CHAPTER II.

THE SEVENTEENTH CENTURY. Bacon and the Inductive Method.—Descartes and Physiology.—Newton.—Boyle and the Royal Society.—The Founders of the Schools of Medical Science.—Sydenham, the English Hippocrates.—Harvey and the Rise of Physiology.—The Microscope in Medicine.—Willis and the Reform of Materia Medica. The seventeenth century is important in the history of medicine as the era of the two greatest discoveries of modern physiology—the circulation of the blood, and the development of the higher animals from the egg (ovum). Both of these are due to Harvey, and both were made in the midst of the troubles of the great Civil War. The history of medicine is so interwoven at this important period with that of science and philosophy in general, that it is necessary to glance awhile at the great factors which were working out the advancement of medical learning. Amongst the greatest figures on the scientific stage at the beginning and middle of the seventeenth century are the following:— FRANCIS BACON (1561-1626) was the great leader in the reformation of modern science, and shares with Descartes the glory of inaugurating modern philosophy. His great work, the _Novum Organon_, was given to the world just as authority and dogmatism had been discarded from scientific thought, and the era of experiment had begun. It was not Bacon’s contributions to science, not his discoveries, which entitle him to the highest place in the reformation of science, but the general spirit of his philosophy and his connected mode of thinking, his insistence upon the need for rejecting rash generalization, and analysing our experience, employing hypothesis, not by guess work, but by the scientific imagination which calls to its assistance experimental comparison, verification, and proof. Bacon’s philosophy of induction was reared upon a foundation of exclusion and elimination. He relegated theological questions to the region of faith, insisting that experience and observation are the only remedies against prejudice and error.[875] The publication of Bacon’s _Novum Organon_ in 1620 resulted in the formation of a society of learned men, who met together in London in 1645 to discuss philosophical subjects and the results of their various experiments in science. They are described as “inquisitive,” a term which aptly illustrates the temper of the times. Taking nothing upon trust, these men inquired for themselves, and left their books to make experiment, as Bacon had urged students of nature to do. About 1648-9 DRS. WILKINS, WALLIS, and others removed to Oxford, and with SETH WARD, the HON. ROBERT BOYLE, PETTY, and other men of divinity and physic, often met in the rooms of DR. WILKINS at Wadham College, and so formed the Philosophical Society of Oxford, which existed only till 1690. About 1658 the members were dispersed, the majority coming to London and attending lectures at Gresham College. Thus, in the midst of civil war, thoughtful and inquiring minds found a refuge from the quarrels of politicians and the babel of contending parties in the pursuit of knowledge and the advancement of research. The Royal Society was organized in 1660, and on 22nd April, 1662, Charles II. constituted it a body politic and corporate. The _Philosophical Transactions_ began 6th March, 1664-5. 1668 Newton invented his reflecting telescope, and on 28th April, 1686, presented to the Society the MS. of his _Principia_, which the council ordered to be printed. RENE DESCARTES (1596-1650), the philosopher, applied himself to the study of physics in all its branches, but especially to physiology. He said that science may be compared to a tree; metaphysics is the root, physics is the trunk, and the three chief branches are mechanics, medicine, and morals,—the three applications of our knowledge to the outward world, to the human body, and to the conduct of life.[876] He studied chemistry and anatomy, dissecting the heads of animals in order to explain imagination and memory, which he believed to be physical processes.[877] In 1629 he asks Mersenne to take care of himself, “till I find out if there is any means of getting a medical theory based on infallible demonstration, which is what I am now inquiring.”[878] Descartes embraced the doctrine of the circulation of the blood as discovered by Harvey, and he did much to popularise it, falling in as it did with his mechanical theory of life. He thought the nerves were tubular vessels which conduct the animal spirits to the muscles, and in their turn convey the impressions of the organs to the brain. He considered man and the animals were machines. “The animals act naturally and by springs, like a watch.”[879] “The greatest of all the prejudices we have retained from our infancy is that of believing that the beasts think.”[880] Naturally such a monstrous theory did much to encourage vivisection, a practice common with Descartes.