Medicine, the science and art of curing disease. Some rude appliances to wounds and injuries, some equally rude observances in cases of internal disease, are common among the most barbarous people. The idea that disease is caused by the anger of superior and invisible beings placed its treatment in the hands of the priests, and the same idea caused that treatment to consist mainly of superstitious rites. In what beyond this consisted the medicine of the Egyptians and the Hindoos is a matter of conjecture only. In Greece as elsewhere the early history of medicine is involved in darkness, and it is idle to guess how much truth is contained in the fables concerning Chiron and his pupil Aesculapius, or the sons of the latter, the Homeric heroes Machaon and Podalirius. We know, however, that the temples of JEs-culapius were from an early period the resort of the sick, who submitted themselves to the regulations of the Asclepiadae, the priests of the temples. It was common among those who were cured to deposit in the temple a votive tablet, on which was inscribed some account of the case and of the remedies by which it was relieved; but if the tablets which have come down to us are fair samples, but little information could have been communicated in this way.
Much more must have been due to the education in the temple, to personal observation, and to the restless and inquiring spirit which animated the early Greeks. But the temples of Aesculapius are not the only source to which the origin of scientific medicine is to be traced; in the schools of philosophy some attention was always paid to the healing art as a branch of general education. When the school of Pythagoras was broken up, and his disciples were dispersed, some of them attended to the practice of medicine; and unlike the Asclepiada?, who confined their consultations to the temples, the Pythagoreans visited the sick at their residences. Of the extent of their knowledge or the value of their treatment we have no means of forming a judgment. Even at this period it seems that there was still another class, the charlatans, who, without any pretension to education, offered their nostrums for sale in the market place. Besides the temples of Aesculapius and the schools of philosophy, the gymnasia undoubtedly contributed to form the earlier physicians.
The gymnasiarchs directed the regimen of those who resorted to the gymnasia; they acquired practical skill in the treatment of the injuries to which their pupils were liable; they set fractures, reduced dislocations, directed frictions, dressings, etc. - In these various ways medicine had already made sensible progress when Hippocrates (born in Cos about 460 B. C.) collected the scattered knowledge of his time, and added to it by his own genius and obseiwation. Of the numerous works ascribed to Hippocrates, enough are decided to be genuine by the unanimous consent of the learned to justify the veneration in which he has always been held as the father of rational medicine. Of anatomy the notions of Hippocrates were crude and limited, and must have been derived solely from the inspection of animals, since the religious prejudices of the ancients prevented the dissection of the human body, until a period long posterior to the one of which we speak. His physiology is on a level with his anatomy. The glands are spongy bodies destined to absorb moisture from the neighboring parts, and the brain, the largest of the glands, draws the vapors from the whole interior of the body.
The use of the muscles is to cover the bones, etc. (Kenouard, llhloire de la medecine.) The body itself is composed of the four elements differently combined in different individuals, and derived from them we have the four humors of the body, blood, phlegm, bile, and black bile, from which acrain are derived the four temperaments. Disease consists in a disordered condition of the fluids; these are subject to coction, which when complete terminates in a critical evacuation, the localization of the disease, and the formation of a critical abscess, the occurrence of erysipelas, etc. When coction could not take place the disease was mortal. Crisis was apt to occur on certain days, hence termed critical. lie speaks of a principle which he terms nature (ocovc), which influences every part of the human frame, superintends all its actions, promotes those that are beneficial, and represses those that are injurious; the great object of the physician was to watch the operation of this principle, to aid or restrain it, rarely to counteract it. lie regarded acute diseases alone as the subject of treatment; chronic affections were esteemed beyond the resources of art.
The great merit of Hippocrates lies in his descriptions of disease, and the sagacity and fidelity of his observations. - Not long after Hippocrates, Fraxagoras of Cos, the last of the Asclepiadce whose name is mentioned in the history of medicine, probably belonging himself to the family of Hippocrates, observed the relation which exists between the pulse and the general condition of the system. None of his writings have been preserved. Aristotle was the son of a physician, and probably in the earlier part of his life practised medicine; his knowledge of the structure of the body, derived entirely from the dissection of animals, was far in advance of that of his contemporaries; and he laid so widely the foundations of comparative anatomy, that for ages little that was new was added to what he had written. He distinguishes between the nutritive, the sensitive, the motive, and the intellectual faculties. The first is common to plants and animals, to everything which lives and dies; the last is confined to a very few species of animals. The first three faculties reside in every part of the body; the intellect alone has a special seat. Where this is he nowhere expressly says, but it is evident from a variety of passages that he placed it in the heart.
