MEDICINE
135
MEDICINE
famous German midwife, published in 1690 a text-
book based upon wide experience (Chur-Branden-
burgische Hoff-Welie-Mutter).
In the first half of the seventeentli century Hugli Cham- berlen invented the obstetrical forceps, selling it to Dutch physicians about 16SS. Jean Palfyn of Ghent (1650-1730) constructed independently a similar instrument (Main de Palfyn), which he submitted to the Paris Academy about 1723. After various im- provements by Lorenz Heister, Duss^, and Gr^>goire, the forceps passed into general practice. The most important accoucheurs of the eighteenth century were: in France, Andr6 Levret (1703-1780; incHnation of the pelvis, forceps, combined examination), Franc^ois Louis Joseph Solayr^s de Renhac (1737-72; mechan- ism of delivery), Jean Louis Baudelocque (1746-1810; pelvimetry), opponent of artificial premature delivery and sympliyseotomy; in England, Fielding Ould (1710-89; mechanism of delivery, perforation), William Smellie (1697-1763; mechanism of deliver^', use of forceps, pelvimetry), William Hunter (1718-93), opponent of the forceps and the Cajsarean operation, Thomas Den- man (173-3-1815), the first to recom- mend artificial jiremature delivery, and William Osborn (1732-1808), opponent of symphyseotomy and of the Cesarean section. The well- founded doubts which in preaseptic times many accoucheurs entertained concerning the Caesarean operation, led to so-called symphyseotomy (Jean Ren6 Siegualt, 1768), which by wid- ening the pelvis would peririit deliv- ery of the foetus. This operation, which from the very outset met with vigorous opposition in Eng- land, is now forgotten. The in- troduction of scientific obstetrics in Germanic countries was compara- tively late. Special schools for mid- wives were instituteil, in 1728 at Strasburg (Johann Jakob Frietl, Baron Kiel v
1689-1769), in 1751 at Berlin (1804
(Johann Friedrich Meckel, 1724-74) and Gottingen (Johann Georg Roderer, d. 176:!), and in 1754 at Vienna (Johann Nep. Crantz, 1756; Valentin von Lebmacher, 1797; Raphael Steidele, 1816). While the Parisian midwives belonged to the College de S. Come as early as 1560 and received a methodical train- ing, those in Germany could receive only private in- struction. Examination by physicians is mentioned at Ratisbon since 1555 and at Vienna since 1642.
Ophthalmology gainetl importance much later than obstetrics. In addition to inflammation of the eye and operations on the eyelid, the Hippocratic writings mention amblyopia, nyctalopia, and glaucoma. Cel- sus describes an operation for cataract (sclerotico- nj-xis). Galen gives us the beginnings of physiological optics. The slight ophthalmological knowledge of the Greeks was borrowed by the Arabs, but their lack of anatomical knowledge prevented all ijrogress. No improvement set in until after the rise of anatomy under Vesahus. Formerly, this branch had been almost completely in the hands of travelling physi- cians (cataract operators), but henceforth surgeons with a fixed abode (e. g. Ambroise Par^, Jacques Guillemeau) began to turn their attention to it. In Germany Georg Bartisch (about 15:',5- 1606), "Court eye specialist" at Dresden, wrote the first mono- graph, a work very highly valued even in later days. Among other things he mentions spectacles for curing squint, eye-glasses and, among operations, is the first to describe extirpation of the pupil. The in- vention of convex spectacles is by some attributed to the Dominican Alexander da Spina (d. 1313), by others to Salvino degli Armati of Florence (d. 1317).
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Concave glasses did not appear until the sixteenth
century.
The foundations for further progress in ophthal- mology were laid by the anatomists and physicists of the seventeenth century. In the first group let us mention the works of Friedrich Ruysch (choroid), van Leeuwenhoek (lens), Heinrich Meibom (1678-1740; glands of the eye-lids), and Stenon (lachrymal appara- tus). Investigations of pliysicists were of great im- portance, especially those of the two astronomers, Johann Keppler (1571-1630) and the Jesuit Christoph Scheiner (1575-1659), concerning accommodation, refraction of light, and the retinal image; RenS Descartes (1596-1650; comparison of the eye with the camera obscura, accommodation); Edmund Marriott (d. 1684; iilind spot, choroid); Isaac Newton (1642- 1727; dispersion of light and origin of colours). In the eighteenth century, besides anatomy and physiol- ogj', the practical side of ophthalmology was also culti- vated. Among anatomists were Wiiislow, Petit, Zinn, Demours (cornea and sclerotic); Buzzi and Sommering (retina); La Hire, J. H. Hoin, Cam- per, and Reil (lens). The theory of the sensibility of the retina to light, established by Haller, was further developed by Porterfield and Thomas Young (1773-1829). The latter also described astigmatism and colour- blindness, and discovered that ac- commodation depended upon a change in the shape of the lens. Boerhave was the first to give clinical lectures on ophthalmology. From him we have the exact definition of niy(i|ii:i and presbyopia. Gray cata- i-.ict iinhiriicta) was first located in the Itiis liy Franr;ois Quarr^ and Remi Lasnier, a view which was cor- roliorated by the anatomist, Wer- ner Rolfink (1599-1673). Frani,-ois Pourfour du Petit (1644-1741), Lorenz Heister, and others also worked on cataract. Jacques Da- viel (1696-1762) performed the first operation for extraction of a cataract in 1745. Of other practitioners we must mention: Brisseau (theory of glaucoma), William Cheselden (1668-1752; artificial pupil). Baron Wenzel the elder (1780; iri- ilectomy), Charles de St. Yves (ablatio retinte, asthe- nopia, staphyloma, strabismus), John Taylor (1708- 60; operation to correct oblique vision, ceratoconus), Dominique Anel (cathetlerism of the lachrymal fistula, 1713), G. E. Stahl, Boerhave, Jonathan Wathen, Lorenz Heister, Johann ZachariasPlatner( 169 1-1747), and August Gottlob Richter (studies on the lachrymal fistula).
Pharmaceutics, Mineral Waters, Cold Water Cures. — Pharmacy had remained the most backward of all the branches of medicine, for it was longest un- der the influence of the Arabs. A large part of the drugs came from the Orient to Venice and Flemish liarbours. Besides simple drugs there were also a great many compound remedies. But, in the latter class, there was great confusion resulting from the many adulterations, and from the fact that not only did individual authors give different compositions for the same remedy, but also under the same name an entirely different preparation was understood by different authors. The most famous panacea, which dated from Roman imperial times antl was used as late as the eighteenth century, was thcriac, a mixture con- sisting of numerous ingrctlicnts, among them being the flesh of vipers. This composition originally came from the Orient, but was made later at Venice, Augs- burg, and Vienna. To get some order into the treas- ury of drugs and to enable ^othecaries to compound their remedies, the college of physicians in Florence
■1878)
