CHAPTER I.

THE NINTEENTH CENTURY.—PHYSICAL SCIENCE ALLIED TO MEDICINE. Exit the Disease-Demon.—Medical Systems again.—Homœopathy.—The Natural Sciences.—Chemistry, Electricity, Physiology, Anatomy, Medicine and Pathology.—Psychiatry.—Surgery.—Ophthalmology. With the dawn of modern science was sounded the death-knell of the disease-demon and its twin brother “Visitation.” When the French Revolution, having at first intoxicated men, had had time to effect its really beneficent aims, the age of modern science was fairly inaugurated, and daily conferred some fresh blessing on the race. The beginning of the nineteenth century saw the steam engine rapidly approaching perfection. In 1801 took place the first experiment with steam navigation on the Thames. In 1814 steam was first applied to printing in the _Times_ office. In 1829 locomotive steam-carriages were employed on railways at Liverpool. In the early years of the century the electric telegraph was being developed. Machinery began to take the place of hand labour in numberless branches of trade and industry. Nobler than these material blessings, however, was the awakening of the English people to a new and higher humanity. It seemed that as Science began to shower her gifts on our nation, it yearned to become the almoner of mankind, and in its turn to bless the world with the precious gifts of freedom, education, improved sanitation, and the means of developing the dormant higher powers of the species. The slave trade of England was abolished by Parliament in 1807. In 1834 the English government began to make annual grants in aid of education. Sanitary commissions were appointed in 1838 and 1844, which were of incalculable benefit, not only to our own national health, but in suggesting to other countries the means of improving the health and combating the ravages of preventable diseases. In the early years of the century Dr. Birkbeck founded Mechanics’ Institutions, thus commencing the era of enlightenment for the working classes, which has resulted in raising the mental condition of our labouring and lower middle classes to a higher level than that of any other nation of the old world. Everywhere schools sprung up, books and newspapers were multiplied, until everybody who could read had mental provender provided at a merely nominal rate. In relation to the history of medicine, the science of the century has perhaps on the whole done greater service to the healing art by that which it has taught doctors to leave undone than by what it has taught them to do. It has arrested the murderous lancet of the blood-letter; it has stayed the hand of the purger, who merely bled in another manner; it has rescued the unhappy victims of mental disorders from their dungeons, their beds of straw, and the cruel lash of their keepers; it has liberated the invalid from the tyranny of the medicine-monger; it is no longer possible to force down any patient’s throat such a mass of filthy concoctions as the following items of medicine enumerated in an apothecary’s bill for attending one Mr. Dalby, of Ludgate Hill, which in five days amounted to £17 2_s._ 10_d._ The items for _one day_ (August 12) are:— _s._ _d._ An emulsion 4 6 A mucilage 3 4 Jelly of hawthorn 4 0 Plaster to dress blister 1 0 A clyster 2 6 An ivory pipe 1 0 A cordial bolus 2 6 The same again 2 6 A cordial draught 2 4 The same again 2 4 Another bolus 2 6 Another draught 2 4 A glass of cordial spirits 3 6 Blister to the arm 5 0 The same to the wrists 5 0 Two boluses again 5 0 Two draughts again 4 8 Another emulsion 4 6 Another pearl julep 4 6 This is quoted in the _Historical Sketch of the Progress of Pharmacy in Great Britain_,[1022] p. 17, not as an isolated case, but as an illustration of the practice of apothecaries when attending patients of the higher classes. Homœopathy did much to remedy this state of affairs, and by deluding people into believing that the billionth of a grain of a certain drug skilfully manipulated was more effectual than the bolus and decoction of the medicine-monger, tended gradually to destroy the popular faith in the dosing system. The student of medical history is often reminded forcibly of Tennyson’s lines:— “Our little systems have their day; They have their day, and cease to be.” As he reflects on the many schools, sects, and systems which have dominated the practice of physic, he will often, as he passes them in review one by one, ask mournfully with Hans Breitmann:— “Vhere ish dot barty now?” Where now is the Iatro-mathematical School, the party of the Iatro-chemists, the Brunonian sect? One and all vanished into the Ewigkeit! To have maintained, in the zenith of their fame, that either of the great medical schools could ever have so completely perished would have been the rankest heresy; to believe now that the germ theory of disease can ever be superseded is to be subjected to the charge, not of medical heresy alone, but of the completest ignorance of science. Yet there are some bold spirits who have dared even this. The history of the past forbids the cautious historian of medicine to make too sure of the permanence of any theory of disease or system of cure, but the germ theory has claims to our acceptance which far outweigh those of any other theories which we have reviewed. From the length of time it has been under construction, from the marvellous care and minute caution exercised by the profound scientists who have devoted their lives and utmost energies to the innumerable experiments which their researches have embraced, from the fact that not medical theorists merely, but sober-minded scientists as well as practical surgeons and physicians, have everywhere given their adherence to the germ theory of disease, we have good reason to believe that it will hold its ground as a theory of the cause—if not of much value as a system of cure—of a great number of the most serious maladies which afflict the races of men and animals. MEDICAL SYSTEMS. GIOVANNI RASORI (1762-1837), of Milan, introduced a theory which was a revival of Methodism combined with that of Brunonianism. The Methodists held a status strictus and a status laxus, Brown