He speaks of the greater size of the brain in mankind, says it is composed of two lobes and of the cerebellum, and mentions the ventricles. Of the nervous system he was ignorant, confounding the nerves with the tendons. Of the lungs his account is reasonably correct. The blood vessels as well as the nerves he derives from the heart, which alone contains blood of itself, that of the lungs being contained in the vessels connected with the heart. The blood is the most important of the fluids, and is necessary to life; deprived of it to a slight extent, the animal faints, to a greater dies, while its attenuation and alteration give rise to disease. - Soon after its foundation, Alexandria, under the fostering care of the Ptolemies, became the centre of the science and learning of the time. This was especially the case with regard to medicine; the formation of the Alexandrian library at a time when books were rare and expensive, the personal support of the Ptolemies, the new drugs which commerce brought from distant countries, and above all the authorization of human dissections, gave a great impulse to medical science.
But the works of the Alexandrian school have entirely perished, and we can only judge of them by the reports which are scattered through the writings of Aretreus, Celsus, Pliny, Galen, etc. Of the earlier members of the Alexandrian school, Ilerophilus and Erasistratus were the most distinguished. The former was familiar with the lacteal vessels and their connection with the mesenteric glands; the muscles were no longer a mere covering for the bones, but their proper office was attributed to them. Erasistratus was acquainted with the functions of the nerves, and is said to have invented the catheter; while Ammonius, another member of the Alexandrian school, invented an instrument for the crushing of stone in the bladder, thus perhaps anticipating an improvement of our own day. With Herophilus and Erasistratus the zeal for anatomy seems to have died out; between them and himself, a period of nearly 500 years, Galen enumerates five or six physicians only who occupied themselves with human dissections. - Until the rise of the Alexandrian school, dogmatism or rationalism, fortified by the authority of Hippocrates, had been the prevailing system.
The dogmatists maintained that in order to treat disease we must be acquainted with its occult as well as exciting causes, and with the natural actions of the body, as concoction, nutrition, etc. To this Philinus of Cos and Serapion of Alexandria replied that the occult causes of the dogmatist depended entirely upon hypothetical opinions; that the minute motions and changes of the internal parts were beyond our observation; that even where the cause of a disease was known, it by no means followed that such knowledge led to a remedy; and that close observation of disease and experience of the effects of remedies in its treatment were the only safe guides to medical practice. The new doctrine, or empiricism as it was termed, long divided medical opinion with dogmatism, though the writings of its advocates have entirely perished, and we are acquainted with their views mainly through the summary given by Celsus. About 150 years after the origin of empiricism, Asclepiades of Bithynia, at first an eminent rhetorician, began to practise medicine at Rome. A philosopher rather than a physician, he was a follower of Epicurus; and on the theories of his master he founded a new medical doctrine which, aided by the popularity of the Epicurean philosophy, as well as by its novelty and simplicity, soon found numerous followers.
According to Asclepiades, the human body is permeated in every direction by pores through which at all times atoms varying in form and volume are constantly passing. Health consists in the symmetry between the pores and the atoms which pass through them. Disease is an obstruction of the pores or an irregularity in the distribution of the atoms. This theory was further developed by Themison of Laodicea, a pupil of Asclepiades, who made all diseases depend upon constriction or relaxation, or upon a third and mixed condition, while all remedies were divided into astringents and relaxants. Asclepiades, it is said, was the first to divide diseases into the two great classes of acute and chronic. While the dogmatists made the fluids the prime seat of disease, and ascribed the origin of all maladies to some alteration in them, the methodists on the other hand thought the solids were first affected, and that the derangement of the humors was but secondary; and the dispute about the humoral pathology and solidism, thus originated, has continued under various forms to our own time. - For 600 years, according to Pliny, Rome had no physicians; not that no attempt was there made to cure diseases, but that these attempts consisted mainly in superstitious observances.
