MEDICAL PROGRESS: 
By A. N. BELL, M. D, MEDICAL PROGRESS 
AN ORATION 
ON THE 
FOKTY-SEVENTII ANNIVERSARY OF THE MEDICAL 
SOCIETY OF THE COUNTY OF KINGS. 
BY A. N. BELL, M. U, 
Physician to Brooklyn City Hospital. Member of the Medical Society 
of the State of N. Y., of the Medical Society of the 
County of Kings, of the N. Y. Academy 
of Medicine, etc., etc. 
BROOKLYN, APRIL 27th., 1870. MEDICAL PROGRESS. 
Recognizing the importance of professional reputation as a 
society, no less than as individuals, we appear on this our 47th 
Anniversary with increased numbers and strength, to declare again 
our continued allegiance to a lineage as old as the civilization of 
mankind, and to vindicate the honor of our profession by a logical 
sketch of its progress. 
It is the office of logic, in relation to science, to designate, 
systematise and justify data. Ignoring all hypotheses, logic ac- 
cepts facts alone, evolves no theories, and accepts no dicta. The 
facts with which logic deals, hov/ever, are of two kinds, mediate 
and immediate—those which are derived from direct palpable cog- 
nizance of objects, and those that are demonstrable by means of and 
through obvious knowledge, and verifiable, for knowledge is only 
such in virtue of verification. Information may be gained by 
accident, by research, or through systematic laws, but the gaining 
of information is only the beginning of knowledge; the record is 
made by verification; and that which cannot be verified has no 
basis to stand upon. 
Facts in medicine, as in everything else, mediately possess the essential qualities of inference by which asserted discoveries are or 
are not reducible to knowledge. The logical question, therefore, in 
regard to all mere assertions, propositions, or judgments, is not 
whether the assertor, proposer, or judge is worthy of credence, 
but, whether in virtue of certain verifiable facts and laivs, the new 
assertions, propositions, or judgments are true or false. 
My purpose is for the time, to measure medicine by this stand- 
ard, and, as far as practicable, without breaking the chain of my 
thesis, to exorcise falacies and hypotheses by the logic of facts. 
Originally the Medical art was exclusively confined to the priest- 
hood, an hereditary caste of society among ancient nations, that 
embodied and monopolised all philosophy, in its broadest sense, 
comprehending the sum total of human knowledge. 
By the researches of Oriental scholars*, in recent times, it ap- 
pears that Greco-Egyptian Medicine was derived from the Hindus; 
that in the early ages the Hindu philosophers had numerous dis- 
ciples from Egypt and Greece, among whom they claim Plato and 
Pythagoras. The most ancient records of Greece are found to ac- 
cord with recent researches of the East; and when the Greeks 
attained such a degree of enlightenment as to appreciate the arts, 
they sought them in the East. Medicine among the rest was trans- 
planted, and in succeeding ages it was cultivated by a succession of 
men of genius, working in a field of nature under more favorable 
circumstances for accumulating knowledge than had previously 
obtained. Inquiry became the ruling spirit, and a sagacious priest- 
hood was equal to the emergency. In Hippocrates, they stamped 
it with a genius by which the borrower became the owner,—the 
accredited originator. The oral traditions and incoherent records 
of diseases and remedies that hitherto had been locked up among 
the secrets of the priesthood, Hippocrates systematised and arranged 
into a text book of medicine for the schoolmen of many subsequent 
centuries. But in so far as the practice of medicine consists more 
in material things than in words, in like manner does the discoverer 
of remedial means deserve more honor than he who publishes the 
facts or reasons upon them. 
Mankind had long been sensible of the importance of the knowledge 
MEDICAL PROGRESS. 
* Sir Wm. Jones, M. Houdnrt, Thos. A. Wise, M.D. et nls. MEDICAL PROGRESS. 
5 
of remedies to assuage pain; and the discovery of means for 
the prevention and cure of disease was deemed to be too important 
a matter not to be recorded. Information of this kind was preserved? 
and modified or extended according to the accumulated experience 
of the most enlightened portion of the community—the priesthood. 
Hippocrates recognized the fundamental truth, that in medicine 
the basis of all onr knowledge is the accurate observation of actual 
phenomena, and the correct generalization of these phenomena 
the sole foundation of sound reasoning. The ancient route, of 
which he speaks, is the route of observation and experience ; and in 
submitting this, he made full acknowledgment of the advantage he 
had derived from his predecessors. 
From the time of Hippocrates, there was no material progress 
until the establishment of the School of Alexandria, two centuries 
later. Aristotle had demonstrated that the heart of animals was 
the source ot the blood vossels, but as the bans of religious repro- 
bation obtained against the touching of the human dead body, this 
important fact had not been utilised. Theophrastus, a pupil of 
Aristotle, followed the example of his master in the study of 
natural history, by arranging and systematising plants. 
Comparative Anatomy and Botany thus became auxiliaries of 
medicine, even before they had worked out their own names. The 
School of Alexandria eclipsed from the first the yEsculapian temples 
of Greece, and Alexandria speedily became the resort of all who 
aspired to a knowledge of medicine. Early in the progress of the 
Alexandrian School, first became apparent the benefit (of integra- 
tion. The advanced knowledge of the natural history of animals 
and plants, as exclusively cultivated by Aristotle and his pupils, 
was, indeed, something more than a suggestive basis for the inte- 
gration of medicine; it was a practical illustration of the benefit 
to be derived from a more enlarged field of inquiry, by which these 
studies were not only recognised as natural preludes to surgery and 
pharmacy as parts sf the Medical Art, but essential to it. 
The success of this Greco-Egyptian Institution, was mainly due 
to the collection of animals and plants, and to the authorization of 
dissection. But scarcely had two centuries elapsed ere ltoman 
domination checked its progress, and by prohibiting dissection, ul- 
timately gave it a retrogade movement. The legacy of Hippocrates MEDICAL PROGRESS. 
became the bone of contention for innumerable sects, each claiming 
to be his true disciples. Men who held or taught pretended prin- 
ciples, acknowledged authority only unto themselves; all else was 
error. 
Pliny, the naturalist, among the rest, derided medicine, while by 
his researches in natural History he added to its resources. And 
Dioscorides, although a dogmatic sectator, made substantial additions 
by a treatise on Materia Medica. 
Celsus, in his work “ On Medicine,” evinced considerable pro- 
gress, and the more remarkable, since it does not appear that he 
was ever a practitioner of the art, on which he was unquestionably 
the most accomplished of ancient authors. Indeed, Celsus’ work 
is the only one which gives information on the state of surgery 
from Hippocrates to his own time ; and by it we learn that many 
of what are now termed capital operations in surgery seem to have 
been understood and frequently practiced during that early period. 
Previous to and at the time Celsus wrote, medicine in Rome was 
on a grade with the lowest occupations of a servile populace, which 
would seem to account for the circumstance that one so accom- 
plished as he was, never engaged in its practice. Ilis knowdedge 
was wholly of foreign origin, notwithstanding he wrote at Rome, 
and he seems to have regarded the wrangling sects of his native 
countrymen who called themselves physicians, as beneath his notice. 
