THE DAWN OF MODERN MEDICINE
FROM THE EARLY PART OF THE EIGHTEENTH
CENTURY TO ABOUT 1860
-------
CONTINUATION OF THE ACCOUNT GIVEN IN THE WORK
ENTITLED “THE GROWTH OF MEDICINE”
------------------------------------------------------------------------
PUBLISHED ON THE FOUNDATION
ESTABLISHED IN MEMORY OF
WILLIAM CHAUNCEY WILLIAMS
OF THE CLASS OF 1822, YALE MEDICAL SCHOOL
AND OF
WILLIAM COOK WILLIAMS
OF THE CLASS OF 1850, YALE MEDICAL SCHOOL
------------------------------------------------------------------------
[Illustration:
PORTRAIT OF ANTOINE LAURENT LAVOISIER
The French chemist and biologist who contributed more than anyone
else to our knowledge of the chemistry and physiology of oxygen.
(Copied from the frontispiece of Volume I of Lavoisier’s “Works,”
published by the French Government in 1864.)
]
------------------------------------------------------------------------
THE DAWN OF MODERN
MEDICINE
AN ACCOUNT OF THE REVIVAL OF THE SCIENCE
AND ART OF MEDICINE WHICH TOOK PLACE
IN WESTERN EUROPE DURING THE LATTER
HALF OF THE EIGHTEENTH
CENTURY AND THE FIRST PART
OF THE NINETEENTH
BY
ALBERT H. BUCK, B.A., M.D.
FORMERLY CLINICAL PROFESSOR OF DISEASES OF THE EAR, COLUMBIA
UNIVERSITY, NEW YORK: CONSULTING AURAL SURGEON,
NEW YORK EYE AND EAR INFIRMARY, ETC.
[Illustration]
NEW HAVEN: YALE UNIVERSITY PRESS
LONDON: HUMPHREY MILFORD
OXFORD UNIVERSITY PRESS
MDCCCCXX
------------------------------------------------------------------------
COPYRIGHT, 1920, BY
YALE UNIVERSITY PRESS
------------------------------------------------------------------------
THE WILLIAMS MEMORIAL PUBLICATION FUND
The present volume is the third work published by the Yale University
Press on the Williams Memorial Publication Fund. This Foundation was
established June 15, 1916, by a gift made to Yale University by Dr.
George C. F. Williams, of Hartford, a member of the Class of 1878, Yale
School of Medicine, where three generations of his family studied—his
father, Dr. William Cook Williams, in the Class of 1850, and his
grandfather, Dr. William Chauncey Williams, in the Class of 1822.
------------------------------------------------------------------------
PREFACE
This work is in the main a continuation of the volume entitled “The
Growth of Medicine,” but it is also intended to serve as an
amplification of the latter part of that work, which, owing to various
circumstances that were in large measure beyond my control, lacked
completeness. The most troublesome of these adverse circumstances was
the fact that I had failed, during a recent visit to Europe, to find
those sources of trustworthy information upon which alone such a
narrative could properly be based; and later still, when I made my first
attempts to construct the text of the present volume, I again
encountered the same kind of obstacles, but in an even greater degree,
and was then strongly disposed to abandon the undertaking altogether. At
this juncture of affairs, however, I was much surprised and pleased to
receive from Mrs. Charles F. Norton, the librarian of Transylvania
College at Lexington, Ky., a letter in which she stated that the college
had in its possession a large collection of medical works which had been
purchased at Paris, France, in 1819, at which period of its history the
institution bore the title of Transylvania University and possessed a
flourishing medical department; and that the president of the
institution would be happy to extend to me every possible facility for
utilizing this great mass of historical material. Shortly afterwards, in
reply to my request that I might be furnished with a partial list of the
books contained in this collection, in order that I might determine how
many of them related to the period in the history of French medicine in
which I was at that time particularly interested,—the period, mainly,
from about 1760 to 1830,—I received a card catalogue of the titles of
over 100 French, English and Latin treatises. This information removed
all doubts from my mind concerning the wisdom of my visiting Lexington,
and I accordingly signified my prompt acceptance of the cordial
invitations extended to me by President Crossfield.
As I write these lines I am prompted to add the further statement that
during my stay at Lexington, which covered a period of seven months, I
received every assistance from the Transylvania College authorities that
I could possibly desire; and in particular I wish to express my deep
sense of gratitude to the librarian, Mrs. Norton, for the interest which
she manifested in my work and for the valuable assistance which she
rendered in hastening its completion.