Thus, according to Livy, following the advice of the Sibylline books, pestilence was repeatedly stayed at Rome by erecting a temple to Apollo or to Aesculapius, by celebrating public games, or by the dictator driving a nail into the capitol; and Cato the Censor trusted to simples with charms and incantations. When intercourse with Greece became common, Grecian philosophy and science were transplanted to Rome. Asclepiades was the friend of Cicero, and Caesar when he was taken by the pirates was accompanied by his physician. On attaining supreme power, Caesar decreed that all physicians at Rome should enjoy the privileges of citizenship. After the names of Asclepiades and Themison, that of Soranus occurs prominently among those practising medicine at Rome; there were probably three physicians of this name, but the most celebrated was a Greek educated at Alexandria and settled at Rome; his writings have perished, unless, as some have supposed, those of Caelius Aurelianus are a translation of them. Caelius is said to have been a native of Numidia, and probably flourished in the 2d century. Of numerous works of which he was the author, that on acute and chronic diseases is alone preserved. It is written in barbarous Latin, but in its description of disease is a great advance on earlier authors.
Cselius, like Soranus, belonged to the methodic sect, and is its principal exponent. Of the few Latin medical authors, Celsus is the chief. He appears to have lived in the 1st century, and to have written voluminous treatises on architecture, rhetoric, philosophy, etc, all of which have perished. His book De Medicina is a digest of what was known to the ancients on the subject, and shows the great progress which medicine had made^ in consequence of the labors of the anatomists of Alexandria. Celsus treats of most of the great operations of surgery, of the operations for stone and hernia, of wounds of the intestines, of cataract; he gives directions for the use of the catheter, speaks of the trephine in injuries of the brain, and of the use of the ligature in divided or lacerated blood vessels, in varices, and in hemorrhoids. The name of Andromachus, a native of Crete and physician to Nero, has come down to us as the inventor of certain polypharmaceutical compounds, one of which, the theriac, containing the dried flesh of vipers, with GO other ingredients, was retained in the pharmacopeias of the last century; and ho is.likewise the first to whom was given the title of archiater.
Probably contemporary with Caelius Aurelianus was Aretseus of Cappadocia; we know nothing of him but his birthplace; he has left a treatise on diseases remarkable for accurate and spirited description, and which is one of the most valuable of the medical works of antiquity. Galen (born in Pergamus, A. IX 130), after Hippocrates, has had a far wider share of renown than any other physician; for more than 12 centuries his authority reigned supreme in the schools; even facts were disputed if they were against the authority of Galen. He adopted the Hippocratic theory of the four elements, the four humors, and the four qualities, elaborating and refining upon them at great length and with great subtlety, and making them the groundwork of his doctrines. Besides the solids and the fluids, he assumed a third principle, the spirits, as entering into our composition. These spirits were of three kinds: the natural spirits, derived from the venous blood; the vital spirits, formed in the heart by the action of the air we breathe upon the natural spirits, and which are driven through the arteries; and the animal spirits, formed in the brain from the vital spirits.
He also supposed the human soul to be composed of three parts: a vegetative, residing in the liver; an irascible, in the heart: and a rational, having its seat in the brain. The most valuable of the works of Galen are those in which he treats of anatomy and physiology. He appears to have dissected animals only, and he recommends students to visit Alexandria, where they could study from the human skeleton. Considering the narrowness of his resources, his descriptions are wonderfully correct, and they comprehend all that was known of anatomy until the time of Vesalins. Dioscorides, who lived probably in the early part of the 2d century, for many centuries shared the authority of Galen. He has left a work on the materia medica which comprises all that was known to the ancients upon the subject; its arrangement is bad, and the descriptions of the articles so vague that many of them can no longer be recognized with certainty; yet imperfect as it may be, it was for 1,400 years a standard treatise. - From the time of Galen medicine began to participate in the decline which had already overtaken art and literature.
