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 MEDICINE

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MEDICINE

man language. But, as early as 1528, he was com- pelled, on account of the hostility he evoked, to leave Basle secretly. After this he travelled through various countries working constantly at his numerous writings, until death overtook him at Salzburg in 1514. Paracelsus, like a blazing meteor, rose and disappeared ; he shared the fate of those who have a violent desire to destroy the old without having any substitute to offer. Passing over his philosophic views, which were based upon neo-Platonism, we find practical medicine indebted to him in various ways, 6. g. for the theory of the causes of disease (etiology), for the introduction of chemical therapeutics, and for his insistence on the usefulness of mineral waters and native vegetable tlrugs. He exaggerates indeed the value of experience. His classification and diagnosis of diseases are quite unscientific, anatomy and physi- ology being wholly neglected. He thought that for each disease there should exist a specific remedy, and that to discover this is the chief object of medical art. With him diagnosis hung upon the success of this or that remedy, and because of this he named the diseases according to their specific remedies. Directly repudiated by the Italian schools, Paracelsus found adherents mainly in Germany, among them being the Wittenberg professor Oswakl Croll (about 1560-1609). He also found numerous friends among the travel- ling physicians and quacks. His teachings met with the most hostile reception from the Paris faculty. Al- though the further progress of anat- omy and physiology indicated clearly to physicians the right path, we meet even in the eighteenth and nine- teenth centuries with two men who start directly from Paracelsus: Samuel P'riedrich Hahnemann (1755- 1S43), the originator of homoeopathy, and Johann Gottfried Rademacher (1772-1850), advocate of erapiri- Ba^on J^-^n-Nl^ cism. (1755

Surgery in the Sixteenth Century: Ambroise Pare. — The first fruits of the progress in anatomy were enjoyed by surgery, especially since most Italian anatomists were practical surgeons. After the intro- duction of fire-arms in war, the treatment of gimshot wounds was especially studied. While surgery had always enjoyed a high rank in Italy and France, in Germany it was in the hands of barbers and surgeons, unconnected with the universities and poorly edu- cated; hence it is readily understood wliy the best surgeons lived in the cities nearest the Romance coun- tries, especially Strasburg. With the member of the Teutonic Order, Heinrich von Pfolspeundt (" Biindth- Ertzney", 1460), the most important representatives were the Strasburg surgeons, Hieronymus Brunschwig (d. about 1534), and Hans von Gersdorff ("Feldtbuch der Wundtartzney ", 1517). Their equal was a .some- what younger man, Felix Wiirtz of Basle (1518-74). We are intlebted to the French field-surgeon Am- broise Pare for a marked change in the treatment of gunshot woimds and arterial hemorrhage. He aban- doned the .\rabic method of work with a red-hot knife, declared that supposedly poisoned gunshot wounds were simple contused wounds, and proceeded to ban- dage them without using hot oil. He was the first to employ the ligature in the case of arterial hemorrhage. Next to him in importance stands Pierre Franco (about 1560), known as the perfecter of the operation of lithotomy and that for hernia. Gaspare Taglia- cozzi of Bologna (1546-99) deserves credit for reintro- ducing and improving the ancient plastic operations. In the sixteenth century the Cesarean operation (Sectio ciEsarea, laparotomy) was performed on living persons.

Discovery op the Ciucul.ition op the Blood; William Harvey and his Ti.me. — Galen's theory, ac- cording to which the left heart and the arteries con- tained air, the blood being venerated in the liver, had long been regarded as improbable, but in spite of every effort no one had as yet discovered the truth about circulation. The solution of this problem, which brought about a complete fall of Galen's system and a revolution in physiology, came from the English physi- cian William Harvey of Folkstone (1578-1657), a pupil of Fabricius ab Aquapendente. Harvey's dis- covery published in 1628, that the heart is the centre of the circulation of the blood and that all blood must return to the heart, at first received scant notice and was even directly opposed by Galen's adherents ; but further investigation soon made truth victorious. Even as early as 1622, Gaspare Aselli (1581-1626) found the chyle vessels, but correct explanation was possible only after the discovery of the thoracic duct (ductus thoracius) and its opening into the circulation by Jean Pacquet (1622-74) and Johann van Home (1621-70), and of the lymphatic ves- sels by Olaus Rudbeck (1630-1702) and Thomas Bartholinus (1616-SO). A new field of investigation was opened by the invention of the micro- scope, by which Marcello Malpighi (1628-94) discovered the smaller blood-vessels and the blood corpus- cles. From Harvey's time starts a series of important anatomists and physiologists, among them the Eng- lishmen Thomas Wharton (1614- 73 ; glands) and Thomas Willis (1621 -75; brain) ; the Netherlanders Peter Paaw (1564-1617), his pupil Niko- las Pieterz Tulp (159.3-1678), both teachers of anatomy at Leyden, and Antony van Leeuwenhoek (1632- 1723) and Johann Swammerdam (1647-80), micro.scopists; Reinierde Graaf (1641-73; ovary); Nikolaus ^^.w uia CoRn.-,jiRT Stcuo of Copenliagcn (1638-86), and IS-') the Germans, Moriz Hofman (1621

-98) and George Wii-sung, who investigated the pancreas.

Iatrophysicists and Iatrochemists. — The doc- trine of the circulation is based to a large extent upon the laws of physics. Consequently among a number of physicians, influenced by the works of Alfonso Borelli (1608-78) on animal motion, there was a marked effort to explain all physiological processes according to the laws of physics (iatrophysicists). Opposed to them was a party, which, influenced by the progress in chemistry, sought to make use of it for explaining medical facts (iatrochemists). This ten- dency goes back to Paracelsus am 1 his adherent Johann Baptist von Helmont (157S-1644). Helmont, who was an important chemist (the discoverer of carbonic acid), recognized the importance of anatomy, and de- serves credit for his work in therapeutics, although his failure to appraise the needs of his time prevented his doctrine from influencing the development of medicine, latrophysics was cultivated mainly in Italy and Eng- land; iatrochemistry in the Netherlands and Ger- many. The chief adherent of latrophysics in Italy was Giorgio Baglivi (d. 1707), professor at the Sapienza in Rome; in practical medicine, however, he held mainly to Hippocratic principles, while the English- man, Archibald Pitcairn (1652-1713), tried to follow out latrophysics to its utmost consequences.

Owing to the greater progress made in physics, iatrochemistry found fewer followers, and that it took root at all is the service of its chief representative Franz de le Boe Sylvius (1614-72), who in 1658 be- came professor of practical medicine at Leyden. At the .school there, founded in 1575, Jan van Heurne had