CHAPTER IV -- THE RENAISSANCE AND THE RISE OF ANATOMY AND PHYSIOLOGY

THE "reconquest of the classic world of thought was by far the most

important achievement of the fifteenth and sixteenth centuries.

It absorbed nearly the whole mental energy of the Italians.... The

revelation of what men were and what they wrought under the influence of

other faiths and other impulses, in distant ages with a different ideal

for their aim, not only widened the narrow horizon of the Middle Ages,

but it also restored self-confidence to the reason of humanity."(1)

(1) J. A. Symonds: The Renaissance in Italy; the Revival of

Learning, 1877, p. 52.

Everywhere throughout the Middle Ages learning was the handmaid of

theology. Even Roger Bacon with his strong appeal for a new method

accepted the dominant mediaeval conviction--that all the sciences did

but minister to their queen, Theology. A new spirit entered man's heart

as he came to look upon learning as a guide to the conduct of life.

A revolution was slowly effected in the intellectual world. It is

a mistake to think of the Renaissance as a brief period of sudden

fruitfulness in the North Italian cities. So far as science is

concerned, the thirteenth century was an aurora followed by a long

period of darkness, but the fifteenth was a true dawn that brightened

more and more unto the perfect day. Always a reflex of its period,

medicine joined heartily though slowly in the revolt against

mediaevalism. How slowly I did not appreciate until recently. Studying

the earliest printed medical works to catch the point of view of the men

who were in the thick of the movement up to 1480--which may be taken to

include the first quarter of a century of printing--one gets a startling

record. The mediaeval mind still dominates: of the sixty-seven

authors of one hundred and eighty-two editions of early medical books,

twenty-three were men of the thirteenth and fourteenth centuries, thirty

men of the fifteenth century, eight wrote in Arabic, several were of

the School of Salernum, and only six were of classical antiquity, viz.,

Pliny (first 1469), Hippocrates (1473) (Hain (*)7247), Galen (1475)

(Hain 7237), Aristotle (1476), Celsus (1478), and Dioscorides

(1478).(**)

(*) This asterisk is used by Hain to indicate that he had seen a

copy.--Ed.

(**) Data added to a manuscript taken from the author's summary

on "Printed Medical Books to 1480" in Transactions of the

Bibliographical Society, London, 1916, XIII, 5-8, revised from

its "News-Sheet" (February, 1914). "Of neither Hippocrates nor

Galen is there an early edition; but in 1473 at Pavia appeared an

exposition of the Aphorisms of Hippoerates, and in 1475 at Padua

an edition of the Tegni or Notes of Galen." Ibid., p. 6.

Osler's unfinished Illustrated Monograph on this subject is now

being printed for the Society of which he was President.--Ed.

The medical profession gradually caught the new spirit. It has been well

said that Greece arose from the dead with the New Testament in the one

hand and Aristotle in the other. There was awakened a perfect passion

for the old Greek writers, and with it a study of the original

sources, which had now become available in many manuscripts. Gradually

Hippocrates and Galen came to their own again. Almost every professor

of medicine became a student of the MSS. of Aristotle and of the Greek

physicians, and before 1530 the presses had poured out a stream of

editions. A wave of enthusiasm swept over the profession, and the best

energies of its best minds were devoted to a study of the Fathers. Galen

became the idol of the schools. A strong revulsion of feeling arose

against the Arabians, and Avicenna, the Prince, who had been clothed

with an authority only a little less than divine, became anathema. Under

the leadership of the Montpellier School, the Arabians made a strong

fight, but it was a losing battle all along the line. This group

of medical humanists--men who were devoted to the study of the old

humanities, as Latin and Greek were called--has had a great and

beneficial influence upon the profession. They were for the most part

cultivated gentlemen with a triple interest--literature, medicine and

natural history. How important is the part they played may be gathered

from a glance at the "Lives" given by Bayle in his "Biographic Medicale"

(Paris, 1855) between the years 1500 and 1575. More than one half of

them had translated or edited works of Hippocrates or Galen; many of

them had made important contributions to general literature, and a large

proportion of them were naturalists: Leonicenus, Linacre, Champier,

Fernel, Fracastorius, Gonthier, Caius, J. Sylvius, Brasavola, Fuchsius,

Matthiolus, Conrad Gesner, to mention only those I know best, form a

great group. Linacre edited Greek works for Aldus, translated works

of Galen, taught Greek at Oxford, wrote Latin grammars and founded

the Royal College of Physicians.(*) Caius was a keen Greek scholar,

an ardent student of natural history, and his name is enshrined as

co-founder of one of the most important of the Cambridge colleges.

Gonthier, Fernel, Fuchs and Mattioli were great scholars and greater

physicians. Champier, one of the most remarkable of the group, was

the founder of the Hotel Dieu at Lyons, and author of books of a

characteristic Renaissance type and of singular bibliographical

interest. In many ways greatest of all was Conrad Gesner, whose mors

inopinata at forty-nine, bravely fighting the plague, is so touchingly

and tenderly mourned by his friend Caius.(2) Physician, botanist,

mineralogist, geologist, chemist, the first great modern bibliographer,

he is the very embodiment of the spirit of the age.(2a) On the flyleaf

of my copy of the "Bibliotheca Universalis" (1545), is written a fine

tribute to his memory. I do not know by whom it is, but I do know from

my reading that it is true:

(*) Cf. Osler: Thomas Linacre, Cambridge University Press,

1908.--Ed.

(2) Joannis Caii Britanni de libris suis, etc., 1570.

(2a) See J. C. Bay: Papers Bibliog. Soc. of America, 1916, X,

No. 2, 53-86.

"Conrad Gesner, who kept open house there for all learned men who came

into his neighborhood. Gesner was not only the best naturalist among the

scholars of his day, but of all men of that century he was the pattern

man of letters. He was faultless in private life, assiduous in study,

diligent in maintaining correspondence and good-will with learned men in

all countries, hospitable--though his means were small--to every scholar

that came into Zurich. Prompt to serve all, he was an editor of other

men's volumes, a writer of prefaces for friends, a suggestor to young

writers of books on which they might engage themselves, and a great

helper to them in the progress of their work. But still, while finding

time for services to other men, he could produce as much out of his own

study as though he had no part in the life beyond its walls."

A large majority of these early naturalists and botanists were

physicians.(3) The Greek art of observation was revived in a study of

the scientific writings of Aristotle, Theophrastus and Dioscorides and

in medicine, of Hippocrates and of Galen, all in the Greek originals.

That progress was at first slow was due in part to the fact that the

leaders were too busy scraping the Arabian tarnish from the pure gold of

Greek medicine and correcting the anatomical mistakes of Galen to bother

much about his physiology or pathology. Here and there among the great

anatomists of the period we read of an experiment, but it was the art of

observation, the art of Hippocrates, not the science of Galen, not the

carefully devised experiment to determine function, that characterized

their work. There was indeed every reason why men should have been

content with the physiology and pathology of that day, as, from a

theoretical standpoint, it was excellent. The doctrine of the four

humors and of the natural, animal and vital spirits afforded a ready

explanation for the symptoms of all diseases, and the practice of the

day was admirably adapted to the theories. There was no thought of, no

desire for, change. But the revival of learning awakened in men at

first a suspicion and at last a conviction that the ancients had left

something which could be reached by independent research, and gradually

the paralytic-like torpor passed away.

(3) Miall: The Early Naturalists, London, 1912.

The sixteenth and seventeenth centuries did three things in

medicine--shattered authority, laid the foundation of an accurate

knowledge of the structure of the human body and demonstrated how its

functions should be studied intelligently--with which advances, as

illustrating this period, may be associated the names of Paracelsus,

Vesalius and Harvey.

PARACELSUS

PARACELSUS is "der Geist der stets verneint." He roused men against the

dogmatism of the schools, and he stimulated enormously the practical

study of chemistry. These are his great merits, against which must be

placed a flood of hermetical and transcendental medicine, some his own,

some foisted in his name, the influence of which is still with us.

"With what judgment ye judge it shall be judged to you again" is the

verdict of three centuries on Paracelsus. In return for unmeasured abuse

of his predecessors and contemporaries he has been held up to obloquy

as the arch-charlatan of history. We have taken a cheap estimate of

him from Fuller and Bacon, and from a host of scurrilous scribblers

who debased or perverted his writings. Fuller(4) picked him out as

exemplifying the drunken quack, whose body was a sea wherein the tide

of drunkenness was ever ebbing and flowing--"He boasted that shortly

he would order Luther and the Pope, as well as he had done Galen and

Hippocrates. He was never seen to pray, and seldome came to Church.

