The growth of medicine from the earliest times to about 1800

by Albert H. Buck

Up to the end of the sixteenth century almost all the work done in anatomy was effected with the aid of the scalpel alone, the object being to isolate and expose clearly to view the larger tissues and organs, such as muscles, arteries, veins, nerves, etc. In a very few instances more elaborate methods were devised, even as early as during the fifteenth century, by men of exceptional cleverness. Thus, for example, in 1490, Alexander Benedetti, Professor of Anatomy at Padua, invented a method of preserving muscles, nerves and blood-vessels as permanent dry specimens, and it is said that he sold such preparations for large sums of money. As already stated on a previous page, the injection of blood-vessels with certain fluids was also employed to a very limited extent at this early period as a means of distinguishing them more easily from the surrounding structures; but this practice gave place, during the seventeenth century, to the better method of employing, as an injecting material, a semi-fluid preparation which became quite solid soon after it had penetrated well into the interior of the vessels, and to which any desired opaque color might be given. This method was invented by the Hollander, John Swammerdam (1627–1680) and perfected by Van Horne. It was largely by the employment of this procedure that Friedrich Ruysch of Amsterdam (1638–1731), Professor of Anatomy and Botany in the university of his native city, gained such celebrity throughout Europe for the great beauty of his permanent anatomical preparations. Hyrtl mentions the fact that Peter the Great of Russia, who resided for a certain length of time at Zaandam, near Amsterdam, in order that he might familiarize himself with the art of ship-building, was in the habit of visiting Ruysch from time to time in his museum and laboratory; and finally (in 1717) bought from him, for the sum of 30,000 florins, his entire collection of specimens, together with the formula of the mixture which he employed in making his injections. The collection itself, it should be stated, contained not only specimens illustrative of normal human anatomy (e.g., the various solid and hollow organs, the organs of special sense, and objects belonging to the vascular, muscular, nervous and osseous systems), but also many specimens illustrating pathological and comparative anatomy, and a great variety of monstrosities.

Ruysch also attained remarkable success in restoring the rosy color and soft flexibility of the skin and the natural facial expression in certain dead bodies by the employment of a preservative fluid widely known as “Liquor balsamicus.” Tradition says that in one instance, that of a child whose corpse had been treated in this manner by Ruysch, the face presented such a perfectly life-like appearance that the Czar, as he passed near the object, thought he was looking upon a sleeping child and gave it a kiss.

The aged professor lived to be ninety-three, and continued giving his lectures on anatomy almost up to the day of his death, which resulted from accidental injuries. When it became clear that these were of so serious a nature that he could not possibly recover, he asked to be carried on a stretcher into the assembly room in order that he might say a farewell to the students who had been attending his lectures.

Although some critics have intimated that Ruysch should be ranked merely as a very clever mechanic in the domain of anatomy, there are certain well-established facts which show that this estimate of the man is unfair. It is known, for example, that he was the first anatomist to call attention to the features which distinguish the male from the female skeleton (e.g., the differences in the form of the pelvis and of the thorax). Ruysch also advanced our knowledge of the vascular system by means of the improvements which he effected in the method of injecting blood-vessels. His skill in this special work was so great that people were wont to say of him that he possessed the fingers of a fairy and the eyes of a lynx. It was Ruysch too who furnished the first descriptions of the bronchial blood-vessels and of the vascular plexuses of the heart. Finally, the term “membrana Ruyschiana,” in connection with the choroid of the eye, bears testimony to the fact that he was also an original worker in this very difficult corner of the field of human anatomy.

The crowning event in the life of Ruysch—an event which shows how wasteful many of us men are of our productive powers when we deliberately retire from all participation in active work, physical or mental, at the comparatively early age of sixty-five—occurred in 1717, when he had attained the age of seventy-nine. Peter the Great had hardly left the premises with the great collection of specimens for which he had paid such a fabulous price, when Ruysch began the making of a new collection; and at this task he worked so diligently that in less than ten years he was able to deliver to John Sobieski, King of Poland, the greater part of the new collection (for which he received the sum of 20,000 florins). Then followed a period of about three years during which he continued active work as a teacher of anatomy, death alone seeming to possess the power to arrest his extraordinary energy.

Ruysch’s only published works are the following: Catalogue of the Specimens contained in his Museum, Amsterdam, 1691; and a Thesaurus Anatomicus, in 10 volumes, Amsterdam, 1701–1715.

