which he continued to
pursue for a period of twenty years. His faith in his
discovery was so implicit that he vaccinated his own son on
three several occasions. At length he published his views in a
quarto of about seventy pages, in which he gave the details of
twenty-three cases of successful vaccination of individuals,
to whom it was found afterwards impossible to communicate the
smallpox either by contagion or inoculation. It was in 1798
that this treatise was published; though he had been working
out his ideas as long before as 1775, when they began to
assume a definite form. How was the discovery received? First
with indifference, then with active hostility. He proceeded to
London to exhibit to the profession the process of vaccination
and its successful results; but not a single doctor could be
got to make a trial of it, and after fruitlessly waiting for
nearly three months, Jenner returned to his native village.
{2141}
He was even caricatured and abused for his attempt to
'bestialize' his species by the introduction into their
systems of diseased matter from the cow's udder. Cobbett was
one of his most furious assailants. Vaccination was denounced
from the pulpit as 'diabolical.' It was averred that
vaccinated children became 'ox-faced,' that abscesses broke
out to 'indicate sprouting horns,' and that the countenance
was gradually 'transmuted into the visage of a cow, the voice
into the bellowing of bulls.' Vaccination, however, was a
truth, and notwithstanding the violence of the opposition
belief in it spread slowly. In one village where a gentleman
tried to introduce the practice, the first persons who
permitted themselves to be vaccinated were absolutely pelted,
and were driven into their houses if they appeared out of
doors. Two ladies of title,—Lady Ducie and the Countess of
Berkeley,—to their honor be it remembered,—had the courage
to vaccinate their own children; and the prejudices of the day
were at once broken through. The medical profession gradually
came round, and there were several who even sought to rob Dr.
Jenner of the merit of the discovery, when its vast importance
came to be recognized. Jenner's cause at last triumphed, and
he was publicly honored and rewarded. In his prosperity he was
as modest as he had been in his obscurity. He was invited to
settle in London, and told that he might command a practice of
£10,000 a year. But his answer was, 'No! In the morning of my
days I have sought the sequestered and lowly paths of
life,—the valley, and not the mountain,—and now, in the
evening of my days, it is not meet for me to hold myself up as
an object for fortune and for fame.' In Jenner's own lifetime
the practice of vaccination had been adopted all over the
civilized world; and when he died, his title as Benefactor of
his kind was recognized far and wide. Cuvier has said, 'If
vaccine were the only discovery of the epoch, it would serve
to render it illustrious forever."
_S. Smiles,
Self-help,
chapter 4._
ALSO IN:
_J. Barron,
Life of Edward Jenner._
MEDICAL SCIENCE: 18th Century.
The Brunonian System of Stimulation.
"John Brown, born of obscure parents in a village of Berwick,
in Scotland, was remarkable, from his early youth, for an
extraordinary aptitude for acquiring languages, a decided
inclination for scholastic dispute, a pedantic tone and
manner, and somewhat irregular conduct. Having abandoned
theology for medicine, he fixed his residence in Edinburgh.
… He was particularly entertained and countenanced by
Cullen, who even took him into his family in the character of
preceptor of his children. This agreeable relation subsisted
during twelve consecutive years between these two men, whose
characters and minds were so different. … But some trifling
matters of mutual discontent grew at length into coldness, and
changed the old friendship which had united them into an
irreconcilable hatred. Their rupture broke out about the year
1778, and in a short time after, Brown published his Elements
of Medicine. … Brown employed some of the ideas of his
master to develop a doctrine much more simple in appearance,
but founded entirely on abstract considerations; a doctrine in
which every provision seems to be made for discussion, but
none for practice. Cullen had said that the nervous system
receives the first impression of excitants, and transmits it
afterwards to the other organs endowed with motion and
vitality. Brown explains thus, the same thought: 'Life is only
sustained by incitation. It is only the result of the action
of incitants on the incitability of organs.' Cullen regarded
the atony of the small vessels as the proximate cause of
fever. Brown, improving on this hypothesis, admits, with
hardly any exceptions, only hyposthenic diseases. … The
Scotch physiologist distinguished only two pathological
states—one consisting in an excess of incitability, which he
names the sthenic diathesis; the other, constituted by a want,
more or less notable, of the same faculty, which he designates
as the asthenic diathesis. Besides, Brown considers these two
states as affecting the entire economy, rather than any organ
in particular. … After having reduced all diseases to two
genera, and withdrawn from pathology the study of local
lesions, Brown arrives, by a subtile argumentation, to
consider the affections of the sthenic order as prevailing in
a very small number of instances, so that the diseases of the
asthenic type comprehend nearly the totality of affections.
According to this theory, a physician is rarely ever mistaken
if he orders in all his cases, remedies of an exciting nature.
… Never since the days of Thessalus (of charlatan memory)
had anyone simplified to such a point the study and practice
of medicine. We may even say that in this respect the Scotch
pathologist left far in the rear the physician of Nero. To
this attraction, well calculated to tempt students and
practitioners, the doctrine of Brown joined the advantage of
being presented in an energetic and captivating style, full of
imagery, which suffices to explain its rapid progress. But
this doctrine, so seductive in its exposition, so easy in its
application, is one of the most disastrous that man has been
able to imagine, for it tends to propagate the abuse of
diffusible stimulants, of which spirituous liquors make a
part, an abuse excessively injurious to health in general, and
the intellectual faculties in particular—an abuse to which
man is too much inclined, naturally, and which the sophisms of
Brown may have contributed to spread in all classes of English
society. … Notwithstanding its defects, the system of Brown
made rapid progress, principally in Germany and Italy."
_P. V. Renouard,
History of Medicine,
pages 555-560._
MEDICAL SCIENCE: 18th Century.
The System of Haller.
"About the time when we seniors commenced the study of
medicine, it was still under the influence of the important
discoveries which Albrecht von Haller [1708-1777] had made on
the excitability of nerves; and which he had placed in
connection with the vitalistic theory of the nature of life.
Haller had observed the excitability in the nerves and muscles
of amputated members. The most surprising thing to him was,
that the most varied external actions, mechanical, chemical,
thermal, to which electrical ones were subsequently added, had
always the same result; namely, that they produced muscular
contraction. They were only quantitatively distinguished as
regards their action on the organism, that is, only by the
strength of the excitation; he designated them by the common
name of stimulus; he called the altered condition of the nerve
the excitation, and its capacity of responding to a stimulus
the excitability, which was lost at death.
{2142}
This entire condition of things, which physically speaking
asserts no more than the nerves, as concerns the changes which
take place in them after excitation, are in an exceedingly
unstable state of equilibrium; this was looked upon as the
fundamental property of animal life, and was unhesitatingly
transferred to the other organs and tissues of the body, for
which there was no similar justification. It was believed that
none of them were active of themselves, but must receive an
impulse by a stimulus from without; air and nourishment were
considered to be the normal stimuli. The kind of activity
seemed, on the contrary, to be conditioned by the specific
energy of the organ, under the influence of the vital force.
