THE HISTORY OF INTERNAL MEDICINE 229 



12. Brimonianism, founded by John Brown (1735-1788) of Scot- 

 land, based on the doctrine that vital and morbid processes depend 

 on irritability or stimulations varying in intensity. It continued into 

 the nineteenth century, especially in Germany and Italy, and has the 

 evil reputation of having been the most vicious and harmful medical 

 system ever practised. 



In the first third of the nineteenth century : 



13. The theory of excitement, a form of Brimonianism, in vogue 

 in Germany. 



1-1. The Italian system of stimulus and contrastimulus, an otf shoot 

 from Brunonianism, developed by Basori (1762-1837). 



15. Homeopath}', founded by Hahnemann (1755-1843), first pro- 

 mulgated in 1810, and still surviving as an example of ancient medi- 

 cal beliefs. 



16. Broussaisism, .so-called " physiological medicine," founded by 

 Broussais (1772-1838) of France, and in vogue for a decade or two 

 from about 1816, which looked upon gastro-enteric inflammation and 

 irritation as the cause of diseases in general. 



Thus the history of internal medicine shows a succession of ephem- 

 eral systems and theories from Hippocrates down to about the second 

 quarter of the nineteenth century. In the various systems that devel- 

 oped a few factors stand out prominently around which the theories 

 centered. Thus, the fundamental distinction between spirit and matter, 

 or between living and non-living matter, furnished grounds for basing 

 medical philosophies on the spiritual (or vitalistic) principle or on 

 material factors, respectively. Among the materialistic medical sys- 

 tems, some (the " solidistic " theories) were grounded on the solid 

 structures of the body, others (" humoral " systems) on the body fluids; 

 some ascribed vital processes and derangements to chemical activities, 

 others to the physical, mechanical or dynamic activities of the body 

 structures ("mechanistic" theories). 



Although centuries after the end of the middle ages in other 

 respects, the second quarter of the nineteenth century may be fixed 

 upon as the approximate termination of the medieval period of internal 

 medicine, since down to that time the dominant tone of medical 

 thought was about the same as it had been throughout the middle ages, 

 or indeed since the time of Hippocrates. There had of course been some 

 advance since Hippocrates, as in the differentiation of various diseases 

 and the discovery and introduction of remedial agents; moreover, the 

 development of scientific anatomy, physiology and chemistry could 

 hardly fail to have had a salutary influence on medicine. Yet the 

 dominant conceptions in pathology and etiology and the rationale of 

 therapeutic practise were practically not more advanced, more rational, 

 or more efficient a hundred years ago than they were two thousand 



