CHAPTER VII.

THE EIGHTEENTH CENTURY. The Sciences accessory to Medicine.—The great Schools of Medical Theory.—Boerhaave and his System.—Stahl.—Hoffman.—Cullen.—Brown.—Hospitals.—Bichat and the New Era of Anatomy.—Mesmer and Mesmerism.—Surgery.—The Anatomists, Physiologists, and Scientists of the Period.—Inoculation and Vaccination. The medical history of the eighteenth century affords but a meagre result, notwithstanding the brilliant talents and indefatigable industry of the famous men who devoted their energies to the healing art. Their great aim was to create systems of medicine which should be philosophical and complete. It is not only in what is strictly the art of healing that the members of the medical profession have ever been amongst the greatest benefactors of the world, but in what are known as the accessory sciences many of the most distinguished, enlightened, and self-sacrificing of the heroes of science have been affiliated to the profession of medicine. Not only the heroes, but the martyrs of medicine, crowd the scientific calendar. The seventeenth and eighteenth centuries were fertile in the efforts to apply the results of discoveries in the physical sciences to the relief of human suffering. If these efforts were but partially successful, so far as medicine—considered apart from surgery—was concerned, it was not in consequence of less industry in that department, but because speculation and theorising about the causes of disease monopolised the attention which, if devoted to observation of facts, would have been fertile in result. Schools, Systems, and Sects were the chief product of the medical activity of the eighteenth century. Although not perhaps of much direct benefit to medicine, indirectly the study of the sciences accessory to it must have been of considerable benefit as an educational factor in the training of the intellect of physicians. THE GREAT SCHOOLS OF MEDICAL THEORY. Whewell, in his _History of Scientific Ideas_,[990] classifies the successive biological hypotheses under the heads: (1) THE MYSTICAL SCHOOL; (2) THE IATRO-CHEMICAL SCHOOL; (3) THE IATRO-MATHEMATICAL SCHOOL; (4) THE VITAL-FLUID SCHOOL; (5) THE PSYCHICAL SCHOOL. THE MYSTICAL SCHOOL found its most distinguished representative in Paracelsus; it derived its doctrine of the _Macrocosm_ and the _Microcosm_ from the Neoplatonists, and was largely imbued with alchemy and magic, the doctrines of the Cabala and the fanciful interpretations of the Bible. Later Paracelsists, Rosicrucians, and other speculators of the same character, such as Sir Kenelm Digby, brought the Mystical School of Medicine down to the seventeenth century. Our modern Theosophists are striving to restore much of the mystical teaching of Paracelsus and his followers. Again we meet the “astral bodies,” “the elementary spirits,” the cabalistic interpretations of the Bible, and the astrological absurdities of a pre-scientific period. THE IATRO-CHEMICAL SCHOOL really arose from PARACELSUS, who amongst many absurdities held much important truth. SPRENGEL indicates LIBAVIUS of Saxony as the person who first cultivated chemistry apart from theosophy, and he names ANGELUS SALA as his successor. LEMERY, in the middle of the seventeenth century, began to reform pharmaceutical chemistry. After PARACELSUS chemistry became an indispensable study to every physician. Our word _tartar_, the scale which forms on the teeth, is of Paracelsian origin. He taught that the basis of all diseases was a thickening of the juices and the formation of earthy matter, which he called _Tartarus_, because it burns like the fire of hell. After PARACELSUS we have VAN HELMONT, a true chemical discoverer who sought in chemistry a theory of disease of which his doctrine of fermentation in the body holds an important place. Next we have SYLVIUS, with his doctrine of the opposition of acid and alkali. Digestion he considered a process of fermentation or effervescence of the acid of the saliva and pancreatic juice with the alkali of the gall. When either the acid or the alkali predominated, disease was supposed to follow. The human body was regarded as a laboratory, the stomach as a sort of test tube. BOYLE made objections to the doctrines of this school, and HERMAN CONRING taught that the proper place of chemistry was not in physiology and pathology, but in pharmacy. VIRIDET of Geneva endeavoured to prove that the fluids of the body are either acid or alkaline by experiment. RAIMOND VIEUSSENS declared that he had discovered an acid in the blood and a ferment in the stomach. HECQUET opposed him, and said that digestion was not a process of fermentation, but of trituration. PITCAIRN in England, BOHN and HOFFMAN in Germany, and BOERHAAVE in Holland opposed the iatro-chemists, and proved by observation that digestion is not fermentation, and that the acid and alkali theories of disease supported by SYLVIUS were false. By the influence and authority of these eminent physicians, the reign of the chemical school of physiology was overturned. The great fault of the iatro-chemists was their neglect of the effect of the solids of the animal body; they assimilated the work of the physician, as Whewell says, to that of the vintner or the brewer. THE IATRO-MATHEMATICAL or MECHANICAL SCHOOL attacked, defeated, and superseded the iatro-chemists. According to this sect, the human body is a mere machine. Whewell explains that the Mechanical