He was not onely skilled in naturall Magick (the utmost bounds whereof

border on the suburbs of hell) but is charged to converse constantly

with familiars. Guilty he was of all vices but wantonnesse: . . . "

(4) Fuller: The Holy and Profane State, Cambridge, 1642, p. 56.

Francis Bacon, too, says many hard things of him.(5)

(5) Bacon: Of the Proficience and Advancement of Learning, Bk.

II, Pickering ed., London, 1840, p. 181. Works, Spedding ed.,

III, 381.

To the mystics, on the other hand, he is Paracelsus the Great, the

divine, the most supreme of the Christian magi, whose writings are too

precious for science, the monarch of secrets, who has discovered the

Universal Medicine. This is illustrated in Browning's well-known poem

"Paracelsus," published when he was only twenty-one; than which there

is no more pleasant picture in literature of the man and of his

aspirations. His was a "searching and impetuous soul" that sought to win

from nature some startling secret--". . . a tincture of force to flush

old age with youth, or breed gold, or imprison moonbeams till they

change to opal shafts!" At the same time with that capacity for

self-deception which characterizes the true mystic he sought to cast

Light on a darkling race; save for that doubt,

I stood at first where all aspire at last

To stand: the secret of the world was mine.

I knew, I felt (perception unexpressed,

Uncomprehended by our narrow thought,

But somehow felt and known in every shift

And change in the spirit,--nay, in every pore

Of the body, even)--what God is, what we are,

What life is--. . .(6)

(6) Robert Browning: Paracelsus, closing speech.

Much has been done of late to clear up his story and his character.

Professor Sudhoff, of Leipzig, has made an exhaustive bibliographical

study of his writings,(7) there have been recent monographs by Julius

Hartmann, and Professors Franz and Karl Strunz,(8) and a sympathetic

summary of his life and writings has been published by the late Miss

Stoddart.(9) Indeed there is at present a cult of Paracelsus. The

hermetic and alchemical writings are available in English in the edition

of A. E. Waite, London, 1894. The main facts of his life you can find

in all the biographies. Suffice it here to say that he was born at

Einsiedeln, near Zurich, in 1493, the son of a physician, from whom

he appears to have had his early training both in medicine and in

chemistry. Under the famous abbot and alchemist, Trithemiusof Wurzburg,

he studied chemistry and occultism. After working in the mines at

Schwatz he began his wanderings, during which he professes to have

visited nearly all the countries in Europe and to have reached India

and China. Returning to Germany he began a triumphal tour of practice

through the German cities, always in opposition to the medical faculty,

and constantly in trouble. He undoubtedly performed many important

cures, and was thought to have found the supreme secret of alchemistry.

In the pommel of his sword he was believed to carry a familiar spirit.

So dominant was his reputation that in 1527 he was called to the chair

of physic in the University of Basel. Embroiled in quarrels after

his first year he was forced to leave secretly, and again began his

wanderings through German cities, working, quarrelling, curing, and

dying prematurely at Saltzburg in 1541--one of the most tragic figures

in the history of medicine.

(7) Professor Sudhoff: Bibliographia Paracelsica, Berlin, 1894,

1899.

(8) R. Julius Hartmann: Theophrast von Hohenheim, Berlin, 1904;

ditto, Franz Strunz, Leipzig, 1903.

(9) Anna M. Stoddart: The Life of Paracelsus, London, John

Murray, 1911.

Paracelsus is the Luther of medicine, the very incarnation of the spirit

of revolt. At a period when authority was paramount, and men blindly

followed old leaders, when to stray from the beaten track in any field

of knowledge was a damnable heresy, he stood out boldly for independent

study and the right of private judgment. After election to the chair at

Basel he at once introduced a startling novelty by lecturing in German.

He had caught the new spirit and was ready to burst all bonds both in

medicine and in theology. He must have startled the old teachers and

practitioners by his novel methods. "On June 5, 1527, he attached a

programme of his lectures to the black-board of the University inviting

all to come to them. It began by greeting all students of the art of

healing. He proclaimed its lofty and serious nature, a gift of God to

man, and the need of developing it to new importance and to new renown.

This he undertook to do, not retrogressing to the teaching of the

ancients, but progressing whither nature pointed, through research into

nature, where he himself had discovered and had verified by prolonged

experiment and experience. He was ready to oppose obedience to old

lights as if they were oracles from which one did not dare to differ.

Illustrious doctor smight be graduated from books, but books made not a

single physician.(10) Neither graduation, nor fluency, nor the knowledge

of old languages, nor the reading of many books made a physician, but

the knowledge of things themselves and their properties. The business

of a doctor was to know the different kinds of sicknesses, their

causes, their symptoms and their right remedies. This he would teach, for

he had won this knowledge through experience, the greatest teacher, and

with much toil. He would teach it as he had learned it, and his lectures

would be founded on works which he had composed concerning inward and

external treatment, physic and surgery."(11) Shortly afterwards, at

the Feast of St. John, the students had a bonfire in front of the

university. Paracelsus came out holding in his hands the "Bible of

medicine," Avicenna's "Canon," which he flung into the flames saying:

"Into St. John's fire so that all misfortune may go into the air with

the smoke." It was, as he explained afterwards, a symbolic act: "What

has perished must go to the fire; it is no longer fit for use: what is

true and living, that the fire cannot burn." With abundant confidence in

his own capacity he proclaimed himself the legitimate monarch, the very

Christ of medicine. "You shall follow me," cried he, "you, Avicenna,

Galen, Rhasis, Montagnana, Mesues; you, Gentlemen of Paris, Montpellier,

Germany, Cologne, Vienna, and whomsoever the Rhine and Danube nourish;

you who inhabit the isles of the sea; you, likewise, Dalmatians,

Athenians; thou, Arab; thou, Greek; thou, Jew; all shall follow me, and

the monarchy shall be mine."(12)

(10) And men have oft grown old among their books

To die case hardened in their ignorance.

--Paracelsus, Browning.

(11) Anna M. Stoddart: Life of Paracelsus, London, 1911, pp.

95-96.

(12) Browning's Paracelsus, London, 1835, p. 206 (note).

This first great revolt against the slavish authority of the schools had

little immediate effect, largely on account of the personal vagaries of

the reformer--but it made men think. Paracelsus stirred the pool as had

not been done for fifteen centuries.

Much more important is the relation of Paracelsus to the new chemical

studies, and their relation to practical medicine. Alchemy, he held, "is

to make neither gold nor silver: its use is to make the supreme

sciences and to direct them against disease." He recognized three

basic substances, sulphur, mercury and salt, which were the necessary

ingredients of all bodies organic or inorganic. They were the basis of

the three principles out of which the Archaeus, the spirit of nature,

formed all bodies. He made important discoveries in chemistry; zinc, the

various compounds of mercury, calomel, flowers of sulphur, among others,

and he was a strong advocate of the use of preparations of iron and

antimony. In practical pharmacy he has perhaps had a greater reputation

for the introduction of a tincture of opium--labdanum or laudanum--with

which he effected miraculous cures, and the use of which he had probably

learned in the East.

Through Paracelsus a great stimulus was given to the study of chemistry

and pharmacy, and he is the first of the modern iatro-chemists. In

contradistinction to Galenic medicines, which were largely derived

from the vegetable kingdom, from this time on we find in the literature

references to spagyric medicines and a "spagyrist" was a Paracelsian who

regarded chemistry as the basis of all medical knowledge.

One cannot speak very warmly of the practical medical writings of

Paracelsus. Gout, which may be taken as the disease upon which he had

the greatest reputation, is very badly described, and yet he has one or

two fruitful ideas singularly mixed with mediaeval astrology; but he

has here and there very happy insights, as where he remarks "nec praeter

synoviam locqum alium ullum podagra occupat."(13) In the tract on

phlebotomy I see nothing modern, and here again he is everywhere

dominated by astrological ideas--"Sapiens dominatur astris."

(13) Geneva ed., 1658, Vol. I, p. 613.

As a protagonist of occult philosophy, Paracelsus has had a more

enduring reputation than as a physician. In estimating his position

there is the great difficulty referred to by Sudhoff in determining

which of the extant treatises are genuine. In the two volumes issued in

English by Waite in 1894, there is much that is difficult to read and

to appreciate from our modern standpoint. In the book "Concerning Long

Life" he confesses that his method and practice will not be intelligible

to common persons and that he writes only for those whose intelligence

is above the average. To those fond of transcendental studies they

appeal and are perhaps intelligible. Everywhere one comes across

shrewd remarks which prove that Paracelsus had a keen belief in the

all-controlling powers of nature and of man's capacity to make those

powers operate for his own good: "the wise man rules Nature, not Nature

the wise man." "The difference between the Saint and the Magus is that

the one operates by means of God, and the other by means of Nature."