The riot of ignorance continued to rage for a little more than a 
century later, when it was attacked by the immortal Galen. Unlike 
Hippocrates in being surrounded by an appreciative fraternity of 
learned men, he stood alone as it were, in the midst of pretenders 
and revilers, effort tended to debase the art which he 
loved. Possessing superior advantages of birth and education, he 
used them with energy, He laid out and accomplished for himself 
a broader scope and higher degree of scholarship in all the learning 
of the period, than any other that had preceded him. He studied 
philosophy and the arts in the schools of highest repute, while he 
scrupulously kept aloof from contending factions.’ Ilis knowdedge 
of medicine he principally acquired at Alexandria, after which he 
traveled through various countries for the express purpose of gain- 
ing information. Finally secure in his acquirements and confident 
of his powrer, he devoted himself scarcely less to the exposition of impostors than to his profession. And so far was he in advance of 
his contemporaries, that tlie futility of their reasoning served but 
to display his superiority. The result was, that on all subjects 
connected with medicine, he acquired a hold on the public mind 
that has never been equalled by any other physician. Praxagoras 
had previously distinguished the arteries from the veins, but the ar- 
teries he considered air vessels. Aristotle and Erisistratu,s adopted 
and taught tliis view. Galen refuted it, by showing that the arter- 
ies being wounded always gushed blood. And he turned this know- 
ledge to good effect, by tying them for the purpose of stopping 
hemorrhage. He also showed progress by his accurate knowledge of 
the human skeleton, and the organs of motion. He demonstrated 
the muscular filaments, and the ramification of the blood vessels 
and nerves between them. lie traced the nerves of the brain and 
spinal marrow, and, by experiments on animals, he distinghished 
the nerves of sensation and motion. lie enumerated and classified 
the nerves into pairs and groups, and discovered several of the 
ganglia. He recognised the natural divisions of the human body 
into cavities, and was familiar with the locality and appearances of 
the chief organs; indeed, his knowledge of particular structures 
was general, and, in the main, so correct as to constitute the basis 
of all subsequent anatomical classification. Galen’s chief means of 
acquiring this knowledge, appears to have been the vivisection and 
dissection of animals; for, while he is authority for human dissec- 
tion having previously been practiced by others, we have no evidence 
that he ever practiced it himself. Put we have evidence that in 
the latter part of the second century of the Christian era, shortly be- 
fore the downfall of the Alexandrian School, and about the time 
of Galen’s attendance there, Ilerophilis and Erisistratus not only 
dissected the human body, but that they also vivisected condemned 
criminals.* Galen also contributed to improve therapeutics, by 
pointing out the two-fold (primary and consecutive) effects of many 
medicines; and diagnosis, by defining the shades of difference in 
the pulse. And to Galen’s works, especially, are we indebted 
for the preservation of the Medical Art in the turmoil of the 
middle ages. In the final complete destruction of Alexandria, by the 
MEDICAL PROGRESS. 
* Kenouard, History of Medicine, from its origin to the ldth century, translated from the 
French by C. O. Comegos, M.D., Professor, etc., Philadelphia, 1807, p. 1711. MEDICAL PROGRESS. 
Arabian?, in the seventh century, “ some books escaped from the 
general wreck of literature and science; and there were not want- 
ing some individuals capable of estimating their value. Among 
these relics were the writings of Galen ; and, at an early period of 
the Saracenic Empire, these books began to be held in very high 
estimation. They were translated into Arabic; were commented 
upon in various ways, and soon accpiired a degree of celebrity, 
scarcely short of what they had previously enjoyed among the 
Greeks themselves.* ” 
The first reproduction of Galen’s writings, by the Arabians, was 
by Rhazes, about the end of the 9th century. The only progress 
indicated by him, is the free employment of what were called chemi- 
cal remedies, and his description of small pox and measles. For 
his knowledge of small pox, however, he refers to an Alexandrian 
physician, named Alirun, who had described it nearly three cen- 
turies before. 
Avicenna, two centuries later, gained a reputation by his medical 
writings, for great profundity of learning, while his highest ambi- 
tion seems to have been a thorough knowledge of the works of 
Galen, which he believed to contain the sum of medical wisdom. 
He made a large collection of material from all quarters, almost re- 
gardless of its value. And it is particularly notable that, in his 
chapter on leeches, he acknowledges Indian authority; and his de- 
scription is word for word that of Susruta, who wrote a thousand 
years before the Christian era.f Indeed, all of the accredited im- 
provements made by the Arabians seem to have been derived from 
the same source. They were gatherers and conservators, but not 
originators. And by the intervention of the crusades between the 
Asiatics and Europeans, the Arabians only gave back in a netv 
dress, that which they had derived, in the first place, from the relics 
of Alexandria, and that which they obtained from India. 
The first Christian prince who concerned himself with medicine, 
was Roger, the founder of the kingdom of Sicily, A.D. 1140. lie 
proclaimed an ordinance, requiring every person who purposed to 
devote himself to medicine, to obtain authority from a magistrate, 
* Cyclopcedia of Practical Medicine, vol. 3, p. 200. 
t Boyle, Asiatic Journal, vols. 3, 4 and 5. Keview of the Ilistory of Medicine, by Tbos. 
A. Wise, M D., 2 vols. London, 1367. MEDICAL PROGRESS. 
9 
under pain of confiscation and imprisonment. From this time 
many other princes followed his example, in establishing regulations 
and restraints, which, in the end, led to medical organizations, and 
the institutions of faculties and universities. In the thirteenth cen- 
tury, Frederick II., grandson of Roger, issued an edict, in virtue of 
which no one could practice medicine in the kingdom of Naples 
who had not been examined and created a master in the School of 
Salerno. To effect this, candidates were required to be of legitimate 
birth, to be twenty-five years of age, to have studied logic three years, 
medicine—including surgery—five years, and to undergo public ex- 
amination on the therapeutics of Galen, and the aphorisms of Hippo- 
crates; which, being satisfactory, an oath was administered for faith- 
ful conduct—to submit to the rules regulating practice, not to share 
the profits of the apothecary, and to gratuitously attend the poor. 
The School of Salerno flourished from the eighth to the thir- 
teenth centuries, and is said to have been founded about the middle 
of the seventh century, by some of the professors who escaped 
from Alexandria when it was overrun by the Saracens. 
In the time of Charlemaigne, the cathedrals of France, generally, 
possessed schools where writing, reading, arithmetic, singing, theo- 
logy, and sometimes medicine, were taught; and before the portals 
medical advice was given to the poor. From mere medical advice, 
in the first place, sprang the practice of dressing wounds, and 
simple surgical operations. On account of this, about the middle 
of the twelfth century, the Pope declared the practice of surgery 
incompatible with the priestly office, and forbad every bloody opera- 
tion, on pain of excommunication; but in order to still maintain 
jurisdiction over learning, medicine was made a branch of univer- 
sity education, and it was thus that during the thirteenth century 
most of the great universities of Europe were created. Practical 
medicine still remained in the hands of the priests, the only men 
who, at that time, could maintain pretention to learning, while 
surgery was abandoned to the ignorant and irreligious barbers, ba- 
thers and bonesetters, who were looked upon with such contempt 
as to be excluded by birth from apprenticeship to an artisan. 
Early in the fourteenth century, the School of Salerno was ex- 
celled by that of Bologna, by the revival of the dissection of the 
human body. In A. D. 1315, Mondini, a professor in the School of 10 
MEDICAL PROGRESS. 
Bologna, dissected the bodies of two women, and shortly after wrote 
an account of it, illustrated with drawings from nature. To him, 
therefore, belongs the credit of being the first to add pictorial illus- 
tration to anatomical description. IIis dissection, however, was 
scarcely less crude than that practiced by the ancient Hindus. 
“ Beneath the veins of the forearm,” he remarks, “ Ave see many 
muscles, and many large and strong cords, of which it is not neces- 
sary to attend in the anatomy of such a corpse (a recent one), but 
on one dried in the sun for three years, as I have shown otherwise 
in developing the number and the anatomy of those of the superior 
and inferior extremities.” lie takes an opposite and unnatural 
course to discover the nerves, advising maceration in running 
water.* For more than a century later, no one dared to follow the 
example of Mondini, in applying the dissecting knife to the human 
body. Mondini’s conscience seems to have smote him for his 
first attempt, since he did not venture to open the skull, for fear of 
committing mortal sin. And his scruples were more than con- 
firmed by the bull of Pope Boniface, forbidding eviseration and 
anatomical cooking. A practice which Halfinx states Avas only in- 
tended to prohibit the custom of the Crusaders of cutting up and 
boiling the bodies of their relatives deceased in infidel countries, 
so as to send them to their burial places in holy ground ! It is cer- 
tain, liOAvever, that the same bull Avas interpreted as prohibiting 
the dissection of the human body, for, in 1482, the University of 
Tubingen had recourse to the authority of Pope Sixtus IV., to ob- 
tain permission for dissection.f 
During the middle ages, charitable institutions, hospitals and 
medical schools Avere extensively multiplied ; and popes, princes 
and priests gave examples of devotion to the religious sentiment of 
the age, by personally attending the diseased and Avounded. During 
the general prevalence of plague and other epidemics, public baths 
Avere instituted in many cities and this measure alone, probably, 
did more to appease the ravages of plague than all other means 
combined. War, famine and disease concurred to test the zeal of 
devotees, to a degree unequalled at any other time. ‘‘During the 
period of universal distress, the monasteries of Constantinople had 
* Itenounrd—First practised by the Hindus, 
t Hist, de 1'Ad itomie lib. v., part iv.—Kenouard, p. 291. MEDICAL PROGRESS. 
