A few more words with reference to the origin and distribution of syphilis throughout the world may not seem inappropriate in this place. J. K. Proksch, the author of the most recent history of this disease,[102] says it has been fully proved that syphilis existed among the inhabitants of India as long ago as during the Middle Ages, and he adds that the evidence thus far collected justifies the further belief that it was not an uncommon malady among the ancient Greeks and Romans, and even among the Babylonians and Assyrians. Doubtless a good deal of what was called “leprosy” in early times was in reality syphilis. Another syphilographer—Raphael Finckenstein—makes the following sensible remarks about the efforts that have been made to ascertain the precise date when this disease first appeared in Europe:—[103]
It is just as foolish to suppose that the date of the first appearance of syphilis may be discovered as it is to hope that the disease will ever entirely disappear. As long as wealth and idleness continue to exist, as long as there are men who remain unmarried and women whose moral character is of a yielding nature, and as long as it is not possible for the police to creep into every nook and corner, just so long will licentiousness and indulgence in fleshly lusts continue to disturb the peace of the community. These are the conditions necessary to the development and spread of syphilis.
Some account of the treatment of this form of venereal disease comes next in order. It is commonly believed, says the author just quoted, that it was from the Spanish physicians of the sixteenth century that we learned how to treat syphilis by the methodical employment of mercurial preparations. (See footnote at the bottom of page 542.) He adds that there was published by Juan Almenar at Venice, in 1502, a book which bears the title: “A treatise on the Morbus Gallicus, in which it is demonstrated how the patient may be treated in such a successful manner that the disease will never return, nor will any objectionable lesions develop in the mouth; and yet, during the progress of the treatment, the patient is not required to remain in bed.” The author of this book, who was a resident of Valencia, Spain, was a man of noble birth. His treatise passed through eight successive editions, the last of which was printed at Basel in 1536. Almenar’s plan of treatment was to employ mercurial inunctions in such moderate doses as not to induce salivation. If, at the end of a few days, he saw evidences of an approach of this symptom, he substituted baths and evacuant remedies (rhubarb and senna) for a short time, and also prescribed a more nourishing diet and the taking of various internal remedies. Then, later, the inunctions were resumed. The exact duration of such a course of treatment is not stated. So far as I am able to judge from the account given by Finckenstein, Almenar found it necessary in some cases to repeat the series of mercurial inunctions as many as four times. His aim, in other words, was to accomplish a radical cure of the disease, whereas his contemporaries, who were mainly ignorant and uneducated physicians, were satisfied to carry out a purely symptomatic treatment. Morejon, the historian of Spanish medicine, expresses the belief that Almenar was the first to use steam baths in the treatment of syphilis. Both Hensler and Simon, the best modern authorities with regard to the history of syphilis, agree that Almenar’s inunction method of treating this disease forms, notwithstanding its crudeness in certain respects, the basis of all modern methods of the same general character. Unfortunately, the physicians of a later period did not follow the relatively mild and safe inunction method advocated by Almenar, but so modified it for the worse that it became a common thing for men to say that the cure was worse than the disease.
A Few Special Advances Worthy of Note.—The beginnings of medical journalism belong to the second half of the seventeenth century. In 1665, for example, there appeared for the first time, a medical article in the “Journal des Scavans,” and during the same year similar articles were printed in the “Philosophical Transactions of the Royal Society of London.” According to August Hirsch the earliest periodical that was devoted entirely to the interests of the medical profession was the “Journal des découvertes en médecine,” which was first published in 1679 and continued, in 1680, under the title of “Le Temple d’Esculape.” Then followed soon afterward: “Le Journal des Nouvelles Découvertes en Médecine” (1681–1683); “Le Mercure Savant” (1684); “Le Zodiacus Medico-Gallicus” (1680–1685), which was published in Latin in Geneva, by Bonet; etc.
In addition to the more important advances in anatomy and physiology that have already been mentioned on previous pages, the following deserve to receive at least a passing notice: In the department of anatomy and physiology, William Briggs (1642–1704), one of the physicians of St. Thomas’ Hospital, London, published at Cambridge in 1676, under the title of “Ophthalmographia,” a most important contribution to the anatomy and physiology of the eye; and there were four other English anatomists who, during the seventeenth century, gained well-merited credit by the original work which they did in the fields of anatomy and physiology—viz., Thomas Willis (1622–1675), Francis Glisson (1597–1677), Thomas Wharton (1610–1673), and Nathaniel Highmore (1613–1684). The part played by Germany in these gains in anatomy and physiology, during the period now under consideration, was chiefly that of a sympathetic recipient; for the political conditions at that time were entirely unfavorable to any active participation on the part of the physicians of that country. Early in the eighteenth century, however, they began in earnest to do their share of work in advancing the science of medicine.
