The growth of medicine from the earliest times to about 1800

by Albert H. Buck

(Courtesy of Dr. Eugen Hollander, author of Die Medizin in der klassischen Malerei, Stuttgart, 1903.)

During the first half of the sixteenth century there developed a belief, among the more ignorant physicians, that, in many cases of illness, important information may be derived from a simple naked-eye inspection of the patent’s urine as exposed to view in a flask-shaped glass vessel. In the Hippocratic writings no adequate grounds for such a belief are discoverable, but in one of Galen’s treatises there have been found statements which appear(?) to give some sanction to this new idea. However this may be, it is an established fact that uroscopy was taken up at the time named with great zeal by all the quacks in the land and by large numbers of practitioners of medicine who saw in this procedure an easy and safe method of bettering their fortunes. The public at large were greatly impressed with this new and wonderful manner of detecting disease, and for a long period—indeed, for more than half a century—this piece of clap-trap charlatanry continued to thrive, and to reflect only discredit upon the medical profession. There came a time, however, when people generally began to suspect that uroscopy was not all that the charlatans claimed it to be, and these suspicions were voiced in the popular saying, “The pulse is good, the urine is normal, and yet the patient dies.” The writers who were the most active in showing up the hollowness of the claims of the uroscopists were Scribonius of Marburg, Germany, Peter Foreest (1522–1597) of Alkmaar, Holland, and Leonardo Botallo of Asti, in Piedmont (born in 1530). The latter authority, it may be recalled, owes his chief distinction to the fact that he rediscovered what has been erroneously named in his honor the “foramen Botalli”—i.e., the ductus arteriosus in the foetus. He also attained some distinction in another direction. He revived the violent disputes about venesection by recommending a resort to this therapeutic procedure in nearly all illnesses. He went so far as to advocate four or five bloodlettings in the course of an acute attack, in each one of which operations from three to four pounds of blood should, as he believed, be abstracted. Indeed, he claimed that in an extreme case it might be perfectly proper to abstract as much as seventeen pounds(!). Inasmuch as Botallo’s practice was largely confined to the strong soldiers of Northern Italy it is easier to understand how such extravagant bloodletting did not more often prove fatal than it did. When, soon afterward, the Paris Faculty condemned the practice in the strongest possible terms, Botallo’s followers characterized sarcastically the French physicians as “pigmy bloodletters” (petits saigneurs).

But the efforts of Scribonius, Botallo and others to put an end to the uroscopy scandal were—I fully believe—not the only or perhaps even the most potent factors in bringing about the suppression of the evil. As many of our readers will remember, the art collections of European capitals contain admirably painted specimens of Dutch and Flemish genre pictures representing every phase of this uroscopic fraud, and these striking masterpieces, revealing, as they undoubtedly did to the community at large, the ridiculous character of the claims made by the charlatans, could scarcely have failed to give a deadly blow to the fraud. (See Fig. 17.)

In the early part of the sixteenth century Jean Fernel of Amiens (1497–1558) was one of the leading medical authorities of France. After receiving his degree of Doctor of Medicine at Paris, in 1530, he settled in that city and soon acquired considerable reputation, not only as a practitioner but also as a lecturer. In 1545 he was called upon to take charge, professionally, of Diane de Poitiers, the mistress of Henry, the son of Francis the First, King of France. About the same time he was asked to serve as First Physician to the Dauphin, but he was not disposed to accept the latter position, as he disliked the duties of the office and also because he feared that they would interfere with his favorite studies. He pleaded poor health, and his excuse was accepted as valid. That Fernel was held in very high esteem by the royal family is evident from the events which succeeded this refusal. In the first place, it was insisted that he should accept the stipend (600 livres) attached to the office, as a mark of the royal favor; and then, in 1547, when Henry was crowned king (Henry the Second), Fernel was urged to become his First Physician; but again he declined the honor, this time on the ground that Louis de Bourges, who had held the position with great credit under Francis the First (Henry’s father), was entitled to be retained in office. The King yielded to Fernel’s generous intervention in behalf of de Bourges. But in 1556, when the latter died, Fernel felt obliged to accept the position which had then become vacant; and from that time forward, until the time of his death on April 26, 1558, he accompanied the King on all his military expeditions. As he did not possess a robust constitution, his health suffered not a little from the frequent exposures to hardships of all sorts to which he was subjected; and, in addition, during this long period he saw very little of his wife to whom he was devotedly attached.

Fernel is universally admitted by French physicians to have been one of the most cultivated teachers and practitioners of medicine of his day. He was a very clear writer, and would doubtless have made a number of valuable additions to the science if he had not been carried off by illness at a comparatively early age.

Of his published writings the following are reckoned the most important: “Universa medicina,” Paris, 1567; “De abditis rerum causis,” Paris, 1548, and “Therapeutices universalis seu medendi rationis libri VII.,” Paris, 1554. (Many editions of each of these works were published.)

In his discussion of various questions relating to physiology Fernel maintains that the component elements of the body are vivified by means of heat, and he elaborates this idea very much in the same manner as Hippocrates does that of the “callidum innatum.” The spiritual life, he says, is presided over by the soul (“anima”). When he comes, however, to consider the individual powers of the soul, Fernel treats the subject exactly as does Galen. He gives expression to one rather bright idea: “The specific functions of each of the different organs may be inferred in large measure from the character of the structural elements of which they are composed.”

In his scheme of pathology Fernel divides diseases into simple (“similares”)—diseases of the tissues; compound (“organici”)—diseases involving entire organs; and complicated (“communes”)—diseases in which the normal relations between the different parts are broken up.

In the chapter which Fernel devotes to the subject of therapeutics, there is a section relating to venesection which, according to Haeser, is well worth reading, as it reveals the power of the writer to grasp the leading points and to reason correctly from them.

Two English Physicians Who Became Famous During the Sixteenth Century.—In the early part of the sixteenth century the medical profession of Great Britain was in a most unsatisfactory state. Humbuggery, ignorance and superstition were at that period of time the most prominent characteristics of the majority of physicians upon whom the people at large had to depend for the relief or cure of their bodily ailments, and there were very few and very untrustworthy measures in force for the production of a better class of practitioners. Just at this juncture there appeared on the scene a man who was eminently well equipped to rescue England from this lamentable state of affairs and to put her on the high road to the acquisition of an honorable body of medical men and of a corps of apothecaries who could be trusted to dispense pure drugs properly compounded. I refer to Thomas Linacre, who was born at Canterbury in 1461 or 1462, was a Fellow of All Souls College, Oxford, and a graduate of the University of Padua, and whose biography is sketched by John Freind (1675–1728) in such an admirably clear, concise and appreciative manner that I cannot do better—in view of the great importance of this event in the history of medicine in England—than to reproduce it here in considerable fulness of detail.