Skip to main content

Full text of "Annals of medical history"

See other formats 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

University  of  Toronto 


http://www.archive.org/details/annalsofmedicalh01pack 


ANNALS  OF 
MEDICAL  HISTORY 

VOLUME  I 

SPRING,  SUMMER,  AUTUMN 
AND  WINTER 

1917 


ANNALS    OF 

MEDICAL  HISTORY 


EDITOR 
FRANCIS  R.  PACKARD,  M.D.,  Philadelphia,  Pa. 


ASSOCIATE  EDITORS 

HARVEY  CUSHING,  M.D Boston 

CHARLES  L.  DANA,  M.D New  York 

GEORGE  DOCK,  M.D St.  Louis 

MORTIMER  FRANK,  M.D Chicago 

FIELDING  H.  GARRISON,  M.D.       .       .       .      Washington 

ABRAHAM  JACOBI,  M.D New  York 

HOWARD  A.  KELLY,  M.D Baltimore 

ARNOLD  C.  KLEBS,  M.D Washington 

SIR  WILLIAM  OSLER,  M.D Oxford 

WILLIAM  PEPPER,  M.D Philadelphia 

LEWIS  STEPHEN  PILCHER,  M.D Brooklyn 

DAVID  RIESMAN,  M.D Philadelphia 

CHARLES  SINGER,  M.D Oxford 

EDWARD  C.  STREETER,  M.D Boston 


VOLUME  I 


NEW  YORK 

PAUL  B.  HOEBER,  PUBLISHER 

67-69  EAST  59th  STREET 


COPYRIGHT,    I9I8. 

BY  PAUL  B.  HOEBER 


ANNALS  OF  MEDICAL  HISTORY 

VOLUME  I 

CONTENTS 

SPRING  NUMBER 

The  Scientific   Position  of  Girolamo  Fracas 

toro  14787-1553  with  Especial  Reference  page 
to  the  Source,  Character  and  Influence 

of  His  Theory  of  Infection        ....   Charles  and  Dorothea  Singer  .      .  1 
The  Greek  Cult  of  the  Dead  and  the  Chtho- 

nian  Deities  in  Ancient  Medicine        .      .  Fielding  H.  Garrison  ....  35 

The  Three  Characters  of  a  Physician.      .      .   Enricus  Cordus 53 

Voltaire's  Relation  to  Medicine     ....   Pearce  Bailey 54 

An  Unpublished  Bronze  Ecorche     ....   Edward  Streeter 73 

Burke  and  Hare  and  the  Psychology  of  Mur- 
der        Charles  W.  Burr 75 

Hebrew  Prayers  for  the  Sick CD.  Spivak 83 

Laryngology  and  Otology  in  Colonial  Times  .   Stanton  A.  Friedberg  ....  86 

Editorial 102 

The  Legend  of  the  Mandragora 102 

Book  Reviews 

Singer.    The  Cures  of  the  Diseased 106 

Dana.     Poetry  and  the  Doctors 106 

Buck.    The  Growth  of  Medicine 106 

Eyclesheimer.     Anatomical  Names 108 

SUMMER  NUMBER 

Eulogy  of  Dr.  John  Shaw  Billings       .      .      .  Abraham  Jacobi 109 

The  Hygienic  Idea  and  Its  Manifestations  in 

World  History Karl  Sudhoff 1 1 1 

A    Patronal     Festival    for    Thomas    Willis 

(1621-1675)  with  Remarks  by  Sir  William 

Osler,  Bart.,  f.r.s Henry  Viets 118 

Medicine  and  Mathematics  in  the  Sixteenth 

Century David  Eugene  Smith        .      .     .     125 

Historical  Development  of  Our   Knowledge 

of  the  Circulation  and  Its  Disorders     .  Philip  S.  Roy 141 

The  Jetons  of  the  Old  Paris  Academy  of  Med- 
icine in  the  Numismatic  Collection  in  the 

Army  Medical  Museum  at  Washington    .  Albert  Alleman 155 


CONTENTS 


PAGE 

The  History  of  Infection Arnold  C.  Klebs i, 


Text  of  William  Shippen's  First  Draft  of  a 
Plan  for  the  Organization  of  the  Military 
Hospital  During  the  Revolution 174 

The  Beginnings  of  Intravenous  Medication  .   Horace  Manchester  Browri      .      .     177 

The  Legislative  and  Administrative  History 
of  the  Medical  Department  of  the  United 
States  Army  During  the  Revolutionary 
Period  (1 776-1 786) William  0.  Owen 198 

Editorial 217 

Memorial  Notice  Sir  Marc  Amand  Ruffer     .  Fielding  H.  Garrison  .      .     .      .     218 

Book  Reviews 

Malloch.     Finch  and  Baines 221 

Spalding.     Dr.  Lyman  Spalding 222 

Garrison.    An  Introduction  to  the  History  of  Medicine 223 

FALL  NUMBER 

Figurations  of  Skeletal  and  Visceral  Anat- 
omy in  the  Books  of  Hours Wilfrid  M.  de  Voynicb  and 

Fielding  H.  Garrison  ....      225 

Babylonian-Assyrian  Medicine Morris  Jastroiv,  Jr 231 

On  a  Greek  Charm  Used  in  England  in  the 

Twelfth  Century Charles  Singer 258 

The  Legislative  and  Administrative  History 
of  the  Medical  Department  of  the  United 
States  Army  During  the  Revolutionary 
Period  (1776-1786).     Section  II        ...    William  0.  Oiven 261 

Military  Sanitation  in  the  Sixteenth,  Seven- 
teenth and  Eighteenth  Centuries       .      .   Charles  L.  Heizmann  ....     281 

A  Check  List  of  Medical  Incunabula  in  the 

Surgeon-General's  Library 301 

Notes  and  Queries 316 

Editorial 

Dr.  Stephen  Smith,  the  Nestor  of  American  Surgery.     Portrait  .     .     .     318 

Book  Reviews 

Long.     Early  History  of  the  North  Carolina  Medical  Society    .  .     325 

Sister  Mary  Rosaria.    The  Nurse  in  Greek  Life 325 

Leonardo  da  Vinci:  Quaderni  d'Anatomia  V  e  VI 32^ 

Gerster.    Recollections  of  a  New  York  Surgeon 327 


CONTENTS 

WINTER  NUMBER 

The    First    Printed    Documents    Relating   to  page 

Modern  Surgical  Anaesthesia    ....   William  Osier 329 

Byzantine  Medical  Fragments Charles  Singer 333 

The  Legislative  and  Administrative  History 
of  the  Medical  Department  of  the  United 
States  Army  During  the  Revolutionary 
Period  (1776- 1786).     Section  III      .      .      .   William  0.  Owen 342 

The  New  York  Medical  College  1 782-1906    .  Abraham  Jacobi 368 

Studies  in  Paleopathology.  I.  General  Con- 
sideration of  Evidences  of  Pathological 
Conditions  Found  Among  Fossil  Animals    Roy  L.  Moodie 374 

Plague  Tractates Dorothea  Waley  Singer  and 

Reuben  Levy 394 

The  Medical  Phrases  of  Victor  Hugo       .      .  Hubert  Ashley  Royster      .      .      .     412 

Editorials 

Franciscus  Dela  Boe  Sylvius 422 

The  Tubercle  of  Carabelli  and  Congenital  Syphilis 423 

The  "Anatomie  Universelle"  of  Pare 424 

Historical  Notes 

Early    Instructions   in   Bacteriology   in 

the  United  States Bergey 426 

The  Evolution  in  Dermatology      .     .      .  Heimann 427 

Book  Reviews 

Singer.     Studies  in  the  History  and  Method  of  Science 429 

Robin.    The  Old  Physiology  in  English  Literature 430 

Correspondence 

Marx.     Bibliographical  Notes  on  "Plague  Tractates" 431 

Singer.     Project  to  Translate  into  English  the  Entire  Works  of  Galen  .     433 

Announcement   of   Catalogue   of   Manuscripts   of   Scientific 
Interest  in  the  British  Isles 434 

A  Modernist's  View  of  Medleval  Science 435 


VOLUME    1 


NUMBER    l 


ANNALS    OF 

MEDICAL  HISTORY 


^ 


FRANCIS  R'PACKARD'M'D'EDITOR  [PHILADELPHIA] 
PUBLISHED  QUARTERLY  BY  PAUL  *  B  <  HOEBER 
67-69  EAST  FIFTY-NINTH  STREET'  NEW  YORK  CITY 


a 


ANNALS  OF  MEDICAL  HISTORY 


Volume  i 


Spring  1917 


Number  i 


THE  SCIENTIFIC   POSITION   OF  GIROLAMO   FRACASTORO 

[14787-1553] 

WITH  ESPECIAL  REFERENCE  TO  THE  SOURCE,  CHARACTER 
AND  INFLUENCE  OF  HIS  THEORY  OF  INFECTION 


By  CHARLES  AND  DOROTHEA  SINGER 

OXFORD,    ENGLAND 


IROLAMO  FRAC- 
ASTORO was  born 
in  Verona  in  1478 x 
and  he  died  in  his 
villa  near  that  city 
in  1553.  He  came  of 
an  honorable  stock 
which  had  produced 
many  distinguished  physicians.  Of  one  of 
these,  Aventino  Fracastoro,  who  was  prac- 
tising medicine  as  early  as  1325  we  read 
that  he  was  medica  clarissimus  arte,  astra 
poli  novit  novitque  latencia  rerum,  utile 
consilium  civibus  et  dominis.2 

I.    THE    CHARACTER    AND    WRITINGS    OF 
FRACASTOR 

The  subject  of  our  study,  Girolamo 
Fracastoro,  was  himself  brought  up  in  what 

1  The  date  usually  given  for  Fracastor's  birth  is 
1483.  Reasons  for  referring  the  event  to  1478  are 
given  by  Professor  Roberto  Massalongo  in  his 
"Girolamo  Fracastoro  e  la  rinascenza  della  medicina 


has  been  called  the  "academic"  period  of 
the  Renaissance  and  received  the  most 
complete  education  available  in  his  day.  In 
his  youth  he  attended  the  University  of 
Padua,  where  he  had  a  number  of  brilliant 
associates,  several  of  whom  exercised  con- 
siderable influence  upon  him.  Among  them 
were  Gaspare  Contarini  (1 483-1 542)  who 
later,  as  cardinal,  sought,  at  the  diet  of 
Ratisbon,  to  effect  a  reconciliation  between 
Catholics  and  Protestants;  Giambattista 
Rhamnusio  (1485-1557),  the  Italian  Hak- 
Iuyt,  who  inscribed  to  Fracastoro  his  great 
Viaggi  et  Navigationif  the  fine  scholar 
Andrea  Navagero  (1483-1529)  to  whom 
Teobaldo  Manucci  dedicated  the  editio  prin- 
ceps  of  Pindar4  and  who  himself  edited  for  the 
Aldine  press  the  works  of  Quintilian,  Virgil, 
Lucretius,  Ovid,  Terence,  Horace  and  the 

in  Italia,"  Venice,  1915,  p.  20.  If  Massalongo  is  right 
Fracastor  must  have  been  rather  older  than  most 
students  when  he  attended  the  University. 
2  Giuseppe    Biadego,    "  Medici    veronesi    e    una 


Annals  of  Medical  History 


Speeches  of  Cicero;  and  three  distinguished 
brethren,  townsmen  of  Fracastoro,  whose 
father,  Girolamo  Delia  Torre,  a  learned 
physician,  perhaps  determined  the  student's 
application  to  his  own  profession,  while  one 
of  the  sons,  who  died  at  an  early  age,  stimu- 
lated Fracastor  to  embark  on  his  astro- 
nomical research. 

Among  such  companions  Fracastor  early 
developed  facility  as  a  writer  of  elegant 
verse,  and  although  to  a  later  generation 
the  enthusiasm  with  which  his  effusions 
were  greeted  may  appear  excessive,  he  yet 
gained  through  their  composition  a  clear- 
ness of  style  which  is  not  the  smallest  of  his 
excellencies  as  a  scientific  writer.  But  there 
was  another  fellow  student  of  Fracastor 
for  whom  was  reserved  a  destiny  far  greater 
than  that  of  any  whom  we  have  named. 
The  young  Pole,  Nicholaus  Koppernigk 
(1473- 1 543),  had  already  spent  several 
years  in  the  study  of  Law  at  Bologna,6 
when  in  1501  he  entered  his  name  as  a 
student  of  medicine  at  Padua.  Copernicus 
remained  in  the  medical  school  for  some 
four  years,  and  from  that  period  dates  his 
dissatisfaction  with  the  Ptolemaic  doctrine 
of  a  geocentric  Universe.  Fracastor  was  him- 
self a  keen  critic  of  Ptolemy's  teaching,  and 
it  seems  more  than  probable  that  the  two 
young  men  had  exchanged  ideas  during  the 
period  when  they  must  often  have  sat  side 
by  side  in  .the  lecture  rooms  at  Padua.6 
During  the  later  part  of  the  sojourn  of 
Copernicus  in  Padua,  Fracastor  was  ap- 
pointed tutor  in  anatomy  (conciliarius  ana- 
tomicus)  and  the  Polish  student,  who  was 
nevertheless  the  older  of  the  two,  must  have 
attended  his  former  classmate's  demonstra- 
tions.7 

Iibreria  medica  del  sec.  XIV"  in  the  Atti  del  reale 
istituto  veneto  di  scienze,  lettere  ed  arti  LXXV,  parte 
secunda  5723,  Venice,  1916. 

*  Giambattista  Rhamnusio,  "Viaggi  et  naviga- 
tion!," Venice,  1550. 

4  Aldus  Manutius:  "Pindar,"  Venice,  1 5 1 3. 

•  Carlo  Malagola,  "Niccold  Coppcrnico  ncllo  studio 


Perhaps  the  deepest  impression  on  Fra- 
castor's  mind  in  these  formative  days  was 
made  by  the  conflict  between  the  opposing 
schools  of  Aristotelians  that  divided  the 
University  during  the  early  years  of  the 
sixteenth  century.  The  two  protagonists 
were  the  Bolognese  anatomist  Alessandro 
Achillini  (1463-15 18),  who  had  left  his  own 
University  to  profess  a  form  of  Averroism 
at  Padua,  and  Pietro  Pomponazzi  (1462- 
1525),  also  a  physician,  who  inclined  to  the 
interpretation  of  Alexander  Aphrodisias  and 
whose  even  more  heterodox  teaching  ulti- 
mately led  to  his  emigration  in  the  reverse 
direction  from  Padua  to  Bologna.  Though 
he  is  said  to  have  been  incapable  of  inter- 
preting Aristotle  to  his  hearers  from  the 
original  Greek,  Pomponazzi  was  yet  a  very 
spirited  and  original  teacher,  of  great  in- 
dependence of  thought.  He  was  wholly 
divorced  from  the  religion  of  his  day  and 
he  died  repudiating  the  hope  of  Christi- 
anity. 

But  Pomponazzi  represents  a  movement 
of  far  more  importance  than  any  mere 
school  of  Aristotelian  interpretation.  He 
stands  for  Naturalism,  for  the  attempt  to 
explain  the  World  and  all  that  it  contains 
on  the  basis  of  known  or  discoverable  laws. 
That  many  of  the  laws  considered  by  him 
as  demonstrated  now  seem  absurdities,  that 
on  insufficient  evidence  he  regarded  certain 
earthly  events  as  related  to  the  movements 
of  the  heavenly  bodies  with  the  same  assur- 
ance that  we  now  ascribe  them  to  climatic 
or  meteorological  conditions,  these  are  errors 
in  the  application  of  his  method  that  need 
not  affect  our  judgment  of  the  importance 
of  his  philosophical  position. 

Thus  Pomponazzi   stood  for  the  reign  of 

di  Bologna"  in  " Monografie  storiclic  sullo  studio 
Bolognese,"  Bologna,  1888. 

•  In  the  dedication  of  the  "Dc  revolutionibus"  to 
the  Pope  (1542)  Copernicus  says  that  it  is  now  "four 
nines  of  years"  since  the  heliocentric  system  was 
conceived.  This  brings  its  birth  at  least  as  far  back 
as  1506,  and  he  did  not  leave  Padua  till  1505. 

7  Antonio  Favaro,  "Lo  studio  di  Padova  al  tempo 


The  Scientific  Position  of  Girolamo  Fracastoro 


natural  law  as  does  Fracastor,  his  assiduous 
pupil,  although  the  latter  became  in  certain 
other  respects  the  opponent  of  his  teacher.8 
Fracastor  was  himself,  however,  constitu- 
tionally incapable  of  the  controversial  at- 
titude of  Pomponazzi.  In  the  serene  de- 
tachment of  his  humanism  he  exhibited  no 
opposition,  either  open  or  concealed,  to  the 
current  of  Christianity,  nor  did  he  shun  the 
company  of  clerics.  But  the  churchmen  that 
Fracastor  made  his  associates  were  of  the 
class,  common  enough  in  the  early  sixteenth 
century,  in  whom  Catholic  tradition  was 
almost  entirely  displaced  by  the  prevailing 
literary  paganism.  His  friend,  Cardinal 
Pietro  Bembo,  the  recipient  of  the  poem 
"Syphilis"  and  the  lover  of  Lucrezia  Borgia, 
was  also  a  pupil  of  Pomponazzi,  and  was 
hardly  more  influenced  by  Christianity 
than  his  great  teacher.  When  Pomponazzi's 
treatise  on  "The  Immortality  of  the  Soul" 
was  condemned  by  the  Lateran  Council, 
Bembo  used  his  influence  on  its  author's 
behalf,  not  out  of  any  principle  of  tol- 
eration, but  prompted  by  his  admiration 
for  the  literary  and  philosophical  qualities 
of  the  work.  Bembo's  own  compositions 
include  poems  as  obscene  as  any  in  litera- 
ture, and  we  find  the  same  Cardinal  urging 
Sadoleto  to  "avoid  the  Epistles  of  St.  Paul 
lest  his  barbarous  style  should  spoil  your 
taste." 

Hardly  less  pagan  were  the  two  men 
bearing  the  name  Alessandro  Farnese,  to 
whom  other  of  Fracastor's  works  were 
dedicated.  Of  these  Farnese,  the  elder  as- 
sumed the  new-fangled  heathen  title  of 
Pontifex  Maximus  when  he  ascended  the 
throne  as  Paul  III  to  commence  his  corrupt 
papal    career    (Alessandro    Farnese,   1468- 

di  Niccold  Coppernico,"  Padua,  1880.  German  trans- 
lation by  Curtze  in  Mittbeilungen  des  Copernicus 
Vereins  Jilr  Wissenschaft  und  Kunst  zu  Thorn, 
Thorn,  1881,  p.  49. 

8  Recent  studies  of  the  philosophy  of  Pomponazzi 
are  contained  in  A.  H.  Douglas,  "The  Philosophy 
and  Psychology  of  Pietro  Pomponazzi,"  Cambridge, 
1910,  and  in  a  very  interesting  chapter  in  C.  C.  J. 


1549,  Pope  1 534- 1 549).  Nor  was  Alessandro 
Farnese  the  younger,  Cardinal  and  patron 
of  the  arts,  to  whom  Fracastor  dedicated 
the  "De  contagionibus"  and  the  poem 
"Joseph,"  less  influenced  by  the  prevailing 
humanism  or  more  addicted  to  theological 
studies  than  his  august  relative,  the  prince 
of  nepotists  who  sat  in  Peter's  Chair. 

Fracastor's  temper  of  mind,  like  that  of 
these  men,  was  widely  removed  from  theo- 
logical and  scholastic  topics.  He  had,  how- 
ever, a  nobler  motive  than  the  empty  and 
mainly  sensuous  classicism  that  was  the 
prevailing  note  of  the  intellectual  Italians 
of  his  day.  His  greatest  preoccupation  was 
the  extension  of  knowledge,  and  he  is  seen 
at  his  best  as  he  applies  the  philosophical 
teaching  of  Pomponazzi  in  seeking  to  un- 
ravel natural  laws  from  the  complicated 
skein  of  natural  phenomena.  The  ponderous 
conceits  of  his  poems  were  the  affectation 
of  a  period  when  the  most  skilled  writers 
were  but  the  "apes  of  Cicero."  But  intel- 
lectually he  is  a  child  of  the  new  age  and  is 
begotten  of  the  spirit  of  science  in  the 
matrix  of  humanism. 

Fracastor  spent  the  greater  part  of  his 
life  at  his  villa  in  the  neighborhood  of 
Verona,  devoting  himself  largely  to  study. 
It  is  probable  that  motives  of  humanity,  as 
well  as  interest  in  the  subject,  moved  him, 
as  it  did  Copernicus,  to  the  practice  of 
medicine  among  the  neighboring  peasantry. 
It  is  at  least  certain  that  his  accurate  clinical 
knowlege  can  only  have  been  won  by  pains- 
taking bedside  experience.  He  took  much 
interest  in  geographical  discovery,  which  he 
followed  on  specially  constructed  globes. 
He  was  a  devoted  student  of  astronomical 
and  mathematical  problems.  He  was  a  very 

Webb's  "Studies  in  the  History  of  Natural  The- 
ology," Oxford,  1915,  p.  313.  Pomponazzi's  teaching 
which  thus  influenced  Fracastor,  is  set  forth 
in  his  "De  naturalium  effectuum  admirandorum 
causis  seu  de  incantationibus,"  Basle,  1567.  This 
volume,  however,  was  not  published  until  long  after 
the  death  of  its  author  (in  1525)  and  of  Fracastor 
(in  1553). 


Annals  of  Medical  History 


constant  reader,  and  it  is  said  that  his 
favorite  authors,  Plutarch  and  Polybius, 
were  seldom  out  of  his  hands.  He  delighted 
also  in  music.  He  lived  in  simple  fashion, 
only  occasionally  emerging  from  his  com- 
parative seclusion  to  visit  distinguished 
invalids,  to  give  his  opinion  in  difficult 
cases,  or  to  study  epidemics  of  unusual 
interest  or  gravity.  His  reputation  alike  as 
poet,  humanist,  physician  and  astronomer 
extended  all  over  the  civilized  world.  He 
was  a  man  of  extremely  various  and  culti- 
vated tastes,  who  took  all  the  knowledge  of 
his  day  to  be  his  province.  Such  of  his 
correspondence  as  has  come  down  to  us 
reveals  a  scholarly  recluse,  of  genial  and 
even  jovial  temper  withal,  whose  high 
personal  character,  extensive  intellectual 
interests  and  numerous  literary  friendships 
made  him  indifferent  to  worldly  advance- 
ment. 

In  spite  of  the  distinguished  position  that 
Fracastor  held  in  the  opinion  of  his  con- 
temporaries, the  material  for  a  detailed 
biography  is  by  no  means  abundant.  The 
earliest  account  is  anonymous  and  is  pre- 
fixed to  the  1555  edition  of  his  collected 
works.9  It  is  probably  from  the  pen  of  Paolo 
Rhamnusio,  a  relative  of  his  friend  Giam- 
battista  Rhamnusio.  A  more  comprehensive 

•"Hieronymi  Fracastorii  Veroncnsis,  Opera 
Omnia,"  Venice  (Giunta),  1555. 

10  F.  O.  Mencke,  "  De  vita  et  moribus  scriptis 
meritisque.  .  .  .  Hieronymi  Fracastorii  Veronensis," 
Leipzig,  1 73 1. 

11 W.  P.  Greswell,  "Memoirs  of  Angelus, 
Politianus,  A.  S.  Sannazarius,  Pietrus  Bembus, 
Hieronymus  Fracastorius.  .  .,"  Manchester,  1801, 
p.  161. 

"Giovanni  Orto  Manara,  "Intorno  alia  casa  di 
Girolamo  Fracastoro  nella  terra  d'lncafTi,"  Venice, 
1842. 

u  Ronchini,  "Girolamo  Fracastoro,"  in  Alii  delta 
Deputazione  delta  Storia  palria  modenense.  Modcna, 
1868. 

"Antonio  Agostini  in  "Protomoteca  Veronese," 
Verona,  1883. 

"  William  Osier  in  Proceedings  <>J  ibe  Cbaraka 
Club,  N.  Y.,  Vol.  2,  December  1906,  II,  5-20. 


but  very  unattractive  compilation  is 
Meneke's,  dating  from  1731.10  Among  the 
more  important  modern  accounts  are  those 
of  W.  P.  Greswell  (1801),11  Giovanni  Orto- 
Manara,  Podesta  of  Verona  (1842), 12  Ron- 
chini (1868), 13  Antonio  Agostini  (1883),14 
William  Osier  (1906)  15  and  Roberto  Massa- 
Iongo  (1915).16  Perhaps  the  most  valuable 
recent  work  on  Fracastoro  is  from  the  hand 
of  Professor  Giuseppe  Rossi,  17  who  deals  in 
detail  with  his  philosophical  position.  Other 
modern  authors  who  have  handled  special 
aspects  of  Fracastor's  activity  are  Symonds 
(1882)  18  and  Barbarani  (1891),19  who  dis- 
cuss his  claims  as  a  poet,  Fiorini  (1900),20 
who  deals  with  his  attitude  towards  geo- 
graphical science,  Crescimanno  (1904),21  who 
discourses  upon  his  relationship  to  the 
spirit  of  Italian  unity,  and  Dreyer  (1906)  22 
who  deals  with  the  interesting  topic  of  the 
relation  of  his  theory  of  the  Cosmos  to  the 
Heliocentric  doctrine  of  Copernicus.  Fra- 
castoro's  work  on  the  venereal  plague  of  the 
Renaissance  has  itself  given  rise  to  an 
extensive  literature  and  has  been  translated 
into  practically  every  European  language. 
Valuable  material  is  contained  in  the  edi- 
tions of  Colognese  ( 1 8 1 3)  ,23  Choulant  (1830)  ,24 
Yvaren  (1847) 25  and  Fournier  (1870).29  The 
poem  has  been  translated  into  English  on 

16  Roberto  Massalongo,  "Girolamo  Fracastoro  e  la 
rinascenza  della  medicina  in  Italia,"  Venice,  1915. 

17  Giuseppe  Rossi,  "Girolamo  Fracastoro  in  rela- 
zione  all'  Aristotelismo  ed  alle  scienze  nel  Renas- 
cimento,"  Pisa,  1893. 

18  J.  A.  Symonds,  "The  Renaissance  in  Italy," 
London,  1882,  II,  476-481. 

19  Emilio  Barbarani,  "Girolamo  Fracastoro  e  le 
sue  Opere,"  Venice,  1891. 

10  M.  Fiorini,  "Qualche  cenno  sopra  Girolamo 
Fracastoro"  in  the  Rivista  geografica  ilaliana,  Rome, 
1900. 

21  G.  Crescimanno,  "Fra  due  poeti  medici"  (Gio- 
vanni Meli  e  Girolamo  Fracastoro),  Catania,  i<)<>'>. 

r  J.  L.  E.  Dreyer,  "  History  of  Planetary  Systems." 
Cambridge,  1906,  pp.  296-301. 

a  Vinccnzo  Bcnini  Colognese,  "Della  sililidc  ov- 
vero  del  morbo  gallico  di  Girolamo  Fracastoro," 
Milan,  1813. 


The  Scientific  Position  of  Girolamo  Fracastoro 


several  occasions.  The  earliest  attempt  is 
probably  that  of  Nahum  Tate  (1686)  " 
whose  effort  is  in  keeping  with  the  other 
productions  of  one  of  the  worst  of  the  poets 
that  have  occupied  the  position  of  laureate. 
The  other  work  of  Fracastor  that  has  been 
rendered  into  our  tongue  is  the  poem 
"Joseph."  The  version  by  Joshua  Syl- 
vester 28  (1563-16 1 8)  has,  at  least,  a  certain 
absurd  quaintness  to  recommend  it. 

The  student  of  Fracastor  will  find  that 
the  most  convenient  editions  of  his  works 
are  the  Giunta  Opera  Omnia  of  1555,  1574 
or  1584.  There  is  also  a  small  but  useful 
collection  of  letters  printed  at  Venice  in 
1560 29  and  re-edited  at  Padua  in  1739.30 
These  reveal  something  of  the  personal  side 
of  our  author. 

A  number  of  prints,  portraits  and  statues 
purporting  to  reproduce  the  features  of 
Fracastor  have  survived.  They  differ  so 
greatly  from  each  other  that  it  is  hard  to 
believe  that  they  represent  the  same  man. 
His  iconography  has  been  the  subject  of 
a  recent  study  by  Klebs.31 

11.  fracastor's  contributions  to  science 

By  far  the  best  known  of  Fracastor's 
compositions  is  his  poem  Syphilis  sive  de 
morho  gallico,  written  on  the  model  of 
Manilius,  or  as  some  have  thought,  on  that 
of  the  Urania  of  Giovanni  Pontano  (1426- 
1503).32  This  pseudo-classical  composition 
was  dedicated  to  Cardinal  Pietro  Bembo, 
and  was  first  published  at  Verona  in  1530. 
On  the  artificial  style  and  false  imagery  of 
this  work  his  contemporaries  lavished  the 
most  extravagant  praise,  but  the  modern 

24  Ludwig  Choulant,  "Hieronymi  Fracastorii 
Syphilis  sive  morbus  gallicus,"  Leipzig,  1830. 

25  Prosper  Yvaren,  "  La  syphilis.  Poeme  en  vers 
latins  de  Jerome  Fracastor  traduit  en  vers  francais 
precede  d'une  etude  historique  et  scientifique  sur 
Fracastor,"  Paris,  1847. 

26  Alfred  Fournier,  "Fracastor  La  syphilis  (1530), 
Le  mal  francais,"  Paris,  1870. 

27  Nahum  Tate,  "Syphilis,"  London,  1686. 


reader  will  find  interest  rather  in  the  nar- 
rative itself  than  in  the  form  in  which  it  is 
cast.  It  is  useful  and  interesting  as  a  com- 
pendium of  the  views  held  at  the  time  on 
the  origin,  nature,  symptoms  and  treatment 
of  the  condition  which  it  discusses.  While  it 
is  a  valuable  storehouse  of  information  it 
cannot  be  regarded  as  an  original  scientific 
contribution  in  the  modern  sense,  and  it 
displays  little  of  Fracastor's  most  remark- 
able powers.  It  is  rather  in  his  purely 
scientific  works,  and  especially  in  the  "Ho- 
mocentrica  seu  de  stellis"  (1538)  and  the 
"De  contagionibus  et  contagiosis  morbis" 
(1546)  that  we  encounter  at  its  best  the 
clear  cold  light  of  Fracastor's  intellect.  In 
these  works  we  not  only  find  an  acute  and 
lucid  analysis  of  the  problems  of  which  they 
treat,  but  we  also  discern  a  perception  in 
its  author  of  the  meaning  of  the  experi- 
mental method  many  years  before  the 
treatises  of  Francis  Bacon  and  Rene  Des- 
cartes. These  scientific  works  of  Fracastoro 
are  replete  with  suggestions  that  have 
proved  of  value,  as  the  course  of  science 
has  broadened,  down  to  our  own  time. 

In  a  writer  of  the  first  half  of  the  six- 
teenth century  we  can  hardly  hope  to  find 
a  large  number  of  careful  scientific  con- 
clusions worked  out  on  a  detailed  basis  of 
observation  and  experiment.  It  is  only  in 
his  work  on  infection  that  Fracastor  rises 
to  a  height  that  places  him  among  first- 
class  modern  investigators.  But  in  addition 
to  this  great  contribution,  he  throws  out  a 
number  of  hints  which  have  since  yielded 
valuable  results  in  other  hands.  In  the  ex- 
tensive literature  that  has  arisen  around  his 
name   this    purely   scientific   side   of   Fra- 

28  Joshua  Sylvester,  "The  Maiden's  Blush,"  Lon- 
don, 1620. 

29"Lettere  di  XIII  huomini  illustri,"  Venice, 
1560. 

30  "Hieronymi  Fracastorii  Carmina,"  Padua,  1739- 

31  A.  C.  Klebs,  Iconographic  notes,  Johns  Hopkins 
Hospital  Bulletin,  Baltimore,  1915,  xxvi,  378- 
380,  1  pi. 

32  J.  A.  Symonds,  Renaissance  in  Italy,  II,  364. 


Annals  of  Medical  History 


castor's  works  has  been  largely  neglected 
in  favor  of  certain  other  interests  which 
they  present.  We  therefore  endeavor  to 
summarise  such  suggestions  and  conclusions 
in  his  writings  as  have  since  become  ab- 
sorbed into  the  mass  of  natural  knowledge. 

(i)  The  thesis  of  the  work  "Homoeen- 
trica"  (1538)  is  to  oppose  the  eccentric  or 
epicyclic  view  of  the  movements  of  the 
planets  as  laid  down  by  Hipparchus  of 
Nicsea  (circa  150  B.C.)  and  handed  on  to 
the  Middle  Ages  by  Claudius  Ptolemaeus.33 
It  is  thus  a  preparation  for  the  epoch- 
making  Heliocentric  work  of  Copernicus,34 
which  did  not  see  the  light  until  the  great 
astronomer  lay  on  his  death-bed  in  1543, 
though  preliminary  drafts  had  been  made 
at  a  somewhat  earlier  date.36  Both  the 
"Homocentrica"  of  Fracastoro  and  the 
"De  revolutionibus  orbium  coelestium"  of 
Copernicus  were  dedicated  to  the  same 
patron,  Pope  Paul  III.  Although  it  would 
be  absurd  to  compare  the  importance  of 
the  two  works,  they  are  yet  both  conceived 
in  the  same  broad  spirit  of  naturalism,  the 
seed  of  which  was  perhaps  sown  in  the 
student  days  of  the  two  men  by  Pomponazzi 
at  Padua.  It  is  likely  that  Fracastor  was 
one  of  the  very  earliest  to  embrace  the 
heliocentric    theory   of   his    fellow-student. 

(2)  Fracastor    was    greatly    puzzled    at 

u  The  astronomical  system  of  Copernicus  is 
described  by  J.  L.  E.  Dreyer,  Ioc.  cit. 

M  Nicholaus  Koppernigk  "De  revolutionibus 
orbium  coelestium.  Libri  VI,"  Nuremburg,  1543. 
The  first  to  point  out  that  Fracastoro  was  in  certain 
senses  a  predecessor  of  Copernicus  was  J.  S.  Bailly 
in  his  "Histoire  de  I'astronomie  moderne  en 
Europe,"  pp.  19,  20,  Paris,  1805.  He  is  opposed  by 
Siegmund  Giinther,  "Studien  zur  Geschichte  der 
math,  und  physikalisch.  Geographic,"  Halle,  1877, 
I  left  I,  37,  but  supported  by  Favaro,  Ioc.  cit. 

"A  "Commentariolus"  or  short  summary  of  the 
work  appears  to  have  been  written  out  by  Copernicus 
about  1530  while  his  pupil  Rheticus  printed  a  short 
account  of  it  as  "Narratio  prima"  at  Danzig  in 
1540.  Both  these  works  are  reprinted  by  K.  Prowe 
in  his  "Nicolaus  Coppcrnicus,"  2  vols.,  Berlin, 
1883-4. 


being  unable  to  fit  in  his  own  observations 
of  the  relation  of  the  ecliptic  to  the  fixed 
stars  with  the  records  of  Ptolemy  and  other 
astronomers.  He  explains  the  divergence  as 
due  to  a  movement  of  the  ecliptic  itself.36 

(3)  After  the  theory  of  Copernicus  had 
been  firmly  established  through  the  labors 
of  Galileo  and  of  Kepler,  it  became  custom- 
ary to  fashion  models  illustrating  the  move- 
ments of  the  planets.  These  engines  became 
a  vogue  in  the  eighteenth  century  and 
received  in  England  the  name  Orrery.*1  It 
is  probable  that  the  first  Orrery  was  con- 
structed for  Fracastor  himself.38  We  read  of 
him  demonstrating  on  such  "an  instrument 
made  according  to  the  newly  discovered 
motion  of  the  heavens"  in  the  Discorso 
sopra  parti  viaggi  per  li  quali  sono  state 
condotte  et  si  potrian  condurre  le  spetierie, 
which  was  published  by  his  friend  Rham- 
nusio  in  1550.39 

(4)  Fracastor  takes  a  definite  place  in 
the  history  of  geographical  science.  He  is 
the  first  writer  to  apply  the  term  pole  to 
the  globe  of  the  earth  itself.40  Again,  the 
first  great  Italian  collection  of  voyages  was 
dedicated  to  him  and  to  that  work  he  him- 
self contributed  an  article  on  the  source  of 
the  Nile.  The  origin  of  the  White  Nile  he 
places  not  very  inaccurately  in  a  great  lake 
about  midway  between  the  tropic  of  Capri- 

w  Homocentrica,  I,  15. 

17  After  the  Earl  of  Orrery,  brother  of  Robert 
Boyle. 

M  Moving  models  of  the  universe,  based,  however, 
on  the  geocentric  system  had  been  known  in  ancient 
Greek  times. 

59  The  "Discorso"  of  Giambattista  Rhamnusio  is 
to  be  found  on  p.  398  recto  of  the  1550  edition  of 
the  "Viaggi  et  Navigationi."  On  p.  401  recto  of  this 
work  occurs  the  phrase  quoted,  "uno  instrumento 
fatto  sopra  un  moto  de'  cieli  trovato  di  nuovo." 
The  passage  was  probably  written  in  1547,  possibly 
earlier,  but  the  instrument  must  have  taken  some 
time  to  manufacture.  We  are  thus  brought  very  near 
to  1543,  the  date  of  Copernicus'  book.  On  the  ques- 
tion of  the  date  and  nature  of  this  "Orrery"  see  M. 
Fiorini  in  "Rivista  geografica  italiana,"  1900,  pp. 
438-445- 


The  Scientific  Position  of  Girolamo  Fracastoro 


corn  and  the  Equator,  while  he  knows  that 
the  Blue  Nile  gathers  its  waters  in  the  high- 
lands of  Ethiopia.41 

One  of  the  great  difficulties  of  the  early 
map-makers  was  the  absence  of  a  satisfac- 
tory system  of  projection.  Globes  were  not 
only  difficult  to  construct  but  were  of  their 
nature  only  applicable  for  very  large  geo- 
graphical areas.  The  "portolano"  charts 
represented  distances  actually  measured  by 
travel  and  were  hardly  maps  in  our  sense 
of  the  word.  The  Ptolemy  MSS.  usually 
contain  maps  of  the  cylindrical  type  of 
projection.  In  one  or  two  works,  both 
printed  and  manuscript,  an  equally  clumsy 
method,  the  "pseudoconic  equidistant,"  had 
been  introduced. 

It  was  not  until  1569,  sixteen  years  after 
Fracastor's  death;  that  the  Fleming  Ger- 
hard Kremer  (Gerardus  Mercator,  15 12- 
1594)  produced  his  first  rectilinear  map  on 
the  system  now  known  as  Mercator's  pro- 
jection.42 In  a  letter  to  Rhamnusio  dated 
May  10,  1549,  first  published  in  1560, 
Fracastoro  had  suggested  the  use  of  this 
very  system  and  expressed  surprise  that  it 
had  not  been  adopted  by  cartographers. 

(5)  Fracastor  was  the  first  to  hold  that 
V  estern  European  land  and  water  was 
subject  to  secular  changes  of  elevation,  so 
that  an  area  now  dry  and  even  raised  to 
mountainous  height  may  once  have  been 
submerged.  "If  a  man  consider,"  he  writes, 
"how  islands  and  mountains  come  into 
being,  he  will  recognize  that  time  was  when 
they  were  built  out  from  the  sea  and  that 

40  E.g.  De  sympathia  et  antipathia  rerum,  Cap.  7. 

41  "Risposta  delloexcellentissimo  messer  Hieronimo 
Fracastorio  del  crescimento  del  Nilo  a  messer  Gio- 
vanni Battista  Rhamnusio"  in  "Navigationi  et 
Viaggi,"  Venice,  1550,  p.  284  verso. 

42  Gerhard  Kremer  (Gerardus  Mercator),  "Nova 
et  aucta  orbis  terrae  descriptio  ad  usum  navigantium 
emendate  accomodata."  "Aeditum  est  opus  hoc 
Duisburgi  an.  D.  1569  mense  Augusto."  A  map  that 
appears  to  be  constructed  on  the  same  principle  as 
Mercator's,  the  work  of  Claudius  Clavus,  and  dated 
1427  is  to  be  found  in  the  library  at  Nancy.  See.  A 


time  will  be  when  land  now  covered  by  the 
waves  will  be  habited  and  tilled,  and  yet 
again  in  future  time  will  be  again  hidden 
by  Ocean."43  The  doctrine  of  the  secular 
changes  of  land  and  sea  had  already  been  set 
forth  in  the  thirteenth  century  by  the  Ara- 
bian writer  Kazrini,  whose  views  must  have 
been  widespread  since  numerous  MSS.  of  his 
"Wonders  of  Nature"  have  survived  in 
both  Arabic  and  Persian.  Fracastor  either 
originated  the  idea  anew  or,  at  least,  intro- 
duced it  to  the  West.44  This  theory  of 
geological  elevation  was  seized  by  several  of 
Fracastoro's  contemporaries,45  by  Hieron- 
ymo  Cardano  (1501-1575),  by  Bernard 
Palissy  the  potter  (15 10-1590),  by  Andrea 
Cesalpino  (15 19-1603),  by  Conrad  Gesner 
(15 16-1565).  These  all  used  the  theory  to 
explain  the  presence  of  fossil  marine  forms 
at  heights  above  the  sea,  and  the  idea  was 
further  elaborated  by  the  Dane,  Niels 
Stensen  (Nicolaus  Steno,  1638- 1686)  in  the 
following  century,  in  a  work  which  laid  the 
foundations  of  modern  geology.46 

(6)  Fracastor  was  one  of  the  few  writers 
of  his  day  who  had  any  idea  of  the  nature 
of  refraction  of  light.  In  his  application  of 
this  conception,  though  he  is  sometimes 
confused,  he  is  yet  in  some  ways  superior  to 
any  of  his  predecessors,  Alhazen  (died  1038), 
Roger  Bacon  (12147-1294),  Vitellio  (circa 
1300),  or  John  of  Peckham  (died  1292). 
Fracastor's  views  were  hardly  improved 
upon  until  the  researches  of  Francesco 
Maurolico  (about  1575)  and  Willibrod  Snell 
van  Royen  (about  1620). 

E.  Nordenskiold,  "Facsimile-Atlas,"  Stockholm, 
1889,  p.  49. 

43  Homocentrica,  I,  12. 

44  Kazrini's  geological  doctrine  is  discussed  by  R. 
Knox,  Anthropological  Review,  1863,  I,  p.  263. 

45  It  is  encountered  in  an  Irish  tract  that  perhaps 
borrowed  from  Fracastor.  See  Maura  Power,  "An 
Irish  Astronomical  Tract  based  .  .  .  on  Messehalah," 
London,  19 14,  p.  37- 

46  Nicolaus  Steno,  "De  solido  intra  solidum  natur- 
aliter  contento  dissertationes,  prodromus,"  Florence, 
1669. 


8 


Annals  of  Medical  History 


(7)  Fracastor  was  probably  the  first  to 
suggest  the  combination  of  lenses  as  an  aid 
to  vision;  and  he  thus  gives  the  first  hint 
in  literature  of  the  construction  of  a  tele- 
scope. We  here  render  the  most  important 
passages  in  his  writings  on  the  subject  of 
the  refraction  of  light  and  the  use  of  lenses. 

In  reading  this  account,  the  technical 
meaning  attached  to  the  word  species  in 
Mediaeval  and  Renaissance  optics  must  be 
borne  in  mind.  It  was  held  that  visible 
objects  were  constantly  emitting  images  of 
themselves  or  species  as  they  were  called. 
These  emissions,  if  they  collided  with  certain 
other  emissions  of  the  so-called  visual  spirit, 
which  was  held  to  proceed  from  the  retina, 
resulted  in  the  production  of  visual  sensa- 
tion. The  collision  was  supposed  to  take 
place  in  the  forefront  of  the  eye.  The 
variation  in  the  size  of  the  pupil  was  re- 
garded as  a  device  for  regulating  the  amount 
and  intensity  of  the  collision. 

It  must  further  be  remembered  that  the 
universe  was  regarded  as  composed  of  a 
series  of  concentric  spheres  placed  one  in- 
side the  other  like  the  skins  of  an  onion.  In 
the  center  was  the  earth,  around  it  the 
atmosphere,  and  around  that  seven  spheres 
or  heavens  corresponding  one  to  each  of  the 
seven  planets.  Beyond  the  outermost  of 
these  seven  spheres  (in  which  moved  the 
planet  Saturn),  was  the  heaven  containing 
the  fixed  stars.  In  order  to  reach  the  earth, 
the  species  from  a  fixed  star  had  therefore 
to  penetrate  the  seven  spheres  of  the  seven 
planets  and  finally  the  atmosphere. 

"We  maintain  that  the  planets  do  not 
really  vary  in  altitude  [as  some  have 
claimed]  but  that  they  seem  to  do  so  for 
certain  reasons,  of  which  one  depends 
upon  the  medium.  By  medium  is  meant 
that  transparent  body  through  which  the 
species  of  visible  things  reach  the  vision. 

If  the  medium  is  subtle,  all  things  in  it 

47  Cf.  Seneca,  Quacstiones  naturales  I,  3  and  1, 6.  It  is 
doubtful  whethei  deas  of  refraction  could 

have  been  derived  from  Aristotle.  The  conception  of 


seem  smaller  and  more  remote;  if  thick 
and  dense  they  appear  larger  and  nearer 
as  may  be  seen  in  water,  glass  and  crystal. 
Thus  was  discovered  the  application  of 
those  lenses  (specillorum)  that  are  called 
ocularia  [  =  spectacles].  Thus  also,  objects 
such  as  oars,  that  are  part  in  air  and  part 
in  water,  look  as  though  broken,47  for  the 
part  in  water  appears  nearer  than  it  would 
if  viewed  directly  through  the  air. 

"Now  this  factor,  which  depends  upon 
the  medium,  does  not  seem  to  have  been 
sufficiently  considered  by  those  authors 
who  maintain  the  eccentric  [i.e.  epicyclic] 
theory,  for  they  have  considered  no  media 
other  than  air  and  water.  Thus  Ptolemy, 
for  instance,  having  perceived  that  the 
cause  of  certain  phenomena  could  not  be 
explained  as  due  to  the  atmosphere,  re- 
jected the  medium  altogether  as  a  cause  of 
these  appearances.  We,  however,  consider 
that  air  and  water  and  their  kinds  are  not 
the  only  sorts  of  media  through  which 
species  reach  us  from  the  stars,  but  that 
the  heavens  themselves  and  their  strata 
(partes)  provide  such  media. 

"That  the  heavens  are  transparent  is 
manifest,  but  that  they  are  denser  in 
some  parts  and  rarer  in  others  is  demon- 
strated by  the  stars  and  by  the  disc 
(corpus)  of  the  moon.  For  there  are  in  the 
spheres  (oribus)  certain  most  rare  and 
subtle  strata  (partes)  through  which  such 
species  as  of  the  stars  pass  unaltered 
(nihil  repacta)  and  there  are  others,  utterly 
dense,  through  which  the  species  may  in 
no  wise  pass,  but  are  wholly  reflected 
back.  And  there  are  yet  other  media  from 
which  the  species  are  in  part  reflected, 
but  through  which  they  do  in  part 
penetrate. 

"Somecall  this  [latter  process]  refraction, 
distinguishing  refraction  from  reflexion.  In 
reflexion  the  incident  species  do  not  pene- 

thc  refraction  of  light  was  to  some  c\t<nt  developed 
in  the  Middle  Ages  by  Alhazen,  Roger  Bacon,  Vhellio 
and  John  of  Pcckham. 


The  Scientific  Position  of  Girolamo  Fracastoro 


trate  but  are  wholly  thrown  back  again. 
In  refraction,  however,  although  there 
may  be  a  degree  of  reflexion  yet  the 
species  do  penetrate  and  affect  vision 
directly.  Now  such  parts  of  the  spheres 
(orbium)  as  refract  the  species  render  all 
objects  larger  and  nearer.  So  with  the 
stars  which  are  subject  to  such  factors 
both  in  the  air  and  also  in  the  heavenly 
spheres,  some  of  which  are  denser,  some 
subtler. 

"As  regards  the  atmosphere  we  may 
observe  that  in  calm  winter  weather  and 
especially  towards  the  south  the  stars  look 
larger,  while  in  summer  and  towards  the 
north  they  appear  smaller.  The  influence 
of  the  heavenly  spheres  is  similar,  as 
we  shall  show  later. 

"Now  a  deep  medium  makes  objects 
appear  larger  and  nearer;  and  the  deeper 
it  is  the  greater  its  effects,  so  that  the 
further  the  species  come  through  a  dense 
medium,  the  greater  [relatively]  appear 
the  objects.  Thus  in  the  same  mass  of 
water,  objects  at  the  bottom  are  relatively 
more  enlarged  than  those  at  the  top.48  So 
ij  one  looks  through  two  lenses  (specilla 
ocularia)  placed  one  injront  of  the  other,  all 
objects  look  much  larger  and  nearer.  In  the 
same  way  there  are  certain  stars  which, 
when  near  the  horizon  appear  larger  and 
nearer,  but  when  towards  the  zenith  (in 
medio  cell)  seem  smaller  and  more  remote. 
For  species  near  the  horizon  come  through 
a  greater  depth  of  medium,  and  they  come 
through  more  of  the  atmosphere  which  is 
loaded  with  the  multitude  of  vapors  that 
are  ever  about  the  earth  than  do  species 
from  the  region  of  the  zenith  (e  medio 
celi).  .  .  . 

"Let  efgh  be  the  earth  and  abcd 
the  sphere  of  vapors  around  it.  Let  be 
be  the  horizon.  Then  a  star  near  the 
horizon  will  be  seen  along  the  line  be, 
one  at  the  zenith  along  ae.  But  be  is 

48  This  property  of  water   was,   of  course,   well 
known  to  the  ancients  and  is   mentioned  among 


greater  than  ae  and  therefore  the  species 
in  that  region  have  to  pass  through  more 
vapors. 

"For  the 
same  reason,  all 
stars  as  they 
rise  northward 
appear  less  to 
us  [i.e.,  in  Italy] 
and  as  they 
pass  east 
greater;  then 
as  they  sink  southward  they  are  yet 
greater  and  returning  on  the  east  less 
again.  For  with  us  [in  Italy]  a  star  is  near 
the  horizon  when  it  turns  southward  and 
it  passes  eastward  near  the  zenith. 

"Let  abcd  be  the  earth  and  fa  our 
horizon,  efgh  the  sphere  of  vapors, 
kl  the   equator  k 

and  e  a  northern 
and  f  a  southern 
star.  But  the 
southern  star  is 
near  our  horizon 
and  is  seen  along 
the  line  fa,  the 
northern  star  is, 
however,  nearer 
the  zenith  and  seen  along  the  line  ea, 
which  is  less  than  fa. 

"For  a  similar  reason  some  of  the 
planets  seem  larger  when  they  are  in 
quadrature  to  the  sun,  so  that  his  species 
is  refracted  through  a  greater  part  of 
their  sphere,  a  matter  of  which  we  shall 
treat  presently. 

"But  (not  only  the  character  but)  also 
the  position  of  the  medium  affects  the 
appearance  of  the  object  seen,  as  may  be 
observed  with  lenses  (in  specillis  ocular- 
ibus).  For  if  a  lens  be  placed  midway 
between  eye  and  object,  it  appears  much 
larger  than  if  the  lens  is  made  to  approach 
the  object  or  the  eye.49 

others  in  the  Problemata  of  Aristotle  and  by  Archi- 
medes, Seneca  and  Heron  of  Alexandria. 


10 


Annals  of  Medical  History 


"Now  concerning  the  differing  appear- 
ance of  the  moon,  according  as  it  is  in 
quadrature  or  rapid  motion  [i.e.  perigee]. 
In  both,  it  appears  larger  and  nearer  and 
its  appearance  varies  greatly.  .  .  .  The 
moon  appears  larger  and  nearer  when  in 
quadrature  because  the  species  of  the  sun 
falling  upon  the  moon  is  refracted  through 
a  greater  part  of  the  sphere  than  when 
the  moon  is  in  any  position  other  than 
quadrature. 

"Let  gfdh  be  the  moon's  sphere  and 
let  kh  represent  its  depth,  the  sun  being 
at  a,  above 
the  moon  in 
quadrature  at 
c  or  e.  Species 
or  rays  from 
the  sun  come 
to  the  moon 
along  the  lines 
bc  or  those 
which  are  re- 
fracted at  l 
H  through  lc. 
Similarly  in 
the  other 
quad  rature 
they  come 
through  de  or  le,  nor  can  there 
be  any  longer  lines  than  these  [i.e.  re- 
fracted through  a  greater  depth  of  medi- 
um] when  the  moon  is  in  other  positions.50 
Wherefore  the  species  of  the  sun  is  more 
refracted  in  quadrature  than  in  any  other 
position;  wherefore  the  moon  appears 
larger  and  nearer  for  the  same  reason  that 
do  objects  in  a  depth  of  water. 

"In  the  same  way  glasses  (specilla  ocu- 
laria)  may  be  made  oj  sucb  density  that  ij 
any  one  looks  through  them  at  the  moon  or 
at  any  star  tbey  appear  near  and  hardly 
higher   than   the   steeples    (turres)    and    it 

*"  Homocentrica,  II,  8. 

M  This  passage  is  based  on  a  misunderstanding  of 
the  nature  of  refraction  which  he  supposes  to  take 
place  only  when  the  rays  fall  vertically  on  the  surface 
of  the  medium. 


ought  not  therefore  to  appear  incredible 
that  sections  of  the  spheres  may  have  the 
same  effect.  An  instance  of  this  is  the 
fact  that  the  other  planets  may  appear 
greater  in  quadrature  as  I  have  often 
observed  with  Jupiter."61 

The  remaining  more  important  scientific 
conceptions  with  which  Fracastor  was  con- 
cerned are  contained  in  his  work  "De  Con- 
tagionibus"  which  we  shall  presently  discuss 
in  detail.  They  may  be  thus  briefly  enumer- 
ated. 

(8)  He  enunciated  clearly,  perhaps  for  the 
first  time,  the  modern  doctrine  of  the 
specific  characters  of  fevers. 

(9)  He  was  among  the  first  to  distinguish 
clearly  as  a  clinical  entity  the  disease  now 
know  as  typhus  fever. 

(10)  He  laid  the  true  basis  of  the  whole  of 
modern  teaching  on  the  subject  of  infection 
by  means  of  his  doctrine  of  "  seminaria." 

in.    fracastor's    theory    of    infection 

At  the  back  of  all  modern  views  on  the 
nature  of  infectious  disease  lies  the  work  of 
Fracastor.  In  the  words  of  a  younger 
contemporary  "it  was  he  who  first  opened 
men's  eyes  to  the  nature  of  contagion."" 
To  Fracastor  belongs  the  credit  of  finally 
and  clearly  distinguishing  the  three  catego- 
ries of  infection,  by  contact,  by  fo mites  and 
at  a  distance.  His  doctrine  of  infection 
arising  from  and  conveyed  by  hidden  germs 
or  seeds  has  formed  the  basis  of  most  of  the 
best  work  on  the  subject  in  the  centuries 
that  have  followed. 

For  generations  but  little  advance  was 
made  on  his  teaching,  but  at  length  it 
became  incorporated  in  the  work  of  a  school 
mainly  composed  of  Italian  writers  who, 
led  by  Francesco  Redi  (1626- 1694),  Giovan- 
ni Maria  Lancisi  (1654-1720),  and  Antonio 

11  Homocentrica,  III,  23. 

M  Hieronymo  Mercuriali.  Praelectiones  Patavii 
habitae  1577  in  quibus  de  peste  tractatur.  De  piste 
in  universam,  praesertim  vero  de  Veneta  et  Patavina. 
Venice,  1577.  Cap.  XIII. 


The  Scientific  Position  of  Girolamo  Fracastoro 


i  i 


Vallisnieri  (1661-1730),  took,  in  the  seven- 
teenth and  eighteenth  centuries  another 
step  towards  a  scientific  demonstration  of 
the  nature  of  infection.  The  third  great  step 
belongs  to  the  history  of  modern  medicine 
and  is  associated  with  that  group  of  ideas 
that  cluster  around  the  names  of  Pasteur, 
Lister,  and  Koch.  But  to  Fracastor  as  to 
the  father  of  modern  rational  pathology  we 
must  always  return,  and  the  influence  of  his 
ideas  is  discernible  even  in  recent  develop- 
ments of  that  science. 

For  the  study  of  epidemics  Fracastor 
lived  in  a  peculiarly  favorable  locality  and 
period.  When  he  was  yet  a  lad  of  about 
sixteen,  the  venereal  plague  was  first  recog- 
nized in  Italy.  It  was  at  this  period,  accord- 
ing to  him,  that  the  disease  was  given  the 
name  of  morbus  gallicus,  a  title  confirmed 
perhaps  by  the  extensive  infection  that 
grew  up  in  Paris  two  years  later,  when 
matters  had  reached  such  a  pass  that  a 
decree  was  issued  requiring  all  infected 
persons  to  leave  the  town  within  twenty- 
four  hours.63  In  his  manhood  Fracastor  was 
the  witness  of  successive  waves  of  plague 
and  of  epidemic  typhus  which  swept  over 
the  peninsula.  He  had  ample  opportunity  to 
study  phthisis  and  rabies,  and  in  speaking 
of  these  he  shows  much  knowledge  and 
clinical  acumen.  Of  diseases  which  came  less 
directly  within  his  observation  such  as  the 

63  It  has  been  shown,  however,  that  the  term  "mal 
franzoso"  was  in  use  as  early  as  the  fourteenth 
century.  See  Karl  Sudhoff,  "Zur  historischen  Biologie 
der  Krankheitserreger,"  Heft  5.  "Mai  Franzoso  in 
Italien  in  der  ersten  Halfte  des  15.  Jahrhunderts. 
Ein  Blatt  aus  der  Geschichte  der  Syphilis."  Giessen, 
1912,  See  also  the  same  author  in  Dermatologiscbe 
Zeitscbrijt,  Band  XX,  Heft  14,  1913,  also  "Der  Ur- 
sprung  der  Syphilis.  Vortrag  gehalten  auf  dem  inter- 
nationalen  medizinischen  Kongress  zu  London  am 
August  7,  1913,"  Leipzig,  1913,  and  "Ein  neues 
Syphilisblatt  aus  dem  Ende  des  15.  Jahrhunderts" 
in  Arch,  fur  Gescb.  der  Med.,  Vol.  I,  p.  374,  Leipzig, 
1908.  Also  Paul  Richter,  "Ueber  Conrad  Schellig  und 
sein  'consilium  in  pustulas  malas,'  "  in  Arch. 
Jut  Gescb.  der  Med.,  Vol.  Ill,  p.  135,  Leipzig, 
1910. 


English  Sweat  and  Leprosy  he  writes  with 
discretion  and  judgment. 

The  doctrine  of  disease  germs  or  seeds 
which  forms  Fracastor's  best  claim  to 
scientific  eminence  had  dawned  upon  him 
before  1530.  It  is  foreshadowed  in  a  Lucre- 
tian  passage  in  the  "Syphilis"  that  was 
printed  in  that  year.  At  that  date,  however, 
he  still  regarded  alteration  in  the  air  itself, 
"miasma,"  as  the  main  cause  of  epidemic 
disease.64  His  reputation  as  a  scientific 
medical  writer  is  more  safely  based  upon 
his  "De  contagionibus  et  contagiosis  morbis 
et  eorum  curatione."65  which  appeared  at 
Venice  in  1546. 

The  excellences  of  this  work  are  so  numer- 
ous as  to  mark  an  epoch  in  the  history  of 
medicine.  It  is  written  in  a  clear  and 
straightforward  style  and  is  not  of  inordinate 
length.  Essentially  a  practical  work,  yet 
written  in  a  thoughtful  and  philosophical 
mood  by  a  physician  of  experience,  it  betrays 
an  industrious  accumulation  of  clinical  data 
and  relies  little  on  mere  hearsay.  There  is 
almost  complete  freedom  from  the  weari- 
some list  of  quotations  from  the  writings  of 
others  through  which  the  reader  has  to  wade 
in  most  contemporary  treatises.  In  this  as 
in  all  his  works,  the  author  shows  himself 
singularly  devoid  of  superstition,  although 
he  naturally  shares  some  of  the  errors  of  his 
time. 

64  Quumque  animadvertas  tam  vastae  semina  Iabis 
Esse  nee  in  terrse  gremio,  nee  in  asquore  posse, 
Haud  dubie  tecum  statuas  reputesque,  necesse  est, 
Principium,  sedemque  mali  consistere  in  ipso 
Aere,  qui  terras  circum  diffunditur  omnes, 
Qui  nobis  sese  insinuat  per  corpora  ubique, 
Suetus  et  has  generi  viventium  immittere  pestes. 
Aer  quippe  pater  rerum  est,  et  originis  auctor. 
Idem  saepe  graves  morbos  mortalibus  affert, 
Multimode  natus  tabescere  corpore  molli, 
Et  facile  affectus  capere,  atque  inferre  receptos. 
Nunc  vero,  quonam  ille  modo  contagia  traxit, 
Accipe:  quid  murate  queant  Iabentia  sascla. 

Syphilis,  Lib.  I. 
66  The  "De  sympathia  et  antipathia  rerum"  ap- 
peared at  the  same  time  and  in  the  same  volume. 
With  this  work,  however,  we  are  not  here  concerned. 


12 


Annals  of  Medical  History 


The  relationship  between  epidemics  as  a 
result  and  infection  as  a  cause  is  clearly 
grasped  and  philosophically  expounded  by 
Fracastor  and  is  not  confused  by  specula- 
tion onjthe  barren  topic  of  miasma,  which 
proved^  a  snare  Vto  ^  many  ^contemporary 
writers.  The  orders  of  infection  are  logically 
distinguished.  Lastly,  the  theme  of  the  con- 
veyance of  infection  by  minute  particles 
having  some  of  the  properties  of  seeds  is 
skillfully  developed  and  interwoven  with  the 
humoral  pathology.  Fracastor  had  not  the 
modern  conception  of  universal  biogenesis. 
It  is  probable,  from  his  philosophic  stand- 
point, that  he  would  have  refused  to  accept 
the  usual  modern  scientific  distinction  be- 
tween the  organic  and  the  inorganic.  It  is 
therefore  idle  to  discuss  whether  he  regarded 
these  germs,  seeds  or  semina  as  living  or 
non-living  since  the  distinction  would  not 
have  appeared  important  to  him.  In  any 
event,  he  believed  that  infectious  diseases 
could  be  originated  anew.  But  for  this 
heresy,  there  is  little  enough  in  the  main 
outline  of  his  views  that  would  need  re- 
construction by  an  orthodox  pathologist  of 
to-day. 

To  appreciate  justly  the  place  of  the  "  De 
Contagionibus"  in  the  history  of  medical 
thought,  it  is  necessary  to  consider  the 
general  current  of  the  teaching  on  the 
subject  of  infection  up  to  the  date  of  its 
publication.  In  the  following  chapter  we 
seek  to  pass  this  in  rapid  review. 

IV.     KNOWLEDGE     OF     THE     PHENOMENA     OF 
INFECTION    AMONG   THE    ANCIENTS 

(a)  Among  Primitive  Folk. 

To  the  primitive  mind  the  properties  of 
all  matter  appear  capable  of  transference  to 
contiguous  or  neighboring  substance,  even 
of  dissimilar  nature.  In  a  kind  of  savage 
logic  described  by  modern  folk-Iorists  under 
the  term  "Magic,"  primitive  man  exhibits 
a  crude  species  of  reasoning,  based  some- 
times on  propinquity,  sometimes  on  simi- 


larity. Those  governed  by  such  ideas  regard 
all  material  things  as  presenting  contagious 
properties,  the  infection  either  passing  from 
one  body  to  another  in  actual  physical 
juxtaposition  or  at  a  distance  through  the 
agency  of  "sympathetic"  or  "symbolic" 
magic.  Purity  and  defilement  have  hardly 
yet  risen  to  their  ritual  significance.  These 
conditions  are  as  yet  a  part  of  daily  life  and 
follow  on  natural  contact  with  clean  and 
unclean  objects.  Thus  to  the  savage,  the 
phenomena  of  infectious  and  contagious 
disease  are  but  part  of  the  general  order  of 
his  world. 

In  a  higher  state  of  culture,  Religion  has 
become  differentiated  from  its  parent,  or 
cousin,  Magic.  The  untoward  and  unex- 
pected events  of  life — and  among  these 
epidemics  take  a  prominent  place — are  now 
attributed  to  the  intervention  of  super- 
natural powers.  From  the  earliest  historic 
ages,  epidemics  have  indeed  puzzled  the 
mind  and  terrified  the  heart  of  man.  It  is 
the  unknown  that  is  most  dreaded,  and  the 
pestilence  that  walketh  in  darkness  has  been 
ever  more  terrible  than  the  arrow  that  flieth 
by  day.  The  Biblical  writer  strikes  a  true 
human  note  when  he  makes  the  appearance 
of  the  very  Angel  of  Death  at  the  threshing 
floor  of  Araunah  come  as  a  relief  to  the 
stricken  King  of  Israel. 

Probably  all  races  that  have  reached  the 
level  of  social  complexity  implied  by  formal 
legislation  have  exhibited  some  knowledge 
of  the  phenomena  of  infectious  disease. 
Babylonians,  Hebrews,  Egyptians,  Indians 
and  Chinese,  all  had  codes  adapted  to  the 
prevention  of  infection.  The  Buddhist  to 
this  day  avoids  some  water-borne  diseases 
by  drinking  only  filtered  water,  lest  he 
shouldsin  by  consumingthe  minute  creatures 
that  abound  in  brooks,  rivers  and  springs: 
the  Hebrew  has  for  ages  escaped  a  certain 
amount  at  least  of  tuberculous  disease  by 
following  the  law  which  bids  him  reject  the 
carcasses  of  cattle  with  diseased  lungs; 
and  even   races  very   low   in   the  scale   ol 


The  Scientific  Position  of  Girolamo  Fracastoro 


13 


civilization  will  measure  around  the  camp  a 
space  within  which  the  taboo  forbids  the 
deposit  of  excreta.  While  the  religious  bases 
of  such  actions  may  be  very  foreign  to  the 
modern  mood,  the  actions  themselves  are 
not  infrequently  in  close  accord  with  modern 
hygienic  doctrine. 

(b)  Knowledge  oj  Injection  oj  the  Ancient 
Greek  and  Roman  Writers. 

To  the  physicians  of  Greece  and  Rome 
epidemics  of  all  kinds  were  known  as 
common  accompaniments  of  warfare  and  of 
natural  catastrophes,  although  infection 
proper  as  we  understand  it,  was  seldom 
distinguished  by  them  from  that  general 
infection  which  we  call  an  epidemic.  Among 
the  Greeks  the  direct  influence  of  the  gods 
was  passing  into  the  background  and  it  was 
recognized  that  outbreaks  of  certain  types 
of  disease  followed  rather  on  certain  natural 
events,  such  as  excessive  rainfall,  for  epi- 
demics had  been  observed  to  prevail  with 
special  winds  and  at  the  changes  of  the 
seasons.  Overcrowding  again,  and  the  in- 
halation of  air  breathed  by  others  were 
regarded  as  modes  of  breeding  disease: 
w'lile  unburied  corpses,  exhalations  set  free 
by  earthquakes  and  even  defective  drains, 
were  all  considered  dangerous  to  health. 
These  observations  combined  with  crude 
notions  on  spontaneous  generation  were  not 
without  influence  in  leading  speculation 
towards  a  theory  of  zymotic  disease. 

But  to  most  of  the  Greek  and  Latin 
medical  authors  whose  works  have  come 
down  to  us,  the  mechanism  of  widespread 

66  The  Hippocratic  writings  seem  to  present  a 
contrast  in  this  respect  to  the  somewhat  earlier 
Levitical  code.  It  must,  however,  be  noted  that 
although  the  regulations  of  that  code,  as  regards 
leprosy,  presumably  imply  a  belief  in  infection,  such 
a  belief  is  nowhere  stated,  and  the  facts  are  capable 
of  other  interpretation.  Cp.  M.  Jastrow.  "The  so- 
called  Leprosy  Laws."  Jewish  Quarterly  Review, 
New  Series,  IV,  358.  Philadelphia  1914. 