11 
been, for some time, the refuge of the learned men who had been 
driven from Italy, by the perpetual wars in which that country had 
been engaged. They had taken with them what they had consid- 
ered their most precious treasures,—the manuscripts of the ancient 
classical writers—probably regarding them more as objects of curi- 
osity than of real importance. These manuscripts had now been 
buried for a long time in their libraries, their existence being un- 
known to the rest of the world. When the Monks were expelled 
from their retreats by the Turks, and flying into Italy, they carried 
back with them their manuscripts. A spirit of improvement had 
already begun to manifest itself in Italy, which was considerably 
incited by their guests, who, in their turn, by their change of situa- 
tion, and by the new society into which they were introduced, be- 
came more aware of the value of their literary treasures; while 
their own acquirements, limited as they were, gave them a degree 
of respect with their new associates, which tended to inspire them 
with a desire of further improvement.* ” It was thus that, A. D. 
1483, Mahomet II., having undertaken to destroy all the treasures, 
of Greek learning, was instrumental in preserving them. The art 
of printing had been invented but a few years before, and the 
AVestern world was thus supplied with an amount of the most 
valuable material. The taste for Greek literature, which had already 
begun in Italy, was cultivated with such ardor that the Arabic was 
speeedily displaced. The monuments of Greek and Latin learning 
were collected and published, and the pathway of science paved 
with imperishable lore. In addition to this, the art of printing 
supplied the means of circulating monographs of particular diseases 
and cases, with the reports of hospitals and other institutions for 
the care of the sick. These early publications on medical subjects, 
although intrinsically of little worth, served to re-establish a habit 
of observation, and to direct attention to facts as the foundation of 
true medical philosophy. 
At the beginning of the fourteenth century, Pitard founded a 
College of Surgeons, in Paris, out of the Brotherhood of St. Cone, 
a society of barbers, which occupied asortof middle ground, above 
the barber surgeons, and below the physicians, and in communion 
* Acker nnn, ch. xxvii Cab inis,—C/clopaelii of Practicil Mjliclm, vo\ li!., p. 2J(5. MEDICAL PROGRESS. 
with both. In the course of a century, the institution had so pros- 
pered, that it was admitted to a union with the university, and from 
that moment, says Malgaigne, a new state of things commenced. 
The medical schools of Padua, Pavia, Milan, Rome, Naples and 
other cities, all acquired celebrity; yet they confined their curricu- 
lum almost exclusively to the works of Galen. In the latter part 
of the fifteenth century, Thomas Linacre, of Canterbury, who is 
said to have been the first of his nation who learned to speak 
purely the language of the Romans, perfected his studies in Italy, 
and was, soon after, made physician in ordinary to Ilenry VII. and 
Princess Mary. Through his learning and translation of the works 
of Hippocrates and Galen, two chairs were founded at Oxford and 
Cambridge, the incumbents of which had to explain the writings 
of these ancient worthies. Linacre was also the chief instrument 
in founding the College of London. At that time, the bishops alone 
had the right of bestowment of medicine in their dioceses; whence 
it was that the practice of medicine continued in the hands of 
monks and illiterate empirics. Linacre had need of all his learn- 
ing and position at court, to do away with these prerogatives of 
the bishops ; but his perseverance and enlightened zeal were equal 
to the task. He obtained the issue of letters patent, prohibiting 
the practice of medicine by any one who had not received his degree 
in one of the two universities in the kingdom, and who had not 
been examined by the president of the college at London, assisted 
by three physicians, delegated expressly for that purpose. Chiefly 
through the efforts of Linacre, celibacy ceased to he obligatory on 
medical men, and ecclesiastical benefices were no longer sought as 
desirable for a physician.* 
In 1536, Ambrose Pare, a barber surgeon, of Paris, made his first 
campaign as surgeon to Marshall de Monte. Freed from the yoke 
of authority, which had for centuries environed medicine wi'.i 
superstitious blindness, he determined to observe for himself, and 
to accept the suggestions of experience, based upon accurate obser- 
vation, as paramount to the doctrines of the ancients. Galen’s me- 
thod of tying the vessels for the purpose of stopping hemorrhage, 
which had long since fallen into disuse, Pare restored; and he was 
* Friend. MEDICAL PROGRESS. 
13 
probably, the first to employ the ligature after amputations, instead 
of the actual cautery. 
Hitherto gunshot wounds were thought to be poisonous, and 
were treated by the application of boiling oil, hot pitch, or red hot 
iron. Among Parc’s first observations, was, that wounds which had 
escaped these severe applications were the better for it, and from 
that time he discarded them. Notwithstanding, barber surgery 
continued to prevail in its most contemptible aspects. 
In 1542, the barber surgeons of London were, by act of parlia- 
ment, raised to a dignity similar to that of the College of Sr. 
Cone, of Paris, under the name of “ Company of Barbers and Sur- 
geons.” The same act directed that the masters, or governors, of 
the said company, should have at their free liberty and pleasure 
“ the bodies of four felons to experiment upon.*” It is uncertain 
whether dissection was forthwith proceeded with in England ; but, 
in 156G, anatomical demonstrations were made at stated periods, in a 
public hall set apart for that purpose; and there was also a readership 
of anatomy held by physicians appointed by Royal authority. 
Early in the sixteenth century, the popes, who still stood at the 
head of scientific movements, withdrew their interdictions of 
anatomy, and the universities of Italy gave the first examples 
of dissection. Achillini, Benedetti, and perhaps also, Jacques Ber- 
renger, dissected at Bologna and Padua, previous to A. D. 1500. 
But there was no substantial progress until about the middle of the 
sixteenth century. Vesalius was the first after Pare, who dared to 
subordinate Galen, and show his errors, on the ground that the 
greater part of Galen’s dissections having been of monkeys and 
other animals, did not represent the human structure. This made 
him many enemies, but also some friends and followers. Dissection, 
which had at the first been pursued privately, was now practiced 
openly, in amphitheatres erected for the purpose. Anatomical 
chairs were created, and paid out of the public treasury, and per- 
mission given to use the.dead bodies of criminals not only, but 
others. Human intelligence, long buried in a lethargic sleep, 
gradually roused up, and signified its rising by discoveries of the 
highest importance. Learning emerged from the cloisters, and once 
* Ctaelius Surgery, vol. i., p. 19, Philadelphia, 1S47. 14 
MEDICAL PROGRESS. 
more showed itself abroad as in the days of Pythagoras, but with 
means of improvement far more numerous and efficient. Greek 
and Latin literature was exhumed from the dust of the convents, 
and studied with avidity. Soon these monuments of ancient learn- 
ing were found to he insufficient to satisfy inquiry. Criticism more 
and more severe revealed numerous defects, and finally stripped 
these still venerated relics of their sacred character, and assigned 
them a place from which they might henceforth he improved upon, 
and perfected in proportion to the advancement of human intelli- 
gence. The scalpel took the place of the razor, and the foundation 
of rational medicine was laid in anatomy. Plates made muscular 
fibre distinguishable from nerve expansion ; lymphatic vessels ap- 
preciable ; the muscular structures of the heart apparent; and the 
circulation of the blood became a desideratum. The pulmonary 
circulation was almost discovered in 1550, by Servetus. lie denied 
that any blood passed through the septum, as then taught by others, 
and asserted that it all passed through the lungs, by the pulmonary 
artery, and returned by the pulmonary veins. Andrew Cesalpine 
had discovered and taught, that “ the openings in the heart are 
disposed in such a manner, that the passage is free from the vena 
cava into the right ventricle, and from that cavity into the lung; a 
communication from the lung to the left ventricle, and from this 
last, into the aorta. Membranes are placed at the orifices of the 
various conduits in such a way, that a retrograde flux of the liquid 
column is impossible.”* Aided by Aquapendente, he demonstrated 
the course of the blood through the lungs, and added that the last 
or most minute ramifications communicated with the veins; that 
the blood passed from the arteries into the veins during sleep, which 
he inferred from the swelling of the veins, and the diminution of 
the pulse at that time. The valves of the veins were also known ; 
and it had been ascertained that the ligation of an artery stopped 
the pulse below, and that a ligated vein shrunk above the ligature. 
