the evolution of modern medicine-第31部分

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　full　of　fanciful　ideas；　Van　Helmont　had　the　experimental　spirit　and　was　the　first　chemist　to　discover　the　diversity　of　gases。　Like　his　teacher；　he　was　in　revolt　against　the　faculty；　and　he　has　bitter　things　to　say　of　physicians。　　He　got　into　trouble　with　the　Church　about　the　magnetic　cure　of　wounds；　as　no　fewer　than　twenty…seven　propositions　incompatible　with　the　Catholic　faith　were　found　in　his　pamphlet　（Ferguson）。　The　Philosophus　per　ignem；　Toparcha　in　Merode；　Royenborch；　as　he　is　styled　in　certain　of　his　writings；　is　not　an　easy　man　to　tackle。　I　show　the　title…page　of　the　〃Ortus　Medicinae；〃　the　collection　of　his　works　by　his　son。　　As　with　the　pages　of　Paracelsus；　there　are　many　gems　to　be　dug　out。　The　counterblast　against　bleeding　was　a　useful　protest；　and　to　deny　in　toto　its　utility　in　fever　required　courage　a　quality　never　lacking　in　the　Father　of　Modern　Chemistry；　as　he　has　been　called。

A　man　of　a　very　different　type；　a　learned　academic；　a　professor　of　European　renown；　was　Daniel　Sennert　of　Wittenberg；　the　first　to　introduce　the　systematic　teaching　of　chemistry　into　the　curriculum；　and　who　tried　to　harmonize　the　Galenists　and　Paracelsians。　　Franciscus　Sylvius；　a　disciple　of　Van　Helmont；　established　the　first　chemical　laboratory　in　Europe　at　Leyden；　and　to　him　is　due　the　introduction　of　modern　clinical　teaching。　In　1664　he　writes：　　〃I　have　led　my　pupils　by　the　hand　to　medical　practice；　using　a　method　unknown　at　Leyden；　or　perhaps　elsewhere；　i。e。；　taking　them　daily　to　visit　the　sick　at　the　public　hospital。　There　I　have　put　the　symptoms　of　disease　before　their　eyes；　have　let　them　hear　the　complaints　of　the　patients；　and　have　asked　them　their　opinions　as　to　the　causes　and　rational　treatment　of　each　case；　and　the　reasons　for　those　opinions。　Then　I　have　given　my　own　judgment　on　every　point。　Together　with　me　they　have　seen　the　happy　results　of　treatment　when　God　has　granted　to　our　cares　a　restoration　of　health；　or　they　have　assisted　in　examining　the　body　when　the　patient　has　paid　the　inevitable　tribute　to　death。〃＇39＇

＇39＇　Withington：　　Medical　History　from　the　Earliest　Times；　London；　1894；　pp。　312…313。


Glauber；　Willis；　Mayow；　Lemery；　Agricola　and　Stahl　led　up　to　Robert　Boyle；　with　whom　modern　chemistry　may　be　said　to　begin。　Even　as　late　as　1716；　Lady　Mary　Wortley　Montagu　in　Vienna　found　that　all　had　transferred　their　superstitions　from　religion　to　chemistry；　〃scarcely　a　man　of　opulence　or　fashion　that　has　not　an　alchemist　in　his　service。〃　To　one　scientific　man　of　the　period　I　must　refer　as　the　author　of　the　first　scientific　book　published　in　England。　　Dryden　sings：

　　Gilbert　shall　live　till　load…stones　cease　to　draw　　　Or　British　fleets　the　boundless　ocean　awe。

And　the　verse　is　true；　for　by　the　publication　in　1600　of　the　〃De　Magnete〃　the　science　of　electricity　was　founded。　　William　Gilbert　was　a　fine　type　of　the　sixteenth…century　physician；　a　Colchester　man；　educated　at　St。　John's　College；　Cambridge。　　Silvanus　Thompson　says：　　〃He　is　beyond　question　rightfully　regarded　as　the　Father　of　Electric　Science。　　He　founded　the　entire　subject　of　Terrestrial　Magnetism。　　He　also　made　notable　contributions　to　Astronomy；　being　the　earliest　English　expounder　of　Copernicus。　In　an　age　given　over　to　metaphysical　obscurities　and　dogmatic　sophistry；　he　cultivated　the　method　of　experiment　and　of　reasoning　from　observation；　with　an　insight　and　success　which　entitles　him　to　be　regarded　as　the　father　of　the　inductive　method。　That　method；　so　often　accredited　to　Bacon；　Gilbert　was　practicing　years　before　him。〃＇40＇

