* Aij.yj. eft ? . ENCYCLOPAEDIA LONDINENSIS V,' v OR, UNIVERSAL DICTIONARY OF ARTS, SCIENCES, AND LITERATURE: COMPREHENDING, UNDER ONE GENERAL ALPHABETICAL ARRANGEMENT , ALL THE WORDS AND SUBSTANCE OF EVERY KIND OF DICTIONARY EXTANT IN THE ENGLISH LANGUAGE. IN WHICH THE IMPROVED DEPARTMENTS OF THE MECHANICAL ARTS, THE LIBERAL SCIENCES, THE HIGHER MATHEMATICS, AND THE SEVERAL BRANCHES OF POLITE LITERATURE, ARE SELECTED FROM THE ACTS, MEMOIRS, AND TRANSACTIONS, OF THE MOST EMINENT LITERARY SOCIETIES IN EUROPE, ASIA, AND AMERICA. FORMING A COMPREHENSIVE VIEW OF THE RISE, PROGRESS, AND PRESENT STATE, OF HUMAN LEARNING IN EVERY PART OF THE WORLD. EMBELLISHED WITH A MOST MAGNIFICENT SET OF COPPER-PLATE ENGRAVINGS, ILLUSTRATING, AMONGST OTHER INTERESTING SUBJECTS, THE MOST CURIOUS, RARE, AND ELEGANT, PRODUCTIONS OF NATURE, IN EVERY PART OF THE UNIVERSE; AND ENRICHED WITH PORTRAITS OF EMINENT AND LEARNED PERSONAGES, IN ALL AGES OF THE WORLD, COMPILED, DIGESTED, AND ARRANGED, By JOHN WILKES, of MILLAND HOUSE, in the COUNTY of SUSSEX, Esquire; ASSISTED BY EMINENT SCHOLARS OF THE ENGLISH, SCOTCH, AND IRISH, UNIVERSITIES. VOLUME XIX. CONTAINING O-- A comprehenlive Treatife on PATHOLOGY ; And a Hiftory of PERSIA and PERU to the present Time. Eontfon : PRINTED FOR THE PROPRIETOR, AT THE ENCYCLOPEDIA OFFICE, 17, AVE-MARIA-LANE, ST. PAUL’S; AND SOLD BY ALL The BOOKSELLERS. J. and C. ADLARD, Printers 33, Bartholomew Close. 1823. • «\ DESCRIPTION OF THE FRONTISPIECE ILLUSTRATING PATHOLOGY. APOTHEOSIS OF HIPPOCRATES. SEATED IN AN ANTIQUE CAR, DRAWN TOWARDS THE TEMPLE OF IMMORTALITY BY CHIRON AND ANOTHER CENTAUR EQUALLY VERSED IN THE ART OF HEALING,— HIPPOCRATES HOLDS IN HIS RIGHT HAND THE PATERA OF HEALTH, AND IN HIS LEFT THE STAFF AND SERPENT OF jESCULAPIUS, WHOSE DAUGHTER HYGEIA IS REPRESENTED ABOVE,— STREWING MEDICINAL FLOWERS ON THE HEAD OF THE FIRST PATHOLOGIST IN THE WORLD ; WHILST APOLLO, SHOOTING FROM THE CLOUDS 4T THE SERPENT PYTHON, AN EMBLEM OF PESTILENCE, SETS FREE FROM THE CAVERN OF THE MONSTER THE VICTIMS OF DISEASE. DEATH AND THE DEMONS OF LINGERING ANGUISH AND EXCRUCIATING PAIN ARE SEEN FLYING OFF; AND NAUSEATING SICKNESS IS EXEMPLIFIED BY AN EMACIATED FIGURE ON THE FOREGROUND ENCYCLOPAEDIA LONDINENSIS OR, AN UNIVERSAL DICTIONARY OF ARTS, SCIENCES, and LITERATURE. PATHOLOGY. PATHOL'OGY, f [from the Gr. waOo?, fufFering, and Aoyos, a difcourfe.] The fcience or doitrine of difeafes. — 'This tree may naturally be conceived to have been under fome difeafe indifpofing it to fuch fruftifi- cation. And this, in the pathology of plants, may be the difeafe of fuperfoliation mentioned by Theophraftus. Sir T. Browne’s M if cell.- — That part of medicine which relates to diftempers, with their differences, caufes, and effects incident to the human body. As Physiology teaches the nature of the fundtions of the living body in a Hate of health; fo Pathology relates to the various derangements of thefe fundtions which conftitute difeafe. Its objedts, therefore, are to afcertain the various fymptoms which charadterife the different diforders of each organ of the body, and efpe- cially the diagnojlic and pathognomonic fymptoms, which afford the means of difcrimination between difeafes that referable each other; to determine the caufes, both pre- difpofing and exciting, by which difeafes are induced ; to point out the prognojis, or the tendency and probable event of each difeafe, from the changes and combination of the fymptoms ; and daftly, to teach the indications of cure, and the nature and operation of the remedies adapted to the various circumftances and periods of difeafe. The ftudy of pathology prefuppofes an intimate ac¬ quaintance with anatomy and phyf.ology ; or, in other words, with the ftruiture, laws, and operations, of the animal body in a ftate of health. An obfervance of the figns or fymptoms which denote a deviation from this ftate, conftitutes the firft branch of medicine, or J'ympto- matology : an acquaintance with the ufual concatenations obferved by thofe figns, diagnofis. Nqfology regards the arrangement of thefe figns or fymptoms; and atiology ap¬ plies to the cognizance of their caufes, whether external or internal. The application of the properties of inani¬ mate matter to the removal of thefe caufes, or figns, is denominated therapeutics. The fubftances ufed for this latter purpofe are termed materia medica. Before entering into any further examination of thefe fubjeits, it will be neceffary to give a fiiort Iketch of the hiftory of this art; in the courfe of which it will be feen, that its profeffors have been employed for the moft part in endeavouring to explain the phenomena of difeafe and the operation of remedies according to the principles of fome favourite or faftiionable ftudy. Thus mechanics, che- miftry, and metaphyfics, have each in their turn formed the bafis of celebrated medical theories : theories long fince exploded, but of which the recollection may ferve as beacons to warn us from the like errors. It is not, however, for this purpofe only that the writings of the ancients merit our regard. The perufal of them en¬ larges the field of our experience : we often find in them, Vol. XIX, No. 1283, remarks which ferve to explain anomalies in difeafe, and defcriptions which their beautiful and forcible language renders more interefting, and imprints more firmly on our minds. They likewife furnifti hints for the further profecution of inquiry, by fliowing the various lights in which the fame circumftances have been viewed by diffe¬ rent men ; and the long chain of fads they difplay to our view enables us in fome meafure to appreciate the effeds of climate, diet, and even manners, on theconfti- tution of our fpecies. It may be remarked moreover, that fcarcely any fyftem of medicine has been framed, however abfurd, which has not contributed, by the fpirit of inveftigation it excited, and by the new flock of fads its eftabliftiment neceffarily developed, to advance the pro- grefs of the art. RISE and PROGRESS of MEDICINE. The origin of the medical art is involved in great ob- fcurity : yet, its antiquity is undoubtedly great, fince, from its intimate relation with the life of man, the difco- very of it muft have been coeval with that of the moft fimple mechanical arts. The little we know of the earlieft hiftory of our race, leads to the fuppofition, thatfurgery was the firft branch of medicine cultivated. While mankind fubfifted prin¬ cipally by hunting or filhing, they muft, of neceffity, have been fubjeded to a variety of accidents ; fradures, luxations, &c. muft have been frequent among them, and to cure or alleviate thofe obvious maladies muft have been their firft care. It is impoflible to conjedure what means were purfued for the attainment of this end, yet, it is natural to fuppofe, they w'ere, fora long period, very in¬ efficient, and that the knowledge acquired in this ftate of fociety was very confined. It is probable, however, that anatomy was not wholly negleded in this barbarous age. The frequent daughter of wild beafts, and the various purpofes of food, raiment, &c. to which their different parts were appropriated, muft have led to a curfory ac¬ quaintance with the ftrudure of thofe animals ; and thus laid the foundation of comparative anatomy, an acquifi- tion by no means ufelefs in chirurgical operations. En¬ gaged, too, in perpetual hoftility, thefavage probably re¬ garded the examination of human bodies with little or none of that horror which has proved fo inimical to the ftudy of anatomy in more civilized times ; and indeed, (if we may judge from the accounts handed to us by the ancients,) he feems to have felt a brutal pleafure in man¬ gling and deforming the perfons of his deceafed enemies. Thus Homer relates of the Greeks over the body of Heitor, that, OvJ’ ago. oi ti; aiwrw ys tcciq soto. It was in times when more refined habits of life ob¬ tained, and in fituations where gentler purfuits occupied B the Vs a 2 PATHOLOGY. the attention of mankind, that the application of reme¬ dies to the cure of internal maladies took its rife. The tending of flocks and herds, which then became a very general employment, mull have induced habits of leifure and contemplation extremely favourable to theacquifition of experimental knowledge : we may fuppofe that the paf- tors obferved the effects of certain plants on their flocks ; and by a natural and eafy tranfition were induced to admi- nifter the fame fubftances in ailments of their own bodies : a fuppolition which the faffs related by Herodotus and others feem to confirm. The above-mentioned author obferves, that Melampus difcovered the melampodium, or black hellebore, to be poffeffed of a purgative property from having obferved its effect on goats which had broufed in paftures where this herb was indigenous and frequent. Again, we are informed, that the firft ufe of enemas was taught mankind by the Ibis, a bird which is reported to have the power of introducing its bill into the anus, and injefting thereby a quantity of water up the inteftines. Pliny likewife mentions a circumftance to which he attributed the introduflion of phlebotomy; viz. that the Hippopotamus has a cuftom, whenever it becomes large and unwieldy, of opening a vein in its leg by means of a (harp reed which grows on the banks of the Nile. The accuracy of the two latter relations may be queftioned ; yet probably they had their origin in fads, though tradition and the lapfe of time had altered or ex¬ aggerated them. However this may be, there can be little doubt, but that in this branch of medicine, as in anatomy, the phenomena difplayed in the brute creation furniflied man with ufeful hints, and contributed, in a few inftances, to introduce medical herbs to his notice. The confideration of the more or lefs falubrious qualities of his own food led to the introduction of certain regimen, or fyftem of diet, which in thefe times, with the occafional ufe of a few Ample cathartics, was probably fufficient for the cure of mod internal complaints ; and thefe obferva- tions, naturally communicated from father to fon, from one generation to another, and eftabliflied by long and multiplied experiments, at length laid the bafis of materia medica and therapeutics. This empirical pradice, how¬ ever, being often found to fail in affording the expeded relief, a minute attention was paid to the concomitant circutnftances under which previous cures had been ef- feded, and they were imitated accordingly. Thus one plant was direded to be gathered in the night, another when the moon was on the wane, See. accompanied with abfurd and fuperflitious incantations. With refped to the modus operandi of thefe remedies, their firft employers mud have been totally uninformed, in confequence of their ignorance of natural philofophy ; to divine agency therefore they referred the effeds of medicinal herbs, rather than to any innate virtue in the fubftances themfelves. To this agency likewife they af- cribed the occurrence of difeafe, or the reftoration of health ; an idea which appears in feme meafure conneded with that branch of heathen mythology which attributed to every member of the body its guardian genius. Up to this period every man was more or lefs a phy- fleian, and contributed his individual flock of experience to the general good ; but, when the increafing wants and number of the human race compelled them to adopt the forms of political government, and they eftabliflied the military ruler or chieftain on the one hand, and the prieft, druid, or brahmin, on the other, the pradice of medicine fell exclufively into the hands of thofe who executed the facerdotal fundion. They feized with avidity the exer- cile of an art, the unknown or uncertain origin of which favoured the illufion that it was derived immediately from the gods : an art which, clothed in fuperftition, and ve¬ nerable from its antiquity, lent them increafed influence over the vulgar, and was indeed hardly lefs ufeful for that purpofe than the facred or legiflatorial offices which they likewife affumed. They taught that peftilence or difeafe was inflided by the angel of the enraged gods, and eafily found means to perfuade the futferers that fuch dire vifitations were only to be removed through the me¬ dium of prieftly interceffion, joined with lacrifices and offerings. From that paffage in Genefis in which it is faid, that “ Jofeph commanded his fervunts the phyficians to em¬ balm his father,” (Gen. 1. 2.) the writer of the article Medicine in the Encyclopaedia Britannica concludes that the firft phyficians of the Egyptians were not priefts; becaufe, in that age, the Egyptian priefts were in fuch high favour, that they retained their liberty, when, through a public calamity, all the reft of the people were made flaves to the prince. This, however, we do not think a valid objedion; for we cannot doubt that every rank of perfons, priefts as well as others, might, under an abfolute monarchy, be very properly ftyled fervants of the prince, and alfo of his prime minifter. The fame writer feems more founded in his conjedure that the phyficians of the Jews were originally diftind from their priefts ; for we read that, when king Afa was difeafed in his feet, “ he fought not to the Lord, but to the phyficians.” (2Chron.xvi. 12.) Now, feekingtothe priefts, had they been the phyficians, would have been the fame thing as feeking to the Lord; and hence it is fuppofed, that among the Jews the medical art was looked upon as a mere human invention ; and it was thought that the Deity never cured difeafes by making people acquainted with the virtues of this or that herb, but only by his miraculous power. That the fame opi¬ nion prevailed among the nations who were neighbours to the Jews, is alfo probable from what we read of Aha- ziah king of Judah, who, having fent meffengers to in¬ quire of Baalzebub, god of Ekron, concerning his dif¬ eafe, did not defire any remedy from him or his priefts, but limply to know whether he ffiould recover or not. (2 Kings i. 2.) We ffiall now quote a few verfes from a book of Scrip¬ ture (Apocrypha), written “ in the latter times, after the people had been led away captive, and called home again, and almoft after all the prophets.” In this book phy¬ ficians are fpoken of with a much greater degree of re- fpeft, but not as if they were priefts. “My foil, in thy ficknefs be not negligent : but pray unto the Lord, and he will make thee whole. Leave oft" from fin, and order thine hands aright, and cleanfe thy heart from all wick- ednefs. Give a fweet favour, and a memorial of fine flour; and make a fat offering. Then give place to the phyfician, for the Lord hath created him : let him not go from thee, for thou haft need of him. There is a time when in their hands there is good fuccefs. For they fhall alfo pray unto the Lord, that he would profper that which they give for eafe and remedy to prolong life. He that finneth before his Maker, let him fall into the hand of the phyjician. Ecclefiafticus xxxviii. 15. “ What feems moft probable on this fubjeft therefore is, that religion and medicine came to be mixed together only in confequence of that degeneracy into ignorance and fuperftition which took place among all nations. The Egyptians, we know, came at laft to be funk in the moft ridiculous and abfurd fuperftition ; and then, indeed, it is not wonderful that we fliould find theirpriefts com¬ mencing phyficians, and mingling charms, incantations, &c. with their remedies. That this was the cafe, long after the days of Jofeph, we are very certain ; and in¬ deed it feems as natural for ignorance and barbarifm to combine religion with phyfic, as it is for a civilized and enlightened people to keep them feparate. Hence we fee, that among all modern barbarians their priefts or conju¬ rors are their only phyficians.” Ency. Brit. vol. xiii. However this may be, the union of medicineand religion continued for many centuries; but, whatever difeoveries may have been made, the myftery attendant on moft fa¬ cred inflitutions has prevented communication of them to pofterity. Neverthelefs this union was not perhaps fo prejudical to the interefts of fcience as many have fup¬ pofed. 3 PATHOL O G Y. pofed. Conftant facrifice and the frequent habit of in- fpeftingthe “ /pirantwexta” of tire victims, matt have ma¬ terially advanced the progrefs of comparative anatomy ; and the written records firlh adopted by the priefts at lead prevented eftablilhed faffs from falling into oblivion, even if further experience in the cure of difeafe was but (lowly attained. The Egyptians afcribed the invention of medicine to Thoth, ( the Hermes Trifmegiftus of the Greeks,) to whom divine honours were paid ; and they reported that he was the founder of all ufeful knowledge. But there is fome confufion in this account 5 for, on fome occafions, this difcovery was attributed to Ifis or Ofiris, while at other times Apis and Serapis laid claim to the merit of it. It Ihould be recollected, however, that thefe deities werenot like Thoth, mortals who had divine honours paid to them after their deceafe, but embodied or perfonified agents, by means of which the philofophers of the time en¬ deavoured to explain all the laws and operations of matter. They were not likely therefore to be commemorated as the inventors of medicine, although they were undoubt¬ edly invoked as prefiding over health. Athotis, one of the Egyptian kings, left writings on anatomy, a fcience in which the nation could hardly have been deficient, on account of the frequent opportunities they enjoyed of acquiring it while engaged in embalming the bodies of the dead. But the other branches of medicine remained a long time ftationary, fettered by abfurd regulations. In the firft place, the chief-priefts confined themfelves entirely to the exercife of magic rites and prophefies, which they confidered the higher branch of the art, and left the exhibition of remedies to th epajiophori, or image- bearers. Secondly, the priefts of every denomination ■were compelled to follow implicitly the medical precepts of the facred records contained in the fixhermetical books ; for, if they deviated from thefe eftablilhed rules, or intro¬ duced new modes of pra&ice, their temerity was punifhed with death, whether their meafures were fuccefsful or not; thus precluding all idea of improvement. We know very little of the details of their pradtice, as they concealed them with myftic ceremonies ; but that they did not interfere much with the operations of nature may be inferred from a circumftance mentioned by Ariftotle, viz. that they did not adopt adfive treatment till after the fourth day of the difeafe. They had, however, a com- prehenfive fyftem of diet ; for they excluded filh,pork, and fuch other aliments as they confidered injurious to health. They were alfo acquainted with a few valuable remedies, among which may be enumerated fquills, which they ad- miniftered to dropfical patients, and iron, which they ufed as a tonic in cachedlic difeafes ; but they were la¬ mentably deficient in furgery, fince they were unable to cure a common luxation of the foot, which Darius the foil of Hyftafpes met with in hunting. We pafs briefly over the hiftory of this fcience among the Jews, becaufe we find little recorded on the fubjedt except miraculous cures, which cannot properly be faid to apply to natural medicine. Indeed the Jews feem to have been wholly ignorant of the art of phyfic until their in¬ troduction into Egypt, when they found its principles eftablilhed. The alleviation of human infirmity, as recorded in Scrip¬ ture, forms a fubjedl rather to exercife the faith of the theologian than to engage the attention of the patho- logift. It is true, Mofes has arranged a code of medi¬ cinal and dietetic maxims, and has defcribed feveral va¬ rieties of leprofy with the minutenefs of a practical phy- fician ; but it does not appear that he attributed much to the virtue of medicines in thofe complaints. Indeed the adminiftration of remedies could hardly feem necef- fary to a people who were informed by a direCt revelation from the Lord, that, if they would diligently hearken unto his voice, and do that which was right in his fight, he would put none of thofe difeafes on them with which he had afflidfed the Egyptians. To the tribe of Levi was appropriated the adminiftration of the facred remedies. Solomon was celebrated for his knowledge of plants and animals ; and he compofed a treatife on the cure of dif¬ eafes which was deltroyed by Ezekias, left it fliould caufe the facred remedies, rendered more efficacious by the fa- crifices of the priefts, to fall into difufe. Ifaiah the pro¬ phet was likewife famed for medical knowledge : he re- itored Ezekias to life by applying to his wounds cata- plafms of figs. Soon after this period the Jews were dif- perfed in Media and Aflyria, and fubmitted to the yoke of Babylon. It is fuppofed that medicine was cultivated at a very early period among the Hindoos. Of this there can be little doubt. Whether this people were originally de¬ rived from the Egyptians, or the Egyptians from them, the fimilitude in arts, manners, and religion, clearly in¬ dicates that the one nation arofe from the other. Ac¬ cordingly we find the art (food in former times nearly on the fame footing in Hindooftan as it (food in Egypt. The brahmins held the two offices of priefts and phyficians; and, as among the Egyptians, allotted a few difeafes only to the notice of each individual among themfelves. In China, the progrefs of this art feems to have fol¬ lowed a retrograde courfe. For this we are at a lofs to account : certain it is, however, that the authority of the Chinefe'on medical fubjeCts was formerly held in much greater eftimation than it isatprefent. Thejefuits have informed us, that the kings of China paid particular at¬ tention to the encouragement of medicine ; and that Eu¬ ropeans were wont to put greater confidence in the phy¬ ficians of this country than in thofe of any other. More¬ over this fcience was taught in their public fchools, in conjunction with aftronomy. Thefe fchools no longer exift : the Chinefe phyficians implicitly follow the direc¬ tions of the medical code of Hoang-Ti, written, as they aflert, 4000 years ago; and their knowledge is fo fmall and inaccurate, that the emperor Cam-hi commanded Parenhi totranflate the anatomical treatife of Dionis in¬ to the Tartarian language. In Greece, medicine was profecuted with greater ar¬ dour, and its collateral fcience anatomy was inveftigated more fully, than had been the cafe in any country before. The Greeks, like the Egyptians, afcribed the introduc¬ tion of this art to divine revelation: their Apollo and Minerva anfwered to the Ifis and Ofiris of the latter nation ; and Orpheus, the prieft, poet, and phyfician, ufurped the place of Thoth ; and the fable of his bringing his wife Eurydice from Hell probably applies to his fkill in difeafes. But the priority has been given by fome to Me- lampus, who was a phyfician of great celebrity at Pylos. He cured the daughters of Praetos king of Argos, who were afflidfed with leprofy and madnefs ; and he removed like¬ wife the impotence of Iphiclus, by which cure he alfo faved his own life. The next on record i3 the centaur Chiron, who was preceptor to moll of the warriors and great men of his age, but with the greateft fuccefs to Aifculapius, or Afclepias, a king of Theffaly (and reputed fon of Apollo), who made fo great proficiency, that the fable fays Jupiter was obliged to remove him from the earth to preferve his brother Pluto’s kingdom from depopulation. His fons, Podalirius and Machaon, received from their father the art of healing, which they exereifed with fuccefs at the fiege of Troy, and tranfmitted to their defcendants the Afclepiades. At firft, the Afclepiades promulgated their doCtrines as priefts in the temples of the god of health; but, as fchifms arofe among the different fe&s, each tem¬ ple became in time a diftinCt medical fchool. Thus the fchool of Ceredos and Cos were founded, in which for fome time the defcendants of Asfculapius alone were per¬ mitted to pra&ife : but it was afterwards judged necef- fary to admit a limited number of pupils from other fa¬ milies, who bound themfelves by oath to obferve the rules 4 PATHOLOGY. rules of the Afclepiades. From the fchool of Cos arofe Hippocrates, the fourteenth in defcent from Aifculapius. But the ftudy of medicine was not confined to this fa¬ mily ; it formed part of the education of kings and heroes. Hercules received from Chiron, in earlier times, the ru¬ diments of medicine. Ariftasus, king of Arcadia, was likewife a fcholar of the centaurs : to him we owe the in¬ troduction of the herb Jylphium, fuppofed by fome to be aflafcetida. Jafon, Telamon, Thefeus and Peleus,Ulyfles, Diomed, Hippolytus, and Achilles, were proficients in this art. Achilles is faid indeed to have firft ufed verdi¬ gris for the purpofe of cleaning foul ulcers. But all of them were inferior to the accomplilhed, the injured, Pa- lamedes ; by the excellent rules of diet and exercife to which he fubmitted the foldiers, he prevented the plague from entering the Grecian camp after it had carried its ravages over raoft of the cities of the Hellefpont and even Troy itfelf. ./Efculapiusflouriftied about 50 years before the Trojan war 5 and we have feen that his two Tons diftinguilhed themfelves in that war both by their valour and by their ikill in curing wounds. This indeed is the whole of the medical Ikill attributed to them by Homer ; for, in the plague which broke out in the Grecian camp, l.edoes not mention their being at all confulted. Nay, what is (fill more ftrange, though he fometimes mentions his heroes having their bones broken, he never takes notice of their being reduced or cured by any other than fupernatural means; as in the cafe of ^Eneas, whofe thigh-bone was broken by a Hone call at him by Diomed. The methods which thefe two famous furgeons ufed in curing the wounds of their fellow-foldiers, feems to have been the extracting or cutting out the darts which inflicted them, and applying emollient fomentations orftyptics to them when neceflary : and to thefe they undoubtedly attributed much more virtue than they could poflibly poflefs ; as appears from the following lines, where Homer defcribes Eurypylus as wounded and under the hands of Patroclus, who would certainly praCtife according to the directions of the furgeons of that time : Patroclus cut the forky fteel away ; Then in his hand a bitter root he bruis’d, The wound he walh’d, the llyptic juice infus’d. The clofing flefli that injtant ceas’d to glow; The wound to torture, and the blood to flow. Iliad, xi. The philofophers of Greece, by adapting their fpecula- tions to the elucidation of this fcience, lent it material aid. Pythagoras vifited Egypt and India, collected the therapeutic and dietetic maxims of thofe nations, and in¬ troduced them into his own country: unfortunately, in fo doing, he forgot the difference of climate and habits, .and endeavoured to apply the vegetable regimen too ftriCtly. He attended diligently to the ltudy of the ani¬ mal economy ; and he founded the fchool of Crotona, whence arofe Alcmaeon, an anatomift of great repute. With refpeCt to the knowledge this latter perfonage pof- fefled of the human ftruCture, it admits of doubt ; but his /kill in comparative anatomy is well attefted by Ariftotle, Diogenes, and Plutarch: with him too originated the firft theory of fleep : he fuppofed, that, when the blood flows in the larger veflels only, fleep is induced; but, when it returns in the finaller ones, waking occurs. Empedocles, the diftinguiflied philofopher, was another ornament of the Pythagorean feCt. Befides thefe philofophers, and the Afclepiades, there were, at this period, other perfons who devoted them¬ felves to the profeflion of phyfic, and who occafionally were remunerated by a fixed falary. Thus Democetes of Crotona was retained at the court of the Samian tyrant Polycrates, with an allowance of two talents yearly : being afterwards taken prifoner, and carried as a flave in- do Perfia, he acquired great repute by curing Darius of a •fprained foot, after the Egyptian phyficians had failed ; iand alfo by his fuccefsful treatment of a tumour of the breaft, under which Atofia, the daughter of Cyrus, and wife of Darius, had laboured for a confiaerable time. (Herodot. iii. 133.) Such pradlitioners, from their wan¬ dering lives, were fometimes defignated by the name of s-Egio&vrat. Of this clafs, one of. the moll confpicuous was Acron of Agrigentum, the contemporary and rival of Empedocles, refpedting whom Pliny has fallen into a ftrange error, in defcribing him as the founder of the empiric fedt “under the fandtion of Empedocles.” Ac¬ cording to Diogenes, he was the author of fome books on medicine and dietetics, written in the Doric dialed! ; and he fignalized himfelf at Athens, in the time of the great plague, by introducing the pradtice of fumigations, and thus affording relief to many. (Plut. de Ifld. et Ofir.) The gymnafia of ancient Greece feem alfo to have con¬ tributed to the improvement of the art. It belonged to the gymnafiarch, or pulajlrophylux , to regulate the diet of the youths who were trained in thefe feminaries ;_the yt //Avaran were prefumed to be converfant with difeafes; and it was the bufinefs of the ctXtiiflai to perform venefec- tion, to drefs wounds, fradtures, &c. They were fome¬ times called phyficians. It was in thefe feminaries that the gymnaftic fyftem of medicine originated, under the au- fpices of Iccus of Tarentum, and Herodicus of Selymbria. About this time, and contemporary with Hippocrates, flourilhed Democritus of Abdera, who made the firft public difledtion on record: he applied himfelf to this talk for the purpofe of afcertaining the nature and courfe of the bile; and difledted with fo much afliduity, that the Abderites fufpedted him of infanity, and accordingly fent for Hippocrates (as it is reported) to cure him : but the latter, fo far from finding him mad, difcovered that he was extremely wife, as he exprefles himfelf in a letter to his friend Damagetus. As we are now arrived at an era in which the hiftory of pathology will afl’ume, as it were, a tangible fliape, we fliall divide our large field of information into three fec- tions ; the firft reaching to the decline of the art during the dark ages ; the fecond from that time to the end of the fixteenth century; and the third, to the prefent time. I. From the Time of Hippocrates to the dark Ages. Hippocrates has juftly been ftyled the Father of Me¬ dicine, fince his writings are the moft ancient exprefsly on this fubjedt which have been preferved. His tran- fcendent merit alone would, however, fecure to him that title. He has left behind him uleful hints on almoft every branch of medicine; and has inveftigated fome of them with an exadtnefs which has left us little to defire. On anatomy, though probably he did. not himfelf make dif- fedtions, he has compiled all the information extant in his time ; and his theory of medicine, though long fince exploded, merits, in comparifon with the hypothetical and extravagant notions that had preceded it, much en¬ comium. It was certainly more comprehenfible, and more explanatory of known fadts, than the dodtrine of Pythagoras, which accounted for every thing by the fcience of numbers ; or than that of Empedocles, which referred all phenomena to the agency of an ethereal fpi- rit. It is, however, the practical part of medicine that Hippocrates has fo much elucidated. We difcard his theory of Nature, his concodtions* and infpiflations ; but in his account of difeafes, in the accurate hiftories he has afforded us of figns or fymptoms, their relations and ef- fedts, he Hands unrivalled. His prognojlics, too, have comparatively been little improved in the prefent day : indeed he carried them to fo great a degree of perfedtion, that he and his pupils were regarded by the vulgar as prophets. It ftiould be likewife recorded of him, that he endeavoured to dived the art he profefled of all that myl- teryand fuperftition in which he found it enveloped, and that he gave the firft outline of a fubjedt of great impor¬ tance, medical ethics. His authority has been revered for ages, and his maxims have been received as dogmas, not only in the fchools, but in the courts of law. We need 1 not PATHOLOGY. not therefore be furprifed that many men of inferior ce¬ lebrity fhould have endeavoured to render their works popular by afcribing them to this famous phyfician. Ac¬ cordingly we find many writings extant bearing his name, which are evidently fpurious. It fhould be remarked however, that thefe writings are nearly of the fame date as his genuine cOmpofitions, and contain the prevalent doftrines of his time. The pathology of Hippocrates was founded on the af- fumption, that a principle exifis in the animal, tending to the prefervation of health, and the- removal of difeafe. To this principle, which he denominates Nature, heap- pears to have attributed fome degree of intelligence, and even in one place applies to it the epithet of juji. “ The manner in which Nature adts, or commands her fubfer- vient power to adt, is by attracting what is good and agreeable to each fpecies, and by retaining, preparing, and changing, it ; and on the other fide in rejedting what¬ ever is fuperfluous or hurtful, after fhe has feparated it from the good.” This is the foundation of the dodtrine of depuration, concoction, and criiis, in fevers, fo much infilled upon by Hippocrates and many other phyficians. He fuppofes alfo, that every thing has an inclination to be joined to what agrees with it, and to remove from every thing contrary to it ; and like wife that there is an affinity between the feveral parts of the body, by which they mutually fympathife with each other. Hippocrates referred the production of mod difeafes to diet and air ; to the former of which he attached fo much importance, that he compofed feveral books concerning it : yet in another part of his works he gives the judicious maxim, that while in health we fhould by no means at¬ tach ourfelves to nice and delicate habits of living, or live with too much regularity; becaufe thofe who have once begun to live by rule, become difordered if they depart in the lead from it. In the choice of fituation with regard to the purity of air, he was particularly care¬ ful ; and noted efpecially the winds, the times of the fol- dices and equinoxes, & c. He likewife took into con- lideration the effects produced by deep, watching, exer- cife, &c. and attached great importance to certain hu¬ mours, particularly blood and bile. His claffification of difeafes was arranged according to the circumdances of their danger, duration, or locality : thus fome difeafes were mortal, dangerous, or curable; others acute or chronic; and again others were divided into endemical, epidemical, and l'poradic. Hereditary difeafes he likewife noticed. We are obliged to Hippocrates for the remark, that there are certain ftages in every didemper; a point of great practical importance. He generally noticed four; the beginning, the augmentation, the height, and the decline. In mortal difeafes, death took place indead of the decline ; on which account this latter was reckoned by Hippocrates to be worthy of particular in vedigation. He conceived that during this dage a crifis took place ; i. e. that the mortified matter which. produced the difeafe was by fome means feparated from the body ; but this feparation never occurred until the humour was fuffi- ciently concoded ; that is to lay, brought into a fit date for expuifion from the body, by the efforts of Nature. Moreover, this author fuppofed, that, as every fruit has a limited time to ripen in, fo concottion could not be ac- complilbed unlefs within a certain period. He took much pains to edabiilh critical day*, or the times when thefe concoctions and crifes fnculd take place; and he deemed them moll favourable when they occurred on odd days. In noting the ligns and characters of difeafe, Hippo¬ crates was extremely minute, and that chiefly with a view to foretelling the event of the malady. He obferved the altered appearance of every feature of the face, the com¬ plexion ; the dim, fierce, fparkling, or other exprefiion, of the eyes. He paid attention to the poflure and atti¬ tude of the fufferer •. he remarked the debility which ge¬ nerally attends the continued fupine pofition ; and he noticed the picking of the bed-clothes, the uneafy and Vol. XIX. No. 1283. 5 tremulous motions, and likewife the fubfultus tendinum, which denote death in patients affected with fevers. Hippocrates paid particular attention to the refpiration, the different Hates of which affilled him in forming his prognofis. He examined the urine with great care ; but, as his remarks on it chiefly regarded his humoral hypo- thelis, they are now of little intereft. He noticed, how¬ ever, that the crifis of fever was often brought about when the urine became very abundant, and the thick ap¬ pearance of it denoted difeafe of the bladder ; he was in the habit of comparing the appearance of this evacuation with that of the tongue. The faeces too were invelligated, in re¬ lation to their odour, confluence, and colour, by this au¬ thor. But he has recorded more important fails concerning the expectoration which arifes in pulmonary complaints: he fays that, when it is mixed with blood (in chronic cafes), when it is entirely wanting, or when it is fo co¬ pious as to caufe rattling in the throat, it denotes ex¬ treme danger; but that, when it is mixed with puru¬ lent matter, it indicates confumption, and terminates in death. Concerning perfpiration, Hippocrates has re¬ corded the beneficial effects derived from its occurrence in fevers; when it is general, it often produces the crifis : but he has well remarked the danger of cold and partial fweats. It has been doubted whether this celebrated.phyfician underltood any thing about the pulfe. It has been fup¬ pofed that the paffages found in his works apply only to the pulfation which is feit in an inflamed part. But his knowledge mull have extended further than this on the fubjedt; becaufe he talks of flow and tremulous pulfes; and in his Coucce Pranotionrs he remarks, that the feniible pulfation of the artery in the elbow indicates delirium, or the prelenceof violent anger. Exercife was not neglected by Hippocrates; but he jullly blames his preceptor Herodicus for recommending it to thofe afflidled with fevers or inflammatory affedlions. Indeed the latter phyfician was fo fond of gymnaftics, that he made his patients walk from Athens to Megara, a diftance of twenty-five miles, and return as foon as they had touched the walls of the city. Yet Hippocrates juflly appreciated the advantage of exercife in chronic difeafes; and even tells 11s that “ we mull fometimes pufh the timorous out of bed, and roufe up the lazy.” Hippocrates gave many general rules of importance in regard to the ellablilhment of health, among which are the importantones of keeping up, in molt cafes, a regular difcharge; to deplete the plethoric by low living, and to avoid fudden expofure to increafed or diminiffied tempe¬ rature. The therapeutical maxims of Hippocrates were few and Ample, and all founded on his theory of Nature cu¬ ring difeafes ; infomuch that all that could be done was to remove fuch things as were injurious to the agency of that principle, or to affiil it in its operations when it was deficient. He alferted, in the firft place, “That con¬ traries, or oppofltes, are the remedies for each other;” and this maxim he explains by an aphorifm ; in which he fays, that evacuations cure thofe dillempers which come from repletion, and repletion thofe that are caufed by evacuation : fo heat is deflroyed by cold, and cold by heat, & c. In thelecond place, he alferted that phyfic is an ad¬ dition of what is wanting, and a fubtr.idlion or retrench¬ ment of what is fuperfluous : an axiom which is thus ex¬ plained, that there are fome juices or humours, which in particular cafes ought to be evacuated, or driven out of the body, or dried up ; and fome others which ought to be reftored to the body, or caufed to be produced there again. As to the method to be taken for this addition or retrenchment, he gives this general caution, “That you ought to be careful how you fill up, or evacuate, all at once, or too quickly, or too much ; and that it is equally dangerous to heat or cool again on a fudden ; or, rather, you ought not to do it : every thing that runs to an excels being an enemy to nature.” In the fourth place, he allowed that we ought fometimes to C dilate. G PATHOLOGY. dilate, and fometimes to lock up ; to dilate, or open the paftages by which the humours are voided naturally, when they are not fufficiently opened, or when they are clofed ; and, on the contrary, to lock up or ilraiten the paftages that are relaxed, when the juices that pafs there ought not to pafs, or when they pafs in too great quantity. He adds, that we ought fometimes to linooth, and fometimes to make rough ; fometimes to harden, and fometimes to fatten again; fometimes to make more fine or fupple; fometimes to thicken ; fome¬ times to roufe up, and at other times to ftupify or take away the fenfe ; all in relation to the folid parts of the body, or to the humours. He gives alfo this farther lef- fon, That we ought to have regard to thecourfe the hu¬ mours take, from whence they come and whither they go; and in confequence of that, when they go where they ought not, that we make them take a turn-about, or carry them another way, almoft like the turning the courfe of a river; or, upon other occafions, that we en¬ deavour, if poffibie, to recaj, or make the fame humours return back again ; drawing upward fuch as have a ten¬ dency downward, and drawing downward fuch as tend upward. We ought alfo to carry off, by con venient ways, that which is necelfary to be carried off; and not let the humours once evacuated, enter into the veffels again. Hippocrates giVes alfo the following inftruflion ; “ That, when we do any thing according to reafon, though the fuccefs be not anfwerable, we ought not eafily, or too haftily, to alter the manner of afliug, as long as the rea- fons for it are yet good.” But, as this maxim might fometimes prove deceitful, he gives the following as a cor¬ rector to it : “We ought (fays he) to mind with a great deal of attention what gives eafe, and what creates pain ; what is eafily fupported, and what cannot be endured. We ought not to do any thing raflily ; but ought often to paufe, or wait, without doing any thing: by this way, if you do the patient no good, you will at ieaft do him no hurt.” Thefe are the principal and moll general maxims of the pradtice of Hippocrates, and which proceed upon the iuppontion laid down at the beginning, viz. that Nature cures difeafes. We next proceed to confider particularly the remedies employed by him, which will ferve to give us further inftruflions concerning his practice. Diet was the firft, the principal, and often the only, re¬ medy made life of by this great phyfician to anfwer moll of the intentions above mentioned; by means of it he oppofed the moift to dry, hot to cold, See. and what he looked upon to be the mod confiderable point was, that thus he fupported Nature, and affifted her to overcome the malady. The dietetic part of medicine was fo much the invention of Hippocrates himfelf, that he was very de- firous to be accounted the author of it ; and, the better to make it appear that it was a new remedy in his days, lie fays exprefsly, that the ancients had written almoft no¬ thing concerning the diet of the fick, having omitted this point, though it was one of the mod ed'ential parts of the art. There were many difeafes for which he judged the bath was a proper remedy ; and lie takes notice of all the cir- cumdances that are necelfary in order to caufe t lie pa¬ tient to receive benefit from it, among which the follow¬ ing are the principal. The patient that bathes himfelf mud remain dill and quiet in his place, without fpeaking, while the adidants throw water over his head or are wiping him dry; for which lad purpofe he defired them to keep fponges, indead of that indrument called by the ancients Jtrigil, which ferved to rub od’ from the fkin the dirt and nadinefs left upon it by the unguents and oils with which they anointed themfelves. He mud alfo take care not to catch cold; and mud not bathe immediately after eating or drinking, nor eat or drink immediately after coming out of the bath. Regard mud alfo be had whether the patient has been accudomed to bathe while in health, and whether he has been benefited or hurt by it. Ladly, he mud abdain from the bath when the body is too open, or too codive, or when he is too weak ; or if he has an inclination to vomit, a great lofs of appetite, or bleeds at the nofe. When he found that diet, exercife, and bathing, were not fufficient to Vale nature of a burden of corrupted hu¬ mours, he was obliged to make ufe of other means ; of which vomiting, bleeding, and purging, were the chief. Vomits were a favourite remedy with Hippocrates. He preferibed them to people in health, by way of preventa- tives, direfling them to be taken once or twice a-month in the winter and the fpring. The mod fimple of thefe was a decoftion of hyfl'op, with the addition of a littie vinegar and fait. With regard to the fick, he fometimes advifed them to the fame, when his intentions were only to cleanfe the domach. But, when he had a mind to re- cal the humours, as lie termed it, from the in mod recedes of tiie body, he made ufe of brifker remedies. Among thefe was white hellebore; and this indeed he mod fre¬ quently ufed to excite vomiting. He gave this root par¬ ticularly to melancholy and mad people; and from the great ufe made of it in thefe cafes by Hippocrates and other ancient phyficians, the phrafe, to have need of helle¬ bore, became a proverbial exprefiion for being out of one’s fenfes. He gave it alfo in deduxions, which come, accor¬ ding to him, from the brain, and throw themfeives on the nodrils or ears, or fill the mouth with faliva, or that caufe dubborn pains in the head, and a wearinefs or an extra¬ ordinary lieavinefs, or a weaknefs of the knees, or a fwel- ling all over the body. He gave it to confumptive per- ions in broth of lentils, to fuch as were afflicted with the dropfy called leucnphlegmatia, and in other chronical dif- orders. But we do not find that he made ufe of it in acute didempers, except in the cholera morbus, where he fays he preferibed it with benefit. Some took this medi¬ cine fading; but mod took it after fupper, as was com¬ monly praftifed with regard to vomits taken by way of prevention. The reafon why he gave this medicine mod commonly after eating was, that by mixing with the ali¬ ment, its acrimony might be fomewhat abated, and it might operate with lefs violence on the membranes of the domach. In the didemper called empyema (ora colleftion of mat¬ ter in the bread), he made ufe of a very rough medicine. He commanded the patient to draw in his tongue as much as he was able; and, when that was done, he endea¬ voured to put into the hollow of the lungs a liquor that- irritated the part, which, railing a violent cough, forced the lungs to difeharge the purulent matter contained in them. The materials that he ufed for this purpofe were of different forts; fometimes he took the root of arum, which he ordered to be boiled with a little fait in a fuffi- cient quantity of water and oil ; difl'olving a little honey in it. At other times, when he intended to purge more drongly, he took the flowers of copper and hellebore; after that he (hook the patient violently by the fhoulders, the better to loofen the pus. This remedy, according to Galen, he received from the Cnidian phyficians ; and it has never been ufed by fucceeding ones, probably be- caufe the patients could not fuller it. Blood-letting was another method of evacuation pretty much ufed by Hippocrates; and in inflammatory affec¬ tions he praflifed it in a large and decided manner; for he fometimes opened the veins of both arms, and kept them running till the patient fainted. The principal maladies in which he had recourfe to bleeding were in¬ flammations of the liver, fpleen, lungs, or other vifeera ; quinfy, pleurify, and pain in the head; but in fome in- liances of chronic difeafe, as dropfy and jaundice, he likewife performed this operation. In fevers he difap- proved of venefeflion, becaufe he conceived thofe difeafes were produced by certain humours which could not be expelled by that means : it muff, however, be underftood, that he did not extend this rule to fymptomatic fevers, but rather to thofe which were not preceded by figns of local PATHOLOGY. local inflammation. Indeed, in his writings, the term fever is only applied to that clafs which we call idiopathic ; and there feems good reafon to fuppofe, that, in the com¬ mencement of a fever ariling out of vilceral inflammation, he bled very copioufly. He likewife performed cupping ■with fcarificators ; and occafionally ufed the femicupium, which he fuppofed would draw the humours from the affeCted part by means of aUrudiion. As molt of the purgatives in ufe in the time of Hip¬ pocrates were very violent in their operation, often pro¬ ducing ficknefs, he prefcribed them with great caution. He did not give them to pregnant women, old people, or children ; nor during the dog-days. He ufed them more frequently in chronic than acute difeafes, and chiefly with a view to the expulfion of fome particular humour; to each of thel'e humours he applied a leparate kind of pur¬ gative ; hence the diltinCtion of thofe fubftances into hy- d-ragogues, cholagogues, &c. now juflly exploded. Hip¬ pocrates likewife ufed errhines, which he laid relieved pain in the head by drawing the phlegm from the brain; i'udoriflcs and diuretics, which were likewife for the pur- pofe of evacuating fome peccant humour, and narcotics, or, as he called them, hypnotics, to produce fleep. But of thefe laft he was very lparing. To medicines which ex¬ perience had proved to be efficacious, but of which the operation was inexplicable by this humoral pathology, he applied the term Jpecifics. He ufed fomentations, in which different herbs were boiled, either by direCt application or in the form of vapour. Nor did he neglect cataplafms, ointments, cauftics, and collyria ; all of which he pre¬ pared himfelf, or caufed to be made by his fervants un¬ der his own immediate infpeCtion. The pharmaceutical diftinCtions of medicines into mixtures, powders, and pills, were obferved in this time, and likewife fomething analogous to our lozenge was ufed ; it was called a lum- lative, was of a foft confidence, and was retained in the patient’s mouth until flowly diffolved. The practice of Hippocrates was beneficial to himfelf; for it is generally underftood that he reached the age of a hundred years, and died about 360 years before the birth of Chrift. Soon after the death of Hippocrates, the profeffors of medicine became divided into two feCts ; the Dogmatifts and the Empirics. The feed of the Dogmatists was founded by Theffalus and Draco the fons, and Polybus the fon-in-law, of Hip¬ pocrates. Their leading tenets are recorded in the book “On the Nature of Man,” which has falfely been attri¬ buted to Hippocrates. Ariftotle conjedtures that it was written by Polybus. The Dogmatilts were fometimes coiled logici, or logicians, from their ufing the rules of logic and reafon in the fubjedts of their profeflion. They fet out with the rule, that, “when experience fails, rea¬ fon mayfuffice.” Unfortunately, however, they took lit¬ tle pains to confult experience, but were perpetually oc¬ cupied with endeavouring to trace difeafe to its fecret and remote caufes. The fyftem of the Empirics, as the term imports, was founded altogether upon experience-, and thofe who be¬ longed to this fedt have remarked, that there are three modes by which we learn, from experience, to diltinguith what is advantageous and what is prejudicial, in regard to our health. 