Among the most diligent students of anatomy, of the time, was 
William Harvey. Returning to London, from Padua, where he had 
studied the requisite five years for his degree, he entered upon pro- 
fessional life, while he continued to prosecute the study of anatomy, 
making, in conjunction with his dissections, a large number of 
* Kenouard, p. 298. MEDICAL PROGRESS. 
15 
vivisections. Possessed of all the facts that had previously been 
made known, and endowed with a spirit of inquiry and persever- 
ance equal to the importance of his pursuit, every step of his pro- 
gress was a crucial experiment. Thoroughly embued with the idea 
that certain truth could only be known by the regular and constant 
succession of one another, he was content to labor 
many years for its accomplishment. Gradually the object besought 
revealed itself to him, and took form. Fortified alike with a 
knowledge of the falacies, as well as the facts of all who had pre- 
ceded him in the same field of research, he hesitated not to declare 
the whole truth, and to defend it against all opposition. The whole 
process of Harvey’s researches was in accordance with the principle 
of “induction‘upon data carefully collected and considered.” The 
motion of the blood, and its existence in the arteries and veins, had 
been long known ; but the important fact that it made a continuous 
transit from the arteries into the veins without interruption, was 
reserved for Harvey. Yet he never satv this. He knew not how 
the blood got from the arteries into the veins. But the fact he was 
sure of, by induction, as a necessary consequence of mediate data 
he had carefully collected and considered. Ilarvey lived to see his 
discovery universally accepted, though it was not fully demonstrated 
until three years after his death, by Malpighi, who, in 1G61, de- 
monstrated, for the first time, by aid of the microscope, the pro- 
gression of the blood through the capillaries. 
Until about the time of Harvey, it had been the practice for 
many centuries, to place at the head of all philosophical treatises 
certain axioms improperly named “principles,” as an index of the 
writer’s purpose. And the axiom of Aristotle, “Nihil est in in- 
telledu quod non prius fuerit in sensu,” had been received as the 
quintessence of scholastic philosophy. But at the beginning of the 
seventeenth century, scientific progress had so far comprehended 
scholastic philosophy as to shake to the surface all that was of 
value; and we find medical philosophers practicing the reverse of 
Aristotle’s dogma. To seize upon, and combine this new process of 
improvement into a system, was the work of Francis Bacon; but, 
that “particular ideas are the basis of the pyramid, and axioms the 
summit; to study and apply what is known to the discovery of new 16 
MEDICAL PROGRESS. 
truths by induction, by which our senses are guarded against error;”* 
that these ideas were actuating principles long before they were 
enunciated by the great philosopher, admits of no question. And 
it has been truly remarked, that had Bacon been wanting an ex- 
ample to illustrate the truth of his doctrine, it would not be easy 
to adduce a more striking example of the way in which ultimate 
rational truth is arrived at, by a succession of inferences, than is 
contained in Harvey’s Essay on the Heart and Blood.f 
The spirit of Harvey was contagious. The process by which he 
had arrived at such an important truth opened up new fields of 
research. The discovery of the circulation of the blood was, after 
dissection, in a great measure due to the vivisection of animals, the 
only means, other than experiments on the human body, by which 
such knowledge is attainable. There was, at that time, a sentimen- 
tal criticism of Harvey’s experiments, such as has frequently mani- 
fested itself from various quarters since. To intelligent minds, 
generally, the importance of Harvey’s discovery and its congeries, 
are an all-sufficient reason. But, unfortunately, for the good of 
scientific inquiry, there always exists a respectable number of persons 
who, incapable of appreciating the motives of profound inquiries for 
the good of mankind, arrogate to themselves the sum of humanity. 
They cannot be made to see that every step taken in the science of 
man’s life, is an important part of the progress that adds to the 
sum of human happiness for both the present and the future. 
Shortly after the time of Harvey’s discovery, Asellius, of Milan, 
while examining the abdominal viscera of a dog that had been 
killed soon after eating, discovered the process of nutrition—the 
lacteal circulation. His discovery, like Harvey’s, had been preceded 
by certain intimations, as it were, by Fallopius and Eustachius, half 
a century before ; but neither of them comprehended anything of 
the use, cr the relation of the lacteal vessels to the sanguiferous sys- 
tem. Asellius regarded the lacteals as having a distinct function, 
and traced them to their origin in the mucous surface of the intes- 
tines ; but their termination in the thoracic duct, was not discovered 
until thirty years later, by Pocquet. The lymphatic and absorbent 
systems were discovered in a similar manner, by other observers. 
* Nov. Organ: lib. 1, ch. 1. 
t Works of Harvey, by Robert Willis, M. D. Introduction. MEDICAL PJiOGRESS. 
17 
These discoveries led to the use of high magnifying powers in 
anatomical researches, the pioneers being Malpighi and Leeuenhoec. 
By this means they were the first to demonstrate the movements of 
the blood discs in the capillaries. By the same means, De Graaf, 
Mayo, and others, made important progress in the knowledge of 
respiration, generation and gestation ; and Vieusens, "Willis, Pinel, 
Kepler, and others, improved our knowledge of the nervous system. 
Meanwhile, there were “Mechanical,” “Chemical,” “Metaphysical,” 
and other sects, and numerous individuals, as at the present day, 
who professed to possess certain cures for all the diseases that flesh 
is heir to, without any rational knowledge of the human organism, 
or of the remedies which they used. Joubert, a sprightly "writer of 
the time, after having shown the presumption of so many persons 
assuming to act as physicians, without the requisite knowledge, 
narrates the following adventure:—“It is said that the duke of 
Ferrara, Alpiionso d’Este, at one time proposed, in a familiar way, 
the question,—‘In what calling are most men engaged?’ One 
said, ‘shoemakers;’ another, ‘tailors;’ a third, ‘carpenters, ma- 
sons, pettifoggers and laborers.’ Gonelle, his famous buffoon, 
said there were more ‘ physicians’ than any other class of men, 
and made a bet with the duke, who denied it, that he would prove 
it in twenty-four hours. The next morning, Gonelle left his lodg- 
ing, Avearing a great night cap, and a cravat tied round his chin ; 
then a hat over all, and his mantle drawn up over his shoulders. 
In this attire he took a route through a populous street leading 
to the palace of his master. The first person he met asked him 
what Avas the matter ? He replied that he had a raging tooth- 
ache. “Ha, my friend,” said the stranger, “I knoAv the best 
remedy in the world against it,” and told it to him. Gonelle in- 
scribed his name on his tablet, pretending that he Avas Avritingdown 
his recipe. A step further on, he found tAVo or three together, avIio 
all asked the same question, and each one gave him a remedy. lie 
inscribed their names, as the first. And thus he pursued his 
course, very gingerly, to the end of the street, not meeting a single 
person who did not offer him a recipe, and different from the rest, 
each one assuring him that his remedy Avas established, certain and 
nearly infallible. He Avrote doAvn the names of all. Approaching 
the loAver court of the palace, he found himself surrounded Avitli MEDICAL PROGRESS. 
gentlemen (for they all knew him), who, after having learned his 
affliction, compelled him to take their recipes also, which each one 
assured him was the best in the world. lie thanked them all, and 
wrote down their names. When he entered the chamber of the 
duke, his excellency cried out, “Eh! what is the matter, Gonelle ?” 