Physiologists came into existence in consequence of the splendid results obtained by the schools of Galileo and Newton. It was not so much the exposure of the weaknesses of the chemical physiology as the effects produced upon the world by the explanation of so many of the phenomena of the external universe by the men who had revolutionized astronomy by their discoveries; it was naturally hoped that that which served to explain the great world of matter might also elucidate the little world of man. Whewell divides the school into two parts—the Italian and the Cartesio-Newtonian sect. The Italian calculated and analysed the properties of the animal body which are undoubtedly purely mechanical, the Cartesio-Newtonians went much further than this and introduced many baseless hypotheses. The Italians occupied themselves with such calculations as the force of muscles and the hydraulics of the animal fluid. BORELLI was the first great investigator on these lines; his work _De Motu Animalium_ (Rome, 1680), treats of the forces and action of the bones and muscles. JOHN and DANIEL BERNOUELLI and HENRY PEMBERTON pursued the same line of research. The principles of hydrostatics were brought to bear on the questions of the blood pressure and the breath. KEILL endeavoured to estimate the velocity of the blood. The other school occupied itself with the corpuscular hypothesis in physiology. The organs were considered as a species of sieves. Both NEWTON and DESCARTES sought to explain physiology on a theory of round particles passing through cylindrical tubes, pyramidal ones through pores of a triangular shape, cubical through square openings. The diameter and curves of the different vessels formed subjects of calculations, and BELLINI, DONZELLINI, and GUGLIELMINI in Italy, PERRAULT and DODART in France, COLE, KEILL, and JURIN in England, devoted themselves to their study.[991] The investigation of the size and shape of the particles of the fluids, and the diameter and form of the invisible vessels, formed a large part of the physiology of the beginning of the eighteenth century. CHEYNE thought that fevers of the acute sort arise from glandular obstruction; and MEAD, the royal physician and friend of Newton, explained the action of poisons on mechanical principles. The error of this school, as Whewell explains, lay in considering the animal frame as a lifeless compound of canals, cords and levers; the physicians, to its adherents, were merely hydraulic engineers. Some iatro-mathematicians were, in fact, at the same time teachers both of engineering and medicine.[992] THE VITAL-FLUID SCHOOL. The mechanical explanation of the motions of the animal body may satisfy some observers up to a certain point; there, however, they must confess their theory fails them. How does motion _originate_ in the living frame? FRIEDRICH HOFFMAN, of Halle (b. 1660), assumed a principle, material, yet of a higher kind than the adherents of the mechanical sect were inclined to recognise. This principle is exceedingly subtle, and is endued with great energy. It is the ether diffused through all nature, and which has its seat in the brain of animals and acts upon the body through the nerves. This vital fluid operates by laws which at one time were explained on the principles of a higher mechanics, of which we know little, and at another on metaphysical grounds, of which we know less. Naturally the discoveries connected with electricity imported a new element into these speculations. The vital principle was then held to be a modification of the electric fluid. JOHN HUNTER discerned it in the blood. CUVIER believed the vital fluid to be nervous. The objections to the doctrine of a vital fluid “as one uniform material agent pervading the organic frame,” are many. If the vital principle be the same in every part of the body, how does it happen that the secretions are all so different? How does the blood under the same influence furnish all the different fluids produced by the glands? How is it the liver secretes bile, the kidneys their peculiar fluid, the lachrymal gland the tears? The hypothesis of a vital fluid really explains nothing. THE PSYCHICAL SCHOOL held the doctrine of an immaterial vital principle. This is at least as old as ARISTOTLE,[993] who attributes the cause of motion to the soul. According to that philosopher the soul has different parts: the _nutritive_ or _vegetative_, the _sensitive_, and the _rational_. STAHL, the great discoverer in chemistry, opposed the physiological theories of HOFFMAN, and declared that there is something in living bodies which cannot be accounted for by mechanics or chemistry. “All motion,” according to him, “is a spiritual act.” Nutrition and secretion belong to the operations of the soul; but he overlooked the fact that these are not peculiar to animals, but are characteristics of vegetables, which have no soul. CHEYNE and MEAD, PATERFIELD and WHYTT in England inclined to Stahl’s views. BOISSIER DE SAUVAGES defended them in France. HOFFMAN and afterwards HALLER opposed them, the latter inventing the theory of Irritability. BOERHAAVE (1668-1738), professor of medicine at Leyden, was a man of varied and profound erudition, conversant with the teaching of the ancient philosophers and the Greek and Arabian physicians; he was in addition fully conversant with all the discoveries connected with the healing art down to his own time. Beyond this he was