56o THE POPULAR SCIENCE MONTHLY 



of cold for anesthesia, Claude Bernard's puncture of the fourth ventricle 

 and his demonstration of the glycogenic function of the liver and of the 

 vasomotor nerves; the discovery of Triclwphyton tonsurans and Balan- 

 tidium coll by Malmsten, the invention of the spirometer by Hutchinson 

 and of the ophthalmoscope by Helmholtz, and the sphygmograph by 

 Vierordt. Altogether Jacobi tells of a host of observations made in a 

 short period of six years. And the list is not one of laboratory dis- 

 coveries only. It includes important advances in clinical medicine and 

 surgery, as Meigs's discovery of the importance of thrombosis as a cause 

 of death in puerperal women, Marion Sims's vesico-vaginal operation, 

 Detmold's operation for abscesses of the cranial cavity, Walker's work 

 on the infectious nature of secondary syphilis, Eomberg's studies of 

 tabes dorsalis, Pravaz's invention of subcutaneous injection, Kuchen- 

 meister's discovery of the connection between tsenia and the scolex 

 found in pork, Bigelow's resection of the femur and Bennet's work on 

 leucocythemia. 



More could be quoted from Jacobi's impression of this period, but 

 this is enough to show that medicine was advancing not only in the 

 laboratory, but in the clinic. One may, as Jacobi says, " recognize in 

 my fragmentary enumeration, facts of crucial import." 



These advances in clinical medicine and surgery were due to several 

 factors ; to the increasing use of the methods of physics, chemistry and 

 biology, to the influence of pathology, to the introduction of new 

 procedures in diagnosis, and in surgery, to the facility of operation 

 offered by anesthesia. What a change in the practise of medicine these 

 observations and applications brought about! How different their 

 influence from that of the earlier schools and systems with which we 

 associate the names of Brown, Cullen, Broussais, Hoffman and Stahl ! 



Such schools and systems, while of interest to the general historian 

 of medicine, offer no assistance to one seeking the lines of advance 

 dependent on investigation or research in medicine. Fortunately for 

 the history of clinical medicine the systematists did not occupy the field 

 to the exclusion of those guided by objective observation, for we find 

 Sydenham (1624-1689) and Boerhaeve (1668-1738) studying disease 

 unbiased by schools or systems, and applying the methods of close 

 observation which we now recognize as those of modern clinical medi- 

 cine. But although Sydenham and Boerhaeve and their followers aided 

 progress by the addition of some positive knowledge to clinical medicine, 

 their influence on the development of medicine was not great, for they 

 were before the days of Morgagni, Haller, Hunter, Bichat and Eoki- 

 tansky and the methods associated with these names.* Without patho- 



•• Before and about the time of the period so represented, some of the impor- 

 tant contributions made to clinical medicine and pathological anatomy were as 

 follows: aneurism and diseases of the heart by Lancisi, Albertini and Senac; 

 an investigation by Fothergill, of the diseases now known as diphtheria and tie 