Dissections were no longer made; the earlier Christians had as great a horror of profaning the dead body as the pagans, and medical writers, appearing at rare intervals, contented themselves mainly with abridging or copying the works of Galen. Oribasius in the 4th century, Aetius about 500, Alexander Tral-Hanus in the 6th century, and Paulus Aegineta in the 7th, all wrote in Greek, and were all zealous Galenists. It is but just to observe that Paulus seems to have been fuller than his originals in the description of surgical diseases and operations. It was only when medicine already tended toward its decline that it became legally organized. In the pagan world every one practised at his will, making his way by s"uch qualities as he possessed. The injury done by quackery and imposture led finally to a remedy. Under the Christian emperors every town of a certain size had its archiaters (chief physicians), and no one could practise medicine without having undergone an examination by them. They were paid by the state, and in return were bound to attend the poor gratuitously. In a number of the principal towns medical schools were established, in which the professors and lecturers received a regular salary.
The archiaters of the emperors had the title of count or duke, and ranked with the principal officers of state. - Hospitals and dispensaries owe their origin to Christianity; the pagans appear to have had no analogous institutions. The first hospital seems to have been founded at Jerusalem by St. Paula toward the end of the 4th century, and the example was soon followed by the pious, the powerful, and the wealthy. - While the western empire had sunk into barbarism, and the eastern, sadly limited, was struggling for existence, medical science found refuge among the Arabians. Excepting on two points, they contributed little or nothing to its advancement; but Rhazes, Ali Abbas, Avicenna, Albucasis, with the Spanish Saracens Avenzoar and Averroes, were all voluminous writers. Their writings consist mainly of compilations from the Greek authors, chiefly from Galen, whose subtleties and refinements were suited to their genius; yet the "Canon" of Avicenna was for several centuries the received text book in the medical schools of both the Arabians and Europeans; and nil the knowledge Europe had of the Greek authors was derived from the translations of the Arabs. In two particulars, as was mentioned, the writings of the Arabians are of high interest: 1. In them we get the earliest clear account of the existence of eruptive fevers; these were divided by them into two forms, variola (smallpox) and morlilli (tne little pests), the latter including measles, scarlet fever, and probably other non-vesicular eruptions. 2. Not only do we derive from the Arabians a number of our milder purgatives, cassia, manna, senna, rhubarb, together with tamarinds, camphor, etc, but in their pursuit of alchemy they produced distilled liquors, some of the metallic salts, and many new pharmaceutic preparations, and aid the foundations of a science which has been of the most essential service to medicine. - As order began to emerge again from the chaos of barbarism which succeeded the fall of the western Roman empire, monks and priests became the principal physicians, and a little medicine was taught in some of the monasteries; for a long time the Benedictine monks of Monte Casino enjoyed in this respect an extended reputation.
From the 9th to the 13th century the Jews, acquiring in their commerce with the Saracens such knowledge as was possessed by the latter, became celebrated as physicians; and as such, despite the laws which forbade them to administer remedies to Christians, obtained access to courts and even to the palace of the Roman pontiffs. One small town affords a glimmer of light during the darkness of this period. The school of Salerno is said to have been founded about the time of the destruction of the Alexandrian library by the Saracens. Toward the end of the 8th century it had attained reputation, and from the 10th to the 13th was at the height of its celebrity. The Regimen Sanitatis Salerni, the dietetic precepts of the school of Salerno, composed by John of Milan for the use of Robert duke of Normandy, the son of William the Conqueror, has been frequently republished and commentated (translated by Prof. Ordronnaux, New York, 1872). The most celebrated member of this school was Constantinus Africanus, who, driven from his native country as a sorcerer, for a time taught at Salerno. His works, which are numerous, are translations from the Arabic, written in barbarous Latin. In the early part of the 13th century Frederick II. published an edict that no one should practise medicine in the kingdom of Naples until he had been examined by the faculty of Salerno. The candidate, after completing his course of studies, was examined on the Therapeutics of Galen, the first book of Avicenna, and the Aphorisms of Hippocrates. He afterward swore to be pure in his life, to be submissive to the laws, to attend the poor gratuitously, and not to share the profits of the apothecary.