Increase or diminution of the excitability was the category
under which the whole of the acute diseases were referred, and
from which indications were taken as to whether the treatment
should be lowering or stimulating. The rigid one-sidedness and
the unrelenting logic with which … [John] Brown had once
worked out the system was broken, but it always furnished the
leading points of view."
_H. Helmholtz,
On Thought in Medicine
(Popular Lectures, series 2, lecture 5)._
MEDICAL SCIENCE: 18th. Century.
Physiological Views of Bichat.
Marie Francis Xavier Bichat, was born in 1771 and died in
1802, accomplishing his extraordinary work as an anatomist and
physician within a lifetime of thirty-one years. "The peculiar
physiological views of Bichat are to be found stated more or
less distinctly in all his works; and it is a merit of his
that he has always kept in sight the necessary connexion of
this part of the science of medicine with every other, and, so
far as he has developed his ideas upon the subjects of
pathology, materia medica, and therapeutics, they seem all to
have been founded upon and connected with the principles of
physiology, which he had adopted. … Everything around living
bodies, according to Bichat, tends constantly to their
destruction. And to this influence they would necessarily
yield, were they not gifted with some permanent principle of
reaction. This principle is their life, and a living system is
therefore necessarily always engaged in the performance of
functions, whose object is to resist death. Life, however,
does not consist in a single principle, as has been taught by
some celebrated writers, by Stahl, Van Helmont, and Barthez,
&c. We are to study the phenomena of life, as we do those of
other matter, and refer the operations performed in living
systems to such ultimate principles as we can trace them to,
in the same way that we do the operations taking place among
inorganic substances. … His essential doctrine … is that
there is no one single, individual, presiding principle of
vitality, which animates the body, but that it is a collection
of matter gifted for a time with certain powers of action,
combined into organs which are thus enabled to act, and that
the result is a series of functions, the connected performance
of which constitutes it a living thing. This is his view of
life, considered in the most general and simple way. But in
carrying the examination farther, he points out two remarkable
modifications of life, as considered in different relations,
one common both to vegetables and animals, the other peculiar
to animals. … Those which we have in common with the
vegetable, which are necessary merely to our individual,
bodily existence, are called the functions of organic life,
because they are common to all organized matter. Those, on the
other hand, which are peculiar to animals, which in them are
superadded to the possession of the organic functions, are
called the functions of animal life. Physiologically speaking,
then, we have two lives, the concurrence of which enables us
to live and move and have our being; both equally necessary to
the relations we maintain as human beings, but not equally
necessary to the simple existence of a living thing. … The
two lives differ, in some important respects, as to the organs
by which their functions are performed. Those of the animal
life present a symmetry of external form, strongly contrasted
with the irregularity, which is a prominent characteristic of
those of organic life. In the animal life, every function IS
either performed by a pair of organs, perfectly similar in
structure and size, situated one upon each side of the median
dividing line of the body, or else by a single organ divided
into two similar and perfectly symmetrical halves by that
line. … The organs of the organic life, on the contrary,
present a picture totally different; they are irregularly
formed, and irregularly arranged. … This symmetry of the
form is accompanied by a corresponding harmony in the
functions of the organs of the animal life. … The functions
of the organic life are constantly going on; they admit of no
interruption, no repose. … In those of the animal life, the
case is widely different. They have intervals of entire
repose. The organs of this life are incapable of constant
activity, they become fatigued by exercise and require rest.
This rest, with regard to any particular organ, is the sleep
of that organ. … Upon this principle, Bichat founds his
theory of sleep. General sleep is the combination of the sleep
of particular organs. Sleep then is not any definite state,
but is more or less complete rest of the whole system in
proportion to the number of organs which require repose. …
The two lives differ also in regard to habit; the animal being
much under its control, the organic but slightly. … But the
principal and most important feature in the physiological
system of Bichat, is the complete, and entire, and exclusive
explanation of all the phenomena of the living system upon the
principles of vitality alone. Former physiologists have not
always kept this distinctly in view. … The human body has
been regarded, too often, as a mass of matter, organized to be
sure, but yet under the direction of physical laws, and the
performance of its functions has been ascribed to the powers
of inorganic matter. Hence, physiology has generally been
somewhat tinctured by the favorite science of the age, with
some of its notions. … With Bichat the properties of life
were all in all. The phenomena of the system, whether in
health or disease, were all ascribed to their influence and
operation."
_J. Ware,
Life and Writings of Bichat
(North American Review, July, 1822)._
{2143}
MEDICAL SCIENCE: 18-19th Centuries.
Pinel and the Reform in treatment of the Insane.
Philippe Pinel, "who had attained some distinction as an
alienist, was appointed, 1792, to fill the post of
superintendent of the Bicêtre, which then contained upwards of
200 male patients, believed not only to be incurable, but
entirely uncontrollable. The previous experience of the
physician, here stood him in good stead. He had been a
diligent student of the authorities of his own and foreign
countries on diseases of the mind, and in his earlier years
had been appointed by the French government to report on the
condition of the asylums at Paris and Charenton. On assuming
the oversight of the Bicêtre, he found 53 men languishing in
chains, some of whom had been bound for a great number of
years. These were regarded by the authorities as dangerous and
even desperate characters; but the sight of men grown gray and
decrepit as the result of prolonged torture, made a very
different impression on the mind of Pinel. He addressed appeal
after appeal to the Commune, craving power to release, without
delay, the unhappy beings under his charge. The authorities
tardily and unwillingly yielded to the importunity of the
physician. An official, who was deputed by the Commune to
accompany the superintendent and watch his experiment, no
sooner caught sight of the chained maniacs than he excitedly
exclaimed: 'Ah, ça! citoyen, es-tu fou toi-même de vouloir
déchaîner de pareils animaux?' The physician was not to be
deterred, however, from carrying out his benevolent project,
and did not rest satisfied until all of the 53 men had been
gradually liberated from their chains. Singular as it may
appear, the man who had been regarded as the most dangerous,
and who had survived forty years of this severe treatment, was
afterwards known as the faithful and devoted servant of Pinel.
The reforms of Pinel were not confined to the Bicêtre, an
establishment exclusively for men, but extended to the
Salpêtrière, an institution for women. There is, perhaps, no
more touching event in history than that of this kind-hearted
and wise physician removing the bands and chains from the
ill-fated inmates of this place of horrors. The monstrous
fallacy of cruel treatment once fully exposed, the insane came
to be looked upon as unfortunate human beings, stricken with a
terrible disease, and, like other sick persons, requiring
every aid which science and benevolent sympathy could provide
with a view to cure. Governmental inquiries were instituted
with a view to the attainment of better treatment, and in
different countries, almost simultaneously, the provision of
suitable and adequate accommodation for the insane was
declared to be a State necessity."