Cuvier, the celebrated naturalist, in a memoir which he read before the
Royal Institute of France, makes the following statement: “It is not
through a perusal of the insufficient extracts that are commonly made
from the published works of distinguished men, nor through the
incomplete indications which the recital of their discoveries may
furnish, that we derive the greatest pleasure from the eulogies
pronounced after the death of these men. This desirable result is more
likely to be obtained when we are made intimately acquainted with their
individual traits of character,—when we are, so to speak, permitted to
know these men in a social way; when we are given the opportunity of
contemplating, close at hand, their distinct qualities, their virtues,
yes, even their faults,—provided the facts are plainly stated by one who
is skilled in such portraiture. Furthermore, the reader is sure to
derive the greatest pleasure, and also to be the most benefited, when
every page of the eulogy furnishes evidence of the genuine happiness and
wonderful serenity which characterize the lives of those who devote
themselves to the culture of the sciences. Compare these men with those
who have been intent on securing glory through devastating the world,
and note how frequently they live to be septuagenarians or even
octogenarians.” Deeply impressed by the wisdom of the advice thus
briefly given by the celebrated French naturalist, I have striven, in
the following chapters, to act upon it as circumstances might permit.
After making several unsuccessful attempts to classify my chapters
according to the special fields in which the different men attained
distinction, I came to the conclusion that the difficulties which stand
in the way of adopting such a classification are well-nigh
insurmountable; and chief among these difficulties may be mentioned the
fact that many of the leading physicians attained distinction in two or
more different fields. Botany, for example, was frequently combined with
anatomy and surgery; chemistry with physiology; and so on. On the whole,
therefore, it seemed better to rest satisfied, wherever this was found
to be practicable, with the simple subdivision according to geographical
districts—viz., Northern and Central Germany, Austria, Italy, France,
Switzerland and England.
The relatively few Americans who played an important part in advancing
the science and art of medicine during the latter half of the eighteenth
century and the early part of the nineteenth make it preferable, as it
seems to me, to omit all reference to them in the present work, leaving
to the writer of a volume devoted to modern medicine, the duty of
honoring their achievements.
ALBERT H. BUCK.
Cornwall, Orange County, N. Y.
October 3, 1919.
------------------------------------------------------------------------
CONTENTS
PAGE
Preface ix
BOOK I
THÉOPHRASTE RENAUDOT, PHYSICIAN, FOUNDER OF THE FIRST FRENCH NEWSPAPER
Chapter I. Théophraste Renaudot, Physician, 3
Philanthropist, and Founder of the First French
Newspaper
BOOK II
STATE OF MEDICINE IN WESTERN EUROPE AT THE BEGINNING OF THE EIGHTEENTH
CENTURY
Chapter II. Low State of Medical Affairs in 15
Germany at the Beginning of the Eighteenth
Century
Chapter III. Physicians who Attained Distinction 18
in Some of the Departments of Medicine during
the First Half of the Eighteenth Century
Chapter IV. Distinguished Swiss Physicians who 34
Played a Prominent Part in the Development of
the Science and Art of Medicine in Germany
Chapter V. The Earliest Publication in Europe of a 43
Systematic Treatise on Hygiene, Public Health
and Medico-Legal Science
Chapter VI. Two Eminent German Surgeons of the 48
Pre-Antiseptic Period
Chapter VII. A General Survey of German Medicine 52
at the End of the Eighteenth Century
BOOK III
THE VIENNA SCHOOL OF MEDICINE
Chapter VIII. Gerhard Van Swieten 59
Chapter IX. Anton Stoerck, Van Swieten’s 71
Successor, and the Progress of Medical Affairs
at Vienna under the Management of Joseph II
Chapter X. Prochaska, Hyrtl and Rokitansky, Three 79
of the Most Distinguished Teachers at the
Medical School of Vienna during the Early Part
of the Nineteenth Century
BOOK IV
MEDICINE IN ITALY
