An Epitome of the History of Medicine

by Roswell Park

[Original]

John Hunter (1728-1793), younger brother of William, enjoyed even greater reputation than the latter. He was a pupil not only of his brother, but also of Cheselden and Pott. Beginning the practice of surgery in 1763, he became surgeon to St. George's Hospital in 1768, and Surgeon-general of the English forces in 1790. So memorable were the labors and services of this man that at the Royal College of Surgeons, of London, there is given annually an "Hunterian Oration," intended in some way to commemorate his labors or to draw some lesson from his life and work, To do justice to John Hunter would require a volume, hence we must at present dismiss the subject with this brief reference.

Almost equally famous as a surgeon, though by no means such an omnivorous student as Hunter, was Benjamin Bell, of Edinburgh, who died in 1806. He employed tubes of lead and silver for the purpose of drainage. Sir Charles and John Bell, also of Edinburgh, are eminent names pertaining to the latter part of the eighteenth and first part of the nineteenth century. The latter was Professor of Anatomy, Surgery, and Obstetrics, a busy practitioner, a fertile writer, and not only one of the most successful operators of his day, but an excellent classical scholar; his Principles of Surgery appeared from 1801 to 1807. Sir Charles, who died in 1842, belongs more to the present century, but was equally distinguished as an operator, surgeon, and writer, and best known, perhaps, lor his Bridgewater Treatise on the Hand.

Among the Dutch an eminent surgeon was Peter Camper (1722-1789), who, in order to acquire manual dexterity, learned to use various mechanical tools. He was a fruitful author, and did not consider it beneath his dignity to write a treatise about the best form of shoes, published in Vienna in 1782, but recently translated and republished in England as something new. Sandifort, of Leyden, discussed ruptures, dislocations, etc., and reported the first observation of downward dislocation of the femur.

As already noted, the surgeons of the eighteenth century were often obstetricians,—William Hunter conspicuously. The most important obstetrician of his time was William Smellie (1680-1763), of London, who invented numerous instruments, wrote a large treatise on the theory and practice of midwifery, and greatly advanced our knowledge of deformed pelves. He was the first to distinguish one diameter from the other, and to point out the importance of cephalic version and version of the breech. Parenthetically, it may be remarked that William Hunter, great as he was, was the uncompromising foe of instrumental midwifery, and was in the habit of showing his forceps, covered with rust, as evidence that he never resorted to such aids. A rival of Smellie and Hunter was Thomas Denman (1753-1815), best known, perhaps, because of his demonstration of the portability of puerperal infection.

The researches of anatomists during the eighteenth century were, for the most part, directed toward the minute, more difficult, and less striking parts, and to increased thoroughness and accuracy of description. Microscopical anatomy suffered a relative quiescence. Pathological and general anatomy, which were destined to control the medicine of the succeeding century, were newly created and not yet regarded as sciences by themselves, but merely as special branches. The most important feature was the revival and more accurate study of experimental physiology, which had been scarcely resorted to since the time of Galen, except for Harvey's discoveries. This revival, which really seemed an epoch in the history of medicine, was effected by the great Haller (1708-1777), of Berne,—a man who really deserved the title of "Great," as he was a universal and indefatigable savant, possessed of thorough conscientiousness, marvelous capacity for work, great ingenuity, natural endowments, and an inextinguishable love for art and science; he was certainly one of the most versatile scholars and thinkers of any time, distinguished not only in his chosen field of medicine, but as a poet, botanist, and statesman. Like all Swiss poets, he never passed beyond the didactic and the homely in his versification. From his tenth year he wrote poems in Latin and German, and even when eight years old had made most extensive compilations from Bayle's dictionary. At fifteen he went to the University of Tubingen, where, in the second year of his sojourn, he disputed with one of his teachers. In 1725 he went to Leyden, where Boerhaave and Albinus found in him a most indefatigable follower. At nineteen he received the degree of doctor. In the excess of his zeal for anatomy he purchased for a considerable sum, from Albinus, half of a corpse, the other half of which his teacher had dissected; and, while in Paris, he even engaged in grave-robbing, and, being betrayed by his own carelessness, was compelled to save himself by flight. In many other States, and in more than one country, he studied with the best of teachers, lecturing at times himself. At the age of twenty-six he became professor and hospital director at Berne, and in 1752 published his famous researches on irritability. Three years later he accepted a call to Gottingen as Professor of Anatomy, Surgery, Chemistry, and Botany. He was the founder of a botanical garden; for many years was so busy that he slept and lived in his library; and, in spite of his enormous and unique correspondence with the savants of the world, he never left a letter unanswered. Strange to say, his permanent influence upon the practice of medicine was only indirect; and, although he was professor of surgery, and performed many vivisections, he was never able to persuade himself to perform a single surgical operation upon the living human being. He it was that introduced into Germany the use of the watch in counting the pulse. Like Hunter, Haller demands a special historian, and it is possible here to outline only a few of the services he rendered to medicine. He enriched the anatomy of the heart, of the brain and dura, and pointed out the venous nature of the sinuses; taught that the uterus should be regarded as a muscle: advanced the knowledge of the lymphatic system, and believed in and taught a developmental theory that every individual is descended or derived from a preceding one. In the mechanism of the heart his doctrine of irritability especially maintained itself. He administered the death-blow to the doctrine of vital spirits, and was, in fact, the father of modern nerve-physiology. His doctrine of irritability moved the minds of his century in a way that has no parallel, unless we compare it with the doctrine of Darwin. Glisson had established the general principles of irritability, and Haller followed, teaching it by the inductive method, and proving its existence by experiments,—proving, moreover, that it is a peculiarity of the muscular substance and not governed by ordinary sensation. His researches deserve the more credit because he lacked modern aids to physiological study. The first physiological institute was founded in Breslau by Purkinje, some fifty years ago. Haller had no such opportunity; even his successor, the great Müller, possessed no such advantages. The profound impression made by Haller's teachings may be measured by the number of his supporters and opponents; he was a great man, second only in wide-spread influence to Boerhaave, and one who left a more lasting impress upon the world than even the latter.

The two best known of Haller's opponents were: Wolf (1733-179-4), of St. Petersburg, who regarded each generation as an actual new creation, and was the first to teach the doctrine of the blastodermic membranes; and Blumenbach (1752-1840), of Gotha, who did great service by investigations in general anthropology, of which he was, in fact, the founder, and whose researches in comparative anatomy and the history of development have rendered him famous.

Of the famous anatomists of the century may be mentioned Sommerring (1755-1830), of Frankfort,—the first to distinguish the facial and auditory nerves from eacli other, and whose published works are well known, because of the beautiful illustrations furnished him by the well-known artist, Koeck.

The ablest French anatomist of the century was Winslow (1669-1760),—a man of Danish birth, but who became a professor in Paris, and is best known by the foramen named for him. There were, also, Portal (1742-1832), physician to Louis XVIII, who wrote a famous history of anatomy and surgery; and Vicq d'Azyr (1748-1794), known equally well for his labors in the department of anatomy, especially of the brain, nervous system, and the vocal organs. Bichat (already mentioned) would deserve to be placed at the head of French anatomists were it not for his superior rank in clinical medicine.