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 MEDICINE

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MEDICINE

improvement of herniotomy); Antonio Ciucci (about 1650; re-introduction of lithotripsy); in France, Bar- tholomffus Saviard (1656-1702; digital compression of arteries), Jacques BeauMeu (1651-1714), a travel- ling surgeon and later a hermit (Frere Jacques), who improved the method of lateral lithotomy, and helped people for a "God-bless-you"; in Amsterdam, Al)ra- ham Cyprianus (about 1695; lithotomy). The most important German surgeon is Wilhelm Fabry of Hil- den (Fabrioius Hildanus, 1560-1634; simpUfied treat- ment of wounds, amputation); next to liiin Joliann Schultes (Schultetus, 1595-1646), author of "Arma mentarium chirurgicum", and Mattliias Gottfried Purraann (1648-1721; field surgery). Of English surgeons Richard Wiseman, (about 1652; amputa- tion, compression of aneurisms), John Woodall (about 1613), and Lowdham (about 1079) are the most emi- nent.

In the eighteenth century surgery was essentially stimulated by the numerous wars; in France also through the establishment of an academy in 1731 by

Georges Mareschal (165S-1 736) and

Francois Gigot de la Peyronie (167S -1747). Of Frenchmen we must also name Jean Louis Petit (1674- 1750), the inventor of the screw tourniquet, Henri Fran^'ois le Dran (1685-1770; lithotomy, lacerations of scalp), Pierre Joseph Boucher (1715-93; amputation); Toyssaint Bordenave (1728-82; amputation), Antoine Louis (1723-92; operation for hare-lip, bronchotomy, simplifi- cation of instruments), Pierre Joseph Dcsault (1744-95, founder of the Paris surgical clinic, ligature of vessels, treatment of aneurism, dislocations, fractures), Francois Chopart (1743-95, methods of ampu- tation), and finally the monk and lithotomist Frdre Come (Jean de St. Cosme, Baseilhac, 1703-81), the in- ventor of the lithotome-cach4. Baron Guillau The founder of modern English (1777- surgery is William Cheselden (1688-1752; lateral lithotomy, artificial pupil). Samuel Sharp (about 1700-78) wrote a text-book; William Bromfield (1712 -92), invented an artery-retractor and the double gor- geret; and Percival Pott (1713-88) established the doctrine of arthrocace (malum potti). The most eminent and versatile surgeon is the already-men- tioned John Hunter (treatment of aneurisms, theory of inflammation, gunsliot wounds, sj^pliilis). Sur- gery was on a much lower plane in the Germanic coun- tries. For the better training of the Prussian military surgeons and on the proposal of Surgeon-General Ernst Konrad Holtzendorff (1688-1751), there was founded in Berlin a Collegium medico-chirurgicum in 1714; later in 1726 the Charity school, and in 1795 the Pepiniere academy. Surgery made great progress through Johann Zacharias Platner (1094-1747) at Leipzig; Johann Ulrich Bilguer (1720-90) and Chris- tian Ludwig Mursinna (1744-1833) at Berlin; Karl Kasper Siebokl (1736-1807) at Wiirzburg, and espe- cially through August Gottlob Richter (1742-1812) at Gottingen (surgical library). A school for military surgeons was founded at Vienna in 1775 at the sugges- tion of Anton Storck (1731-1803), ten years after which was established the Josephinum academy, under the direction of the army Surgeon-in-chief Johann Alexander von Brambilla (1728-1800).

Study of Physiology; Albrecht von Haller AND His Time. — The great discoveries in the field of gross and minute (microscopic) anatomy naturally im- pelled men to investigate also the vital functions, liut the results of the efforts c£ both iatrophysicists and latrochemists were far from satisfactory, since scien-

tific aid was sadly lacking. Physiology for the first time received systematic treatment at the hands of the versatile scholar, Albrecht von Haller of Bern (1708- 77), professor in Gottingen from 1737 to 1753 (Ele- menta physiologia>, 1757-66). Haller, a pupil of .\1- binus and Boerhave, was the first to recognize the im- portance of experiments on animals. We are indebted to him for the best description of the vascular system and for studies in hremodynamics, in which fieldj how- ever, the English clergyman, Stephen Hales (d. 1761), had already broken the soil. He correctly recognized the mechanism of respiration without being able to in- vestigate its physiological importance (exchange of gases), since Joseph Priestley did not discover oxygen until 1774. He disproved the view that there was air between the lungs and the pleura by a simple experi- ment on animals. Haller became best known through the discovery of irrital)ility and sensibility. When external stimuli are applied to tissues, especially mus- cles, the latter react either by contracting and moving (irritability), or by experiencing a sensation or sense of pain (sensibility), or at times by both. Sensibility disappears when the corresponding nerve is cut, while irritability persists indepen- dent of the nerves and even con- tinues some time after death. This theory met with great opposition, especially among the practical phy- sicians (Anton de Haen), who did not, however, take the trouble to re- peat the experiments on animals. Even though Haller knew neither the central cause of the two phe- nomena, nor the correct structure of the tissues, it nevertheless stands to his eternal credit that lie was the first to point out the facts and open up new roads for physiology. Hal- ler's investigation was generally welcomed, especially in Italy by Abbate Lazzaro SpaUanzani (1729- DupuYTREN 99), the first scientific opponent of 1S35) spontaneous generation. His experi-

ments along the lines of artificial fertilization of frogs' eggs, and concerning digestion are famous. Felice Fontana (1730-1805), repeating the experiments con- cerning irritability, reached the same results as Haller. William Hewson (1729-74) studied the qualities of the blood (coagulation). The most important Ger- man physiologist after Haller is Kasper Friedrich Wolfi' (1735-94), known for his investigations in the field of evolution and for pointing out the fact that both animals and plants are composed of the same elements, wiiich he called little "bubbles" or "glob- ulee". Joseph Priestley's discovery of " dephlogisti- cated air" (1774), as oxygen was then called, was of the highest importance in the development of the theory of respiration, of the process of tissue-decora- position, of formation of the blood, and of metaboUo phenomena.

Medical Systems in the Eighteenth Centuhy. — The three great discoveries in the second half of the century (oxygen, galvanism, and irritability), con- trary to what one might expect, led scientists astray, and gave rise to systems whose foundations were of a pureiy hypotlietical nature. Especially interesting are the neuro-pathological theories, connected to some extent with irritability. William Cullen (1712-90), accepting irritability as liis starting-point, supposes a "ton\is" or fluid inherent in the nerves (Newton's ether), whose stronger or weaker motions produce either a spasm or atony. In addition "weakness" of the brain and " vital power" played a great part in his explanation of diseases. Cullen's pupil, John Brown (about 1735-88), modified this doctrine by explaining that all living creatures possess excitability, located in