a sthenic diathesis and an asthenic diathesis. Rasori taught a combination of these theories modified by his own. His doctrines were accepted by a multitude of learned and eminent medical men, yet his teaching was simply atrocious, and a study of it almost makes one despair of any real advance for the healing art. His system of therapeutics consisted in the endeavour to make a diagnosis of the disease by watching the effects of the remedies which make it better or worse! Bleeding was held to be the best diagnostic means: if it did the patient good, the sthenic diathesis was assumed; if it made him worse, the asthenic was demonstrated. He administered enormous doses of powerful drugs, such as would be considered nothing less than simply poisonous now. Baas says he gave 1 to 4 grammes of gamboge for diarrhœa, and 60 to 90 grammes of saltpetre a day[1023]—doses which would be large for a horse. The wonder is that anybody survived the treatment. Homœopathy, faith-healing, peculiar-people treatment, anything, however heterodox, is better than this licensed system of murder, which actually received the adhesion of famous professors at Italian universities, where the art of medicine was supposed to be taught sixty years ago. JOHANN A. ROESCHLAUB (1768-1835), a highly cultivated German physician, was the founder of a medical system on the “Theory of Excitement.” Life depends upon irritability which belongs to the natural disposition. To be healthy, the body must be in a state of moderate irritation and moderate excitability. Disease disturbs the happy medium upwards as hypersthenia, or downwards as asthenia; in other words, by inducing too much strength or actual debility. JOHANN STIEGLITZ (1767-1840) was an eminent physician who opposed the theory of excitement, saying, “There is no such thing as one only saving system.” He was the founder of Etiological diagnosis (or diagnosis dependent on a knowledge of the causes of disease). C. W. VON HUFELAND (1762-1836), professor at Jena, and afterwards in Berlin, opposed the theory of excitement. He used to say, “Successful treatment requires only one-third science and two-thirds _savoir faire_,” and, “To him who fails to make a religion of the healing art, it is the most cheerless, wearisome, and thankless art upon earth; indeed, in him it must become the greatest frivolity and a sin.” F. J. W. BROUSSAIS (1772-1838), a physician of the vitalist school, was a devoted follower of Bichat, who made it his chief aim to find an anatomical basis for all diseases. He is particularly known for his theory that all fevers arise from irritation or inflammation of the intestinal canal. His long-exploded theory led to an enormous misuse of bleeding. He christened his system “Physiological Medicine,” which by directing attention to the morbid changes in the organs, led to the rise of the pathological school of Corvisart, Laënnec, and Bayle. The systems of Brown and Broussais must have destroyed, says Dr. De Noé Walker, more human beings than the whole revolutionary wars from 1793 to 1815. SAMUEL C. F. HAHNEMANN (1755-1843), the founder of Homœopathy, was born at Meissen, near Dresden. He studied medicine at Leipsic, and afterwards at Vienna, graduating at Erlangen in 1779. In his first medical treatise he takes a despondent view of medical practice in general, and of his own in particular, as he is candid enough to own that most of his patients would have done better had they been let alone. In a letter to Hufeland upon the necessity of a regeneration in medicine (1808), he declares that after eight years’ practice he had so learned the delusive nature of the ordinary methods of treatment as to be compelled to relinquish practice. He devoted much attention to the science of chemistry. Berzelius said of him, “That man would have been a great chemist had he not been a great quack.” He translated Cullen’s _Materia Medica_ in 1790, and the necessary study of medicinal agents which this involved set him thinking of a new theory of disease and cure which should replace that which he had found so unsatisfactory; he came to the conclusion, as the result of his researches, that “medicines must only have the power of curing diseases similar to those which they produce in the healthy body, and only manifest such morbid actions as they are capable of curing in diseases.”[1024] He thus proceeded to lay down the homœopathic law that the power of medicines to alter the health must be _proved_ on the healthy body. He endeavoured to discover a rule by which the effect of remedies might be ascertained, and which should supersede the old method of working in the dark. Considering the endless powers which medicines possess, and feeling sure that the Creator intended them to have some purpose, and that to lighten the afflictions of the race, he felt that there must be a better way of employing them than that which he considered had so grievously failed in the past. He was therefore henceforth the enemy of all empiricism. Antipathy, or the method by which contraries are cured by contraries, so that the diseased part is acted upon by something that opposes it, he considered a fatal error in medical practice. Contrary medicine he held could at best be palliative and temporary, not curative. He designated as Allopathy the method by which it is attempted to remove natural disease from one part by exciting artificial disease in another, or the principle of counter irritation. The sciences of anatomy and physiology are quite superfluous to the homœopathist; the remedies being merely addressed to symptoms, the knowledge of their causes can have little or no concern to those who follow Hahnemann’s doctrines. The application of a remedy for facial neuralgia, as Dr. Mapother points out,[1025] has been applied over the motor nerve of the face, the inventor being ignorant that it has no connection with sensibility. Hahnemann taught that all chronic maladies proceed from the itch. Amongst other remedies for the itch, or psora, the swallowing of lice or a decoction of them was seriously recommended, because these parasites tickle the skin, and on the like-cures-like