67  Hippocrates.  Airs  Waters  and  Places  Caps  1, 
10,  15,  etc.  Epidemics  Bk.  1.  §  1  and  2,  Bk.  3.  §  3. 
Aphorisms  3. 


infection  was  frankly  incomprehensible.  The 
ancients  of  the  classical  period  of  Greece 
and  Rome  were  as  anxious  as  any  modern 
scientist  to  seek  the  immediate  real  causes 
of  disease.  But  in  those  days  as  in  these, 
aetiological  literature  largely  consisted  of 
what  were  even  then  felt  to  be  either  simply 
verbal  explanations  or  mere  lists  of  associ- 
ated conditions,  to  be  used  in  the  absence 
of  better  means,  for  the  satisfaction  of  the 
ignorant.  ^Esculapius,  by  the  bedside  a  god, 
became  like  his  modern  representative,  a 
sorely  puzzled  soul  when  he  had  gained  the 
reflective  solitude  of  his  study. 

The  Father  of  Medicine  (arc.  400  B.C.) 
appears  to  have  had  no  conception  that 
epidemic  diseases  were  infectious,56  in  the 
sense  in  which  we  now  use  the  word.  By  him 
they  were  regarded  as  due  primarily  to 
atmospheric  conditions.  He  is  reported  to 
have  extinguished  the  plague  of  Athens  by 
lighting  fires  as  an  atmospheric  corrective, 
a  procedure  widely  adopted  in  such  emer- 
gencies until  recent  times.  It  will  indeed  be 
seen,  as  we  proceed,  that  all  the  causes 
regarded  by  the  early  medical  writers  as 
leading  to  epidemics  were  to  some  extent 
connected  with  a  "change  in  the  atmos- 
phere." 

Hippocrates  observed  the  immense  in- 
fluence of  climate  on  health  57 — and  urged 
the  study  both  of  permanent  and  temporary 
climatic  factors.  In  the  doubtfully  Hippo- 
cratic treatise  "On  the  Nature  of  Man"58 
we  find  a  discussion  of  the  phenomena  of 
epidemics,59  where  the  air  is  given  as  the 
only  possible  "universally  acting  cause"  of 

68  Pseudo-Hippocrates.  "On  the  Nature  of  Man," 
Cap.  9.  According  to  Greenhill  and  Adams  this  work 
comprises  fragments  by  different  authors,  probably 
about  contemporary  with  Hippocrates. 


69  Cf.  also: 
By  unknown  author 
about  contemporary 
with  Hippocrates. 

By  various  authors 
rather  later  than- 
Hippocrates. 


Humors  14. 
Epidemics 


Humors  8. 
Epidemics 


Bk.  2,  §1,3; 
I-  Bk.4,§7,§46. 

Bk.  6,  §5,  §7- 

Bk.  7,  §  105. 
Bk.  5,  §  94- 


14 


Annals  of  Medical  History 


widespread  disease,  an  idea  which  deeply 
affected  mediaeval  beliefs. 

The  teaching  of  the  Hippocratic  school  on 
the  subject  of  atmospheric  conditions  was 
elaborated  in  the  succeeding  centuries.  Thus 
the  author  of  the  treatise  known  as  the 
Problems  of  Aristotle  recognized  certain 
phenomena  of  infection,  discussed  the  vari- 
ous "epidemic  constitutions"  and  dwelt 
especially  on  the  result  of  a  hot  sun  drawing 
up  mists  from  the  earth.60  Similar  views  are 
to  be  found  in  Lucretius,61  Diodorus  Sic- 
ulus,62  Silius  Italicus,63  Lucan,64  Manilius,65 
and  Marcus  Aurelius.66  Galen  develops  the 
same  theme,  noting  the  effects  of  climate 
both  directly  on  the  patient  and  more  in- 
directly through  the  degradation  of  the  air 
breathed  by  him.67  Among  the  potent  causes 
of  this  degradation,  he  mentions  marshes 
and  stagnant  water.  Oribasius  68  also  gives 
marshes  and  fogs  among  the  causes  of 
fevers,  and  is  followed  by  Aetius,69  Paul  of 
Aegina,70  Ammianus  Marcellinus,71  Alexan- 

80  Problems.  §i.  cap.  21. 

61  Titus  Lucretius  Carus.  De  Rerum  Natura. 
lib.  VI,  line  noo  et  seq.  of  H.  A.  J.  Munro's 
version. 

62  Diodorus  Siculus.  Bibliotheca  Historica.  Bk.  14. 

§291- 

83  Silius  Italicus,  Punica,  Bk.  XIV. 

84  Marcus  Annseus  Lucanus,  Civiles  belium  vel 
Pharsalia  VI. 

86  Marcus  Manilius.  Astronomicon. 

88  Marcus  Aurelius  Antoninus.  Meditations.  Bk. 
IX,  cap.  2. 

87  Galen.  Commentary  1  on  Epidemics  of  Hip- 
pocrates, lib.  1;  Ad  Glaucum  de  methodo  medendi 
preface  and  lib.  1;  De  diff.  feb.  lib.  I,  cap.  6;  de 
methodo  medendi  bk.  1,  cap.  n;  com.  3.  on  Hipp, 
de  humoribus,  and  Com.  2  on  Hippocrates  "De 
natura  hominis."  Cap.  4. 

88  Oribasius,  Synopsis  VI.  24. 

"Aetius.  Contracts  medicina;  tetrabibli.  Bk.  1. 
sermo  3.  Cap.  CLXII,  CLXIII:   Bk.   2.   sermo  1, 
•  5.  cap.  XCIV. 

70  Paulus  Aegineta,  Bk.  2,  §  35. 

71  Ammianus  Marcellinus,  Res  gestae,  Bk.  XIX, 
cap.  4. 

72  Alexander  Aphrodiseus,  Aphorisms  6$,  159. 

n  Eustathius  Diaconus,  Commentary  on  Homer's 
Iliad.  5  LXI. 


der  of  Aphrodisias,72  and  Eustathius   Dia- 
conus.73 

The  first  writer  to  whom  can  be  traced  a 
definite  and  formal  belief  in  the  passage  of 
specific  infectious  disease  from  person  to 
person  is  Thucydides  (B.C.  471-391).  In  his 
description  of  the  plague  of  Athens  the 
historian  definitely  commits  himself  to  the 
view  that  those  who  came  most  intimately 
in  contact  with  the  sick  were  the  most  liable 
to  contract  the  disease.74  Very  similar  views 
are  found  in  a  long  list  of  writers  among 
whom  may  be  mentioned  the  author  of  the 
"Problems  of  Aristotle"  75  (b.c.  384-322), 
Lucretius  (b.c.  95-55),'*  Virgil 77  (b.c.  70- 
a.d.  19),  Dion  Cassius  of  Utica 78  (circa 
b.c.  40),  Dionysius  of  Halicarnassus  79  (died 
b.c.  7),  Livy  80  (b.c.  59-A.D.  17),  Diodorus 
Siculus 81  (circa  b.c.  20),  Ovid 82  (b.c.  43- 
a.d.  18),  Seneca83  (circa,  a.d.  60),  Pliny 
the  Elder84  (a.d.  23-79),  Silius  Italicus86 
(a.d.  25-100),  Plutarch86  (circa  a.d.  80), 
Appian  87  (circa  a.d.  120),   Eusebius  ^(a.d. 

74  Thucydides,  History  of  the  Peloponnesian  War, 
Book  II,  cap.  47  et  seq. 

76  Problems,  §  VII.  Cap.  8. 

78  Lucretius,  De  rerum  natura  VI,  especially  from 
line  1230  onward. 

77  Virgil,  Eclogues  I,  50;  Georgics,  III.  469. 

78  Dion  Cassius,  Roman  History.  Reign  of  Augus- 
tus, Book  53.  (Protulus  covers  his  nose  and  mouth 
with  his  hand  to  let  the  company  know  that  it  was 
unsafe  to  breathe  the  same  air  as  Largus,  who  had 
accused  his  friend  Gallus.) 

79  Dionysius  of  Halicarnassus.  Romanorum  anti- 
quitatum.  Lib.  X.  cap.  53. 

80  Livy  Patavinus,  Res  gestae  populi  Romani, 
Bk.  25. 

81  Diodorus  Siculus,  Bibliotheca  historica,  Bk.  14. 
§291. 

82  Ovid.  Metamorphoseon,  Lib.  VII.  551. 
M  Seneca,  De  tranquillate  animi,  §  7. 

84  Pliny  the  Elder,  Naturalis  Historia,  XXIII.  80. 

86  Silius  Italicus,  Punic  Wars,  Bk.  14. 

88  Plutarch,  Symposiaca  problemata,  Decas  IV, 
Problem  7. 

87  Appian  of  Alexandria.  Historia  Romano.  Lib. 
X,  cap.  1. 

88  Eusebius  Pamphili,  Bishop  of  Caesarea  in 
Palestine.  Historia  ecclesiastica,  Lib.  VII.  cap.  21, 
quoting  "Paschal  Epistle  of  Dionysius." 


The  Scientific  Position  of  Girolamo  Fracastoro 


15 


264-340),  Gregoras  Nicephoras89  (died  A. 
d.  394),  St.  John  Chrysostom 90  (347-407 
a.d.),  Evagrius  of  Epiphania  91  (a.d.  536- 
594),  and  Vegetius 92  and  many  others.93 
The  popular  writings  of  Isidore  of  Seville 
(died  a.d.  636)  may  be  regarded  as  the 
medium  through  which  the  doctrine  of 
contagion  passed  from  classical  antiquity 
into  mediaeval  and  barbarian  Europe.94 

Aretaeus  the  Cappadocian  95  who  lived  in 
the  second  century  of  the  present  era  is  the 
earliest  writer  known  to  us  who  extended 
the  theory  of  infection,  so  as  to  distinguish 
definitely  between  the  conveyance  of  a 
disease  by  contact  or  at  a  distance.  "A 
man,"  he  says,  "may  be  seized  with  rabies 
from  respiring  the  effluvia  of  the  tongue  of 
a  dog,  without  having  been  bitten."  Al- 
though the  observation  on  which  he  bases 
his  view  is  inaccurate,  he  was  thus  on  the 
road  to  a  more  correct  conception  of  con- 
tagion. Ccelius  Aurelianus  makes  a  similar 
distinction  for  hydrophobia,96  elephanti- 
asis 97  and  perhaps  for  plague.  Galen  had  a 
clear  view  of  the  distinction  between  infec- 
tion and  contagion  and  regarded  as  infec- 
tious consumption  98  as  well  as  those  other 
diseases  which  gave  rise  to  fetid  respiration. 
Aetius  (sixth  century)  99  believed  in  the 
contagion  of  "elephantiasis"  and  Paul  of 
Aegina  10°  recommended  the  segregation  of 
patients  from  this  disease  since  it  is  "no 
less  easily  communicable  than  the  plague." 

Thus  the  doctrine  of  infection  was  well 
known  to  the  classical  writers  of  Greece  and 
Rome.    Nevertheless    it    is    important    to 

89  Gregoras  Nicephoras.  History  of  Byzantium. 
Bk.  16,  Chap.  1,  §  798. 

90  St.  John  Chrysostom.  In  Joan.  Orat.  57. 

91  Evagrius  Scholasticus.  Historia  ecclesiastica, 
Cap.  29  (contagion  among  various  other  puzzling 
phenomena). 

92  Renatus  Vegetius.  Ars  veterinaria  sive  mulo 
medicina,  Lib.  Ill,  Caps.  2,  23. 

93  For  a  masterly  review  of  the  doctrine  of  con- 
tagion in  the  classical  period  of  Greece  and  Rome 
the  reader  may  be  referred  to  Francis  Adams'  "The 
Seven  Books  of  Paulus  Aegineta."  3  vols.,  London, 
1844.  See  especially  commentary  on  Book  II,  Sec- 


remember  that  infection  formed  with  them 
only  a  minor  factor  in  the  production  of 
disease.  Its  existence  was  admitted,  but 
far  more  stress  was  laid  on  the  physical 
conditions  in  which  epidemics  arose  than  on 
the  passage  of  the  condition  from  person  to 
person.  Thus  in  the  description  that  Lucre- 
tius gives  of  the  plague  (De  Rerum  Natura 
VI)  although  some  200  lines  are  devoted  to 
the  subject  and  the  atmospheric  influences 
are  fully  discussed,  the  passage  of  the  disease 
from  person  to  person  is  dismissed  in  a  few 
words.  With  the  ancients,  in  fact,  it  was 
always  "miasma"  rather  than  contagion 
that  was  feared. 

Before  leaving  these  medical  writers  of 
Greece  and  Rome  we  may  consider  certain 
of  their  pathological  theories,  which  were 
involved  in  their  conception  of  the  nature 
of  infection  and  contagion.  These  concep- 
tions dominated  medical  thought  until  the 
seventeenth  century  and  their  influence  lay 
heavy  on  Fracastor  and  may  be  traced  even 
in  modern  times. 

The  Hippocratic  school  recognized  the 
four  humors,  blood,  phlegm,  black  bile  and 
yellow  bile  and  the  corresponding  qualities, 
heat,  cold,  dryness  and  moisture.  Hippoc- 
rates himself  attributed  diseases,  including 
epidemics,  to  a  disturbance  in  the  distribu- 
tion and  quality  of  the  humors,  due  most 
often  to  atmospheric  changes.  An  observant 
physician  could  not  fail  to  note  the  element 
of  putridity  in  many  infectious  conditions, 
especially  in  the  group  associated  with 
various    forms   of  septic   throat   or  "cyn- 

tion  XXXVI.  "On  the  Plague,  from  the  works  of 
Rufus,"  Vol.  I,  p.  277  et  seq. 

94  Thus  Isidore  of  Seville  De  natura  rerum.  De 
Pestilentia  XXXIX,  2,  is  taken  from  Lucretius  VI, 
1 100. 

95  Aretaeus  Cappadox,  The  Causes  and  Symptoms 
of  Acute  Diseases,  Book  I,  Ch.  7. 

96  Coelius  Aurelianus.  Celerum  passionum.  Book 
III,  Ch.  9  and  13. 

97  Ibid.  Tardarum  passionum,  Book  I,  Ch.  1. 

98  Galen,  De  diff.  febr.  1.  4. 

99  Aetius,  Sermo  XIII,  Cap.  120. 
100  Paulus  Aegineta,  Book  4,  §1. 


i6 


Annals  of  Medical  History 


anche,"  as  it  was  called,  and^with  various 
forms  of  skin  eruption  in  which  a  pustular 
element  was  liable  to  supervene.  The  term 
"putridity"  or  "fermentation"  of  the  hu- 
mors became  a  sort  of  epidemiological 
master-key,  the  use  of  which  continued 
right  down  to  the  nineteenth  century.  Thus 
the  learned  and  eloquent  Sir  Thomas  Wat- 
son wrote  in  1848: 

"The  ancients  attributed  various  dis- 
orders to  a  fermentation  of  the  animal 
fluids.  The  cause  of  fever,  according  to 
Hippocrates  was  some  morbid  matter  in 
the  blood.  This  matter,  by  a  process  of 
concoction,  was  brought,  in  a  certain 
number  of  days,  into  a  state  in  which  it 
was  ready  for  expulsion  from  the  body. 
.  .  .  The  doctrine  thus  enunciated  by  the 
father  of  physic  is  very  nearly  the  same 
with  that  which  Liebig  is  teaching  in  the 
nineteenth  century."1 

This  doctrine  of  fever  and  contagion  as 
related  to  a  putridity  or  fermentation  of  the 
humors  had  thus  lasted  for  over  twenty- 
two  centuries  before  it  was  appreciably 
modified  by  the  workers  who  have  given  us 
our  modern  theories  on  the  subject. 

It  was  early  recognized,  however,  that  not 
all  infectious  diseases  were  associated  with 
demonstrable  putrescence.  The  explanation 
was  that  the  change,  confined  to  the  hu- 
mors, need  not  necessarily  exhibit  itself 
externally,  although  it  could  convey  its  own 
nature  to  the  circumambient  air  and  thus 
infect  others.  Fevers  were  therefore  divided 
into  putrid  and  non-putrid,  a  simple  clas- 
sification that  was  adopted  by  Cullen  in 
the  eighteenth  century  and  has  persisted 
into  modern  times.  The  distinction  of  the 
tertian  and  quartan  group  of  malarial  in- 
fection from  either  of  the  above  categories 
was,  however,  usually  recognized. 

1  Sir  Thomas  Watson.  "Lectures  on  the  Principles 
and  Practice  of  Physic,"  London,  1843.  Vol.  II,  p. 
669.  A  large  part  of  Justus  von  Liebig's  early  work 


(c)  Knowledge  of  Injection  among  Arabian 
W  liters. 

The  medical  theories  of  the  Mediaeval  and 
Renaissance  periods  were  derived  from  two 
main  sources.  Firstly,  they  were  formed  by 
Greek  medical  works  in  more  or  less  defec- 
tive Latin  translations.  Secondly,  they  were 
molded  by  Arabian  writings  which  were 
themselves,  in  the  main,  little  but  corrupted 
versions  of  the  Greek  works  from  which 
they  ultimately  derived.  Latin  translations 
of  these  Arabian  writings  filtered  into 
Europe  continuously  from  the  eleventh  to 
the  sixteenth  century.  In  spite  of  the 
revived  interest  in  Greek  among  scholars  of 
the  fifteenth  century,  Arabian  influence  by 
no  means  passed  into  abeyance.  The  relative 
importance  of  Greek  and  Arabian  writers 
at  the  time  may  be  gathered  from  the 
following  table  of  the  number  of  editions 
of  various  medical  writers,  printed  before 
the  year  1500. 

Hippocrates  ol 
Dioscorides  2  r  Greeks 
Galen  1 J 

Rhazes         14] 

Mesue  1 8  [  Arabians 

Avicenna     2 1 J 

Nor  must  it  be  considered  that  the  in- 
fluence of  the  Arabians  stopped  even  with 
the  close  of  the  fifteenth  century.  Further 
editions  of  Mesue  were  issued  during  the 
next  100  years  and  the  work  was  used  in  the 
formation  of  the  first  London  Pharmacopeia, 
issued  in  the  reign  of  James  I;  while  the 
Canon  of  Avicenna  served  as  a  text-book 
and  continued  to  appear  in  ponderous  folio 
editions  until  the  wane  of  the  seventeenth 
century.  It  is  therefore  necessary  to  consider 
the  Arabian  doctrines  of  contagion  in  order 
to  estimate  the  influences  on  Renaissance 
medical  conceptions.2 

was  devoted  to  the  subject  of  fermentation  and 
paved  the  way  for  Pasteur. 
1  For  the  analysis  of  the  views  held  by  Moham- 


The  Scientific  Position  of  Girolamo  Fracastoro 


17 


Little  is  known  of  Arabic  views  in  the 
pre-Mohammedan  era  on  the  subject  of 
epidemics.  It  would  seem  that  such  phe- 
nomena were  regarded  as  due  to  the  direct 
and  baleful  influence  of  the  Djinn,  no 
attempt  being  made  to  analyze  their  nature 
further.  With  the  advent  of  the  Mussulman 
period  this  was  changed.  Mahomet  himself 
appears  to  have  halted  between  two  views. 
During  the  early  years  that  he  had  spent  as  a 
herdsman  he  had  remarked  that  disease 
seemed  to  be  conveyed  from  one  animal  to 
another,  rather  than  imposed  on  the  whole 
group  from  without.  This  observation,  how- 
ever, when  extended  to  human  epidemics 
was  with  difficulty  reconciled  with  his  later 
faith  in  the  direct  intervention  of  Allah  in 
all  human  affairs.  The  confusion  or  perhaps 
fusion  of  ideas  is  found  throughout  Arabic 
medical  literature.  It  is  well  illustrated  in 
the  "Book  of  the  Pest"  by  the  celebrated 
author,  al-Bokhari  (810-870  a.d.): 

"The  owner  of  a  sound  flock  should  not 
go  near  an  infected  flock.  .  .  .  If  you  per- 
ceive that  the  pest  reigns  in  a  land,  enter 
not  therein,  but  if  you  are  in  an  infected 
country,  pass  not  out  therefrom.  .  .  .  The 
plague  is  a  punishment  from  Allah  and 
inflicted  by  his  will.  It  has  been  created 
in  pity  for  the  sake  of  the  true  believers 
and  it  proceeds  not  from  man.  Therefore 
any  man  [to  whom  that  fate  may  come] 
should  die  calmly  in  his  own  country 
knowing  well  that  he  endures  what  Allah 
has  preordained;  for  him  the  plague  is  a 
martyr's  crown."3 

The  advice  thus  offered  was  not  in  fact 
always  applied  by  the  Mohammedan  hosts. 
Thus  on  the  approach  of  an  epidemic,  Omar 
ben  al-Khattab  and  the  generals  who  suc- 
ceeded him  dispersed  their  soldiers  in  the 

medans  on  the  subject  of  contagion  we  are  largely 
indebted  to  Dr.  E.  Seidel.  "Les  I  dees  des  Arabes  du 
moyen-age  sur  la  contagion"  in  La  Revue  medicale 
d'Egypte,  1912,  and  "Die  Lehre  von  der  Kontagion 
bei  den  Arabern"  in  the  Arcbiv  fur  Gescb.  der  Med., 
VI,  1913.  We  had  ourselves  made  a  somewhat  exten- 


mountains  or  the  desert  and  there  they 
remained  until  the  pestilence  had  spent  its 
force. 

However  much  the  doctrine  of  pre- 
destination may  be  a  Mohammedan  dogma, 
its  practical  application  has  varied  accord- 
ing to  the  theological  complexion  of  place 
and  period.  Wise  action  such  as  that  of  Omar 
would  especially  appeal  to  such  sects  as  the 
heretical  Qadarites  of  Basra  and  their 
successors.  These  people  considered  that 
Allah,  while  determining  the  more  sweeping 
and  important  world  movements,  did  not 
exercise  the  same  minute  surveillance  over 
the  smaller  details  of  life  and  thus  they 
tended  to  become  more  anti-fatalistic.  Under 
the  reign  of  Motawahkil  Jaafar  Abu 'I  Farl 
(847-881)  and  his  successors,  there  was  a 
fatalistic  reaction  and  many  lives  were 
sacrificed  to  the  fanatical  interpretation  of 
the  doctrine  of  predestination.  The  sale 
even  of  medical  books  containing  heretical 
views  was  strictly  forbidden.  The  works  of 
Galen,  however,  fortunately  escaped  the 
ban,  perhaps  owing  to  their  strongly  ex- 
pressed teleological  views.  They  thus  sur- 
vived to  earn  the  approval  of  the  orthodox 
and  to  form  the  basis  of  Arabic  medicine,  so 
that  Galen,  the  unbeliever,  came  to  occupy  a 
somewhat  similar  place  in  the  affections  of 
the  followers  of  the  crescent,  that  Virgil,  the 
worthiest  of  the  heathen,  earned  among  the 
Christians. 

Passing  from  the  general  tendencies  that 
influenced  Arabic  medicine,  we  may  con- 
sider the  views  on  infection  that  arose 
among  its  professors.  Already  in  the  seventh 
century  the  Christian  Ahron  of  Alexandria 
regarded  epidemics  as  a  result  of  the  consti- 
tution of  the  air,  a  view  clearly  derived 
from  Greek  sources.  Rhazes  (died  932),  in 
spite  of  his   clinical   acumen,    contributed 

sive  research  into  the  Arabian  literature.  We  hap- 
pened, however,  to  be  in  Germany  on  the  outbreak 
of  war  in  August,  1914,  when  our  notes  were  seized 
by  the  authorities,  who  have  hitherto  refused  to 
relinquish  them. 

3  Quoted  from  Seidel,  Ioc.  cit. 


i8 


Annals  of  Medical  History 


little  to  the  subject  of  contagion  though  he 
introduced  the  element  of  "fermentation"  4 
also  of  Greek  origin.  He  mentions  among 
the  diseases  "which  are  transmitted  from 
one  person  to  another"  lepra  (?  elephan- 
tiasis), itch,  consumption  and  "pestilential 
fever."  These  are  infectious  "when  one  is 
shut  up  in  a  narrow  house  with  those 
afflicted  thereby  or  when  one  sits  upon  their 
windward  side."  Ophthalmia  and  smallpox 
he  considered  as  also  sometimes  contagious.6 

The  earliest  Arabic  writer  in  whom  a 
definite  advance  on  these  views  is  to  be 
found  is  the  Persian  Haly  Abbas  (Ali  ben 
Abbas — died  994).  His  works  were  trans- 
lated and  printed  6  but  their  popularity  was 
rather  before  than  after  the  period  of  the 
invention  of  printing,  when  they  became 
almost  entirely  superseded  by  the  writings 
of  Rhazes  and  Avicenna.  Haly  Abbas  dis- 
tinguishes clearly  enough  between  wind- 
borne  diseases  and  those  which  are  simply 
"infectious."7  In  the  latter  group  he  places 
leprosy  (goudham),  scabies,  phthisis,  small- 
pox, and  ophthalmia — all  diseases  that  are 
conveyed  by  intercourse  with  an  infected 
person.8 

As  regards  influence  on  European  medical 
thought,  the  most  important  of  all  Arabic 
writers  is  Avicenna  (980-1037),  whose  pon- 
derous Canon  enjoyed  a  vogue  from  the 
twelfth  to  the  seventeenth  century  and  has 
probably  been  read  more  than  any  other 
text-book  of  medicine.  Avicenna  following 
Galen  recognized  the  contagious  quality  of 
"lepra."9  He  regarded  "varioli"  and  "mor- 
billi"  as  "of  all  diseases  the  most  con- 
tagious."10 He  laid,  however,  far  more  stress 
on  the  factors  of  "fermentation"  within  the 

*  Rhazes,  Liber  de  Pestilentia  (i.e.  mainly  Variola), 
cap.  1. 

*  Ibid.  AI  Mansor.  Lib.  IV.  cap.  24. 

*  At  Venice  in  1492  and  at  Lyons  in  1523. 

7  Haly  Abbas,  lib.  V,  ch.  10  and  11  of  the  Latin 
edition  of  1523. 

8  Seidel,  Ioc.  cit.,  quoting  from  the  Arabic.  \\ 
unable    to    verify    this    statement    from    the    Latin 
translations. 


body  and  of  corruption  of  the  air  without 
than  on  any  contagious  element  of  disease, 
and  thus  reproduced  the  well-known  views 
of  the  ancients  on  the  subjects  of  epidemics,11 
and  served  to  stereotype  them  for  many 
centuries. 

As  to  the  existence  of  contagion,  the 
western  Avenzoar  (died  in  Spain,  1162)  was 
more  definite  than  his  Bokhariote  predeces- 
sor Avicenna.  Avenzoar 12  thus  gives  to 
contagion  a  chief  place  among  the  causes  of 
'  lepra": 

"There  occurs  at  times  in  the  bodies  of 
men  a  very  bad  cancer  which  is  lepra:  .  .  . 
and  this  arises  mostly  from  nearness  to 
lepers  and  intercourse  with  them." 

Again,  as  to  the  influence  of  air  he  says,13 
citing  Hippocrates  that: 

"Hot  and  moist  air  is  injurious  because 
in  this  state  the  air  is  more  apt  to  receive 
the  putrefaction  of  others;  and  those  of 
the  same  kind  (as  the  infected)  are  more 
especially  apt  to  receive  this  putrefac- 
tion. 

Again  14: 

"If,  in  the  course  of  an  epidemic,  some 
persons  die  suddenly,  the  cause  is  the 
putrefaction  and  the  malignity  of  the  air. 
For  it  is  possible  to  live  for  some  days 
without  food  or  drink,  but  not  for  one 
hour  without  air  suitable  to  be  breathed." 

In  the  same  chapter  he  clearly  enunciates 
the  miasma  doctrine. 

"But  corruption  of  the  air,  pestilence 
and  epidemics  are  caused  by  stagnant 
waters   without   How,    which   teem   with 

•Avicenna,  Liber  canonis,  Lib.  4,  fen.  3,  tr.  3. 
cap.  I. 

10  Ibid.  Lib.  4,  Fen.  1,  Tr.  4,  cap.  6. 

11  Ibid.  Lib.  4,  fen.  1,  tr.  4,  cap.  1. 

12  Avenzoar,  The  Tzir,  Lib.  II,  Tr.  VII.  cap.  12. 
18  Ibid.  Lib.  Ill,  tractatus  III,  cap.  1. 

14  Ibid.  Lib.  Ill,  tractatus  III,  cap.  2. 


The  Scientific  Position  of  Girolamo  Fracastoro 


19 


fecal  substances  and  effervesce,  putrefy 
and  smell,  thus  giving  birth  to  fevers, 
agues  and  mortal  apostemata.  .  .  .  This 
epidemic  which  arises  from  the  putre- 
faction of  evil  waters  is  worse  than  all 
others." 

Averrhoes  (died  in  Spain  in  1198)  in  his 
"CoIIiget"  takes  a  view  of  the  nature  of 
contagion  practically  identical  with  that  of 
Avenzoar,  and  his  medical  work  contains  no 
marked  original  elements.  Indirectly,  how- 
ever, he  did  much  to  establish  a  rational 
doctrine  of  contagion  by  his  effective  phil- 
osophic opposition  to  determinism.  This 
enthusiastic  follower  of  Aristotle  thus  suc- 
ceeded in  founding  a  school  of  thinkers  who 
sought  the  direct  physical  causes  of  disease 
and  epidemics  just  as  for  other  natural 
phenomena,  and  thus  paved  the  way  for  the 
methods  of  modern  science.  The  doctrine  of 
Averrhoes  took  root  in  Mohammedan  Spain, 
notwithstanding  persecution,  and  with  the 
eminent  writer  Ibn  al  Khatib  (131 3—1 374), 
who  endeavored  to  completely  liberate 
prophylactic  methods  from  the  dead  weight 
of  philosophical  determinism,  we  reach  the 
high-water  mark  attained  by  the  Arabian 
writers  in  this  respect.  As,  however,  Ibn  al 
Khatib's  work  was  not  translated  or  printed 
until  the  nineteenth  century,16  his  views 
exercised  little  influence  in  Europe.  He  is 
especially  interesting  because  he  clearly 
believed  the  doctrine  of  fomites  and  is  thus 
to  be  ranked  among  the  predecessors  of 
Fracastor.  For  prophylactic  treatment  of 
the  plague  he  advises,  first  "a  disinfection 
of  the  circumambient  air  by  good  cold 
smells,  by  flowery  perfumes,  etc.,"  and 
secondly  "the  avoidance  of  the  places  where 
one  may  suspect  corruption  from  those  sick 
and  dead  of  the  disease,  their  clothes,  vessels 
and  utensils,  avoidance  of  entry  into  an 
infected  house  or  of  approach  to  the  neigh- 
borhood of  the  sick,  or,  if  this  is  impossible, 

16  See  M.  J.  Mliller  in  Sitzungsberichte  der  kbnig- 
lichen  bayerischen  Akademie  der  Wissenscbaften  zu 
Muncben,  June,  1863. 


the  visit  must  be  rapid  and  accompanied  by 
every  precaution."  He  proceeds  with  a 
philosophical  and  rational  exposition  of  his 
views  on  infections,  and  deals  with  objec- 
tions not  only  on  theoretical  grounds  but 
also  on  the  basis  of  experience. 

A  writer  of  the  distinction  of  Ibn  al 
Khatib  must  have  had  many  disciples,  and 
when  the  stores  of  unexplored  Arabic 
medical  works  come  more  fully  within  the 
purview  of  the  Western  reader,  his  theories 
and  views  will  probably  be  found  to  be  no 
isolated  phenomenon. 

(d)  Knowledge  oj  Injection  in  Mediaeval 
Europe. 

In  no  age  and  in  no  part  of  the  world 
have  epidemics  had  a  larger  influence  upon 
social  conditions  than  in  Western  Europe 
between  the  middle  of  the  fourteenth  and 
the  beginning  of  the  sixteenth  century. 
That  stretch  of  time  opens  with  the  appall- 
ing visitation  of  the  Black  Death  of  1347-9, 
and  closes  with  the  epidemic  outbreaks  of 
typhus,  syphilis  and  plague  that  swept 
repeatedly  over  the  continent  from  1490  to 
1540.  Between  these  two  larger  groups  of 
visitations  were  many  others  of  which  the 
individuality  is  sometimes  obscured  by  their 
frequency  and  tendency  to  overlap.  Time 
and  again  influenza,  plague,  typhus,  small- 
pox, syphilis  and  sweating  sickness  devas- 
tated the  overcrowded  mediaeval  towns, 
often  spread  by  movements  of  armies  or 
social  upheavals,  or  associated  with  famines, 
earthquakes,  floods  or  other  disasters. 

The  general  medical  ideas  of  the  period 
were  derived  mainly  from  Arabian  sources, 
but  in  part  more  directly  from  Greek 
medicine.  In  the  matter  of  such  immediate 
and  vital  importance  as  epidemics,  however, 
the  Middle  Ages  were  not  quite  so  devoid 
of  originality  nor  so  wholly  dependent  on 
outside  sources  as  in  most  other  branches  of 
medicine. 

The  repeated  onset  of  epidemics  gave  rise 
to  a  semi-original  plague  literature,  mostly 


20 


Annals  of  Medical  History 


in  the  form  of  tractates  a  few  folios  in 
length.  This  tractate  literature  was  so  ex- 
tensive and  popular  that  there  is  no  large 
general  manuscript  collection  in  Europe  that 
does  not  contain  examples.  All  languages  are 
represented.  The  mass  of  these  plague  trac- 
tates are  in  Latin,  but  examples  are  known 
in  English,  French,  Provencal,  German, 
Italian,  Flemish,  the  Scandinavian  lan- 
guages, Hebrew,  Arabic,  Bohemian,  Spanish 
and  Portuguese.  This  tractate  literature, 
which  needs  more  extended  study,  yields  us 
the  best  picture  of  the  mediaeval  beliefs  as 
to  the  nature  of  contagion.  Many  of  the 
plague  tracts  point  out  that  the  ancients  had 
far  less  experience  of  the  pestilence  than  was 
afforded  to  more  modern  writers,  and  that 
contemporary  works  were  therefore  more 
valuable  than  the  classics  of  medicine  in 
regard  to  the  treatment  of  this  disease.16 

In  the  medical  literature  of  Greek  and 
Arabian  origin  the  idea  of  contagion  is  never 
so  much  emphasized  as  in  some  of  the 
plague  tractates  written  between  1350  and 
1500.  There  was  indeed  a  gradual  strength- 
ening of  the  belief  in  infection  throughout 
the  Middle  Ages.  Furthermore  the  distinc- 
tion between  infection  by  contact  and  in- 
fection at  a  distance  that  had  been  but 
lightly  touched  by  the  ancient  writers, 
assumes  progressively  a  more  and  more 
important  role  until  finally  at  the  hands  of 
Fracastor  the  whole  group  of  ideas  is  sub- 
mitted to  a  true  scientific  analysis. 

The  three  methods  of  infection,  by  con- 
tact, through  the  air  and  by  means  of 
fomites,  seem  to  have  been  recognized  in 
the  earlier  Middle  Ages.  The  conception  is 

"The  plague  tractate  literature  has  been  recently 
studied  by  Dorothea  W'aley  Singer,  "Some  Plague 
Tractates,"  Trans,  of  Royal  Society  oj  Med.  His- 
torical Section,  1916,  and  K.  SudhofT  whose  "P<  b- 
schriften  aus  den  ersten  150  Jahrcn  nach  der 
Epidemic  des  'schwar/en  Todes,'  1348,"  has  been 
in  progress  in  the  Arcbiv  fur  Cescb.  der  Med.  since 
1910. 

17  A.  C.  Klebs,  "The  I  listoric  Evolution  of  Variola- 
tion," Johns  Hopkins  I  illctin,  Baltimore, 


clearly  represented  in  verses  of  the  school  of 
Salerno,  of  the  tenth  or  eleventh  century,17 
where  it  is  urged  that  in  smallpox,  "Children 
should  avoid  touching  the  contagium  of  the 
disease:  (a)  the  sick  person,  (b)  the  breath 
of  the  sick,  (c)  the  clothes,  the  coverings, 
the  garments  and  such  clean  bodies  as  he 
may  have  infected  with  his  hand." 

A  belief  in  the  three  types  of  contagion 
is  implied  in  a  number  of  writings  which 
appeared  in  the  fourteenth  and  fifteenth 
centuries.  Thus  in  a  "plague  regimen"  put 
together  by  Cardo  of  Milan  in  1378  we  read 
that  one  "must  take  the  greatest  care  in 
approaching  a  plague  patient  since  the  air 
itself  is  contagious,"  deriving  this  quality 
from  the  sufferer.13  Again  Bartolommeo 
Santa  Sofia  (circa  1464)  assures  us  that  "a 
man  may  carry  the  plague  even  though  he 
have  it  not,"19  and  from  an  official  publica- 
tion of  the  town  of  Nuremberg  issued  in 
1496  to  guard  against  the  spread  of  syphilis, 
we  learn  that  clothes  were  regarded  as 
capable  of  carrying  that  infection.20 

Views  such  as  these  are  reflected  in  the 
writings  of  Boccaccio  whose  Decameron, 
which  first  appeared  about  1350,  is  based  on 
the  isolation  of  its  actors  during  the  Black 
Death  of  1348.  Boccaccio  in  his  introduction 
"to  the  ladies,"  writes  that: 

"The  disease,  by  being  communicated 
from  the  sick  to  the  well,  seemed  daily 
to  get  ahead,  and  to  rage  the  more,  as 
fire  will  do  by  laying  on  fresh  com- 
bustibles. Nor  was  it  given  by  conversing 
only,  or  coming  near  the  sick,  but  even 
by  touching  their  clothes,  or  anything 
that  they  had  touched.  .  .  .  Such  I  say 

1913,  XXIV,  70—83.  S.  de  Renzi,  "  Flos  medicinse 
Schohe  Salcrni,"  Naples,  1889. 

18  Karl  SudhofT,  "Pestschriften  aus  den  ersten  150 
Jahrcn  nach  clcr  Epidemic  des  'schwarzen  Todes,' 
1348,  Arcbiv  fur  Gescbicbte  der  Medizin,  Bd.  V,  5, 
1913,  p.  319.      "  Ibid.,  p.  352. 

10  Karl  SudhofT,  "Die  ersten  Massnahmen  tier 
Stadt  Nurnbcrg  gegen  die  Syphilis  in  den  Jahreo 
1496  und  1497,"  Arcbiv  fur  Dermatologie  und 
Syiibilis,  CXVI,  Heft  1,  1913,  p.  3. 


The  Scientific  Position  of  Girolamo  Fracastoro 


21 


was  the  quality  of  the  pestilential  matter, 
as  to  pass  not  only  from  man  to  man,  but, 
what  is  more  strange  and  has  been  often 
known,  that  anything  belonging  to  the 
infected,  if  touched  by  any  other  creature 
would  certainly  infect  and  even  kill  that 
creature  in  a  short  space  of  time.  One 
instance  I  took  particular  notice  of,  name- 
ly that  the  rags  of  a  poor  man  just  dead, 
being  thrown  into  the  street,  and  two  hogs 
coming  by  at  the  same  time  and  rooting 
amongst  them  and  shaking  them  about  in 
their  mouths,  in  less  than  an  hour  turned 
round  and  died  on  the  spot.  These  ac- 
cidents, and  others  of  the  like  sort,  oc- 
casioned various  fears  and  devices  amongst 
those  people  that  survived,  all  tending  to 
the  same  uncharitable  and  cruel  end: 
which  was  to  avoid  the  sick,  and  everything 
that  had  been  near  them,  expecting  by 
that  means  to  save  themselves." 

About  the  end  of  the  fifteenth  and  the 
beginning  of  the  sixteenth  century,  great 
stress  was  laid  on  these  different  methods 
by  which  infectious  disease  might  be  con- 
veyed, although  the  conception  was  often 
obscured  by  the  importance  attached  to  the 
factors  of  predisposition  and  of  atmospheric 
influence.  Thus  in  1497,  Alessandro  Bene- 
detti 21  writes  that : 

"Four  factors  by  which  bodies  affect 
each  other  [with  the  plague]  have  to  be 
considered:  (1)  the  actual  strength  of  the 
infection,  (2)  the  disposition  of  the 
patient,  (3)  the  nearness  of  the  two  bodies, 
and  (4)  the  duration  of  exposure.  .  .  .  And 
so  it  comes  about  that  while  some  are 
smitten  down,  others  linger  on  in  sickness 
and  yet  others  recover.  .  .  .  It  is  indeed 
remarkable  how  linen  garments  especially 
can  long  preserve  the  pest.  I  have  heard 

21  Alexander  Benedictus,  "  De  observatione  in 
pestilentia,"  Venice,  1497,  ch.  III. 

22  Johannes  Widman,  called  also  Salicetus  and 
Mechinger,  Meichinger  and  Mochinger,  "Tractatus 
de  pestilentia,"  Tubingen,  1501,  Ch.  1.  Widman  is 


how,  in  my  father's  time  at  Venice,  a 
suspected  mattress  was  put  by  in  a 
gentleman's  house,  and  seven  years  later 
the  mistress  of  the  house  ordered  it  to 
be  split  open,  and  the  servant  who  did 
this  was  straightway  seized  with  the 
plague." 

The  same  four  factors  are  repeated  more 
definitely  by  Widman  who,  writing  in  1501, 
tells  us  22 

"That  we  have  to  consider  in  pestilence, 
First,  Susceptibility  (passi  dispositio)  and 
what  bodies  are  subject  to  pestilence. 
Secondly,  the  strength  of  the  acting  cause 
and  what  is  the  infective  agent  in  the  air, 
in  what  way  and  with  what  force  it  acts. 
At  what  season  this  evil  quality  is  in  the 
air  which  so  strongly  tends  to  the  cor- 
ruption of  the  human  frame.  .  .  .  Thirdly, 
whether  there  is  actual  contact  or  merely 
proximity  of  the  agent  to  the  patient,  jor 
it  appears  that  air  may  become  pestilential 
in  the  same  manner  [as  another  object].  .  .  . 
And  Fourthly,  there  is  the  question  of  the 
duration  of  exposure." 

Benedetti  and  Widman  are  typical  writers 
of  the  period,  whom  we  have  selected  to 
show  what  conceptions  were  available  to 
Fracastor  before  the  publication  of  his  great 
work. 

An  obscure  writer,  Remade  Fuchs  of 
Limburg  (15 10-1587),  discloses  an  outlook 
on  infection  which  even  more  definitely 
approaches  that  of  Fracastor.  His  work  on 
the  morbus  gallicus  or  "Spanish  disease,"  as 
he  called  it,  appeared  in  1541.23  We  may 
quote  him  also  as  giving  the  contemporary 
pathology  of  fevers  and  illustrating  the 
usual  stress  laid  on  obstruction  of  the 
humors.  Fuchs  tells  us: 

said  to  have  been  one  of  the  first  physicians  in 
Europe  to  have  openly  advocated  the  use  of  mercury 
in  syphilis. 

23  Remade  Fuchs  of  Limburg,  Morbi  hispaniol, 
quern    alii    gallicum    alii    neapolitanum    appellant, 


Annals  of  Medical  History 


"The  disease  can  be  contracted  merely 
by  contact  and  mutual  intercourse,  but 
above  all  by  sleeping  constantly  with 
infected  persons  or  by  touching  their 
garments,  underclothes  or  linen  which 
have  come  into  contact  with  the  ulcerated 
places.  For  the  corrupted  humors,  passing 
through  the  porosities  of  the  tissues,  are 
carried  by  the  force  of  the  pulse  to  the 
surface  of  the  skin.  And  if,  owing  to  their 
adhesiveness  and  density,  the  humors 
cannot  be  insensibly  exhaled,  they  corrupt 
the  skin  by  their  acid  and  biting  quality 
and  give  rise  to  ulcers  from  which  flow 
virulent  matter.  This  clings  to  neighbor- 
ing parts  and  corrupts  and  infects  every- 
thing disposed  to  putrefaction.  So  dis- 
eases, such  as  lepra,  scabies,  variola  and 
pestilential  fever  and  putrid  abscesses 
pass  from  one  person  to  another." 

Remade  Fuchs  speaks  also  of  the  "semi- 
narium"  of  disease,  a  word  which  he  uses  to 
translate  the  oiropabmbv  of  Galen.24 

The  doctrine  of  the  three  degrees  of 
infection  received  full  official  recognition  in 
Paris  during  the  pestilence  of  1533,  when  a 
police  ordinance  was  printed  and  posted 
over  the  town  containing  instruction  for  the 
conduct  of  the  citizens  as  well  as  of  the 
officials.  In  this  ordinance  the  conveyance 
from  house  to  house  of  all  substances  likely 
to  act  as  fomites,  such  as  bedding  and 
clothes  of  the  sick,  was  strictly  forbidden. 
Special  medical  attendants  were  appointed 
for  the  plague-stricken  and  were  prohibited 
from  attending  those  suffering  from  other 
diseases  lest  they  might  convey  the  infec- 
tion.24 Thus  the  idea  of  the  various  degrees 
of  infection  and  especially  of  infection  by 
fomites  was  familiar  both  to  medical  men 
and  even  to  the  laity  before  Fracastor 
formulated  his  doctrines  in  1546. 

curandi    per    Iigni    indici    quod    Guayacum    vulgo 
dicitur   decoctum   exquisitissimum    methodus    .    .    . 
Paris,  1541.  Quotation  from  Chapter  VI. 
u  Remade  Fuchs,  loc.  crt.,  cli.  1. 


V.  THE  CONTENTS  OF  THE   DE  CONTAGION- 
IBUS"  OF  FRACASTOR. 

"  The  Different  Types  oj  Injection."  (Book 
1,  Chapter  2.) 

"The  essential  types  (prima  differentia)  of 
contagion  are  three  in  number: 

(1)  Infection  by  contact  only. 

(2)  Infection  by  contact  and  by  fomites 
as  scabies,  phthisis,  area?,  leprosy  (elephan- 
tiasis) and  their  kind.  I  call  fomites  such 
things  as  clothes,  linen,  etc.,  which  although 
not  themselves  corrupted,  can  nevertheless 
foster  the  essential  seeds  (seminaria  prima) 
of  the  contagion  and  thus  cause  infection. 

(3)  Finally  there  is  another  class  of  infec- 
tion which  acts  not  only  by  contact  and  by 
fomites  but  can  also  be  transmitted  to  a 
distance.  Such  are  the  pestilential  fevers, 
phthisis,  certain  ophthalmias,  the  exanthem 
that  is  called  variola,  and  their  like." 

The  distinction  of  the  degrees  of  infection 
is,  as  we  have  seen,  by  no  means  original 
to  Fracastor,  although  the  admirable  clear- 
ness with  which  he  classifies  and  discusses 
them  is  all  his  own.  Notably  the  conception 
of  fomites  is  encountered  in  many  earlier 
writings.  The  actual  term  Jomes,  however, 
may  have  been  introduced  by  Fracastor  him- 
self to  express  the  special  substance  or  carrier 
in  which  the  germs  of  disease  may  lurk. 
The  word  is  used  by  Virgil  to  mean  a 
"touchstone"  or  "tinder."  It  is  from  the 
same  root  as/orere  which,  meaning  original- 
ly "to  keep  warm,"  came  to  imply  in  poetic 
usage  "to  keep  warm  for  the  winter,"  "to 
hibernate,"  and  so  "to  lie  hidden  or  latent," 
a  shade  of  meaning  which  our  author  has 
transferred  to  his  own  special  use  of  the 
word. 

Injection  hy  Contact  Alone.  (Book  1, 
Chapter  3.) 

"  The  infection  which  passes   between 

"This  ordinance,  a  copy  of  which  is  now  in  the 
British  Museum,  has  been  translated  and  in  part 
published  by  Charles  Singer.  Annak  oj  Tropical 
Medicine  and  Parasitology,  Vol.  VI,  p.  392,  191 2. 


The  Scientific  Position  of  Girolamo  Fracastoro 


23 


fruits  is  markedly  of  this  kind,  e.g.  as 
from  one  cluster  of  grapes  to  another  and 
from  apple  to  apple.  .  .  .  The  putrefaction 
that  thus  passes  from  one  fruit  to  another 
is  really  a  dissolution  of  the  combination 
(mistionis)  of  innate  heat  and  moisture 
by  the  process  of  evaporation. 

The  humidity  [thus  set  free]  softens 
and  relaxes  the  parts  and  makes  them 
separable,  and  the  heat  effects  the  sep- 
aration. ...  I  regard  the  particles  of  heat 
and  of  moisture  separately,  or  in  the  case 
of  moisture,  perhaps  in  combination  as 
the  essential  germs  of  the  resulting  putre- 
faction (esse  principium  et  seminarium 
ejus  putrejactionis)  I  speak  here  of  the 
particles  of  humidity  in  combinationbec&use 
in  the  evaporative  process  of  putrefaction, 
it  often  happens  that  the  very  minute 
particles  mingle  themselves  and  thus 
generate  new  corruptions.  This  mingling 
or  commistion  is  indeed  especially  favor- 
able for  the  propagation  of  putrefactions 
and  infections." 

The  word  mistio  or  commistio  is  a  techical 
term  of  mediaeval  science  and  is  of  Aris- 
totelian origin.  It  is  used  to  denote  the 
manner  and  proportion  in  which  the  qualities 
or  the  elements  are  mingled  in  any  body. 
This  must  not  be  taken  to  imply  a  belief  in 
"elements"  in  the  modern  sense  of  the  word, 
a  conception  which  perhaps  first  finds  no 
place  in  scientific  literature  earlier  than  the 
works  of  Robert  Boyle  in  the  seventeenth 
century.26  In  earlier  writings,  the  concept  of 
the  elements  implies  rather  the  separable 
qualities  or  attributes  which  can  be  traced 
back  to  Aristotle's  sets  of  opposing  qualities. 
(1)  heat  and  (2)  cold,  (3)  dryness  and  (4) 
moisture,  to  which  were  sometimes  added 
(5)  rareness  and  (6)  density.  From  the  com- 
patible binary  combination  or  mistio  of  the 
first  four  of  these  six  qualities  were  derived 
the  four  elements  fire,  air,  water  and  earth. 
Thus: 

26  Robert  Boyle,  "The  Sceptical  Chymist,"  First 
edition,  London,  1661. 


elements.  qualities. 

fire      is  hot  and  dry — rare 

air       is  hot  and  moist — intermediate 

water  is  cold  and  moist — intermediate 

earth  is  cold  and  dry — dense 

These  combinations  thus  form  a  series 
with  fire,  exhibiting  especially  the  quality  of 
rarity  at  one  end  and  earth  exhibiting 
especially  the  quality  of  density  at  the  other. 
In  each  element,  therefore,  occurs  a  definite 
"commistio,"  dissolved  only  by  the  separa- 
tion of  one  of  the  essential  "qualities"  from 
its  fellow.  This  "commistio"  or  as  it  is 
sometimes  termed  "complexio"  is  made 
more  complex  by  the  fact  that  in  matter  as 
we  encounter  it,  all  the  four  elements  are 
themselves  supposed  to  be  mixed  in  various 
proportions. 

Qualities  such  as  moisture  and  heat  were 
thus  regarded  as  having  an  existence  apart 
from  the  material  in  which  they  exhibited 
themselves.  The  Mediaeval  and  Renaissance 
scientist  was  not  as  accustomed  as  we  are  to 
distinguish  vital  from  purely  chemical  phe- 
nomena. He  therefore  did  not  hesitate  to 
import  the  same  ideas  directly  into  the 
realm  of  physiology.  The  quality  heat  was 
thus  identified  with  the  warmth  of  living 
bodies.  This  warmth  or  innate  heat  was 
given  off,  as  needed,  from  the  place  of  its 
origin  and  storage,  the  heart.  For  health,  a 
definite  relationship  and  combination  be- 
tween heat  and  moistness  (among  other 
qualities)  was  considered  necessary.  If  this 
combination  and  relationship  broke  down, 
disease  resulted.  At  death,  the  innate  heat 
departed,  a  conception  intimately  related  to 
the  "abdication  of  the  Archeus"  of  later 
writers.  The  sodden  state  of  the  tissues  of  a 
corpse  was  in  like  manner  regarded  as  a 
dissolution  of  the  relationship  of  moisture 
and  innate  heat.  A  similar  but  less  marked 
dissolution  of  the  same  relationship  was 
supposed  to  be  exhibited  in  the  cedematous 
and  watery  limbs  of  the  dropsical  or  as  a 
diathesis  in  moist  and  phlegmatic  persons. 
In  other  conditions,  again,  the  qualities  of 


24 


Annals  of  Medical  History 


hotness  and  dryness  were  considered  to  be 
in  excess.  Such  were  phthisis  and  continued 
fevers  in  which  the  patient  wasted  while 
his  temperature  was  raised.  All  these  con- 
ceptions can  be  easily  traced  back  to  their 
Greek  origins. 

Injection  by  Means  oj  Fomites.  (Book  i, 
Chapter  4.) 

"  It  may  be  questioned  whether  the  in- 
fection by  a  fomes  is  of  the  same  nature 
(principium)  [as  infection  that  acts  only 
by  actual  contact].  The  nature  of  infec- 
tion by  a  fomes  appears,  indeed,  to  be 
different  since  having  left  its  original  focus 
(primo  injecto)  and  passed  into  a  fomes  it 
may  there  last  for  long  unchanged.  It  is, 
indeed,  wonderful  how  the  infection  of 
phthisis  or  pestilential  fevers  may  cling 
to  bedding,  clothes,  wooden  articles,  and 
objects  of  that  kind  for  two  or  even  three 
years,  as  we  have  ourselves  observed. 

"On  the  other  hand  those  minute  par- 
ticles given  off  by  a  body  affected  with 
putrefaction  do  not  appear  to  preserve 
their  virulence  for  long  and  on  that  ac- 
count are  not  to  be  regarded  as  of  identical 
essential  nature  (idem  principium)  either 
with  those  of  fomites  or  with  those  that 
act  by  contact  alone.  .  .  .  Not  all  sub- 
stances are  liable  to  become  fomites,  but 
only  those  that  are  porous  and  more  and 
more  or  less  calorific,  for  in  their  recesses 
the  seeds  of  contagion  can  lurk  hidden 
and  unaltered  either  by  the  medium  itself 
or  by  external  causes,  unless  these  are 
excessive,  e.g.  they  cannot  withstand  fire. 
Thus,  iron,  stone,  and  cold,  impervious 
substances  of  this  kind,  are  hardly  likely 
to  act  as  fomites;  on  the  other  hand  linen, 
cloth  and  wood  are  much  more  apt  to  do 
so." 

Fracastor  here  regards  the  "seeds  of 
disease"  as  comprising  two  distinct  groups. 
Infection  by  contact,  he  has  already  ex- 
plained as  comparable  to  what  we  may  call 
coarse  chemical  action.  In  the  case  of  infec- 


tion by  fomes,  on  the  other  hand,  he  pre- 
supposes invisible  particles  which  convey 
the  condition  and  which  are  capable  of 
lurking  in  the  recesses  of  a  pervious  sub- 
stance. It  is  to  these  that  he  applies  the 
term  "semina."  If  we  seek  for  a  parallel  in 
modern  scientific  conceptions  we  may  per- 
haps compare  the  action  of  these  to  cat- 
alytic action,  provided  always  that  we 
remember  that  Fracastor  does  not  draw  the 
distinction  between  chemical  action  and  the 
action  of  living  organisms  which  is  a  com- 
monplace with  us. 

Injection  at  a  Distance.  (Book  1,  Chapters 

5-7.) 

"It  is  well  known  that  the  pestilential 
fevers,  phthisis  and  many  other  diseases 
are  liable  to  seize  on  those  who  live  with 
the  infected,  although  they  have  come 
into  no  direct  contact  with  them.  It  is  no 
small  mystery  by  what  force  the  disease 
thus  propagates  itself.  .  .  .  For  this  type 
of  contagion  appears  to  be  of  quite  a 
different  nature  and  to  act  on  a  quite 
separate  method  to  the  others.  .  .  .  Thus 
a  patient  with  ophthalmia  may  give  his 
disease  to  another  by  merely  looking  at 
him  (per  vocatas  species  et  simulacra 
rerum).  .  .  This  well  illustrates  the  rapid 
and  almost  instantaneous  penetrative 
power  of  this  type  of  contagion  .  .  . 
which  may  be  compared  to  the  poisonous 
glances  of  the  catablepha." 

The  catablepha  is  one  of  the  few  instances 
in  which  our  author  describes  an  event 
which  we  should  regard  as  miraculous.  The 
description  of  the  creature  doubtless  reached 
him  through  Pliny  27  where  we  read: 

"In  the  eastern  part  of  Ethiopia  is  the 
source  of  the  Niger  and,  as  many  think,  of 
the  Nile  also.  There  dwells  a  savage  beast 
called  the  Catoblepas,  small  in  size  and 
slow  of  movement,  and  with  a  head  of 
disproportionate  greatness  and  only  with 

"  C.  Plinius  Sec.  Naturalis  historia,  VIII,  21. 


The  Scientific  Position  of  Girolamo  Fracastoro 


25 


difficulty  borne  so  that  it  carries  it  always 
on  the  ground.  The  animal  has  eyes  which 
are  fatal  to  mankind,  for  all  on  whom  it 
looks  fall  suddenly  dead.  The  basilisk  has 
the  same  power." 

Before  the  invention  of  the  microscope 
and  the  resulting  discovery  of  minute  living 
things  it  was  just  such  analogies  that 
afforded  suggestions  for  the  mysterious 
conveyance  of  infectious  disease.  Through- 
out the  sixteenth  and  the  following  century, 
the  works  of  the  ancients,  as  well  as  travel- 
ers' tales  of  newly  discovered  countries, 
were  ransacked  again  and  again  to  provide 
such  analogies  for  the  process  of  infection. 
The  last  hours  of  many  a  wretched  sufferer 
must  have  been  embittered  by  the  sordid 
fear  of  his  companions  lest  a  touch  or  even 
a  glance  or  a  word  from  him  might  convey 
some  dread  disease.28  The  kindred  belief  in 
the  evil  eye  lingers  yet  in  Fracastor's 
country. 

In  the  passage  above  quoted,  Fracastor 
meets  with  the  first  great  difficulty  of  the 
germ  theory,  the  passage  of  infection  from 
one  body  to  another  through  intervening 
space.  He  hastens  to  assure  us,  however, that 
"the  causes  of  infection  acting  at  a  distance 
need  not  be  referred  to  occult  influences" 
and  proceeds  to  elaborate  a  suggestion  as  to 
how  "the  seeds  of  contagion  may  be  carried 
to  a  distance  and  on  to  the  world  at  large" 
(Chapter  7).  This  doctrine  we  may  call  the 
theory  oj  halitus  or  doctrine  oj  exhalation.  It 
was  very  popular  in  the  sixteenth  century 
and  was  further  elaborated  by  Hieronymo 
Cardano  (1 501-1576)  and  Andrea  Cesalpino 
(1519-1603).  The  theory  supposes  that  all 
bodies,  and  especially  the  more  moist  and 
volatile,  are  constantly  giving  oft  particles 
that  may  make  themselves  appreciable  to 
the   senses    as    vapors    or    odors.     If    the 

28  A  good  collection  of  stories  concerning  the 
miraculous  conveyance  of  disease  by  glances,  etc., 
may  be  found  in  a  work  by  the  learned  Alexander 
Ross,  the  opponent  of  Sir  Thomas  Browne,  entitled 
"  Microcosmography, "  London,  16. 


halitus  of  an  onion — which  we  can  ap- 
preciate by  the  sense  of  smell — can  produce 
a  watery  discharge  from  the  eye,  why  should 
not  the  halitus  of  an  ophthalmia,  acting 
similarly  at  a  distance,  produce  a  purulent 
discharge?  Furthermore  many  such  sub- 
stances may  have  the  properties  of  poisons 
or  of  remedies.  Men  may  be  suffocated  by 
vapors  or  they  may  be  revived  from  faint- 
ing by  the  minute  particles  that  make  up 
subtle  and  acrid  smells.  There  is  this  differ- 
ence between  such  exhalations  and  those  of 
disease;  the  former  act  at  once,  the  latter 
after  an  interval  or  incubation  period.  Here 
Fracastor  has  an  hypothesis  ready: 

"One  method  of  penetration  of  the  seeds 
of  infection  is  by  propagation  and  genera- 
tion (sobolem).  For  the  seeds  attach  them- 
selves to  those  humors  with  which  they 
have  an  affinity  and  produce  others  like 
to  themselves,  until  at  last  the  whole  mass 
and  body  of  the  humors  is  affected. 
Another  method  is  by  attraction  and 
entering  by  inspiration  or  by  dilatation  of 
the  vessels.  For  when  the  admixed  semi- 
naria  are  sucked  in  with  the  breath,  though 
it  is  easily  inhaled  it  is  not  so  readily 
exhaled  and  may  thus  adhere  to  the 
humors  and  even  the  spirits  which, 
expelling  that  which  is  contrary  and 
inimical,  send  them  to  the  heart." 

The   Affinities   (Analogise)   oj   Injections. 
(Book  1,  Chapter  8.) 

"The  affinities  (analogic)  of  infections 
are  numerous  and  interesting.  Thus  there 
are  plagues  of  trees  which  do  not  affect 
beasts  and  others  of  beasts  which  leave 
trees  exempt.  Again  among  animals  there 
are  diseases  peculiar  to  men,  oxen,  horses 
and  so  forth.  Or,  if  separate  kinds  of  living 
creatures  are  considered,  there  are  diseases 
affecting  children  and  young  people  from 
which  the  aged  are  exempt  and  rice  versa. 
Some  again  only  attack  men,  others 
women,  and  others  again  both  sexes. 
There  are  some  men  that  walk  unharmed 


26 


Annals  of  Medical  History 


amid  the  pestilence  while  others  fall. 
Again  there  are  infections  which  have 
affinities  for  special  organs.  Thus  oph- 
thalmia affects  only  the  eye.  Phthisis  has 
no  effect  upon  that  most  delicate  organ 
but  acts  especially  upon  the  lungs.  Alo- 
pecia? and  Areae  confine  themselves  to  the 
head." 

Is  Injection  a  Sort  oj  Putrefaction?  (Book 
i,  Chapter  9.) 

"We  here  consider  whether  all  infection 
is  a  sort  of  putrefaction  and  also  whether 
putrefaction  is  not  itself  infectious.  .  .  . 
Now  with  Rabies  have  we  not  infection 
without  any  putrefaction?  Again,  when 
wine  becomes  vinegar  have  we  not  infec- 
tion without  putrefaction?  For,  if  left  to 
putrify,  it  is  later  that  it  becomes  fetid 
and  undrinkable — the  sure  signs  of  putre- 
faction— and  thus  differs  from  vinegar 
which  is  pleasant  to  take  and  is  indeed 
resistant  to  putrefaction. 

But  it  must  be  remembered  as  regards 
putrefaction  that  sometimes  there  is  but 
a  simple  dissolution  of  the  combination 
(mistio)  of  humidity  and  innate  heat  with- 
out any  new  generation — we  then  speak 
of  it  as  simple  putrefaction.  Sometimes  on 
the  other  hand,  in  the  process  of  this 
dissolution,  there  is  a  true  animal  genera- 
tion or  generation  of  some  substance 
definitely  organized  and  arranged  (gen- 
eratio  aliqua  provenil  aut  animalis  aut 
alterius  quod  J or  mam  unam  el  certain  habel 
et  mistionis  rationem,  ac  digestionem  suam). 

When  there  is  simple  putrefaction,  there 
is  no  new  generation  but  a  fetor  and  a 
horrible  taste  arise  .  .  .  but  when,  on  the 
other  hand,  there  is  production  of  a  new 
generation,  there  is  neither  the  abominable 
smell  nor  taste  but  a  definite  redistribu- 
tion of  the  qualities  (digestio  ordoque 
partium  pro  certa  Jorma).  As  with  wine 
...  so  also  with  milk  and  with  phlegm, 
the  first  stage  ol  putrescence  is  acidity. 
Similarly  with  Rabies,  we  must  suppose  a 


preliminary  stage  in  which  there  is  a 
certain  amount  [of  the  same  preliminary 
type]  of  putrescence.  It  is,  however,  latent 
because  putrefactions  which  take  place  in 
the  living  animal  do  not  make  themselves 
immediately  apparent.  It  is  an  observed 
fact,  however,  that  dogs  which  are  becom- 
ing rabid  are  usually  seized  with  febrile 
symptoms.  If,  therefore,  we  regard  the 
matter  inductively  (si  igitur  in  omnes 
contagiones  inductiofiat),  we  shall  consider 
that  all  infections  may  be  reduced  ulti- 
mately to  putrefaction.  .  .  .  Furthermore, 
all  putrefactions  are  liable  to  produce 
putrefactions  of  like  kind  to  themselves, 
and,  if  all  infection  is  putrefaction,  in- 
fection in  the  ordinary  sense  oj  the  word  is 
nothing  else  thaii  the  passage  oj  a  putrejac- 
tion  jrom  one  body  to  another  either  con- 
tiguous with  it  or  separated  jrom  it." 

The  use  of  the  word  generation  in  six- 
teenth century  science  is  often  puzzling. 
The  term  is  constantly  used  by  chemists 
and  alchemists,  e.g.  Paracelsus,  CampancIIa 
and  Comenius,  without  any  thought  of 
attributing  specifically  living  properties. 
The  conception  is  adopted  from  the  Aris- 
totelian system  in  which  generation  is  the 
equivalent  of  the  coming  of  a  thing  into 
being  and  is  the  opposite  of  decay  or  cor- 
ruption which  is  the  passing  of  a  thing  out 
of  being,  both  being  regarded  as  varieties  of 
motion,  a  term  that  also  had  for  Aristotelians 
a  meaning  wider  than  is  now  given  it.29  We 
must  therefore  note  again  that  a  vitalistic 
interpretation  must  not  be  placed  on  the 
word  generation  as  used  by  Fracastor. 

In  What  Respects  Injections  Resemble  Poi- 
sonsandin  What  They  Differ.  (Book  1,  Chap- 
ter 11.) 

"There  are  certain  infections  which 
resemble  .  .  .  poisons,  since,  like  them, 
their  venom  lies  insidiously   latent   until, 

"Aristotle,  "  I  )c  DlOtU  animalimn,"  Seet.  5,  unci 
the  "Dc  corruptione  et  generatione." 


The  Scientific  Position  of  Girolamo  Fracastoro 


27 


having  reached  the  heart  they  kill  the 
animal  and  on  this  account  certain  fevers 
are  frequently  called  venomous.  But  there 
is  really  a  great  distinction  between  them. 
Poisons  cannot  in  themselves  produce  pu- 
tridity, nor  can  they  reproduce  in  a  second 
body  such  seeds  and  essence  of  their  nature 
as  may  be  in  that  primarily  affected.  Those 
who  are  poisoned  do  not  infect  others. 

Now  of  poisons  there  are  two  kinds. 
The  one  acts  through  its  spiritual  quality. 
Such  is  the  poison  of  most  serpents  and 
glance  of  the  Catablepha.  The  other  acts 
through  its  material  quality." 

Concerning  Other  Differentiae  0/  Injections. 
(Book  i,  Chapter  12.) 

"It  is  manifest  that  the  seeds  of  con- 
tagion arise  first  in  ourselves.  This  takes 
place  not  only  in  scabies,  achores,  and 
phthisis  but  even  in  the  pestilential  fevers. 
The  production  of  these  is  as  follows:  the 
corrupted  humors  being  obstructed  are 
delayed  and  finally  stopped,  they  give 
rise  to  these  seeds.  That  these  [seeds]  are 
the  carriers  of  the  contagion  we  have  said 
above,  and  that  they  are  the  first  origin 
of  the  disease  there  can  be  no  doubt.  It 
is  a  more  vexed  question  whether  in  one 
secondarily  affected,  there  is  the  same 
putrefaction  of  obstructive  and  corruptive 
origin  or  no.  For  if  not  how  do  the  new 
seeds  arise  which  enable  a  third  person  to 
be  infected?  But  if  this  putrefactive  pro- 
cess does  ensue,  how  can  it  arise  when  the 
same  causes  are  not  acting  in  the  second 
body  that  were  acting  in  the  first?  .  .  . 

To  this  it  must  be  answered  that  there 
is  indeed  produced  in  the  second  body  an 
obstructive  and  corruptive  putrefaction 
.  .  .  and  that  this  process  is  produced  by 
the  clogging  effect  (inhsesionem)  of  the 
same  seeds.  Thus  the  essence  (principium) 
and  seeds  of  the  disease  were  exactly  the 
same  in  the  second  body  as  in  the  first 
and  it  may  be  considered  that  the  force 
of  the  disease  lies  in  those  seeds,  since 


they  have  the  power  to  propagate  and 
reproduce  their  own  kind." 

In  order  to  explain  the  first  origin  of  a 
fever,  Fracastor  associates  with  his  view  of 
putridity  of  the  humors,  the  current  theory 
of  "obstructions"  of  the  humors.  The 
humors  in  health  were  represented  as 
perpetually  flowing,  and  many  pathological 
appearances  such  as  abscesses,  pulmonary 
tubercles,  lymphatic  nodules  and  fibrotic 
areas  were  interpreted  as  due  to  the  inter- 
ruption of  the  flow  and  the  consequent 
humoral  change,  which  led  to  their  solid- 
ification. 

