FOUNDATIONS OF MODERN MEDICINE 



15 



observe and to record their observations; and, indeed, it is during 

 this period that Girolamo Fracastoro, studying syphilis and 

 typhus, started modem epidemiology by formulating the theory 

 of contagion. 



The subject of infection has been recently studied in a most able manner 

 by C. and D. Singer, who have shown that to primitive peoples infection and 

 contagion are in the general order of things, and not to be questioned, but 

 that Hippocrates had no idea as to the spread of epidemic disease by infection. 

 They point out that it was Thucydides (471-391 B.C.), while studying the 

 ' plague of Athens,' who first established spread of disease by contact, and 

 Aretaeus the Cappadocian who added conveyance of infection from a dis- 

 tance, facts recognized by some of the Arabians like Haly Abbas, while the 

 School of Salerno clearly stated that disease could be spread by contact, air, 

 and fomites; and Remade Fuchs (1510-1587) was not merely clear on these 

 points, but wrote about the ' seminaria,' or seeds of disease. All these were, 

 however, merely the precursors of Fracastoro (i 478-1 553), whose doctrine 

 of disease seeds or germs, foreshadowed in his ' Syphilis ' in 1530, is clearly 

 stated in his ' De contagionibus et contagiosis morbis et eorum curatione ' in 

 1546, in which he details different types of infection, by contact alone, by 

 contact and fomites, by contact, fomites, and from a distance. He considers 

 infection to be nothing else than ihe passage of a putrefaction from one body 

 to another. He distinguishes infections from poisons because the former 

 possess seeds which can reproduce their like in a second body. In addition, 

 he was the first to recognize typhus fever and the specific characters of fevers. 



These factors — viz., new methods of warfare changing society, 

 new methods of spreading knowledge and apparently new epidemics 

 ■ — were the forces which in our opinion laid the foundations of 

 modern medicine. 



The Discovery of the Tropics. — It will be noted that in early times 

 medicine was relatively highly developed in Egypt and India, while 

 it was very primitive in the Temperate Zone, but the question as to 

 the supremacy of East over West was settled by the Battle of 

 Salamis, and thenceforth the general tendency was that learning 

 advanced in the West and languished in the East. But the West knew 

 that there was an East : the question was how to get there. A few 

 travellers lived to return and tell the tale of the overland journeys 

 to the East, and these were sufficient to indicate that the overland 

 route was unsuited for traffic on a large scale, though trade came 

 through gradually. 



The problem of finding a way to the East was solved by the 

 Portuguese, who in 141 5 established contact with the Atlantic 

 Islands, in 1444 with the West Coast of Africa, and later with the 

 Congo and Angola. In i486 they reached the Great Fish River, 

 and in the last decade of the fifteenth century the route to India 

 via the Cape was made known. 



While this was going on in the East, Colombus was tracing a 

 route to America across the Atlantic in 1492, and in 1519 Magellan 

 passed through the Straits to which his name has been given, and 

 showed the route to the East, while still later the complete voyage 

 round the world was carried out successfully. 



China and Tibet, however, remained unknown until the seven- 

 teenth century and Central Africa until the nineteenth century. 