principle, would be beneficial for itch![1026] THE NATURAL SCIENCES. The Natural Sciences in the closing years of the eighteenth century began to render the most important services to the art of medicine, and from that time onwards it has marked its progress step by step with the advances of botany, chemistry, and physics. Linnæus invented a system of the classification of plants which Adanson, Jussieu, De Candolle, and others did much to improve; the anatomy and physiology, and even the pathology of plants were closely studied, with results of the greatest value to scientific medicine. Buffon excited the interest of men of science by his declaration that there is no essential difference between animals and plants, and that all organic life follows the same plan. He explained the geographical distribution of the animal kingdom. Hunter, Blumenbach, St. Hilaire, Cuvier, and others advanced the sciences of comparative anatomy and physiology, and Lamarck divided bony animals into _vertebrata_ and _invertebrata_. Cuvier, by founding the doctrine of types, explained the general plan on which animals are modelled. Pander and Baer rendered the greatest services to the study of development—the former by his researches on the development of the chick, the latter by his observations on the cleavage in the ovum. To Hunter, Kielmeyer, and Owen in a later period we owe the most important discovery—that the higher animals, even man himself, in the embryo pass through the stages of development of the lower animals. CHEMISTS. JOSEPH PRIESTLY discovered oxygen in 1772, and thus introduced a new chemical era. LAVOISIER, however, was the first to observe the vast importance of the discovery, and CAVENDISH established his theories by his researches on the composition of the air, water, and acids. It is to Lavoisier’s discoveries in relation to oxygen that physiology is indebted for the knowledge of the influence of that element on respiration and the blood. Doctors looked upon it as the “air of life,” and in its excess or deficiency saw the causes of certain diseases. FOURCROY applied himself to the study of medical chemistry. BERTHOLLET discovered the composition of ammonia, and the bleaching properties of chlorine. He discovered chlorate of potash, and founded the doctrine of chemical affinity. DALTON (1776-1844) by his atomic theory and his discovery of the law of multiple proportions still further advanced the science; in 1794 he first described colour-blindness. BERZELIUS (1779-1848) developed the atomic theory and improved our knowledge of animal chemistry. GAY-LUSSAC in 1805, with ALEXANDER VON HUMBOLDT, discovered that water is composed of one volume of oxygen and two volumes of hydrogen. SIR HUMPHRY DAVY (1788-1829) discovered the anæsthetic effect of nitrous oxide gas, invented the safety-lamp for miners, and greatly advanced the study of agricultural chemistry. DUMAS (1800-1884) investigated the alkaloids. PELLETIER in 1820 discovered quinine. ORFILA (1787-1853), one of the most eminent men of the French school of medicine, founded modern toxicology, the science of poisons. His fame chiefly rests on his _Treatise of General Toxicology_ (1814), which is a vast mine of experimental research on the symptoms of every kind of poisoning. SIR WILLIAM HYDE WOOLASTON, M.D. (1766-1828), was a distinguished philosopher and chemist. One of his great discoveries was the malleability of platinum, which is said to have produced him no less than thirty thousand pounds. He was even more famous as a student of ophthalmology than as a chemist. MICHAEL FARADAY (1791-1867) was the great chemist, whose glory in chemical science was overshadowed by his electrical discoveries. JUSTUS VON LIEBIG (1803-1873) influenced the history of chemistry by his successful efforts to spread the knowledge of the science by improving the methods of investigation, and above all by the application of chemistry to physiology, agriculture, and the arts. ELECTRICIANS. The history of electricity has an important bearing on that of medicine. It will be necessary at least to indicate the chief points in its progress. GILBERT published a treatise on the magnet in 1600. He speaks of magnetic phenomena, and the extravagant stories circulated about the attraction of magnets and amber by persons who gave no reason from experiment. He distinguished magnetic from electric forces,[1027] and it is to him that we owe the term “electric” itself.[1028] Boyle repeated the experiments of GILBERT, but seems to have made no discoveries. OTTO GUERICKE, of Magdeburg, next discovered that there is electric force of repulsion as well as of attraction. HAWKSBEE, in his _Physico-Mechanical Experiments_, 1709, observed the effects of attraction and repulsion on threads hanging loosely. DUFAY, in 1733, 1734, and 1737, observed that electric bodies attract all those that are not so, and repel them as soon as they are become electric by the vicinity or contact of the electric body. In 1729, GREY discovered the properties of _conductors_. FRANKLIN distinguished between positive and negative electricity in 1747, and demonstrated the identity of the electric spark and lightning in 1752. GALVANI in 1791 laid the foundation of the Galvanic Battery. VOLTA discovered the “Voltaic pile” in 1800. Henceforward year by year the science progressed by leaps and bounds. The use of the magnet in medicine was known to Aetius, who lived A.D. 500. He says: “We are assured that those who are troubled with the gout in their hands or their feet, or with convulsions, find relief when they hold a magnet in their hand.” Beckmann says[1029] this is the oldest account of this virtue of the magnet. The more ancient writers refer only to its internal uses. Lessing ascribes the external use of the magnet as a cure for toothache and other disorders to Paracelsus. Marcellus in the fifteenth century assures us that the magnet cures toothache, as also does Leonard Camillus in the sixteenth century. Wecker about the same period says it cures headache. Porta (1591) confirms this, and Kircher (1643) states that it was worn about the neck to prevent convulsions and nervous disorders. Magnetic toothpicks and ear-pickers were extolled as cures for disorders of the teeth, ears, and eyes about the end of the seventeenth century.