[881] “The recluses of Port Royal,” says Dr. Wallace,[882] “seized it eagerly, discussed automatism, dissected living animals in order to show to a morbid curiosity the circulation of the blood, were careless of the cries of tortured dogs, and finally embalmed the doctrine in a syllogism of their logic: no matter thinks; every soul of beast is matter, therefore no soul of beast thinks. He held that the seat of the mind of man was in that structure of the brain called by anatomists the pineal gland.” MALEBRANCHE (1638-1715) was a disciple of Descartes, who thought his system served to explain the mystery of life and thought. In his famous _Recherche de la Verite_ he anticipated later discoveries in physiology, _e.g._, Hartley’s principle of the interdependence of vibrations in the nervous system and our conscious states. BLAISE PASCAL (1623-1662), as a natural philosopher, rendered great services to science. The account of his experiments, written in 1662, on the equilibrium of fluids, entitles him to be considered one of the founders of hydrodynamics. His experiments on the pressure of the air and his invention for measuring it greatly assisted to advance the work begun by Galileo and Torricelli. Not only in the great work done, but in those which were undertaken in consequence of his inspiration, we recognise in Pascal one of the most brilliant scientists of a brilliant age. HOBBES (1588-1679), the famous author of the _Leviathan_, endeavoured to base all that he could upon mathematical principles. Philosophy, he said, is concerned with the perfect knowledge of truth in all matters whatsoever. If the moral philosophers had done for mankind what the geometricians had effected, men would have enjoyed an immortal peace. BENEDICT DE SPINOZA (1632-1677), the philosopher, had some medical training. His spirit has had a large share in moulding the philosophic thought of the nineteenth century. Novalis saw in him not an atheist, but a “God-intoxicated man.” His philosophy indeed was a pure pantheism; the foundation of his system is the doctrine of one infinite substance. All finite things are modes of this substance. SIR ISAAC NEWTON (1642-1727), the greatest of natural philosophers, in the years 1685 and 1686—years for ever to be remembered in the history of science—composed almost the whole of his famous work, the _Principia_. ROBERT BOYLE (1626-1691), one of the great nature philosophers of the seventeenth century, and one of the founders of the Royal Society, published his first book at Oxford, in 1660, entitled _New Experiments, Physico-Mechanical, touching the Spring of Air, and its Effects_. He was at one time deeply interested in alchemy. He was the first great investigator who carried out the suggestions of Bacon’s _Novum Organon_. He was a patient researcher and observer of facts. PIERRE BAYLE (1647-1706), the author of the celebrated _Historical and Critical Dictionary_, was a sceptic, of a peculiar turn of mind. He knew so much concerning every side of every subject which he had considered, that he came to the conclusion that certainty was unattainable. VAN HELMONT (1578-1644) was one of the most celebrated followers of Paracelsus. He learned astronomy, astrology, and philosophy at Rouvain, then studied magic under the Jesuits, and afterwards learned law, botany, and medicine; but he became disgusted with the pretensions of the latter science when it failed to cure him of the itch. He became a mystic, and attached himself to the principles of Tauler and Thomas à Kempis. Then he practised medicine as an act of charity, till, falling in with the works of Paracelsus, he devoted ten years to their study. He married, and devoted himself to medicine and chemistry, investigating the composition of the water of mineral springs. Few men have ever formed a nobler conception of the true physician than Van Helmont, or more earnestly endeavoured to live up to it. Notwithstanding his mysticism, science owes much to this philosopher, for he was an acute chemist. We owe to him the first application of the term “gas,” in the sense in which it is used at present. He discovered that gas is disengaged when heat is applied to various bodies, and when acids act upon metals and their carbonates. He discovered carbonic acid. He believed in the existence of an Archeus in man and animals, which is somewhat like the soul of man after the Fall; it resides in the stomach as creative thought, in the spleen as appetite. This Archeus is a ferment, and is the generative principle and basis of life. Disease is due to the Fall of Man. The Archeus influus causes general diseases; the Archei insiti, local diseases: dropsy, for example, is due to an obstruction of the passage of the kidney secretion by the enraged Archeus. Van Helmont gave wine in fevers, abhorred bleeding, and advocated the use of simple chemical medicines. FRANCIS DE LA BOË (Sylvius), (1614-1672) was a physician who founded the Medico-Chemical Sect amongst doctors. Health and disease he held to be due to the relations of the fluids of the body and their neutrality, diseases being caused by their acidity or alkalinity. THOMAS GOULSTON, M.D. (died 1632), was a distinguished London physician, who was not less famous for his classic learning and theology than for the practice of his profession. He founded what are known as the Goulstonian lectures, which are delivered by one of the four youngest doctors of the Royal College of Physicians, London. “A dead body was, if possible, to be procured, and two or more diseases treated of.” THOMAS WINSTON, M.D. (born 1575), was professor of physic in Gresham College. His lectures included “an entire body of anatomy,” and were considered, when published, as the most complete and accurate then extant in English. The Anatomy Lecture at Oxford was first proposed to the University on Nov. 17th, 1623, with an endowment of £25 a year stipend. Out of this the reader had “to pay yearly to a skilful Chirurgeon or Dissector of the body, to be named by the said reader, the sums of and £3 and £2 more by the year towards the ordering and burying of the body.”