Part 182

_T. J. Pettigrew, Superstitions connected with the History and Practice of Medicine and Surgery, pages 34-37, and 117-121._

MEDICAL SCIENCE: 16th Century. Paracelsus.

Paracelsus, of whose many names this one stands alone in history to represent him, was an extraordinary person, born in Switzerland, in 1493. He died in 1541. "His character has been very variously estimated. The obstructives of his own age and many hasty judges since have pronounced him a quack. This is simply ridiculous. As a chemist, he is considered to have been the discoverer of zinc, and perhaps of bismuth. He was acquainted with hydrogen, muriatic, and sulphurous gases. He distinguished alum from the vitriols; remarking that the former contained an earth, and the latter metals. He perceived the part played by the atmosphere in combustion, and recognized the analogy between combustion and respiration. He saw that in the organic system chemical processes are constantly going on. Thus, to him is due the fundamental idea from which have sprung the chemico-physiological researches of Liebig, Mulder, Boussingault, and others. By using in medicine, not crude vegetables, but their active principles, he opened the way to the discovery of the proximate principles of vegetables, organic alkalis, and the like. But perhaps the greatest service he rendered to chemistry, was by declaring it an essential part of medical education, and by showing that its true practical application lay not in gold-making, but in pharmacy and the industrial arts. In medicine he scouted the fearfully complex electuaries and mixtures of the Galenists and the Arabian polypharmacists, recommending simpler and more active preparations. He showed that the idea of poison is merely relative, and knew that poisons in suitable doses may be employed in medicine. He prescribed tin as a remedy for intestinal worms, mercury as an anti-syphilitic, and lead in the diseases of the skin. He also used preparations of antimony, arsenic, and iron. He employed sulphuric acid in the treatment of saturnine affections. The astonishing cures which he undoubtedly performed were, however, due not so much to his peculiar medicines, as to his eminent sagacity and insight. He showed the importance of a chemical examination of urine for the diagnosis of disease."

_J. W. Slater, Paracelsus (Imperial Dict. of Univ. Biog.)._

MEDICAL SCIENCE: 16th Century. The first English College of Physicians.

"The modern doctor dates only from the reign of Henry VIII., when the College of Physicians in England was founded as a body corporate by letters patent in the tenth year of the reign. This grant was in response to a petition from a few of the most notable members of the profession resident in London, who were perhaps moved by both a laudable zeal in the interests of science, and a compassion for the sufferings of the subjects of astrological and toxicological experiments. The charter thus obtained, though probably drafted by the promoters themselves, was found to be so inadequately worded and expressed, that it became necessary to obtain powers to amend it by Act of Parliament. Among these early members were Linacre, Wotton, and others, famous scholars beyond doubt, though possibly but indifferent practitioners. In fact, we are constantly struck throughout the early history of the profession by the frequent occurrence of names associated with almost every other branch of study than that strictly appertaining to the art of medicine. We have naturalists, magneticians, astronomers, mathematicians, logicians, and classical scholars, but scarce one who accomplished anything worthy to be recorded in the annals of medical science. Indeed it is difficult to conceive any useful object that could have been attained by the existence of the College as a professional licensing body, other than the pecuniary interests of the orthodox. … It is most significant as to the social degradation of the science of medicine, that most of the notorious empirics of the latter half of the sixteenth century were both highly recommended and strenuously supported in their resistance to the proctors of orthodoxy by some of the greatest names of the age. These self-deluded victims of quackery were not indeed adverse in theory to the pretensions of more regular members of the profession. {2133} They would patronize the Court physicians, or, if favorites of the Crown, they might even submit to the Sovereign's recommendation in that behalf; but none the less their family doctor was in far too many cases some outlandish professor of occult arts, retained in learned state on the premises, who undertook the speedy, not to say miraculous, cure of his patron's particular disease by all the charms of the Cabala."

_H. Hall, The Early Medicus (Merry England; also in Eclectic Magazine, June, 1884)._

MEDICAL SCIENCE: 16th Century. The System of Van Helmont.