_W. P. Letchworth,
The Insane in Foreign Countries,
chapter 1._
MEDICAL SCIENCE: 19th Century.
The Discovery of Anæsthetics.
"In 1798, Mr. Humphry Davy, an apprentice to Mr. Borlase a
surgeon at Bodmin, had so distinguished himself by zeal and
power in the study of chemistry and natural philosophy, that
he was invited by Dr. Beddoes of Bristol, to become the
'superintendent of the Pneumatic Institution which had been
established at Clifton for the purpose of trying the medicinal
effects of different gases.' He obtained release from his
apprenticeship, accepted the appointment, and devoted himself
to the study of gases, not only in their medicinal effects,
but much more in all their chemical and physical relations.
After two years' work he published his 'Researches, Chemical
and Philosophical, chiefly concerning Nitrous Oxide.' … He
wrote, near the end of his essay: 'As nitrous oxide in its
extensive operation appears capable of destroying physical
pain, it may probably be used with advantage during surgical
operations in which no great effusion of blood takes place.'
It seems strange that no one caught at a suggestion such as
this. … The nitrous oxide might have been of as little
general interest as the carbonic or any other, had it not been
for the strange and various excitements produced by its
inhalation. These made it a favourite subject with chemical
lecturers, and year after year, in nearly every chemical
theatre, it was fun to inhale it after the lecture on the
gaseous compounds of nitrogen; and among those who inhaled it
there must have been many who, in their intoxication, received
sharp and heavy blows, but, at the time, felt no pain. And
this went on for more than forty years, exciting nothing
worthy to be called thought or observation, till, in December
1844, Mr. Colton, a popular itinerant lecturer on chemistry,
delivered a lecture on 'laughing gas' in Hartford,
Connecticut. Among his auditors was Mr. Horace Wells, an
enterprising dentist in that town, a man of some power in
mechanical invention. After the lecture came the usual
amusement of inhaling the gas, and Wells, in whom long wishing
had bred a kind of belief that something might be found to
make tooth-drawing painless, observed that one of the men
excited by the gas was not conscious of hurting himself when
he fell on the benches and bruised and cut his knees. Even
when he became calm and clear-headed the man was sure that he
did not feel pain at the time of his fall. Wells was at once
convinced—more easily convinced than a man of more scientific
mind would have been—that, during similar insensibility, in a
state of intense nervous excitement, teeth might be drawn
without pain, and he determined that himself and one of his
own largest teeth should be the first for trial. Next morning
Colton gave him the gas, and his friend Dr. Riggs extracted
his tooth. He remained unconscious for a few moments, and then
exclaimed, 'A new era in tooth-pulling! It did not hurt me
more than the prick of a pin. It is the greatest discovery
ever made.' In the next three weeks Wells extracted teeth from
some twelve or fifteen persons under the influence of the
nitrous oxide, and gave pain to only two or three. Dr. Riggs,
also, used it with the same success, and the practice was well
known and talked of in Hartford. Encouraged by his success
Wells went to Boston, wishing to enlarge the reputation of his
discovery and to have an opportunity of giving the gas to some
one undergoing a surgical operation. Dr. J. C. Warren, the
senior Surgeon of the Massachusetts General Hospital, to whom
he applied for this purpose, asked him to show first its
effects on some one from whom he would draw a tooth. He
undertook to do this in the theatre of the medical college
before a large class of students, to whom he had, on a
previous day, explained his plan. Unluckily, the bag of gas
from which the patient was inhaling was taken a way too soon;
he cried out when his tooth was drawn; the students hissed and
hooted; and the discovery was denounced as an imposture. Wells
left Boston disappointed and disheartened; he fell ill, and
was for many months unable to practise his profession. Soon
afterwards he gave up dentistry, and neglected the use and
study of the nitrous oxide, till he was recalled to it by a
discovery even more important than his own. The thread of the
history of nitrous oxide may be broken here.
{2144}
The inhalation of sulphuric ether was often, even in the last
century, used for the relief of spasmodic asthma, phthisis,
and some other diseases of the chest. … As the sulphuric
ether would 'produce effects very similar to those occasioned
by nitrous oxide,' and was much the more easy to procure, it
came to be often inhaled, for amusement, by chemist's lads and
by pupils in the dispensaries of surgeons. It was often thus
used by young people in many places in the United States. They
had what they called 'ether frolics.' … Among those who had
joined in these ether-frolics was Dr. Wilhite of Anderson,
South Carolina. In one of them, in 1839," a negro boy was
unconscious so long that he was supposed for some time to be
dead. "The fright at having, it was supposed, so nearly killed
the boy, put an end to the ether-frolics in that
neighbourhood; but in 1842, Wilhite had become a pupil of Dr.
Crauford Long, practising at that time at Jefferson (Jackson
County, Georgia). Here he and Dr. Long and three fellow-pupils
often amused themselves with the ether-inhalation, and Dr.
Long observed that when he became furiously excited, as he
often did, he was unconscious of the blows which he, by
chance, received as he rushed or tumbled about. He observed
the same in his pupils; and thinking over this, and emboldened
by what Mr. Wilhite told him of the negro-boy recovering after
an hour's insensibility, he determined to try whether the
ether-inhalation would make any one insensible of the pain of
an operation. So, in March, 1842, nearly three years before
Wells's observations with the nitrous oxide, he induced a Mr.
Venable, who had been very fond of inhaling ether, to inhale
it till he was quite insensible. Then he dissected a tumour
from his neck; no pain was felt, and no harm followed. Three
months later, he similarly removed another tumour from him;
and again, in 1842 and in 1845, he operated on other three
patients, and none felt pain. His operations were known and
talked of in his neighbourhood; but the neighbourhood was only
that of an obscure little town; and he did not publish any of
his observations. … He waited to test the ether more
thoroughly in some greater operation than those in which he
had yet tried it; and then he would have published his account
of it. While he was waiting, others began to stir more
actively in busier places, where his work was quite unknown,
not even heard of. Among those with whom, in his unlucky visit
to Boston, Wells talked of his use of the nitrous oxide, and
of the great discovery which he believed that he had made,
were Dr. Morton and Dr. Charles Jackson. … Morton was a
restless energetic dentist, a rough man, resolute to get
practice and make his fortune. Jackson was a quiet scientific
gentleman, unpractical and unselfish, in good repute as a
chemist, geologist, and mineralogist. At the time of Wells's
visit, Morton, who had been his pupil in 1842, and for a short
time, in 1843, his partner, was studying medicine and anatomy
at the Massachusetts Medical College, and was living in
Jackson's house. Neither Morton nor Jackson put much if any
faith in Wells's story, and Morton witnessed his failure in
the medical theatre. Still, Morton had it in his head that
tooth-drawing might somehow be made painless. … Jackson had
long known, as many others did, of sulphuric ether being
inhaled for amusement and of its producing effects like those
of nitrous oxide; he knew also of its employment as a remedy
for the irritation caused by inhaling chlorine. He had himself
used it for this purpose, and once, in 1842, while using it,
he became completely insensible. He had thus been led to think
that the pure ether might be used for the prevention of pain
in surgical operations; he spoke of it with some scientific
friends, and sometimes advised a trial of it; but he did not
urge it or take any active steps to promote even the trial.