Chapter XI. Baglivi, Morgagni, Scarpa, 91
Spallanzani, Tissot and Galvani; Italy’s most
Illustrious Physicians during the Eighteenth
Century
BOOK V
SMALL-POX, ONE OF THE WORLD’S GREATEST SCOURGES
Chapter XII. Measures Adopted for the Control of 107
Small-Pox; Inoculation, Vaccination
BOOK VI
AWAKENING OF THE CHEMISTS, PHYSIOLOGISTS AND PATHOLOGISTS
Chapter XIII. The English and French Chemists 119
Contribute Their Share toward the Advance of
Medical Knowledge
BOOK VII
MEDICINE IN ENGLAND
Chapter XIV. English Leaders in Medicine and 129
Surgery during the Eighteenth and Early
Nineteenth Centuries (First Group)
Chapter XV. English Leaders in Medicine and 139
Surgery (Second Group)
Chapter XVI. English Leaders in Medicine and 150
Surgery (Second Group continued)
BOOK VIII
MEDICINE IN FRANCE
Chapter XVII. Bordeu and Bichat; The Beginning of 159
Experimental Physiology and Experimental
Pathology in France
BOOK IX
MEDICINE AT THE HEIGHT OF THE FRENCH REVOLUTION
Chapter XVIII. Types of French Physicians who 171
Flourished about the Time of the Reign of Terror
Chapter XIX. Laënnec and the Invention of the 195
Modern Method of Auscultation; Paul-Joseph
Barthez
Chapter XX. Early Studies of the Disease now 202
Universally called Typhoid Fever: Bretonneau
BOOK X
BROUSSAIS AND BROUSSAISM
Chapter XXI. The Harmful Effects of Broussais’ 207
Teaching
BOOK XI
THE GOLDEN AGE OF SURGERY IN FRANCE
Chapter XXII. J. L. Petit, of Paris, and his 215
Contemporaries in Surgery—Sabatier, Chopart,
Desault and Dupuytren
Chapter XXIII. Workers in Special Departments of 230
Surgery: Demours, Descemet, Delpech, Fauchard,
Jourdain, Gariot
BOOK XII
DESGENETTES AND LARREY, FRANCE’S MOST CELEBRATED MILITARY SURGEONS
Chapter XXIV. Military Surgery in France, as 241
represented by Desgenettes and Baron Larrey
BOOK XIII
A FEW OF THE IMPORTANT HOSPITALS AND THE PRINCIPAL ORGANIZATIONS IN
PARIS FOR TEACHING MEDICINE AND MIDWIFERY
Chapter XXV. Hospital of “La Maternité,” the Great 253
French Midwifery School
Chapter XXVI. Further Details Concerning the Paris 258
Faculté de Médecine and Concerning some of the
Larger Hospitals of Paris
Chapter XXVII. Armand Trousseau, one of the last 265
of France’s Great Clinical Teachers
List of the More Important Authorities Consulted 271
General Index 277
Footnotes 300
------------------------------------------------------------------------
LIST OF ILLUSTRATIONS
Portrait of Antoine Laurent Lavoisier, the French Frontispiece
chemist and biologist who contributed more than
anyone else to our knowledge of the chemistry
and physiology of oxygen. (Copied from the
frontispiece of Volume I of Lavoisier’s “Works,”
published by the French Government in 1864.)
Loudun. This photograph, which was taken from one 4
of the highest points in the village of Loudun,
shows its elevated position above the
surrounding country and affords a bird’s-eye
view of the adjacent river, the Martray.
(Courtesy of Monsieur le Pasteur Paul Barnaud,
of Sainte Foy la Grande [Gironde], France.)
Cardinal Duc de Richelieu. (From a portrait 6
engraved on copper by Nanteuil in 1655.)
Statue of Théophraste Renaudot at Loudun, France. 8
(Courtesy of Monsieur le Pasteur Paul Barnaud,
of Sainte Foy la Grande [Gironde], France.)
Hufeland. (From Eugen Hollaender’s “_Medizin und 28
Plastik_,” by permission.)
Albrecht von Haller 34
Vignette from the title-page of Haller’s 36
“_Elementa Physiologiae_,” Lausanne, 1757
Gerard Freyherr Van Swieten 60
Medal commemorating the discovery of vaccination. 108
(From Eugen Hollaender’s “_Medizin und
Plastik_,” by permission.)
Edward Jenner. (Copied from Thomas J. Pettigrew’s 110
“Medical Portrait Gallery,” London, 1838. The
original portrait was painted by Sir Thomas
Lawrence, Royal Academy.)
Sir Astley Cooper. (Copied from a print in the 136
possession of the New York Academy of Medicine.)
William Hunter. (Copied from Thomas J. Pettigrew’s 140
“Medical Portrait Gallery,” Fisher & Son,
London, 1838. The original portrait was painted
by Pyne; the engraving was done by J. Thomson.)
John Hunter. (Copied from Thomas J. Pettigrew’s 144
“Medical Portrait Gallery,” London, 1838. The
original portrait was painted by Sir Joshua
Reynolds; the engraving was done by G. H.
Adcock.)