[883] Dr. Clayton, the King’s Professor of Physic, was the first reader, and the first chirurgeon was Bernard Wright.[884] GIOVANNI ALFONSO BORELLI (1608-1679), the founder of the Mathematical School of Medicine, which attempted to subject to calculation the phenomena of the living economy, was professor of medicine at Florence. He restricted the application of his system chiefly to muscular motions, or to those which are evidently of a mechanical character. Physiology is exceedingly indebted to this school for many valuable suggestions, and Boerhaave distinctly acknowledged them in his _Institutions_.[885] GEORGE JOYLIFFE, M.D. (died 1658), was partly concerned in the discovery of the lymphatics. It is not possible to say precisely to whom the discovery of the lymphatics was due; they seem to have been observed independently about the year 1651 to 1652 by Rudbeck a Swede, by Bartholine a Dane, and by Joyliffe.[886] A new era in medicine was inaugurated by THOMAS SYDENHAM, M.D. (1624-1689), “the British Hippocrates,” whose only standard was observation and experience, and whose faith in the healing power of nature was unlimited. He studied at Oxford, but he graduated at Cambridge. He was the friend of Locke and of Robert Boyle. He was looked upon by the faculty with disfavour as an innovator, because, in his own words to Boyle, he endeavoured to reduce practice to a greater easiness and plainness. His fame as the father of English medicine was posthumous. It was indeed acknowledged in his lifetime that he rendered good service to medicine by his “expectant” treatment of small-pox, by his invention of his laudanum (the first form of a tincture of opium such as we have it), and for his advocacy of the use of Peruvian bark in agues. Yet his professional brethren were inclined to look upon him as a sectary, and considerable opposition was manifested towards him. Arbuthnot, in 1727, styled him “Æmulus Hippocrates.” Boerhaave referred to him as “Angliæ lumen, artis Phœbum, veram Hippocratici viri speciem.” He did the best he could to cure his patients without mystery and resort to the traditional and often ridiculous dogmas of the medical craft. Many good stories are extant which illustrate this fact. He was once called to prescribe for a gentleman who had been subjected to the lowering treatment so much in vogue in those days. He found him pitifully depressed. Sydenham “conceived that this was occasioned partly by his long illness, partly by the previous evacuations, and partly by emptiness. I therefore ordered him a roast chicken and a pint of canary.” When Blackmore first engaged in the study of medicine, he asked Dr. Sydenham what authors he should read, and was told to study DON QUIXOTE, “which,” he said, “is a very good book; I read it still.” He used to say that there were cases in his practice where “I have consulted my patients’ safety and my own reputation most effectually by doing nothing at all.” Sydenham, having long attended a rich man for an illness which had arisen and was kept going chiefly by his own indolence and luxurious habits, at last told him that he could do no more for him, but that there lived at Inverness a certain physician, named Robinson, who would doubtless be able to cure him. Provided with a letter of introduction and a complete history of the “case,” the invalid set out on the long journey to Inverness. Arrived at his destination, full of hope and eager expectation of a cure, he inquired diligently for Dr. Robinson, only to learn that there was no such doctor there, neither had there been in the memory of the oldest inhabitant. The gentleman returned to London full of indignation against Sydenham, whom he violently rated for sending him so far on a fool’s errand. “But,” exclaimed Sydenham, “you are in much better health!” “Yes,” replied the patient, “I am now well enough, but no thanks to you.” “No,” answered Sydenham; “it was Dr. Robinson who cured you. I wished to send you a journey with some object and interest in view; in going, you had Dr. Robinson and his wonderful cures in contemplation; and in returning, you were equally engaged in thinking of scolding me.” The Civil War, which violently upset the speculations and research at Oxford, when, as Antony Wood says, the University was “empty as to scholars, but pretty well replenished with Parliamentary soldiers,” afforded just that stimulus to thought and that upheaval of dogma and prejudice which were eminently favourable to the advance of medical science. Men had learned to treat old doctrines with little respect for their mere antiquity; authority was