(8.) Which effect being entirely removed, health is recovered.
(9.) It may be removed by correcting the illness itself in particular, viz., by the applications of medicines to the particular diseased part, or by some remedies which operate equally upon the whole: the first we’ll call a particular, the latter a general cure.
(10.) The way to both is discovered either by observation, or by comparing one case with another, or by a true reasoning from them both.
(13.) He who doth, with the greatest exactness imaginable, weigh every individual thing that shall happen or hath happened to his patient and may be known from the observations of his own or of others, and who afterward compareth all these with one another, and puts them in an opposite view to such things as happen in an healthy state; and lastly, from all this, with the nicest and severest bridle upon his reasoning faculty, riseth to the knowledge of the very first cause of the disease, and of the remedies fit to remove them; he, and only he, deserveth the name of a true physician.
Then Boerhaave proceeds to make a classification of diseases, and among the very first groups which one finds in this classified list are the following: “Distempers of a lax and weak fibre”; “Distempers of the stiff and elastic fibre”; “Distempers of the less and larger vessels”; “Distempers of weak and lax entrails”; “Distempers of the too strong and stiff entrails”; etc.—from which it is apparent that the old doctrine of the strictum and the laxum, which was taught by the Methodists in the early centuries of our era, has here been adopted by Boerhaave in all its essential characters; and also that the treatment which he recommends for some of these classes of maladies does not materially differ from that advocated by this ancient school of medicine. The following extracts, I believe, will suffice to give the reader a fairly clear understanding of what Boerhaave means by the expressions “distempers of the solid simple fibre,” “distempers of a lax and weak fibre,” and “distempers of the stiff and elastic fibre,” and will at the same time show what methods he employed for overcoming these distempers. At the time when Boerhaave made use of the term “fibre” (fibra) in the very uncertain sense in which he here employs it, Leeuwenhoek and Malpighi were demonstrating, by aid of the newly perfected microscope, that the so-called simple tissues were in reality quite complex structures; and one’s first impulse, therefore, is to express surprise that a physician of such high standing as our author should have used the term. But we moderns must not forget that, in those early days, it took decades for knowledge of this nature to spread even a very short distance, as from Delft to Leyden, and then to exert its legitimate influence upon medical thought—that is, to be digested and afterward permanently appropriated. There can be scarcely any doubt that, at the time (1709) when Boerhaave wrote these aphorisms, he had already heard about the existence and the capabilities of the recently perfected microscope, but it is not at all likely that he had as yet digested the gains in anatomical knowledge which had been acquired through the assistance of this instrument. The extracts referred to above are the following:—
DISTEMPERS OF THE SOLID SIMPLE FIBRE
(21) Those parts (which, being separated from the fluid contained in the vessels, are applied and sticking to each other by the strength of the living body, and make the least fibre) are the least, the simplest, earthy, and hardly changeable from or by virtue of any cause, which are found in our living bodies.
DISTEMPERS OF A LAX AND WEAK FIBRE
(24) The weakness of the fibre is that cohesion of the minutest parts described (21), which is so loosely linked that it may be pulled asunder even by that degree of motion which is requisite in healthy bodies, or not much exceeding it.
(26) The weakness produceth easily a stretching and a breaking of the small vessels made up of those weak fibres (24), and consequently abates of their power over the fluids therein contained; from which distensions arise tumors, from the stagnating or extravasated liquids putrefactions, and, farther, all such innumerable ills as are the consequences of them both.