THE EARLIEST PUBLICATION IN EUROPE OF A SYSTEMATIC TREATISE ON HYGIENE,
PUBLIC HEALTH AND MEDICO-LEGAL SCIENCE
In the early part of the eighteenth century municipal and private-house
sanitation existed in comparatively few cities of Europe, and then only
in the wealthier quarters. Such a thing as sanitary police was
practically unknown, and public health was considered only when the
inhabitants were threatened with a serious epidemic like that of
cholera, the plague, or leprosy. This indifference to public sanitation
persisted down to the end of the nineteenth century. On arriving in
Paris in the spring of 1857, at a time when the city was overcrowded
with travelers, my friend and I were glad to secure a room on the fourth
story of a modest hotel situated in the central part of the city, quite
near the Palais Royal. We found no good reason to complain of the room
itself; it was clean and adequately well ventilated. But the toilet
facilities were such as one might expect to find in a hotel of the
fourteenth or fifteenth century. On the roof of our building a lean-to
had been constructed alongside a broad brick chimney, and this shack,
which was distant at least forty feet from the doorway that led by a
short stair-case to the fourth story of the hotel, could be reached only
over a narrow plank walk that was wholly unprotected by a railing. Then
again, on a bicycling trip which I made in 1896, through the central
part of France, my friend and I experienced more than one surprise of a
similar nature. For example, in several of the smaller towns we found
that the ancient practice of throwing the slops out of the second-story
windows into the middle of the narrow street, still persisted. But, in a
matter of this kind, nothing is to be gained by entering into many
details; “enough is as good as a feast.” I merely wish to emphasize the
fact that even France, where civilization was so far advanced in many
respects, was fearfully slow in adopting the first principles of house
and municipal sanitation. It was only toward the end of the nineteenth
century that London, the birthplace of the finest types of house and
municipal sanitation, began to give serious attention to this subject.
During the early part of the eighteenth century, however, even this
great metropolis was very backward in manifesting any marked desire to
improve the sanitary condition of its dwellings; for, was it not the
Earl of Chesterfield who, at this very period of time (about 1750) made
the statement, in a letter to his natural son, that “the lanes or narrow
passage-ways in Holland are cleaner than the houses are in London?”
It was in Germany, many of my readers will doubtless be surprised to
learn, that the first really serious attempt was made to present to the
world a scientific treatise on this subject, a work which was published
in several consecutive volumes and which even to-day is consulted as a
most trustworthy and remarkably complete authority on municipal and
private-house sanitation. The work referred to was written by J. P.
Frank.
* * * * *
JOHANN PETER FRANK, more commonly spoken of as Peter Frank, was born in
1745 at Rothalben, a village located in territory which at that time
belonged to the Grand Duchy of Baden. He received a good preliminary
training at the High School of Pont-à-Mousson, and then afterward took
courses at the Universities of Heidelberg and Strassburg. His medical
degree was bestowed upon him in 1766 by the first of these institutions,
the subject of his thesis being “Medical Police.” Two years later he
commenced the practice of his profession at the city of Baden-Baden, and
in 1769 was appointed Court Physician at Rastatt.
During these early years of his career he did not lose interest in the
subject which he had chosen for his thesis, but continued to work upon
it until, in 1768, he was ready to submit to a bookseller the manuscript
of Vol. I. The latter, after receiving from a so-called medical expert
an unfavorable report on the quality of the text, expressed his
unwillingness to publish the work. Frank’s discouragement over this
result was so great that he proceeded without delay to throw the
manuscript into the fire. Then, after further reflection, he decided to
begin work afresh on the same theme, and thus it came about that he
devoted the following eleven years to the preparation of a new text for
Vol. I. In 1779 this first volume was published. In 1780, 1783, 1788 and
1813 four more volumes were issued. Volume VI and two supplementary
volumes were issued between the years 1817 and 1819.
“Notwithstanding its defects,” says Puschmann, “this work is one of the
most important, one of the greatest and most creditable pieces of
medical literature of which the Germans may rightfully boast. Blumenbach
called it a classic, the first treatise of its kind and indeed
possessing a unique character.”
Of the other works published by Peter Frank, works which deal with
pathology and the practice of medicine, the most important is that
entitled “_De Curandis Hominum Morbis Epitome_” (“An abridged treatise
on the diseases to which man is liable”). As he progressed with the
writing of this treatise Frank undoubtedly discovered that he could not,
with any degree of satisfaction, accomplish his original design of
compressing what he had to say into an “epitome”; and so, from this time
forward, he carried on the work, without paying any further attention to
his original plan of an abridgment, until the book had reached its sixth
volume; and even then it was not completed.[8] Despite its
incompleteness this work passed through several editions, for it was
highly appreciated for its practical character and for the clearness of
its descriptions of disease.
In 1785 Frank accepted an invitation to take charge of the clinical
instruction at the University of Pavia, in the place of Tissot who
had resigned. Through Frank’s advice and persistent efforts the
medical department of the Pavia University was enriched by the
addition of a chair of physiology and comparative anatomy, an
anatomical theatre capable of seating 400 auditors, and a collection
of pathologico-anatomical preparations to which all the hospitals of
that part of Lombardy were obliged to contribute suitable specimens.
The establishment of a surgical clinic was another of the
improvements in the teaching facilities of the University that
should be credited to Peter Frank. The length of the medical course
was at his suggestion extended to five years. Among his associates
in the Faculty at this period were the following distinguished men:
Scarpa, in the chair of surgery, Scopoli, in that of pharmacology,
and Volta in physics.
In November, 1795, Frank returned to Vienna and was almost immediately
appointed Director of the Allgemeine Krankenhaus and Professor of the
Medical Clinic with a salary of 5,000 florins and the privilege of
occupying rent-free a house that was located in the immediate
neighborhood of the hospital. At the same time the title of Aulic
Councillor (_Hofrath_) was conferred upon him. One of the first
improvements which he effected in the clinic was to have the small wards
for male and female patients materially enlarged so that when
twenty-five or thirty patients were present, as was often the case, the
air might not become noticeably contaminated and thus rendered unfit for
all who were present to breathe.
In his teaching Frank never forgot, on all possible occasions, to
impress upon the students the importance of thinking independently on
the subjects that were brought before them, as in this way they would
learn to distinguish the false from the true. Whenever he discovered
that he had made a mistake in one of his statements he did not hesitate
to confess the fact. His son, Joseph, is responsible for the statement
that his father never seemed to him happier than when he had an
opportunity of making to his auditors some such speech as the following:
“Gentlemen! Strike out this or that line in one of the volumes of my
work! When I wrote it I believed that it was correct; but now I am
convinced that the very opposite is the truth!” When Brunonianism was
first transplanted from Great Britain to the Continent and was received
enthusiastically by many physicians, Frank was not disposed immediately
to accept its teachings, and yet at the same time he did not believe
that it was quite fair to ignore the thing altogether. Not a few men
inferred from this hesitating attitude on his part that he rather
favored Brown’s system. As a matter of fact he was an eclectic in his
views and was always ready to appropriate whatever seemed to him good in
any system or school of doctrines. As Director of the Allgemeine
Krankenhaus he adopted the plan of having the leading physicians and
surgeons of the Clinic first report publicly once a week what were the
important diseases that had come under observation during that period;
and then he would call upon the auditors to discuss the subject freely.
Peter Frank died at his home in Vienna on April 24, 1821.
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