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.

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    account of chorea, of hysteria, and of gout have become classical in the literature. But it was in treatment that he showed a still more revolu- tionary spirit. He had a supreme faith in nature as the true healer, to whom the physician played a secondary part, assisting her when she was feeble, restraining her when excessive and violent, lliat many diseases got well if left to themselves was a novel doctrine in the seventeenth century. But it was in his new method of treating fever, and particularly smallpox, by cooling measures, plenty of drink and fresh air, that he departed most strongly from the practice of his day and achieved signal success. One of the most interesting figures in the history of clinical medicine, Sydenham has impres-sed his method on his countrymen, who have always cared less for the theoretical conceptions than for the ])rac- tical, common-sense aspects in the consideratiefn of disease. Several of Sydenham’s contemporaries in England were keen clinical physicians who have left on record valuable contributions to medicine. Glisson in particular may be mentioned as a man in whom were combined the anatomical and clinical features so characteristic of the teachers of this period. His treatise, dc Rachidide, 1G50, is the first extensive monograph on a single disease published in England (Cains’ Sweating Sickness, published a century earlier, had not the same ambitious scope). Not only are the clinical aspects of the disease given in great detail, but the morbid anatomy and the etiology also are fully discussed. Morton, too, was an admirable systematic writer and his works Pyrctologia (1692) and Phthisiologia (1689) show accurate study, and the subjects are presented in a more orderly and logical way than in the writings of Sydenham. Brilliant and even revolutionary as was the work of this small group of English physicians, it did not immediately influence the progress of clin- ical medicine until the advent of the Dutch Hippocrates, Boerhaave, upon whom fell the mantle of Sydenham. But meanwhile there had arisen on the Continent the iatro-physical school, based upon the mechanical concep- tions of the Cartesian philosophy and supported by the experiments of Sanctorius, of Harvey, of Borrelli and others. Silvius, of Leyden, and Pitcairn, Mead and Friend were the chief exponents of this system, in which everything was explained in terms of mathematical reasoning; and w'hile it did good service in combating the dominant doctrine of the humors, the extravagance of its professors hastened the downfall of a school which, after all, rested on a strong basis of truth. As with nearly everything of value in the practical aspects of modern life, agriculture, horticulture, banking, colonization, etc., so in clinical medicine the Dutch were our masters. The great Italian teachers of the sixteenth and seventeenth centuries were also practitioners, and there must have been some instruction in the art as well as in the science of medicine, but it was everywhere desultory and unsystematic until the Dutch physicians organized regular clinical instruction as part of the University teaching. Professor Pell tells me that the hospital clinic at Utrecht preceded that at Leyden, but it was at this latter place, under the influence of Boerhaave, that it became most effective. The history of this University illustrates the importance of men in forming an educa- tional centre; students flocked to it from all parts of Europe to sit at the feet of such teachers as Silvius, Crotius, the younger Scaliger, Bidloo, and Pitcairn. After teaching botany and chemistry, Boerhaave sticcceded