He replied, very piteously and complainingly, “The toothache, the 
worst that ever was.” To which his excellency replied,—“ Ha ! 
Gonelle, I know a thing which will drive off the pain at once, with- 
out touching the tooth. Mr. Antonio Musa Brussavolo has never 
employed a better one. Do so and so, and immediately you ivill 
be healed.” Gonelle suddenly threw off his head dress, and his other 
attire, crying oat, “And you, also, my lord, are a physician!” 
Look at my list, and see how many others I have found, between 
my lodging and your palace. Here are nearly two hundred, and I 
have not passed through one street. I will engage to find ten thou- 
sand in the city, if I go everywhere. Find me as many persons in 
any other business.”* 
At about the beginning of the 18th century, the spirit of inquiry 
was severely contesting authority in everything. And in medicine 
particularly, numerous important facts were in process of discovery. 
Great names had lost their potency, and inquiries after truth were 
gradually working into the necessity of self-reliance. Many well 
conducted experiments and accurately observed phenomena had 
been wrought out by enthusiasts in quest of shadows ; but there 
were some reflective minds who made it their purpose to acquaint 
themselves with all the facts that had been adduced, for strictly 
utilitarian purposes. Foremost among these were Sydenham and 
Boerhaave. Although they were not wholly free from the hypo- 
thetical doctrines of the time, these were never allowed to gain such 
ascendancy over their minds as to interfere with a sound judgment. 
With them, experience, based on accurate observation, always took 
precedence of theory. Their uncommon sagacity in the diagnosis 
of disease, and discrimination of remedies, were due to a deter- 
mined subordination of theories to facts, and not facts to theories. 
They were both not only learned in their profession, but in its 
collaterals ; and they possessed in a high degree the faculty of 
availing themselves of the knowledge of their con temporaries, and 
♦Erreurs populates par Laurent Joubert, 1587. medical progress. 
19 
of so utilizing it its to increase the resources of medicine. With 
unselfish devotion and industry that never contemplated less than a 
knowledge of everything conducive to the successful application of 
their profession, they impersonated in an extraordinary degree the 
qualities essential to a sound progress. To Boerhaave, especially, 
are we indebted for the permanent revival of clinical instruction. 
This means of improvement was first practiced in the latter part of 
the sixteenth century, at the Hospital of St. Francis, Padua; and 
subsequently by Sylvius, at Leyden, whose clinics were held in high 
repute, and caused him to be regarded as the founder of this mode 
of instruction. But his successors let it fall into disuse for more 
than forty years, when it was revived by Boerhaave, who became so 
renowned that auditors attended him from all parts of Europe. 
And, owing to his success, clinical instruction was speedily estab- 
lished among all civilized nations. 
The interval from Harvey to Boerhaave is particularly notable 
for the number and industry of its laborers, and the number of is- 
olated facts brought to light. By the increase of anatomical know- 
ledge, the publication of hospital reports, essays and treatises, oper- 
ative surgery, especially, and the treatment of injuries, advanced to 
a high degree. Post-mortem examinations had occasionally been 
made from the earliest times,* but they had not earned a name. No 
records of such examinations seem to have been preserved until 
from about the beginning of the sixteenth century of the Christian 
Era. A. 1)., 1507, Antony Benivieni, of Florence, prosecuted post- 
mortem examinations, extending even to the practice of other phy- 
sicians. Eustachius, also pursued the same course, and thus made 
many important contributions to anatomy. But much prejudice 
existed against the practice, and great perseverance was necessary 
to overcome it. Among those who'made the most progress in this 
direction was Marcell us 1 ionatus. “ Let those,” said he, “ who inter- 
dict the opening of bodies well understand their errors. When the 
cause of disease is obscure, in opposing the dissection of a corpse 
which must soon become the food of worms, they do no good to the 
inanimate mass, and they cause a grave damage to the rest of man- 
kind, for they prevent the physicians from acquiring a knowledge 
* Pliny. MEDICAL PROGRESS. 
which may afford the means of great relief eventually to individu- 
als attacked by a similar disease. No less blame is applicable to 
those delicate physicians, who from laziness or repugnance, love 
better to remain in the darkness of ignorance than to scrutinize la- 
boriously, truth; not reflecting that by such conduct they render 
themselves culpable towards God, towards themselves, and towards 
society at large.’"* 
For nearly a century subsequent, superstition outweighed the ef- 
forts of physicians to gain information by the opening of the hu- 
man dead body. And although a number of medical philosophers 
from time to time assayed to improve their knoAvledge by this means 
there was no substantial progress. A sagacious mind was wanted 
who might rehearse, collate and classify the material facts that had 
been discovered in the progress of anatomical researches,, and so 
generalize them as to induce truth. 
Haller, the pupil of Boerhaave, trained from early age to the habit 
of close observation and study, entered upon the investigation of 
anatomical facts and physiological phenomena with a clearness of 
perception and judgment which led him to reject all mere matters 
of opinion and to receive nothing without personal verification- 
He pursued his investigations with characteristic patience in con- 
nection with well directed researches and experiments, and induced 
from the facts he had verified, irritability and sensibility as 
specific properties of all the muscular and nervous systems; that to 
either one, or both of these properties jointly, may be attributed all 
vital phenomena. He also traced out and discovered the process of 
developement of the fcetal heart and circulation, and originated the 
science of teratology. Iudeed, his labors contemplated a reinvesti- 
gation of all that had been previously made known in the progress 
of anatomy and the functions of the human organism. “It can be 
shown,” he remarked, “ even by positive calculation, that it is not 
possible in twenty years to work out thoroughly all parts of the 
human body. Animals must be dissected, but it is by no means 
* Marcel Ins Donatna, Medica Histona, lib. IV. Kenouard, p. 305. 21 
MEDICAL PROGRESS. 
sufficient to dissect their dead bodies ; they must be vivisected. In 
a dead body motion is wanting. It is necessary, therefore, if we 
would witness motion, to observe the living animal.”* 
The example of Haller in carefully abstaining from all specula- 
tive opinions and of confining his researches exclusively to experi- 
ment and observation, was scarcely less beneficial than his material 
improvements. He, in this way, gave a new impulse to science by 
the spirit with which he conducted his investigations. Cullen, the 
cotemporary of llaller, pursued the same philosophical spirit. He 
estimated the properties of medicines by careful and almost skepti- 
cal observations, by which he avoided errors and inconsistencies, 
and distinguished the effects of remedies from physiological phe- 
nomena. His vis medicatrix natures expresses his appreciation of 
the specific effort of the natural powers of the organism to resist 
and overcome disease, and an intelligent recognition of the impor- 
tance of accurate knowledge of morbid phenomena. 
From Haller to Bichat was but a single step. The ancients im- 
agined that every solid organ was reducible to what they ealled ele- 
mentary fibre—a compound of earth, iron and oil, and everywhere 
the same. Haller’s conception of this elementary fibre was, that it 
was to the anatomist what the line is to the mathematician. His 
genius endowed it with a quality only; of its substance he was ig- 
norant. Following Haller’s minute dissections, a number of inves- 
tigators recognized the resemblance of certain membranes in dif- 
ferent parts of the organism which previously had been regarded as 
independent structures. One of the earliest of these observers was 
Andrew Bonn, who published a Thesis in 1763, entitled, “Be 
Conditionibus Membranarum.” Fifteen years later, Carmichael 
Smyth, read a paper on Inflammation, wherein he attributed the 
causes of the specific distinctions in the various forms of inflamma- 
tion, to the differences in natural texture, lie cites examples of in- 
flammation of the mucous membranes, serous membranes, muscu- 
lar fibres, etc., in each of which the inflammation is distinguishable 
by peculiar characters—though in different parts, f This appears to 
have been the earliest effort to classify disease according to the 
* Preface to Elements. 
t Medical Communications!, Vol. II, p. 163 MEDICAL PROGRESS. 
structure of the organ or tissue in which it exists. About the same 
time Bui llie and Pinel each adopted a similar method of designating 
diseases according to organic structure. Insignificant as these be- 
ginnings in the study of structural anatomy now appear, they were 
the preludes of the most important discovery in the progress of 
medicine. The ideas of Bonn, Smyth, Baillie and Pinel, were sei- 
zed upon by Bichat and elaborated into a substantial organic basis 
of a new science. Devoting himself with almost unparalled pa- 
tience to the investigation of minute anatomy, Bichat sacrificed 
every thing else to the advancement of the object of his research. 