He had great faith in nature and the light of nature, holding that man

obtains from nature according as he believes. His theory of the three

principles appears to have controlled his conception of everything

relating to man, spiritually, mentally and bodily; and his threefold

genera of disease corresponded in some mysterious way with the three

primary substances, salt, sulphur and mercury.

How far he was a believer in astrology, charms and divination it is not

easy to say. From many of the writings in his collected works one would

gather, as I have already quoted, that he was a strong believer. On the

other hand, in the "Paramirum," he says: "Stars control nothing in us,

suggest nothing, incline to nothing, own nothing; they are free from

us and we are free from them" (Stoddart, p. 185). The Archaeus, not the

stars, controls man's destiny. "Good fortune comes from ability, and

ability comes from the spirit" (Archaeus).

No one has held more firmly the dualistic conception of the healing art.

There are two kinds of doctors; those who heal miraculously and those

who heal through medicine. Only he who believes can work miracles. The

physician has to accomplish that which God would have done miraculously,

had there been faith enough in the sick man (Stoddart, p. 194). He

had the Hippocratic conception of the "vis medicatrix naturae"--no one

keener since the days of the Greeks. Man is his own doctor and finds

proper healing herbs in his own garden: the physician is in ourselves,

in our own nature are all things that we need: and speaking of wounds,

with singular prescience he says that the treatment should be defensive

so that no contingency from without could hinder Nature in her work

(Stoddart, p. 213).

Paracelsus expresses the healing powers of nature by the word "mumia,"

which he regarded as a sort of magnetic influence or force, and he

believed that anyone possessing this could arrest or heal disease

in others. As the lily breaks forth in invisible perfume, so healing

influences may pass from an invisible body. Upon these views of

Paracelsus was based the theory of the sympathetic cure of disease

which had an extraordinary vogue in the late sixteenth and seventeenth

centuries, and which is not without its modern counterpart.

In the next century, in Van Helmont we meet with the Archaeus everywhere

presiding, controlling and regulating the animate and inanimate bodies,

working this time through agents, local ferments. The Rosicrucians had

their direct inspiration from his writings, and such mystics as the

English Rosicrucian Fludd were strong Paracelsians.(14)

(14) Robert Fludd, the Mystical Physician, British Medical

Journal, London, 1897, ii, 408.

The doctrine of contraries drawn from the old Greek philosophy,

upon which a good deal of the treatment of Hippocrates and Galen was

based--dryness expelled by moisture, cold by heat, etc.--was opposed by

Paracelsus in favor of a theory of similars, upon which the practice of

homeopathy is based. This really arose from the primitive beliefs, to

which I have already referred as leading to the use of eyebright in

diseases of the eye, and cyclamen in diseases of the ear because of its

resemblance to that part; and the Egyptian organotherapy had the same

basis,--spleen would cure spleen, heart, heart, etc. In the sixteenth

and seventeenth centuries these doctrines of sympathies and antipathies

were much in vogue. A Scotchman, Sylvester Rattray, edited in the

"Theatrum Sympatheticum"(15) all the writings upon the sympathies and

antipathies of man with animal, vegetable and mineral substances, and

the whole art of physics was based on this principle.

(15) Rattray: Theatrum Sympatheticum, Norimberge, MDCLXII.

Upon this theory of "mumia," or magnetic force, the sympathetic cure of

disease was based. The weapon salve, the sympathetic ointment, and the

famous powder of sympathy were the instruments through which it acted.

The magnetic cure of wounds became the vogue. Van Helmont adopted these

views in his famous treatise "De Magnetica Vulnerum Curatione,"(16) in

which he asserted that cures were wrought through magnetic influence.

How close they came to modern views of wound infection may be judged

from the following: "Upon the solution of Unity in any part the ambient

air . . . repleted with various evaporations or aporrhoeas of mixt

bodies, especially such as are then suffering the act of putrefaction,

violently invadeth the part and thereupon impresseth an exotic miasm or

noxious diathesis, which disposeth the blood successively arriving at

the wound, to putrefaction, by the intervention of fermentation." With

his magnetic sympathy, Van Helmont expressed clearly the doctrine of

immunity and the cure of disease by immune sera: "For he who has once

recovered from that disease hath not only obtained a pure balsaamical

blood, whereby for the future he is rendered free from any recidivation

of the same evil, but also infallibly cures the same affection in his

neighbour . . . and by the mysterious power of Magnetism transplants

that balsaam and conserving quality into the blood of another." He was

rash enough to go further and say that the cures effected by the relics

of the saints were also due to the same cause--a statement which led to

a great discussion with the theologians and to Van Helmont's arrest for

heresy, and small wonder, when he makes such bold statements as "Let the

Divine enquire only concerning God, the Naturalist concerning Nature,"

and "God in the production of miracles does for the most part walk hand

in hand with Nature."

(16) An English translation by Walter Charleton appeared in 1650,

entitled "A Ternary of Paradoxes."

That wandering genius, Sir Kenelm Digby, did much to popularize this

method of treatment by his lecture on the "Powder of Sympathy."(17) His

powder was composed of copperas alone or mixed with gum tragacanth.

He regarded the cure as effected through the subtle influence of the

sympathetic spirits or, as Highmore says, by "atomicall energy wrought

at a distance," and the remedy could be applied to the wound itself,

or to a cloth soaked in the blood or secretions, or to the weapon that

caused the wound. One factor leading to success may have been that

in the directions which Digby gave for treating the wound (in the

celebrated case of James Howell, for instance), it was to be let alone

and kept clean. The practice is alluded to very frequently by the poets.

In the "Lay of the Last Minstrel" we find the following:

(17) French edition, 1668, English translation, same year. For a

discussion on the author of the weapon salve see Van Helmont, who

gives the various formulas. Highmore (1651) says the "powder is

a Zaphyrian salt calcined by a celestial fire operating in Leo

and Cancer into a Lunar complexion."

But she has ta'en the broken lance,

And wash'd it from the clotted gore,

And salved the splinter o'er and o'er.

William of Deloraine, in trance,

Whene'er she turn'd it round and round,

Twisted, as if she gall'd his wound,

Then to her maidens she did say,

That he should be whole man and sound,

(Canto iii, xxiii.)

and in Dryden's "Tempest" (V, 1) Ariel says:

Anoint the Sword which pierc'd him with the Weapon-Salve,

And wrap it close from Air till I have time

To visit him again.

From Van Helmont comes the famous story of the new nose that dropped off

in sympathy with the dead arm from which it was taken, and the source

of the famous lines of Hudibras. As I have not seen the original story

quoted of late years it may be worth while to give it: "A certain

inhabitant of Bruxels, in a combat had his nose mowed off, addressed

himself to Tagliacozzus, a famous Chirurgein, living at Bononia, that he

might procure a new one; and when he feared the incision of his own arm,

he hired a Porter to admit it, out of whose arm, having first given

the reward agreed upon, at length he dig'd a new nose. About thirteen

moneths after his return to his own Countrey, on a sudden the ingrafted

nose grew cold, putrified, and within few days drops off. To those of

his friends that were curious in the exploration of the cause of this

unexpected misfortune, it was discovered, that the Porter expired,

neer about the same punctilio of time, wherein the nose grew frigid and

cadaverous. There are at Bruxels yet surviving, some of good repute, that

were eye-witnesses of these occurrences."(18)

(18) Charleton: Of the Magnetic Cure of Wounds, London, 1650, p.

13.

Equally in the history of science and of medicine, 1542 is a starred

year, marked by a revolution in our knowledge alike of Macrocosm and

Microcosm. In Frauenburg, the town physician and a canon, now nearing

the Psalmist limit and his end, had sent to the press the studies of a

lifetime--"De revolutionibus orbium coelestium." It was no new thought,

no new demonstration that Copernicus thus gave to his generation.

Centuries before, men of the keenest scientific minds from Pythagoras on

had worked out a heliocentric theory, fully promulgated by Aristarchus,

and very generally accepted by the brilliant investigators of the

Alexandrian school; but in the long interval, lapped in Oriental

lethargy, man had been content to acknowledge that the heavens declare

the glory of God and that the firmament sheweth his handiwork. There

had been great astronomers before Copernicus. In the fifteenth century

Nicholas of Cusa and Regiomontanus had hinted at the heliocentric

theory; but 1512 marks an epoch in the history of science, since for all

time Copernicus put the problem in a way that compelled acquiescence.

Nor did Copernicus announce a truth perfect and complete, not to be

modified, but there were many contradictions and lacunae which the work

of subsequent observers had to reconcile and fill up. For long years

Copernicus had brooded over the great thoughts which his careful

observation had compelled. We can imagine the touching scene in the

little town when his friend Osiander brought the first copy of the

precious volume hot from the press, a well enough printed book. Already

on his deathbed, stricken with a long illness, the old man must have had

doubts how his work would be received, though years before Pope Clement

VII had sent him encouraging words. Fortunately death saved him from the

"rending" which is the portion of so many innovators and discoverers.

