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 MEDICINE

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MEDICINE

to encroach upon the domain of the special articles, Karl Langer (1819-87; mechanism of the joints),

let us summarize in a few brief words the most im- Karl Toldt (b. 1840; histology, anthropometry), and

portant achievements of recent times; in anatomy, Karl Wedl (1815-91; normal and pathological histol-

theory of tissues — Bichat; in pathological anatomy ogy) are others of this School. The professors at

and pathology cellular, pathology — Virehow; in physi- present teaching this subject in the Austrian univer-

ology — Johannes Mijller; in practical medicine, aus- sities still belong chiefly to the school of Hyrtl-Langer.

cultation — Laennec, Skoda; in surgery, treatment of In North America anatomy was cultivated especially

wounds — Joseph Lister; narcosis — ^Jackson, Simpson; in Philadelphia, where, besides the school founded in

obstetrics, cause of puerperal fever — Semmelweiss in ophthalmology — Albrecht von Griife and (specu- lum oculi) Helmiioltz; in bacteriology and serother- apy — Pasteur, Koch, and Behring. The subject of skin diseases was most ingeniously elaborated by Ferdinand Hebra.

General Anatomy. — A splendid basis for the further development of modern medicine was laid by Marie Francois Xavier Bichat (1771-1802), through his in- vestigation of the vital qualities of tissues. What Haller had tried to do for the muscles, Bichat at- tempted to accomplish for all the tissues of the body. Bichat was the first to promulgate the idea that each tissue might by itself become ilis- eased, and that the symptoms of diseased organs depend upon tissue changes. Gilbert Breschet (1784- 1845) worked on the lyinpathic ves- sels and the lustory of development, and Isidore Geoffrey Saint-Hilaire (1772-1884) on comparative anat- omy. Of Italian and English anato- mists are to be mentioned: Paolo Mascagni (1752-1815; lymphatic vessels, comparative anatomy), An- tonio Scarpa (1747-1832; structure of the bones, organs of sense) ; the brothers John and Charles Ball, the latter (1774-1842) known also as a physiologist (brain, nerves); and Robert Knox (1793-18(32; compar- ative anatomy) . Germany performed the greatest services in perfecting anatomy and allied branches. The first to be named in this connexion i-- im I

is Theodor Schwann (1810-82), the U^ii-i

discoverer of the cell as the fundamental element omy, of the body of plants and animals. Johann Ev. ~ Purkynje (1787-1869) worked along the same Unes, and Rudolph Albert Kolliker (b. 1817; pensioned 1901) followed close in their wake. Work in com- parative anatomy was done by Johann Friedrich Blumenbach (1752-1840), Ignaz Blumenbaeh (1752- 1850), Ignaz DoUinger (1770-1841), Karl .Osmund Rudolphi (1771-1832), and Johann Friedrich Meckel

(1781-1G33). Friedrich Gustav .Jakob Henle (1809- 85), and Wilhelm Menke (1834-96) were prominent teachers of general anatomy and histology; Fried- rich Tiedemann (1781-1861) was an eminent brain anatomist, Vt'hile Nikolaus Rudinger (1832-96; in- jection of carbolic for the preservation of corpses m the dissecting room), Friedrich Sigmund Merkel (b. 1845; topographical anatomy), and Wilhelm His (b. 1831; history of development), must also be men- tioned.

Following the reform of studies under van Swieten in 1749, anatomy was cultivated in Vienna more than ever before. The more important men were Lorenz Gasser (professor 1757-65; trigeminus), Joseph Barth (technique of injection), George Prochaska (1749- 1820; mu.scle and nerves), Franz Joseph Gall (1758- 1828), the well-known phrenologist and founder of the theory of cerebral locahzation, and Joseph Berres (1796-1S44; microscopic anatomy). The founder of the modern anatomical school of Vienna was the highly gifted Joseph Hyrtl (1811-94; technique of injection and corrosion, organ of hearing, comparative and topographical anatomy), known as a pre-eminent teacher, investigator, and a man of noble character.

1764, there existed from 1820 to 1875 a private insti- tution established by John Balentine O'Brien Law- rence (d. 1823), "The Philadelphia School of Anat- omy". In 1775 Japan became acquainted for the first time with the anatomical knowledge of Europe through a translation of a work by the German Johann Adam Kulmus which had appeared in 1725. A dili- gent study of anatomy and of medicine in general be- gan when the University of Tokio was established in 1871.

Pathological Anatomy was placed upon a new basis by Bichat's theory of the tissues, and it was later greatly advanced by physiology, physiological chemis- try, and by improved means of in- vestigation (compound achromatic oljjective lens of the microscope). The increased attention, which clini- cal physicians bestowed on this sub- ject, exercised no small influence on its progress. Among these must be especially mentioned Laennec, who defined tuberculosis and studied the pathological anatomy of lung diseases, especially of phthisis. Nu- merous though the able investigators were who performed meritorious services in perfecting this branch, the development of modern patho- logical anatomy will forever be inti- mately connected with the names of the pioneers, Rokitansky and Vir- ehow. The first pathological prosec- torship at Vienna was held by Alois Rudolph Vetterfrom 1796 to 1803, well known as the author of the first German work on pathological anat- In 1832, after the death of Joseph Wagner, Karl Rokitansky (1804-78; later Freiherr von) became pro- sector and professor. He was educated in the views of Johann Friedrich Meckel (1781-1833), Johann Georg Christian Freidrich Martin Lolstein (1777- 1835), but particularly of Gabriel Andral of Paris (1797-1876), a leading representative of humoral pathology. Rokitansky's training was thus based upon the French school, but he subsequently brought

about a still closer connexion between anatomical and physical diagnostics. His endeavour to become ac- quainted with the entire course of development of pathological changes was greatly assisted by the valuable material for dissecting which the metropolis afforded. His excellence is seen in his descriptions of pathological changes; he replaced the previous symp- tomatic pictures of disease by creating an anatomical pathology and anatomical types of disease. He was not so successful in establishing his doctrine of crasis based upon humoral pathology, and just here Vir- chow's fruitful activity begins.

Rudolf Virehow (1821-1902), professor in Beriin and a pupil of Johannes Miiller and Johann Lucas Schonlein, early became acquainted with the cellular doctrine of Schwann. Virehow is the creator of cellular pathology, which to-day is universally recog- nized, a pathology based strictly upon natural science which definitively extinguished Hippocratic specula- tive humoral pathology. According to Virehow, there is life in the smallest units of the body, in the cells which increase by fission {omnis cellula e cellula). He applied his doctrine to the various tissues, and showed their behaviour under normal and abnormal condi-