VIII
MEDICINE IN THE SIXTEENTH AND SEVENTEENTH
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A History of Science: in Five Volumes. Volume II: The Beginnings of Modern Science | ||
8. VIII
MEDICINE IN THE SIXTEENTH AND SEVENTEENTH
CENTURIES
OF the half-dozen surgeons who were prominent in the sixteenth century, Ambroise Paré (1517-1590), called the father of French surgery, is perhaps the most widely known. He rose from the position of a common barber to that of surgeon to three French monarchs, Henry II., Francis II., and Charles IX. Some of his mottoes are still first principles of the medical man. Among others are: "He who becomes a surgeon for the sake of money, and not for the sake of knowledge, will accomplish nothing''; and "A tried remedy is better than a newly invented.'' On his statue is his modest estimate of his work in caring for the wounded, "Je le pansay, Dieu le guarit''—I dressed him, God cured him.
It was in this dressing of wounds on the battlefield that he accidentally discovered how useless and harmful was the terribly painful treatment of applying boiling oil to gunshot wounds as advocated by John of Vigo. It happened that after a certain battle, where there was an unusually large number of casualties, Paré found, to his horror, that no more boiling oil was available for the surgeons, and that he should be obliged to dress the wounded by other simpler methods. To his amazement the results proved entirely
As Paré did not understand Latin he wrote his treatises in French, thus inaugurating a custom in France that was begun by Paracelsus in Germany half a century before. He reintroduced the use of the ligature in controlling hemorrhage, introduced the "figure of eight'' suture in the operation for hare-lip, improved many of the medico-legal doctrines, and advanced the practice of surgery generally. He is credited with having successfully performed the operation for strangulated hernia, but he probably borrowed it from Peter Franco (1505-1570), who published an account of this operation in 1556. As this operation is considered by some the most important operation in surgery, its discoverer is entitled to more than passing notice, although he was despised and ignored by the surgeons of his time.
Franco was an illiterate travelling lithotomist—a class of itinerant physicians who were very generally frowned down by the regular practitioners of medicine. But Franco possessed such skill as an operator, and appears to have been so earnest in the pursuit of what he considered a legitimate calling, that he finally overcame the popular prejudice and became one of the salaried surgeons of the republic of Bern. He was the first surgeon to perform the suprapubic lithotomy operation—the removal of stone through the abdomen instead of through the perineum. His works, while written in an illiterate style, give the clearest descriptions of any of the early modern writers.
As the fame of Franco rests upon his operation for
In the sixteenth century Germany produced a surgeon, Fabricius Hildanes (1560-1639), whose work compares favorably with that of Paré, and whose name would undoubtedly have been much better known had not the circumstances of the time in which he lived tended to obscure his merits. The blind followers of Paracelsus could see nothing outside the pale of their master's teachings, and the disastrous Thirty Years' War tended to obscure and retard all scientific advances in Germany. Unlike many of his fellow-surgeons, Hildanes was well versed in Latin and Greek; and, contrary to the teachings of Paracelsus, he laid
Hildanes was particularly happy in his inventions of surgical instruments, many of which were designed for locating and removing the various missiles recently introduced in warfare.
The seventeenth century, which was such a flourishing one for anatomy and physiology, was not as productive of great surgeons or advances in surgery as the sixteenth had been or the eighteenth was to be. There was a gradual improvement all along the line, however, and much of the work begun by such surgeons as Paré and Hildanes was perfected or improved. Perhaps the most progressive surgeon of the century was an Englishman, Richard Wiseman (1625-1686), who, like Harvey, enjoyed royal favor, being in the service of all the Stuart kings. He was the first
In Italy, Marcus Aurelius Severinus (1580-1656) and Peter Marchettis (1589-1675) were the leading surgeons of their nation. Like many of his predecessors in Europe, Severinus ran amuck with the Holy Inquisition and fled from Naples. But the waning of the powerful arm of the Church is shown by the fact that he was brought back by the unanimous voice of the grateful citizens, and lived in safety despite the frowns of the theologians.
The sixteenth century cannot be said to have added much of importance in the field of practical medicine, and, as in the preceding and succeeding centuries, was at best only struggling along in the wake of anatomy, physiology, and surgery. In the seventeenth century, however, at least one discovery in therapeutics was made that has been an inestimable boon to humanity ever since. This was the introduction of cinchona bark (from which quinine is obtained) in 1640. But this century was productive of many medical systems, and could boast of many great names among the medical profession, and, on the whole, made considerably more progress than the preceding century.
Of the founders of medical systems, one of the most widely known is Jan Baptista van Helmont (1578-1644), an eccentric genius who constructed a system of medicine of his own and for a time exerted considerable
The principles of the Iatrochemical school were the use of chemical medicines, and a theory of pathology different from the prevailing "humoral'' pathology. The founder of this school was Sylvius (Franz de le Boë, 1614-1672), professor of medicine at Leyden. He attempted to establish a permanent system of medicine based on the newly discovered theory of the circulation and the new chemistry, but his name is remembered by medical men because of the fissure in the brain
The Iatrophysical school (also called iatromathematical, iatromechanical, or physiatric) was founded on theories of physiology, probably by Borelli, of Naples (1608-1679), although Sanctorius; Sanctorius, a professor at Padua, was a precursor, if not directly interested in establishing it. Sanctorius discovered the fact that an "insensible perspiration'' is being given off by the body continually, and was amazed to find that loss of weight in this way far exceeded the loss of weight by all other excretions of the body combined. He made this discovery by means of a peculiar weighing-machine to which a chair was attached, and in which he spent most of his time. Very naturally he overestimated the importance of this discovery, but it was, nevertheless, of great value in pointing out the hygienic importance of the care of the skin. He also introduced a thermometer which he advocated as valuable in cases of fever, but the instrument was probably
Harvey's discovery of the circulation of the blood laid the foundation of the Iatrophysical school by showing that this vital process was comparable to a hydraulic system. In his On the Motive of Animals, Borelli first attempted to account for the phenomena of life and diseases on these principles. The iatromechanics held that the great cause of disease is due to different states of elasticity of the solids of the body interfering with the movements of the fluids, which are themselves subject to changes in density, one or both of these conditions continuing to cause stagnation or congestion. The school thus founded by Borelli was the outcome of the unbounded enthusiasm, with its accompanying exaggeration of certain phenomena with the corresponding belittling of others that naturally follows such a revolutionary discovery as that of Harvey. Having such a founder as the brilliant Italian Borelli, it was given a sufficient impetus by his writings to carry it some distance before it finally collapsed. Some of the exaggerated mathematical calculations of Borelli himself are worth noting. Each heart-beat, as he calculated it, overcomes a resistance equal to one hundred and eighty thousand pounds;—the modern physiologist estimates its force at from five to nine ounces!
THOMAS SYDENHAM
But while the Continent was struggling with these illusive "systems,'' and dabbling in mystic theories that were to scarcely outlive the men who conceived
The influence on future medicine of Sydenham's teachings was most pronounced, due mostly to his teaching of careful observation. To most physicians, however, he is now remembered chiefly for his
Notes
VIII
MEDICINE IN THE SIXTEENTH AND SEVENTEENTH
CENTURIES
A History of Science: in Five Volumes. Volume II: The Beginnings of Modern Science | ||