[1030] ANTHROPOLOGY. JOH. F. BLUMENBACH (1752-1840), professor in Göttingen, was the founder of Anthropology. He collected a great museum of skulls, and was famous as a comparative anatomist. He wrote on physiology, anatomy, and natural history. PHILOSOPHERS. VON SCHELLING (1775-1854) taught that “God is the indifference of the ideal and real, soul and body, and the identity of subjectivity and objectivity. In a word, the All.” He held that health is the harmony of reproduction, irritability, and sensibility; disease, the alteration of dimensions of the organism, by which it ceases to be a pure, untroubled reflex of the All. G. W. F. HEGEL (1770-1831) was the philosopher whose supreme principle was absolute reason, and to whom in a great measure is due what is known as Modern Materialism. He was opposed by R. H. LOTZE (1817-1884), a medical philosopher of Göttingen, the author of the _Mikrokosmos_ and works on pathology, physiology, and psychology. He laid it down that the significance of the phenomena of life and mind would only unfold itself when by an exhausted survey of the entire life of man, individually, socially, and historically, we gain the necessary data for explaining the microcosm by the macrocosm of the universe. The world of facts and the laws of nature are only to be understood by the idea of a personal deity. * * * * * CHARLES DARWIN (1809-1882), grandson of Erasmus Darwin, startled and shocked the whole Christian world by his theory that man has possibly descended at a highly remote period from “a group of marine animals resembling the larvæ of existing Ascidians.” He traced our ancestry through the fish, amphibian, marsupial, and ape species; a theory which, despite the original opposition it excited, is now generally accepted. He is best known in connection with medical science by his famous work, _On the Origin of Species by means of Natural Selection_, 1859, his _Descent of Man and Selection in Relation to Sex_, 1871, and _The Expression of the Emotions in Man and Animals_, 1872. At first his theory of the Descent of Man was held to teach that “A very tall pig with a very long nose Puts forth a proboscis quite down to his toes, And then by the name of an elephant goes.” Darwin recognised not merely a God but a Creator. ANATOMISTS AND BIOLOGISTS. SIR RICHARD OWEN, M.D., F.R.S., etc. (1804-1892), the celebrated comparative anatomist and palæontologist, made it possible for us to see what the extinct monsters were when he enabled us to construct scientifically the models of the megatherium, plesiosaurus, and other animals of remote ages. It has been well said of him that “the most characteristic of his faculties was a powerful scientific imagination. Fragments of bone which might be meaningless to less alert observers enabled him to divine the structure and to present the images of whole groups of extinct animal forms.” At the suggestion of Dr. Abernethy (whose pupil he had been) he was invited in 1828 to prepare the catalogue of the Hunterian collection in the museum of the Royal College of Surgeons, of which Mr. Clift (whom he eventually succeeded and whose daughter he married) was conservator. This great work largely occupied some of the best years of Owen’s life, the three quarto volumes on the Fossil Vertebrates and Cephalopods of the collection not appearing till 1855. Meanwhile he had given to the world his _Odontography_, his _Lectures on Comparative Anatomy and Physiology_ (which won a continental reputation), and his famous work on the _Archetype and Homologies of the Vertebrate Skeleton_. In 1849 he issued an important memoir _On Parthenogenesis_. In 1856 Owen was appointed Superintendent of the Department of Natural History in the British Museum, which, through his untiring exertions, was at last to be suitably housed at South Kensington. In 1861 he published his manual of _Paleontology_; from 1865 to 1877 a succession of works on British Fossil Reptiles and the Fossil Reptiles of South Africa. F. G. HENLE (1809-1885) so early as 1840 advocated the germ theory of disease. It was first suggested, however, by Latour’s discovery of the yeast plant in 1836. ST. GEORGE MIVART, M.D., F.R.S. (born 1827), the distinguished anatomist and zoologist, is to a certain extent the opponent of Darwin, as he denies that the doctrine of Evolution is applicable to the human intellect. He is the author of many works on anatomy, biology, and zoology. THOMAS HUXLEY, F.R.S., M.D. (born 1825), the famous physiologist and comparative anatomist and biologist, is a well-known writer on natural science, and the most prominent of the scientific opponents of revealed religion. DR. ALFRED RUSSEL WALLACE (born 1822), the eminent naturalist, published his _Contributions to the Theory of Natural Selection_ in 1870, and in 1878, in his volume _Tropical Nature_, still further contributes to our knowledge of sexual selection, etc. ERNST HAECKEL (born 1834), a celebrated German naturalist and writer on science, is the chief supporter in Germany of Darwin’s theories. It may be remembered in this connection that these were anticipated to some extent by Lamarck (1744-1829) and Goethe (1749-1832). HERBERT SPENCER (born 1820) has devoted his life mainly to the working out of his “System of Synthetic Philosophy,” which proposed “to carry out in its application to all orders of phenomena the general law of evolution.” GEORGE J. ROMANES, F.R.S. (born 1848), an ardent member of the Darwinian school, is a distinguished physiologist and biologist. PHYSICIANS AND PATHOLOGISTS. LEOPOLD AUENBRUGGER (1722-1809), a physician of Vienna, was the inventor of the method of detecting diseases of the chest by percussion. By striking the chest _directly_ with the tips of the fingers (not as we do now by interposing a finger of our left hand while we percuss the chest mediately with the fingers of the other hand) he diagnosed by the sound evoked the condition of the organs of the thorax. His system was at first received with contempt and