"As  has  been  said  there  is  a  power  in  these 
seeds  that  they  may  multiply  and  propagate 
their  like.  Those  causes  then  which  pro- 
duce obstructions,  plethoras  and  corrup- 
tions of  the  humors  by  which  they 
become  fouled,  putrified  and  occluded 
give  rise  to  seeds  that  can  convey  the 
infection  to  others,  whether  the  same 
causes  and  dispositions  be  acting  in  those 
others  or  not,  whence  they  may  carry  the 
same  contagion  to  a  second  and  third. 

But  the  essence  and  seminaria  of  con- 
tagion may  also  come  to  us  from  an 
extrinsic  source.  Thus  we  see  diseases 
spreading  in  the  population  as  a  whole. 
Epidemics  as  they  are  called,  of  which 
some,  though  not  contagious,  may  affect 
many  cities  or  regions  and  are  then  called 
communes;  others  again  of  these  are  con- 
tagious and  pass  from  one  to  another 
without  atmospheric  disposition,  these 
are  called  non  communes." 

Thus  Fracastor  also  declares  his  belief  in 
the  spontaneous  generation  of  the  semina  or 
rather  he  assumes  it  as  a  matter  of  course. 
Since  no  question  of  universal  biogensis 
such  as  that  professed  to-day  had  or  could 
have  reached  Fracastor,  the  whole  question 
as  to  whether  he  regarded  his  "seeds  of 
disease"  as  living  or  not  has  very  little 
meaning.  The  lower  animals  were  regarded 
by  him  and  his  contemporaries  as  frequently 


28 


Annals  of  Medical  History 


"generated"  from  mud  and  slime,  a  belief 
often  referred  to  Aristotle  but  which  could 
be  traced  with  more  reason  far  beyond  him 
and  back  to  the  realm  of  primitive  belief. 
For  writers  of  the  sixteenth  century  the  gap 
that  was  later  recognized  between  the 
organic  and  inorganic  world  did  not  exist, 
and  the  cleavage  between  materialists  and 
vitalists  had  therefore  not  assumed  any 
defmiteness. 

The  chapter  continues  with  an  interesting 
reference  to  an  epidemic  of  typhus  and 
another  of  foot  and  mouth  disease. 

"That  pestilence  which  swept  through 
Greece  and  is  described  by  Thucydides 
was  contagious  and  so  were  those  which 
have  in  our  time  appeared  in  Italy  and 
are  by  some  called  lenticulx,  by  others 
puncticula.  We  may  refer  also  to  the 
extraordinary  infection  of  the  year  15 14 
which  broke  out  in  cattle  which  appeared 
first  at  Friuli  and  thence  spread  to  our 
district.  The  beast  would  first  refuse  food 
without  any  reason  that  could  be  dis- 
cerned in  the  mouth  by  the  herdsmen, 
then  a  roughness  with  little  pustules 
became  distinguishable  on  the  palate  and 
throughout  the  mouth.  If  the  infected 
beast  was  not  segregated  without  delay 
it  would  infect  the  whole  herd.  Slowly 
the  tetter  (labes)  would  reach  the  feet.  If 
a  change  then  set  in,  they  almost  all 
recovered,  but  if  it  did  not  they  mostly 
died." 

There  follows  a  declaration  in  the  belief 
of  the  celestial  origin  of  some  epidemics  and 
a  statement  of  the  value  of  astrology. 

"Of  the  causes  which  act  from  without 
the  most  potent  is  air  itself  though  waters 
and  marshes  have  also  their  influence. 
Now  it  must  be  remembered  that  air 
varies  in  quality  with  heating,  cooling, 
drenching,  and  drying,  and  not  only  so 
hut  vapors  pass  into  our  bodies  both 
simple  and  also  containing  seminaria  of 
contagion.  .  .  . 


It  should  perhaps  be  considered 
whether  any  contagions  are  derived  from 
the  heaven  and  from  the  stars  since 
astrologers  have  often  foretold  future  dis- 
eases and  epidemics.  At  any  rate  it 
appears  that  they  foretold  the  syphilis 
or  morbus  gallicus  many  years  before  it 
appeared." 

It  may  be  at  first  startling  to  find  a  belief 
in  astrology  expressed  by  one  so  tempera- 
mentally sceptical  as  Fracastor.  It  must  be 
remembered,  however,  that  in  the  first  half 
of  the  sixteenth  century  the  influence  of  the 
planets  on  human  affairs  was  the  working 
hypothesis  of  the  advocates  of  Naturalism. 
It  was  a  view  of  Nature  that  stood  in  broad 
opposition  to  the  theocratic  teaching  of 
Christianity.  The  theory  thus  occupied  a 
place  among  the  naturalistic  school  some- 
what similar  to  that  filled  by  the  Theory  of 
Evolution  in  the  last  third  of  the  nineteenth 
century. 

Thus  closes  the  first  book  of  the  De 
Contagionibus.  With  the  two  remaining 
books  we  are  hardly  concerned  here.  The 
second  describes  the  varieties  of  infectious 
disease  known  to  Fracastor  and  includes 
phthisis.  The  third  deals  with  remedies. 
We  may  terminate  our  extracts  with  Fra- 
castor's  description  of  epidemic  typhus 
which  he  tells  us  broke  out  with  especial 
virulence  in  his  country  in  1505  and  1528, 
though  it  had  been  known  previously  in 
Cyprus  and  the  neighboring  isles.  His 
description  of  this  disease  gives  a  fair  idea 
of  his  clinical  method. 

"This  fever  is  infectious  but  it  is  not 
conveyed  through  the  air  (ad  distans)  nor 
by  fomites  but  by  the  actual  handling  of 
the  sick.  The  onset  as  with  all  pestilential 
fevers  is  insidious  (placidus)  and  mild  so 
that  the  patient  hardly  desires  to  see  a 
doctor  and  thus  many  physicians  have 
been  misled  looking  to  an  early  resolu- 
tion of  the  malady.  Soon,  however,  the 
signs   of  a    malignant    fever   put    in    an 


The  Scientific  Position  of  Girolamo  Fracastoro 


29 


appearance,  and  after  the  manner  of  such 
disease,  the  patient  may  not  feel  marked 
febrile  symptoms  yet  constitutional  dis- 
turbance (perturbatio  interne)  becomes 
obvious.  There  is  prostration  and  lassi- 
tude of  the  whole  body,  as  though  he  were 
exhausted.  He  lies  supine,  the  head  aches, 
the  senses  are  dulled,  the  mind  wanders, 
the  eyes  are  reddened  and  he  chatters 
constantly. 

"The  urine  is  at  first  copious  and  clear, 
later  it  becomes  ruddy  and  turbid  like 
pomegranate  wine.  The  pulse  becomes 
small  and  slow,  the  motions  corrupt  and 
fetid.  About  the  fourth  or  seventh  day, 
reddish  spots  appear  on  arms,  back  and 
chest.  Often  they  are  punctiform  like  flea 
bites  or  larger  and  of  the  size  of  lentils. 

"There  is  little  or  no  desire  for  drink  but 
the  tongue  is  covered  with  sordes.  Some 
patients  are  somnolent,  others  restless,  in 
others  the  conditions  alternate.  This  state 
continues  for  seven  or  fourteen  days  or 
even  longer.  In  others,  there  is  reten- 
tion of  urine,  a  sign  of  the  utmost  gravity. 
Women  seldom  die  of  this  disease,  old 
people  seldomer  and  Jews  never.  It  chiefly 
carries  off  the  youthful  and  especially  the 
gentle,  contrary  to  the  pestilences  which 
rage  among  the  poorer  classes.  The  follow- 
ing are  of  evil  prognosis : 

"If  the  patient  feels  prostration  at  the 
onset  of  the  disease,  if,  when  he  be  given 
a  medicine,  the  result  is  out  of  proportion 
to  the  dose,  if  no  relief  comes  from  the 
crisis  (we  have  seen  a  case  where  three 
measures  of  blood  burst  from  the  nose 
and  shortly  after  the  patient  yielded  up 
the  ghost).  It  is  an  ill  sign  if  there  is 
retention  of  urine,  if  the  eruption  does  not 
appear  or  is  but  slight  or  if  it  is  livid  and 
very  spotty.  If  all  or  many  of  these  are 
present,  a  fatal  issue  is  certain." 

VI.  THE  SOURCES  OF  FRACASTOR's  SEMINARIA 
HYPOTHESIS 

The    ultimate    source    of   the    seminaria 


hypothesis  expounded  by  Fracastor's  work 
is  to  be  sought  in  the  atomic  theories  of 
Democritus  and  other  early  Greek  writers. 
This  atomistic  view  of  matter  was  developed 
by  Epicurus  and  his  followers,  as  well  as  by 
their  opponents  of  other  schools.  In  the 
hands  of  Lucretius,  atomism  is  very  definite 
but  is  associated  with  a  conception  of  growth 
or  development  in  nature,  whereby  many 
things  are  regarded  as  arising  from  "seeds" 
or  semina  by  the  attraction  to  these  semina 
of  other  material  particles. 

In  spite  of  the  opposition  to  Epicurean- 
ism, of  the  non-materialistic  schools  of  later 
Greek  thought,  views  on  the  atomic  nature 
of  matter  were  largely  absorbed  by  the 
Gnostics,  Basilidians  and  Neoplatonists:  al- 
though, among  all  these  sects,  the  philo- 
sophical necessity  of  deriving  the  Universe 
in  some  way  from  the  ultimate  divine 
essence  or  logos  enforced  the  addition  of  the 
element  of  generation,  an  idea  that  is  ex- 
cluded in  the  system  of  Lucretius.  Thus 
among  these  mystically  inclined  sects  we 
find  the  conception  of  the  material  universe 
as  a  whole  and  also  its  constituent  parts 
arising  in  turn  from  such  seeds  planted  by 
the  godhead.  In  a  Gnostic  work  of  the  third 
century  attributed  to  Hippolytus,  we  read 
how  before  the  Universe  yet  was: 

"The  seed  of  the  cosmos  had  all  things  in 
itself;  just  as  the  mustard-germ  gathers 
together  in  the  tiniest  point  and  holds 
at  the  same  time — roots,  stem,  branches, 
and  leaves,  the  countless  products  of  the 
one  plant's  germs,  when  other  and  still 
many  other  plants  shed  in  turn  their 
seeds,"  and  the  same  writer  speaks  re- 
peatedly in  the  same  phrases  as  Lucretius 
but  with  a  different  meaning  of  "the  seed 
power  of  the  seeds  of  every  kind  of  thing 
that  is  in  this  material  world."30 

30  See  E.  Miller  "Origenis  philosophumena," 
Oxford  185 1  and  L.  Duncker  and  F.  C.  Schneidewin, 
"S.  Hippolyti  Ref.  Om.  Haer,"  Gottingen,  1859.  The 
work  is  translated  by  G.  R.  S.  Mead  in  "The  Quest," 
V,  1,  p.  58,  Oct.  1913. 


30 


Annals  of  Medical  History 


Such  Gnostic  or  Neoplatonic  conceptions 
were  seized  by  St.  Augustine  (354-430),  who 
transmitted  them  to  later  times.  Augustine 
considered  that  God  had  deposited  in 
matter  a  hidden  treasure  of  active  forces. 
These  were  the  seminal  principles  or  rationes 
seminales,zl  whose  successive  germination 
in  the  womb  of  matter  produce  the  different 
species  of  corporeal  beings.  There  was,  he 
considered,  a  distinct  germ  corresponding  to 
each  natural  kind  or  species  of  body.32  This 
Augustinian  conception  lasted  right  through 
the  Middle  Ages.  The  saintly  mystic  St. 
Bonaventure  (died  1274)  had  recourse  to 
these  rationes  seminales  in  order  to  dis- 
tinguish mere  transformations  of  natural 
substances  from  creation  and  annihilation,33 
and  the  same  position  was  assumed  by 
Albert  the  Great  (1 193-1280),  who  in  this 
respect  deviated  from  the  Aristotelian  notion 
of  primal  matter  purely  potential.  The 
works  of  both  Bonaventure  and  Albert  were 
very  frequently  printed  in  Italy  in  the  latter 
fifteenth  and  early  sixteenth  centuries. 

But  there  was  another  and  more  direct 
source  of  the  doctrine  of  seminaria  than 
either  the  Church  fathers  or  the  scholastic 
doctors  that  lay  open  to  a  sixteenth  century 
humanist.  The  work  of  Lucretius  himself, 
neglected  throughout  the  Middle  Ages  as 
Epicurean  and  antitheistic,  had  been  dis- 
covered by  the  scholar  Poggio  as  early  as 
141 8.  The  first  printed  edition  of  the  "De 
rerum  natura"  appeared  at  Brescia  in  1473 
and  it  was  reprinted  in  Fracastor's  own  city 
of  Verona  in  i486.  Moreover,  Navageo, 
Fracastor's  most  intimate  friend  and  a 
fellow  pupil  of  Pomponazzi,  reedited  Lu- 
cretius for  the  Venice  Aldine  edition  of  15 16. 
The  atomic  theory  of  Lucretius  was  thus 
quite  familiar  to  Fracastor.34  Now  in  the 
De  rerum  natura  we  may  find  actual  refcr- 

"  St.  Augustine  De  gen.  ad  litt.,  VII,  28. 
"Sec  Maurice  dv  Wulf,  History  of  Mediaeval  Phi- 
by  P.  Coffey,  London  1909,  p.  93. 
a  M.  de  Wulf,  Loc.  cit.,  p.  287  and  Quaracchi, 
edition  t  II.  p.  198. 

**Cp.   Fracastor's  "Dc  sympathia  et  antipathia 


ence  to  the  "seeds"  of  diseases,  and  although 
these  Lucretian  seeds  were  by  no  means 
identical  with  those  of  Fracastor,  it  may  be 
safely  assumed  that  the  Renaissance  writer 
owed  a  large  element  in  his  conception  to 
his  Epicurean  predecessor.  "  I  will  explain," 
writes  Lucretius,  "the  law  of  diseases"  .  .  . 

"I  have  already  shown  that  there  are 
seeds  of  many  things  helpful  to  our  life, 
and  there  must  also  be  many  that  fly 
about  conducing  to  death  and  disease. 
When  these  by  chance  happen  to  gather 
together  and  disorder  the  atmosphere  the 
air  becomes  distempered."  35 

Again  in  another  part  of  the  poem  the 
disease  of  erysipelas  is  described  as  arising 
from  such  seeds.36 

Fracastor's  "seeds"  of  disease  combine 
some  of  the  qualities  of  the  "semina"  of 
Lucretius  with  the  "seeds"  of  the  species 
of  things  in  the  patristic  writings.  It  is 
noteworthy  that,  in  setting  forth  his  seminal 
hypothesis,  Fracastor  does  not  seem  to  con- 
sider that  he  is  making  any  especially 
original  contribution.  He  rather  assumes  a 
knowledge  of  "semina"  on  the  part  of  his 
readers  and  does  not  attempt  to  explain 
their  essential  nature.  It  is  on  this  applica- 
tion of  the  theory  rather  than  on  the  theory 
itself  that  he  spends  himself,  and  it  is  Fra- 
castor's specific  use  of  the  terms  "semina" 
and  "seminaria"  which  was  so  pregnant  with 
suggestion  in  his  own  and  the  following 
centuries. 

VII.      KINDRED      HYPOTHESES     OF     SOME     OF 
fracastor's  CONTEMPORARIES 

With  a  Discussion  of  the  Influence  0/  tbt 

Doctrine  of  Seminaria 
The  sources   from   which   we   have  sug- 
gested that  our  author  derived   his  views 

rerum,"  Ch.  5.  "De  attractions  et  motu  siinilium 
ad  similia." 

M  Lucretius  Dc  rerum  natura,  Lib.  VI,  line  1090 
it  ttq.  in  II.  A.  J.  Munro's  edition. 

**  Loc.  cit.  Lib.  VI,  line  660  in  II.  A.  J.  Munro's 
edition. 


The  Scientific  Position  of  Girolamo  Fracastoro 


3i 


were  open  to  others  besides  Fracastor.  Of 
these  we  have  already  mentioned  Remade 
Fuchs  of  Limburg,  who  uses  the  word  semi- 
naria  in  much  the  same  sense  as  Fracastor 
himself.  Another  contemporary  who  dwells 
on  the  same  theme  was  Paracelsus  (1490- 
1541).  Life  this  writer  regarded  as  a  per- 
petual germinative  process,  controlled  by  an 
indwelling  spirit  or  Archeus.  Developing 
this  idea,  Paracelsus  attained  a  sufficiently 
clear  conception  of  the  method  by  which 
disease  is  propagated  to  lead  him  to  speak 
of  the  morbific  "seeds." 

Whatever  may  be  the  verdict  on  this 
extraordinary  man  as  a  pioneer  of  medical 
thought,  it  is  certain  that  he  had  none  of 
the  clearness,  brevity  and  skill  in  classifica- 
tion of  his  humanist  contemporary  Fra- 
castor, nor  had  he  the  same  power  of  con- 
secutively developing  a  subject.  We  here 
quote  a  passage  involving  the  theory  of 
"semina"  from  his  work,  "The  Doctor's 
Labyrinth."37  The  chapter  gives  a  fair  idea 
of  the  intricacies  and  difficulties  of  his  style. 
We  have  added  a  certain  amount  of  explan- 
atory material  derived  from  other  parts  of 
the  same  work. 

0/  the  Book  0/  the  Birth  of  Diseases,  to  be 
Recognized  from  the  True  Philosophy. 

"One  thing  further  it  is  necessary  to 
explain,  namely  the  origin  of  diseases 
according  to  the  content  of  philosophy. 
Thus  you  all  know  well  that  the  ancients 
set  forth  the  teaching  of  the  four  Humors, 
how  that  from  them  all  diseases  arise  and 
in  them  they  take  their  birth;  but  they 
forget  withal  the  veritable  origin  of  disease, 
that  is,  from  the  seeds  from  which  the  dis- 
eases grow.  None  the  less,  I  know  full  well 
that  man  is  a  Microcosm,  wherefore  he 
must  have  within  him  the  four  Elements 

37  The  "Labyrinthus  medicorum  errantium"  first 
appeared  in  1553  after  the  death  of  Paracelsus.  We 
have  not  been  able  to  see  the  original  edition  but 
have  translated  the  passage  from  the  version  in 
Huser's  edition,  Strassbourg,  1598. 


which  they  call  Humors.  [Thus  the 
Elements  of  the  Macrocosm  are  equated 
with  the  Humors  of  the  Microcosm]. 
Now  the  Elements  (like  the  Humors) 
give  naught  but  only  receive.  And  even 
as  a  woman  cannot  become  pregnant 
without  a  man,  so  must  the  feminine 
Elements  receive  from  their  man  as  from 
the  aforesaid  Vulcan  [i.e.  the  Elements 
must  act  the  part  of  the  female  Venus 
towards  the  seeds  which  are  the  male 
Vulcan],  as  this  following  example  show- 
eth  forth.  The  apple  groweth  from  its  seed 
and  the  seed  is  in  the  apple,  and  is  the 
Sperm  of  Vulcan.  But  in  the  Elements  it 
findeth  a  Matrix,  it  taketh  therefrom 
Nourishment,  Substance,  Form  and  its 
complete  Being  and  it  emergeth  therefrom 
according  to  the  nature  of  its  Predestina- 
tion, as  a  child  emergeth  complete  from 
out  of  its  mother. 

[i.e.  the  seed  of  the  apple  acts  as  male  to 
the  substance  or  elements  of  the  apple 
which  are  female.  It  must  be  remembered 
that  Paracelsus  knew  nothing  of  sex  in 
plants  or  of  the  fertilization  of  flowers 
necessary  to  produce  fruits.  He  sought,  how- 
ever, like  many  after  him,  to  bring  the 
generation  of  plants,  which  was  for  him  an 
apparent  case  of  equivocal  generation,  into 
line  with  the  better  understood  types  of 
sexual  generation]. 

"  Thus  diseases  are  caused  not  by  the 
Elements  themselves  but  by  the  seeds  which 
are  soivn  therein,  which  accordingly  grow 
in  them  into  their  final  being  and  material. 
.  .  .  He  then  who  would  understand 
Disease  will  recognize  it  under  the  simile 
of  a  tree.  One  will  bear  apples,  another 
pears,  another  nuts  and  so  on.  Thus  also 
is  the  difference  between  diseases,  and 
thus  shall  diseases  be  recognized  accord- 
ing to  the  Humors,  that  is  according  to 
the  Father  and  not  according  to  the 
Mother.  The  child  is  truly  born  of  the 
Mother,   but  also  of  the   Father.   Who 


32 


Annals  of  Medical  History 


therefore  will  say  or  admit  that  one 
should  seek  the  disease  as  a  Humor  and 
judge  the  Humor  to  be  the  Disease?" 

Another  interesting  contemporary  of  Fra- 
castor  was  Jerome  Cardan  (1501-15-6),  who 
although  he  did  little  directly  to  develop 
the  theory  of  infection,  yet  made  suggestions 
that  in  the  hands  of  others  became  exceed- 
ingly fertile.  Cardan's  conception  of  matter 
as  more  or  less  animated  was  derived  either 
from  the  Timseus  itself  or  more  probably 
from  some  Neoplatonic  author.  It  was  Car- 
dan who  gave  a  hint  to  many  writers  of  the 
succeeding  century  who  combined  his  con- 
ceptions of  animated  matter  with  the  views 
of  Fracastor  on  the  semina  of  disease.  The 
early  Epicurean  thinkers,  like  modern  ma- 
terialistic writers,  had  sought  to  bridge  the 
gulf  between  atoms  and  living  things  by 
explaining  life  as  due  to  atomic  action. 
Cardan,  the  Neoplatonist,  like  Plato  in  his 
Timseus  before  him  and  like  Leibnitz  and 
many  after  him,  got  over  the  difficulty  by 
attributing  living  qualities  to  the  atoms 
themselves. 

The  discursive  style  of  Cardan  has  none 
of  Fracastor 's  accuracy,  although,  when  deal- 
ing with  purely  mathematical  or  physical 
questions,  he  could  be  incisive  enough.  In 
the  writings  of  Cardan,  we  should  seek  in 
vain  for  the  worked-out  conclusions  that  we 
now  associate  with  scientific  authorship. 
Nc\  ertheless, his  volumes  of  hazy  philosophy 
contain  buried  in  their  learned  and  ingenious 
pages  a  mass  of  original  and  suggestive 
thought  bearing  on  scientific  subjects  that 
is  probably  not  exceeded  in  importance  by 
any  writer  of  his  century.   As  an  author  he 

"The  worm-like*  original  of  animals  is  fore- 
shadowed by  Aristotle  (Historia  animalium.  Book 
V,  ch.  17)  and  could  doubtless  be  traced  Forward 
through  Neoplatonic  and  Gnostic  channt -Is. 

"Cardan's  scientific  views  are  contained  mainly 
in  his  De  subtilate,  first  (imperfect)  edition  Nurem- 
berg, 1550,  second  edition,  Paris,  1551,  and  his  De 
e,  1556.  For  a  careful  analysis  of  the  difficult 
subject  of  his  views  on  the  essentially  living  nature 
of  all  matter  see  the  analysis  of  Rimer  and  Siber, 


was  suggestive  and  subtle  rather  than  direct 
and  obvious  and  we  may  continually  meet 
his  phrases  quoted,  often  perhaps  uncon- 
sciously, by  the  writers  of  his  own  and  the 
succeeding  age.  His  name  may  for  our 
present  purpose  be  specially  associated  with 
the  belief  that  the  seeds  of  disease  are  truly 
living.  Cardan  regarded  the  inorganic  world 
as  animated  no  less  than  the  organic,  while 
in  his  suggestions  that  all  animals  were 
originally  worms  and  that  all  creation  is  of 
the  nature  of  a  progressive  development,  a 
view  shared  to  some  extent  by  his  contem- 
porary ParaceIsus,3S  we  may  discern  the 
germinal  ideas  of  some  modern  philosophic 
and  scientific  conceptions.39 

Suggestions  similar  to  those  of  Cardan, 
but  bearing  even  more  directly  on  the 
subject  in  hand,  were  made  by  Victor  de 
Bonagens  (1556),  who  freely  compared  the 
generation  and  conveyance  of  fevers  to 
the  putrefactive  processes  which  produce 
"worms"  in  corpses.40  In  dealing  with  the 
question  of  fomites  de  Bonagens  shows 
considerable  grasp  of  Fracastor's  theories, 
and  he  cites  Scabies  especially  in  this  con- 
nection. 

Among  the  early  writers  who  contributed 
somewhat  to  develop  Fracastor's  theories 
are  Thomas  Jordan  (1576)41  and  Johannes 
Marinelli  (1577).42  Both  of  these  authors 
not  only  accepted  the  theory  of  scminaria 
but  also  described  the  seeds  as  multiplying 
themselves  in  their  state  as  seeds  and  thus 
helping  to  spread  the  contagion  wider.  In 
the  conception  of  these  two  writers,  there- 
fore, the  seminaria  are  more  definitely  vital 
than  in  the  work  of  Fracastor.  This  point 

Ioc.  cit.  Vol.  n,  pp.  67-87,  and  elsewhere.  For  the 
vermicular  origin  of  all  animals  see  De  varietate, 
Lib.  VII  76.  Desubt.,  Lib.  IX. 

40  Victor  de  Bonagcntibus  or  de  Bonagens  "Decern 
problemata  de  peste,"  Venice,  1556. 

a  Thomas  Jordan,  Pest  is  phenomena  seu  de  iis  qual 
circa  febrem  pestilentem  apparent  exercrtationes, 
Frankfort)  1576. 

"Joannes  Marinelli,  De  peste  ac  pcstilenti  contagii 
liber,  Venice,  1577. 


The  Scientific  Position  of  Girolamo  Fracastoro 


was  made  by  none  better  than  by  Francis- 
cus  Alphanus  (1577)43  who  wrote  that  "both 
infection  and  contagion  come  primarily  from 
certain  minute  particles.  These  particles, 
however,  are  themselves  infected  by  mediat- 
ing seeds  called  by  some  seminaria.  For  seeds 
have  power  to  generate  that  which  is  similar 
to  themselves  and  these  seminaria  [like 
seeds]  proceed  from  one  case  to  another 
generating  that  disease  from  which  they 
were  derived." 

Further  progress  was  made  by  another 
obscure    Italian    writer,   Jacob    Trunconi,44 
who  in  1578  published  at  Florence  a  work  on 
the  Pest  which  showed  the  influence  both  of 
Fracastor   and   of  Cardan.    Accepting   the 
seminaria  hypothesis  of  Fracastor,   he  at- 
tributes living  qualities  to  the  particles  as 
they  are  given  off  by  the  stricken  patients, 
and  speaks  of  them  as   "breeding"    (pul- 
lulantes)  and  bringing  forth  after  their  kind 
and  thus  playing  the  part  of  agents  in  the 
spread  of  disease.  He  compares  the  appear- 
ance of  these  "semina"  of  disease   to  the 
breeding  of  animals  in  stagnant  waters  and 
swamps  and  thus  attributes  to  them  fully 
vital  function.  A  hazy  follower  of  Cardan 
along  somewhat  the  same  lines  as  Trunconi 
wa;  the  mystical  Paracelsist,  Roch  Ie  Baillif, 
Sieur  de  la  Riviere  (died  1603),45  Dut  more 
definite   contributions    were    made   by   the 
versatile    Gabriel    Falloppius    (1523-1562) 
whose  premature  death  prevented  the  fur- 
ther development  of  his  views.    In   a  post- 
humously published  work,  Falloppius  46  con- 
nected  the   living   and   exhaled   corpuscles 
more  especially  with  phthisis  and  syphilis. 
One  passage  in  this  book  might  indeed  be 
interpreted  as  implying  a  knowledge  of  the 
corpuscles  of  the  blood.  This  and  similar 
passages  were  a  stumbling-block  to  certain 

43  Franciscus  Alphanus,  Opus  de  peste  et  febre 
maligna  necnon  de  variolis  er  morbillis  quatenus 
nondum  pestilentes  sunt,  Naples,  1577  (Ch.  V). 

44  Jacobo  Trunconi,  De  peste  and  pestilenti  morbo 
libri  quatuor  .  .  .   Florence,  1578. 

46  Roch  Ie  Baillif,  Sieur  de  la  Riviere,  Du  remede 
a  la  peste  charbon  et  pleurisie  et  du   moyen  cog- 


33 

of  the  microscopists  of  the  following  century, 
who  interpreted  the  blood  corpuscles,  which 
they  really  did  see,  in  the  light  of  the  hypo- 
thetical corpuscles  of  Falloppius,  Fracastor 
and  others.  The  lines  in  question  in  Fal- 
loppius' book  may  be  translated  as  follows: 

"Every  contagious  disease  spreads  itself 
throughout  the  whole  infected  substance. 
Thus  in  phthisis,  this  force  of  contagion 
is  conveyed  by  the  vapor  which  comes 
from  the  lungs.  This  vapor  contains 
certain  minute  corpuscles  of  the  blood, 
which  issue  forth  with  the  breath,  and 
are  spread  by  the  circumambient  air. 
So  they  are  attracted  to  the  lungs  of 
another,  and  if  they  thus  reach  a  suitable 
soil,  they  infect  it  and  communicate  the 
disease." 

Fracastor's  works  were  widely  read  from 
the  very  date  of  their  publication,  and  his 
brilliant  exposition  of  the  essential  nature  of 
infectious  diseases  held  the  field  against  the 
similar  hypotheses  of  Paracelsus,  Cardan,  de 
Bonagens  and  others.  For  three  centuries 
following  his  death,  however,  the  views 
generally  held  were  in  the  main  retrograde 
as  compared  to  his.  The  great  majority  of 
writers  who  quoted  him  (with  or  without 
acknowledgment)  were  mere  copyists  who 
added  nothing  to  the  conceptions  of  the 
master,  and  it  would  be  impossible  to 
mention  here  even  a  tithe  of  those  sixteenth- 
century  writers  on  the  plague  and  other 
infectious  diseases  who  owed  their  theories 
entirely  to  Fracastor.  Among  those  of  his 
countrymen  who  comprehended  him  more 
thoroughly  may  be  mentioned  the  botanist, 
Pietro  Andrea  Mattioli  (1554),47  who  applies 
the  theory  specially    to    rabies,    Giovanni 

noistre  quel  element  Ies  excite  .  .  .   Paris  1580. 

46  Gabriele  Falloppio,  De  morbo  gallico  tractatus 
1564.  Quotation  from  Ch.  XXI.  De  modo  genera- 
tione  morbi  gallici.  An  edition  of  1563,  which  we  have 
not  seen,  is  also  known. 

"  Pietro  Andrea  Mattioli,  Commentarii  ad  Iibros 
sex  pedacii  dioscoridio,  Venice,  1554.  fol. 


34 


Annals  of  Medical  History 


Francesco  Boccalini  (1556),48  Hieronymo 
Donzellini  (died  1560),49  Giovanni  Phillipo 
Ingrassia  (1510-1580),50  Andrea  Gratiolo  di 
Salo  (1576),61  Thomaso  Somenti  (1576),52 
Pietro  Sali  (1583),53  and  Diomedes  Amico 
(1599).54 

There  is  throughout  the  history  of  the 
subject  a  recrudescence  of  theories  of  the 
nature  of  infection  with  every  large  epidem- 
ical outbreak.  In  the  last  decade  of  the  six- 
teenth century,  eastern  Europe  was  devas- 
tated by  a  widespread  outbreak  of  typhus 
fever,  and  a  large  literature  arose  on  the 
subject  of  the  "Febris  Ungarica."  The 
peculiarly  infective  properties  of  this  disease 
gave  a  great  stimulus  to  the  "seminaria" 
hypothesis  which  was  lucidly  expounded 
in  several  works  on  the  Hungarian  dis- 
temper.65 

Fracastor's  doctrines  were  closely  followed 
also  by  the  learned  French  physicians  J.  A. 
Saracenus  (1572),66  Le  Paulmier  de  Grente- 

48  Giovanni  Francesco  Boccalini,  De  causis  pesti- 
lentialibus  urbem  Venetani  opprimentis,  Venice, 
1556,  80. 

"  Hieronymo  Donzellini,  De  natura,  causis  et 
Ieghima  curatione  febris  pestilentie,  Venice,  1570. 

'"Giovanni  Philippo  Ingrassia,  Informazione  del 
pestifero  e  contagioso  morbo  il  quale  afflige  et  have 
afflitta  questa  citta  di  Palermo  e  moltre  altre  citta 
a  Terre  di  questo  Regno  di  Sicila  nell'  Anno  1575  et 
1576.  Data  alio  invittissimo  et  Potestissimo  Filippo 
Re  de  Spagna,  1 576. 

"  Andrea  Gratiolo,  Discorso  de  peste  .  .  .  con  un 
catalogo  di  tutti  le  Peste  piu  notabili  de  tempi 
passati,  Venice,  1576. 

"  Thomas  Somenti,  De  morbis  qui  per  finitimos 
populos  adhuc  grassantur,  et  nunc  ill i  ad  pestilentes 
rcferendi  sint,  post  prima  responsa  Mantua  allatu, 
brevis  disputatio,  Cremona,  1576. 

M  Petrus  Salius  Diversus.  Dc  febre  pestilenti 
tractatus  et  curationes  quorundam  particulaiium 
morborum  .  .  .  atque  annotationes  in  artem  medi- 
caid .  .  .  Bologna,  1583. 

M  Diomedes  Amico,  Dc  morbis  communibus  liber 
.  .  .Venice,  1596, 40.  Tractatus  tres,  Venice,  1599,  and 
Dc  morbis  sporadibus  opus  novum,  Venice,  1605,  40. 

"  E.g.  the  Jesuit  Balthasar  Conradin,  De  febris 
ungarica  cjusque  symptomatum  curatione,  Passau, 
1394,  and  Martin  Rulandtu  (films)  De  morbo 
Ungarico,  Frankfort,  1600,  and  other  editions. 


mesnil  (Jul.  Palmarius  1576),57  Francis  Val- 
Ieriola  (died  1580), 58  and  Francois  de  Cour- 
celles  (1595),59  as  well  as  by  the  anatomist 
John  Guinter  of  Andernach  (1487-1574)60 
the  teacher  of  Vesalius,  and  by  the  Spaniards 
Aloysius  Toreus  (1574)61  and  Nicolao  Bocan- 
gelino  (1600). 62  Especial  mention  should  be 
made  of  Jerome  Mercurialis  (1530- 1603), 
the  distinguished  writer  on  gymnastics,  who 
followed  Fracastor  very  closely.  Mercurialis 
shows  much  acumen  in  discussing  the  spec- 
ificity of  the  viruses  of  different  contagious 
diseases  as  well  as  in  developing  the  doctrine 
of  fomites.63 

With  the  seventeenth  century  the  views 
of  Fracastor  became  so  widely  accepted  that 
to  give  a  list  of  the  authors  who  quote  him 
or  accept  his  views  would  be  to  provide  a 
fairly  complete  medical  bibliography  of  the 
period,  and  as  the  overwhelming  mass  of 
this  literature  is  mere  repetition  we  may 
here  part  with  our  subject. 

56  J.  Antonius  Saracenus,  Dc  peste  commentarius 
in  quo  praeter  pestis  naturael,  praecautionis  etiam 
atque  curationis  ipsius  uberiorem  explicationem,  non 
pauca  qua;  super  eadem  materia  hoc  nostro  secula 
et  coelo  in  contentionem  plerumque  veniunt  obiter 
strictimque  tractantur,  Lyons,  1572. 

57 Le  Paulmier  de  Grentemesnil,  De  morbi  con- 
tagionis  libri  septem  .  .  .  De  Iue  venerea  libri  duo; 
Paris,  1578. 

68  Francis  Valleriola,  Loci  medicinae  communes, 
tribus  Iibris  digesti;  Lyons,  1562. 

69  Francois  de  Courcelles,  Traite  de  la  peste  clair 
et  tres  utile  .  .  .  Sedan,  1595. 

60  Johan  Guinter  or  Winter  of  Andernach,  De 
pestilentia  commentarius  in  quatuor  dialogos, 
1565. 

61  Aloysius  Toreus,  De  febris  epidemicae  et  novae, 
qua;  Latine  puncticularis  vulgo  tavardillo  et  pintas 
dicitur,  natura,  cognitione  et  medela  .  .  .  Burgos. 
1574.  The  book  is  interesting  as  identifying  the 
tabardillo  with  typhus  fever. 

"Nicolao  Bocangelino,  De  morbis  malignis  el 
pestilcntilnis  causis  presagiis  et  medendi  methodo 
.  .  .  Madrid,  1600.  An  edition  in  Spanish  was 
printed  in  the  same  year. 

"Hieronymo  Mercurialis,  Praelectiones  patavii 
habit  a  1577  in  quibus  de  peste  ti.Ktatur.  Dc  pette 
in  universam,  pra^crtim  vero  de  Veneta  <  i  Patavina. 
Venice,  1577. 


THE  GREEK   CULT  OF  THE   DEAD   AND  THE   CHTHONIAN 
DEITIES    IN    ANCIENT   MEDICINE 

By  FIELDING   H.  GARRISON,  M.D. 

WASHINGTON,  D.  C. 
"Mortui  placantur  sacrificiis,  ne  noceant." 


IT  is  seldom  that  the  aims  of  classical 
philology  have  been  more  nobly  justi- 
fied than  in  Rohde's  "Psyche,"1  that 
remarkable  synthetic  work  in  which  one  of 
the  most  interesting  of  human  cults,  the  be- 
lief of  the  ancient  Greeks  in  the  immortality 
of  the  soul,  has  been  made  to  stand  out  in 
almost  definite  outlines  from  the  bare  de- 
tails, sometimes  the  most  shadowy  hints, 
in  the  classical  writers.  "Psyche"  is  to 
Greek  mythology  what  Frazer's  "Golden 
Bough"  is  to  comparative  folklore.  Over 
the  carefully  inlaid  mosaic  of  footnotes  is 
woven  an  argument  of  singular  originality 
and  power,  revealing  in  its  gifted  author 
some  of  the  emotional  aspirations  of  the 
poet  and  the  artist. 

Erwin  Rohde  (1845-98),  of  Hamburg, 
one  of  the  most  learned  and  talented  Hellen- 
ists of  modern  times,  was  a  man  who  saw 
antiquity  in  the  spirit  of  Goethe,  Schiller, 
Herder,  Winckelmann  and  Ottfried  Miiller, 
and  one  who  endeared  himself  to  his  pupils 
and  his  contemporaries  by  his  charming 
personality  and  his  genial,  urbane  spirit. 
His  field  was  the  literary  and  psychological 
interpretation  of  the  Greek  classics,  in  which 
he  was  unsurpassed.  His  greatest  works  are 
his  study  of  the  Greek  romances  (1870),  and 
his  Psyche  (189 1-4),  in  which  the  Greek 

1 E.  Rohde:  "Psyche:  Seelencult  und  Unsterb- 
Iichkehsglaube  der  Griechen."  3.  AufL,  Tubin- 
gen &  Leipzig,  1903. 

2  Lessing:  "Wie  die  Alten  den  Tod  gebildet" 
(1769). 


cult  of  the  soul  is  developed  at  length  from 
the  vague  traditional  lore  of  the  Homeric 
poems  up  to  its  culmination  in  Plato.  It  is 
shown  that  the  Greek  doctrine  is  analogous 
in  its  origins  to  the  genesis  of  similar  ideas 
in  all  primitive  peoples.  The  savage's  con- 
clusions are  drawn  from  the  experience  of 
dreams  and  other  unconscious  or  ecstatic 
states,  and  so  it  was  with  the  Greeks. 

If  we  contrast  Rohde's  exegesis  with 
the  famous  essay  of  Lessing,2  the  former 
seems  like  an  expanded  series  of  symphonic 
variations  upon  the  theme  of  the  elder 
writer:  "How  did  the  ancients  conceive  of 
death?" 

On  the  graphic  side,  Lessing's  work  has 
been  continued  and  completed  in  Dr.  F. 
Parkes  Weber's  "Aspects  of  Death  in  Art 
and  Epigram"  (1914),  in  which  the  em- 
blematic concepts  of  death  in  poetry,  liter- 
ature and  art  have  been  most  exhaustively 
and  attractively  set  forth.  The  intention 
of  Rohde's  work  is  psychological.  The  seri- 
ous and  austere  character  of  his  argument 
leaves  with  one  the  impression  of  a  clear, 
cold,  beautifully  balanced  mind,  capable  of 
handling  the  difficult,  complex  subject  with 
the  same  large  steady  grasp  of  thematic 
material  which  his  fellow  townsman  Brahms 
displayed  in  the  Haydn  variations  or  the 
F  major  symphony. 

Rohde  begins  with  the  concept  of  death 
in  the  Homeric  poems.  A  favorite  device  of 
later  poets  is  to  see  life  and  death  in  an 
inverted  order,  just  the  opposite  of  what  we 
think  them,  as  in  the  verse  of  Euripides, 


35 


36 


Annals  of  Medical  History 


which  Montaigne  is  said  to  have  inscribed 
over  the  rafters  of  his  library: 

Who  knows  but  life  itself  is  only  dying, 
And  that  which  we  call  death  the  gate  of  life. 

This  thought,  which  we  find  again  in  Words- 
worth ("Our  birth  is  but  a  sleep  and  a  for- 
getting"), in  Hood  ("Life  is  dying,  and 
Death  is  living"),  in  Shelley — 

Death  is  the  veil  which  those  who  live  call  life; 
They  sleep,  and  it  is  lifted — 

is  also,  as  we  know,  the  prevailing  concept 
of  the  Christian  faith.  In  medieval  times, 
as  Parkes  Weber  says,  "a  morbid  brooding 
and  a  pathological  love  of  death,"  over- 
shadowed everything.  After  the  Revival 
of  Learning,  when  Fame  was  conceived  of 
as  triumphing  over  Death,  Time  over  Fame, 
Eternity  over  all,  as  in  Petrarca's  Trion.fi,3 
there  was  the  robust  attitude  of  Shake- 
speare's Caesar — 

Cowards  die  many  times  before  their  deaths; 
The  valiant  never  taste  of  death  but  once. 

This  jocund  acceptance  of  death  as  an 
ineluctable  event  in  nature  we  find  again  in 
Sir  Thomas  Browne,  in  Browning's  "Pro- 
spice,"  in  Whitman's  Lincoln  poem  and 
frequently  in  Swinburne.  In  Heine,  in 
Leopardi,  the  laureate  of  death,  in  Musset's 
apotheosis  of  Leopardi,  in  Matthew  Arnold, 
in  Leconte  de  Lisle,  in  the  lines  in  Turge- 
nieff's  "Fathers  and  Sons"  which  are  so 
vibrant  with  emotion,  in  all  the  Russian 
poets,  death  is  considered,  often  with  charm, 
from  many  curious  angles.  Weltschmerz, 
maladie  du  siecle,  morbidezza,  "the  strange 
disease  of  modern  life,"  is  over  all,  and 
what  Dr.  Keen  calls  "the  cheerfulness  of 
death,"4  the  sense  of  death  as  a  natural 
physiological  event,  is  seldom  felt.  "  One 
does  not  find  a  single  man,"  says  Edmond 
de  Goncourt,  "who  would  tare  to  live  his 
life  again.  Hardly  will  you  find  a  woman 
who  would  wish  to  live  over  her  first  eigh- 

•  Parkin    Weber:  "Aspects    of    Death    in    Art," 
London,  1914,  1 15-121. 
»W.  W.  Ki  en:  Outlook,  N.  Y.,  1903,  LXXV,  446. 


teen  years:  that  appraises  life."  Cela  juge 
la  vie.  But  such  was  not  the  attitude  of 
the  Homeric  Greeks.  Matthew  Arnold 
has  sensed  it  in  one  of  his  narrative  poems: 

From  his  limbs 
Unwillingly  the  spirit  fled  away, 
Regretting  the  warm  mansion  which  it  left, 
And  youth,  and  bloom,  and  this  delightful  world. 

So  the  Greeks  evaluated  life.  "To  turn 
away  from  life  as  a  whole,"  says  Rohde, 
"would  never  have  occurred  to  any  Ho- 
meric Greek.  .  .  .  And  indeed,  only  for  the 
strong,  the  wise,  the  mighty,  did  the  Ho- 
meric world  exist.  To  them,  life,  existence 
upon  this  earth,  was  such  a  certain  good  that 
the  attainment  of  all  individual  joys  was 
conditional  upon  it.  No  danger,  then,  that 
death,  the  state  which  follows  life,  would 
ever  be  confused  with  life  itself."  "Argue 
not  with  me  concerning  death,"  cries 
Achilles  to  Odysseus  in  Hades;  "rather 
would  I  choose,  being  on  earth,  to  be  thrall 
to  a  man  of  no  estate,  of  no  substance,  than 
to  rule  here  over  all  the  departed  dead."6 
Nothing,  Rohde  concludes,  was  so  hateful 
to  the  Homeric  Greeks  as  death  and  the 
gates  of  Hades.  "For  this  very  life,  this 
lovely  life  in  the  sunshine,  surely  ends  with 
death,  come  after  it  what  may."6 

But  the  early  Greeks  by  no  means  re- 
garded death  as  the  end  of  all.  In  Erebos, 
Hades  and  Persephone  did  not  rule  over 
nothing.  In  the  gloomy  house  of  Hades, 
the  souls  of  the  departed  dead  were  con- 
ceived of  as  eidola,  mere  indefinite  images  of 
living  beings,  comparable  with  smoke  (Iliad, 
XXII,  100)  or  shadows  (Odyssey,  X,  495; 
XI,  207),  not  formless,  but  void  of  strength 
and  substance,  like  figures  on  a  film,  exist- 
ing in  a  state  of  half  consciousness,  endowed 
with  feeble  chirping  voices,  and  no  more 
vital  than  the  reflections  in  a  mirror.  The 
Homeric  Psyche  is  not  identical  with  the 
"vital  spirit,"  w  hich  dies  out  with  the  death 
of  the  body.  The  Psyche  is  the  alter  ego, 

'Odyssey,  XI,  489-494. 
•Rohde,  "Psyche,"  5.  ed.,  2. 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine       37 


the  Doppelgdnger,  the  invisible  "astral 
body"  of  the  living  being.  Like  the  Greek 
concept  of  life  as  a  breath  (pneuma),  this  is 
one  of  the  commonest  conceptions  of  primi- 
tive people  everywhere.7  In  Homer,  the 
departed  souls  are  shut  up  in  the  house  of 
Hades,  girt  by  Oceanus  and  Acheron,  never 
to  return.  But  this  restriction  was  condi- 
tioned by  the  rite  of  cremation.  In  the 
twenty-third  Iliad,  the  ghost  of  Patroclus 
upbraids  Achilles  for  neglecting  to  give  his 
body  its  "due  of  fire,"  and  counsels  him  to 
proceed  with  the  necessary  rites,  that  his 
soul  "may  pass  through  the  gates  of 
Hades."  "Far  off  the  spirits  banish  me, 
the  phantoms  of  men  outworn,  nor  suffer 
me  to  mingle  with  them  beyond  the  River, 
but  vainly  I  wander  along  the  wide-gated 
dwelling  of  Hades."  Achilles  then  burns  the 
body  in  the  night  on  a  funeral  pyre  heaped 
up  with  flayed  sheep  and  oxen,  and  the  bodies 
of  twelve  Trojan  youths,  put  to  the  sword. 
Bloody  sacrifices  to  the  dead  in  the  night 
were  in  the  nature  of  a  chthonic  rite,  one 
commonly  dedicated  to  the  gods  of  the 
underworld.  Apart  from  these,  such  sac- 
rifices were  only  offered  on  the  graves  of 
deified  heroes  who  had  died  for  their  coun- 
try. Among  the  primitive  Greeks,  ritual 
incineration  was  apotropaic,  designed  to 
lay  the  ghosts  and  avert  the  wrath  of  the 
departed,  and  springing  in  part  from  that 
fear  of  the  return  of  the  dead  which  char- 
acterizes primitive  man.8  Only  by  fire  were 
the  dead  appeased   (Iliad,  VII,  440),   but 

7  Rohde,  op.  cit.,  2-8. 

s  Incineration,  among  the  Persians,  Teutons,  Slavs 
and  Asiatic  or  Ionian  Greeks,  was  essentially  the 
custom  of  a  nomadic  people  to  whom  burial  was  un- 
thinkable, since  it  exposed  the  dead  body  to  the  con- 
vulsions of  nature  and  the  depredations  of  wild  ani- 
mals, and  deprived  it  of  the  customary  food  offer- 
ings. The  urns  containing  the  ashes  of  the  dead 
Were  carried  with  the  wandering  tribe,  or  buried  in 
a  hillside,  as  with  the  heroes  who  died  on  the  windy 
plains  of  Troy.  Through  the  Neolithic,  Cretan  and 
Mycenaan  periods,  coffinless  burial  in  rockhewn 
crypts  (shaft-burial)  or  bee-hive  tombs  was  the  rule. 
The  piles  of  stone  (scopelism)  or  rough  monuments 


once  in  Hades,  return  to  the  upper  world 
was  impossible,  and  they  were  forgotten  by 
the  living  (Iliad,  XXII,  389).  Thus,  the 
cult  of  the  dead  in  Hades,  and  that  of  the 
xdbvioi,  the  gods  of  earth  and  the  under- 
world, were  identical  among  the  early 
Greeks,  although  they  became  widely  sep- 
arated in  later  time. 

Apart  from  the  shadow  life  in  the  prison 
of  Hades,  the  Greeks,  as  we  know,  conceived 
of  favored  souls  as  snatched  away  to  the 
Elysian  Fields  in  the  Islands  of  the  Blessed, 
at  the  far  ends  of  the  flat  earth,  beyond 
Oceanus.  In  the  later  Eleusinian  cult,  this 
hope  was  held  out  to  all  who  had  been  ini- 
tiated into  these  nocturnal  mysteries,  which 
in  all  probability  represented  the  abduction 
of  Persephone  by  Hades,  their  marriage  in 
the  lower  regions,  and  the  wanderings  of  the 
Earth  Goddess,  Demeter,  in  search  of  her 
daughter.  The  gods  could  also  confer  per- 
sonal immortality  during  lifetime,  as  with 
Tithonus,  Ganymede,  Iphigenia  at  Tauris  or 
Menelaus,  whom  Zeus  rendered  immortal 
as  being  his  son-in-law  through  his  marriage 
with  Helen,  in  other  words,  through  no 
merits  of  his  own,  but  simply  as  "Helena's 
husband."9  So,  too,  Calypso,  in  the  island 
of  Ogygia,  desired  to  render  Odysseus  im- 
mortal as  a  mark  of  divine  favor,  and  Aphro- 
dite, as  Hesiod  relates,  made  Phaethon  a 
"  god-dsemon.10  Another  species  of  im- 
mortality was  conferred  by  the  gods  through 
causing  favored  beings  to  be  swallowed  up 
in  the  bowels  of  the  earth,  wherein  they  con- 
over  the  graves  were  originally  designed  to  prevent  the 
deceased  from  resuming  his  (astral)  body,  as  also 
to  prevent  the  destruction  of  his  physical  body.  Incin- 
eration, in  the  Homeric  period,  had  the  same  purpose, 
and,  for  this  reason,  the  burial  of  weapons  and  fune- 
ral gifts  with  the  dead  disappears  with  incineration. 
When  burial  was  revived  in  the  post-Homeric  period 
(8th-7th  centuries  B.C.),  the  Krepea  were  again  buried 
with  the  dead.  In  time,  the  fear  of  the  return  of  the 
dead  gradually  merged  into  a  desire  to  attract  them, 
even  to  the  extent  of  having  meals  in  common  with 
departed  spirits. 

9  Rohde,  op.  cit.,  I,  80. 

10  Rohde,  I,  135,  footnote  1. 


38 


Annals  of  Medical  History 


tinued  to  live  on  eternally  as  ehthonian 
beings.  Thus,  in  Pindar  and  the  dramatists, 
there  are  countless  references  to  the  Argive 
hero  and  seer,  Amphiaraus,  of  the  race  of 
Melampus,  who,  being  pursued  in  battle  by 
Periclymenus,  was  saved  from  a  spear  thrust 
by  a  thunderbolt  of  Zeus  and  carried  with 
horses,  chariot  and  charioteer  into  the 
depths  below.11  In  Bceotia,  the  architect 
Trophonius,  being  pursued  by  enemies,  was 
likewise  swallowed  by  the  earth  and  made 
immortal.1*  Likewise  Cseneus,  one  of  the 
Lapitha?,  being  belabored  with  trunks  of 
trees  by  the  Centaurs,  stamped  upon  the 
ground  with  his  foot  and  disappeared  into 
the  earth.13  The  same  subterranean  im- 
mortality befell  Althaimenes,  the  founder 
of  the  Greek  island  cities,  and  his  son  Am- 
philochus.11  The  idea  recurs  in  the  legends 
about  Charlemagne,  Frederick  Barbarossa, 
King  Arthur,  Holger  Danske,  and  in  the 
many  fanciful  beings  of  German,  Moham- 
medan and  Mexican  mythology.15  Amphi- 
araus had  an  oracle  at  Cnopia  near  Thebes; 
Trophonius  in  a  cave  near  Lebadea.  The 
sacrifices  made  to  them  in  the  night  were 
those  rendered  to  the  ehthonian  or  earth 
gods.  In  their  ehthonian  aspect,  the  gods 
usually  appeared  as  serpents,  or  attended 
by  serpents,  and  so  Trophonius  appeared  in 
his  Lebadean  cave.  Another  attribute  of 
the  ehthonian  or  cave-gods  was  divination 
through  their  oracles.  In  the  temple  of 
Apollo  Pythoktonos  at  Delphi,  the  god,  as 
snake-  or  dragon-slayer,  sat  upon  a  mound 
{omphalos)  under  which  was  buried  the 
serpenl  Python,  son  of  the  earth  goddess 
Gaia,  and  from  the  slaying  of  Python,  as 
we  read  in  Euripides  (Iphigenia  in  Tauris, 

11  Rohde,  I,  113. 

«u  Rohde,  I,  115. 

"  Rohde,  I.  116. 

'   Rohde,  I,  124. 

"  Sn  Arthur  J.  Evans:  The  Mycensan  Tree  and 
Pillar  '  .ult,  I  ondon,  1901,  1 ;  1  5   17. 

•  ■  was  the  ancient  home  of  the  class  of  seers 
or  visionaries,  who,  like  Abatis,  Aristeas,  Hermo- 
tiiMNs  and  I  iii|m  dot  les,  attained  to  b1  it'    ol  ecstasy 


1245  et  seq.),  Apollo  derived  his  prophetic  or 
iatromantic  powers: 

Glitt'ring  in  the  burnished  shade, 
By  the  laurel's  branches  made, 
Where  th'  enormous  dragon  lies, 
Brass  his  scales,  and  flame  his  eyes, 
Earth-born  monster,  that  around 
Rolling  guards  th'  oracular  ground: 
Him,  while  yet  a  sportive  child 
In  his  mother's  arms  that  smiled, 
Phoebus  slew,  and  seized  the  shrine 
Whence  proceeds  the  voice  divine; 
On  the  golden  tripod  placed. 
Throne  by  falsehood  ne'er  disgraced, 
Where  Castalia's  pure  stream  Hows, 
I  le  the  fates  to  mortal  shows. 

In  the  Theogony  of  Hesiod  (453-491),  we 
read  that  Rhea  gave  birth  to  Zeus  in  a  cave 
in  Crete,  in  order  to  prevent  him  from  being 
swallowed  by  his  father  Kronos: 

Him  did  vast  Earth  receive  from  Rhei 
in  wide  Crete  to  nourish  and  to  bring  up. 
Thither  came  Earth  carrying  him  swiftly 
through  the  black  night  to  Lyctus  first, 
and  took  him  in  her  arms  and  hid  him  in 
a  remote  cave  beneath  the  secret  places 
of  the  holy  earth  on  thick-wooded  Mount 
Aegeum. 

This  cave,  fabled  to  lie  in  the  mountain 
crag  of  Dicta  or  on  Mount  Ida,  near  Knossos 
has  since  been  found.  At  the  mouth  of  the 
Idsean  cave  is  a  colossal  rock-hewn  altar; 
in  the  bottom  of  the  Dictaean  cave,  a  stea- 
tite libation  table  was  discovered.18  In 
Homer,  Minos,  the  son  of  Zeus,  is  repre- 
sented as  holding  converse  with  his  father 
at  this  Cretan  cave  every  nine  years.17  In 
his  investigations  of  the  Minoan  civilization 
in  the  palace  at    Knossos  (1903),  Sir  Ait  Inn 

(alienatio  mentis)  in  which  the  soul  left  the  body  to 
identify   itself  with  godhead,  thus  conferring  the 

power  to  predict  the  future,  interpret  the  past,  per- 
form cathartic  rites,  banish  demons  and  check 
epidemic  diseases.    Of  these  seers,   Epimenides  "I 

(irtc,    who    abode    in    the   cave    of    Dictaan    ZeUS 

i"i    many   years,  to  emerge  as   prophet,   cathart- 

ist   and   he&Ier,  was    the  archetype.     Rohde,   II,  89 

00. 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine      39 


Painted  terra-cotta  pillars,  surmounted  by 
doves,  from  sanctuary  of  dove  goddess  in  the 
palace  at  Knossos.  Each  column  is  a  separate 
religious  entity  (uranic  or  celestial  aspect).  In 
the  Minoan  Age,  objects  of  worship  were  usually 
aniconic,  as  a  rule  trees,  large  stones  or  columns 
of  stone.  (See,  Sir  Arthur  Evans:  Mycenaean 
Tree  and  Pillar  Cult,  London,  1901). 


Female  votary,  surmount- 
ed by  dove,  from  shrine  of 
the  Double  Axes  in  the 
Palace  at  Knossos.  This 
terra-cotta  figurine  shows 
the  transition  from  the  ani- 
conic idol  to  the  icon. 


Faience  figure  of  the  Snake  Goddess 
(probably  the  Magna  Mater  of  Crete 
in  her  chthonic  aspect).  One  of  the 
temple  repositories  from  the  Central 
Palace  Sanctuary  (Knossos). 


Faience  figure  of  female  votary  from  same  sanc- 
tuary. I  From:  Ann.  Brit.  School,  Athens,  1901-2, 
viii,  29;  99:  1902-3,  ix,  75;  77.) 


4° 


Annals  of  Medical  History 


Evans  discovered  several  clay  seal  impres- 
sions of  a  warrior  god  and  goddess,  attended 
by  lions,  which  perhaps  represent  Dictsean 
Zeus  and  Rhea  in  their  chthonian  aspect. 
The  snake,  the  special  symbol  of  the 
xdovioi,  appears  in  the  remarkable  faience 
figures  of  the  goddess  and  her  female  votary 
which  were  found  in  the  temple  repositories 
of  the  palace.  The  figure  of  the  goddess  is 
34.2  cm.  (131 2  inches)  in  height,  sur- 
mounted by  a  high  tiara  of  purplish-brown 
color.  About  this  is  coiled  a  snake,  the 
head  of  which  projects  above  the  tiara  while 
the  tail  end  is  plaited  about  the  hips.  Two 
other  snakes  are  interlaced  around  the  hips 
and  diagonally  across  the  shoulders  and 
down  the  arms.  The  votary  grasps  a  twisted 
snake  in  either  outstretched  hand.  Goddess 
and  votary  are  attired  in  garments  of  high- 
ly fashionable  cut,  a  tight  fitting  jacket 
bodice,  with  decorations  of  volute  patterns, 
a  double  apron  or  polonaise,  and  a  bell- 
shaped  skirt,  which,  in  the  votary,  consists 
of  seven-terraced  llounccs  apparently  over 
a  "foundation."  In  her  description  of  these 
costumes  of  4,000  years  ago,  Lady  Evans 
observes  of  the  molding  of  the  figures  that 
"the  lines  adopted  are  those  considered 
ideal  by  the  modern  corset  maker  rather 
than  those  of  the  sculptor."  The  bell-shaped 
skirts,  effect  of  the  pronounced  tups  and 
stcatopygy  of  the  primitive  woman,  are 
identical  in  shape  with  the  garments  of  the 
[ate  neolithic  period  figured  on  the  walls 
of  the  prehistoric  caves  of  Cogul  and 
Alpera,  and  which  are  still  worn  by  the 
peasant  women  of  Northern  Albania.  The 
hieratic  gestures  and  the  grasping  of  ser- 
pents by  both  goddess  and  her  votary  is 
strongly  suggestive  of  the  snake  dance  of 
t  he  Hopi  I  Moqui)  Indians  lor  the  purpose  of 
rain  making,  and  may  inipb  all  that  is  con- 
tained in  the  generic  concept  of  "making 
medicine."  The  snake  is,  in  fact,  the 
chthonic  symbol  of  medicine.  Of  the 
mythologic  significance  of  these  figures,  Sir 
Arthur  Evans  observes: 


"The  snake's  head  rising  above  the 
summit  of  the  tiara  in  the  present  figure 
naturally  recalls  the  urseus  as  seen  above 
the  heads  of  Egyptian  divinities  and  royal 
personages.  A  winged  serpent  or  asp  by 
itself  appears  as  the  representative  of 
Nekhebet,  identified  by  the  Greeks  with 
Eileithyia,  the  Goddess  of  Childbirth,  and 
of  her  twin  sister  the  'Nurse'  Uatchet  or 
Buto.  Its  connexion  with  the  Egyptian 
.Mother  Goddess  Hathor  derives  a  special 
importance  from  the  fact  that,  as  I  have 
elsewhere  shown,  the  Hathoric  stall  with 
tw  oserpents  coiled  around  its  loot  supplies 
the  prototypeof  the  rayed  pillars  with  simi- 
lar snakes  on  Cypro-M\  censean  signets,  in 
association  with  a  Goddess  whoso  attri- 
butes are  lions  and  doves. 

"Of  the  influence,  at  least  of  the  formal 
creations,  of  Egyptian  religious  art  on 
that  of  Minoan  Crete  there  can  be  no 
doubt.  .  .  .  The  ankb  itself  was  adopted 
by  Minoan  symbolism.  Neither  can  there 
be  any  hesitation  in  regarding  the  Cow 
and  Calf  reliefs  found  in  the  same  Temple 
Repository  with  the  Snake  Goddess  and 
her  votaries  as  taken  over  from  the  service 
of  Hathor.  .  .  .  But  the  argument  can 
hardly  be  carried  beyond  this  point. 
Taken  as  a  whole  neither  the  Snake  God- 
dess nor  her  votaries  present  any  special 
Egyptian  characteristics.  As  a  matter  of 
fact  they  are  clad  in  the  last  fashions  of 
the  Knossian  Court. 

"The  pronounced  matronly  forms  of 
the  Goddess  seem  to  point  to  her  as  ;i 
Great  Mother,  and  resemble  those  of  the 
female  member  of  the  divine  pair  whose 
cult  is  so  well  illustrated  throughout  the 
Palace,  including  the  Repository  in  which 
the  figure  itself  was  found.  It  may  be 
added  that   the  sacral  value  of  the  girdle, 

emphasized  here  both  by  the  plaited 
snakes  that  encompass  the  loins  ol  the 
divinity  and  by  the  appearance  ol   the 

girdle  as  a  separate  \otivc  object,   points 

to  a  Goddess  of  Maternity.  The  snake  form 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine       41 


of  Nekhcbet,  the  Egyptian  Eileithyia,  has 
also  a  comparative  value  in  this  connex- 
ion. Nor  must  it  be  forgotten  that  some 
of  the  oldest  religious  traditions  of  the 
spot  that  survived  to  Classical  times  refer 
not  only  to  the  cult  of  the  Mother  God- 
dess Rhea,  whose  grove  and  the  ruins  of 
whose  shrine  were  pointed  out  near  the 
later  Knossos,  but  to  Eileithyia  whose 
cave  sanctuary  opened  on  the  side  of  a 
rocky  height  above  its  ancient  haven,  the 
mouth  of  the  Amnisos. 

"Of  the  special  cult  aspect  presented  by 
the  Snake  Goddess  and  her  votaries  no 
other  hint  has  as  yet  been  supplied  by  the 
Palace  remains.  It  is  possible  that  we  have 
here  to  deal  with  a  specially  chthonic  as- 
pect of  the  cult  of  the  same  Mother  God- 
dess whose  worship  is  otherwise  so  well 
illustrated  here.  Or,  on  the  other  hand,  the 
Snake  Goddess  may  represent  an  associ- 
ated divinity,  a  o-iWWos,  having  a  shrine 
of  her  own  within  the  larger  sanctuary. 

"In  either  case  the  snakes  must  by  all 
analogy  be  taken  to  show  the  chthonic 
character  of  the  worship  here  represented. 
It  is  an  obvious  feature  of  primitive  cult 
that,  just  as  the  bird  descending  on  the 
sai  red  object  or  person  is  the  outward  and 
visible  sign  of  its  possession  by  a  celestial 
spirit,  so  the  serpent  approaching  from  the 
crevices  of  the  earth  becomes,  as  at  Del- 
phi, the  sign  of  its  spiritual  possession 
from  the  Underworld.  The  two  chief  cult 
images  as  yet  found  in  the  Palace  illus- 
trate these  alternative  sources  of  inspira- 
tion in  an  interesting  way.  In  the  one  case 
a  dove  is  seen  settled  on  the  head  of  the 
image.  In  the  case  of  the  present  figure  the 
snake's  head  appears  in  the  same  position. 
The  parallel,  indeed  may  be  carried  a  step 
further  if  we  compare  the  semi-aniconic 
images  of  Gournia  and  Prinias  with  the 
triple  columns  of  the  terracotta  sanctuary 
found  on  the  East  side  of  the  Knossian 
Palate.  In  the  case  of  the  columns  the  set- 
tled dove  again  witnesses  the  divine  pos- 


session. In  the  case  of  the  images  the 
snakes  are  seen  coiling  up  the  cylindrical 
base,  which  seems  to  represent  the  earlier 
columnar  form  of  the  cult  object. 

"  It  is  hardly  necessary  to  point  out  that 
a  Mother  Goddess  has  essentially  a 
chthonic  side.  Demeter,  daughter  of  Rhea, 
whose  early  connection  with  Crete  comes 
out  in  the  Homeric  hymn,  is  herself,  in  her 
character  of  Erinys,  a  Snake  Goddess.  The 
Cretan  Eileithyia  is  a  cave  divinity.  It  is, 
moreover,  interesting  to  notice  that  the 
indigenous  Nature  Goddess  of  the  Island, 
who  retained  her  Eteocretan  names,  Dic- 
tynna  and  Britomartis,  to  Classical  times, 
was  also  identified  with  Hekate. 

"This  indigenous  Goddess,  of  whom 
Rhea  as  well  as  Artemis  may  often  be  re- 
garded as  the  Hellenised  equivalent,  be- 
longs to  the  very  ancient  class  of  Virgin 
Mothers.  She  presides  over  human  births 
and  fosters  the  young  both  of  land  and 
sea.  Like  Artemis,  she  combines  the  at- 
tributes of  nurture  and  of  the  chase.  On 
Cretan  coins  we  see  her  in  the  place  of 
Rhea,  guarded  by  the  Corybantes,  with 
the  infant  Zeus  at  her  bosom.  .  .  .  The  seal 
impressions  of  the  figure  of  a  Warrior 
Goddess  attended  by  lions  bring  us  very 
near  to  Rhea;  and  the  companion  piece, 
showing  the  Warrior  God,  can  hardly  be 
other  than  an  early  version  of  the  Cretan 
'Zeus'. 