discredited, it was subjected to test, observation and criticism; men no longer believed those doctrines about God and His counsels which the Fathers and the Church taught them about religion, much less were they inclined to bow to Aristotle and Galen when they dictated to them on medicine. Anciently, when bitten by a mad dog, it was enough for them to believe with the fathers of medicine that it was sufficient for the patient to hold some herb dittany in the left hand, while he scratched his back with the other to ensure his future safety. Men took to thinking for themselves; the spirit of investigation was aroused; men’s minds, in every condition of society, in every town and village, were aroused to activity. There probably never was a time when there was more activity of thought in Oxford than at this period. The stimulus of collision evoked many sparks of genius, and the Civil War produced at our Universities wholesome disturbance, not destruction of any good things. Sydenham, therefore, was distinctly the product of his age. He does not seem to have been a very learned man, neither, on the other hand, was he wholly untaught. There are not many evidences in his works of very wide reading of medical literature, though he was a sincere admirer of Hippocrates, evidently from a sound acquaintance with his works. Sydenham’s first medical work was published in 1666. It consisted of accounts of continued fevers, symptoms of the same, of intermittent fevers and small-pox, and was entitled _Methodus Curandi Febres, Propriis observationibus superstructa_. In it the author maintains that “a fever is Nature’s engine which she brings into the field to remove her enemy, or her handmaid, either for evacuating the impurities of the blood, or for reducing it into a _new state_. Secondly, that the true and genuine cure of this sickness consists in such a tempering of the commotion of the blood, that it may neither exceed nor be too languid.”[887] It was about this period that Peruvian bark was first introduced into European medicine. Perhaps no other drug has ever been so widely and deservedly used as this American remedy for fevers, agues, and debility. The earliest authenticated account of the use of Cinchona bark in medicine is found in 1638, when the Countess of Cinchon, the wife of the Governor of Peru, was cured of fever by its administration. The Jesuit missionaries are said to have sent accounts of its virtues to Europe, in consequence of one of their brethren having been cured of fever by taking it at the suggestion of a South American Indian. The University of Montpellier, at the time of our great Civil War, was much derided by the Paris Faculty for its laxity in granting degrees in medicine. The enemies of Montpellier said that a three-months’ residence, and the keeping of an act and opponency, sufficed to make a man a Bachelor of Medicine. The professors were accused of neglecting their lectures and selling their degrees; but, worse than all, it was alleged that blood-letting and purging had fallen into disuse, and that the Montpellier treatment was “more expectant than heroic, and more tonic than evacuant.”[888] Friendly historians, on the other hand, say that at this period the medicinal uses of calomel and antimony were better taught there than elsewhere; that museums, libraries, and good clinical teaching flourished, so as to afford the student excellent means of acquiring a sound knowledge of his profession.[889] WILLIAM HARVEY, M.D., the famous discoverer of the circulation of the blood, and the greatest physiologist the world has ever seen, was born at Folkestone, 1578. He entered Caius College, Cambridge, 1593. Having taken his degree, he travelled through France and Germany, and then visited Padua, the most celebrated school of medicine of that time. Fabricius ab Aquâpendente was then professor of anatomy, Minadous professor of medicine, and Casserius professor of surgery. In 1615 Harvey was appointed Lumleian lecturer, and he commenced his course of lectures in the following year—the year of Shakespeare’s death. In this course he is supposed to have expounded his views on the circulation of the blood, which rendered his name immortal. His celebrated work, _Exercitatio Anatomica de Motu Cordis et Sanguinis_, was published in 1628; but he says in that work that for more than nine years he had confirmed and illustrated his opinion in his lectures, by arguments which were founded on ocular demonstration. He was appointed physician extraordinary to James I. in 1618. He was in attendance on King Charles I. at the battle of Edgehill. The king had been an enlightened patron of Harvey’s researches, and had placed the royal deer parks at Hampton Court and Windsor at his disposal. In 1651 Harvey’s _Exercitationes de Generatione_ was published. ARISTOTLE knew but little of the vessels of the body, yet he traced the origin of all the veins to the heart, and he seems to have been aware of the distinction between veins and arteries. “Every artery,” he says, “is accompanied by a vein; the former are filled only with breath or air.”