Sir Benjamin Collins Brodie, Bart., F.R.S., 148
Sergeant Surgeon to the Queen. (Copied from
Thomas J. Pettigrew’s “Medical Portrait
Gallery,” London, 1838. The original portrait
was painted by H. Room; the engraving was done
by J. Brain.)
Sir Charles Bell. (Copied from a print in the 154
possession of the New York Academy of Medicine.)
Bichat 162
Costume worn by Paris physicians in the eighteenth 172
century. (From Alfred Franklin’s “_La Vie Privée
d’Autrefois_,” Paris, 1892.)
Gaspard Laurent Bayle 182
A candidate for the degree of “Doctor of Medicine” 184
defending his thesis before the examining
committee of the Paris Faculty of Medicine.
(From “_La Vie Universitaire_,” Paris, 1918.)
Corvisart. (Copied from an old French print in the 188
possession of the New York Academy of Medicine.)
Laënnec. (Copied from an old French print in the 196
possession of the New York Academy of Medicine.)
The _Faculté de Médecine_ and the Cathedral at 198
Montpellier, France. (Courtesy of Monsieur le
Pasteur Paul Barnaud, of Sainte Foy la Grande
[Gironde], France.)
The “Court of Honor” of the _Faculté de Médecine_ 200
at Montpellier, France. (Courtesy of Monsieur le
Pasteur Paul Barnaud, of Sainte Foy la Grande
[Gironde], France.)
Montpellier. Vestibule of the _Faculté de 202
Médecine_ at Montpellier, France. (Courtesy of
Monsieur le Pasteur Paul Barnaud, of Sainte Foy
la Grande [Gironde], France.)
Charles A. P. Louis 204
Broussais 208
Jean-Louis Petit 216
Dupuytren 226
Desgenettes 242
Baron Larrey 244
Eighteenth-century plan showing the relations of 258
the Paris _École de Médecine_ to _Hôtel-Dieu_,
the Cathedral of Nôtre Dame and the River Seine.
(Reduced copy of the cut printed in Franklin’s
“_La Vie Privée d’Autrefois_,” Paris, 1892.)
Side of the Paris _Faculté de Médecine_ which 260
fronts on the _Rue de l’École de Médecine_.
(From “_La Vie Universitaire_.”)
View of the former _École de Médecine_ since it 260
has been incorporated with the new structures of
the _Faculté de Médecine_. (From _“La Vie
Universitaire.”_)
Musée Dupuytren. Formerly the refectory of the 260
Convent of the Cordeliers (Franciscans), in the
fifteenth century. (From “_La Vie
Universitaire_.”)
Device of the _École de Médecine de Paris_. 262
(Adopted by the Faculty in 1597.) (Three storks,
each holding a twig of origanum in its beak; and
at the top of the design the motto “_Urbi et
Orbi Salus_” [Health to the City and to all the
World].)
Hôpital Saint-Louis, Paris. Planned and drawn by 264
Claude Chatillon, architect, in 1608. (Copied
from Tenon’s “_Mémoires sur les Hôpitaux de
Paris_,” Paris, 1816; reduced about one-half.)
Trousseau 266
Velpeau. A contemporary of Trousseau and one of 268
France’s most distinguished surgeons. (Copied
from a print in the possession of Transylvania
College, Lexington, Kentucky.)
------------------------------------------------------------------------
BOOK I
FOUNDATION OF THE FIRST NEWSPAPER IN PARIS, FRANCE, AND THE
ESTABLISHMENT OF PRIVATE AGENCIES FOR AIDING THE POOR
------------------------------------------------------------------------
CHAPTER I
THÉOPHRASTE RENAUDOT, PHYSICIAN, PHILANTHROPIST, AND FOUNDER OF THE
FIRST FRENCH NEWSPAPER (1586–1653)
_Prefatory Remarks._—As the present volume purports to deal with events
that occurred chiefly during the eighteenth century, the reader may
think it strange that I should introduce here a sketch which relates to
a physician whose life covers a period nearly one century earlier. My
reason for departing, in this instance, from the proper chronological
order, in the arrangement of my text, is of a twofold nature. In the
first place, I did not discover Gilles de la Tourette’s interesting
memoir—almost the only satisfactory source of information available
concerning Renaudot—until about February 1, 1918—that is, nearly one
year after “The Growth of Medicine” had been published; and, second, on
looking over the principal treatises on the history of medicine, I
failed to find any adequate account of the remarkable work accomplished
by Renaudot. Puschmann, so far as I have been able to learn, is the only
authority who gives this great philanthropist due credit for the
important part which he played in reflecting honor upon our profession.