One evening, Morton, who was now in practice as a dentist,
called on him, full of some scheme which he did not divulge,
and urgent for success in painless tooth-drawing. Jackson
advised him to use the ether, and taught him how to use it. On
that same evening, the 30th of September, 1846, Morton inhaled
the ether, put himself to sleep, and, when he awoke, found
that he had been asleep for eight minutes. Instantly, as he
tells, he looked for an opportunity of giving it to a patient;
and one just then coming in, a stout healthy man, he induced
him to inhale, made him quite insensible, and drew his tooth
without his having the least consciousness of what was done.
But the great step had yet to be made. … Could it be right
to incur the risk of insensibility long enough and deep enough
for a large surgical operation? It was generally believed that
in such insensibility there was serious danger to life. Was it
really so? Jackson advised Morton to ask Dr. J. C. Warren to
let him try, and Warren dared to let him. It is hard, now, to
think how bold the enterprise must have seemed to those who
were capable of thinking accurately on the facts then known.
The first trial was made on the 16th of October, 1846. Morton
gave the ether to a patient in the Massachusetts General
Hospital, and Dr. Warren removed a tumour from his neck. The
result was not complete success; the patient hardly felt the
pain of the cutting, but he was aware that the operation was
being performed. On the next day, in a severer operation by
Dr. Hayward, the success was perfect; the patient felt
nothing, and in long insensibility there was no appearance of
danger to life. The discovery might already be deemed
complete; for the trials of the next following days had the
same success, and thence onwards the use of the ether extended
over constantly widening fields. … It might almost be said
that in every place, at least in Europe, where the discovery
was promoted more quickly than in America, the month might be
named before which all operative surgery was agonising, and
after which it was painless."
_Sir J. Paget,
Escape from Pain
(Nineteenth Century, December 1879)._
MEDICAL SCIENCE: 19th Century.
The Study of Fermentation and its results.
"It was some time ago the current belief that epidemic
diseases generally were propagated by a kind of malaria, which
consisted of organic matter in a state of motor-decay; that
when such matter was taken into the body through the lungs,
skin, or stomach, it had the power of spreading there the
destroying process by which itself had been assailed. Such a
power was visibly exerted in the case of yeast. A little
leaven was seen to leaven the whole lump—a mere speck of
matter, in this supposed state of decomposition, being
apparently competent to propagate indefinitely its own decay.
Why should not a bit of rotten malaria act in a similar manner
within the human frame? In 1836 a very wonderful reply was
given to this question. In that year Cagniard de la Tour
discovered the yeast-plant—a living organism, which when
placed in a proper medium feeds, grows, and reproduces itself,
and in this way carries on the process which we name
fermentation. By this striking discovery fermentation was
connected with organic growth. Schwann, of Berlin, discovered
the yeast-plant independently about the same time."
_J. Tyndall,
Fragments of Science,
volume 1, chapter 5._
{2145}
The question of fermentation "had come to present an entirely
new aspect through the discovery of Cagniard de la Tour that
yeast is really a plant belonging to one of the lowest types
of fungi, which grows and reproduces itself in the fermentable
fluid, and whose vegetative action is presumably the cause of
that fermentation, just as the development of mould in a
jam-pot occasions a like change in the upper stratum of the
jam, on whose surface, and at whose expense, it lives and
reproduces itself. Chemists generally—especially Liebig, who
had a fermentation theory of his own—pooh-poohed this idea
altogether; maintaining the presence of the yeast-plant to be
a mere concomitant, and refusing to believe that it had any
real share in the process. But in 1843, Professor Helmholtz,
then a young undistinguished man, devised a method of stopping
the passage of organic germs from a fermenting into a
fermentable liquid, without checking the passage of fluids;
and as no fermentation was then set up, he drew the inference
that the 'particulate' organic germs, not the soluble material
of the yeast, furnish the primum mobile of this change,—a
doctrine which, though now universally accepted, had to fight
its way for some time against the whole force of chemical
authority. A little before Cagniard de la Tour's discovery, a
set of investigations had been made by Schulze and Schwann, to
determine whether the exclusion of air was absolutely
necessary to prevent the appearance of living organisms in
decomposing fluids, or whether these fluids might be kept free
from animal or vegetable life, by such means as would
presumably destroy any germs which the air admitted to them
might bring in from without, such as passing it through a
red-hot tube or strong sulphuric acid. These experiments, it
should be said, had reference rather to the question of
'spontaneous generation,' or 'abiogenesis,' than to the cause
of fermentation and decomposition; its object being to
determine whether the living things found by the microscope in
a decomposing liquid exposed to the air, spring from germs
brought by the atmosphere, or are generated 'de novo' in the
act of decay—the latter doctrine having then many upholders.
But the discovery of the real nature of yeast, and the
recognition of the part it plays in alcoholic fermentation,
gave an entirely new value to Schulze's and Schwann's results;
suggesting that putrefactive and other kinds of decomposition
may be really due, not (as formerly supposed) to the action of
atmospheric oxygen upon unstable organic compounds, but to a
new arrangement of elements brought about by the development
of germinal particles deposited from the atmosphere. It was at
this point that Pasteur took up the inquiry; and for its
subsequent complete working-out, science is mainly indebted to
him: for although other investigators—notably Professor
Tyndall—have confirmed and extended his conclusions by
ingenious variations on his mode of research, they would be
the first to acknowledge that all those main positions which
have now gained universal acceptance—save on the part of a
few obstinate 'irreconcilables'—have been established by
Pasteur's own labours. … The first application of these
doctrines to the study of disease in the living animal was
made in a very important investigation, committed to Pasteur
by his old master in chemistry (the eminent and eloquent
Dumas), into the nature of the 'pébrine,' which was
threatening to extinguish the whole silk culture of France and
Italy. … Though it concerned only a humble worm, it laid the
foundation of an entirely new system and method of research
into the nature and causes of a large class of diseases in man
and the higher animals, of which we are now only beginning to
see the important issues. Among the most immediately
productive of its results, may be accounted the 'antiseptic
surgery' of Professor Lister; of which the principle is the
careful exclusion of living bacteria and other germs, alike
from the natural internal cavities of the body, and from such
as are formed by disease, whenever these may be laid open by
accident, or may have to be opened surgically. This exclusion
is effected by the judicious use of carbolic acid, which kills
the germs without doing any mischief to the patient; and the
saving of lives, of limbs, and of severe suffering, already
brought about by this method, constitutes in itself a glorious
triumph alike to the scientific elaborator of the
germ-doctrine, and to the scientific surgeon by whom it has
been thus applied. A far wider range of study, however, soon
opened itself. The revival by Dr. Farr of the doctrine of
'zymosis' (fermentation),—long ago suggested by the sagacity
of Robert Boyle, and practically taken up in the middle of the
last century by Sir John Pringle (the most scientific
physician of his time),—as the expression of the effect
produced in the blood by the introduction of a specific poison
(such as that of small-pox, measles, scarlatina, cholera,
typhus, &c.), had naturally directed the attention of
thoughtful men to the question (often previously raised
speculatively), whether these specific poisons are not really
organic germs, each kind of which, a real 'contagium vivum,'
when sown in the circulating fluid, produces a definite
'zymosis' of its own, in the course of which the poison is
reproduced with large increase, exactly after the manner of
yeast in a fermenting wort. Pasteur's success brought this
question to the front, as one not to talk about, but to work at."
