*P^^^»«PTTT" ^tf yrsn* v«r THE RISE, TROCjRESS, AND "PRESENT STATE OF MEDICINE. DISCOURSE, Delivered at Concord, July 6th, 1791. BEFORETHE MIDDLESEX MEDICAL ASSOCIATION. B Y B. WATERHOUSE, M. D. Professor of the theory and practice of 1'hy ;c in the University of CAMBRIDGE, and Vice-President of the Association. Concordia parv« res crescunt. „^—"-^ Salluft. - —>■ 11 1, t iji "fl---------------- BOSTON: Printed by Thomas and John FleeTj MjPCCjXCII. i i I f fciMfffcCW AT a Meeting of the Middle/ex Medical Ajfociation, held at Concord, July 6th, 1791, VOTED, That the Hon. Oliver Trefcott, James Winthrop, Efq; and the Rev. -Ezra Ripley, be a Committee to wait on Doctor Benjamin Waterhoufe, and return him the Thanks of this AfTbciation for his inge- nious and learned Difcourfe, delivered this Day, and requeft of him a Copy for thePrefs. Atteft. Jofeph Hunt, Secretary, IV OHOULD this Difcourfc ever be read beyond ti:e bounds of the MaJJ'achu'etts^ ii perhaps would be ne- celTary to inform the reader, that the Middlesex Medical Affociation is Co called from it's being compofed of practitioners living in the County of Middlefex only. This county deviates a little from a fquare, but it's area is nearly equal to a fquare of forty miles on a fide. It is divided into forty one towns, and fiom a late enume- ration is found to contain rather more than forty two thoufand inhabitants. The principal towns are Cambridge, Concord, Charles- town, Medford and Watertown. Cambridge is di- ftinguifhed by the University. A Society, that has for more than a century fur,nifhtd fupplies of Statefmen, qualified to fupport the rights of mankind, and men eminent in every branch of literature. Concord, a town pleafant and flourifhini, is iitu- ated nearly in the center of the county. Charles- town is connected with Boston by a bridge fifteen hundred feet long. Cambridge, Concord, and Charies- town, were rendered famous by the military events of 1775 and 1776. Middlefex is watered by five rivers; the Merimac, the Charles, the Concord, the Najhua-, and the Mijlic. The fouthern and northern fides of the country are hilly ; but cannot be confidered as mountainous, few of the hills exceeding an hundred feet in height, being generally wooded or cultivated quite to the fummit. The climate is very fine, the air generally ferene, and the temperature mild. The extreme variation of Fahrenheit's thermometer may be confidered as an hundred degrees in an year; but it is in very few in- fiances that in the courfe of the yc«r it reaches either extreme. V extreme. K'nety-two degrees may be confined as the extr'm- of fummer heat ; and five or fix degrees below O as that of the winter cold. Inftances ar to be found of it's exceeding thf-fe limits, but they a c fo tare, as to be exceptions to the general rule.* Apples, pears, prunes, cherries, grapes, and currants arc among our fruits, and by cultivation arrive c QUERIES pat to each Memher at the op.r.iug of every ;neeti;:z. '•R. - J. A AVE you met with any thi'g in any hvj h:a! author, fince our Jaft meeting, fuitab'.c u be communi- cated to this affociation ? 2. What was the laft Epidemic (hat vifitcd the diftrift whrre yc-j refidc, and what were the remedies particularly ferviccabje ia it } 3. Do you know of any inftance, fince our laff. meeting, of the refufcitation of any one apparently dead ; and the method purfjed ? 4. Is Jure any difficult point in the theory or prac- tice of phyfic, which you would gladly hive diLuffed at this time ? 5. D.) you know of any oefervin^; beginner in the practice of phytic, to-) young t> be:om^ a member, whom this aiTociation can any wiy ferveor encourage ? 6. Have you any weighty tfiv.ir in hand as a phy- sician, in which you think the advice of this aiTociation may be of fervice ? 