"The  general  associations  in  which  the 
figure  of  the  Snake  Goddess  and  her  vo- 
taries were  found,  are  thus  seen  to  illus- 
trate certain  broad  aspects  of  the  ancient 
Cretan  cult,  of  which  a  living  tradition 
survived  to  historical  time.  The  last  exam- 
ples especially,  the  lion-guarded  Goddess, 
namely,  and  her  male  satellite  fit  on  to  the 
typical  cult  of  the  Palace  and  of  Minoan 
Crete  as  a  whole.  It  may  therefore  be  pref- 
erable to  regard  the  Snake  Goddess  not 
as  a  separate  religious  entity  but  rather  as 
a  chthonic  version  of  the  same  matronly 
divinity  otherwise  so  well  represented  on 


42 


Annals  of  Medical  History 


this  and  other  Minoan  sites."  (Ann.  Brit- 
ish School  Athens,  London,  1902-3,  IX, 
-4-87O 

The  ehthonian  gods  were  first  investi- 
gated by  the  celebrated  Hellenist  Ottfried 
Miiller,  who  differentiated  their  cult  from 
that  of  the  Olympian  deities.  That  the 
ehthonian  or  infernal  and  the  uranic  or 
celestial  are  only  different  aspects  of  identi- 
cal gods  in  their  capacity  for  evil  or  good  is 
the  theory  of  another  philologist,  H.  D.  Miil- 
ler. To  discuss  the  complex  details  of  this 
matter  would  lead  us  too  far,  but  the  key 
to  its  comprehension  lies  in  the  fine  ob- 
servation of  Walter  Pater  that  the  Greeks, 
a  self-willed,  composite  people,  of  diverse 
racial  strains,  existing  in  independent  island 
and  city  states,  combining  only  in  wartime, 
"had  not  a  religion  but  religions,  a  theology 
with  no  central  authority,  no  link  on  his- 
toric time,  liable  from  the  first  to  an  un- 
observed transformation."  Apart  from  the 
worship  at  the  great  national  temples, 
there  existed  a  vast  network  of  local 
polytheism,  each  community  having  some 
particular  god  or  gods  of  its  own.  In  this 
way,  gods  of  identical  function  came  to  be 
worshipped  under  different  names,  many 
different  gods  acquired  identical  or  over- 
lapping functions,  some  gods  were  poly- 
morphic or,  at  least,  passed  through  many 
strange  metamorphoses  in  course  of  time, 
and  sundry  gods  were  suppressed  or  dis- 
placed in  their  own  localities  by  other  gods. 
Nearly  all  the  Olympian  gods  had  medical 
functions,  could  visit  plagues  and  epidemics 
upon  mankind  or  a\  ert  them  at  need,  and  so 
also  the  xilovwi.  Among  the  Cretans,  the 
Mycenaean   and   the   pre-Homeric   Greeks, 

who,  like  neolithic  man,  buried  their  dead, 
the  ehthonian  gods,  identical  with  Ira/.cr's 
"Spirits  of  the  Corn  and  tin-  Wild,"  were 
originally  gods  of  the  earth  and  agriculture, 
promoters  of  fertility  of  the  soil,  growth  of 
crops,  fecundity  in  women,  and  the  general 

'•Rohde,  II,  411  415. 
"  Rohde,  I,  2i}. 


well-being  of  man.  Among  the  Homeric 
Greeks,  who  burned  their  dead  that  the 
soul  of  the  departed  might  enter  the  gates 
of  Hades,  these  gods  became  associated  with 
the  underworld,  acquired  infernal  functions, 
thirsted  for  the  blood  of  human  sacrifice, 
were  feared  for  their  power  to  wreak  evil 
upon  mankind,  were  never  addressed 
directly  by  name  but  pleno  titulo,  with  flat- 
tering appellations,  and  were  placated  by 
apotropaic  rites  or  piacular  sacrifices  con- 
ducted at  dead  of  night.  With  these 
deities,  as  we  have  seen,  were18  associated 
(in  the  older  cult)  the  arafa^  perturbed 
spirits  of  the  dead  who  had  not  been  cre- 
mated, the  owpoi,  souls  of  those  who,  through 
fatal  accident  or  suicide,  had  died  before 
their  appointed  time,  the  tfioavaroi,  souls  of 
stillborn  infants,  and  the  immortalized 
or  deified  heroes  who,  through  divine  favor, 
had  been  either  snatched  up  to  Olympus  or 
carried  into  the  bowels  of  the  earth.  The 
caves  of  cave-gods,  such  as  Dictsean  or 
[dean  Zeus  or  Zeus  Trophonius,  were 
regarded  as  the  sites  of  chthonic  oracles, 
(Psychomanteia)  and  deep  clefts  in  the 
earth  as  entrances  to  Hades  (Psycho- 
pompcia)19.  Thus  the  xdbvioi  presided 
variously  over  agriculture,  divination  and 
some  aspects  of  medicine.  Hesiod,  in 
"Works  and  Days"  (465),  counsels  the 
Boeotian  farmer  to  "pray  to  Zeus  of  the 
Earth"  before  plowing.  In  the  Iliad 
(IX,  457)  the  same  god  (Hades,  Aidoneus) 
is  styled  Zeus  Katacht honios.  Later,  he 
becomes     Pluto    or    Klymenos.-"      Demeter 

Chthonia  and  Persephone  I  Kore),  goddess  of 
death  and  "the  poppied  sleep,"  were  wor- 
shipped at  Hermione,  Eleusis  and  through 
the  Peloponnesus.  At  Delos  and  Amorgos, 
Zeus  Eubuleus,  Demeter,  and  Kore  were 
jointly  worshipped;  in  Cnidos,  I  lades, 
Demeter,    Kore,   Epimachos,   and    Hermes 

PsychopompoS,  the  conductor  ol  souls  to 
I  hides   (Odyssey,    XXIV,    1  9).    The  earth 

'Sec  K.  Lehrs:  Popul&re  Aufs&tze,  2.  Aull.,  1  eip- 
zig,  [87$,  288. 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine       43 


goddess  Gaia,  Hecate  (Gorgo,  Mormo, 
Lamia,  Enodia,  Empusa),  who  with  her 
nightly  swarm  of  dogs,  Ataphoi,  Aoroi 
and  Biothanatoi,  brought  on  terror  and 
disease,  Cerberus,  the  guardian  of  Hades, 
the  Erinnyes,  the  Harpies,  the  Keres 
(goddesses  of  doom),  Thanatos  himself, 
were  all  numbered  among  the  x*?°  «".21 
That  such  beings  inspired  fear  and  to 
the  extent  of  being  seldom  addressed  di- 
rectly by  name  is  comprehensible.  In  the 
poets  and  dramatists,  Persephone,  in  her 
chthonic  aspect,  is  always  addressed  or  re- 
ferred to  as  "The  Maiden"  (Kore).  So, 
too,  /Eschylus  entitles  his  tragedy,  not 
"The  Erinnyes"  but  "The  Eumenides." 
At  the  beginning 
of  the  Choep- 
horae  of  /Eschy- 
Ius,  when  Electra 
invokes  jointly 
Hermes  Psycho- 
pom  pos  and  the 
shade  of  her 
father  Agamem- 
non, Hermes  is 
styled  Xtfoeios;  the 
name  of  Aga- 
mei  mon  is  not 
mentioned.  The 
chthonian  cult, 
as  something  fearsome  and  awful,  is  but 
dimly  shadowed  forth  in  the  classical  writers. 
In  expiation  of  the  crime  of  murder,  certain 
deities  were  invoked  who  were  euphemis- 
tically styled  Zeus  Meilichios  or  Zeus 
Apotropaios,  and  these  deities,  as  Ottfried 
Miiller  showed,  were  invariably  chthonian.22 
To  the  apotropaic  gods,  an  animal  was 
sacrificed  (as  a  kind  of  scapegoat)  in  place 
of  the  murderer.  In  the  Hippocratic  treatise 
c't  insomniis,  those  suffering  from  bad 
dreams  sacrifice  to  the  apotropaic  deities,  to 

21  Rohde,  I,  205-212. 

22  Rohde,  I,  273,  footnote  1.  The  opposite  of  Zeis 
airorpoiraios,  the  averting  god,  is  7,tm  TposTpoiraios, 
the  avenging  god.  Erythraean  inscriptions  also  refer 


Gaia  and  to  the  Heroes.  In  Plutarch,  The- 
seus is  purified  and  freed  from  the  stain 
(piaofia)  of  murder  by  sacrifice  to  Demeter 
and  Zeus  Meilichios.  On  votive  tablets 
from  the  Piraeus  and  elsewhere,  Zeus 
Meilichios,  like  /Esculapius,  was  represented 
and  worshipped  in  the  form  of  a  serpent. 
Another  chthonian  existence  which  ap- 
peared in  serpent  form  was  the  ayatios  baipov 
the  "good  daemon"  of  the  Greek  house- 
hold, often  mentioned  by  Attic  writers, 
an  analogue  of  the  lars  familiaris  of  the 
Romans,  and  in  its  original  form  (Rohde 
surmises),  the  soul  of  the  pater jamiliasp 
In  certain  Vatican  MS.  investigated  by 
Rohde,  Archigenes  describes  a  species  of 
non-poisonous 

Snakes     as      ayado- 

Saipovts.  These 
were  worshipped 
in  Alexandria  as 
"the  good  house- 
spirits  in  serpent 
guise."24  This 
brings  us  to  the 
cult  of  .Escula- 
pius as  a  chthon- 
ian deity  and  the 
significance  of 
the  snake  in 
medicine. 

To  understand  Rohde's  peculiar  inter- 
pretation of  the  /Esculapian  myth,  let  us 
consider  briefly  what  he  says  about  Erech- 
theus    and    Hyacinthus.23  In    Homer's 

catalogue  of  the  ships,  it  is  related  of 
Erechtheus  that  the  earth  bore  him,  but 
Athena  reared  him  and  placed  him  in  her 
costly  temple  at  Athens,  where  he  was 
worshipped  with  annual  sacrifices  of  steers 
and  sheep.  In  the  Odyssey,  Athena  re- 
turning to  Athens,  enters  "the  compact 
house  of  Erechtheus,"  which  later  became 

to     Athena    apotropaia    and    Apollo    apotropaios. 
28  Rohde,  I,  254. 
24  Rohde,  I,  254,  footnote  2. 
-'  Rohde,  I,  1 35-14 1. 


Zeus  Meilichios  in  serpent  form  (chthonic  aspect).  Attic 
votive  tablet  in  bas-relief  (4th  century  B.C.)  from  the 
Piraeus  (Old  Museum,  Berlin).  From  Eugen  Hollander's 
"Plastik  und  Medizin,"  Stuttgart,  F.  Enke,   1912,  p.  37. 


44 


Annals  of  Medicd  History 


an  Erechtheion,  in  which  the  two  were 
worshipped  in  common.  In  a  crypt  of 
this  temple,  Erechtheus  was  supposed  to 
live  on  eternally  in  chthonic  form  as  a 
serpent.  A  later  tradition  describes  him  as 
"buried"  in  one  place  or  another.  Here 
we  have  three  characteristic  stages  in  the 
progress  of  a  tradition:  an  ancient  chthon- 
ian  god,  living  in  the  depths  of  the  earth,  is 
transformed  into  a  mortal  hero  rendered 
immortal  by  an  Olympian  goddess,  sharing 
her  temple;  finally,  a  mortal  hero  again,  he 
is  buried  in  the  same  place.  So,  too,  in  the 
temple  of  Apollo  at  Amvche    in    Laconia, 


favor,  a  buried  mortal  suppressed  and 
supplanted  by  a  god.  Achilles,  a  mortal 
hero  in  Homer,  was  worshipped  as  a  god  in 
Epirus,  Astypalaea  and  Erythraea;  at  Elis, 
he  was  revered  as  a  hero  with  mantic 
powers,  and,  at  his  annual  festival,  women 
mourned  over  his  empty  "grave"  at  sunset. 


Votive  relief  tablet  to  Zeus  Meilichios  from  the 
Piraeus  (National  Museum,  Athens).  From  Hol- 
lander's "Plastik  und  Medizin,"  p.  118. 


Votive  stone  to  Zeus  Meilichios  (Berlin 
Museum),  showing  the  worship  of  the  god 

in  his  chthonic  aspect.  From  Hollander, 
op.  cit.,  p.  117.  /Esculapius  was  also 
worshipped  in  chthonic  form  and  as 
"  I  leros  Iatros."  According  to  the  elder 
Pliny  and  Ovid,  the  cult  of  .-Esculapius  as 
a  medical  divinity  was  transplanted  from 
Epidaurus  to  Rome  in  the  form  of  a 
huge  serpent  {"in  serpenie  deus"). 


the  bronze  statue  of  the  god  surmounted  an 
altar  under  which  Hyacinthus  was  said  to 
lie  buried.  The  decorations  on  the  altar 
depicted,  not  the  tender  Annclaan  youth 
beloved  of  Phoebus,  but  a  mature,  bearded 
man.  As  in  the  Python  legend,  we  have 
here  an  ancient  earth-god  suppressed  and 
displaced  by  the  Hyperborean  deity,  prob- 
ably, Rohde  thinks,  "after  the  Dorian 
invasion  of  the  Achaian  land."  The  changes 
rung  upon  tradition  are  the  same:  an 
aboriginal  earth  god,  a  beautiful  youth 
changed    into   a    Rower    through    a    ^od's 


In  the  cult  of  .Esculapius,  the  tradition 
undergoes  the  same  transformations.  In 
his  original  form,  he  is  an  ancient  I  hes- 
salian  earth  divinity,  a  local  daemon,  who 
combined  healing  powers  with  the  gift  ol 
prophecy.  In  Homer,  he  is  a  mortal  hero, 
who  learned  medicine  from  Chiron,  and 
whose  sons,  Machaon  and  Podalirius,  figure 
as  actual  military  surgeons  in  the  Iliad. 
Struck  by  a  thunderbolt  of  jealous  /ens, 
he  is  snatched  to  the  skies  and  rendered 
immortal."      In      statue,      coin      or      bust, 

Esculapius  i^  mack'  to  resemble  Zeus,  in 


hde,  I,  141    1  ti.  "/Esculapius,  ut  in  deum  surgat,  fulminatur."  Minucius  Felix,  XXII,  7- 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine      45 


token  of  his  uranic  or  celestial  aspect. 
Sophocles  was  actually  heroized,  acquired 
a  hero-cult,  because  he  once  entertained 
the  god  yEsculapius  in  his  house.27  In 
Athens,  a  Hero-Physician  ("Hpus  iarpos) 
was  worshipped  at  a  special  shrine,  near 
the  Theseion  (Demosthenes).28  Finally, 
,-EscuIapius  becomes  a  mortal  again,  and 
his  "grave"  is  shown  in  various  places.29 
Machaon  acquires  a  grave  and  a  shrine  at 
Gerenia,  on  the  Laconian  coast.  Podalirius 
has  a  grave  and  "Heroon"  near  Mount 
Garganus  in  Apulia,  where  incubation 
(temple  sleep)  is  practised  by  the  sick, 
and  rams  are  sacrificed.  His  son,  Polemoc- 
rates,  had  a  shrine  at  Eua  in  Argolis. 

Alexanor,  brother  of  Polemocrates,  had 
a  Heroon  at  Titane  near  Sicyon.  Aristo- 
machus,  another  Heros  Iatros,  had  a 
healing  oracle  at  Marathon.  And  so  with 
all  the  Asclepiads.30  The  original  chthonic 
character  of  ^sculapius  is  suggested  by 
the  fact  that  the  snake  was  not  only  sacred 
to  him  and  associated  with  him,  but,  as 
with  the  cave-gods  and  the  heroes,  x&ovwi 
both,  he  himself  appeared  in  serpent  form. 
The  cock  sacrificed  to  him  by  Socrates  on 
lea1  ing  the  world  was  a  chthonic  offering. 
The  snake  of  the  Epidaurian  temple  is  the 
ayados  Sai/xwu,  the  "  good  daemon "  of 
the  household  cult,  a  cult  which  was  later 
transplanted  to  Rome  with  the  worship  of 
/Esculapius,  as  we  shall  see.  The  staff, 
entwined  with  a  serpent,  was  the  symbol  of 
Serapis,  Hermes  and  yEscuIapius.  Doubt- 
less the  strange  aspect  of  the  serpent,  its 
cold  eye  and  the  fascination  attributed  to 
it,  its  darting  tongue,  its  capacity  for  chang- 
ing its  appearance  by  rapid  coiling  and 
uncoiling,  its  swift  progression  and  attack, 
the  death-dealing  powers  of  the  poisonous 
species,  its  supposed  value  as  a  remedy  in 

27  Rohde,  I,  176,  footnote  6. 

28  Rohde,  I,  173,  footnote  3. 

29  Rohde,  I,  142-143.  30  Rohde,  I,  185-186. 
31  See  E.  Hollander,  "Die  Schlange,"  "Plastik  und 

Medizin,"  Stuttgart,  1912,  87-95. 


certain  diseases,  may  have  given  color  to 
the  notion  that  the  creature  was  possessed 
of  daemonic  powers. 31  Max  Hofler  calls 
attention  to  the  fact  that  the  Greek  word 
6<£is  (from  which  root  o<£i?aX//os  is  also 
derived)  implies  "the  gazing  animal,"  the 
creature  that  is  always  looking  at  one.32 
The  fact  that  the  snake  lives  in  holes  in  the 
ground  gave  it  a  natural  association  with 
the  chthonian  underworld,  and  made  it  the 
logical  guardian  and  genius  loci  of  temples, 
shrines,  oracles  and  healing  springs.  Parkes 
Weber  says  that  "the  harmless  snakes, 
which  at  the  present  time  abound  in  the  hot 
caverns  and  natural  or  artificial  galleries 
where  thermal  springs  arise  in  the  Pyrenees, 
are  probably  the  same  as  those  connected 
with  the  worship  of  Asclepios  (/Esculapius) 
in  Greece  and  Rome."33  The  size,  strength 
and  dangerous  character  of  the  Asiatic  and 
African  pythons  may  well  have  suggested 
a  giant  transformed  or  a  metamorphosed 
god.  In  the  several  votive  tablets  to  the 
apotropaic  snake-god  Zeus  Meilichios,  in 
the  museums  at  Athens  and  Berlin  (Plate 
II),  the  huge  pythons  are  represented  as 
awe-inspiring.  The  elder  Pliny,  in  his 
Natural  History  (XXIX,  22),  relates  that 
the  ^Esculapian  cult  was  introduced  into 
Rome  from  Epidaurus  in  this  chthonic 
form,  and  that,  in  consequence,  the  rearing 
of  tame  snakes  in  private  houses  soon 
became  an  obnoxious  fashion  among  the 
Roman  dames: 

"The  yEscuIapian  snake  was  first 
brought  to  Rome  from  Epidaurus,  but  at 
the  present  day  it  is  commonly  reared  in 
our  houses  even;  so  much  so,  indeed,  that 
if  the  breed  were  not  kept  down  by  the 
frequent  conflagrations  it  would  be  im- 
possible to  make  head  against  the  rapid 
increase  of  them." 

32  M.  Hofler:  Die  volksmedizinische  Organother- 
apie,  Stuttgart,  1908,  142. 

33  F.  Parkes   Weber:    "Aspects  of  Death  in  Art 
and  Epigram,"  2.  ed.,  London,  1914,  386. 


46 


Annals  of  Medical  History 


The  introduction  of  the  ^Esculapian  cult, 
which  was  occasioned  by  a  devastating 
epidemic  in  293  B.C.,  gradually  displaced 
the  worship  of  Febris,  Mephitica,  Angeronia, 
Fluonia,  and  the  other  Roman  household 
gods  of  medicine.  Ovid  (Metamorphoses, 
XV,  626-744)  indulges  poetic  license  to  the 
extent  of  conceiving,  at  great  length,  how 
/Esculapius  himself  proceeded  from  Epi- 
daurus  to  Rome  in  the  form  of  a  gigantic 
serpent — how,  upon  the  advent  of  a  ghastly 
pestilence,  the  oracle  of  Apollo  directed  the 
stricken  Romans  to  seek  the  aid  of  Apollo's 
son,  how  the  embassy  proceeded  to  Epi- 
daurus,  how  yEscuIapius  appeared  to  them 
in  a  dream,  announcing  that  he  would 
change  himself  into  a  serpent,  how  the  god 
revealed  himself  to  them  in  the  temple 
next  morning  in  this  form — 

Cum  cristis  aureus  altis 
In  serpen te  deus  prsenuntia  sibila   misit — 

how  he  condescended  to  sail  with  them  to 
Rome,  weighing  down  the  ship  with  his 
immense  bulk,  and  how,  upon  arriving, 
he  resumed  his  heavenly  aspect,  ended  the 
pest  and  became  health-bringer  to  the  city — 

Et  finem  specie  caeleste  resumpta 
Luctibus  imposuit  venitque  salutifer  urbi. 

In  commemoration  of  this  event,  the 
Romans  gave  the  eastern  corner  of  an  island 
in  the  Tiber  (now  the  Isola  S.  Bartolommeo) 
the  form  of  the  bow  of  a  ship,  shaped  out 
by  a  facade  of  travertine,  the  mast  being 
represented  by  an  obelisk,  and  the  prow 
being  decorated  with  a  bust  of  ^Esculapius, 
with  the  staff  and  chthonic  snake.  In 
what  remains  of  the  ancient  travertine, 
the  bust  has  been  sawn  off  flush  with  the 
surface.  The  staff  and  serpent  remain, 
and  were  photographed  in  1867,  although 
now  covered  with  sand  and  slime.  M 

In   the   ancient   Roman    Pantheon,    the 

"Hollander:  "Plastik  und  Medizin,"  Stuttgart, 
1912,  90-92. 

"Kissel:  Janus,  Breslau,  1848,  III,  600-603. 

"Heidel:  Harvard  Stud.  Class.  Philol.,  191 1, 
XXII,  ni-172. 


equivalents  of  the  chthonian  Hades  and 
Persephone  were  Orcus,  also  called  Dis, 
Viduus  or  Consus,  and  Libitina  (Lubentia, 
Lubia).  To  Orcus  and  Mania  (the  mother 
of  the  Lares),  Tarquinius  Superbus  insti- 
tuted the  sacrifice  of  children  during  the 
Compitalia;  but  after  the  expulsion  of  the 
Tarquins,  the  consul  Lucius  Junius  Brutus 
substituted  garlic  and  poppies  as  offerings 
to  these  gods. 3S 

It  is  a  curious  fact  that  the  apotropaic 
medicine  of  the  ancients  was  directly  con- 
nected with  the  omnipresent  idea  of  the 
efficacy  of  invisible  effluvia,  the  impercep- 
tible evaporation  from  substances.  Era- 
pedocles  instances  the  hounds  following  the 
scent,  and  Lucretius  the  drying  or  moisten- 
ing of  garments  at  the  seaside,  the  gradual 
wearing  away  of  a  ring  on  the  finger,  of 
pavements,  ploughshares,  statues,  seaside 
cliffs  by  gradual  attrition,  the  salt  taste  in 
the  mouth  at  the  seaside,  as  showing  "the 
existence  of  effluvia  streaming  unceasingly 
from  all  bodies"  (Heidel).  Fumes  of 
pitch,  asphalt  and  sulphur  were  thought  to 
purify.  Juniper  branches  which  supplied 
part  of  the  incense  of  ancient  sacrifices, 
were  burned  in  the  Middle  Ages  to  disinfect 
houses  of  the  plague.  Hemp  (Cannabis 
indica),  which  Herodotus  (I,  202,  IV,  75) 
says  was  burned  by  the  Messagetae  and 
the  Scythians  in  order  to  intoxicate  them- 
selves with  its  fumes,  formed  one  of  the 
mediaeval  substitutes  for  surgical  anesthesia 
by  inhalation.  Long  before  the  Middle 
Ages,  Dioscorides  (IV,  81)  stated  that 
anesthesia  could  be  produced  by  inhalation 
of  mandragora  wine.  Professor  William 
A.  Heidel,  in  his  study  of  the  "Antecedents 
of  Greek  Corpuscular  Theories, "  36  gives 
an  admirable  summary  of  the  matter  on 
the  mythological  side: 

"The  primitive  Greek  saw  in  nature  the 
play  of  daemonic  beings:  the  religion  of  the 
people,  however  much  glossed  over  by  the 
Homeric  and  post-Homeric  tradition,  was 
at  bottom  one  of  magic  and  of  occult 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine      47 


powers.  Spirits  were  everywhere,  and  spir- 
its were  believed  to  be  chiefly  of  chthonic 
origin.  The  evidence,  which  is  to  be  found 
in  the  handbooks,  need  not  here  be  re- 
peated. Every  one  is  acquainted  with  such 
facts  as  that  mephitic  vapors  were  the  ob- 
jects of  worship;37  that  Plutonia,  Charo- 
nia,  or  hell-gates,  where  vapors  or  hot- 
springs  issued  from  the  earth,  were  sa- 
cred,38 because  the  exhalations  were  re- 
garded as  spirits, — spirits  of  the  dead.  It 
was  to  these  spirits  that  women  looked  for 
fertility39  and  mankind  for  increase  of 
flocks  and  herds  and  for  the  fruitfulness  of 
the  soil.  From  Hades,  we  are  told,  or  from 
the  dead,  come  not  only  the  souls  of  the 
living,  but  also  life,  nourishment,  growth, 
and  the  seeds  of  fruitfulness.40  The  spirits 
of  the  winds  are  earth-born,  and  lord  it 
over  the  surface  of  the  earth.41  It  is  to  the 
occult  influences  which  they  exercise  that 
tabooed  objects  owe  their  sacredness.42 
The  Pythia  derived  her  inspiration  partly 
from  the  aroma  of  the  laurel,  chewed  and 
burned,  partly  from  the  vapors  issuing 
from  the  fissure  above  which  her  tripod 
was  placed.  Smoke  and  aromatics  were 
quite  generally  regarded  as  producing  'en- 
thusiasm' or  possession  by  the  godhead.43 
Aromatics,  which  possess  the  power  of 
throwing  off  continuous  streams  of  effluvia 
without  perceptible  diminution,  had  great 
significance  to  Greek  thought,  although  it 
has  been  generally  overlooked.  The  Foun- 
tain of  Youth  in  Ethiopia,  described  by 
Herodotus,  was,  like  the  incense,  the 
pleasant  savor,  and  the  ambrosia  on  which 
the  gods  fed,  aromatic  and  so  ethereal  as 
to  be  almost  comparable  to  a  vapor-bath; 
the  foods  partaken  at  the  wedding-feast 

37  Frazer:  Adonis,  Attis,  Osiris  (Golden  Bough,  pt. 
IV),  London,  1914,  I,  203-206. 

38  Rohde,  I,  213,  footnote  1. 

39  Rohde,  I,  246-249. 

40  Hippocrates:    De    diaeta,    92     (Littre,    VI,    p. 
658). 

41  Rohde,  I,  247. 

42  Farnell:  Cults  of  the  Greek  States,  III,  132. 


and  at  the  sacramental  meal  of  the  Mys- 
teries are  all  pungent  or  aromatic,  as  are 
also  the  herbs  laid  beneath  the  dead  at 
funerals. 

"  But  it  is  a  bad  rule  that  does  not  work 
both  ways.  The  same  exhalations  which 
are  welcome  to  one  being  will  prove  to  be 
unwelcome  to  another.  What  is  one  dae- 
mon's poison  is  another's  meat.  Thus  ex- 
halations or  effluvia  of  various  kinds  are 
the  chief  apotropaic  and  purificatory 
means  employed  in  the  most  diverse  cir- 
cumstances. .  .  . 

"Sunlight,  as  the  power  of  a  superior 
god,  is  itself  purifying;  fire  again  is  the 
purifying  and  apotropaic  agency  par  ex- 
cellence, as  possessing  the  most  evident 
and  most  various  emanations.  Loud  noises 
and  the  means,  chiefly  metallic,  of  pro- 
ducing them,  are  considered  especially  ef- 
fective; but  hardly  less  the  effluvia  which 
strike  the  sense  of  smell.  'The  daemons 
love  not  the  reek  of  torches.'44  The  purifi- 
catory use  of  sulphur  is  known  to  Homer.45 
During  the  great  plague  at  Athens  they 
burned  'sweet-smelling  wood.'46  Almost  all 
cathartic  simples  known  to  the  materia 
medica  of  the  Greeks  possess  a  strong  odor, 
rank  or  aromatic;  wines  are  diuretic,  dia- 
choretic,  or  constipating  according  as  they 
are  aromatic  or  not;  flatulent  (in>tvij.aTw5ris) 
food  was  tabooed  by  the  Pythagoreans 
and  Empedocles.47  The  efficacy  of  olive  oil 
as  a  daily  unguent  and  at  burial  was  no 
doubt  partly  due  to  its  aromatic  proper- 
ties; hence  also  the  use  of  it,  or  of  wine,  in 
the  first  bath  given  to  the  infant,  and  sub- 
sequently in  Christian  baptism.  Nor 
should  we  overlook  the  extensive  use  of 
fumigations  by  Greek  physicians;  such  as 

43  Rohde,  II,  60. 

44  Plato,  Phaon,  apud  Athen.,  10,  58,  442A. 
46  Iliad,  XVI,  228;  Odyssey,  XXII,  481. 

46  Wellmann :  Fragmente  der  griechischen  Aerzte, 
I,  109. 

47  Rohde,  II,  162,  footnote  6;  164,  footnote  1;  181, 
footnote  2.  Hippocrates:  De  diaeta,  II,  45  (Littre, 
VI,  542). 


48 


Annals  of  Medical  History 


the  internal  fumigation  of  women  after 
childbirth,  and  as  an  emmenagogue.48 
Finally,  water,  a  universal  means  of  puri- 
fication, doubtless  owed  its  power  in  part 
to  the  abundant  evaporation,  which  con- 
nected it  on  the  one  side  with  the  fructify- 
ing spirits  which  give  fertility,  and  on  the 
other  side  with  apotropaic  functions." 

Max  Hofler  has  shown,  in  a  very  exhaus- 
tive way,  that  the  chthonian  deities  exerted 
a  strange  influence  upon  Greek  pharma- 
cology and  therapeutics.  The  very  opening 
lines  of  the  Iliad  bring  us  in  touch  with  the 
legendary  aetiology  and  prophylaxis  of 
pre-Hippocratic  medicine — the  pestilence 
visited  upon  the  Grecian  host  by  the  wrath 
of  Apollo,  and  the  elaborate  transactions 
and  sacrificial  ritual  required  to  avert  it. 
From  what  is  known  of  the  chthonian 
deities,  we  can  better  understand  the 
significance  of  the  Hippocratic  treatise 
"On  the  Sacred  Disease,"  the  strongest 
brief  for  a  rational  pathology  before  the 
time  of  Galen.  The  locus  classicus  (in 
Francis  Adams'  translation)  is  as  follows: 

"They  who  first  referred  this  disease  to 
the  gods,  appear  to  me  to  have  been  just 
such  persons  as  the  conjurors  (nayoi), 
purificators  (Kadaprai),  mountebanks  (ayip- 
t<u)  and  charlatans  (aXafovej)  now  are, 
who  give  themselves  out  for  being  exces- 
sively religious,  and  as  knowing  more  than 
other  people.  Such  persons,  then,  using  the 
divinity  as  a  pretext  and  screen  of  their  own 
inability  to  afford  any  assistance,  have 
given  out  that  the  disease  is  sacred,  add- 
ing suitable  reasons  for  this  opinion,  they 
have  instituted  a  mode  of  treatment  which 
is  safe  for  themselves,  namely,  by  apply- 
ing purifications  and  incantations,  and 
enforcing  abstinence  from  baths  and  many 

u  Diils:  Anonymi  Londinensis,  37,  30  et  seq. 

49  In  Plato  (Phacdrus,  244),  diseases  are  said  to 
originate  raKaiCiv  ix  /iTjvi/iirojv —  which  may  mean 
"from  ancient  wrath"  (of  unburied  dead  of  past 
"or  from  ancient  bloodshed."  In  Soph- 
ocles (Trachinia:,  1235),  insanity  is  a  "possession  by 


articles  of  food  which  are  unwholesome  to 
men  in  disease.  Of  sea  substances,  the  sur- 
mullet, the  blacktail,  the  mullet,  and  the 
eel;  for  these  are  the  fishes  most  to  be 
guarded  against.  And  of  fleshes,  those  of 
the  goat,  the  stag,  the  sow,  and  the  dog: 
for  these  are  the  kinds  of  flesh  which  are 
aptest  to  disorder  the  bowels.  Of  fowls,  the 
cock,  the  turtle,  and  the  bustard,  and  such 
others  as  are  reckoned  to  be  particularly 
strong.  And  of  potherbs,  mint,  garlic  and 
onions;  for  what  is  acrid  does  not  agree 
with  a  weak  person.  And  they  forbid  to 
have  a  black  robe,  because  black  is  ex- 
pressive of  death;  and  to  sleep  on  a  goat's 
skin,  or  to  wear  it,  and  to  put  one  foot 
upon  another,  or  one  hand  upon  another; 
for  all  these  things  are  held  to  be  hin- 
drances to  the  cure.  All  these  they  enjoin 
with  reference  to  its  divinity.49 .  . .  By  such 
sayings  and  doings,  they  profess  to  be  pos- 
sessed of  superior  knowledge,  and  deceive 
mankind  by  enjoining  lustrations  and 
purifications  upon  them,  while  their  dis- 
course turns  upon  the  divinity  and  the 
godhead.  And  yet  it  would  appear  to  me 
that  their  discourse  savors  not  of  piety,  as 
they  suppose,  but  rather  of  impiety,  and 
as  if  there  were  no  gods,  and  that  what 
they  hold  to  be  holy  and  divine,  were  im- 
pious and  unholy.  This  I  will  now  explain. 
For,  if  they  profess  to  know  how  to  bring 
down  the  moon,  and  darken  the  sun,  and 
induce  storms  and  fine  weather,  and  rains 
and  droughts,  and  make  the  sea  and  land 
unproductive,  and  so  forth,50  whether  they 
arrogate  this  power  as  being  derived  from 
mysteries  or  any  other  knowledge  or  con- 
sideration, they  appear  to  me  to  practice 
impiety,  and  either  to  fancy  that  there  are 
no  gods,  or,  if  there  are,  that  they  have  no 
ability  to  ward  off  any  of  the  greatest 

fiends"  (the  Babylonian  sibtu);  in  Furipides  (Her- 
cules Fureus,  907)  it  is  "Tartaric  disquietude." 

60  It  is  interesting  to  note  that  all  this  comes  within 
the  scope  of  the  North-American  Indian's  concept  of 
"making  medicine,"  the  special  function  of  the  med- 
icine-man. 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine 


49 


evils.  How,  then,  are  they  not  enemies  to 
the  gods?  For  if  a  man  by  magical  arts  and 
sacrifices  will  bring  down  the  moon,  and 
darken  the  sun,  and  induce  storms,  or  fine 
weather,  I  should  not  believe  that  there 
was  anything  divine,  but  human,  in  these 
things,  provided  the  power  of  the  divine 
were  overpowered  by  human  knowledge 
and  subjected  to  it.  But  perhaps  it  will  be 
said,  these  things  are  not  so,  but,  men 
being  in  want  of  the  means  of  life,  invent 
many  and  various  things,  and  devise  many 
contrivances  for  all  other  things,  and  for 
this  disease,  in  every  phase  of  the  disease, 
assigning  the  cause  to  a  god.  Nor  do  they 
remember  the  same  things  once,  but  fre- 
quently. For,  if  they  imitate  a  goat,  or 
grind  their  teeth,  or  if  their  right  side  be 
convulsed,  they  say  that  the  mother  of  the 
gods  is  the  cause.  But  if  they  speak  in  a 
sharper  and  more  intense  tone,  they  re- 
semble this  state  to  a  horse,  and  say  that 
Poseidon  (Neptune)  is  the  cause.  Or  if  any 
excrement  be  passed,  which  is  often  the 
case  owing  to  the  violence  of  the  disease, 
the  appellation  of  Enodia  (Hecate)  is  ad- 
hibited; or,  if  it  be  passed  in  smaller  and 
denser  masses,  like  bird's,  it  is  said  to  be 
from  Apollo  Nomius.  But  if  foam  be  emit- 
ted by  the  mouth,  and  the  patient  kick 
with  his  feet,  Ares  (Mars)  gets  the  blame. 
But  terrors  which  happen  during  the 
night,  and  fevers,  and  delirium,  and  jump- 
ings  out  of  bed,  and  frightful  apparitions, 
and  fleeing  away, — all  these  they  hold  to 
be  the  plots  of  Hecate,  and  the  invasions 
of  the  Heroes,61  and  use  purifications  and 
incantations,  and,  as  appears  to  me,  make 
the  divinity  to  be  most  wicked  and  most 
impious.  For  they  purify  those  laboring 
under  this  disease,  with  the  same  sorts  of 
blood  and  the  other  means  that  are  used 
in  the  case  of  those  who  are  stained  with 

61  See,  also,  the  Hippocratic  De  insomniis;  for 
the  Greek  ritual  of  purification  in  case  of  murder, 
and  its  relation  to  therapeutics,  see  Rohde,  I,  259- 
300. 


crimes,52  and  of  malefactors,  or  who  have 
been  enchanted  by  men,  or  who  have  done 
any  wicked  act;  who  ought  to  do  the  very 
reverse,  namely,  sacrifice  and  pray,  and, 
bringing  gifts  to  the  temples,  supplicate 
the  gods.  But  now  they  do  none  of  these 
things,  but  purify;  and  some  of  the  purifi- 
cations they  conceal  in  the  earth,  and 
some  they  throw  into  the  sea,  and  some 
they  carry  to  the  mountains  where  no  one 
can  touch  or  tread  upon  them.63  But  these 
they  ought  to  take  to  the  temples  and 
present  to  the  god,  if  a  god  be  the  cause  of 
the  disease.  Neither  truly  do  I  count  it  a 
worthy  opinion  to  hold  that  the  body  of 
man  is  polluted  by  god,  the  most  impure 
by  the  most  holy;  for  were  it  defiled,  or  did 
it  suffer  from  any  other  thing,  it  would  be 
like  to  be  purified  and  sanctified  rather 
than  polluted  by  god.  For  it  is  the  divinity 
which  purifies  and  sanctifies  the  greatest 
of  offenses  and  the  most  wicked,  and 
which  proves  our  protection  from  them. 
And  we  mark  out  the  boundaries  of  the 
temples  and  the  groves  of  the  gods,  so  that 
no  one  may  pass  them  unless  he  be  pure, 
and  when  we  enter  them  we  are  sprinkled, 
with  holy  water,  not  as  being  polluted,  but 
as  laying  aside  any  other  pollution  which 
we  formerly  had.  And  thus  it  appears  to 
me  to  hold,  with  regard  to  purifications. 
But  this  disease  seems  to  me  to  be  nowise 
more  divine  than  others;  but  it  has  its  na- 
ture such  as  other  diseases  have,  and  a 
cause  whence  it  originates,  and  its  nature 
and  cause  are  divine  only  just  as  much  as 
all  others  are,  and  it  is  curable  no  less  than 
the  others,  unless  when,  from  length  of 
time,  it  is  confirmed,  and  has  become 
stronger  than  the  remedies  applied.  Its 
origin  is  hereditary,  like  that  of  other  dis- 
eases." 

62  Rohde,  II,  69-80,  405-407. 

63  The  sacrificial  offerings  (Kadapcna)  of  the  rite  of 
purification  or  the  water  of  lustration  became 
Kadapnara  (rejects)  after  the  ceremony  and  were 
thrown  away  (Rohde,  II,  79,  footnote  1). 


50 


Annals  of  Medical  History 


The  writer  of  this  Hippocratic  treatise 
makes  a  clean  sweep  of  all  the  superstitions 
which  were  the  basis  of  Greek  therapy  in 
the  period  between  Homer  and  the  Periclean 
age.  The  centric  feature  of  this  therapy 
was  the  idea  of  catharsis,  lustration  or 
purification  by  priests,  seers  or  magicians 
from  "miasms"  cast  upon  the  soul  or  the 
body  by  angered  gods,  spirits  of  the  un- 
buried  dead  (Ataphoi),  spirits  of  dead 
heroes,  daemons,  spirits  of  the  untimely 
dead  (Aoroi),  and  spirits  of  the  unborn  dead 
(Biothanatoi).  As  with  primitive  savage 
man,  priest,  soothsayer  (Mantis)  and  mage 
were  originally  one  and  the  same.  The 
parturient  woman,  the  new  born  child  and 
the  dead  were  "unclean,"  and  medicine 
was  either  cathartic,  designed  to  cast  out 
these  malign  influences,  apotropaic,  designed 
to  avert  them,  or  hilastic,  designed  to 
propitiate  angered  gods  and  departed  souls. 
If  a  "hero"  slaughtered  an  enemy  or  exer- 
cised bloody  revenge  upon  the  murder  of  a 
relative,  he  was  conscious  of  no  moral 
qualms,  of  the  kind  sensed  by  the  Athenians 
when  they  ceased  to  bear  arms,  but  of  the 
need  for  "purification"  from  the  evil  in- 
fluence (niaona)  arising  from  his  contact  with 
the  dead  and  supposed  to  emanate  from 
his  person;  furthermore,  he  sought  pro- 
tection from  the  revengeful  deities  of  the 
underworld.  In  the  second  Iliad,  the 
Greeks  avert  the  pestilence  sent  by  Apollo 
through  the  sacrifice  of  oxen,  of  which  they 
partake  in  a  huge  barbecue.  In  the  Odyssey 
(XXII,  481-494),  after  slaughtering  the 
suitors,  Odysseus  fumigates  the  house  with 
sulphur  (lustration).  The  things  inter- 
dicted by  the  professional  cathartists  in 
their  dietetic  treatment  of  the  "sacred 
disease" — the  fish,  goat,  sow,  dog,  cock,  as 
also  the  potherbs — were  sacred  to  the 
chthonian  gods.  The  animals  sacrificed  to 
them  were  usually  inedible  and  black  (or 
otherwise    uniform)    in   color.  The   apotro- 

MSee  Rohde,  passim,  and  Holler,  14,  etc. 
u  Mesiod:  Works  und  Duys,  41. 


paic  shrubs,  laurel,  myrtle,  whitethorn, 
squills,  hellebore,  mallow,  asphodel,  figs, 
and  such  ingredients  of  sacrificial  incense 
as  juniper,  made  up  a  kind  of  sacred 
botany,  set  apart  for  ritual  purification, 
and  only  partaken  of  by  the  worshippers 
during  the  act  of  sacrifice.54  Hesiod  says 
that  asphodel,  mallow  and  squills  (plants 
dedicated  to  the  Chthonioi)  were  only  eaten 
by  very  poor  and  ignorant  people.55  In  the 
purely  religious  cult,  the  sharing  of  the 
sacrificial  cakes  and  other  altar  offerings 
was  regarded  as  entering  into  communion 
with  the  god  or  as  part  of  the  mystic 
ceremony  of  "eating  the  god,"  which 
Frazer  found  common  to  so  many  primitive 
peoples.56  In  these  apotropaic  rituals, 
the  priests  and  the  worshippers  acted 
openly  and  e.v  officio;  but  apart  from  the 
priesthood,  the  cathartists  and  magicians 
sought  in  secret  to  enlist  the  aid  of  the 
Chthonioi  and  the  spirits  of  the  departed 
by  similar  rites.  Thus  arose  a  kind  of 
ritual  therapy,  in  which  certain  plants  and 
the  parts  of  certain  animals  gradually  came 
to  be  used  as  actual  therapeutic  devices. 
In  Dioscorides,  Pliny,  the  magic  papyri  and 
the  Abraxas,  as  Hofler  shows,  artemisia  is 
"the  blood  of  Hephaistus, "  camomile  the 
blood  of  Hestia,  cedar  resin  the  blood  of 
Kronos,  juniper  the  blood  of  Saturn,  Ver- 
bena officinalis  the  blood  of  Hermes. 57 
The  fumes  of  incense,  ashes  and  rejects  of 
sacrifice  acquired  therapeutic  values.  The 
fox,  wolf,  dog,  weasel,  cow,  ram,  goat,  lion, 
mouse,  and  certain  birds,  fishes  and  reptiles, 
being  all  animals  dedicated  to  the  Chthonioi, 
made  up  an  extensive  animal  therapy, 
based  largely  upon  these  associations.  That 
this  therapy  was  mainly  an  associative 
therapy  is  obvious  from  the  painstaking 
researches  of  Hofler,  who  shows  that  each 
remedy  became,  in  some  sort,  an  open  secret, 
justified    by    its    mythologic    associations. 

M  Sir  J.  G.  Frazer:  Spirits  of  the  Corn  and  the  Wild 
(Golden  Bough,  pt.  V),  London,  1912,  II,  48-108. 
•'  Httfler,  op.  cit,  1 7-20. 


Greek  Cult  of  the  Dead  and  Chthonian  Deities  in  Ancient  Medicine     51 


In  the  ancient  Thargelian  festivals  of  the 
Ionic  cities,  a  town  was  "purified"  by 
selecting  as  scapegoats  (Pharmakoi)  two 
vagabonds  who  were  flogged  with  squills 
and  agnus  castus  and  driven  into  the  sea,68 
just  as  the  catharmata  (rejects  of  lustration 
or  penitential  sacrifice)  were  scattered 
at  crossroads  or  cast  into  the  water. 
But  even  as  the  drug  (<t>apnaicov)  was  sacred 
in  a  good  and  a  bad  sense,  through  its  asso- 
ciation with  the  chthonic  idea  of  atonement 
or  propitiation  by  means  of  a  substitute 
or  scapegoat  (0ap^a/c6s),59  so  this  empirical 
therapy  became  more  and  more  detached 
from  the  priestly  cult  of  the  shrines  and 
Asclepieia.  Of  the  innumerable  simples 
and  animal  remedies  recommended  by  Dios- 
corides  and  Pliny,  it  is  obvious  that  but 
few  have  any  pharmacologic  rationale  in 
the  sense  of  Schmiedeberg  and  Cushny. 
Black,  hellebore  (Helleborus  niger),  with 
which  the  seer  Melampus  purged  the 
daughters  of  Proitus  of  their  insanity  and 
which  Hippocrates  used  as  a  rational  purge, 
was  originally  sprinkled  about  to  "purify" 
houses  and  hearths;  but  white  hellebore 
(Veratrum  album)  which  was  employed  as 
a-i  emetic,  was  never  associated  with  the 
heart.  The  strangest  animal  remedies  were 
employed  against  sterility  and  to  promote 
fecundity  in  women,  the  point  d'appui  of 
Greek  gynecology.  Furthermore,  the 
chthonic  animal  remedies  were  used  in  the 
most  varied  and  capricious  way  in  the 
treatment  of  visceral  disease,  a  subject 
of  which  the  ancients  knew  little  or  nothing. 

58  Rohde,  II,  78,  footnote  2. 
69  Hofler,  26. 

60  Hofler,  279-291. 

61  See  Frazer's  chapter,  "The  homoeopathic  magic 
of  a  flesh  diet"  in  "Spirits  of  the  Corn  and  the  Wild," 
London,  191 2,  II,  138-168. 

62  P.  Stengel:  Chthonischer  und  Totenkult.  Fest- 
schr.  z.  50  jahr.  Doktorjubil.  L.  Friedlander,  Leipzig, 
1895,  414-432. 

63  The  Greek  equivalents  were  the  Genesia,  birth- 
day festivals  of  the  dead,  and  the  feast  of  all  souls, 
which  formed  part  of  the  Dionysian  Anthesteria, 
early  in  the  spring.  These  were  regarded  as  "impure 


The  Greeks  had  no  more  to  do  with  the  mod- 
ern theory  of  animal  extracts  than  had  the 
repulsive  prescriptions  of  the  Dreckapotheken 
or  the  early  London  Pharmacopoeias.  From 
a  careful  analysis  and  tabulation  of  1254 
therapeutic  prescriptions  of  the  ancients 
(including  those  of  the  Northern  races), 
Hofler  shows  that  the  different  parts  of  the 
animal  body  were  never  employed  exclu- 
sively to  heal  diseases  of  the  same  parts  in 
the  human  body,  but  haphazard,  according 
to  the  tenets  of  the  chthonian  cult.60 
In  other  words,  Greek  organotherapy  was 
homoeopathic  magic  in  Frazer's  sense,61  but 
hardly  isotherapy,  in  the  sense  of  "like 
cures  like." 

In  accepting  Hofler's  conclusions,  we 
should  not  lose  our  respect  for  Greek 
therapy,  bearing  in  mind  that  Galen  was 
one  of  the  greatest  rational  therapeutists 
who  ever  lived,  and  that  Dioscorides  con- 
tains almost  every  sample  known,  up  to  the 
days  of  analytic  and  synthetic  chemistry. 
Further,  Hofler's  sweeping  inclusion  of  the 
spirits  of  the  dead  among  the  Chthonioi 
must  be  modified  and  corrected.  In  the 
Friedlander  Festschrift,  Paul  Stengel62  shows 
that  the  Greek  cult  of  the  dead,  while 
originally  apotropaic,  became  in  time  purely 
pietistic,  a  quiet,  intimate  family  cult,  like 
that  of  our  All  Souls'  Day.63  The  chthonian 
gods  were  appeased  by  piacular  sacrifices, 
that  is  by  propitiatory  or  penitential  offer- 
ings. The  sacrificial  offerings  to  the  dead  were 
nutritive  libations  without  which  they  would 

days,"  when  all  the  dead  returned  (the  Roman  mun- 
dus  patet),  when  the  temples  of  the  gods  were  closed 
and  all  business  suspended.  Hawthorn  leaves  were 
chewed  at  dawn  and  the  doorposts  were  smeared  with 
pitch,  the  fumes  of  which  were  apotropaic;  private 
familial  offerings  were  made  and  libations  of  wine 
poured  out;  on  the  last  day  of  the  feast,  which  was 
dedicated  to  Hermes  Psychopompos,  pots  containing 
cooked  fruits  and  seeds  of  the  earth  were  set  apart 
"for  the  dead."  Like  the  "Ilicet"  which  dismissed  a 
Roman  funeral,  the  feast  terminated  with  the 
words:  "Away,  ye  KeresI  the  Anthesteria  are  over" 
(ddpafc  K-qpts,  o(ik  It'  'AvdtoT-qpia),  Rohde,  I,  234- 
239. 


52 


Annals  of  Medical  History 


starve,  always  poured  over  the  grave  it- 
self with  averted  countenance,  and  any  good 
which  accrued  to  the  offerer  was  of  secon- 
dary importance.  The  Chthonioi  required 
human  sacrifice,  or  the  substitution  of 
certain  non-edible  animals  as  scapegoats, 
or  else  sacrificial  cakes  made  of  the  burnt 
products  of  the  soil,  or  nephalia  (mixtures 
of  water,  milk  and  honey),  but  no  wine. 
Sacrifices  to  the  dead  were  seldom  human, 
but  usually  required  female  or  castrated 
animals,  and  always  included  wine. 
Sacrifices  to  the  Chthonioi  and  the  Heroes 
were  made  at  dead  of  night  on  low  lying 
altars.  And  the  cult  remained  immemorially 
the  same.  Sacrifices  to  the  dead  were  made 
originally  at  night,  later  in  broad  day, 
always  upon  a  grave,  and  their  apotropaic 
intention  finally  resolved  itself  into  in- 
timate familial  piety.  In  the  ancient  cult, 
the  dead  were  shrouded  in  royal  purple, 
the  color  of  the  Chthonioi. 

In  the  graphic  and  plastic  arts,  as  Lessing, 
and  after  him  Parkes  Weber  have  shown, 
the  ancient  figurations  of  death  were  usually 
serene  and  beautiful.  In  the  Iliad,  Hypnos 
and  Thanatos,  Sleep  and  Death,  are  twin 
brothers;  the  one  figured  on  antique  gems 
as  a  youth  with  wings  attached  to  his 
temples,  the  other,  as  he  appears  in  the 
Alcestis  of  Euripides,  a  winged  figure  clad 
in  black  with  drawn  sword.64  Hermes 
Psychopompos,  the  conductor  of  souls,  is 
the  Cyllenian  Mercury  of  the  Odyssey, 
with  the  golden  wand,  the  winged  golden 
sandals  and  kerykeion  (caduceus).  The 
soul  (Psyche)  is  figured  as  a  butterfly, 
sometimes  resting  on  the  shoulder  of 
Hermes,65  suggesting  the  animula,  vagula, 
blandula,  of  Hadrian,  or  the  charming  image 
of  Flaubert,  comme  une  psyche  curieuse, 
comme  une  time  vagabonde.  On  the  Roman 
memorial    tablets    and    gems,    Death    is    a 

M  For  a  picture  of  a  bas-relief  representing  Alcestis 
between  Hermes  and  Thanatos  (British  Museum), 
see  Parkes  Weber,  op.  cit.,  382. 

**  Parkes  Weber,  362,  388-390. 


cupid  with  an  inverted  extinguished  torch 
(Lessing).  The  skeleton  frequently  appears, 
on  antique  gems  and  wine-cups,  but  merely 
as  a  memento  mori,  never  as  an  image  of 
death.66  Some  of  these  skeletons  are  even 
tipsy  (Parkes  Weber).  The  mediaeval 
figurations  of  death  as  a  skeleton  may,  as 
Parkes  Weber  suggests,  have  come  from 
the  late  Roman  idea  of  representing  larvse 
as  skeletons  or  skin-and-bone  figures; 67 
but  it  is  also  highly  probable  that  the 
skeletons  in  the  Dance  of  Death  of  the 
younger  Holbein  may  have  been  derived 
from  the  innumerable  manuscript  illus- 
trations of  anatomy  which  began  to  be 
common  in  the  period.  Many  of  these 
represented  shriveled  or  hastily  dissected 
skeletal  preparations,  what  Sudhoff  terms 
the  Lemurengestalt.  In  the  passaca^lia 
which  forms  the  last  movement  of  Brahms' 
E  minor  symphony,  a  movement  which 
Max  Kalbeck  interprets  as  expressing  the 
sovereignty  of  Death  (Thanatos  Basileus), 
the  Holbein  idea,  Hermes  Psychopompos 
with  the  divinity  of  the  inverted  torch,  form 
the  leading  motive  of  the  lovely  interlude  in 
E  major.68 

But  what  Frazer  calls  "the  perils  of  the 
soul"  were  sensed  by  the  ancient  Greeks 
in  a  way  far  removed  from  the  sublime 
ne  me  perdas  of  Mozart's  Requiem  or 
even  the  sentiment  of  Plato.  In  Swin- 
burne's "Ilicet,"  which  dramatizes  the 
sensations  of  a  pagan  funeral,  we  ^ot  the 
feeling  of  primitive  man  about  the  necessity 
of  bloody  human  sacrifice  to  the  dead: 

Yea,  for  their  sake  and  in  death's  favor 
Things  of  sweet  shape  and  of  sweet  savor 
We  yield  them  spice  and  flower  and  wine; 
Yea,  costlier  things  than  wine  or  spices, 
Whereof  none  knoweth  how  great  the  price  is, 
And  fruit  that  comes  not  of  the  vine. 

M  Parkes  Weber,  18  (Boscoreale  wine  cup),  338-357. 
"  Parkes  Weber,  48. 

"Max  Kalbeck:  Johannes  Brahms,  Berlin,  1912, 
[11,476-83. 


Greek  Cult  of  the  Dead  and  Chthoman  Deities  in  Ancient  Medicine       53 


From  boy's  pierced  throat  and  girl's  pierced  bosom 
Drips,  reddening  round  the  blood-red  blossom, 
The  slow  delicious  bright  soft  blood, 
Bathing  the  spices  and  the  pyre, 
Bathing  the  flowers  and  fallen  fire, 
Bathing  the  blossom  by  the  bud. 

Repulsive,  sadistic  even,  as  these  lines 
may  seem  to  our  modern  taste,  they  yet 
stand  for  something  figured  on  scores  of 
antique  gems,69  something  which  undoubt- 
edly thrilled  the  primitive  Greek  with 
awe.  Concerning  this,  Havelock  Ellis  says: 
"There  can  be  no  ideal  conception  of  Life 
and  no  true  conception  of  Nature  if  we 
seek  to  shut  out  Death  and  Pain.  It  is 
the  feeble  shrinking  from  Death  and  the 
flabby  horror  of  Pain  that  mark  the  final 
stage  of  decay  in  any  civilization.  Our 
ancestors,  too,  offered  up  human  sacrifice 
on  their  altars,  and  none  can  say  how  much 
of    their    virility    and    how    much    of    the 

69  See  A.  Furtwangler,  Die  antiken  Gemmen, 
Leipzig,  1900,  or  the  figurations  of  human  sacrifice 
from  the  same  in  Hofler,  op.  cit.,  10-11. 


promise  of  the  future  they  held  in  their 
grasp  were  bound  up  with  the  fact."  70 
Rohde  tells  of  even  darker  rites.71  In 
the  Choephorae  of  /Eschylus  ('439)  and 
the  Electra  of  Sophocles  (445),  Clytaem- 
nestra  is  hinted  to  have  cut  off  the  hands 
and  feet  of  the  murdered  Agamemnon  and 
suspended  them  around  his  neck  (/uao-xaW- 
n6s),  lest  dead  hands  return  (as  in  Mau- 
passant's grisly  "La  Main" J  to  wreak 
vengeance.  "By  way  of  lustration"  (/ccbri 
\ovTpoi<nv),  she  wiped  the  bloody  weapon 
upon  his  head.  In  another  apotropaic  or 
cathartic  rite,  mentioned  in  .-Eschylus  (Fr. 
354),  the  wounds  of  the  murdered  body 
were  sucked  thrice  by  the  slayer  and  eject- 
ed from  the  mouth  in  three  successive 
spurts.  But  these  are  traits  of  the  raw 
primitive  which  we  can  stomach  for  a 
moment  but  upon  which  it  is  not  good 
to  dwell. 

70  Havelock    Ellis:    Impressions    and    Comments, 
Boston,  1914,  24-. 

71  Rohde,  I,  322-326. 


THE  THREE   CHARACTERS  OF  A    PHYSICIAN 


Enricus  Cordus.  1 486-1 555. 

Tres  medicus  Iiabet  facies,  unam,  quando  rogatur 
Angelicam;  mox  est,  cum  juvat,  ipse  Deus. 
Post  ubi  curato,  poscit  sua  praemia,  morbo. 
Horridus  apparet,  terribilisque  sathan. 

Three  Jaces  ivears  the  doctor:  when  first  sought 
An  angel's!  —  and  a  god's,  the  cure  half  wrought: 
But  when,  that  cure  complete,  he  seeks  his  fee, 
The  Devil  then  looks  less  terrible  than  be. 


VOLTAIRE'S  RELATION  TO  MEDICINE* 
Br  PEARCE  BAILEY,  M.D. 


NEW   YORK 


IN  idealizing  the  great  men  whose  dis- 
coveries have  transformed  what,  a  short 
time  ago,  was  little  more  than  a  specu- 
lative system  of  philosophy,  into  a  science 
whose  bounds  are  fixed  only  by  the  limiting 
qualities  of  humanity,  it  should  be  remem- 
bered that  the  followers  of  Hippocrates  are 
not  the  only  ones  who  merit  gratitude  for 
what  they  accomplished  for  medicine.  Med- 
ical growth  implies  more  than  the  work  of 
gifted  doctors  alone.  All  who  have 
striven  for  human  development 
have  furthered  this  art  which 
joins  or  crosses  every  thread 
of  social  fabric  and  which 
has  always  been  more  than 
a  system  of  healing. 

Medicine  must  be  the 
last  barrier  but  one  be- 
tween man  and  the  fates. 
It  stands  at  the  entrance 
and  exit  of  life  and,  since 
it  seems  nearest  the  mys- 
tery, it  has  always  been 
patiently  looked  to  to  dis- 
close what  lies  behind  that 
strange  curtain  which  rises 
and  drops  so  abruptly.  It 
is  so  bound  up  in  our  souls  with  the  arts  and 
humanities,  that  its  history  is  inseparable 
from  the  history  of  all  human  thought  and 
behavior.  Its  records,  at  first  sight  seeming 
to  mark  a  development  and  ascendancy 
quite  its  own,  are  really  the  records  of  the 
desires  and  fears  and  beliefs  universal  to 
humanity;  and  neither  they  nor  the  men 
who  helped   make  them  can   be  understood 

by  themselves. 

long  as  thought  was  not  free,  medicine, 
in  common  with  other  branches  of  learning, 
had  to  Struggle  with  tradition,  dogma,  prej- 


Francois  Marie  Arocet  di.  Voltaire 

(1694-1778). 


udice,  superstition,  all  backed  by  the  might 
of  church  and  state.  Society,  inevitably 
averse  to  reality,  placed,  as  long  as  it  could, 
these  deadly  taboos  across  the  path  of  what- 
ever might  bring  it  and  reality  face  to  face. 
It  was  only  as,  little  by  little,  opinions 
ceased  to  be  matters  reviewed  by  the  police, 
and  when  investigation  was  no  longer  re- 
garded as  offensive  to  God,  that  the  prob- 
lems of  medicine,  so  long  waiting  solution, 
could  be  brought  into  the  light  to  be 
%>v       studied. 

The  broader  vision  which 
made  this  development  pos- 
sible came  from  the  men 
outside  of  our  profession 
quite  as  much  as  from 
those  within  it;  and  it  was 
these  allies  of  ours  espe- 
cially who  risked  their  lives 
in  the  struggle  for  the  es- 
tablishment of  tolerance. 
They  fought  our  battles, 
and  their  names  must  he 
placed  with  the  names  of 
actual  medical  craftsmen 
who,  in  wresting  secrets 
from  Nature,  made  com- 
mentary give  plaee  to  observation  and  con- 
trolled fancy  by  experiment.  Euripides  and 
Petrarch  and  Bacon  and  but  her,  each  in  his 
own  way  and  according  to  his  lights,  helped 

to  break  down  the  barriers  w  hich  kepi  men's 
e\  esfrom  the  truth;  each  helped  to  mold  pub- 
lic opinion  to  a  point  w  hereseientilic  medicine 
became  possible.  Some  did  tin-  work  which 
resulted  ultimately  in  advantage  to  our  art 
without  having  touched  on  medical  subjects 
at  all;  others,  like  Athanasius  kircher 
I  [602    l68o),    the   Jesuit    priest,    the   earliest 

microscopist;  likeAntonj  van  Leeuwenhoek 


i  a  meeting  of  the  Harvard  Medical  History  Club,  Boston,  \l;hv,  November  t,  1916. 

54 


Voltaire's  Relation  to  Medicine 


55 


(1632-1723),  the  wealthy  brewer's  son  of 
Delft,  who  gave  the  first  accurate  figura- 
tions of  bacteria,  who  demonstrated  the 
capillary  anastomosis  between  arteries  and 
veins,  who  presented  twenty-six  microscopes 
to  the  Royal  Society  and  contributed  many 
papers  to  it;  like  Descartes (1 596-1 650), who, 
in  establishing  the  physical  theory  of  vision, 
laid  the  foundation  of  ophthalmology;  men 
such  as  these  threw  light  on  our  problems 
through  solving  problems  of  their  own. 

Among  the  men  who  figured  in  shaping 
medical  history  in  more  ways 
than  one,  must  be  counted 
Voltaire.  It  would  be  super 
lluous  to  add  one  word  here 
as  to  what  Voltaire's  wit 
and  fancy  and  satire  ac 
complished  to  estab- 
lish truth  in  the 
world  as  a  principle. 
But  it  seems  not  un- 
reasonable to  suggest 
that  in  fighting  for 
general  tolerance,  he 
did  more  to  advance 
our  profession  than 
some  of  its  own  mem- 
b(  rs  who,  however 
distinguished,  com- 
promised with  the 
old  dogmas.  It  may 
be  remembered  that 
Sir  Thomas  Browne 
(1605-82),  in  writing 
to  correct "  Vulgar  Errors, "  was  proved  hope- 
lessly enmeshed  in  them  himself.  But  Vol- 
taire, in  addition  to  being  a  social  reformer, 
did  much  to  spread  actual  medical  learning. 
As  an  encyclopedist  he  was  obliged  to  treat 
of  medical  subjects,  and  he  gave  himself 
a  wide  range;  throughout  all  he  wrote  on 
these  topics  appears  an  uncanny  sagacity 
which  led  him  to  champion  those  explana- 
tions of  human  behavior  which,  as  it  turns 
out,  have  best  stood  the  test  of  time.  Per- 
haps it  cannot  be  said  of  him  that  he  was 


Marmontel,    whose    Moral    Tale; 
salons  of  Paris. 


an  original  thinker.  His  genius  was  of  a 
different  order  from  Franklin's,  whose  most 
casual  glance  at  a  subject  resulted  in  some 
entirely  new  benefit  to  it.  But  he  assembled 
from  all  parts  of  the  earth  stray  bits  of  in- 
formation, fused  them  together  and  pre- 
sented them  as  a  whole,  in  his  own  way. 
Thanks  to  his  special  talent  he  was  able  to 
give  to  the  world  views  on  medical  topics 
saner  than  those  held  by  most  of  the  physi- 
cians of  the  times. 

He  is  represented  as  the  ruthless  icono- 
clast, bitter  and  sarcastic  and 
unforgiving.  But  he  has  a  way 
of  tempering  his  invectives 
with  a  naive  or  witty  word 
which  reveals  a  funda- 
mental belief  in  the 
good  intentions  of  hu- 
manity; and  many 
incidents  in  his  life, 
of  which  I  recall  two, 
indicate  quite  plainly 
to  me  that  as  a  man 
he  was  of  an  essential- 
ly kindly  nature.  Ap- 
preciating Marmon- 
tel's  verses,  he  urged 
this  young  man,  a 
total  stranger  to  him, 
to  come  to  Paris  from 
the  Limousin,  with 
the  assurance  that 
the  Controller  Gen- 
eral of  Finance,  \1. 
Orri,  would  take  care  of  him.  But  when  the 
future  author  of  the  Moral  Tales  arrived  in 
Paris,  Orri  was  no  longer  in  favor  and  could 
do  nothing  for  him.  While  he  was  staggering 
under  this  blow,  Voltaire  said  to  him,  "I 
have  not  invited  you  here  to  abandon  you. 
I  will  suffer  you  to  have  no  other  creditor 
than  Voltaire."  And  in  another  and  more 
intimate  relationship,  Voltaire's  gentleness 
of  character  for  those  he  really  loved  seems 
to  have  been  unmistakable.  This  was  when 
he   discovered  that   Madame  du   Chatelet 


delighted    the 


56 


Annals  of  Medical  History 


had  been  untrue  to  him.  After  hours  of 
unhappiness  and  despair,  when  she  came 
to  him  and  asked  his  forgiveness,  he  said  to 
her,  "Madame,  everything  you  do  is  right," 
and  really  forgave  her. 

He  seems  to  have  been  born  with  a  mania 
for  liberty  which  his  early  troubles  only 
deepened.  Thrown  into  the  Bastile  more 
than  once,  banished  from  France  for  years, 
he  never  really,  except  for  tactical  purposes, 
changed  his  views  on  oppression  and  or- 
ganized dishonesty. 

During   the   XVIII    century 
Great   Britain    was   the   only 
European     country     which 
had  curtailed  the  arbitrary 
powers    of    Royalty.    In 
France  Louis   XV  was 
able  to  forbid  the  pub- 
lication  of  the  famous 
encyclopedia,  and  many- 
writers  were  persecuted 
without  reason  and  with 
scant  mercy.  It  seemed 
that  there  was  an  un- 
mistakable    advantage 
to  learning  in  England 
as    compared   with    its 
position  in  France,  and 
Voltaire  was  incited  to 
work  for  a  similar   in- 
tellectual    enfranchise- 
ment   for   his   country- 
men. 

It  was  during  his  visit 
to  England  as  a  young  man,  that  he  came 
to  realize  how  much  France  was  remaining 
behind  in  the  development  of  true  wisdom. 
While  there,  he  attended  the  stately  funeral 
of  Newton,  and,  as  Parton  informs  us, 

"In  extreme-  old  age  his  eye  would 
kindle  and  his  countenance  light  up 
when  he  spoke  of  having  lived  in  a  land 
where  a  professor  of  mathematics,  solely 
because  he  was  greal  in  his  vocation, 
could    be   buried    in   a   temple  where  the 


Lady  Mary  Wortley  Montagu,  through 
whose  determination  inoculation  was  intro- 
duced into  England. 


ashes  of  kings  reposed  and  the  highest 
subjects  in  the  kingdom  felt  it  an  honor 
to  assist  in  bearing  thither  his  body." 

His  British  experiences  seem  to  have 
vitalized  the  main  springs  of  his  mind  and 
to  have  given  direction  to  his  energy.  But 
he  was  too  accurate  an  observer  of  human 
nature  to  confuse  political  with  intellectual 
freedom.  He  knew,  as  well  as  Le  Bon,  how 
the  crowd  is  made  up;  he  saw  that  democ- 
racy was  a  dream  and  realized  that 
the  few  govern.  But  he  saw 
also,  and  just  as  unerringly, 
that  the  advancement  of 
humanity  depended  on 
learning. 

