appears again, but with still further complications—the whole body
being controlled by the archeus influus, and the organ of the soul
and its various parts by the archei insiti, which are subject to the
central archeus. Many of the symptoms of diseases were caused
by the passions and perturbations of the archeus, and medicines
acted by modifying the ideas of the same archeus. These and other
notions cannot be here stated at sufficient length to be intelligible.
It is enough to say that on this fantastic basis Helmont constructed
a medical system which had some practical merits, that his therapeutical
methods were mild and in many respects happy, and that
he did service by applying newer chemical methods to the preparation
of drugs. He thus had some share, though a share not generally
recognized, in the foundation of the iatro-chemical school, now to
be spoken of. But his avowed followers formed a small and discredited
sect, which, in England at least, can be clearly traced in
the latter part of the century.
Discovery of the Circulation of the Blood.—The influence of Harvey’s discovery began to be felt before the middle of the century. Its merits were recognized by Descartes, among the first, nine years after its publication. For the history of the discovery, and its consequences in anatomy and physiology, we must refer to the article Harvey. In respect of practical medicine, much less effect was at first noticeable. But this example, combined with the Cartesian principles, set many active and ingenious spirits to work to reconstruct the whole of medicine on a physiological or even a mechanical basis—to endeavour to form what we should now call physiological or scientific medicine. The result of this was not to eliminate dogma from medicine, though it weakened the authority of the old dogma. The movement led rather to the formation of schools or systems of thought, which under various names lasted on into the 18th century, while the belief in the utility or necessity of schools and systems lasted much longer. The most important of these were the so-called iatro-physical or mechanical and the iatro-chemical schools.
Iatro-Physical School.—The iatro-physical school of medicine grew out of physiological theories. Its founder is held to have been G. A. Borelli (1608–1679), whose treatise De motu animalium, published in 1680, is regarded as marking an epoch in physiology. The tendency of the school was to explain the actions and functions of the body on physical, and especially on mechanical, principles. The movements of bones and muscles were referred to the theory of levers; the process of digestion was regarded as essentially a process of trituration; nutrition and secretion were shown to be dependent upon the tension of the vessels, and so forth. The developments of this school belong rather to the history of physiology, where they appear, seen in the light of modern science, as excellent though premature endeavours in a scientific direction. But the influence of these theories on practical medicine was not great. The more judicious of the mechanical or physical school refrained, as a judicious modern physiologist does, from too immediate an application of their principles to daily practice. Mechanical theories were introduced into pathology, in explanation of the processes of fever and the like, but had little or no influence on therapeutics. The most important men in this school after Borelli were Nicolaus Stensen (Steno), (1638–1686), Giorgio Baglivi (1669–1707) and Lorenzo Bellini (1643–1704). An English physician, William Cole (1635–1716), is also usually ranked with them. One of the most elaborate developments of the system was that of Archibald Pitcairne (1652–1713), a Scottish physician who became professor at Leiden, to be spoken of hereafter.
Iatro-Chemical School.—The so-called iatro-chemical school stood in a much closer relation to practical medicine than the iatro-physical. The principle which mainly distinguished it was not merely the use of chemical medicines in addition to the traditional, or, as they were called in distinction, “Galenical” remedies, but a theory of pathology or causation of disease entirely different from the prevailing “humoral” pathology. Its chief aim was to reconcile the new views in physiology and chemistry with practical medicine. In some theoretical views, and in the use of certain remedies, the school owed something to Van Helmont and Paracelsus, but took in the main an independent position. The founder of the iatro-chemical school was Sylvius (1614–1672), who belonged to a French family settled in Holland, and was for fourteen years professor of medicine at Leiden, where he attracted students from all quarters of Europe. He made a resolute attempt to reconstruct medicine on the two bases of the doctrine of the circulation of the blood and the new views of chemistry. Fermentation, which was supposed to take place in the stomach, played an important part in the vital processes. Chemical disturbances of these processes, called acridities, &c., were the cause of fevers and other diseases. Sometimes acid sometimes alkaline properties predominated in the juices and secretions of the body, and produced corresponding disturbances. In nervous diseases disturbances of the vital “spirits” were most important. Still in some parts of his system Sylvius shows an anxiety to base his pathology on anatomical changes. The remedies he employed were partly galenical, partly chemical. He was very moderate in the use of bleeding.