a natural philosopher, chemist, botanist, and anatomist, and an indefatigable experimentalist. In teaching medicine he simplified its study as much as possible by rejecting the absurd and useless speculations which encumbered it, and putting in their place the facts which he believed his own experience and observation had enabled him to ascertain. He published his system of medicine in two volumes, one entitled the Instructions or Theory and the other the Aphorisms or Practice of Medicine. “These short treatises,” says Dr. Thomson,[994] “which gave to medicine a more systematic form than it had previously exhibited, are remarkable for brevity, perspicuity, and elegance of style, for great condensation of ideas, and for the number of important facts which they contain relative to the healthy and diseased states of the human economy.” The genius of Boerhaave raised the medical school of Leyden to the highest distinction. Princes in all countries sent him pupils; Peter the Great took lessons in medicine from him, and so great was his reputation that when a Chinese mandarin directed a letter to him, “To the illustrious Boerhaave, physician in Europe,” it was duly delivered. He held the study of Mind to form an important part of physiology. He taught that the change produced upon the extremity of the sentient nerve must be transmitted by the nerve to the brain before sensation can be produced. He considered the nerves to be hollow undulatory canals. He also held that each of the senses has its distinct seat in the common sensory or brain. His lectures on the mental faculties are full of varied and curious information. Considering the human body as a combination of various machines arranged in one harmonious whole, he endeavoured to explain its phenomena in health and disease on the principles of natural philosophy and chemistry to the almost entire exclusion of vital forces, which, however, he did not reject. He denied that all medical phenomena are to be explained upon mechanical principles. He lamented that “physiological subjects are usually handled either by mathematicians unskilful in anatomy, or by anatomists who are not versed in mathematics.” Yet his system of physiology embraced but a poor conception of the mystery of life. He says, “Let anatomy faithfully describe the parts and structure of the body; let the mechanician apply his particular science to the solids; let hydrostatics explain the laws of fluids in general, and hydraulics their actions, as they move through given canals; and lastly, let the chemist add to all these whatever his art, when fairly and carefully applied, has been able to discover; and then, if I am not mistaken, we shall have a complete account of medical physiology.” It is to BOERHAAVE that we owe the peculiar chemical idea of affinity, that mutual virtue by which one chemical substance loves, unites with, and holds the other (_amat_, _unit_, _retinet_). He called it love. “We are here to imagine, not mechanical action, not violent impulse, not antipathy, but love, at least if love be the desire of uniting.” It is to BOERHAAVE, therefore, we are indebted for a view of chemical affinity which enables us to comprehend all chemical changes.[995] The idea of affinity as marriage naturally leads to analysis as divorce. Thus affinity, imperfectly understood before the time of Boerhaave, made analysis possible. One of the first to express this conviction was DR. MAYOW, who published his Medico-Physical Tracts in 1674. He shows how an acid and an alkali lose their properties by combination, a new substance being formed not at all resembling either of the ingredients. He explains that, “although these salts thus mixed appear to be destroyed, it is still possible for them to be separated from each other, with their power still entire.”[996] GEORGE ERNEST STAHL (1660-1734), chemist, was professor of medicine at Halle (1694) and physician to the King of Prussia (1716). He opposed materialism, and substituted “animism,” explaining the symptoms of disease as efforts of the soul to get rid of morbid influences. Stahl’s “anima” corresponds to Sydenham’s “nature” in a measure, and has some relationship to the Archeus of Paracelsus and Van Helmont. STAHL was the author of the “phlogiston” theory in chemistry, which in its time has had important influence on medicine. Phlogiston was a substance which he supposed to exist in all combustible matters, and the escape of this principle from any compound was held to account for the phenomenon of fire. According to STAHL, diseases arise from the direct action of noxious powers upon the body; and from the reaction of the system itself endeavouring to oppose and counteract the effects of the noxious powers, and so preserve and repair itself.[997] He did not consider diseases, therefore, pernicious in themselves, though he admitted that they might become so from mistakes made by the soul in the choice, or proportion of the motions excited to remove them, or the time when these efforts are made. Death, according to this theory, is due to the indolence of the soul, leading it to desist from its vital motions, and refusing to continue longer the struggle against the derangements of the body.