He then received a diploma, but for the first year was compelled to practise tinder the superintendence of an older physician. - About the year 1315 Mondino, a professor in the university of Bologna, dissected the bodies of two females; he afterward published an anatomical description of the body, which for the next 300 years was used as a text book in the Italian universities. His merit consists mainly in the boldness of his undertaking, as his anatomy was not much in advance of that of Galen. He did not open the cranium, for fear of committing a mortal sin. Before the year 1500 human dissections were prosecuted at Bologna, Padua, and Pavia. Toward the commencement of the 16th century Du Bois, or Sylvius, as his name was Latinized, used the human body in his demonstrations at Paris as often as it could be procured. Galen was still looked up to as an indisputable authority; and when the results of dissection did not coincide with his descriptions, they were looked upon as exceptions to the general rule, or as evidence of the degeneracy of the human race.
Such was the state of things when, ahout the year 1543, Vesalius, professor of anatomy in the university of Padua, published his great work on anatomy, in which he pointed out the errors of Galen, and maintained that his descriptions were taken, not from human dissections, but from those of apes. The age was one of anatomical discovery, and Columbus, the successor of Vesalius at Padua, Eusta-chius at Ptome, and Fallopius, confirmed and increased the discoveries of Vesalius. The prejudices against human dissection were mitigated, subjects became comparatively abundant, and printing and engraving served to spread abroad and perpetuate the discoveries that were made. - After the fall of Constantinople, learned Greeks carried a knowledge of their language and literature to the western world. Previous to this date the Greek medical writers had been read only through the medium of faulty Arabic translations; but medical men now availed themselves of this new source of information, and translations of Galen, Hippocrates, Dioscorides, and others were made directly from the Greek. Thomas Linacre, physician to Henry VIII. and to Mary, distinguished himself in this career; he established professorships at Oxford and Cambridge for illustrating the works of Hippocrates and Galen, and laid the foundations of the royal college of physicians at London. Among those distinguished in the same path were Mercuriali, Foes, and J. Fern el; and the attention of physicians as of the learned throughout Christendom was directed to rescuing and illustrating the remains of antiquity rather than to original research. - While medicine was thus recovering the ground it had lost, surgery also was improving.
Physicians in the middle ages being invariably priests, whom a canon of the church forbids to shed blood, surgical operations commonly fell into the hands of an inferior and ignorant class of barber surgeons, who frequently were itinerants. Gradually matters improved; the clerical physicians occasionally operated, while the barber surgeons struggled to raise themselves to a higher rank. Gui de Chauliac, a learned priest who published about the year 1363 the earliest modern work on surgery, operated himself; while in the 16th century the great anatomists Vesalius, Fallopius, etc, were likewise distinguished surgeons. But surgery received its greatest impulse from Ambroise Pare\ who commenced his career as a barber surgeon. At that period wounds received from firearms were considered poisonous, and it was customary on this account to cauterize their track with boiling oil. In 1636, on one occasion, while serving as surgeon with the French army in Provence, Pare's supply of oil failed him. He could not sleep for anxiety, but in the morning he found that those who had not been cauterized were doing better than those who had, and this soon led to a revolution in practice.
The application of the ligature instead of the actual cautery to restrain haemorrhage after amputations was another of his discoveries. - While the authority of Galen was disputed by the anatomists on matters of fact, his opinions were attacked by a new school of physicians, who were the offshoot of the prevailing study of alchemy. Of this school Paracelsus obtained the greatest notoriety. He publicly burned the works of Galen and Avi-cenna at Basel, but had nothing to substitute for them but wild and incoherent speculations. Perhaps it was partly owing to the growing spirit of independent observation that we first hear during the 15th century of a number of new diseases. Whooping cough, scurvy, the sweating sickness, and syphilis were now first described. Of scurvy we must believe that the causes which produce it at present must have produced it from all time; and that if it seldom occurred in ancient times, it must have been because of the different modes of living and the short duration of the voyages.