* * * * *
THÉOPHRASTE RENAUDOT was born at Loudon, a small town in Western France,
picturesquely situated on a high hill about thirty miles northwest of
Poitiers. His parents, who were wealthy Protestants, died while he was
still a mere lad. Théophraste, who inherited the entire fortune left by
his parents, developed at a remarkably early age strong humanitarian
ideas, and it was under the stimulus of these that he shaped his course
in life. With a clear idea of the kind of training that would best fit
him for the work which he proposed to undertake, he decided to study
medicine, as this career, better than any other, would enable him to
accomplish his purpose. Accordingly he went to Montpellier, took the
regular course of instruction in the university, and received the degree
of Doctor of Medicine in 1606, before he had reached his twentieth year.
Recognizing the fact that a physician should be of a certain age before
he can reasonably expect to command the confidence of his fellowmen, he
decided to utilize the time following his graduation in visiting some of
the more important capitals of Europe. The first country which he
visited was Italy, where he undoubtedly gained some familiarity with the
manner in which the _monts-de-piété_ (the prototypes of our modern
pawnbrokers’ shops) were managed under the guiding control of the popes.
It is also highly probable that he visited in turn the universities of
Holland and Belgium as well as the two great English universities—Oxford
and Cambridge. Then, upon his return to France, he went to Paris and
began the study of chemistry at the Collège de Saint-Côme. During his
stay in the French metropolis, he was made painfully aware of the
prevalence of poverty, the streets being filled everywhere with
shameless beggars, and Hôtel-Dieu, the great city hospital, being
overcrowded with the sick, among whom were large numbers of children
affected with contagious diseases and infants starving to death from
lack of wet-nurses. The first thought that occurred to the practical
mind of Renaudot was to find work for many of these poor people; but
when he set about doing this he at once encountered many obstacles; and
finally, in despair over his lack of success, was forced to abandon
further efforts in this direction and return to his home in Loudon.
While there, he frequently met the influential Capucin Monk Leclerc du
Tremblay, commonly known as his “Gray Eminence,” and through him he was
brought to the notice of Cardinal Richelieu, then or soon afterward,
Secretary of State of Marie de Médicis, the queen-mother of Louis XIII.
Although the cardinal, for political reasons, antagonized the Huguenots,
he personally entertained no unfriendly feelings toward men of the
Protestant faith, and consequently he was quite prepared to aid Renaudot
when he laid before him, as he did shortly after his return to Paris,
his schemes for the betterment of the poor in that great city. One of
these schemes called for the establishment of a “_bureau d’adresse ou de
rencontre_,” an office depot where, by the payment of three sous,
anybody was entitled to have the address of his place of business
entered upon the registers of the bureau; and where also employer and
employee might meet for arranging terms. If any person wished to learn
the address of any given place of business, the desired information
would be furnished upon the payment of a fee of the same value; but _no
charge whatever was to be made in the case of a poor person_. This
scheme proved a complete success in a very short time. Then, as a
further step in the development of his _bureau_, Renaudot joined what he
termed “_ventes à grâce troque ou rachapt_”—that is, “sales with the
privilege of exchange or redemption.” This was the first step toward the
establishment of his “_mont-de-piété_,” an institution which was not
fully organized by him at Paris until 1637. The tax upon loans was fixed
at 3 per cent—just enough to pay the expenses of running the bureau. His
motto was: “Loan money without expectation of profit.” His solution of
the social problem was summed up in the following aphorism: “In every
organized community or state the rich shall afford aid to the poor, all
harmony between the two classes ceasing when one of them grows richer at
the expense of the other.”
[Illustration:
Loudun. This photograph, which was taken from one of the highest
points in the village of Loudun, shows its elevated position above
the surrounding country and affords a bird’s-eye view of the
adjacent river, the Martray. (Courtesy of Monsieur le Pasteur Paul
Barnaud, of Sainte Foy la Grande [Gironde], France.)