_W. B. Carpenter,
Disease-Germs
(Nineteenth Century, October, 1881)._
ALSO IN:
_L. Pasteur,
Studies in Fermentation._
_Dr. Duclaux,
Fermentation._
MEDICAL SCIENCE: 19th Century.
Virchow and Cellular Pathology.
"That really gifted scholar and paragon of industry and
attainment, Rudolph Virchow, announced in 1858 a theory known
as Modern Vitalism which was borrowed from natural scientific
medicine and is distinguished from the vitalism of the
previous century in this, that it breaks up the old vital
force, which was supposed to be either distributed throughout
the entire body, or located in a few organs, into an
indefinite number of associate vital forces working
harmoniously, and assigns to them all the final elementary
principles without microscopic seat. 'Every animal principle
has a sum of vital unities, each of which bears all the
characteristics of life.
{2146}
The characteristics and unity of life cannot be found in any
determinate point of a higher organism, e. g., in the brain,
but only in the definite, ever recurring arrangements of each
element present. Hence it results that the composition of a
large body amounts to a kind of social arrangement, in which
each one of the movements of individual existence is dependent
upon the others, but in such a way that each element has a
special activity of its own, and that each, although it
receives the impulse to its own activity from other parts,
still itself performs its own functions.' This it will be seen
is nothing but another way of expressing the cell doctrine to
which most medical men are now committed, which means that our
bodies are built up with cells, and that each cell has a unity
and a purpose of its own. Sir Robert Hooke in 1677 discovered
plant cells. Schwann discovered animal cells, and Robert Brown
discovered cell nuclei, but it remained for Virchow, using the
microscope, to supply the gap which had risen between
anatomical knowledge and medical theory, that is, to supply a
'cellular pathology,' since which time the cell has assumed
the role which the fibre occupied in the theories of the 17th
and 18th centuries. Time alone can decide as to the ultimate
validity of these views. This theory was from its announcement
most enthusiastically received, and so far has responded to
nearly all the requirements which have been made of it. Even
its author was almost startled with its success. … As a
result of Virchow's labors there has arisen in Germany what
has been called the medical school of natural sciences of
which Virchow is the intellectual father. This school seeks
mainly by means of pathological anatomy and microscopy,
experimental physiology and pathology, and the other applied
sciences, or rather by their methods, to make medicine also an
exact science."
_Roswell Park,
Lectures on the History of Medicine (in MS.)._
MEDICAL SCIENCE: 19th Century.
The development of Bacteriology.
"The traditional expression contagium vivum received a more
precise meaning in 1840 from Henle, who in his 'Pathologischen
Untersuchungen,' showed clearly and distinctly that the
contagia till then invisible must be regarded as living
organisms, and gave his reasons for this view. … If we are
forced to recognise the characteristic qualities of living
beings in these contagia, there is no good reason why we
should not regard them as real living beings, parasites. For
the only general distinction between their mode of appearance
and operation and that of parasites is, that the parasites
with which we are acquainted have been seen and the contagia
have not. That this may be due to imperfect observation is
shown by the experiments on the itch in 1840, in which the
contagium, the itch-mite, though almost visible without
magnifying power, was long at least misunderstood. It was only
a short time before that the microscopic Fungus, Achorion,
which causes favus, was unexpectedly discovered, as well as
the Fungus which gives rise to the infectious disease in the
caterpillar of the silkworm known as muscardine. Other and
similar cases occurred at a later time, and among them that of
the discovery of the Trichinae between 1850 and 1860, a very
remarkable instance of a contagious parasite long overlooked.
Henle repeated his statements in 1853 in his 'Rationelle
Pathologie,' but for reasons which it is not our business to
examine, his views on animal pathology met with little
attention or approval. It was in connection with
plant-pathology that Henle's views were first destined to
further development, and obtained a firmer footing. It is true
that the botanists who occupied themselves with the diseases
of plants knew nothing of Henle's pathological writings, but
made independent efforts to carry on some first attempts which
had been made with distinguished success in the beginning of
the century. But they did in fact strike upon the path
indicated by Henle, and the constant advance made after, about
the year 1850, resulted not only in the tracing back of all
infectious diseases in plants to parasites as their exciting
cause, but in proving that most of the diseases of plants are
due to parasitic infection. It may now certainly be admitted
that the task was comparatively easy in the vegetable kingdom,
partly because the structure of plants makes them more
accessible to research, partly because most of the parasites
which infect them are true Fungi, and considerably larger than
most of the contagia of animal bodies. From this time
observers in the domain of animal pathology, partly
influenced, more or less, by these discoveries in botany, and
partly in consequence of the revival of the vitalistic theory
of fermentation by Pasteur about the year 1860, returned to
Henle's vitalistic theory of contagion. Henle himself, in the
exposition of his views, had already indicated the points of
comparison between his own theory and the theory of
fermentation founded at that time by Cagniard-Latour and
Schwann. Under the influence, as he expressly says, of
Pasteur's writings, Davaine recalled to mind the little rods
first seen by his teacher, Rayer, in the blood of an animal
suffering from anthrax, and actually discovered in them the
exciting cause of the disease, which may be taken as a type of
an infectious disease both contagious and miasmatic also, in
so far as it originates, as has been said, in
anthrax-districts. This was, in 1863, a very important
confirmation of Henle's theory, inasmuch as a very small
parasite, not very easy of observation at that time, was
recognised as a contagium. It was some time before much
further advance was made. … The latest advance to be
recorded begins with the participation of Robert Koch in the
work of research since 1876."