[890] Aristotle thought that the windpipe conveys air into the heart. Although _Galen_ understood the muscles very well, he knew little of the vessels. The liver he held to be the origin of the veins, and the heart of the arteries. He knew, however, of their junctions or anastomoses.[891] MONDINO, the anatomist of Bologna, who dissected and taught in 1315, had some idea of the circulation of the blood, for he says that the heart transmits blood to the lungs.[892] The great Italian anatomists, diligent students as they were of the human frame, all missed the great discovery. SERVETUS, who was burnt by Calvin as a heretic in Geneva in 1553, is the first person who distinctly describes the small circulation, or that which carries the blood from the heart to the lungs and back again to the heart. He says:[893] “The communication between the right and left ventricles of the heart is made, not as is commonly believed, through the partition of the heart, but by a remarkable artifice the blood is carried from the right ventricle by a long circuit through the lungs; is elaborated by the lungs, made yellow, and transferred from the _vena arteriosa_ into the _arteria venosa_.” Still, his theories are full of fancies about a “_vital spirit_, which has its origin in the left ventricle,” and are accordingly unscientific to that extent. Servetus was, however, certainly the true predecessor of Harvey in physiology; this is universally admitted.[894] REALDUS COLUMBUS[895] is thought by some writers to have had a still greater share than Servetus in the discovery of the circulation. He denies the muscularity of the heart, yet correctly teaches that the blood passes from the right to the left ventricle, not through the partition in the heart but through the lungs. Harvey quotes Columbus, but does not refer to Servetus. It must be remembered that when the unfortunate Servetus was burnt at the stake, his work was destroyed with him, and only two copies are known to have escaped the flames.[896] The discovery of the valves of the veins by SYLVIUS and FABRICIUS[897] undoubtedly was the chief factor in the preparation for Harvey’s discovery of the circulation. It was he who first appreciated their significance, and grasped the full meaning of the pulmonary circulation. CÆSALPINUS, in his _Quæstiones Peripateticæ_ (1571), is another claimant for the honours due to Harvey; he had certain confused ideas of the general circulation, and he made some experiments which enabled him to understand the pulmonary circulation, but he certainly did not know the circulation of the blood as a whole; he knew no more of it, in fact, than he gathered from Galen and Servetus.[898] Even Harvey, splendid as was the work he did, could not entirely demonstrate the complete circulation of the blood. He was not able to discover the capillary vessels by which the blood passes from the arteries to the veins. This, the only missing point, was reserved for MALPIGHI to discover. In 1661 this celebrated anatomist saw in the lungs of a frog, by the aid of the newly invented microscope, the blood passing from one set of vessels to the other. Harvey began his investigations by dissecting a great number of living animals. He examined in this way dogs, pigs, serpents, frogs, and fishes. He did not disdain to learn even from slugs, oysters, lobsters, and insects, and the chick itself while still in the shell. He observed and experimented upon the ventricles, the auricles, the arteries, and the veins. He learned precisely the object of the valves of the veins—to favour the flow of the blood towards the heart; and it was to this latter observation, and not the vivisection, that he attributed his splendid discovery. “I remember,” says Boyle, “that when I asked our famous Harvey what were the things that induced him to think of a circulation of the blood, he answered me, that when he took notice that the valves in the veins of so many parts of the body were so placed, that they gave a free passage to the blood towards the heart, but opposed the passage of the venal blood the contrary way, he was incited to imagine that so provident a cause as Nature had not placed so many valves without design; and no design seemed more probable than that the blood should be sent through the arteries, and return through the veins, whose valves did not oppose its cause that way.” What clear views of the motions and pressure of a fluid circulating in ramifying tubes must have been held by Harvey to enable him to deduce his discovery from a contemplation of the simple valves! It was observation, experience, which led him to this. “In every science,” he says,[899] “be it what it will, a diligent observation is requisite, and sense itself must be frequently consulted. We must not rely upon other men’s experience, but our own, without which no man is a proper disciple of any part of natural knowledge.” Dr. J. H. Bridges, of the Local Government Board, delivered the Harveian oration on October 20th, 1892, at the Royal College of Physicians. Dr. Bridges said: “In his discovery William Harvey employed every method of biological research, direct observation, experiment, above all the great Aristotelian method of comparison to which he himself attributes his success. His manuscript notes show how freely he used it. They