756 



MEDICINE. 



science according to their notions, nnd left it not un- 

 improved in respect of practical application and phar- 

 macology. Arabian medicine reached its highest 

 point under Avicenna (born 980), who, for some time, 

 was esteemed even higher than Galen; the opinion of 

 the latter's superiority, however, eventually revived. 

 The Western medicine begins with the medical school 

 of Salerno, perhaps existing as early as in the ninth 

 century, but well established in 1143 and 1238, 

 where medicine was taught according to the princi- 

 ples of the Greeks. During the rest of the middle 

 ages, there existed a Galeno-Arabian science of 

 medicine, mostly fostered by ignorant monks, and 

 only gradually struggling on, after suffering, per- 

 haps, more than any other science, from every super- 

 stition and every misconception of nature. In the 

 fourteenth century, anatomy was improved by Mon- 

 dini; later, the knowledge of medicaments, by the 

 discovery of new and distant countries, practical 

 medicine, by the appearance of new diseases, and not 

 a little by the frightful syphilis. The love of Greek 

 literature was revived by the scholars driven from 

 Greece by the conquest of Constantinople (in 1453), 

 and men having begun to read the Greek medical 

 writers, especially Hippocrates, in the original lan- 

 guage, a more scientific and liberal spirit of investiga- 

 tion took the place of slavish adherence to antiquated 

 prejudice. Thus the fall of the Galenic system was 

 prepared, which was completed in the sixteenth cen- 

 tury, and forms the essential part of the reformation 

 produced by Theophrastus Paracelsus (1526). The 

 chemico-theosophical system of this enthusiast was 

 refined and arranged by J. B. von Helmont (who 

 died in 1644), until, deprived of its theosophical 

 character, it passed over into the chemico-material 

 system of Francis Sylvius (who died in 1672), and, 

 at length, into the psychiatric system (from tar^x,*, 

 cure) of Stahl (who died in 1734.) Yet, soon after 

 Harvey's great discovery of the circulation of the 

 blood (in 1619), the iatromathematical doctrine, under 

 Alphonso Borrelli (who died in 1679), developed 

 itself, which finally took the shape of the dynamic 

 system of Fr. Hoffmann (died 1742), from which the 

 dynamic schools of modern times proceeded. Hoff- 

 mann, who may be called the morning star of the 

 reformation of medicine, feeling the insufficiency of 

 all the opinions of his predecessors, and clearly per- 

 ceiving that the animal body was influenced by laws 

 quite different from those presiding over inanimate 

 matter, dedicated himself to a careful examination 

 of the nature of the operations of the respective parts 

 of the body, whereby he perceived that certain organs 

 possessed specific actions, and that those of the brain 

 and nerves were of all others the most remarkable, 

 and unlike what was to be observed in the other 

 objects of nature. To the nervous system, therefore, 

 he referred the effects of vitality, and to the nervous 

 influence he attributed the production of two diseased 

 states of the system, dissimilar and opposite to each 

 other, to which he applied the terms of spasm and 

 atony the first expressing the condition of increased, 

 the second, of diminished activity. 



Upon this doctrine, Dr Cullen of Edinburgh laid 

 the foundations of his system. Discarding, in the 

 most positive manner, the merely mechanical powers 

 of matter as accounting for the phenomena of vitality, 

 and resting all his opinions upon the specific proper- 

 ties of the living body, he taught that the great 

 agents in all the operations either of health or disease 

 are the minute fibres of the nerves and muscles, 

 which, he says, are the immediate cause, not only of 

 sensation and motion, but of all the changes gradually 

 effected in the internal economy of the system ; that 

 the most important of these changes are produced 

 Uirough the medium of the minute terminations of 



the arteries, and that the action of these vessels was 

 perfectly competent to produce all the changes that 

 occur, both in the state ot the fluids and solids. He 

 adopted the spasm and atony of Hoffmann, but refined 

 so far upon their nature, as to conceive it possible for 

 the two conditions to exist at the same time in dif- 

 ferent parts of the system. 



Soon after the promulgation of this system, Dr 

 John Brown, also of Edinburgh, proposed another 

 equally novel and striking. He taught that every 

 living being possesses a specific power or excitability, 

 from which all its appropriate functions arise ; that, 

 every circumstance, either external or internal, which 

 can affect a living animal is an excitement or stimulus, 

 and contributes to expend a portion of its excitabi- 

 lity ; that upon the proper action of these excite- 

 ments depends the due development of the vital 

 powers ; so that, whenever they are applied in an 

 immoderate degree, the excitability is too speedily 

 expended, the animal becomes exhausted, {ind 

 falls into a state of indirect debility. But that, 

 if, on the contrary, there should be a deficiency of 

 stimulus, the powers of life become languid from a 

 want of being called into play, and a contrary state, 

 or direct debility, ensues, and the excitability becomes 

 preternaturally accumulated. Thus, when the body 

 suffers from the want ot food, it falls into a state of 

 direct debility ; whereas, if the system has been 

 inordinately excited by a large quantity of wine, and 

 a state of languor follows from it, the condition so 

 induced is that of indirect debility the first being 

 from defect, and the latter from excess of excitement; 

 that the state of the body, as to sensibility, is ever 

 the same in kind, and can only vary in degree, being 

 always invariable in the same individual, except what 

 may depend upon the smaller or greater quantity of 

 excitability called into action at different periods ; 

 moreover, that the portion of excitability possessed by 

 each individual was allotted to him at birth, and that 

 this original stock cannot by any means be increased : 

 but that it cannot be expended at more than a given 

 rate without producing a diseased condition of the 

 body, and that, if, from any cause, this rate be ex- 

 ceeded, acertain portion of time is requisite to restore 

 the balance between the supply and deficiency ; that 

 the excitability resides both in the muscles and nerves; 

 that its quantity in the different parts of the body 

 exists always in .the same proportion as relates to 

 each other, whereby whenever it becomes excessive 

 or defective, in any one organ, it likewise does so in 

 every other part, owing to the balance naturally 

 existing between them. Hence, he concluded, that 

 all diseases may be divided into two great classes 

 either of excess or defect or, as he calls them, 

 sthenic orasthenic of which the principal differences 

 in each class consist in the parts which they affect, 

 modified by peculiarities in the temperament, sex, 

 age, habits of life, &c., c. 



The system of the celebrated Darwin is similar, in 

 many respects, to that of Brown. He commences 

 by assuming the existence of a certain power or 

 faculty attached to the living body, which is the im- 

 mediate cause of all the phenomena of life, to which 

 he gives the name of spirit of animation, or sensorta* 

 power. This resides both in the muscles and nerves, 

 and is equally the origin of motion and sensation. 

 It is called forth by the action of various stimulating 

 powers, and is capable of accumulation and exhaus- 

 tion, upon which states of excess or defect all the 

 diseased trains of action depend. That there are two 

 kinds of debility, either from defect or from excess ot 

 excitement. But he differs from Brown in not limit- 

 ing the portion of excitability, for he conceives that 

 the sensorial power may be generated, from time to 

 time, by the nervous system, exactly as it is required 