1. The firlt of thefe, and the molt Ample, arifes from accident. A perfon, for example, having a violent pain in the head,' happens to fall, and divides a veffel in the forehead ; and it is obferved that, having loll blood, his pain is relieved, Under the fame mode, they include the experience which is acquired by obfer- ving the fpontaneous operations of the conftitution, where no remedy has been applied, as in the following cafe : a perfon labouring under a fever, finds his difeafe mitigated, after a hemorrhagy from the nofe, a profufe perfpiration, or a diarrhoea. 2. The fecond mode of gaining experience is, that in which fomething is done by deftgn , with a view to afeertain what will be the fuccels of it; as, for inftance, when a perfon, having been bitten ? by a ferpent, or other venomous creature, applies to the bite the firft herb that he finds ; or when a mart' attempts to alleviate the fymptoms of an acute and burning fever, by drinking as copioufly as he is able of cold water ; or when a perfon tries a remedy, fuggefted tohimby a dream, as was frequently done in heathenilh times. 3. The third mode of experimenting is, that which the empirics termed imitative; W'hicb is purfued in cafes, when, after having remarked the e fleets refulting from accident, or the fpontaneous aCtions of the fyftem, on the one hand, or from dejign on the other, we make an attempt to ac- complilh afimilar refult by imitating that which u!as done on thofe occafions. This laft fort of experience, they contend, is that which peculiarly conftitutes the art of medicine, when it lias been frequently repeated. They call that obj'ervation (r'/5p7j(7K,) or autopfia, (avr ottcicc,) which each individual fees himfelf ; and ufe the term hijlory or record, (i{Topi:t,) for fuch obfervation, when committed to writing; that is, the autopfia , or perfonal experience, confifts of the obfer- vations which each perfon has made, by his attention to the progrefs of a difeafe, whether in regard to its fymp¬ toms and changes, or to the remedies employed ; while the record is a fort of narration or regifter of all that was obferved by thofe individuals ; which regifter being com¬ pleted, (i. e. including all the difeafes incident to man¬ kind, and the remedies adminiftered for their alleviation, ) the art of medicine w'ould be eftabliflied with a confider- able degree of certainty. But, as new difeafes fometimes occur, in regard to which neither our perfonal experience, nor the obfervations of others, can furnilh us with any afliftance; and we meet with diforders in particular fitua- tions, where the means of relief, fanCtioned by experience elfewhere, are not within our reach ; we mull neceffariiy have recourfe to fome other expedient in order to allevi¬ ate the bufferings of the patient. The empirics were pro¬ vided againfl this particular difficulty, in what they termed a J'ubjiitution of fimilar means, ( tranjltus ad fimile , as the Latins have tranflated it.) This was a new experi¬ ment, which they inftituted, after having compared one difeafe with another ; or one part of the body with ano¬ ther, of fimilar ftruCture; or, lartly, one remedy, the na¬ ture of which was afeertained by experiment, with ano¬ ther which refembled it. “ They tried, for example, in herpetic eruptions the remedies which had relieved eryji- pelus ; and, in the difeafes of the arms, they employed the expedients which had been praCtifed in thofe of the /egs ; &c. & c.” Obfervation, then, record, and the j'ubjiitution of fimilar means, were the three fundamental refources of the art of medicine, according to the empirics: and thefe were denominated, by Glaucias and others, “ the tripod of medicine.” There is obvioufly a great deal of good fenfe and found philofophy in this doctrine of empincifm. It points out the true mode of invelfigating the phenomena of nature by unwearied experiment; the mode which Bacon la¬ boured to inculcate, which Newton fuccefsfully purfued, and which has led the philofophers of later times to the development of that fund of natural knowledge in the fciences of electricity, chemiltry, mechanical, and every branch of natural, philolophy, by which modern inquiry is diftinguifhed. Compared with this fpecies of invefti- gation, how futile are the lpeculations, mifnamed philo- lophy in the fchools, relative to elements and ellences, which had no exiftence except in the imagination of the difputants. At firft much rancour and animofity fubfifted between thefe two parties ; but, in procefs of time, their practice was found to coincide in many material points; for, though the dogmatifts were much addicted to hypothefis, they could not fail to make clinical obfervations when en¬ gaged in practice; and the empirics did not entirely con- tine tliemlelves to their profeffed mode of acquiring know¬ ledge, but occafionally indulged in that paflion for the¬ ory and generalization which is fo common in a philofa- phic. 8 PATHOLOGY. phic age. It is evident, then, that both the dogmatic and empiric phyficians appealed to experience, and that nei¬ ther excluded altogether the dictates of reafon and re¬ flexion. The principal difference in their tenets appears to have confided in this : that the empirics real'oned only from the facts afcertained by obfervation, without at¬ tempting to explain their effential and infcrutable nature by hypothefesj and that the latter fpeculated upon the mode and nature of every phenomenon in the animal body, and took thefe fpeculations as the bafis of their reafoning: an error in the inveftigation of nature, which, as we have before faid, was fo well expofed by lord Bacon in modern times; and which was practically illuf- trated in the triumph of Newton’s empirical doXrines, over the dogmatical hypothefes of Des Cartes. The empirical feX had not enjoyed great influence or diffemination till Serapion of Alexandria, in the year be¬ fore Chrift 280, took up and defended their doXrines with great fpirit : hence fome have called him the foun¬ der of the feX. His works are loft; hut what has been tranfmitted of his opinion by other authors, tends to prove that he followed the praXice of Hippocrates with great fidelity, though he feverely criticifed his reafon- ings. It is chiefly to the induftry of the ancient empirics that we are indebted for the introduction, or rather for the full knowledge, of fedative and n'arcotic remedies; on the liberal ufe of which probably depended the l'upe- rior reputation acquired by fome of them over their more cautious antagonifts. Of this fuperiority, a lingular in- ftance occurs in the many exifting teftimonies to the fame of Heraclides of Tarentum. Celfus Aurelianus calls him “Empiricorum Princeps;” and Galen fpeaks of him in very high terms. He fo far deviated from the praCiice of the flriCt empirics, that he fearched after the caufes of difeafe with almoft as much pertinacity as the dogmatifts; by no means however negleCting the practical obferva- tions which were taught in the empirical fchool. This union of theory and praCtice led him to many ufeful refults, more particularly in refpeCt to acute and dangerous difeafes, his treatment of which appears to have been extremely judicious. He feems to have made a more liberal ufe of aCtive medicaments, efpecially of the narcotic clafs, than his predeceflbrs, having been the firft to introduce opium into ufe as a medicine-; and was very induftrious in his inveftigation of animal, vegetable, and mineral, fubftances, with a view to enrich the catalogue of the materia medica. To the books Which he wrote upon this fubjeX, he gave the name of the individuals to whom he dedicated them, according to Galen; entitling one “Aftydamas,” and another “ Antiochis.” He likewife wrote on the fubjeX of diet, and the regimen to he obferved in difeafes, in which abftinence feems to have been pufhed to a great extent. It is eafy to fee, however, that the direXion of medical inquiry, given by the empirical phyficians, to the difeo- Very of the qualities of medicinal fubftances, or drugs, would in all probability lead to many abufes and evils. Experiment of this fort being much eafier, at lealt when careiefsly made, than that unremitting and accurate ob¬ fervation of the phenomena of difeafes which alone can conftitute the fcientific phyfician, the ignorant and idle would content themfelves with pharmaceutic experi¬ ments, and negleCf the talk of pathological inveftigation ; and fejfilh craft and dilhonefty would loon learn toimpofe on the credulity of the people, in the adminiftration of fe£ ret remedies, when the ufe of a particular drug, and not the general treatment of a difeafe, was fuppofed to be the efler.ee of medicine. Hence it actually happened, even in the early ages of phyfic, that thefe ignorant and illiberal pretenders to panaceas, and infallible remedies, who did not know one difeafe from another by its l'ymp- tonis, appeared in Egypt, Greece, and Arabia, and were much complained of by their more rational contempora¬ ries. In all fucceeding ages, the race of thefe illiterate pretenders has been multiplied, under the abufed name of empirics, by which we now underftand thofe perfons who fell or adminifter a particular drug, or compound, as a remedy for a given diforder, without any confidera- tion as to the variations of that diforder, in its different ftages, or degrees of violence, or as it occurs in different conllitutions, climates, or feafons, or in perfons of dif¬ ferent age, fex, ftrength, &c. Such a practice implies a total ignorance of the nature of the human conftitu- tion, both in health and difeafe ; and therefore is ge¬ nerally found to be the refort of the illiterate and felfifli, not to fay difhoneff, part of mankind. After the death of Heraclides, the ftudy of the materia medica took a new direXion, in confequence of the at¬ tention that was paid to the fubjeX of poifons and their antidotes, by the kings of Pergamus and Pontus. The antidote which was invented by the latter is well known, though its efficacy has never been proved. Even Sere- nus, who is in general fufnciently credulous, feems to have had no very high opinion of its virtues : Antidofus vero multis Mithridatica fertur Confociata modis, fed Magnus ferinia regis Cum caperet viXor, viiem deprehendit in illis Synthefin, et vulgata fatis medicamina rifit. Nicander of Colophon, who was the contemporary of Attalus king of Pergamus, acquired great fame as a grammarian, a poet, and a phyfician. He endeavoured with the vvorft fuccefs to clothe medicine in flowing num¬ bers? Kis only pieces extant are the Alexipharmica and Theriaca, which contain obfervations concerning poifon and their antidotes, which (as we have faid) became a very favourite purfuit about his time. See Nicander, vol. xvii. p. 45. ■ At the time that the fons of Hippocrates founded the dogmatic feX ; Eudoxus of Cnidos framed a lylleni of medicine founded on the philofophy of Pythagoras, and the praXice of the Egyptians. It was therefore princi¬ pally direXed to the dietetic part of medicine. He was followed by his pupil Chryfippus, of wliofe praifice we have nothing memorable to relate, but that he regarded cabbage as a very important remedy, and was very averfe to the operation of bleeding or the exhibition of purga¬ tives. He was the preceptor of the renowned Erafiftratus. Diocles of Caryflus was about this period a praXitioner of repute ; though placed by the Biographia Literaria as low as A. D. 500. an error of 800 years ! Pie applied himfelf to comparative anatomy with fome fuccefs, and invented an inftrument, which was called after him Dlo- cleus graphifeus, for the extraXion of arrow-heads. His contemporary Praxagoras rendered important fervices to medicine ; he firft difeovered the difference between arte¬ ries and veins, deferibed the cotyledons of the human uterus, and explained the phenomenon of the pulfe, a fubjeX which had been very imperfedfiy underftood by Elippocrates himfelf. It is remarked, however, by Galen, that his information was not fo correX, but that he in¬ volved himfelf in many difputes and contradiXionS. This phyfician was very fond of emetics : he adminiftered them in the iliac paflion, and in dofes fo large and fo fre¬ quently repeated, that the ftoois were ejeXed by the mouth. His furgical treatment of the fame difeafe ihows him to have been a bold and fkilful operator: Aurelian fays, that he direXs an incifion to be made through the belly and inteftines, the indurated feces to be removed, and the bowels then fowed up. The progrefs of this art now became advanced by the labours of men not exaXly interefted in its praXice. Ariftotle, who, from the unbounded liberality of his pa¬ tron Alexander, poffefled opportunities of difleXing ani¬ mals on a moft extended fcale, acquired a.mafs of infor¬ mation which we read with inftruXion and admiration even in the prefent age. Nor were his metaphyfical doc¬ trines without their influence on the philofophy of me¬ dicine ; they continued to influence it (fometimes un¬ favourably) 4 ■ 9 PATHOLOGY. favourably) for ages. The beautiful fyftem of ethics, likewife, to which Zeno and Epicurus gave birth, were not developed without a fubfequent change in this fci- ence. The tenets of Epicurus and Pyrrho were adopted by the empirical fedft, while the dogmatifts attached themfelves to the ftoical fyftem, particularly the dietetic method. For, we mull remark, that, foreign as thefe fubje&s may appear. to the pradlice of phyfic, yet its higher branches cannot be fuccefsfully ftudied without occafional reference to every branch of phiiofophy, whe¬ ther moral or phyfical. The eftabliftmient of the Alexandrian School forms an important epoch in the hiftory of medicine. But we have to regret that the deftru&ion of its fplendid library, by the hands of barbarous conquerors, has left us little to relate concerning its doftrines or its practice. We have little hefitation, however, in faying, that the advancement of medicine muft have been very great in a fituation where it derived aftiftance from long cultivation of its principles in Greece, Egypt, and India, a fituation too where fcience in general was patronifed with fo much earneftnefs by illuftrious kings. Moreover this city of Alexandria, on account of the connexion it held with all the world as a commercial emporium, muft have been frequently vilited by foreigners whole diet, clothing, ha¬ bits of life, not to mention a free communication of their own medical rules, muft have ill uftrated the fpeculations of the Alexandrian phyficians in a very luminous manner. The long feries of fafts collefted by the Egyptian priefts was here treafured up; the obfervations of the Hebrews, who, long difperfed over the plains of Aflyria and Media, had united their own medical doctrines with the tenets of Zoroafter and Ham, were examined; while the Greeks, uniting the ufeful part of this defullory and obfcure in¬ formation with the found practice of their anceftor Hip¬ pocrates, with the anatomical knowledge they were ra¬ pidly acquiring, and with their own profound phiiofophy, advanced the progrefs of the healing art in an unexampled manner. Erafiftratus and Herophilus were the firft phyficians of note in this fchool. The former flourifhed about the time of Seleucus, B. C. 270. His attention was directed for the inoft part to furgery and anatomy; but, that his medical tact was of no mean defcription, we have ample proof in the ftory told of his difcovering the love of Antiochus for Stratonice, whom Seleucus his father had then lately married. He made this dil'covery from ob- ferving, that the colour of the prince changed, and his pulfe quickened, when Stratonice entered the room, and that no fuch effects followed the prefence of any other woman. Erafiftratus was likewife confirmed in this opinion, becaufe he was unable to trace elfewhere the caufe of the prince’s extreme illnefs ; for it fhould be re¬ marked, that Erafiftratus held the lame opinion as the dogmatifts, that a difeafe could not be cured without a knowledge of its caufe. The fame incident likewife Ihows the high rank which the phyficians held in thofe days ; fince, by the influence of Erafiftratus, Seleucus was perfuaded not only to give up his wife, but alfo part of his kingdom, to Antiochus. Erafiftratus fuppofed that inflammation was produced by the coagulation of blood in the fmall arterial veflels. In his practice he was fond of Ample remedies, more efpe- cially of J'uccory ; and he even delcended to defcribe the beft mode of boiling it. He taught that medicines did not operate on the bowels by attraction, as had been fuppofed ; and that the humours which they difcharged were not the lame in the body as they appeared after their evacuation, but were altered by the adtion of thofe remedies. To purging, however, he had an objedlion, and fupplied the want of it by clyfters. Emetics were frequently prefcribed by him ; and he recommended abltinence in a great de¬ gree. Venefedtion he difapproved of for fome very fool- ilh reafons ; among which, it may be fuflicient to mention, ift. That we cannot fee the vein; 2dly. That we may Vol. XIX. No. 1283. cut the artery ; 3dly. That we do not knowhow much to take. His attachment to his theory of inflammation was the principal theory, however, why he objedted to bleed¬ ing, becaufe it did not appear to him, that the abftradtion of blood was likely to relieve the coagulation of that fluid in its veflels. Some very barbarous adds are related of this phyfician ; for inltance, that he fometimes cut open the bodies of pa¬ tients afflidted with complaints of the liver, and applied remedies immediately to the fubftance of that organ. Yet he objedted to the operation of parucentefis, or tap¬ ping, becaufe he conceived that, the water being evacu¬ ated, the furrounding vifcera would prefs upon the liver, and produce fatal confequences. He had a notion, that death changed the ftrudture of the body, as well as^the relation of its parts. In this opinion he was ftrongly fup- ported by Herophilus; and we turn with horror from the contemplation of 600 victims whom thefe barbarians are reported to have difiedted alive, and blulh that fuch a re¬ cord fhould be found in th.e annals of medicine. Yet the refined Celfus, after enumerating the advantages which accrued from this atrocious deed, excufes the cruelty of it by obferving, that “It cannot be juftly deemed cruel to put a few guilty individuals to torture, with a view to afcertain means of relief for all the innocent among man¬ kind in all fucceeding ages.” Herophilus added, to the anatomical refearches in which he aflifted his contemporary, an intimate acquain¬ tance with pharmacy. He made ufe of a great number of medicines, both Ample and compound. In his works, we find the firft mention of a difeafe which he calls palfy of the heart ; it produced fudden death, and it has been fup¬ pofed that this muft anfwer to what we now call angina pedoris. About this period, according to Celfus, the practition¬ ers of medicine w'ere formed into three divifions: 1. Thofe who attended to diet, regimen, and domeftic ma¬ nagement, who were particularly careful to diftinguifh the caufes and fymptoms of difeafes, and were of the firft rank. 2dly. Thofe who adminiftered remedies, in the preparation of which they affeCted to be particularly care¬ ful. And, laftly, thofe who performed the operations of furgery. Anterior to this time, the preparation of medi¬ cine among the Greek phyficians was entrufted to their or ftudents, as well as the chirurgical depart¬ ment, though the latter was often executed by the phy¬ ficians themfelves. The combination of the three branches continued, however, for ages, in a few inftances, among the Greeks, the Romans, and the Arabians. The Romans, as Pliny affures us, had continued without phyficians, if not without phyfic, during a period of 600 years. The few manual operations which W'ere found indifpenfably necefiary were performed by their Haves or freedmen ; and inftances are not wanting, in which their ficill was rewarded by the honour of citizen- fh ip. On the occafion of a deftruClive epidemic, in the year 463 A.U.C. however, they fent a deputation to the temple of ZEfculapius at Epidaurus. Inftead of an oracle, they received one of the facred ferpents ; and, following the indication of its fpringing from the fhip upon theifland of the Tiber, they there founded a temple to the god of medicine, and eftablifhed his worfhip on the fame footing as at Epidaurus. Shortly afterwards, a temple was dedi¬ cated to the Grecian Hygeia, and the worfhip-of Ifis and Serapis was borrowed from the Egyptians : but, befides thefe, the Romans afterwards ereCted fanes in honour of medical deities peculiar to themfelves. A prevalent dread of certain maladies caufed them to offer up prayers to the deities who were fuppofed to inflict them. Hence they worftiipped Febris on the Palatine Mount, and Mephitis at Cremona. They had likewife a goddefs Offipaga, who prefided over the growth of bones, and Carna, who took care of the vifcera, and to whom they offered bacon and bean-broth, as being nutritious articles of diet. The firft perfon who praftifed medicine at Rome in a regular man- D ner. 10 PATHOLOGY. ner, was one Archagathus, a Greek, B. C. 219. The Roman fenate at firft Teemed to give him much encou¬ ragement, and even bought a (hop Tor him, and prefented him with the freedom of the city. But his frequent ufe of the knife, and of the adtual cautery, Toon brought him into difrepute. The populace were loud in their clamours againlt his cruelty, attached to him the name of Carriifex, Butcher, and eventually baniflied him from Rome. Afclepiades, of Prufa in Byth.ynia, was the next phy.fi- cian of note who appeared at Rome after Archagathus, hut feparated from him “ longo intervallo.” He had ftudied at Alexandriaand Athens, and came toRome,in the 654th year A.U.C. or 100 years before the Chriltian era, as a teacher of rhetoric: but, not finding that profeflion fufficiently lucrative, he fuddenly turned phyfician ; and, by his confummate addrefs, in a fhort time brought him- Telf into great notice. The prototype of all fucceeding quacks, Afclepiades affefted to contemn every thing that had been done before him — “ omnia abdicavit ; totamque medicinam, ad caufam revocando, colijedturam fecit.” He ridiculed Hippocrates for his patient obfervation of nature, and called his fyftem “a meditation on death.” His fame, however, would have been incomplete, if he had not introduced a fyftem of his own. Accordingly, taking for the bafis of it the philofophy of Epicurus and Heraclides of Pontus, he attempted to explain all the functions of the human body, and all the operations of health and difeafe, by means of eorpvjcles and pores. He aflerted, that matter confidered in itfelf was of an un¬ changeable nature; and that all perceptible bodies were compofed of a number of final ler ones, between which there were interfperfed an infinity of final! fpaces totally void of all matter. He thought that the foul itfelf was compofed of thefe fmall bodies. He laughed at the prin¬ ciple called Nature by Hippocrates, and alfo at the ima¬ ginary faculties faid by him to be fubfervient to her ; and Hill more at what he called Attradion. This laft principle Afclepiades denied in every inftance, even in that of the loadftoneand fteel, imagining that this phenomenon pro¬ ceeded from a concourfe of corpufcles, and a particular difpofition or modification of their pores. He alfo main¬ tained, that nothing happened or was produced without fotne caufe ; and that what was called nature was in reality no more than matter and motion. From this laft principle he inferred that Hippocrates knew not what he faid when he fpoke of Nature as an intelligent being, and aferibed qualities of different kinds to her. For the fame reafon he ridiculed thedodlrine of Hippocrates with regard to crifes; and aflerted that the termination of difeafes might be as well accounted for from mere matter and motion. He maintained, that vve were deceived if we imagined that Nature always did good ; fince it was evident that (lie often did a great deal of harm. As for the days particularly fixed upon by Hippocrates for crifes, or thole on which we ufually obferve a change either for the better or the worfe, Afclepiades denied that fuch alterations happened on thole days rather than on others. Nay, he alferted that the crifis did not happen at any time of its own ac¬ cord, or by the particular determination of nature for the cure of the dilorder, but that it depended rather on the addrefs and dexterity of >lve phyfician ; that we ought never to wait till a diftemper terminates of its own accord, but that the phyfician by his care and medicines mull haften on and advance the cure. He accufed Hippocrates and other ancient phyficians of “attending their patients rather with a view to obferve in what manner they died than in order to cure them;” and this under pretence that Nature ought to do all herfelf, without any afiiftance. The practice of Afclepiades was principally geftation, fridtion, and the ufe of wine.' By various exercifes he propofed to render the pores more open, and to make the juices and fmall bodies, which caufe difeafes by their re¬ tention, pafs more freely ; and, while the former phyficians had not recourfe to geftation till towards the end of long- continued diforders, and when the patients, though en¬ tirely free from fever, were yet too weak to take fuffleient exercife by walking, Afclepiades ufed geftation from the very beginning of the moll burning fevers. He laid it down as a maxim, that one fever was to be cured by another; that the ftrength of the patient was to be ex- haufted by making him watch and endure thirft to fuch a degree, that, for the two firft days of the diforder, he would not allow them to cool their mouths with a drop of water. Celfus alfo obferves, that, though Afclepiades treated his patients like a butcher during the firft days of the diforder, he indulged them fo far afterwards as even to give directions for making their beds in the fofteft manner. On feveral occafions Afclepiades ufed fridlions to open the pores. The dropfy was one of the diftempers in which this remedy was ufed; but the moll fingular at¬ tempt was, by this means, to lull phrenetic patients afleep. Though he enjoined exercife fomiuch to the fick, he denied it to thofe in health ; a conduit not a little furprifing and extraordinary. He allowed wine freely to patients in fevers, provided the vioience of the diftemper was fomewhat abated. Nor did he forbid it to thofe who were afflicted with a phrenfy : nay, he ordered them to drink it till they were intoxicated, pretending by that means to make them deep; becaufe, he faid, wine had a narcotic quality and procured fleep, which he thought ab- folutely neceflary for thofe who laboured under that dif¬ order. To lethargic patients he ufed it on purpofe to excite them, and roufe their fenfes : he alfo forced them to fmell ftrong-feented fubftances, fuch as vinegar, caftor, and rue, in order to make them fneeze; and applied to their heads cataplafms of muftard made up with vinegar. Befides thefe remedies, Afclepiades enjoined his pa¬ tients abftinence to an extreme degree. For the firll three days, according to Celfus, he allowed them no ali¬ ment whatever; but on the fourth began to give them victuals. According to Caslius Aurelianus, however, he began to nourilh his patients as foon as the acceffion of the difeafe was diminilhed, not waiting till an entire re- mifflon ; giving to fome aliments on the firft, to fome on the fecond, to fome on the third, and fo on to the feventh, day. It Teems almoll incredible to us, that people Ihould be able to fall till this laft-mentioned term; but Celfus allures us, that abftinence till the feventh day was en¬ joined even by the predeceflors of Afclepiades. The divifion of difeafes into acute and chronic appears to have originated with him. The remedies which he employed (as we have feen) were chiefly dietetical ; but he was no enemy to phlebotomy, though he dilcouraged vomiting and purgation: inftead of the latter he recom¬ mended clyfters. He was a great advocate for the ufe of cold water externally as well as internally; though he probably ingratiated himfelf with the Romans more by his free adminillration of wine in diforders where it had not formerly been allowed. Sprengel fuppoles him to have been the inventor of the balnea penjilis, or Ihower-bath. That: Afclepiades, notwithllanding his arrogance, was a man of obfervation and difeernrnent, is evident from his defeription of difeafes ; and from the faCl, that he always continued to enjoy great reputation among the Roman people, and l^iat his leClures, which, according to Pliny, embraced the three branches of pathology, midwifery, and pharmacy, were very numeroully attended. Galen accufes him of humouring the caprices of his patients at the expence of his own better reafon and judgment. The principles of this author’s pathology gave the firft outline of the methodic pradlice of phyfic, which was more fully developed by Themifon and Theflalus, and afterwards by Soranus. The Methodics, or Methodists, endeavoured to fleer a courfe unconnedled with the Dogmatifts or the Empirics. They objedled to the former fedl, on account of their hypothetical principles; and to the latter, on ac¬ count of the tedious manner in which they acquired their knowledge. In confequence of this, they began to claffify and generalize ; and obferved, as they conceived, two PATH two dates or conditions of body which attended all forts of complaints. To one of tliefe dates they gave the name of fir icl urn, which implied a general conftridlion of the whole body; to the latter, the epithet of luxum, by which they meant a correfponding relaxation. Cafes, however arofe, that were not referrible to either of thefe claffes : confequently, the Methodifts were obliged to in¬ vent a third, which partook of the properties of both the others. Hence they admitted the contradiftion of a (late of relaxed contraction, an expreffion of which no conception can be formed. It has been fuppofed, however, by M. Cabanis, that this mixed (late of laxutn and JlriClum meant an irregular dif- tribution of vital power, or irregularity of tone. If his idea be corredl, this clafs would comprehend all difeafes, without the afliftance of the other two ; for we know of no difeafe that is not marked at times by an unequal dif- tribution of vital energies. As to the praSice of the me¬ thod ills, it may be obferved, that they wholly overlooked the healing powers of the fyltem, and, without regard to the peculiar circumftances of the cafe, or the nature of the part affedled, were l'olely intent on fulfilling thofe general indications that were conformable to their theo¬ ry. It is true, that they paid particular attention to days ; not, however, as connedled with the dodlrine of criles, for which the founders of this left entertained a marked contempt ; but only as affording them a meafure of the duration of the diforder, and a guide for the method of treatment. In the firft days, they followed the llarving fyftem ; afterwards they purfued the fuppofed general in¬ dications of conftri&ing, or of relaxing: during the ex¬ acerbation of the difeafe, they endeavoured to moderate the violence of it ; during its decline, they fupported the powers of the fyllem by nutritive diet. This was their mode of proceeding in all acute difeafes : but, in chronic complaints, to which it was lefs applicable, they had re- courfe to what they termed the ^T-oco-vyr.^ait, or re-in¬ corporation, of which the profeffed object was to reltore the proper relations between the atoms and pores, and for which they prepared the patient by the ocvx or re- fumplrtie circle. It was, in fadl, little elfe than their practice in acute difeafes reverfed : they firft fought to ftrengthen the patient by a generous diet, and then they adminiftered a fucceffion of violent remedies, to fubdue the original malady. Among the difciples of Themifon, one Theflalus of Trallis, a man of low birth and coarfe manners, made himfelf confpicuous by the fhamelefs audacity with which he fought to difparage the labours of others, arrogating to himfelf the title of I&t ^ony.ri;, or Conqueror of Phy- ficians, and that, it would appear, without the flighted: pretenfions to either learning or talents. (Plin. xxix. i.) He held forth, that he could qualify any one for a phy- fician in the fpace of fix months, and aftually fucceeded in obtaining a great number of pupiTs ; but they were from among the lowed order of artifans, fuch as rope-makers, weavers, cooks, butchers, fullers, and fuch like. Thefe he took with him to vilit his patients for the ftipulated time; and then he conferred upon them the privilege of pradlifing for themfelves. From his time it became the cuftom for the Roman phyficians to vifit their patients attended by all their pupils; in allufion to which, we have the epigram of Martial : Languebam ; fed tu eomitatus protinus ad me Venifii, centum , Symmache, dijcipulis. Centum me tetigere manus aquilone gelata : Non habuifebrem , Symmache : nunc habeo ! I’m ill. I fend for Symmachus ; he’s here. An hundred pupils following in his rear. All feel my pulfe with hands as cold as fnow : I had no fever then ; I have it now. The methodic fcliool acquired much greater repute from the labours of Soranus and Caelius Aurelianus. The former a native of Epliefus, who had ftudiedat Alex- O L O G Y. 11 andria, and came to Rome during the reign of Trajan ; the latter an African by birth. Free from the prejudices which had difgraced his predeceffors, Soranus cultivated the ftudy of anatomy, and wrote a book on the female organs of generation, which is dill extant, and difplays conftderable acquaintance with the fubjedt. Many of his obfervations (how that he was pofleffed of great fagacity and ftrength of judgment. To Cadius Aurelianus, on the other hand, we are indebted for an account of his doc¬ trines and pradlice, and for one of the bed works on me¬ dicine which have come to us from ancient times ; writ¬ ten it is true, in a barbarous ftyle, but highly deferving of perufal, on account of the accurate defcription of dif¬ eafes,. and the different methods of treatment, which it contains. Anatomy and the other auxiliary fciences, though they had been fo much negledled by the Methodifts, were now receiving important additions from other quarters. Rufus of Ephefus, who lived in the time of the emperor Trajan, applied himfelf zealoufly to the dilTe<5lion of ani¬ mals, particularly of apes, and defcribed from analogy the different organs of the human body. Fie traced the nerves from their origin in the brain, and divided them into- thofe of fenfation and thofe of voluntary motion. The heart he believed to be the feat of life, of animal beat, and the caufe of pulfation ; and he (bowed the difference of ftrudlure and capacity between the right and the left ventricle. The fpleen he held to be an ufelefs organ. Marinus, whom Galen calls the reftorer of anatomy, and to whofe labours he was himfelf probably indebted for much of his knowledge on the fubjedl, rendered dill greater fervices to the fcience. He inveftigated the ab¬ sorbent fyftem with great care, and difcovered the me- fenteric glands ; he diftributed the nerves into feven pairs: the N. palatinus (then called the fourth pair) was firft defcribed by him; and he is faid to have been the dif- coverer alfo of the par vagum, which he termed the fixth pair. Flis numerous writings have all perilhed. The ftudy of the materia rnedica, and of the other branches of natural hiftory, was profecuted with no lefs vigour ; and we owe to the firft century of the Chriftian era the invention of many remedies which are (till retained in our pharmaceutical fyltems. The elder Pliny, fecond only to Ariftotle in the univerfality of his genius, but furpafiing even that great man in his infatiable third for knowledge, had collected in his Hiftoria Mundi all that the ancients knew of natural fcience. Diofcorides of Anazarba, devoting himfelf to botany and materia rae- dica, produced a work which ferved for a guide in thefe fciences till a very late period. His defcriptions of fome of the more valuable drugs, fuch as myrrh, laudanum, af- fafoetida, ammoniac, opium, fquills, and their different preparations, are entitled to great praife. The efficacy of feveral remedies, which he recommends, has been ad¬ mirably confirmed by later experience, fuch as of the elm-bark in cutaneous difeafes, of potafti as a cauftic, of the male fern againft worms, &c. &c. Some of the con¬ temporaries of Diofcorides, as Scribonius Largus, Xeno- crates, and Andromachus, cultivated the materia rnedica, but with lefs fuccefs. To Menecrates, who lived in the reign of Tiberius, and who, according to an infcription in Montfaucon, appears to have been the author of 15s books, we are indebted for the invention of the diachy- lon-plafter; and Damocrates is well known as the author of feveral complicated remedies which bear his name. Herennius Philo, of Tarfus, is mentioned by Galen as the inventor of an anodyne compofition, called, after him, Philonium, and which confided of opium, euphor- bium, and different aromatics ; and Afclepiades Pharmacion was the introducer of numerous remedies from the animal kingdom, which, though long honoured with a place in our pharmacopoeias, have now defervedly fallen into difrepute. Before quitting this period of medical hiftory, it will be neceflary to fay a few words refpedting two other fedls, which 12 PATHOLOGY. which arofe foon after the eftablilhment of the Methodic fchool : we mean the Ecledic and Pneumatic feds. The founder of the latter, Ariftseus of Cilicia, flourilhed as a phyfician at Rome about the middle of the firft: century, and diftinguilhed himfelf by his oppofition to the-tenets of Afclepiades, and his attachment to the Stoical fyftem : he extended the theory of pre-exiftent germs ; treated the dodrine of the pulfe with dialedic fubtlety, referring its varieties to the exhalation of the nvBv^a. from the heart and arteries ; and cultivated feveral branches of patholo¬ gy ; but was more fuccefsful in his dietetic researches, particularly with refped to the influence of the atmof- phere. His pupil Agathinus, endeavouring to reconcile his principles with thofe of the Methodic and Empiric feds, acquired the name of Epifynthetic or Ecledic; and thus eftablilhed the Ecledic fyftem, on which, however, he does not appear to have conferred much repute by his own labours. That merit was referved for Archigenes and Aretasus, who, adopting the leading tenets of the Pneumatic theory, gave it a more fcientific form, and enriched it by many valuable obfervations. The former attempted to reform the language of medicine, but with¬ out much effed 5 for even Galen has occafion to complain of the obfeurity of his phrafeology ; he was, befides, too fond of fubtleties: but many of his practical obfervations, which Galen has recorded, are excellent. The merits of Aretasus, as a tkilful and attentive obferver, and as an elegant deferiber of difeafe, are familiar to every one. To Caflius the Iatrofophilt, another Eclectic, we are in¬ debted for many valuable pathological remarks concern¬ ing the difeafes of afi’oeiation, and the fympathies of the nervous fyftem. On the fubjed of Aretasus and Archigenes, Dr. Huxham has the following note. “ It is pretty furprifing that none fliould take notice of Aretasus Cappadox before Aetius Amidenus, in the fifth century; (he is indeed named in the Euporifta attributed to Diofcorid.es, but few think that piece to be the genuine work of that au¬ thor.) Neither Galen, Caslius Aurelianus, nor Oribafius, mention him; though fo particular in enumerating all the phyficians of note, antecedent to, or cotemporary with them. And yet Aretteus feems to have been a very confiderable practitioner, and a man of great learning and judgment : he aft'eds a very Angular ftyte, ufing many oblolete words, Homeric and Hippocratic phrafes, and the Ionic dialed ; which, at the time he wrote in, was almoft entirely difufed : for, notwithftanding the conceit of Voflius, he undoubtedly did not write till after the time of Nero. All this one would think fliould have made him remarkable ; efpecially if he praCtifed in or near Rome ; which is not improbable, as he advifes Roman wines to the lick ; particularly the Falernian, Surrentine, Signine, and thofe of Fundi. But Galen and Aetius quote from Archigenes feveral paffages, which are exadly the fame, as to fenfe, dodrine, method of cure, and manner of expreflion, with what we find in Aretasus ; only the latter gives them the Ionic turn. They both coincide in recommending fome particular medicines, which are fcarce to be met with in any others, particularly the external ufe of cantharides ; which I think is not to be found in any preceding author, except Celfus. Did Archigenes then borrow from Aretasus, or the latter from the former? It is certain, Archigenes pradifed at Rome with a very great reputation, was a very celebrated phyfician and author, and as fucli is re¬ ferred to by Juvenal, Galen, Caslius, Oribafius, Aetius, Sec. He is ftridly criticifed by Galen, fometintes cen- fured, fometimes commended, but never reckoned a mere compiler. Aretasus, on the contrary, is mentioned by none but Aetius and Paulus Avgineta; nay, which is not a little to be wondered at, he is not fo much as found in Photius’s Bibliotheca. This is really ftrange, and not eafily accounted for, and would incline one to think that Aretasus borrowed from Archigenes ; or ra¬ ther tranferibed and new-modelled him, giving him the Hippocratic didion and Ionic dialed. Poftibly Aretteus might do by Archigenes fomething like what Caslius Aureliar., not long after, did by Soranus: but, iffo, he hath vaftly much better grascifed Archigenes than Caslius hath latinized (as he calls it) Soranus. Upon this fuppo- fition, we need not wonder at finding the Roman wines recommended in Aretasus, though lie might pradife and write in Cappadocia, or any where elfe, at the greateft diftance from Rome. Be the matter as it will, in Aretasus we have a molt valuable work, a moft accurate defeription of difeafes, and in general a very proper and judicious method of cure ; and it is greatly to be lamented, that the work comes fo maimed to us.” Huxham on Fevers, Pref. During this period, furgery received confiderable im¬ provement; particularly from the labours of Heliodorus and of Antyllus. Of the former, who was an eminent furgeonat Rome in the time of Trajan, Nicetas has pre- ferved feveral pradical obfervations on injuries of the head and difeafes of the bones, which evince no mean profi¬ ciency in his art. The latter is perhaps (till more deferv- ing of notice, as being the firft who gives any account of the extradion of the catarad : he recommends this ope¬ ration to be performed while the catarad is final!, being of opinion, that, when enlarged, it cannot be extraded without bringing the humours of the eye along with if. His diredions concerning the preparation of plafters and ointments, and concerning the choice of veins in phle¬ botomy, are very minute. In dangerous cafes of cynunche, he advifes bronchotomy ; and in hernia humoralis he ope¬ rated by incifion. Philagrius, who lived about the time of Valens, appears to have been the firft who attempted to extrad a ftone from the bladder by the high operation. Aetius has alfo tranfmitted to us an account of the fur- gical pradice of one Leonides of Alexandria, whofe ob¬ fervations on hernia, fcrofula, and glandular fwellings, on hydrocele, and on inflammation of the ferotum, fhow confiderable difeernment. In canceroqs affedions of the bread, he reforted to amputation, and the adual cautery ; in fiftula, his method of operation differed but little from that recommended by Pott. Having difpatched feveral names of fmaller eminence, we now come to the illuftrious Celfus, who lived at Rome, as fome think, about the reign of Tiberius. His native place is unknown ; and many writers have fuppofed that lie was never in pradice. Yet his minute deferiptions of many pharmaceutical preparations could hardly have been acquired unlefs he had compounded them with his own hands; nor could his excellent diredtions in furgery have been penned without fome knowledge of the manual operations. In many parts of his works, he follows the Father of Medicine fo clofely, that he has been called the Latin Hippocrates ; though that name is equally appli¬ cable to him on account of the purity of his language. (See Celsus, vol. iv.) In his work on furgery, all the improvements from Hippocrates to his own days are colleded ; the moft mi¬ nute and trifling difeafes are not omitted. An eminent furgeon of the moderns emphatically exhorts every perfon in that profeflion “ to keep Celfus in his hands by day and by night.” He follows Hippocrates, but with much improvement in his chirurgical diredions ; efpe¬ cially in the mode of trepanning, in applying fplints, bandages, Sec. in the manner of extending and fixing fradured limbs and likewife in the medical treatment of the patient. In luxations of the fhoulder, he mentions feveral methods of giving force to the extenfion, and of replacing the diflocated bone. One method fimilar to that of Hippocrates was, to fufpend the patient by the arm ; the fore part of the fhoulder, at the fame time, refting upon the tep of a door, or any other fuch firm fulcrum. Another method was to lay the patient lupine, fome af- fiftants retaining the body in a fixed pofition, and others extending the arm in the contrary diredion ; the furgeon. PATHOLOGY. in the mean time, attempting, by his hands, forcibly to reduce the bone into its former place. He made the diltin&ion into fnnple and compound fractures, as it exifts in the prefent day ; and his direc¬ tions in the cure of fractured ribs are extremely judicious. The different fpecies of hernias are well defcribed by him ; and he feems to have pfed a bandage and comprefs after the reduction of the bowels, on the fame principle as we now ufea trufs. In fome cafes, after the return of in- teftitial ruptures, he diminiflied the quantity of loofe fkin, and formed a cicatrix, fo as to contract over the part, to render it more rigid and capable of relilting. He defcribes various dil'eafes of the genital parts, the hy¬ drocele or dropfy of the fcrotum, a difficulty of urine, and the manner of drawing off the water by a catheter ; the figns of ftone in the bladder, and the method of founding or feeling for that ftone. Lithotomy was at that time performed by introducing two fingers into the anus ; the done was then preffed forward to the perinteum, and a cut made into the bladder ; and by the finger or by a fcoop the ftone was extracted. He defcribes the manner of performing this operation on both the fexes, of treat¬ ing the patient, and the figns of recovery and of danger. Celfus gives excellent inltruftions with regard to in¬ flammation in general ; and mentions fome ufeful topical applications in ophthalmia. The operations for the cata¬ ract (which confifted in depreffing the cryftalline lens), and for fiftula, are likewife defcribed by him ; as alfo the mode of performing the operation of paracentefis. The external application of arfenic as a cure for cancer origi¬ nated with Celfus. In external gangrene, he cut into the found flefli ; and, when the difeafe, in fpite of every effort, fpread, he advifed amputation of the member. After cutting to the bone, the fleffi was then feparated from it, and drawn bach, in order to fave as much fleffi as poffible to cover the extremity of the bone. He de¬ fcribes the fymptoms of that dangerous inflammation the carbuncle, and direfls immediately to buril or corrode the gangrened part. To promote the fuppuration of abfceffes, he orders poultices of barley-meal, or of marffimal- lows, or the feeds of linfeed and fenugreek. He alfo mentions the compofitions of feveral repellent cataplafms. In the eryjipelas, he applies cerufe, mixed with the juice ofSolanum, or nightlhade. He is very diffufe in thofe parts of his works which relate to pharmacy, giving for¬ mula for a great many external and internal remedies now' defervedly aboliftied. Though Celfus followed the praClice of Hippocrates in many refpefts, yet he very much differed from him in others. He particularly ridiculed his dodtrine of critical days, which he attributed to anabfurd application of the Pythagorean dodlrine of numbers ; and he differed from that phyfician in regard alfo to bleeding; for he held it dangerous to take much blood from patients at once, and rather preferred the abllradlion of it at repeated intervals. In regard to abflinence, he feems to have followed Afclepiades, enjoining the fick to endure hunger and thirft during the firft days of their illnefs, and afterwards allowing them plenty of food. He entirely difregarded the indications of the pulfe, from having obferved that it was accelerated or depreffed by many adventitious cir- cumllances, as well as from having found it very different in complaints of a fimilar nature. The moft confiderable of the Roman pathologifts, and the laft of any great eminence, was Galen, who flourilhed about a hundred and thirty years after Celfus, and was phyfician to the emperor Marcus Aurelius. This great man was confidered for many centuries afterwards the moft infallible authority in all matters relating to patho¬ logy. Impreffed at an early age with the important truths contained in the writings of Hippocrates, he viewed with contempt and difguft the jargon and obfcurity which en¬ veloped them in the fchools of medicine. Accordingly he became lrimfelf the expofitor of Hippocrates. He re¬ peated and extended his obfervations, prefented his opi- Vol. XIX. No. 1283. 