_A. De Bary,
Lectures on Bacteria,
pages 145-148._
"M. Pasteur is no ordinary man; he is one of the rare
individuals who must be described by the term 'genius.' Having
commenced his scientific career and attained great distinction
as a chemist, M. Pasteur was led by his study of the chemical
process of fermentations to give his attention to the
phenomena of disease in living bodies resembling
fermentations. Owing to a singular and fortunate mental
characteristic, he has been able, not simply to pursue a rigid
path of investigation dictated by the logical or natural
connection of the phenomena investigated, but deliberately to
select for inquiry matters of the most profound importance to
the community, and to bring his inquiries to a successful
practical issue in a large number of instances.
{2147}
Thus he has saved the silkworm industry of France and Italy
from destruction, he has taught the French wine-makers to
quickly mature their wine, he has effected an enormous
improvement and economy in the manufacture of beer, he has
rescued the sheep and cattle of Europe from the fatal disease
'anthrax,' and it is probable—he would not himself assert
that it is at present more than probable—that he has rendered
hydrophobia a thing of the past. The discoveries made by this
remarkable man would have rendered him, had he patented their
application and disposed of them according to commercial
principles, the richest man in the world. They represent a
gain of some millions sterling annually to the community. …
M. Pasteur's first experiment in relation to hydrophobia was
made in December 1880, when he inoculated two rabbits with the
mucus from the mouth of a child which had died of that
disease. As his inquiries extended he found that it was
necessary to establish by means of experiment even the most
elementary facts with regard to the disease, for the existing
knowledge on the subject was extremely small, and much of what
passed for knowledge was only ill-founded tradition."
_E. R. Lankester,
The Advancement of Science,
pages 121-123._
"The development of our knowledge relating to the bacteria,
stimulated by the controversy relating to spontaneous
generation and by the demonstration that various processes of
fermentation and putrefaction are due to microörganisms of
this class, has depended largely upon improvements in methods
of research. Among the most important points in the
development of bacteriological technique we may mention first,
the use of a cotton air filter (Schröder and Von Dusch, 1854);
second, the sterilization of culture fluids by heat (methods
perfected by Pasteur, Koch, and others); third, the use of the
aniline dyes as staining agents (first recommended by Weigert
in 1877); fourth, the introduction of solid culture media and
the 'plate method' for obtaining pure cultures, by Koch in
1881. The various improvements in methods of research, and
especially the introduction of solid culture media and Koch's
'plate method' for isolating bacteria from mixed 'cultures,
have placed bacteriology upon a scientific basis. … It was a
distinguished French physician, Davaine, who first
demonstrated the etiological relation of a microörganism of
this class to a specific infectious disease. The anthrax
bacillus had been seen in the blood of animals dying from this
disease by Pollender in 1849, and by Davaine in 1850, but it
was several years later (1863) before the last-named observer
claimed to have demonstrated by inoculation experiments the
causal relation of the bacillus to the disease in question.
The experiments of Davaine were not generally accepted as
conclusive, because in inoculating an animal with blood
containing the bacillus, from an infected animal which had
succumbed to the disease, the living microörganism was
associated with material from the body of the diseased animal.
This objection was subsequently removed by the experiments of
Pasteur, Koch, and many others, with pure cultures of the
bacillus, which were shown to have the same pathogenic effects
as had been obtained in inoculation experiments with the blood
of an infected animal."
_G. M. Sternberg,
Manual of Bacteriology,
page 6._
"In 1876 the eminent microscopist, Professor Cohn, of Breslau,
was in London, and he then handed me a number of his
'Beiträge,' containing a memoir by Dr. Koch on Splenic Fever
(Milzbrand, Charbon, Malignant Pustule), which seemed to me to
mark an epoch in the history of this formidable disease. With
admirable patience, skill, and penetration Koch followed up
the life-history of bacillus anthracis, the contagium of this
fever. At the time here referred to he was a young physician
holding a small appointment in the neighbourhood of Breslau,
and it was easy to predict, and indeed I predicted at the
time, that he would soon find himself in a higher position.
When I next heard of him he was head of the Imperial Sanitary
Institute of Berlin. … Koch was not the discoverer of the
parasite of splenic fever. Davaine and Rayer, in 1850, had
observed the little microscopic rods in the blood of animals
which had died of splenic fever. But they were quite
unconscious of the significance of their observation, and for
thirteen years, as M. Radot informs us, strangely let the
matter drop. In 1863 Davaine's attention was again directed to
the subject by the researches of Pasteur, and he then
pronounced the parasite to be the cause of the fever. He was
opposed by some of his fellow-countrymen; long discussions
followed, and a second period of thirteen years, ending with
the publication of Koch's paper, elapsed before M. Pasteur
took up the question. I always, indeed, assumed that from the
paper of the learned German came the impulse towards a line of
inquiry in which M. Pasteur has achieved such splendid
results."
_J. Tyndall,
New Fragments,
pages 190-191._
"On the 24th of March, 1882, an address of very serious public
import was delivered by Dr. Koch before the Physiological
Society of Berlin. … The address … is entitled 'The
Etiology of Tubercular Disease.' Koch first made himself
known, and famous, by the penetration, skill, and thoroughness
of his researches on the contagium of anthrax, or splenic
fever. … Koch's last inquiry deals with a disease which, in
point of mortality, stands at the head of them all. 'If,' he
says, 'the seriousness of a malady be measured by the number
of its victims, then the most dreaded pests which have
hitherto ravaged the world—plague and cholera included—must
stand far behind the one now under consideration.' Then
follows the startling statement that one-seventh of the deaths
of the human race are due to tubercular disease. Prior to Koch
it had been placed beyond doubt that the disease was
communicable; and the aim of the Berlin physician has been to
determine the precise character of the contagium which
previous experiments on inoculation and inhalation had proved
to be capable of indefinite transfer and reproduction. He
subjected the diseased organs of a great number of men and
animals to microscopic examination, and found, in all cases,
the tubercles infested by a minute, rod-shaped parasite, which
by means of a special dye, he differentiated from the
surrounding tissue. 'It was,' he says, 'in the highest degree
impressive to observe in the centre of the tubercle-cell the
minute organism which had created it.' Transferring directly,
by inoculation, the tuberculous matter from diseased animals
to healthy ones, he in every instance reproduced the disease.
To meet the objection that it was not the parasite itself, but
some virus in which it was imbedded in the diseased organ,
that was the real contagium, he cultivated his bacilli
artificially for long periods of time and through many
successive generations.
{2148}
With a speck of matter, for example, from a tuberculous human
lung, he infected a substance prepared, after much trial, by
himself, with the view of affording nutriment to the parasite.
In this medium he permitted it to grow and multiply: From the
new generation he took a minute sample, and infected therewith
fresh nutritive matter, thus producing another brood.