7. Do you think of any thing at prefent in which this affociation may be ferviceable o mankind, to their country, or to themfelves ? The OFFICERS of the MIDDLESEX MEDICAL ASSGCIA TION for the year 1792. Honb!e OLIVER PRESCOTT, M. D. President. BENJAMIN WATERHOUSE, 4/. D.VicePresident. Honble JOHN BROOKS, j TOSIAH BARTLETT, M. B. i Counsellors. ISAAC HURD, A. M. 3 TIMOTHY M1NOT, A. M. Treasurer. " JOSEPH HUNT, A. M. Secretary. O >" I O N T H E RISE, PROGRESS, and PRESENT STATE of MEDICINE, A DISCOURSE. AN complying with the reo^eft of this aflbcia- tion, I perceive nothing more difficult, than to bellow on what is common the grace of novelty, and to render fo dry a fubject as phyfick in any degree entertaining to a mixed audience. Our theme leading to the frigid and formal ftyle of a lecture, rather than the animated (trains of an oration. The hiftory of the medical art is fo well known to the members of this fociety, that my talk will be rather to remind than inform them: Yet what fubject can be more fuitable for our firft difcourfc, than the hiilory of the rife and pvogrefs of the healing art : That art whole improve- ment and diiiVlion is the end and aim of our aiTcc ration ? Tin The origin of mod arts is involved in fable, and wrapt in great obfcurity ; that of medicine feems covered with almoft an impenetrable veil. Until the greater purpofes of focietv were anfwcred, the necefhties of mankind fupplied, architecture and other nee effary arts introduced, men of genius had neither leiftire nor inclination to record their theories of the origin of mankind, and the rife of the arts. The remedies firft fought for, in the earlier ages, were probably fome mild, tenacious, plaftic fubftanccs, fuitable to defend a wound from air, and fecure it from external injuries. Accident and random experiment may have en- creafed the number of fuch fimplc remedies, which may have been treafured up by a particular family, or fome individual of a tribe. But at thefe early periods of fociety, when letters were unknown, what was once out of fight was loft forever. If we fearch the oldeft book we have for infor- mation on this fubject, we fearch in vain. This will not appear fo extraordinary to thofe, who re- flect that the facred hiflory is confined to but a part of Ajia, and a fmall portion of the north call part of Africa ; and that it is fo concifc in regard to time, that the hiflory of twenty centuries is comprifed in eleven fhort chapters.* • Se: Cciefus We 3 We find the author of thcfc annals, the hebrew legiflator and general, giving directions for the health of his people; but no mention is made of Phyficians, as a diftinct profcffion, until the em- balming of Jacob. Prior to thcfc writings, is the sera ofabfolute darknefs ; and we have no account by which we can judge of ancient tradition, un- lefs we admit that of the Chinrfe, whofe great an- tiquity, corroborated by agronomical obferva- tions, carries the hiflory of the human race a valr u ay further back. Yet their flight acquaintance vuth anatomy, and their ignorance of chemiftry, render their great knowledge in phyfic as doubt- ful as their chronology. As we receive fo little light from thcfc ancient profe writers, let us turn towards thofe earlier luminaries the Poets. Poetry has every where preceded profe, auri the powers of the imagination ahvavs hnve ocert indulged, before the operations of the judgment were exerciled. Thofe early cifufions of genius were epic poetry, or exaggerated hiftoiy> record- ing battles, heroes and ghofls; dwelling on the marvellous, and often the incredible. In thefe f.-.bu'eus age3 it war, the cuftom to drefs inflrucl;G!i :n the garb of allegory. Thus the Egyptian, Grs- iia,i and Roman poets attributed the origin of the Healing Arc to the Sun, v. ho was called Orus by 4 the Egyptians, Pbcclns and . Ipf'ic by the Greek* and Romans. Conceiving the fun to be the pa- rent of life and cheerfulnefs, whofe genial warmth and vivifying energy animated and fuflained all nature; they adored it as the refplcndent fource of light, life, health and joy. They faw nothing on earth which bore fo flriking a refemblance to this heavenly luminary, as he, who relieved pain, diflipated melancholy, difpelled difeafes, and pro- longed life. Thence they concluded that the firft phyfician was an offspring or emanation of the "Prime cheerer light." Accordingly we find the claffical poets reprefenting Apollo, as the primary GOD of phyfic ; and his fon /Efculapius whom they alfo deified, as its firft profeflbr. They like- ned the human body to a delicate mulical inftru- ment, eafily difordered, and therefore united mufic and medicine in Apollo. They conceived that the office of the phyfician, was to tune this com- plicated organ the body, to make every part-act in concert, and reduce the whole to harmony. * The perfon of JEfculapius is fo envellooed in fable, that we fcarcely know when, or where he lived. He is confounded by fome with Melam- pus, who lived about ioo years after Mofes, and who having travelled into Egypt, brought from thence into Greece, not only the art of phylic, but much of their theology and fuperllition, together with their magic or divination. . Trom * See Bacon de augment. Scientiar. 