13 nions in new lights, and fupported his dodtrines with all the aids which w'ere derivable from fpeculative reafoning or the comparifon of fadls. Yet Galen in fome meafure fell into the fame error of which he accufed his predecef- fors and contemporaries. He obferved the naked faffs and fimple truths related almofl without comment by the coarle fage. He applied himfelf too much to explain, arrange, and fyftematize, a very fmall ftock of informa¬ tion ; and, by endeavouring to illullrate a very uncertain fcience by means of others not more exadl, he permitted his imagination to frame hypothefes in the higheft degree gratuitous and aflumptive. Thefe obfervations are fully exemplified by the following Iketch of his fyftem. He firft begins with eftablilhing four qualities in the ani¬ mal body; heat, cold, moifture, and drynefs. The pe¬ culiar combinations which thefe qualities undergo, or in other words the changes which may be rung on them, pro¬ duce eight conftitutions, or temperaments; i. e. hot, cold, moilt, and dry ; hot and moift, cold and moift, hot and dry, and cold and dry. (See Galen, vol. viii.) Idiofyncracy is that temperament which cannot be referred to any of thefe qualities, and is therefore fuppofed to arife from occult caules. With Hippocrates, Galen admitted the operation of Nature ; but to this agent he added three other faculties, or, as we thou Id call them, vital properties. The firft and molt important, he calls the animal faculty ; it has its feat in the brain, .performs the operations of mind, and by means of the nerves diftributes the proper¬ ties of motion and fenfation to all parts of the body. The fecond is called the natural faculty ; it has its feat in the liver, and is the principal agent in giow’th, generation, and nutrition. The third, denominated the vital facul¬ ty, is lodged in the heart, and from thence, by means of the arteries, dilleminates heat and vitality through the whole fyftem. Thefe three faculties were adled upon by Nature as a primum mobile. Their production was fuppo¬ fed to be owing to the agency of certain Jpirils, or faille vapours, which he likewife divided into three kinds, bear¬ ing the names of vital, natural, and animal. Galen ad¬ mits the exiftence of the four humours of blood, phlegm, yellow, and black bile, firft infilled on by Hippocrates. With that phyfician he likewife divides the body into three component parts ; fpirits, humours, and parts, or, as we call them ,folids. The laft-inentioned fubllances he divides into organical and fimilar. It were ufelels to enter into a detail of the minute diftinc- tions of difeafesand their caufes in which Galen has in¬ dulged. Suffice it to fay, that the increafe, deficiency , or ir¬ regular diftribution,of the different humours,qualities,&c. which we have enumerated, was regarded by him as the eflential caufe of difeafe ; confequently the abllradlion of redundant, the reproduction of deficient, or the correc¬ tion of peccant, humours, formed the principal indications in his pathology. In anatomy and phyfiology, Galen dil- covered or arranged many important fadls. His affiduous diffedlions of animals furnifhed him with many ufeful ob¬ fervations : he likewife preferved in his writings much of the anatomical knowledge of the Alexandrian fchool ; and has indeed corrected by experiment the errors into which that fchool had fallen, particularly in regard to the circulation of the blood. Hippocrates had afierted, that all the veffels communicated with each other, and that the blood underwent a kind of flux and reflux to and from the heart, like the ebbing and flowing of the lea; and he mentions the throbbing of the temporal arteries, as an evidence of this fail. The.anatomifls at Alexandria had adopted a different ©pinion ; as they found the ar¬ teries empty, and the veins containing blood, in their diffedlions, they imagined that the former were tubes for the diftribution of air, (and gave them that name which they have borne ever fince;) and that the veins were the only channels for the blood. The heart of man confid¬ ing of two lets of cavities not communicating with each other, and its connexion with the lungs, were to them delufive circumftances, and feemed to favour their opi- E nions. 34 PATHOLOGY. nions. If is true they fometimes found blood in the ar¬ teries, and in the left cavities of the heart ; but then they believed that the air or fpirit had efcaped, and that the blood had oozed through the fides of thefe air-veflels, and fupplied its place. Galen refuted this opinion by expe¬ riment. He laid bare one of thefe vetfels in a living ani¬ mal, and by tying it in two places, and opening it between the ligatures, he afcertained that it contained blood and nothing elfe. He therefore concluded, that both veins and arteries ferved the fame purpofe-, that of diftributing blood for the fupply of the body, but that the florid ar¬ terial blood contained more air than the purple blood of the veins. We need hardly remark, that Galen did not underhand the natural courfe of the blood, though he had thus made known its containing vefl'els. Galen did not apply himfelf much to the furgical de¬ partment of the art : however, he occafionally performed the operation of arteriotomy, and opened the jugular veins ; and he defcribed with accuracy the different kinds of hernia. In a hiftory of this kind it feems right to mention the effect of anatomical ftudies on the mind of Galen. After contemplating the ftrufture of the bones of a fkeleton, and their "adaptation to their different fundiions, he breaks out into an apoftrophe, which has been much ad¬ mired, and in which he isfaid to have exceeded any an¬ cient in pointing out the nature, attributes, and proper worfhip, of the Deity. “In explaining thefe things,” he fays, “I efteem myfelf as compoiing a folemn hymn to the author of our bodily frame ; and in this I think there is more true piety than in facrificing to him heca¬ tombs of oxen, or burnt-offerings of the moft coftly per¬ fumes : for I firffc endeavour to know him myfelf, and af¬ terwards to (how him to others, to inform them how great is his wifdom, his virtue, his goodnefs.” Medicine improved very flowly after the time of Galen ; his fucceflors were more employed in compiling and com¬ menting on the works of their predeceflors, than in en¬ deavouring to extend the bounds of fcience by original obfervation. Among the moft diftinguilhed of thefe we may record the names of Oribaftus, Aetius, Alexander Trallian, and PaulusAEgineta. Oribafius flourifhed about the year 360, and was phy- ffcian to the emperor Julian. Though commonly rec¬ koned a Sardian, he was born at Pergamus, and bred up, together with Magnus and Ionicus, in the ichool of Zeno the Cyprian, who taught then at Sardis, though after¬ wards he removed to Alexandria, where he became a famous profeflbr. Eunapius reprefents Oribafius as the greateft fcholar and phyfician of his time, and a very en¬ gaging and agreeable man in converfation. He defcribes him as no lefs confiderable in his intereft than in his learning : according to his account, he contributed very much to the advancement of Julian to the empire, who in return made him quasftor-of Conftantinople, and who, as appears by one of his letters, had an entire confidence in him. Ip. the fucceeding emperor’s time, through the envy of his enemies, he fell into difgrace, had all his ef- tates confifcated, was banifhed, and delivered into the hands of barbarians ; amongft whom, in a little time, by his courage and flcill, he gained fo much love and' reve¬ rence, that they, feeing what great cures he performed, adored him as a god. At laft he was recalled by the Ro¬ man emperor, and flourithed in reputation and riches at the very time when Eunapius wrote this account, which muft be near the year 400. Oribafius wrote feventy (according to Photius) or (ac¬ cording to Suidas) feventy- two books of colledtions, which he compiled not only from Galen, but from all the preceding phyficians, and his own experience, at the defire of Julian; the fifteen firft of which are only remain¬ ing, and two others treating of anatomy, Afterwards he made an epitome of this great work, and reduced it into nine books for the ufe of his fon, Eullathius. Paulus mentions this epitome ; but it is now loft, as are fome other tradfs which Suidas takes notice of. Thefe works, though chiefly compilations, are, by no means without their ufe to the medical ftudent ; for both Oribafius and Aetius have preferved fome fragments of antiquity, and thofe of fome value, which are no-where elfe to be met with ; that is, they compiled from the now-loft-vvorks of Galen and others, and added much original matter of their own. We will give only one inftance of what is either omitted by Galen, or is loft together with fome other of Galen’s works; namely, the firft defeription of the lalivary glands, which is this : “ On each fide of the tongue, iie the orifices of the vefl'els, which difehargethe fpittle, and into which you may put a probe. Thefe vef- fels take their rile from the root of the tongue, where the glands are fituated. They rife from thefe glands, in much fuch a manner as arteries ufually do, and convey the falivary liquor, which moiftens the tongue, and all the adjacent parts of the mouth.” Oribafius, lib. xxiv. c. 8. Oribafius, either from Apollonius or himfelf, fpeaks very fully of the good eftedts of bleeding by way of fca- rification, a thing little taken notice of by former writers : and allures us, from his own experience, how fuccefsful he had found it in a fupprelfion of the menfes, defluxions of the eyes, headache, lfraitnefs of breathing, even when theperfon was extremely old. He tells his own cafe par¬ ticularly, when the plague raged in Afia, and he himfelf was taken ill, that the fecond day he fcarified his leg, and took away two pounds of blood; by which method he en¬ tirely recovered, as did feveral others who ufed it. Here we may obferve, that this was a different method of fca- rifying from that performed by the help of cupping. The Arabian phyficians feem to have'had a notion only of the latter practice : but, from this place, as well as from fome pafiages of Galen, it is plain, that the ancients made deep incifions into the Ikin by the knife ; and therefore thought, by the large quantity of blood they could draw off, that this method was equivalent to opening. a vein. The Egyptians make ufe of it to this very day; and Profper Alpinus defcribes at large the apparatus : they make, firft a ftrait ligature under the ham, then rub the leg, and put it into warm water, and beat it with reeds to make it fwell, and fo fcarify. A procefs in every par¬ ticular differing from cupping ; and therefore, in the cure of giddinefs, Oribafius himfelf fpeaks of them as two diftindt operations. We find in this author the firft account of a ftrange and lurprifing diftemper Avy.a.vfya'rrix, a fpecies of melancholy and madnefs, which he defcribes thus : “The perfons af fedied go out of their houfes in the night-time, and in every thing imitate wolves, and wander among the fepul- chresofthe dead till day-break. You may know them by thefe fymptoms: their looks are pale; their eyes heavy, hollow, dry, without the leaft moifture of a tear : their tongue exceedingly parched and dry : no fpittle in the mouth, extreme thirft ; their leg', from the falls and bruifes they receive, full of incurable fores and ulcers.” Aetius gives the very fame defeription, with fome little variation ; only calls it K.v'jxvitjco'mx as well as Av/.xv^^ani and obferves it prevails moft in February. Aetius takes this paflage, as he fays, that is, makes a paraphrafe of it, from Marcellus Sidetes, an author who lived under Adrian and M. Antoninus; and who wrote forty-two books concerning diftempers, in heroic verfe. Paulus has tranforibed the fame account of this difeafe word for word. The Greek term ufed to denote this difeafe ex- prefles the nature of it veryjuftly; and yet Vanderlindenis fo carelefs a writer, that lie makes it a fynonymous term for the madnefs of the wolves themfelves. We conceive the difeafe to have been a fpecies of mania, in which the aflociation of the mind with deceafed relatives produced an inclination to wander among the tombs. Of the epilepfy, Oribafius defcribes the cure both in the acute and the chronical fort ; that is, in the fit as well as out of it. When the litis over, he orders bleeding; and. 15 PATHOLOGY. and, after four or five days, when the body is a little re- veterate afthma, after all other remedies have been tried cruited, purging ; three days after, cupping and fcarifying. in vain. One, he fays, fiiould be made on each fide, near He repeats thefe evacuations, and fometimes finapifms, at the middle of the joining of the clavicle, taking care convenient diftances, and in the intervals gives proper not to touch the wind-pipe: two other little ones are nourilhment, and ufes warm medicines, fuch as caftor, then to be made near the carotids under the chin, one on mint, rue, and the cyrenaic juice. Whether this be taken out of Pofidonius, as, by reading Aetius upon the fame head, there may be fome reafon to fufpeCt, we can¬ not tell ; but the method is certainly right, and agreeable to a rational practice. The epitome of what Galen had faid upon the fame argument, in the next chapter, is by no means fo full and circumflantial. Thefe few infiances will be fufficient to (how, that even this author, though he be chiefly a collector, may furnifii us with fome new and ufeful reflections in phyfic; and he who reads him with this view, may find fome other paflages of the fame kind, not to be met with in the more ancient writers. Aetius lived very near the end of the fifth or the be¬ ginning of the fixth century. He was a native of Amida in Me!opo.tamia, ftudied at Alexandria, and was probably a Chriftian, which perhaps may be the reafon why many have confounded him with another of that name, a fa¬ mous Arian of Antioch, who lived in the time ot Julian. In fome manufcripts he has the ftyle of Kopn; O-vJ/ixta, Comes ObJ'equii ; i.e. the chief officer of thole who ufed to go before the emperor, as his attendants and harbin¬ gers. We find in hint feveral particularities relating to the Egyptian pharmacy. He has collected a great multi¬ tude of receipts, particularly thofe which had been much celebrated, or ufed as noltrums by their inventors. Some of thefe he feems to mention with no other defign than to expofe them, and to let us fee the extravagant rate people were induced to pay for them : for inftance, the colly- riutn of Danaus, which was fold in Confiantinople for one hundred and twenty numifmata, and with great difficulty obtained from him ; the colical antidote of Nicofiratus, called very prefumptuoufly Ifotheos, bought for two ta¬ lents. He feems alfo to be the firft: Greek writer among the Chriftians who gives us any fnecimen of medicinal fpells and charms, fo much in vogue with the old Egyp¬ tians ; fuch as that of St. Blafius, in removing a bone which flicks in the throat ; and another in relation to two fiftulse. The followfing fample of a remedy for the gout is re¬ marked by Dr. Freind as being the firll ofits kind in the hiflory of phyfic. It is an external medicine : he calls it the grand dryer : the patient is to ufe it for a whole year, and obferve the following diet befides in each month. He calls the months by the Alexandrian or Egyptian names, but in Engliffi, the direction runs thus : “ In Sep¬ tember to eat and drink milk : in October to eat garlick : in November to abltain from bathing: in December not to eat cabbage: in January fo take a glafs of pure wine in the morning: in February to eat no bete : in March to mix fweet things both in eatables and drinkables: in April not to eat horfe-radifh : nor in May the filh called polypus : in June to drink cold water in a morning : in July to avoid venery : and laftly, in Augufi to eat no mallows.” This may give us fome idea of the quackery of thofe times. In the works of Aetius we find many obfervations omitted by Celfus and Galen, particularly on furgical operations and on difficult parturition. He firft took no¬ tice of the Dracunculus, or Guinea worm, not known to Galen. It is curious to remark the exceffive extent to which the aCtual and potential cauteries were carried in the time of this practitioner. In a palfy, he fays, that he fiiould not at all hefitate to make an elchar either way, and this in feveral places; one in the nape, where the fpinal marrow takes its rife, two on each fide of it; three or four on the top of the head, one juft in the middle, and three others round it : he adds, that, in this cafe, if the ulcers continue running a conliderable time, he fiiould not doubt'of a perfect recovery. He is ftill more parti¬ cular when he comes to order this application for an in- each fide, fo that the cauftic may penetrate no further than the fkin ; two others under the breafts, between the third and fourth ribs ; and again, two more backwards towards the fifth and fixth ribs. Befides thefe, there ought to be one in the middle of the thorax, near the be¬ ginning of the xiphoid cartilage, over the orifice of the rtomach ; one on each fide between the eighth andninth ribs; and three others in the back, one in the middle, and the two others juft below it, on each fide of the vertebra;. Thofe below the neck ought to be pretty large, not very fuperficial, not very deep : and all thefe ulcers fiiould be kept open for a very long time. » Alexander, who flouriffied in the reign of Jultinian, is a more original author than either of the two former. He was furnamed Trallianus, being born at Tralles, a famous city of Lydia, where the Greek language was fpo- ken in great perfection : he lived in the fixth century, fome time after Aetius. He was a man of very extend ve praftice and of great fame, whence he was emphatically called Alexander the phyfician. His therapeutical direc¬ tions are very full and explicit, aft d were chiefly the re- fults of experiments made by hirnfelf. His practice was remarkable for the judicious introduction of aperient me¬ dicines in cafes of fever, and the ufe of bleeding in fyn- cope, adifeafe which, according to his defeription, feems to apply to the epilepfy of our own times. But the molt valuable part of Alexander’s writings was his book on gout, for the cure of which he recommends purging, and particularly with the herb hermodadlylus, which is fiip- pofed to be the colchicum lately brought up again and ac¬ quiring great reputation in the. cure of the fame complaint. He is the firft author who recommended the life of- rhu¬ barb, which he had recourfe to in vveaknefs of the liver and in dyfentery. Alexander is recommended by Dr. Freind as one of the bell practical writers among the an¬ cients, and well worthy the perufal of any modern. Paulus, the fourth and laft of the old Greek writers, was born in the ifland Aigina, and lived in the feventh century, though placed by Mr. le Clerc as high as tlie fourth. He vras a great traveller, and had opportunities of feeing an extenfive practice in different countries. He tranferibes a great deal from Alexander and other phyficians. His deferiptions are fhort and accurate. He treats particularly of women’s diforders ; and feems to be the firft inftance upon record of a profeffed man-midzoije , for fo he was called by the Arabians : and accordingly he begins his work with the diforders incident to pregnant women. He treats alfo very fully of furgehy, and gives fome direClions, according to J>r. Freind, not to be found in the more ancient writers. He direCls the manner of extruding darts, and of operating for hernia ; he deferibes one fpecies of aneurifm ; treats of the mode of opening the jugular veins, and alfo the arteries behind the ear. He likewife deferibed the operation'of bronchotomy, and ftiowed the propriety of performing it in cafes of fuffoca- tion. This operation had been derided by Aurelianus, and fome fevere objections were Halted againftit by Are- taeus. It was firft; performed by Antyllus, from whom Paulus copied it. With Paulus clofes the period of the Greek clujjlcal phyficians: fo we venture to call them; becaufe, if we compare any of the Greek writers on pathology, from the very firfi of them, Hippocrates, to the time we are now fpeaking of, with the very bell of their contempora¬ ries in any art or profeffion whatever, they will be found not at all inferior to them either in the difpofition of their matter, the clearnefs of their reafoning, or the propriety of their language. Some of them have even written above the ftandard of the age they lived in ; an incon- teftible inftance ®f which is Aretseus. Galen, alfo, was not 1G PATHOLOGY. not the only bed phyfician, but the bed fcholar and cri¬ tic, of his time. So great an honour have thefe authors done to their profefiion, by being verfed in other arts and fciences as well as their own. And the great St. Bafil, whom his own continual illnefs made a phyfician, and who has a great many allufions and fimiles taken from that art, was (to ufe the words of Photius) for the neat- nefs, the propriety, the perfpicuity, and fluency, of his ityle, one of the bed writers among the fathers ; as St. Luke’s Greek comes nearer to the ancient Aandard than that of the other evangelifls. We cannot omit faying,fomething of one author more, whom we may reckon one of the ancients, though not properly a writer in phyfic ; Nemefius, bilhop of Emilia, w'ho wrote a treatife concerning the nature of man, near the end of the fourth century: becaufe his Oxford edi¬ tor afcribes two difcoveries to him, one of which was the mod conliderable that ever was made in phyfic. The firfl is concerning the bile, “ which is condituted (as Neme- iius fays) not only for itfelf, but for other purpofes; for it helps digeflion, and contributes to the expulfion of the excrements ; and therefore it is in a manner one of the nourifliing powers: befides, as a vital faculty, it imparts a fort of heat to the body. And for thefe reafons it feems to be made for itfelf ; but, becaufe it purges the blood, it feems to be formed for the fake of the blood.” Here, fays the editor, the fyflem of the bile is plainly and ac¬ curately delivered ; that very fydem which Sylvius de le Boe with fo much vanity boaded he had invented himfelf in 3658. And indeed fo far is true, that here is the intire foundation of Sylvius’s reafoning: and, if this theory be of any ufe in phyfic, Nemefius has a very' good title to the difcovery. But there follows a much more material point ; and the fame editor contends, that the circulation of the blood, an invention which tpe 17th century fo much boafts of, was known to Nemefius, and defcribed in very plain and iignificant terms, which are thefe : “ The motion of the pulfe takes its rife from the heart, and chiefly from the left ventricle of it : the artery is with great vehemence dilated and contrafled, by a fortiof condant harmony and order. While it is dilated, it draws the thinner part of the blood from the next veins, the exhalation or vapour of which blood is made the ali¬ ment for the vital fpirit. But, while it is contradled, it exhales whatever fumes it has through the whole body, and by fecret paflages. So that the heart throws out whatever is fuliginous through the mouth and the nofe by expiration.” Upon this Angle (lender proof does he attribute this great difcovery of the circulation to Neme¬ fius ; and thefe who have infided that it was known both to Hippocrates and Galen, have full as good arguments on their fide. But it is evident enough, from this very defeription, and from what the fame author fays of the liver in the fame chapter,- that it miniders nouriflnnent to the body by the veins, that Nemefius had no idea of the manner in which the circulation of the blood is really performed. To refume the thread of our hiflory, we mud come now to home other Greek writers of a lower rank and a later date: but, as the greated part of thefe contain little that is new, we lhall give a very (hort account of their works, and only be as particular as we can in adjuding their fe- veral ages ; concerning which all our authors have left us in great confufion ; though indeed this is the lefs to be wondered at, confidering that from the time of Agathias, that is, from the year 560, to the reign of Ifaac Comnenus in 1060, there is a chafm of five hundred years- in the Grecian hidory; fo that we know very little of all that interval, except what fome (lender account of the reigns of a few emperors, chiefly Mauritius and Heraciius, fur- nifhes us with. Palladius, called Sophifi or Iatrafophid, was bred, as he himfelf feems to hint, at Alexandria. We place him firfl among the more modern Greeks, but cannot agree with the Bibliotheca literaria, which computes that heflou- rifned about theyear 126. Albinus better places him after Galen, i. e. after the year 200. In fa ft, he quotes Galen very often, and it may be proved, that he lived not only after Galen, but after Afctius and Alexander too, whofe words he frequently makes ufe of. His Commentaries upon Fradlures are imperfect; however, what of them remains is enough to let us fee that we have no great lofs by it. In thofe upon the Epidemics, he with great per¬ spicuity and exadfnefs, illuflrates not only Hippocrates, but feveral paflages of Galen ; and obferves particularly, that the done increafed much in his time, and was lefs curable; and he imputes this to the luxury of the age, to much eating, and want of exercife. He is the firfl au¬ thor now extant who has treated profefledly of urine : and he has very well explained the caufes of its colour and confidence ; what didempers thefe refpedtively indi¬ cate, and what prognodics may be drawn from them. There are feveral paflages exprefled in the fame words, as we may read in a book upon the like fubjedl, falfely af- cribed to Galen. He has written in much the fame man¬ ner concerning the faeces. Stephen, the Athenian or Alexandrian, called fome- times the one and fometimes the other, from the place ei¬ ther of his birth or his refidence, wrote a commentary upon Galen’s Fird Book to Glauco; a book that does not feem to want any comment to make it more intelli¬ gible. But there is reafon to think, that the chief physi¬ cal learning of his time confided in reading upon Galen ; and Abi Olbeia, the Arabian biographer, tells us of feven Alexandrian phyficians, among which Stephanus is one, who digeded the works of Galen into lixteen books; which again, according to the different matter, they di¬ vided into feven clafles : that thefe were the only books they dudied, and that in their turn they made it their whole buiinefs to comment upon them and explain them to their auditors. And therefore it is not at all probable that he lived in the third century, as Mr. le Clerc, without any authority, fuppofes ; and, indeed, it is plain, from this very comment of Stephen, that he was much more modern, for he himfelf mentions very ancient expofitors of this particular book of Galen ; and, in flec¬ tion 140, concerning a quartan, he feems to allude to a wrong interpretation which Alexander had made of Galen’s fenfle in this place. If this writer be the fame with Stephen the chyrnid (as he is called), his age is ea- fily known, for that author dedicates his work, de Chry- fopceia, to Heraciius, and this will make his age confident with what has already been obferved. We read of a Ste¬ phen too, and an Alexandrian likewife, in this very em¬ peror’s reign, who was a famous aflrologer, and foretold the great power to which the Saracens fliould arrive, as they did in fome years after. Vanderlinden calls Stephen the lad of the old Greek authors, though, if this account of his age be true, it will appear that feveral others wrote in Greek after that time. Of thefe Nonus feems to be in order next, who com- pofed a fort of phyfic-manual, in which is contained fome (hort account of mod didempers and their cure. He in- feribes it to Condantine Porphyrogenitus ; who, accord- ingto Lambecius, was the feventh emperor of that name, the fon of Leo, and died in theyear 959, and who, as he had fome tindlure of learning himfelf, was a great patron of it. But Jer. Martius, who publiflied an edition of this author in Greek and Latin, thinks the Condantine here meant (a Porphyrogenitus as well as the other) was the fon of Condantine Ducas, who died in 1067 ; for this reafon, that Ducas, though unlearned enough him¬ felf, was an admirer and encourager of letters, and had this faying often in his mouth, “ That he had rather be en¬ nobled by learning than by fovereignty;” To which of thefe Conflantines Nonus inferibed his work, is not very material ; I (hall only take notice, that we may collect from Anna Comnena’s hidory, that in the interval be¬ tween thefe two emperors, learning was extremely de¬ clining, if not quite extindf. 4 This 17 PATHOLOGY. This epitome is little elfe than a tranfcript from Aetius, medicines, fuch as caflia, manna, fenna, myrobalans ; Alexander, and Paulus. And he is fo free with the la- the two laft he fays were brought from foreign parts to bours of his predeceflors, that he even affumes their ex- his country, i. e. from Syria and Egypt. Senna he de- perience to himfelf. He gives a particular defcription of fcribes as a .fruit, by which, no doubt, he means the fame melancholy, and, with the air of a great praftitipner, is thing as Serapion does by the vagina, and Mefue by the full of the good effects he had feen himielf from the Ar- folliculus, which contains the feed; for neither thefe au- menian lfone, and therefore prefers it to white hellebore : thors, nor Adluarius, mention any thing of the leaves; he talks very fenfibly about the bite of a mad dog, and remarks, that when once a hydrophobia comes on, he never, in all his experience, knew one recover; and yet every word in the firft cafe is tranfcribed from Alexander, and in the latter from Paulus. Michael Pfellus lived not long after Nonus, and in- fcribedthe book which he put together, Concerning the Qualities and Virtues of Aliments, to Conftantine the emperor. Lambecius thinks this Conftantine is he who is called Monomachus, and who reigned from 1043 to 1055; but if, according to his account, Pfellus died in 1078, it is at lead as probable it might be Conftantine Ducas: and what adds to the probability is, that it ap¬ pears from Zonaras, he was preceptor to Michael Ducas, that emperor’s fon. The fame Zonaras gives this writer the character of a perfon wholly unfit to have the tuition of a prince, as being not at all qualified in any fort of letters ; but Anna Comnena, who lived a few years after him, on the contrary, extols him as one who was a perfect mafter of philofophy, one of great natural parts, and of profound learning both in Greek and Chaldaic. The fame encomiums are bellowed upon him by Leo Allatius, who (by his diflertation de Pfellis) feems to be fond of this very name, and defcribes him as one of the firft rank of writers. However there is nothing to be found in his tfeatife which can do any author much credit ; for it is only a collection from the elder Greek phyficians, who themfelves collected this part of knowledge chiefly from Galen, as he had done before from Diofcorides. He was perfecuted and dripped of every thing by Nice- phorus Botoniates, turned monk, and foon after died, very old. There are many other trails writ by this au¬ thor, an account of which we may read at large in Leo Allatius. And yet, though Pfellus was fuch a compiler as has been mentioned, Simeon of Antioch, writing upon the fame fubjeCl, but indeed in a very impure ftyle, copied moftly from him, which is the more extraordinary, fince the book he tranfcribed from was then frelh in every one’s memory: for Simeon mull have been his contemporary, though no doubt younger, becaufe he dedicated this trea- tife to Michael Ducas called Paripanaceus, who religned the empire in 1078, the very year in which Pfellus, as we are informed, died. There are many other works of this Simeon, particularly we owe to him the tranflation (out of Arabic into'-Greek) of a very fantaftical book. Concerning the Wifdom of the Indians, which Perzoes, a phyfician, collected at the defire of Chofroes, king of Perfia. ACtuarius, the fon of Zachary, fo called without doubt from the employment he held as chief phyfician to the emperor, is an author of a better character than thofe we have juft mentioned. He wrote feveral treatifes, in which occur many things worth our reading. He prac- tifed at Conftantinople, and, as it appears, with fome de¬ gree of credit; his fix books concerning the method of cure being compiled for the ufe of one of the chief offi¬ cers at court, the lord chamberlain, who was fent upon an embafly into the North. Fabricius by miftake makes ACtuarius himfelf the ambaflador. Tn thefe books, though he chiefly follows Galen, and very often Aetius and Paulus, without naming them, yet he makes ufeof whatever he finds to his purpofe, both in the old and modern writers, as well barbarians as Greeks ; and, to do him juftice, we may find feveral things in him not to be met with any where elfe. Thus, for inftance, he is the firft Greek writer who has mentioned or defcribed the milder forts of purging Vol. XIX. No. 1284. and, though thefe are chiefly in ufe now, yet the pods are fometimes made ufe of too; and, by what we can learn from thefe writers were probably the only part of fenna which was then adminiftered in phyfic. Another thing which we meet with in no Greek writer before Ac- tuarius, is the mention of diftilled liquors, as diftilled rofe-water, See. See. There are not proofs clear enough to point out to us the time where we might fix the precife age of this wri¬ ter. He is commonly, but without any good authority, reckoned to have lived in the eleventh century by fome, and in the twelfth by others. Lambecius brings him down as low as the beginning of the fourteenth ; but from his ltyle we may conclude that he was more ancient ; for, if we compare him either with Pfellus or Simeon, he will appear to have a much greater purity in his diCtion ; and indeed after 1200, we lhall fcarce meet with any writer but who has fome mixture of modern Greek, or fome barbarifms taken from other languages. We have brought down this feCtion to a much later pe¬ riod than we intended, in order to complete the hillory, as far as we could ground it upon any good authorities, of the few Greek phyficians who appeared after the time of Galen. There has been a prevailing opinion that no¬ thing was done among the ancients towards advancing this art, but what is comprifed in the voluminous works of that great man. What gave the firft rife to fuch a no, tion probably might be this : that becaufe thofe who fuc- ceeded Galen did tranferibe a great deal from him, many were inclined to think, without giving themfelves the trouble of examining and comparing their writings, that they did nothing elfe but tranferibe. And no editor of thefe authors has yet taken the leaft pains to undeceive them in this point, what has been left us by way of comment, being chiefly employed in grammatical or critical remarks, without any view of explaining what relates either to the hillory or the practice of phyfic in the time of each re- fpedtive writer. But we have given fome inftances, and more might be given, where the phyficians we have been fpeaking of have defcribed diftempers which were omit¬ ted before ; where they have taught a new way of treat¬ ing old ones; where they have given an account of new medicines, both fimple and compound, and where they have made large additions in the practice of furgery. And, if thefe be any real improvements of the art, it cannot be denied but that phylic was ftill making a pro- grefs till the year 600. As to furgery in particular, we may, without derogation to the more ancient writers, affirm, that whoever carefully looks into Aetius and Paulus, will be convinced that a great many improve¬ ments have been made in that branch of pathology which are not recited in Galen or any where elfe. And in general it may be remarked, once for all, that the wri¬ ters mentioned in this period, till the beginning of the 7th century, and thofe whofe remains they have preferved, were not fuch collectors (which is commonly the cafe) as had little knowledge of the fubjedt they undertook to treat of, but were every one of them men of experience and pradtice. And, if the later Greek writers who fuc- ceeded, were perfons of a lower character, and made little advancement in the art they profelfed, it is the lefs to be wondered at, fince, for many centuries, univerfal ignorance prevailed over all the world; and it could not be expedited that phyfic fliould make any progrefs, when all other fciences and all forts of learning were almoft quite extindl, or that it fliould be exempt from the common calamities of thofe times. F II. From 18 PATHOLOGY. II. From the Dark Ages to the end of the Sixteenth Century. After the downfal of the Roman empire, and when the inundation of Goths and Vandals had almoft com¬ pletely exterminated literature of every kind in Europe, medicine, though a practical art, (hared the fame fate with more abftraft fciences. Learning in general, banifhed from the feat of arms, took refuge among the eailern nations, where the arts of peace ftili continued to be cul¬ tivated. The Arabians, from their vicinity to Alexandria, from their intercourfe with the fed! of Neltorians and with the Greek philofophers, who had been compelled by the perfecution of Jultinian to take refuge in the Ma¬ hometan dates, had acquired a tafte for literature and the fciences. The knowledge which they polTeffed of medi¬ cine is a fubjedt of curious inquiry. In the anatomical branch, they did little more than tranflate and paraphrale the Greek w riters. The errors which their originals had made in anatomy became facred ; and, if the Arabs have defcribed certain parts of the body with more exadtnefs than Galen, thefe defcriptions were only conjedlures, or the confequence of the ftudy of fome Greek authors who have not defcended to us. The Mahometan laws prohibit diffedtions, becaule, in the opinion of the Muffulmans, the foul does not depart from the body at the moment of death : it paffes from one member to another till it cen¬ ters in the bread, where it remains for a coniiderable time. The examination by the angels, of the deceafed per- fon in his tomb, could not be made on a mutilated corpfe. The phyficians of the Arabs dudied, therefore, only fkeletonsdn the cemeteries, and in mod furgical cafes im¬ plicitly followed the ancients. Chemidry, with the red of the fciences, being banilhed from the other parts of the world, alfo took refuge among the Arabs. Geber in the feventh or eighth, and others in the ninth, century of the Chridian asra, wrote feveral chemical, or rather alchymical, books, in Arabic. In thefe works of Geber are contained fuch ufeful directions concerning the manner of conducting didillation, calci¬ nation, fublimation, and other chemical preparations, and fuch pertinent obfervations refpedting various mine¬ rals, as judly feem to entitle him to the character which fome have given him of being the father of chemidry, the difcoverer of the key to the ricked treafures of nature, though he himfelf modedly confelTes that he has done little elfe than abridge the dodtrine of the ancients con¬ cerning the tranfmutation of metals. He mentions fe¬ veral mercurial preparations, fuch as the corrofive fubli- mate and red precipitate, nitric acid, muriatic acid, and many other chemical compofitions. The Herbal of Diol'corides was enriched by the Saracens with the addition of two thoufand plants, and their knowledge of the vegetable world enabled them to infert in their pharmacopoeia feveral remedies which had been unknown to the Greeks. One great difference between the Grecian and Saracen difpenlatories was, that the me¬ dicines in the latter were of a milder nature than thofe in the former: another difference was the common ufeof fugar in lieu of hopey. Diofcorides, fpeaking of the va¬ rious fpecies of honey, fays, that there is a kind of it in a concrete date, called, Jaccliaron, which is found in reeds in India and Arabia Felix : he alfo defcribes its medicinal virtues. Galen writes upon it nearly in the fame man¬ ner; but the hidory of the artificial preparation of fugar, by boiling or other means, was very imperfedtly known. The Saracens appear, however, to have underdood the art ; for, by a mixture of fugar with other ingredients, they made various medicines with which the ancients were unacquainted. The caliphs had done much to render the Arabians thus eminently learned. In the feventh century, Almanfor, and his famous fuccefior Harun A1 Rafchid, patronifed feveral medical fchools, founded hofpitals and academies, and afiiduoufly cultivated the introduction of Grecian learning. Unfortunately, the Arabian phyficians mixed abfurd and myderious fuperftitions with the knowledge they thus acquired. The popular tade for the marvellous induced them to refort to every means of impofing on the vulgar. Adrology was introduced, par¬ ticular pofitions and appearances of the liars were ftudied in dangerous cafes, and amulets were in the poffellion of every fuccefsful and popular pradtifer of medicine. As difcoverers and inventors, the Saracens have few claims to praife, but they formed the link which unites ancient and modern literature; and, fince their relative fituation with Europe fomewhat refembled the relative fituation between Egypt and Greece, they are entitled to a portion of our refpedt and gratitude. When the princes of the wed began to emerge from barbarifin, they cor¬ rectly acknowledged the Moors to be the great depofitaries of knowledge. Many ufeful treatifes, now loll in the original, for example the fifth, fixth, and’ feventh, books of the Conic Sections of Apollonius Pergamus, and fome of the commentaries of Galen and Hippocrates, were pre- ferved in the language of the Saracens, or Arabians, as they are indifferently called. Among the moll eminent of the Arabian phyficians, we may reckon Rhazes, Avicenna, Albucafis, and Avenzoar. Rhazes, one of the olded and mod didinguifhed, was born at Rei, in the province of Chorafan, about the year 852. There was a fchool in his native town, at which he received his early education ; but he is laid not to have commenced the dudy of medicine till fomewhat late in life, having given up his time much to the cultivation of nuific. After he was thirty years of age, he removed to Bagdad ; and then he turned his attention to philofophy, and afterwards to phyfic. He became, however, indefa¬ tigable in his application; and was continually occupied in obferving, reading, and writing, until he obtained the highed reputation ; and he was feledted out of a hundred eminent phyficians, who were then refident at Bagdad, to fuperintend the celebrated hofpital of that city. The hif- torians confidered him as the Galen of the Arabians ; and, from his long life and conftant practice, during which he paid the moll affiduous attention to the varieties of difeafe, he obtained the appellation of the Experimenter, or the experienced. He was faid alfo to be profoundly fkilled in all the fciences, efpecially in philofophy, aftronomy, and rnufic. Fie travelled much in purfuit of knowledge, and made frequent journeys into Periia, his native country, and was much confulted by feveral princes, particularly by Almanfor, the chief of Chorafan, with whom he fre¬ quently correfponded, and to whom he dedicated feveral of his writings. Abi Ofbaia enumerated 226 treatifes compofed by Rhazes, among which the ten books addrelfed to his patron Almanfor are mentioned, and therefore are doubtlefs genuine, although Haly Abbas, who has given an account of him and his works, has not noticed them. This work Rhazes defigned as a complete body of phyfic, and it may be deemed the great magazine of all the Ara¬ bian medicine : the ninth book, indeed, which treats of the cure of difeafes, was in fuch general ellimation for feveral centuries, that it was the text-book of the public fchools, and was commented upon by the moll learned profellbrs. Neverthelefs, like the rell of the Arabian writings, it contains very little more than the lubllance of the wmrks of the Greeks, from whom the Arabians borrowed almoft all their medical knowledge. They have, indeed, and Rhazes in particular, given the firlt diltindl account of the JinalL-pux, a pellilential malady which the Greeks have no¬ where accurately defcribed, and which is, therefore, gene¬ rally inferred to have been unknown among that people. This is quellionable ; but, at all events, the firlt lpecific account of the fmall-pox is to be found in the works of Rhazes. He was the author, alfo, of the firlt treadle ever compofed refpedting the difeafes of children. His book on. the affedtions of the joints is interelling, and contains an account of fome remarkable cures, effected chiefly by co¬ pious blood-letting. He defcribes the fymptoms of hy- 4 drophobia PATHOLOGY. 19 drophobia very well ; and alfo Tome difeafes peculiar to eaftern countries, as the ignis perilous, vena medinenfis, See. and he fil'd noticed the difeafe called fpina ventofa. Rhazes had the reputation of being a ikilful alchemift; the art of chemiftry, in fa£t, originated with the Arabians; and Rhazes is the firft, as Dr. Freind has fliown, who men¬ tions the ufe of chemical preparations in medicine. He has a chapter on the qualifications of a phyfician ; and a Angular trail on quacks and impoftors, in which he has pourtrayed that claft of pretenders to the life ; and his detail of their pretenfions (flows that they were at leaft as numerous, and ingenious in their contrivances of cheatery, as in more recent times. Rhazes lived to the age of eighty, and loft his fight : he died in the year 932. His works that have come down to us, through the me¬ dium of tranflations in Latin, are, 1. A fort of common¬ place book, entitled Continent, or Libri Continent es. a. A much more perfect work, the Libri Decern, ad ' Alnutnf or em, publifhed at Venice, 1510. 