＇40＇　Silvanus　P。　Thompson：　　Gilbert　of　Colchester；　Father　of　Electrical　Science；　London；　Chiswick　Press；　1903；　p。　3。



CHAPTER　V

THE　RISE　AND　DEVELOPMENT　OF　MODERN　MEDICINE

THE　middle　of　the　seventeenth　century　saw　the　profession　thus　far　on　its　waycertain　objective　features　of　disease　were　known；　the　art　of　careful　observation　had　been　cultivated；　many　empirical　remedies　had　been　discovered；　the　coarser　structure　of　man's　body　had　been　well　worked　out；　and　a　good　beginning　had　been　made　in　the　knowledge　of　how　the　machinery　workednothing　more。　What　disease　really　was；　where　it　was；　how　it　was　caused；　had　not　even　begun　to　be　discussed　intelligently。

An　empirical　discovery　of　the　first　importance　marks　the　middle　of　the　century。　　The　story　of　cinchona　is　of　special　interest；　as　it　was　the　first　great　specific　in　disease　to　be　discovered。　In　1638；　the　wife　of　the　Viceroy　of　Peru；　the　Countess　of　Chinchon；　lay　sick　of　an　intermittent　fever　in　the　Palace　of　Lima。　　A　friend　of　her　husband's；　who　had　become　acquainted　with　the　virtues；　in　fever；　of　the　bark　of　a　certain　tree；　sent　a　parcel　of　it　to　the　Viceroy；　and　the　remedy　administered　by　her　physician；　Don　Juan　del　Vego；　rapidly　effected　a　cure。　　In　1640；　the　Countess　returned　to　Spain；　bringing　with　her　a　supply　of　quina　bark；　which　thus　became　known　in　Europe　as　〃the　Countess's　Powder〃　（pulvis　Comitissae）。　A　little　later；　her　doctor　followed；　bringing　additional　quantities。　Later　in　the　century；　the　Jesuit　Fathers　sent　parcels　of　the　bark　to　Rome；　whence　it　was　distributed　to　the　priests　of　the　community　and　used　for　the　cure　of　ague；　hence　the　name　of　〃Jesuits'　bark。〃　Its　value　was　early　recognized　by　Sydenham　and　by　Locke。　　At　first　there　was　a　great　deal　of　opposition；　and　the　Protestants　did　not　like　it　because　of　its　introduction　by　the　Jesuits。　　The　famous　quack；　Robert　Talbor；　sold　the　secret　of　preparing　quinquina　to　Louis　XIV　in　1679　for　two　thousand　louis　d'or；　a　pension　and　a　title。　That　the　profession　was　divided　in　opinion　on　the　subject　was　probably　due　to　sophistication；　or　to　the　importation　of　other　and　inert　barks。　It　was　well　into　the　eighteenth　century　before　its　virtues　were　universally　acknowledged。　　The　tree　itself　was　not　described　until　1738；　and　Linnaeus　established　the　genus　〃Chinchona〃　in　honor　of　the　Countess。＇1＇

＇1＇　Clements　R。　Markham：　　Peruvian　Bark；　John　Murray；　London；　1880；　Memoir　of　the　Lady　Anna　di　Osoria；　Countess　of　Chinchona　and　Vice…Queen　of　Peru；　1874。


A　step　in　advance　followed　the　objective　study　of　the　changes　wrought　in　the　body　by　disease。　　To　a　few　of　these　the　anatomists　had　already　called　attention。　　Vesalius；　always　keen　in　his　description　of　aberrations　from　the　normal；　was　one　of　the　first　to　describe　internal　aneurysm。　　The　truth　is；　even　the　best　of　men　had　little　or　no　appreciation　of　the　importance　of　the　study　of　these　changes。　Sydenham　scoffs　at　the　value　of　post…mortems。