Generation after generation of bacilli were developed in this
way, without the intervention of disease. At the end of the
process, which sometimes embraced successive cultivations
extending over half a year, the purified bacilli were
introduced into the circulation of healthy animals of various
kinds. In every case inoculation was followed by the
reproduction and spread of the parasite, and the generation of
the original disease. … The moral of these experiments is
obvious. In no other conceivable way than that pursued by Koch
could the true character of the most destructive malady by
which humanity is now assailed be determined. And however
noisy the fanaticism of the moment may be, the common-sense of
Englishmen will not, in the long run, permit it to enact
cruelty in the name of tenderness, or to debar us from the
light and leading of such investigations as that which is here
so imperfectly described."
_J. Tyndall,
New Fragments,
pages 423-428._
MEDICAL SCIENCE: 19th Century.
The Theory of Germ Diseases.
"An account of the innumerable questions and investigations in
this department of modern pathogenesis, of the various views
on certain questions, etc., does not fall within the compass
of our brief sketch. Nor are we able to furnish a consistent
theory, simply because such an one does not [1889] exist. One
fact alone is agreed upon, to wit, that certain of the lower
fungi, as parasites within or upon the body, excite diseases
(infectious diseases). As regards the modus operandi of these
parasites two main theories are held. According to one theory,
these parasites, by their development, deprive the body of its
nutriment and endanger life particularly when, thronging in
the blood, they deprive this of the oxygen necessary for
existence. According to the other theory, they threaten life
by occasioning decompositions which engender putrid poisons
(ptomaines). These latter poisons were first isolated by P. L.
Panum in 1856, and have been recently specially studied by
Brieger (Ueber Ptomaine, Berlin, 1885-86). They act
differently upon bodies according to the variety of the
alkaloidal poison. Metschnikoff regards the white
blood-corpuscles as antagonists of these parasites (thus
explaining the cases of recovery from parasitic diseases), and
in this point of view calls them 'phagocytes.' On the other
hand E. Salmon and Theodore Smith ('Transactions of the
Washington Biological Society, February 22d, 1886) were the
first to demonstrate that sterilized nutritive solutions or
germ-free products of change of matter of the virulent
exciters of disease, when injected, afford protection. A.
Chauveau as early as 1880 had brought forward evidence of the
probability of this fact, and Hans Buchner in 1879 admitted
the possibility of depriving bacteria of their virulence.
Pasteur, however, believes he has demonstrated that by
continued cultures (also a sort of bacillary Isopathy)
'debilitated' germs act as prophylactics against the
corresponding parasitic diseases, and he even thinks he has
confirmed this by his inoculations against hydrophobia—a
view, at all events, still open to doubt. … The chief
diseases regarded as of parasitic origin at present are:
anthrax (Davaine, 1850); relapsing fever (Obermeier, 1873);
gonorrhœa and blenorrhœa neonatorum (Neisser, 1879); glanders
(Struck, 1882, Loeffler and Schütz); syphilis (Sigm.
Lustgarten, 1884); diphtheria (Oertel, Letzerich, Klebs);
typhus (Eberle, Klebs); tuberculosis (Koch, 1882); cholera
(Koch, 1884); lepra (Armauer-Hansen); actinomycosis (Bollinger
in cattle, 1877; Israel in man, 1884); septicæmia (Klebs);
erysipelas (Fehleisen); pneumonia (Friedländer); malarial
fever (Klebs, Tommasi-Crudeli, Marchiafava); malignant œdema
(Koch); tetanus (Carle and Rattone, Nicolaier, Roeschlaub
assumed a tetania occasioned by bacilli); cancer (Scheuerlen;
priority contested by Dr. G. Rappia and Prof. Domingo Freire
of Rio Janeiro); yellow fever (microbe claimed to have been
discovered by Freire); dysentery (bacillary diphtheritis of
the large intestine); cholera nostras (Finkler and Prior);
scarlet fever (Coze and Feltz, '72); variola and vaccina
(Keber, Zülzer, Weigert, Klebs); acute yellow atrophy of the
liver (Klebs, Waldeyer, Eppinger); endocarditis (Ziegler);
hæmophilia neonatorum (Klebs, Eppinger); trachoma (Sattler);
keratitis (Leber—aspergillus); ulcus rodens corneæ (Sattler);
gonorrhœal rheumatism (Petrone, Kammerer). If the bacterial
theory of infection, constantly threatening life by such
numerous pathogenic varieties of infecting organisms, must be
looked upon as a gloomy one, the anti-bacterial Phagocyte
Theory of Metschnikoff, professor of zoology in Odessa, is
adapted to make one feel more comfortable, inasmuch as it
brings into view the possibility of an antagonism to these
infecting organisms, and explains the method of nature's
cures. Metschnikoff observed that the wandering cells—the
white blood corpuscles—after the manner of amœbæ, surround,
hold fast, digest ('devour,' hence 'phagocytes'), and thus
render harmless the bacteria which have entered the body. …
The prophylactic effects of inoculation are explained on the
theory that by means of this operation the wandering cells are
prepared, as it were, for subsequent accidental irruptions of
similar pathogenic bacteria, are habituated or compelled
thereby to at once devour such organisms when they enter the
body spontaneously, and thus to render them harmless.
Inoculation would thus be a sort of training or education of
the phagocytes. The immunity of many persons from infectious
diseases, so far as it is not effected by inoculations, would
by analogy be explained on the theory that with such
individuals the phagocytes are from the outset so constituted
that they at once render harmless any stray bacteria which
come within their domain by immediately devouring them. …
When … in spite of the phagocytes, the patients die of
infectious diseases, the fact is to be explained by the
excessive number of the bacteria present, which is so great
that the phagocytes are unequal to the task of 'devouring'
them all."
_J. H. Baas,
Outlines of the History of Medicine,
pages 1007-1009._
{2149}
MEDICAL SCIENCE: 19th Century.
Sanitary Science and Legislation.
"Together with the growth of our knowledge of the causes of
disease there has been … slowly growing up also a new kind
of warfare against disease. It is this science of hygiene
which is now promising to transform all the old traditional
ways of dealing with disease, and which now makes possible the
organisation of the conditions of health. And this science of
hygiene, it must be repeated, rests on the exact knowledge of
the causes of disease which we are now obtaining. … At the
beginning of the eighteenth century Mead, a famous physician
of that day, whose reputation still lives, had proposed the
formation of a central board of health to organise common
measures for the public safety. It was not, however, until
more than a hundred years later, in 1831, under the influence
of the terror of cholera, that this first step was taken; so
that, as it has been well said and often since proved, 'panic
is the parent of sanitation.' In 1842 Sir Edwin Chadwick
issued his report on 'The Sanitary Condition of the Labouring
Population of Great Britain.' This report produced marked
effect, and may truly be said to have inaugurated the new era
of collective action, embodying itself in legislation directed
to the preservation of national health, an era which is thus
just half a century old. Chadwick's report led to a Royal
Commission, which was the first step in the elevation of
public health to a State interest; and a few years later
(1847) Liverpool, and immediately afterwards London, appointed
the first medical officers of health in Great Britain. In 1848
another epidemic of cholera appeared, and a General Board of
Health was established. During this epidemic Dr. Snow began
those inquiries which led to the discovery that the spread of
the disease was due to the contamination of drinking-water by
the intestinal discharges of patients. That discovery marked
the first great stage in the new movement. Henceforth the
objects to be striven for in the evolution of sanitation
became ever more clear and precise, and a succession of
notable discoveries in connection with various epidemics
enlarged the sphere of sanitation, and revealed new
possibilities in the prevention of human misery."
