MEDICINE
134
MEDICINE
the nen'es and niuselcs. which arc excited to activity
by external and internal iniluences (stimuli). Dfs-
eases occur acconiini; to increase or dinuuiition of the
stinmh and excitaliility. stroii;; stiinuU causing in-
creased excital)iHty (sthrnid) anil weak stinnili dimin-
ishe<l excitaliility (<islltcni<i). Death is caused either
by an increase of excitability with a lack of stimuli, or
by exhaustion of excitability from too strong stimuli.
Brown's theorj' was little noticed in England and
France, but in (iermany it was highly lauded. Chris-
toph Cirtanner (17(i0-18Q0) and Jo,seph Frank (1771-
1SJ2) spri-ad its fame. Out of this Brunonianism
Johann Andreas Riischlauli (17GS-1S:!5) developed
the so-called theory of excitability which was so encr-
getieallv opposed bv .\lexander von Humboldt and
Chri,sti.an Wilhelm Ilufeland (1762-1S36). Giovanni
Rasori (17ti2-lS37), building also on Brown's theory,
developed his contra-stimulistic system, namely that
there are influences which directly diminish excite-
ment (contra-stimuli) or remove existing stimuli (in-
direct contra-stimuli); he, therefore, distinguishes
two groups of diseases — diathesis of the stimulus and
that of the contra-stimulus.
Another group of systematizers, the Vitalists, bas- ing their views upon Stahl's doctrine of the soul (Animism) and Haller's irritability, consider vital energy to be the foundation of all organic processes. The chief representatives of Vitalism, a system de- veloped especially in France and later predominant in Germanv, are: Theophile Bordeu (1722-76), Paul Jo.seph Barthez (17.34-1S06), Philippe Pinel (175o- 1826), Johann Friedrich Blumenbach (1752-1840), and Johann Christian Reil (1759-1813). But, while these physicians adhered to Hippocratism in practice and (e. g. Reil) were eminently active in de\'eloping anatomy and phj'siology, the same may not be said of the three Germans, Mesmer, Hahnemann, and Rade- macher, who were the last followers of Paracelsus. The doctrine of animal magnetism (Mesmerism), es- tablished by Friedrich Anton Mesmer (1734-1815), is connected with Vitalism in so far as Mesmer presup- poses a magnetic power to exist in the body, and ac- cordingly tries, at first l)y means of magnets and later by touching and stroking the body, to effect an inter- change of forces, a transfusion or cure. Mesmer through his manipulations very likely induced real hj-pnotic sleep in many cases. His doctrine, however, which at first met with a sharp rebuff and was subse- quently characterized in many circles as a fraud, was degraded by his immediate followers to somnam- bulism and clairvoyance, and in later times it became altogether discredited from having fallen into the hands of quacks. Nevertheless, mesmerism forms a basis for hypnotism, which in 1S41 was established by James Braid.
Hornaopathij, founded by Samuel Friedrich Chris- tian Hahnemann, seems to have the promise of a long lease of life. Hahnemann regards disease as a dis- turbance of \ital energy. The latter in itself has no power to heal, for a cure can take place only when a similar severer disease simultaneously occurs. The best way to produce such a disease is to give highly diluted drugs wiiich are capable of producing a similar set of symptoms. The rest of this "drug-disease" is destroyed by the vital energy, which is possible only when the doses are small. As chief principle, there- fore, Hahnemann sets up the doctrine that like cures like. Since he denies the possibility of investigating the nature of disease, and completely disregards patho- logical anatomy, it is necessary to know all simple drugs which produce a set of symptoms similar to those of th(^ existing disease. With his pupils Hahne- mann undertook the task of testing the effects of all simple drugs, but tlic result of this gigantic piece of work could not be absolutely objective, since it is based upon the purely subjective feeling of the experi- mentalists. Never before had a physician built a
system upon so many purely arbitrary h.\pot,lieses aa
Hahnemann. Paracelsus also hail di'darcd war upon
the old medicine, ami had attrihutcd lillle \alu(> to
anatomical and physiological investigation, which,
however, was still in its initi.al period of development;
but, with his reverence for Ili[ipocratcs, he neverthe-
less ranks higher than Hahnoniaini, who is the rejire-
sentative of empiricism and the despiser of all the
positive successes which medicine had ])rcviously at-
tained. Hahnemann's more .scn.silile pupils dicl not
follow their master blindly, but regarded his method
as that which under the most favourable circum-
stances it may be, viz., a purely therapeutical method
that does not disregard clinical science. To this ra-
tional standpoint, together with eclecticism, homoe-
opathy owes its long life and wide dissemination. One
service of physicians of this school is that they simpli-
fied prescriptions, and appreciatively studied obsolete,
but nevertheless valuable vegetalile drugs. Hahne-
mann's pupil. Lux, extended homtropathy to isother-
apy, which in modern times cclelirated its renascence
in organotherapy. Widely removed from scientific
progress was the "empirical medical doctrine" of
Johann Gottfried Rademaeher (1772-1850), which
is to-ilay completely discredited. Starting from the
doctrine of nostrums of Paracelsus, he names the dis-
eases according to the effective drug (e. g. nux-vomica
strychina, liver disease), and classifies diseases as
universal and organic in accordance with universal
and organic drugs. His therapeutics was a purely
empirical one, uninfluenced by pathology or clinical
diagnosis.
Some Special Branches of Medicine at the end OF THE Eighteenth Century. — Obstetrics. — Down to the sixteenth century obstetrics w-as almost exclusively in the hands of midwives, who were trained for it as for a trade. Only in rare cases was a surgeon called in. All the achievements of ancient times seemed for- gotten, and it was only after anatomical studies had been resumed and surgery had made some progress that things began to improve. The most important accounts of the condition of ancient operative obstet- rics are found in the Hippocratic writings (position of the cliild, version or turning, dismemberment of the fcFtus, parturition chair for facilitating delivery), and in later times in the works of Soranus of Ephesus (second century A. d.; protection of the perinseum), Galen, Celsus, Aetius, and in those of the female physi- cian Trotula of Salerno. The oldest book on mid- wifery in the Middle Ages (Rosengarten) was written by Eucharius Roslin (d. 1526), who, in addition to numerous drugs assisting delivery, mentions "ver- sion". Version was put into practice again by Ambroise Par6. In the sixteenth century attempts were made to perform the Caesarean operation on. the living (Jakob Nufer, a Swiss, c. 1500); in an- cient times it was done only after the death of the mother. The first work about this operation was published by the Paris surgeon, Fran^-ois Rousset (1581). In the domain of practical obstetrics, Giulio Casare Aranzio (1530-89) was the first to point out those malformations of the pelvis which exactly indi- cated the necessity for the Ctesarean section. Much was done to extend the study of this branch of medi- cine by the works of Jacques Guillemeau (1560-about 1609), Scipione Mercurio (1595, German translation by Gottfried Welsch, 1653), Francois Mauriceau (1637-1709), investigators on eclampsia, and Philippe Peu (1694), Pierre Dionis, and Guillaume Manquest de la Motte (1655-1737), pelycologists. The splendid development of obstetrics in France explains why male assistance was more and more sought there, especially after Jules Clement had been called in 1673 to the court of Louis XIV. The most important accoucheur in the Netherlands was Hendrik van Deventer (1651- 1724; axis of the pelvis, placenta pra'via, asphyxia neonatorum). In Germany Siegemundin, the most
