Volume 1

A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae.

Date:
1907-10
Catalogue details

Licence: In copyright

Credit: A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    27/986
    century chemists lias led to the jiresent most fruitful results. Thirdly, we may trace as a direct effect of the Renaissance the revival of experi- ment in medicine which had been introduced by Galen. The work on metabolism by Sanctorius, and the demonstration by Harvey of the circulation of the blood gave an immense impetus to the scientific investi- gation of the functions of the body and of the causes of disease. It cannot be said that Harvey’s work had any very sjx'cial influence on clinical medicine except in conjunction with the mechanical philosophy of Descartes and the foundation of the so-called iatro-mcchanical school. How little actual progress had been made in clinical medicine is illus- trated by what a leading jiractitioner, Willis, in the middle of the seventeenth century thought of such a disease as inflammation of the lungs. The essential cause was believed to be that the blood boiled feverishly, and “sticking within the more narrow passages of the lungs engendered there an obstruction causing inflammation.’’ Neither in the description of the symptoms nor in the discussion of the prognosis is there any radical advance upon the position of Hippocrates and of Galen. A case, the particulars of which he gives, shows the heroic character of the treatment: “I drew blood twice or thrice day after day.’’ “Frequent clysters were administered; moreover) apozems, juleps, also spirits of ammoniac and powder of fish shells were administered by turns,’’ When phlebotomy was no longer safe very large blisters were applied to the arms and thighs. One is surprised to learn that the patient recovered, but he suffered greatly from the blisters which did “run hugely and afterwards for almost a month daily discharged great plenty of a most sharp ichor.’’ III. Not truly scientific and uninfluenced by his friends, Boyle and Locke, (who appreciated fully the importance of the scientific movement of the day), Sydenham restored in a measure the practical methods of the Hippocratic school, careful observation, guided by common sense. If to that remarkable conception of diseases as objects of study and classifica- tion, as in the subjects of botany and natural history, Sydenham had added the methods of Harvey, experiment and postmortem observation, the real revolution in clinical medicine might not have had to wait until the beginning of the nineteenth century. A prince among ])ractical physicians, the limitations impo.sed upon him.sclf re.stricted his view, and Sydenham never got to the “seats and causes of di.sea.se’’ as did his great succe.s.sor, Morgagni; but as a portrayer of their objective features he has had few equals, and in this he even bettered the instruction of his master, Hipjiocrates. In his study of fevers Sydenham displayed a remarkable independence, not more in the graphic pictures which he lias left us than in his insistence upon the importance of a knowledge of their natural history as a basis of rational treatment. I'liat he was led away by too great belief in an epidemic constitution was only to be expected in .so clo.se a follower of Hippocrates. No one before him had .so clearly grasped the conception that the manifestations of a fever reprc.sented the efforts of nature to get rid of the injurious agents causing the di.sea.se. Many of his descriptions of chronic diseases have never been surpas.sed, and his