[998] Here we have the “expectant treatment” so much in vogue with many medical men. “Trusting to the constant attention and wisdom of nature,” they administered inert medicines as placebos, while they left to nature the cure of the disease. But they neglected the use of invaluable remedies such as opium and Peruvian bark, for which error it must be admitted they atoned by discountenancing bleeding, vomiting, etc.[999] Stahl’s remedies were chiefly of the class known as “Antiphlogistic,” or antefebrile. DE SAUVAGES (1706-1767), the French physicist, was a disciple of Stahl, and adopted his theory of soul as the cause of the mechanical action of the body. He invented a system of classifying diseases under the title of _Nosologia Methodica_, founded on the principles of natural history. FRIEDRICH HOFFMAN (1660-1742) was a fellow-student with Stahl at Jena. He was the author of a system of medicine in some respects original. He distinguished in the human economy three principal agents: Nature, or the Organic Body; the Sentient Soul; and the Rational Soul; corresponding to the classification of the Scripture of body, soul, and spirit—a classification which originated doubtless in Indian philosophy. Hoffman did not admit with Stahl that the organic functions of the human body depend on the agency of an intelligent soul or any immaterial agent whatsoever, but are merely mechanical and chemical properties of the elements which compose our bodies. The functions most essential to life he considered to be the circulatory, secretory, and excretory motions, and these seemed to him to depend upon the dilating and contracting powers of the muscular fibres of the vascular system. These powers then he held to be the cause of the organic functions which depend on the animal spirits, an ethereal fluid contained in the nerves and the blood.[1000] Hoffman first made known the virtues of the Seidlitz waters; he also invented a nostrum which was popular for a long time, and called “Hoffman’s Anodyne Liquor.” PHYSICIANS. ARCHIBALD PITCAIRN, M.D. (1652-1713), was a famous physician of Edinburgh. In 1692 he occupied a professor’s chair at Leyden with great distinction. Among his pupils were MEAD and BOERHAAVE, who both attributed much of their skill to his tuition. On his return to Edinburgh he greatly interested himself in improving the teaching of anatomy. He begged the Town Council to permit the dissection of the bodies of paupers; and though the chief surgeons of the place did all they could to oppose his efforts, they were successful, and Pitcairn had the credit of laying the foundation of the great Edinburgh school of medicine. He insisted on the strict adherence to Bacon’s method of attending to facts of experience and observation. “Nothing,” he said, “more hinders physic from being improved than the curiosity of searching into the natural causes of the effects of medicines. The business of men is to know the virtues of medicines; but to inquire whence they have that power is a superfluous amusement, since nature lies concealed. A physician ought therefore to apply himself to discover by experience the effects of medicines and diseases, and reduce his observations into maxims, and not needlessly fatigue himself by inquiring into their causes, which are neither possible nor necessary to be known. If all physicians would act thus, we should not see physic divided into so many sects.” In his DISSERTATIONS (1701) he discusses the application of geometry to physic, the circulation of the blood, the cure of fevers by purgation, and the effects of acids and alkalis in medicine. A learned and skilful physician, an accomplished mathematician, and a thorough classical scholar, he was not discreet in his political utterances. His library was purchased by Peter the Great of Russia. JOHN RADCLIFFE, M.D. (1650-1714), was famous for “his magnificent regard for the advancement of learning and science.” The Radcliffe infirmary and observatory at Oxford were built from funds bequeathed by him. SIR HANS SLOANE, M.D. (1660-1753), was a physician whose noble museum and library were the foundation of the British Museum. SIR RICHARD BLACKMORE, M.D. (1650-1729), wrote on inoculation for small-pox, on consumption, gout, rheumatism, scrofula, diabetes, jaundice, etc. WALTER NEEDHAM, M.D. (died 1691), made important investigations in the anatomy of the fœtus, and the changes of the pregnant uterus. CLOPTON HAVERS, M.D. (died 1702), was the author of a standard work on the bones, certain canals of which were called after him Haversian canals. JAMES DOUGLAS, M.D. (1675-1742), was an excellent anatomist, who was one of the first to demonstrate from anatomy that the high operation for stone might be safely performed. He was a skilful accoucheur, an accomplished botanist, and a man of letters. Pope mentions him in the _Dunciad_, and in a note describes him as a physician of great learning and no less taste. He wrote several works, the most famous of which is _Myographiæ Comparatæ Specimen; or a comparative description of all the muscles in a man and in a quadruped; added is an account of the muscles peculiar to a woman_. London, 1707. WILLIAM CULLEN, M.D. (1710-1790), was the first professor in Great Britain to deliver his lectures in the English language.