show that he had dissected no less than eighty species of animals. It is sometimes said that experimentation on living animals was the principal process of discovery. This I believe to be an exaggerated view, though such experiments were effective in convincing others of the discovery when made. It need not be said that no ethical problem connected with this matter was recognised in Harvey’s time. The first to recognise such a problem was that great and successful experimenter, deep thinker, and humane man, Sir Charles Bell. What were the effects of Harvey’s discovery? It was assuredly the most momentous event in medical history since the time of Galen. It was the first attempt to show that the processes of the human body followed or accompanied each other by laws as certain and precise as those which Kepler and Galileo were revealing in the solar system or on the earth’s surface. Henceforth it became clear that all laws of force and energy that operated in the inorganic world were applicable to the human body.” The case for Harvey’s originality is well put by the author of the article on Harvey in the _Dictionary of National Biography_. “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.” “That there is one blood stream, common to both arteries and veins, that the blood poured into the right auricle passes into the right ventricle, that it is from there forced by the contraction of the ventricular walls along the pulmonary artery through the lungs and pulmonary veins to the left auricle, that it then passes into the left ventricle to be distributed through the aorta to every part of the animal body; and that the heart is the great propeller of this perpetual motion, as in a circle. This is the great truth of the motion of the heart and blood, commonly called the circulation, and must for ever remain the glorious legacy of William Harvey to rational physiology and medicine in every land.”[900] Harvey explains how he was led to his great discovery: “When I first gave my mind to vivisections as a means of discovering the motions and uses of the heart, and sought to discover these from actual inspection, and not from the writings of others, I found the task so truly arduous, so full of difficulties, that I was almost tempted to think with Frascatorius, that the motion of the heart was only to be comprehended by God. For I could neither rightly perceive at first when the systole and when the diastole took place, nor when and where dilatation and contraction occurred, by reason of the rapidity of the motion, which in many animals is accomplished in the twinkling of an eye, coming and going like a flash of lightning; so that the systole presented itself to me now from this point, now from that; the diastole the same; and then everything was reversed, the motions occurring, as it seemed, variously and confusedly together. My mind was therefore greatly unsettled, nor did I know what I should myself conclude, nor what believe from others. I was not surprised that Andreas Laurentius should have written that the motion of the heart was as perplexing as the flux and reflux of Euripus had appeared to Aristotle. At length, and by using greater diligence and investigation, making frequent inspection of many and various animals, and collating numerous observations, I thought that I had attained to the truth, that I should extricate myself and escape from this labyrinth, and that I had discovered what I so much desired, both the motion and the use of the heart and arteries.”[901] JOHN LOCKE (1632-1704). The great philosopher was a thoroughly educated physician engaged in the practice of medicine. He was the friend of Sydenham, whose principles he defended and whose works are doubtless permeated with the thoughts of the author of the famous treatise on the Human Understanding. In a letter of Locke’s to W. Molyneux he says: “You cannot imagine how far a little observation carefully made by a man not tied up to the four humours [Galen], or sal, sulphur, and mercury [Paracelsus], or to acid and alkali [Sylvius and Willis], which has of late prevailed, will carry a man in the curing of diseases, though very stubborn and dangerous; and that with very little and common things, and almost no medicine at all.” Locke declared that we have no innate ideas, but that all our knowledge is derived from experience. The acquirement of knowledge is due to the investigation of things by the bodily senses. Surgery about this period began to flourish in England. RICHARD WISEMAN (1625-1686), the “Father of English Surgery,” was in the royal service from Charles I. to James II. His military experience greatly assisted him in his profession. He treated aneurism by compression, practised “flap-amputation,” and laid down rules for operating for hernia. JAMES PRIMROSE, M.D. (died 1659), was a voluminous writer who opposed the teaching of Harvey on the circulation of the blood. BALDWIN HAMEY, jun., M.D., was the most munificent of all the benefactors of the London College of Physicians. He was lecturer on Anatomy at the College in 1647, and a voluminous writer, though he published little or nothing. FRANCIS GLISSON, M.D. (died 1677), was one of the first of the group