His great contemporary reformer, Luther, expressed the view of the day

when he said the fool will turn topsy-turvy the whole art of astronomy;

but the Bible says that Joshua commanded the Sun to stand still, not

the Earth. The scholarly Melanchthon, himself an astronomer, thought

the book so godless that he recommended its suppression (Dannemann,

Grundriss). The church was too much involved in the Ptolemaic system to

accept any change and it was not until 1822 that the works of Copernicus

were removed from the Index.

VESALIUS

THE same year, 1542, saw a very different picture in the far-famed city

of Padua, "nursery of the arts." The central figure was a man not yet in

the prime of life, and justly full of its pride, as you may see from

his portrait. Like Aristotle and Hippocrates cradled and nurtured in an

AEsculapian family, Vesalius was from his childhood a student of nature,

and was now a wandering scholar, far from his Belgian home. But in Italy

he had found what neither Louvain nor Paris could give, freedom in

his studies and golden opportunities for research in anatomy. What an

impression he must have made on the student body at Padua may be judged

from the fact that shortly after his graduation in December, 1537,

at the age of twenty-four, he was elected to the chair of anatomy and

surgery. Two things favored him--an insatiate desire to see and handle

for himself the parts of the human frame, and an opportunity, such as

had never before been offered to the teacher, to obtain material for the

study of human anatomy. Learned with all the learning of the Grecians

and of the Arabians, Vesalius grasped, as no modern before him had done,

the cardinal fact that to know the human machine and its working, it is

necessary first to know its parts--its fabric.

To appreciate the work of this great man we must go back in a brief

review of the growth of the study of anatomy.

Among the Greeks only the Alexandrians knew human anatomy. What their

knowledge was we know at second hand, but the evidence is plain that

they knew a great deal. Galen's anatomy was first-class and was based

on the Alexandrians and on his studies of the ape and the pig. We have

already noted how much superior was his osteology to that of Mundinus.

Between the Alexandrians and the early days of the School of Salernum we

have no record of systematic dissections of the human body. It is even

doubtful if these were permitted at Salernum. Neuburger states that the

instructions of Frederick II as to dissections were merely nominal.

How atrocious was the anatomy of the early Middle Ages may be gathered

from the cuts in the works of Henri de Mondeville. In the Bodleian

Library is a remarkable Latin anatomical treatise of the late thirteenth

century, of English provenance, one illustration from which will suffice

to show the ignorance of the author. Mundinus of Bologna, one of the

first men in the Middle Ages to study anatomy from the subject, was

under the strong domination of the Arabians, from whom he appears to

have received a very imperfect Galenic anatomy. From this date we meet

with occasional dissections at various schools, but we have seen that in

the elaborate curriculum of the University of Padua in the middle of the

fifteenth century there was no provision for the study of the subject.

Even well into the sixteenth century dissections were not common, and

the old practice was followed of holding a professorial discourse,

while the butcher, or barber surgeon, opened the cavities of the body. A

member of a famous Basel family of physicians, Felix Plater, has left

us in his autobiography(19) details of the dissections he witnessed at

Montpellier between November 14, 1552, and January 10, 1557, only eleven

in number. How difficult it was at that time to get subjects is shown by

the risks they ran in "body-snatching" expeditions, of which he records

three.

(19) There is no work from which we can get a better idea of the

life of the sixteenth-century medical student and of the style of

education and of the degree ceremonies, etc. Cumston has given

an excellent summary of it (Johns Hopkins Hospital Bulletin,

1912, XXIII, 105-113).

And now came the real maker of modern anatomy. Andreas Vesalius had a

good start in life. Of a family long associated with the profession,

his father occupied the position of apothecary to Charles V, whom he

accompanied on his journeys and campaigns. Trained at Louvain, he had,

from his earliest youth, an ardent desire to dissect, and cut up mice

and rats, and even cats and dogs. To Paris, the strong school of the

period, he went in 1533, and studied under two men of great renown,

Jacob Sylvius and Guinterius. Both were strong Galenists and regarded

the Master as an infallible authority. He had as a fellow prosector,

under the latter, the unfortunate Servetus. The story of his troubles

and trials in getting bones and subjects you may read in Roth's

"Life."(20) Many interesting biographical details are also to be found

in his own writings. He returned for a time to Louvain, and here he

published his first book, a commentary on the "Almansor" of Rhazes, in

1537.

(20) M. Roth: Andreas Vesalius Bruxellensis, Berlin, 1892. An

excellent account of Vesalius and his contemporaries is given by

James Moores Ball in his superbly printed Andreas Vesalius, the

Reformer of Anatomy, St. Louis, 1910.

Finding it difficult, either in Paris or Louvain, to pursue his

anatomical studies, he decided to go to Italy where, at Venice and

Padua, the opportunities were greater. At Venice, he attended the

practice of a hospital (now a barracks) which was in charge of the

Theatiner Order. I show you a photograph of the building taken last

year. And here a strange destiny brought two men together. In 1537,

another pilgrim was working in Venice waiting to be joined by his six

disciples. After long years of probation, Ignatius Loyola was ready to

start on the conquest of a very different world. Devoted to the sick

and to the poor, he attached himself to the Theatiner Order, and in the

wards of the hospital and the quadrangle, the fiery, dark-eyed, little

Basque must frequently have come into contact with the sturdy young

Belgian, busy with his clinical studies and his anatomy. Both were to

achieve phenomenal success--the one in a few years to revolutionize

anatomy, the other within twenty years to be the controller of

universities, the counsellor of kings, and the founder of the most

famous order in the Roman Catholic Church. It was in this hospital that

Vesalius made observations on the China-root, on which he published a

monograph in 1546. The Paduan School was close to Venice and associated

with it, so that the young student had probably many opportunities of

going to and fro. On the sixth of December, 1537, before he had reached

his twenty-fourth year and shortly after taking his degree, he was

elected to the chair of surgery and anatomy at Padua.

The task Vesalius set himself to accomplish was to give an accurate

description of all the parts of the human body, with proper

illustrations. He must have had abundant material, more, probably, than

any teacher before him had ever had at his disposal. We do not know

where he conducted his dissections, as the old amphitheatre has

disappeared, but it must have been very different from the tiny one

put up by his successor, Fabricius, in 1594. Possibly it was only a

temporary building, for he says in the second edition of the "Fabrica"

that he had a splendid lecture theatre which accommodated more than five

hundred spectators (p. 681).

With Vesalius disappeared the old didactic method of teaching anatomy.

He did his own dissections, made his own preparations, and, when human

subjects were scarce, employed dogs, pigs or cats, and occasionally a

monkey. For five years he taught and worked at Padua. He is known

to have given public demonstrations in Bologna and elsewhere. In the

"China-root" he remarks that he once taught in three universities in one

year. The first fruit of his work is of great importance in connection

with the evolution of his knowledge. In 1538, he published six

anatomical tables issued apparently in single leaves. Of the famous

"Tabulae Anatomicae" only two copies are known, one in the San

Marco Library, Venice, and the other in the possession of Sir John

Stirling-Maxwell, whose father had it reproduced in facsimile (thirty

copies only) in 1874. Some of the figures were drawn by Vesalius

himself, and some are from the pencil of his friend and countryman,

Stephan van Calcar. Those plates were extensively pirated. About this

time he also edited for the Giunti some of the anatomical works of

Galen.(21)

(21) De anatomicis administrationibus, De venarum arterinrumque

dissectione, included in the various Juntine editions of Galen.

We know very little of his private life at Padua. His most important

colleague in the faculty was the famous Montanus, professor of medicine.

Among his students and associates was the Englishman Caius, who lived in

the same house with him. When the output is considered, he cannot have

had much spare time at Padua.

He did not create human anatomy--that had been done by the

Alexandrians--but he studied it in so orderly and thorough a manner

that for the first time in history it could be presented in a way that

explained the entire structure of the human body. Early in 1542 the MS.

was ready; the drawings had been made with infinite care, the blocks for

the figures had been cut, and in September, he wrote to Oporinus urging

that the greatest pains should be taken with the book, that the paper

should be strong and of equal thickness, the workmen chosen for their

skill, and that every detail of the pictures must be distinctly visible.

He writes with the confidence of a man who realized the significance of

the work he had done. It is difficult to speak in terms of moderation of

the "Fabrica." To appreciate its relative value one must compare it with

the other anatomical works of the period, and for this purpose I

put before you two figures from a text-book on the subject that was

available for students during the first half of the sixteenth century.