[1001] He was appointed lecturer on chemistry at Glasgow University in 1746, and in 1751 was chosen regius professor of medicine. In 1756 he became professor of chemistry in the University of Edinburgh; in 1760 he was made lecturer on materia medica. Dr. Cullen earned great distinction as a lecturer on medicine; he opposed the teaching of Boerhaave and the principles of the humoral pathology, founding his own teaching on that of Hoffman. His system was to a great extent based on the new physiological doctrine of irritability as taught by Haller. He attached great importance to nervous action in the induction of disease, considering even gout as a neurosis. His _First Lines of the Practice of Physic_ was long exceedingly popular, but his fame as a medical writer rests on his _Nosology_, or _Classification of Diseases_. In all his labours Dr. Cullen aimed at the practical rather than the theoretical. “My business is not,” he remarks,[1002] “so much to explain how this and that happens, as to examine what is truly matter of fact.” “My anxiety is not so much to find out how it happens as to find out _what_ happens.” Cullen invented no ingenious hypothesis, rather he new-modelled the whole practice of medicine; “he defined and arranged diseases with an unrivalled accuracy, and reduced their treatment to a simplicity formerly unknown.”[1003] JAMES GREGORY, M.D. (1758-1822), exercised the greatest influence on the progress of medicine in England. As the successor of Cullen, and as the author of the famous _Conspectus Medicinæ Theoreticæ_, the name of Gregory, borne by many ornaments of British science, became still more distinguished. SIR GILBERT BLANE, M.D. (born 1747), rendered important medical services to the State by his researches on the diseases incident to seamen. He banished scurvy from the fleet by his arrangements for provisioning ships on foreign stations, particularly by making lemon juice a regular ingredient of diet. SIR WILLIAM WATSON, M.D. (1715-1787), was a devoted botanist and student of electricity. His electrical researches raised him to a position of European fame. He was the first in England who succeeded in igniting spirit of wine by electricity; he was the first to note the different colour of the spark, as drawn from different bodies; and his researches in the power and accumulation of electricity, the nature of its conductors, etc., qualified him to take part in the experiments carried out in 1747 and 1748, by which the “electric current was extended to four miles in order to prove the velocity of its transmission.”[1004] The doctor’s house in Aldersgate Street was long the resort of the most distinguished men of science in Europe. He was not less the benign and generous friend to the poor and suffering, than the ardent investigator of the secrets of Nature. His work _Experiments and Observations on Electricity_ is quite a remarkable production considering the age in which it was published (1768). ROBERT WILLAN, M.D. (1757-1812), was the founder of the science of skin diseases in England. His attention was directed in 1784 to the elementary forms of eruption, and on this basis he erected his magnum opus, _The Description and Treatment of Cutaneous Diseases_ (1798). JOHN BROWN (1735-1788), was a systematizer of medicine, whose popularity was even continental. He endeavoured to explain the processes of life and disease and the principles of cure upon one simple idea, the property of “excitability.” The “exciting powers” are the external forces, and the functions of the body are stimulants, so that “the whole phenomena of life, health as well as disease, consist in stimulus and nothing else.” Diseases he divided as _sthenic_, attended with preternatural excitement, and _asthenic_, characterized by debility. Ninety-seven per cent. of all diseases, he declared, require a “stimulating treatment.” One good result of this theory was that it introduced a milder treatment of disease than the bleeding and purging doctors of his time advocated. The theory was called the Brunonian, and received greater attention in Italy than in England. JOHN MORGAN, M.D. (1736-1789), was born in Philadelphia. He wrote an essay on his graduation at Edinburgh (1763), wherein “he maintained that pus is a secretion from the vessels, and in this view anticipated John Hunter.”[1005] ROBERT JAMES, M.D. (1703-1776), was the inventor of the celebrated fever-powder which bears his name. FRANCIS DE VALINGEN, M.D. (1725-1805), was a Swiss who practised in London. He was the first to suggest the employment of chloride of arsenic in practice. His preparation was admitted into the London Pharmacopœia. ERASMUS DARWIN (1701-1802), a physician of Lichfield, was a true poet of science. His fame rests on the _Botanic Garden_, in which he describes the _Loves of the Plants_ according to the Linnæan system. His most important scientific work is his _Zoonomia_, a pathological work, and a treatise on generation, in which he anticipated the views of Lamarck. He asks: “Would it be too bold to imagine that in the great length of time since the earth began to exist, perhaps millions of ages before the commencement of the history of mankind, would it be too bold to imagine that all warm-blooded animals have arisen from one living filament, which the Great First Cause endued with animality, with the power of acquiring new parts, attended with new propensities, directed by irritations, sensations, volitions, and associations, and thus possessing the faculty of continuing to improve by its own inherent activity, and of delivering down these improvements by generation to its posterity, world without end!” He believed that plants possess sensation and volition. EDWARD SPRY, M.D. (lived in 1756). At the fire of Eddystone lighthouse an old man was injured by the fall of a quantity of molten lead upon him. Dying of his injuries in twelve days, he was examined by Dr. Spry, who stated that he found in the stomach a lump of lead three and three-quarter inches long by one and a half in breadth. As no surgeon would believe this story, Dr. Spry performed a number of experiments upon animals by pouring molten lead down their throats, with the result that at the Royal Society, Dr. Huxham, in his letter to Sir William Watson, “testified to his own belief in Mr. Spry’s veracity.”