Some notion of his ardor and industry may be formed from the fact 
that in the short space of six months he personally examined over 
six hundred human dead bodies.* His indomitable energy was but 
the counterpart of a genius w orthy of the task he undertook. Ver- 
ifying all that was known before, he grasped the residue, and from 
it accomplished the brilliant achievement of separating the human 
body into its elementary tissues. And these he not only defined and 
described in a morphological point of view, but in detail—in their 
physiological functions and morbid conditions ; in such wise as to 
render them easily recognizable by fixed properties under whatever 
circumstances and wherever they may be found. The elementary 
tissues so well described by Bichat, are the origin and foundation of 
Histology in all its phases, and the scientific basis of modern medi- 
cine. 
For the next thirty years after the discovery of Bichat, many 
anatomists occupied themselves in rehearsing his researches in quest 
of new truths, in projecting instruments, and in experimental in- 
quiries and clinical observations on the functions of organic life. 
The examination of the elementary tissues of animals, found anala- 
gous researches into the tissues of plants. Robert Brown, Slack 
and others published important observations on the elementary 
structures and physiology of plants; and Schleiden, penetrating 
still further in a paper entitled “ Phytogenesis,”f pointed out small 
sharply defined granules, generated in a granular substance sur- 
rounded by cell nuclei or cytoblasts, which he likened to granulous 
* Notice Historique sur Bichat. Mainguult, Edition of the Gen’l Anat. 
t Muller’s Archiv fnr Anatomic. MEDICAL PROGRESS. 
coagulations around the granules. These observations were com- 
municated to Schwann, who was struck with similar appearances 
in animal tissues, and thereupon conceived the idea that the same 
character of developement which Schleiden had discovered in plants 
would be found equally true of animals. From this time Histolo- 
gy made rapid progress, and in no other way can we so well present 
this most important step in medical progress, as in the words of 
Kolliker, one of its greatest promoters, “In the year 1838, the de- 
monstration of Dr. Thomas Schwann of the perfectly identical cel- 
lular composition of all animal organisms, and of the origin of 
their higher structures from these elements, afforded the appropri- 
ate conception which united all previous observations, and a clue 
for further investigations. If Bichat founded Histology more the- 
oretically by constructing a system and carrying it out logically, 
Schwann has by investigation afforded a basis of facts, and has thus 
won the second laurels in the same field. What has been done in 
this science since Schwann, has been indeed of great importance to 
physiology and medicine, and in fact of great value in a peculiarly 
scientific point of view, inasmuch as a great deal which Schwann 
only indicated or shortly adverted to as the genesis of the cell, the 
import of the nucleus, the developement of the higher tissues, their 
chemical relations, etc., has received a further development, but all 
this has not amounted to a step so greatly in advance as to consti- 
tute a new epoch. If without pretensions to prescience, it be per- 
mitted to speak of the future, this condition of Histology will last 
as long as no essential advance is made towards penetrating more 
deeply into organic structure, and becoming acquainted with the 
elements, of which that which we at present hold to be simple is 
composed. If it be possible that the molecules which constitute 
cell-membranes, muscular fibrils, axile fibre of nerves, etc., should 
be discovered, and the laws of their apposition and of the alterations 
which they undergo in the course of their origin, the growth and 
the activity of the at present so-called elementary parts should be 
made out, then a new era will commence for Histology, and the 
discoverer of the law of cell-genesis, or of a molecular theory, will be 
as much or more celebrated than the originator of the doctrine of 
the composition of all animal tissues out of cells. * * * * * AIETHCAL PROGRESS. 
As regards the general positions of Histology, the science has made 
no important progress since Schwann; however much has been at- 
tained by the confirmation of the broad outlines of his doctrines. 
The position that all the higher animals at one time consist of 
cells, and develope from them higher elementary parts, stands firm, 
though it must not be understood as if cells, or their derivities were 
the sole possible or existing elements of animals. In the same way 
Schwann’s conception of the genesis of cells though considerably 
modified and extended, has not been essentially changed; since the 
cell-nucleus still remains as the principal factor of cell-development 
and of cell multiplication. Least advance has been made in the 
laws which regulate the origin of cells and of the higher elements; 
and our own acquaintance with the elementary processes which take 
place during the formation of organs, cannot be regarded as very 
slight. Yet the right track in clearing up these points has been 
entered upon ; and a logical investigation of the chemical relations 
of the elementary parts, and of the molecular forces after the man- 
ner of Donders, Dubois, Ludwig, and others, combined with a more 
profouud microscopic examination of them, such as has already 
taken place with regard to the muscles and nerves, and further, a 
histological treatment of embryology, such as has been attempted 
by Reichert, Vogt and myself, will assuredly raise the veil and bring 
us step by step nearer to the desired, though, perhaps, never to be 
reached end.”* 
Of the nature of disease and its discovery, the ancients for the 
want of anatomical knowledge regarded all morbid phenomena or 
symptoms as evidences of something that had entered into or graft- 
ed itself upon the body. Hence their treatment consisted in an ef- 
fort to dislodge it, and chiefly consisted in the use of evacuants. 
For this reason the introduction of Peruvian bark and some other 
useful remedies in the treatment of disease were opposed on the 
ground that they produced no sensible evacuation, and were there- 
fore inconsistent with accepted theory—that no disease was cura- 
ble without the expulsion of bile, phlegm or other humors. The 
Stahlites regarded fever as a natural and salutary effort of the soul 
to free itself from an injurious substance; to arrest it Avas contrary 
* Introduction to Manual of Human Histology. MEDICAL PliOOliESS. 
to the vital principle and therefore likely to do more harm than 
good. The Arabians held that small pox was innate to man ; and 
therefore to prevent its development was to oppose the action of 
nature, and to keep the enemy in his place. By the improvement 
of modern times, disease is known to consist of an intrinsical change 
in the structure of the organism. The name of a disease may, and 
usually does express some important fact or characteristic, but this 
is only an integral part of the existing change. The symptoms 
present indicate the nature of the changes produced and these 
changes (not the symptoms), constitute the disease. And, inas- 
much as no single organ can undergo a change of structure, or 
function depart from its healthy standard, without corresponding 
changes in all the rest, it is apparent that the foundation of the 
medical art must be laid in an accurate knowledge of the structure 
and functions of the human body. It may be safely stated in this 
connection, that not a single remedy for any disease whatever, has 
ever been discovered by following a theory or hypothesis. But, on 
the contrary, as truly remarked by Virchow, “ the history of medi- 
cine teaches us, if we will only take a somewhat comprehensive 
survey of it, that at all times permanent advances have been mark- 
ed by anatomical innovations, and that every more important epoch 
has been directly ushered in by a series of important discoveries 
concerning the structure of the body.*” The maxim that “knowl- 
edge of disease is half its cure,” was appreciated, however, though 
it may not have been expressed, even before the era of Histology. 
Pathology had already involved the fundamental art of diagnosis 
as the foundation of all enlightened practice. But the means of 
exercising the art of diagnosis were far more limited; and the 
practical results correspondingly inefficient. 