Again　we　have　to　go　back　to　Italy　for　the　beginning　of　these　studies；　this　time　to　Florence；　in　the　glorious　days　of　Lorenzo　the　Magnificent。　The　pioneer　now　is　not　a　professor　but　a　general　practitioner；　Antonio　Benivieni；　of　whom　we　know　very　little　save　that　he　was　a　friend　of　Marsilio　Ficino　and　of　Angelo　Poliziano；　and　that　he　practiced　in　Florence　during　the　last　third　of　the　fifteenth　century；　dying　in　1502。　　Through　associations　with　the　scholars　of　the　day。　he　had　become　a　student　of　Greek　medicine　and　he　was　not　only　a　shrewd　and　accurate　observer　of　nature　but　a　bold　and　successful　practitioner。　He　had　formed　the　good　habit　of　making　brief　notes　of　his　more　important　cases；　and　after　his　death　these　were　found　by　his　brother　Jerome　and　published　in　1507。＇2＇　This　book　has　a　rare　value　as　the　record　of　the　experience　of　an　unusually　intelligent　practitioner　of　the　period。　There　are　in　all　111　observations；　most　of　them　commendably　brief。　The　only　one　of　any　length　deals　with　the　new　〃Morbus　Gallicus；〃　of　which；　in　the　short　period　between　its　appearance　and　Benivieni's　death；　he　had　seen　enough　to　leave　a　very　accurate　description；　and　it　is　interesting　to　note　that　even　in　those　early　days　mercury　was　employed　for　its　cure。　The　surgical　cases　are　of　exceptional　interest；　and　No。　38　refers　to　a　case　of　angina　for　which　he　performed　a　successful　operation。　This　is　supposed　to　have　been　a　tracheotomy；　and　if　so；　it　is　the　first　in　the　fourteen　centuries　that　had　elapsed　since　the　days　of　Antyllus。＇3＇　There　are　other　important　cases　which　show　that　he　was　a　dexterous　and　fearless　surgeon。　But　the　special　interest　of　the　work　for　us　is　that；　for　the　first　time　in　modern　literature；　we　have　reports　of　post…mortem　examinations　made　specifically　with　a　view　to　finding　out　the　exact　cause　of　death。　Among　the　111　cases；　there　are　post…mortem　records　of　cases　of　gallstones；　abscess　of　the　mesentery；　thrombosis　of　the　mesenteric　veins；　several　cases　of　heart　disease；　senile　gangrene　and　one　of　cor　villosum。　From　no　other　book　do　we　get　so　good　an　idea　of　a　practitioner's　experience　at　this　period；　the　notes　are　plain　and　straightforward；　and　singularly　free　from　all　theoretical　and　therapeutic　vagaries。　He　gives　several　remarkable　instances　of　faith　healing。

＇2＇　De　abditis　nonnullis　ac　mirandis　morborum　et　sanationum　causis。　8th；　Florence；　Gandhi；　1507。

＇3＇　Possibly　it　was　only　a　case　of　angina　Ludovici；　or　retro…pharyngeal　abscess。


To　know　accurately　the　anatomical　changes　that　take　place　in　disease　is　of　importance　both　for　diagnosis　and　for　treatment。　The　man　who　created　the　science；　who　taught　us　to　think　anatomically　of　disease；　was　Morgagni；　whose　〃De　sedibus　et　causis　morborum　per　anatomen　indagatis〃＇4＇　is　one　of　the　great　books　in　our　literature。　During　the　seventeenth　century；　the　practice　of　making　post…mortem　examinations　had　extended　greatly；　and　in　the　〃Sepulchretum　anatomicum〃　of　Bonetus　（1679）；　these　scattered　fragments　are　collected。＇5＇　But　the　work　of　Morgagni　is　of　a　different　type；　for　in　it　are　the　clinical　and　anatomical　observations　of　an　able　physician　during　a　long　and　active　life。　The　work　had　an　interesting　origin。　A　young　friend　interested　in　science　and　in　medicine　was　fond　of　discoursing　with　Morgagni　about　his　preceptors；　particularly　Valsalva　and　Albertini；　and　sometimes　the　young　man　inquired　about　Morgagni's　own　observations　and　thoughts。　Yielding　to　a　strong　wish；　Morgagni　consented　to　write　his　young　friend　familiar　letters　describing　his　experiences。　I　am　sorry　that　Morgagni　does　not　mention　the　name　of　the　man　to　whom　we　are　so　much　indebted；　and　who；　he　states；　was　so　pleased　with　the　letters　that　he　continually　solicited　him　to　send　more　and　more　〃till　he　drew　me　on　so　far　as　the　seventieth；