]
At the time when Renaudot came to Paris, there existed no such thing as
the “_Journal_”—that is, a printed periodical such as he contemplated
and afterward founded. At an interview with Cardinal Richelieu, the
Secretary of State of Louis XIII., Renaudot proposed that all the news
received from the outside world, the king’s edicts, and treaties made
with other nations should be brought together and published at stated
intervals in a single printed sheet. The cardinal at once saw how
important the proposed journal would be for his own interest, especially
if its management were intrusted to a man who agreed with him in regard
to political questions. Then, in addition, the mere fact that it was an
official sheet, the only strictly French periodical, would be of special
value at that moment, when the princes of the blood were forming
alliances with the enemy. So, on May 30, 1631, Louis XIII. granted to
Renaudot “the privilege to make, print and sell, through any agent whom
he might select and wherever it seemed to him best to sell copies, the
news, the official appointments and accounts of all events occurring
both within and outside the kingdom.” The first number of the “_Gazette
de France_”—which was the name that Renaudot gave to his
periodical—appeared on the day mentioned above. The price at which this
sheet of four pages sold was two _liards_.[1]
One year later, the size of the Gazette was increased by the addition of
four separate pages which bore the title, “_Nouvelles_,” and
simultaneously the price of the entire journal (8 pages) was increased
to one sou. It is scarcely necessary to state that the Gazette was
directly inspired by Richelieu, and that even the king occasionally took
a hand in editing it. Gilles de la Tourette, the author of the memoir
from which I have compiled the present brief sketch, says that he
examined all the issues of the Gazette from 1631 to 1653 but failed to
find in them a single _réclame_—advertisement or editorial puff.
From the very day on which it was first published, the Gazette proved a
brilliant success. I should have mentioned, at the beginning of this
sketch, the fact that for a certain length of time Renaudot contributed
liberally from his own funds toward the support of his pet schemes of
benevolence, but it does not appear, in the account given by de la
Tourette, whether the Gazette enterprise should not be counted as one of
these schemes. At the same time, the thought naturally suggests itself
that this physician’s motive in advocating the publishing of an official
newspaper like the Gazette was probably a strong desire to win for his
humanitarian schemes the strong support which the Cardinal and the King
would be able to grant. Whether this be true or not, the idea of
creating an official newspaper under the protection of the highest
authority in France certainly showed far-sighted wisdom on the part of
Renaudot. In 1640,—_i.e._, nine years after the founding of the Gazette
as an official dispenser of political and civic news,—Renaudot changed
its scope by adding to it the character of a medical journal. After
1640, therefore, the Gazette may rightly be classed as representing the
first attempt to publish a medical periodical in France.
[Illustration:
CARDINAL DUC DE RICHELIEU
(From a portrait engraved on copper by Nanteuil in 1655.)
]
Another important feature was added by Renaudot to his philanthropic
scheme in this same year 1640. He obtained from the King a decree
authorizing him to establish a “_Bureau de Consultations Charitables
pour les Pauvres Malades_.” The manner in which this Bureau was to be
conducted may be briefly explained in the following words. At certain
fixed hours fifteen physicians, all of them friends of the founder, and
a smaller number of apothecaries presented themselves at the Bureau,
where, seated at a few separate tables, the physicians listened to the
statements made by the poor people who had come there in the hope of
obtaining relief from their maladies. In the simpler cases, a single
physician was fully equal to the task of prescribing whatever the
patient’s condition called for, but in those of a more obscure nature,
two or three of the physicians present joined in a consultation. After
the question of a suitable treatment had been decided, one of the
apothecaries in attendance prepared the remedy or remedies which had
been prescribed, and at the same time a written statement of the
diagnosis was handed to the patient. If the ailment happened to be of a
surgical nature, the measures required for its treatment were carried
out on the spot. Some of the patients who presented themselves at the
Bureau were easily able to pay for professional advice; and, when such a
person appeared, an opportunity was afforded for dropping into a
suitable box the fee which he or she was disposed to give. This money
was utilized in paying for the remedies furnished the poor. In
exceptional cases, it was perfectly evident that drugs alone could not
afford the desired relief; the need was rather for more and better food.
Fully realizing this need, and acting under his strongly benevolent
impulses, Renaudot not infrequently placed money in the hands of these
suffering dispensary patients when they were about to return to their
homes. The exact amount of these gifts is not known, but they must in
the aggregate have been large; for his biographer says that, in addition
to the sums which his more prosperous patients placed in his hands for
the benefit of the poor, he contributed annually out of his own purse,
toward the maintenance of these free consultations, the sum of 2,000
livres (the “livre” being of about the same value as the franc). The
success of the Bureau was so great that in the course of a few months it
became necessary that a certain number of physicians should be at the
consulting rooms of the institution at all times during the day.