With syphilis the case is different; the theory of the American origin of the disease is now shown to be unfounded, and whether it had existed obscurely for a long time, or whether it arose, as some think, from a degeneration of the leprosy so prevalent in the middle ages, its sudden explosion at Naples at the end of the 15th century and its rapid spread throughout Europe are equally unaccountable. - The great anatomists of the 16th centurv had paved the way for the discovery of the circulation of the blood. Caesalpinus, in his Speculum Art in Medicm Hip-pocraticum, had shown a knowledge of the system of the circulation of the blood. Servetus had proclaimed the lesser circulation through the lungs; the valves of the heart, of the aorta, and of the veins were known; it was proved by experiments on living animals that when an artery was tied the blood no longer fiowed, and the pulse ceased on the side most distant from the heart; that when a vein was tied it swelled below the ligature, while it became empty on the side toward the heart. And yet the last step was not made.
At length William Harvey, after having for about 10 years taught the circulation of the blood in his lectures, in 1628 published his doctrine to the world; and though meeting at first with opposition from some of the older members of the profession, it made rapid progress and was universally adopted during the lifetime of its discoverer. In 1661 Malpighi by the aid of the microscope showed the course of the globules of the blood in the smaller vessels, and 30 years later Leeu-wenhoek was able to follow the circulation into the minutest capillaries. The true theory of respiration soon followed the discovery of the circulation. The ancients taught that the minute bronchial tubes inosculated with the pulmonary veins, and that the air thus found its way into the heart. In 1661 Malpighi demonstrated the vesicular substance of the lungs, and about the same time Borelli and others showed the mechanism by which respiration is accomplished. In 1622 Gaspard Asselli, professor of anatomy at Milan, discovered the lacteal vessels; and about 30 years later Jean Pecquet demonstrated the reservoir which bears his name, together with the thoracic duct from its commencement to its termination in the left subclavian.
The lymphatic system, the nerves, the brain, and the organs of special sense were all studied with care. In 1747 llaller published his Prima Linetv Physiologic and 10 years later his Elementa Physiologic Corporis Humani; and from this period physiology had a distinct existence as a science. - In the mean time the materia medica had been enriched by a number of new articles. The chemists had introduced a variety of metallic and alkaline salts, and the new world had yielded guaiacum, sar-saparilla, ipecacuanha, etc.; but two remedies from their importance require a more special notice. On the first appearance of syphilis the surgeons had attacked it by means of mercurial frictions, and with success; but their employment in numerous instances was attended by such terrible consequences, that they gradually fell into disuse. Paracelsus had employed mercury internally, hut in the hands of such a practitioner it could rarely be productive of other than mischief; the Galenists condemned its use, and the chemical physicians gave it rarely and secretly.
Gradually it again came into favor, and in 1750 Van Swieten, the physician of Maria Theresa, directed all the cases of syphilis in the military and civil hospitals of the Austrian empire to be treated with small doses of corrosive sublimate in solution, and the practice soon became common throughout Europe. The ancients, with whom malarious diseases were common, had no specific means of arresting their attack; even mild in-termittents often continued for an indefinite time, and finally induced organic changes and dropsy. In 1639 Peruvian bark is said to have been introduced into Spain by the countess of Cinchon; and though the extravagance of its price, the adulterations it sometimes met with, and its nauseousness were obstacles to its success, its use soon became common throughout Europe. - As chemistry, from vain search after the philosopher's stone or the elixir vitce, began to assume the aspect of a science, it influenced more markedly the prevailing medical doctrines. Francis de le Hoe or Sylvius, a Fleming called to the professorship of practical medicine in 1658 was the first to present a chemical theory of the actions of the animal economy.
According to this theory, digestion and nutrition were the consequence of specific fermentations in which the saliva, the pancreatic juice, and the bile take part. Fevers were produced by other fermentations caused by a vicious bile or lymph. Certain of the humors were naturally acid, others alkaline; in a state of health those were in equilibrium, but disease was consequent upon the predominance of one or the other. This doctrine, more or less modified, had many followers, and for a time was prevalent both on the continent and in England. Willis and Thomas Sydenham may be ranked among the iatro-chemists; but Sydenham is much the more remarkable for the careful and conscientious manner in which, uninfluenced by theory, he gave himself up to the observation of disease. - While the chemical school was taking form at the north, in Italy the progress of physical science was turning the attention of theoretic physicians in a new direction. Alfonso Borelli, a profound mathematician, was the originator of what has been termed the iatro-mathematical school.