[1006] JOHN COAKLEY LETTSOM, M.D. (1744-1815), was a learned and amiable philanthropist, who published several important medical and scientific works. His _Reflections on the Treatment and Cure of Fevers_ and _The Natural History of the Tea Tree_ appeared in 1772. He wrote the following lines:— “When patients sick to me apply, I physics, bleeds, and sweats ’em. Sometimes they live, sometimes they die: What’s that to me? I. Lettsom.” He gave away immense sums in charity, he was not so unfeeling as his verse would make him appear. WILLIAM STARK (1742-1770) was the earliest writer who distinguished between tuberculosis and scrofula. JEAN ASTRUC (1684-1766), professor at Montpellier, the oldest of the celebrated French obstetricians, was the author of a work on the diseases of women from the pathological point of view. JOHANN E. WICHMANN (1740-1802), a scientific physician of Hanover, in 1786 explained the cause of itch as due to the itch-mite passing from one individual to another. He experimented upon himself. BONOMO had, however, discovered the insect in the itch pustules in 1687. Wichmann suggested the contagiousness of consumption, whooping cough, diarrhœa, and several other complaints. J. P. FRANK (1745-1821) was “the founder of medical police as a distinct department of science.”[1007] HOSPITALS. The condition of the hospitals for the sick in the eighteenth century was scandalous almost beyond belief. Thus, in the Hôtel Dieu of Paris, the mortality at one time was 220 per 1,000; a state of affairs which, however, we surpassed in the present century, when in the British hospitals at Scutari the mortality reached between 400 and 500 per 1,000. In both cases this was due to overcrowding. At the Hôtel Dieu two or three small-pox cases, or several surgical cases, or sometimes even four lying-in women would be packed into one bed. A large proportion of the beds were purposely made for four patients, and six were frequently crowded in. JOHN HOWARD (1726-1790), the philanthropist, by his splendid and devoted labours in connection with the reform of prisons, hospitals, and lazarettos, drew attention to the means of preventing the communication of the plague and other infectious fevers. In the words of Burke “his philanthropic spirit led him to dive into the depths of dungeons; to plunge into the infection of hospitals; to survey the mansions of sorrow and pain; to take the gauge and dimensions of misery, depression, and contempt; to remember the forgotten; to attend to the neglected; to visit the forsaken, and to compare and collate the distresses of all men in all countries.” Not the least of his services were those he rendered to the cause of sanitary science and public health. THÉOPHILE DE BORDEU (1722-1776) was a professor of anatomy and midwifery at Montpellier. By his great work, _Recherches sur le Pouls_, he so enraged his professional brethren (who, like the Jews, always either maim or kill the prophets sent unto them), that he was attacked in his personal character with disgraceful malignity for several years. He rendered very great services to the progress of medical science. His physiology was far in advance of his age, and many men have found in his researches on the functions of the glands a mine of wealth for the establishment of their own reputation. M. F. X. DE BICHAT (1771-1802) was a celebrated French anatomist and physiologist, whose great work, _Anatomie Générale_, was the foundation of the reform of French medicine at the intellectual awakening after the great revolution. Pathology, the science of disease, would have been impossible without such researches as those of Bichat. He first took a “commanding view,” not merely of the organs of the body, but of the tissues of which they are built up. He resolved the complex into its elements, and investigated the structure of each. He completed the overthrow of the iatro-mathematical school, regarding the properties of the _living_ tissues as _vital_ actions. He classified the functions as _organic_ and _animal_, and greatly aided in systematising the phenomena of life. MESMERISM. FREDERICK ANTON MESMER (1733-1815) studied medicine at Vienna. He embraced astrology, and believed in the influence of the stars on living beings. He came to think that cures might be effected by stroking with magnets; afterwards he discarded the magnets, and convinced himself that he could influence others by stroking them with his hands alone. In 1778 Paris was greatly excited over the miraculous cures of mesmerism. The medical faculty denounced him as a charlatan, though a Government Commission in its report admitted many of the facts, while tracing them to physiological causes. The Marquis de Puysegur revolutionised the art of mesmerism by producing all the phenomena without the mummeries and violent means resorted to by Mesmer. Dr. John Elliotson in England in 1830 