ridicule by his profession; but in 1808, Corvisart translated Auenbrugger’s great work, the _Inventum Novum_, into French, and the method quickly achieved an European reputation. RENÉ T. H. LAËNNEC (1781-1826), the celebrated French pathologist, was the inventor of the stethoscope. His great discovery was purely accidental—a fact which he declares in his famous work. “In 1816 I was consulted by a young woman labouring under general symptoms of diseased heart, and in whose case percussion and the application of the hand were of little avail on account of the great degree of fatness. I happened to recollect a simple and well-known fact in acoustics, and fancied it might be turned to some use on the present occasion. The fact I allude to is the great distinctness with which we hear the scratch of a pin at one end of a piece of wood, on applying our ear to the other. Immediately, on this suggestion, I rolled a quire of paper into a kind of cylinder, and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised and pleased to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by the immediate application of the ear.”[1031] JEAN N. CORVISART (1755-1821) introduced into France Auenbrugger’s method of percussion, one of the most important aids to _physical diagnosis_. GASPARD L. BAYLE (1774-1816) made those important researches on tubercle and the changes in the lungs and other organs in consumption which form the basis of our present knowledge of the subject. From this time French physicians introduced great precision in their study of symptoms, so as to invest them with a really scientific character. Combined with the perfected methods of anatomical observation, a new era in clinical medicine dates from this period. LOUIS (1787-1872) made important researches on pulmonary consumption and typhoid fever, and introduced the numerical or statistical method in medical science, which was an important step towards making it an exact science. SIR ROBERT CHRISTISON (1797-1882) discovered the effects and properties of Calabar bean, and was the most famous of all English investigators of poisons and poisoning. JOHN CHEYNE (1777-1836), in conjunction with WILLIAM STOKES (1804-1878), a great clinical teacher and author of works on diseases of the chest and heart, discovered the form of breathing in certain disordered conditions which is called “Cheyne-Stokes’ respiration.” ROBERT J. GRAVES (1797-1853), a great observer and clinical teacher, gave his name to a disease. SIR WILLIAM JENNER, M.D. (born 1815), was the first to establish beyond dispute the difference between typhus and typhoid fevers. JOHN HUGHES BENNETT, M.D. (1812-1875), was the first to introduce the use of cod-liver oil in consumption into English practice (1841). He claimed also to have discovered leucocythemia before Virchow. ALFRED SWAYNE TAYLOR, M.D. (1806-1880), was the founder of forensic medicine in England, and his great work on Medical Jurisprudence (published 1836) has long been the standard authority in medico-legal cases. THOMAS HODGKIN (1797-1866) discovered the disease which goes by his name. CHARLES MURCHISON, M.D. (1830-1879), is celebrated for his researches in epidemic diseases. SIR THOMAS WATSON (1792-1882) was the author of the ever-popular lectures, _The Practice of Physic_, a work whose graces of style and elegance of phraseology entitle it to be considered a medical classic. MATTHEW BAILLIE (1761-1823) was a famous pathologist. He devoted special attention to the pathology of the brain, heart, lungs, stomach, and intestines. It was he who first described the grey miliary tubercle of consumption. In all his profound researches he never failed to remember their practical end in the cure of disease. JOHN ABERCROMBIE (1780-1844) is celebrated for his researches on diseases of the brain and spinal cord. RICHARD BRIGHT (1789-1858), the reformer of renal pathology, was the discoverer of the disease which bears his name. THOMAS ADDISON (1793-1860) discovered the disease of the suprarenal bodies which is called after him. KARL V. ROKITANSKY (1804-1878), one of the most famous of the founders of the New Vienna School, was so indefatigable a pathologist that he is said to have celebrated his thirty-thousandth post-mortem in 1866. His great work, _The Handbook of Pathological Anatomy_, was published in 1841. JOSEPH SKODA (1805-1881), a physician of the New Vienna School, improved physical diagnosis by his application of the laws of sound. He rendered percussion more perfect by correctly explaining the import of the various sounds heard on striking the chest. He threw great light upon our knowledge of the phenomena of heart diseases. HEBRA (1816-1880) created a revolution in the science of skin diseases by basing it upon pathological anatomy. WUNDERLICH (1815-1877) introduced the use of the clinical thermometer as an important aid to diagnosis, and claimed that “pathology is the physiology of sick men.” RUDOLPH VIRCHOW (born 1821), the constructor of the cellular pathology, is a celebrated German pathologist and anthropologist. On the basis of the cellular theory, which teaches that the cells live their own independent life, have their own active properties, proliferations and degenerations, Virchow built up his cellular pathology into a comprehensive system, attaching greater importance to the cell changes than to an altered condition of the circulation or quality of the blood, as was previously held to account for pathological changes. The theory explains many facts which were previously obscure, but is not wholly satisfactory. Virchow’s system led to the foundation of pathological histology. SIR ANDREW CLARK, M.D., F.R.S., President of the College of Physicians, London (born 1826), is a physician distinguished alike for his profound scientific knowledge and his admirable skill in its application to the relief and cure of disease. As a physiologist, anatomist, and pathologist, especially in connection with the organs of respiration, the kidneys, and digestive functions, Sir Andrew Clark occupies the foremost place in English medical practice of the time. He has written extensively on diseases of the chest, is one of the most brilliant clinical lecturers of the day, and for many years has been a chief attraction in the teaching power of the London Hospital. SIR EDWARD H. SIEVEKING, M.D., etc. (born 1816), was with Dr. H. Jones joint-author of the well-known _Manual of Pathological Anatomy_ (1854). SAMUEL WILKS, M.D., F.R.S., etc. (born 1824), is an eminent pathologist and neurologist. He published his excellent _Lectures on Pathological Anatomy_ in 1859.