There  was  no  lack  of 
proof  in  his  time  of  the 
terrible  penalties  men 
were  forced  to  pay  for 
expressing  the  most  ab- 
stract ideas.  It  may  be 
remembered  that  in  the 
century  in  which  Vol- 
taire was  born  the 
French  Parliament  is- 
sued a  decree  which 
forbade  all  persons,  un- 
der pain  of  death,  to 
hold  or  to  teach  any 
method  contrary  to  the 
ancient  and  approved 
authors.  This  decree 
came  about  from  the 
visit  of  two  chemists  to  Paris  who  au- 
daciously recognized  five  elements  differ- 
ent from  the  lour  elements  of  Aristotle, 
and  who  further  failed  to  agree  with  the 
categories  and  substantial  forms  of  the 
master.  They  were  tried,  their  books 
were  solemnly  burned  and  they  wire  ban- 
ished. But  Parliament  passed  the  Act  re- 
ferred to  in  order  to  show  that  it  did  not 
propose  to  deal  so  leniently  with  similar 
offenders  in  tin-  future.  Regarding  this 
incident  Voltaire  sa\s,  "Respect  for  tradi- 


Voltaire's  Relation  to  Medicine 


57 


tion  has  hindered  intellectual  progress  for 
centuries  and  was  extended  in  the  case  of 
Aristotle  to  the  most  servile  credulity." 
The  same  Parliament  of  Paris  which 
avenged  the  insult  by  the  chemists  to 
Aristotle,  forbade  the  use  of  quinine  and 
emetics.  Against  prejudices  such  as  these 
Voltaire  made  war  to  the  end  of  his  days. 

In  our  boyhood,  we  heard  chiefly  of  Vol- 
taire as  the  ruthless  atheist  who  wanted  to 
destroy  religion.  As  a  matter  of  fact,  he 
attacked  everything,  whether  military  or 
ecclesiastical  or  political  or  social,  in  which 
he  saw  domination  and  oppression,  with 
pretence  and  quackery  tagging  inevitably 
behind  them.  "Fanaticism,"  he  writes,  "is 
a  mental  disease  as  contagious  as  smallpox. 
Once  it  has  eaten  into  the  brain,  it  is  almost 
incurable."  And  elsewhere  he  says,  "  The 
world  is  full  of  quacks,  in  medicine,  in 
theology,  in  politics,  in  philosophy,"  and 
he  asked  to  be  saved  from  such  men  as  Mes- 
mer.  The  ideas  which  he  stood  for  and 
scattered  (and  he  was  the  most  read  author 
of  his  day),  and  which  were  thought  as  out- 
rageous for  so  long,  are  now  largely  current. 
They  had,  perforce,  to  become  so  before 
medicine  could  come  to  its  own. 

The  century  in  which  he  passed  his  adult 
years  was  poorer  in  great  medical  men  than 
the  preceding  one.  Harvey  and  Malpighi 
and  Redi  and  Sylvius  and  Willis  and  Syden- 
ham had  done  their  work  and  joined  the 
immortals.  In  Voltaire's  own  century,  the 
work  of  Pinel  and  Jenner  was  accomplished 
after  his  own  was  finished;  of  Voltaire's 
contemporaries,  Von  Haller,  of  whom  it  was 
said  that  the  only  things  that  he  lacked 
were  the  faults  common  to  great  men,  stands 
out  now  as  the  chief  towering  figure;  Boer- 
haave  was  the  teacher  acclaimed  every- 
where, and  John  Hunter  was  revolutionizing 
surgery  in  England.  But  it  was  chiefly  a 
century  of  progress  in  the  collateral  sciences 
of  botany  and  chemistry,  as  is  shown  by 
such  names  that  stand  out  in  it  as  those  of 
Linnaeus,  Priestley  and  Lavoisier. 


There  was  no  clinical  instruction  until 
1745,  and  quackery  and  imposture  of  all 
kinds  llourished  like  weeds  in  a  garden  badly 
kept.  The  insane  were  regarded  as  menag- 
erie animals  to  be  viewed  in  some  places  on 
the  payment  of  a  fee.  Until  the  middle  of 
the  century  in  Germany,  surgeons  were 
called  "  Feldscheerer, "  because  their  duties 
included  shaving  the  officers;  and  in  France 
surgeons  were  separated  from  barbers  and 
wig-makers  only  in  1743,  following  by  twen- 
ty years  the  establishment  of  the  Academy 
of  Surgery,  which  was  accomplished  by 
Voltaire's  friend,  Francois  de  L.  La  Peyronie 
( 1 678-1 747)  of  Montpellier.  The  great 
physicians  were  well-to-do  and  often  culti- 
vated men,  but  far  less  inspiring  than  in  the 
preceding  century.  Medicine  itself  was  in 
a  rather  chaotic  condition,  as  few  members 
of  the  profession  had  profited  in  an  all 
around  way  by  its  most  advanced  teaching. 

But  in  spite  of  the  fact  that  medicine  was 
sterile  in  his  time,  throughout  all  that  Vol- 
taire wrote  about  physicians  and  medicine 
it  is  easy  to  recognize  the  witty  author  as 
their  loyal  admirer  and  defender.  Physi- 
cians whom  he  thinks  unworthy  he  attacks, 
sometimes  with  scant  justice;  but  every- 
where through  his  writings  shines  his  un- 
failing belief  in  this  oldest  of  arts,  and  his 
admiration  for  its  prophets. 

He  had  much  to  say  about  doctors,  past 
and  contemporaneous.  Against  Gerhardt 
Van  Swieten  (1700- 1772),  first  physician  to 
Maria  Theresa,  who  opposed  the  introduc- 
tion into  Vienna  of  certain  books  on  philos- 
ophy (one  of  them  Voltaire's)  and  who  also, 
like  his  teacher  Bocrhaave,  opposed  in- 
oculation against  smallpox,  Voltaire  directed 
the  following  satirical  verses: 

Un  certain  charlatan,  qui  s'est  mis  en  credit 
Pretend  qu'a  son  example,  on  n'ait  jamais  d'esprit. 
Tu  n'y  parviendras  pas,  apostat  d'Hippocrate,. 
Tu  guerirerais  plutot  Ics  vapeurs  dc  ma  rate. 
Va  cesser  de  vexer  les  vivants  et  les  niorts 
Tyran  de  ma  pensee,  assassin  de  mon  corps. 
Tu  peux  bien  empecher  les  maladcs  de  vivre. 


5* 


Annals  of  Medical  History 


Tu  peux  Ies  tuer  tous,  mais  mon  pas  un  bon  Iivre. 

Tu  Ies  brules,  Jerome;  et  de  tes  condamnes 

La  flamme,  en  m'eclairant,  noircit  ton  vilain  nez. 

Of  Simon-Andre  Tissot  (1728-97)  the 
famous  practitioner  of  Lausanne  who  be- 
came widely  known  through  his  popular 
writings  on  onanism,  on  the  hygiene  of 
literary  men,  and  on  the  diseases  of  men  of 
the  world,  Voltaire  writes  to  a  woman 
friend, — "He  has  never  cured  anybody  and 
is  more  ill  than  everybody  while  he  writes 
his  little  medical  books." 

But  much  of  the  evil  he  says  against 
doctors  was  justified  or  put  out  in  the  spirit 
of  pure  fun.  "I  know  nothing  more  laugh- 
able," he  writes  a  friend,  "than  a  doctor 
who  does  not  die  of  old  age."  And  again, 
"Illness  more  cruel  than  Kings  persecutes 
me.  It  only  needs  doctors  to  finish  me  off." 
As  a  matter  of  fact,  he  believed  in  them. 

"The  first  to  bleed  or  purge  happily  a 
patient  with  apoplexy;  the  first  to  conceive 
the  idea  to  put  a  bistoury  into  the  bladder 
for  the  purpose  of  extracting  a  stone  and 
then  to  close  the  wound  up  again,  the  first 
who  knew  how  to  keep  gangrene  from  some 
part  of  the  body — these  men  were  almost 
divine  and  not  at  all  like  the  physicians 
described  by  Moliere.  You  may  see  fevers 
and  ills  of  all  kinds  being  cured  without  it 
being  proved  whether  nature  or  the  doctor 
worked  the  cure.  You  see  diseases  whose 
outcome  cannot  be  foretold;  twenty  doctors 
are  mistaken  until  the  one  who  has  the 
finest  intelligence,  the  clearest  vision,  dis- 
covers the  nature  of  the  disease.  It  is, 
therefore,  an  art  and  the  superman  knows 
the  line  points  of  it.  Thus  La  Peyronie 
made  the  diagnosis  that  a  certain  courtier 
must  have  swallowed  a  sharp  bone  which 
resulted  in  an  ulcer  and  endangered  his  life; 
Boerhaave  found  the  cause  of  the  cruel  and 
hidden  disease  of  the  Count  Yassenaar. 
I  here  is,  therefore,  a  true  art  of  medicine; 
but  in  every  art,  then,  are  Yirgils  and  Mal- 
\ius."  And  elsewhere  he  Says,  "  I  .es  mala- 
dies sont   plus  anciennes  que  la   medecine 


et  tous  Ies  besoins  ont  existe  avant  le 
secours." 

"Moliere  made  no  mistake  in  ridiculing 
physicians,"  he  said,  "for,  for  a  long  time, 
out  of  every  hundred  doctors,  ninety  were 
quacks.  But  it  is  just  as  true  that  a  good 
doctor  can  often  save  life  and  limb.  Men 
who  pass  their  lives  restoring  health  to 
others  would  be  superior  to  all  the  great 
ones  of  the  earth  and  would  resemble 
divinity.  To  conserve  and  repair  is  almost 
as  fine  as  to  make.  For  live  hundred  years 
the  Romans  had  no  doctors;  being  occu- 
pied solely  with  killing  they  made  no  at- 
tempt to  save  life.  What,  then,  did  they 
do  at  Rome  when  they  had  putrid  fever  or 
bubonocele  or  pneumonia?  They  dic^d."  In 
writing  concerning  Van  Dale,  the  Dutch 
physician,  he  said:  "The  Devil  should  not 
try  his  tricks  on  a  clever  physician.  Those 
familiar  with  nature  are  dangerous  for  the 
wonder-workers.  I  advise  the  Devil  always 
to  apply  to  the  faculty  of  theologj  not  to 
the  medical  faculty." 

He  had  the  keenest  appreciation  of  the 
Greeks,  and  of  Harvey,  and  of  Boerhaave, 
and  of  men  of  their  kind,  and  he  speaks 
with  affection  ol  the  various  men  who 
attended  him  in  his  illnesses.  He  resents 
Rousseau's  ungrateful  treatment  of  Cabanis, 
a  surgeon  of  great  reputation,  who  passed 
sounds  on  the  author  of  the  "Social  Con- 
tract." "It  seems  that  ingratitude  holds 
a  high  place  in  the  philosophy  of  Jean 
Jacques,"  Voltaire  exclaims.  Voltaire  knew 
Ilaller  and  appreciated  his  rare  talents, 
though  he  thought  him  still"  and  unbending, 
and  said  of  him  that  his  "Protestant  zeal 
makes  intolerance  a  fashion  in  the  Canton 
of  Berne."  There  was  ill-feeling  on  both 
sides.  Casanova,  the  Venetian  charlatan 
and  gossip  and  "homme  a  bonnes  fortunes," 
relates  that  after  a  visit  to  the  Swiss  sa\ant 
he  visited  Voltaire,  to  w  hom,  in  Ins  mischief- 
making  way,  he  broughl  up  the  name  ol 
Von  Mailer.  "There,"  exclaimed  Voltaire, 
"is  a  great   man     one  we  must  all  bow   to." 


Voltaire's  Relation  to  Medicine 


59 


"I  am  sorry,"  Casanova  replied,  "to  inform 
you  that  Von  Haller  entertains  no  such 
opinion  of  you."  "Well,"  Voltaire 
answered,  "the  fact  is  that  in  all  probability 
we  both  are  mistaken." 

To  Doctor  Doran,  who  invented  bougies, 
he  sent  his  compliments  though  he  did  not 
need   him.    He  summons  L'Eeluse,  surgeon 
dentist  of  the  King  of  Poland  (formerly  a 
concert  hall  singer),  to  repair  the  "irrepar- 
able teeth"  of  his  niece.  He  recounts  with 
great  satisfaction  that  it  was  Lilio,  a 
Roman  physician,  and  not  Greg- 
ory XIII,  who  reformed  the 
calendar.     "It     wasn't     so 
with  the  Greeks,"  Voltaire 
adds;    "with    them    the 
glory  of  the   invention 
remains  with  the   art- 
ist." 

In  sending  his  por-  fl 
trait  in  1775  to  Dr.  J.  0 
B.  Silva  (1682-1742), 
first  doctor  to  the 
Queen,  who  had  at- 
tended him,  he  in- 
cluded   these    verses: 

At  the  shrine  of  Epidau- 
us   it   was   etiquette 
to  bring 

An  image  of  the  person 
\\  hom  the  gods  had 
cured  or  saved; 

So  to  Silva,  who  in  mas- 
tering death  has  like 
a  god  behaved, 

We  should  offer  the  same  thing. 

O  Modern  Esculapius,  I  owe  my  days  to  you 

And  you  look  upon  your  handiwork  in  seeing  me 
anew. 

He  tells  us  that  Theophraste  Renaudot 
( 1 586-1653)  the  founder  of  the  Gazette  de 
France,1  published  thirty-four  years  (1631) 
before  the  first  Oxford  Gazette,  was  a  doctor. 

1  These  early  gazettes,  like  the  Roman  Ada  Diurna, 
contained  official  announcements  of  current  events. 
Ken.iudot's  information  came  directly  from  Rich- 
elieu. 


Von  Haller,  the  great  man  without  humor 


He  forgives  J.  B.  Morin  (1 583—1656),  who 

cast  the  horoscope  of  Louis  XIV.  "He  was 
a  savant  in  spite  of  the  prejudices  of  the 
times,"  he  exclaims.  Of  G.  Patin  (1602- 
1672)  he  says  that  he  was  more  famous  for 
his  letters  than  for  his  medicine.  "This 
man  seems  to  prove  that  those  who  hastily 
write  up  current  events  are  misleading 
historians."  It  is  the  letters  of  Patin,  who 
was  Dean  of  the  Paris  Faculty,  which 
Garrison  cited  as  showing  the  "sterile 
inefficiency  of  the  internists  of  the 
seventeenth  century." 

Through  Voltaire's  works 
allusions  to  medicine  and 
physicians  abound.  In 
writing  of  physicians, 
he  says,  "The  small 
number  of  great  phy- 
sicians who  came  to 
Rome  were  slaves. 
Thus,  to  the  Grand 
Seigneurs  of  Rome, 
a  doctor  became  a 
luxury  like  a  chef. 
Every  rich  man  had 
in  his  suite,  perfu- 
mers, bathers,  musi- 
cians and  doctors.  The 
celebrated  Musa, 
physician  to  Augus- 
tus, was  a  slave.  He 
was  given  his  freedom 
and  made  a  Roman 
Knight,  and  from 
then  on,  medical  men  became  persons  of 
importance.  When  Christianity  became 
established,  various  councils  forbade  monks 
to  practice  medicine,  which  was  just  the 
opposite  which  should  have  been  done  if 
good  to  the  human  race  was  to  be  gained. 
How  fortunate  it  would  have  been  if  monks 
had  been  made  to  study  medicine  and  to 
cure  the  ills  of  humanity  for  the  love  of  God. 
Having  nothing  but  Heaven  to  gain,  there 
would  have  been  no  quacks.  They  might 
have  poisoned  infidels,  but  this  would  have 


6o 


Annals  of  Medical  History 


been  good  for  the  church.  Perhaps  then 
Luther  would  never  have  robbed  our  holy 
father,  the  Pope,  of  the  half  of  Christian 
Europe;  for  at  the  first  fever  of  the  Augustin 
Luther,  a  Dominican  could  have  given  him 
pills.  You  may  say  he  would  have  refused 
to  take  them;  but  perhaps  they  could  have 
found  a  way  of  making  him." 

He  abhorred  the  ceremonials  that  were 
and  still  seem,  in  a  way,  inseparable  from 
the  practice  of  medicine,  as  he  abhorred 
shams  of  all  kinds.  "I  have  always  had  a 
secret  aversion  for  that  Swiss  doctor  of 
yours,"  he  wrote  a  friend.  "I  despise  a  man 
who  dares  not  tell  you  what  remedy  it  is 
that  he  is  giving  you.  The  absurd  quackery 
of  diagnosticating  diseases  by  temperaments 
and  by  urine  is  the  shame  of  medicine  and 
of  reason."  And  elsewhere  he  says,  "How 
foolish  it  is  that  we  know  what  the  cook 
gives  us  for  supper,  and  don't  know  what  a 
doctor  gives  us  when  we  are  ill." 

When  in  1778  he  died  at  the  age  of  eighty- 
lour,  his  organs  were  all  normal,  only  "dry," 
as  the  autopsy  report  has  it.  But  he  was 
frequently  ill,  as  may  be  expected  of  a  body 
lodging  a  mind  to  which  repose  is  unknown, 
and  he  wrote  much  about  illness. 

"I  regard  long  illnesses  as  a  kind  of 
(hath  which  separates  us  from  the  rest  of 
the  world  and  makes  it  forget  us.  I  am 
trying  to  get  used  to  this  first  kind  of 
death  so  that  the  second  shall  not  frighten 
me  so  much." 

"It  is  the  lot  of  old  age  to  be  ill  and 
these  little  warnings  are  the  clock  strik- 
ings  which  announce  that  very  soon  there 
will  be  no  more  time  for  us.  Animals  have 
the  advantage  of  humans;  no  clock  sounds 
their  hour  and  they  die  without  guessing 
it;  they  have  no  theologians  to  tell  them 
the  lour  ends  of  lite  or  to  pester  their  last 
moments  with  impert  i  runt  ceremonies;  it 
costs  them  nothing  to  be  buried  and  no  one 
contests  their  wills.  But  we  ha\e  the  l>est 
ol    them    alter    all,    lor    they    know    only 

habit  while  we  have  friendship." 


Throughout  all  his  writings  one  may  find 
perspicacity  and  common  sense  in  his 
recommendations  as  to  the  conduct  of  life 
and  the  care  of  body  and  mind.  When  well 
himself,  he  praised  hygiene  above  remedies 
and  was  an  advocate  of  the  Natura  Victrix 
formula.  Under  the  heading  of  "Medicine" 
in  the  philosophical  dictionary,  the  doctor 
says  to  the  Princess: 

"Let  Nature  be  your  doctor  in  chief.  It 
is  she  who  does  everything.  Of  all  those 
who  have  extended  their  life  to  one  hundred 
years,  not  one  belongs  to  the  faculty.  The 
King  of  France  (Louis  XV)  has  already 
buried  forty  of  his  physicians." 

The  Princess  replies: 

"In  truth  I  hope  to  bury  you  too." 

Voltaire  relates  many  anecdotes  which 
throw  light  on  some  of  the  quasi-medical 
customs  of  the  times.  One  of  them  shows 
the  distinction  between  social  position  and 
justice.  Constantin,  a  midwife,  performed 
a  criminal  operation  on  a  lady  of  the  court 
so  unskillfully  that  the  patient  was  fatally 
injured.  She  was  in  great  suffering,  and 
her  lover,  when  he  saw  her,  wishing  to 
relieve  her  sufferings,  became  possessed  <»l 
what  might  now  seem  an  access  of  kindly 
zeal,  and  killed  her  by  breaking  open  her 
head.  He  fled  and  was  banished,  but  later, 
after  arranging  an  advantageous  marriage 
for  the  King's  brother,  was  again  welcomed 
at  court.  But  for  the  unfortunate  midwife 
there  was  no  such  mercy.  She  was  hanged 
and  thrown  into  quicklime.  "There  would 
have  been  no  use  in  coming  to  visit  her," 
says  the  sprightly  Patin,  "there  was  nothing 
left  to  recognize  her  by." 

Regarding  witchcraft  he  relates  that  the 
Marechale  d'Ancre,  an  Italian  friend  of 
Marie  de  Medicis,  whose  husband,  Coneini, 
had  been  murdered  with  at  least  theconm- 
vance  of  Louis  XIII,  called  a  I  Iebrcw  doctor 
called     MontaltO    from     Italy     to    see     her, 

having  first  complied  with  the  recognized 
formula  in  such  matters  by  obtaining  per- 
mission   from    the    Pope.    At     that    time,    it 


Voltaire's  Relation  to  Medicine 


61 


may  be  remembered,  Paris  physicians  did 
not  have  as  good  reputations  as  the  Italians, 
it  being  these  latter  who  were  reputed  as 
masters  of  all  the  arts.  It  was  claimed 
against  the  Marechale  that  this  Montalto 
was  a  magician  and  that  he  had  sacrificed 
a  white  cock  at  the  Marechale's.  At  any 
rate,  he  could  not  cure  the  lady  of  her 
vapors,  which  were  so  compelling  that 
instead  of  believing  herself  a  witch,  she 
conceived  the  counter  idea  that  she  was 
bewitched  herself.  She  then  had  the 
weakness  to  summon  two  exorcist 
priests  from  Milan,  who  said 
masses  for  the  vaporous  lady 
and  assured  her  she  was 
cured.  But  when,  in  ad- 
dition to  the  charges 
against  her  of  magic, 
she  had  questions  put 
to  her  regarding  the 
death  of  Henry  IV, 
husband  of  Maria  de 
Medicis,  she  collapsed. 
Having  laughed  at  the 
accusations  of  magic, 
she  wept  when  ques- 
tioned about  the  dead 
king  and  made  a  bad 
impression  on  the 
judge.  She  was  be- 
headed and  cast  into 
the  flames.  Voltaire 
opposed  with  violence 
and  with  ridicule  the 
idea  so  popular  in  his  time,  of  the  fre- 
quency with  which  people  were  disposed 
of  by  poison.  The  most  celebrated  of 
women  poisoners  who  experimented  with 
poison  on  the  sick  she  visited  in  the 
hospitals,  and  who  was  beheaded  and 
burned  for  her  crimes  in  1676,  Madame  de 
Brinvilliers,  has  more  crimes  accredited  to 
her  than  she  committed,  he  says.  He  holds 
the  same  opinion  in  regard  to  Catherine  de 
Medicis.  It  is  only  in  recent  years  that  it 
has  become  increasingly  probable  that  he 


Silva,   physician  to  the  Faculties  of  Paris  and 
Montpellier. 


was  right  about  this;  and  that  appendicitis, 
and  kindred  abdominal  diseases  were  the 
real  cause  of  many  of  the  reputed  cases  of 
poisoning. 

He  understood  fully  the  contagion  which 
robs  crowds  of  their  wits.  It  is  true  that 
he  had  almost  unparalleled  opportunities  for 
observing  examples  of  hysteria  in  the  con- 
vulsionists  as  they  were  called,  who,  in  the 
XVIII  century  flocked  to  the  tomb  of  the 
Diacre  de  Paris,  or  the  saint  Paris,  in  the 
remote  little  cemetery  of  St.  Medard. 
The  miracles  that  were  worked 
there   were  looked   upon   by 
the  simple  people  as  a  rec- 
ognition by  the  Almighty 
of  the  cult  launched  by 
the    unhappy    Jansen, 
who    died     without 
knowing  what  a  fuss 
i       his  earnestly  conceiv- 
ed book  was  to  kick 
up.  Singing,  dancing, 
groaning,    grunting, 
barking,  mewing,  hiss- 
ing,    declaiming, 
prophesying,  with  the 
ordinary     motor    ac- 
companiments    of 
feeling,  reached  such 
a  height  in  this  hither- 
to   quiet    churchyard 
that   the    king  found 
it  necessary  to  close  it 
— or,  as  a  wit  put  it, 
"By  order  of  the   king;  God  is  forbidden 
to  perform  miracles  in  this  place." 

Voltaire  wrote  much  about  these  oc- 
currences, and  analyzed  them  as  did  Col- 
lins,2 who  described  them  anew  in  1908. 

One  of  Voltaire's  burlesques  took  the 
form  of  the  following  verse,  relative  to  this 
famous  tomb: 

The  deity,  to  lighten  France's  night 
Within  this  tomb  encloses  all  its  might. 
Hither  the  blind  come  hurrying;  and  then 

2  N.  Y.  Medical  Record,  July  4,  1908. 


62 


Annals  of  Medical  History 


With  hands  that  grope  their  way,  return  again. 
The  halt  come  limping  to  this  tomb,  and  all 
Crying  bosanria,  dance  and  leap) — and  fall. 
The  listening  deaf  approach — and  hear  no  sound. 
"La  Pucelle" — 9— III— 63. 

In  Voltaire's  time,  hospitals  were  in  an 
overcrowded  and  unsanitary  condition;  filth 
was  everywhere,  contagion  flourished,  and, 
as  Bass  says  of  them,  "even  physicians 
declined  hospital  service  as  equivalent  to  a 
sentence  of  death."  Voltaire  perceived  the 
menace  of  the  huge  ^^^^^^^^^^^^ 
Hotel  Dieu  and  want- 
ed it  split  up  into  a 
number  of  smaller  pa- 
vilions, scattered  in 
different  parts  of  the 
city.  Of  hospitals  in 
general  he  said: 

"There  is  hardly 
a  city  in  Europe  to- 
day without  hos- 
pitals. Turkey  has 
them  for  animals, 
which  sec nis  an  ex- 
travagant charity. 
It  would  be  better 
to  forget  animals 
and  save  more  men. 
The  great  mass  of 
charitable  institu- 
tions proves  a  truth 
to  which  little  at- 
tention is  paid — it 
is  this,  that  man- 
kind is  not  so  bad  as 


Marqi  isi   di    Brinvillii  rs  trying  out  her  poisons 

on  the  patients  in  the  H6td  Dieu. 


it  is  painted;  that,  in  spite  of  all  the  false 
opinions  that  he  holds,  in  spite  of  the 
horrors  of  war,  which  change  a  man  into 
a  brute,  it  is  easy  to  believe  that  this 
animal  is  really  kind  and  only  ugly  when 
aroused,  like  other  animals.  The  trouble' 
is  that  he  is  teased  too  much.  Modern 
Rome-  has  almost  as  many  houses  of 
charity  as  antique  Rome  had  triumphal 
arches  and  other  monuments  of  conquest. 
1  In-    I  limtc  in    Rome  once  maintained 


445,000  pilgrims  for  three  days — but  per- 
haps that  is  an  encouragement  to  vaga- 
bondage more  than  an  act  of  charity,  as 
pilgrims  are  usually  tramps.  Of  all  hos- 
pitals, the  Hotel  Dieu  of  Paris  receives 
daily  more  poor  patients  than  any  other. 
There  are  often  from  4000  to  5000  at  a 
time.  In  this  case,  the  number  defeats  the 
purpose  of  the  charity.  At  the  same  time 
it  is  the  receptacle  of  all  terrible  human 
miseries  and  the  temple  of  the  true  virtue 
which  tries  to  succor 
them.  It  would  be 
well  to  bear  in  mind 
the  contrast  between 
a  I  etc  at  Versailles, 
between  an  opera  at 
Paris,  where  all  the 
delights  and  magnif- 
icence are  united  with 
such  art,  and  of  a 
hospital  where  all  the 
suffering,  despair  and 
death  are  crowded  to- 
gether with  such  hor- 
ror. Large  cities  are' 
like  that.  In  the  char- 
itable institutions,  the 
drawbacks  are  often 
greater  than  the  ad- 
vantages. A  proof  of 
the'  abuse-  connected 
with  them  is  that 
the  poor  de\  ils  w  horn 
they  take  there  arc 
afraid  to  be  there.  It 
is  especially  bad  when  the  town  gets  too 
big,  when  there  are  lour  or  five  patients 
in  one  bed,'  when  a  poor  fellow  gives  the 
SCUrvy  to  the  neighbor  from  whom  he 
catches  the  smallpox.  The  futility  and 
even  the  danger  of  medicine  under  these 
circumstances  is  proved.  It  lias  often  been 
proposed  to  split  up  the  H6tel  Dieu  into 
several  better  situated  hospitals     but  the 

I'),  ds  were  I  milt  with  tin-  purpose  ol  accommodat- 
ing several  people  at  once. 


Voltaire's  Relation  to  Medicine 


63 


money  is  never  forthcoming.  It  is  easy  to 
get  it  to  send  men  out  on  the  border  to 
be  killed — but  then  there  is  none  left  to 
save  them  with." 

Voltaire's  most  striking  characteristic  as 
an  author  in  general  is  his  modernity,  and 
this  is  particularly  remarkable  in  that  it 
continues  into  matters  scientific.  It  seems 
less  surprising  that  Euripides  should  have 
seen  into  the  real  hearts  of  men  through  the 
veils  of  symbolism  that 
surrounded  human  cus- 
toms in  ancient  Greece, 
than  it  is  that  a  French 
wit  and  playwright  and 
letter  writer  should  have 
so  unerringly  picked  out 
the  truth  from  the  many 
medical  systems  of  his 
time. 

Much  that  he  says 
about  medical  subjects 
could  be  incorporated 
in  textbooks  to-day.  He 
was  dead  before  Pinel 
( 1 745-1 826)  wrote  his 
first  book,  and  yet  in 
the  article  on  madness 
in  the  Philosophical  Dic- 
tionary may  be  found  the 
same  prophetic  teach- 
ings which  have  made 
Pinel  immortal  as  the 
savior  of  the  insane. 

"What  is  madness?  It  is  having  incoher- 
ent thoughts  and  conduct.  Madness,  dur- 
ing the  waking  state,  is  a  disease  which 
prevents  a  man  from  thinking  and  acting 
as  other  people  do.  No  longer  capable  of 
directing  his  affairs,  they  are  taken  from 
him;  Society  excludes  him  for  not  being 
able  to  hold  the  ideas  which  suits  it;  if 
he  is  dangerous,  he  is  shut  up;  if  violent, 
he  is  restrained.  Sometimes  he  is  cured  by 
baths,  by  blood  letting,  or  by  a  chosen 
regimen. 


Le  diacre  dc  Paris. 


"Such  a  man  is  not  destitute  of  ideas; 
he  has  them,  like  every  one  else  when 
awake  and  often  when  sleeping.  One 
might  ask  how  this  immortal  spiritual 
mind,  the  brain's  tenant,  receiving  all  its 
ideas  by  the  senses,  never  delivers  a  sane 
judgment.  It  sees  objects  just  as  the  minds 
of  Aristotle  and  Plato  and  Locke  and 
Newton  saw  them.  It  hears  the  same 
sounds  and  has  the  same  sense  of  touch. 
How  does  it  happen,  then,  that  it  collects 
such  an  extravagant 
mess,  without  being  able 
to  make  use  of  the  per- 
ceptions it  receives  in 
common  with  the  philos- 
ophers? If  this  simple 
and  everlasting  sub- 
stance is  subserved  by 
the  same  instruments  as 
serve  the  minds  which 
are  lodged  in  the  brains 
of  the  wisest  of  men, 
why  does  it  not  reason 
as  they  do? 

"I  will  admit  at  once, 
if  my  madman  sees  red 
and  the  wise  men  see 
blue;  if,  when  these  lat- 
ter hear  music,  my  mad- 
man hears  an  ass  bray- 
ing; if,  when  they  are 
at  church,  my  madman 
fancies  himself  at  the 
play;  if,  when  they  hear 
'yes,'  he  hears  'no' — why  then  his  mind 
might  think  the  opposite  of  what  theirs 
do.  But  my  madman  has  the  same  per- 
ceptions as  they  have  and  there  is  no 
evident  reason  why  his  mind,  having  been 
furnished  with  all  the  tools  by  the  senses, 
should  not  make  use  of  them. 

"Close  reflections  make  one  suspect  that 
the  faculty  of  thinking,  the  divine  gift  to 
man,  is  subject  to  derangement  like  the 
other  senses.  A  lunatic  is  a  sick  man  whose 
brain  suffers,  as  the  gouty  man  is  one  who 


64 


Annals  of  Medical  History 


is  ill  in  hands  and  feet;  he  thought  with 
his  brain  as  he  walked  with  his  feet,  with- 
out understanding  his  incomprehensible 
power  of  walking  any  more  than  he  un- 
derstood his  incomprehensible  power  of 
thinking.  There  is  a  gout  of  the  brain  as 
well  as  of  the  feet.  Finally,  after  all 
reasoning,  perhaps  faith  alone  can  con- 
vince us  that  a  simple  and  immaterial 
substance  can  be  ill. 

"The  physicians  say  to  an  insane  patient, 
'My  friend,  you  have  lost  common  sense. 
Your  mind  is  as  pure  and  as  spiritual  as 
ours,  but  ours  is  well  situated,  while  yours 
is  not.  For  yours,  the  windows  are  shut — 
it  lacks  air  and  suffocates.'  The  patient, 
in  a  sane  moment,  might  answer,  'My 
friend,  you  assume  the  question;  my 
windows  are  as  wide  open  as  yours  are, 
as  I  see  the  same  things  and  hear  the 
same  words;  so  it  follows  that  my  mind 
makes  good  use  of  the  senses,  or  that  it  is 
itself  a  perverted  sense,  a  deteriorated 
quality,  or  my  mind  itself  is  insane,  or 
else  I  have  no  mind  at  all.' 

"One  of  the  doctors  might  answer,  'My 
dear  friend,  perhaps  God  has  created  un- 
balanced minds  as  he  has  created  balanced 
ones.'  To  which  might  be  answered,  'If  I 
believed  that  I  would  be  madder  than  I 
am  now.  Come,  you  who  know  so  much, 
tell  me  why  I  am  mad.'  If  the  doctors 
have  a  little  sense  left,  they  will  reply, 
'I  do  not  know  at  all.'  In  a  moment  of 
lucidity,  the  madman  might  say  to  that, 
'Poor  fellows — you  who  do  not  know  the 
cause  of  my  trouble  and  cannot  cure  it, 
tremble  lest  you  become  just  like  me — or 
perhaps  worse.  You  are  of  no  better  stock 
than  Charles  VI  of  France,  Henry  VI  of 
England,  or  the  Emperor  Venceslas,  all  of 
w  horn  lost  the  faculty  of  reasoning  in  the 
same  century.  Your  minds  are  not  better 
than  those  of  Blaise  Pascal,  Jacques 
Abbadie,  and  Jonathan  Swift,  all  three  of 
whom  died  mad.  The  last  of  these  at  least 
founded    a    hospital    lor    11s.    Would    you 


like   me  to  engage  a  place   for   you    in 
it?'  " 

And  by  way  of  appendix  he  adds: 

"I  am  distressed  that  Hippocrates  pre- 
scribed asses'  blood  for  insanity,  and  still 
more  that  the  'Manuel  des  dames'  says 
that  poor  people  become  sane  when  they 
catch  the  itch.  These  are  pleasing  receipts; 
they  appear  to  have  been  invented  by  the 
patients." 

Voltaire  wrote  much  about  syphilis,  the 
grand  pox,  as  he  called  it.  He  draws 
distinction  between  it  and  leprosy  and 
believed,  as  many  of  the  best  informed  still 
do,  that  syphilis  originated  in  America. 
Two  things  prove  this,  he  says: 

"First,  that  quantities  of  authors,  phy- 
sicians and  surgeons  of  the  XVI  century 
attest  the  truth  of  it.  Second,  the  silence 
of  all  physicians  and  poets  of  antiquity, 
who  did  not  know  this  disease  and  never 
pronounced  its  name.  This  seems  very 
conclusive.  Physicians,  from  Hippocrates 
down,  could  not  have  failed  to  describe 
the  disease,  to  name  it,  to  see  remedies 
for  it.  The  poets,  as  mischievous  as  the 
doctors  are  industrious,  would  have 
spoken  in  their  satires,  of  the  clap,  the 
chancre,  the  bubo,  all  the  things  which 
precede  and  follow  this  awful  malady. 
You  will  find  no  word  in  Horace,  in  Catul- 
lus, in  Martial,  in  Juvenal,  which  has  the 
slightest  relation  to  it,  although  they  write 
freely  of  all  the  effects  of  dissipation.  It  is 
certain  that  the  smallpox  was  not  known 
to  the  Romans  till  the  VI  century,  and 
that  the  American  pox  was  not  brought 
to  Europe  until  the  end  of  the  \\ 
century,  ami  that  leprosy  is  as  different 
from  both  of  them  as  it  is  from  St.  Vitus' 
dance. 

In  [496,  the  Parliament  of  Paris  passed 
a  decree  which  read  that  all  affected  with 
the  great  pox  who  were  not  citizens  of 
Paris,  should  leave  town  within  twenty- 
four  hours  or  l>e  hanged.  The  decree  was 


Voltaire's  Relation  to  Medicine 


65 


neither  Christian  nor  legal  nor  reasonable; 
but  it  proves  that  the  pox  was  regarded 
as  a  new  menace,  which  had  nothing  to 
do  with  leprosy,  since  they  did  not  hang 
lepers  who  slept  in  Paris.  Men  can  give 
leprosy  to  each  other  through  dirt,  but  as 
for  the  pox,  it  is  Nature  that  has  made 
this  present  to  America.  We  have  already 
reproached  this  Nature,  so  good  and  so 
bad,  so  clear-sighted  and  so  blind,  for 
having  defeated  its  object  by  poisoning 
the  source  of  life,  and  we  still  lament 
being  unable  to  find  a  solution  for  this 
terrible  difficulty-" 

The  societies  for  prophylaxis  of  venereal 
diseases    might    turn    to    their    profit    the 
conversation  between  the  surgeon  and  his 
questioner    in    "L'Homme    aux    quarante 
Ecus."  The  surgeon  replies  to  the  question 
as  to  how  syphilis  may  be  gotten  rid  of: 
"There  is  only  one  way,  and  that  is  for 
all  the  princes  of  Europe  to  form  a  league, 
as  in  the  days  of  Godfrey  of  Bouillon.  A 
crusade  against  syphilis  would  surely  be 
more  sensible  than  those  directed  in  old 
times  against  Saladin,  Melecsala  and  the 
Albigenses.  It  would  be  better  to  form  an 
agreement  for  the  purpose  of  stamping 
out  this  enemy  common  to  all  humanity, 
than  to  be  always  busy  watching  for  the 
right  moment  to  devastate  the  earth  and 
cover  the  fields  with  dead,  for  the  purpose 
of  filching  from  one's   neighbor  two  or 
three  cities  or  a  few  villages.  I  am  speak- 
ing against  my  own  interest,  for  war  and 
the  pox  make  my  fortune." 

It  was  inevitable  that  the  speculation  and 
experiments  on  a  subject  like  generation, 
which  were  active  in  his  time,  should  have 
excited  the  human  Voltaire.  Harvey,  under 
the  stimulus  of  his  teacher,  Fabricius,  did 
an  enormous  amount  of  work  on  animals 
along  these  lines,  and  in  165 1  published  his 
book  "  Excitationes  de  generatione"  and,  as 
Voltaire  puts  it,  took  for  his  devise  "Onmium 
ah  ore." 


Before  Harvey,  practically  all  views  had 
been  molded  on  Aristotle's  theory  that  the 
male  parent  furnished  the  body  of  the 
future  embryo,  while  the  female  only  nour- 
ished and  formed  the  seed. 

It  was  argument  based  on  the  denial  of 
the  maternal  relationship  that  secured  the 
acquittal  of  the  accused  in  .-Eschylus's 
"Furies."  Apollo  defended  Orestes  charged 
with  murdering  his  mother,  Clytemnestra, 
by  saying: 

Not  the  true  parent  is  the  woman's  womb 

That  bears  the  child — she  doth  but  nurse  the  seed 

New  sown :  the  male  is  parent — she  for  him 

As  stranger  for  a  stranger,  hoards  the  germ 

Of  life,  unless  the  gods  its  promise  blight, 

And  proof  hereof  before  you  will  I  set. 

Birth  may  from  fathers,  without  mothers  be: 

See  at  your  side  a  witness  of  the  same, 

Athena,  daughter  of  Olympian  Zeus 

Never  within  the  darkness  of  the  womb 

Fostered,  nor  fashioned,  but  a  bud  more  bright 

Than  any  Goddess  in  her  breast  might  bear. 

(Trans,  by  Morshead.) 

In  1677  Leeuwenhoek  communicated  to 
the  Royal  Society  of  London  the  discovery 
which  his  pupil  Hamen  had  made,  by  means 
of  the  microscope,  of  the  living  spermatozoa. 
Leeuwenhoek  believed  that  the  moving  ele- 
ments of  the  semen  might  be  germs  which 
enter  the  egg  and  become  embryos.  Op- 
ponents to  this  theory  called  them  para- 
sites, a  view  which  is  responsible  for  a  part 
of  their  name. 

It  was  not  until  after  the  death  of  Vol- 
taire that  Spallanzani  proved  by  ingenious 
experiments  that  the  spermatozoa  were 
necessary  for  fertilization.  So  Voltaire  was 
not  the  only  one  at  sea  when,  in  1777,  he 
devoted  the  ninth  dialogue  of  Evhemere  to 
this  topic.  Evhemere  represents  a  philoso- 
pher of  Syracuse,  and  Callicrate  serves  him 
as  interlocutor,  or  "end  man." 

Callicrate  —  I  have  always  been  as- 
tounded that  Hippocrates,  Plato  and 
Aristotle,  all  of  whom  had  children,  did 
not  agree  as  to  how  Nature  worked  this 


66 


Annals  of  Medical  History 


perpetual  miracle.  They  all  say  that  the 
two  sexes  cooperated  in  that  each  fur- 
nished   some    fluid;    but    Plato,    putting 
theology  ahead  of  nature,  of  course,  con- 
siders nothing  but  the  harmony  of  the 
number  three,  the  engender,  the  engen- 
dered,   and    the    female    in    whom    the 
generation  takes  place.  That  constitutes 
a  harmonious  proportion  for  Plato,  even 
if  the  accoucheur  fails  to  grasp  it.  Aris- 
totle limits   himself  to  saying  that  the 
female    produces    the    material 
of  the  embryo  and  the  male 
determines  its  form.   That 
does  not  help  us  much 
Tell    me,    has    no    one 
seen  Nature  at  work, 
as  sculptors  are  seen 
making  figures  from 
clay  or  from  marble 
or  from  wood? 

Evbemer  c — The 
sculptor  works  in 
the  open  but  Na- 
ture in  the  dark. 
All  that  we  knew 
up  till  now  was  that 
the  fluid  is  always 
spent  by  the  male 
when  he  copulates, 
but  that  it  is  some- 
times missing  in 
women.  But  now  a 
great  English  phys- 
icist, aided  by  cer- 
tain Italians,  has  substituted  eggs  for 
the  two  generating  fluids.  This  gnat 
dissector,  Harvey,  is  more  credible  from 
the  fact  that  he  has  seen  the  blood 
circulate;  something  which  Hippocrates 
never  saw  and  Aristotle  never  sus- 
pected. He  dissected  over  one  thousand 
quadruped  mothers  who  had  received  the 
male  fluid  but  when  he  had  examined 
Inn's  eggs,  be  conceived  the  idea  thai 
everything  originates  in  an  egg;  the  differ- 
ence   between    birds   and    other   species 


being  that  the  former  set  and  the  latter  do 
not.  A  woman  is  a  white  hen  in  Europe, 
and  a  black  one  in  Africa. 

Collier  ate — -Then  the  mystery  is  cleared 
up! 

Evhemere — Not  at  all.  Recently  all  has 
been  changed  again.  We  do  not  come  from 
an  egg  after  all.  It  seems  that  a  Batavian 
(Leeuwenhoek)  has,  with  the  microscope, 
seen  in  the  seminal  fluid  of  men  a  race  of 
little   beings,   fully   formed  and  running 
about   with  great  activity.   Many 
curious  men  and  women  have 
since  tried  the  same  experi- 
ment and  become  persua- 
ded that  the  question  of 
generation     is    solved. 
They  thought  they  saw 
little  men  in  the  semen 
of  their  fathers.   But 
u  nfortu  nately,  the 
very     activity      with 
which  the  little   men 
swam  has  discredited 
them.  How  could  men 
who  ran  about  so  ac- 
tively in  a  drop  of  liq- 
uid be  expected  to  re- 
main for  nine  months 
almost    motionless   ir 
their  mother's  womb? 


M  \DAME    DC    ClIATI.LF. 


itician  and  friend 


of  Voltaire. 


Voltaire  was  forced 
to  leave  the  question 

here. 
"All  theories,"  he  said  in  a  letter  to 
Thieriot,  "as  to  how  we  come  into  the 
world  have  been  overthrown.  The  only 
thing  that  has  proved  changeless  is  the 
\\a\    people  make  love." 

He   was    no   slower   than    the    rest    ol    us, 
for  tWO  centuries,    less    two   years,    elapsed 

between  the  discovery  of  the  spermatozoa, 

in  10 — ,  and  llertuig's  (1841}-  )  demon- 
stration in  [875,  that  fertilization  Is  effected 
b\   the  entrance  of  one  spermatozoon  into 


Voltaire's  Relation  to  Medicine 


67 


the  egg  and  the  union  of  its  nucleus  with 
the  egg  nucleus. 

In  Voltaire's  time,  smallpox  was  still  a 
terrible  scourge.  "Of  one  hundred  people," 
he  states,  "at  least  sixty  get  smallpox;  of 
these  sixty,  ten  die  and  ten  retain  the 
marks.  Thus  this  malady  kills  or  disfigures 
one-fifth  of  mankind." 

Voltaire  had  this  disease  when  a  young 
man  and  wrote  his  views  as  to  the  treatment 
of  it.  Personal  experience  may  have  stimu- 
lated his  interest  in  the  subject,  but, 
as  far  as  inoculation  w 
cerned,  his  interest  was 
selfish,  as  he  was  firmly 
the  opinion  that  smaIIpo> 
never  came  twice  to  the 
same  person.  As  he  was 
the  first  continental  to 
write  of  the  new  phys- 
ics from  England,  so 
was  he  also  the  first 
real  sponsor  in  Europe 
(1727)  for  variolation 
for  smallpox,  although 
Dr.  La  Coste  had  com- 
posed a  brief  note  con- 
cerning  it  before  any 
writings  of  Voltaire's 
on  the  subject  saw 
the  light  and  although 
the  subject  had  been 
taken  as  an  inaugural 
thesis  by  J.  B.  N. 
Boyer  (1693- 1768)  of 

Mnntpellier  in  1717.  La  Coste  probably 
received  the  idea  from  reports  to  the 
Royal  Society  in  17 14-16  by  physicians 
who  had  visited  Constantinople.  The  adop- 
tion of  the  practice  in  England  was  due 
to  Lady  Mary  Wortley  Montagu,  who 
learned  it  from  the  Turks  and  who  practiced 
it  on  her  children  in  1718,  while  her  hus- 
band was  Ambassador  at  Constantinople. 
This  courageous  action  of  hers  preceded 
by  eighty  years  Jenner's  transference  of  the 
cow-pox  from  the  milkmaid  to  James  Phipps. 


Catherine    II,    royal    sponsor    for    inoculation 
Russia. 


Lady  Mary  Wortley  Montagu  combined 
determination  with  charm,  but,  as  Voltaire 
said,  she  wrote  for  all  peoples  who  wished 
to  learn.  In  one  of  her  letters  from  Constan- 
tinople, she  said,  "  I  would  write  our  London 
doctors  if  I  believed  them  big  enough  to 
sacrifice  their  own  interest  to  those  of 
humanity.  But  I  fear  their  resentment,  if  I 
should  undertake  to  lessen  the  revenue  that 
smallpox  brings  them.  But  on  returning  to 
London  I  shall  perhaps  have  zeal  enough  to 
open  the  war." 

did,    and    succeeded,    and 
)Itaire  reports  that  the  doc- 
tors instead  of  opposing  in- 
oculation, took  it  up  and 
were  better  recompensed 
by    royalty    for    their 
inoculations  than  they 
would  have  been  had 
they  brought  the  dead 
to  life. 

Dr.  Richard  Mead, 
one  of  the  wealthy 
possessors  of  the  Gold 
Headed  Cane,  first 
practiced  inoculation 
in  England  in  1721. 
Royalty  came  to  the 
support  of  the  cause, 
especially  Queen  Car- 
oline of  England,  a 
woman  whom  Vol- 
taire admired  im- 
mensely. The  Due 
d'Orleans,  King  of  Denmark,  King  of  Swe- 
den, and  Queen  of  Hungary  all  had  it  done 
in  their  families. 

Catherine  II,  Empress  of  Russia,  wrote 
Voltaire  in  1768,  saying  that  Dr.  Thomas 
Dimsdale  (171 1-1800)  of  England  had  come 
to  Russia.  He  had  inoculated  6000,  with 
only  one  death,  and  that  death  a  child  of 
three.  Catherine  was  inoculated  and  had  no 
ill  effects  from  the  operation.  She  did  not 
go  to  bed  and  saw  company  every  day.  Dr. 
Dimsdale  made  inoculations  in  Petersburg 


68 


Annals  of  Medical  History 


in  schools  and  in  specially  constructed  hos- 
pitals, receiving  as  his  fee  .£10,000  down 
and  an  annuity  of  ^.500. 

It  is  interesting  to  note  that  at  about  the 
time  that  inoculation,  or  "buying  the  small- 
pox" as  it  was  called,  was  gaining  in  Eng- 
land, an  epidemic  visited  Boston,  for  the 
first  time  in  sixteen  years.  The  impassioned 
Cotton  Mather,  who  had  studied  medicine 
for  a  time  and  who  was  the  first  American 
elected  to  the  Royal  Society  (17 13),  aroused 
by  the  reports  of  the  new  method  which  he 
received  from  England,  sent  copies  of  them 
to  the  Boston  practitioners,  and  Dr.  Zabdiel 
Boylston  (1679- 1766)  a^so  a  member  of  the 
Royal  Society,  first  introduced  (as  is  re- 
corded on  his  tombstone  in  Boston),  the 
practice  into  America.  Within  six  months 
he  had  inoculated  244  persons.  But  several 
of  his  patients  died  and  the  Selectmen  of  Bos- 
ton, with  true  Puritan  insight,  forbade  its  fur- 
ther practice,  saying  "that  the  operation 
tends  to  spread  and  continue  the  infection  in 
a  place  longer  than  otherwise  it  might  be." 
This  fact  of  the  contagiousness  of  inoculated 
smallpox  was  late  in  attracting  the  observa- 
tion of  Europeans.  Voltaire  does  not  speak, 
of  it.  It  was  a  feature  of  more  importance 
in  America  than  in  Europe,  in  which  latter 
continent  the  ravages  of  smallpox  were  so 
continuous  and  so  widespread. 

Inoculation  was  probably  a  folk  custom 
originally  and  was  prevalent  in  many  primi- 
tive- people  and  is  still  practiced  in  certain 
African  tribes.  But  Voltaire's  letter  about  it 
is  no  less  interesting. 

"It  was  an  immemorial  custom,"  he 
says,  "for  Circassian  women  to  give 
smallpox  to  their  children  at  the  age  of 
six  months,  In  making  an  incision  on  the 
arm  and  by  inserting  in  this  incision  a 
pustule  from  the  body  of  another  child. 
I  he  inoculated  child  served  as  source  of 
supply  of  pustules  for  other  children. 

Maternal  instinct  and  tenderness  intro- 
duced this  custom  in  Circassia.    The  Cir- 


cassians are  poor  and  their  children  are 
very  pretty  and  it  is  with  the  daughters 
that  their  chief  trade  lies.  They  supply 
the  beauties  of  the  harems  of  kings  and  of 
others  rich  enough  to  buy  and  maintain 
such  valuable  merchandise.  They  bring 
up  the  girls  to  caress  men,  to  dance  and 
to  excite,  by  the  most  voluptuous  artifices, 
the  taste  of  the  supercilious  masters  for 
whom  they  are  destined.  Every  day  the 
little  girls  rehearse  their  lessons  with  their 
mothers,  like  children  who  learn  the 
catechism  without  understanding  'any- 
thing about  it.  But  smallpox  would  make 
futile  all  these  pains. 

A  commercial  nation  is  always  alert  for 
its  interests  and  neglects  no  information 
which  might  foster  its  trade.  The  Circas- 
sians observed  that  smallpox  practically 
never  came  twice  to  the  same  person. 
They  perceived,  further,  that  benign 
smallpox  leaves  no  mark  and  concluded 
that  if  a  child  of  six  months  or  one  year 
had  benign  smallpox  it  would  neither  die 
nor  be  pockmarked,  but  would  be  rid  of 
the  disease  for  the  rest  of  its  life.  So  they 
treated  their  children  in  this  way.  The 
Turks  adopted  this  custom  and  it  became 
practically  universal  in  Turkey.  Of  all 
those  inoculated  in  Turkey  or  England, 
none  die,  except  the  very  feeble,  none  are 
pockmarked,  and  none  acquire  the  disease 


lie  reproaches  Louis  XV,  who  died  of 
smallpox,  with  not  having  profited  by  the 
examples  of  others  and  with  not  having 
been  inoculated.  But  this  reproach  is  hardl\ 
justified,  as  he  states  elsewhere  that  this 
monarch  had  had  the  smallpox  as  a  boy  of 
fourteen. 

Years  afterwards,  in  1763,  when  inocula- 
tion,    though    current,     was     meeting    with 

opposition,  the  Parliament  of  Paris  ordered 

that  the  question  as  to  its  value  should  he 
referred  to  the  faculties  of  theo|og\  and 
medicine.   In  a  sarcastic  pamphlet,  Voltaire 


Voltaire's  Relation  to  Medicine 


69 


says,  "You  gentlemen,  who  are  the  best 
theologians  and  the  best  physicians  in 
Europe,  you  should  issue  an  injunction 
against  smallpox,  just  as  you  have  against 
Aristotle's  categories,  against  the  circulation 
of  the  blood,  against  emetics  and  quinine." 
Inoculation  did  not  become  general  in 
France  until  1756,  and  Voltaire  was  an  old 
man  when  he  addressed  the  following  verses 
to  that  medical  friend  of  his  who  had  done 
most  to  make  the  practice  accepted  by  the 
French,  and  who  had  20,000  successful 
operations  to  his  credit.  This  was  Theodore 
Tronchin  (1709-81),  of  Geneva,  the  same 
one  who  demonstrated  that  the  "Colica 
Pictonum"  was  caused  by  lead  used  to 
sweeten  wine,  and  who  was  the  first  to 
show  that  plumbism  might  result  from 
water  drawn  through  lead  pipes.  The  verses 
were  written  on  the  occasion  of  Tronchin 
cutting  short  a  visit  to  Voltaire  to  go  to 
inoculate  the  king's  grandsons. 

A.  M.  Tronchin 

Since  your  departure  yesterday, 
Renewed  is  all  my  suffering, 
But  I  can  bear  it  and  be  gay 
Because  I  know  you  went  away 
To  save  the  grandsons  of  the  king. 

Some  prejudices  serve  an  end, 
But  others  grow  like  noxious  weeds; 
To  triumph  over  these,  one  needs 
A  sage,  a  man  of  valiant  deeds. 
Your  clever  hands  their  aid  did  lend 

When,  long  ago,  I  told  my  nation 
(And  youth,  perhaps,  was  my  excuse) 

About  inoculation. 

Which — thanks  to  you  in  common  use — 

Was  thought  imagination 
And  met  with  foul  abuse 

Like  Newton's  gravitation. 
I  saw  the  truth,  but  could  not  then 
The  world  of  that  same  truth  convince; 
Nor  was  I  hailed,  before  or  since, 
A  prophet  by  my  countrymen. 

"How  can  we,"  people  said,  "believe 
Truths  made  in  England?     How  suppose 
That  any  one  can  good  receive 
From  those  who  are  our  foes?" 


Ah,  France,  it  was  at  last  your  fate 
To  ask  of  England  all  she  knew, 
Nor  need  we  blush  to  imitate 
Those  whom  we  fairly  overthrew. 
For  equally  in  all  men's  sight 
The  sun  performs  its  daily  race, 

And  Truth,  impartial,  sheds  her  light 
In  every  age,  in  every  place; 

Let  us — not  asking  whence  they  come, 

Nor  whose  the  honor  and  the  praise — 
Receive  with  joy  her  blessed  rays, 

And  may  the  whole  world  be  her  home! 

Besides  these  subjects,  he  wrote  on  fistula, 
which  killed  Richelieu.  It  was  for  fistula  that 
Louis  XIV  paid  the  son  of  the  elder  Felix 
(d.  1703)  in  a  property  worth  50,000  ecus,4 
in  return  for  the  skillful  operation  he  per- 
formed on  him.  Voltaire  also  wrote  on  the 
stone  and  on  leprosy.  He  had  the  vagueness 
of  view  regarding  gonorrhea  which  lasted 
till  the  time  of  Ricord  (1 799-1 899).  Of  gout 
he  made  the  remark  that  "it  confounds  the 
pretended  art  of  medicine."  He  was  very 
enthusiastic  about  the  first  veterinary  school 
founded  in  France,  in  1672,  which  was  the 
beginning  of  veterinary  medicine  in  Europe. 
He  wrote  its  founder  and  director,  Claude 
B.  Bourgelat  of  Lyons  (b.  171 2)  author  of 
"Elements  de  I'art  Veterinaire"  (Lyons, 
1765-69), — "You  are  not  like  those  physi- 
cians who  without  hesitation  take  the  place 
of  God  and  create  a  world  with  a  word.  You 
have  opened  a  new  career  by  the  way  of 
experience." 

In  his  "Century  of  Louis  XIV,"  Voltaire 
states  that  surgery,  "the  most  useful  of  all 
the  arts,"  attained  its  highest  supremacy  in 
France  during  Louis'  reign.  People  flocked 
there  from  everywhere  to  avail  themselves 
of  the  skill  of  the  surgeons  and  to  obtain 
the  instruments  which  there  attained  the 
highest  degree  of  perfection.5 

4  The  ecu  did  not  have  a  constant  value,  being 
worth  between  3  and  6  Iivres,  a  Iivre  being  tin- 
equivalent  of  the  franc.  The  purchasing  power  of 
the  franc  then  and  now  is  put  at  1-10. 

5  It  was  John  Hunter  who  transferred  surgical 
supremacy  to  England. 


70 


Annals  of  Medical  History 


Voltaire's  varied  activities  with  the  stage, 
with  court  life,  with  the  wise  investment  of 
money,  with  agriculture,  and  with  practical- 
ly all  the  questions  of  his  day,  left  him  time 
to  acquire  a  discriminating  interest  in  the 
history  and  trend  of  the  medical  art,  to  fix 
his  belief  in  its  ideals  and  to  make  him 
jealous  of  its  good  name.  But  the  fact  that 
his  writings  on  medical  subjects  represent 
so  very  small  a  portion  of  his  works,  makes 
surprising  the  accuracy  of  his  knowledge  of 
medical  subjects,  his  free  and  correct  use  of 
medical  terms,  including  those  of 
anatomy,  and  his  perception  of 
medicine's  final  promise. 

It  would  be  interesting 
to  know  whether  his  ob- 
servations and  criticisms 
covering  the  theories  of 
Newton  and  Descar- 
tes, Ins  views  of  Locke 
and  Spinoza  and  Hel- 
vetius  and  other  phi- 
losophers, his  state- 
ments in  history,  his 
opinions  on  law  and 
on  bees  and  lawyers 
and  actors  and  au- 
thors and  dancers 
came  as  near  to  the 
truth  as  his  medical 
opinions.  He  is  said 
to  have  failed  to  ap- 
preciate Shakespeare; 
but  he  seems  to  have 
had  a  good  line  on  Aristotle,  and  I  for  one  am 
inclined  to  accord  him  the  compliment  of 
believing  that  he  was  right  oftener  than 
most  men  from  the  very  tact  that  he  was 
so  often  right  in  matters  1  happen  to  know 
about,  but  which  wire  side  issues  to  him. 

Mis  views  ot  crime  and  punishment  have 
not  been  improved  much  since  his  day. 
"Whoever  gives  himself  a  master,"  he  says, 
"was  born  to  have  one."  lit-  saw  dementia 
in  all  ^rreat  crimes,  and  notes  the  religious 
fanaticism  associated  with  so  many  of  them. 


Tkonchin,  most  prominent  French  inoculator 


"Bibles,  not  Virgils,"  he  says,  "are  found 
in  the  pockets  of  regicides."  In  illustration 
of  this  he  cites  the  case  of  Jean  Chatel,  who 
attempted  to  assassinate  Henry  IV.  The 
young  man  had  conceived  the  idea  from 
Jesuit  priests  that  he  was  damned.  He 
wanted  to  die,  and  contemplated  a  bestial 
crime  in  public,  with  the  idea  that  he  would 
be  killed  at  once.  He  changed  this  plan  to 
that  of  assassinating  the  king,  and  stabbed 
him  in  the  mouth.  The  Protestant  d'Aubigne 
wrote  to  Henry  IV  about  this,  saying,  "You 
have  denied  God  with  your  mouth 
and  he  has  struck  your  mouth; 
take  care  that  you  never  deny 
him  with  your  heart." 

As  to  capital  punish- 
ment, Voltaire  asks  if  it  is 
reasonable  to  suppose 
that  men  can  be  taught 
to  hate  homicide  when 
the  magistrates  are 
homicides  themselves 
and  kill  a  man  with 
a  great  show.  Should 
not  the  criminal  make 
good  the  damage  he 
has  done  his  country 
by  working  for  it 
death  makes  nothing 
good." 

To-day  the  great 
problem  in  education 
is  that  of  selection, 
the  organization  of  the 
means  to  find  out  the  faculties  of  the 
individual  and  to  adapt  education  to  the 
perfecting  them.  We  find  Voltaire  realizing 
this  already  and  saying  that  education  in 
colleges  and  convents  is  bad,  for  the  reason 
that  there'  the'  same'  things  arc  taught  to  a 
hundred  pupils,  all  with  different  talents; 
and  he  makes  Caneliele'  say,  at  the'  end  of 
his  varied  and  exciting  experiences,  that  the 
tiling  for  each  one'  to  do  is,  alter  all,  to 
cultivate  his  ow  n  garden. 

Regarding   the   importance   of  youthful 


Voltaire's  Relation  to  Medicine 


7i 


impressions  in  forming  character,  he  puts 
in  the  mouth  of  Zaire,  the  Christian  captive 
in  Jerusalem,  reared  in  ignorance  of  her 
faith  and  country,  and  beloved  by  the 
Mohammedan  ruler  of  the  region: 

the  love  that  encircles  and  nurtures  our  youth 

Molds   our   feelings  and   conduct  and  grasp  of  the 

truth. 
A  slave  to  false  gods,  I  had  been  as  sincere 
As  a  Christian;  in  Paris;  or  Mussulman  here. 
The  hands  of  our  parents,  their  training,  tho'  brief, 
Engrave  in  our  heart  every  early  belief 
Which  example  and  custom  so  often 

retrace 
And  which,  it  may  be,  only  God 

can  efface.    II,  560. 

In  Chariot  he  brings 
out  the  Socratic  doc- 
trine, overthrown  by 
Aristotle  and  revived 
in  our  days  by  Freud, 
that  knowledge  and 
virtue  are  the  same 
thing.  Le  Marquis, 
an  overbearing  and 
spoiled  young  man, 
excuses  himself  to  his 
mo*  her  by  saying: 
"Jesuisfortnaturel," 
to  which  his  mother, 
the  countess,  replies: 

Oui,  mais  soyez 

aimable — 
Cette  pure  nature  est  fort 

insupportable. 
Vos  pareils  sont  polis;  pour  quoi?  e'est  qu'ils  ont  eu 
Cette  education  qui  tient  lieu  de  vertu; 
Leur  ame  en  est  empreinte;  et  si  cet  avantage 
N'est  pas  la  vertu  meme,  il  est  sa  noble  image 
Dompter  cette  humeur  brusque,  ou  le  penchant  vous 

Iivre, 
Pour  vivre  heureux,  mon  fils,  que  faut  il? 

Savoir  vivre. 

A  balance  runs  through  his  opinions  which 
is  truly  remarkable  for  a  man  who  took  such 
personal  prejudices  as  he  did.  He  hated  war, 
and  relative  to  a  hand-book  of  tactics  by 


Bourgelat,   founder  of  first  veterinary  schoo 
France. 


Guibcrt,  which  was  used  by  the  French 
officers  in  this  country  during  our  Revolu- 
tion, and  which  was  later  highly  prized  by 
Napoleon,  he  wrote: 

Fevers,  gout  and  catarrh  and  a  hundred  worse  ills 
With  a  hundred  learned  charlatans  working  their 

wills — 
You  might  think  the  world  evil  enougli  as  things  are, 
Without  man's  inventing  the  great  art  of  war.6 

But  feeling  in  this  way  did  not  prevent 
him  from  realizing  that  "the  nation  best 
provided    with    steel    will    always 
subjugate  the  one  which   has 
more  gold  and  less  courage." 
Dr.  John  Moore,  a  prac- 
titioner of  London,  whose 
letters  about  his  travels 
gained  him  some  liter- 
ary reputation,  while 
tutor   of    the    young 
Duke     of    Hamilton 
visited     Voltaire     at 
Ferney    in    the    last 
year  of  Voltaire's  life 
(1778).  He  has  left  a 
lively    picture  which 
seems  to  have  escaped 
the    great    French- 
man's   English   biog- 
raphers. 

"  This  skeleton,"  he 
writes,  "has  a  keener 
and  brighter  glance 
of  the  eye  than  any 
human  being,  with 
the  vigor  of  maturity  and  all  the  advan- 
tages of  the  most  bubbling  youth.  In  his 
face  may  be  read  his  genius,  his  pene- 
tration, and  his  extreme  sensibility.  He 
maintains  a  systematic  correspondence 
with  the  whole  of  Europe,  and  from  it  he 
gets  the  news  of  all  noteworthy  events  and 
all  literary  productions  as  soon  as  they 
appear.   The   greater  part  of  his   time   he 

6  For  this  and  the  preceding  renditions  of  the 
French  into  English  verse  the  writer  is  indebted  to 
Mrs.  Alice  Duer  Miller. 


72 


Annals  of  Medical  History 


spends  in  his  study,  reading  or  being  read 
to,  and  always  with  his  pen  in  his  hand  with 
which  to  make  notes  or  comments." 

He  must  have  passed  his  whole  life  in  the 
way  Dr.  John  Moore  describes  his  last  days. 
With  a  pen  in  his  hand  and  with  his 
mind  turning  from  his  immediate 
surroundings  to  rove  to  the 
uttermost  parts  of  the  earth, 
keen  for  material  and  crit- 
ical for  the drawingof  far- 
reaching  conclusions.     / 
Every  fact,  familiar  or 
alien,  served  him  for 
thinking.  When  Wil- 
liam Cheselden  ( 1 688- 
1-52),   the    English 
surgeon,    and    physi- 
cian to  Sir  Isaac  New- 
ton,   made  an  artifi- 
cial pupil  on  a  patient 
congenitally  blind, 
thereby     supplying 
him  with  vision,  Vol- 
taire was  greatly  ex- 
cited at  the  discovery 
that  it  took  the  pa- 
tient   some    time    to 
acquire    the    idea    of 

distance.  Apropos  of  this,  he  said,  "It  is 
impossible  to  be  unhappy  through  the 
deprivation  of  things  of  which  one  has  no 
idea." 

He  possessed,  perhaps  better  than  any 
one,  the  capacity  to  look  tilings  in  the  face 
and,  in  spite  of  what  he  saw  there,  to  main- 
tain  with   humility   the   high     level    of    his 


Dr.  John   Mooki-.,   who   left   a   lively  account   of 
Voltaire's  activity  during  the  last  year  of  his  life. 


constructive  mental  energy.  It  would  be 
hard  to  find  a  more  exacting  test  of  intellect 
and  courage  than  that — than  to  contemplate 
correctly  the  verities,  and  still  show  undis- 
mayed the  feelings  and  actions  of  an  opti- 
___^  mist.  To  stand  such  a  test  re- 
quires, in  addition  to  the  purely 
intellectual  critical  qualities, 
the  kind  of  understanding 
of  humanity  which  is  in- 
separable from  the  love 
of  it. 

Medicine,  as  well 
as  other  branches  of 
learning,  owes  its 
chief  debt  to  men  like 
\  oltaire,  who  were  at 
once  brave,  know  ing 
and  humble.  Voltaire 
used  to  say  that  his 
desire  was  to  try  and 
sow  broadcast  what 
he  perceived  so  clear- 
ly himself.  lie  com- 
plained that  the  fields 
were  ungrateful,  not 
realizing,  perhaps, 
that  only  men  of  fiber 
like  his  own  can  grasp 
truth  firmly  and  hold  it.  Judged  by  the 
events  which  have  had  a  bearing  on  the 
conclusions  that  he  drew,  he  made  sing- 
ularly few  errors  in  principle.  He  seems 
to  have  illustrated  his  own  saying: 

Lc  gout  conduit   pour  le  genie  ne   fait 
jamais  de  fautes  grossieres. 


AN   UNPUBLISHED   BRONZE   ECORCHE 


13 


By  EDWARD  C.  STREETER,  M.D. 