In the first part of his work De Motu Animalium he applies the received principles of physics to the subject of muscular action, treats of the various attitudes and modes of progression of men and animals, of walking, running, leaping, flying, swimming, and enters into learned and curious calculations of the amount of force which is expended in particular acts. In the second part he treats of the internal movements, of those of the heart, of the blood in the vessels, and of the action of the intestinal canal; the whole body was regarded as a machine, and the laws of mechanics, of hydraulics and hydrostatics, were rigidly applied to it. As an instance of the futile but elaborate calculations into which the mathematical physicians were led, Borelli calculates that the heart at each contraction overcomes a weight of 180,-000 lbs. The physiology of the mathematical school had its influence upon their pathology; and the terms derivation, revulsion, lentor, obstruction, resolution, etc, all founded on physical principles, were universally used.
The mathematical school had many and eminent followers throughout Europe: in Great Britain, Pitcairn, Freind the historian of medicine, and Mead; in Holland and Germany, Boer-haave and John Bernoulli; in France, Sau-vages, the eminent and learned nosologist, and Senac, the physician of Louis XIV. Hermann Boerhaave, professor of medicine at Leyden, had great talent and immense learning, and was an accurate observer and a sagacious practitioner. He was one of the first to devote himself to clinical teaching, and he was fortunate in the devotion of such pupils as Van Swieten and Haller. Unfortunately for his permanent reputation, he lived in an age of transition, and his system, generally received during his lifetime, scarcely survived its author. Jean Senac, another of the mathematical physicians, to whom Morgagni applies the epithet of "great," published a book on diseases of the heart, which has only been rendered obsolete by the introduction of the new methods of auscultation and percussion. - While the chemical and mathematical physicians were reducing the actions of the living body to the laws which govern inert matter, a wholly opposite tendency manifested itself in Germany. Previously indeed Van Helmont, a mystic and alchemist rather than a physician, in accounting for the vital operations, had introduced what he termed the archmus, now a chemical ferment and now an intelligent being, as a controlling power; but his opinions found no followers, and only influenced indirectly the progress of medicine.
Georg Ernest Stahl, a great chemist as well as physician, appointed professor of medicine in the university of Halle in 1694, was the author of the new system. According to Stahl, the anima (soul) is the great motor and directing principle of the human body. It exercises a recuperative and superintending influence, and guards against injuries, or when they occur takes the best means of repairing them; it is the common source of all motion, of all secretion, of all the vital actions. In showing the insufficiency of the known chemical or physical forces to account for the vital actions, Stahl is happy and ingenious; but in his subtle disquisitions on his own agent, he becomes confused and unintelligible. He has the merit of showing much more clearly than had hitherto been done the influence which the mind exerts over the body. Stahl's opinions, contrary to most theories, exerted a controlling influence over his medical practice, reducing the office of the physician to that of watching and forwarding the operations that nature undertakes for her own relief; while his doctrines, set forth with great logical subtlety, at a time when metaphysical speculations were in vogue, though they found few direct followers, yet had a large influence on the minds of the profession.
Friedrich Hoffmann, a fellow professor with Stahl at Halle, was a voluminous writer, whose reputation has extended to our own time. He attributed to the nervous system most of the functions and influences which Stahl ascribed to the anima. In speaking of the animal fibre, he ascribes to it a certain natural "tone," which maybe increased into " spasm" or diminished to "atony;" and connected with both these hypotheses, while admitting the fluids to be sometimes primarily diseased, in the majority of cases he thought the solids were first affected. - As early as1752 Boissier de Sauvages of Montpellier published his methodic nosology, in which he endeavors to class and distinguish diseases in the same manner as the vegetable kingdom is classed and described by the botanists. His work was of great use in the advancement of medicine, and remained the standard treatise on the subject until the publication in 1772 of the nosology of Cullen. This author, a professor first in the university of Glasgow and afterward in that of Edinburgh, contributed greatly to raise the latter school to the high rank which it has since enjoyed.