John Baptist van Helmont "was born at Brussels in the year 1577. … His parents were noble, and he was heir to great possessions. He pursued in Louvain the usual course of scholastic philosophy. … Becoming accidentally acquainted with the writings of Thomas à Kempis and John Tauler, he from that day adopted what goes by the vague term of mysticism. That is, thoroughly convinced that there was a spiritual world in intimate and eternal union with the spirit of man; that this spiritual world was revealed to that human soul which submitted to receive it in humility; and that the doctrines of Christianity were not to be looked upon as a system of philosophy; but as a rule of life, he resolved to follow them to the letter. The consequence of this resolution was, that he devoted himself to the art of medicine, in imitation of the Great Healer of the body as well as of the soul; and as the prejudices of his time and country made his rank and wealth an obstacle to his entrance into the medical profession, he made over all his property, with its honours, to his sister; that, 'laying aside every weight, he might run the race that was set before him.' He entered on his new studies with all the zeal of his character, and very soon had so completely mastered the writings of Hippocrates and Galen, as to excite the surprise of his contemporaries. But although styled a dreamer, and having a mind easily moved to belief in spiritual manifestation, he was not of a credulous nature in regard to matters belonging to the senses. And as he believed that Christianity was to be practised, and to be found true by the test of experiment, so he believed that the doctrines of Hippocrates and of Galen were to be subjected to a similar trial. An opportunity soon occurred to himself. He caught the itch and turned to Galen for its cure. Galen attributes this disease to overheated bile and sour phlegm, and says that it is to be cured by purgatives. Van Helmont, with the implicit faith of his simple nature, procured the prescribed medicines, and took them as ordered by Galen. Alas, no cure of the itch followed, but great exhaustion of his whole body: so Galen was not to be trusted. This was a serious discovery; for if he could not trust Galen, by whom the whole medical world swore, to whom was he to turn? … Van Helmont resolved to work out for himself a solution of the great problem to which he had devoted his life. Van Helmont's system may be called spiritual vitalism. The primary cause of all organization was Archæus. By Archæus, a man is much more nearly allied, he says, to the world of spirits and the Father of spirits than to the external world. Archæus is the creative spirit which, working upon the raw material of water or fluidity, by means of 'a ferment' excites all the endless actions which result in the growth and nourishment of the body. Thus, digestion is neither a chemical nor a mechanical operation; nor is it, as was then supposed, the effects of heat, for it is arrested instead of aided by fever, and goes on in perfection in fishes and cold-blooded animals; but, on the command of Archæus, an acid is generated in the stomach, which dissolves the food. This is the first digestion. The second consists in the neutralization of this acid by the bile out of the gall bladder. The third takes place in the vessels of the mesentery. The fourth goes on in the heart, by the action of the vital spirits. The fifth consists in the conversion of the arterial blood into vital spirits, chiefly in the brain. The sixth consists of the preparation of nourishment in the laboratory of each organ, during which operation Archæus, present everywhere, is itself regenerated, and superintends the momentary regeneration of the whole frame. If for digestion we substitute the word nutrition, we cannot fail to be struck by the near approach to accuracy in this description of the succession of processes by which it is brought about. Van Helmont's pathology was quite consistent with his physiology. As life and all vital action depended upon Archæus, so the perturbation of Archæus gave rise to fevers, and derangements of the blood and secretions. Thus, gout was a disease not confined to the part in which it showed itself, but was the result of Archæus. It will be seen that by this theory the entire system of Galen was non-suited. There is no place for the elements and the humours."

_J. R. Russell, History and Heroes of the Art of Medicine, chapter 8._

MEDICAL SCIENCE: 17th Century. Harvey and the Discovery of the Circulation of the Blood.