BOSTON 


IF  proof  were  needed  of  the  complete 
concurrence  of  science  with  the  serious 
figure  arts  at  Florence  four  hundred 
years  ago,  it  could  readily  be  drawn  from 
the  most  cursory  study  of  the  bronze  figurine 
reproduced  on  this  page.  This 
little  bronze  is  scant  six  inches 
measurement,  of  brassy  tex- 
ture and  without  particular 
patina;  it  dates  from  the  first 
quarter  of  the  XVI  century 
and  is  said  to  be  the  work  of 
Jacobo  Sansovino.  With  equal 
reason,  we  should  think,  it 
could  be  assigned  to  Andrea, 
Jacobo's  teacher,  pu- 
pil of  Antonio  Pol- 
laiuolo  who  was  "the 
virtual  beginner  of 
artistic  anatomy  in 
Italy." 

Whatever  attribution  we 
give  it,  this  choice  bronze  nug- 
get still  serves  to  blazon  and 
proclaim  a  new  passion  (or  is 
it  the  revival  of  an  old?),  name- 
ly a  passion  for  uncompromis- 
ing realism  on  the  part  of  the 
great  figure-painters  and  sculp- 
tors of  Florence;  realism  that 
led  into  paths  of  purely  objec- 
tive inquiry.  Artists,  for  the 
nonce,  became  anatomists. 
"Art  ceased  to  be  symbolic 
and  became  scientific."  Act- 
ually, at  times,  more  human 
dissections  were  performed  in 
the  city  of  Florence  by  masters  of  art  than 
by  the  appointed  masters  of  Medicine. 
Anatomy  was  a  discipline  which  no  worker 
"in  the  round"  could  ignore.  To  such  it 
was  the  supreme  enabling  gift.    It   meant 


XVI  Century  Italian  bronze 
figurine  of  an  ecorche  or 
flayed  man.  Attributed  to 
Jacobo  Sansovino. 

(Reproduced  bv  permission  of  Gimpel  and 
Wiklenstein.) 


technical  excellence,  power  to  portray  pres- 
sures and  mass  beneath  contour.  It  gave 
reality  and  firm  substance  to  the  represen- 
tations of  form  and  movement.  It  brought 
fresh  vision  and  vigor  to  assail  each  vital 
plastic  problem. 

The  new  naturalism,  aiming 
at  a  scientific  reproduction  of 
nature,  took  the  Florentine 
Schools  by  storm.  No  "bot- 
tega"  but  felt  the  vast  stir  of 
this  momentous  development. 
The  "Ars  et  Mysterium"  of 
figure-drawing  and  of  form- 
modeling  was  revolutionized  ; 
her  ancient  ante-chambers 
converted  into  veritable  halls 
for  dissection.  Donatello  and 
Andrea  del  Castagno  witnessed 
anatomies;  PoIIajuolo  and  Ver- 
rocchio,  their  pupils,  performed 
them.  From  1450  until  the 
decline  of  the  school  of  the 
Carracci  at  Bologna,  anatomy 
had  a  more  or  less  secure  place 
in  North  Italian  schools  of 
Art.  Leonardo,  Michelange- 
lo, and  all  their  spiritual  off- 
spring. Piero  della  Francesco, 
Luca  Signorelli,  Andrea  Ma- 
tegna,  Roselli,  Piero  di  Cosi- 
mo,  Andrea  del  Sarto,  Pon- 
tormo,  Rosso  Fiorentino, 
Montorsoli,  Sebastian  del  Pi- 
ombo  and  scores  of  others 
might  be  cited  as  men  who 
were  held  in  thrall  to  this 
new  technique  at  the  basis  of  unclouded 
draughtsmanship. 

But  only  the  powerful  ones  among  these 
artists  could  secure  bodies  on  which  to  make 
their    studies   and   preparations.   Subjects, 


73 


74 


Annals  of  Medical  History 


too, soon  became  unserviceable.  Scarcit}-  and 
impermanency  of  material  thus  led  artists 
to  adopt  the  plan  of  making  a  sustained  and 
systematic  series  of  drawings  of  such  parts 
as  they  needed.  These  current  studies  of 
the  scale  of  parts  and  the  essential  myologic 
details,  i.e.  "omnes  musculi  sub  cute  ime- 
diate  Iocati,"  circulated  among  pupils  and 
minor  craftsmen.  "I  pray  you  remember 
on  coming  to  Rome,"  writes  Seb.del  Piombo 
to  Michelangelo,  "to  bring  along  some  of 
those  drawings  of  legs,  bodies  or  arms,  which 
I  have  wanted  this  great  while,  as  you  are 
aware."  Such  drawings  did  valiant  service, 
as  did  casts  in  gesso,  preparations  in  wax, 
etc.  But  results  registered  in  haste,  on 
materials  liable  to  destruction,  were  further 
enriched  and  supplemented  by  the  anatom- 
ical notes  taken  down  by  sculptors  in  per- 
durable bronze.  Of  the  precise  way  in 
which  this  was  done,  our  little  ecorche  forms 
a  shining  example. 

Life-casts  of  the  human  figure  were  taken 
even  by  the  Giottesschi,  but  it  remained  for 
the  men  of  the  Cinquecento  to  develop  those 
intricacies  of  labored  anatomy  found  in  the 
ecorche.  We  have  found  that  knowledge  oi 
the  superficial  and  skeletal  muscles  was  es- 
sential alike  to  the  sculptor  and  the  maker 
of  little  bronzes,  for  it  gave  the  possessor  a 
neat  and  quick  vein  for  molding  the  outer 
form  with  the  utmost  finesse.  The  call  for 
the  ecorche  was  insistent,  and,  we  assume, 
fairly  met.  Mathias  Duval  gives  in  his 
"  I  listoire  dc  L'Anatomic  Plastiquc"  (Paris, 
itt<;8)  some  scattering  comments  on  the 
notable  replicas  of  flayed  figures  in  collec- 
tions abroad, — but  he  is  woefully  incom- 
plete. He  fails  to  mention  Marco  Agrati's 
"si.  Bartholomew"  in  Milan  cathedral,  the 
most  impressive  flayed  figure  extant.  Duval 
reproduces  the  ecorches  attributed  by  tradi- 
tion to  Michelangelo  and  Bandinelli,  also 
that  of  Ludovico  Cardi  (Cigoli,  i  559  -161 3), 


whose  wonderful  wax  figures  were  modeled 
for  his  master  Allori.  He  mentions  the  lost 
anatomical  modelings  of  the  Spanish  artist 
Gaspar  Becerra,  who  redrew  the  Vesalian 
plates  for  J.  Valverde's  Anatomy  (and  there- 
to added  a  spirited  muscle-man  of  his  own 
contriving,  suggestive  of  St.  Bartholomew). 
Duval  gives  no  data  dealing  with  Italian 
figurines  of  the  Renaissance. 

In  all,  about  ten  "musclemen"  in  this 
class  of  little  bronzes  are  partially  described, 
or  at  least  known  to  exist,  to-day.  Of  these, 
three  are  in  the  Berlin  Museum,  one  in  the 
Louvre,  two  in  the  Victoria  and  Albert 
Museum,  one  in  the  Royal  College  of  Sur- 
geons. The  one  in  the  v.  Rho  collection  in 
Vienna  and  this  one  in  the  possession  of 
Messrs.  Gimpel  and  Wildehstein  account 
for  nine.  Then  there  is  the  germane  plaque 
described  by  Bode:  Beriehte  XXXIII,  Abb. 
105.  Other  pieces  doubtless,  similar  to  these, 
exist  in  private  hands.  All  the  great  collec- 
tions such  as  the  Morgan,  the  Pringsheim, 
and  others  in  southern  Germany  and  Italy, 
should  be  scrutinized  anew.  The  above  list 
by  no  means  exhausts  the  possibilities. 

Finally  it  must  be  admitted  that  in  the 
matter  of  attribution  much  remains  to  be 
done.  Where  experts  such  as  Dr.  Bode 
and  Goldschmidt  oscillate  perpetually,  like 
shore  birds  minus  the  hind  toe,  as  between 
John  of  Bologna,  Francavilla  and  Prospero 
Beresciano,  what  can  an  ignorant  searcher 
do  but  muddle  along  as  best  he  can  and 
"welter  in   the  prevailing  chaos"? 

bibliography: 

Goldschmidt  (Fritz).  "Die  Italienischen  Bron- 
zen  der  Renaissance  und  des  Barock."    Berlin,    MM  I. 

Bodi  .    "Bronze  statuettes  <>f  the  Renaissance." 
v.  Schlosser.     "Jahrbuch  der  k.  Sammlungen," 
XXXI,  S.   L04. 


7i>' 


BURKE  AND  HARE  AND  THE  PSYCHOLOGY  OF  MURDER* 
By  CHARLES  W.  BURR,  M.D. 

PHILADELPHIA. 


THE  people  whose  lives  I  purpose  dis- 
cussing are  immortal  in  criminal  an- 
nals on  account  of  the  number  and 
the  nature  of  their  crimes.  Their  life  histories 
offer  abundant  material  for  a  clinic  in  criminal 
psychology,  and  they  are  the  more  useful 
as  subjects  for  study  because  of  the  sim- 
plicity of  their  characters.  They  do  not 
present  that  tangle  of  different  tendencies, 
that  fighting  of  different  motives,  shown 
by  more  complex  natures.  We  are  prone 
to  associate  simplicity  with  goodness  but 
there  is  a  simplicity  of  evil  as  well  as  of 
good  and  these  people  possessed  it.  There 
are  fewer  unknown  quantities  in  the 
equations  of  their  characters  than  are 
present  in  people  of  more  complicated 
mental  makeup.  The  simplest  human  mind 
is  complicated  enough,  but  in  Burke  and 
Hare  the  solution  of  the  problem  as  to  why 
th  v  were  criminals  is  a  little  less  hard 
than  in  men  and  women  of  more  complex 
and  higher  natures  in  whom  there  is  a 
struggle  between  good  and  evil  before  they 
succumb  wholly  to  evil.  Their  vocation 
was  to  murder  people  in  order  to  sell  their 
bodies  to  teachers  of  anatomy.  They  were 
not  originators  of  the  trade,  nor  do  I  know 
who  was,  but  they  were  the  only,  or  at  all 
events  the  most  notorious,  wholesalers. 
Years  before  their  appearance  on  the  scene, 
as  early  indeed  as  1752,  Helen  Torrence 
and  Jean  Waldie  were  executed  in  Scotland 
for  a  similar  crime.  It  seems  that  these 
women  had  promised  some  students,  they 
themselves  being  nurses  of  a  sort,  to  obtain 
a  body  for  them.  They  were  unsuccessful, 
so  one  day  meeting  in  the  streets  a  woman 
*Readatthe  meeting  of  the  Section  on  Medical  History 


and  a  little  boy  eight  or  nine  years  old  they 
tempted  her  with  drink  and  she,  nothing 
loath,  accepted.  While  one  woman  enter- 
tained her  the  other  took  the  boy  to  her 
own  house  and  there  and  then  suffocated 
him  with  the  bedclothes.  They  were  paid 
for  the  body  two  shillings  and  tenpence, 
and  an  extra  sixpence  to  her  who  carried 
the  burden,  but  they  themselves  paid  by 
going  to  the  gallows. 

Body  snatching,  we  must  not  call  it 
stealing  because  there  were  no  property 
rights  in  a  dead  body  in  those  days  and 
the  resurrectionists  were  careful  always  to 
leave  the  grave  clothes,  began  in  Edin- 
burgh from  scientific  necessity.  The  govern- 
ment required  that  students  should  dissect 
but  did  nothing  to  provide  material. 
Anatomical  advance  could  not  be  made 
save  by  studying  the  human  body:  the 
physicians  of  continental  Europe  were  mak- 
ing great  discoveries  and  the  Scottish 
faculty  had  no  intention  of  being  left  behind 
in  the  search  after  knowledge.  Montieth 
proposed,  in  the  last  decade  of  the  seven- 
teenth century,  that  if  he  were  allowed  to 
have  the  bodies  of  poor  people  dying  in 
the  workhouse  who  had  no  one  to  bury 
them  he  would  treat  the  living  poor  free 
and,  more  than  this,  do  for  anatomy  in  a 
few  years  more  than  had  been  done  in 
Leyden  in  thirty.  His  proposal  was  ac- 
cepted with  certain  restrictions  but  the 
supply  of  bodies  was  still  too  small.  To 
help  out,  and  because  they  were  not  suf- 
fering from  over-refinement  and  much  en- 
joyed sport  of  the  rougher  sort  tinctured 
with    danger    to    life    and    limb,    medical 

oft  he  College  of  Physicians  of  Philadelphia,  Nov.  21,1916. 

15 


76 


Annals  of  Medical  History 


students  became  body  snatchers  and  this 
led  to  such  grave  scandals  that  finally 
a  clause  was  put  in  the  indentures  of 
students  (they  served  apprenticeships  in 
those  days)  binding  them  not  to  take  part 
in  violating  graves,  but  I  do  not  think  that 
physicians,  teachers  of  anatomy  at  any 
rate,  ever  very  seriously  sought  for,  or, 
when  found,  verj-  severely  punished  the 
youths  who  visited  graveyards  at  night 
with  rope  and  shovel.  Ever}-  now  and  again 
there  were  outbursts  of  popular  anger  on 
account  of  the  desecration  of  graves  and 
about  i  ~ij  Monro's  anatomical  establish- 
ment was  destroyed  by  a  mob.  Not  only 
students  but  sometimes  physicians  deprived 
the  worms  of  their  food  and  Dr.  Pattison 
of  Glasgow  was  arrested  and  tried  but 
acquitted  on  legally  interesting  grounds. 
It  was  proven  that  the  body  or  parts  of  the 
body  produced  in  court  were  from  a  woman 
who  had  never  had  a  child  while  the  woman 
whose  body  he  was  accused  of  stealing  had 
been  a  mother.  Though  acquitted,  public 
feeling  was  so  strong  that  he  had  to  emigrate 
to  America.  During  the  whole  time  that 
body  snatching  lasted,  until  it  became 
associated  with  murder,  the  law-making 
body  took  much  less  interest  in  the  matter, 
regarded  it  much  less  seriously,  than  the 
people.  This  was  partly  because,  as  a  rule, 
the  bodies  taken  were  those  of  the  friend- 
less and  the  poverty-stricken  who  rarely 
left  behind  any  one  who  had  any  interest 
in  what  became  of  either  their  bodies  or 
their  souls,  though  sometimes,  especially 
if  the  deceased  had  had  an  interesting 
disease  with  interesting  lesions,  even  im- 
portant people  were  not  safe  in  their  gra\  es. 
Things  came  to  a  climax  with  Burke  and 
I  hire.  They  created  a  new  industry  or,  at 
hast,  formed  the  first,  and  I  think  the  only 
copartnership,  the  business  of  which  was 
tin-    selling    of    the    bodies    of    people    tlu\ 

murdered.  Others  had  done  this  occasion- 
ally, casually,  before,  and  others  did  it 
later  but  they  alone  made  it  a  business. 


They  never  robbed  graves;  murder  was 
much  easier  and  less  laborious.  Fortu- 
nately their  business  career  lasted  only  a 
short  time,  but  it  was  carried  on  in  a  rather 
wholesale  fashion  since  confessedly  they 
committed  sixteen  murders  between  the 
1 2th  of  February  and  the  ist  of  November, 
1828. 

They  were  led  into  murdering  as  an 
occupation  by  the  following  almost  ac- 
cidental occurrence.  Burke,  his  mistress 
Helen  M'Dougal,  Hare  and  his  wife,  at 
least  she  figured  as  such,  all  lived  together 
in  Edinburgh  where  Hare  ran  a  vagrant's 
boarding  house.  An  old  pensioner  named 
Donald,  a  harmless,  useless  old  man,  not  a 
criminal  but  one  of  the  many  unfortunates 
who  from  inborn  inability  was  never  able 
to  lay  by  much  for  old  age  and  hence  could 
not,  nor  is  there  evidence  he  much  desired 
to,  live  among  the  thrifty  and  clean,  boarded 
with  Hare.  He  died  owing  Hare  four 
pounds  and  Hare  decided  to  get  this  back 
by  selling  the  body.  The  parish  authorities 
sent  a  colli n  to  the  house  and  the  body  was 
put  in  it  but  Hare  and  Burke,  while  left 
alone,  ripped  up  the  coffin  lid,  took  out 
the  body,  hiding  it  in  the  bed,  and  replaced 
it  by  tanner's  bark  of  which  there  was 
aplenty  in  the  yard.  They  sold  the  body 
to  Dr.  Knox's  assistants,  William  Ferguson, 
later  Sir  William,  and  Thos.  Wharton 
Jones.  The  fee  they  received  was  seven 
pounds  ten  shillings.  This  was  easy  money 
and  being  men  of  criminal  instincts  and  not 
mere  weaklings  led  astray,  the  usual  excuse 
of  criminals,  and  not  being,  or  at  least  not 
thinking  themselves,  the  victims  of  the 
crimes  of  respectable  society,  the  most  up- 
to-date  and  erroneous  explanation  of  crime, 
but  wanting  money  and  neither  of  them 
having  any  conscience  to  boast  of,  they 
decided  they  would  take  up  murder  as  a 
business  because  the  wage  was  high  and 
the  labor  light. 

Their   method    may    be   illustrated    by   an 
early    case,    that    of    Abigail    Simpson.    She 


Burke  and  Hare  and  Psychology  of  Murder 


77 


was  a  drunken  old  hag  who  lived  in  the 
outskirts  of  Edinburgh.  Hare,  ever  on 
the  lookout  for  game,  saw  her  on  the  street, 
thought  she  was  a  likely  subject,  accosted 
her,  was  met  in  friendly  spirit,  and  took 
her  home  to  Log's  house  in  Tanner's  court 
(Log  was  Mrs.  Hare's  first  husband).  Here 
she  was  plied  with  liquor  and  the  crew 
danced  and  sang,  and  swore  and  drank  still 
more.  Next  morning  Abigail  was  sick, 
very  sick,  and  cried  to  be  taken  home  to 
her  daughter.  Instead  they  gave  her, 
pretending  kindness  and  friendliness  and 
pity,  more  whiskey  and  porter  and  she 
again  became  helplessly  drunk.  Now  was 
the  time.  Hare  placed  his  hand  over  her 
mouth  and  nose  and  Burke  laid  himself 
across  her.  She  made  no  resistance,  and 
soon  was  dead.  They  bundled  her  body 
into  a  chest  and  afterward  sold  it  to  Dr. 
Knox  for  ten  pounds.  There  is  no  need  to 
relate  the  other  murders  since  they  were 
all  done  in  the  same  way.  Men  and  women, 
often  of  the  outcast  class,  were  first  made 
friends  with  by  offering  them  a  drink  or 
even  sometimes  a  home,  and  they  unsus- 
picious and  very  happy  that  some  one  in 
their  hard  world  had  been  kind  to  them, 
drank  to  stupor  and  then  were  suffocated 
because  that  left  no  wound.  Wounds  on 
the  body  might  have  led  to  unpleasant 
questions  as  to  how  they  came  there. 

There  was  a  break  in  the  partnership 
for  awhile.  The  agreement  was  that  each 
was  to  share  in  the  proceeds  of  every 
murder  even  though  only  one  did  it. 
Burke  was  out  of  town  for  a  time  and  when 
he  returned  found  that  Hare  had  more 
money  than  he  could  account  for.  Hare 
denied  that  he  had  been  doing  business  on 
his  own  account  but  Dr.  Knox  said  he  had 
bought  a  body  recently.  A  fight  ensued, 
not  on  the  ground  that  Hare  had  not 
played  fair — that  only  happens  among  the 
criminals  of  fiction,  but  because  Burke 
wanted  money.  Bloody  and  fierce  as  the 
fight  was  neither  man  so  far  forgot  himself 


as  to  say  anything  that  would  make  the 
neighbors  suspect  he  was  anything  more 
than  a  highly  respectable  resurrectionist. 
This  will  give  some  inkling  of  their  power 
of  inhibition,  of  their  real  self-control. 
After  the  fight  Burke  and  M'Dougal  went 
to  live  with  John  Broggan,  whose  wife  was 
a  cousin  of  Burke's,  but  he  soon  became 
friends  with  Hare  again  and  business  re- 
lations were  resumed. 

One  murder  more  than  all  the  others 
aroused  the  people  of  Edinburgh,  indeed  of 
all  Scotland,  in  righteous  wrath  against 
these  men.  It  was  that  of  James  Wilson, 
called  Daft  Jamie.  He  was  what,  in  the 
old  language,  before  science  had  given 
long  hard  names  to  the  different  kinds  of 
imbeciles,  before  enthusiastic  sociologists 
had  accepted  the  hypothesis  that  all  things 
can  be  cured  by  education,  and  before  men, 
i.e.,  ordinary  unlearned  men,  had  begun  to 
have  opinions  about  everything  but  still 
believed  that  feeble-mindedness,  like  most 
things,  was  a  visitation  of  God,  just  hap- 
pening so  and  not  produced  by  inevitable 
and  irremediable  causes,  was  called  a 
natural.  Everybody  in  Edinburgh  knew 
and  liked  or  at  least  warmly  pitied  him. 
He  was  a  familiar  figure  in  the  streets. 
He  was  harmless  and  happy,  earning  a 
precarious  living  by  fetching  and  carrying. 
He  was  medically  interesting  (though  not 
to  many  of  the  scientific  men  of  his  own 
day)  because  he  was  one  of  those  imbeciles 
who  have  a  prodigious  memory  for  useless 
things,  e.g.,  he  knew  the  number  of  the 
street  lamps  in  the  town.  He  also  had  a 
fondness  which  some  of  us  believe,  it  may 
be  because,  to  use  present  day  slang,  we 
are  "highbrows,"  always  indicates  mental 
weakness,  a  passionate  love  of  conundrums. 
He  lived  in  holes  and  corners,  hurting  no 
one  and  hurt  by  none  save  the  young 
barbarians  of  the  street  who  hooted  and 
plagued  him.  He,  instinctively  knowing 
discretion  was  the  better  part  of  valor  and 
"  being  too  proud  to  fight, "  always  ran  away 


78 


Annals  of  Medical  History 


when  they  appeared.  He  was  suspicious 
of  no  one  past  boyhood,  so  one  day  when 
Mrs.  Hare  accosted  him  on  the  street  and 
began  to  talk  to  him,  he  willingly  accepted 
her  invitation  to  go  to  her  home.  When 
they  arrived  there  she  offered  him  drink: 
he  demurred  at  first  but  finally  drank  to 
drunkenness  and  Burke  and  Hare,  who 
had  meanwhile  been  summoned,  smothered 
him,  not,  however,  without  a  long  hard 
struggle,  for  he  was  strong  and  not  com- 
pletely under  the  influence  of  drink,  and 
sold  his  body.  He  enjoyed  a  brief  im- 
mortality or,  to  use  more  accurate  language, 
a  transient  post-mortem  fame,  from  doggerel 
verse  peddled  on  the  streets  but  now  hidden, 
dust  covered,  in  the  libraries  of  medical 
antiquarians. 

The  murder  that  led  to  discovery  was 
that  of  a  woman  named  Docherty.  She 
disappeared.  Inquiries  were  made  and  it 
was  evident  that  Burke  or  Hare  or  both 
had  killed  her.  Several  questions  con- 
fronted the  city  authorities:  Could  the 
crime  be  proved  against  both?  Was  it 
better  to  let  one  of  the  guilty  persons 
escape  punishment  in  order  to  be  sure  of 
convicting  the  other  by  his  corroborative 
evidence?  If  one  (or  rather  one  couple 
because  there  was  evidence  against  the 
women)  only  was  to  be  tried  which  ought 
it  to  be?  Who  was  the  leader?  It  was 
decided  (and  I  think  quite  justly  though 
there  was  much  public  anger  at  the  time) 
that  Burke  and  M'Dougal  were  the  guil- 
tiest or  at  least  the  two  against  whom  the 
evidence  was  strongest.  The  trial  began 
December  24,  1829.  Hare  was  accepted 
as  a  state  witness.  Burke  was  convicted, 
M'Dougal  given  a  verdict  of  not  proven. 

It  was  not  a  day  of  indecent  delay  be- 
tween verdict  and  execution:  courts  of  ap- 
peal could  not  intervene,  because  they  did 
ool  exist,  and  executive  act  quickly  followed 
judicial  word.  Soon  after  the  judge  sen- 
tenced a  man  to  hanging  the  man  got  hanged 
and  there  was  an  end  of  the  business.  This 


method  has  much  to  recommend  it.  Our 
friends  the  eugenists  ought  especially  to 
approve  of  it,  because  certainly  the  best 
way  to  prevent  bad  stock  from  being  prop- 
agated is  to  hang  or  otherwise  kill  its  mem- 
bers. This  English  and  Scotch  juries  did 
and  it  is  very  possible  that  Great  Britain's 
relative  freedom  from  crime  against  the 
person  during  the  Victorian  era  (a  freedom 
in  marked  contrast  to  our  own  noble  age  and 
glorious  country) — an  era  so  full  of  sound 
sense,  social  pomposity,  and  scientific  ra- 
tionalism now  so  rapidly  fading  away,  was 
in  part  due  to  the  fact  that  previous  gen- 
erations had  let  a  good  bit  of  blood  and  so 
purified  the  citizenry. 

It  was  a  day  of  public  hangings  and  the 
place  of  Burke's  execution  was  Lilberton's 
Wynd.  Crowds  watched,  during  the  night 
before,  the  building  of  the  scaffold  and  when 
finally  the  transverse  beam  was  fixed  in 
place  the  multitude  gave  rousing  cheers. 
As  a  rule  it  was  difficult  to  get  men  to  build 
a  scaffold  but  this  time  carpenters  aplenty, 
more  than  enough,  volunteered.  Many 
hours  before  the  time  set  (Jan.  28th),  people 
gathered  in  larger  and  larger  numbers. 
Thrifty  householders,  not  averse  to  making 
an  honest  penny,  sold  windows  overlooking 
the  execution  place  at  high  prices  and  people 
stayed  in  the  houses  all  the  night  before  in 
order  to  be  sure  they  would  not  lose  their 
places.  Speculators  bought  rights  to  the 
use  of  windows  and  roofs  and  resold  at  a 
profit,  reasoning  it  was  an  ill  wind  that 
brought  no  one  good  and  that  thrift  was 
praiseworthy.  The  night  before  was  cold, 
rainy,  dismal,  but  that  did  not  deter  the 
crowd  from  wanting  to  be  in  time  to  get  a 
good  place  to  see  justice  done  and  a  man 
suffer.  On  the  morning  of  the  execution 
the  rain  ceased  and  the  crowd  increased  to 
twenty  or  thirty  thousand.  It  was  not  a 
serious-minded,  quiet  crowd;  on  the  con- 
trary it  was  a  merry  mob,  cracking  jokes, 
laughing,  shouting,  playing  tricks,  wanting 
to   be  amused  and  yet  withal  bloodthirsty. 


Burke  and  Hare  and  Psychology  of  Murder 


79 


At  eight  o'clock  in  the  morning  the  march 
to  the  gallows  started  and  as  soon  as  the 
condemned  man  appeared  he  was  met  with 
yells  and  cat  calls  and  demands  that  Hare 
too  should  hang.  Burke  seems  to  have  been 
the  most  self-contained  man  there.  He 
walked,  news  reporters  say,  though  they 
perhaps  were  no  more  accurate  than  re- 
porters of  to-day,  with  steady  step.  He  was 
unkempt,  dressed  in  a  black  suit  much  too 
large  for  him,  and  lacked 
all  the  externals  neces- 
sary for  dignity,  yet  he 
seems  to  have  shown 
dignity,  at  least  the 
dignity  of  self-control. 
When  the  rope  was  ad- 
justed to  his  neck  he 
stood  composed,  un- 
flinching, motionless. 
With  a  gesture  as  of 
impatience,  at  least  on- 
lookers so  interpreted 
it,  he  gave  the  signal  to 
let  the  drop  fall.  A  cry, 
many  cries  of  satiated 
vengeance,  greeted  the 
fall  which  really  was 
only  a  few  inches  and 
did  not  cause  instant 
death.  The  crowd 
waited  and  watched  and 
when  several  times  the 
body  jerked  convul- 
sively roars  of  anger 
broke  forth.  The  con- 
duct of  these  people  is 
a  good  example  of  what 
to-day  we  call  mob  psychology,  which  is  noth- 
ing more  than  imitativeness  and  an  uncon- 
scious desire  to  follow  a  leader:  individual 
initiative  and  inhibition  break  down,  indi- 
vidual opinion  ceases  or  rather  all  succumb 
to  the  stronger  will  of  the  leader.  It  does 
not  matter  whether  it  is  a  street  mob,  or, 
in  a  democracy,  a  gathering  of  legislators. 
The  nature  of  its  acts,  good  or  evil,  depends 


Portrait  of  Dr.  Robert  Knox  lecturing  his  class. 
This  picture  was  made  by  Edward  Forbes,  one 
of  his  students.  It  appeared  in  the  Students' 
Maga,  and  was  reprinted  in  Lonsdale's  "Life 
of  Knox." 


merely  upon  lucky  or  unlucky  chance, 
whether  saint  or  devil,  wise  man  or  knave 
happens  to  control.  In  this  case  the  mob 
was  justified  in  its  anger,  but  its  conduct 
would  have  been  the  same  if  the  man  had 
been  innocent.  Not  many  years  before  in 
Paris,  another  mob  had  cried  for  blood  and 
made  obscene  jokes  and  laughed  as  the  tiger 
laughs  with  a  snarl  and  roared  and  swore 
when  an  innocent  man  suffered  by  the  guil- 
lotine not  for  his  sins 
but  for  his  fathers'  and 
the  mob's  fathers'  sins. 
Louis  XVI  went  to  his 
grave  no  more  execrated 
than  Burke  though  by 
a  larger  number  of  less 
respectable  people. 

Burke  being  dead  the 
mob  wanted  vengeance 
on  Dr.  Knox.  Their  an- 
ger broke  forth  and  only 
the  police  prevented 
murder. 

The  day  after  the  ex- 
ecution Burke's  corpse 
was  taken  from  thelock- 
H  up  house  to  the  college 
4-  i  and  placed  in  one  of  Dr. 
:.  Monro's  rooms.  Here  a 
sort  of  private  view  was 
first  held,  Mr.  Liston, 
Geo.  Combe,  the  phre- 
nologist, and  Sir  William 
Hamilton  being  among 
those  present.  Mr.  Jos- 
eph, an  eminent  sculp- 
tor, made  a  bust.  The 
affair  seems  to  have  been  quite  fashionable. 
Some  visitors  noted  withsurprisetheplacidity 
of  the  features  of  the  corpse,  forgetting,  just 
as  novelists  are  prone  to  forget,  that  in  the 
palsy  of  death  there  is,  there  must  be, 
placidity.  The  cases  in  which  death  stiffen- 
ing comes  so  quickly  as  to  fix  the  features 
in  their  last  expression  are  rather  apocry- 
phal.    The  eye  usually  sees  what  it  looks 


8o 


Annals  of  Medical  History 


for  and  the  subconscious  mind  of  the  aver- 
age man  expects  to  find  the  mark  of  Cain 
even  in  death  in  the  features  of  a  murderer 
and  hence  usually  finds  it.  The  onlookers 
who  made  the  observation  must  have  been, 
as  indeed  they  were,  men  far  above  the 
common,  for  they  saw  what  was,  not  what, 
from  their  preconceptions  ought  to  have 
been  but  was  not.  Professor  Monro  dis- 
sected the  body  in  public  and  the  police 
had  to  stop  a  crowd  of  too  enthusiastic  stu- 
dents: enthusiastic  I  fancy  not  for  knowl- 
edge. 

Monro  found  the  brain  normal,  but  Combe 
and  the  other  phrenologists  found  that 
Burke's  character  was  just  what  the  bumps 
indicated  because  the  bumps  indicative  of 
badness  negatived  those  indicative  of  good- 
ness. They  were  consistent  enough  and 
clear  seeing  enough  to  find  bumps  of  both 
qualities. 

The  most  interesting  question  is,  what 
manner  of  people  were  these  four  who  made 
a  business  of  murder.  I  include  the  women 
because  though  M'Dougal  was  dismissed 
from  court  with  the  verdict  of  not  proven, 
and  Burke  to  the  end  said  no  word  against 
her  and  Mrs.  Hare  was  never  tried,  there  is 
no  doubt  the  women  knew  what  the  men 
were  doing  and  were  morally  guilty.  We 
can  learn  something  from  their  lives. 

William  Burke,  the  son  of  a  laborer,  was 
born  in  county  Tyrone  in  1792.  He  had 
some  education  and  his  parents  were  not 
criminals.  In  this  he  followed  the  rule,  for 
murderers  are  more  often  the  offspring  of 
weak  than  of  criminal  people.  As  a  youth 
he  entered  the  service  of  a  Presbyterian 
pastor  as  a  servant  but  soon  tiring  of  this, 
he  worked  in  turn  as  a  baker,  a  weaver  and  a 
shoemaker.  He  learned  no  trade  thorough- 
ly, and  this  is  characteristic  of  his  mental 
type,  and  after  trying  his  hand  at  several  he 
volunteered  in  the  militia  as  a  fifer  or  a 
drummer.  After  a  time  the  regiment  was 
disbanded  and  (now  married)  he  again  be- 
came  a  servant.     He   quarreled   with   his 


father-in-law,  deserted  his  wife  and  went  to 
Scotland  about  181 8.  He  became  a  laborer 
on  the  Union  canal  and  there  by  chance  or 
fate  the  actors  in  the  drama  all  came  to- 
gether. He  met  Helen  M'Dougal  who  had 
never  been  an  altogether  good  person.  She 
had  had  a  child  by  M'Dougal  while  his  wife 
lived  and  when  she  died  lived  with  him  and 
bore  his  name  until  he  was  carried  off  by 
typhus.  Then  she  went  with  Burke.  The 
priest  tried  to  induce  him  to  go  back  to  his 
wife  but  he  suffered  excommunication  rather 
than  do  so.  Really  she  seems  to  have  been 
a  proper,  honest  person  and  a  true  wife  but 
something  in  M'Dougal  held  him,  that 
strange  affinity  of  protoplasm,  quite  as  real, 
quite  as  resistless  as  chemical  affinity  and 
having  just  as  much,  or  as  little,  to  do  with 
intellect  or  beauty  as  it  has:  the  thing  bru- 
tality cannot  kill  nor  kindness  create.  They 
went  to  Edinburgh  and  lived  in  "the  Beg- 
gars' Hotel."  He  became  a  cobbler  again 
and  M'Dougal  peddled  the  old  shoes  he 
begged  or  bought  and  repaired.  The  hotel 
burned  down  and  MacGregor  (the  historian 
of  Burke  and  Hare,  basing  his  account  large- 
ly on  "The  Westport  Murders,"  a  book 
printed  at  that  time)  states  he  lost  among 
other  things  these  books:  Ambrose's  "Look- 
ing unto  Jesus";  Boston's  "Fourfold  State," 
"The  Pilgrim's  Progress";  and  Booth's 
"Reign  of  Grace."  MacGregor  says  these 
books  probably  belonged  to  the  M'Dougal 
woman  because  they  were  the  kind  found 
in  every  Scotch  home  but  that  Burke  all 
through  life  was  "of  a  naturally  religious 
turn  of  mind  and  that  in  all  his  after  actions, 
brutal  and  godless  as  they  were,  the  inward 
warning  voice  never  left  him  at  peace,  ex- 
cept when  his  senses  were  steeped  in  drink." 
Helen  M'Dougal  seems  to  have  been  re- 
garded as  the  principal  bad  influence  ha 
Burke's  life  but  he  never  made  the  old  ex- 
cuse "the  woman  tempted  me  and  I  did 
eat":  whether  she  was  really  the  stronger 
character  and  like  that  greatest  murderess 
in  drama,  Lady  Macbeth,  led  her  man  to 


Burke  and  Hare  and  Psychology  of  Murder 


81 


his  own  destruction  remains  unsolved.  At 
all  events  the  two  stuck  together  till  the  end, 
almost  ten  years,  notwithstanding  fights  and 
brawling.  Once  he  beat  her  almost  to  death 
but  still  they  remained  together.  In  1827 
they  went  to  live  with  the  Hares. 

Hare  was  Irish.  He  also  worked  on  the 
Union  canal  and  met  his  mistress  there  and 
lodged  at  Log's  house.  He  later  became  a 
traveling  huckster  selling  fish,  crockery, 
and  old  iron.  He  was  always  fighting,  al- 
ways drunk  and  could  neither  read  nor 
write.  His  father  was  a  Protestant,  his 
mother  a  Catholic.  He  was  about  twenty- 
five  years  old  at  the  time  of  Burke's  trial. 
A  man  who  saw  him  says  "he  possessed  not 
the  slightest  moral  perception  of  the  enor- 
mity of  his  conduct."  "His  forehead  was 
low  as  in  all  murderers"  (this  may  be  an- 
other example  of  things  being  as  we  see 
them  because  not  a  few  murderers  have  ma- 
jestic foreheads,  and  many  passable  ones), 
"the  eyes  watery,  curiously  shaped  and 
having  a  look  between  a  lure  and  a  squint." 
He  was  five  feet  six  inches  tall  and  "a  poor 
silly  looking  body." 

An  anonymous  literary  professor  in  the 
University  is  quoted  as  saying  that  Burke, 
whom  he  examined,  was  an  intelligent  man, 
strong-minded  and  with  understanding  above 
his  position  though  his  conduct  displayed 
nothing  like  remorse  or  contrition.  "His 
education,"  the  professor  continues,  "and 
rank  in  life,  instead  of  having  been  by  any 
means  of  the  lowest  order,  were  such  as,  in 
the  judgment  of  the  world,  and  on  the  au- 
thority of  experience,  are  held  of  necessity 
to  humanize  and  inform  the  mind,  and  to 
communicate  perfectly  just  conceptions  of 
moral  distinctions."  This  may  be  a  beauti- 
fully balanced  sentence  and  grammatically 
and  rhetorically  worthy  of  a  professor  of 
literature  but  it  states  untruth  as  truth. 
Rank  in  life  and  schooling,  and  that  is  what 
the  professor  means  by  education,  do  not 
prevent  crime  nor  change  potential  crim- 
inals into  honest  men. 


Margaret  Hare  was  Irish.  Log,  her  hus- 
band, a  decent  man,  cut  small  parts  of  the 
Union  canal  and  she,  dressed  as  a  man, 
worked  like  a  man.  She  seems  to  have  been, 
without  knowing  it,  an  early  believer  in  the 
emancipation  of  women.  On  leaving  the 
canal  they  went  to  Edinburgh  and  kept  a 
lodging  house  for  vagrants  and  he  sold 
things  in  the  street.  He  died.  She  had  an 
affair  with  a  young  man  but  he  left  her  and 
she  took  up  with  Hare.  Her  first  child  by 
Hare  died  of  neglect,  if  not  by  murder,  and 
one  other  lived. 

What  became  of  the  Hares  and  M'Dougal 
after  the  trial  no  one  knows.  Years  after 
tales  were  told  that  one  or  the  other  of  them 
had  been  seen  in  one  place  or  another  but 
nothing  was  sure. 

The  great  question  in  the  study  of  the 
minds  of  murderers  is,  Are  they  a  type  apart, 
separate  and  distinct  from  other  men,  or 
are  they,  even  as  the  rest  of  us,  led  to 
murder  by  external  causes?  Before  answer- 
ing the  question  we  must  define  our  term: 
What  do  we  mean,  what  do  psychologists 
and  alienists  mean,  by  murder?  We  may 
dismiss  at  once  killing  in  self-defense.  But 
psychologically  speaking  we  exclude  several 
other  acts  resulting  in  killing.  We  of  course 
exclude  the  frankly  insane, — the  man  who, 
influenced  by  delusions  of  persecution  kills, 
as  he  thinks,  to  save  himself;  the  maniac, 
who  in  his  madness  neither  reasons  nor 
knows,  but  kills  blindly,  and  the  dement  who 
is  so  deprived  of  reason  that  he  does  not 
realize  the  nature  and  consequences  of  his 
act.  Further  the  sane  man  who,  beside  him- 
self with  rage,  kills  is  not  necessarily  a  mur- 
derer. He  is  responsible,  it  may  be,  for  he 
should  not  allow  himself  to  get  into  a  mur- 
derous rage  but  he  is  different  from  the  real 
murderer.  The  murderer  from  the  psychol- 
ogist's point  of  view  is  the  man  who  without 
any  temporary  change  in  his  usual  psychic 
condition  can  coldly  contemplate  and  leis- 
urely plan  the  killing  of  another  for  his 
own  seeming  benefit.    Such  a  man  psycho- 


82 


Annals  of  Medical  History 


logically  is  a  murderer  whether  he  ever 
kills  or  not.  He  is  in  the  same  class  if, 
after  planning  the  act,  he  must  drink  to 
give  himself  physical  courage  to  do  it  or  if 
he  simply  plans  and  hires  some  one  else  to 
carry  out  his  desire.  Men  of  the  murderous 
type  are  fortunately  rare  but  they  consti- 
tute a  distinct  psychologic  species  of  the 
human  race.  They  are  what  they  are  not 
on  account  of  environment  but  because  of 
their  inherent  nature:  They  are  the  vic- 
tims of  their  protoplasm.  Men  are  born, 
they  do  not  become,  murderers.  Social 
standing  has  nothing  to  do  with  the  fre- 
quency or  infrequency  of  their  appearance. 
Wealth  does  not  prevent  their  entrance 
into  the  world  nor  poverty  produce  them. 
Education,  in  the  sense  of  training  in  self- 
control  and  suppression  of  the  emotions, 
may  help  a  little  in  curing  or  rather  making 
them  control,  their  instincts  but  book 
learning,  even  carried  to  extreme  erudition, 
does  not  alter  a  man's  nature  one  jot  or 
tittle.  Neither  intellectual  wealth  nor  intel- 
lectual poverty  is  a  factor  in  their  produc- 
tion. 
All  classes  of  men,  as  they  are  classified 


by  external  qualities,  have  given  examples 
of  murderers. 

The  one  quality  I  have  found  lacking  in 
all  the  sane  murderers  I  have  ever  examined 
was  the  moral  sense,  and  by  that  I  mean  the 
realization  that  one  owes  a  duty  to  others, 
that  others  have  the  right  to  live.  They 
are,  as  some  one  has  said,  color  blind  to 
morals.  I  have  never  known  a  murderer, 
as  here  defined,  who  felt  remorse  or  who 
grieved  at  the  dead  man's  fate.  I  have  seen 
more  than  one  who  ate  and  slept  well  while 
awaiting  execution  and  the  man  who  eats 
and  sleeps  well  is  not  suffering  any  emo- 
tional pain.  What  causes  absence  of  the 
moral  sense  we  no  more  know  than  we  know 
what  produces  it.  That  it  is  entirely  sep- 
arate and  distinct  from  intellect  I  am  con- 
vinced because  I  have  known  men  who, 
mentally  far  above  the  average,  lacked  it 
entirely.  Further,  so  far  as  my  experience 
goes,  nothing  creates  it  in  him  who  has  it  not. 
I  have  more  than  once  studied  murderous 
criminals  whose  environment  in  childhood 
and  youth  was  of  the  best  and  yet  who  went 
their  own  terrible  way.  The  only  cure  for  them 
is  death  and  the  best  treatment  execution. 


HEBREW   PRAYERS   FOR  THE  SICK 


By  C.  D.  SPIVAK 

DENVER,    COLO. 


THERE  is  no  doubt  in  my  mind  that 
of  all  therapeutic  measures  with 
which  the  primitive  man  used  to 
defend  himself  against  his  greatest  enemy — 
disease,  prayer  was  the  oldest,  even  older 
than  hemostasis  which  Weir  Mitchel  so 
beautifully  described  in  his  poem  "The 
Physician."  ]  We  will  go  a  step  farther  and 
assert  that  even  unto  our  day  the  majority 
of  mankind  turn  to  prayer  first  or  last  in 
disease,  especially  in  the  "last  disease."  The 
prayers  may  differ  in  their  content,  in 
the  manner  they  are  offered  or  to  whom 
they  are  addressed,  but  the  orthodox, 
the  agnostic  and  the  infidel  are  all  offering 
up  a  prayer  for  recovery.  Wishing  is 
praying,  and  who,  if  sick,  does  not  wish 
with  all  the  intensity  of  his  soul  for  recovery? 
The  confidence  reposed  by  the  sick  in  his 
attending  physician  is  tantamount  to  a 
prayer.  To  quote  Professor  James:  "Few 
men  of  science  can  pray,  I  imagine.  Few 
can  carry  on  any  living  commerce  with 
'God.'  Yet  many  of  us  are  well  aware 
how  much  freer  in  many  directions  and  abler 
our  lives  would  be  were  such  important 
forms  of  energizing  not  sealed  up."2  In 
fact  Dr.  Hyslop  said  before  the  British 
Medical   Association   at   their   meeting   in 

1  "The  hunt  is  o'er — the  stone-armed  spears  have 
won; 
Dead  on  the  hillside  lies  the  mastodon. 
Unmoved  the  warriors  their  wounded  leave; 
The  world  is  young  and  has  not  learned  to  grieve. 

"But  one  gentler  sharer  of  the  fray 
Waits  in  the  twilight  of  the  westering  day, 
Where  'neath  his  gaze  a  cave-man,  hairy,  grim, 
Groans  out  the  anguish  of  his  mangled  limb. 

"Caught  in  the  net  of  thought  the  watcher  kneels, 


1905  "that  of  all  hygienic  measures  to 
counteract  disturbed  sleep,  depressed  spirits 
and  all  the  miserable  sequels  of  a  dis- 
tressed mind,  I  would  undoubtedly  give 
the  first  place  to  the  simple  habit  of 
prayer."  ' 

But  whether  prayer  can  no  longer  do 
for  the  men  and  women  of  the  present  day 
what  they  have  done  or  supposed  to  have 
done  in  the  days  gone  by,  it  certainly 
deserves  from  the  medico-historical  stand- 
point careful  study  and  a  sympathetic 
consideration. 

I  have  limited  myself  to  the  simple 
labor  of  collating  the  material  from  the 
domain  of  Hebrew  lore,  beginning  with 
the  Bible,  and  following  with  the  material 
scattered  in  the  two  Talmuds,  Midrashim, 
etc. 

JEHOVAH    WOUNDS    AND    HEALS 

Jehovah  causes  "consumption,  burning 
ague  that  shall  consume  the  eyes  and  cause 
sorrow  of  the  heart"  (Leviticus  xxvi,  16). 
"He  smites  with  fever  and  with  an  in- 
flammation and  with  extreme  burning  with 
the  botch  of  Egypt  and  with  the  emerods 
and  with  the  scab  and  with  the  itch — 
with  madness  and  blindness  and  astonish- 

With  tender  doubt  the  tortured  member  feels 
And,  first  of  men  a  healing  thought  to  know, 
He  finds  his  hand  can  check  the  life's  blood  flow." 

("The  Physician."  By  S.  Weir  Mitchel.  Transac- 
tions of  the  Congress  of  American  Physicians  and 
Surgeons,  1900,  p.  91.) 

2  "The  Varieties  of  Religious  Experience,"  by 
Professor  James. 

3  Quoted  in  "  Psychological  Phenomena  of  Chris- 
tianity," by  Cutte.  (1909,  p.  412.) 


Annals  of  Medical  History 


ment  of  heart  (Deut.  xxviii,  22,  27,  28). 
He  makes  the  "plagues  wonderful,  of  long 
continuance  and  sore  sicknesses"  (Ibid.  59). 
He  can  bring  "all  the  diseases  of  Egypt" 
(Deut.  xxvii,  60)  and  moreover  he  can 
bring  "every  sickness  and  every  plague 
which  is  not  written  in  the  book  of  the 
Law"  (Deut.  xxviii,  61).  Jehovah  therefore 
is  looked  upon  as  the  efficient  cause  of 
disease.  He  can  consequently  remove  the 
cause,  for  he  says  "I  wound  and  I  heal" 
(Deut.  xxxii,  39).  It  is  natural  that  one 
stricken  with  disease  should  appeal  to 
Jehovah  for  relief. 

THE  SHORTEST  PRAYER  ON  RECORD 

The  text  of  only  one  prayer  for  the  sick 
is  recorded  in  the  Pentateuch.  When 
Miriam  spoke  against  Moses  her  brother 
because  of  the  Ethiopian  woman  whom  he 
had  married,  the  anger  of  the  Lord  was 
kindled  and  behold  Miriam  became  leprous, 
white  as  snow.  Aaron  appealed  to  Moses 
on  her  behalf  and  begged  "Let  her  not  be 
as  one  dead,  of  whom  the  flesh  is  half 
consumed  when  he  cometh  out  of  his 
mother's  womb"  (Num.  xii,  12).  And 
Moses  made  a  prayer  which  is  the  shortest 
on  record.  It  consists  of  five  short  words: 
"EI  no  rfa  na  la,"  "Oh  God,  do  thou  heal 
her,  I  beseech  thee"  (Num.  xii,  13). 

PRAYING    FOR    RECOVERY 

Abraham  prayed  for  the  recovery  of 
Abimelech  (Gen.  xx,  17).  David  prayed 
for  the  recovery  of  his  little  son  (II  Sam. 
xii,  16).  Elisha  prayed  for  the  recovery 
of  a  boy  (II  Kings  iv,  33).  Hezekiah 
prayed  for  his  own  recovery  (II  Chron. 
xxxii,  24).  There  are  recorded  in  the  Bible 
hundreds  of  cases  of  death,  but  no  mention 
is  made  of  any  prayers  having  been  recited 
for  their  recovery. 

JOB    IS    PRAYERLESS 

Job  is  the  personification  of  misery, 
and    the   description    of   his   sufferings    is 


harrowing.  He  curses  the  day  he  was  born, 
and  the  night  in  which  he  was  conceived. 
"When  I  lie  down  I  say,  When  will  I 
arise,  and  the  night  be  gone?  and  I  am 
full  of  tossings  to  and  fro  unto  the  dawning 
of  the  day.  My  flesh  is  clothed  with 
worms  and  clods  of  dust,  my  skin  is  broken 
and  become  loathsome"  (Job  vii,  4,  5). 
But  Job  prays  not.  He  rages  and  fumes. 
He  cries  out,  "I  will  not  refrain  my  mouth; 
I  will  speak  in  the  anguish  of  my  spirit; 
I  will  complain  in  the  bitterness  of  my 
soul — Why  hast  thou  set  me  as  a  mock 
against  thee  so  that  I  am  burden  to  myself?" 
(Job.  vii,  11,  21).  His  wife  too  seems  not 
to  believe  in  the  efficacy  of  prayer.  For 
not  only  does  she  herself  not  pray  and  does 
not  counsel  her  husband  to  pray,  but  on 
the  contrary  she  encourages  him  in  his 
defiance:  "Dost  thou  still  retain  thine 
integrity?  Curse  God  and  die"  (Job  ii,  9). 

DAVID    IS    PRAYERFUL 

The  sweet  singer  David  is  the  antithesis 
of  Job.  He  believes  in  the  Lord  and  in  his 
ability  to  heal  him  of  all  disease.  The 
following  prayers  for  recovery  are  incom- 
parable for  loftiness  of  style,  for  the  sim- 
plicity of  expression,  for  the  graphic  de- 
scription of  disease  and  for  the  childlike 
confidence  in  Jehovah: 

THE    PSALMIST'S    CONFIDENCE    IN   JEHOVAH'S 
POWER    OF    HEALING 

"Into  thine  hand  I  commit  my  spirit — 
Have  mercy  upon  me,  O  Lord,  for  I  am  in 
trouble:  mine  eye  is  consumed  with  grief, 
yea,  my  soul  and  my  body.  For  my  life 
is  spent  with  grief  and  my  years  with 
sighing;  my  strength  faileth  because  of 
mine  iniquity  and  my  bones  are  consumed" 
(Ps.  xxxi,  6,  10,  n). 

"Yea,  though  I  walk  through  the  valley 
of  the  shadow  of  death,  I  will  fear  no  evil; 
for  thou  art  with  me;  thy  rod  and  thy 
staff  they  comfort  me"  (Ps.  xxiii,  4). 

"Blessed  is  he  that  considereth  the  poor: 


Hebrew  Prayers  for  the  Sick 


85 


the  Lord  will  deliver  him  in  time  of  trouble. 
The  Lord  will  preserve  him  and  keep  him 
alive — The  Lord  will  strengthen  him  upon 
the  bed  of  languishing;  thou  wilt  make  all 
his  bed  in  sickness"  (Ps.  xli,  2,  3,  4). 

descriptive   prayers 

"0  Lord,  rebuke  me  not  in  thy  wrath; 
neither  chasten  me  in  thy  hot  displeasure. 
For  thine  arrows  stick  fast  in  me,  and  thy 
horn  presseth  me  sore.  There  is  no  sound- 
ness in  my  flesh  because  of  thine  anger, 
neither  is  there  any  rest  in  my  bones  because 
of  my  sin — My  wounds  stink  and  are 
corrupt  because  of  my  foolishness — For 
my  loins  are  filled  with  loathsome  disease, 
and  there  is  no  soundness  in  my  flesh. 
I  am  feeble  and  sore  broken:  I  have  roared 
by  reason  of  the  disquietness  of  my  heart — 
my  heart  panteth,  my  strength  faileth  me; 
as  for  the  light  of  mine  eyes,  it  also  is  gone 
from  me"  (Ps.  xxxviii,  1-10). 

"Have  mercy  upon  me,  O  Lord,  for  I 
am  weak;  0  Lord,  heal  me,  for  my  bones 
are  vexed — I  am  weary  with  my  groaning, 
all  the  night  make  I  the  bed  to  swim, 
I  water  the  couch  with  my  tears"  (Ps.vi, 

3»  7)- 

"Their  soul  abhorreth  all  manner  of 
food,  and  they  draw  near  unto  the  gates  of 
death.  Then  they  cry  unto  the  Lord  in 
their  trouble  and  he  saveth  them  out  of 
their  distress.  He  sent  his  word  and 
healeth  them"  (Ps.  cvii). 

"The  sorrows  of  death  compassed  me 
and  the  pains  of  hell  gat  hold  of  me — For 
thou  hast  delivered  my  soul  from  death, 
mine  eyes  from  tears  and  my  feet  from 
falling.  I  will  walk  before  the  Lord  in  the 
land  of  the  living"  (Ps.  cxvi,  3,  8,  9). 

"Bless  the  Lord  my  soul,  and  all  that  is 
within  me  bless  his  holy  name — who  healeth 
all  thy  diseases;  who  redeemeth  thy  life 
from  the  pit — who  satisfieth  thy  mouth 
with  good  things  so  that  thy  youth  is 
renewed  like  the  eagles — As  for  man,  his 
days  are  as  grass,  as  the  flower  of  the  field 
so    he   flourisheth.    For  the  wind  passeth 


over  it  and  it  is  gone,  and  the  place  thereof 
shall  know  it  no  more"  (Ps.  ciii,  1,  3,  5, 
15,  16). 

"Hide  not  thy  face  from  me  in  the  day 
when  I  am  in  trouble;  incline  thine  ear 
unto  me:  in  the  day  when  I  call  answer  me 
speedily.  For  my  days  are  consumed  like 
smoke,  and  my  bones  are  burned  as  a 
hearth.  My  heart  is  smitten  and  withered 
like  grass;  so  that  I  forget  to  eat  my  bread. 
By  reason  of  the  voice  of  my  groaning  my 
bones  cleave  to  my  skin"  (Ps.  cii,  4,  5,  6). 

"For  my  sighing  cometh  before  I  eat 
and  my  roarings  are  poured  out  like  water" 
(Job  iii,  24). 

"O  Lord  my  God,  I  cried  unto  thee  and 
thou  hast  healed  me.  O  Lord,  thou  hast 
brought  up  my  soul  from  the  grave;  thou 
hast  kept  me  alive  that  I  should  not  go 
down  to  the  pit"  (Ps.  xxx,  3,  4). 

figurative  prayers 

"Praise  ye  the  Lord — He  healeth  the 
broken  in  heart,  and  bindeth  up  their 
wounds"  (Ps.  cxlvii,  1,  3). 

"He  (the  Lord)  keepeth  all  his  bones; 
not  one  of  them  is  broken"  (Ps.  xxxiv,  21). 

"The  Lord  raiseth  them  that  are  bowed 
down"  (Ps.  cxlvi,  8). 

"Consider  and  hear  me,  O  Lord  my  God; 
lighten  mine  eyes  lest  I  sleep  the  sleep  of 
death"  (Ps.  xiii,  4). 

A    PHILOSOPHIC    PRAYER 

"Lord  make  me  to  know  mine  end  and 
the  measure  of  my  days  what  it  is,  that  I 
may  know  how  frail  I  am.  Behold  thou 
hast  made  my  days  as  a  handbreadth, 
and  mine  age  is  as  nothing  before  thee. 
Verily,  every  man  at  his  best  state  is 
altogether  vanity,  Selah"  (Ps.  xxxix,  5,  6). 

THE  PRAYER  OF  YOUTH 

"  I  said,  0,  my  God,  take  me  not  away 
in  the  midst  of  my  days"  (Ps.  cii,  24). 

THE  PRAYER  OF  OLD  AGE 

"Cast  me  not  off  in  the  time  of  old  age; 
forsake  me  not  when  my  strength  faileth" 
(Ps.  Ixxi.j)). 


LARYNGOLOGY  AND  OTOLOGY  IN  COLONIAL  TIMES 


By  STANTON  A.  FRIEDBERG,  M.D. 

CHICAGO,  ILL. 


THROUGH  the  kindness  of  Dr. 
Fielding  H.  Garrison,  of  Washing- 
ton, I  have  in  my  possession  a  man- 
uscript which  contains  so  much  of  value  to 
the  history  of  early  American  medicine  that 
I  have  considered  it  a  duty  to  present  at 
length  in  a  separate  paper  the  subjects  that 
are  of  special  interest  to  those  of  us  en- 
gaged in  the  practice  of  laryngology  and 
otology.  No  attempt  will  be  made  to  enter 
into  a  close  analysis  of  the  matter  present- 
ed, my  object  being  only  to  place  in  a  per- 
manent state  the  information  contained  in 
the  work  with  the  hope  that  it  may  be  of 
some  benefit  to  future  historians. 

The  author  of,  or  at  least  the  sponsor  for, 
the  manuscript  was  Matthew  Wilson,  a 
minister  and  at  the  same  time  a  physician, 
an  association  of  professional  activities  that 
we  would  consider  unique  at  present  but 
which  we  find  occurring  very  frequently  in 
our  early  history.  Although  a  native  of 
Chester  County,  Pennsylvania,  where  he 
was  born  January  15,  1734,  he  found  the 
field  for  his  active  career  in  Lewis,  Dela- 
ware, where  he  lived  until  his  work  was 
ended  March  30,   1790. 

His  education  was  directed  by  Dr.  Fran- 
cis Alison,  a  minister  of  prominence,  a 
patron  of  learning,  and  a  man  of  great  in- 
tellectual force  and  power.  As  rector  of 
the  University  of  Pennsylvania,  his  name, 
I  believe,  may  be  found  on  the  first  Ameri- 
can medical  diploma.1  There  is  no  evidence 
that  Dr.  Wilson  possessed  a  degree  in  medi- 
cine.  By  his  biographers  it  is  stated  that 
his  medical  studies  were  pursued  under  tin- 
tutelage  of  the  Rev.  Dr.  McDowell,  like- 
wise a  man  of  great  versatility  and  of  con- 
siderable influence  in  his  day  and  time. 


Dr.  Wilson  was  licensed  to  preach  in  1754, 
and  two  years  later  was  installed  as  pastor 
of  two  congregations,  one  at  Lewis  and  the 
other  at  Cool  Spring,  Maryland.  A  few 
years  later  another  congregation  was  added 
at  Indian  River.  Coincident  with  the  as- 
sumption of  his  ministerial  duties  he  en- 
gaged in  the  practice  of  medicine,  and  in 
addition  gave  instruction  at  a  nearby  acad- 
emy in  Hebrew,  Latin,  Greek,  and  the 
learned  sciences.  Although  so  busily  oc- 
cupied for  nearly  twenty-nine  years,  time 
was  not  lacking  for  him  to  participate  in 
the  solution  of  important  religious  as  well 
as  the  grave  political  questions  preceding 
the  Revolution. 

Viewed  in  any  light,  he  was  indeed  a  re- 
markable man.  To  quote  Thacher,2  "the 
joint  functions  of  minister  of  the  Gospel 
and  physician  were  sustained  and  dis- 
charged by  him  with  an  ability  and  popu- 
larity which  evinced  he  was  a  man  of  ex- 
traordinary talents,  attainments,  and  en- 
ergy. His  ardent  industry  and  the  com- 
prehensiveness of  his  mind  reduced  every 
obstacle,  and  embraced  every  object  of 
knowledge.  He  wrote  an  able  compend  of 
medicine,  which  was  called  a  Therapeutic 
Alphabet.  Commencing  with  the  classifica- 
tion of  Sauvages,  it  contained  the  diseases 
in  alphabetical  order,  with  definitions, 
symptoms,  and  method  of  cure.  It  was  pre- 
pared for  the  press,  used  by  himself,  and 
transcribed  by  his  students,  but  never  pub- 
lished." 

It  is  from  this  Therapeutic  Alphabet  that 
1  have  taken  the  material  that  will  be  pre- 
sented. The  book  itself  is  a  small,  thick 
volume,  bound  by  hand,  and  made  up  of 
over  three  hundred  leaves.     It  is  very  evi- 


86 


Laryngology  and  Otology  in  Colonial  Times 


87 


dent  that  a  number  of  individuals  took  part 
in  the  transcription  as  is  shown  in  the  varia- 
tions of  penmanship,  spelling,  punctuation, 
and  corrections.  The  construction  of  the  text 
also  varies;  in  some  places  the  style  seems 
almost  modern  while  in  others  we  have 
the  quaintness  common  to  writers  of  that 
period.  Several  of  the  articles  have  the 
signature,  M.  Wilson,  appended.  As  is 
stated  in  "The  Preface  by  the  Editors," 
Wilson  himself  wrote  the  articles  on  the 
principal  diseases,  but  the  definitions  of  the 
lesser  complaints  were  generally  trans- 
lated by  his  pupils  from  Vogellius,  CuIIen, 
Linnaeus,  Brooks,  and  Sauvages.  Regret 
is  expressed  that  on  account  of  the  multi- 
plicity of  the  author's  business,  time  did 
not  permit  him  to  examine  into  the  cor- 
rectness of  these  translations  by  a  com- 
parison with  his  own  notes. 

There  are  two  title  pages,  the  second 
being  separated  from  the  first  by  a  number 
of  intervening  pages  upon  which  are  writ- 
ten the  preface,  praecognita  and  prognos- 
tics. The  title  pages  differ  only  in  minor 
details,  with  the  exception  that  at  the  lower 
part  of  the  second  occurs  the  statement 
that  "it  is  now  transcribed  from  M.W., 
D.D.  Notes,  &c,  by  Thomas  B.  Chrag- 
head  &  other  students.  A.D.,  1787,  Janu- 
ary, 29."  From  this  date  it  may  be  seen 
that  the  contents  of  the  manuscript  are  the 
result  of  an  experience  extending  over  the 
years  from  1756  to  1787,  truly  the  most 
epoch-making  period  in  the  life  of  the  col- 
onies. Had  the  intention  to  print  the  work 
been  carried  out  it  would  have  been  the 
first  book  on  the  practice  of  medicine  pub- 
lished by  an  American  author. 

The  title  page  reads  as  follows: 

Multum  in  parvo 

being  a  new 

Therapeutic — Alphabet  or 

A  Pocket-Dictionary,  oj 

Medicine,  Midwifery,  &  Surgery; 

extracted  from 

Short  Medical  Notes  on  about 

Nine  Hundred  Diseases,  in  both 


their  Technical  and  English  names; 

with  many  new  and  old  successful  Remedies, 

important  Precognita,  Crises  &  Presages; 

Containing  a  concise  yet  full  History  &• 

Theory  of  all  the  Principal  Diseases,  with  a vulgar 

and  Medical  Recipes  adapted  to  the  Middle  States  of  N. 

America. 

By  Matthew  Wilson  D.D.  Presbyter  eY 

Physician  at  Lewes,  about   29  years. 

Nullius  addictus  jurare  in   Verba  Magistri.  "  Hor. 

To  every  candid  Reader. 

As  America,  in  any  Northern  Latitude,  is  more 
than  ten  Degrees  colder  than  the  same  Latitudes  in  the 
Old  World;  so  in  experience  it  is  very  certain  that  the 
Diseases,  even  of  the  same  Name  are  very  different: 
The  Physical  Writers,  therefore,  in  Europe  do  often 
lead  young  American  Physicians  into  fatal  Mistakes. 
— To  prevent  this  &  be  of  some  use  to  my  Country  was 
the  Design  of  permitting  the  present  Publication,  in 
this  rough  unpolish'd  Dress. 

M.  Wilson. 

In  selecting  the  various  subjects  of  Iaryn- 
gological  and  otological  interest  the  text 
has  been  closely  followed  with  here  and 
there  an  addition  or  change  in  punctuation 
to  render  the  meaning  clearer.  It  will  be 
noted  that  most  of  the  articles  are  short 
and  concise.  Definitions  of  diseases  with 
their  cross  references  are  given  in  order 
that  a  proper  conception  may  be  had  of 
the  exact  comprehensiveness  of  the  medi- 
cal knowledge  of  Dr.  Wilson  and  his  pupils. 
The  prevalence  and  importance  of  the  dif- 
ferent diseases  may  be  judged  by  the 
amount  of  space  devoted  to  their  descrip- 
tion and  treatment.  A  reference  to  the 
various  throat  conditions  will  show  the 
lack  of  anatomical  and  pathological  dis- 
tinctions common  to  the  medical  knowl- 
edge of  the  period.  In  the  account  of  the 
"Throat  Disorder  in  America,"  the  dis- 
ease which  is  now  recognized  as  diphtheria, 
the  work  of  Douglas  is  mentioned.  In  a 
note  under  "Quinsy  Malignant"  is  the 
statement  of  an  Epidemic  Cynanche  in 
which  New  York  physicians  found  a  new 
membrane  in  the  larynx.  This  undoubt- 
edly refers  to  the  work  of  Samuel  Bard  and 


88 


Annals  of  Medical  History 


Richard  Bayley.  A  full  description  of  early 
American  literature  on  the  throat  distem- 
per may  be  found  in  Elsberg's  "Laryn- 
gology in  America."  3  Wright  in  his  his- 
tory *  has  analyzed  carefully  the  steps  in 
the  progress  of  the  differentiation  of  the 
various  throat  diseases  from  the  earliest 
times  down  to  the  present  day. 

THE   THROAT    DISORDER    IN    AMERICA. 

This  dire  contagious,  putrid  &  nervous 
Disease  began  in  N.  England  a.d.  1735 
&  gradually  moved  on  Westward,  thro' 
most  Part  of  North  America.  Children  & 
young  People  were  more  generally  affected, 
yet  some  Old  Persons  have  died  of  it. — It 
prevails  most  among  the  Poor  and  Scorbu- 
tic, who  feed  much  on  Pork  &  live  in  wet 
&  low  Grounds. — In  Some  Families  it 
spreads  like  the  Plague — Others  at  the 
same  Season  take  it  without  Opportunity 
of  Contag  (ion) — Some  have  it  very  mildly 
&  none  die,  &  yet  I  have  heard  of  4  Chil- 
dren dying  in  one  House  in  a  Few  Days. — 
It  will  often  keep  in  a  Neighbour  (hood) 
for  some  years — Some  have  it  more  than 
once.  Some  seem  to  have  it  long  hatching, 
before  it  breaks  out  as  appearing  by  the 
Languishing  Scorbutic  Habit,  Corrosive 
Humors  &c. 

Symptoms. — The  common  attending  Fe- 
vers (but  seldom  Nausea  or  Vomiting) 
putrid  Heat,  but  moist  &  seldom  parch'd. 
— A  frequent  irregular  Pulse — Countenance 
dejected- — Lowness  of  Spirits — The  Tongue 
much  furr'd,  wc  continues  to  the  Tonsils  & 
Throat. — When  milder  the  Tonsils  only 
swelled,  wt  white  spots,  at  most  V6  an  Inch 
Diameter — thrown  off  from  Time  to  Time 
in  Cream  colour'd  sloughs — When  these 
come  off  the  Tonsils  appear  deeply  pitted 
&  corroded — The  Sloughs  soon  renew  again 
— Sometimes  the  Throat  is  swollen  inter- 
nally &  Externally,  and  frequently  mor- 
tify— But  generally  the  Swelling  does  not 
endanger  Suffocation — Sometimes  they  im- 


posthumate — The  last  Symptoms  are  Op- 
pression great  of  the  upper  Part  of  the  Chest, 
difficult  breathing,  a  deep  hollow  hoarse 
Cough — livid  Countenance — Then  Death. 
— N.  Some  walk  about  till  near  Dying, 
their  Danger  not  apprehended  by  their 
Friends — Some  die  the  4  or  5  day — others 
the  fourteenth — The  putrefaction  is  so 
great  that  nature  cannot  excite  a  Fever, 
when  they  die  suddenly  of  a  Mortification. 