His teachings and writings exercised a wide influence, and their effects can still be traced in English medicine in our own day; his descriptions of disease in particular are remarkable for their force and conciseness, but the progress of science has shown the fallacy of the views on which his system was founded. A contemporary and rival of Cullen, John Brown, a man of genius but of wayward and ill regulated character, was likewise the author of a system which enjoyed a temporary popularity, and which, somewhat modified, found eminent followers in Italy within a recent period. - The end of the last century witnessed the most important practical discovery ever made in medicine. Up to that period smallpox annually committed the most fearful ravages; the deaths from it in Europe alone were estimated to amount to 400,000 a year, while it left many blind or disfigured. The practice of inoculation, brought from Constantinople by Lady Mary Wortley Montagu, had indeed diminished the evil, but the remedy itself was attended with great inconvenience, and was not destitute of danger.
The discovery of Jenner, announced in his "Inquiry into the Causes and Effects of the Variolae Vaccinae" (London, 1798), has placed the disease completely under our control; and if it still commits occasional ravages, it is owing to the laxity of the laws and the carelessness of individuals. Another great improvement in practical medicine, the use of lemon juice, sour krout, etc, in the dietary of seamen, by which scurvy, which formerly committed fearful havoc on both the naval and mercantile marine, has become almost unknown, is due to the naval surgeons of the last century. - In the present century practical medicine has made greater advances than in any other similar period. This may be attributed: 1, to the brilliant discoveries which have rendered chemistry a new science, by the aid of which we are now able to comprehend much more clearly than before the processes of nutrition, respiration, calorification, secretion, and excretion; 2, to the increased attention paid to microscopy, by which the mode of development of the germ, the organization and growth of the different tissues, the process of repair and that of inflammation, and other morbid processes, have been investigated; 3, to the rapid progress of experimental physiology, aided by chemistry and microscopy; 4, to the increased cultivation of comparative anatomy and physiology; 5, to the cultivation of morbid anatomy not only in relation to the symptoms of disease during life, but to the various degrees of morbid developments, and to the relation which those developments bear to each other; 6, to the new and more perfect methods of investigating disease, by which its diagnosis has become more certain.
Lnder the last head two discoveries are prominent, which have changed the whole face of medicine, giving it a degree of certainty which at one time seemed hopeless: that by Laennec of auscultation and percussion, and that by Bright of the disease of the kidney which bears his name. The development and perfecting of each of these discoveries has employed and is employing the lives and founding the reputation of a vast number of learned, zealous, and able men. 7. The discovery by pharmaceutical chemists of the active principles of various drugs, has not only rendered those drugs more certain and less nauseous, but has enabled us to exhibit necessary doses which the stomach otherwise would be unable to retain. 8. Not only has the materia medica been benefited in the maimer above mentioned, but by the discovery of various other remedies, by which diseases hitherto rebellious have been rendered more amenable to the resources of art, and by that of anesthetics. - Eclectic Medicine is a term used to designate a school of medicine whose distinctive doctrines are the selection of whatever may be thought the best practice of other schools, and the employment of "specific medication." These "specifics" are not directed to symptoms merely, but are designed to obviate particular pathological conditions.
Thus, a certain class of diseases generate similar morbid products, and remedies calculated to remove these through the various excretory organs are termed by the eclectics specific remedies. Dr. Benjamin Thompson of Concord, N. H., the founder of what was at one time known as the botanic or Thomp-sonian practice in America, was one of the older members of the school, and also Dr. Wooster Beach, who many years ago founded in New York the " Reformed Medical College," which was soon relinquished. Another was established at Worthington, Ohio, which, at the end of 10 or 12 years was also discontinued, and another at Cincinnati, Ohio, in 1845, under the name of the " Eclectic Medical Institute.*' This is regarded as the parent school of eclecticism, and has matriculated 5,375 and graduated 1,80-4 students. The doctrine of specific medication is of recent introduction by Prof. John M. Scudder, the present professor of practice and pathology in the Cincinnati institution. - See "American Eclectic Practice of Medicine," by J. G. Jones, M. D., and William Slier wood, M.D. (Cincinnati, 1857); " Chronic Diseases," by Prof. John King (1807); and "American Dispensatory," by the same (1874). (See Homceopathy, Hydropathy, Medical Electricity, and Surgery).