In the figures and text of the "Fabrica" we have anatomy as we know it;

and let us be honest and say, too, largely as Galen knew it. Time will

not allow me to go into the question of the relations of these two

great anatomists, but we must remember that at this period Galen ruled

supreme, and was regarded in the schools as infallible. And now, after

five years of incessant labor, Vesalius was prepared to leave his

much loved Padua and his devoted students. He had accomplished an

extraordinary work. He knew, I feel sure, what he had done. He knew that

the MSS. contained something that the world had not seen since the great

Pergamenian sent the rolls of his "Manual of Anatomy" among his friends.

Too precious to entrust to any printer but the best--and the best in the

middle of the sixteenth century was Transalpine--he was preparing to go

north with the precious burden. We can picture the youthful teacher--he

was but twenty-eight--among students in a university which they

themselves controlled--some of them perhaps the very men who five years

before had elected him--at the last meeting with his class, perhaps

giving a final demonstration of the woodcuts, which were of an accuracy

and beauty never seen before by students' eyes, and reading his

introduction. There would be sad hearts at the parting, for never had

anyone taught anatomy as he had taught it--no one had ever known anatomy

as he knew it. But the strong, confident look was on his face and with

the courage of youth and sure of the future, he would picture a happy

return to attack new and untried problems. Little did he dream that his

happy days as student and teacher were finished, that his work as an

anatomist was over, that the most brilliant and epoch-making part of his

career as a professor was a thing of the past. A year or more was spent

at Basel with his friend Oporinus supervising the printing of the

great work, which appeared in 1543 with the title "De Humani Corporis

Fabrica." The worth of a book, as of a man, must be judged by results,

and, so judged, the "Fabrica" is one of the great books of the world,

and would come in any century of volumes which embraced the richest

harvest of the human mind. In medicine, it represents the full flower

of the Renaissance. As a book it is a sumptuous tome a worthy setting

of his jewel--paper, type and illustration to match, as you may see for

yourselves in this folio--the chef d'oeuvre of any medical library.

In every section, Vesalius enlarged and corrected the work of Galen.

Into the details we need not enter: they are all given in Roth's

monograph, and it is a chapter of ancient history not specially

illuminating.

Never did a great piece of literary work have a better setting. Vesalius

must have had a keen appreciation of the artistic side of the art of

printing, and he must also have realized the fact that the masters of

the art had by this time moved north of the Alps.

While superintending the printing of the precious work in the winter of

1542-1543 in Basel, Vesalius prepared for the medical school a skeleton

from the body of an executed man, which is probably the earliest

preparation of the kind in Europe. How little anatomy had been studied

at the period may be judged from that fact that there had been

no dissection at Basel since 1531.(22) The specimen is now in the

Vesalianum, Basel, of which I show you a picture taken by Dr. Harvey

Cushing. From the typographical standpoint no more superb volume

on anatomy has been issued from any press, except indeed the second

edition, issued in 1555. The paper is, as Vesalius directed, strong and

good, but it is not, as he asked, always of equal thickness; as a rule

it is thick and heavy, but there are copies on a good paper of a much

lighter quality. The illustrations drawn by his friend and fellow

countryman, van Calcar, are very much in advance of anything previously

seen, except those of Leonardo. The title-page, one of the most

celebrated pictures in the history of medicine, shows Vesalius in

a large amphitheatre (an imaginary one of the artist, I am afraid)

dissecting a female subject. He is demonstrating the abdomen to a group

of students about the table, but standing in the auditorium are elderly

citizens and even women. One student is reading from an open book. There

is a monkey on one side of the picture and a dog on the other. Above

the picture on a shield are the three weasels, the arms of Vesal. The

reproduction which I show you here is from the "Epitome"--a smaller work

issued before (?) the "Fabrica," with rather larger plates, two of which

represent nude human bodies and are not reproduced in the great work.

The freshest and most beautiful copy is the one on vellum which formerly

belonged to Dr. Mead, now in the British Museum, and from it this

picture was taken. One of the most interesting features of the book are

the full-page illustrations of the anatomy of the arteries, veins

and nerves. They had not in those days the art of making corrosion

preparations, but they could in some way dissect to their finest

ramifications the arteries, veins and nerves, which were then spread on

boards and dried. Several such preparations are now at the College of

Physicians in London, brought from Padua by Harvey. The plates of the

muscles are remarkably good, more correct, though not better perhaps, on

the whole, than some of Leonardo's.

(22) The next, in 1559, is recorded by Plater in his

autobiography, who gave a public dissection during three days in

the Church of St. Elizabeth.

Vesalius had no idea of a general circulation. Though he had escaped

from the domination of the great Pergamenian in anatomy, he was still

his follower in physiology. The two figures annexed, taken from one

of the two existing copies of the "Tabulae Anatomica," are unique in

anatomical illustration, and are of special value as illustrating the

notion of the vascular system that prevailed until Harvey's day. I

have already called your attention to Galen's view of the two separate

systems, one containing the coarse, venous blood for the general

nutrition of the body, the other the arterial, full of a thinner, warmer

blood with which were distributed the vital spirits and the vital

heat. The veins had their origin in the liver; the superior vena cava

communicated with the right heart, and, as Galen taught, some blood was

distributed to the lungs; but the two systems were closed, though Galen

believed there was a communication at the periphery between the

arteries and veins. Vesalius accepted Galen's view that there is some

communication between the venous and arterial systems through pores

in the septum of the ventricles, though he had his doubts, and in the

second edition of his book (1555) says that inspite of the authority

of the Prince of Physicians he cannot see how the smallest quantity of

blood could be transmitted through so dense a muscular septum. Two years

before this (1553),(*) his old fellow student, Michael Servetus, had in

his "Christianismi Restitutio" annatomical touch with one another!

(*) See the Servetus Notes in the Osler Anniversary Volumes, New

York, 1919, Vol. II.--Ed.

The publication of the "Fabrica" shook the medical world to its

foundations. Galen ruled supreme in the schools: to doubt him in the

least particular roused the same kind of feeling as did doubts on the

verbal inspiration of the Scriptures fifty years ago! His old teachers

in Paris were up in arms: Sylvius, nostrae aetatis medicorum decus, as

Vesalius calls him, wrote furious letters, and later spoke of him as

a madman (vaesanus). The younger men were with him and he had many

friends, but he had aroused a roaring tide of detraction against which

he protested a few years later in his work on the "China-root," which

is full of details about the "Fabrica." In a fit of temper he threw

his notes on Galen and other MSS. in the fire. No sadder page exists in

medical writings than the one in which Vesalius tells of the burning of

his books and MSS. It is here reproduced and translated.(23) His life

for a couple of years is not easy to follow, but we know that in 1546

he took service with Charles V as his body physician, and the greatest

anatomist of his age was lost in the wanderings of court and campaigns.

He became an active practitioner, a distinguished surgeon, much

consulted by his colleagues, and there are references to many of his

cases, the most important of which are to internal aneurysms, which he

was one of the first to recognize. In 1555 he brought out the second

edition of the "Fabrica," an even more sumptuous volume than the first.

(23) Epistle on China-root, 1546, p. 196. Vesalius may be quoted

in explanation--in palliation:

"All these impediments I made light of; for I was too young to seek

gain by my art, and I was sustained by my eager desire to learn and to

promote the studies in which I shared. I say nothing of my diligence in

anatomizing--those who attended my lectures in Italy know how I spent

three whole weeks over a single public dissection. But consider that in

one year I once taught in three different universities. If I had put

off the task of writing till this time; if I were now just beginning

to digest my materials; students would not have had the use of my

anatomical labours, which posterity may or may not judge superior to

the rechauffes formerly in use, whether of Mesua, of Gatinaria, of some

Stephanus or other on the differences, causes and symptoms of diseases,

or, lastly, of a part of Servitor's pharmacopoeia. As to my notes, which

had grown into a huge volume, they were all destroyed by me; and on the

same day there similarly perished the whole of my paraphrase on the ten

books of Rhazes to King Almansor, which had been composed by me with far

more care than the one which is prefaced to the ninth book. With

these also went the books of some author or other on the formulae and

preparation of medicines, to which I had added much matter of my own

which I judged to be not without utility; and the same fate overtook all

the books of Galen which I had used in learning anatomy, and which I had

liberally disfigured in the usual fashion. I was on the point of leaving

Italy and going to Court; those physicians you know of had made to the

Emperor and to the nobles a most unfavourable report of my books and of

all that is published nowadays for the promotion of study; I therefore

burnt all these works that I have mentioned, thinking at the same time

that it would be an easy matter to abstain from writing for the future.

I must show that I have since repented more than once of my impatience,

and regretted that I did not take the advice of the friends who were

then with me."

There is no such pathetic tragedy in the history of our profession.

