Page:EB1911 - Volume 18.djvu/67

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HISTORY]
MEDICINE
 49

large number of metallic preparations, in the introduction of some of which he did good service, and, among vegetable preparations, the tincture of opium, still known by the name he gave it, laudanum. In this doubtless he derived much advantage from his knowledge of chemistry, though the science was as yet not disentangled from the secret traditions of alchemy, and was often mixed up with imposture.

German historians of medicine attach great importance to the revolt of Paracelsus against the prevailing systems, and trace in his writings anticipations of many scientific truths of later times. That his personality was influential, and his intrepid originality of great value as an example in his own country, is undeniable. As a national reformer he has been not inaptly compared to Luther. But his importance in the universal history of medicine we cannot estimate so highly. The chief immediate result we can trace is the introduction of certain mineral remedies, especially antimony, the use of which became a kind of badge of the disciples of Paracelsus. The use of these remedies was not, however, necessarily connected with a belief in his system, which seems to have spread little beyond his own country. Of the followers of Paracelsus some became mere mystical quacks and impostors. Others, of more learning and better repute, were distinguished from the regular physicians chiefly by their use of chemical remedies. In France the introduction of antimony gave rise to a bitter controversy which lasted into the 17th century, and led to the expulsion of some men of mark from the Paris faculty. In England “chemical medicine” is first heard of in the reign of Elizabeth, and was in like manner contemned and assailed by the College of Physicians and the Society of Apothecaries. But it should be remembered that all the chemical physicians did not call Paracelsus master. The most notorious of that school in England, Francis Anthony (1550–1623), never quotes Paracelsus, but relies upon Arnald de Villanova and Raimon Lull. From this time, however, it is always possible to trace a school of chemical practitioners, who, though condemned by the orthodox Galenists, held their ground, till in the 17th century a successor of Paracelsus arose in the celebrated J. B. Van Helmont.

Consequences of the Revival of Ancient Medicine.—The revival of Galenic and Hippocratic medicine, though ultimately it conferred the greatest benefits on medical sciences, did not immediately produce any important or salutary reform in practical medicine. The standard of excellence in the ancient writers was indeed far above the level of the 16th century; but the fatal habit of taking at second hand what should have been acquired by direct observation retarded progress more than the possession of better models assisted it, so that the fundamental faults of medieval science remained uncorrected.

Nevertheless some progress has to be recorded, even if not due directly to the study of ancient medicine. In the first place the 15th and 16th centuries were notable for the outbreak of certain epidemic diseases, which were unknown to the old physicians. Of these the chief was the “sweating sickness” or “English sweat,” especially prevalent in, though not confined to, the country whence it is named. Among many descriptions of this disease, that by John Kaye or Caius, already referred to, was one of the best, and of great importance as showing that the works of Galen did not comprise all that could be known in medicine. The spread of syphilis, a disease equally unknown to the ancients, and the failure of Galen’s remedies to cure it, had a similar effect.

In another direction the foundations of modern medicine were being laid during the 16th century—namely, by the introduction of clinical instruction in hospitals. In this Italy, and especially the renowned school of Padua, took the first step, where Giovanni De Monte (Montanus), (1498–1552), already mentioned as a humanist, gave clinical lectures on the patients in the hospital of St Francis, which may still be read with interest. Pupils flocked to him from all European countries; Germans are especially mentioned; a Polish student reported and published some of his lectures; and the Englishman Kaye was a zealous disciple, who does not, however, seem to have done anything towards transplanting this method of instruction to his own country. Inspections of the dead, to ascertain the nature of the disease, were made, though not without difficulty, and thus the modern period of the science of morbid anatomy was ushered in.

Medicine in the 17th Century.—The medicine of the early 17th century presents no features to distinguish it from that of the preceding century. The practice and theory of medicine were mainly founded upon Hippocrates and Galen, with ever-increasing additions from the chemical school. But the development of mathematical and physical science soon introduced a fundamental change in the habits of thought with respect to medical doctrine.

These discoveries not only weakened or destroyed the respect for authority in matters of science, but brought about a marked tendency to mechanical explanations of life and disease. When William Harvey by his discovery of the circulation furnished an explanation of many vital processes which was reconcilable with the ordinary laws of mechanics, the efforts of medical theorists were naturally directed to bringing all the departments of medicine under similar laws. It is often assumed that the writings and influence of Bacon did much towards introducing a more scientific method into medicine and physiology. But, without discussing the general philosophical position or historical importance of Bacon, it may safely be said that his direct influence can be little traced in medical writings of the first half of the 17th century. Harvey, as is well known, spoke slightingly of the great chancellor, and it is not till the rapid development of physical science in England and Holland in the latter part of the century, that we find Baconian principles explicitly recognized.

The dominant factors in the 17th-century medicine were the discovery of the circulation by William Harvey (published in 1628), the mechanical philosophy of Descartes and the contemporary progress of physics, the teaching of Van Helmont and the introduction of chemical explanations of morbid processes, and finally, combined of all these, and inspiring them, the rise of the spirit of inquiry and innovation, which may be called the scientific movement. Before speaking in detail of these, we may note that by other influences quite independent of theories, important additions were made to practical medicine. The method of clinical instruction in hospitals, commenced by the Italians, was introduced into Holland, where it was greatly developed, especially at Leiden, in the hands of Francis de la Boë, called Sylvius (1641–1672). It is noteworthy that concurrently with the rise of clinical study the works of Hippocrates were more and more valued, while Galen began to sink into the background.

At the same time the discovery of new diseases, unknown to the ancients, and the keener attention which the great epidemics of plague caused to be paid to those already known, led to more minute study of the natural history of disease. The most important disease hitherto undescribed was rickets, first made known by Arnold de Boot, a Frisian who practised in Ireland, in 1649, and afterwards more fully in the celebrated work of Francis Glisson (1597–1677) in 1651. The plague was carefully studied by Isbrand de Diemerbroek, in his De Peste (1646), and others. Nathaniel Hodges of London (1629–1688) in 1665 seems to have been the first who had the ' courage to make a post mortem inspection of a plague patient. Christopher Bennet (1617–1655) wrote an important work on consumption in 1654. During the same period many new remedies were introduced, the most important being cinchona-bark, brought to Spain in the year 1640. The progress of pharmacy was shown by the publication of Dispensatories or Pharmacopoeiae—such as that of the Royal College of Physicians of London in 1618. This, like the earlier German works of the same kind (on which it was partly founded), contains both the traditional (Galenical) and the modern or chemical remedies.

Van Helmont.—The medicine of the 17th century was especially distinguished by the rise of systems; and we must first speak of an eccentric genius who endeavoured to construct a system for himself, as original and opposed to tradition as that of Paracelsus. J. B. Van Helmont (1578–1644) was a man of noble family in Brussels, who, after mastering all other branches of learning as then understood, devoted himself with enthusiasm to medicine and chemistry. By education and position a little out of the regular lines of the profession, he took up in medicine an independent attitude. Well acquainted with the doctrines of Galen, he rejected them as thoroughly as Paracelsus did, and borrowed from the latter some definite ideas as well as his revolutionary spirit. The archeus of Paracelsus