of anatomists in England who, incited by Harvey’s example, devoted themselves to enthusiastic research. His account of the cellular envelope of the portal vein in his work _De Hepate_, published in 1654, has immortalised his name in the designation “Glisson’s capsule.” He wrote a work on rickets, _De Rachitide seu Morbo Puerili_. Glisson ascribed to the lymphatic vessels the function of absorption. JONATHAN GODDARD, M.D. (died 1674), frequented the meetings which gave birth to the Royal Society. He was a good chemist, and invented the famous volatile drops known on the Continent as the Guttæ Anglicanæ. He made the first telescope ever constructed in this country. DANIEL WHISTLER, M.D. (died 1684), wrote an essay on “The Rickets,” which is the earliest printed account we have of that disease. THOMAS WHARTON, M.D. (died 1673), was a very distinguished anatomist, who remained in London during the whole of the plague of 1666. He was the author of the most accurate work on the glands of the body and their diseases which up to that time had appeared. RAYMOND VIEUSSENS in 1684 published a great work on the anatomy of the brain, spinal cord, and nerves. He investigated the sympathetic nerve and the structure of the heart. LEEUWENHOECK (1632-1723) discovered the corpuscles in the blood and the spermatozoa. MARCELLO MALPIGHI (1628-1694), by his microscopical researches, first explained the organization of the lung and the terminations of the bronchial tubes. He traced the termination of the arteries in the veins, and thus completed the discovery of the circulation of the blood; by his researches in the deeper layer of the cuticle, and certain bodies in the spleen and kidney, he has given his name to these structures. The invention of the MICROSCOPE in 1621 was of the utmost importance to the study of minute anatomy and physiology. PIERRE DIONIS (died 1718), a famous French surgeon, published a work on the anatomy of man, which was translated into Chinese at the emperor’s request. He also wrote on rickets in relation to the pelvis, and advanced the study of dentistry. He explained the circulation, and wrote a monograph on catalepsy. THOMAS BARTHOLIN (1619-1680), professor of anatomy at Copenhagen, made important investigations on the lacteals and lymphatic vessels. CASPAR ASSELLIUS (1581-1626) discovered the chyliferous vessels in the dog; FABRICE DE PEIRESC (1580-1637), dissecting a criminal two hours after execution, discovered them in man; VAN HORNE (1621-1670), in 1652, first demonstrated the vessels in man. (It has, however, been claimed that George Jolyffe discovered the lymphatics in 1650.) JEAN PECQUET (1622-1674), a French physician, published, in 1651, his _New Anatomical Experiments_, in which he made known his discovery of the receptacle of the chyle, till then unknown, and described the vessel which conveys the chyle to the subclavian vein. OLAUS RUDBECK (1630-1702), a Swedish surgeon, shares with Jolyffe the honour of the discovery of the termination of the lymphatic vessels. He demonstrated them in the presence of Queen Christina, and traced them to the thoracic duct, and the latter to the subclavian vein. GERARD BLAES (died 1662) made numerous discoveries in connection with the glands. ANTONY NUCK (1650-1692) first injected the lymphatics with quicksilver, rectified various errors in the work of his predecessors, and by his own researches did much to complete the anatomy of the glands. PAUL SARPI (1552-1623), of Venice, was a monk of whom La Courayer said, “Qu’il était Catholique en gros et quelque fois Protestant en détail.” He was the friend of Galileo, and, though he did not invent the telescope, was the first who made an accurate map of the moon. It is not true that he anticipated Harvey in his discovery of the circulation, though he was a great physiologist, and discovered the contractility of the iris. NATHANAEL HIGHMORE (1613-1685) was a physician and anatomist who is chiefly remembered for his description of the cavity in the superior maxillary bone which bears his name. It had, however, been previously described by Cassørius. He demonstrated the difference between the lacteals and the mesenteric veins. GEORGE WIRSUNG (died 1643) was a prosector to Vesalius. He discovered the excretory duct of the pancreas. SIR CHRISTOPHER WREN (1632-1723) was the first to suggest the injection of medicines into the veins. THORBERN, a Danish peasant, about this time invented an instrument for amputating the elongated uvula. JAN SWAMMERDAM (1637-1686) was the first to prove that the queen bee was a female. THOMAS MILLINGTON (_circ._ 1676) pointed out the sexual organs of plants. FELIX VICQ D’AZYR (1748-1794) was one of the zoologists whose researches exercised an important influence on the progress of anatomy. He investigated the origin of the brain and nerves, and the comparative anatomy of the vocal organs. SIR THOMAS BROWNE, M.D., of Norwich (1605-1682), the author of the immortal _Religio Medici_, studied medicine at Montpellier, Padua, and Leyden. He was a man who, in his own words, _could not do nothing_. Though he wrote a famous work on _Vulgar Errors_, he could not rise superior to the commonest one of his time—the belief in witchcraft. THOMAS WILLIS, M.D. (1621-1675), was celebrated for his researches in the anatomy and pathology of the brain. Unfortunately he neglected observation for theorising. Dr. Freind said of Willis that he was the first inventor of the nervous system. Willis taught that the cerebrum is the seat of the intellectual faculties, and the source from which spring the voluntary motions. He consigned the involuntary motions to the cerebellum; these go on in a regular manner, without our knowledge and independently of our will. He supposed that the nerves of voluntary motions arise chiefly from the cerebrum, and those of the involuntary motions from the cerebellum or its appendages.