Before the age of thirty Vesalius had effected a revolution in anatomy;

he became the valued physician of the greatest court of Europe; but call

no man happy till he is dead! A mystery surrounds his last days. The

story is that he had obtained permission to perform a post-mortem

examination on the body of a young Spanish nobleman, whom he had

attended. When the body was opened, the spectators to their horror saw

the heart beating, and there were signs of life! Accused, so it is said,

by the Inquisition of murder and also of general impiety he only escaped

through the intervention of the King, with the condition that he make a

pilgrimage to the Holy Land. In carrying this out in 1564 he was wrecked

on the island of Zante, where he died of a fever or of exhaustion, in

the fiftieth year of his age.

To the North American Review, November, 1902, Edith Wharton contributed

a poem on "Vesalius in Zante," in which she pictures his life, so

full of accomplishment, so full of regrets--regrets accentuated by the

receipt of an anatomical treatise by Fallopius, the successor to the

chair in Padua! She makes him say:

There are two ways of spreading light; to be

The candle or the mirror that reflects it.

I let my wick burn out--there yet remains

To spread an answering surface to the flame

That others kindle.

But between Mundinus and Vesalius, anatomy had been studied by a group

of men to whom I must, in passing, pay a tribute. The great artists

Raphael, Michael Angelo and Albrecht Durer were keen students of the

human form. There is an anatomical sketch by Michael Angelo in the

Ashmolean Museum, Oxford, which I here reproduce.(*) Durer's famous work

on "Human Proportion," published in 1528, contains excellent figures,

but no sketches of dissections. But greater than any of these, and

antedating them, is Leonardo da Vinci, the one universal genius in

whom the new spirit was incarnate--the Moses who alone among his

contemporaries saw the promised land. How far Leonardo was indebted to

his friend and fellow student, della Torre, at Pavia we do not know,

nor does it matter in face of the indubitable fact that in the

many anatomical sketches from his hand we have the first accurate

representation of the structure of the body. Glance at the three figures

of the spine which I have had photographed side by side, one from

Leonardo, one from Vesalius and the other from Vandyke Carter, who did

the drawings in Gray's "Anatomy" (1st ed., 1856). They are all of the

same type, scientific, anatomical drawings, and that of Leonardo was

done fifty years before Vesalius! Compare, too, this figure of the

bones of the foot with a similar one from Vesalius.(24) Insatiate

in experiment, intellectually as greedy as Aristotle, painter, poet,

sculptor, engineer, architect, mathematician, chemist, botanist,

aeronaut, musician and withal a dreamer and mystic, full accomplishment

in any one department was not for him! A passionate desire for a mastery

of nature's secrets made him a fierce thing, replete with too much

rage! But for us a record remains--Leonardo was the first of modern

anatomists, and fifty years later, into the breach he made, Vesalius

entered.(25)

(*) This plate was lacking among the author's illustrations, but

the Keeper of the Ashmolean Museum remembers his repeatedly

showing special interest in the sketch reproduced in John

Addington Symonds's Life of Michelangelo, London, 1893, Vol. I,

p. 44, and in Charles Singer's Studies in the History and Method

of Science, Oxford, 1917, Vol. I, p. 97, representing Michael

Angelo and a friend dissecting the body of a man, by the light of

a candle fixed in the body itself.--Ed.

(24) He was the first to make and represent anatomical cross

sections. See Leonardo: Quaderni d'Anatomia, Jacob Dybwad,

Kristiania, 1911-1916, Vol. V.

(25) See Knox: Great Artists and Great Anatomists, London, 1862,

and Mathias Duval in Les Manuserits de Leonard de Vince: De

l'Anatomie, Feuillets A, Edouard Rouveyre, Paris, 1898. For a

good account of Leonardo da Vinci see Merejkovsky's novel, The

Forerunner, London, 1902, also New York, Putnam.

HARVEY

LET us return to Padua about the year 1600. Vesalius, who made the

school the most famous anatomical centre in Europe, was succeeded by

Fallopius, one of the best-known names in anatomy, at whose death an

unsuccessful attempt was made to get Vesalius back. He was succeeded in

1565 by a remarkable man, Fabricius (who usually bears the added name

of Aquapendente, from the town of his birth), a worthy follower of

Vesalius. In 1594, in the thirtieth year of his professoriate, he built

at his own expense a new anatomical amphitheatre, which still exists

in the university buildings. It is a small, high-pitched room with six

standing-rows for auditors rising abruptly one above the other. The

arena is not much more than large enough for the dissecting table which,

by a lift, could be brought up from a preparing room below. The study of

anatomy at Padua must have declined since the days of Vesalius if this

tiny amphitheatre held all its students; none the less, it is probably

the oldest existing anatomical lecture room, and for us it has a very

special significance.

Early in his anatomical studies Fabricius had demonstrated the valves in

the veins. I show you here two figures, the first, as far as I know, in

which these structures are depicted. It does not concern us who first

discovered them; they had doubtless been seen before, but Fabricius

first recognized them as general structures in the venous system, and he

called them little doors--"ostiola."

The quadrangle of the university building at Padua is surrounded by

beautiful arcades, the walls and ceilings of which are everywhere

covered with the stemmata, or shields, of former students, many of them

brilliantly painted. Standing in the arcade on the side of the "quad"

opposite the entrance, if one looks on the ceiling immediately above the

capital of the second column to the left there is seen the stemma which

appears as tailpiece to this chapter, put up by a young Englishman,

William Harvey, who had been a student at Padua for four years. He

belonged to the "Natio Anglica," of which he was Conciliarius, and

took his degree in 1602. Doubtless he had repeatedly seen Fabricius

demonstrate the valves of the veins, and he may indeed, as a senior

student, have helped in making the very dissections from which the

drawings were taken for Fabricius' work, "De Venarum Osteolis," 1603.

If one may judge from the character of the teacher's work the sort of

instruction the student receives, Harvey must have had splendid training

in anatomy. While he was at Padua, the great work of Fabricius, "De

Visione, Voce et Auditu" (1600) was published, then the "Tractatus de

Oculo Visusque Organo" (1601), and in the last year of his residence

Fabricius must have been busy with his studies on the valves of the

veins and with his embryology, which appeared in 1604. Late in life,

Harvey told Boyle that it was the position of the valves of the veins

that induced him to think of a circulation.

Harvey returned to England trained by the best anatomist of his day. In

London, he became attached to the College of Physicans, and taking his

degree at Cambridge, he began the practice of medicine. He was elected

a fellow of the college in 1607 and physician to St. Bartholomew's

Hospital in 1609. In 1615 he was appointed Lumleian lecturer to the

College of Physicians, and his duties were to hold certain "public

anatomies," as they were called, or lectures. We know little or nothing

of what Harvey had been doing other than his routine work in the care

of the patients at St. Bartholomew's. It was not until April, 1616, that

his lectures began. Chance has preserved to us the notes of this first

course; the MS. is now in the British Museum and was published in

facsimile by the college in 1886.(26)

(26) William Harvey: Prelectiones Anatomiae Universalis, London,

J. & A. Churchill, 1886.

The second day lecture, April 17, was concerned with a description of

the organs of the thorax, and after a discussion on the structure and

action of the heart come the lines:

W. H. constat per fabricam cordis sanguinem

per pulmones in Aortam perpetuo

transferri, as by two clacks of a

water bellows to rayse water

constat per ligaturam transitum sanguinis

ab arteriis ad venas

unde perpetuum sanguinis motum

in circulo fieri pulsu cordis.

The illustration will give one an idea of the extraordinarily crabbed

hand in which the notes are written, but it is worth while to see the

original, for here is the first occasion upon which is laid down in

clear and unequivocal words that the blood CIRCULATES. The lecture gave

evidence of a skilled anatomist, well versed in the literature from

Aristotle to Fabricius. In the MS. of the thorax, or, as he calls it,

the "parlour" lecture, there are about a hundred references to some

twenty authors. The remarkable thing is that although those lectures

were repeated year by year, we have no evidence that they made any

impression upon Harvey's contemporaries, so far, at least, as to excite

discussions that led to publication. It was not until twelve years

later, 1628, that Harvey published in Frankfurt a small quarto volume

of seventy-four pages,(27) "De Motu Cordis." In comparison with the

sumptuous "Fabrica" of Vesalius this is a trifling booklet; but if not

its equal in bulk or typographical beauty (it is in fact very poorly

printed), it is its counterpart in physiology, and did for that science

what Vesalius had done for anatomy, though not in the same way. The

experimental spirit was abroad in the land, and as a student at Padua,

Harvey must have had many opportunities of learning the technique of

vivisection; but no one before his day had attempted an elaborate piece

of experimental work deliberately planned to solve a problem relating to

the most important single function of the body. Herein lies the special

merit of his work, from every page of which there breathes the modern

spirit. To him, as to Vesalius before him, the current views of the

movements of the blood were unsatisfactory, more particularly the

movements of the heart and arteries, which were regarded as an active

expansion by which they were filled with blood, like bellows with air.