As a natural result of this increase in the Bureau’s popularity the
celebrity of Renaudot also increased, until it extended to every part of
the kingdom; and, as a further result, the institution itself now began
to take on the character of a school for clinical instruction—an
entirely new feature; for at that period no facilities of this kind were
provided by the Paris Faculty of Medicine. When Renaudot observed this
new and unexpected development of the work carried on at the Bureau he
petitioned the King for permission to erect, at his own expense, in the
Faubourg St. Antoine, the most populous quarter of the City of Paris, a
“_Hostel des Consultations Charitables_”—in other words, a free hospital
for the poor.
[Illustration:
Statue of Théophraste Renaudot at Loudun, France. (Courtesy of
Monsieur le Pasteur Paul Barnaud, of Sainte Foy la Grande [Gironde],
France.)
]
Up to the year 1638 Renaudot had got along very amicably with the Paris
Faculty. He had often consulted with them and he had entered the names
of his two sons, Isaac and Eusebius, as students at the medical school.
Furthermore, there could not have existed any prejudice against him on
religious grounds as—upon the advice of Richelieu and Father Joseph
(Leclerc du Tremblay, or “His Gray Eminence”)—his two sons had been
educated in the Roman Catholic faith. It appears, however, that these
favorable considerations were not strong enough to prevent professional
jealousy, on the part of the Paris physicians, from setting to work to
undermine all Renaudot’s good work. The real truth—viz., that the
newcomer’s success was robbing them of some of their paying practice—was
not confessed by these men openly, but instead they objected to his
having, with the King’s permission (granted in 1640), established
furnaces for the manufacture of chemical remedies. They also claimed
that he was injuring the profession of medicine through his doctrine
that good effects were obtainable from the employment of both opium and
antimony as internal remedies, and also through his maintenance of the
new doctrine (1616) of the circulation of the blood. Were not these
professional sins, they claimed, sufficiently heinous to justify them in
summoning him before the magistrates as an impostor? They believed that
they were fully justified in so doing; and accordingly they proceeded
without further delay to bring suit against Renaudot.
It would require much additional space to furnish here even a condensed
account of the events which characterized this disgraceful attack by the
Paris Faculty—and especially by Guy Patin, who was at that time its
Dean—against Renaudot, and I have therefore no hesitation in omitting
all but one or two further details of this part of Renaudot’s history.
In the first place, Cardinal Richelieu and the King stood firmly by
Renaudot to the very end; and, on July 14, 1641, the King’s Council
condemned the Faculty on all points of their charge, and in this manner
granted complete authorization to Renaudot’s work. He himself,
notwithstanding the great victory which he had won over his unscrupulous
enemies, all of them physicians of high social position, resumed his
efforts to win them over to a friendly attitude—not toward himself
individually, but toward the benevolent schemes which he was doing his
best to establish on a firm footing. All his efforts, however, toward
pacification proved of no avail.
Not long afterward Renaudot’s two sons, both of whom had by this time
completed the regular course of studies at the Medical Schools, made a
respectful request to the Faculty for permission to appear before them
for the examination to which all candidates for the degree of Doctor of
Medicine were obliged to submit. In the meantime, as if to show his
approval of the request which Renaudot’s sons had made, Richelieu had
taken Eusebius with him as his physician-in-ordinary when he joined
Louis XIII. at the seat of war in the southern part of France. But
neither this kindly act on the part of the Cardinal, nor any of the
other efforts made by Renaudot’s friends in behalf of his two sons,
seemed to make any impression upon the Faculty. They refused point blank
to grant the desired opportunity for an examination. As a last resort,
Isaac appealed to Parliament “to issue a decree to the effect that the
Faculty of Medicine must confer the degree of M.D. on both Isaac and
Eusebius Renaudot _within fifteen days_; and declaring that, if the
decree should not be obeyed within the prescribed limits of time, the
decree itself should serve as full equivalent for the title in
question.” The Faculty duly entered the decree upon their registers, but
in secret they determined that the two Renaudot brothers should be
excluded from all their official meetings. Théophraste Renaudot
protested and the Faculty of the University of Montpellier pleaded
warmly in his behalf, but it was of no avail. After the death of
Richelieu the Paris Faculty had no difficulty in thwarting nearly all
the excellent schemes of Renaudot. He was obliged to abandon the plan of
building, at his own expense, a hospital, and his two sons were not
permitted to practice medicine in Paris. He continued, however, to edit
the Gazette up to the time of his death in 1653.