The eighteenth century closed with a concurrence of effort on 
the part of a number of individuals all tending to the same goal— 
to lift the medical art out of the conjectural hypotheses of ages and 
establish it upon a scientific basis. The great achievement of Bich- 
at, as already shown, was not accomplished single-handed. Others 
had begun to clear the way. The young giant quickly ran his brilli- 
ant career, but left behind him worthy followers. Laennec, the pupil 
* Cellular l’atologv of Corvisart, while attending his master’s lectures at La Charite, be- 
came strongly impressed with the importance of discovering inter- 
nal lesions by external signs. As early as 17G3, Avenbrngger, a 
German physician, had introduced percussion as a means of diag- 
nosis, but it had been rejected by the profession and was not again 
revived until by Corvisart, thirty years afterwards. Boyle, a fellow 
student with Laennec, applied his ear to the chest, while attending 
Corvisart’s lectures. Laennec followed suit, and conceived the idea 
of increasing his powers of discrimination by artificial means. 
May 14, 1815, fifteen days after having read a paper on his favorite 
study (before the Societe del’Ecole), he added the stethescope to his 
means of diagnosis. He was shortly afterwards appointed to the 
Hospital Beaujon, and soon after to the Necker, which afforded him 
abundant means for the cultivation of his ear, and the verification 
of his diagnosis. After three years assiduous study, he published 
his treatise on Mediate Auscultation. Louis, Andral, Cruveilheir, 
Meckel, Abercrombie, Mayo, Hope, Carswell, and others progress- 
ed in the same direction as Laennic, by diligently studying all the 
functions of the human body during life, and examining all the or- 
gans after death. 
Bichat condensed anatomical knowledge into a grand reservoir 
that ever since his day has been overflowing its hanks and fertilizing 
a continuously expanding field of scientific culture. 
Willis, Cabanis, Camper, and other collaborators of Bonn, Smythe, 
Pinel and Bailie, investigated the nervous system, and were the first 
to regard the brain as the viscera of the understanding, with spe- 
cial functions in communication with different parts of the organ- 
ism. The first to discover a difference in the functions of the dif- 
ferent roots of the spinal nerves, was Alexander Walker;* and 
shortly after him, Sir Charles Bell published his “ Idea of a New 
Anatomy of the Brain,” showing a difference between the nervous 
elements employed in the different functions of the nervous system. 
Subsecpiently he showed that the nerves of motion were distinct 
from those of sensation, and suggested that the posterior or gangli- 
onic roots of the spinal nerves are nerves of sensation, while the 
MEDICAL PROGRESS. 
* Archives of Universal Science, 1809. anterior roots are nerves of motion. This suggestion was taken up 
and first claimed by Magendie, and subsequently adopted by a num- 
ber of anatomists, who have since demonstrated that the difference 
in the nerves of motion and nerves of sensation as first discovered 
by Bell, finds its true distinction in the grey and white matter ;— 
the former being the principal conductor of the sensitive impres- 
sions, and the latter, impressions of motion. The demonstration of 
this truth, and still further the decussation of the conductors of 
sensitive impressions in the spinal cord, and the decussation of the 
conductors of motive impressions in the medulla oblongata, with 
elaborate pathological conclusions, have been the result of vivisec- 
tions and clinical observation. 
The discovery of physiological tissue genesis by Schwann, was 
followed by the still more profound researches of Johannes Muller* 
establishing pathology on the same basis; in determining the fun- 
damental law of similarity between pathological and physiological 
tissue development, which has since .been so abundantly verified by 
Wedl, Virchow and others. Vogel, Lebert, Rokitansky, Paget and 
others, have elaborated morbid Histology in the same vein. Mean- 
while the free cell-development of Schwann or blastema formation, 
has been investigated anew by Reichert Ilenle, Maudl and Remak ; 
the last of whom in 1852, declared free cell-development an error, 
and announced “ Omnis cellula in cellula,”* as the true conception 
of cell growth. Two years later Virchow7 echoed the same doctrine 
in “ Omnis cellula e cellula,”f which is now well nigh the accepted 
basis of cellular pathology. Virchow’s waitings are so recent and of 
such easy access that an attempt to state his doctrines is unnecessa- 
ry. With a profound respect for the past, he uses the deficiencies 
of his predecessors as means of improvement for himself, while he 
enhances their excellences by presenting them in a more favorable 
aspect. Virchow’s labors from the first have been characterized by 
the same generous spirit. A truth was no sooner known to him- 
self than it was communicated to the profession. And his name is 
identified in the progress of medicine for the last twenty years to a 
degree scarcely equalled by any other. By this means his discover- 
MEDICAL PROGRESS. 
* Bau der Krankbaften Gegchwulste. 
* Muller’s Archives, 1852. 
t Beitr. 2 Spec. Pathologie und Thuapie, 1854. MEDTCAL PROGRESS 
ies and views have been subjected to examination from all quarters. 
The result has been that when the time came for him to consolidate 
his writings, as in the several volumes which he has published during 
the last ten years, he had the benefit of all his collaborators, and he 
has so compacted their and his own labors together, and so con- 
nected them with the past as to present the sum of anatomical im- 
provement acquired during the present century. 
The sum of medical progress now rests upon :— 
(1.) An anatomy, which in a descriptive point of view is perfect 
and thoroughly worked out, and structurally nearly so. 
(2.) A Physiology comprehending not only an accurate knowledge 
of the functions of the chief organs and tissues which constitute 
them, but of the molecules of less than one twenty-thousandth part 
of an inch in diameter, and almost the process of their development. 
The growth, contractility and movements of the living molecules, 
being demonstrable by means of the microscope with the same de- 
gree of accuracy as the largest cells and fibres; and these molecules 
are known to possess independent vital actions,—to produce nuclei, 
cells, fibres, tubes and membranes which unite and form the vari- 
ous tissues and organs of the body. 
(3.) A Pathology, which determines after death the relations of 
morbid conditions and the symptoms of the diseases that cause 
them, in the same manner as the healthy body is explored with a 
view to a knowledge of its structure—and no less completely. In- 
deed as descriptive anatomy is perfect, to the same degree is patliol- 
ogy—uniting with anatomy and physiology, to constitute Histology, 
the highest mark of medical progress. 
(4.) A Diagnosis j—Aided by the Microscope, Stethescope, Laryn- 
goscope, Opthalmoscope, Endoscope, Spectroscope, Thermometer, 
Sphigmograph, Dynamograph, and various other speculi and in- 
struments, by means of which the chemico-physiological and patho- 
logical changes are studied and recognized. Elementary forms and 
deposits, amorphous granules, crystaline structures, simple and or- 
ganized cells—capable of growth or otherwise; granules fibres and 
compound corpuscles ; exudations of every degree of consistence ; 
pigments of various shades—all, in their healthy or morbid states, 
discoverable, countable, definable. No amount of professed ex peri- MEDICAL PR0GRB8S. 
cnee merely, exclusive doctrine or speculative theory can withstand 
the logical facts elucidated by these means. And they not only 
doom to inevitable oblivion existing fallacies, but they are a bul- 
wark for the future. Standard specimens of organic forms which 
compose all the textures of the .human body, are now within the 
reach of every student. And most of the recent works on practi- 
cal medicine, surgery and histology, are illustrated by the arts of the 
engraver with what may be deemed standards of comparison for 
verifying the accuracy of observations by the aid of instruments. 
Chemistry and Philosophy, are also instruments of diagnosis. 
By means of these, plants and animals are transformed in all stages 
of growth and development; the relations between them and the 
atmosphere determined ; the nature of all substances—organic and 
inorganic, solid, liquid, or gaseous—are ascertained with precision. 
Physical and vital actions, chemical, electrical and mechanical in- 
fluences—are utilized in diagnosis, and among the moans at our 
disposal. 
The present status of medicine, and the means by which it 
has been attained, distinctly point to the source of all future pro- 
gress. It is in the held of exact scientific investigation into <|ues- 
tions and problems which the most recent advances have opened to 
view. Each new fact, patiently grounded on exact knowledge and 
established beyond question,though it may for a time appear to be 
an idle and useless addition, may eventually fructify into some use- 
ful generalization applicable in the most unexpected and startling 
manner to the prevention or cure of disease, and the promotion of 
human happiness. 
THERAPEUTICS. 
The art of therapeutics, comprehending the treatment of 
disease is commonly considered the rear rank of medical progress. 