Cure:  It  was  long  at  first  fatally  treated 
as  an  Angina,  with  the  usual  Evacuations — 
And  it  is  still  fatal  when  Physicians  are 
unacquainted  with  the  manner  of  treating 
this  uncommon  Malady. — All  Evacuants 
in  general  are  Fatal — Bleeding — Blister- 
ing— Purging — Sweating  hasten  fatal  Mor- 
tifications. And  what  is  surprising  tho'  so 
putrid  Cold-Air,  &  Jesuits  Barks  are  per- 
nicious.— All  Flesh  Meats,  Fish,  &  Spirits 
are  very  hurtful.  At  last  it  was  discovered 
by  Dr.  Douglas  of  Boston  that  the  only 
Way  to  cure  it  is  by  confining  the  Sick  to 
Bed  in  a  gently  moderate  Warmth  for 
many  Days — Giving  very  small  Doses  of 
Snakeroot,  but  not  to  sweat,  but  only  a 
gentle  Diaphoresis  with  Sage  Tea,  for  some 
time  after  all  the  Symptoms  Disappeared. 

N.  It  has  also  been  found  when  mild  to 
be  attended  with  a  Miliary  Eruption  on 
the  Skin. — Hence  Calomel  join'd  with  Cam- 
phire  has  been  thought  to  answer  the  same 
End  as  these  Eruptions. 

N.  All  greasy  Applications  are  hurtful. 

N.  Gargles  are  useful  of  Sumack  Bur- 
ries,  Snakeroot  &c  a  little  Allom  dissolved 
in  it. —Gargle  before  Swallowing. — 

N.  Wash  ye  sores  wt  Tinct.  of  Myrrh 
&  Allocs  wt  Honey. 

N.  Externally  Poultices  of  Rue  &  bitter 
Herbs.  Sal  Amnion  wt.  sharp  Vinegar. 

N.  Some  have  had  Sores  in  other  Parts, 
even  ye  Privates,  &  less  in  the  Tonsils,  & 
wire  relieved  in  the  same  Way. 

N.  Wine  freely  to  a  Glass  every  few 
Hours  has  cured  some  very  low  in  Nervous 
Fevers — 


Laryngology  and  Otology  in  Colonial  Times 


89 


See  Putrid  Fevers,  Typhus,  Scarlatina, 
Biliosa  &c. 

Acataposis: — Is  a  difficulty  of  swallow- 
ing. Vide  Angina. 

Aglutitio: — Is  a  deprav'd  swallowing. 
Vide  Angina. 

Ageustia  or  Agehustia: — Is  a  diminish- 
ed or  deprav'd  taste.  Vide  gastritis. 

Angina — Quinsy: — Is  a  pain,  Tumor,  in- 
flammation of  the  Fauces,  with  a  contin- 
ual, inflammatory  nervous  or  putrid  Fever; 
attended  with  a  difficulty  of  Breathing  or 
Swallowing  or  fear  of  Suffocating.  Vid. 
Cynanche. 

There  are  five  species  enumerated.  The 
Best  Rule  is  to  treat  according  to  the  Fever. 
If  inflammatory:  Bleed  the  Arms  &  under 
the  Tongue,  blow  Allum  often  in  the 
Throat — Purge  wt  Glysters,  Give  Nitre, 
Steams  of  hot  Vinegar — ,  Puke  wt  White 
Vitriol,  Anodynes  etc.  See  under  Quinsy 
ye  Theory.  If  Putrid,  Dont  Bleed,  but 
Puke  &  Suit  the  symptoms.  Contrayerva 
is  good,  blow  Allum,  Poultis  wt  Jews  Ears, 
or  Rue  or  Horehound  Leaves,  &  a  little 
Milk,  Stew'd  with  Salt  &  Vinegar.  Inter- 
nally Vin  Antimon,  Camphor,  Bathe  wt 
Saponacious  Liniment,  Gargle  wt  Tincture 
of  Myrrh  or  Acid  Elix;  Use  Barks  &  Snake- 
root  with  Wine,  Exercise,  Milk  in  Decoc- 
tion of  Alder. 

Gentle  Sudorifics,  Check  Purging,  Some 
Syringe  the  Throat  with  Acet.  Egyptiacum 
&c.  If  nervous  &  Suffocative  the  Mucus 
is  thickened  to  a  membrane,  (Endemic 
here),  it  is  cured  wt  Mercury  by  thinning 
the  Mucus,  by  its  accrimony  with  Anyo- 
dynes,  Sudorifics;  Salivation  does  it  no 
harm.  Bathe  with  Volatiles,  Saponacious 
Balsams  &c.  Convulsiva — Vide  Angone 
cujus  est  species.  See  Sore  Throat. 

Angone: — Is  a  Spasmodic,  sharp  choak- 
ing  of  the  Fauces  without  an  inflammation. 
Vide  Asthma. 

Cure;  By  a  Dose  of  Opium,  Camphor, 
Volatile  &  Traumatic  Balsam  mixt  together. 
Repeat  if  needfull,  this  Cured  an  Epidemic 


(at  Indian  River)  after  great  numbers  had 
died.  This  scarcely  failed,  only  blowing 
Allum  Powder  in  the  Throat  &c. 

Anosmia: — Is  a  defect  of  Smelling.  See 
Nervosi  Morbi. 

Antipathia: — Is  a  particular  Aversion 
to  an  Object  of  Sight,  Smell,  or  Taste, 
so  as  to  be  thrown  into  grievous  Symp- 
toms by  them,  as  Col.  Robertdeau  at  a  cat 
&  Mrs.  Boyd  at  the  smell  of  Tar  &  mySelf 
at  Cod  Fish. 

The  Cure  is  commonly  Death. 

Aphonia:  —  Is  a  deprav'd  Voice  and 
the  same  wt  Paraphonia.  This  may  be 
from  many  Causes.  If  from  Cold  see  Ca- 
tarrhus.  If  from  a  Fright  see  Hysteria.  If 
from  Lues  Venerea,  see  Scorbutis.  If  from 
any  other  Cause,  remove  the  Cause.  But 
if  from  ill-configuration  of  the  Parts,  it 
seems   incurable. 

Aphthae;  Thrush:  —  Are  little  whitish 
Ulcers  affecting  all  parts  within  the  Mouth 
&  sometimes  the  Pudendum. 

The  Cure:— Vomit  Infants  wt  the  vinum 
Antimonii  gut.  5-12  in  Breast  Milk.  Vide 
Erysipelas  from  which  it  differs  only  by 
the  Weather. 

Juice  of  Horehound  mixt  with  Honey  & 
give  a  little  often.  Give  also  Cathartics, 
Alteratives,  Antisceptics,  Astringents  in- 
wardly. Externally  wash  with  Juice  of 
Green  Persimmon  &  Loaf  Sugar,  or  rusty 
Nails  and  Vinegar,  or  with  Horse  Radish 
Root  Juice  or  Strong  Tea  of  Oak  Moss  wt 
a  little  Honey,  and  Allum  to  wash  the  sores 
&c.  Vide  Mouth  Sore.  N.B.:  Onion  Juice 
cures  it  by  sending  it  to  the  Skin  in  dan- 
gerous cases. 

History  &  Theory  of  the  Thrush. 

Aphthae: — for  which  there  is  no  English 
Name,  unless  Sore  Mouth  or  Thrush, 
is  a  frequent  and  fatal  Disease,  especially 
among  Infants,  &  pregnant  Women  in  this 
Place,  tho'  little  considered  or  understood. 
These  are  small,  round,  superficial  Ulcers, 
on  the  inside  of  the  Mouth,  which  Boer- 


9o 


Annals  of  Medical  History 


haave  found  on  Accute  inquiry  to  be  the 
Exulcerations  of  the  Excretory  Ducts  of 
the  Glands,  which  separate  Salivery  Hu- 
mours &  convey  them  to  the  Mouth.  Now 
this  Fluid  rendered  too  thick  and  Viscid 
stops  up  the  Extremities  &  Causes  them 
to  inflame,  in  all  parts  where  ever  these 
Excretory  Ducts  should  discharge  them- 
selves as  the  Lips,  Gums,  Cheeks,  Tongue, 
Palate,  Fauces,  Uvula,  Throat,  Stomack, 
&  Intestines.  In  low  and  Marshy  Ground, 
&  in  hot  &  rainy  Seasons,  Infants  &  Old 
People  are  most  affected  by  the  Apthae. 

The  Prolegomena  or  Causes. 

Continual  putrid  Fever,  wt  a  Diarrhea, 
or  Dysentery,  perpetual  Nausea,  Vomiting, 
loss  of  appetite,  Febrile  Anxiety,  Pain  at 
the  Pit  of  the  Stomack,  often  returning; 
great  Weakness;  considerable  Evacuations; 
Stupor,  &  Heaviness,  but  perpetual  Drowsi- 
ness &  pain  about  the  Stomack.  Those  that 
appear  at  first  with  one  Pustle,  and  are 
afterwards  white  &  Pellucid  like  pearls, 
unequal,  are  mild  &  safe.  Those  which  first 
appear  in  the  Throat  like  New  Bacon  with 
a  white  thick  crust,  beginning  in  the 
Stomack,  &  slowly  Ascending  to  the  mouth, 
these  are  Opaque  because  of  thickness,  & 
very  dangerous.  Those  which  appear  over 
the  whole  mouth  wt  a  hard  firm  thick  tena- 
cious kind  of  Crust,  turning  brown,  yellow, 
or  livid,  are  very  often  Fatal.  But  those 
which  break  out  in  the  same  way,  &  then 
turn  black,  are  worst  of  all,  &  commonly 
take  life.  The  sooner  the  Separation  the 
better;  the  longer  before  they  fall  off,  the 
more  dangerous  to  the  Patient.  The  Salival 
Juices  are  discharged,  thro'  the  whole  in- 
ternal surface  of  the  Mouth,  in  order  to  be 
mix'd  with  the  Aliments  in  Mastication; 
there  are  also  numberless  mucous  Cryptae, 
or  Cells  in  the  back  of  the  Tongue,  Tonsils, 
Velum  of  the  Palate,  Pharynx,  and  Gula, 
which  excrete  thick  Mucus  for  the  Lubri- 
cation of  those  parts.  But  the  eruptive 
Aphthae   happen   when   this   Mucous   Hu- 


mour is  inspissated,  and  cannot  be  Driven 
thro'  the  Ducts,  but  Adheres  and  blocks 
up  the  Opennings  into  the  Mouth,  as  may 
be  seen  through  a  Microscope.  Nine  days 
are  said  to  bring  the  Crisis  of  this  Fever — 
but  sometimes  it  goes  much  longer. 

The  Aphthae  or  Thrush  are  Seldom  Ob- 
served in  hot  Countries  except  in  some  In- 
fants; for  being  more  thin  and  lax,  they 
are  more  disposed  to  perspire  &  Sweat. 
Sweats  &  Urine  carry  off  the  Apthae,  if 
copious  &  render  them  mild.  Hence  all 
diets,  drinks,  &  nursing  which  interrupt 
these  are  always  detrimental.  Van  Swieten, 
(If  I  recollect  the  Author)  Observes  when 
Apthae  don't  appear,  as  in  Hot  Countries, 
then  Miliary  Spots  white  &  red,  are  fre- 
quently to  be  seen  on  the  Skin;  and  con- 
jectures that  the  Humor  deposited  is  the 
same.  The  Miliary  Eruptions  and  Apthae 
attend  the  same  Diseases  ex  such  accute 
Fevers  as  have  the  same  disagreeable 
smell  of  Vapid  Vinegar. 

He  remarks  the  miliary  Eruptions  or 
Pustules  are  filled  with  similar  pelucid 
Liquor,  perfected  above  the  Cuticle,  & 
after  they  dry  up,  that  they  scale  off,  & 
are  often  renew'd  as  in  the  Apthae.  Both 
are  preceded  by  Anxiety  about  the  Heart, 
Weakness,  Slight  but  continual  dosing,  &. 
unequal  intervals.  If  the  Apthae  &  Miliary 
spots  sudently  disappear,  there  is  great 
danger  of  their  oppressing  the  Stomack  & 
Heart.  N.  Then  there  is  no  hope,  but  by 
expelling  the  Apthae  again  outward  to  the 
Skin.  Stupor,  &  Heaviness  presage  the 
Apthae;  sometimes  they  thicken  The  Duc- 
tus Communis,  &  Pancreas,  (not  having 
the  way  clear  into  the  Duodenum)  by  a 
thick  Apthous  Crust;  there  is  great  Anx- 
iety, about  the  Precordia.  But  when  the 
obstructing  Crust  is  removed,  we  need  not 
wonder  that  the  accumulated  bile,  breaks 
loose;  Hence  the  severest  gripes  in  the 
Bowels,  almost  Excorriated,  &  hence  dan- 
gerous Diarrhoeas  &  Dysenteries  arise. 
Hence  on  giving  a   Purge  a   fatal   Hyper- 


Laryngology  and  Otology  in  Colonial  Times 


9i 


catharsis  may  suddenly  arise  from  the 
Acrid  Bile  &  Pancreatic  Juice,  rushing  into 
the  excorriated  Bowels.  N.  a  Salivation 
follows  the  Thrush,  before  the  Dilated  Ves- 
sels can  recover  their  former  size. 

Now  the  Stomack  &  Intestines  being  in 
the  same  State,  it  is  no  wonder  that  the 
body  is  exhausted  like  a  Consumption 
after  it  by  the  Purging  &c.  N.  Apthae  of 
the  Mouth  in  Pregnant  Ladies  may  cause 
Abortion  by  destroying  digestion,  and  ab- 
sorbing of  the  Chyle.  But  she  needs  nour- 
ishment for  two  bodies,  of  which  the 
weaker,  the  Foetus,  dies. 

N.  A  Hickup  at  the  beginning  is  worse 
than  at  the  End  of  the  Apthae,  as  denot- 
ing the  Stomack  lined  with  thick  Apthae. 
N.  Cold  Applications  in  this  Disease  are 
Dangerous. 

Cure:  Whey,  Vapour  Baths,  Weak  Pan- 
ada, Gargarisms,  Glysters,  Corroborating 
healing  drinks,  as  Alder  &  Mallows,  & 
Soot,  M.  in  Tea  with  Milk.  Jellies  con- 
stantly on  the  Tongue  &c  &c.  with  the 
Remedies  first   Mentioned. 

Apogeusis:  —  Is  a  defect  of  Taste. 
Vide  Ageustia.  Find  the  Cause  and  try  to 
remove  it. 

Apophlegmatizantia: — Provokers  of  Spitt- 
ing. These  stimulate  the  Glands  of  the 
Palate,  Fauces,  and  Salival  ducts,  &  purge 
off  the  viscid  Phlegm.  They  are  proper 
in  defects  of  Taste,  Hardness  of  Hear- 
ing, to  drive  viscid  humours  from  the 
Head,  in  Catarrh  &  Obstructions  of  the 
Fauces.  They  are  preservative  Agt.  con- 
tagious Diseases.  V.  Salivantia.  Tobacco 
chew'd  or  Smok'd,  Chewing  Hickory  Bark, 
Ginger,   Mistletoe,   Mercury  &c. 

Arcditas: — Is  a  dryness  of  the  Skin, 
Nostrils,  Mouth  &  Tongue  from  a  dissipa- 
tion of  the  Watery  Juices  by  the  febrile 
Heat;  while  the  impervious  Blood  distend- 
ing the  Vessels  make  the  skin  rough  &  dry. 
Vid.  Typhus,  Sore  Throat  &c. 

Asaphia  (Aphasia?) : — A  Defect  of  the 
Voice.     Vide     Aphonia,     Cophosis,     Muti- 


tas.  See  Sauvages  ingenious  Treatise  of 
Mutitas. 

Balbuties: — Is  a  Stammering  &  Loosing 
Letters  in  Speaking.  Vide  Psellotis.  See 
kinds  of  it  in  Sauvages  Chap.  vi. 

Battarismus: — Vide    Balbuties. 

Blaesitas:  —  A  depraved  Pronunciation 
of  the  Letters  S  &  R.  Vide  Traulotis. 

Black  Dry  Tongue:  —  Worst  Presage 
in  Fevers  owing  to  a  Deficiency  of 
Lymph,  or  when  the  larger  Vessels,  sur- 
charged with  Blood,  press  &  stop  the 
smaller.  Hence  the  Tongue,  Index  of  the 
Stomack,  is  dry  and  gangrenous.  See  putrid 
Fevers. 

Bronchocele  or  Goitre: — Is  a  large  swell- 
ing which  is  formed  on  the  fore  part  of  the 
Neck,  between  the  Skin  &  the  Wind  Pipe, 
&  sometimes  hangs  from  the  Neck  like 
a  large  Bladder;  It  contains  atheromat- 
ous, steatomatous,  fleshy,  or  honey-like 
Matter.  See  Encysted  Tumors. 

Bronchotomy,  the  Operation: — This  Ope- 
ration is  chiefly  useful  in  the  Angina,  when 
the  Throat  is  exceedingly  enlarged  by 
the  Tumor  of  the  Thyroid  Gland  &  Part 
adjoining,  called,  Bronchocele,  which  press- 
ing on  the  Trachea,  prevents  the  free 
Course  of  the  Air  to  &  from  the  Lungs.  It 
is  an  incision  made  in  the  Aspera  Arteria 
to  admit  the  Air  to  the  Lungs  to  preserve 
Life,  in  a  violent  compression  of  the 
Larynx. 

Frightful  Cautions  have  been  laid  down 
by  Writers,  for  fear  of  dividing  the  recur- 
rent nerves,  or  the  great  Blood  Vessels. 
But  there  is  scarce  any  danger  at  all;  for 
they  lie  quite  out  of  the  reach  of  any  In- 
strument in  a  tolerable  cautious  Hand. 

The  Manner  is  simply  this;  Pinch  up 
the  skin  a  little  below  the  Tumor,  but  as 
near  it  as  you  can  if  it  be  low;  &  make  an 
Incision  quite  thro'  the  Skin,  three  quar- 
ters of  an  Inch  long.  It  is  commonly  in  the 
3rd  or  4th  Ring  of  the  Trachea,  but  the 
Tumor  will  not  sometimes  permit  you  to 
choose  the  Place.  Then  part  the  lips  of  the 


92  Annals  of  Medical  History 

Wound,  make  a  small  transverse  Incision  &  often  produces  mild  Consumption,  called 

into   the   wind-pipe   &   immediately   intro-  the  DefHuxion  on  the  Lungs. 

duce  a  Silver  Cannula,  near  half  an  Inch  Catarrhs  are  distinguished  according  to 

long,  \vt  a  couple  of  little  Rings  at  the  top  an  old  Verse: 

of  it,  thro'  which  pass  a  Ribband  to  pass 

,      .        XT     ,             i             •      r          .         i  Si  rluat  ad  pectus  dicatur  rheuma  Catarrhus; 

round   the    Neck   to    keep   it    last    in   the  Ajr           £       ,          ,NT           t   ^ 

r  Ad  tauees,  Bronchus,  ad  Nares  esto  Loryza. 
Wound. 

N.  After  the  Patient  is  cured  of  the  Besides  an  obstructed  Perspiration,  some 
Quinsy,  &  can  breathe  by  the  natural  pass-  other  causes  may  produce  Catarrh,  as  the 
age  you  may  wtdraw  the  Tube,  which  Stoppage  of  usual  evacuations,  or  Natural 
leaves  only  a  Simple  Wound  and  requires  Secretions  as  of  Urine  &c,  or  as  Weaken- 
only  a  superficial  application.  ing  digestion  as  only  to  produce  a  Watry 

~     .                  .   ~             i      i     „   •  Chyle  &  Blood,  when  its  fluid  Parts  will 

Lapistrum: — A  bpasm  closely  &  immov-  .,    ,       ,     XT                 ~,      , 

...       .               i      »,       too  escape  more  easily  by  the  Numerous  Glands 

ably  shutting  up  the  Mouth.  See  Spasmus  t           i     TT     j    r»                    i_ 

w     -ii       •  r    -    ••    e>      ^  ■  about  the  Head,  Prognostics  here  are  easy, 

Maxillae  mfenoni.  See  Opium.  .f  ^  CatarrhaI  Matter>  is  but  ^  &  not 

Catarrhus — Catarrh: — Is  perhaps  the  most  Acrid  &  discharged  only  by  the  Nose,  the 
common  Disease  in  our  County,  yet  the  least  Cure  is  easy.  If  discharged  by  the  Throat 
examined  or  understood.  When  People  are  it  is  more  difficult.  But  when  it  is  very 
taken  wt  it,  they  only  say  they  are  very  poorly,  Acrid,  &  falls  in  a  copious  Manner  on  the 
&  have  catched  a  bad  Cold,  &  no  further  Lungs,  especially  in  one  advanced  in  Years, 
Notice  is  taken  of  it,  'till  it  frequently  ends  or  who  is  liable  to  Cough,  Asthma,  or  Con- 
in  dangerous  Pleurisies,  Peripneumonies,  sumption,  it  is  both  very  difficult  &  dan- 
Consumption  &c.   It  may  be  defined  "An  gerous. 

Unusual  Deduction  of  Lymph,  Serum  or  Cure  in  general;  Softning  the  Serous  hu- 
Mucus,  from  the  Glands  about  the  mours,  drinking  large  Draughts  of  Hy- 
Head,  Jaws  &  Throat,  exciting  a  Cough,  dromel  warm,  or  Tissots  Elder  Flowers, 
distressing  &  frequent.  It  is  attended  wt  Balsam  Traumatic,  Vomits,  Blisters,  Ano- 
Hoarseness  generally  &  an  inflammatory  dynes  wt  Camphor,  Antimon,  Vin.,  Flan- 
Fever."  nel  Shirts,  Cough  Mass,  Volatiles,   Issues, 

The  cause  is  called  taking  Cold,  tho'  in  Smoking    Tobacco. — See    Peripneum.    Ca- 

fact  it  is  more  frequently  by  Violent  Heat;  tarrh.,    See   the   Theory   of  Opium.    More 

however,  it  is  generally  caused  by  a  Diminu-  particularly    The    Diet    should     be    soft, 

tion    of   insensible    Perspiration,    the   out-  smooth,   &   balsamic;   most  Authors  agree 

ward  Skin  being  exposed  to  the  Air,  Where-  to   give   a    gentle   Vomit    at    first,    if   the 

by  a  Plethora  arising,  the  great  Author  of  strength  will  permit,  and  if  the  Patient  be 

Nature  has  provided  an  internal  Perspira-  Phlethoric  or  Asthmatic  Bleeding  may  be 

tion  by  the  Mucous  Cryptae  of  the  Skin  necessary,  but  in  no  other  Case.  It  will  be 

of  the  Mouth,   Fauces,  Bronchiae,   Lungs,  necessary  to  give  gentle  Purges  as 

&c.    But   too   great   quantities  collected  in  „ 

these,  by  the  Heat  of  the  Parts  becoming  Infus.  Sena 5  iij 

Viscous,    are    cast    off,    after    they    have  Mannae 3  ' 

caused     much     trouble     &     Irritation     by  Sal  Glauber 3  ss 

Coughs,  Sneezing,  &  Running  at  the  Nose,  Acl-  Nux  Muschatae 5  ij 

..„«.•!  _          u          n     «.     i        u-   l     ..    n-              o  M.S.  Patio  Mane  Sumanda. 
until  more  be  collected,  which  stutls  up,  & 

often  rattles  in  the  Breast.  This  frequently  If  there  be  Restlessness,  &  Anxiety,  give 

produces  wt  is  called  the  Catarrhal  Fever  a  gentle  Anodyne,  with  large  Draughts  of 


Laryngology  and  Otology  in  Colonial  Times 


93 


Rosemary  or  Bran  Tea  &c.  made  into  Hy- 
dromel  &  a  Stronger  Purge  of  Rusl's  Pills 
or  of  Soap  &  Alloes. 

When  the  Cough  is  troublesome: 

^ 

Conserv.  Rosar, 
Syrup.  Balsam, 

Syr.  e.  mecon aa5  i 

Spt.  Vitriol,  tenuis q.s. 

ad  Ievem  Aciditatem,  m.  cap.  cochl., 
subinde,  urgente  Tussi, 

or  else, 

Terr,  japan 3 ij 

Bal.  tolutan 3  J 

cog.  in  Aq.  font 5  xii  ad  3  viij 

colat,  add 

Syr.  e  mecon 5  ij 

M.  cap.  cochl ij 

h.  s.  et  urgente  Tussi 

After  removing  the  cause,  it  may  be 
necessary  to  thicken  the  Juices  &  restrain 
the  Flux  of  sharp  Acrimonious  Matters. 

^ 

Conserv.  Rosar 5  i 

Bals.  Cocatalli 3  ij 

Sperm.   Citi,  Terr,  japonic 555  i 

Oliban  pulv 3  iss. 

Syrup.  Balsam.,  q.  s.  m.f.  Electar. 
Dos.  q.  n.  m. 

In  the  meantime  Cupping  &  Blistering 
&  Issues  may  be  applied  to  the  side  or  part 
affected,  according  to  the  Symptoms.  Also 
to  divert  the  Defiuction  from  falling  on 
the  Lungs,  let  him  use  freely  Diuretics  & 
Diaphoretics  for  some  time. 

Therac,  Androm,  Oliban aa  3  ss. 

Gum  Ammoniaci,  croci 55  gr.  v 

Syrup  q.  s.  f.  Bolus,  to  be  taken  three  times 
a  day. 

Lime  Water  &  Milk  &  Tar  Water,  &  Tea 
of  Pine  Buds,  or  Pine  saw  dust,  or  ground- 
ing, &  Sassafras  will  make  good,  common 
Drink,  not  much  inferior  to  the  above  ele- 
gant   Forms    from    London.    See    Treatise 


under   Phthisis.   See  Syrup  of  Horehound 
under  Tussis  from  a  French  Physician. 

Catarrhus  Suffocativus: — Is  a  very  difficult 
Respiration,  Attended  \vt  a  sudden  Inter- 
ception of  the  Senses  &  Motion,  snoring  & 
intermitting  Pulse.  See  Pnigma,  Bleed, 
Vomit,  Bathe,  purge,  Barks  of  Alder,  Tea 
of  common  Scotch  Thistle  &c.  See  Asthma, 
Angina. 

Cionis: — Is  a  painful  thickness  of  the 
Uvula  &  Palate.  See  Angina  &  Sore  Throat. 

Clamor: — Is  an  anxious  Exaltation  of  the 
Voice;  often  in  Mania. 

Clangor: — Is  a  Sharp  screeching  Voice. 
See  Paraphonia.  See  Sauvages. 

Coryza: — Is  an  extraordinary  Running 
of  a  thin  Serum  from  ye  Nose  or  a  Catarrh 
of  the  Nostrils.  See  the  Latin  Verse  under 
Catarrhus. 

Cough : — See  Tussis,  Pertussis,  Catarrhus. 
Syrup  of  Horehound  or  Sulphur  &  the  Yolk 
of  an  Egg,  or  take  Barbadoes  Tar,  Honey  & 
ye  Yolk  of  an  Egg  &c. 

Cynanche: — Quinsy:  Is  an  inflamma- 
tory &  sometimes  putrid  Fever;  attended 
wt  pain  &  Redness  in  ye  Fauces,  a  diffi- 
cult swallowing  &  Breathing  wt  a  Sense 
of  Straightness  in  ye  Fauces.  See  Angina, 
&  Quinsy.  If  Inflammatory:  Blood  under 
Tongue,  in  ye  Arm  or  Feet.  Bathe  Feet  in 
warm  water,  blow  Alum  or  Nitre  into  ye 
Throat  often.  Apply  a  Chin  Stay  of  Bals. 
Sapon.  or  Camphorated  Spts.,  purge  by 
Mouth  &  wt  Glysters.  Blister  if  pain  in  ye 
Head.  Gargle  the  Throat  with  Oak  Oose 
or  persimmon  bark  wt  01.  Vitriol  &  Honey, 
Snuff  Honey.  Apply  Poultises  of  Jews  Ears 
or  Horehound,  plantane  &  Vinegar.  If 
putrid;  Mercury  is  called  a  Specific.  V. 
Malignant  quinsy. 

Dysphagia: — A  difficulty  of  Swallowing 
wtout  any  remarkable  difficulty  in  Breath- 
ing. Vide  Angina. 

Epistaxis: — Is  a  Profusion  or  Haemor- 
rhage of  blood  from  ye  Nostrils,  wt  pain 
&  heviness  of  ye  Head,  Redness  of  ye  Face. 
Vid.  Hemorrhagia,  Haemorr.  Nar.  &c. 


94 


Annals  of  Medical  History 


Original  Epistaxis: — is  a  Haemorrhage 
from  a  Plethora.  Symptomatic  Epistaxis : 
are  ist  from  internal  Causes:  Febrile  Haem- 
orrhage, critical  Haemorrhage,  insalutary 
Haemorrhage.  2nd:  From  external  Causes; 
common  Haemorrhage,  Haemorrhage  by 
Leeches  &c. 

Cure:  Bleed  Feet,  Purge,  Sweat  over 
bath  of  Cedar  Tops,  Epithem  in  each  Nos- 
tril of  Pulv.  Alumen,  on  Lint  &c. 

Fauces: — Pain'd  or  inflamed;  See  Angina. 

Glossagra: — Is  a  Rheumatism  of  yeTongue 
and  is  a  Species  of  Rheumatismus.  Q.  Vide. 

Glossocele:  —  Is  a  spasmodic,  violent  & 
sharp  Extrusion  of  ye  Tongue. 

Glossocoma: — Is  a  spasmodic,  violent  & 
sharp  Revulsion  or  hauling  in  of  ye  Tongue. 

Gravido: — Cold  in  ye  Head;  Is  a  kindred 
Catarrh  of  ye  Nostrils  \vt  a  painful  uneasi- 
ness &.  heaviness  of  ye  Head,  hoarse  Voice 
&  difficult  Breathing,  Vid.Catarrhus,  Frigus. 

Cure:  Thrust  roots  of  ye  Thin  Yellow- 
rind  of  an  Orange  up  each  Nostril,  hold  ye 
Head  over  Steam  of  hot  Infusions. 

Hiccup: — Seems  to  be  a  Convulsion  of 
ye  Oesophagus  drawing  ye  Diaphragm  up- 
wards, whilst  it  is  suddenly  seized  wt  a 
convulsive  Paroxysm  &  drawing  down- 
wards &  proceed  either  from  Repletion 
of  Inanition.  See  Singultus. 

Hoarseness: — See  Catarrhus,  Pertussis,  &c. 

Himantosis: — Is  a  greater  Length  or 
Slenderness  of  ye  Palate  yn  usual  wt  Pain. 

Hypostapbyle:  —  Is  a  Prolapse  or  Produc- 
tion of  ye  Palate  wn  it  is  either  relax'd,  in- 
llamed,  ulcerated,  incrassated,  attenuated  or 
forked.  V.  Scorbutus.  Blow  Allum  or  Nitre 
on  it.  Wash  Acid  Elixir,  Honey  &c. 

Iscbnopbonia: — Is  a  Fault  of  Pronuncia- 
tion in  wc  one  Syllable  can't  join  another 
quickly.  V.  Psellimus. 

Labium  Leporinum: — Hare  Lip.  See  La- 
gocheilos. 

Lagocbeilos: — Hare  Lip.  Is  a  Deformity  in 
which  ye  Lip  is  divided  by  Chasms  or  Fissures. 
See  Lab.  Leporin.  The  Operation  should  be 


omitted,  untill  ye  Child  has  some  Reason  to 
suffer  it  to  be  done.  On  wc  see  Van  Swieten, 
Sharp.  It  is  pretty  common  for  ye  Roof  of  ye 
Mouth  to  admit  of  Reunion.  Fissures  of  ye 
Palate  often  close  in  some  years.  Separate  ye 
Lip  from  ye  upper  Jaw;  divide  ye  Frenulum 
wc  connects  it  to  ye  Gums.  If  ye  Dentes 
Incisorii  too  much  projected,  cut  ym  out 
in  Infants.  Cut  off  ye  callous  Lips  wt  Scis- 
sors ye  whole  length,  but  take  Care  to 
make  ye  Wound  in  Straight  Lines.  Then 
bring  ye  two  Lips  of  ye  wound  exactly  to- 
gether, &  pass  a  couple  of  pins,  one  pretty 
near  ye  Top  &  ye  other  as  near  ye  bottome, 
thro'  middle  of  both  edges  of  it,  &  secure 
ym  in  yt  Situation  by  twisting  a  Piece  of 
Wax'd  thread,  across  &  round  ye  pins  7  or 
8  times.  Then  cut  off  ye  points,  lay  a  small 
Bolster  of  Plaster  under  ym,  to  prevent 
their  Scratching.  Wn  only  ye  lower  Part 
of  ye  Hare  Lip  can  be  brought  into  Con- 
tact, one  Pin  is  Sufficient.  The  practice  of 
bolstering  ye  Cheek  upward  does  more  in- 
jury to  ye  Patient,  yn  good  to  ye  Wound. 
Dress  superficially  as  often  as  is  Necessary 
for  Cleanliness.  In  8  or  9  Days  ye  parts 
generally  are  found  united,  yn  gently  ex- 
tract the  Pins  &  apply  dry  Lint  and  Ad- 
hesive Plaster.  This  method  may  be  use- 
ful in  some  Fistulae  &c.  Silver  Pins  & 
Steel  Points  suit  ye  Pomp  of  ye  Great,  but 
common  Pins  Answer  ye  End  fully  as  well. 
See  CuIIen  on  Copper. 

Lagostoma: — The  Upper  Lip  divided.  See 
Lagocheilos. 

Leptopbonia:  —  Is  a  fault  of  ye  Voice 
which  is  very  Weak.  See  Paraphonia. 

Mumps:  —  Species  of  Angina.  Q.  Vid. 
Poultis  wt  Wormwood  &  Vinegar.  Give 
them  Antimonial  Essence  freely.  Avoid 
Greasy  things  internally  &  externally. 

Moutb  Sore: — See  Scorbutus,  Parotis, 
Parulis,  Apthae.  Wash  wt  a  Decoction 
of  Hyssop,  Sage,  Oak  Moss,  mixt  in  honey 
&  a  little  Allum.  Horse  Radish  Root  Juice 
&  Honey.  Purge  wt  Mullein  Juice.  Bathe 
the  Head  wt  Rum,  Glyster  Saline,  Tea  of 


Laryngology  and  Otology  in  Colonial  Times 


95 


Black  courrants.  Rhubarb  in  Soot  Tea, 
Syrup  of  Mulberries  &c. 

Mutitas:  —  Is  an  Impotency  in  pro- 
nouncing Articulated  or  joined  words.  See 
Aphonia. 

Nejrendis: — Is  a  Deformity  in  wc  ye 
Teeth  is  out  of  the  Head. 

Noma: — Is  an  Ulcer  wc  does  not  con- 
sume &  eat  ye  Afflicted  Part  alone,  but  all 
ye  Neighboring  Parts.  See  Cancer,  Ulcus. 

Odaxismus: — Is  a  pain  of  ye  Gums  yt 
Infants  have  whilst  Teething.  See  Den- 
titis. 

Oesophagismus: — Is  a  Spasm  of  ye  Oes- 
ophagus wc  detains  ye  Food  in  ye  Gullet 
after  Swallowing  it,  attended  wt  great 
Pain.  See  Spasms. 

Oxyphonia: — Is  a  shrill  Voice,  such  as 
is  commonly  uttered  in  Wailing  &  Lam- 
entation. See  Paraphonia. 

Ozaena: — Is  a  putrid  Ulcer  of  ye  Nos- 
trils, from  wc  a  stinking  Mucus  distills. 
See  Ulcus.  Wn  it  is  venerial,  see  Syphilis; 
if  not,  Tobacco  Ointment  or  Honey  of 
Roses  wt  a  little  red  Precipitate;  See 
Polypus. 

Palate   Diseased: — See   Hypostophyle. 

Palsy  of  ye  Gullet: — See  Oesophagis- 
mus. 

Palsy  of  ye  Mouth: — Gargle  wt  Sage 
Juice,  purge  well,  chew,  mustard. 

Palsy  of  ye  Tongue: — See  Paraglossa. 

Paraglossa: — A   Swoln  Tongue. 

Paraphonia: — A  Deprav'd  sound  of  ye 
Voice.  Remove  the  Cause  if  possible. 
Chew  Ginger  &c.  See  Aphonia.  See  Pr. 
Sauvages. 

Parotis: — Is  a  Swelling  of  ye  Parotid 
Gland  (See  Boils,  Syphilis).  Inflammation 
of  Glands  behind  ye  Ears  after  an  imper- 
fect Crisis.  Suppurate  wt  Leeks  &  treat  as 
Phlegmon,  Q.  Vide. 

Parulis: — A  Tubercle  on  ye  Gums,  giving 
much  Pain,  &  of  ye  Inflammatory  Kind. 
See  Phlegmone. 

Pertussis: — See  Chin-Cough.  The  Whoop- 
ing or  Chin-Cough  Is  a  Contagious  Disease, 


attended  wt  a  convulsive  &  Suffocating 
Cough;  a  sonorous  inspiration  and  Expira- 
tion; &  oftentimes  a  Vomiting. 

Cure: — Lobs  Tincture  3  i  bis  vel  ter  die 
in  Juice  of  Pennyroyal  z  ss,  M.  Purge  once 
a  Week.  Mistletoe  &  Garlic,  or  Wild  Onion 
Teas  freely;  Baum  de  Vie  Pt.  vij,  Tinct. 
Canthar  Pt.  j.  m.  is  also  good;  Glyster 
daily. 

N.  B. :  After  a  Dose  of  Train  Oil  &  Onion 
Juice  ye  Whoop  no  more. 

N.  B.:  Our  Epileptic  Pills;  Tar  Water  is 
good  after  it.  Tea  of  Scots  Thistle,  Electar. 
of  Sulph.,  Honey  &  Yolk  of  Egg,  m. 

Polypus  of  Ye  Nose: — Is  an  Excresence 
filling  ye  Cavity  of  one  or  both  Nos- 
trils, almost  suffocating,  or  at  least  making 
Respiration  difficult,  arising  from  ye  La- 
minae Sangiosae  Membrane.  There  are 
several  Species.  Some  resembling  ye  Hyda- 
tides  of  ye  Liver,  as  in  some  Dropsies; 
Some  like  Ganglions  of  Nerves,  wc  borrow 
their  Coats  from  its  Vessels.  Those  wc  are 
soft  like  Serum  are  form'd  of  Water,  con- 
tained in  Cysts;  these  are  too  tender  to  be 
extracted;  but  should  be  left  to  harden, 
wc  in  time  ye  commonly  do.  If  ye  are 
Viscid,  tho'  ye  cannot  be  drawn  out  at 
once  by  ye  Roots  yet  at  several  attempts 
ye  may  be  brought  away  in  Bits.  There  is 
another  sort  neither  so  soft  as  to  be  squiezed 
to  Pieces,  nor  so  hard  &  brittle  as  to  crum- 
ble, nor  adhere  to  ye  Membrane.  This  is 
ye  favourable  Kind,  yt  suits  for  Extrac- 
tion by  ye  Forceps.  But  there  is  another 
Kind,  &  ye  worst  of  all,  wc  is  hard  &  Scir- 
rhus,  adhearing  so  as  to  tear  rather  yn 
Separate,  wc  often  ends  in  a  Cancer  wc 
See. 

The  Polypus  sometimes  grows  large  as 
to  alter  ye  Bones  of  ye  Face.  When  ye  Poly- 
pus appears  in  ye  Throat,  Surgeon  Sharp 
advises  to  extract  it  yt  way  because  ex- 
perience has  taught,  it  is  more  easy  to  be 
Separated,  wn  pulled  yt  Way. 

Operation  on  the  Polypus.  Let  ye  Pa- 
tient lie  Supine  2  or  3  hours  to  bring  it  fur- 


9^  Annals  of  Medical  History 

ther  down  before  ye  Operation.  Extract  it  used  for  some  Years  wt  amazing  Success 

by  a  Pair  of  Forceps,  yt  will  take  a  good  &  instances.  Also  take  a  Tea  Cup  of  honey 

hold,  introduc'd  into  ye  Nostrils  an  inch  &  &  as  much  Good  Vinegar  &  12  of  boiling 

half,  to  make  more  sure  of  its  roots.  Then  hot  Sage  or  Alder  or  Rosemary  Tea,  &  let 

twisting  ym  a  little  from  one  Side  to  an-  him  drink  abundantly  till  he  Sweats.  Take 

other,  continue  in  yt  action,  while  vou  pull 

away  very  gradually  ye  Body  of  ye  Poly-                 ?"umb _°.[  Breradu  "  \  !ij 

xr  ■     1         1  x-  Sweat  Oil  or  fresh  Butter gi 

pus.  It  it  breake,  you  must  repeat  ye  hx-  \Y\\\l 
traction  so  long  as  any  remains,  unless  at- 
tended with  a  Violent  Hemorrhage;  wc  An  Onion  beaten,  boil  into  a  Poultis  & 
often  happens  if  ye  Polypus  is  Schirrous.  apply  hot  to  ye  Throat  &  keep  it  hot.  Wn 
But  be  not  Alarm'd  ye  Vessels  presently  ye  inner  Membrane  of  ye  Larynx  is  in- 
collapse.  Dry  Lint,  or  Lint  dipt  in  some  flamed,  ye  Danger  is  greater.  Give  20 
Styptic  will  readily  stop  it.  We  prevent  its  grains  of  Nitre  in  every  hour  in  his  Hydro- 
future  Growth  by  Vitriol  in  Toddy  on  mel  if  he  can  Swallow.  If  a  redness  appear 
Lint  wn  applied.  The  Cauteries  &  Setons  on  ye  Neck  &  Breast,  ye  patient  oft  re- 
of  some  are  very  good.  covers.   Another  sort  of  Quinsy,   &   much 

Psellimus:  —  Is  a  stammering  in  Speech,  more   common,   is   wn   one   of  ye  Tonsils 

or   a    fault   in   pronouncing  some   Letters,  grows  red,  &  swelled,  &  painful,  <x  ye  Pain 

Words,  or  Syllables.  commonly  extends  to  ye  Ear  on  ye  same 

Psellotis:  —  Is  a  Fault  in  Pronunciation,  Side.  In  a  day  or  two  ye  Disease  attacks 

wn  one  Syllable  or  Letter  is  left  out  or  taken  ye  Glands  of  ye  other  Side,  ye  first  disap- 

away.  pearing.  These  must  be  treated  according 

Quinsies  or  Sore  Throat:  See  Angina.  Are  to  ye  Pulse.  And  if  ye  Pulse  be  hard  & 

Various  but  always  mean  a  Sense  of  Pain  in  quick    Phlebotomy    is    necessary,    &    if  ye 

yeThroat  impeding  in  some  Degree  Swallow-  Redness,  Swelling  of  ye  Throat,  &  difficulty 

ing  or  Breathing  or  both. The  first  Division  is  of  Breathing  do  not  abate,  bleed  again;  If 

respectingTumour.  A  Quinsy  wtout  Swelling  ye    Pulse    be    natural    omit    Bleeding;    ye 

is  called  CatarrhusSuffocativus  by  Some.  Wn  Hydromel,  Nitre,  Powder  blown  &  Purges 

there  is  a  Tumour  it  is  again  very  various,  or  Glysters,  (wt  Syrrup  of  Black  Currants 

Aqueous,  Scirrhus,  Inflammatory,  Convul-  called  a  Specific)  and  Nitrous  Decoctions 

sive,  Catarrhus,  Oedmatous,  Purulent,  Can-  &c  are  Sufficient. 

cerous,  &  Gangrenous.  All  these  must  be  N.   If  these  Disorders  are  neglected  too 

treated  differently  according  to  ye  Causes  long,  or  ye  inflammation  is  too  great,  yn 

&  Symptoms.  See  ye  Original  Diseases  In-  Suppuration  ensues,  wc  is  known  if  ye  red 

flamatio,  Oedema,  Cancer,  &c.  Wn  inflam-  Tumour  last  above  3  Days  unabated.  Then 

matory  it  is  called  Cynanche,  ye  Breath  use  emollient  Gargles  perpetually,  wt  Poul- 

much  interupted,  ye  Voice  much  sharpen'd,  tises,  Glysters  <xc.  In  ye  Cynanche  &  some 

ye  Anxiety  considerable  &c.  There  is  great  Quinsies,  to  save  life,  Heister  used  safely 

danger  Indeed  &  Death  sometimes  ensues  to  open  one  or  more  of  ye  Cartilaginous 

in  8  hours  or  less.  Rings,  so  that,  even  that  is  not  dangerous. 

For  Cure:  Bleed  a  large  quantity  imme-  Only  beware  of  ye  Blood  Vessels.  Keep  ye 

diately,  apply  Cupping  Gourds  or  Glasses  Canula  in  'till  ye  inllammation  cease.  To 

around  ye  Neck.  Give  a  good  purge  imme-  know  Wn  stop  ye  orifice  of  ye  Canula  \\  t 

diately.  Immediately  blow  Powder  of  Alum  ye  Finger,  &  if  ye  Patient  can  breathe  easy, 

or  Nitre  on  ye  Palate,  Larynx  &c.  &  repeat  by  ye  Mouth,  take  out  the  Tube,  &  heal 

as  often  as  needful.  It  is  a  Remedy  I  have  up    ye    Wound.    Support    wt    nourishing 


Laryngology  and  Otology  in  Colonial  Times 


97 


Glysters.  Embrocate  wt  Volatile  Liniments. 
Give  Powder  of  Camphor  &  Nitre,  Drink 
Hydromel,  Gruel,  Panada  &c.  (See  Bron- 
chotomy). 

For  ye  Gangrenous  Quinsy  or  putrid 
Sore  Throat  (V.  Gangrena,  Cancer,  Ty- 
phus). Medicines  not  only  Vegetable  Acids, 
but  Fossils  too,  as  Spt.  Sulph.  Nitr.,  Spt. 
Vitriol,  Spt.  Sal  Marine  wt  Honey  of  Red 
Rose  &c.  constringe  ye  Vessels  &  prevent 
ye  too  great  Expansion,  repel  ye  imper- 
vious particles,  in  ye  larger  Trunks  &  cure 
or  prevent  putrid  Gangrines.  Sydenham  & 
Swieten  used  these  as  Gargles. 

The  Ancients  used  Alum,  Flax,  Oris,  & 
Stercora  of  Animals.  The  Farmers  of  Zea- 
land are  fam'd  for  curing  Quinsies  by 
touching  ye  Uvula  often  wt  White  Vitriol, 
Sal.  Ammoniac,  &  Crude  Alom,  to  ye 
great  relief  of  ye  Patient.  At  first  I  puke 
wt  White  Vitriol  gr.  25.  Give  Salts  every 
day.  I  Keep  up  ye  Vis  Vitae.  I  would 
Gargle  wt  Strong  Oose  of  Persimmon  Root 
Bark,  Honey  &  Alom.  I  give  ye  Bark  a 
Teaspoonful  every  2  hours  wt  Spt.  Sal 
Amoniac  3  j  in  each  Dose  in  Wine.  I  give 
Antimonial  Wine  3  j  thrice  a  Day.  I  have 
Mist.  Sal.  Tart.  Guaiacum,  Camphire, 
Nitre  &  Sal  Amoniac  aa  3  j  in  Spt.  Vin. 
3  iij  often  wt  Success.  Poultis  wt  Rue  Jews 
Ears,  Horehound  &  Lees. 

Quinsy  Malignant:  Cynanche  Maligna; 
CuIIen.  History  or  Description;  It  is  Con- 
tagious; Seldom  Sporadic,  i.e.  Endemic. 
Affecting  few  People  in  a  Season.  Com- 
monly Epidemic,  attacks  all  Ages  &  Con- 
stitutions, but  more  commonly  ye  Young 
&  infantile  &  infirm.  It  first  Shews  itself 
in  a  Pyrexia,  Cold  Shiverings,  Sickness, 
Anxiety,  Vomiting,  yn  Stiffness  of  ye  Neck, 
Uneasy  Fauces,  Hoarse  Voice,  ye  internal 
Fauces  of  a  dep  red  &  some  Tumour, 
Deglutition  is  seldom  painful.  White  Ash 
Colour'd  Spots  wc  Spread  &  Unite  in  thick 
Sloughs  over  ye  Fauces;  These  falling  off 
discover  Ulcerations.  A  Coryza  of  thin 
Acrid    &    foetid    Matter    attend;    Infants 


purge  then,  Acrid,  excoriating  Stools.  Pulse 
small,  frequent,  irregular,  worst  in  ye 
Evening.  Great  Debility,  Delirium  &  Coma. 
On  ye  Second  Day,  sometimes  later,  Efflores- 
cences appear  on  ye  Skin,  patches  of  a  red 
colour  first  on  ye  Face,  yn  over  ye  whole 
Skin,  wt  wc  ye  Fingers  are  stiff  and  swell. 
This  usually  continues  4  Days  before  Dis- 
quamation,  but  still  ye  Fever  remains. 
Ulcers  in  ye  Throat  livid  &  black,  breath 
foetid,  Gangrenous  Symptoms,  Fever  pu- 
trid, some  die  on  ye  2d  (?)  Day,  but  more 
on  ye  Seventh;  Purification  Continues 
along  ye  whole  Alimentary  Canal  wt  Diar- 
rhoeas. Large  Swellings  of  ye  Lymphatic 
Glands  of  ye  Neck,  wc  sometimes  suffocate, 
Respiratory  Organs  hurt  too.  Wn  ye  Ulcers 
are  more  mild,  ye  Efflorescence  disqua- 
mates  after  3  or  4  Days.  The  Cure  comes 
by  gentle  Sweats  on  or  before  ye  Seventh 
Sleep  &  Appetite  return  &c. 

Cures:  Avoid  Bleeding  &  Purges.  Attend 
to  Septic  Tendency.  Antiseptic  Gargles,  & 
Injections.  Neutral  Antiseptics  as  Cortex. 
Emetics  both  by  Vomit  &  Nausea.  Wn 
Tumours,  Blisters,  Flux,  Essence,  Throat 
Powder;  Anasarcal  Drink;  Volatiles;  See 
Cancer  Poultises  &c. 

Scarify:  Cup  between  the  Shoulders  & 
repeat  it;  Shun  Antimon.  Purges:  Use  gen- 
tle EmmoIIient  Glysters;  Blister  ye  Shoul- 
ders; Also  round  ye  Throat.  For  ye  putres- 
cent Diathisis  Cortix  &  Serpentaria;  For 
ye  Diarrhoea,  Anodynes  &  Antihysteric 
Mixture.  Throat  Powder;  Our  Anasarcal 
Drinks.  Bathe  Neck  wt  Fucus  &  Rum,  m., 
Haustus  Cardiacus;  Camphor  &  Volatiles. 
Apply  ye  White  of  an  Egg  &  good  Mustard 
&  red  Pepper  to  ye  Pain  of  ye  Throat. 
Pulv.  Antispasmodic.  Antiseptic  Drops  in 
ye  Ears,  also  internally.  Poultises  of  Lees 
&  Rue  from  Ear  to  Ear. 

N.  B.  A  fatal  Epidemic  Cynanche  was 
found  by  Prof.  Monro  &  by  ye  New  York 
Physicians  to  have  a  new  membrane  in  ye 
larynx,  of  wc  ye  only  cure  was  Mercurials 
&c. 


98  Annals  of  Medical  History 

Ranula: — Is  an  Encysted  Tumour  seated  may  arise  from  a  Phlegm  or  Mucous  ac- 

upon  ye  Frenum  of  ye  Tongue,  containing  a  cummulated    &    hardend    adhereing   to   ye 

thick  tobaccous  Matter.  Trachea    &    Bronchia,    like   ye   membrane 

Raucedo: — Hoarseness.  Is  a  rough  &  ob-  discover'd  by  Dr.  Monroe  (&  wc  has  been 

scure  Voice,  wc  cannot  be  heard  unless  by  discovered    here    in    a    putrid    contagious 

those  standing  very  near.  Quinsy,  at  New  York,  many  Years  since) 

Cure:— Swallow  slowly  ye  Juice  of  Horse  difficulty   seperable   from   ye   Larynx.    For 

Rhadish  Root,  Chew  peruvian  Bark  &  Gin-  Cure   I   would   bathe  ye  Throat  often  wt 

ger,  Figs,  Starch,  Liquorice,  Oily  draught,  ye  Saponacious    Balsam.   Put  his  Feet  in 

Balsamics  &c.   Lohoch   Pectorale;  hot   Water;   if  plethoric,    bleed.    Puke   wt 

R  Antimonial   Wine.   Mix   a   little  Camphire 

Sperm.  Citi.  &  White  Soap aa  3  ij  m  Sweat  Oil  and   add   Honey,   wt  a   few 

The  Yolk  of  an  Egg,  01.  Lin 5  iss  Drops  of  wc  moisten  ye  Throat,  removes 

Syr.  Althae 5  iii  ye  Mucous   Membrane   and   removing   ye 

M.S.  Lohoch;   rub  ye  Soles  of  ye  Feet  wt  Hogs  Spasm  wt  Lobb's  Tincture,  or  a  Grain  of 

Lard  before  ye  Fire.     See  Peetoralis.  0pium>    carefuIIy    dissoIved    in    Soot    Tea 

Rencbus: — Is  a  Sound  uttered  thro'  ye  3  viij   by  Spoonfuls    till    better.    I    would 

Nose.  See  Stertor.  recommend  Onion  Tea,  Saline  Glysters,  & 

Rhenophonia:  —  A     Speaking     thro'     ye  a   Plaster  of  Turpentine  &  Camphor    be- 

Nose.  Is  a  nasal  Voice  wc  is  not  altogether  tween  ye  Shoulders, 
uttered  from  ye  Nostrils.  Thrush: — See  Aphthae,  Purge  wt  Rhu- 

Rbachmos:  —  Is  a  sterterous  Sound  wtin  barb.  Glyster  2  a  day,  wash  ye  Mouth  often 

ye  Fauces.  See  Stertor.  wt  Strong  Tea  of  Sage,  Hysop  &  Alder  wt 

Screatus: — Is    Sonorous    Evacuation    of  honey  &  Alom  mixt.  Melasses  wt  Juice  of 

Mucus  from  ye  Fauces.  Horse  Radish  Root  is  good. 

Sternutatio : — Sneezing.   Is  a  Convulsive  Tooth  Ache: — See  Odontalgia:  Blow  To- 

Agitation  of  ye  Membranes  of  ye  Nose  wt  bacco  Smoke  in  ye  Ear  of  ye  affected  Side 

an  impetous  Inspiration  of  Air,  &  presently  &  put  Oil  of  White  Oak  in  ye  Tooth  made 

making  ye  like  Expulsion  thro'  ye  Nostrils  by  burning  ye  twigs  on  a  Cold  Ax,  or  Pewter 

wt  a  Sound.  dish. 

Suffocatio: —   Is    a    Suppression    of    the  Tortura: — Is  a  bending  of  ye  Mouth  to 

Breathing  or  Respiration,  from  a  continued  one  Side. 

contraction,  or  narrowness  of  ye  Fauces  or  Traulotis:  —  Is  a  vitious  Pronouncingofye 

Trachea,   wtout   a   Fever;   a   Symptom   of  Letters  S  &  R  (See  Blaesitos). 
Asthmas,    Hysterics,   Some  Quinsies.   Also  Chinese    Cure: — H.     Pomegranate   Rind 

See  Dyspnoea,  Orthopnoea,  Ephialtes  &c,  wt   Pepper   four   Seeds   beat   &   apply   as 

&c.  Snuff.  But  if  from  Cold  Blood,  ye  Smell  to 

Suffocatio  Stridula :  —  A  Disorder  in  Chil-  a  Composition  of  Sal.  Ammoniac  &  Lime 
dren  called  here<x  in  Ireland  ye  Hives,  in  Scot-  Water  tied  up  in  a  Rag.  If  from  atrophy, 
land  ye  Croup,  &  in  some  Places  Chock  or  ye  drink  Wine  wt  some  Frankincense  in- 
Stuffing.  In  England  ye  rising  of  ye  Light  (See  fused  in  it  &c.  Vomit,  Cold  Baths,  Snuff 
ye  Pennsylvania  Journal  No.  1410).  It  seems  ye  Dew  from  Mallows  Leaves.  Drink  a 
to  be  a  Species  of  Asthma  attended  wt  very  Decoction  of  Primrose.  Wash  ye  I  had  wt 
Violent  Symptoms. The  Infants  arc  seized  wt  a  Decoction  of  Sage,  Mustard  Seed  gr.  30 
a  Sudden  &  great  Difficulty  of  Breathing,  wc  every  Morning. 

is  soon  Mortal  unless  relieved.  It  seems  to  be  Vocijeratio: — Is  a  painful  c\  exalted   Ex- 
Nervous   &   Spasmodic.    It   is  probable  yt  clamation  of  ye  Voice,  to  harden  ye  Body. 


Laryngology  and  Otology  in  Colonial  Times 


99 


Uvula- Relaxed: — Blow  in  Alom,  Nitre 
&c.  Infusion  of  Mustard  Seed.  Decoction 
of  Water  Dock. 


Relatively  little  space  is  devoted  to  aural 
conditions.  This  is  not  surprising  when  we 
stop  to  realize  that  real  interest  in  otology 
received  its  first  great  stimulus  only  about 
the  middle  of  the  last  century  through  the 
work  of  Wilde,  Kramer  and  others.  An  in- 
teresting side  light  may  be  found  in  the 
article  on  Otitis.  The  rules  of  Dr.  Graham 
are  given  and  commented  upon  with  an 
underlying  spirit  of  combativeness  and 
antagonism.  James  Graham  was  perhaps 
one  of  the  earliest  ear  quacks,  in  the  true 
sense  of  the  word,  in  America.  He  flour- 
ished in  Philadelphia  about  1773.  Bass5 
gives  the  following  notice  copied  from  the 
Neiv  York  Gazette;  and  the  Weekly  Mer- 
cury, July  19,  1773:  "Doctor  Graham, 
Oculist  and  Aurist,  is  arrived  in  this  City, 
from  Philadelphia,  and  may  be  consulted 
at  his  apartments  at  Capt.  Fenton's  op- 
posite Trinity  Church,  in  the  disorders  of 
the  Eye  and  its  appendages;  and  in  every 
species  of  deafness,  hardness  of  hearing, 
ulcerations,  noise  in  the  Ears,  etc.  Persons 
born  Deaf  and  Dumb,  and  those  labour- 
ing under  any  impediment  in  their  Speech, 
by  applying  personally,  will  probably  be 
assisted.  The  Doctor  intends  to  sail  for 
England  in  a  few  months;  those,  there- 
fore, who  have  occasion  for  assistance, 
must  apply  immediately." — His  London 
career,  with  his  Temple  of  Health,  Celes- 
tial Bed  and  Elixir  of  Life,  makes  an  inter- 
esting tale  but  like  many  other  famous 
quacks  his  end  was  obscure.  B 

Otitis,  The  Ear-ach  is,  an  inflamma- 
tion of  ye  Ear.  Otites,  Diseases  of  ye  Ear 
are  internally  &  externally,  especially  ye 
former  attended  wt  very  Severe  Pain, 
Head-ach  &  Alienations  of  Mind  (See  De- 
lirium) a  Loss  of  Sleep,  &  sometimes  Con- 
vulsions &c.  See  Odontalgia.   It  occasions 


great  Restlessness  &  Anxiety,  Pain,  Red- 
ness, Heat  &  Fever,  like  other  Inflamma- 
tions (wc  see)  proceading  from  Suppres- 
sion of  Perspiration,  exposing  ye  Head,  to 
cold  Water  or  Air  wn  Sweating.  Cure  in 
this  case  must  be  by  Bleeding  ye  Arm  or 
Jugulars,  Cupping  the  Neck,  giving  Anti- 
monial  Wine  &  Hydromel,  Powder  of  Cam- 
phor &  Nitres.  Fomenting  the  Ear  wt  ye 
Steams  of  Warm  Water  Or  applying  ye 
Ear  to  a  Jug  filled  wt  a  Decoction  of  Cedar 
Tops  or  Camomel  &c. — Bathing  ye  Feet 
in  Warm  Water — And  all  around  ye  Ear 
wt  Volatile  Liniment  &c.  &c.  If  it  cannot 
be  dispersed  yn  it  will  be  best  Suppurated 
by  Juice  of  roasted  Onions  &  a  drop  of  Sweet 
Oil  often  applied  in  ye  Ear. — If  it  break  & 
run  white  &  laudable  Pus,  wash  it  a  little 
wn  needful  wt  Honey  &  Rum,  &  dress  wt. 
Onion  Juice  &  Honey  mixt  till  well. 

2.  A  Defluxion  of  an  Acrimoneous  hu- 
mour, this  has  not  ye  great  heat,  burning 
&  pulsation,  but  is  painful  from  Irritation. 
See  Opium.  Blow  tobacco  Smoke  thro  an 
inverted  Pipe  into  ye  Ear  wc  eases  ye  Pain. 
Then  gently  Syringe,  wt  a  Decoction  of 
wild  Cherry  Bark. — Mix  Camphire  in  Sweat 
Oil  &  drop  into  it  daily — or  Syringe  wt 
Warm  Wine  or  drop  Rosemary  &  Sage 
Juice  in  ye  Ear  often — Drink  Barks  *.V 
Guiacum  in  Decoction. 

3.  Ear  Ach  from  Worms,  Wn  there  is 
felt  a  sharp  shooting  Pain,  a  gnawing,  & 
horrible  Noise  in  ye  Head,  as  wn  a  Flea 
or  any  insect,  has  made  its  Way  to  ye  Drum 
of  ye  Ear. — In  this  Case  a  Drop  in  ye  Ear 
of  Sweat  Oil,  or  Brandy,  or  Juice  of  Worm- 
wood, or  even  Warm  Milk  quickly  destroys, 
or  dislodges  ye  Insect,  wn  it  will  come  out 
on  ye  Cotten,  or  be  cautiously  extracted. 

4.  Ear  Ach  from  Morbific  Matter  trans- 
lated, as  in  ye  Decline  of  Malignant  Fevers 
&  generally  a  favourable  symptom,  tho'  it 
may  cause  Deafness.  This  may  be  eased 
by  ye  smoak  of  Tobacco,  Camphorated 
Oil  &  Onion  Juice. 

5.  Tinnitus  Aurium,  a  tingling  Noise  in 


100 


Annals  of  Medical  History 


in  the  Ears,  often  attends  Nervous  &  Malig- 
nant Fevers  &  is  also  frequently  a  chronic 
Disorder,  &  very  troublesome,  &  often  end- 
ing in  e(n)tire  Deafness,  wc  is  seldom 
cured,  &  if  relieved  a  while  is  apt  to  return 
again.  See  Phrenismus. 

6.  Deafness  and  Thickness  of  Hearing 
differ  only  in  degrees.  Sounds  unless  very 
loud  make  little  impressions  on  them. 
This  distressing  Mallidy  is  seldom  cured, 
because  ye  fine  Organs  of  Hearing  cannot 
be  seen,  nor  their  Disorders  well  ascer- 
tain'd,  in  living  subjects  &  ye  dead  have 
no  use  for  it.  It  is  however  sometimes  oc- 
casioned by  hard  Wax  in  the  Meatus 
Auditorius,  Si.  other  pituitous  Matter.  This 
may  be  relieved  by  gently  syringing  the 
Ears  with  Warm  Water. 

If  ye  Tympanum  &c  be  too  tight  Sweat 
Oil  &  Camphor,  or  Onion  Juice  in  ye  Ears 
on  Cotten  will  have  a  good  Effect,  as  I 
have  often  found.  But  if  it  be  too  lax  & 
debilitated,  washing  ye  Ear  with  strong 
Decoction  of  Wild  Cherry  Tree  Bark,  or 
black  Alder  Bark,  or  Wine  wt  sage  &  Rose- 
mary stewed  in  it,  may  do  good.  Steams 
of  Rue,  Rosemary  &.  Garlic,  thro'  a  Funnel 
may  be  safely  tried.  Many  have  tried  ye 
Fumes  of  Amber  &  Olibanum,  &  Spirit  Sal 
Ammoniac,  but  it  should  be  wt  Caution. 
Some  have  applied  Musk,  Amber  &  Civit 
in  a  Dossil  of  lint  in  ye  Ears,  wc  seems 
rational  to  affect  the  sluggish  Nerves — 
Some  use  Galls  of  Eels  &  Partridges  &  even 
Fumes  of  Sulphur,  But  the(se)  appear  to 
me  improbable  &  dangerous. — Some  com- 
mend ye  Eggs  of  Ants  in  Onion  Juice  as 
almost  infallible,  but  I  have  never  ven- 
tured it.  Some  try  Salivation  by  Mercurial 
Unction  as  the  last  probable  Remedy. 

Dr.  Graham  ye  Otistis  Rules  by  wc  He 
pretended  to  cure  inveterate  Deafness  were 
these  (i)  Bleed  the  Jugular  I  xiij  every  10 
Days  for  three  times. — (2)  Three  Emetic 
Boluses  given  one  ye  Day  after  each  Bleed- 
ing.— (3)  A  Mixture  Night  &  Morning 
(perhaps  Tinctura  Sacra  &  Amara  mixt) 


drinking  Sage,  Sasafras  &  Fennel  Seeds 
Tea. — (4)  His  Accoustic  Essence  is  each 
Ear  &  yn  wt  Force  s(n)uffing  it  up  ye  Nos- 
trils as  long. — But  Juice  of  Ground  ivy, 
Rue,  Rosemary  &  Garlic  3  ii  in  hot  Tar 
Water  would  be  perhaps  better. 

(5)  Then  his  Caephalic  snuff  wc  was  no 
better  yn  Powder  of  ye  Bark  of  Myrtle 
Root,  or  white  Hellbore  &  Ginger,  was 
often  to  be  taken,  yt  ye  must  sneeze,  keep- 
ing ye  mouth  shut,  &  ye  Nostrils  pressed 
together. — 

(6)  His  Etherial  Essence  (not  so  good  as 
camphorated  Spirits)  were  applied  to  ye 
Ears  &  volatiles  to  ye  nose  for  5  minutes. 

(7)  His  warm  Drops  for  Deafness  (per- 
haps Sweat  Oil  camphorated)  5  or  6  on 
Lint  in  each  Ear. 

(8)  Pen(e)trating  Spirits  3  i  (Juice  of 
Horse  Rhadish  Root  is  better)  on  ye  Tongue 
applied  to  ye  Palate  &  keeping  ye  Mouth 
shut  long  after. 

(9)  All  these  were  done  at  night  &  re- 
peated next  morning,  three  times  ye  first 
Week  &  only  twice  a  Week  after. 

(10)  Twice  a  Week  ye  Legs  &  Feet  were 
beathed  wt  warm  Water.  Semicupia  of 
Decoction  of  Cedar  Tops  had  been  better. 

(11)  He  embrocated  the  Head  some- 
times wt  perhaps  ye  Volatile  Liniment. — 
This  was  a  Prescription  for  one  born  Deaf 
but  by  some  mischance  did  not  fully  suc- 
ceed tho'  it  made  a  considerable  change. 
N.B.  I  once  knew  a  Deafness  cured  by  put- 
ting on  Cotton  some  drops  of  a  hot  Pickle 
of  Allom  Salt  applying  it  in  ye  Ear  often. 

Auditus: — See  Cophosis  &  Surditas,  & 
the  Theory  under  Otalgia. 

Copbosis: — A  difficulty  or  Impotency  of 
hearing  or  perceiving  Sounds  from  some 
Impediment  wtin  or  wtout  the  Labirinth 
of  ye  Ear.  See  Surditas.  Try  Camphorated 
Oil,  Juice  of  Sage  &c.  Electricity  has  suc- 
ceeded in  Nervous  Cases.  Bleeding  or 
Blistering  in  inflammatory.  If  Ulcers  in- 
ject Tinct.  of  Myrrh  &  Honey.  Insects, 
remove  by  Oil. 


Laryngology  and  Otology  in  Colonial  Times 


ioi 


Buzzing  in  Ears:  See  Otalgia  &  Tinnitus 
Aurium. 

Dullness  of  Hearing:   See   Cophosis. 

Ears  pain'd ;  See  Otalgia,  Surditas,  Vermes. 

Epiphlogisma: — Heat  of  some  part,  as  if 
made  by  a  burning  Coal,  attended  wt  pain. 
If  in  the  Ear  it  is  called  Pyrosis. 

Giddiness:  See  Vertigo. 