3. Six books of Aphorifms, publiflied under the title of Liber de Secretis, gui Aphorif- morum appellatur, Bononiae, 1489. 4. A trail on the fmall-pox and meafles, entitled, De Pejlilentia. This laft was tranflated by Dr. Mead in 1747, and by Mr. Chan- ning in 17 66. As it is a fubjeil fo much in difpute, we (flail give an extrail from the very firft chapter. “ As to thofe phyficians who affirm, that the mod excellent Galen lias made no mention of the fmall-pox, and therefore that lie did not know this diftemper ; furely they have either never read his works at all, or only very curforily; nay, ,moft of them do not know, whether what he plainly fays of it is to be underftood of that difeafe. For Galen, in a certain treatife, fays, this drug does good this and that way, and alfo againft the fmall-pox. And in the beginning of the fourteenth book, of pulfes, that the blood is putre¬ fied in an extraordinary degree, and that the inflammation runs fo high, that it burns the fkin ; fo that the fmall-pox and peftilent carbuncle are bred in it, and quiteconfume it. And in the ninth treatife of the book of the Ufe of the Parts, he obferves, that the fuperfluous parts of ali¬ ments, which are not turned into blood, and remain in the members, putrefy, and in time increafing do ferment; whence, at laft, are generated the peftilential carbuncle, the fmall-pox, and confluent inflammations. Laftly, in the fourth part of his Commentary upon the Timteus of Plato, he fays, that the ancients gave the name cp\iyp.otrt to every thing which produces rednefs,as the carbuncle and fmall- pox ; and that thefe difeafes are bred in thofe in whom bile abounds. But, as for thofe who allege; that he has propofed no remedy or cure, nor explained the nature of this diftemper, they indeed fay what is true : for he men¬ tions no more than what we have cited. But God knows whether he might not have done it in fome other books, which have not yet appeared in Arabic.” Avicenna’s Canon Medicines, or General Syftem of Me¬ dicine and Surgery, was for many ages celebrated through all the fchools of phyfic. It was principally compiled from the writings of Galen and Rhazes. The latter had, in difficult labours, recommended the fillet to aflift in the extrafilion of the foetus 5 and, for the fame purpofe, Avicenna recommends the forceps. He deferibes the compofition of feveral cofmetics to polifh the fkin, and make the hair growq or fall off. See the article Avi¬ cenna, vol. ii. Albucafis flourifhed about a hundred years after Avi¬ cenna : the date of his birth is not known, but he died in 1106. He is chiefly eminent as a furgeon ; and, al¬ though much of what he has left on the fubjedt of his art is copied from Rhazes, from Paulus -Eginasta, and other preceding writers; he has many original obferva- tions ; and by thofe who love to fee the firft dawnings of improvement in fcience, his works will be dill turned over with pleafure. He infilled on the neceflity of a fur- geon’s being fkilled in anatomy, to enable him to ope¬ rate with fuccefs; he alfo held it to be equally neceflary that he fhould be acquainted with the materia medica, or the properties of the medicines employed in curing dif¬ eafes ; and inveighs againft thofe who undertake for gain the cure of difeafes, of the nature and caufes of which they are unacquainted. It appears from his writings, that he extracted polypi from the noftrils, performed the operation of bronchotomy, and ufed a preparation fimilar to the lapis infernalis, as a cauftic. He enumerates a tremendous lift of operations, fufficient to fill us with horror. The hot iron and cauteries v.'ere favourite re¬ medies of the Arabians ; and, in inveterate pains, they repofed, like the F.gyptians and eaftern Aliatics, great confidence in burning the part. He deferibes accurately the manner of tapping in afeites; mentions feveral kinds of jnllrunients for drawing blood ; and has left a more ample and corredl delineation of lurgical inftruments than any of the ancients. He gives various obftetrical direc¬ tions for extrafling the feetus in cafes of difficult labour. He mentions the bronchocele, or prominent tumour on the neck, which, he tells us, was mofl frequent among the female fex. We are alfo informed by this writer, that the delicacy of the Arabian women did noUpermit male furgeons to perform lithotomy on females 5 but, when neceflary, it was executed by one of their own fex. Of Avenzoar nearly all that is known has been com¬ municated under his article. The date of his birth is uncertain ; he is faid to have lived to the great age of 135 years ; but, as he had a fon of the fame name and pro- feflion, it is very probable that the age of both is in¬ cluded in this term. He (or his fon) died at flforocco in 1166, or at Seville in 1162. Avenzoar prepared his own medicines, reduced luxated bones, and performed other chirurgical operations. The work by; which he is principally known is a compendium of the praflice of medicine; in which fome difeafes are deferibed not found in other writers. It includes a number of cafes, candidly, it fhould feem, related, as the author does not conceal thofe in which he was unfuccefsful. See Avenzoar, vol. ii. Thus we fee, that, in confequence of the general decay of learning in the weftern parts of the w'orld, the Greek writers were entirely neglefled, becaufe nobody could read the language ; and the Arabians, though principally copiers from them, enjoyed all the reputation that was due to the others. The Arabian phyfic was introduced into Europe very early, with the mofl extravagant ap- plaufe : and not only this, but other branches of their learning, came into repute in the weft ; infomuch that in the nth century, theftudies of natural philofophy and the liberal arts were called “ the fludies of the Saracens.” This was owing partly to the crufades undertaken againft them by the European princes ; and partly to the lettle- ment of the Moors in Spain, and the intercourfe they and other Arabians had with the Italians. For, long be¬ fore the time of the crufades, probably in the middle of the 7th century, there were Hebrew, Arabic, and Latin, profeffors of phyfic fettled in Italy and Spain. The uni- verfity of Cordova, which had been founded by Alhakem, became the molt celebrated in the world, and maintained its repute for a long courfe of years. As early as the tenth century, Cordova could boaft of the largeft library in the weft; a library of 250, ooo'books, and of which the catalogue is faid to have filled forty-four volumes. In the twelfth century, there were no lefs than feventy public libraries in Spain : Cordova had produced 1 50 authors, Almeria 52, and Murcia 62. At Seville, at Toledo, and at Murcia, academies were alfo eftablifhed, which continued to flourifh during the whole period of the dominion of the Arabians. In the tenth century, the rich and maritime city of Salerno, in the Neapolitan territory, arrefted the attention of the predatory Muflulmen. Frequently engaged either in war or in negociation, they became mixed with the Chriftians, and gradually communicated their literary attainments ; and, in the year 802, Charlemagne founded in Salerno a fchool, which in procefs of time^ became the moll 20 PATHOLOGY. mod celebrated in the world. About the latter end of the nth century, Conftantine the African introduced into the Salernian fchooi the Grecian authors, as well as the learning which he had obtained from a long refidence in Babylon and Bagdad. In the twelfth century, how¬ ever, this fchooi arrived at its higheft fame; and was much frequented by the crufaders in their paftage to and from the Holy Land. Among thefe, Robert, the ion of William the Conqueror, had the honour of having the well-known “ Regimen Sanitatis Salerni” dedicated to him. In the year 1140, the emperor Frederic II. con¬ ferred particular privileges on the fchooi of Salerno, and regulated the courfe of ltudies, and the probations which phyficians and furgeons ihculd undergo before they were permitted to praftife. Many of the ordinances iliow great judgment. The Salernian fchooi continued accordingly to flouriih till the middle of the fourteenth century, when it appears to have begun to decline. “Fuiffe Salerni,” fays Petrarch, “medicinas fontem fama eft ; fed nihil eft, quod non fenio exarefcat.” Gariopontus, Nicolaus, AEgidiu-s, Enos, and John of Milan, the author of the Regimen Sanitatis, are the chief writers whom this fchooi boafts. This fchooi was perhaps, the firft that eftabliftied the form of public examination and admiftion, and pof- fefled the power of conferring medical licenfes and de¬ grees. It recognifes molt obvioufiy the exiftence of apo¬ thecaries, and enforces the propriety of difcriminating the three branches of the medical profeflion from each other. The phyfician was under the neceftity of pro¬ ducing teftimonials that he had been a medical ftudent for feven full years ; the furgeon that he had attended to anatomy for at leaft one ; and the apothecary was pro¬ hibited from charging more than an eftabliftied ratio for the medicaments he compounded or employed. While the eaftern nations aftiduoufty cultivated the knowledge of the Greek writers, and while their caliphs and rulers encouraged fcience by a liberal patronage, a very different part was followed by the Chriftians. The clergy, actuated by avaricious motives, feized upon the province of the phyfician ; and the moft ignorant priefts and rn.onks ventured upon the practice of medicine, with¬ out any proper ftudy or preparation. At length the evil became too crying to be any longer endured ; and the firft Lateral! council, held in 1123, forbade the regular clergy to vifit any longer the lick. The prohibition was re¬ peated, in other terms, by the council of Rheims in 1131, and by the fecond general Lateran council in 1139 ; and thofe monks and canons who applied themfelves to phy¬ fic, “ordinis fui propofitum nullatenus attendentes, pro de- teftunda peeunia fmitalem pollicentes ,” were threatened with fevere penalties ; and all bifhops, abbots, and priors, who connived at their mifconduft, were ordered to be fuf- pended from their ecclefiaftical funftions. “ But the French priefts and monks,” fays Cabanis, “bade defiance to thefe thundering anathemas ; and it was not till three hundred years after, that common fenfe, and a regard to propriety and the public good, triumphed finally over their artifices. A fpecial bull, procured by the cardinal d’Eftonteville, in 145a, which permitted phyficians to marry, effected their complete feparation from the clergy ; and, l this means alone, put a flop to a variety of fliame- ful abufes. To the honour of our country, however, be it men¬ tioned, that thefe abufes do not appear to have prevailed to fuch an extent among us. The clergy did not indeed praftife phyfic, but they were armed with great autho¬ rity over thofe who did. In the days when benefit of clergy had a laving fignification in courts of law, the minifters of religion were regarded with great reverence; and their powers over the practice of medicine are not yet quite extinft. The firft control exercifed over the practice of phyfic in England appears to have been ecclefiaftical, though the end and purpofe of the interference of the church on this occafion, as in moft others in thofe times, .as not fo much the health of the body as the welfare of the foul, ecclefiaJUcaUy underflood. One of the confti- tutions of Richard Wetherfhed, archbilhop of Canterbury anno 1229, in the fourteenth year of the reign of Henry III. runs as follows : “Under pain of anathema, we for¬ bid any phyfician to give advice for the health of the body which may prove perilous to the foul, which is much more precious than the body. But, when it happens that he is called to a lick man, let him firft effeftually perfuade him to call for the phyfician of the foul ; that, when the fick man has taken fpiritual cure, he may, with better effeft, proceed to the bodily medicines. Let not the tranfgreftors of this conftitution efcape the punilhment appointed by the council.” The punilhment here de¬ nounced againft phyficians fo offending, was a prohibi¬ tion from entrance into the church till they had made fatisfaftion, according to chap. xxii. of the council of Lateran, under Pope Innocent III. from whence this conftitution is taken. It was nearly two centuries after this, namely, in the reign of Henry V. anno 9. that the firft ftatute was enafted relative to praftitioners in phyfic. The preamble to this aft, after reciting the mifchiefs arifing from illiterate praftifers, ftates, “ that if no man praftifed therein but all only conynge men, and approved, fufficiently ylearned in art, filofofye, and fifyk, as it is kept in other londes and roiaumes, therftiuld many man that dyeth for de- faute of help lyve, and no man perilh of unconnyng.” The petition then goes on to pray, that no perfon be allowed to praftice phyfic, “ but he have long time yufed the fcoles of fifyk within fome univerfitee, and be gra¬ duated in the fame.” The next aft reftraining the praftice of phyfic in London and its immediate vicinity, to perfons of approved competency, was palled in the third year of the reign of Henry VIII. feven years prior to the eftablilhment, by charter, of the prefent College of Phyficians. Its title was, “ An Aft for the appointing of Phyficians and Sur¬ geons.” It was enafted that no perfon within the city of London, nor within feven miles of the fame, take upon him to exercileand occupy as a phyfician or furgeon, except he be firft examined, approved, and admitted, by the bilhop of London, or by the dean of Paul’s, for the time being, calling to him or them four doftors of phyfic, and, for furgery, other expert perfons in that faculty. When the Charter of the College of Phyficians was granted by the king, it was on the petition of a prieft, the cardinal Wolfey, chancellor of England, in conjunftion with John Chambre, Thomas Linacre, Ferdinand de Victoria, foreign graduates, the king’s phyficians, and Nicholas Halfwell, John Francis, and Robert Yaxley, phyficians. And the archbilhop of Canterbury can, and does to this day, by his diploma, conftitutea phyfician. To return from this digrelfion. — After Salernum, the Univerfities of Montpellier, Paris, Boulogne, Pavia, Padua, and Ferrara, became the moft diftinguilhed femi- naries for medical education ; but the fervile attachment to ancient dogmas which obtained in their fchools ma¬ terially retarded their progrefs. In 1271, the College of Surgeons at Paris was eftabliftied by Pitard, a man who, according to Quefnay, was born for the advancement of his art ; and furgery was henceforth cultivated with much fuccefs in France, as a diftinft branch of the profeflion. Several writers on phyfic appeared in England ; among whom Gilbert has the merit of having furnilhed the belt defcription of the leprofy of the middle ages ; but he trod in the footfteps of the Arabians, and gave into the fcho- laftic ftyle. The fame remark applies to his fucceftors, John of St. Giles, Richard of Windermere, Nicolas of Farneham, John of Gaddefden, &c. It was in Italy that medical fcience was revived in the trueft fpirit. In the year 1315, Mondini de Luzzi, profeffor at Bologna, aftoniflied the whole world, to ufe vicq d’Azyr’s expref- fion, by the public difleftion of two human bodies. His example was followed in other univerfities ; but the utility of the praftice was in a great degree fruftrated by PATH the predilettion for ancient opinions, which made the anatomifts of the age lefs anxious to difcover new fatts, than to reconcile the appearances which they obferved with the dogmas of Galen and Avicenna. An abfurd bull of pope Boniface VIII. forbidding the maceration and preparation of Ikeletons, alfo concurred to impede the progrefs of anatomy; (Blumenbach, Hift. Med. Litterar. p. 99.) but from this time forward, the Italian profeffors maintained a high repute for anatomical fcience, and have ranked among the inoft zealous contributors to our knowledge of the human frame. Though the crufades had conferred no direct benefits on fcience, they had given a new impulfe to the human mind, by the fpirit of commerce which they excited. They were alfo the occafion of the rapid fpreading of leprofy and fome other difeafes in the Weft, and of the confequent increafe of inftitutions for the relief of the fick, after the example of the Oriental nations. Several orders of knighthood, as the Templars, the knights of St. John, of St. Lazarus, the Hofpitalarii Santti Spiritus, &c. were founded with this charitable view ; the mem¬ bers devoting themfeives to the cure of fuch pilgrims as were afflitted with difeafe. In the fifteenth century feveral new difeafes appear to have invaded mankind, or, at leaft, to have attacked them with a degree of violence that was before unknown. The whooping-cough was epidemic in France in the year 14.14: and, according to Mezeray, it attacked all defcrip- tions of perfons, even, the oldeft men. The fweating ficknefs, which broke out firft in the fame country, was brought to England by the foldiers of the duke of Rich¬ mond (afterwards king Henry VII.) upon his landing at Milford-haven in 1485; and fpread itfelf at London from the 21ft of September to the end of Ottober. It returned there five times, and always in fummer; firft in 14 95, then in 1506, afterwards in 1517, when it was fo violent that it killed many in the fpace of three hours, fo that numbers of the nobility died, and of the com¬ monalty in feveral towns often the one-half perilhed. It appeared the fourth time in 1528, and then proved mortal in fix hours ; many of the courtiers died of it, and Henry VIII, himfelf was in danger. In 1529, and only then, it infefted the Netherlands and Germany, in which laft country it did much mifchief. The laft return of it was in 1551 ; and in Weftrninfter it carried off 120 in a day. At this time alfo a new difeafe overran the world, and threatened greater deftruttion than almoft all the old ones put together, both by the violence of its fymptcms,and its baffling the moft powerful remedies at that time known. This was the venereal difeafe, which is fuppofed to have been imported from the Weft Indies by the companions of Chriftopher Columbus. Its firft remarkable appear¬ ance was at the fiege of Naples in 1494, from whence it was foon after propagated through Europe, Afia, and Africa. The fymptoms with which it made the attack at that time were exceedingly violent, much more fo than they are at prefent ; and confequently were utterly un¬ conquerable by the Galenifts. At this period, as fea- voyages of confiderable duration were more frequent, the fcurvy became a more common diftemper, and was of courfe more accurately defcribed. But probably, from 1'uppofed analogy to the contagions which at that time were new in Europe, very erroneous ideas were enter¬ tained with regard to its being of an infettious natures and it is not impoflible, that, from* its being attended alfo with ulcers, it was on fome occafions confounded with fyphilitic complaints. Dreadful as the inflittion of thefe maladies muft have been on the fuffering world, we have reafon to believe that they were not without their ufe in leading to the improvement of medicine. The phyficians of the time, finding the rules of their favourite authors quite inap¬ plicable to the cure of diftempers fo malignant, naturally began to obfefve and judge for themfeives. Manardi and Leoniceno (fee their refpedlive articles) laboured to Vol. XIX. No. 1284. O L O G Y. 21 expofe the errors of the Arabs, and bring back, their followers to the ftudy of Nature and Hippocrates. In this laudable undertaking they were feconded by the German, French, and Englilh, profeffors ; and particu¬ larly by the labours of Dodoneus, Schenkius, Foreftus, and Platerus. In the early part of the fixteenth century, Briffot of Poitou revived a fubjett which had before engaged phy¬ ficians in violent difputes. According to the Hippocratic mode of treating inflammation, which was to take* the blood from the inflamed part as clofely as poflible, the Greek phyficians were wont, in pleurify, to bleed in the arm of die fame fide as was affetted with pain. Avicenna had objetted to this, and recommended venefettion in the oppofite arm. This produced a great deal of alter¬ cation ; and in the end a decree of the univerfity of Palermo iffued forth which forbade any one to bleed ex¬ cept in the contrary arm ; and the profeffors endeavoured to perfuade the emperor Charles V. to fecond it by an edidt. Briffot met with almoft as much opposition in reviving the old method as the Salernitans had done in introducing the new one : but at length the difpute was fettled in favour of Briffot by the great anatomical dif- coverers of that century. The fcience of anatomy gradually became imnroved in the hands of Zerbi, Winter, Laguna, and Sylvius ; which laft taught anatomy at Paris in 1532. But it was referved for the great and comprehenfive mind of Vefalius to throw off the fhackles which had fo long fettered the progrefs of anatomy. So far from adopting as infallible dogmas the anatomical relations of Galen, he attached himfelf particularly to difclofing the errors of that author. He firft advifed anatomifts to injett co¬ loured fluids into the veffels of the body, in order to fa¬ cilitate the labour of minutely tracing them. Wliilft he was a young man at college, he purfued anatomical in¬ quiries with great ardour and afliduity, and publilhed fome of his difcoveries before he was twenty-five years of age, and feven books on the anatomy of the human body before he was twenty-nine, A. D. 1542. Thefe books contain great difcoveries, and, in many circumftances, correct the ancients. But, although they have entitled their author to the gratitude of pofterity, they procured to him fcarcely any thing but animofity from his con¬ temporaries. The authority of Galen was ftill held in high veneration ; and, when Vefalius expofed his errors, the hatred of all feemed turned againft him. People could not bear to be fet right by fo young a man; and even Sylvius denounced perpetual enmity againft him. But, confident in the certainty with which diffettion furninied him, he acquired a complete afcendancy over liis adver¬ saries : fo much fo, indeed, that his lettures were fome- tiines attended by 500 pupils. He preffed Sylvius, his mafter, fo hard, in. thefe controverfies, that the latter, rather than admit his favourite Galen was wrong, afferted* that “ the Jtrudiure of the human body hud become altered in fomeparticularsjin.ee the time of Galen, and. that man’s nature had degenerated !” Thus, for inftance, the number of the pettoral bones occafioneda difpute, which was carried on with great acrimony between them. Galen had adopted feven in the human ikeleton ; but Vefalius proved that there were only three, and that his opponent had again been milled by the Ikeleton of a monkey. But Sylvius objetted to this, “ that men had been larger and taller in the time of Galen, and had feven pettoral bones, but that, in this dwarfilh century, three only could be found.” Vefalius afferted, that the bones of the hand are not totally deftitute of medullary fubftance, as Galen had maintained ; and Sylvius again endeavoured to re¬ fute his affertion, by the abfurd argument, “that the bones in former times had been firmer and harder, and confequently required no fuch fubftance.” Vefalius re¬ jetted the large curvature which Galen aferibed to the os humeri, and the os ilium; while Sylvius defended Galen, by afferting, that the bones had become more G ftraight 22 PATHOLOGY. ftraight by the modern mode of drefs. He vindicated, in a fimilar manner, Galen’s neglect in defcribing the car¬ tilages of the extremities of the bones: ‘'In former times,” faid he, “ the bones were more folid, and confe- quently required no cartilages !” Thefe prejudices had not paffed away from among the French phyficians even in the following century; for we find Moliere, in his Medecin malgri lid (Mock DoCtor), alluding to the abfurdity we have juft mentioned, of fome parts of the vifcera having changed their places. “ Dodlor. Now thefe vapours of which I am fpeaking having palled from the left fide, which is the feat of the liver, to the right, where the heart is fituated, then the Jungs, which we call in Latin armyan, communicating with the brain, which in Greek we call nafrnus , by means of the vena cava, which is cubile in Hebrew, meets in its way with thefe vapours, which fill the ventricles of the omoplate ; and, fince thefe vapours pofiefs a certain ma¬ lignity caufed by the acridity of the humours engendered in the concavity of the diaphragm, it therefore happens that thefe vapours — in fiiort, this is precifely the reafon why your daughter is dumb. “ Father. Nothing in the world can be clearer than this reafoning. Only one difficulty occurs to me ; namely the feat of the liver and of the heart. I always thought the heart to have been on the left fide, and the liver on the right. e‘ Doflar. Yes ; it was fo formerly ; but we have altered all that, and medicine is now adminijiered in a manner to¬ tally new." Mock Doftor, aft ii. Vefalius had great advantages over his predeceffors in being able to perpetuate his labours by means of the beautiful reprefentations which Titian and others painted for him. In 1561, Fallopius, in Italy, publifhed his Ob- fervationes Anatomicte ; he was an indefatigable anato- mift, and made great difcoveries. About the fame time, Euftachius made himfelf confpicuoufly eminent by pro¬ moting anatomical knowledge. He feemed calculated for fubtle inveftigations ; he drew many figures of the human body, and engraved his own plates, the accuracy of which cannot fail of exciting furprife in an anatomift of the prefent day. When the labours of thefe eminent men had, as it were, fmoothed the path, anatomy was taught with a moderate degree of correCinefs and mi- mitenefs in the different fchools of Europe. But the moft important difcovery of this fcience was that of the circulation of the blood. Berengar, who had paid great attention to the ftruCfure of the heart, conjeffured the right ufe of the femilunar valves. In 1547, Cannani and Amatus obferved the valve at the ter¬ mination of the vena azygos; but they did not turn the difcovery to account; and it was referved for Fabricius of Aquapendente to prove the prefence of valves throughout the whole courfe of the veins. Five years afterwards, the circulation of the blood through the lungs was imperfeCHy defcribed by Servetus, who had availed himfelf of the refearches of Berengar and Vefalius. In the year 157-1, Csefalpinus had the merit of ftating it more clearly, and even of fuggefting the firft hint of the greater circulation ; but the full honour of the latter difcovery muft be afcribed to our countryman, Harvey. This improvement in anatomical knowledge was ne- ceffarily accompanied by a ccrrefponding one in forgery. The Italian furgeon, Maggi, corre&ed the abfurd no¬ tions that his predeceffors had inculcated, viz. that gun- fhot wounds were conneCled with combuftion, and that gunpowder poifoned the wound. He fhowed that, fince the balls did not fet the wadding on fire when they came firft from, the barrel of the gun, they could not be hot; nor could gunpowder poifon a wound, fince it was com- pofed of none but harmlefs materials. Maggi likewife left fome ufefnl directions concerning amputation. Am- brofe Pare introduced into France the treatment of gun- fliot wounds eftablifhed by Maggi. The fame praCfice v.as likewife adopted by John Baptift. Carcano Leone, profeffor at Pavia. Pare was, however, unqueftionably the moft celebrated furgeon of the 3 6th century. Be- fides the improved treatment of gun-fhot wounds, which he had the merit of introducing, together with many other peculiarmethods in operative furgery, he has ren¬ dered effential fervice to different branches of that fcience. He treated, for inftance, the hydrocele withafeton; as the dangerous confequences of incifion were in that age more frequently obferved than they are at prefent. He did not apply the aCtual cautery to wounded blood-vel- fels, according to the old practice, but fecured them by the ligature. The fraCture of the collum offis femoris, formerly confidered as a luxation of that bone, was firft afcertained by him wfith accuracy ; he alfo reprobated the frequent dreffmg of ulcers, and the application of the trepan to the futures of the cranium and the temporal bones. He made very judicious remarks on concuflions of the brain, of which Henry II. died, and on fuppura- tions of the liver arifing from injuries of the head. Wounds of the throat, in which one of the jugular veins, and even the trachea, was cut through, he did not confideras mortal. He fuccefsfully treated an injury of the nervus medianus from venefeCtion, and thereby ac¬ quired theconfidence of Charles IX. who had been fubjeCt to that dangerous accident. A perfon who, from lofing a great part of his tongue, had been fpeechlefs for a con- fiderable time, accidentally recovered the power of fpaech, by thruftiiig a table-fpoon into his mouth. Pare ingeni- oufiy imitated this method, by contriving an appropriate inftrument. Amatus, or, according to fome, his mafter Aldaretti, had invented the ufe of bougies; and thofe inftruments now catne into very general ufe, both flmple and caufti- cated. The doCirine of lithotomy was confiderably improved in this century, by the invention of two different me¬ thods of operating, namely, the great and the high opera¬ tion. Germain Colot had undertaken a fuccefsful opera¬ tion for the ftone, in the fifteenth century, and proba¬ bly by the high operation : but it does not appear that learned furgcons had imitated this method, till an obfcure praCiitioner at Cremona, John de Romani, in 1525, be¬ gan to adopt what is commonly called the high opera¬ tion : he taught it to Mariano Santo de Berletta, a lur- geon at Naples, who defcribed the particulars of it in a feparate treatife, publifhed at Venice in 3543, wherein he profefies to have been a pupil of Romani. It is probable that previous to this time no other method of operating was praCtifed than that known under the name of the J mailer apparatus, which can be employed only on children under fourteen years of age. In fome rare inftances which are related by Benivieni and Chrift. de Vega, par¬ ticularly in women, the ftone had been found in the ure¬ thra itlelf, in which cafes it could be more eafily ex¬ tracted. But, fince that period, the pafifage was cleared by the application of the gorget, by means of which the forceps could be introduced into the bladder. Mariano Santo made ufe of the following apparatus:' he firft em¬ ployed a curved found, which he introduced into the urethra fo as to direct the point to the left fide ; he ex- prefsly cautioned the operator againft the incifion into the perinaeum, and is therefore unjuftly cenfured for hav¬ ing attempted the incifion in the middle. His found was excavated, and he performed the incifion in the direction of the groove; then introduced the found, and along with it the conductors, and afterwards the gorget, which, ac¬ cording to its original conftruCtion, terminated in a blunt point; and laftly, he extracted the ftone with the forceps, and removed the remaining particles of it, as well as the gravel or fand, by means of the litbotomical fpoon. By the application of the blunt dilator, the parts were ne- ceffarily lacerated, and the wound occafioned by this la¬ ceration could not be healed without great difficulty. Hence Le Dran endeavoured to improve upon this me¬ thod, efpecially by making an incifion through the prof- tate 23 PATHOLOGY. fate gland and the bladder with his guarded knife ( cou- teuu en rondaclie); and the immortal Schmucker of Ber¬ lin was uncommonly fuccefsful in ufing the great appa¬ ratus for lithotomy in that improved ftate. The difcovery of the high operation was the work of necefiity and accident. Peter Franco, of Turrieres in Provence, furgeon at Berne, Laufanne, and Orange, was requefted in the year 1560 to perform this operation for lithotomy, at Laufanne, on a child two years of age. He had already begun to operate with the fmall apparatus, when he found that the Hone was of the fize of a hen’s egg, and confequently too large to be removed in that manner. The child’s parents infilled that the operation Ihould neverthelefs be finilhed; and, as the bladder very much projefted above the ofla pubis, he determined upon making the incifion above thefe bones. Although he eventually fucceeded in this bold attempt, yet he pru¬ dently diffuades his brethren from imitating that practice; and indeed the danger to be apprehended from the effu- fion of the urine into the abdomen is fo great, that even the improvements made by Douglas, on the high appa¬ ratus of Franco, have not much diminilhed it. In order to remove the lione from female patients, Franco rejefts both the large and fmaller apparatus, while he propofes merely the dilatation of the urethra, by means of an in- ilrument invented by himfelf; after which he extracts the Hone with the forceps, without difiefting the parts. He likewife invented a gorgeret, and a forceps, the arms of which expand in the bladder; but the ufe of thefe inftraments has been fuperfeded by others that are more convenient. A very painful but curious operation excited great at¬ tention during this century, although it had been pre- vioufly performed. The reader will perhaps fmile at an attempt to repair and reftore that prominent part of the human face, the nofe, when mutilated by accident. Barri, an Italian author, in his “ Italia illuftrata,” 1600, ccmfiders Vincent Vianeo as the inventor of this lingular pra&ice. However that may be, two Sicilian furgeons of the name of Branca, father and fon, had, fo early as the latter end of the fifteenth century, acquired celebrity by the fuccefsful renovation of nofes; an art which be¬ came hereditary in the family of the Bojani. But Caf- par Tagliacozzi, profefl'or at Bologna, railed this art to fuch high perfe&ion, as to render it one of the principal branches of furgery : he became fo celebrated by his ope¬ rations, that his contemporaries erefted a public monu¬ ment at Bologna, where he is reprefented with a nofe in his hand. This operation is defcribed in an interefting work, intitled, “ Tagliacot. de Curtor Chirurg.” fol. Venet. 1597 ; in which he compares it to the ingrafting of trees, expatiates on the dignity and ornament of the nofe, and endeavours to prove that there is not the leaf! danger in cutting out a piece from the biceps mufcle of the arm. With refpeft to the diet to be obferved during the ope¬ ration, he gives ample and rigid inftrudlions, while he maintains that the inoculated nofe is poflefled of a more acute fra ell, and that it generally grows much larger and ftrcmger than the organ which had been accidentally loft. We may fuppofe that this operation became lefs fuccefs¬ ful in the hands of other furgeons, and fo fell into difufe and contempt, as we find it ridiculed by Butler in the s 7th century : So learned Taliacotius from The brawny part of porter’s bum Cut fupplemental nofes, which Would laft as long as parent-breech; And, when the date of that vras out, Off dropt the fympathetic fnout. Hudibras, Canto i. It has, however, been revived in the prefent day ; and has been praftifed with great fuccefs by Mr. Carpue, Mr. Linn, and others. We might here mention the names of other practitioners who improved and illuftrated the ufeful art of furgery : as John de Vigo, Jacob Berenger de Carpi, and Mariano Santo de Berletta ; tile latter of whom abolifhed the aftual cau¬ tery in haemorrhages, and urged the fuperiority of a pro¬ per ligature. The anatomift Fallopius, likewife culti¬ vated furgery with fuccefs, as did moft of the anatomifts of his age; and among them we might enumerate many who have contributed important improvements, would our limits permit. The obftetric art, that important branch of furgery, began to emerge from its barbarity during the fixteenth century, and to excite the attention of furgeons more than it had hitherto done. There appeared feveral in¬ troductions to midwifery, the greater number of which, however, contained much ufelefs and abftrufe reafoning on the generation of man, and the vitality of the em¬ bryo in certain months, while they were extremely defi¬ cient in well founded and practical rules for facilitating delivery. See the article Parturition in the preceding volume. The military furgeons of ancient times are very little mentioned in hiftory. Perhaps they were not in very great eftimation 3 as feems probable from the perfons with whom they are claffed in the military code made at Mans by Henry V. where, under the head of the perfons fubjeCt to the conftable and marfiial, the mediei are intro¬ duced in the following company : “ Whether foldiers, flioemakers, taylors, barbers, phyficians, or ■wajher-wo- men.” See Upton de Re Militari. The low ftate of military furgery in France, even fo late as the time of Francis I. (contemporary with our Henry VIII.) may be gathered from the following extraft from an old and fcarce book called TreuJ'ure of Ancient and Modern Times : “In the year of our Lord 1536, the vic¬ torious king Fraunces fent a great army into Piedmont to vitaile Thurin, &c. I was at that time but a young chirurgion, and but little experienced in the art, becaufe I never had as yet feen the curation of wounds made by gun-fhot. True it is, I had read John de Vigo, his firfte booke of wounds in general!, chap. 8. where he faith, that thofe wounds made by fiery engines do participate of venenofity, becaufe of the powder 5 and for their cura¬ tion he commands to cauterize them with the oile of elders, mixed with a little treacle. Yet nevertheleffe, becaufe I would not be deceived, before I made ufe of the faid boyiing oile, knowing that it brought extreme paine to the patient, I obferved the method of other chi- rurgeons in the firft drefiinge of fuch wounds, which was by the application and infufion of the aforefaid oile, as hot as poflibly they could fuffer it, with tents and fetons ; wherefore I became emboldened to do as they did. But in the end ray oile failed me, fo that I was conftrained to ufe, inftead thereof, a digeftive made of the yolk of an egge, oil of rofes, and terebinth. The night following I could hardly deep at mine eafe, fearing left that, for want of cauterizing, I ftiould find my patients, on whom I had not ufed the aforefaid oile, dead and em- poyfoned; which made me rife early in the morning to vifit them, where, beyond my expectation, I found them on whom I had ufed the digeftive medicine, to feele but little paine, and their wounds without inflammation or tumour, having refted well all that night; the reft, on whom the aforefaid oile was applied, I found them incli¬ ning to feavers, with greate paine, tumour, and inflam¬ mation, about their wounds ; then I refolved with my- felfe, never to burne fo cruelly the wounded patients by gun-fliot any more. A famous chirurgion at Turin, propofed a balm for gun-lhot wounds as follows: Two young whelps, one pound of earth-worms, two pounds of the oil of lilies, fix ounces of the terebinth of Venice, and one ounce of aqua vitae. In my prefence he boiled the w'helps alive in the faid oile, untill the flelh deferted from the bones afterwards he took the worms, having before killed and purified them in white wine, to purge themfelves of the earth which they have always in their bodies ; being fo prepared, he boiled them alfo in the 3 24 PATHOLOGY, faid oil, till they became dry; this he ftrained thorow a napkin without any great expreffion ; that doone, hee added thereto the terebinth ; and laftly the aqua vita; ; and called God to witneffe that this was his balme, which he ufed in all wounds made by gun-lhoot, and in others which required fuppuration; withall praying me not to divulge his fecret.” How terrible muft have been the ftate of the military hofpitals, and what numbers of men muft have fallen a facrifice to ignorance, who under proper management might have been recovered to the fervice of their country! But, bad as the furgeons were, fome were neverthelefs necefiary in curarmies; and, although thegeneral modeof railing and paying them is not handed down, certainly fome regular form of doing it muft have exifted. In the wardrobe-account of the pay of the army raifed againft the Scots, byHenryll. in the 15th yearof his reign, many of the Wellh corps have an officer ftyled Medicus ; but whether by that term a phylician or furgeon is meant, feems doubtful, as the word medicus is foinetimes ufed for both a furgeon and an apothecary. None of thefe phyficians or furgeons are charged to the Englifii levies. And to the Welch they feem to bear no regular propor¬ tion to the number of private men; a corps of 1907 men having only one, and another of 968 having two ; the wages of all, except the two laft-named, was 6d. per diem each ; thofe which were raifed on the king’s land in Cardiganfhire had only 4d. each per diem. In the lift of the troops that attended Edward III. to the liege of Calais, only one furgeon is mentioned, who feems to have been part of the retinue of the prince of Wales; and, in the military eftablilhment of the 18th df. the faid reign, as given in the accounts of Walter Wentwayt, treafurer of the houfehold, there is one fur¬ geon for the king’s houfehold-troops ; four dodlors and one furgeon. for the army of North Wales; two doftors and one furgeon for that of South Wales ; a fupply by no means competent to the number of men to which they were appointed. Suppolingthe inferior furgeons to have been ftyled barbers, like the field-lhaver of the Germans, it feems reafonable to expefl they would fomewhere ap¬ pear on the mufter-roll. Henry V. A. D. 14.15, engaged Mailer Nicholas Colnet, a phylician, to ferve him for one whole year, in the voyage then to be made either to the duchy of Guyenne or France. Colnet was to bring wdth him three archers. If the expedition went to Guyenne, he was to have for his own wages forty marks, and twenty marks for each of his archers, for the whole year. If to France, for his own wages is. and to each of his archers 6d. a day, with regards. In the fame year the king engaged Thomas de Moreftede, a furgeon, who contradled to bring with him twelve other furgeons and three archers. Moreftede was to be paid as a man at arms, iad. by the day; and his- twelve alfiftants and three archers, each 6d. with the ufual regard. The fame con¬ ditions were covenanted, in cafe the campaign lay in Guyenne, that were made with Colnet. Upon a peti¬ tion, the king granted Moreftede one waggon and two fumpter-horfes, for the carriage cf the baggage and ne- ceffaries for himfelf and the twelve other furgeons. He likewife petitioned for money to buy necelfaries for his office, but it was not granted. The next year the king employed Moreftede, joining with him William Brede- wardyn, with the title of his furgeons, in a ccmmilfion to imprefs as many furgeons as they thought necefiary for the expedition, with a fulficient number of artificers for making their inftruments, to be taken wherever they could be found. Among the different perfons who indented in the 14th of Edward IV. to ferve that king in Normandy and France, for one year, are the following phyficians and fur- geor.s : Mailer jacobus Fryle, king’s phyfician, 2s. per diem, with twolervants at 6d. per diem; Mafter William Hobbis, phylician and furgeon of the king’s body, iSd. per diem; feven furgeons at i2d. and five other furgeons every one at 6d. per diem, for their attendance in the faid fervice beyond fea. It is remarkable, that here are juft twelve furgeons, the fame number that appears to have been employed on the expedition under Henry V, In the expedition to St. Quintin’s in the reign of Philip and Mary, 1557, an army confiding of five hun¬ dred heavy armed horfe, five hundred light horfe, four thoufand foot, and two hundred pioneers, with officers and a train of artillery proportionable, there were fifty- feven furgeons, tw’o of them belonging to the fuite of the general, one to the lieutenant-general, one to the high marifchal, one to the general of the horfeman, one to the general of the infantry, and one to the mafter of the ordnance ; all thefe at the daily pay of 1 s. each. The remainder belonged to the corps of horfe, light horfe, and infantry, in the proportion of one furgeon to an hundred men ; the daily pay of a furgeon of heavy horfe was 2s. of light horfe is. 6d. and of infantry is. No furgeon is charged for either the ordnance or pioneers. Befides the king’s pay, it feems as if the furgeons of former times, as well as thofe of late, received a weekly ftoppage from the private men. This may be gathered from the following defcription of the duties of a mili¬ tary furgeon, written in the reign of Queen Elizabeth, “Surgeons ffioulde be men of fobrietie, of good con- fcience, and fkillfull in that fcience, able to heal all foares and woundes, fpecially to take oute a pellett oute of the fame. All captaines muft have fuche furgeons, and ought to fee them to have all their oyles, balmes, falves, and inftruments, and necefiary ftuffe to them be- longinge, allowinge and fparinge carriadge for the fame. That every fouldier, at the paye daye, doe give unto the furgeon 2d. as in tymes paji hathe bcene accujlomed, to the augmentation of his wages ; in confideration whereof, the furgeon oughte readilieto employ his induftrie uppon the foare and wounded fouldiers, not intermedlinge with any other cures to them noyfome. Regarde that the furgeon bee truelye paid his wages, and all money due to hym for cures, that bye the fame hee maye bee able to provide all fuche ftuffe as to him is needfull. Such fur¬ geons mufte weare their baldricke, whereby they may be knowen in the tyme of daughter : it is their charter in the field.” From this paffage it Ihould feem that fur¬ geons formerly wore a diftinguilhing belt over their ftioulders, like that now ufed by the itinerant farriers, vulgarly ftyled fow-gelders, in order to prote6l their per¬ fons whilft adminiftering to the wounded in the field of battle ; a precaution now rendered unneceffary by the apparatus of bandages, &c. carried by furgeons attending a party where fervice is expeiled, or in a field of battle. In an eftimate made, anno 1620, for an army of twen¬ ty-five thoufand foot, five thoufand horfe, and twenty pieces of artillery, propofed by king James to be fent to the Palatinate, a number of furgeons is appointed, but no allowance or provifion whatever appears in the efti¬ mate for medicines or an hofpital, although there is a very minute detail of almclt every other necefiary (lore ; and this feems the more extraordinary, as many of the moft experienced officers of that time were called in to affift in forming the eftimate. The medicinal lift appointed for this expedition were : “ In the general’s trayne, two phyficians, at 6s. 8d. per diem each ; two apothecarys, at 3s. 4d. and two furgeons, each at 6s. 8d. Every regU mentof foot confifted of twelve companies of 150 men each, and had one chief furgeon, at 4s. per diem, and another furgeon to each company at is. per diem. Among the general officers of horfe is one chief furgeon at 4s. a- day, probably to fuperintend the furgeons of troops. To every troop, which was to confift of a hundred men, one furgeon was allotted ; his daily pay, 2S. 6d. To the ord¬ nance, pioneers, &c. there was allowed one barber-fur- geon, at 2s. per diem ; and two under barber- furgeons, at 6d a-day each.” Or.e realon may be affigned for our ancient armies being 25 PATHOLOGY. being able to do with fo fmall a number of furgeons ; which is, that, immediately after a battle, fuch of the meaner fort of foldiers, whofe wounds feemed to require a con- fiderable time for cure, were by the general difmifled, with a fmall pecuniary provifion to carry them home : this, according to Barnes’s Hillory of Edward III. was done immediately after the battle of PoiSliers. Perhaps likewife the inferior furgeons, ftyled barbers, were taken from the ranks, and therefore paid and multered as pri¬ vate men. The prafticeof medicine did not keep pace in improve¬ ment with anatomy and furgery. In the early part of the i6th century the moll conspicuous name we meet with is that of Paracelfus. This- bold and conceited che- mill, who had been' greatly neglefted in his education, endeavoured to combine the principles of alchemy, me¬ dicine, and altrology. He travelled much in fearch of remedies, which he did not difdain to accept from old women, gipfies, and conjurers. He acquired very great