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THE HISTORY OF INTERNAL MEDICINE

posed to be secreted by the brain, and by flowing downward ("defluxions") into the respiratory and alimentary passages produced catarrhal and other diseases. Black bile was an entirely fanciful secretion of the adrenals. In crude or corrupted state the humors were supposed to be "acrid"—toxic or morbific; during the course of the disease they were believed to undergo a process of ripening or digestion—"coction" as it was called—to be finally expelled from the body at the crisis of the disease. The aim of treatment was to remove the acrid humors, or to promote their concoction and expulsion. Free bloodletting and other vigorous depleting measures were in general use.

About the sixteenth century began the great awakening of the world known as the Renaissance, which marks the end of the middle ages and the beginning of the modern era. This movement brought about a revolution in medical thought and yielded enormous acquisitions of medical knowledge.

The awakening in medicine was first manifested, in the sixteenth century, in the development of anatomical knowledge, as we have it to-day, under Vesalius (1514-1564), Jacobus Sylvius (1478-1555), Eustachius (1500-1574), Fallopius (1523-1562) and their successors, many of whose names are immortalized in our anatomical nomenclature more enduringly and more nobly than by monuments of bronze. The sixteenth century saw the labors of Ambroise Paré (1509-1590), the father of modern surgery, and important contributions in obstetrics and gynecology. In the seventeenth century modern microscopy was developed, and modern physiology may be said to have been founded by the epochal discoveries of William Harvey (1578-1657) relating to circulation and generation.

In the domain of internal medicine the Renaissance of the sixteenth century effected a revolution in, or release from, the rigid and dogmatic doctrines previously current. Nevertheless, the new doctrines were no nearer true or more effective than the old, and for three centuries longer internal medicine was destined to remain at a standstill before it too was really born into the family of modern sciences.

The first change was the overthrow of the authority of Galen (and the Arabians), which had previously been the main support of medical thought. This was brought about partly by the exact researches of Vesalius disclosing the errors in the anatomical teachings of Galen, partly by the effusions of the spectacular and mystical Paracelsus (14931541). The authority of Hippocrates continued to have weight for a much longer time.

Subsequent to Paracelsus and the break up of the ancient and Arabian medicine there developed a succession of speculative systems or schools of medical doctrine and practise, each of which had more or less general acceptance for a while, only to die out and be superseded by