[1032] BRAIN AND NERVE SPECIALISTS. PHILIPPE PINEL (1745-1826), a French physician, published a translation of Cullen’s _Nosology_ (1785) in the language of his country. His claim to our gratitude rests on the fact that he was among the first to introduce the humane treatment of the insane. With his own hands he, when physician to the Bicêtre and Salpêtrière, removed the bonds of insane patients who had been chained to the wall for years. SIR CHARLES BELL (1774-1842) made the greatest discoveries in physiology since those of Harvey. We owe to him the knowledge that in the nervous trunks are special sensory filaments whose office is to convey impressions from the periphery to the sensorium, and special motor filaments which convey motor impressions from the brain or other nerve centre to the muscles. This great discovery of the functions of the nerves, concerning which there previously existed much confusion amongst physiologists, was published in 1807, and entitles England to claim that in Bell and Harvey she has given to science the two most distinguished physiologists of the world. FRANZ J. GALL (1757-1828) was a skilful Viennese anatomist, who, by his researches upon the anatomy of the brain, came to the conclusion that the talents and dispositions of men may be inferred with exactitude from the external appearance of the skull, and thus founded phrenology. CASPAR SPURZHEIM (1776-1832), an anatomist, was a pupil of Gall, and assisted in the development of phrenology. JEAN M. CHARCOT (born 1825) is a Paris physician greatly distinguished by his important investigations in diseases of the nervous system, upon which he has written many works. PIERRE FLOURENS (1794-1867), a distinguished French physiologist, sought to assign their special functions to the brain, corpora quadrigemina, and lesser brain by experiments. In 1847 he directed the attention of the Academy of Sciences to the anæsthetic effect of chloroform upon animals. Chloric ether in the same year was used at St. Bartholomew’s Hospital as an anæsthetic in operations by Dr. Furnell. ARMAND TROUSSEAU (1801-1866) was an eloquent and popular clinical lecturer on medicine. He introduced tracheotomy in croup, and largely contributed to our knowledge of laryngeal phthisis, etc. CLAUDE BERNARD (1813-1878), the celebrated experimental physiologist and pathologist, made numerous researches on the digestion of fat by the pancreatic juice, the formation of sugar in the liver, and the artificial production of diabetes by puncturing the fourth ventricle of the brain, etc. He wrote _Physiologie et Pathologie du Systeme nerveux_, 1858. BROWN-SEQUARD (born 1817), the experimental physiologist, discovered the vaso-motor nerves. He has investigated the functions of the spinal cord, its normal and pathological states, the brain and sympathetic nerves and ganglions, the inhibitory and other nerves. PAUL BERT (1833-1886) was a physiologist and neuro-pathologist. G. B. DUCHENNE (1806-1875) introduced electro-therapeutics by means of the induced current in diseases of the nervous system. ROBERT REMAK (1815-1865) still further pursued the treatment of nervous diseases by means of the constant current. He investigated the subject of the parasitic origin of certain diseases of the skin, and produced favus experimentally. ELIE VON CYON (born 1843) continued the investigation of electro-therapeutics. MARSHALL HALL (1790-1857) discovered reflex action, which fact he communicated to the Royal Society in 1833. JAMES BRAID, a Manchester surgeon, in 1841 investigated mesmerism, and discovered what is now called hypnotism. He found that he could artificially produce “a peculiar condition of the nervous system, induced by a fixed and abstracted attention of the mental and visual eye on one object, not of an exciting nature.” Thus Braid was the first to investigate the subject scientifically, and to trace the phenomena of mesmerism to their true physiological cause. Dr. Rudolf Heidenhain, of Breslau, has recently traced these phenomena to inhibitory nervous action.[1033] HENRY MAUDSLEY, M.D. (born 1835), is the author of several important works on mental diseases: _The Physiology of Mind_, _The Pathology of Mind_, _Body and Mind_, and _Responsibility in Mental Disease_. JOHN CONOLLY (1796-1866) was physician to Hanwell Asylum. To him is due the honour of having first in England pressed upon the notice of his profession the advantages of the “No Restraint” system in mental diseases. DR. FORBES WINSLOW was a popular and humane “mad doctor.” JOHN C. BUCKNILL, M.D., F.R.S., etc. (born 1817), is a distinguished student of mental diseases, and the author of several treatises on Unsoundness of Mind in relation to Crime and Drunkenness. He is one of the original editors of _Brain_, and for nine years he has edited the _Journal of Mental Science_. DAVID FERRIER, M.D., F.R.S., etc. (born 1843), a specialist in brain surgery, is well known for his researches in cerebral physiology and pathology, and has acquired great celebrity throughout the English-speaking world for his investigations connected with the localisation of the functions of the brain. PAUL BROCA (1824-1880), the surgeon and anatomist, discovered that the faculty of speech lies in the third left frontal convolution of the brain, which in his honour is called Broca’s convolution. JULES BECLARD (1818-1887) was a distinguished French physiologist. HENRY C. BASTIAN, M.D., F.R.S. (b. 1837), is a pathological anatomist and cerebral physiologist. His _Brain as an Organ of Mind_, 1880, is one of his best known works, and his articles in Quain’s _Dictionary of Medicine_, on Diseases of the Spinal Cord and Nervous System generally, are