reputation ; and on his return to Germany he was ap¬ pointed profeffor of furgery to the univerfity of Bade. The pathological dodlrines of Paracelfus are very im¬ perfectly underltood. It appears, however, that he ad¬ mitted three component parts of the animal body, fait, mercury, and fulphur. We mull not fuppofe that he carried his notions fo far as to conceive that thefe che¬ mical fubllances were really exillent in our frame. On the contrary, he appears to have merely ufed the above- mentioned terms to ill ullrate his meaning by analogy. Thus, mercury is fuppofed to mean the principle of fluid¬ ity, fulphur that of inflammability, and fait folidity. The vital principle of Paracelfus he denominated Archaus$ it was feated in the Itomach, and was the principal agent in digeftion; it feparated the noxious, and prepared for aflimilation the nutritious, parts of our aliment, with a great deal of intelligence, and was the principal agent in the recovery and prefervation of health. Paracelfus like¬ wife mentioned a humour as producing difeafe, though he had abufed with fo much virulence the humoral pa¬ thology of Galen. This humour he called Turturus ; it produced rigidity of the folids, vifcidity of the fluids, See. but it fhould be remarked, that this author did not, like Galen, impute difeafe to the prefence of humour, but humour to difeafe; for the proximate caufe of this Tartarus he contended was the irregular aCtion of the Archsus, or prefiding fpirit. He moreover mentioned five remote caufes of difeafe, viz. ens ujlrule, ens veneni, ens naturale, ens fpirituule, and ens deale. Diverted of che¬ mical jargon and obfcurity, the theory of Paracelfus feems to be this. He remarked, with many others before him, the three principles of the animal frame ; folidity, fluidity, and contradlility or irritability ; and he endeavoured to trace their origin in fubllances which poflefl'ed properties bearing to them a remote analogy. In the fecond place, in tracing the phenomena of difeafe, he referred to the defective or inordinate energy of the vital power the alfi- snilation of noxious particles of food into the blood: hence a humour which, circulating in all parts, produced the varied phenomena of difeafe. Paracelfus in his prac¬ tice ufed the chemical remedies with fome luccefs : he has the merit of firft introducing mercury as a cure for the venereal difeafe, which had before his time been treated with inert quintefcences, diet-drinks, guaiacum, Sec. He was likewife the fit'll who prefcribed opium freely ; and he was no friend to that abfurd practice, which had come into vogue with the Arabian phyficians, of com¬ pounding 50 or 60 fimples together, under the miftaken notion that all the fubllances would retain and exert their feparate virtues, or that among fo great a number forne- thing would be found applicable to the cafe. Modern pharmacy may be faid to commence about the middle of the fifteenth century, at which time it appears to have been in a moll deplorable ftate of empirical bar¬ barity. Though it is probable that, among the earlier pradlitioners of medicine, remedies were employed in Vol.XIX. No. 1284. their moll Ample forms, the art of compounding a num¬ ber of fimples together into one medicine had, by the time of which we are now fpeaking, arrived at a pitch of extravagance which has never been exceeded. What carried this oftentation of compofition to thehigheft ex¬ cels, was the project of framing antidotes, which being previoufly adminiftered, might defend againft any poifon whatever that fliould afterwards be taken into the body. To this fcheme is owing the multitudinous compofition of the celebrated Mithridate and the Theriaca; for fuch medicines muft of courfe recommend themfelves by the number and variety of their ingredients, as they were to contain a proper antidote for every poflible fpecies of poifon, and more el'pecially as thefe compofitions were to be farther wrought up into little lefs than univerfal remedies forall difeafes to which the human body is fubjedt. The firft of thefe antidotes was faid to be compofed from the refult of experiments made feparately with all kinds of Ample antidotes by the famous king whofe name it bears 5 but, as no records are left us of any of thofe particular experiments, we may reafonably confider this tale as fabulous. As’ it is not likely that this medicine or the Theriaca will ever again appear in our Pharmaco¬ poeias, we Ihall, for the amufement of our readers, de- feribe the compofition of each, as given in the London Pharmacopoeia publifhed in 1746. The Mithridate is thus compofed. “ Take of cinnamon 14 drams, of myrrh n drams ; agaric, fpikenard, ginger, faffron, feeds of treacle muftard, or of mithridate muftard, frankincenfe, Chio turpentine of each 10 drams; camel’s hay, coftus, or in its Head ze- doary, Indian leaf, or in its Head mace, French lavender, long pepper, feeds of hartwort, juice of the rape of cif- tus, ftrained ftorax, opoponax, (trained galbanum, balfam of Gilead, or in its Head exprefled oil of nutmegs, Ruffian caftor, of each an ounce ; poley-mountain, water-ger¬ mander, the fruit of the ’balfam-tree, or in its Head cu- bebs, white pepper, feeds of the carrot of Crete, bdellium ftrained, of each feven drams; Celtic nard, gentian-root, leaves of dittany of Crete, red rofes, feeds of Macedonian parfley, the lefler cardamom-feeds freed from their hulks, fweet fennel-feeds, gum Arabic, opium ftrained, of each five drams ; root of the fweet flag, root of wild vale¬ rian, anile-feed, fagapenum ftrained, of each three drams ; fpignel, St. John’s wort, juice of acacia, or in its Head Japan earth, the bellies of feinks, of each two drams and a half; clarified honey, thrice the weight of all the reft. Difl'olve the opium firft in a little wine, and then mix it with the honey made hot; in the mean time melt toge¬ ther in another veffel the galbanum, ftorax, turpentine, and the balfam of Gilead, or the exprefled oil of nutmeg, continually ftirring them round, that they may not burn ; and, as loon as thefe are melted, add to them the hot honey, firft by fpoonfuls, and afterwards more freely: laftly, when this mixture is nearly cold, add by degrees the reft of the fpecies reduced to powder.” The preparation of the Theriaca Andromuchi, or Venice treacle, is thus directed. “Take of the trochesof fquills, half a pound; long pepper, opium ftrained, dried vipers, of each three ounces; cinnamon, balm of Gilead, or in its Head exprefled oil of nutmeg, of each two ounces ; agaric, the root of Florentine orris, water-germander, red rofes, feeds of navew, extradl of liquorice, of each an ounce and a half; fpikenard, faffron, ammomum, myrrh, coftus, or in its Head zedoary, camel’s hay, of each an ounce; the root of cinque-foil, rhubarb, ginger, Indian leaf, or in its Head mace, leaves of dittany of Crete, of horehound, and of calamint, French lavender, black pepper, feeds of Macedonian parfley, olibanum, Chio turpentine, root of wild valerian, of each fix drams ; gentian-root, Celtic nard, fpignel, leaves of poley- mountain, of St. John’s wort, of ground-pine, tops of creeping-germander with the feed, the fruit of the balfam-tree, or in its Head cubebs, anifefeed, fweet fen¬ nel-feed, the lefler cardamom-feeds freed from their H hulks, 20 PATHOLOGY. hulks, feed of bilhop’s-weed, of harttvort, of treacle- muitardor mithridate-muftard, juice of the rape of ciftus, acacia, or in its ftead Japan earth, gum Arabic, iforax drained, fagapenum ftrained, Lemnian earth, or in its Head bole-armenic or French bole, green vitriol calcined, of each half an ounce ; root of creeping birtluvort, or in its Head of the long birthwort, tops of the lefler centaury, feeds of the carrot of Crete, opoponax, galbanum ftrained, Rullia'caftor, Jews pitch, or in its Head white amber pre¬ pared, root of the fweet flag, of each two drams ; of cla¬ rified honey thrice the weight of all the reft. The ingre¬ dients are to be mixed in the fame manner as in the Mithridate.” The Theriaca may be confidered as a modification of the Mithridate by Andromachus, though we are not informed what were his reafons for the varia¬ tions, except that by the addition of the viper’s fielh the medicine was rendered more ufeful againft the bite of that animal. The Theriaca was in fo great repute before the decline of the Roman empire, that even the wife Marcus Aurelius was induced to make a daily ufe of it, to' the great prejudice of his health ; for we are told by Galen, that his head was fo much affedted, that he dofed in the midft of bufinefs ; and, when on this account he omitted the opium in the coinpofition, he could not lleep at all. When the alchemifts had extended the bounds of their art from the mere drudgery of manufacturing gold and filver to the more noble and phiiofophic employment of compoling an univerfal elixir that fhotild fecure its pof- fefior from difeafe, and prolong his life to an indefinite period, pharmacy derived from their labours confiderable and folid advantages. The experiments inftituted by thefe vifionaries with the metals, led to the accidental difcovery of fome of the molt efficacious remedies which we at prefent employ, efpecially the preparations of anti¬ mony and mercury, and molt of what are called the neu¬ tral or fecondary 1'alts. By calling in the aid of fire, they ’ enabled us to produce in bodies changes which, with¬ out the affiftance of this powerful agent, we fhould have been unable to efl'eCt. Now, every thing was fubmitted to digrjhon, calcination, fermentation, diftillation , and fitb- limution-, but, as generally happens in cafes of innovation or reform, thefe new methods of obtaining active reme¬ dies were carried to an abfurd and ridiculous extent. Finding that the healing powers of many fubftances were eliminated or increafed by the application of heat, they feemed to imagine that the fimple medicine could in no cafe poffefs any medical virtue till it had been placed upon the fire or kept for fome hours in a furnace. Hence the immenfe number of diftilled waters and fpirits, elfential and empyreumatic oils, with which the old pharmacopoeias are crowded, and which feem in many cales to poliefs no other powers than what they de¬ rive from the water or the fpirit that forms the bulk of the preparation. Not only plants and minerals, but ani¬ mals and animal matters of all kinds, were diftilled, di- gefted, or calcined. Thus, we find a water of Jhails, a fpirit of millepedes , an oil of earth-worms. See, See. The abfurd and pompous names by which the preparations were diftinguifned, are truly ridiculous. Magijierial balfqm, Hicra picra, Ethiops mineral, Ens Veneris, Flores Martis, Calmnclas, Aqui'tu alba, are a few which long re¬ tained their feat both in public and private difpenfatories. As’ thefe preparations were, from their contrivers, deno¬ minated chemical, the more ancient medicines which ■were drawn almcft entirely from the animal and vege¬ table kingdoms, were denominated Galenical, becaufe chiefly employed by the followers of Galen. Hence the divifion of medicines into Galenical and Chemical, a divi- fion which obtained for fome hundred years, and which only a few years ago was prelerved in the fale-caialogues of the London druggifts. The chief follower of Paracelfus was Van Helmont. He made many important chemical difcoveries ; ftrongly op- poled the Galenical dodlrir.e ; and, though often milled in his fpeculations by a ftrong bias to theofophifm, he ob- ierved Nature very attentively; he pointed out more fully than Paracelfus had done, the influence of the epi- gaftric organs on all the other parts of the lyftem ; and he gave fome account of the origin of urinary calculi. The nature of inflammation was likewife explained by him, and the pernicious confequences of exceffive bleeding welfpointed out. Van Helmont had not, however, many adherents at the time he lived. His theory was afterwards taken up by Defcartes, who attempted to explain all the phenomena of life according to chemical and mechanical principles. Thus, the circulation of the blood and animal heat were produced, according to him, by the ebullition or fermentation that took place in. the heart; digeltion was likewife performed by a fpecies of fermentation ; and the fenfation of hunger proceeded from the acid which was evolved during the procefs. To explain the nature' of fecretion, Defcartes had recourfe to> the corpufcular philofophy; comparing the fecreting organs to lieves, which allowed only the more minute and homogeneous particles to pafs through, while the coarfer and hetero¬ geneous bodies were rejected : the round particles were luppofed by him to enter into cylindrical tubes ; pyrami¬ dal particles penetrated by triangular pores, and cubical particles by fqtiare pores; and in this way each fecretion remained diftindt, at leaft in the healthy ftate. Thefe ideas were eagerly embraced by the Dutch phylicians of the time, and may be confidered as forming the ground¬ work of the chemical and mechanical fyftems, which di¬ vided the medical world at the end of the fevenreeuth cen¬ tury, notwithftanding the claims to originality which le- veral of their followers have put in. After the revival of genuine philofophy in the fixteenth century, it might naturally be expected that medical fci- ence would immediately avail itfelf of its light, and par¬ take of its benefit; but this was fo far from being the cafe, that, in the firft inftance, it proved a new fource of error, and threw f re fin impediments in the road which was fuppofed to be opened to the improvement of rational medicine. The difcovery of the circulation of the blood may, indeed, be confidered as one of the firft fruits of the inquiries into nature begun in that age. But, though this is a fundamental element in the economy of the living body, it throws little or no light on the principles' peculiar to life, being purely of a mechanical nature ; and, abftradtedly confidered, hardly admits of any application to the pradiice of medicine. On the contrary, this difco¬ very, by its perverted application, tended to corrupt and millead, by a loofe adoption of the principles of mechani¬ cal philofophy, fo well laid down in that age by Galileo and others. Boreili, in inveftigating the force of the heart by experiment, eftimated it at 180,000 pounds; Hales, at 51 pounds; Keil, at 1 pound. The mechanical powers of the ftomach were, about the fame time, fub- jedled to experimental refearch by Pitcairn, who gravely gave out that he found this vifeus, in the human lubjedt, exerted a force equal to 12,900 pounds, in compreifing food in the procefs of digeftion. Others, conceiving that chemical power had the chief lhare in this fundlion, en¬ deavoured to evince that the change in the foot! was brought about by means of heat and fermentation. Sounder principles have referred thefe changes to powers which have nothing in common with the mechanical and chemical powers which characterize inanimate nature. From the picture that has been exhibited of the innu¬ merable doubts and difficulties which clog the attainment of medical knowledge, and embarrafs the application of it to pradrical purpofes, the timid, fceptical, and indolent, may be difeouraged from ftudies apparently fo arduous in their prol'ecution, and fo queftionable as to the efficiency and utility of their refult. But it i§ not from charadlers of this defeription that much good can be expedled in any of the ufeful arts of life, If a like defpondency were to pervade mankind in general, there would be an end to all that enterprife and energy which alone can enable them to 27 PATHOLOGY. to aft up to their deftiny, and follow up thofe purfuits upon which the perfection of their nature depends. As the fenfes would have lain dormant for ever had there been no external objefts to dimulate them, fo the faculties and virtue which characterize rational nature and civilized life could never have been developed, but through the excitement of thofe pains, wants, difficulties, and dangers, infeparable from human life. By no other arrangement could our duties, our happinefs, our mental and bodily perfections, have been bound togetherin one harmonious and confillent fyltem. Let us compare the art of medi¬ cine, under this afpeCt, with thofe of navigation and agriculture. Had man been furniffied by the Creator with wings, by which he could have traverfed all feas and oceans, fo as to fuperfede the life of ffiips, where would have been that hardihood of character, and ail thofe inge¬ nious devices which have called forth the aCtive energies and deep refearches of the human mind ? If, contrary to the aCtual inltitutions of Providence, the life of man had been fuftained by the fpontaneous productions of nature, inftead of the products of indudry, neither the faculties of the mind nor the powers of the body could ever have been developed : man would have been little fuperior to the brutes; his aCtive and inventive energies would have lain alleep for ever ; there would have been no room for the talents exercifed in the procuring of food, raiment, and Ihelter, r.or in commercial intercourfe; all the mutual and endearing ties and dependences of facial and civilized life, all trades, profeffions, arts, and fciences, whether miniltering to accommodation or elegance, conilituting man's greatelt felicity, whether as objefts of purfuit or enjoyment, would have been unknown and untafted. It is obvious that this reafoning, being founded on a general law of nature, mud apply equally to medicine. In a pro¬ bationary exiftence, it was neceffary that man ffiould be tried, not only by pain and ficknefs, but by the difficul¬ ties of remedying them, as exercifes of virtue and inge¬ nuity. Why ffiould the road to medical relief lie through fewer and (lighter druggies and dangers, than thofe of navigation and agriculture ? But the fubjeCt is more concifely and emphatically illudrated by the philofophical poet, than by any amplitude of illudration, or farther multiplicity of words which we could employ : . - Pater ipfecolendi ( medendi), Haud facilem efle viam voluit, primuique per artem, Movitagros, (ggros,) curis acuens mortalia corda. We ffiall conclude our view of the general date of pa¬ thology in the lixteenth century, with fome account of the violent difputes which prevailed in France, on the prero¬ gatives of the medical art over thofe of furgery, but par¬ ticularly on theconteded privileges of the furgeons. Al¬ though the documents relative to this fubjeft have been partly printed, or have at lead not been withheld from the inlpeftion of hidorians, yet no part of medical hidory has been condufted with more partiality, and lei's regard to truth, by both parties. The author of the work entitled “Recherches furl’Origine et la Progres de la Chirurgie en France” is guilty of the grolfed mifrepreferitation, though this book has by fome been afcribed to Franc. Quefnay. Pafquier, in his “Recherches de la France,” fol. Paris, 1620, defervesmuch more credit; and, therefore, the mod important points relative to that extraordinary difpute are here briefly collefted from his more authentic Aatement. And this alfo will remind the reader of flmilar difputes in our own country, and about the fame time : for, it has been already hinted, that, during great part of the 16th century, furgery was praftifed indilcriminately by barbers, farriers, and fow-gelders. We know that barbers and furgeons continued for 200 years after to be incorporated in one company, both in London and Paris. d In Holland and fome parts of Germany, we are told, that, even to this day, barbers exercife the razor and lancet alternately. The furgeons of Paris had, fince the time of Lanfranc, (1295), formed a didinft body, called the College of St. C6me ; and they obtained additional and refpeftable pri¬ vileges from Philip the Fair, in 1311, which entitled them to equal rank with the members of the medical faculty; hence they could not bear the idea that barbers ffiould ul’urp the right of bleeding, applying pladers,and treating external injuries and ulcers. In confequence of this en¬ croachment, the furgeons, in 14.25, obtained an aft or arret of the parliament of Paris, by which the performance of chirurgical operations was prohibited to the barbers, while they were permitted to drel’s wounds, and extirpate corns by the knife. But the phyflcians embraced the caufe of the barbers, and indrufted them in the practice of furgery, with a view to take revenge on the furgeons, who, it was affirmed, had ufurped medical privileges. The complaint of grievances which the furgeons, on this occaflon, laid before the faculty, in the years 14.91 and 1494., were not attended with any efl'eft; and the members of the faculty were even permitted to deliver anatomical leftures to barbers in the French language. The furgeons again, though in vain, reprefented to the faculty, that they afted contrary to the laws made by themfelves, by permitting their members to indraft barbers' in the knowledge of anatomy, and this in their native language. However, no other redrefs could be obtained, but that of licenftng the furgeons to undertake public difleftions, and of granting them a certain rank above the barbers, for which they paid lixty folidos annually to the treafurer of the faculty. This event took place in the year 1 502 ; and in 1505 the furgeons renewed their application in the charafter of fcholars or pupils to the faculty, whom they intreated to confirm their privileges; but Helin, the fenior of that body, fent them the difcouraging anfwer, that their pretended rights or immunities had been ac¬ quired by furreptitious means. In the fame year, the phylicians of Paris, as Pafquier exprefles himfelf, “ palled the Rubicon,” and entered into a formal contraft with the barbers, who, on account of their implicit obedience, were patronized in preference to the furgeons. The barbers were confequently, in con¬ tempt of the furgeons, pronounced to be “ the true fcho¬ lars of the faculty:” they were matriculated under that name; but a promife was exafte'd from them, according to which they were not allowed to adminider internal medicines, without confulting, in every cafe, a member of the medical faculty; they farther agreed to undergo an examination, previous to their commencing bufinefs as maders. After that period, the barbers were no longer called Barbitovfores, the complaifmt faculty having con¬ ferred on them the more honourable title of Chiriirgici a. Tonjtrina, or TonJ'o'res Chirurgici. A few days after this change, the faculty proceeded to fuch extremities as to profecute the furgeons in a court of law, becaufe they had received information, that leveral furgeons had prefcribed internal remedies without the previous advice of a phyfician. At that time, probabty, no man of genius and aftivity prefded over the Coliege of St. Come ; for no fooner was Stephen Barat elefted prefident of that college, than the fituation of affairs was thoroughly changed. In the year 1515, he urged the faculty to exempt the fociety of fur¬ geons from the oppreffive tax they were obliged to pay an¬ nually, and not to compel them to attend the leftures given by members of the faculty. As Barat addrefl'ed himfelf to the whole univerfity, and as old Helin, the mod zealous antagonid of the furgeons, died in the fame year, this remondrance had the deiiredefleft. The univerfity ilfued a decree, by which the furgeons of Paris were no¬ minated Scholu/tici, or perpetual fcholars of the faculty. But diil greater immunities were granted to the furgeons in 1545, by the good offices of William Vavafleur, principal furgeon at the court of Francis I. He effefted a complete feparaticn of the barbers from the furgeons ; and at the fame timeobtained a decree, in conformity to which every mafler of the chirurgical art, if he wiffied to obtain the privilege PATHOLOGY. privilege of exercifing his profeflion, was obliged to ftudy the Latin language, logic, and other elementary fciences. By this favourable regulation, the College of Surgeons was at once raifed to the rank of a learned fchool, and obtained at length the right of creating Mailers, Bache¬ lors, Licentiates, and Doctors, of Surgery. In confequence of this arrangement, Henry II. granted to the members of the Chirurgical College of St. Louis, all the preroga¬ tives attached to a faculty ; and the patent ifl'ued on that occafion was regiftered in the parliamentary laws, under the name of Lettres d'Ociroi. In the j’ear 1551, the medical faculty, under the deanery of John du Hamel, re-commenced the difpute againll the furgeons. Although Rudolph le Fort, dean of the College of St. Louis, zealoufly defended the fur¬ geons, yet du Hamel found the means of procuring a re¬ peal of the decree enadled in 15155 and, contrary to the fpirit of that law, the furgeons were again obliged to fub- mit to an examination before the medical faculty. Under Henry III. however, the furgeons once more obtained a confirmation of their privileges, in 1577, by virtue of which they were entitled to confer academical dignities ; and, notwithftanding the newoppoiition of the faculty in 1579, the furgeons, as well as the univerfity of Paris, were in the fame year favoured with an indult of pope Gregory XIII. while de Thou vindicated the caufe of the former, in a fpirited and fuccefsful manner, againft the opprelfions of the faculty. The colleges fubfequently eitablilhed by fur¬ geons acquired fuch a degree of authority, that, in the year 1596, they were empowered to give poll tive orders to the barbers, in difficult chirurgical cafes always to con- fult a fworn furgeon, and upon no account to undertake the treatment of any other but the flighted: external inju¬ ries. Thefe privileges and prerogatives of the furgeons of Paris were further confirmed by Henry IV. in 1602, and by Louis XIII. in 1614. About this time was framed the following oath, which to this day is taken by every phyfician who takes a degree at the univerfity of Montpelier. “ I, ■ -, be¬ fore the image of Hippocrates, in prefence of the profef- fors of this fchool, and of my dear fellow-coilegians, do fwear, in the name of the Supreme Being, to be faithful to the laws of honour and probity in the exercife of medicine. I will give my care gratuitoufiy to the indigent, and will not exa6t a falary beyond my juft demands. Admitted into the interior of families, my eyes fhall not fee what they ought not to fee, nor fhall my tongue betray any fecrets confided to me 5 nor fhall my profeflion be made available to corrupt morals, or to favour guilt. Re- fpeFtful and grateful to my mailers, I will endeavour to return to their children the inltrmSlion which I have gathered from the fathers. May men grant me their efteem in proportion as I am faithful to this oath ; and may I be difgraced among my colleagues when I fwerve from it.” III. From the Seventeenth Century to the present Time. The moll brilliant difcovery of the 17th century was that of the circulation of the blood, by our countryman Harvey, who was born in the year 1578. He firft opened the difcovery in 1616, in his leisures in the Latin lan¬ guage, which are preferved in MS. in the Britiffi Mufeum ; but his work, containing the details, was not publifhed till the year 1628, when his “ Exercitatio anatomica de Motu Cordis et Sanguinis in Animalibus” appeared at Frankfort : and this is the only edition which bears the ftamp of Harvey’s own authority. This treatife, which Haller has moll appropriately flyled aurcum opufcuhm, is conftrucled entirely upon the refult of experiment, and contains an excellent arrangement of the fubjefit. The author was now created phyfician to king Charles I. and demonflrated the circulation before him in a living animal. The vail importance of this difcovery to the whole fcience of phyfiology; the influence which it neceftarily exerted on the doftrines of pathology ;■ and the general revolution which arofe from this fource throughout the whole circle of medical knowledge; will juftify us in giving a flight hillorical fxetch of the fubjecl, and in pointing out the opinions held by thofe anatomifts and phyiiologifts who preceded- our immortal countryman Harvey. To him, indeed, the glory of this greateft of all phyfiological difcoveries has been affigned by the almoft unanimous concurrence of his fucceffors. Some, however, have endeavoured to deprive him of his well-earned fame, by afcribing a knowledge of the circulation to various preceding writers. Mr. Dutens, in the fecond volume of his “ Recherches fur l’Origine des Decouvertes attributes aux Modernes,” has brought forward paflages from Hippocrates, Plato, Ariftotle, Julius Pollux, Apuleius, and others, in order to prove that they knew the courfe of the blood. After the pofitive dogmatical alfertions with which the author fets out, we are furprifed by the weaknefs and inadequacy of his proofs, and can only ac¬ count for the inconfiftency by fuppofing him to have been utterly ignorant of the fubjedl. He quotes a few inf¬ lated paflages which cannot, by the moll favourable inter¬ pretation, beconftrued into the femblance of a proof, that the writers in queftion knew the circulation of the blood. But the only fair and unexceptionable method of deter¬ mining whether any individual was acquainted with a particular fa 61, is to confider all that he has faid on the iubjedl, and to draw our inferences from the refult of this general examination. Such an inquiry will prove moll clearly, that a knowledge of the circulation, fuch as we pofiefs at prefent, can be afcribed to no one before Harvey ; although a part of the fubje£t,viz. the paflage of the blood through the lungs, had been defcribed by feve- ral perfons before the time of that illuftrious character. That the blood moves, has been univerfally known and admitted, fince the fcience of medicine has aflfumed a dif- tinfl form : how much of its courfe, and of the laws that regulate its motion, has been afcertained at any given pe¬ riod, is another queftion. The circulation is fo generally known in the prefent day, and the proofs on which it refts are fo obvious and familiar to every tyro in the profeflion, that we feel furprifed how they Ihould fo long have ef- caped the obfervation of the numerous ingenious and learned characters, whofe names adorn the annals of ana¬ tomy. We muft remember that the courfe of the blood, taken altogether, forms a fubjeft of confiderable intricacy; that the purfuit of anatomy was attended in the early periods of the fcience with confiderable difficulty and danger; and that the unlimited fway which the authority of Galen held over the minds of men for fome centuries, precluded all attempts at further inveftigation. Hippocrates Hates that the blood meets with obftacles in its courfe, which retard or entirely arreft its progrefs; that it goes from the internal parts towards the furface ; and vice-verfd, that the blood muft flow forwards from the heart, fince the valves hinder its return, and that the arteries are diftended when their blood is flopped. In fpeaking of the blood’s motion, he compares it to the courfe of rivers, to the ebbing and flowing of the fea, and even to the revolutions of the planets. He affigns the origin of the arteries to the heart, and that of the veins to the liver; and fuppofes that there are two oppofite mo¬ tions in the temporal arteries, by which their pulfations are produced. He fpeaks of four fluids in the body, the blood, water, mucus, and bile, which come from the heart, head, fpleen, and liver; all thofe parts are, how¬ ever, fuppiied from one principal fource, the ftomach. Can we difcover any traces of a knowledge of the circu¬ lation in this confulion of ideas; and may we not be jullly furprifed, to find that enlightened men Ihould be fo led away by their prejudices, as to allow to Hippocrates the knowledge of a difcovery, which no one had per¬ ceived in his writings for nearly three thoufand years ? The obfervations of the founder of medicine had led aftray x PATHOLOGY. a ft ray all who followed him to the time of Harvey; but, when the refearches of that great man had unfolded the myftery of the circulation, his enemies dared to affirm, that the writings of Hippocrates had furnilhed the lights which guided him in the path of difcovery. The philofophers who joined theftudyof medicine to that of the other fciences, feem to have been equally ig¬ norant of the laws which regulate the blood’s motion. Thus, Ariftotle exprefsly ftates that the blood never re¬ turns to the heart. The Alexandrian anatomifts main¬ tained that the arteries held no blood, but were filled with air; from which circumftance they gave them the name, which they have conftantly retained, from a»p, air, and T'/jfsw, to hold. To explain the occurrence of blood in thele veflels after death, they fuppofed the exiftence of fubtle communications with the veins. The genius of Galen difdained to follow blindly the iteps of his predeceffors ; and he endeavoured at leaft to difcover the truth by experiments and obfervations on the ftrmSture of the body. By thefe means he afcertained fome fafts, although he could not fucceed in piercing the veil which concealed the fecret of the circulation. He feems to have recognized the ufe of the valves at the two orifices of the ventricles. He proved, by tying an artery with two ligatures, that thefe veflels contain blood during life; and ftates that they are filled by the contraction of the heart, in confequence of which they pulfate. Thefe circumftances feem to indicate a confiderable advance¬ ment in the knowledge of the circulation ; but we mult mention, in the fame fpirit of impartiality, the contradic¬ tions and uncertainty which prevail in the works of Galen on this fubjeCt, and the limits which his labours could not exceed. He ftill referred, with Hippocrates, the origin of the veins to the liver, and fuppofed a paflage of the blood through thefeptum of the ventricles, while a fmall portion entered the pulmonary artery to nourilh the lungs : he imagined, lallly, that it might pafs recipro¬ cally between the pulmonary artery and veins. There could be little reafon to expeCt, that in the troubled and barbarous times which followed the age in which Galen fiourilhed, the fecret of the circulation fliould be difcovered ; ftill lefs that it Ihould be explained to phyficians by men whofe purfuits were foreign to the fcience of medicine. Yet it has been boldly afierted that Nemefius, bifhop of Emefa, knew' the courfe of the blood, as it has been afcertained by the fubfequent la¬ bours of Harvey. The editor of the Oxford edition of his works, has imbibed the true fpirit of a commentator ; who difcovers in the writings of the ancients, meanings which never were in the contemplation of the authors; and abufes the moderns as plagiarifts, for decorating themfelves with the difcoveries of antiquity. But on what grounds does Nemefius claim the honour of a difcovery, denied to fo many great geniufes ? Becaufe, according to Freind, the bifnop ftates, that the blood palfes from the arteries into the veins during fleep. This reftriftion im¬ mediately overturns the claim ; which would indeed be deftroyed by the kind of motion that he fuppofes to take place, viz. a reciprocal alternation of undulations, like that of the Euripus. In another paflage cited by Dutens, he fpeaks of the arteries in their dilatation attracting the blood from the veins; but this paflage, which we have already quoted at p. 16, fufficiently proves that he knew nothing of the matter; and exemplifies ftill further the abfurdity of a perfon’s attempting to dogmatize, as Dutens lias done, on fubjeCts of which, as being foreign to his profeflion, and difficult of inveftigation, he cannot reafonably be expected to be a competent judge. “Thus,” to ufe the words of Senac, “a theologian writes on the nature of man; a fubjedt which does not very properly belong to fuch a writer : on no other tefti- mony than fome vague and ridiculous expreflions, he gains the credit of knowing the circulation, of which the greateft phyficians and anatomifts had been hitherto com¬ pletely ignorant. Thus it is, that interpreters and com- Vol. XIX. No. 1285. 29 mentators are milled by a blind zeal for antiquity, and difcover hidden meanings in the moft Ample expreflions. How would their boldnefs and aflurance have been aug¬ mented, if Nemefius had exprefled himfelf as clearly as an ancient fcholiaft of Euripides has done, where he fays, “ that the blood flows through the veins, and that thefe veflels receive it from the arteries.” Should we, how'ever, on this infulated and cafual expreflion, be juftified in be¬ llowing on a weigher of words, and meafurer of phrafes, the honour of a difcovery, which had eluded the re¬ fearches of the greateft philofophers ? The date of darknefs and ignorance, in which the hu¬ man mind languifhed during the fucceeding ages, does not allow us to expeCt that any writer of that period can dif- pute with Harvey the honour of the great difcovery. About the fixteenth century the curiofity of mankind was again excited to the inveftigation of this interefting fubjeCl. Reafon, which had hitherto fubmitted to the yoke of authority, began to aflert her rights ; and feveral phyficians were bold enough to examine fubjeCts which Hippocrates and Galen had not been able to develope. Thefirft ray of light was thrown on the circulation, by a man, whofe name cannot be mentioned without ex¬ citing feelings of compaflion for his unmerited and barba¬ rous treatment, and of indignation at the unrelenting bigotry of. his cruel perfecutor. Gifted with an ardent and penetrating genius, Servetus made a rapid progrefs, at a very early age, in the fciences of natural philofophy and divinity. Compelled to leave Spain, his native country, he paffed into France, and ftudied medicine at Paris, under Winter d’Andernach, who was profeflor in the college lately fotinded by Francis I. He vifited dif¬ ferent parts of France and Germany, and, after various perfecutions on account of his religious opinions, fettled in Dauphiny. But Calvin, being too narrow-minded to grant to a rival that freedom of thought and liberty of confcience which he had fo 1'uccefsfully exerted in his ' own perfon, had him feized and condemned to the flames. Thus, fays Portal, “ one heretic deftroyed ano¬ ther ; but the difference was, that an ambitious and de- figning knave pronounced the condemnation, and one of the fineft and moft enlightened geniufes of Europe was the lamented vifitim of this iniquitous fentence.” The paflage, which proves Servetus to have been ac¬ quainted with the pulmonary circulation, occurs in his work de Rejiitutione Chrijlianifmi ; which, having been carefully deftroyed on account of the herefy which it contains, is now extremely fcarce ; fo that two or three copies only are fuppofed to exift, and the duke de la Valiere gave the fum of 1 32I. for one. It ftates, that the vital fpirit is compofed of the moft fubtile parts of the blood, and of the air, which infinuates itfelf into the lungs ; and that the fource of this blood is in the right ventricle. “But the communication, that is to fay, the paflage of the blood, from the right to the left ventricle, does not take place acrofs the middle feptum, as perfons have generally imagined ; it depends on a more Angular ftrufilure. In the long windings of the lung, this fubtile blood is agitated, and prepared by the aCtion of the vifcus, and gains a yellow colour. From the vena arteriofa (pulmonary artery) it palfes into the arteria venofce (pul¬ monary veins) where it becomes mingled with the air that has entered the lungs, and lofes its fuliginous excre¬ ments. Laftly, it enters the left ventricle, which attracts it in its dialtole. Such is the preparation of the blood, from which the vital fpirit is formed ; this prepa¬ ration, and this paflage from the arterial vein into the ve¬ nous artery, are evidently proved by the fize of the vef- fels; which would not be fo large,' nor poflefs fo many branches; nor carry to the lung fo great a volume of blood, if it were deftined to the nourifhment only of the vifcus.” He adds, that the vital fpirit is lent from the ieft ventricle into all the arteries of the body. This repre- fentation proves inconteftably that Servetus knew the minor circulation. He laid the foundation of a building, I which PATHOLOGY. 80 which had baffled all the efforts of the great geniufes of antiquity. In order to perfedt this defign, it was only ne- ceffary to extend the ideas of the firft architedt. He in¬ dicated the route, through which the blood paffes from the right to the left ventricle ; it remained to be proved that all the blood takes this paffage, and that it returns again to the heart from the arteries through the veins. The obfcure Iketch of the circulation, which was fur- niffled by Servetus, appears in a more finilhed and lu¬ minous form in the works of Realdus Columbus. He defcribes the entrance of the blood into the heart from the vena cava, and its fubfequent paffage through the lungs into the left ventricle and aorta. He advanced a ftep farther than Servetus ; for he dates that the whole blood paffes through the lungs, and not the vital fpirit only. But he falls into the fame error with preceding anatomifts on the fubjedt of the liver; fuppofing that gland to be the fource of the blood which nourilhes the ftomach, fpleen, & c. Arantius and Caefalpinus defcribed more perfedtly and clearly than Columbus the paffage of the blood through the lungs ; which they confirmed by feveral arguments drawn from the ftrudture of the parts, and particularly from the pofition and mechanifm of the valves. The latter indeed approached very nearly to the grand deiideratum, the paffage of the blood from the ar¬ teries through the veins to the heart. He obferves that a vein fwells below' the ligature; but he did not follow this up to prove the circulation. He fays that the blood returns to the heart through the veins during fieep; but he fuppofed it to move backwards and forwards in the fame veffels, like the Euripus. He was milled alfo in the labyrinth of the liver, where fo many phyfiologifts have loft themfelves. The arrangement of the arteries and veins in this organ prefents fuch an intricate combi¬ nation, that we need not wonder at its proving, for fo long a time, a fource of miftake and illufion. Paul Sarpi, the learned hiftorian of the council of Trent, is one of thofe to whom the circulation is faid to have been knowm; but the want of all arguments that bear the leaft convic¬ tion on the fubjedt, will juftify us in declining any par¬ ticular consideration of his claim, as well as thofe of Fabri a Jefuit, of Helvicus Dietericus, and others. Notwithftanding the labours and writings of the ana¬ tomifts whofe opinions we have thus curforily examined, the minds of men were ftill enflaved by thofe errors, which, having prevailed for fo many centuries, had ac¬ quired the fandtion which time and authority beftow on any opinions, however abfurd. The moft enlightened phyficians were fatisfied with the labours of their precie- ceffors ; and Harvey alone had fufficient courage and in¬ formation to canvafs thefe inveterate prejudices, which length of time had confecrated as infallible truths. He obferved and defcribed the true courfe of the blood with a wonderful fagacity and clearnefs. None of the argu¬ ments, which prove the circulation, efcaped the refearches of this acute obferver; fo that a modern phyfiologift, in recounting the proofs of this phyfiological fadl, could add little, if any thing, to what is accumulated in the ori¬ ginal work of Harvey. He was not contented with de- monftrating the circulation in fome parts only ; but fol¬ lowed up the fubjedt in all the vifcera of the body. He traced the courfe of the blood through the liver, where every preceding anatomift had difcovered nothing but perplexity and confufion. The work of Harvey is, in (hort, one of thofe rare and precious produdtions which embrace a fubjedt in its whole extent, and prefent it to the mind in fo perfedt and finilhed a form, as fcarcely to admit a tingle addition or improvement. The merits of our countryman, whofe fame can never perilh while medical fcience continues to be cultivated, will be exalted to a ftill higher pitch, when we confider the ftate of medical knowledge in England at that time. While anatomical fchools had been long eftablilhed in Italy, France, and Germany, and feveral teachers had rendered their names illuftrious by the fuccefsful purfuit of the fcience, anatomy was ftill unknown in England, where diffedfion had hitherto hardly begun. Yet, at this inaufpicious period, did Harvey make the difcovery, which may be considered as a fecond and more perfedt foundation of the fcience of medicine ; and which amply juftifies Haller in ranking him as fecond to Hippocrates only. The publication of this grand difcovery roufed the attention of all Europe. The old profeffors, accuftomed to pay a blind and implicit deference to the authority of Galen, which wras now utterly fubverted, and, aftiameci of confeffing that their whole life had been fpent in teach¬ ing the groffeft errors, took up their pens in oppofition to the author of thefe innovations. One party afferted that the difcovery was not a new one : that it had been known to feveral perfons, and, indeed, to all antiquity. Such were the aflertions of Nardi, Vander Linden, Hart- mahn, Almeloveen, Barra, Drelincourt, Patin, Falconet, Heifter, Regnault, &c. A fufficient refutation of thefe ftatements will be found in the hiftorical Iketch, which we have already exhibited. Other adverfaries of Harvey proceeded in a more rational manner; and attempted to difprove his ftatements by experiment and reafoning. Primerofeled the wayin this attack, and he was followed by Emilius Parifanus, John Riolan, Cafpar Hoffman, and others. If men of fuch acknowledged erudition as Riolan and Hoffman were fo utterly unacquainted with the circulation as to deny it altogether, may we not fafely conclude that the fubjedt is not defcribed in any of the writers who preceded Harvey ? Out of all his numerous opponents, this illuftrious man anfwered Riolan only, in his “Secunda et Tertia Exercitatio de Circulatione Sanguinis.” The reply was rather extorted by the rank and fame of Riolan, than by the ftrength of his argument. If we feek to define exactly the precife (hare of merit which Harvey may claim in the grand difcovery of the circulation, it will be necteffary to hold a middle courfe between the grofs and palpable ablurdity of thofe who difcover a knowledge of the circulation in the writings of Solomon, Hippocrates, Plato, Ariftotle, &c. and the too great partiality of fuch as would deny all knowledge of the fubjedt to every anatomift who preceded Harvey. It feldom happens, that fo extenfive and intricate a fub¬ jedt as that which we are now confidering, is furveyed and brought to light in all its branches by the labour of an individual ; nor has it happened in the prefent inftance. For Servetus, Columbus, Arantius, and Cae- falpinus, were acquainted with the courfe of the blood through the lungs ; and the latter writer has even an ob¬ fcure hint towards the greater circulation. But no one attempted to prove the latter point by arguments and experiment before the time of Harvey: the expreffions of Caefalpinus, which are by no means clear or fatisfadiory, had been before the public for half a century without exciting the leaft inveftigation, and without fuggefting to Fabricius the true office of the valves in the veins. The entire merit of the greater circulation may, there¬ fore, be afcribed to our illuftrious countryman ; and, if we compare the luminous method and irrefragable proofs which are found in his expoiition of the other part of the fubjedt, with the partial and confufed ftatements of pre¬ ceding authors, his merit will here be only fecond in de¬ gree to that of adtual difcovery. The dodtrine of the circulation met with fome fup- porters on its firft promulgation. Walaeus of Leyden ex¬ erted himfelf ftrenuoufly on this fide, and defended the propofitions of Harvey in two excellent letters addreffed to Bartholin. Des Cartes alfo, whofe authority at that time carried vaft weight with it, took a decided part in the controverfy in favour of Harvey, from its commence¬ ment. The dodlrine was pretty generally admitted throughout Europe before the deceafe of its propofer. The nature of the communication between the arte¬ ries and veins was left undetermined by Harvey, who decided no point which he could not make the fubjedt of experiment. 