232 MEDICINE 



The characteristic scepticism of the eighteenth 

 century had a healthy influence upon medical 

 practice, the absurd medication of the middle ages 

 being gradually, though slowly and grudgingly, 

 given up. Another tendency of this century, 

 however, its delight in speculation and deduction, 

 stood in the way of medical advance. "What a 

 vast literature," writes Sir William Osier, referring 

 to our knowledge of fevers, "exists between Syden- 

 ham and Broussais. What a desolate sea of 

 theory and speculation ! " This desolation extended 

 from the middle of the seventeenth to the early 

 years of the nineteenth century. On the nearer 

 shore of the sea, where speculation gave way to 

 the solid ground of observations properly recorded, 

 we see the heroic figure of the Frenchman Louis 

 (born 1787). "For nearly seven years, including 

 the flower of his bodily and mental powers (from 

 the age of 33 to 40) he consecrated the whole of 

 his time and talents to rigorous impartial observa- 

 tion. All private practice was relinquished and 

 he allowed no consideration of personal emoluments 

 to interfere with the resolution he had formed. 

 For some time his extreme minuteness of inquiry 

 and accuracy of description was the subject of 

 sneering and ridicule, and ' To what end ? ' was 

 not unfrequently and tauntingly asked...." Never- 

 theless it was in no small part due to Louis' influence 

 that half way through the last century clinical 

 teaching and clinical practice had become essentially 