5 From every account we muft conclude, that JEfculapius was highly venerated for his know- ledge and ufefulnefs. The antients not only pla- ced him among their GODS, but erected more than fixty temples to his honor in Greece, and in the Grecian colonies; Thefe ^Efculapian temples were the firft fchools of phyfic. People reforted to them from all quarters, in order to be healed of their difeafes. Remarkable cures were engra- ven and hung round their walls in form of votive tablets ;* and from thence were fent out the firft clinical practitioners. Among the ruder nations, the prieft, the conju- ror, and the phyfician were united in the fame perfon. f It was fo among the ^Egyptians, Baby- lonians and Grecians; among the people of India, C where * The learned Cruterus has preferved feveral of thefe inferiptions. One is as follows : " Lucio afeilo laterit dolore, et defperato ab omnibus hominibut, oraculum reddidit Deus. Veniret; :t ex tribomo tolleret cinerem, et una cum vino comifceret, <& poneret fupra I at us* Et convaluit; et publics gratias egit Deo ; */ populus congratulatus eji Hit." What a pompous account of that application fo frequently employed by our country people, a bag of afhes for thsfdeach! \ Diodorus relates that it was the cuftom antiently ta apply to the profeflbrs of vaticination to obtain health. L. v- p. 235. We find in fcripture, that when A fa ap- plied to the phyficians, it was condemned «s an impiety. Chron.xvi. 12. Jjr^1"- infect his wife tothep •ophe:\vI:cP his fon Ahijah was lick. 6 Where they are called Brachmans; among the art-* tient Germans, French, and Britons, where they were called Druids. It was fo among the Mex~ icans and Peruvians; and obtains at this day jtmong our Aboriginals. The untutored mind iff apt to afcribe all difmal difeafes and {hocking accidents to the influence of inviuble beings : and the priefts, not only cherifhed this opinion, but ftudioufly inculcated, that their cure muft be fought from the Deities, through the interpolation of their minifters. The ftate of phync in Greece, at the period celebrated by Homer, was very fimilar to what it now is among the aboriginals of this continent. Like their heroes, our Indians know how to treat wounds; and when baffled in the cure of any ter- rible diforder, have recourfe like the Grecians, to incantations and inchantments.* They likewife derived their Ikill from the fame fource, random trials, or empericifm. The Philofophers of Greece we're fo much en- gaged in the vain and ufelefs fearch after the pri- mary matter, that they neglected medicine, which wasfo far from being digefted into'afy Item, that no one gave it fufficient attention to make it a diftinct profeflion. This was the cafe till about 400 years before Chrif, when the famous Hyppoc rates made collections from the public records of cure the * See Homer's account of the plague in theGrccian camp, B. r. / the inscriptions or tablets in the jEfculapian tem- ples, where he was educated, reduced the whole into fome order of fcience, and laid fo juft and rational a foundation of phyfic for future ages, that he defervedly obtained the name of the Father of Mepicine.* Themison was the founder of the methodic feet. He profefTed to have difcovered a fhort, and eafy .method of attaining medical know ledge, by redu- cing all difeafes into tvoclaffes, viz. from tenfton, and from the oppofite fault, relaxation.^ As this rJoctrine has lately been revived, we fhall fpeak of it, with its patron Themifon and his follower Theffalus, in another place. About 200 years before the chriftian sera, phy- fic and furgery, which in Greece had been prac- tifed by the fame perfon, were fcparated at Rome into three diftinct provinces, the Dieictic, Phar- maceutic and Surgical. The above mentioned fects were in exiftence when the celebrated Galen quitted his native country, Afia minor, tq practice ill Rome. Galen was a man of real genius, im- proved by a careful education under the beft teachers of the age He laid the foundation of his greatnefs in the fchool of the Stoics, then ftudied with the Academics, and finifh'd with the Peri- pate :.l:j * Bgerhaav. academ. Lc«5l. v. t. f Juvenal fpeaking of him, fays, " Quot Them'tfsn segro autumno occiJerit uno." Whether this be intended &s a goinpliaient, c: farcafrn, we leave critics to c--.