31 PATHOLOGY. •experiment. The art of injecting the veffels of the dead body, which has been difcovered and carried to great perfection fince his time, has Shown a continuation of canal joining the two fyftems of blood-veffels ; and the employment of the microfcope has completed the proof, by demonstrating the circulation in the tranfparent parts o ffrogs, See. during life. The transfufion of the blood o fone animal into the veifels of another, which has been performed with fuccefs in many inftances, has added another ftrong proof to the demonftration of the circu* iation. See the Hiftoire de l’Anatomie et de la Chi- rurgie of Portal, and the Bibliotheca Anatomica of Haller, in the articles concerning the writers whofe names are mentioned in this account. Francis de le Boe, otherwife Sylvius, was born at Hanau in 1614 ; and became profeflor of medicine at the univerfity of Leyden in 1658. He will be therefore readily distinguished from James du Bois, who is alfo called Sylvius, the mailer and violent adverfary of Vefalius, of whom we have fufficiently fpoken in the preceding Sedition. Francis Sylvius wasamuch morediltin- guiilied perfonage : he was alfo one of the earlieft advo¬ cates for Harvey’s doctrine of the circulation of the blood, and was the principal caufe of its reception into the medical ichool of Leyden. In other refpe'dts, how¬ ever, he was inilrumental in retarding the progrefs of medical fcience, by the invention of an hypothecs re- fpeCling the caufe of difeafes, which contributed much to excite the attention of the medical world, and to ex¬ tend his own fame. He aferibed all the morbid a<5tions of the vital fyftem to certain chemical operations, to fermentations, and ebullitions, which he believed gave origin to an excefs of acid or of alkali, to the neutraliza¬ tion of which all the efforts of the medical art were of courfe to be directed : whence he adminiltered volatile alkali, abforbent earths, and cordials, largely, paying little regard to the different llages of a diiorder, or the charafterof prevailing epidemics. The extent to which this doctrine was received and defended in molt parts of Europe, founded as it was upon a gratuitous hypothefis, and therefore produftive in many cafes of much mifehief, is furprifing, and the interruption which it occafioned to the improvement of medicine was confiderable. In faft, the chemical fyftem of Sylvius was admitted in almoll every country in which chemical fcience was cultivated : it was in Holland and in Germany however that it was carried to the moll extravagant pitch. While one phy- fician was earneftly employed in changing the acid Hate of the blood, another took great pains to counteract the alkaline properties of'the fame fluid. While Bontekoe, deducing all morbid phenomena from the vifeidity of fluids, eulogized the medical properties of tea, and drenched his patients with fifty cups in fucceflion of that liquor ; Van Ruftingh preferibed afliduoully large quan¬ tities of volatilefalts in the moll inflammatory complaints ; believing that the two elements of fire and water compofed the fubltance of all living bodies, and that to rellore their balance of power or equilibrium was the only pro- pofitum of the medical art. In our own country the more moderate of thefe tenets, with fome degree of modification, acquired celebrity. Willis, Flower, and others, adopted them, and, multi¬ plying on the acid and alkaline humours of Sylvius, af- ferted the exiftence of a great many different humours, viz, mucilaginous, vitriolic, corroiive, See. each of which they thought had the effeCt of producing a diforder J'ui generis : and hence they endeavoured to trace the various characters of difeafe. The phenomena of fever they like- wife attempted to explain according to the chemical laws of fermentation and ebullition. And, though Willis probably ufed thefe terms merely in an analogical fenfe, yet many phyficians of his time applied them to the human frame in their llriCl and chemical fignification. With refpeCt to the precife mode by which thefe aCiions were thought to bring about the phenomena of health or difeafe, the following is a brief fummary. Digellion was fuppofed to be carried on by fermentation. If this procefs was too aCtive, or, on the contrary, too weak, improper or tinfermented particles of aliment remained, which, when aflimilated and introduced into the blood, pro¬ duced the fame efteCt on that fluid as certain fubftances called ferments do upon vinous liquors; viz. they pro¬ duced fermentation. Now, viewing the matter in this light, thefe chemical pathologifts defined fever to be a fermentative procefs which nature instituted. for the pur- pofe of throwing off the aforefaid offending humours or cacochymias. If nature fucceeded in performing this talk, health was reflored ; if not, death enfued. Some difeafes were however produced by external caufes; for instance, infectious and contagious diftempers, &c. but then each of thofe diforders was brought about by means of humours, whether derived from the air by means of refpiration, or from aCtual contaCt. It is rather remarkable, that thefe phyficians admitted a third caufe of production of cacochymite, which went to overturn their whole fyltem. They exprefsly Hated, that organic difeafe of any of the vifeera engendered a peccant humour ; hence we naturally infer, that in this cafe the folid or fibrous (IruClure was the firft caufe of difeafe. In Italy, where mechanical fcience had made much progrefs, the chemical doCtrine obtained few fupporters. Indeed, anterior to the period we are treating of, Sanc- torius had, in his expofition of the cutaneous functions, taught phyfiologifts the illuilration which the vital de¬ rived from the confideration of the mechanical laws. He endeavoured to diltinguilh the different alimentary mat¬ ters according to their fpecific gravity, and referred difeafe to an obflruCled Hate of the exhalant fyftem : an opinion, however, which this author carried too far, and which was by no means conducive to his fuccefsful prac¬ tice. Neverthelefs it has been of great importance to his more enlightened fucceffors. Sydenham was born about the year 1624. One of the greateft benefits which he conferred upon the fcience of medicine was that of detaching phyficians from this and other hypothetical fyftems, and of leading them to the only true path, obfervation and experience. He intro¬ duced a great reform into medical pradice. Though not entirely free from the humoral hypothefes which were fo prevalent in his time, yet he took care to lludy na¬ ture with exa&nefs, and he reported her appearances with fidelity, even when oppofed to his own reafonings. Indeed in many parts of his writings he takes occafion to deprecate the practice of his predeceffors, becaufe they not only did not fufficiently remark the minute pheno¬ mena of difeafe, but becaufe they actually mifreprefented thofe phenomena for the purpofe of corroborating their fanciful theories. Nor did Sydenham admit the chemi¬ cal explanation of difeafe which was fo ilrongly infilled on by his contemporaries, and even fucceflors; for he exprefsly ftates, that, although he has no objection to the terms ebullition and fermentation, yet he rather ufes them as illustrating certain morbid proceffes by analogy than in their own commonly-received fenfe : and indeed he quotes fome very judicious arguments tending to dis¬ prove the identity of thofe chemical procefies with dif- eafed actions. This author followed very clofely the Heps of Hippocrates : like him, he was principally intent on obfervingthe minute features of difeafe, and of referring them to their obvious and immediate caufes; like hint, he admitted to a great extent the falutary operation of nature, and the deleterious agency of humours ; and like him too he paid particular attention to atmofphe- rical changes, and the effects of them on the human body. Indeed the chief merit of Sydenham confifted in writing clearly, fully, and from his own individual ob¬ fervation, the hiftory of difeafes. He inveftigated the minuteft changes which occurredin them, whether fpon- taneoufly or from the adtion of remedies, as well as thofe 1 arifing PATHOLOGY, arifing from temper, age, conftitution, or other adven¬ titious circumftances. A fyftem of therapeutics founded on fuch a bafis could fcarcely deviate from the right path; and accordingly the works of this author remain molt important ftudies, whether regarded as indications to the art of diagnofis, or to the cure of difeafe. His pradtice was in the molt eminent degree fuccefsful ; and among the remedies he had recourfe to we may remark many which are again firmly eltablifhed after having long fallen into difcredit under the inaufpicious influence of fpeculative theorifts. Among thefe, the ufe of bleeding, and other antiphlo- giftic methods, in the treatment of continued eruptive fevers, has conduced very materially to the prefervation of the lives of our fpecies. We may remark, that in this aflumption we are borne out by the fatality which oc¬ curred during the exhibition of alexipharmics and hot cordials by the chemifts, which the cooling fyftem has very much obviated. The dodlrines of Sydenham, not- withftanding the interefting ftyle in which they were written, the fame they acquired for their author, and their confonance with nature, were by no means gene¬ rally received ; and the chemical dodtrines continued to be advocated by many till the commencement of the fol¬ lowing century. In proportion as true chemical fcience advanced, the partiality for chemical explications of the functions of the living fyftem abated ; and phyficians feem to have difcovered, for the firft time, that the theory of the hu¬ mours, even with all the improvements which it derived from the corpufcular philolophy, threw no light whatever on the adtions of the folids. A new hypothefis, there¬ fore, was projedted; and, as men in avoiding one error are apt to run into the oppoiite extreme, phyfiologifts now attempted to explain all the phenomena of life ac¬ cording to the mere mechanical powers of the organs, and to reduce the laws of the animal economy to the rigid calculations of geometry. They imagined, that they could illuftrate every operation of the human body, by comparing it to a fyftem of ropes, levers, and pulleys, limited with a number of rigid tubes of different lengths and diameters, containing fluids, which, from variations in the impelling caufes, moved with different degrees of velocity. When the fibres of this machine were not fufficiently flexible ; when the pulleys and joints of the levers were not kept in fufficient repair ; or when the apertures of the pipes were not fufficiently free ; the movements were neceffarily fufpended, or lefs perfedlly performed ; and they were only to be brought into pro¬ per regulation, according to the pradtitioners who adopted this fanciful theory, by removing the above-defcribed impediments. The cotnpofition of the fluids was fup- poled to be the refult of their motion in the tubes ; and in thefe nothing was attended to but the forces of gra¬ vity and cohefion ; as in calculating the adtion of a pump, or other hydraulic engine. “ If the chemical fchool,” to ufe the words of Sprengel, “ had degraded the phyfician to the rank of a brewer or diftiller, the difciples of the iatro-mechanical fchool, on the other hand, were glad to be efteemed as hydraulic engineers; and feveral of them, in fadt, ferved in the double capa¬ city of engineers and profeffors of medicine.” One of them, Dionis, a profeuor of furgery at the Jardin du Roi, went fo far as to compare the circulatory fyftem to the water-works at Marly, by which the water of the Seine is raifed to confiderable height, and from thence made to fall again upon the great wheel. Among the caufes which conduced to the eftablifliment of this fedt, the difcovery of the circulation of the blood is the moft prominent. When it was found that the blood flowed in a regular manner, through certain con¬ duits, from the heart, and returned to that organ, by other veffels, from the extremities, phyficians fet about calculating the mechanical force which they luppofed ne- ceffary for enabling the heart and arteries to produce this effedl ; and, elated with their apparent fuccefs, were led by degrees to transfer their calculations to the other fundtions of the body. Geometry had become the pre¬ vailing ftudy of the learned ; and focieties for the pro¬ motion of experimental philofophy were eftablifhed in the different countries of Europe, among which the Florentine Academy del Cimento took, in fome meafure, the lead. It was in Italy that mathematics had been moft afliduoufly cultivated ; and it was there that the firft attempt was made to introduce them into medicine. In the year 1614, Sandtorius publifhed his Medicina Sta¬ tical in which heendeavoured to (how the great influence which the infenfible perfpiration has upon health, and to calculate with precifion all the variations in its quan¬ tity, in the different conditions of the body. According to Iris theory, difeafes originated from the noxious par¬ ticles of the food being retained in the fyftem, in con- fequence of the ftoppage of the tranfpiration ; and, till the latter fundtion was reftored to the proper ftandard, no cure could well take place. Sandtorius diftinguiffied the different alimentary matters according to their fpe- cific gravities, and according as they appeared more or lefs fitted to pafs off in the way of infenfible perfpiration. He even ventured to apply his maxims to the paflions of the mind ; fhowing how joy and equanimity favoured the . excretions, while forrow and fear impeded them ; how fevers and melancholy arofe from the obftrudted perfpi- rable matter, where grief was long continued ; and how they were to be removed by reftoring the fufpended ex¬ halation. Among the aphorifms of Sandtorius, there are many found obfervations ; and medical fcience is under confiderable obligations to him for having diredted the attention of phyfiologifts to the fundtions of the fkin, which, till then, had been in a great meafure overlooked ; but his views, like thofe of moft theorilts, were far too partial ; and there can be little doubt that, in one re- fpect, they had a moft injurious influence, viz. by en¬ couraging phyficians in the univerfal employment of fu- dorifics, to which they were already too prone ; and no one will now fubfcribe to the judgment of Boerhaave, who fays of Sandtorius and his work, “ Nullus medicorum, qui ante eum fcripferunt; cardinem rei ita adtigit ; nec ullus liber in re medica ad earn perfedtionem fcriptus eft.” The mechanical philofophers began by calculating the force of the contradtile power of the heart neceffaVy to produce the phenomenon of circulation : but in this cal¬ culation they proceeded on the erroneous datum, that the refiftance oppofed by cohefion and gravity was the fame in living veflels as in inanimate pipes. Even if this fuppofition had been true, yet they had no means of meafuring the numerous diameters of thefe veflels, their curves, angles, &c. circumftances indifpenfably necef- fary to be known before the above-mentioned calculation could have been made. A more ingenious mode of il- luftrating the procefs of circulation was that adopted by Borelli. This author affumed that the power of a mufcle was in diredl ratio to the fize of fibrous portion : - hence, taking the deltoid mufcle for an example, and having found the force that mufcle was capable of exerting, he next proceeded to calculate the force which the contrac¬ tion of the heart mult exert according to its proportion - ably larger fize. This aflumption, however, is unfounded; for exercife increafes the power of a mufcle, without, in every inftance, increafing its fize: nor does it appear by what means he could precifely infulate tire adtion of the deltoid mufcle, feeing that it is infeparably con¬ joined with feveral others which co-operate with its mo¬ tions. The experiments of Kiel and others, though founded on different aflumptions, were not more fatis- fadtory than thofe of Borelli. At this period, however, geometry was fuch a favourite purfuit among the learned, that its cultivation rendered the mind almoft diffatisfied with every theory which did not bear the teft of mathe¬ matical demonftration. Thefe calculations therefore, to 33 P A T II O L O G Y. to which we muil allow the merit of ingenuity, became generally received. Mechanical principles were applied to every function of the body: not only the motion of the blood, but the compofition of that fluid, and the va¬ rious and elaborate precedes of nutrition, fecretion, &c. were referred to the fame laws. Thisabfurd application of mathematical knowledge to vital phenomena, led thefe philofophers into a labyrinth of error aftonifhing to com¬ mon fenfe. For inftance, while one author calculated the contractile power of the femoral artery at upwards of 1000 pounds, he overlooked the very obvious circum- ftance, that the pulfation of that vedel may be immedi¬ ately fufpended by the ufe of a tourniquet which fcarcely exerts the predure of a few pounds. Indeed, the con¬ tradictory refults arrived at by thefe experimenters (howed the abfurdity of their experiments. Thus, Borelli af- ferted that the contraction of the heart was equal to a refiftance of 180,000 pounds ; Keil, that it was equal to five, or, at molt, eight ounces. Hecquet calculated the digeltive (or, ac, cording to him, triturative) powers- of the Itomach, in conjunction with the abdominal mufcles, to be equal to 261,000 pounds ; Altruc ftated the amount of that power at four pounds three ounces. Yet was this mode of inveftigating the fcience of life by no means ufelefs ; for, by teaching pathologifts to re¬ fort frequently to experiment in proof of their afi'ertions, it deftroyed the attachment to fanciful and gratuitous hypothefis which had fo long prevailed : it directed their attention to parts and aCtions of the animal economy which the humoral phyficians had paded over unnoticed and undeferibed ; and, what was of ftill more impor¬ tance, it induced correCt and analytical habits of reafon- ing. Accordingly, we find, during the 17th century, which may be confidered as the period at which the me¬ chanical philofophers principally flourilhed, difeoveries which have flood the teft of time, and theories, concern¬ ing the correCtnefs of which we are ftill earneftly em¬ ployed in difeuflion. Phyfiology and the minute parts of anatomy were inveftigated with the grandeft refults ; the circulatory fyftem was gradually and fuccefsfully il- luftrated by many diftinguifhed phyfiologifts. Excellent deferiptions of the ItruCture and relative pofition of the heart were given by Steno and Lower. The microfcopi- cai experiments of Leeuwenhoek and others ferved to eftablifh the important faCl of the continuation of arte¬ ries and veins with each other. Ruyfch likewife, by the great degree of nicety in the ufe of injections to w hich he attained, was enabled to throw much light on this fub- jeCl. Some important parts of the arterial fyftem were difeovered by VieulTens. The necefiity of the abforption .of oxygen gas through the lungs was firft inculcated by Mayow. Malpighi improved the knowledge of the ftruc- ture of thofe organs. The mechanical part of refpiration, the compound ac¬ tions of the mufcles, See. were beautifully demonftrated by Borelli; and Kepler applied mechanical principles to the explanation of the functions of the eye in a manner the moft clear and fatisfaCtory. He firft pointed out the true ufe of the cryftalline lens, and fhowed how the images of external objects are formed, in an inverted po¬ fition, on the retina. A public experiment with the eye of an ox, which was made at Rome, in 1625, by the Je- fuit Scheiner, fully confirmed Kepler’s theory: but af¬ terwards Mariotte, having found that the images of ob¬ jects difappeared when they fell on the fpot where the optic nerve enters the eye, called in queftion the fenfibi- lity of the retina, and maintained that the choroid coat was better calculated to receive and rranfmit the percep¬ tions of fight; and a controverfy arofe concerning the aCtual feat of vifion, which was carried on, with great eagernefs, by Pecquet, Perrault, and St. Yves, and which had the effeCt of eliciting many valuable obferva- tions. The Newtonian difeoveries, refpeCting the pro¬ perties of light, contributed ftill more to the accurate analyfis of the functions of the eye ; and the treatifes of Vol. XIX. No. 1285. Du Petit, Porterfield, and Zinn, which followed foon after, have left little for their fuccefiors to accomplifh. The lymphatic fyftem was likewife brought into notice during this century. To Cafpar Afellius is due the merit of having taken the firft ftep in the inveftigation of this important part of the animal frame. While diffeCl- ing a dog, for the purpofe of demonftrating the recur¬ rent nerves, the appearance of a milk-like fluid iffuing from fome fmall white veflels arrefted his attention. Examining them more minutely, he traced them to the villous coat of the inteftines; and repeated difleClions informed him, that thefe veflels -were only obfervable in the animal which had lately fed. Hence he concluded thefe to be the vafa chylifera. He confefled, however, that thefe veflels had been mentioned by ancient au¬ thors, though deferibed in a very imperfeCl manner; but he juftly claimed the honour of having firft pointed out their ufe. Afellius, however, entertained erroneous ideas as to the termination of the ladeals : he fup- pofed that they united together in the pancreas, and pafled from that gland into the liver. This error was corroded by the rel’earches of Pugent, who, obferving on one occafion a milky fluid in the vena cava of a dog, traced carefully the progrefs of that veflel, and difeovered the thoracic duCt. This difeovery was difputed however with much acrimony ; and the character of Harvey was tarniflied by the circumftance, that he flood forth among the moft illiberal of its opponents. The abforbents of the large inteftines were difeovered by Olaus Rudbeck in the year 1651 ; he likewife refuted the received opi¬ nion, that the liver poflefled laCteals, and, by their means, aflimilating powers : he fhowed that the only ab- forbent veflels exifting which could have led to this error, were the lymphatics of the hepatic glands. The glandular fyftem in general was afterwards more fully illuftrated by the writings of Gliifon and Wharton, the experiments of Lower, Drelincourt, Lifter, and Mufgrave; and the anatomical refearches of Nuck, Pacchioni, and Duverney. Nor were the more abftrufe and difficult queftions of phyfiology negleCted by the philofophers of this age. With much talent Willis fupported the hypothefis of a nervous fluid, the vehicle of animal fpirits ; and, when deficient or exceffive, the caufe of diforder ; and he feems in fome refpeCts to have anticipated the fpeculations of Spurzheim and Gall, in referring to particular parts of the brain peculiar mental faculties. The errors of this author on the former fubjeCl were pointed out by Mal¬ pighi, who moreover inveftigated the cerebral ftruClure with great minutenefs, particularly in reference to tire exiftenceof fibres in the cortical fubftance. Here too the injections of Ruyfch and the microfcopical experiments of Leeuwenhoek were ufefully employed to fliow the vaf- cularity of the brain. Many improved deferiptions were furniflied by Cafferius, Duverney, Riverius, Vieuflens, and others, of the ftruClure of the ear. The tunica arachnoides was deferibed by Swammerdam and Blaes. Many interefting experiments were made on the genera¬ tion of animals ; among which the moft famous, though certainly not the moft ufeful, was that of Leeuwenhoek on the animalculae of the feminal fluid. See our article Animalcule, vol. i. p. 727. To the “ triumviate,” as they have been called, Stahl, Hoffman, and Boerhaave, pathology and therapeutics are indebted for many important illuftrations. The firft of thefe phyficians has rendered himfelf famous by the in¬ troduction of an hypothefis, which, with various altera¬ tions, has maintained its ground until the prefent day. We allude to the exiltence of an immaterial principle, or effence, as producing the phenomena of life. The particu¬ lar tenets, however, on which this theory was founded, had been promulgated before the time of Stahl : Rene des Cartes had taught his followers to conlider matter as purely paflive, and to refer all the changes to which it is fubjeCted to a fpiritual caufe : the union of body and K fpirit 34 PATHOLOGY, fpirit was, in his eftimation, merely one of its modes, or accidental conditions. Malebranche, extending the Cartefian dodlrine, endeavoured to explain more fully the nature of this union, and to fliow that the foul had a more or lefs diftindl confcioufnefs of all the movements and affedlions of the body. From thefe tenets, the tran- fition to the fyftem developed by Stahl was very eafy ; and an attentive review of the progrefs of the opinions in queftion mud: convince every one that the Stahlian hypo¬ thecs, far from being entitled to the merit of originality which its author claimed, was nothing more than an off- fpring of the Cartefian philofophy. Educated under Wedel, who was a devoted adherent of Sylvius, and an affiduous teacher of his do£lrines, Stahl began very early to queftion the fufficiency of thofe chemical explanations which he heard applied to all the phenomena of life. It appeared very wonderful to him, that the humours of the body, which are, of themfelves, fo difpofed to putre¬ faction, fliould yet fo feldom fall into that ftate ; and that the daily prefence of fo many faline fubftances, as we are in the habit of receiving in our food, fhould produce fo few fymptoms of acrimony. The intervention of animal /pints he conceived to be a very unfatisfa&ory fuppofi- tion; and all the attempts which had been made to ex¬ plain the theory of life on pure chemical and mechanical principles he held very cheap. Taking the paffivenefs of matter for the balls of his fyftem, he maintained, “ that the body, as body, had no power to move itfelf, but was put in motion only by immaterial fubftances ; that all motion, therefore, was immaterial, and a fpiritual aCt.” It had been alw'ays obferved, that there is a certain power in the animal body of refilling injuries, and correcting fome of its diforders ; and Van Helmont had afcribed fome degree of intelligence to this power : but it w'as referved for Stahl to refer it entirely to the rational foul, which, he affirmed, not only originally formed the body, but is the foie caufe of all its motions, not excepting di- geftion, affimilation, and fecretion, in the conftant excite¬ ment of wdiich life confifts. While he referred to this principle the actions by which health is eftablilhed, he attributed to its irregularity the occurrence of difeafe; admitting however, to a very great extent, the operation of flighter caufes, among which plethora held a favoured rank. To this ftate Stahl fuppofed the human frame was perpetually difpofed, and that at particular periods of life this difpofition manifefted itfelf with great precilion in different parts of the body. Hence arofe, according to him, in infancy complaints of the head, during adolef- cence in the pulmonary ftruCtures, and in old age in the digeftive organs. Fever he defcribed as an autocratic ef¬ fort of nature to conquer the morbific caufe, and to expel it from the body ; and all the fymptoms, not excepting rigor, were only fo many proofs of the tonic aCtion which was thus excited. Congeftions were fuppofed, in con- tradiftindlion to obftrudlions, to refult from an afflux of the fluids occafioned by the fame tonic power; when ob- ftruftion followed, or when the objeCt of the congeftion, i. e. evacuation, w as not accompliffied, inflammation took place; and the tendency of the violent actions which ac¬ companied it, wras to difperfe the obltrufted humour. If this end was not attained, the obftrufted matter be¬ came vitiated, and pus was formed. Hypochondriafis, gout, melancholy, and almoft all cachectic diforders, were attributed to a diminution of the tonic power of the vena portae, and the confequent ftoppage of the blood in it ; while fpafmodic difeafes were thought to indicate an excefs of the general tonic power of the fyftem. Rejecting the aids derivable from anatomical refearches, of the ufe of which in medicine Stahl entertained a very mean opinion, he proceeded, in conformity to the general principles we have related, to the treatment of difeafe. It may very naturally be fuppofed that a theory which attributed (o much to the falutary operations of nature, was not likely to lead to very active practice : accord¬ ingly we find that Stahl adopted, to a very great extent. the Hippocratic mode of watching thefe healing opera¬ tions, without interfering with them farther than to affift their weaknefs or moderate their excefs: and, in fact, he and his followers, trailing principally to the operations of nature, zealoufiy oppofed the ufe of fome of the moil efficacious remedies, as opium, cinchona, and mercury ; and were extremely referved in the employment of bleed¬ ing, vomiting, See. Notwithftanding, however, the hy¬ pothetical notions of Stahl, his inert practice, and Iris con¬ tempt for anatomical refearch, yet much praife is due to him for having directed the attention of pathologifts to the phenomena of vitality, and firowing the fallacy of the chemical hypothefes, a talk for which he was pre-emi¬ nently qualified by his profound inveftigations in tire fcience of chemiftry. Hoffman was a phyfician who obtained great celebrity at this period, lefs however on account of his fuperior mental faculties than for his extenfive erudition, and the art he had of difplaying it to advantage. He was edu¬ cated under the mechanical fed of phyiicians ; and it is rather remarkable, that Stahl, who had been taught the chemical doctrines, fhould have difearded entirely chemi¬ cal illuftrations of difeafe, while Hoffman, who had been taught by the mechanifts, admitted the exiftence of acid cacochymite, and even attempted to fliow how the union of this acid with blood produced neutral files which were the caufe of gout, calculi, rheumatifm, and cutaneous difeafes. Though engaged at one period of his life in controverting the opinions of Stahl, on the fuppofed ground of their atheiftical tendency, yet the theory of Hoffman, as far as the vital or motive principle was con¬ cerned, fcarcely differed from that of his enlightened colleague: for, though he applied to it the appellation of nervous fluid, or ether, and fixed its feat in the nervous fyftem ; yet, in attributing to it the faculties of mind, fenfe, and intelligence, he cauled it to approach very nearly to the anima, or foul, of Stahl. Like Stahl, too, he allowed that morbid aCtions were frequently induced by a plethoric ftate of the fyftem; and, in conformity likewife with the views of that author, he referred much to the obftrudlions of the humours, efpecially in the vena portae. Fever and inflammation he fuppofed to arife from fpafm, or conftridlion of the capillary veffels, particularly of the fkin, an opinion which was illuflrated and im¬ proved in after-times, and more fully developed in the famous theories of Cullen. In the practical department of the art, however, Hoff¬ man left Stahl far behind him. We have to obferve in his treatment of inflammatory diforders great decifion and corredtnefs, and confequently a great degree of fuc- cefs. He aboliflied too, in a great meafure, the fudorific plan of treatment which the humoral pathologifts had pradtifed to a very dangerous extent, and to which Stahl was particularly attached. To him likewife we are in¬ debted for the ufe of the Liquor anodynus, an excellent and well-known article of the materia medica. • He like¬ wife fhowed the great ufe of bark in intermittent fevers, and of chalybeates in chronic diforders. Moreover he in- veftigated, with great care, the -compofition of mineral waters, and taught the a<5l of preparing them artificially. We ought not to forget to remark that, in the work of Hoffman, “ De Confenfu patium nervofarum,” many va¬ luable obfervations will be found, particularly thofe which regard the influence which various organs exert upon one another. But the phyfician who obtained at this period the higheft rank as a pathologill was Boerhaave. Educated by his father with a view to the miniftry, he imbibed at an early age a knowledge of the learned languages ; af¬ terwards applying himfelf with affiduity to the Itudy of mathematics, and then to the profound inveftigations of moral philofophy, he next proceeded to botany and na¬ tural hiftory, by which he laid the foundation for a very extenfive acquaintance with the fcience of medicine, which at length he adopted for his profeffion. See Boer- I HAAVE, •35 PATHOLOGY. haave, vol.iii. Anatomy (of which his works. betray great deficiency) was the only branch of his education which feems to have been negie&ed ; which is neverthelefs fur- prifing, becaufe he differed forfome time underNuck, an anatomift of much repute. Boerhaave conceived that that theory of medicine rauft be the belt which reconciled- the opinions of allfefts; and, accordingly, he laboured to unite the chemical doftrines of the day with the valuable obfervations derived from the other fchools and from Hippocrates. Of the father of medicine he profefi'ed to be a great admirer, and affe&ed to return to the good and ancient method of acquiring knowledge by obferva- tion and experiment; but unfortunately forgot his own rules, yielded to the influence of early ftudies and a love of theorifing, and in many inftances obfcured the fcience his abilities had otherwife enabled him to adorn in a moft eminent degree. However, the plaufibiliiy of Boerhaave’s dodtrines, the beauty of his ftyle, and the graces of his delivery, gained for him an afcendancy which is almoft unparalleled. We may form fonte idea of the importance attached to his labours when vve read, that, on his beginning a courfe of le&ures, the occur¬ rence was deemed of fo much confequence, that the whole city was illuminated. Boerhaave adopted a notion, of which his philofophical education (hould have taught Jiim the abfurdity ; viz. the exiftence of an intermediate Jubilance between matter and fpirit, a principle which regulated or produced all the vital functions. He had taken this idea from an ancient dogma found in one of the writings attributed to Hippocrates; and his nephew, Kaan Boerhaave, followed up and illuftrated this hypo¬ thecs with much fpirit, and, unfortunately, with the ad¬ miration of his contemporaries, who adopted it almoft: univerfally, until the fplendid dilcourfes of Haller began to wean them from opinions fo diflonant to the refults of found reafoning. Boerhaave died in the year 1738 ; fo that we have now fairly got into the eighteenth century, and have arrived at a period when phyliology, long obfcured by the mifap- plication of the natural fciences, at length began to be fludied according to the dictates of found reafoning and the refults of experiment. The name of Haller (who ftudied under Boerhaave) (lands in lofty pre-eminence among the cultivators of medical fcience during this cen¬ tury. Panegyric has been feldom more properly applied than to this diftinguiflied author. His biographers have (hown how afliduoufly, at the earlieit periods of his life, his mind was bent on the acquilition of knowledge ; and they have reported his varied, his extenfive, accompii(h- ments. His poem of the Alps (hows how eminently he poflefled fublimity of imagination and the harmony of numbers; and his refearches in our own fcience manifeft the profundity of his reafoning; while the admirable picture is clofed by the relation of his earned regard for the intereds of morality and^religion. In a word, Haller feems to have almod realized the account given of the gods, or inventors of medicine, who individually united the four grand fciences of- poetry, legiflature, phyfic, and divinity. See the article Haller, vol. ix. The irritability of the body was the point to the efta- blifhment of which a very large proportion of Haller’s refearches were diredted ; and in this principle he formed a ready folution of many phenomena which had puzzled his predeceffors and given rife to much idle and fanciful fpeculation. We may be excufed, however, from en¬ tering into the phyfiological difcoveries of Haller, as we (hall have cccaflon to treat of them fomewhat largely in our article Physiology. It (hould be mentioned, how'- ever, that the Elementa phyjiologice of Haller is a work of thegreated merit, and which, notwithftanding the won¬ derful progrefs of phyfiology in our own time, may dill be referred to, as containing an immenfe body of refearch arranged in a very beautiful manner. And this book would probably have dill remained the text-book of every phyfiological fchool, had not the profound re¬ fearches of our countryman Hunter led mankind to de¬ tect its errors and deficiencies, and (hown how much dill remained to be done ere the fabric of this fcience could be confidered as reding on a ftable foundation. It would appear that Haller was not an operating fur- geo n ; for, in- h Js Bibliotheca Chirurgica, vol. ii. he fays, <e Although I have pradtifed furgery feventeen years, and exhibited the mod difficult operations on the dead body, I have never ventured to apply a cutting indrument to a living fubjedt, through a fear of giving too much pain.” Among the other phyfiologids who flouriflied' during the early part of the eighteenth century, we may men¬ tion Porterfield, Whytt, and Borden. The two former were diftinguiflied by their refearches on mufcular .ac¬ tion and nervous influence; and the latter has the merit of having pointed out the importance of the cellular tilfue, and of defcribing many properties belonging to it which his predeceffors had overlooked. We can fcarcely draw a ftronger contraft as to the different methods of acquiring knowledge than by men¬ tioning the name o f John Hunter immediately after that of Haller: the one pofie fling every advantage which col¬ lateral knowledge could procure, a man of the moft per¬ fect fkill in languages, and profoundly erudite ; the other ignorant of the moft Ample and elementary branches of education. Yet they (land each unrivalled in the annals * of our art. The name of Hunter will frequently come before us when treating the fciences of phyfiology and zoology ; but we mud here paufe to defcribe, in fome meafure, the fpeculation which he adopted on the fubjedt of life, or vitality, becaufe it has probably had much in¬ fluence on pathological dodlrines. Before the time of Hunter, many authors had remarked that a vital prin¬ ciple exilled in the body independent of organization ; but he firft afierted, (to ufe the words of his own enlight¬ ened eulogift,) that “ life actually conftrufted the very means by which it carried on its various procefles ; and that it could operate in femi-fluid, and even fluid, fubdances.” This fpecimen of hypothetical reafoning which Hunter has left us, forms the only exception to the unqualified admiration with which we are difpofed to regard him. But certainly, this notion of a vital principle is very ex¬ travagant ; and, in attributing to it fome degree of intelli¬ gence (which he has done when 'treating of the abforb- ents,) he has rendered himfelf liable to be oppofed by the fame conclufive arguments which had long fince refuted the notions of Stahl. The labours, however, of Hunter, by giving a more certain and fixed character to phyfio¬ logy, have caufed that fcience to be ufed as the bads of medical pradtice and every modern fyflem of nofology ; and his extenfive refearches in comparative anatomy, opened a field of which the further cultivation has pro¬ duced, and is dill producing, great information in regard to the fcience of life, and, hence, to the fcience of medi¬ cine. The furgical operative improvements which Hun¬ ter made, were lome new methods of treatment in rup¬ ture of the tendo achillis, and in the operations for hy- . drocele and fiftula lacrymalis ; and likewife in the mode of operating for popliteal aneurifm, by taking up the femoral artery in the fore part of the thigh. The publications for which John Hunter is moft diflin- guiftied, are — his work on the Veneral Difeafe, 1786, and his Treatife on the Blood, Inflammation, and Gun-(hot Wounds, not given to the public till after his death. Nor (hould we omit to notice the very numerous and im¬ portant papers which he prefented to the Royal Society, in rapid fucceflion, efpecially between the years 1773 and 1 7 83, chiefly relating to comparative anatomy and phyfi¬ ology. His fame, however, will principally reft upon his various difcoveries in this branch of fcience ; and it would be injuftice to his charadier not to defcribe, as amply as our limits will admit, the Anatomical Mufeum, the for¬ mation of which may be regarded as having been the main objedf 136 PATH objeft of his life. In its plan it was abfolutely unique, and the perfection to which he brought it rendered it the admiration of all who were capable of judging of its value. It embraced the grand delign of expofing to view the gradations of nature, from the moll limple ftate in which life is found to exilr, to the molt perfect and com¬ plete piece of animal mechanifm, that of man. This collection of anatomical faCts is arranged according to the functions they are intended to illuflrate, the different parts of animal bodies intended for fimilar ufes being brought together in feries, fothat the various links in the chain of perfection are readily followed, and clearly un¬ derflood, This arrangement comprehends four great or¬ ders : the firft, parts conftruCted for motion ; fecond, parts eflentia! to animals refpeCting their own internal economy and prefervation ; third, parts fuperadded for purpofes connected with external objeCts ; and, fourth, parts for the propagation of the fpecies, and the maintenance of the young. The Firft Order exhibits the fluids of living bodies in a feries, from the Ample colourlefs fap of fome vegetables to the coloured and coagulating blood; the mufcles, from the ffcraigh t Ample mufcle to the moll com¬ plicated flruCture with elaltic ligaments ; the growth of bone, horn, fhell, Sec. and the varieties of joints. The Second Order comprehends the organs of digeftion, be¬ ginning with the hydatid, which is itfelf a Ample pouch, and pafling to the polypus, the leech, and more compli¬ cated animals, including a feries of flomachs, of inteftinal canals, and of the glands connected with them, as livers, fpleens, See. After the organs of digeftion follows the iyftem of abforbing vefiels, from the roots of plants up to the laCteals and lymphatics of different animals. The next ftep is to the heart, which, in the caterpillar, is a Ample canal, and receives various additions as we afeend in the fcale, until we find it a double heart in man and quadrupeds: this leads to the ItruCture of arteries and veins. Then the lungs are fhown in all their gradations, from the Ample vafcular lining of the egg-fhell, which ferves as lungs for the chicken, to thofe of the more per¬ fect animals, including gills. Sec. The windpipe and organs of voice are Aiown under their different forms. And, lallly, the kidneys are exhibited, which feparate the fuperfiuous fluids from the circulation. The Third Order takes up the brain from its funplefl ftate in- the leech, to the fnail, infeCts, fii'h, &c. upwards; the varieties of all the organs of fenfe in the different tribes of living things ; and, laftly, the external coverings of hair, fea¬ thers, feales, &c. the weapons of offence and defence, as fpurs, hoofs, horns, flings, and eleCtric organs. As an Appendix to this Order, fome peculiar ftruCtures are added, fuch as the air-bladder in fifh, Sec. The Fourth Order includes all the variety of parts connected with the procefs of generation in plants and animals, from the polypus and coral to the perfeCt animals; thofe of females in the maiden and impregnated Hate, including the pro¬ ducts of feeds, fpawn, eggs, Sec. the pregrefs of incuba¬ tion ; the peculiarities of the fetus ; and the various or¬ gans for the nourifhment of the young. This (ketch gives a very inadequate idea of the amazing number of objeCts, from every department of nature, which the col¬ lection comprifed; but it contains, befides, a large feries of whole animals, arranged according to their internal flruCture, many of them the rareft ever brought into this country; fuch as the camelopard, hippopotamus, &c. It comprehends, moreover, a feries of lkulls of different ani¬ mals, and fkeletons of almoft every known genus; an immenfe number of calculi, urinary, biliary, and intefti- nal ; a large collection of fhells and infeCts; and a moil complete aflortment of extraneous foflils. By his will, Mr. Hunter directed that this Mufeum fhould be offered to the purchafe of government ; and, after fome negocia- tion, it was bought for the public life for the futn of 1 5,000 /. and given to the College of Surgeons, on condi¬ tion of expofing it to public view on certain days in the week, and giving a fet of annua! leCtures explanatory of O L O G Y. its contents. A large building for its reception has been completed in Portugal-flreet, connected with the College of Surgeons, in Lincoln’s-Inn Square ; and, in the fpring of the year 1810, the firft courfe of leCtures was delivered by Mr. Home and Sir William Blizard, One of the very firft furgeon9 of the prefent day, Mr. Lawrence, in a LeCture at the College of Surgeons a few months ago, fpeaks of John Hunter in the following terms : “ Mr. Hunter is the glory of England in the 18th century. In vigour and originality of genius, in compre- henfion and depth of thought, in unwearied induftry, he has been furpafled by none. He was one of the men who gave a character to the age in which they live, whole names are affociated to the great asras of fcience, and who do honour to the country which produces them. Occu¬ pied by a laborious profeflion, and defraying from its hard earnings the expenfes of his multifarious inquiries, he accomplifhed what appears almoft incredible. What might he not have done, had his time been devoted ex- clulively to his favourite purfuits, and had they been aided by that pecuniary afiiftance and foftering fupport, which the rulers of mankind fo feldom and fo unwillingly fpare from their fchemes of war and conqueft ? He fur- veyed anatomy and phyfiology with the eye of a philofo- pher ; proceeding conftantly , with the aid of diflection and experiment, to afeertain the flruCture of animals, and to determine the nature of their functions. There is fcarcely a branch of phyfiology which he has not illuf- trated by fome original refearches, while he has examined each organ in every animal that he could procure. His Mufeum is arranged on this truly philofophical principle.; a plan followed by Arillotle, and to be completed, I hope, by Cuvier.” This laft eminent perfon is mentioned by the fame diftingui filed authority, as one who hasfufrered no . corner of the wide field of zoology toefcape his pene¬ trating glance: “Equal (obferves Mr. Lawrence) to Buffon in enlarged views and comprehenfive grafp of mind, and much fuperior to him in patient refearch, mi¬ nute obfervation, and learned inquiry, he prefents a rare union of all the great requifites for promoting natural knowledge. He has been notlefs fortunate in his fitua- tion than in his qualifications; devoting his whole time to fcience, and furrounded by numerous able afliflants, he could avail himfelf, to their full extent, of thofe liberal inftitutions for the advancement of natural knowledge, and that uniform encouragement of talent, for which fci¬ ence will ever be indebted to the late French government. Accordingly, his progrefs has been every-where marked by improvement and difeovery.” Dr. William Hunter, the elder brother of John, was a very diftinguifhed phyfician, anatomift, and accoucheur. We have already devoted two pretty long articles in our ninth volume to the Hunters. We need, therefore, only add, that to William the profeflion is indebted for the difeovery of the membrima decidua rejlexa ; and to remind our readers how much , we have availed ourfelves of his fplendid work, the Anatomy of the Gravid Uterus, in our articles Anatomy and Parturition, vols. i. and xviii. His Mufeum, which is extremely valuable, though of a different nature from that of his brother, is now in the univerfity of Glafgovv, having been fent there by Dr. Bailliefome years before the time mentioned in his uncle’s will. See JIunter, vol. ix. p. 481, 2. Among the molt diftinguifhed anatomifls of the 18th century, as enumerated by Haller in his Bibliothecas, we have the names of Morgagni, Window, Chefelden, See. which were dated in about the firft 30 years of that cen¬ tury, except Morgagni’s work, de Sedibus and Caufis Morborum, which he publiflied at an advanced age. Under the title of the perJ'eSt Jlate of anatomy, Halier reviews the works of Albinus, Senac, Monros, (the father and fon,) Nicholls, Lieutaud, Ludwig, Leiberkuyn, Daubenton, Camper, Walther, Meckel, Zinn, Fontana, Wriiberg, Spalanzani, Hewfon, Portal, Sabatier, Scarpa, Blumenbach, Troja, Sec. whofe writings extend to the time PATHOLOGY. 