Gilles de la Tourette, in his interesting memoir, makes the following
reflection upon the career of this pioneer journalist:—“All the innocent
inventions of this benefactor of humanity are prospering to-day. In
addition to his plan for building a hospital, he was the first to
organize the whole scheme of Public Assistance—viz., charitable
consultations (not unlike our dispensary work) and gratuitous visits at
the residences of the poor. And, in addition to these, he introduced the
_Monts-de-Piété_ into Paris and also his Bureau of Addresses of exchange
and redemption. To this man whose guiding maxim was ‘Lend money to the
poor without expecting any return,’ posterity owes some reparation, and
I hope that soon it will be possible to erect in one of our public
squares a monument that will perpetuate the memory of the greatest
philanthropist of the seventeenth century.”[2]
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BOOK II
MEDICINE IN NORTHERN AND CENTRAL GERMANY DURING THE EIGHTEENTH CENTURY
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CHAPTER II
LOW STATE OF MEDICAL AFFAIRS IN GERMANY AT THE BEGINNING OF THE
EIGHTEENTH CENTURY
The intellectual activity of Germany was very low during the first half
of the eighteenth century, and this statement applies with equal truth
to all the departments of learning. It was only at the time of the
French Revolution and for a few months previous to this period that the
signs of an awakening began to show themselves. The prevailing unrest
and turmoil in the political world are commonly assumed to have
furnished ample cause for this widespread intellectual inactivity; and
yet, on the other hand, it is conceivable that it was these very
disturbances in the domain of politics which had the effect of
stimulating the marked increase in mental activity which soon followed.
This certainly seems to have been true of general literature, for it was
toward the end of the period named that what are admitted to be the
classical works of German authors—for instance, the writings of
Klopstock, Lessing, Herder, Gellert, Wieland, Goethe, Schiller and the
philosopher Kant—were first published. In medicine, says August Hirsch,
one of the leading German historical authorities, other influences,
beside those of a political nature, contributed powerfully toward the
advancement of the science of medicine. The medical students and the
younger practitioners, according to his statements, began at this period
to show evidences of a wish to become more learned in things relating to
their calling and to possess greater refinement in their manners and
habits. Trips were made by them more and more frequently to the leading
cities of France, Italy and England for the purpose of acquiring
additional knowledge of medical science. Thus, little by little, the
medical profession of Germany gained increased standing and respect from
the community. Beginning with Prussia the governments of the different
German states, one after the other, established examinations for the
purpose of determining the fitness of the applicants for the right to
practice medicine. Then, following the example of their rulers, members
of the aristocracy adopted the practice of taking a physician with them
on their travels, and the wish to be chosen for this privileged office
acted upon the younger physicians as a decided stimulus to acquire
greater skill and knowledge. Thus gradually the family physician, in
many instances, came to be considered an adviser of greater importance
than the clergyman. Then, beside, the knowledge that he had acquired
this increased power and that he was held in greater esteem by society,
reacted upon the physician’s character, rendering him more and more
ambitious to excel and to deserve confidence.
While, during the earlier part of the eighteenth century, medical
affairs in Northern and Central Germany were in the condition described
above, there was taking place at Vienna, the capital of Austria, the
most effective revival of medical science of which we possess any
record. Of this important event, however, I will say nothing further at
present. A reasonably full account will be found in one of the later
chapters.
Although I have spoken of the early and middle portions of the
eighteenth century as constituting a barren or stagnant period in the
history of medicine, I would not wish to convey to my readers the
impression that it was a colorless and uneventful period. Far from it.
There was nothing colorless, for example, in Hahnemann’s eventful
career, and yet to all appearances he was not contributing in any way to
the genuine and solid advance of the science of medicine. Then, again,
Hufeland is not commonly supposed to have contributed in any material
degree to the advance of medical science, and yet his “_Makrobiotik_,”
his “Art of Prolonging Life,” is a veritable mine of useful information
that the practitioner of medicine can scarcely afford to classify as
trivial. Hufeland also deserves the credit of having founded one of the
earliest medical journals, a periodical which still, in many of its
numbers that were issued during the later years of the eighteenth
century, furnishes reading matter that to-day possesses the power to
entertain even a twentieth-century reader. At a somewhat later date
(1779) J. Peter Frank founded the first journal or archives distinctly
devoted to hygiene and medico-legal science. Farther on I will supply a
few details concerning these two rather important contributions to
medical knowledge.
Finally, there are a few men who, during this same relatively barren
period of German medical science, made permanently valuable
contributions to our stock of knowledge. Among these stands out
conspicuously Johann Christian Reil (1759–1813). Although lack of space
prevents me from doing anything like full justice to these worthy
representatives of our profession, I will endeavor to furnish in the
next chapter at least sufficient information concerning their work and
characters to enable the reader to place them in their proper niches in
the history of medicine.
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