Page:Popular Science Monthly Volume 79.djvu/233

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THE HISTORY OF INTERNAL MEDICINE

12. Brunonianism, founded by John Brown (1735-1788) of Scotland, based on the doctrine that vital and morbid processes depend on irritability or stimulations varying in intensity. It continued into the nineteenth century, especially in Germany and Italy, and has the evil reputation of having been the most vicious and harmful medical system ever practised.

In the first third of the nineteenth century:

13. The theory of excitement, a form of Brunonianism, in vogue in Germany.

14. The Italian system of stimulus and contrastimulus, an off shoot from Brunonianism, developed by Basori (1762-1837).

15. Homeopathy, founded by Hahnemann (1755-1843), first promulgated in 1810, and still surviving as an example of ancient medical beliefs.

16. Broussaisism, so-called "physiological medicine," founded by Broussais (1772-1838) of France, and in vogue for a decade or two from about 1816, which looked upon gastro-enteric inflammation and irritation as the cause of diseases in general.

Thus the history of internal medicine shows a succession of ephemeral systems and theories from Hippocrates down to about the second quarter of the nineteenth century. In the various systems that developed a few factors stand out prominently around which the theories centered. Thus, the fundamental distinction between spirit and matter, or between living and non-living matter, furnished grounds for basing medical philosophies on the spiritual (or vitalistic) principle or on material factors, respectively. Among the materialistic medical systems, some (the "solidistic" theories) were grounded on the solid structures of the body, others ("humoral" systems) on the body fluids; some ascribed vital processes and derangements to chemical activities, others to the physical, mechanical or dynamic activities of the body structures ("mechanistic" theories).

Although centuries after the end of the middle ages in other respects, the second quarter of the nineteenth century may be fixed upon as the approximate termination of the medieval period of internal medicine, since down to that time the dominant tone of medical thought was about the same as it had been throughout the middle ages, or indeed since the time of Hippocrates. There had of course been some advance since Hippocrates, as in the differentiation of various diseases and the discovery and introduction of remedial agents; moreover, the development of scientific anatomy, physiology and chemistry could hardly fail to have had a salutary influence on medicine. Yet the dominant conceptions in pathology and etiology and the rationale of therapeutic practise were practically not more advanced, more rational, or more efficient a hundred years ago than they were two thousand