equally valuable contributions to this department of medical science. JOHN HUGHLINGS JACKSON, M.D., F.R.S., although distinguished as an ophthalmologist, is more famous for his researches and discoveries in connection with the nervous system and the localisation of cerebral functions. DR. JULIUS ALTHAUS has made many valuable contributions to our knowledge of the nervous system. VICTOR A. H. HORSLEY, F.R.S., etc., pathologist and brain surgeon, is the author of many papers on the functions of the brain and spinal cord, and has made important contributions to our knowledge of the functions of the thyroid gland, hitherto little understood, by which the treatment of myxœdema will, it is hoped, be greatly improved. SURGEONS. The founding of museums of anatomy and surgical pathology by the HUNTERS, DUPUYTREN, CLOQUET, BLUMENBACH, BARCLAY, and a great number of other anatomists and surgeons, has greatly assisted to advance the practical surgery of this century. Some of the more important improvements in the art as practised at the present time are the following, which are given in the article on Surgery in the _Encyclopædia Britannica_:—The thin thread ligature for arteries, introduced by JONES, of Jersey (1805); the revival of the twisting of arteries to arrest bleeding by AMUSSAT (1829); the practice of drainage in large wounds and after operations by CHASSAIGNAC (1859); aspiration or the application of the principle of the air-pump for removing pus and fluid from tumours, etc., by PELLETAN and others; the plaster-of-Paris bandage and other similar immovable applications for fractures, etc. (an old Eastern practice recommended in Europe about 1814 by the English consul at Bassorah); the re-breaking of badly set fractures; galvanocaustics and écraseurs; the general introduction of resection of joints (FERGUSSON, SYME, and others); tenotomy by DELPECH and STROMEYER (1831); operation for squint by DIEFFENBACH (1842); successful ligature of great arteries by ABERNETHY and ASTLEY COOPER (1806); crushing of stone in the bladder by GRUITHUISEN of Munich (1819), and CIVIALE of Paris (1826); cure of ovarian dropsy by the removal of the cyst, discovery of the ophthalmoscope, and great improvements in ophthalmic surgery by VON GRÄFE and others; application of the laryngoscope in operations on the larynx by CZERMAK (1860) and others, together with additions to the resources of aural surgery and dentistry. In the treatment of fractures English surgery was inferior to that of continental practice, especially French, in the early part of the present century. M. ROUX in 1814 pointed out our shortcomings in this respect, contrasting English with French methods much to our disadvantage.[1034] SIR WM. BLIZZARD (1743-1835) was the first surgeon who tied the superior thyroid artery for goitre. He founded in conjunction with Maclaurin the medical school of the London Hospital. BENJAMIN BELL (1763-1820), of Edinburgh, was the elder brother of Sir Charles Bell. He was professor of anatomy, surgery, and obstetrics, a man of letters and a famous operator. He published a _System of the Anatomy of the Human Body_ and _The Principles of Surgery_. JOHN ABERNETHY (1764-1831), the celebrated surgeon and lecturer on anatomy, became the founder of the distinguished school of surgery and anatomy at St. Bartholomew’s Hospital, London. SIR ASTLEY COOPER (1768-1841) was the first surgeon to tie the abdominal aorta. SIR BENJAMIN BRODIE (1783-1862) was an anatomist and physiologist, as well as a distinguished surgeon. ABRAHAM COLLES, M.D. (1773-1843), was an eminent Dublin surgeon, the author of a work on _Surgical Anatomy_, who has given his name to the fracture of the radius at the wrist. JOHN BURNS, M.D. (1775-1850), was a teacher of surgery and midwifery at Glasgow. His world-wide reputation was gained for him by his _Principles of Midwifery_. JAMES WARDROP (1782-1869) was the author of a well-known treatise on the pathology of the human eye. BENJAMIN TRAVERS (1783-1858) was celebrated for his theory of “Constitutional Irritation.” LISTON (1794-1847) was famous for his resections of the elbow and other joints. SIR WM. LAURENCE (1783-1867) was one of the greatest clinical teachers the British school of surgery has produced. GEORGE GUTHRIE (1785-1856) accompanied Wellington in his campaigns, and was in his time the great English authority on military surgery. JAMES SYME (1799-1870) was a distinguished teacher of clinical surgery. He improved the operation of exarticulation at the knee-joint, and recommended the operation for amputating at the ankle which goes by his name. SIR JAMES PAGET, F.R.S. (born 1814), the distinguished surgeon, is the author of the _Pathological Catalogue of the Museum of the College of Surgeons_, _Lectures on Surgical Pathology_, etc. JOHN ERIC ERICHSEN, F.R.S. (born 1818), is the author of _The Science and Art of Surgery_, which has not only gone through nine large editions in this country, but has passed through many editions in America, and has been translated into German, Spanish, Italian, and Chinese (partly). Probably no treatise on English surgery has exercised so much influence on the progress of this branch of the healing art as Mr. Erichsen’s noble work. JONATHAN HUTCHINSON, F.R.S. (born 1828), one of the most distinguished surgeons of the Victorian age, is famous throughout the empire as a clinical teacher, especially in connection with specific and skin diseases. SIR HENRY THOMPSON (born 1820), the distinguished surgeon and pathologist, is famous for his researches in the pathology of the urethra and prostate gland, and for his clinical teaching in lithotomy and lithotrity. He has taken an active part in the cremation propaganda. SIR W. J. ERASMUS WILSON (1809-1884) was the famous specialist in skin diseases, whose munificent benefactions to the Royal College of Surgeons have enormously extended the resources of its museum and library. GYNÆCOLOGISTS. SIR T. SPENCER WELLS, M.D. (born 1818), the celebrated ovariotomist, and MR. LAWSON TAIT, well described by Dr. Baas as “the magical operator and despiser of antiseptics,” in abdominal diseases, especially those