William Harvey, "physician and discoverer of the circulation of the blood, was born at Folkestone, Kent, 1 April 1578, in a house which was in later times the posthouse of the town and which still belongs to Caius College, Cambridge, to which Harvey bequeathed it. His father was Thomas Harvey, a Kentish yeoman. … In 1588 William was sent to the King's School, Canterbury. Thence he went to Cambridge, where he was admitted a pensioner in Gonville and Caius College, 31 May 1593. … He graduated B. A. 1597, and, determining to study medicine, travelled through France and Germany to Padua, the most famous school of physic of that time. … He returned to England, graduated M. D. at Cambridge 1602, and soon after took a house in the parish of St. Martin-extra-Ludgate in London. … On 4 August 1615 he was elected Lumleian lecturer at the College of Physicians, … and in the following April, on the 16th, 17th, and 18th, he delivered at the college in Knightrider Street, near St. Paul's Cathedral, the lectures in which he made the first public statement of his thoughts on the circulation of the blood. The notes from which he delivered these lectures exist in their original manuscript and binding at the British Museum. … In 1628, twelve years after his first statement of it in his lectures, he published at Frankfurt, through William Fitzer, his discovery of the circulation of the blood. The book is a small quarto, entitled 'Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus,' and contains seventy-two pages and two plates of diagrams. The printers evidently had difficulty in reading the author's handwriting, and there are many misprints. … {2134} He begins by modestly stating how the difficulties of the subject had gradually become clear to him, and by expressing with a quotation from the 'Andria' of Terence, the hope that his discovery might help others to still further knowledge. He then describes the motions of arteries, of the ventricles of the heart, and of its auricles, as seen in living animals, and the use of these movements. He shows that the blood coming into the right auricle from the vena cava, and passing then to the right ventricle, is pumped out to the lungs through the pulmonary artery, passes through the parenchyma of the lungs, and comes thence by the pulmonary veins to the left ventricle. This same blood, he shows, is then pumped out to the body. It is carried out by arteries and comes back by veins, performing a complete circulation. He shows that, in a live snake, when the great veins are tied some way from the heart, the piece of vein between the ligature and the heart is empty, and further, that blood coming from the heart is checked in an artery by a ligature, so that there is blood between the heart and the ligature and no blood beyond the ligature. He then shows how the blood comes back to the heart by the veins, and demonstrates their valves. These had before been described by Hieronymus Fabricius of Aquapendente, but before Harvey no exact explanation of their function had been given. He gives diagrams showing the results of obstructing the veins, and that these valves may thus be seen to prevent the flow of blood in the veins in any direction except towards the heart. After a summary of a few lines in the fourteenth chapter he further illustrates the perpetual circuit of the blood, and points out how morbid materials are carried from the heart all over the body. The last chapter gives a masterly account of the structure of the heart in men and animals, and points out that the right ventricle is thinner than the left because it has only to send the blood a short way into the lungs, while the left ventricle has to pump it all over the body. This great and original book at once attracted attention and excited discussion. In the College of Physicians of London, where Harvey had mentioned the discovery in his lectures every year since 1616, the Exercitatio received all the honour it deserved. On the continent of Europe it was received with less favour, but neither in England nor abroad did anyone suggest that the discovery was to be found in other writers. … Before his death the great discovery of Harvey was accepted throughout the medical world. The modern controversy … as to whether the discovery was taken from some previous author is sufficiently refuted by the opinion of the opponents of his views in his own time, who agreed in denouncing the doctrine as new; by the laborious method of gradual demonstration obvious in his book and lectures; and, lastly, by the complete absence of lucid demonstration of the action of the heart and course of the blood in Cæsalpinus, Servetus, and all others who have been suggested as possible originals of the discovery. It remains to this day the greatest of the discoveries of physiology, and its whole honour belongs to Harvey."

_N. Moore, Harvey (Dict. of National Biog., volume 25)._

ALSO IN: _R. Willis, William Harvey: A history of the Discovery of the Circulation of the Blood._

MEDICAL SCIENCE: 17th Century. Discovery of the Lymphatic Circulation.

"The discovery of the lymphatic vessels and their purpose was scarcely less remarkable than that of the circulation of the blood. It has about it less of eclat, because it was not the work of one man, but was a matter of slow development. Herophilus and Erasistratus had seen white vessels connected with the lymph nodes in the mesentery of certain animals, and had supposed them to be arteries full of air. Galen disputed this, and believed the intestinal chyle to be carried by the veins of the mesentery into the liver. In 1563 Eustachius had described the thoracic duct in the horse; in 1622 Aselli, professor of anatomy at Milan, discovered the lacteal vessels in a dog which had been killed immediately after eating. Having pricked one of these by mistake, he saw a white fluid issue from it. Repeating the same experiment at other times he became certain that the white threads were vessels which drew the chyle from the intestines. He observed the valves with which they are supplied, and supposed these vessels to all meet in the pancreas and to be continued into the liver. In 1647 Pecquet, who was still a student at Montpelier, discovered the lymph reservoir, or receptaculum chyli, and the canal which leads from it, i. e., the thoracic duct, which he followed to its termination in the left subclavian vein. Having ligated it he saw it swell below, and empty itself above the ligature. He studied the courses of the lacteals, and convinced himself that they all entered into the common reservoir. His discovery gave the last blow to the ancient theory, which attributed to the liver the function of blood making, and it confirmed the doctrine of Harvey, while, like it, it had been very strongly opposed. Strangely enough, Harvey in this instance united with his great opponent, Riolan, in making common cause against the discovery of Pecquet and its significance. From that time the lymphatic vessels and glands became objects of common interest and were investigated by many anatomists, especially Bartholin, Ruysch, the Hunters, Hewson, and above all by Mascagni. He was the first to give a graphic description of the whole lymphatic apparatus."

