PROBLEMS OF INTERNAL MEDICINE 211 



Gradually, however, the first "lonely mountain peaks of mind" 

 were followed by an ever increasing number of earnest and un- 

 trammeled students. In the seventeenth century the opportunity 

 to give one's life freely to the search for truth had become more 

 and more open to all. The mysticism and animism of Stahl, which, 

 in the early part of the eighteenth, hung over the medical world, 

 was already breaking away. The study of the natural sciences 

 was pursued more eagerly and generally than ever before. Reau- 

 mur and Black and Haller and Spallanzani and Hunter and Priest- 

 ley and Lavoisier had lived. Morgagni, sweeping aside the dog- 

 matism of the old schools, had demonstrated the local changes in 

 many diseases and had opened the way for the objective patholog- 

 ical anatomy of Bichat. In the field of practical medicine such men 

 as Sydenham and Morton and Torti and Lancisi practiced and taught 

 much which holds good to-day. Boerhaave had introduced clinical 

 instruction. Cullen and Cheyne and Huxham and Pringle and 

 Heberden and Van Swieten and De Haen were all in many ways 

 true and faithful students; yet methods and doctrines that were 

 often strangely fantastic still held general sway such, for in- 

 stance, as the Brunonian system. A perusal of the writings of Stoll, 

 one of the wisest practitioners of his day, cannot fail to impress one 

 with the meagerness of the basis of anatomy and physiology, normal 

 and pathological, on which medicine rested, the almost entire lack 

 of diagnostic methods, the absence of a rational therapy - - how 

 much of the conjectural, how little of the scientifically exact there 

 was in medicine. 



Diagnosis, based largely upon gross clinical conceptions, was 

 necessarily vague and uncertain. 



Prophylaxis, in the absence of any certain knowledge of the 

 causes and manner of origin of disease, was devoid of any sound 

 basis. 



Treatment was almost wholly empirical, and, where it was not 

 empirical, it was frequently based upon some theoretical system 

 so arbitrary and dogmatic that the unfortunate sufferer was too 

 often stimulated or purged, fed or bled, as he fell into the hands 

 of a Brown or a Broussais, rather than according to the nature of 

 his malady. 



In the Dictionnaire de PAcademie frangaise for 1789, a year 

 which marks the end of an era in the world at large, one finds the 

 following definition: "Medecine. s. /. L'art qui enseigne les moyens 

 de conserver la sante & de guerir les maladies. (La medecine est 

 un Art conjectural. * *) " Medicine a conjectural art! Such was 

 the estimate placed upon our profession by the French Academy 

 a little over one hundred years ago. 



But the seeds of a new life had been sown and the germination 