(<■:;•.:.::.?. s patetics and Epicureans. After this he devoted himfelf to medicine, and collected the writings of the moft celebrated phyficians, efpecially Hippo-* crates,Vi\\om. he profeffed to admire and follow. There is, however, fays Boerhaave, this effential difference between the doctrine of Hippocrates and Galen, the firft is almoft always fupported by experience, and confifts of obfervations, wjiile the other depends almoft wholly on reafoning; and it has accordingly happened, that the fyftem of Hippocrates has afforded but little matter of ex- ception to thofe who came after him, whereas, that of Galen has been afubject of juft and well groun- ded cenfure. Neverthelefs, Galen's doctrine, though in general falfe, and inapplicable, fjys Cult en, was received and implicitly followed by all the Phyficians of A fa, Africa, and Europe, for more than 1400 years ! He was fuppofed to have brought every part of medicine to perfection, and his fyftem thought infallible, and univerfally appealed to as an oracle. We cannot fet a very high value on the theories oftheantient phyficians, when we consider the data upon which they reafoned. Their notions re-i fpectingthe animal ceconomy wereabfurdandcon- fufed to the higheft degree. They fuppofed that the veins had their origin in the liver ; that they were the only veffels that conveved blood through the f _ the body; that in thefe it only moved backward and forward : that the arteries arifing from the heart, contained the animal fpirits which were ela- borated in that organ. They believed that the blood never entered t\\c arteries, unlefs in a difeafed ftate. As ,tb the means of our nourifnment, they bad no juft idea of it, and even fuppofed that the chyle was abforbed in the liver, and there con-' cocted into blood.* After the fixth century, a dark and difmal chaf-u intervened in medicine, literature, and the arts. All was ignorance, wonder, and credulity. f he human mind, neglected, uncultivated, and op- pre Jed, f ink, h:> the io weft grade of d-bafement.f The moft remarkable revolution recorded in the hiflory of the human mind, is, the darknefs and ignorance which enveloped Eurcpe, while the Arabians were making progrefs in ufeful Jcnowledge. The Caliph Haroun Al Rafchid eftablifhed an Univerfity at Bagdad, and qualified his countrymen to be inftructors of all Europe, Wherever thefe Mahometans built a temple for worfhip, there they erected a medical fchool and an hofpital. They firft introduced chemiftry into medicine j and, though blended w ith many abfur-r dities, its introduction occafioned a great revo- lution in the theory and practice of phyfic. Difeafes * Aikins' Med. Memoir*; f Millot Elements of Hift. 20 Difeafes were now fuppofed to arife from a pre- dominant acid, or an alkali 5 and the various ope- rations of the human body, were attempted to be explained on the principles of fermentation or ifprvefcence. Nay, they afterted that all the ope- rations of the Univerfe were explicable on che- mical principles. At this period, many wafted their time and talents in the delirious purfuit of t:anfmutingthe bafer metals into gold. In the beginning of the xvnth century, the Whole fyftem of Galen, as well as the theory of the chemifts, was overturned by the difcovery of the circulation of the blood by Harvey ; who de- monftrated that the human body was an hydraulic machine, whofe aSions and offices depended upon the circulation of fbe blood, which alone being ftopp'd, the whole mufi perifh. For, in this fyftem, the blood was confidered as the primmn mobile of the whole machine j and to fomething in the blood were attributed all the diforders tq which we are liable. Harvey firft made an application of this doctrine by publifhing his. « practice of phyfic " conformable to the laws of the circulation;' and by degrees all Europe followed him. This was the sera of experiment in which fe- veral great geniufes flourifhed. Societies for promoting and diffufing experimental knowledge were eftablifhed in different parts of Europe, and it and patronized by monarchs. * The art of printing had already produced a glorious change in the affairs of men. It gave wings to literature ; and fpread it around the globe. Phihfophy revifited the earth, and converted Europe, which a cen- tury before was one large field of battle, into a theatre of triumph ! Tht. * The Eoglim Bifhops poflefTed the power of licencing practitioners of phyfic until the beginning of the 16th century, when this grievance was redreflcd by the eftablifh- ment of the London College of Plyftcians by an act of Henry viiith. By virtue of this authority it is exprefsly declared, that no one fhall be permitted to exercife phyfic in any of the diocefcs in England till he be ex- amined by the President and three of the Elects, or Cenfors, and have letters teftimonial from them ; unlefs he be a graduate in either Univerfity, who, as fuch, by his very degree, has a right to practife all over England. See Friend's hiftory Phyf. vol. 2. The Edinburgh real College of Phyficians was founded in 1681. It has fimi- lar powers to the royal College of London. But that the rights of the Univerfity may not be infringed,their charter declares, that the College are to licence all petfons, who have taken their degrees in any of the Universities in Scotland----And that all perfons who have taken the degeee of Matter of Arts in faid Univer- Cties, or a degree of Doctor in any celebrated Universi- ties abroad, fhall, upon producing their refpective Diplo- mas to the Prefident and College, be licenced by them to praclife phyfic within their jurifdiclion, without palling a trial on that occafioo. See their charter in Mait- land's hiftory of Edinb. p. 376. The Royal Society of London was founded in 1665. V Acadetuie Roy ale dt Sciences was erected in France 1666. The Academia Natur* Curioforum was eftab- lifhed 12 Upon the difcovery of any new principles by philofophers or the introduction of any new and popular theory, phyficians almoft always attempt to apply them to the explanation of the actions of the human body, and all the caufes of difeafes. Thus, when Galileo had introduced mathematical reafoning,and excited the world to inveftigate the laws of mechanics, phyficians attempted to explain all the phenomena of the animal cecond- my, on mathematical and mechanical principles. The fame was noticed concerning the chemifts, and may be remarked at this time of the laws of electricity. The lifhed in Germany in 1670. A royal literary fociety was inftituted at Berlin in 1711. Another at Peterfbourg 172$. The King of Sweden followed the example of Peter the great, and erefted a literary academy in 1739, as did the King of Denmark in 1746. In 1731 an Aca- demy for furgery was founded in Paris, The prefent King founded the Royal Society for Medicine in 1776. The Univerfty of Parir, founded by Charlemagne in the year 800, was the firft that conferred the degrees of bat- chelor and doctor in the year 1231. The Univerfitf of Leyden was founded in 1574. It has twenty-fix pro- feffors. There is no college of Phyficians in any of the United Provinces. Phyficians, before they can be legally authorifed to practife, are required to produce a Diploma from fome Dutch Univerfity, which is regiftered by the magiftrates of the town in which they mean to re fide. Our Univerfity of Cambridge was founded in 1638, but the medical profefibrfhips not till 1782. The famo*;*; Stahl perceiving the infufficiency *>f the proceeding fyfl.fr.", maintained that the :a-:onal ml immateri ; ;■ ul was the true fource oi every fundion, both vital and natural. Thus experiment, or the ufe of our fenfes, was difcarded for a.time from medicine, and metaphyfics, or rcafonirig on probabilities, ufurped its place. Such was the ftate of medicine when B'-erkaave began to teach. The figure this great man made in the medical Work!, will juftify our dwelling a little on" his character and works. It is perhaps unneceflary to fay, that he was a profeffor in the Univerfity of Leyderi, and that he died about 50 } ea rs ago. Bocrhaaye was fon of the parifh mi ni - fter of a - :!bg: n..ar L"yden, and he himfilf v as educated for that prolciTion. From rise in.for- mation cfhis hi "-graphcrs and his own writings, we kara, that from the perufal of early writers in divinity, he was flruck with the pro founded vene- ration for the iimplicity and purity of their doc- trine;, and the fin ty of their difciplinc ; but as he defcended to the lower ages, he found the peace of chriftianity broken by ufeleC; controverfies, and