The Dawn of Modern Medicine / An Account of the Revival of the Science and Art of Medicine Which Took Place in Western Europe During the Latter Half of the Eighteenth Century and the First Part of the Nineteenth

by Albert H. Buck

CORVISART
(Copied from an old French print in the possession of the New York Academy of Medicine.)

Under such persistent and intelligent training it was not long before Corvisart was himself able to give courses of instruction in anatomy and physiology,—courses which rapidly became very popular with the students.

So far as dress was concerned, Molière succeeded in driving out of fashion the gown and pointed bonnet which the physicians of that day were still, in accordance with the custom of centuries, wearing; but he failed to induce them to abandon the wig which they were expected to wear when engaged in actual service in the hospital wards. This practice continued in force until Hallé and Corvisart both got themselves into trouble by refusing to wear a wig. In the case of Corvisart the following story is told:—A well-known Paris lady (Madame Necker) had just founded a fine hospital to which Corvisart hoped to be appointed the Physician-in-Chief. When he first appeared in one of the wards in his natural hair, the lady founder was much shocked, and declared positively that she was not willing to assume the responsibility of sanctioning any such novelty. Corvisart remained firm in his resolution and the position was given to another physician.

Compensation for this disappointment, says Cuvier, came to Corvisart soon afterward, in the following manner:—Père Potentine, the Superior of the monks connected with La Charité Hospital, had been struck with the faithful manner in which Corvisart had cared for the sick under his charge. So, when Desbois-Rochefort, the pioneer clinical teacher in Paris, died in 1788, he quickly determined that he would, if possible, secure for Corvisart the important position which had just been vacated. His efforts proved successful, and in a short time the new appointee was attracting to La Charité a large number of students who were just as appreciative of Corvisart’s clinical teachings as they had been of the instruction given by his predecessor.

A few years later still—in 1802—he was asked to see in consultation Bonaparte, who was suffering from an acute pulmonary attack; and on this occasion he had the good fortune not only to discover the real cause of the trouble but also to recommend the measures which resulted in curing the disease.

Despite his great success, both as a teacher and as a practitioner, Corvisart experienced his full share of professional disappointments, and was, in consequence, often very much depressed by them. He was wont to express in very plain terms his dislike for those treatises in which the author assigned to each disease a list of sharply defined characteristics, and which caused the reader to believe that the course which it pursued was invariably the same; which spoke of disease, in short, in such a manner as to convey to young men the impression that the science of medicine was one of the physical sciences, and that both diseases and the remedies to be employed might well be reduced to a comparatively few forms. No such simplicity exists in nature; the number of combinations is infinite, and each day the combination is likely to be completely changed. The numerous autopsies which he had made convinced Corvisart that similarly the internal changes vary just as greatly as do the external signs and symptoms.

The two most important treatises of which Corvisart was the author are his “Treatise on Diseases of the Heart” and his “Commentary on Auenbrugger’s Work.” Nowhere in medical literature, says Cuvier, will one find a more methodical or a more clearly written treatise on this subject than the first of these treatises. In the second one the author analyzes the different alterations in the lungs, bronchi and pleura which may be distinguished by means of Auenbrugger’s method. In the form which Corvisart has given to this second work we obtain the clearest evidence of his generous character. Rather than rob this man who had long been dead, and who was entirely unknown to him, of even a small portion of what was his due, Corvisart preferred—to use the expression employed by Cuvier—to immolate his own glory. It appears that before he had learned anything whatever about the work that Auenbrugger had published in 1763, he had himself made the majority of the discoveries set forth in that author’s treatise and was making preparations to publish them to the world. Just at this moment, however, he unexpectedly found a copy of a French translation of Auenbrugger’s dissertation, whereupon he abandoned his original plan and published instead the “Commentaries.” In his preface he gives the following explanation of the course which he adopted:—“I might have—if I had so wished—sacrificed the name of Auenbrugger to my own vanity; but my object is to revive the knowledge of his splendid and legitimate discovery.”

In 1789 Corvisart published the MSS. which Desbois de Rochefort had left to him as trustee. Already in 1788, as stated on a previous page, he had been appointed, by a unanimous vote, Physician to La Charité Hospital. From the very start he took up with enthusiasm the work of clinical instruction in this hospital, and kept it up for nearly twenty years, thus gaining for himself—according to Dupuytren—the reputation of being the leading medical practitioner of his day, and adding great distinction to French medicine. In 1795, when the first École de Médecine was created, he was made “Clinical Professor of Medicine”; and from this time forward, for a period of several years, he carried on the work of clinical teaching practically without a rival.

In addition to the positions which he held at l’École de Médecine and at La Charité Hospital Corvisart was connected in some teaching capacity with the Collège de France. At first he gave instruction in this institution only in the theory of medicine, but after 1795 he was formally installed in the College as a teacher of practical medicine; and from this time forward he was able so to arrange his lectures that those students who attended his clinical instruction at La Charité, would be able to hear him, later in the day, explain more fully the diagnosis, treatment, etc., which he had adopted in the morning. In his manner of conducting these sittings Corvisart was largely guided by Stoll’s “Aphorisms,” a practical work which combined the genius of Boerhaave and that of Stoll,—a work in which problems and demonstrated truth were most happily combined. Corvisart was so impressed with the value of this treatise (“Aphorisms”) that he published a translation of it in 1797.

As a lecturer Corvisart possessed an animated and sparkling style of delivery and great clearness of expression. When asked why he improvised these lectures before the students, instead of writing them out beforehand, he said: “In lecturing I like to feel absolutely at my ease and not to be under the restraint which one feels after a formal preparation beforehand.”