The relationship of the physical sciences to the theory and practice of medicine is not of an intimate nature, and it will therefore not be necessary for me to do more than briefly to enumerate the more important of the discoveries of this character which occurred during the sixteenth and seventeenth centuries.
Galileo (1564–1642), a native of Pisa, Italy, was the creator of the science of motion, and he gave the first satisfactory demonstration of equilibrium on an inclined plane. He devised an imperfect species of thermometer, a proportional compass, and the refracting telescope, by means of which latter instrument he made a number of other important discoveries in the domain of astronomy. His pupil, Evangelista Torricelli (1608–1647), also a native of Italy, discovered the barometer, and in addition arrived at many fundamental truths in mechanics and hydrostatics. Otto von Guericke (1602–1686), a native of Magdeburg, Germany, invented the air pump. Sir Isaac Newton (1642–1727), born at Woolsthorpe, Lincolnshire, one of the world’s greatest authorities in natural philosophy, was the first to formulate clearly the law of gravitation. Edme Mariotte (1620–1684), a native of Burgundy, France, was the discoverer of what is commonly known as “Mariotte’s law”—i.e., a law of elastic fluids, according to which the elastic force is exactly in the inverse proportion of the space which the mass of fluid occupies. He also discovered that the part of the retina at which it meets the optic nerve is not capable of conveying the impression of sight. Finally, Denis Papin (1647–1710), a Frenchman, invented the first steam engine, of an embryonic and not very practical type; for in this apparatus the piston floated on the water in a separate cylinder.
The inventions which I have here briefly enumerated represent the more important discoveries that were made in physical science during the sixteenth and seventeenth centuries.
The Beginnings of a Modern Pharmacopoeia, and One of the Last Attempts of the Disciples of Galen to Maintain Their Ascendancy in Therapeutics.—In the domain of pharmacology the first attempt in modern times to organize this department of practical medicine was made by an apothecary in Barcelona in 1497, and was published by him in printed form in 1521. (Von Gurlt.) This pharmacopoeia was doubtless wholly unknown beyond the borders of Spain. Not far from one hundred years later,—i.e., in the early part of the seventeenth century,—Theodore Turquet de Mayerne, who was born in 1573, in a small village near the city of Geneva, made the second attempt in modern times to organize the pharmacological department of practical medicine. After showing quite early in life a fondness for the study of chemistry, he devoted himself particularly to the investigation of the remedies that are produced in the chemist’s laboratory; the preparations of antimony attracting his especial interest. A little before this time the physicians of Paris were split up into two strongly antagonistic parties as regards the propriety of administering this metal in any form as a remedy; but those who opposed its therapeutic employment finally managed to secure from Parliament, in 1566, a decree prohibiting its use. While this quarrel was in progress, de Mayerne visited Paris (1602) and established himself in that city as an independent lecturer on chemistry. As the regular faculty still held the belief that the teachings of Galen were the only safe guide for physicians to follow, de Mayerne’s action must have appeared to them like an impudent challenge. In one of his writings he strongly recommended the employment of antimonial preparations,—remedies introduced originally by the much-hated Paracelsus,—and he even went so far as to offer some for sale. This was too much for the disciples of Galen to bear without a protest, and consequently in 1603 the Parliament issued a new decree, in accordance with which de Mayerne was prohibited from practicing medicine in Paris. This measure appears to have proved successful in putting a stop effectively to his obnoxious teachings, for we learn that shortly afterward he was known to be living in London, where, in 1611, he was appointed the Physician-in-Ordinary to King James the First, and later to Charles the First. He died in 1655.
Jean Astruc, the distinguished French medical author of the eighteenth century, speaks rather disparagingly of de Mayerne’s attempt to organize a pharmacopoeia. An earlier, more successful, and much more creditable attempt of this nature was made by Valerius Cordus, whose “Dispensatorium pharmacorum omnium” was first published at Nürnberg in 1535. This work, which subsequently bore the title “Pharmacopoeia Augustana,” up to the year 1627 passed through at least seven editions and was utilized to a greater or less extent by the authors or editors of nearly all later pharmacopoeias. To go still further back, the most ancient pharmacopoeia of which we have any knowledge is that which bears the title of “Antidotarium Nicolai,” the author of which work was Nicolaus, the President or Dean of the Medical School at Salerno. The book was written originally during the first half of the twelfth century, but it did not appear in print, at Venice, until the year 1471, and then only in an incomplete form. Quite recently a French translation of the book has been made and published (1896) by Paul Dorveaux, of the Paris School of Pharmacy. Most of the preparations there described have long since been abandoned, but a few of them—such, for example, as citrine ointment, honey of roses, oxymel, and oil of roses—are still to be found in the pharmacopoeias of some nations.