its dodrines fophifticated by the fubtleties of the fchools. He found the holy writers interpreted according to the reigning phiiofephers, and chi- meras of metaphvficians adopted as articles of faith. He then quitted the purfuit of di.iiity, D and H r.nd applied to the ftudy of phyfic, when he was more than xxx years of age. But he found it nearly the fame in phyfic as he experienced in divinity. He perceived that the moderns had widely deviated from the fimplicity and purity of the antients; chimeras and idle notions adopted as articles of belief, or rules of pradice, and the writings of the founder of our profefiion ftrangeiy corrupted and mifapplied. When Bcerhaave began to pradife phyfic, he received but little encouragement. His bufinefs was at firft very fmall, and his circumfiances by no means eafy. But fuperior to every difcourage- ment, he continued his fearch after truth and knowledge; determined that profperity, were he ever to enjoy it, fhould be the confequencc, not of mean artifice, cringing folicitation, or degrading complacency, but of real merit and folid learning. Nor was he difappointed. After giving ledures at Ley den for a feries of years with great applaufe, his reputation bore fome proportion to his merit, and extended itfelf to diftant countries ; infomuch, that fcarcely a learned fociety in Europe, but was eager to eled him a member, fcarcely a crowned head, but fought fome means to honor him. He died at Leyden in the year 1738, a^ed 79 years, leaving behind a glorious and untainted me- mo; . * Bo^rhaave's * ScVi'r?frs life of Boerh. Med. Diet. Art. Buerh. —alfo Iiia life by Jchr.fon, H Boerhaave's Ivftitutes, ox theoretical work, con- Lams all the difcoveries in anatomy and phyfiolo- gy known at that time; and whatever relates to the laws of the animal oeconomy and the operati- ons of medicines. His aphorifns or praclica! work, are colleded from the Greek medicinal writers, the Arabians and fome of the Moderns; and his reafonings are founded on the ftrudure of the parts and laws of mechanics. In his ledures on thefe aphorifms he laboured to ihcw how na- ture ads in producing thefymptoms of diftempers, and her methods of relieving herfelf either with, or without the affiftance of art. Pcrhap.; it com- prifes more medical knowledge, than any book extant of its fizc. The molt ftriking feature in the Boerhaavian theory, is the explanation of all the phaenomena of the animal oeconomy on mechanical principles. It afierts, that the human body is truly a me- chanical ftrudure, and polfefies all the properties belonging to a fubjed belt qualified for mecha- nical (peculation ; therefore a mechanical frame and that the human machine, is by the fame laws explicable by geometry ; and there is nothing, he thinks, in all its folids or fluids but what is ex- plicable upon mathematical prindpici. He founds his path-jlugy, or d?Hri-ie of difeafcr, on the change of the quality of the fluid., pro- ducing fometime; a predominant acid, and fome- times i6 ' times a predominant olkivi. Another fruitful fource of difeafes, was a fpontaneous glut en,or lentor in the fluids, and a too viol, tit motion of the circu- lating blood; this he fuppofed arofe from the preternatural irritation of the heart, or from fome acrimony prefent ih the blood itfetf. Thefe opinions make the foundation of his theory of fcv.rs and ivfanimations. The firft who ventured to attack the Boerbaavi-r an fyftem, was the learned Dr. Frederic Hoffman • who afferted that the body was fo far from de- pending on the quality of the fluids, that the ftatc and crafts of the fluids 'chemfelvcs, entirely de- pended on the nervous power; and that a flight alteration in this power was capable of inftanta- neoufly changing the blood, and all the other hu- mors, into a different nature from what they for- merly were. He therefore published it as his opinion " that the greater part of difeafes, if not all of them, were affedions of the nervous ff em." This hypothefis, amplified and further illuftrated, js the celebrated Ciilknian Syjlem. * Dr* Cullen, who died a year or two fince in Scotland, after bellowing great encomiums on Poerhaave, who he fays improved and refined upon every thing that had before been offered pointed out, as he fuppofed, the imperfedions fr See Encyclop. Brit. Art. Medicine. »7 and deficiencies of this famous fyftem, in order