successfully practised the art. In 1845 BARON VON REICHENBACH declared he had discovered a new force which he called _odyl_, and in 1850 his _Researches on Magnetism_ were translated into English by Dr. Gregory, professor of chemistry in the University of Edinburgh. G. VAN SWIETEN (1700-1772) was a pupil of Boerhaave, and famous in the history of medicine as the founder of the Old Vienna School. He brought about the clinical teaching for which that school has since been so famous. Following the instructions of Paracelsus, he introduced into his practice the use of mercuric perchloride internally in the treatment of syphilis. His commentaries on Boerhaave were considered to be more valuable than the text itself. DE HAEN (1704-1776), of the Hague, studied under Boerhaave, and having been recommended by Van Swieten, was invited to Vienna as president of the clinical school in the hospital of that city. Observation, and the simplest treatment in disease, especially in fevers, made up the chief part of his medical system. Purgatives and emetics and powerful medicines he would use only on the most urgent necessity. Hygiene, both for the patient and the state, he considered of the highest importance in medical education. Clinical thermometry received great attention from De Haen, who demonstrated that in what is considered by the patient the cold stage of fevers there is really a notable increase in the temperature. JAMES YONGE (1646-1721), physician and F.R.S., wrote an important treatise on the use of turpentine as a means of arresting hæmorrhage, entitled _Currus Triumphalis de Terebintho_. He described the flap operation in amputations, and was acquainted with the principle of the tourniquet for the arrest of bleeding during operations. JOHN ADDENBROOKE, M.D., died 1719, leaving by his will four thousand pounds to found a hospital at Cambridge, which now bears his name. JAMES DRAKE, M.D. (1667-1707), wrote a work, once deservedly popular, entitled _Anthropologia Nova; or, a New System of Anatomy_. JOHN ARBUTHNOT, M.D. (1658-1735), physician to Queen Anne, was a man of extensive learning and of great scientific abilities, characterized by Thackeray as “one of the wisest, wittiest, most accomplished, gentlest of mankind.” DANIEL TURNER, M.D. (1667-1741), achieved a certain fame as the inventor of an excellent ointment, still known as “Turner’s Cerate,” composed of oil, wax, and calamine. RICHARD MEAD, M.D. (1673-1754), was the author of the _Mechanical Account of Poisons_, a work which at once established his reputation. He was elected a Fellow of the Royal Society in 1703. On the accession of George II. he was appointed physician-in-ordinary to the King. He was the friend of Radcliffe, and like him a generous promoter of science and learning and of unbounded charity to those in misery. It was Mead who persuaded Guy to bequeath his fortune to found the noble hospital which bears his name. Mead was a political physician, and it is said by Miss Strickland that his prompt boldness occasioned the peaceable proclamation of George I. Mead’s work on the diseases of the Bible, entitled _Medica Sacra_, is a curious and interesting treatise. Excellent physician as he was, he recommended pepper and lichen as a specific against the bite of a mad dog. JOHN FREIND, M.D. (1675-1728), a learned and accomplished physician, is famous as the author of an elaborate work, _The History of Physick from the Time of Galen to the Beginning of the Sixteenth Century_. He laid the plan of this important work whilst a prisoner in the Tower, to which he was committed on suspicion of participation in the so-called “Bishop’s plot.” He was liberated after about three months’ confinement by the firmness of Dr. Mead, who refused to prescribe for Sir Robert Walpole till he consented to admit him to bail.[1008] During his imprisonment Freind wrote a Latin letter _On certain Kinds of Small Pox_. How near the physicians of Mead’s time came towards the discovery of the germ theory of infectious disorders may be seen from his account of the leprosy.[1009] In this treatise he says it has been found by experiments that in the plague and other malignant eruptive fevers the infection once received into articles of clothing remains in them for a long time, and thence passes into human bodies, and “like seeds sown produces the disease peculiar to them.” With reference to the retention of the infection by dry walls, he says, “I thought it probable that they may, by a kind of fermentation, produce these hollow, greenish, or reddish strokes,” etc. SURGEONS. DOMINIQUE ANEL (1679-1730) was the famous French surgeon who invented the operation for aneurism, which Hunter afterwards modified and called by his own name. He successfully treated lachrymal fistula, and invented several surgical instruments which are named after him. J. L. PETIT (1674-1750) in 1718 invented the screw tourniquet for compressing bleeding arteries. He was one of the most famous surgeons in the brightest period of the art in France, and was besides an excellent ophthalmologist. LE CAT (1700-1768) was the famous lithotomist, and opponent of the doctrines of Haller. LE DRAN (1685-1770) performed the first disarticulation of the thigh. MORAND (1697-1773) performed disarticulation of the upper arm. PIERRE JOSEPH DESAULT (1744-1795) was a great French anatomist and surgeon, who instituted a clinical school of surgery at the Hôtel