[902] Willis deserves to be gratefully remembered in medical history as the great reformer of pharmacology. Having been led to consider how it is that medicines act on the various organs of the body, he reflected that there was usually very little relationship between the means of cure and the physiological and pathological processes to be influenced. Medicines were given at random. Mineral poisons, such as antimony, were recklessly prescribed, to the destruction, not of the disease only, but too frequently of the patient also. “So heedlessly,” says Willis, “are these executioners in the habit of sporting with the human body, while they are led to prepare and administer these dangerous medicines, not by any deliberation, nor by the guidance of any method, but by mere hazard and blind impulse.”[903] The object of Willis was to establish a direct and reasonable relationship between the physiological and morbid conditions of the body on the one hand, and the indications for cure and the therapeutic means by which these were to be brought about on the other.[904] It was a great task, and Willis did not wholly succeed; but his method was the right one, however grievously he failed to carry it into practice, for he prescribed blood, the human skull, salt of vipers, water of snails and earthworms, millipeds, and other things which he ought to have known could have no effect on any disease.[905] We must not be too severely critical, for Willis was the first to attempt the reformation of this degraded state of Materia Medica. The state of Materia Medica (or the drugs and chemicals used by the physician) during the end of the seventeenth and the earlier part of the eighteenth century, was remarkable, says Dr. Thomson,[906] for four circumstances. _First_, there was a great number of remedies strongly recommended for the cure of diseases; but many of them were inert and useless, and thus the practitioner was perplexed and confused. _Secondly_, the popular confidence in all these medicines was irrational and extreme. _Thirdly_, it was the custom to combine in one prescription a great number of ingredients. The Pharmacopœias of the period contain formulæ which embraced in some instances from twenty-four up to as many as fifty-two ingredients. Sydenham is the first who exhibits any tendency to greater simplicity in his prescriptions. _Lastly_, there was no rational or logical connection between the disease to be cured and the remedy with which it was treated. Empiricism and superstition to a serious extent dominated medicine, and retarded its progress. Yet, even during the seventeenth century, original thinkers and men of genius connected with one or other of the universities, struck out a path for themselves which led to brighter things. First was Harvey, then came Wharton, Glisson, Willis, Lower, Mayow, Grew, Charleton, Collins, Sydenham, Morton, Bennet, and Ridley; all these men were students of anatomy and ardent investigators in the field of physiology. It is true that it was long before the labours of these pioneers of scientific medicine resulted in any marked improvement in the actual method of treating disease; it is no less certain that our methods of to-day are based upon the labours of the great scientific investigators of the age we are considering. SAMUEL COLLINS, M.D. (died 1710), was celebrated as an accomplished comparative anatomist, whose work was much praised by Boerhaave and Haller. WILLIAM CROONE, M.D. (died 1684), was one of the original Fellows of the Royal Society. In 1670 he was appointed lecturer on anatomy at Surgeons’ Hall. He is gratefully remembered as the founder of what is now called the “Croonian Lecture.” RICHARD LOWER, M.D. (1631-1691), was an anatomist and physiologist, who assisted Willis in his researches, and who wrote a treatise on transfusion of blood, which he practised at Oxford in 1665, and also before the Royal Society. His name is kept in remembrance by anatomists by its association with the study of the heart in the structure known as the “tuberculum Lowerii.” We must not omit to mention FRÈRE JACQUES, who went to Paris in 1697; he was a Franciscan monk, who was a famous operator for the stone. Originally a day labourer, he became so expert a lithotomist that he is said to have cut nearly 5,000 persons in the course of his life. In the height of his success he had no knowledge of anatomy, though he was afterwards induced to learn it. He is for ever celebrated as the inventor of the lateral method in lithotomy.[907]