With a brief glance at this, and 1 will tax your patience no longer. 
It should be borne in mind that this branch of medicine is not only 
the most difficult, but that it is, rationally, at least, always the 
junior. When we reflect upon the number of asserted remedies, 
the pretended discoveries, the healing arts, the certified effects and 
the grave-yard certificates of universal cures as the fruit of credu- 
lity and other obstacles with which we have to contend ; and when MEDICAL PROGRESS. 
we consider how recently the auxilliary sciences of Botany and 
Chemistry have made their chief advances; the still imperfect 
state of meteorology, and other sciences and arts upon which 
our knowledge of therapeutic means so much depends—the 
wonder is that the uncertainty is not much greater than it is, in- 
stead of being marked, as the relative progress of therapeutics cer- 
tainly is, by the most signal triumphs in the history of medicine. 
The art of therapeutics consists in the application of natural and 
artificial products from all sources to the preservation of health and 
the cure of disease, hence this branch of medicine must of ne- 
cessity always remain incomplete. 
Many remedies known to he directly curative of certain diseases, 
such as cinchona and its salts, sulphur, mercury, cod-liver oil, lem- 
on juice, etc., are the result of empirical observation. And so too 
with regard to the specific effects of such agents as anaesthetics and 
vaccinia. By accident or experiment, it is discovered that a certain 
substance is of use in a particular disorder. The same remedy is 
subsequently and repeatedly administered in like condition, and 
upon a number of such data an empirical system is established. 
This kind of practice is in accord with the vulgar acceptation of 
the practice of medicine, and requires but little knowledge. Those 
who accept it as the sum of medical knowledge stand in the same 
relation to modern medicine as the ancients. And by a precipita- 
tion of judgment common to the unenlightened, they assert reme- 
edies of whose properties they know nothing—for diseases of which 
they are equally ignorant, and call themselves physicians. But how- 
ever limited the knowledge, and extensive the danger of such practi- 
tioners, the physio-pathological phenomena in the application of re- 
medies, empiracally, are valuable, because their utility is made known 
by therapeutical proof. Indeed every effort to alleviate human suf- 
fering, however humble, is worthy of the attention of the enlight- 
ened physician. And we should remember that the powers of man- 
kind in this direction are not wholly limited to the votaries of sci- 
ence. Improvements have frequently been derived from most hum- 
ble sources, or seized upon under the most fortuitous circumstan- 
ces. And medical progress as a whole, is the result of the succesful 
labors of many individuals. While a few persons may be identified MEDICAL PROGRESS. 
31 
with certain improvements of their time, it is none the less true, as 
a general rule, that such persons deserve credit for only a part of the 
progress made under their names. Indeed, silent workers often ren- 
der the most efficient service, confirming or refuting the published 
accounts of the few. The final establishment of important truths 
are usually to be recognized in the co-ordinate experiences of many 
observers. And every single step in the direction of prevention 
and cure, is progress. 
Referring to modern improvements, in an address before the Bri- 
tish Medical Association, recently, Sir William Jenner makes the 
following remarks: 
“ Who that has suffered from a painful local affection can think 
of the alleviation of his sufferings which follows from the subcuta- 
neous injections of an anodyne, without gratitude ? Who is there 
that has had to submit to the knife of the surgeon whose heart 
does not overflow with gratitude to those who introduced and per- 
fected anaesthesia ? The electric telegraph, the greatest marvel of 
our time, was a thing which in a rough way scientific men had long 
thought possible ; but to cut for stone, and to know nothing of the 
agony, to have a leg removed and smilingly to ask when the opera- 
tion is over—when are you going to begin ?—these are marvels of 
which no one dreamt; no exaggerations of fiction equal this reali- 
ty. The discovery of the value of subcutaneous injection of ano- 
dynes, and local anaesthesia by ice, ether spray, and of general anae- 
sthesia by ether, chloroform, and nitrous oxide, are advances in al- 
leviate medicine worthy to rank with the advances in preventive, 
curative and prolongative medicines.” 
It well becomes us to be cautious in the adoption of new reme- 
dies, and to accept those only which will admit of logical conclu- 
sions, based upon accurate knowledge of the nature of the remedy 
and the state of the organism at the time ; involving an accurate 
knowledge of both structure and function. AVitli such knowledge 
there is quite as much certainty in medicine as in any other science 
or profession. And he who reproaches physicians with differing 
more than other men in identical pursuits, or charges them with 
being more uncertain in their conclusions than other professions— 
lie who asserts or accepts such propositions has neglected his edu- MEDICAL PROGRESS. 
cation. Physicians are far from assuming that their profession is 
perfect. Well do they know indeed, that the pathway to scientific 
truth is beset with many doubts and clogged with incessant obsta- 
cles. The enjoyment of health and long life are recognized by all 
men as among the greatest boons of human aspirations. The best 
way to promote these blessings—how to relieve pain, to cure and to 
prevent disease—are objects worthy of the highest ambition and of 
the noblest contest. And we maintain that in the exercise of these 
efforts as a profession, no human pursuit surpasses medicine, either in 
the certainty of its conclusions or in its positive and increasing bless- 
ings to mankind. What, indeed, are the certainties and emblems of 
progress in other professions and sciences that the reproach of being 
uncertain and stationary should specially apply to medicine ? The 
law, we are told, is the perfection of human reasoning—its doctrines 
are confined to questions of right and wrong; in which the whole 
moral faculties of man instinctively lead the juilge to decide aright. 
Besides, lawyers and judges render their opinions with the utmost 
deliberation after the amplest opportunity for research. But where 
are the clients who are satisfied with the unerring opinions of law- 
yers or the unappealable judgments of courts ? The law pleads de- 
fectiveness of evidence in extenuation of such uncertainties. But 
is there any one within my hearing that does not know that the in- 
terpretations of organic law, which are wholly free from such ques- 
tions, are not equally uncertain ? Physicians are expected to be in 
a constant state of readiness to decide upon the most difficult ques- 
tion’s at a moment’s warning—but who that is informed on these 
matters will say that their decisions are less certain than the law- 
yers? Of statesmen;—on manufacturing, tariffs,internal improve- 
ments, educational systems, citizenship, banks, legal tenders and 
gold payments—are opinions unanimous and certain on these ques- 
tions ? Mathematics—that certain science from which engineers 
and architects with the amplest data for the most precise investiga- 
tion, are they all of one opinion on the great East River Bridge, or 
other like structures? And, how will physicians compare with 
theologians ? Are these latter all agreed on the most direct road to 
the Celestial World? or even on the meaning of words and the in- 
terpretation of phrases derived from the same sources of knowl- MEDICAL I'KOUKESS. 
edge; or on confessions of faith, administration of ordinances and 
church government ? And, as to being stationary.—Early in the 
history of mankind, physicians were of those only who occupied 
the highest social status, and did most for the promotion of the 
general welfare. And the middle ages were lighted up by stars devoted 
to medicine, whose constellations uncovered the darkness of super- 
stition. Physicians in all ages have attended at the birth of phi- 
losophy and learning—have nurtured them in youth, maintained 
them in manhood and supported them in declining years. In the 
progress of modern civilization which took its rise some four cen- 
turies ago, who among the learned men of the time excelled Linacre ? 
We have already shown that Bacon had his peer in Harvey. 
Newton in the discovery of the universal law of gravitation, also 
had his cotemporary and equal in Haller, who discovered the laws 
and special forces of organic life. An hundred years ago the law 
gave to enlightened nations a Blackstone, but medicine gave them 
a Jenner! And what language is there that can supply the words 
to express the blessings he conferred on mankind! The beginning of 
the present century produced many statesmen, philosophers and sci- 
entists—but who among them all is comparable to Bichat! And 
more recently, of the discovery and application of anesthetics— 
peerless and alone ! The whole world, I fear, will long remain our 
debtor. Medicine uncertain and stationary indeed ! These are no 
gleanings. But only a few of the stars of the first magnitude in 
the midst of a galaxy that illumine the civilization of mankind the 
world over.