The doctrines of Sylvius became widely spread in Holland and Germany; less so in France and Italy. In England they were not generally accepted till adopted with some modifications by Thomas Willis the great anatomist (1621–1675), who is the chief English representative of the chemical school. Willis was as thorough-going a chemist as Sylvius. He regarded all bodies, organic and inorganic, as composed of the three elements—spirit, sulphur and salt, the first being only found abundantly in animal bodies. The “intestine movement of particles” in every body, or fermentation, was the explanation of many of the processes of life and disease. The sensible properties and physical alterations of animal fluids and solids depended upon different proportions, movements and combinations of these particles. The elaborate work Pharmaceutice rationalis (1674), based on these materials, had much influence in its time, though it was soon forgotten. But some parts of Willis’s works, such as his descriptions of nervous diseases, and his account (the earliest) of diabetes, are classical contributions to scientific medicine. In the application of chemistry to the examination of secretions Willis made some important steps. The chemical school met with violent opposition, partly from the adherents of the ancient medicine, partly from the iatro-mechanical school. Towards the end of the 17th century appeared an English medical reformer who sided with none of these schools, but may be said in some respects to have surpassed and dispensed with them.
Sydenham and Locke.—Thomas Sydenham (1624–1689) was educated at Oxford and at Montpellier. He was well acquainted with the works of the ancient physicians, and probably fairly so with chemistry. Of his knowledge of anatomy nothing definite can be said, as he seldom refers to it. His main avowed principle was to do without hypothesis, and study the actual diseases in an unbiassed manner. As his model in medical methods, Sydenham repeatedly and pointedly refers to Hippocrates, and he has not unfairly been called the English Hippocrates. He resembled his Greek master in the high value he set on the study of the “natural history of disease”; in the importance he attached to “epidemic constitution”—that is, to the influence of weather and other natural causes in modifying disease; and further in his conception of the healing power of nature in disease, a doctrine which he even expanded beyond the teaching of Hippocrates. According to Sydenham, a disease is nothing more than an effort of nature to restore the health of the patient by the elimination of the morbific matter. The extent to which his practice was influenced by this and other a priori conceptions prevents us from classing Sydenham as a pure empiric; but he had the rare merit of never permitting himself to be enslaved even by his own theories. Still less was his mind warped by either of the two great systems, the classical and the chemical, which then divided the medical world. Sydenham’s influence on European medicine was very great. His principles were welcomed as a return to nature by those who were weary of theoretical disputes. He introduced a milder and better way of treating fevers—especially small-pox, and gave strong support to the use of specific medicines—especially Peruvian bark. He was an advocate of bleeding, and often carried it to excess. Another important point in Sydenham’s doctrine is his clear recognition of many diseases as being what would be now called specific, and not due merely to an alteration in the primary qualities or humours of the older schools. From this springs his high appreciation of specific medicines.
One name should always be mentioned along with Sydenham—that of his friend John Locke. The great sensational philosopher was a thoroughly trained physician, and practised privately. He shared and defended many of Sydenham’s principles, and in the few medical observations he has left shows himself to be even more thorough-going than the “English Hippocrates.” It is deeply to be regretted in the interests of medicine that he did not write more. It is, however, reasonable to suppose that his commanding intellect often makes itself felt in the words of Sydenham. One sentence of Locke’s, in a letter to William Molyneux, sums up the practical side of Sydenham’s teaching:—
“You cannot imagine how far a little observation carefully made by a man not tied up to the four humours [Galen], or sal, sulphur and mercury [Paracelsus], or to acid and alcali [Sylvius and Willis] which has of late prevailed, will carry a man in the curing of diseases though very stubborn and dangerous; and that with very little and common things, and almost no medicine at all.”
We thus see that, while the great anatomists, physicists and chemists—men of the type of Willis, Borelli and Boyle—were laying foundations which were later on built up into the fabric of scientific medicine, little good was done by the premature application of their half-understood principles to practice. The reform of practical medicine was effected by men who aimed at, and partly succeeded in, rejecting all hypothesis and returning to the unbiassed study of natural processes, as shown in health and disease.
Sydenham showed that these processes might be profitably studied and dealt with without explaining them; and, by turning men’s minds away from explanations and fixing them on facts, he enriched medicine with a method more fruitful than any discoveries in detail. From this time forth the reign of canonical authority in medicine was at an end, though the dogmatic spirit long survived.
The 18th Century.—The medicine of the 18th century is notable, like that of the latter part of the 17th, for the striving