The question of the transmission of blood through the thick septum

and the transference of air and blood from the lungs to the heart were

secrets which he was desirous of searching out by means of experiment.

(27) Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis

in Animalibus, Francofurti, 1628.

One or two special points in the work may be referred to as illustrating

his method. He undertook first the movements of the heart, a task so

truly arduous and so full of difficulties that he was almost tempted to

think with Fracastorius that "the movement of the heart was only to be

comprehended by God." But after many difficulties he made the following

statements: first, that the heart is erected and raises itself up into

an apex, and at this time strikes against the breast and the pulse is

felt externally; secondly, that it is contracted every-way, but more

so at the sides; and thirdly, that grasped in the hand it was felt

to become harder at the time of its motion; from all of which actions

Harvey drew the very natural conclusion that the activity of the heart

consisted in a contraction of its fibres by which it expelled the blood

from the ventricles. These were the first four fundamental facts which

really opened the way for the discovery of the circulation, as it did

away with the belief that the heart in its motion attracts blood into

the ventricles, stating on the contrary that by its contraction it

expelled the blood and only received it during its period of repose or

relaxation. Then he proceeded to study the action of the arteries and

showed that their period of diastole, or expansion, corresponded with

the systole, or contraction, of the heart, and that the arterial pulse

follows the force, frequency and rhythm of the ventricle and is, in

fact, dependent upon it. Here was another new fact: that the pulsation

in the arteries was nothing else than the impulse of the blood within

them. Chapter IV, in which he describes the movements of the auricles

and ventricles, is a model of accurate description, to which little has

since been added. It is interesting to note that he mentions what is

probably auricular fibrillation. He says: "After the heart had ceased

pulsating an undulation or palpitation remained in the blood itself

which was contained in the right auricle, this being observed so long as

it was imbued with heat and spirit." He recognized too the importance of

the auricles as the first to move and the last to die. The accuracy and

vividness of Harvey's description of the motion of the heart have been

appreciated by generations of physiologists. Having grasped this first

essential fact, that the heart was an organ for the propulsion of blood,

he takes up in Chapters VI and VII the question of the conveyance of the

blood from the right side of the heart to the left. Galen had already

insisted that some blood passed from the right ventricle to the

lungs--enough for their nutrition; but Harvey points out, with Colombo,

that from the arrangement of the valves there could be no other view

than that with each impulse of the heart blood passes from the right

ventricle to the lungs and so to the left side of the heart. How

it passed through the lungs was a problem: probably by a continuous

transudation. In Chapters VIII and IX he deals with the amount of blood

passing through the heart from the veins to the arteries. Let me quote

here what he says, as it is of cardinal import:

"But what remains to be said upon the quantity and source of the blood

which thus passes, is of a character so novel and unheard of that I not

only fear injury to myself from the envy of a few, but I tremble lest

I have mankind at large for my enemies, so much doth wont and custom

become a second nature. Doctrine once sown strikes deeply its root, and

respect for antiquity influences all men. Still the die is cast, and my

trust is in my love of truth, and the candour of cultivated minds."(28)

Then he goes on to say:

(28) William Harvey: Exercitatio Anatomica de Motu Cordis et

Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's

facsimile reprint and translation, Canterbury, 1894, p. 48.

"I began to think whether there might not be A MOVEMENT, AS IT WERE, IN

A CIRCLE. Now this I afterwards found to be true; and I finally saw that

the blood, forced by the action of the left ventricle into the arteries,

was distributed to the body at large, and its several parts, in the same

manner as it is sent through the lungs, impelled by the right ventricle

into the pulmonary artery, and that it then passed through the veins and

along the vena cava, and so round to the left ventricle in the manner

already indicated."(29)

(29) Ibid. p. 49.

The experiments dealing with the transmission of blood in the veins

are very accurate, and he uses the old experiment that Fabricius had

employed to show the valves, to demonstrate that the blood in the veins

flows towards the heart. For the first time a proper explanation of the

action of the valves is given. Harvey had no appreciation of how

the arteries and veins communicated with each other. Galen, you may

remember, recognized that there were anastomoses, but Harvey preferred

the idea of filtration.

The "De Motu Cordis" constitutes a unique piece of work in the history

of medicine. Nothing of the same type had appeared before. It is

a thoroughly sensible, scientific study of a definite problem, the

solution of which was arrived at through the combination of accurate

observation and ingenious experiment. Much misunderstanding has arisen

in connection with Harvey's discovery of the circulation of the blood.

He did not discover that the blood moved,--that was known to Aristotle

and to Galen, from both of whom I have given quotations which indicate

clearly that they knew of its movement,--but at the time of Harvey not a

single anatomist had escaped from the domination of Galen's views.

Both Servetus and Colombo knew of the pulmonary circulation, which was

described by the former in very accurate terms. Cesalpinus, a great

name in anatomy and botany, for whom is claimed the discovery of the

circulation, only expressed the accepted doctrines in the following

oft-quoted phrase:

"We will now consider how the attraction of aliment and the process

of nutrition takes place in plants; for in animals we see the aliment

brought through the veins to the heart, as to a laboratory of innate

heat, and, after receiving there its final perfection, distributed

through the arteries to the body at large, by the agency of the spirits

produced from this same aliment in the heart."(30) There is nothing

in this but Galen's view, and Cesalpinus believed, as did all his

contemporaries, that the blood was distributed through the body by the

vena cava and its branches for the nourishment of all its parts.(*) To

those who have any doubts as to Harvey's position in this matter I would

recommend the reading of the "De Motu Cordis" itself, then the various

passages relating to the circulation from Aristotle to Vesalius. Many

of these can be found in the admirable works of Dalton, Flourens,

Richet and Curtis.(31) In my Harveian Oration for 1906(32) I have dealt

specially with the reception of the new views, and have shown how long

it was before the reverence for Galen allowed of their acceptance. The

University of Paris opposed the circulation of the blood for more than

half a century after the appearance of the "De Motu Cordis."

(30) De Plantis, Lib I, cap. 2.

(*) Cesalpinus has also a definite statement of the circlewise

process.--Ed.

(31) J. C. Dalton Doctrines of the Circulation, Philadelphia,

1884; Flourens Histoire de la decouverte de la circulation du

sang, 2d ed., Paris, 1857; Charles Richet Harvey, la circulation

du sang, Paris, 1879; John G. Curtis Harvey's views on the use of

Circulation, etc., New York, 1916.

(32) Osler An Alabama Student and Other Biographical Essays,

Oxford, 1908, p. 295.

To summarize--until the seventeenth century there were believed to

be two closed systems in the circulation, (1) the natural, containing

venous blood, had its origin in the liver from which, as from a

fountain, the blood continually ebbed and flowed for the nourishment of

the body; (2) the vital, containing another blood and the spirits, ebbed

and flowed from the heart, distributing heat and life to all parts. Like

a bellows the lungs fanned and cooled this vital blood. Here and there

we find glimmering conceptions of a communication between these systems,

but practically all teachers believed that the only one of importance

was through small pores in the wall separating the two sides of the

heart. Observation--merely looking at and thinking about things--had

done all that was possible, and further progress had to await the

introduction of a new method, viz., experiment. Galen, it is true, had

used this means to show that the arteries of the body contained blood

and not air. The day had come when men were no longer content with

accurate description and with finely spun theories and dreams. It was

reserved for the immortal Harvey to put into practice the experimental

method by which he demonstrated conclusively that the blood moved in a

circle. The "De Motu Cordis" marks the final break of the modern spirit

with the old traditions. It took long for men to realize the value of

this "inventum mirabile" used so effectively by the Alexandrians--by

Galen--indeed, its full value has only been appreciated within the past

century. Let me quote a paragraph from my Harveian Oration.(33) "To the

age of the hearer, in which men had heard and heard only, had succeeded

the age of the eye in which men had seen and had been content only

to see. But at last came the age of the hand--the thinking, devising,

planning hand, the hand as an instrument of the mind, now re-introduced

into the world in a modest little monograph from which we may date the

beginning of experimental medicine."

(33) Osler: An Alabama Student, etc., pp. 329-330.

Harvey caught the experimental spirit in Italy, with brain, eye and hand

as his only aids, but now an era opened in which medicine was to derive

an enormous impetus from the discovery of instruments of precision. "The

new period in the development of the natural sciences, which reached

its height in the work of such men as Galileo, Gilbert and Kepler, is

chiefly characterized by the invention of very important instruments for

aiding and intensifying the perceptions of the senses, by means of which

was gained a much deeper insight into the phenomena than had hitherto

been possible. Such instruments as the earlier ages possessed were

little more than primitive hand-made tools. Now we find a considerable

number of scientifically made instruments deliberately planned for

purposes of special research, and as it were, on the threshold of the

period stand two of the most important, the compound microscope and

the telescope. The former was invented about 1590 and the latter about

1608."(34) It was a fellow professor of the great genius Galileo who

attempted to put into practice the experimental science of his friend.