of women, are without rivals in the world as benefactors to humanity by their life-saving discoveries. ANATOMY IN ENGLAND. Until 1832 the bodies of executed murderers were ordered for dissection, by 32 Hen. VIII. c. 42, 1540. Surgeons were granted four bodies of executed malefactors for “_anathomyes_” which privilege was extended in the following reigns; but in consequence of the crimes committed by “resurrection men” in order to supply the medical schools, a new statute was passed in 1832, which prohibited the dissection of murderers, and provided for the necessities of the dissecting room by permitting, under certain regulations, the dissection of the bodies of unclaimed persons dying in workhouses, etc. Inspectors of anatomy were appointed, and various regulations were made for the decent and reverent disposal of the remains. The Anatomy Act was passed in consequence of the scandals connected with the great Anatomy School at Edinburgh, at which Dr. Knox was a celebrated teacher. It was discovered that a murderer named Burke provided bodies for surgeons by killing his victims by suffocation, leaving no marks of violence. The crime was known as Burking, and to remove the temptation to such scandals as the robbery of graveyards, and the murder of persons for the sake of the prices paid for their bodies, the wants of the surgeons were provided for in a legal manner. FRENCH SURGEONS. ALEXIS BOYER (1757-1833), one of the most eminent French teachers of surgery, wrote a great work on surgical diseases and operations, in eleven volumes. JEAN D. LARRY (1766-1842) was a famous military surgeon under Napoleon. His opportunities for studying his profession must have been unique, as he participated in sixty great battles and four hundred engagements. He wrote several treatises on military medicine and invented field ambulances. PHILIBERT J. ROUX (1780-1854), surgeon to the Hôtel Dieu at Paris, practised resections of joints, by which the articular diseased extremity of the bone is removed and a false joint formed. JACQUES LISFRANC (1790-1847) was a famous amputator, whose operation for the partial removal of the foot is known by his name. ARMAND VELPEAU (1795-1867) was a celebrated teacher of clinical surgery. JOSEPH MALGAIGNE (1806-1865) was a very distinguished writer on surgical anatomy and operative surgery. AUGUSTE NELATON (1807-1874) was called “the Napoleon of Surgery.” He invented the probe by which he detected the bullet in the wound of Garibaldi. GERMAN SURGEONS. Plastic operations were revived by C. F. VON GRAEFE, of Warsaw (1787-1840), DELPECH, DIEFFENBACH, B. LANGENBECK, and others. After severe burns there is frequently great loss of skin; it was found that this could be repaired by the transplantation of very minute portions of skin from healthy surfaces; periosteum and bones were also successfully transplanted. VON KERN (1769-1829), the great Viennese surgeon, emphatically insisted that surgery could not be divorced from medicine. He adopted the very opposite treatment of wounds to that followed now by Lister; instead of excluding the air for fear of the germs contained in it, he insisted that operative wounds should be freely exposed to the atmosphere. He applied the simplest dressings of wet lint. F. SCHUH (1804-1865) greatly advanced scientific surgery by advocating the use of the microscope in pathological anatomy. VON WALTHER (1782-1849) was a great and scrupulously careful surgical operator, who, like Kern, declared that surgery and medicine are indivisible. VON CHELIUS (1794-1876), a famous teacher of clinical surgery at Heidelberg, was a well-known writer on surgery. CONRAD J. M. LANGENBECK (1776-1851) and BERNHARD LANGENBECK (1810-1887) greatly contributed to found military surgery in Germany. G. F. L. STROMEYER (1804-1876), a famous military surgeon of Germany, obtained great success in that department of operative surgery known as subcutaneous division of tendons for the relief and cure of deformities such as club foot. FRIEDRICH ESMARCH (born 1823) is famous for his invention of the method of bloodless amputations of limbs by the use of the bandage of india-rubber which goes by his name. AMERICAN SURGEONS. VALENTINE MOTT (1785-1865), the celebrated New York surgeon, is said to have tied more arteries for the relief or cure of surgical diseases than any other surgeon. SAMUEL GROSS (1805-1884), a great American teacher of surgery, was the author of the well-known _System of Surgery_. OPHTHALMIC SURGEONS. J. A. H. REIMARUS (1729-1814), of Hamburg, first employed belladonna in ophthalmic surgery. JOSEPH BARTH (1745-1818), of Malta, founded an ophthalmic hospital, and first lectured on eye diseases and their treatment. JUNG-STILLING (1740-1817) was a celebrated coucher of cataracts. DR. THOMAS YOUNG (1773-1829) rendered great services to optical science, and was the first to describe astigmatism, or the want of symmetry in the anterior refracting surfaces of the eyeball—a disorder of vision which has considerable influence in causing headache. J. A. SCHMIDT (1759-1809) first described syphilitic iritis; he called eye disease with great justice “the elegant diminishing mirror of diseases of the body.” C. HIMLY (1772-1837) used mydriatics (dilators of the pupil, such as hyoscyamus and belladonna) in operations on the eye. Atropine afterwards superseded these. G. J. BEER (1763-1821), a professor of Vienna, founded the famous teaching of the Vienna school of ophthalmology, and greatly improved the practice of the art and the instruments employed in it. H. L. HELMHOLTZ (born 1821) invented that powerful aid to the ophthalmic surgeon—the ophthalmoscope—in 1851. It is said that the observation of the reddening of the pupil in a drowning cat first suggested the invention to Méry in 1704. Helmholtz’s invention made scientific ophthalmology possible. This branch of surgery may be said to date from this great discovery. HERMANN SNELLEN (born 1834), an oculist of Utrecht, introduced test types for ascertaining the distinctness of vision. R. BRUDENELL CARTER, the eminent ophthalmologist, is a well-known and graceful writer on medical and scientific subjects.