to ihew the neceflity of attempting a new one. And he has fiiewn pretty clearly, that the dodrine of acidity, and an- alkali, is erroneous ; and that the caules which Boerkaave adduces as producing the fpontaneous gluten, are by no means probable. Nay, he alTerts farther, that Bocrhaave's dodrine of acrimony and lentor of the fluids is purely hypo- thetical ; and that the reafonings concerning them, are fo far from improving phyfic, that they have often milled the pradice of it. The brain is confidered in the Cullenian hypo- thecs as the primary organ, on which the welfare of the fyftem principally depends ; and die A* r- vous fflcm, as the fubftraturn, or fundamental /.;- men of the whole body : for it fuppofes the living mufcular fibres to be a continuation of t\\c fub- ftance of the brain, or congeries of thcfc infini- tejjimally fmail threads called nerves. * Cullen conjedures, that the cortical part of the brain, or common origin of the nerves,isafecretory orgaufm Which the gluten of the bleed, or cocgulable h;>:pJ:3 being freed from all laline matter, before adhering to it, becomes fit for the nourifhment of the fclids, and * Hippocrates believed that the heart and the hlooJ confli- tuted the mainfpring of motion and fenfation, but was unacquainted with the properties of the N-^vons fyflem, which have been in a gicat meafure overlooked by all his fucceflbrs until the time of Dr Thomas tr ;!!:.<, 1*50, i8 and being poured in a fumciently diluted ftate, upon the origin of the nerves, is filtrated along their fibres, and is thence conveyed to every part of the body for its ncuriihment. Be this fyftem, the circulation of the blood inftead of being the principal, or- vital fundion, as in the Boerhaaviany becomes fo much zfecon- dary one, in the animal oeconomy, that it ferves l;ttle other purpofe than the nutrition of the body. When a large blood-veflel is wounded, the eva- cuation of the blood, caufes a collaps of the vefTels, and d-athenfues : yet Cullcn reminds us, that the vefTds muft neceftarily be in a certain ftate of diftention, in order that the nervous fluid fhould move.* Boerhaave tells us, that when a perfcn faints away, or lies fome time under water, there is wanted a circumgiration of the liquors in the blood velTels. Cullen admitting this, only con- tends, that the firft movement muft arife in the nervous fyftem, which exciting the blood velTels to adion, they propel the fluids contained in them and life immediately returns, with heat, color, agility, cogitation, and every vital and natural ac- tion. Hence we fee that thefe eminent teachers meant the fame thing, they only began the exula- nation in different parts of the circle. It would not be very difficult to prove, that both in their theory and their pradice, the difference is more in * Encyclop. Brit. art. Medicine, *9 in words, than in realny. Cullen confiders almoft all difeafes as arifing from an aflfedion of the nervous power. This power, or vis medicatrix naturae, is the fame that Hippocrates calls " nature," whofe efficacy he fo much celebrates in removing difeafes ; a power acknowledged and extolled by Boerhaave. The ftate of fcience is very different now from what it was 200 years fince. The philofophy of Ariflotle mifunderftood, the falfe theories of Galen, and the jargon of the Cheviifts, formed fo thick a cloud, that truth and nature could fcarcely be feea through it. When this was difpellcd by Lord Bacon and others, the aera of experiment followed. Philofophers and phyficians labored to accumulate fails. Societies were every where eftablifhed for this exprefs purpofe. A diftufive manner of writing crept in, and grew up among authors* It was the fafhion to print not only all that a man thought, but to quote all that he found any body clfe thought: and he was fcarcely efteemed a lite- rary man, who publilhed any thing lefs than a folio. But now it is wholly different. Infiead of that diftufive manner of writing, authors feel the neceflity of confolidating and concentntip^ fcience. They find that the fubftance of folio* may be digefted into a few pages, and the efTjacc of libraries comprefied within a ftw volumes. The The late Tjr John Brown has attempted to fmipliiy the fcience of medicine, by reducing all difeafes to two forms, namely, ftherac and aftheuic, the former fignifying an excefs, and the latter a defect of the vis vit