_Roswell Park, Lectures on the History of Medicine (in MS.)._

MEDICAL SCIENCE: 17th Century. Descartes and the dawn of modern Physiological science.

"The essence of modern, as contrasted with ancient, physiological science appears to me to lie in its antagonism to animistic hypotheses and animistic phraseology. It offers physical explanations of vital phenomena, or frankly confesses that it has none to offer. And, so far as I know, the first person who gave expression to this modern view of physiology, who was bold enough to enunciate the proposition that vital phenomena, like all the other phenomena of the physical world, are, in ultimate analysis, resolvable into matter and motion was René Descartes. The fifty-four years of life of this most original and powerful thinker are widely overlapped, on both sides, by the eighty of Harvey, who survived his younger contemporary by seven years, and takes pleasure in acknowledging the French philosopher's appreciation of his great discovery. {2135} In fact, Descartes accepted the doctrine of the circulation as propounded by 'Harvæus médecin d'Angleterre,' and gave a full account of it in his first work, the famous 'Discours de la Méthode,' which was published in 1637, only nine years after the exercitation 'De motu cordis;' and, though differing from Harvey on some important points (in which it may be noted, in passing, Descartes was wrong and Harvey right), he always speaks of him with great respect. And so important does the subject seem to Descartes that he returns to it in the 'Traité des Passions' and in the 'Traité de l'Homme.' It is easy to see that Harvey's work must have had a peculiar significance for the subtle thinker, to whom we owe both the spiritualistic and the materialistic philosophies of modern times. It was in the very year of its publication, 1628, that Descartes withdrew into that life of solitary investigation and meditation of which his philosophy was the fruit. … Descartes uses 'thought' as the equivalent of our modern term 'consciousness.' Thought is the function of the soul, and its only function. Our natural heat and all the movements of the body, says he, do not depend on the soul. Death does not take place from any fault of the soul, but only because some of the principal parts of the body become corrupted. … Descartes' 'Treatise on Man' is a sketch of human physiology, in which a bold attempt is made to explain all the phenomena of life, except those of consciousness, by physical reasonings. To a mind turned in this direction, Harvey's exposition of the heart and vessels as a hydraulic mechanism must have been supremely welcome. Descartes was not a mere philosophical theorist, but a hardworking dissector and experimenter, and he held the strongest opinion respecting the practical value of the new conception which he was introducing. … 'It is true,' says he, 'that as medicine is now practised, it contains little that is very useful; but without any desire to depreciate, I am sure that there is no one, even among professional men, who will not declare that all we know is very little as compared with that which remains to be known; and that we might escape an infinity of diseases of the mind, no less than of the body, and even perhaps from the weakness of old age, if we had sufficient knowledge of their causes and of all the remedies with which nature has provided us.' So strongly impressed was Descartes with this, that he resolved to spend the rest of his life in trying to acquire such a knowledge of nature as would lead to the construction of a better medical doctrine. The anti-Cartesians found material for cheap ridicule in these aspirations of the philosopher; and it is almost needless to say that, in the thirteen years which elapsed between the publication of the 'Discours' and the death of Descartes, he did not contribute much to their realisation. But, for the next century, all progress in physiology took place along the lines which Descartes laid down. The greatest physiological and pathological work of the seventeenth century, Borelli's treatise 'De Motu Animalium,' is, to all intents and purposes, a development of Descartes' fundamental conception; and the same may be said of the physiology and pathology of Boerhaave, whose authority dominated in the medical world of the first half of the eighteenth century. With the origin of modern chemistry, and of electrical science, in the latter half of the eighteenth century, aids in the analysis of the phenomena of life, of which Descartes could not have dreamed, were offered to the physiologist. And the greater part of the gigantic progress which has been made in the present century is a justification of the prevision of Descartes. For it consists, essentially, in a more and more complete resolution of the grosser organs of the living body into physico-chemical mechanisms. 'I shall try to explain our whole bodily machinery in such a way, that it will be no more necessary for us to suppose that the soul produces such movements as are not voluntary, than it is to think that there is in a clock a soul which causes it to show the hours.' These words of Descartes might be appropriately taken as a motto by the author of any modern treatise on physiology."

_T. H. Huxley, Connection of the Biological Sciences with Medicine (Science and Culture, etc., lecture 13)._

MEDICAL SCIENCE: 17th Century. Introduction of Peruvian Bark.