_H. Ellis,
The Nationalisation of Health,
pages 21-24._
"Of all countries of the civilized world, none has a sanitary
code so complete and so precise as England. In addition,
English legislation is distinguished from that of other
countries, by the fact that the principal regulations emanate
from Parliament instead of being simple administrative orders.
Thus the legislation is the work of the nation, which has
recognised its necessity in its own interest. Consequently the
laws are respected, and, as a rule, religiously observed,
without objection or murmur. In the whole country, the
marvellous results which have been produced can be seen.
Thanks to these laws, the rate of mortality has been lowered,
the mean duration of life increased, the amount of sickness
decreased. They have greatly alleviated the misery in the
houses of the poor, who, thanks to sanitary measures, have a
better prospect of recovering their health and the means of
providing for their subsistence and that of their families.
… The sanitary administration of England is, in accordance
with the Public Health Act of 1875, in the hands of a central
authority, the Local Government Board; and local authorities,
the Local Boards of Health. The Local Government Board
consists of a president, nominated by the Queen, and the
following ex-officio members:—the Lord President of the Privy
Council, all the principal Secretaries of State for the time
being, the Lord Privy Seal, the Chancellor of the Exchequer, a
Parliamentary Secretary, and a permanent Secretary. The
President and Secretaries are, properly speaking, the
directors of the Local Government Board, the other members
being only consulted on matters of prime importance. Nine
special departments are controlled by the Local Government
Board:
1. Poor-law administration.
2. Legal questions.
3. Sanitary regulations respecting buildings.
4. Sanitary regulations respecting sewers, streets, etc.
5. Medical and hygienic matters.
6. Vaccination.
7. The Hygiene of factories.
8. The water supply of London.
9. Statistics.
Medical and sanitary matters are under the direction of a
Medical Officer, and an Assistant Medical Officer."
_A. Palmberg,
Treatise on Public Health: England,
chapter 1._
"The United States have no uniform legislation for the
organization of public hygiene to the present day. Each State
organizes this service as it chooses. … That which
characterizes the sanitary organization of the States is the
fact that, in a large number of States, the right is granted
to the sanitary administrations to carry before the justices
the infractions of the regulations on this subject. It is a
similar organization to that of Great Britain, with a little
less independence, and it is the logical result of the general
system of administration which exists in the American Union.
… Without doubt the day will come when the National Board of
Health will be by act of Congress, with the consent of all the
States, the real superior council of public hygiene of the
American Union."
_E. Sève,
On the General Organization of Public Hygiene
(Proceedings, International Sanitary Conference, 1881)._
"The General Government [of the United States] can do little
in the way of compulsory legislation, which might interfere
with the action of the several States to control their own
sanitary affairs. It is possible that upon the ground of power
to legislate with regard to commerce, it might establish some
general system of quarantine and do something toward the
prevention of the pollution of navigable streams; but it could
probably only do this with such restrictions and exceptions as
would make its action of little practical value, unless,
indeed, it should resort to its right of eminent domain, and
become liable for all damages, individual or municipal, which
its action might cause. … No one would deny that the General
Government can properly create an organization for the purpose
of collecting and diffusing information on sanitary matters;
but comparatively few understand how much real power and
influence such an organization might acquire without having
the slightest legal authority to enforce any of its
recommendations. The passing of sanitary laws, and the
granting to a certain department the power to enforce these
laws, will not ensure good public health unless the public at
large supports those laws intelligently, and it can only do
this through State and municipal sanitary organizations. The
General Government might do much to promote the formation of
such organizations, and to assist them in various ways. … By
the 'act to prevent the introduction of infectious or
contagious diseases into the United States, and to establish a
national board of health,' approved March 3, 1879, the first
step has been taken in the direction above indicated.
{2150}
The act provides for a national board of health, to consist of
seven members, appointed by the President, and of four
officers detailed from the Medical Department of the Army,
Medical Department of the Navy, and the Marine Hospital
Service, and the Department of Justice respectively. No
definite term of Office is prescribed, the Board being
essentially provisional in character. The duties of the board
are 'to obtain information upon all matters affecting the
public health, to advise the several departments of the
government, the executives of the several States, and the
Commissioners of the District of Columbia, on all questions
submitted by them, or whenever in the opinion of the board
such advice may tend to the preservation and improvement of
the public health.' The board is also directed to prepare a
plan for a national public health organization in conjunction
with the National Academy of Sciences."
_J. S. Billings,
Introduction to "A Treatise on Hygiene and Public Health,"
edited by A. IL Buck._
ALSO IN:
_Sir J. Simon,
English Sanitary Institutions_
_Sir J. Simon,
Public Health: Reports of the Medical Officer
of the Privy Council and Local Government Board._
_United States National Board of Health, Annual Reports._
_Massachusetts Board of Health, Annual Reports._
----------MEDICAL SCIENCE: End----------
MEDICI, The.
See FLORENCE: A. D. 1378-1427, and after.
----------MEDINA: Start--------
MEDINA: the City of the Prophet.
By Mahomet's Hegira or flight from Mecca to Yethrib, A. D.
622, the latter city became the seat of Islam and was
henceforward known as Medina—Medinet-en-Neby—"the City of
the Prophet."
_S. Lane-Poole,
Studies in a Mosque,
chapter 2._
See MAHOMETAN CONQUEST: A. D. 609-632.
MEDINA: A. D. 661.
The Caliphate transferred.
See MAHOMETAN CONQUEST: A. D. 661.
MEDINA: A. D. 683.
Stormed and sacked.
In the civil war which followed the accession of Yezid, the
second of the Omeyyad caliphs, Medina was besieged and stormed
by Yezid's army and given up for three days to every
imaginable brutality on the part of the soldiery. The
inhabitants who survived were made slaves.
_Sir W. Muir,
Annals of the Early Caliphate,
chapter 50._
ALSO IN:
_W. Irving,
Mahomet and his Successors,
volume 2, chapter 47._
See MAHOMETAN CONQUEST: A. D. 715-750.
----------MEDINA: End----------
MEDINA DEL RIO SECO, Battle of.
See SPAIN: A. D. 1808 (MAY-SEPTEMBER).