37 time when he wrote, and indeed about twelve years after, fince the two laft of the io vols. of which that noble work confifted were publilhed, in 1788, with additions, by the learned editors, to that time. While fupplying the deficiencies of Haller, and extend¬ ing the enquiries to our own times, we Ihall be convinced of the impropriety of the title of one of his chapters juft quoted, “ the perfeftflate of anatomy,” fince anatomy and furgery, as well as pathology and phyfiology, have been rapidly improving ever fince. This has arif'en from the afiiftance of governments in the different countries. They being convinced that anatomy is one of the moft neceflary fciences, and the groundwork of the whole heal¬ ing art, but particularly of furgery, in many great cities academies were inftituted for the cultivation of practical anatomy ; and fchools were alfo eftablifhed for the inftruc- tion of the theoretical and praftical parts of furgery. Thefe improvements in furgery have been chiefly made in England, France, and Germany; and in all thefe countries a number of very eminent men have appeared. The Englifh furgeons, befides poflefling an accurate knowledge of anatomy, and great abilities in the operative part of their profeflion, were the firft who endeavoured to bring the art to its prefent fimplicity. They directed alfo their attention, in a particular manner, to the diet of pa¬ tients ; the negleft of which had caufed the unfortunate iflue of many operations which had been dexteroufly performed. Among the furgeons of later times, we may firft men¬ tion the name of Sharp. He was a fcholarof Chefelden, and one of the beft furgeons of his day. Fie wrrote a Compendium of Surgical Operations, 1746; and alfo a Critical Inquiry into the State of Surgery ; both of which works are (till in high eftimation. In the year 1719, Dr. Monro, after vifiting the fchools of London, Paris, and Leyden, where he was a pupil of the great Boerhaave, came to Edinburgh ; and this may be confidered as the date of the foundation of the Edin¬ burgh medical fchool. He began by giving leisures on anatomy and furgery, the firft which were delivered in Edinburgh ; and in the year 1721 he was appointed pro- feflor of anatomy and furgery to the univerfity. This eminent anatomift and furgeon, befides filling his chair with the greateft reputation, contributed to the advance¬ ment of our knowledge in many important parts of ana¬ tomy and furgery. His works, publilhed by his fon, be¬ fides his T reatife on Ofteology, which is certainly the beft defcription of the bones that has ever been given, will be found to contain many interefting and valuable obferva- tions on various furgical difeafes. Jofeph Warner, furgeon of Guy’s Hofpital, in London, publifhed his Cafes and Remarks in Surgery in the year 1754, a work which contains many very important practi¬ cal remarks. He afterwards publilhed a very good work, containing a defcription of the human eyeand its adjacent parts, in which he particularly rejefts thefaftening of the eye during the operation of cataraft. He alfo publifhed An Account of the Tefticles, their Common Coverings and Coats, &c, Percival Pott, furgeon of St. Bartholomew’s Hofpital, may be juftly confidered as one of the principal Englilh furgeons of his time. He was not only a fuccefsful prac¬ titioner, but an induftrious and excellent writer. The merits of Pott are indeed confiderable. He threw much light on the doftrine of wounds of the head, by his accu¬ rate arrangement of the different kinds of injuries to which the head is fubjeft. He alfo gives a good account of hydrocele and the other difeafes of the tefticle. For the operation of the fiftula in ano, he made material im¬ provements. He lias given many ufeful hints on fra ft 11 res and diflocations ; and he was a great champion in favour of the operation for cataraft by couching. He was the firft perfon who defcribed the chimney-fweeps cancer ; and on hernia, polypus, and curvatures of the fpine, he Vol. XIX. No. 1283. has made many judicious pathological and praftical cb- fervations. Charles White, furgeon in Manchefter, publilhed an excellent praftical w'ork in the year 1770, in which he recommends amputation of the foot, a little above the ankle-joint, inftead of under the knee, as had ufually been praftifed. He alfo ftiows the eft’eftof fawing off the ends of bones ; and difcuffes feveral other interefting points in furgery. In the fame year, Mr. Elfe, of St. Thomas’s Hofpital, publilhed his treatife on the hydrocele, in which he recommends, the ufe of cauftic in the cure of that difeafe. In the year 1770, Mr. Deafe, of Dublin, wrote an ex¬ cellent treatife on the wounds of the head. Mr. Brom- field, of St, George’s Hofpital, and Mr. Hill, furgeon at Dumfries, alfo diltinguilhed themfelves ; Mr. Bromfield for his Chirurgical Oblervations, and Mr. flill for his Obfervations on Cancers. In the year 1778, Mr. Benjamin Bell publilhed the firft volume of his Syftem of Surgery. The reputation of this work was foon fuch, that it was tranllated into the French and German languages ; and it has fince gone through feveral editions in thefe, and many in Englilh. This work prefented the moft complete fyftem of furgery which had ever appeared ; and in every part of it there is difplayed a talent for praftical obfervation and clearnefs of thought which mull render it ever a ufeful and valua¬ ble prefent to furgery. Like all fuch extenfive works, it is not without faults, and the language in which it is written is in fome places prolix and diffufe ; but, not- withllanding its errors, it certainly mull be confidered as the moft ufeful body of furgery that has yet appeared in this country. We are aware that we have omitted the names of very many eminent Englilh furgeons and anatomifts ; as Douglas, Cowper, Alanfon, Hawkins, Smellie, &c. &c. The details, however, of their refpeftive inventions and difcoveries, would exceed our limits ; and, indeed, may very well be fpared, for there is confefledly great difficulty in afcribing even anatomical fafts to their right difco- verer, much more theabftrufe and obfcure fpeculations of phyfiologifts. Moreover, the fame fafts have been difco- vered by different perfons, ignorant of the refearches of each other, and each has been equally tenacious of his prior claim. Thus, the difcovery of certain parts of the lymphatic fyftem, was made by Dr. Wm. Hunter, and by Monro, jun. of Edinburgh, each unconfcious of the other’s labours. The publication of them aroufed much con- troverfy and litigation. Numerous inllances might be adduced of a fimilar kind. Periodical medical works were fet on foot in Great Britain about this time. Upon the great utility of fuch publications, in diffufing knowledge far and wide, we need not enlarge after what has been faid under the arti¬ cle Magazine, vol. xiv. p. 90. The Edinburgh Medical Eflays were firlt publifned in 1732, being eleven years an¬ tecedent to the appearance of the Memoirs of the French Academy. Italy, during this period, lent fome aid to the improve¬ ment of furgery, by the leftures of Molinelli, Bertrandi, and Mofcati ; while, in Holland, Albinus, Deventer, and Camper, by their difcoveries and improvements, and ftill more by their free communication of them, endeavoured to remove the ftigma which the charlatanifm and fe- crecy obferved by Ruyfcli, Roonhuyfen, and Raw, had thrown on the furgery of that country. In Germany, and the north of Europe, flourifhed Heifter, the feliow-ftudent of Albinus, Blatner, Roederer, Stein, Bilguer, Acree, Brambilia, Theden, Richter, &c. The reign of Louis XIV. has been called, by Richerand, the iron age of furgery in France. Yet the French, at that time, prided themfelves on the almoft exclufive pof- feffion of chirurgical praftitioners. “ Les progres de la chirurgie,” obferves M. De Francheville, “furent fi L rapides PATHOLOGY. 88 rapides et fi celebres dans ce fi&cle, qu’on venait a Paris des bouts de l’Europe, pour toutes les cures, et pour toutes les operations qui demandaient une dexterite non commune. Non feulement il n’y avait gu^res d’excellens chirurgiens qu’en France; mais c’etoit dans ce feul pais qu’on fabriquait parfaitement les inftrumens necelfiaires.” It is fomewhat Angular however, that, amidft all this boafted pofleflion of chirurgical knowledge, the fiftula in ano (hould be a difeafe in which the French furgeons were fearful of operating, and which had often proved fatal beneath their attempts. Cardinal Richelieu fell a facri- fice to the unfkilfulnefs with which the operation was performed ; and, when the king entrufted himfelf to the care of M. Felix, his chief furgeon, fo hazardous was this operation deemed, that all the hofpitals were ran- facked for thofe who had laboured under the fame difeafe; and innumerable confultations were held with other furgeons of known reputation, to determine on the mode of operating that Ihould appear leaft painful and dangerous. The churches alfo were perpetually crowded, and prayers perpetually offered up throughout the whole kingdom, to avert the fatal termination which was fo generally apprehended. And, when this monarch was attacked by the difeafe to which he fell a viftim, he be¬ came diflatisfied with his own phyficians, and employed an empiric, who boafted of being able to cure him fpeedily, but under whole care he expired in a few days. We have gone back to the 17th century to fpeak of theftate of furgery under Louis XIV. as he died at the beginning of the 18th. Yet we cannot help attributing the great perfection the art acquired in the laft century to the exertions of that powerful monarch. He founded hofpitals and colleges, eftablifhed profefforfhips, which he required to be filled only by furgeons of acknowledged talent : he commanded bodies to be liberally fupplied to the anatomifts; and hence Paris became the medical and chirurgical fchool of the greateft celebrity on the con¬ tinent. Petit and Default are the firft and moft confpicuous au¬ thors who come under our obfervation at this time. The eulogium on J. L. Petit, delivered in the Royal Academy of Surgery, of which he was one of the firft and moft dif- tinguilhed members, reprel^nts him as blending the ftudy of anatomy with his amufements when a boy ; and ar¬ dently feeking every opportunity to increafe his know¬ ledge by obfervation. He had had experience enough to publilh, at an early period of his life, his “ Traite fur les Maladies des Os,” Paris, 1705, umo, a work, which for a century was efteemed the belt upon the fubjeCt. It may be noticed, that his fuccefs was moft virulently oppofed by the envious. It was not till after more than thirty years of academical labours and extenfive practice, that he was unanimoufly elected chief of his affociates. This acknowledged fuperiority was the more flattering, as j. L. Petit obtained it at a period when furgery was in a flourifliing ftate in France, and where he held no place from which he could derive an influence foreign to his perfonal merit. While Marefchal, La Peyronie, and La Martiniere, allured him of the royal favour, Quefnay, Morand, and Louis, who corrected his writings, made him fpeak a language that does honour to the famous colleftion to which he contributed his obfervations (fee Memoires et Prix de l’Academie Royale de Chirurgie, 10 vols. 4to.) and in which, if we except fome theoretical explanations, nothing has loft its value by age. In Ihort, it will ever be confidered as one of the moft valuable col- leftions of furgical knowledge. J. L. Petit was alfo the author of a “Traite des Maladies Chirurgicales, et des Operations qui leur conviennent ; Ouvrage pofthume ;” a production that will always Hand high in the eftimation of the judicious furgeon. Of Default we may remark, that he is highly cele¬ brated for the exaftnefs and method which he introduced into the ftudy of anatomy ; the ingenious apparatus which he invented for the treatment of fraftures j a noble ardour in his profefllon, which he knew how to infufe into all his pupils ; and the boldnefs and fimplicity of his modes of operating. His clinical leisures upon furgery were the firft ever delivered. Indeed, fuch was his ge¬ nius, that, when he pra&ifed only methods already un- derftood, lie did them with fo much adroitnefs, that he rather appeared to be the inventor of them. He wrote the Journal de Chirurgie, 4 vols. 8vo. and left behind him CF.uvres Chirurgiques, 3 vols. edited by Bichat. He likewife furnifhed many papers to the Memoirs of the Academy of Surgery, and was a diftinguilhed member of the Ecole de Sante which fucceeded it. What tended principally to raife the reputation of French furgery to fo high a pitch, was the union of indi¬ vidual labours in the Academy of Surgery juft men¬ tioned. This valuable inftitution, which gave our conti¬ nental neighbours fo great an advantage over us, was un¬ fortunately fupprefied at the time of the revolution ; and every one interefted in the improvement of fcience muft deeply regret the difcontinuance of a fociety, in which emulation and talents w.ere fo long united for the benefit of mankind. The various diflertations, publilhed by the illuftrious members of the Academy, will ferve as a perpetual memorial of the fpirit, ability, and fuccefs, with which the obje£Is of the inftitution were purfued ; and centuries hence, pra&itioners fhall reap from the pages of its Memoirs the moft valuable kind of furgical information. Indeed, the “Memoires et Prix de l’Aca- demie Royale de Chirurgie” is a work which is abfo- lutely indifpenfable for every furgeon, and the various parts of which cannot be too often confulted. In it are preferved the labours of Le Dran, Garengeot, De la Faye, Louis, Verdier, Foubert, Hevin, Pibrac, Fabre, Le Cat, Bordenave, Sabatier, Puzos, Levret, and feveral other pra&itioners, who, though lefs famous, have contributed by their exertions and knowledge to form this uleful body of furgical fails. The preceding furgeons alfo dif- tinguifhed themfelves by other productions. Le Dran publilhed, 1. Parallele des differentes Ma- nieres de tirer la Pierre hors de la Veflie, 1 21110. a. Operations de Chirurgie, 2 vols. i2tno. 3. Obfervations de Chirurgie, 2 vols. 121110. 4. Traite des Plaies d’Armes a feu, i2ino. 5. Confultations de Chirurgie, i2mo. Garengeot wrote: 1. Traite des Inftrumens de Chi¬ rurgie, 2 vols. 121T10. a. Traite des Operations de Chirurgie, 3 vols. i2mo. Fabre was the author of Recherches fur l’Art de Guerir, 8vo. Le Cat wrote : Recueil de Pieces fur l’Operation de la Taille. Sabatier publilhed the Medecine Operatoire, 3 vols. 8vo. Puzos compofed Traite des Accouchemens ; Paris, 1759, 4to. Levret wrote, 1. Obfervations fur les Accouchemens laborieux ; Paris, 1747. 2. Art des Accouchemens, demontre paries Principes de Phyfique; Paris, 1761, 8vo. 3. Eflai fur l’Abus des Regies generates, & c. Paris, 1766, 8 vo. 4. Obfervations fur la Cure radicale des Polypes; Paris, 1749. La Motte publilhed: 1. TraitC complet des Accouche¬ mens naturels, non-naturels,et contre Nature. 2. Traite complet de Chirurgie. Miutre-Jean was the author of TraitC des Maladies de l’Oeil, 4to. Goulard wrote : CEuvres de Chirurgie ; Liege, 1763, 2 vols. unto. Ravaton compofed, Le Chirurgien d’Armee. Pouteau : 1. Melanges de Chirurgie, 8vo. a. CEuvres pofthumes, 3 vols. 8vo. David, Obfervations fur laNecrofe ; Paris, 1782, 8vo. The Academy of Surgery, which was overthrown during the French revolution, had at firft a very inferior fubftitute in the Ecole de Sante ; but, fince the reftora- tion, has been fucceeded by the Ecole de Chirurgie, (fee Paris, vol. xviii. p. 467.) which has brought forward Boyer, P A T H B oyer, Heritier, Dubois, Manoury, Lallemand, Richerand, Petit de Lyon, and, above all, Bichat. To Bichat, the ingenious and enlightened Bichat, the world is indebted for the firft truly philofophical view of the ftrudture of the human body. The Ample divifion of it into its component parts, which this great anato- mift and philofopher has pointed out, mult be conlidered as the ground-work of all future anatomical and patho¬ logical inquiries. Bichat demonftrated, that moll of the organs of our body are made up of a variety of elementary parts or textures ; each of which, in whatever part of the body it is found, uniformly has the fame phyfical properties, and prefents the fame morbid phenomena. Thefe he confiders as the elementary parts ; which, by the diverfitv of their combinations, produce all the modifications of ftrudlure and functions exhibited in the different organs of ani¬ mals, This method of confidering organized bodies, accords with every phenomenon with which we are ac¬ quainted, and feems to arife from the eflential nature of their conftitution. We may trace this view of the ftruc- ture of the body in the obfervations of many of the older anatomiffs ; and particularly it may be conlidered as the bafis of fome of the rnoft ingenious philofophical theories of the late ingenious Mr. John Hunter. In order to fix the characters of the elementary tex¬ tures, Bichat employed various modes of inquiry. He performed numerous experiments on living animals ; perfevered in tedious and minute diffe&ions; employed chemical re-agents to fupply the place of the knife ; and examined with minutenefs all the varieties of morbid ltruCture. Having by thefe means accomplilhed his ob¬ ject in tracing the character of each feparate texture, he proceeded next to inveftigate their combinations as they are found in the different organs. The effeCts of this mode of inveftigating the ftruCture of the human body when difeafed, muff be at once ob¬ vious. We learn from it, that difeafes at their com¬ mencement are generally confined to one texture of an organ; the other textures of which the organ is com- pofed remaining found. There is no organ of the body from which this important truth may not be deduced. It may be readily illuftrated from confidering the dif¬ eafes of the mucous, ferous, and mufcular, textures, which compofe the ftomach and alimentary canal ; of the cellular texture of the lungs ; of the mucous membrane of the bronchi, the ferous one of the pleura, and many others. But difeafes are not only confined to one individual texture of any organ, as in the cafes juft mentioned ; the fymptoms and morbid changes are likewife uniformly the fame in textures of a fimilar ftruCture, in whatever parts of the body thefe textures may happen to be found. Thus the ferous membranes which in veil the lungs, the brain, the heart, the abdominal vifcera, have one com¬ mon character when affeCted with any fpecific difeafe; fo alfo have the mucous membranes, whether we trace them in the mouth, the nofe, the vagina, the urethra, or covering the eye-ball ; and the fame may be obferved of every individual texture which enters into the com- pofition of our bodies. Befides the fymptoms and morbid changes which are common to all textures whole ftruCture is fimilar in the natural Hate, there are others which are determined from the particular functions of the organ in which the dif¬ eafed texture exilts. For example, when any of the fe¬ rous membranes are inflamed, the nature of the pain, the degree of fever, and the duration of the fymptoms, are the fame, in whichfoever one it may have taken place. But to thefe fymptoms are added, cough, diffi¬ culty of breathing, See. when it happens to be connected with the organs of refpiration, as in the cafe of pleuritis ; coltivenefs, ftrangury, delirium, lofs of vifion, when the inteftines, the bladder, the brain, or the eye, are in¬ volved in the difeafe. O L O G Y. 39 This view of the fubjeCt naturally fuggefts a corre- fpondent divifion of the fymptoms. The firlt clafs are ge¬ neral, and cbaraCterife a whole genus of textures; the fecond are in a manner accefifory, and depend upon the relative fituation or the particular functions of the or¬ gan into the compoiition of which the affeCted texture enters. But here we mud fet bounds to this theory. The hiftory and progrefs of difeafes Ihow, that we ought not to confine our obfervations within l'uch narrow li¬ mits. The principles which have been Hated, indeed, account admirably well for the propagation of fome af¬ fections ; and for fome of the fympathies which fubfift between different parts of the body; but there are other diforders which advance in a very different manner. In fome difeafes which are termed chronic, for example, the whole ftruCture of an organ becomes gradually altered, although the primary affeCtion was confined to one of its component textures. This is often to be obferved in cancer, fcrofula, lues venerea, Sec. Thefe general obfervations, however, will be fufficient to give an out¬ line of the principles of a pathological lyftem founded on the bafis of anatomical knowledge ; but the details of which are referved for another place. With regard to the Jurgery of the prefent day, we may remark, that our labours have of late been chiefly di¬ rected, by means of phyfiology and pathology, to the treatment of furgical cafes ; and, though in that refpeCl we may be allowed to Hand far before our anceftors, yet even in Ample operations we are not without improve¬ ment. The bold and fuccefsful operations of Larrey will teftify this, as well as the grand operations for aneurifms performed by Abernethy, Lawrence, Aftley Cooper, and others of ourEnglifh furgeons, whofe names however we forbear to mention, convinced of our in¬ ability to do juftice to the merits of all, and unwilling to appear invidious by the exclufion of any. • We now haften to the confideration of thofe patholo¬ gical theories, which, perhaps more than any other branch of medicine, form the criteria of medical prac¬ tice. The medical theorifts, then, of the 18th century, were chiefly Cullen, Brown, and Darwin. If we were inclined to draw companions in regard to merit, the firft of thefe phyficians would deferve ourgreateft encomium ; for he obferved nature with acutenefs, and w>as conliftent and rational in his treatment of difeafe, which cannot be accorded to either of the latter. He likewife made an arrangement of difeafes which had great merit, and which nothing but the increafe of phyliological know¬ ledge, and its fuccefsful application to pathology, that has taken place in our time, can warrant us in departing from, and which indeed we promifed to adopt. See vol. xvii. p. 245. Cullen’s pathological doctrines were a modification of the theory of Hoffman. From that author he took up the dodtrines of l'pafm and debility, and deduced from them all the phenomena of febrile diforders; and he en¬ deavoured to confirm his theory by proofs drawn from the laws of the nervous fyftem, and from the confidera¬ tion of the remote caufes of the difeafes in queftion. Rheumatifm was referred by him to a fpafm of the muf¬ cular fibres, arifing from an increafed afflux of blood; but gout he conceived to originate in atony, efpecialiy in atony of the digeftive organs. In thefe latter difeafes, he rejected the idea of a peculiar morbific matter; yet in his explanations of certain other complaints, as, for inftance, of fcrofula, he had recourfe to the fuppofitiou of an acrimony of the fluids. He laid much ftrefs on the efforts of the vis medlcatrix nature, advocated the hypo- thefisor a nervous fluid and vital principle, and aferibed to the brain a peculiar faculty, by which it was enabled to excite the mufcles to adlion, independently of the mind, and to which he gave the name of irritability of the fenj'orium. Cullen feems to have been much in the fame fituation with Boerhaave as to anatomical and phyliological 40 PATHOLOGY. phyfiological learning, of which many of his fpeculations betray a fad deficiency. In regard to fever, Dr. Cullen’s theory was that the firft change induced in the animal fyftem by the opera¬ tion of the exciting caufes of fever is, “ diminution of the energy of the brain.” The powers of the body and the mind, the functions of fenfation and motion, refpi- ration, circulation, and fecretion, all fail, or are dimi- niflied in the general debility ; but, after a certain time, a morbid increafe of fome of thefe funftions, efpecially of the circulation, takes place, with an augmentation of the heat. The three Hates of debility, of cold, and of heat, which regularly fucceed each other in fever, in the order juft mentioned, are prefumed to exift in the rela¬ tion of caufe and effedt ; the firft ftate being the refult of the fedative or debilitating influence of contagion, rnarfh- miafmata, and cold, which are the exciting caufes. Dr. Cullen acknowledges his inability to explain fatisfadlo- rily, how the debility produces all the phenomena of the cold ftage, efpecially the Jpafmodic conllridtion of the extreme arterial veflels, which is inferred from the luf- penfion of the fecretions, and the flirinking of parts, in the cold ftage, as well as from the continuance of this fufpenfion in the hot ftage, after the aftion of the heart and large arteries is increafed. Were the conftridHon of the cold ftage merely the refult of the weakened adfion of the heart, it is fuppofed, that, on the return of its ordinary or increafed adtion, the conftridfion would be removed, and the fecretions reftored. Here Dr. Cullen reforts to “ the vis medicatrix nature, fo famous in the fchools of phyfic i. e. the innate preferving power of the conftitution, which has been appealed to for the fo- Jution of difficulties by all medical theorifts, from Hip¬ pocrates downwards. This “ fpafm of the extreme vef- fels,” then, is confidered as “ a part of the operation of the vis medicatrix naturae j” at the fame time, Dr. Cullen is of opinion that, during the whole courfe of fever, there is an atony exifting in the extreme veflels, depend¬ ing on the diminifhed energy of the brain, and that the relaxation of the fpafm requires the reftoration of the tone and adtion of thefe. To this atony in the veflels of the fkin, he attributes the lofs of appetite, naufea, and vomiting, the ftomach being affedted by fympathy. The fpafm induced in the extreme veflels throws a load of blood upon the central parts of the circulating fyftem, which proves a fource of irritation to the heart and ar¬ teries, and excites them to a greater adtion, which con¬ tinues till the fpafm is relaxed or overcome. The hy- pothefis is thus briefly recapitulated : “ Upon the whole, our dodlrine of fever is explicitly this. The remote caufes are certain fedative powers applied to the nervous fyftem, which, diminiftiing the energy of the brain, thereby produce a debility in the whole of the fundlions, and particularly in the adtion of the extreme veflels. Such, however, is, at the fame time, the nature of the animal economy, that this debility proves an indiredt ftimulus to the fanguiferous fyftem ; whence, by the in¬ tervention of the cold ftage, and fpafm connedted with it, the adtion of the heart and large arteries is increafed, and continues fo till it has had the effedt of reftoring the energy of the brain, of extending this energy to the ex¬ treme veflels, of reftoring therefore their adtion, and thereby efpecially removing the fpafm affedting them ; upon the removing of which, the excretion of fweat, and other marks of the relaxation of excretories, take place.” Cullen’s Firft Lines, § 46. To this theory it has been objedted, firftly, that it is founded, as far as regards the vis medicatrix natures, on the gratuitous affumption that a principle exifts of which we have fenfible evidence ; fecondly, that, to take the cold ftage as the proximate caufe of the after-phenomena of fever, is difl'onant with evident fact ; for the hot ftage of fever often comes on apparently from external caufes, and unaccompanied by the cold ftage; and thirdly, that, with regard to fpafm of the external veflels, 1'uch an oc¬ currence affords no explanation of febrile phenomena ; and indeed it feems quite abfurd to fuppofe that the hot ftage and the cold ftage can by any means be confequences of the fame adfion ; and that, fo far from the capillaries being contradfed, we have pretty clear evidence tha"t they are extremely diftended with blood during all febrile difeafes in which the fkin is affedted. In a paflage of his “ Inftitutions of Phyfiology,” Cullen fpeaks of a ftate of excitement, or collapfe, of the brain and nervous fyftem, on which he fuppofes the ftrength or debility of the other parts of the body to depend ; and in his other writings, he is constantly labouring to prove ill what manner thefe conditions may be occafioned by the agency of various caufes. Brorcn, feizing upon this idea, let about the formation of a new theory, according to which all the adtions of life were to be referred to the excitement of the body by Jlimuli, and all difeafes reduced to the two general heads of diredl and indiredl debility, or debility ariling from a deficiency, or a previous exoefs, of excitement j or in other words into fthenic and afthe- nic diforders. The Brunonian fyftem might very well be compared with the Methodic, its diftinguilhing features being the referring of all difeafes to two oppofite conditions of the conftitution, Jlhenia and ajlhenia, or ftrength and debility, which might with almoft equal propriety have been called Jlridlum and laxum, (fee p. 11.) and the confequent ex- clufion of all particular inveftigation of the minute dif- tindtions in the phenomena of difeafes which it encou¬ raged. This fweeping arrangement was, however, much lauded in many parts of the continent, and gained a very large proportion of advocates in our country, among thofe who had not fufficient knowledge of nature to de- tedt its fallacy. The molt general of Brown’s principles are thus explained. 1. To every animated being is allotted a certain portion only of the quality or principle on which the phenomena of life depend. This principle is denominated excit- ability. 2. The excitability varies in different animals, and in the fame animal at different times. As it is more in- tenfe, the animal is more vivacious or more fufceptible of the adfion of exciting powers. 5. Exciting powers may be referred to two clafles. 1. External; as heat, food, wine, poifons, contagions, the blood, fecreted fluids, and air. 2. Internal; as the functions of the body itfelf, mufcular exertion, thinking, emotion, and paflion. 4. Life is a forced ftate ; if the exciting powers are withdrawn, death enfues as certainly as when the excit¬ ability is gone. 5. The excitement may be too great, too fmall, or in juft meafure. 6. By too great excitement, weaknefs is induced, becaufe the excitability becomes defective ; this is indi¬ rect debility : when the exciting powers of ftimulants are withheld, weaknefs is induced; and this is diredt debility. Here the excitability is in excefs. 7. Every power that adts on the living frame is ftimulant, or produces excitement by expendingexcitability. Thus, although a perfon accuftomed to animal food may grow weak if he lives upon vegetables, ftill the vegetable diet can only be confidered as producing an effedt the fame in kind with animal, though inferior in degree. Whatever powers, therefore, we imagine, and however they vary from fuch as are habitually applied to produce due excitement, they can only weaken the fyftem by urging it into too much motion, or fuffering it to fink into languor. 8. Excitability is feated in the medullary portion of the nerves, and in the mufcles. As foon as it is any¬ where affedted, it is immediately affedted every-where ; nor is the excitement ever increafed in a part, while it is generally diminifhed in the fyftem ; in other words, dif¬ ferent parts can never be in oppofite ftates of excitement. We 41 P A T H We will not detain our readers by detailing all the numerous controverfies in which this theory has engaged the medical world, nor by repeating the various argu¬ ments which oppofed its adoption among the more en¬ lightened of our own phyficians : for an hypothecs which fails to explain all the phenomena of difeafe cannot be confidered worthy of our notice ; and how could it be fuppofed that Brown, who paid little attention to the minute fymptoms of difeafe, was capable of generalizing fadts fo various and anomalous ? In no inftance does the application of thefe principles form fo much a fubjeCt for regret as in regard to the treatment of fever prac- tifed by the followers of Brown. It may be laid, without exaggeration, to have immolated millions of our fellow- creatures. It inculcated methods of treatment the moll oppofite to thofe indicated by nature and common fenfe. Let the ftatiftical reports of mortality in every climate teftify the truth of this painful affertion. To ftimulate in inflammatory diforders is a mean fo repugnant to the feelings of the patient, or the advice of every practical author, from the time of Hippocrates downwards, that we are aftonifhed at the extenfive prevalence of fo ablurd a practice. We fliould remark, however, that the more enlightened of Brown’s followers modified his doCtrines conliderably, and in their practice often departed ef- fentially from his dogmas. In attempting to explain the phenomena of fever according to the doCtrine of direCl and indirect debility, Brown has the following expref- lions : “ The diftinCtions that phyficians have made about the differences of fevers are all without foundation ; they are all the fame, with no other difference but in de¬ gree ; and, unlefs in that refpeCt, they do not differ from other difeafes of the fame form.” Elements of Medicine, § 662. note m. He does not, however, attempt to ex¬ plain the manner in which the various fucceffion of fymp¬ toms refults from the ftate of debility, or how the various modifications of the pyrexiae are to be accounted for upon this principle. The only approximation to fuch an explanation, is merely an enumeraiion of the leading changes in the fymptoms after the manner of Cullen, but lefs explicit than the one given by that author. We are told, that “ the debility during the cold ftage is the greateft ; that of the hot lefs ; and that of the fweating ftage, wdiich ends in health for the time, is the leaft of all. Hence, in a mild degree of the difeafe, as cold is the moft hurtful power, its effeCt is gradually taken oft'by the agreeable heat of the bed or of the fun, and the ftrength thereby gradually drawn forth. The heart and arteries, gradually excited by the heat, acquire vigour, and, at laft, having their perfpiratory terminations excited by the fame ftimulus, the moft hurtful lymptom is thereby re¬ moved, the hot fit produced, and afterwards the fame procefs carried on to the breaking out of fweat.” § 666. We are farther told, that “ the caufe of all thefe diieafes, (viz. fevers, from the Ample and intermittent to the gaol-fever and the plague,) is the fame with that of dif¬ eafes not febrile, to wit, debility ; differing only in this, that it is the greateff debility compatible with life, and not long compatible with it.” § 670. Such is the vague and inexplicit theory which divided the medical world, which excited fo much intereft in thofe who efpoufed or oppofed it, and infpired fuch a de¬ gree of enthufiafm in the debates and writings efpecially of the pupils of the feminary which gave it birth, that it not unfrequently burft forth with all the violence of re¬ ligious phrenzy. This indeed is little to be wondered at, when we confider that half-educated young men, as is the cafe with the great proportion of medical ftudents, unaccuftomed to patient inveftigation, and fond of no¬ velty, are the moft apt to embrace fuch fpeculations as could be fupportedand defended by ingenious and lubtle reafonings rather than by accurate and extenfive<obferva- tion. It was admirably well calculated to flatter the va¬ nity of the fuperficial, and to abridge the labours of thofe difpofed to be idle, fince it was abundantly more eafy to Vol. XIX. No. 1285. O L O G Y. defcant upon the fthenic and affhenic forms of difeafes, and the excefs and deficiency of excitement, than to de- fcribe the diftribution of the blood-veffels, or to trace the courfe of the nerves. The knowledge of anatomy and phyfiology was toaBrunonian perfectly ufelefs; and the laborious foil requifite for the acquirement of thefe branches of ftudy might well be fpared him, fince the ftruCture of the human frame and the functions of its va¬ rious organs were by no means neceffary confiderations, either in his eftimation of the caufes of difeafes or of the means requifite for their removal. The beautiful Jintpli- city of the fyftem, accordingly, recommended it chiefly to thofe who were moft deficient in that folid knowledge which can alone form the balls of a fuccefsful cultiva¬ tion of medical fcience; whilft its fallacy was too evident to thofe who had opportunities of witnefling its want of accordance with the natural operations of health and the phenomena of difeafes. It is, however, fully admitted, that Dr. Brown poffeffed great vigour of mind, and feems to have been capable of confiderable application. His talents, had they been di¬ rected to more practical and more ufeful objedts, would have probably raifed him to eminent diftinCtion, and ren¬ dered him a valuable member of fociety. The ftyle of his Elementa Medicines is harfli and unpolilhed, and his meaning is often dark and ambiguous. But perhaps this want of perfpicuity is as much owing to the fubjeCts which he treated, the principles of which are far from being fettled, as to the obfcurity of his expreffion. He attempted an unbeaten path ; it is not wonderful that he was often bewildered and loft. A French phyfiologift and pathologift of the prefent day, Dr. Brouffais, (Examen des DoCtrines Medicates, 1821.) has bellowed about a hundred pages on a review of the Brunonian fyftem ; but at length he happily comes to the conclufion, at which all the reft of the medical world had arrived long fince, “That the claflification of difeafes by Brown, into fthenic and althenic, general and local, is quite arbitrary.” He then enters upon the con- fideration of what he calls the Brownifm of the Italian fchool. He firll (hows how readily the Italian phyficians adopted the fyftem of the Scotch reformer in the firll in¬ ftance; and, next, how they fubfequently modified it, by various interpolations of their own, fo as to create a new doctrine, to which the name of contra-ftimulant has been given. According to this fyftem, of which Rafori was the founder, there exift but three claffes of difeafes : ill, thofe arifing from excefs of excitement; 2dly, thofe from want of due excitement; and sdly, thofe refulting from local irritation, or dillurbance of the vital aCtions of the part, differing both from inflammatory excitement and from debility. The two former are, refpeCtively, the fthenic and afthenic maladies of the older fchools. The latter requires a little explanation. According to Guani, the founder of this point of doCtrine, the animal body is endowed with a property, inherent with its organiza¬ tion, by which it either aflimilates to itfelf thole fub- ftances brought into contaCt with it, or enters into a re¬ action for the purpofe of rejecting them. All thofe fub- ftances which it appropriates to itfelf, produce what is termed animal excitement which is the agency of the affi- milative property; whilft thofe which are not afiimilable produce an action called irritation, which is a fort of dif- turbance, tumult, or orgafm, of the part, and which may extend from the part where the irritating caufe is applied more or lefs generally over the fyftem. This ftate, he argues, differs from the two former, becaufe it is not relieved by either ftimulants or fedatives. It obftinately continues as long as the caufe of it exifts ; but, when the caufe is removed, the effeCt inftantly ceafes, and it is never productive of real excitement, but foon, if it per- fift, induces debility. Guani appears to confider that animal excitement pro¬ perly, (by which he means exaltation of the vital aCtions without abfolute change of their qualities,) only arifes hi from 42 P A T H O from the local application of fubftances really affimilable, or from the prefence of fuch in the fyftem generally. This dodtrine of irritation was adopted by Giannini, and applied by him to the explanation of the phenomena of fever arifing from contagion. The virus, he fays, on being admitted into the fyftem, in proportion as it is diffufed and applied to different parts of the body, caufes an irritation, which is improperly called excitement, or the effects of a Jiimulant. This irritation extending throughout the fyftem, becaufe the irritating matter is thus diffufed, carries every- where a local caufe of difeafe, and thus produces a malady that is “univerfally local,” ( una malattia univerfalmente locale,) but which does not conftitute th ejllicnic diathefis of the fchools. This fever is only the tumultus tolo corpore diffufus of Brown ; and is fimilar to the affedtion arifing from the irritation of a ftone in the bladder, or the fever arifing from burns, fe- verefurgical operations, &c. fo well treated by Dumas. Guani, Bondoli, and Rubini, confidered this ftate of irritation as a particular diathefis, and propofed what they imagined to be the caufes of its exiftence and pro- grefs. Profeffor Tommaflini alfo adopted the elementary principles of the fame dodlrine, but modified the propo¬ rtions the phyficians already named had made refpedting its laws. He believes that irritants may at length give rife to real inflammation. The following are the general axioms he endeavours to eftablilh. ift. There exifts an order of fubftances (as well as a partial condition of the animal ftrudture, which rela¬ tively to the reft of the organization is an extraneous body) which, on making an impreflion on the animal economy, produce an adtion different from thofe termed Jiimulant, and fedutive, or more properly contra-Jlimulant ; and which is, properly fpeaking, irritation. adly, Some fubftances are naturally and primitively ir¬ ritative, but which may fecondarily become ftimulants where they give rife to phlogofis ; or they may become contra-ftimulants (fedatives ) when they produce pain or coldnefs, or diftrefling naufea; as pain, coldnefs, and naufea, themfelves, aft as contra-ftimulants. Others are irritants by their quantity or concentration, or the man¬ ner of applying them, which induce either mechanical diftenfion, or chemical decompofition, accidentally, and may by their nature appertain to one or the other of the two clafles of dynamics. 3dly, The ftate they produce may be diftinguifhed from all other ftates by the following charadters: i. by its incurability by means either of ftimulants or contra- ftimulants : 2. by the obftinacy of its duration in fpite of all attempts to remove it, as long as the caufe is pre- i'ent and active: 3. by the readinefs, and as it were in- ftantaneoufnefs, of its ceflation, as foon as the caufe is deftroyed : 4. by the type of the difeafe, which is mani- feftly local, even where the difturbance by fympathetic content is univerfally difperfed. 4thly, Irritating fubftances may be either chemical agents, which enter the organization, or mechanical agents, which torment it, or a difordered ftate of a living part, which becomes a centre of irritation with refpedt to the whole fyftem. 5thly, Inaflimilability, lieterogenity, and inaffinity, cannot be the efi'ential and diagnoftic charadters of irri¬ tants ; becaufe thofe characters do not appertain exclu- fively to them ; nor, perhaps, to them univerfally. 6thly, In the prefent ftate of our knowledge, we are, then, conftrained to define an irritant a pojleriori, that ■which produces the train of morbid phenomena de- feribed under the name of the irritative tumult. 7thly, Irritation very often terminates by inducing phlogofis in the centre of its own adtion, and then it en¬ ters into the clafs of diathefic (inflammatory) difeafes, preferving neverthelefs, not urfrequently, the character of irritation. 1. The difeafes of the firft clafs, thofe confifting in ex- ceflive excitement, may then arife from all irritating and LOGY. exciting caufes, whether contagious virus, mechanical or chemical injury, or excefs of the natural excitants of the economy. Thefe produce, in the firft inftance, local effects of the nature above indicated, which eft'edts are at length diffufed over the fyftem to a greater or lefs extent, according to the violence of the caufe, and the conftitu- tional difpofition of the patient. This inflammatory ex¬ citement is of the fame nature, from whatever caufe it arifes, and in whatever part it may be feated. It is of importance to remark, too, that local excitement pro¬ duces only excitement as far as its influence extends, and not debility of the reft of the fyftem by any concentration of the vital actions, as is taught in fome other fchools. Inflammation may occur, alfo, in an inter.fe degree, in any certain organ, whilft the reft of the fyftem is in a ftate of the utmoft debility ; and it is, indeed, more rea¬ dily excited in a ftate or weaknefs than in vigour, be¬ caufe the animal fibre is then more fufceptible of the in¬ fluence of ftimulants. Inflammation is, however, always originally of a Jlhenic character; and it preferves this as long as it exifts, even in the midft of the molt defolating privation of vital power. All fevers, acute and chronic, whether arifing from the impreflion of cold, excefs of the natural excitants of the body, animal contagion, or marfli-effluvia ; all acute and chronic local inflammations, cutaneous ulcerative difeafes, and phthifis ; take their place in the firft clafs. The general caufes of this clafe of difeafes have already been defignated as thofe of effentially excitant or irrita¬ ting qualities, but, in addition to thofe fliould be men¬ tioned, fome others which, under circumftances, are con¬ tra-ftimulants. Thus, pain, to a certain degree, is a feda- tive ; but it becomes an excitant, when intenfe ; and many fubftances, which are contra-ftimulant in certain quantities, become either excitants or irritants when given in larger quantities; this is the cafe with the tar* tarized antimony, belladonna, digitalis, &c. 2. The fecond clafs of maladies are of the nature which thedodtrines of Brown would term direEl debility, or that depending on want of due excitement. The dodtrine under confideration does not admit the exiftence of fuch as he termed difeafes of indirect debility, or exhauftion from previous excefs of excitement. The effedft of fti¬ mulants is confidered to be conftantly and folely excite¬ ment. 3. The charadter of the difeafes of the third clafs was indicated when the nature of irritation was particularly confidered. This dodirine not only oppofes the moft favourite dogmas of the Brunonians, that of the exiftence of what they term indirect debility ; it alfo attacks their principle of the effentially ftimulating quality of every fubftance making an impreflion on the animal body. It teaches, ift, That many fubftances adt on the animal fibre in a mode diametrically oppofite to the ftimulant agency, whence refult the effedts which Brown attributed only to the negative adtion, or want of adtion, of different fubftances; or to the diminution of the natural exci¬ tants of the fyftem. 2dly, That we may deftroy, by the adminiftration of thefe fubftances, the effedts of exceflive ftimulants, and that without thefe fubftances neceffarily producing any evacuation ; and that we may, by fre¬ quent repetition of their ufe, produce difeafes which are not fufceptible of cure by the intervention of ftimulants. 3dly, That contra-ftimulants, fuch as blood-letting and purgatives, offer the means of cure for all maladies which refult from excefs of ftimulation ; and that, by the fame analogy, the effedts refulting from the abule of contra-ftimulants are combated with efficacy by ftimu¬ lants, fuch as wine, aromatics. See. 4thly, That the animal fibre fupports the agency of ftimulants or contra- ftimulants in a diredt ratio, refpedtively, to the degree of intenfity of the diathefis of excitement or of debility. 5thly, That we may difeover the degree of the diathefis rather by the aptitude to fupport the agency of the one or PATHOLOGY. 43 or the other of thofe claffes of fubftances, than by the apparent fymptoms of the malady. This part of the new doctrine is not, however, fo ex- tenfively adopted in Italy as the former. Many reflexive phyficians (till maintain the opinions of Brown, and can¬ not be induced to believe that tartar emetic, digitalis, and the like, can diredlly deprefs vital adtion in the part to which they are applied. Connedted with this, and bearing fome refemblance to it, is the fyftem of Brouflais himfelf, of which the fol¬ lowing is an outline, i. That the exaggeration of the vital adtions in one tiffue, which fubfequently re-adls on others, conftitutes the far greater proportion of difeafes. a. That all the tiffues'are fufceptible of experiencing this modification, but certain ones are more expofed to it than others. 3. That thofe in which it is ordinarily de¬ veloped, are the mucous tiffues, becaufe they are the organs of relation, (that is to fay, organs which receive imprefiions, and which befides develop other adtions by the influence they exert on the nervous centres,) and be¬ caufe they are all fanguineous and fecretory organs. 4. That thefe tiffues, being formed of capillaries and nervous fubftance, have the irritation they experience participated both by veffels and nerves. 5. That irrita¬ tion being eftabiiflied in a tiffue, calls the fluid to it; and that it is on this phenomenon that all the fecretions, all the vital excretions, and, in a word, the adtions of all the organs, depend. 