With Sanctorius began the studies of temperature, respiration and the

physics of the circulation. The memory of this great investigator has

not been helped by the English edition of his "De Statica Medicina," not

his best work, with a frontispiece showing the author in his dietetic

balance. Full justice has been done to him by Dr. Weir Mitchell in

an address as president of the Congress of Physicians and Surgeons,

1891.(35) Sanctorius worked with a pulsilogue devised for him by

Galileo, with which he made observations on the pulse. He is said

to have been the first to put in use the clinical thermometer. His

experiments on insensible perspiration mark him as one of the first

modern physiologists.

(34) Dannemann: Die Naturwissenschaften in ihrer

Entwickelung..., Vol. II, p. 7, Leipzig, 1911.

(35) See Transactions Congress Physicians and Surgeons, 1891, New

Haven, 1892, II, 159-181.

But neither Sanctorius nor Harvey had the immediate influence upon their

contemporaries which the novel and stimulating character of their work

justified. Harvey's great contemporary, Bacon, although he lost his

life in making a cold storage experiment, did not really appreciate the

enormous importance of experimental science. He looked very coldly upon

Harvey's work. It was a philosopher of another kidney, Rene Descartes,

who did more than anyone else to help men to realize the value of the

better way which Harvey had pointed out. That the beginning of wisdom

was in doubt, not in authority, was a novel doctrine in the world,

but Descartes was no armchair philosopher, and his strong advocacy and

practice of experimentation had a profound influence in directing men to

"la nouvelle methode." He brought the human body, the earthly machine,

as he calls it, into the sphere of mechanics and physics, and he wrote

the first text-book of physiology, "De l'Homme." Locke, too, became the

spokesman of the new questioning spirit, and before the close of the

seventeenth century, experimental research became all the mode. Richard

Lower, Hooke and Hales were probably more influenced by Descartes

than by Harvey, and they made notable contributions to experimental

physiology in England. Borelli, author of the famous work on "The Motion

of Animals" (Rome, 1680-1681), brought to the study of the action of

muscles a profound knowledge of physics and mathematics and really

founded the mechanical, or iatromechanical school. The literature and

the language of medicine became that of physics and mechanics: wheels

and pulleys, wedges, levers, screws, cords, canals, cisterns, sieves and

strainers, with angles, cylinders, celerity, percussion and resistance,

were among the words that now came into use in medical literature.

Withington quotes a good example in a description by Pitcairne, the Scot

who was professor of medicine at Leyden at the end of the seventeenth

century. "Life is the circulation of the blood. Health is its free and

painless circulation. Disease is an abnormal motion of the blood, either

general or local. Like the English school generally, he is far more

exclusively mechanical than are the Italians, and will hear nothing of

ferments or acids, even in digestion. This, he declares, is a purely

mechanical process due to heat and pressure, the wonderful effects of

which may be seen in Papin's recently invented 'digester.' That the

stomach is fully able to comminute the food may be proved by the

following calculation. Borelli estimates the power of the flexors of the

thumb at 3720 pounds, their average weight being 122 grains. Now, the

average weight of the stomach is eight ounces, therefore it can develop

a force of 117,088 pounds, and this may be further assisted by the

diaphragm and abdominal muscles the power of which, estimated in the

same way, equals 461,219 pounds! Well may Pitcairne add that this

force is not inferior to that of any millstone."(36) Paracelsus gave an

extraordinary stimulus to the study of chemistry and more than anyone

else he put the old alchemy on modern lines. I have already quoted his

sane remark that its chief service is in seeking remedies. But there is

another side to this question. If, as seems fairly certain, the Basil

Valentine whose writings were supposed to have inspired Paracelsus was

a hoax and his works were made up in great part from the writings

of Paracelsus, then to our medical Luther, and not to the mythical

Benedictine monk, must be attributed a great revival in the search

for the Philosopher's Stone, for the Elixir of Life, for a universal

medicine, for the perpetuum mobile and for an aurum potabile.(37) I

reproduce, almost at random, a page from the fifth and last part of the

last will and testament of Basil Valentine (London, 1657), from which

you may judge the chemical spirit of the time.

(36) Withington: Medical History from the Earliest Times,

London, 1891, Scientific Press, p. 317.

(37) See Professor Stillman on the Basil Valentine hoax, Popular

Science Monthly, New York, 1919, LXXXI, 591-600.

Out of the mystic doctrines of Paracelsus arose the famous "Brothers of

the Rosy Cross." "The brotherhood was possessed of the deepest knowledge

and science, the transmutation of metals, the perpetuum mobile and

the universal medicine were among their secrets; they were free from

sickness and suffering during their lifetime, though subject finally to

death."(38)

(38) Ferguson: Bibliotheca Chemica, Vol. II, p. 290. For an

account of Fludd and the English Rosicrucians see Craven's Life

of Fludd, Kirkwall, 1902.

A school of a more rational kind followed directly upon the work of

Paracelsus, in which the first man of any importance was Van Helmont.

The Paracelsian Archeus was the presiding spirit in living creatures,

and worked through special local ferments, by which the functions of the

organs are controlled. Disease of any part represents a strike on the

part of the local Archeus, who refuses to work. Though full of fanciful

ideas, Van Helmont had the experimental spirit and was the first chemist

to discover the diversity of gases. Like his teacher, he was in revolt

against the faculty, and he has bitter things to say of physicians. He

got into trouble with the Church about the magnetic cure of wounds, as

no fewer than twenty-seven propositions incompatible with the Catholic

faith were found in his pamphlet (Ferguson). The Philosophus per ignem,

Toparcha in Merode, Royenborch, as he is styled in certain of his

writings, is not an easy man to tackle. I show the title-page of the

"Ortus Medicinae," the collection of his works by his son. As with the

pages of Paracelsus, there are many gems to be dug out. The counterblast

against bleeding was a useful protest, and to deny in toto its utility

in fever required courage--a quality never lacking in the Father of

Modern Chemistry, as he has been called.

A man of a very different type, a learned academic, a professor

of European renown, was Daniel Sennert of Wittenberg, the first to

introduce the systematic teaching of chemistry into the curriculum,

and who tried to harmonize the Galenists and Paracelsians. Franciscus

Sylvius, a disciple of Van Helmont, established the first chemical

laboratory in Europe at Leyden, and to him is due the introduction of

modern clinical teaching. In 1664 he writes: "I have led my pupils

by the hand to medical practice, using a method unknown at Leyden, or

perhaps elsewhere, i.e., taking them daily to visit the sick at the

public hospital. There I have put the symptoms of disease before their

eyes; have let them hear the complaints of the patients, and have asked

them their opinions as to the causes and rational treatment of each

case, and the reasons for those opinions. Then I have given my own

judgment on every point. Together with me they have seen the happy

results of treatment when God has granted to our cares a restoration of

health; or they have assisted in examining the body when the patient has

paid the inevitable tribute to death."(39)

(39) Withington: Medical History from the Earliest Times,

London, 1894, pp. 312-313.

Glauber, Willis, Mayow, Lemery, Agricola and Stahl led up to Robert

Boyle, with whom modern chemistry may be said to begin. Even as late as

1716, Lady Mary Wortley Montagu in Vienna found that all had transferred

their superstitions from religion to chemistry; "scarcely a man of

opulence or fashion that has not an alchemist in his service." To one

scientific man of the period I must refer as the author of the first

scientific book published in England. Dryden sings:

Gilbert shall live till load-stones cease to draw

Or British fleets the boundless ocean awe.

And the verse is true, for by the publication in 1600 of the "De

Magnete" the science of electricity was founded. William Gilbert was a

fine type of the sixteenth-century physician, a Colchester man, educated

at St. John's College, Cambridge. Silvanus Thompson says: "He is beyond

question rightfully regarded as the Father of Electric Science. He

founded the entire subject of Terrestrial Magnetism. He also made

notable contributions to Astronomy, being the earliest English expounder

of Copernicus. In an age given over to metaphysical obscurities and

dogmatic sophistry, he cultivated the method of experiment and of

reasoning from observation, with an insight and success which entitles

him to be regarded as the father of the inductive method. That method,

so often accredited to Bacon, Gilbert was practicing years before

him."(40)

(40) Silvanus P. Thompson: Gilbert of Colchester, Father of

Electrical Science, London, Chiswick Press, 1903, p. 3.