Dieu in Paris. He frequently had an audience of six hundred. He introduced many improvements in surgical practice and in the construction of surgical instruments. G. DE LA FAYE (d. 1781), a great surgeon and oculist, also disarticulated the shoulder joint. A. LOUIS (1723-1792) was a distinguished military surgeon. R. B. SABATIER (1723-1811) was a distinguished surgeon, anatomist, and ophthalmologist, and a man of great and all-round information on medical subjects in general. P. F. PERCY (1754-1825) was a military surgeon who introduced cold-water dressings into French surgery. ANTONIO SCARPA (1748-1832), the famous Italian anatomist, held the chair of anatomy at Modena, was distinguished in every branch of anatomical research, and investigated the minute anatomy of the nerves and bones. He decided the long-debated question whether the heart is supplied with nerves in the affirmative. He wrote on diseases of the eye, on aneurism, and on hernia. He was an elegant scholar, “equally at home in the criticism of the fine arts and in the details of scientific agriculture.” Amongst the principal Italian surgeons of the century were BERTRANDI (1723-1797), TROJA (1747-1827), and PALLETTA (1747-1823). Of the Germans the great names are, SCHMUCKER (1712-1786), RICHTER (1742-1812), and SIEBOLD (1736-1807), who first taught surgery clinically in Germany. CALLISEN (1740-1824), the great Danish surgeon, and ANEL (1741-1801), the founder of the Swedish School of Surgery, are two famous names which must be remembered in the surgical history of the period. WILLIAM CHESELDEN (1688-1752) was famous as a lithotomist and oculist. His dexterity in the performance of lithotomy caused marvellous legends to be told of him, it was even said that he had operated in fifty-four seconds. He published his _Anatomy of the Human Body_ in 1713. SAMUEL SHARP (1700-1778) excelled in nearly every branch of surgery, and was a skilful operator, who by his efforts to stimulate English surgeons to emulate the French did much to advance British surgery. BENJAMIN GOOCH of Norwich, HEY of Leeds, and PARK of Liverpool, were also famous in this period. PERCIVAL POTT (1713-1788) was a surgeon to St. Bartholomew’s Hospital, London, whose life formed a sort of epoch in the history of surgery in England. Samuel Cooper says of him[1010] that he was in his time the best practical surgeon, the best lecturer, the best writer on surgery, the best operator of which the metropolis could boast. JOHN HUNTER (1728-1793) was a physiologist and surgeon combined, unrivalled in the annals of medicine. He raised surgery, which before his time was little more than a mechanical art, to the rank of a scientific profession. As a pathologist and comparative anatomist, he rendered the greatest services to medicine and surgery. He dissected 500 different species of animals. One of the most brilliant surgical discoveries of the century was Hunter’s operation for the cure of popliteal aneurism, by tying the femoral artery above the tumour and without interfering with it. He improved the treatment of rupture of the tendo achillis, and invented a method of curing lachrymal fistula, and of curing hydrocele radically by injection. He was the first to describe phlebitis (inflammation of the veins), and he made the discovery that the white blood corpuscles are antecedent to the red. He investigated the subject of inflammation, the results of which he published in his _Treatise on the Blood, Inflammation and Gun-shot Wounds_. Other works of Hunter’s are his _Treatise on the Natural History of the Human Teeth_, _A Treatise on the Venereal Disease_, and _Observations on Certain Points of the Animal Economy_. “His greatest monument is the splendid museum which he formed by his sole efforts, which he made too when labouring under every disadvantage of deficient education and limited means.” His brother-in-law, Sir Everard Home, prepared the catalogue of the museum and then burned Hunter’s manuscripts, probably that he might conceal the plagiarisms of which he had been guilty in writing his book on Comparative Anatomy. The Government purchased Hunter’s museum from his widow for £15,000, upon condition that twenty-four lectures should be delivered every year to members of the college, and that the museum should be open to the public. CHARLES WHITE, a Manchester surgeon (_circ._ 1768), was the first to introduce what is known as conservative surgery. He first resected[1011] the humerus, and taught the reduction of shoulder dislocations with the heel in the arm-pit. The German surgeons in the seventeenth century held simply the position of barbers; they began life by cutting hair, shaving, cupping and bleeding, and then rose to be dressers of wounds and ulcers, and to treat fractures and dislocations.[1012] In 1713, Berlin acquired its first anatomical theatre for the instruction of military doctors and “medico-surgeons.” Dresden and Hanover began to improve the education of clever barbers about the middle of the eighteenth century. The Military Medical School of Vienna was opened in 1781. Barbers and bathmen in the eighteenth century were trained into district medical officers and surgeons by a course of instruction lasting from two to three years. In Holland students were privileged to assist in operations at the hospitals. The first surgical clinic in Germany was established at Würzburg, in 1769. The Vienna surgical clinic arose in