6. That thefe irritations, with the folicitation of the fluids, being carried to a certain de¬ gree by the influence of certain caufes, conftitute ltates of difeafe. 7. That, whilft we do not diftinguifh in the economy, the four phenomena of inflammation (tumor, dolor, rubor, and color), we fliould not give this name to the irritations which may be manifefted. 8. That, in cer¬ tain fubjedts, they are hardly ever raifed to the degree which merits the name of inflammation ; but that they then conftitute, in fome cafes, the neurofes of authors ; in others, organic affections. 9. That, in fome perfons, thefe irritations, confined for a long time to a certain degree, fuddenly become exalted, and pafs to the ftate of phiegmafla-, that is to fay, we then obferve exaggeration of the aftion of the red capillaries, an extraordinary af¬ flux of blood, with augmentation of heat, pain, See. 10. That, in others, this exaltation takes place fuddenly. 11. That, when then thefe exaggerations of the aCtions of organs have for the refult, not the folicitation of blood, with heat, See. but the accumulation ofcolourlefs fluids, and the predominance of the veffels which con¬ tain them, we then fee the phenomena of irritation in a degree inferior to true phlegmafia, and to which, for this reafon, the name of fub- inflammation may be given. 12. That neurofis, inflammation, and fub-inflammation, conftitute the three varieties of irritation which furnifh the principal and moft important divifion in pathology: that is to fay, neurofis , when the irritation is confined to extraordinary aCtion, without increafe of heat or immi¬ nent danger of diforganization ; inflammation, when heat, with injection of blood, and imminent danger of difor¬ ganization, exift ; fub-inflammation, when the irritation accumulates in the part only lymphatic fluids. Thefe are the morbid phenomena of irritation in the part where it originates. But, in addition to thefe, it fhould be confidered, 1. That, as foon as the organic ac¬ tion is exaggerated in a part, it is tranfmitted to other organs by the nervous cords, (which fliould be diftin- guifhed from the nervous fubftance in the ftate of ex- panfion, or in the pulpy ftate, as it exifts in the organs of fenfe, and in the brain.) 2. That this tranfmiflion of the exaggeration of local organic aCtion is a fympathy. 3. That it takes place, in the ftate of difeafe, according to the fame lav/s, and by the fame means, as in the ftate of health. 4. That the irritation, fympathetically deve¬ loped in an organ. Secondarily affeCted, is of the fame na¬ ture as the primitive irritation. This is the mode in which M. Brouflais has himfelf ftated the principles of his pathology of inflammatory difeafes ; and he has fliown that, when fully developed, they will involve the far greater part of the maladies to which human beings are liable: but to trace thefe ex- tenfions of them does not come within the plan of this feCtion. It is, however, neceffary to advance fo much refpedling this dodtrine, fince it is becoming daily more extenfively adopted in France, and has already obtained the confent and Support of a great proportion of the more refleCtive part of the phyficians of that nation. An union of the reafoning and imaginative faculties has Seldom been poffeffed by an individual with any ad¬ vantage to the interefts of philofophy. Of the truth of this propofition we have a melancholy example in the writings of Darwin. The figurative expreflions and bril¬ liant didtion which fo much adorned his poems, being applied to a ltridter Science, have equally obfeured and tarniftied his compofitions. We" obferve in the medical Speculations of this author a near approach to fome of the Brunonian tenets. Edu¬ cated, however, in a fuperior manner, endued with bet¬ ter tafte, and more minute in his oblervance of nature, Darwin faw that Brown’s two general principles were in¬ adequate to explain many forms of difeafe; and he therefore added a third. Two general laws of the ani¬ mal economy are ftated by Darwin, as well as by Brown : 1. That all excitement or adtion of the living organs and fundtions occafions a diminution or exhauftion of their power, (excitability in the language of the latter, fenforial power in that of the former,) according to the degree of excitement. 2. That reft, inadlivity, or the abftradtion of the ufual ftimuli, render thofe organs more fufceptible of the adtion of the ftimuli fubfequently ap¬ plied. Thus, when a fmall part of the capillary veffels of the fkin are expofed for a fliort time to a cold medium, as, when the hands are immerfed in iced water for a minute, thefe capillaries become torpid or quiefeent, owing to the abftradtion of the ftimulus of heat. The fkin then becomes pale, becaufe no blood paffes through the external capillaries, and appears ftirunk, becaufe their fides are collapfed from inadlivity, not contradled by fpafm; the roots of the hair are left prominent from the Seceding or fubfiding of the fkin around them ; and the pain of coldnefs is produced. But in this fituation, if the ufual degree of warmth be applied, thefe veffels re¬ gain their adlivity ; and, having now become more irri¬ table from an accumulation of the fenforial power du¬ ring their quiefcence, a greater adtion of them follows, with an increafed glow of the fkin, and another kind of pain, which is called the hot-ache, enfues. Thus far the two theories nearly accord ; but beyond this point the Brunonian dodtrine leaves us to a general ftatement of debility, altogether inadequate to account for the various forms and phenomena of fever. But Dr. Darwin appeals to other eftabiiflied fadts in the animal economy, upon which thefe varieties appear to depend. From thefe he deduces a third general law ; namely. That the fundtions of different parts of the fyftem' are fo far catenated, or affociated with each other, as it were in circles, either from diredt connexion in ftrudture, from the habit of adting together, or, more frequently, from caufes at prefent infcrutable, that an increafe or decreafeof the adtion of one organ is followed or accom¬ panied by an increafe or decreafe of the adtion of ano¬ ther; Sometimes by a Similar change, that is, increafe followed by increafe of adlivity, or decreafe by decreafe ; but occafionally by the contrary change, that is, increafe followed by decreafe of adlivity, and vice verfd in the af¬ fociated parts. The former of thefe is termed a direct fympathy ; the latter a reverfe fympathy. The inftances of fympathy between different parts of the animal frame are very numerous ; as, between the ftomach and brain, the ftomach and fkin, the ftomach and heart, the brain and heart, the flein and lungs, the ute¬ rus and mammae, See. And this, which occasioned him to 44 PATHOLOGY, to call his fydem “ the fympathetic theory,” is the mod important part of that theory; for the catenation, or af- fociation, which takes place between various functions when difordered, had, before his time, been very (lightly touched on. A partial view of one circumftance of fym- pathy had made Cullen attribute too much to the date of the jk'm in fever; and infulated faffs of the fame na¬ ture had impreffed almod every pathological fydem with error. Darwin embraced then the whole range of thefe afl'ociated aCtions, and formed the defign of founding a fydem of pathology and therapeutics on the contempla¬ tion of all the laws of animated nature. And hence this may be confidered as the firil fydem condruCted in exaCt conformity with phyfiology. Of this latter fubjeCt, Darwin, however, knew little ; and hence the failure of the fuperflruCture' which he raifed on it. Yet the con¬ ception was grand, and has been aCted upon by all patho- logids (ince his time. The three laws or principles of aCtion in the animal economy, which we have mentioned before, viz. i. The exhaudion or diminution of the fenforial powers by exertion; 2. The recovery or accumulation of the fame powers, during quiefcence, or impaired aCtion ; and 3. The direCt and reverfe adbciation of parts, by which the aCtions of one part give rife to aCtions in others.; are the grounds of Dr. Darwin’s explanation of the phe¬ nomena of fevers. He fuppofes that the cold dage ac¬ crues in confequence of the torpor of the capillary vefiels, from the abflraCtion of the dimulus of heat, or other caufes; the hot dage, in confequence of the renovated activity of the capillaries, from the accumulation of fenforial power during that torpor. Dr. Darwin, how¬ ever, remarks, that this renovated activity of the capilla¬ ries is not owing to the renewed action of the heart, which forces them open by the mechanical impulfe of blood; that the action of the capillaries often re-com- mences fooner than the aCtion of the heart, thefe vefiels having a greater mobility than the heart and large arte¬ ries, as appears in the fudden blufli of (flame ; and that, in low fevers, the capillaries acquire increafed drength, as is evinced by the Audi and heat of the (kin, while the pulfations of the heart and arteries remain feeble. Hence Ample fever is of two kinds ; in one the pulfe is drong, in the other weak : in the fever with drong pulfe, not only the cutaneous capillaries, but alfo the heart and arteries, readily acquire a greater activity by the accu¬ mulation of fenforial power during the torpid date, which lad is farther increafed by direCt fympathy with the increafed activity of the capillaries ; this happens in drong conditutions, and is often feen in vernal intermit- tents : in the fever with weak pulfe, on the contrary, the heart and arteries do not acquire much increafe of fenfo¬ rial power, but continue in fome degree in their date of torpor, while the orgafm of the capillaries is produced ; whence there is a hot fit, 'with feeble pulfe. But, when the fympathies of other parts of the fydem are called into aCtion, together with this torpor and or¬ gafm of the cutaneous vefiels, and of ,the heart and large arteries, the fever-fit becomes more complicated and dangerous. And again, when the torpor commences, from the operation of other exciting caufes of fever in other organs of the body, and extends, with the fubfe- quent orgafm, by direct or reverfe fympathy, to the or¬ gans afl'ociated with them, other various forms and mo¬ difications of febrile difeafe are produced. Thus, if the domach is affeCted with torpor, either primarily, as from the aCtion of contagion fwallowed with the faliva, or fecondarily, by its fympathy with the cutaneous capil¬ laries, or with fome internal vifcus; a total lofs of appe¬ tite occurs, followed by ficknefs and vomiting. If the brain is affeCted, either primarily, as by the depreflive padions, by exhaudion from watching, &c. or feconda¬ rily, as by the influence of contagious or marfli effluvia received into the domach or the lungs, then prodration of the general powers, head-ache, delirium, flupor, tre¬ mors, convulfions, &c. are induced. In the fame way, the fecretions from the internal organs, as from the kid¬ neys, are diminilhed when a torpor takes place in them, either primarily, or by fympathy with the cutaneous ca¬ pillaries, or other parts, and are redored with the reno¬ vated aCtion. Thefe phenomena take place in different degrees in almod all fevers, and vary according to the nature of the organs primarily affeCted, and to the date of the conditution, or of the organs individually. Thus, when the domach is (lightly difordered, as by in- digedible food, or when the vafcular fydem is deranged from expofure to cold, (when no inflammation is pro¬ duced,) the fever which enfues is mild, the brain fuffers little by fympathy, no delirium, See. occur, and health is foon redored. If, on the contrary, a virulent conta¬ gion aCis upon the domach, and through its medium upon the brain, the fenforial powers are greatly exhauded, and the complication of dangerous fymptoms, arifing from the morbid condition of the nervous fydem, and from the total lofs of powers in the organs of digedion, occurs, condituting the contagious, nervous, and malig¬ nant, fever, or typhus, under its various forms and deno¬ minations. Dr. Darwin explains the peripneumony as “generally induced by the patient refpiring very cold air, and this efpecially after being long confined to warm air, or after being much fatigued or heated by exceflive labour or ex- ercife. For we can cover the (kin with more clothes, when we feel cold; but, the lungs not having the per¬ ception of cold, we do not think of covering them, nor have we the power of covering them, if we defined it; and the torpor thus produced is greater, or of longer du¬ ration, in proportion to the previous expenditure of fen¬ forial power by heat or exercife. This torpor of the lungs affeCts the (kin with (huddering, and the domach is alfo fecondarily affeCted ; next follows the violent ac¬ tion of the lungs from the accumulation of the power of irritation, and an inflammation of them follows this vio¬ lent aCtion, &c.” This author clafled difeafes according to their fuppofed origin in didurbed dates of the vital powers ; but the arrangement is quite fanciful, to fay the lead of it; and the frequent repetitions of fpecies which occur under dif¬ ferent heads, (how its imperfection. Thus, he divided difeafes into four kinds; thofe of irritation, fenfation, volition, and affociation ; and, forming his therapeutical doCtrines according to the fame views, he arranged the materia medica intofeven claffes. 1. Nutrientiu, or thofe things which preferve in their natural date the due ex¬ ertions of all the irritative motions. 2. Incitantia , or thofe things which increafe the exertions of all the irri¬ tative motions. 3. Secernentia, or thofe things which in¬ creafe the irritative motions which conflitute fecretion. 4.. Sorbentia, or thofe things which increafe the irritative motions which conditute abforption. 5. Invertentia , or thofe things which invert the natural order of the fucceffive irritative motions. 6. lievertenliu, or thofe things which reflore the natural order of the inverted ir¬ ritative motions. 7. Turpentiu, thofe things which di- minifli the exertions of all the irritative motions. This theory was never very generally received in Eng¬ land ; but, dripped of the hypothetical phrafeology and much modified, it appears to have been taken up and il- ludrated with much fuccefs by the celebrated Hufeland in Germany. We are now arrived at a period when phyficians, no longer dazzled by brilliant hypotiiefes, required in pa¬ thology and phyfiology the clofe analogical reafoning which had been found fo ufeful in every other depart¬ ment of fcience. Hence fyflems of medicine, incapable of embracing all known forms of difeafe, have ceafed to exid. Imprefi'ed with the conviction that our dock of known faCts required much addition ere it could be ge¬ neralized, the pathologids of our time have individually attached themfelves to the acquilition of further expe- s ~ rience PATHOLOG Y. rience in particular difeafes; and, when theory has been promulgated, it has generally had its foundation in new difcoveries in phyfiology. Hence too it is no longer pof- fible to enlift ourfelves under the banners of any one pathologift, and, by quietly affuming the infallibility of his doftrines, fave the trouble of thinking for ourfelves. It mull not therefore be fuppofed, that, becaufe this aera may not tranfmit to pofterity the name of an author whofe works might contain all that we know on medical fubjefts, we have done lefs for the fcience we profefs than our continental neighbours. True it is, that the fpeculations ofBroulfais and Tommafini have fomething better to recommend them than the fyftems of Cullen, Brown, or Darwin; yet ftill many imperfeftions exift in them, imperfeftions necelfarily connefted with the unfinilhed Hate of the ground-work on which pathology is built. Neverthelefs, in real improvement, the firft twenty years of this, the 19th, century, affords the moll: delightful profpeft. The errors of Brown, here firft promulgated, were here firft refuted. Currie introduced the judicious ufe of cold bathing in the molt numerous and formidable complaints to which human nature is liable, viz. fevers. Abernethy and Hamilton have Ihown the efficacy of purgatives in molt difeafes, and the inno¬ cence of their properly-regulated exhibition in all. The bold and decided treatment praclifed by Jackfon, as well as his found theoretical views, deferve the higheft encomium; and we have to regret that the peculiar ftyle and expreflion of that author has fo long oppofed the general reception of opinions which are equally con- fonant with reafon and the long experience of thirty years. To Armftrong, Clutterbuck, and a hoft of others, the infertion of whofe names would tend to render our hiftory a mere catalogue, we owe the prefervation of many of our fellow-creatures. Nor have our inveftiga- tions on thefe topics been confined to our own ifiand. The accounts we receive from our Indian poffeftions ferve to inftruft us in the treatment of acute difeafes, by ftiowing them in the intenfe marked forms which they exhibit in tropical climates. Phyfiology likewife has been by no means neglefted in this age. That fcience, which no longer can be called uncertain, has received auxiliaries from the improve¬ ments daily occurring in the collateral branches of knowledge. Its more general principles have been illus¬ trated by difcufiions which the fpeculative notions of Hunter and Abernethy on the one hand, and Lawrence and the French phyfiologifts on the other, have given rife to. The motive powers of the vafcular fyftem have been illuftrated by Parry, Carfon, Bell, Philips, and Brodie. To the two laft of whom we are moreover in¬ debted for fome ufeful information concerning the phe¬ nomena of fecretion and the dependence of that funftion on nervous influence. The contradictory opinions, how¬ ever, which we meet with on thefe fubjefts, compel us to acknowledge that this fcience bears little proportion in its advancement to that of the practice of medicine. In the early part of the prefent year, Mr. James, a furgeon of Exeter, publilhed “ Obfervations on fome of the General Principles, and on the Treatment, of the different fpecies of Inflammation.” This work is an am¬ plification of the Differtation which gained the Jackfon- ian prize on Inflammation, when the illuftration of this fubjeft was recently propofed by the Court of Afiiftants of the Royal College of Surgeons. This production comprifes many interefting obfervations ; but the author is too much the difciple of John Hunter, and he exhi¬ bits more of the manner of reafoning of that phyfiologift, than aclofe inveftigation into the mode of production of the phenomena he defcribes ; like him, he refts con¬ tented with a fubftitution of terms, inftead of endeavour¬ ing to explain the operations of which they are only the expreflion : in a word, his ideas want precifion, and his pathology depth. Mr. James adduces a new claffifica- Vol. XIX, No. 1286. 45 tion of inflammation. His arrangement, is founded on the difpofition which inflammatory aCtion affumes to fpread ordiffufe itfelf, or to be limited by the adhefive procefs or other means. In this point, too, we recognize John Hunter. As, however, this fortuitous quality of inflammation but feldom conllitutes a generic difference in the form which the difeafe affumes, but depends on feveral varying conditions of temperament and other things in the patient, and on accidental conditions of the atmofphere, and other external circumftances, it ap¬ pears to be objectionable, and not likely to be adopted by the generality of pathologifts. The .author’s conli- derations in other refpefts, efpecially thofe relating to fe- miology and therapeutics, are judicious, and developed with l'uflicient order and perfpicuity. In anatomy, as far as the relative fituation of parts is concerned, our diligent anceftors have left us little to do. So that, if we except a few difcoveries concerning the more minute ftrufture of membranes, the mufcularity of veffels, &c. we have nothing new to tranfmit to our fucceffors on this fubjeft. Far different is the refult of our refearches on morbid anatomy. The labours of Dr. Baillie, accompanied with defcriptions and plates of great accuracy, are too well known to require our com¬ ment ; as likewife the excellent works of Farre, Bell, Sec. in the fame department. And thefe examples have been followed very generally by our moll eminent prac¬ tical phyficians. Of courfe this brief (ketch cannot be fuppofed to em¬ brace all the names or difcoveries which dignify our country in this enlightened sera. We lhall have occa- lion to fpeak largely of them in the body of this article, when we come to notice particularly the treatment of each difeafe; and therefore may be excufed entering in the detail of them here. In the mean time, it may not prove uninterefting to trace a faint outline of the labours of our foreign brethren at this moment. By fo doing, we enlarge the fund of our experience, and thus correct the error into which more limited obfervation might be¬ tray us. France. — If reiterated experiment and unceafing ob¬ fervation be the means which molt forward medical fci¬ ence, the French nation have claim to high honour. In no other country is the fcience of life illuftrated by fo many experiments, elucidated by the application of fo many different fciences, or examined fo ciofely in all its varied and extenfive phenomena : yet weobferve theories continually arifing, opinions afferted one day to be re¬ futed the next. But fome recent labours of the French phyfiologifts, have eftablilhed fafts which ftand on the firmed: bafis : fuch are many of the doctrines of Bichat, of Majendie, and of Brouffais. Of Bichat enough has been faid, in every country where his works have been read, to ftamp him as a phi- lofopher of the greateft merit ; and all who are interefted in the improvement of fcience, muft deeply regret the lofs of one whofe comprehenlive and enlarged mind, whofe minute anatomical ftudies, and whofe brilliant pa¬ thological difcoveries, alike fitted him for re-forming and re-cafting the fabric of medical fcience. This vail de- fign had been formed by Bichat ; and, when a few lec¬ tures had developed his opinions, he was fuddenly car¬ ried off. In teaching mankind to ftudy the minute ftrufture and fabric of the body, rather than to be perpe¬ tually occupied with the defeription of its relative fitna- tions and parts, he feems, like our countryman, John Hunter, to have followed that courfe which Lord Bacon had fo clearly pointed out to anatomifts, and in which much ftill remains to be done: he lays, that “ they (anato- mifts) inquire of the parts and their fubftances, figure, and collocations ; but they inquire not of the diverfity of the parts, thefecrefies of the paffages, and the feats or neftlings of the humours, nor much of the footfteps or impreflions of difeafes ; the reafon of which omiffion I N fuppofe PATHOLOGY. 46 fuppofe to be, becaufe the firft may be fatisfied in the view of one or a few anatomies, and the latter, being comparative and cafual, mull arife from the view of many.” The name of Majendie, already well known by his Elements of Phyfiology, is prefented to us, in every pe¬ riodical work we receivefromFrance, as occupied in fome interefting or ufeful experiment. Palling over his experi¬ ments in regard to the nervous fyftem, to the abforptive power of veins, See. we may remark, that he has lately been endeavouring to difeover fome more effectual mode of controlling the action of rabies than has hitherto been known. And, though it would be premature to offer any opinion on the probable refult of his experiments, we may remark, that he has done the public great fer- vice by Ihowing the complete inefficacy of drugs hitherto reputed fpecifics in the cure of this dreadful difeafe. Of Brouffais’s phyfiological fyftem of pathology we have given a Ihort account at p. 43. Nothing is wanting to the full fuccefs and acceptance of that fyftem, but that everybody Ihould think as well of it as the doftor him- felf does. On its firft appearance, Dr. Hutchinfon, the editor of the London Medical Journal, gave a favourable account of it; not quite fufficiently fo, however, as en¬ tirely to fatisfy the inventor. Dr. Granville, the prefent editor of that work, fpeaks rather contemptuoufly of it; Rafori (the contra-ftimulant fedative Rafori) oppofes it on the continent ; and upon the whole it feems to be going down. Two commentaries on the doftrines of Brouffais, of very different chara&ers, have been recently produced at Paris. One of them, by Monf. Begin, is in¬ tended to advocate his principles, and to difplay them in a more perfpicuousand orderly manner than has been done by Brouffais himfelf; while the other, publifhed anony- moufly in the Revue Medicale, a new monthly journal of great merit, is a jeu d’efprit, full of that fine fatire and delicate ridicule which the French fo well know how to employ, which, while it difplays the chara&er and con¬ duct of Brouffais and the merit of his writings with great force and fufficient eulogy, deferibes his vanities, his in¬ genious obfeurities, the nonchalance with which he cuts the gordian knots he happens to encounter, and apolo¬ gizes for the art with which he has appropriated to him¬ felf the opinions of others, in a manner truly Rabelaic. From this publication we fhallmake an extradl, in read¬ ing which the reader will bear in mind, that Dr. B. con¬ tends that all complaints arife from the ftomach, and that lemonade and leeches are to cure every complaint. “ A diftinguifhed man of letters, who is publiftiing a new edition of Moliere, aware of the ridiculous appear¬ ance of fome modern phyficians, has determined to make fome variations in the celebrated feene of the comedy of that author, entitled Le Malade Imaginaire.- The fol¬ lowing is a fpecimen : Toinettc, (drejffed as a phyfician.) Let me feel your pulfe. Come, come, beat as you ought. Ah ! I’ll foon make you go right. Faith ! this pulfe is mightily imper¬ tinent. I fee plainly it does not know whom it has to deal with. Who is your attending phyfician, fir? Argun. Monfieur Purgon. Toin. That name is not to be found in my pocket- book, amongft the phyficians of eminence. What did he fay was the matter with you ? Arg. He fays my liver is affected : others contend that it is the fpleen. Toin. Pooh ! pooh ! They are a pack of ignoramus. It is your ftomach, fir, that is affected. Arg. The ftomach ? Toin. Yes ! the ftomach. What do you feel ? Arg. I have occaftonally the head-ache. Toin. Exaftly fo. The ftomach. Arg. 1 fometimes fee double ; — I have a veil over my eyes. v Toin. The ftomach ! Arg. And a great difficulty in breathing. Tom- The ftomach again ! Arg. I fuffer from great languor aud laffitude in all my limbs. 'Toin. The ftomach! Arg. And I now and then feel pain in my feet, in my heels, and toes, as if I had the gout. Toin. Exa&ly fo. It is the ftomach ! You eat with good appetite ? Arg. Yes, fir. Toin. The ftomach ! You like to drink a fmall quan¬ tity of wine. Arg. Yes, fir. Toin. The ftomach ! You feel rather drowfy after dinner, and delight in taking a nap ? Arg. Oh yes, fir. Toin. The ftomach, the ftomach, I tell you ! What has your phyfician defired you to eat ? Arg. He delired me to take fome foup. Toin. Onlolugiji! [An appellation of contempt adopted by Dr. Brouffais todefignate all thofe phyficians who feem to have identified or perfonified the different caufes producing difeafes, fuch as the gouty principle, the fcrofulous humour, &c.] .drg. And chicken. Toin. Fatalift ! Arg. And occafionally veal. Toin. Incendiary! Arg. Broth. Toin. Murderer ! Arg. Some frefb eggs. Toin. What an aflaflin ! Arg. And ftewed prunes in an evening. Toin. Incendiary ! the murderous diet of the ontolo- giftic fchool. Arg. And, above all, he defired me to put water to nay wine. Toin. lgnorantus, ignoranta, ignoratum ! This is not the way of a medecin phyfiologifle . You muft drink pure water, which is indeed too nourilhing as it is : it will calm the gaftro-inteftinal irritation under which you la¬ bour ; and thin your blood, which is now too aenfe. You’ll apply five hundred leeches to the pit of the fto¬ mach, which will remove the gaftro-enteriiis in the twinkling of an eye. Don’t you fee that “irritation is preying heavily on the mucous membrane of your ftomach, from whence it extends its malignant power overall the organs of y'our economy, through fympathe- tic irradiations?” Be affured that your phyfician is an ontologijt, who will believe only what he fees. I wiil come again to fee you in a fortnight, if you are alive ; and, above all, reft affured that, if I have abufed my bre¬ thren of the profeffion, it was not through envy, but for the good of mankind. How fuperior to them all the dodlrine phyfiologique makes me ! “ a dodtrine which is deftined to do more good even than the immortal difeo- very of Jenner.” [The two paragraphs in this fpeech marked with inverted commas, are not a parody, but the real words of Brouffais.] The brain has of late been to the French pathologifts what the abdominal vifeera have long been to the Eng- lifh, the great object of intereft and the fubjedt of their efpecial confideration. Several works of much vaiue. have been the refults of their labours. That which pre- fents moft evidence of a talent for original obfervation and profound and comprehenfive reafoning, is one by Dr. F. Lallemand, of Montpellier. The greateft merit in the work of Dr. Lallemand confifts in the admirable precifion and perfpicuity with which the hiftories of dif¬ eafe are given, and, for the moft part, the very judicious reflections with which they are accompanied ; the efpe¬ cial object of which is to trace the relations between the appearances obferved after death, and the fymptoms of the difeafe that were manifefted during life. Dr. Lalle¬ mand differs from Dr. Roftan refpedting the nature and origin of what the.latter has deferibed under the name of ramollijfement du cerveau , and thinks that it is really a confequence 47 PATHOLOGY. confequence of inflammation of a more or lefs chro¬ nic kind. He relates fome cafes which feem to Ihow that it has, at lead fometimes, fuch an origin. He ad¬ vances a carious propofition refpe£ling delirium, that has much apparent probability. He fays, delirium is never obferved in cafes of inflammation of the brain alone; this fymptom appertains efpecially to inflammation of the arachnoid membrane. It is not becaufe the arach¬ noid is the feat of the immediate caufes of delirium ; but becaufe this membrane, when inflamed, irritates the fur- face of the brain which is in contact with it; and, as the tifl'ue of this organ is then not altered, its functions are merely “exalted thefe functions, on the contrary, ceafe (to an extent correfponding with the extent of the inflammation,) when inflammation has its feat in the proper fubftance of the brain. A work of very conflderable value on inflammation of the arachnoid membrane of the brain and fpinal marrow, has been publilhed by two young phylicians of Paris, Drs. Martinet and Parent-Duchatelet, which is the refult of feveral years’ obfervation at the Hotel-Dieu and the Hof- pice des Enfans Malades, under the direction, and indeed afliflance, of Drs. Recamier and Jadelot, phyficians, ref- pe<5tively, to thofe inftitutions. This work prefen ts' fuch a number of cafes (not feledled, and therefore the more valuable, as prefenting a view of what is of ordi¬ nary occurrence,) as will admit of general inferences, of more or lefs validity, refpedling every point of moll inte- rdl in the hiltory of the difeafe. The charafters of arachnitis appear to vary as the dif- eafe occurs in parts of the membrane correfponding to different parts of the brain. Thus, the fymptoms of arachnitis at the bale of the brain, prefent, in general, charadlers by which the difeafe may be recognized, and diftinguiflied from arachnitis in the convexities. There are, however, fome varieties in thofe fymptoms, con- nedled with dfverfities in the age of the patient., In children, for example, who are difpofed to be afFedled with this form of the difeafe-almolt exclufively, the ex- cefflve irritability of their nervous fyllem occanons fpafms in different parts, which give a particular character to the malady. Thefe affections fometimes appear in a fud- den manner, without any previous indications ; at other times, the progrefs to them is more gradual ; the Hate of the intellectual faculties prefents lefs varieties than that of other organs. The degree of energy which the brain pofleffes in adults, and even in adolefcents, ena¬ bles patients of this clafs to refill much longer the difpo- fition to llupor ; fo that this fymptom is much lefs early andcompletely manifelled in them than in children. In both, thelefion of the intellectual faculties refults effen- tially from the want of aCtion of the brain, from the in¬ ertia of this organ, and not from the derangement of its functions, or delirium, which is the predominating cha- radteriilic of arachnitis of the convexities. When in¬ flammation is feated in the portion of the arachnoid which lines the ventricles, the fymptoms are the fame as thofe which refult from it at the bafe of the brain ; and in the greater number of cafes it is prefent alfo in the latter region. Thirteen cafes of inflammation of the arachnoid membrane of the fpinal marrow are related, from which it appears, that the chief charadteriftic fymp¬ toms of this affedlion, areltiffnefs of the neck and trunk, pain along the vertebral column, in addition to the com¬ mon fymptoms of irritation of the nervous fyllem, with the abfenceof fignsof cerebral diforder when the inflam¬ mation is confined to the arachnoid of the fpine, and their coincidence when the ferous membrane of the brain partakes of the inflammation. Two interelting cafes of inflammation, and confequent dilorganization, of the fpinal marrow itfelf, have been lately publilhed by Dr. Pinel the younger, which were characterized by continual convulfive motions of the whole of the trunk of the body, followed by an almoll complete annihilation of the fundlions of the nerves of voluntary motion, and accompanied by a febrile Hate of the fyllem, having a paroxyfmof exacerbation every eve¬ ning. The furgery of France, as far as operations are con¬ cerned, lcarcely appears on an equal footing with the furgery of this country; and, if we were difpofed to cri- ticife our Gallic neighbours, we might further remark, that a great want of attention and refpedt is manifelled by them for the labours of others. Thus Brouffais, juft mentioned above, has been lately labouring to Ihow that we know next to nothing; and very unfairly fupports his affertions by quoting the pradlice or the reveries of fome of the obfcurell contributors to our periodical pub-L lications. And Boyer, a charndter of great repute in France, and author of one of their flandard furgical works, has the blindnefs to rejedl Mr. Hunter’s excellent mode of operating for popliteal aneurifm, and even de¬ nies his claim to the difcovery of it. By the way, we mayjuft extradl from a cafe lately publilhed by DeRoux, an account of the method in which the operation for aneurifm is performed in France : “ I performed the ope¬ ration,” he fays, “ in the place where it is now pradtifed in England. The artery was completely infulated from all adjacent parts, even from the crural vein, for the fpace of an inch. I placed four ligatures at about two lines diltant from each other. Thus there were two li¬ gatures to intercept the blood, the firfl and lall being only left as ligatures d'uttente. I then followed the re¬ commendation of Scarpa, in applying upon the artery a fm all cylindrical body, an inch long and two lines in diameter, upon which I put a piece of linen, which had been dipped in melted plalter ; on this I tied the two middle ligatures. I took care not to let the wound unite, and kept the lips feparated by foft lint.” An Englifii furgeon will have little difficulty in feeing the fcriking contrail exhibited between this operation and the manner it is performed in the hofpitals of London. Let us not however confound all in thiscenfure: there are many who duly appreciate our toils and our merits; and there are many who deferve from us the fame regard. We might mention fcores of names in proof of this ; but Larrey, Richerand, and Dupuytren, are fufficiently known to our medical readers. In parturition, we have two curious recent cafes to re¬ cord.— -A male child was born in May lall, at the Hofpi- tal of la Maternite, at Paris, with the whole furface of the body deeply wrinkled, like that of a very old man. Its hands and feet are double the ordinary length, and are equally wrinkled. It has llrong grey hair, and a beard of the fame colour. In every other refpeCt it en¬ joys perfect health, and is nurfed in the hofpital. — The following is not lefs interelling ; though we have already remarked, (fee the article Parturition, in the prece¬ ding volume,) that the French are in general more fuc- cefsful in thefe defperate cafes than ourfelves. At a meeting of the Royal Academy of Medicine at Paris, on the 7th of July lall, (1821.) M. Beclard, one of the moll dillinguilhed furgeons of that capital, reported that he had, the day before, performed the casfarian operation, by an incifion made in the direction of the linea alba ; and that both mother and child were doing well. The report continues favourable down to the 10th, on which day the account was tranfmitted. The French pay more attention to pharmacy than per¬ haps any other nation, and confequently their attain¬ ments in that branch of the healing art are very great. Simplicity has affumed the place of that multiplicity of formulae which had overrun all the old pharmacopoeias ; and the analyfis of vegetables w-hich at prefent engages fo much the attention of the French chemilts, promifes to afford very important information in regard to the modus operandi of medicinal fubllances; a fubjeCt of which very little is at prefent known. Thefe remarks have occurred to us in perufing the lall Paris Pharmacopoeia, or Codex, publilhed in 1818, in a 1 handfome PATHOLOGY. handfome 4to of 600 pages. But we muft obferve, that the French prefcriptions continue to have more ingre¬ dients in them than our own ; for we find one of the compound tinCtures containing 18 ingredients, another 16, and fo on. They are however, as we faid, impro¬ ving ; for their Alcoholatum vulnerarium, which, in the former edition of the Codex, confifted of 4a ingre¬ dients, is now reduced to 13. We cannot, however, avoid noticing the Ele&uarium opiatum polupharmacum, theriaca dictum; and never was an epithet fo juftly ap¬ plied as the term polupharmacum to a farrago containing upwards of 70 articles. This ne plus ultra of complex¬ ity is ufhered in by the molt folemn affurances that the compilers have not dared to encroach on, or alter in the flighteft degree, the directions given in the preceding Codex (60 years fince), for the preparation of this “ percelebris compofitio and that, although feveral of the compound medicines, which formerly entered its coinpofition, have lately been excluded from the pages of the Codex, yet they have taken efpecial care to intro¬ duce every one of the conftituents of thofe compounds in .the exaCt proportion in which they entered the prece¬ ding formula; forinftance, though the trochifi viperiniare no longer in ufe, yet the caro viperina is carefully pre¬ ferred as an ingredient of the theriaca. In order to give our readers fome idea of the complexity of this for¬ mula, fuffice it to obferve, that the authors have judged it neceffary to divide it into thirteen diftinct heads, for the purpofe of giving us fome infight into the nature and aCtion of this monfter in pharmacy. Thefe are, 1. Acria. 2. Amara. 3. Styptica. 4. Aromatica exotica. 5. Aro- matica ex indigenis. 6. Aromatica ex umbelliferis. 7. Refinae et Balfami. 8. Graveolentia. 9. Virofa. 10. Gummofa. n. Terra inert. 12. Dulcia. 13. Vinum. The amazing complexity of this medicine, the very cir- cumftance on which its celebrity is grounded, is a fuffi- cient caufe of condemnation. How is it poflible to fup- p>ofe, that the fimultaneous exhibition of agents fo oppo- fite, is a defirable objeCl ? It will, no doubt, be always a tEoft valuable acquifition to the quack, who, not know¬ ing what intention he fhould endeavour to fulfil, may reckon with tolerable certainty, that fome of the articles of this panacea are adapted to the wants of his patient. We cannot too ftrongty reprobate the retention of this compound, which has obvioufly arifen from timidity in the authors, who feared to rejeft a remedy of which fo high an opinion is entertained. B ut by whom? They themfelves anfwe? the queftion, and confefs they have aCted according to the willies of thofe who are totally unqualified to form an opinion. One of the reafons given for its introduction into the new Codex is, “ quia a vulgo fsepius requiritur.” A parity of reafoning would lead them to introduce into their Pharmacopoeia all the quack-medicines of the cornpofition of which they could attain a knowledge ; and, indeed, this inten¬ tion they have difplayed on one or two other occafions. It appears to us, that in afligningthe above caufe for the retention of certain remedies, they have miftaken their duty, which is no lefs to decide what medicines ought to be retained or rejected, than to give accurate inftructions for the compounding and preparing of fuch as are judged proper to compofe a part of their materia medics,. After all the ingredients of the theriaca have -been mixed to¬ gether, fecundum artem, they are fet afide for one year, in order to undergo a flow fermentation, as it is directed in the Codex. That they do not undergo this procefs, teems probable front the circumftance that anal-yfis dif- covei's no difference between parcels of theriaca differing much in age, the recent preparation perfectly re fern biin g that which has been of feveral years Handing; Diafcor- di u 1Y1 is another eleCtuary, tranfiated from the old edi¬ tion to the new Codex, in all its priftine complexity, with the fame fcrupulous regard to its cornpofition as that we have juft been confiderirrg. It is only to be wondered how the Theriaca cceleftrs, and the BenediCta laxativa, each of them confifling of at leaft twenty arti¬ cles, could have fo far degenerated as to have forfeited a place in this new edition. A new preparation of opium has been very recently propofed by Mr. Robiquet of Paris. It has been afeer- tained, that the moft aCtive properties of opium refide in two fubftances, which may be obtained in difcinCl forms, and which produce very different effeCts ; narcotine, and morphine , as they have been named. The former is a very powerful irritant to the nervous fyftem, as appears from the experiments of Dr. Majendie ; and it feems to be this fubftance which produces the effeCts which we fo much wifh to avoid in the adminiftration of this medi¬ cine, and which are obviated, to a certain extent, by giving it in the form of the black drop , or other analo¬ gous acid preparations. Morphine, according to the evi¬ dence of the fame experiments, and others made on hu¬ man beings, produces fedative effeCts without fymptoms of the flighteft irritation. To feparate the narcotine, then, from the other parts of opium, is a very defirable object of pharmacy 5 and Mr. Robiquet fays it maybe eafily effected in the following way : “ I macerate,” fays Mr. Robiquet, “common opium, divided into fmall pieces, in cold water, as if it were for the aqueous ex¬ tract of opium ; I filter the folution, evaporate it to the confiftence of a thick fyrup, and treat it, in convenient veffels, with rectified ether ; the whole is then fhaken a great many times, before the ethereous tinCture is poured off; this, being feparated, is then fubmitted to diftillation, that the ether may be drawn from it. This procefs is repeated as often as cryftals of narcotine are obtained as a refidue of the diftillation. When the ether is without aCtion, I evaporate the folution of opium to a confiftence proper for pills; and I obtain, by this means, an extraCl wholly free from narcotine.” In the Revue medicule, before quoted, there is an arti¬ cle continued from time to time, called “ Medical Let¬ ters.” Thefe contain the medical chit-chat of Paris. From the 2d M° of that work, we fnall make a few ex¬ tracts applicable to our prefent purpofe. Thefe letters contain much truth, but not without a mixture of what the French call malice, a term, however, not of fo harlh a meaning as the fame word in our language ; and will certainly give an idea of the ftate of medicine, and the opinions upon it, at this time. “ Paris has long given the ton to Europe ; and fo com¬ pletely dictates to the provinces, that whatever comes from the capital excites the greateft curiofity ; a feeling the more predominant in medical men, from its having been as yet, with regard to them, lefs gratified. The daily papers detail only events of general intereft ; and the fcientific journals exclude all anecdote. To fill fuch a gap will be a difficult enterprife, and the execution of it will offend many ; but the confideration that fcience and the public will gain by it, is a fufficient incitement to the attempt. “ Petitions have been prefented to both chambers, to proteft againft the fuppreifion of the concours (examina¬ tion and competition) in the election of profeffors ; and one of the petitioners has proved to demonftration, that the only objeCt in this fuppreffion is to ferve the interefts of M. Royer- Collard. If this gentleman had taken the trouble to ftudy chemiftry, anatomy, and medicine, by way of qualifying himfeif to deliver a courfe of medical jurifpruder.ee, there is no doubt but he would have faved government from all the blame which this election has thrown upon it. John Hunter, arriving at the age of twenty-two years from the mountains of Scotland, where he exercifed the trade of a carpenter, became ne- verthelefs one of the firft anatomifts of England. M. Royer- Collard, arriving at Paris at the age of forty from ChambCry, where he performed the duties of a commit- fary, might have found fome better method of teaching medical jurifprudence than by reading leCtures copied from a printed book which is known to the whole world. The 49 PATHOLOGY. The fource from which the profefi’or drew thefe waters of fcience was foon difcovered ; each ftudent, being able to tafte them at the fountain-head for the moderate fum of thirty francs, the price of M. Fodere’s excellent Treatife on Medical Jurifprudence, did not hefitaie be¬ tween this expenfe and the fatigue of lifteningto tedious lectures ; fo that the profefl'or found himfelf abandoned by his pupils, and left alone in the vaft amphitheatre of the fchools of the faculty. Such a milhap is certainly a fufficient apology for M. Royer- Collard’s having given fo few leftures in the firft year of his profefTorfhip, and for having, during the fucceeding years, renounced all public inftruftion. Still-we are indebted to the profelfor for the excellent courfe of leftures which his pupils heard in the fummer of 1819. As direftor of the Bibliotheque Medicale, he infured the fuccefs of the work by contri¬ buting the feweft articles to it; as profelfor of medical jurifprudence he felt it his duty to refort to limilar means to recall his truant pupils, and accomplilhed his objeft by employing M. Orfila to lefture for him ; and the fuc¬ cefs of the experiment did not detradl from the reputa¬ tion of the learned author of the Toxicologie. “ Several nominations followed that of this able che- mift. M. Beclard was called to the chair of anatomy, M. Marjolin to that of external pathology. MM. Fou- quier and Roux have alfo been lately appointed ; the firft to the chair of the Clinique de Perfeftionnement, vacant by the death of M. Bourdier; the latter to a chair of pa¬ thology, vacant by the refignation of M. Percy. A-pro- pos of this refignation ; it is faid in the medical world of Paris, that 60,000 francs was the price M. Percy received for this profelforlhip ; certainly a large fura for a place, the receipts and prefervation of which are not certain. The cafe is not without precedent; at Montpellier in 1786, M. de Barthez fold a profeffor’s chair to M. Gri- maud for 30,000 francs. This is great authority for the venality of profeflorfhips ; which, however, has one little inconvenience, i. e. that of excluding the poor man of talent, though it prefents the inappreciable advantage of narrowing the field of favour, a divinity more to be feared than riches. Still we cannot complain of fimilar bar¬ gains, when they bring fuch men as M. Roux into a more extended fphere of ufefulnefs. This excellent fur- geon and learned profelfor muft always have appeared to advantage in a concurrence with any rivals. “Since the fupprellion of the concours , the faculty of medicine prefents to the choice of the committee of pub¬ lic inftruftion four candidates. The three laft are, how¬ ever, only infcribed for form’s fake. This fort