In reading over the account which I have given of the discoveries made in gross anatomy and in physiology during the sixteenth and seventeenth centuries, I find that I have omitted some that may just as appropriately be mentioned in this section as in that which I intend to devote to work done in the domain of minute anatomy. I shall therefore refer to them briefly now, and then pass on to the consideration of the latter branch of my subject.

Eustachius, the famous Italian anatomist, deserves special credit for the experimental methods which he devised and employed in his efforts to gain a better knowledge of the anatomy and physiology of the kidneys. Moritz Hofmann of Fürstenwald discovered in 1641, in the turkey gobbler, the outlet duct of the pancreas, and a short time afterward George Wirsung, a Bavarian, discovered the same structure in the human being. Then, in 1651, Olaus Rudbeck, Professor of Anatomy in the University of Upsala, Sweden, discovered the lymphatics of the intestines, and established (at a later date) the fact that they are a separate system from that of the chyle ducts. Francis Glisson (1597–1677) of Cambridge University, England, one of Harvey’s pupils, made two series of anatomical investigations of a most creditable character—the first concerning the relationship which exists between the intestinal lymphatics and the alimentary canal, and the second regarding the internal construction of the liver (“capsule of Glisson”). Thomas Wharton (1610–1673), a native of Yorkshire, England, and a London practitioner of medicine, discovered the outlet channel of the submaxillary salivary gland, now known as “Wharton’s duct,” and he also published the first exhaustive treatise on the structure of glands in general (thymus, pancreas, submaxillary, etc.). About the middle of the seventeenth century Nathanael Highmore of Oxford, England (1613–1685), discovered and adequately described the cavity in the superior maxilla which bears his name (“antrum of Highmore”), and which in comparatively recent years has assumed such importance from the viewpoint of the practical surgeon. A Danish anatomist, who is known to us English-speaking physicians as Nicholas Steno (1638–1686), but to his own countrymen as Niels Stensen, discovered the outlet duct of the parotid gland (“Steno’s duct”). Stephen Blancaard (1650–1702), a practicing physician of Amsterdam, made the first successful injections of capillary blood-vessels; and Domenico de Marchettis (1626–1688), Professor in the University of Padua, employing Blancaard’s technique, succeeded in proving that the finest ramifications of both veins and arteries communicate the one with the other. To Conrad Victor Schneider, a professor at the University of Wittenberg, Germany (1614–1680), we are indebted for putting an end forever to the erroneous doctrine that the nasal mucus is produced in the brain. He did not, however, have the good fortune to discover the glands from which this mucus actually comes; the credit for this discovery being due to Niels Stensen. Among the host of other successful discoverers in the domain of anatomy during the seventeenth century the following men deserve at least to be mentioned by name: Johann Conrad Peyer (1653–1712) of Schaffhausen, Switzerland; Johann Conrad Brunner (1653–1727), also a native of Switzerland; Theodor Kerckring (1640–1693) of Hamburg, Germany; Anton Nuck (1650–1692), Professor of Anatomy at the University of Leyden, Holland; Reignier de Graaf (1641–1673), a native of the Netherlands; and Thomas Willis (1622–1675) and William Cowper (1666–1709), both of them Englishmen.

And, finally, it may be stated that all the leading anatomists of the sixteenth century devoted a great deal of time to the study of the manner in which the nerves are distributed throughout the body and to ascertaining the arrangement of the intracranial and intraspinal nervous structures. To give even the most superficial account of what these men accomplished would occupy far more space than can well be spared for this purpose. Kurt Sprengel is my authority for saying that, of all the workers in this particular field during the period in question, Fallopius is entitled to receive the greatest credit for what he accomplished.

The First Beginnings of Minute or Microscopic Anatomy.—The anatomy of the tissues—microscopic anatomy—begins with Marcello Malpighi (1628–1694), a native of Crevalcuore, near Bologna, Italy. It is not positively known who was the inventor of the compound microscope. First employed about the year 1620, the instruments of this type came into fairly general use toward the middle of the seventeenth century. But the early compound microscopes were not very satisfactory, and consequently preference was given, for a long time, to those of the simple type. Achromatic instruments were not purchasable until 1780, when the famous German physicist, Leonhard Euler, succeeded in overcoming the obstacles which had up to that time stood in the way of their successful manufacture.