Hearing  (Dullness  of) :  See  Cophosis. 

Hearing  (Diseases  of) :  See  Otitis. 

Nystagmus:  is  an  involuntary  Spasm  of 
ye  Eye  or  Lid. 

Otophlatos:  An  Excretion  of  an  ill-scent- 
ed  Humidity  from  behind  ye  Ears.  This 
was  one  Year  in  Sussex,  endemic  &  fatal 
among  many  Children,  who  had  Agues 
&  Fevers  before.  The  Agues  ceasing 
ye  Children  were  swelled,  bloated,  Oede- 
matious,  &  their  Faces  Cadaverous.  Sores 
came  behind  ye  Ears  &  several  turn'd  to 
Cancer  &  Gangrenes.  At  length  we  suc- 
ceeded in  curing  it  in  ye  same  manner.  See 
Cancer. 

Otopuosis: — Is  an  Efflux  of  Pus  from  ye 
Ear,  or  a  sordid  Catarrh  of  ye  Ear.  See 
Otalgia. 

Otorrhea:  Is  an  Efflux  of  Blood  from  ye 
Ear.  See  Otalgia  &  Haemmorrhagia. 

Paracusis: — Is  a  difficulty  of  hearing 
articulated  Voices,  no  Words  distinctly. 
See  Cophosis,  Otalgia. 

Surditas: — Surdity  or  Deafness:  Is  an 
abolished  Hearing  (See  a  Treatise  under 
Otalgia).  Drop  a  Strong  infusion  of  Allom 


Salt  in  ye  Ear.  Camphor  dissolved  in  Sweat 
Oil.  Some  drop  Juice  of  Ground  Ivy. 

Susurrus:  Is  ye  perception  of  Sound 
not  existing  or  a  buzzing  in  the  Ear  &  Dis- 
order in  ye  Sensation  of  hearing.  See 
Otalgia. 

Tinnitus  Aurium: — Tingling  of  ye  Ears. 
See  Otalgia.  Put  a  clove  of  garlick  dipt  in 
Honey  in  ye  Ear,  alternately  8  or  10  nights. 

Vertigo: — Is  an  Imagination  in  wc  all 
things  appear  to  a  man  to  be  turned  wt 
himself.  See  Epilopsia. 

Chinese  Cure.  B.  Pomegranate  Rind  wt 
Pepper,  four  Seeds,  beat  &  apply  as  Snuff. 
But  if  from  Cold  Blood,  ye  Smell  to  a 
Compositon  of  Sal  Ammoniac  &  Lime 
Water  tied  up  in  a  Rag.  If  from  atrophy, 
ye  drink  Wine  wt  some  Frankincense  in- 
fused in  it  &c.  Vomit,  Cold  Baths,  Snuff 
ye  Dew  from  Mallows  Leaves.  Drink  a 
decoction  of  Primrose.  Wash  ye  Head  wt 
a  Decoction  of  Sage.  Mustard  Seed  gr.  30 
every  Morning. 


bibliography. 

1.  Packard:     The    History    of   Medicine    in    the 
United  States,  page  161. 

2.  Thacher:  American  Medical  Biography. 

3.  Jonathan  Wright:    History  of  Laryngology. 

4.  Elsberg:     Laryngology    in    America.      Trans. 
Am.  Lar.  Assn.    Vol.  I. 

5.  Bass-Henderson:    History  of  Medicine,  p.  824. 

6.  Foster:    Famous  Quacks,  Medical   Pickwick, 
Dec.  1916. 


EDITORIAL 


It  hardly  seems  necessary  to  write  a 
formal  introductory  note  to  a  publication 
such  as  that  of  which  the  first  number 
now  appears.  After  much  preliminary  labor 
and  discussion  of  plans,  a  number  of 
those  who  are  interested  in  the  furtherance 
of  the  study  of  medical  history  in  this 
country  decided  that  the  time  was  ripe  for 
the  undertaking.  There  is  at  present  no 
periodical  published  in  the  English  language 
devoted  exclusively  to  medical  historical 
literature,  although  at  no  time  has  more 
interest  and  assiduity  been  displayed  in 
such  studies.  It  is  believed  that  the  Annals 
will  justify  the  expectations  of  those  who 
have  endeavored  to  put  it  forth.  No  effort 
will  be  spared  to  maintain  it  on  the  highest 
plane.  It  is  hoped  that  it  will  furnish  the 
medium  of  publication  for  the  transactions 
of  many  of  the  societies  which  have  been 
so  active  in  recent  years  in  historical  work 


in  medicine,  and  that  the  material  from 
those  sources  which  has  been  heretofore 
scattered  throughout  various  medical  publi- 
cations may  thus  be  presented  in  a  more 
suitable  form.  New  books  on  the  history  of 
medicine  will  be  reviewed,  and  a  department 
oj  notes  and  queries  will  be  established 
which  should  prove  of  great  use.  It  remains 
to  be  seen  whether  the  demands  for  the 
journal  will  be  such  as  to  justify  its  exist- 
ence. It  is  hoped  that  those  interested  in 
the  study  of  medical  history  in  their  country 
will  realize  the  advantages  offered  by  such 
a  publication  and  give  their  active  support 
to  the  Annals  by  contributing  to  its  columns 
and  by  swelling  the  list  of  its  subscribers. 
It  will  be  noticed  that  no  advertisements 
are  published.  This  materially  lessens  the 
income  from  the  publication  but  enhances 
its  dignity.  Let  us  add, —  it  also  increases 
the  necessity  for  a  large  subscription  list. 


THE  LEGEND  OF  THE  MANDRAGORA 


Mandragora  ojjicinarum  or  mandrake, 
belongs  to  the  order  of  Solanacea,  and  is 
one  of  the  potato  family.  Its  forked  root 
is  very  thick  and  fleshy.  By  the  ancients 
it  was  much  used  as  a  narcotic,  especially 
during  surgical  operations.  Its  forked  root, 
which  somewhat  resembles  the  forking  of 
human  legs,  caused  it  to  be  esteemed, 
according  to  the  doctrines  of  signatures,  as 
an  aphrodisiac,  and  it  was  one  of  the 
commonest  ingredients  of  love  philters.  It 
was    believed    to    utter   shrieks    and    cries 


when  pulled  from  the  earth,  and  that  those 
who  heard  these  cries  were  rendered  insane. 
This  is  alluded  to  by  Shakespeare  when 
Juliet,  pausing  ere  she  drinks  the  sleeping 
potion  in  contemplation  of  the  horrors  of 
the  vault,  says: 

Juliet  What  with  loathsome  smells 

And   shrieks   like    manrakes   torn   out 

of  the  earth, 

That  living  mortals  hearing  them  run 

mad. 

Romeo  and  Juliet,  Act  IV,  Sc.  3. 


102 


The  Legend  of  the  Mandragora 


103 


Furness1  gives  several  instances  in  refer- 
ence to  this  belief.  "In  Webster's  'Duchess 
of  Malfy,'  1623:  'I  have  this  night  dug  up 
a  mandrake,  and  am  grown  mad  with  it.' 
Again,  in  the  'Atheist's  Tragedy,'  161 1: 
'The  cries  of  mandrakes  never  touch'd  the 
ear  With  more  sad  horror.'  In  'A  Christian 
Turns  Turk,'  161 1:  'I'll  rather  give  an  ear 
to  the  black  shrieks  of  Mandrakes.'  In 
'Aristippus  or  the  Jovial  Philosopher': 
'This  is  the  mandrake's  voice  that  undoes 
me. 

In  order  to  avoid  the  danger  of  hearing 
its  cries  it  was  advised  that  to  extract  it 
from  the  earth,  a  string  should  be  attached 
to  the  plant,  and  the  other  end  tied  to  a 
dog.  The  latter  was  then  made  to  run, 
dragging  the  plant  up  by  its  roots. 

Furness  gives  the  following  quotation 
from  BuIIeine's  "  Bulwark  of  Defence  against 
Sickness,"  1575: 

"Therefore  they  did  tye  some  dogge  or 
other  Iyving  beast  unto  the  roote  thereof 
wyth  a  corde,  and  digged  the  earth  in 
compasse  round  about,  and  in  the  mean 
tyme  stopped  their  own  ears  for  fear  of  the 
terrible  shriek  and  cry  of  the  Mandrack. 
In  whych  cry  it  doth  not  only  dye  itselfe, 
but  the  feare  thereof  kylleth  the  dogge  or 
beast  which  pulleth  it  out  of  the  earth." 

J.  F.  Payne2  has  given  a  most  interesting 
resume  of  the  Herbarium  Apuleii  Platonici, 
as  translated  into  Anglo-Saxon  in  the 
eleventh  or  twelfth  century.  The  Latin 
work  of  Apuleius  (not  the  same  as  Apuleius 
who  wrote  the  "Golden  Ass"),  was  written 
about  the  fifth  century,  some  think  in 
Africa.  It  was  evidently  one  of  the  "Leech- 
doms"  or  medieval  textbooks  most  revered 
amongst  the  Anglo-Saxons  and  to  it  is 
probably  largely  due  the  popular  dissemin- 
ation of  the  fallacies  about  the  mandragora 

1  Variorum  Edition,  "  Romeo  and  Juliet." 

2  The  Fitz-Patrick  Lectures  for  1903,  "English 
Medicine  in  Anglo-Saxon  Times,"  Oxford,  1904. 

3  It  is  evident  that  the  Anglo-Saxon  translation 
was  an  error,  since  the  herb  was  not  to  be  touched 


in  the  minds  of  the  English  people.  The  fol- 
lowing is  the  description  of  the  mandrake 
in  the  Anglo-Saxon  version: 

Mandragora  (Mandrake.  Atropa  Man- 
dragora). 

'  1 .  This  wort,  which  is  named  tia.vbpaybpa.%, 
is  great  and  illustrious  of  aspect,  and  it 
is  beneficial.  Thou  shalt  in  this  manner  take 
it.  When  thou  comest  to  it,  then  thou  shalt 
recognize  it  by  this,  that  it  shineth  at  night 
altogether  like  a  lamp.  When  first  thou 
seest  its  head,  then  inscribe  (Latin  text 
surround)3  thou  instantly  with  iron,  lest  it 
flee  from  thee;  its  virtue  is  so  great  and  so 
famous  that  it  will  immediately  flee  from 
an  unclean  man  when  he  cometh  to  it, 
hence,  as  we  said  before,  do  thou  "inscribe" 
it  with  iron;  and  thou  shalt  delve  about  it 
so  that  thou  touch  it  not  with  the  iron,  but 
thou  shalt  earnestly  with  an  ivory  staff 
delve  the  earth.  And  when  thou  seest  its 
hands  and  feet,  then  tie  thou  it  up.  Then 
take  the  other  end  and  tie  it  to  a  dog's 
neck,  so  that  the  hound  be  hungry;  next 
cast  meat  before  him  so  that  he  may  not 
reach  it,  except  he  jerk  up  the  wort  with 
him.  Of  this  wort  it  is  said  that  it  hath  so 
great  might,  that  whatsoever  thing  diggeth 
it  up  shall  soon  in  the  same  manner  be 
deceived,  i.e.  shall  fall  down  dead.4  There- 
fore as  soon  as  thou  see  that  it  be  jerked 
up,  and  have  possession  of  it,  and  wring 
the  juice  out  of  its  leaves  into  a  glass 
ampulla  (or  pitcher),  and  when  need  come 
upon  thee  that  thou  shouldst  therewith 
help  any  man,  then  help  thou  him  in  this 
manner. 

2.  For  headache,  and  in  case  that  a  man 
may  not  sleep,  take  the  juice,  smear  the 
forehead;  and  the  wort  also  in  the  same  man- 
ner relieveth  the  headache;  and  also  thou 
wonderest  how  quickly  the  sleep  cometh. 
4.  For  podagra,  though  it  be  very  severe, 

with  iron.  The  Latin  word  is  circumducere,  meaning 
to  make  a  line  around  or  outside  it  with  iron. 

4  In  the  Latin  text   the  word   decipere,  which  is 
evidently  a  mistake  for  decidere — fall  down  dead,  die. 


104 


Annals  of  Medical  History 


take  of  the  right  hand  of  this  wort  and  also 
of  the  left,  of  either  hand  by  three  pennies' 
weight;  reduce  to  dust;  give  to  drink  in 
wine  for  seven  days;  (the  patient)  will  be 
healed,  not  only  so  that  the  swelling  is 
allayed,  but  it  also  healeth  the  tugging  of 
the  sinews  and  wonderfully  healeth  both 
the  evils. 

5.  For  witlessness,  that  is,  for  devil- 
sickness  (demoniacal  possession),  take  from 
the  body  of  the  same  wort  mandragora  by 
weight  of  three  pennies,  administer  to  drink 
in  warm  water,  as  he  may  find  convenient; 
soon  he  will  be  healed. 

7.  If  any  one  see  some  grave  mischief  in 
his  house,  let  him  take  this  wort  mandra- 
gora, as  much  as  he  may  then  have,  into 
the  middle  of  the  house;  he  banisheth  all 
evils  out  of  his  house.5 

Payne  states  that  the  Latin  edition  con- 
tains the  following  statements  as  to  its  anaes- 
thetic properties  which  is  omitted  in  the 
Anglo-Saxon  version: 

"  If  any  one  has  to  have  a  limb  amputated, 
or  burnt,  or  cut,  let  him  drink  an  ounce  and 
a  half  in  wine,  and  he  will  sleep  so  long  that 
the  limb  may  be  cut  off  without  pain  or 
feeling." 

This  direction  is  contained  in  the  Latin 
edition  printed  by  Philip  de  Lignamine 
about  1840,  and  Payne  thinks  it  is  perhaps 
the  earliest  notice  in  a  Latin  book  of  surgical 
anaesthesia,  though  the  original  observation 
came  from  Dioscorides. 

Payne  adds  that  John  de  Vigo  speaks  of 
its  use  for  this  purpose  but  says  it  is  not 
without  great  danger.  Dr.  Payne's  book 
contains  a  number  of  illustrations  from  the 
manuscript  copies  of  Apuleins  showing  the 
method  of  pulling  up  the  mandrake  by 
attaching  a  dog  to  it  by  a  string. 

In  his  notes  on  Othello,  Furness  gives 
from  Staunton  the  following  quotation  from 
Holland's  "Pliny,"  Book  XXV,  chapter  13, 
"This    herbe    Mandragoras,   some   writers 

6  This  doubtless  refers  to  evil  spirits.  A.-S.L.  i. 
1245. 


call  Circeium,  and  two  kinds  there  be  of  it, 
the  white  which  is  supposed  the  male;  and 
the  black  which  you  must  take  for  the 
female.  ...  It  may  be  used  safely  enough 
for  to  procure  sleep,  if  there  be  good  regard 
had  in  the  dose.  .  .  .  Also  it  is  an  ordinarie 
thing  to  drink  it  .  .  .  before  the  cutting  or 
cauterizing,  pricking  or  lancing  of  any 
member  to  take  away  the  sence  and  feeling 
of  such  extreme  cures.  And  sufficient  it  is 
in  some  bodies  to  cast  them  into  a  sleep 
with  the  smel  of  Mandrage,  against  the 
time  of  such  Chirurgery." 

Gerard  in  his  "Herbal"  (1597)  describes 
the  mandrake  as  occurring  in  two  distinct 
species,  the  male  and  female,  in  which 
mistake  he  probably  followed  Dioscorides. 

Furness  in  his  "Romeo  and  Juliet"  gives 
from  Halliwell  the  following  quotation  from 
the  Works  of  Sir  Thomas  More,  1557: 

"Whereas  the  Latine  text  hath  here 
somnia  speculantes  Mandragore,  I  have  trans- 
lated it  in  Englishe,  our  minds  all  occupied 
wyth  mad  fantasticall  dreames,  because 
Mandragora  is  an  herbe,  as  physicions  saye, 
that  causeth  folke  to  slepe,  and  therein  to 
have  many  mad  fantasticall  dreames." 

Shakespeare  refers  to  the  groans  of  the 
mandragora  in  the  second  part  of  "Henry 
VI"  when  the  Queen  is  talking  to  Suffolk. 
Suffolk.  "Would  curses  kill,  as  doth 

the    mandrake's    groan." — Henry    VI, 

part  II,  Act  III,  Sc.  2. 

The  term  mandrake  was  often  applied  in 
contempt  of  the  physical  appearance  of  a 
man.  Thus  Falstaff  alluding  to  the  diminu- 
tive stature  of  his  page  says, — 

"Thou    whoreson    mandrake,    thou 

are  fitter  to  be  worn  in  my  cap  than  to 

wait  at  my  heels."  —  Henry  IV,  Part 

II,  Act  I,  Sc.  2,  17. 

In  allusion    to   the   vicious   propensities 
engendered  by  it  and  also  having  reference 
to   the   appearance   of   the    root,    Falstaff, 
speaking  of  Justice  Shallow  says: 

"When  a'  was  naked,  he  was  for  all 

the  world,  like  a  forked  radish,  with  a 


The  Legend  of  the  Mandragora 


105 


head  fantastically  carved  upon  it  with 
a  knife:  a'  was  a  forlorn,  that  his  di- 
mensions to  any  thick  sight  were  in- 
visible: a'  was  the  very  genius  of 
famine;  yet  lecherous  as  a  monkey, 
and  the  whores  called  him  mandrake." 
—Henry  IV,   Part   II,  Act  III,   Sc.  2, 

333- 

Bucknill6  directs  attention  to  the  fact 
that  Shakespeare  refers  to  the  herb  six 
times  and  that  on  the  two  occasions  when 
its  real  medicinal  properties  are  the  occasion 
of  its  mention,  the  Latin  term  mandragora 
is  used;  the  vulgar  appellative,  mandrake, 
being  employed  on  the  occasions  where  the 
vulgar  superstitions  are  alluded  to. 

The  use  of  mandragora  as  a  somnifacient 
is  referred  to  twice  by  Shakespeare. 

In  "Anthony  and  Cleopatra,"  the  Queen 
bemoans  the  absence  of  Anthony. 

Cleopatra.  Charmian. 

Charmian.  Madam. 

Cleopatra.  Ha,  ha!  give  me  to  drink 
Mandragora. 

Charmian.  Why,  Madam? 

Cleopatra.  That  I  might  sleep  out 
this  great  gap  of  time.  My  Anthony  is 
away. — Anthony  and  Cleopatra,  Act  I, 
Scene  5. 

In  "Othello"  when  Iago  is  hatching  his  foul 
plot  we  find  the  other  reference,  and  with 
it  an  allusion  to  poppy  (or  opium)  for  the 
same  purpose. 

Iago.  Look  where  he  comes.  Not  poppy 
nor  mandragora, 
Nor  all  the  drowsy  syrups  of  the 
world 

6  "The  Medical  Knowledge  of  Shakespeare,"  page 
218. 


Shall  ever  medicine  thee  to  that 

sweet  sleep 
Which  thou  owd'st  yesterday. 
Othello,  Act  III,  Scene  3. 
When  Archidamus  is  telling  Camilla  of 
the  welcome  that  the  Count  of  Bohemia 
will  extend  to  that  of  Sicily  when  it  shall 
pay  its  promised  visit,  he  tells  him  that  the 
Bohemians  can  hope  to  vie  with  the  mag- 
nificence   of  the  entertainment  which  the 
Sicilians  have  given  them,  but,  he  adds: 

"We  will  give  you  sleepy  drinks, 
that  your  senses,  unintelligent  of  our 
insufiicience,  may,  though  they  cannot 
praise  us,  as  little  accuse  us." — The 
Winter's  Tale,  Act  I,  Scene  2. 

Sir  Thomas  Browne7  says  that  the  idea 
that  the  root  of  the  mandragora  resembles 
a  man  "is  a  conceit  not  to  be  made  out  by 
ordinary  inspection,  or  any  other  eyes,  than 
such  as,  regarding  the  clouds,  behold  them 
in  shapes  conformable  to  pre-apprehen- 
sions."  He  states  subsequently  the  opinion 
universally  held  at  his  time  that  there  is 
really  no  distinction  of  sex  in  the  vegetable 
world,  consequently  there  could  not  be  a 
male  and  female  mandragora  plant.  As 
Wilkins  points  out  in  a  note,  the  sexual 
differences  in  plants  were  not  clearly  defined, 
though  suspected  by  Ray  and  others,  until 
Linnaeus  published  his  "Fundamenta  et 
Philosophia  Botanica"  in  1732,  in  which 
he  clearly  explained  the  difference  in 
function  of  the  stamens  and  pistils.  He 
disregards  altogether  the  traditional  state- 
ments that  the  mandragora  grew  under 
gallows  and  places  of  execution,  being  there 
generated  from  drippings  of  fat  and  blood 
from  the  dead,  and  that  it  gave  vent  to  a 
shriek  when  pulled  from  the  earth. 

7  " Pseudodoxia  Epidemica,"  Book  II,  Chapter  VI. 


BOOK   REVIEWS 


The  Cures  of  the  Diseased.  In  Forraine  At- 
tempts of  the  English  Nation,  London,  1598. 
Reproduced  in  facsimile,  with  introduction  and 
Notes,  by  Charles  Singer,  Oxford,  at  the 
Clarendon  Press,  19 15.     50c. 

This  little  book  is  a  reprint  of  what  is  be- 
lieved to  be  a  unique  copy  of  a  pamphlet  in 
the  British  Museum.  In  the  preface  Singer 
proves  that  its  author,  who  has  concealed 
his  name  by  the  use  of  the  initials  G.  U  ., 
was  George  Whetstone,  a  singular  literary 
genius  who  flourished  in  Elizabethan  times. 
He  also  proves  that  it  is  the  pamphlet  re- 
ferred to  by  Hakluyt  as  having  been  seen  by 
him  in  manuscript  form  before  publication. 
The  work  is  intended  as  a  guide  to  be  used 
by  Englishmen  on  their  voyages,  at  that 
time  so  frequent,  into  tropical  countries. 
The  diseases  of  which  the  cure  is  considered 
are  the  calenture,  or  sunstroke,  tabardilla, 
under  which  the  author  describes  a  very 
deadly  fever  which  was  probably  yellow 
fever  but  may  have  been  typhus,  the  es- 
pinlas,  or  prickly  heat,  cameras  de  sangre, 
or  tropical  dysentery,  erysipelas,  and  scurvy. 

The  publication  is  of  particular  interest  at 
this  time  when  so  much  interest  has  been 
awakened  in  the  study  of  tropical  diseases. 

Packard 

Poetry  and  the  Doctors.  A  Catalogue  of  Poetical 
Works  Written  by  Physicians  with  Biographical 
Notes  and  an  Essay  on  the  Poetry  of  Certain 
Ancient  Practitioners  of  Medicine.  Illustrated 
with  Translations  from  the  Latin  and  by  Repro- 
ductions of  the  Title  Pages  of  the  Rarer  Works. 
By  Charles  L.  Dana,  A.M.,  M.D.,  LL.D.,The  Elm 
Tree  Press,  Woodstock,  Vermont.     $5 .  00 

All  those  who  are  interested  in  the  literary 
side  of  the  medical  profession  owe  a  debt  of 
gratitude  to  Dr.  Dana  for  the  publication 
of   these    delightful    browsings    among    his 


106 


books.  The  learned  essay  on  some  of  the 
ancient  poet-physicians  by  which  the  strictly 
bibliographical  portion  of  the  book  is  pre- 
faced, not  only  displays  the  erudition  of  the 
author  but  also  the  poetic  instinct  which 
has  guided  him  in  his  labors.  In  1874  "Le 
Parnasse  Medical  Francais"  was  compiled 
by  Cherean.  So  far  as  the  reviewer  knows 
this  is  the  only  attempt  at  a  complete  col- 
lection of  the  medical  poetry  of  any  nation 
which  has  thus  far  been  attempted,  and  Dr. 
Dana  observes  that  it  contains  no  really 
good  poetry.  It  is  to  be  hoped  that  if  Dr. 
Dana  carries  out  the  plan  at  which  he  hints, 
of  compiling  an  anthology  of  medically 
originated  poetry,  that  its  contents  will  be 
chosen  with  the  discrimination  of  which  we 
know  he  is  capable,  and  that  the  plan  of 
including  every  poem  written  by  a  physi- 
cian, simply  because  its  author  was  a  medi- 
cal man,  will  not  be  followed.  Dr.  Dana 
mentions  so  many  physicians'  names  who 
have  written  poetry  that  was  worth  while, 
that  there  is  no  doubt  that  a  large  volume 
would  be  required  to  contain  only  selected 
portions  of  their  writings.  The  great  bulk  of 
so-called  poetry  written  by  physicians  can 
be  cheerfully  left  in  the  limbo  of  forgotten 
things.  Let  us  trust  that  Dr.  Dana  will 
carry  out  his  project  and  give  us  a  volume  in 
which  Anglo-Saxons  may  read  with  pride  the 
real  poetic  achievements  of  such  men  as 
Holmes,  Chivers,  and  Weir  Mitchell  not  to 
mention  the  present  poet  laureate. 

Packard 

The  Growth  of  Medicine.  From  the  Earliest 
Times  to  About  1800.  By  Albert  H.  Buck,  M.  D.; 
Yale  University  Press,  New  Haven,  1917.  $5.00. 

It  is  an  ambitious  undertaking  to  survey 
the  growth  of  medicine  in  one  comprehensive 


Book  Reviews 


107 


treatise  and  naturally  particular  attention 
can  be  given  only  to  the  broader  aspects  and 
special  details  must  be  chosen  with  discre- 
tion. In  this  work  there  is  the  effort  to  give 
a  general  account  of  the  development  of  our 
art  in  a  form  attractive  to  the  general  med- 
ical reader.  The  work  does  not  go  beyond 
the  end  of  the  eighteenth  century. 

There  are  three  main  parts,  dealing  with 
Ancient  Medicine,  Mediaeval  Medicine,  and 
Medicine  during  the  Renaissance.  These 
are  convenient  divisions  in  the  telling  of  the 
story  and  these  periods  of  development  are 
further  divided  into  epochs.  The  author 
laments,  and  those  of  us  who  are  interested 
in  medical  history  join  with  him  in  this,  the 
lack  of  knowledge  of  medical  history.  It  is 
of  interest  to  speculate  how  much  we  of  this 
generation  owe  to  the  workers  in  each  of 
these  periods.  When  we  follow  the  course 
of  the  stream  of  medical  knowledge  through 
its  many  wanderings  the  wonder  is  that  the 
continuity  endured  in  spite  of  the  many 
things  which  tended  to  check  it.  Ask 
senior  students  or  many  practitioners  how 
much  they  owe  to  Arabian  Medicine  and 
the  majority  would  not  even  understand  the 
question.  A  query  as  to  our  debt  to  Greek 
Medicine  would  perhaps  be  illuminated  only 
by  a  knowledge  of  the  fact  that  Hippocrates 
once  lived.  Quote  to  them  the  saying  that 
"  Except  the  blind  forces  of  Nature,  nothing 
moves  in  this  world  which  is  not  Greek  in 
its  origin,"  and  a  polite  incredulity  would 
be  the  probable  result.  For  such  this  work 
should  be  particularly  useful,  especially  as 
the  author  has  endeavored  to  trace  reasons 
in  addition  to  giving  facts. 

To  many  the  past  is  a  sealed  book,  the 
sources  of  knowledge  have  no  interest  for 
them  and  while  they  may  not  think  that 
knowledge  will  die  with  them,  yet  they 
consider  that  its  birth  and  their  own  coin- 
cide very  closely.  This  has  been  termed  "an 
inept  derision  and  neglect  of  the  ancients" 
from  which  we  may  be  delivered  by  some 
knowledge  of  history.    Such  knowledge  may 


even  be  of  practical  value  as  in  an  instance 
in  which  a  physician  considered  that  he  had 
made  a  significant  discovery  which  he  was 
eager  to  give  to  the  world.  A  friend  pointed 
out  to  him  that  he  had  been  forestalled  by 
Celsus  nineteen  hundred  years  ago. 

This  work  opens  with  a  short  discussion 
of  the  beginnings  of  medicine  and  then  takes 
up  the  subject  of  Oriental  Medicine  in  which 
with  much  superstition  there  was  a  surpris- 
ingly large  amount  of  sense.  For  the  ac- 
count of  Grecian  Medicine  there  is  more 
material  available  and  naturally  Hippoc- 
rates claims  considerable  attention.  These 
sections  give  an  excellent  summary  of  the 
state  of  medicine  in  Greece  and  explain  its 
association  with  the  schools  of  Alexandria 
and  of  Rome.  Much  interest  belongs  to  the 
formation  of  the  various  sects  and  the  rea- 
sons for  their  development  are  set  out. 
Greek  learning  was  carried  far  and  wide  and 
the  story  shifts  from  Greece  to  Alexandria 
and  then  to  Rome  where  Galen  stood  pre- 
eminent as  the  figure  destined  to  dominate 
medical  thought  for  many  centuries.  The 
introduction  of  Grecian  medicine  to  Rome 
and  the  authoritative  position  so  long  occu- 
pied by  Galen  had  a  tremendous  influence 
on  medical  thought. 

The  second  part  deals  with  Mediaeval 
medicine  and  gives  a  clear  account  of  the 
Arab  Renaissance,  perhaps  one  of  the  most 
surprising  periods  in  the  history  of  medicine. 
The  author  gives  us  explanations  as  to  why 
many  of  the  changes  came  about  and  these 
are  fully  as  interesting  as  the  historical  facts 
themselves.  The  School  at  Salerno  comes 
in  as  a  connecting  link  with  the  development 
in  Europe  during  the  Renaissance.  In  the 
account  of  this  period  we  find  names  which 
are  more  familiar  and  the  course  of  progress 
can  be  given  more  in  detail.  The  account 
of  the  development  of  surgery  in  the  various 
countries  of  Europe  occupies  considerable 
space  and  is  complete.  Dr.  Buck  takes  the 
view  that  the  use  of  Latin  in  medical  publi- 
cations was  a  hindrance  to  development.    It 


io8 


Annals  of  Medical  History 


hampered  medicine  more  than  surgery,  for 
the  physician  using  Latin  was  saturated 
with  a  reverence  for  authority,  mostly  in 
the  person  of  Galen,  while  the  surgeon 
trusted  more  to  his  own  observation.  This 
may  have  been  in  the  mind  of  Sydenham 
when  he  gave  his  celebrated  advice  (as  the 
somewhat  doubtful  story  goes)  as  to  the 
best  reading  in  the  study  of  medicine. 

There  are  many  points  which  might  be 
discussed  if  space  permitted.  The  author 
must  have  had  difficulty  in  choosing  his 
material;  there  is  so  much  of  interest  and 
side  paths  constantly  attract.  But  he  has 
kept  well  to  the  straight  road.  He  refers 
to  the  incident  of  St.  Paul  being  bitten  by 
a  viper  without  hurt.  It  must  have  been  a 
temptation  to  discuss  the  nature  of  the 
Apostle's  "thorn  in  the  flesh."  The  work 
can  be  highly  commended  for  its  interest 
and  style  and  as  an  excellent  contribution 
to  the  study  of  medical  history.  It  is  more 
for  the  beginner  than  for  the  veteran  student 
and  this  does  not  imply  any  criticism — much 
the  contrary.  The  book  is  well  printed  in 
clear  type  and  has  a  number  of  excellent 
illustrations.  It  is  published  by  the  Yale 
University  Press  on  the  Williams  Memorial 
Publication  Fund.  McCrae. 

Anatomical  Names,  Especially  the  Basle  Nom- 
ina Anatomica  (" BNA").  By  Albert  Chauncey 
Eycleshymer,  B.S.,  Ph.D.,  M.D.  Head  of  De- 
partment of  Anatomy,  University  of  Illinois,  as- 
sisted by  Daniel  Martin  Schoemaker,  B.S.,  M.D., 
Prof,  of  Anatomy,  St.  Louis  University,  with 
Biographical  Sketches  by  Roy  Lee  Moodie,  A.B., 
Ph.D.,  Assistant  Professor  of  Anatomy,  Univer- 
sity of  Illinois.  William  Wood  &  Co.,  N.  Y.,  1917. 

No  greater  boon  could  be  conferred  on 
the  American  student  of  anatomy  than  the 
publication  of  this  most  excellent  work  on 
anatomical  nomenclature,  wherein  the  so- 
called  Basle  Nomina  Anatomica  ("BNA"), 
the  now  universally  recognized  standardi- 
zation of  the  scientific  names  for  the  struc- 
tures and  organs  of  the  body  is  fully  put 


forth  and  its  use  explained.  A  very  excel- 
lent preface  describes  the  necessity  which 
had  arisen  for  the  development  of  some 
uniform  system  of  nomenclature,  and  the 
steps  by  which  it  was  developed.  Vesalius 
complained  in  his  time  of  the  disorder  in 
the  study  of  anatomy  which  resulted  from 
the  great  number  of  existing  terms,  and 
that  many  different  names  were  used  by 
the  various  authors  to  designate  a  given 
structure.  A  rapid  sketch  is  given  of  the 
evolution  of  the  terms  in  ordinary  use  by 
anatomists,  and  the  confusion  caused  by 
lack  of  method  and  uniformity  is  well  illus- 
trated. Thus  approximately  fifty  different 
names  were  given  to  the  corpus  pineale, 
before  the  latter  cognomen  was  definitely 
assigned  to  it  in  the  BNA.  The  difficul- 
ties encountered  by  the  German  Anatomic 
Society  from  the  time  when  it  first  took  up 
its  labors  in  1887  until  they  were  terminated 
at  the  meeting  of  Basle  in  1895  were  tre- 
mendous. The  Preface  is  followed  by  a 
translation  of  the  article  by  Wilhelm  His 
giving  an  account  of  the  methods  pursued 
by  the  Committee  and  recounting  some  of 
its  chief  troubles,  such  as  the  question  of 
the  application  of  personal  names  to  ana- 
tomical structures,  on  which  His  confesses 
he  leaned  strongly  towards  the  retention 
of  many,  and  which  was  met  by  a  compro- 
mise, giving  objective  names  to  every  part 
but  where  personal  names  were  very  widely 
used,  adding  them  in  brackets.  Another 
important  point  was  the  consideration  of 
the  anatomy  of  the  various  specialties. 
The  work  was  finally  accomplished  in  a 
manner  which,  as  with  all  human  endeavor, 
has  found  critics,  but  yet  is  satisfactory  to 
the  great  body  of  the  profession. 

The  book  is  accompanied  by  a  series  of 
biographical  sketches  of  the  anatomists  of 
the  world  with  bibliographical  addenda  of 
great  value.  It  concludes  with  one  of  the 
best  compiled  indexes  that  it  has  ever  been 
the  pleasure  of  the  present  reviewer  to  go 
through.  Packard. 


VOLUME    1 


NUMBER    2 


ANNALS   OF 

MEDICAL  HISTORY 


^> 


•? 


? 


FRANCIS  R'PACKARD'M'D'EDITOR  [PHILADELPHIA] 
PUBLISHED  QUARTERLY  BY  PAUL  '  B  *  HOEBER 
67-69  EAST  FIFTY-NINTH  STREET'  NEW  YORK  CITY 


t 


\ 


,»« 


John  Shaw  Billings 
(1838-1913) 


ANNALS  OF  MEDICAL  HISTORY 


Volume  i 


Summer  1917 


Number  2 


EULOGY  OF  DR.  JOHN   SHAW  BILLINGS 


READ    BY   DR.    ABRAHAM    JACOBI    AT   THE   MEMORIAL   MEETING    OF   THE   NEW   YORK 
ACADEMY    OF   MEDICINE,    1913 


HE  death  of  Dr.  John 
Shaw  Billings  has 
robbed  America  of 
one  of  its  greatest 
men.  This  New  York 
Academy  of  Medi- 
cine, the  representa- 
tive and  headquar- 
ters of  medical 
endeavor  in  New  York,  is  anxious  and  eag- 
er to  honor  itself  by  extolling  a  man  who 
was  so  prominent  in  many  fields  of  knowl- 
edge, research,  and  activities  that  each  of 
them  would  have  secured  his  immortality 
both  in  medical  and  general  history.  Indeed 
it  is  mostly  to  mere  specialistic  learning 
-and  labor  that  many  of  our  famous  men 
owe  their  deserved  renown. 

Dr.  Billings  began  his  life  as  a  demon- 
strator of  anatomy  in  a  western  college.  In 
the  Civil  War  he  served  the  country  as  a 
surgeon,  and  finally  as  a  medical  inspector 
of  the  Army  of  the  Potomac.  He  then  set 
out  to  develop  the  scanty  library  of  the 
Surgeon    General's    Office    established    by 


Wm.  A.  Hammond.  A  few  years  of  hard 
work  on  the  part  of  Billings  and  the  liber- 
ality of  Congress  made  the  library  grow  so 
that  in  1876  the  plan  of  publishing  the  In- 
dex Catalogue  was  matured  and  in  1880 
the  first  volume  was  printed.  Of  this  monu- 
mental work  which  amazed  the  world  there 
are  now  thirty-five1  volumes.  The  same 
fertile  genius  created  the  Index  Medicus, 
which  was  continued  by  Fletcher. 

His  military  labors  developed  in  him  an 
inexhaustible  interest  in  public  health  and 
in  hospital  organization.  He  was  the  ad- 
viser and  builder  of  the  Johns  Hopkins  and 
other  hospitals.  He  delivered  courses  on  the 
history  of  medicine  in  Johns  Hopkins  Uni- 
versity, was  professor  of  hygiene  in  the 
University  of  Pennsylvania  and  director  of 
its  new  laboratory  of  hygiene.  In  1896  he 
became  the  director  of  the  New  York  Pub- 
lic Library.  Some  weeks  ago  he  left  behind 
him  two  millions  of  books  and  fifty  branch 
libraries.  For  two  editions  of  the  U.  S.  Cen- 

1  The  completion  of  the  second  series  makes  the 
total  now  thirty-seven  volumes. 


109 


no 


Annals  of  Medical  History 


sus  he  was  the  statistician.  Of  the  Carnegie 
Institution  of  Washington  he  was  the  chair- 
man. 

His  erudition  was  stupendous,  not  only 
in  medicine,  but  in  history  and  the  litera- 
tures of  the  world.  His  vast  reading  and  re- 
tentive memory  carried  him  into  all  conti- 
nents and  zones,  into  sciences  and  trades, 
into  chemistry,  physics  and  meteorology. 

Such  was  the  commanding  genius  with 
the  measured  tones,  the  pleasant  voice,  the 
humorous  remarks,  the  interest  in  all  that 
is  human,  in  social  problems,  and  economic 
and  political  questions.  Withal  he  was  gov- 
erned by  unfailing  modesty  and  a  cheerful 
readiness  for  self  extinction.  In  his  disin- 
terestedness he  did  not  so  much  as  think 
of  complaining,  when  the  inauguration,  two 
years  ago,  of  his  very  creation,  the  Library, 
was  not  even  to  be  graced  by  his  ever 
thoughtful  and  forceful  eloquence. 


The  multiplicity  of  his  virtues,  aims  and 
results  cannot  be  expressed  in  a  few  sen- 
tences. We  trust,  however,  that  it  is  not 
probable  that  the  Iight-heartedness  and  for- 
getfulness  of  an  ungrateful  republic  will 
deal  with  his  memory  as  with  that  of  less- 
er men.  It  is  in  him  that  the  combination 
of  American  idealism  and  creative  con- 
structiveness  is  best  represented,  an  exam- 
ple to  be  emulated  by  all  men,  both  great 
and  small,  in  all  countries.  Though  Billings 
was  rareiy  active  in  this  hall,  his  perfec- 
tions are  known  to  us  and  will  be  appre- 
ciated forever.  His  very  life,  ever  vigorous, 
ever  modest,  ever  bountiful,  is  his  eulogy. 
There  is  nobody  here  who  is  not  impover- 
ished by  the  loss  of  his  efficiency  and  influ- 
ence. To  those  who  were  personally  near  to 
him,  to  the  members  of  his  immediate  fam- 
ily, it  is  for  us  a  sad  and  honorable  duty  to 
express  our  mournful  sympathy. 


TvcbOi  Xeavrop 


What  am  I?     How  produced?    And  for  what  end? 
Whence  drew  I  being?    To  what  period  tend? 
Am  I  th'  abandoned  orphan  of  blind  chance, 
Dropt  by  wild  atoms  in  disordered  dance? 
Or  from  an  endless  chain  of  causes  wrought? 
And  of  unthinking  substance  Born  with  thought. 
The  purple  stream,  that  through  my  vessels  glides, 
Dull  and  unconscious  Flows  like  common  tides. 
The  pipes  through  which  the  circling  juices  stray 
Are  not  that  thinking  I,  no  more  than  they. 
This  Frame  compacted  with  transcendent  skill 
Of  moving  joys  obedient  to  my  will, 
Nurs'd  from  the  fruitful  Glebe,  like  yonder  Tree, 
Waxes  and  wastes,  'tis  mine  but  'tis  not  me. 
New  matter  still  my  mouldering  Mass  sustains 
The  Fabrick  chang'd,  the  Tenant  still  remains. 

John  Arbutbnot  (1675-1743-5). 


THE   HYGIENIC   IDEA  AND    ITS   MANIFESTATIONS   IN 
WORLD   HISTORY1 

By  PROFESSOR  KARL  SUDHOFF 

UNIVERSITY    OF    LEIPZIG 
Translated  by  DR.  FRANK  J.  STOCKMAN 

LIBRARY  OF  THE  SURGEON  GENERAL'S  OFFICE,  WASHINGTON,   D.   C. 


OLD  familiar  childhood  recollec- 
tions and  beautifully  contrived 
poetic  fantasies  of  ancient  and 
modern  impress  flatter  us  with 
the  notion  that,  at  least  in  the  field  of 
hygiene  (as  was  seriously  taught,  centuries 
ago,  of  many  phases  of  human  knowledge), 
the  acme  of  enlightenment  and  achievement 
was  already  attained  in  man's  earliest  in- 
fancy; that,  in  this  science,  at  least,  the 
beginning  of  wisdom  was  synchronous  with 
the  genesis  of  things  in  general. 

Such  teachings  haunted  the  science  of 
chemistry  for  the  longest  period.  As  late 
as  the  seventeenth  century,  it  was  assumed 
thatTubal-Cain  was  her  greatest  master,  and 
that  wise  Solomon,  while  building  his  tem- 
ple, knew  more  of  the  mysteries  of  chemis- 
try than  possibly  the  great  Geber,  Paracel- 
sus, Basilius-Tholde2  and  Andreas  Liba- 
vius  together. 

This  false  idea,  as  being  self-contradic- 
tory, eventually  annihilated  itself.  But 
numberless  ages  ago,  our  ancestors  along 
the  Baltic  Sea  and  the  Bay  of  Biscay,  or 
on  the  Highlands  of  Pamir,  the  residents 
along  the  Euphrates  or  the  Nile,  are  still 
supposed  to  have  imparted  the  most  im- 
portant lessons  in  hygiene,  in  healthy  liv- 
ing and  immunity  from  disease.  Even  to- 
day, some  assume  that  this  is  incontrover- 
tible and  self-evident.  A  well  informed 
man  will  hardly  venture  to  offer  valid  ob- 

1  Deutsche  Revue,  Stuttgart,  191 1,  iv,  40-50. 

2  Sudhoff  is  of  opinion  that  the  writings  of  Basil 
Valentine  are  the  work  of  the  editor,  Johann  Tholde. 


jection  to  that  old  and  oft-quoted  catch- 
phrase  anent  the  "life  comformable  to  na- 
ture." In  fact,  it  would  be  possible  to  de- 
vote a  whole  volume  to  an  account  of  the 
many  times  that  the  cry  "Back  to  Nature" 
has  resounded  in  its  innumerable  varia- 
tions; well  nigh  every  possible  view  of  the 
universe  and  a  stately  array  of  marvelous 
philosophizing  would  necessarily  be  pre- 
sented; a  lengthy  jeweled  chain  of  bril- 
liant names  in  the  history  of  human  thought 
would  pass  in  review. 

I  shall  not  commit  the  heresy  of  denying 
each  and  every  justification  of  this  cry, 
even  though  there  is  more  beating  of  the 
air  on  this  point  than  is  commonly  sur- 
mised. I  shall  be  content  with  demon- 
strating that  the  paradisiacal  condition  of 
a  long  life,  free  from  care,  with  a  late  un- 
encumbered old  age,  was  by  no  means  the 
rule  in  prehistoric  and  ancient  times.  It  is 
true  that,  as  compared  with  the  present, 
those  times  could  boast  of  superiority  in 
some,  but  by  no  means  in  all  respects. 
Upon  inspecting  the  many  early  Egyptian 
and  Nubian  crania,  for  instance,  we  are 
astounded  at  the  perfect  preservation  of 
the  teeth,  although  the  extensive  abrasion 
of  the  masticatory  surfaces  is  rather  start- 
ling, suggesting  simple,  suitable  fare,  but 
mainly  of  vegetable  character,  rich  in  cel- 
lulose and  with  a  generous  adulteration  of 
sand  particles.  We  become  rather  thought- 
ful, however,  on  finding  in  the  majority  of 
adult  skeletons  from  Upper  Egypt  and 
Nubia  of  five  to  seven  thousand  years  ago, 


112 


Annals  of  Medical  History 


signs  of  a  disease  which  to-day  appears 
only  under  the  most  unhygienic  condi- 
tions, and  then  hardly  to  such  degree  as  it 
formerly  affected  a  tremendous  majority, 
even  in  the  third  decade  of  life,  causing 
ankylosis  of  the  joints  and  spine  with  al- 
most absolute  immobility,  so  that  at  an 
early  age  these  unfortunate  people  became 
helpless  dependents.  Osteoarthritis  de- 
formans in  that  "Golden  Age"  afflicted 
humanity  of  both  sexes  with  such  fre- 
quency and  severity  as  to  stagger  all  power 
of  imagination  in  this  our  own  period,  so 
corrupt  with  "refined  culture"  on  the  one 
hand  and  misery  on  the  other.  Even  then, 
constant  sojourn  along,  upon  and  in  the 
waters,  even  more  perhaps  the  dwelling  and 
sleeping  upon  the  damp  ground,  in  wet  pits 
and  caves,  was  a  fruitful  source  of  disease. 
I  have  purposely  begun  with  an  account 
of  conditions  in  the  subtropics,  where  for 
a  long  time  the  cradle  of  mankind  lay  be- 
neath the  palm  trees.  Yet,  the  hygienic 
coefficient  of  life  among  the  early  inhabit- 
ants of  Northern  Europe,  derived  from  a 
study  of  osseous  remains,  differs  but  slightly 
from  the  results  of  investigation  along  the 
Nile.  Less  attention  has  been  paid  to  patho- 
logical findings  in  the  archaeological  re- 
searches north  of  the  Alps,  thus  restricting 
the  material  to  more  modest  proportions; 
but  such  osseous  remains  as  have  been 
carefully  studied  exhibit  exactly  the  same 
tendency.  Rudolph  Virchow's  "cave  gout" 
in  man  and  beast  has  long  since  been  in- 
corporated in  historic  pathology;  the  primi- 
tive Germans,  who  interred  their  heroes 
in  the  long  stone  passages  of  the  "giant 
chambers,"  suffered  to  an  appalling  degree 
(almost  ninety  per  cent  of  adults)  from  gouty 
diseases  of  the  bones  and  joints.  Dietetic 
customs  along  the  Nile  and  the  Baltic  Sea 
were  certainly  the  most  diverse,  but,  in  the 
manner  of  abode,  perfect  parallelism  ex- 
isted in  one  respect,  namely  that  of  damp- 
ness: whether  the  habitation  were  a  lake 
dwelling  over  the  placid  water,  or  a  rustic 


hovel,  depressed  below  the  surface  of  the 
ground  to  the  depth  of  a  meter,  only 
gradually  (at  least  in  the  case  of  sleeping 
quarters),  emerging  from  the  pits  which 
from  the  Stone  Age  to  La-Tene  constantly 
became  more  and  more  shallow.  A  moderate 
advance,  perhaps,  but  highly  important! 

Although  climate  may  exert  only  a 
minor  influence  upon  the  character  of 
habitation,  this  is  not  true  in  the  matter 
of  clothing.  Enthusiastic  as  we  may  be 
about  the  light,  hygienic  clothing  of  the 
Egyptians,  Babylonians,  or  even  of  the 
Greeks,  we  must  nevertheless  properly 
evaluate  the  wisdom  of  the  North  Alpine 
people,  whose  men  were  clothed  in  warm 
trousers  and  waist-coat,  their  women  in 
long  skirt  and  jacket.  Perhaps  the  Greeks 
migrated  from  the  North  in  similar  garb, 
and,  in  a  warmer  climate  and  under  altered 
conditions,  learned  to  know  and  prize  the 
light,  convenient,  Mediterranean  or  sub- 
tropic  costume  of  cloth  simply  thrown  about 
the  body — a  warning  against  premature 
generalizations  about  clothing  problems  for 
all  climates,  even  when  we  exclude  those  of 
the  polar  regions! 

Viewed  in  the  light  of  hygiene  alone, 
classical  antiquity,  Greece  and  Rome,  repre- 
sents a  cultural  pinnacle  of  almost  incom- 
parable height. 

The  Greeks,  a  master  people  (with  a 
substratum  of  slaves),  for  the  first  time  in 
history,  and  in  a  scope  and  degree  never 
again  approached,  undertook  universal 
training  of  boys  (in  some  phratries,  of 
girls  also),  with  a  view  to  the  harmonious 
development  of  all  the  physical  faculties 
and  to  the  attainment  of  the  greatest  meas- 
ure of  strength,  dexterity  and  self-confi- 
dence, of  physical  perfection  and  beauty. 
The  system  was  founded  upon  daily  exer- 
cise from  earliest  youth  to  ripe  manhood, 
under  the  supervision  of  experienced  and 
practised  leaders,  who  not  only  strove  to 
make  it  viable  and  successful,  but  were 
capable    of    intelligent    specialization,    ex- 


The  Hygienic  Idea  and  its  Manifestations  in  World  History 


ii3 


acting  from  each  physical  entity  the  high- 
est possible  accomplishment,  with  constant 
reference  to  general  vigor.  The  teacher  of 
gymnastics  became  the  professional  "gym- 
nast," who  strove  to  comprehend  the  nor- 
mal functions  of  the  body,  vying  with  the 
medical  fraternity,  who  again  studied  the 
value  of  gymnastics  for  a  healthy  physique 
and  took  from  its  storehouse  of  anatomic- 
physiologic  knowledge  the  plumb  line  for 
estimating  the  possibilities  of  each  in- 
dividual. With  the  aid  of  general  dietetics, 
the  physicians  deduced  the  norms  for  the 
application  of  gymnastics  to  the  preven- 
tion of  bodily  ills  and  as  an  auxiliary  in 
the  treatment  of  general  or  organic  dis- 
orders. Under  this  beneficent  rivalry  be- 
tween professional  gymnast  and  physician, 
gymnastics  itself  became  a  scientific  sys- 
tem of  physical  exercise  and  invigoration, 
of  hygiene  of  movement  and  occupation, 
such  as  we  to-day,  with  the  aid  of  modern 
technique  and  instrumental  precision,  are 
intent  upon  creating  anew. 

With  this  central  endeavor  of  Hellen- 
ism, physical  invigoration  by  daily  gym- 
nastic exercise,  the  rest  of  personal  hygiene 
was  in  great  measure  associated,  viz.,  care 
of  the  skin  by  washing  and  bathing,  by 
swimming  and  massage;  physical  cleanli- 
ness, including  care  of  the  hair  and  cloth- 
ing; as  well  as  regulation  of  diet,  rest  and 
sleep,  and  of  the  sexual  life.  The  regulation 
of  the  latter  function  in  the  gymnastic 
exercises  of  girls  was  divorced  from  prud- 
ery and  had  a  definite  eugenic  aim:  vig- 
orous offspring. 

The  public  officers  of  Greece  were  en- 
grossed with  other  questions  of  hygienic 
importance.  Town  planning,  arrangement 
of  streets,  sunning  of  houses,  sewage  dis- 
posal and  water  supply  were  carefully  con- 
sidered and  purposefully  regulated,  es- 
pecially in  the  culminating  cultural  period 
of  the  Age  of  Tyrants.  The  Romans,  among 
whom  solicitude  for  the  purity  of  grain  and 
potable  water  was  recognized  almost  as  a 


religious  and  state  duty,  with  their  eminent 
talent  for  solving  great  questions,  con- 
tributed much  to  public  hygiene.  In  the 
days  of  their  world  empire,  water  sup- 
ply, drainage,  road-building,  town-planning, 
food-control,  heating,  and  baths  were  regu- 
lated with  a  thoroughness  which  evokes 
our  respectful  admiration  even  to-day.  In 
the  cult  of  Vesta  and  Juturna,  the  Roman 
early  evinced  an  inherent  sense  of  the  fun- 
damental necessity  for  purity  of  food,  which 
can  proudly  take  its  place  beside  the  justly 
extolled  cult  of  food-hygiene  of  the  Orient. 
We  shall  deal  with  the  latter  immediately; 
for  Grseco-Roman  antiquity,  we  must  again 
repeat  that,  although  hygienic  requirements 
were  partly  based  on  cult-hygiene,  these 
peoples  soon  outgrew  this  purposeless  in- 
fancy and  set  themselves  conscious  hy- 
gienic goals,  devoted  themselves  to  their 
attainment  in  a  large  genial  manner,  and 
accomplished  results  which,  in  addition  to 
constituting  a  scientific  supervision  of  the 
life  of  the  individual,  will  forever  merit 
admiration  as  the  first  attempt  (conceived 
and  executed  with  genius)  at  personal  and 
public  hygiene  with  definite  aims:  indi- 
rect prophylaxis  by  increasing  the  vigor 
and  resistance  of  two  whole  nations. 

On  the  other  hand,  what  is  the  signifi- 
cance of  the  extolled  cult-hygiene  of  the 
Egyptians,  Babylonians,  and  even  of  the 
Jews,  who  never  conceived  of  hygiene  di- 
rectly and  with  intention,  the  subject  ap- 
pearing in  pre-Hellenic  times  as  something 
incidental  or  as  an  almost  negligible  side- 
issue?  Modern  historic  research  does  not 
support  the  legend  of  a  Moses  leading  his 
people  with  deepest  wisdom  and  confident, 
purposeful  clarity  over  the  road  of  hygiene 
in  religious  garb,  thousands  of  years  ago; 
the  theory  is  as  far  removed  from  truth, 
perhaps,  as  the  assumption  of  a  perfect 
natural  hygienic  condition  of  mankind  at 
the  start.  The  hygienic  contributions  of 
the  Western  Asiatics  (especially  of  the 
Semites)  to   humanity  are   enormous,    but 


U4 


Annals  of  Medical  History 


they  lie  in  a  totally  different  sphere,  as  we 
shall  perceive. 

A  few  preliminary  words  on  the  negative 
side.  It  is  no  longer  correct  to  regard  the 
ritual  hygiene  of  Judaism  as  a  singular 
phenomenon,  as  in  former  days,  when  it 
constituted  the  only  remaining  specimen 
of  an  entire  cultural  cycle,  buried  under  the 
ruins  of  centuries,  from  which  it  has  only 
just  been  unearthed  with  many  eluci- 
dating disclosures.  In  the  midst  of  the 
tides  of  racial  intercourse  flowing  and 
ebbing  from  the  Euphrates  to  the  Nile, 
we  can  imagine  the  Jewish  people  exposed 
to  cultural  currents  from  which  it  adopted 
and  adapted  much.  What  are  to-day  con- 
sidered fixtures  of  ancient  Semitic  cult- 
hygiene,  originated  almost  exclusively  after 
the  exodus,  partly,  therefore,  after  the  time 
during  which  the  people  of  Israel  had  been 
exposed  for  decades  to  the  influence  of 
racially  and  intellectually  kindred  civiliza- 
tions along  the  Euphrates  and  the  Tigris. 
To  trace  externalities  of  custom  to  their 
origins  is  consequently  difficult.  In  the 
period  especially  represented  by  the  com- 
pilation of  the  Talmud,  the  Jews  had  for 
centuries  been  influenced  in  hygienic  mat- 
ters by  Greek  science,  from  which  they  as- 
similated and  amplified  whatever  seemed 
suitable  for  adoption.  In  estimating  and 
evaluating  the  hygiene  of  the  Jews  this  fact 
should  be  borne  in  mind,  without  in  the 
least  detracting  from  their  merits;  claims 
to  special  originality  alone  are  thereby 
given  a  new  aspect. 

Among  all  peoples  of  antiquity,  meat  diet 
was,  so  far  as  the  domestic  animals  are  con- 
cerned, a  sacrificial  cult  in  the  first  instance; 
everywhere,  on  the  Jordan,  Tiber  and 
Cephissus  a  sacrificial  inspection  was  com- 
bined with  this,  which  exhausted  itself 
mostly  in  sophisms,  but  also  (particularly 
in  Mesopotamia)  contributed  a  fund  of 
experience  which  prepared  the  way  for  a 
sanitary  meat-inspection,  and  imparted  a 
viable,   interpretative  basis  to   future   hy- 


gienic knowledge.  The  same  is  true  of  cult 
cleanliness  which,  as  has  already  been 
shown,  was  not  less  developed  among  the 
Greeks  than  among  the  Orientals  along  the 
Euphrates,  Jordan  and  Nile,  upon  whom 
(including  the  Jews),  the  Grecian  amplifi- 
cation of  an  intentional  personal  hygiene 
exerted  undoubted  influence.  Even  ritual 
uncleanness  of  woman  under  special  cir- 
cumstances, is  ancient  property  of  Greece. 
Pope  Gregory  the  Great,  in  eliminating 
this  Jewish  atavism  from  Christian  cus- 
tom, performed  a  liberal  and  noble  service 
to  womanhood,  by  leaving  the  question  of 
church  attendance  during  menstruation  and 
puerperium  to  the  free  decision  of  the  in- 
dividual, thereby  effectively  removing  the 
whole  matter  from  "cult-hygiene" — a  land- 
mark in  the  emancipation  of  woman  from 
unwarranted  guardianship,  which  cannot 
be  commended  too  highly7.  But  to  return 
from  this  digression! 

There  is  no  longer  any  doubt  that  the 
Jews  borrowed  circumcision  of  males  from 
Egypt,  while  the  origin  of  the  custom  for 
both  sexes  is  traceable  to  Central  Africa. 
The  fact  that  the  custom  bears  no  subjec- 
tive hygienic  impress  does  not  deprive  it  of 
objective  hygienic  value,  any  more  than  in 
the  case  of  other  customs  originating  in 
entirely  different  spheres  of  thought.  But 
the  hygienic  importance  of  circumcision  of 
males  is  minimized  by  the  proof  of  the  non- 
existence of  syphilis  in  the  Old  World  in 
pre-Columbian  times,  as  is  to-day  gener- 
ally assumed.  To  cite  congenital  anomalies 
(e.g.,  phimosis)  as  an  argument  for  general 
circumcision  removes  the  whole  question 
to  another  sphere.  Clitorotomy,  of  identi- 
cal religious  origin,  has  to  date  not  been 
proclaimed  a  hygienic  measure.  That  Juda- 
ism did  not  adopt  this  ritual  custom  of  tin- 
Egyptians  is  explained  by  the  fact  that,  in 
the  temple  cult  of  the  Jews,  women  origi- 
nally played  no  role,  in  Fact,  were  Forbidden 
entry  to  the  temple.  The  question  lure 
arises,  whether  at  some  period  in  the  his- 


The  Hygienic  Idea  and  its  Manifestations  in  World  History 


115 


tory  of  Israel,  only  the  priestly  tribe  was 
circumcised,  or  whether  from  the  begin- 
ning, circumcision  characterized  the  whole 
people  as  sacerdotal. 

But  let  me  not  be  misunderstood!  In 
the  history  of  hygiene,  as  well  as  in  the 
history  of  general  culture,  these  questions 
of  cult-hygiene  are  of  transcendent  inter- 
est. None,  however,  is  to  be  considered  a 
landmark  equivalent  to  the  gymnastics  of 
the  Greeks,  the  hygienic  vision  of  Hellen- 
ism and  the  achievements  in  public  sanita- 
tion of  the  Romans.  Two  of  the  greatest 
hygienic  thoughts  of  mankind  owe  their 
origin  to  Semitism,  especially  to  her  intel- 
lectual prime  (Judaism  being  the  bearer, 
intermediary  and  perfecter) :  the  weekly  day 
of  rest  and  the  direct  prophylaxis  of  disease. 

The  first  will  be  immediately  evident  to 
all,  even  though  it  has  not  yet  been 
clearly  recognized  and  proclaimed  as  a 
hygienic  manifestation  of  prime  import- 
ance. Babylonian  civilization  probably  had 
a  precursor  of  the  Jewish  Sabbath.  In 
Babylonian  astrology,  the  7th,  14th,  21st, 
and  28th  days  were  ill-starred;  to  these  was 
added  the  49th  (7x7),  counted  from  the 
beginning  of  the  preceding  month.  No  foods 
could  be  baked  or  roasted  (nor  those  pre- 
pared in  this  manner  ingested);  change  of 
clothing,  sacrifices,  public  acts,  and  medi- 
cal treatment  were  interdicted;  in  fact 
these  days  were  inauspicious  for  the  execu- 
tion of  any  project.  Through  these  numer- 
ous inhibitions,  the  "unlucky"  day  be- 
came, in  part,  a  public  day  of  rest — in  part 
only — and  it  might  seem  that  from  this 
emanated  the  suggestion  of  the  Jewish 
Sabbath.  But  nevertheless,  what  a  wealth 
of  physical  and  spiritual  blessing  was  poured 
upon  the  Jews  by  this,  their  holy  day,  their 
day  of  rest !  More  than  any  other  factor,  it 
gave  them  strength  to  assert  themselves 
among  other  races;  and  by  contributing 
this  hallowed  day  to  Christianity  and  Is- 
lam, they  thus  imparted  its  hygienic  bless- 
ing upon  the  greater  part  of  the  world. 


Had  Judaism  given  nothing  more  to  man- 
kind than  the  establishment  of  a  weekly 
day  of  rest,  we  should  still  be^forced  to 
proclaim  her  one  of  the  greatest  benefac- 
tors of  humanity. 

What    can    be    said    as    to    the    second 
thought,  direct  prophylaxis? 

Although  Greek  medicine  became  of  in- 
comparable importance  in  general  human 
progress  and  bases  its  title  to  fame  chiefly 
upon  the  substitution  of  the  investigation 
of  natural  etiology  for  the  supernatural 
demonic  medicine,  which  ruled  the  whole 
of  pre-Hippocratic  Orient  and  Occident 
(Mediterranean  and  North  Alpine)  and  still 
enslaves  part  of  the  world,  it  is  a  most  in- 
teresting fact  that,  despite  its  theory  of 
natural  causation,  Greek  medicine  was 
blind  to  the  fact  of  contagion,  of  direct 
transmission  of  disease.  Whence  so  glaring 
a  defect  in  the  face  of  such  keen  perception 
of  the  processes  of  nature?  Thucydides' 
history  of  the  Athenian  plague  shows  that 
these  facts  had  not  entirely  escaped  the 
Greeks,  but  Greek  medicine  passed  them 
by,  perhaps,  because  a  natural  explanation 
seemed  impossible,  since  the  populace  so 
readily  satisfied  itself  with  the  "Evil  Eye" 
and  similar  imaginations. 

Along  the  Euphrates,  however,  we  come 
early  upon  the  concept  of  a  chronic,  rarely 
curable  disease,  characterized  by  cutan- 
eous changes  and  capable  of  transmission 
to  others.  Babylonian  culture  in  fact  read- 
ily drew  the  proper  conclusion  and  trans- 
lated knowledge  into  action:  Those  af- 
fected with  this  disease  must  be  debarred 
from  intercourse  with  the  healthy.  Who- 
ever was  defiled  by  issubbu  (leprosy)  was 
banished  to  the  wilderness.  Details  regard- 
ing these  matters  are  still  wanting  in  orig- 
inal sources,  no  matter  how  often  the  facts 
transpire  through  the  Assyro-Babvlonian 
tradition.  But  in  the  Old  Testament ,  we 
have  a  methodic  inspection  of  a  leper  by 
the  priest,  who,  according  to  the  diagnosis, 
isolated    the    patient    temporarily    or    per- 


n6 


Annals  of  Medical  History 


manently,  and  admitted  him  again  to  free 
intercourse  only  after  indubitable  conva- 
lescence or  cure.  To  be  sure,  it  has  never 
been  determined  (because  indeterminate), 
whether  the  zaraath  of  the  third  book  of 
Moses  represents  leprosy  exclusively;  to 
see  in  it  a  harmless  disease,  however,  de- 
grades a  serious,  austere  procedure  of  one 
of  the  most  outstanding  legal  codes  in  his- 
tory to  a  silly  farce.  Any  competent,  un- 
prejudiced investigation  must  lead  to  one 
conclusion,  viz.,  that  the  majority  of  those 
suffering  from  the  s\-mptoms  enumerated 
in  Leviticus  xiii  were  lepers;  the  most  im- 
portant point  historically  is  the  fact  that 
the  Mosaic  Law  gave  to  mankind  the  idea 
of  the  imperative  necessity  of  isolating 
those  afflicted  with  a  chronic  contagious 
disease;  in  addition,  the  purification  meas- 
ures recommended  in  Leviticus  for  infected 
houses  constitute  the  armament  of  mod- 
ern prevention  of  epidemic  diseases.  In  this 
connection,  it  makes  little  difference  to  me 
if  the  so-called  zaraatb  of  houses  had  no 
relation  to  leprosy,  and  that  modern  prophy- 
laxis is  not  derived  directly  from  Leviti- 
cus. (It  is  neither  evident  nor  probable 
that  the  place  of  refuge  of  the  leper  King 
Azariah-Uzziah  represents  a  Ieprosorium 
in  the  mediaeval  sense.)  The  fact  remains, 
however,  that  the  whole  concept  of  the 
transmission  of  serious  disease  by  social 
intercourse  with  the  afflicted,  and  of  the 
consequent  isolation  of  the  diseased  became 
property  of  the  West  by  religious  route. 

When  leprosy  fell  upon  the  ancient  world 
from  the  East,  and  came  to  the  cognizance 
of  Greek  physicians,  especially  of  Alexan- 
dria, these  met  its  appearance  with  an  ad- 
mirable establishment  of  the  semeiology, 
without  penetrating  deeper  into  epidemio- 
logical questions  or  recording  prophylac- 
tic segregation  measures.  Egypt,  where  in 
Hellenic  times  leprosy  spread  and  became 
established,  was  then  its  principal  sally- 
port in  the  West  and  is,  even  to-day,  one  of 
its  most  intensive  fields  of  activity.  From 


Egypt,  the  disease  in  sluggish  epidemic 
form  traversed  North  Africa,  crossed  the 
straits  of  Gibraltar  with  the  continuous 
stream  of  travelers,  and  spread  over  Moor- 
ish Spain;  at  the  same  time  the  germs  were 
carried  by  the  constant  migrations  across 
the  Mediterranean  to  Italy  and  Southern 
France,  across  Byzantium  to  the  Balkan 
and  Danube  states.  The  network  became 
especially  close  over  Southern  Gaul,  and 
even  further  into  Celtic  domain,  over  which 
a  Germanic  stratum  had  been  deposited; 
here,  authentically  in  the  sixth  century,  the 
thought  of  rending  or  cutting  the  threads 
of  the  epidemic  which  coursed  over  the 
lands  was  initially  entertained.  Enlight- 
ened princes  of  the  Church,  moved  by  the 
increasing  misery  of  the  people,  on  the 
strength  of  the  sacerdotal  code  of  the  Old 
Testament,  undertook  the  task  of  interfer- 
ing; the  shepherdess  of  the  mediaeval  peoples 
knew  her  duty.  The  Council  of  Lyons  (583) 
attempted  to  restrict  the  free  migration  of 
lepers!  The  edict  of  Rotharus,  King  of  the 
Lombards,  demonstrates  what  advances 
this  idea  made  in  sixty  years;  the  acts  of 
Charlemagne,  one  and  a  half  centuries 
later,  show  the  same  trend;  the  leprosy 
decretals  of  the  third  Lateran  Council 
(11 79)  represent,  in  a  measure,  the  last 
word  of  the  Church.  Apprehension  of  lep- 
ers became  general  routine  in  the  territo- 
ries of  the  ecclesiastical  and  secular  princes 
of  France  and  Germany;  isolation  camps 
were  established  everywhere,  gradually  in- 
creasing to  thousands.  Thither  the  lepers 
and  suspects  were  taken,  the  former  civilly 
dead  for  the  rest  of  life.  This  system  was 
mercilessly  enforced  for  centuries  with  per- 
fect success.  In  this  tenacious  fight  of  cen- 
turies, the  methods  of  which  were  bor- 
rowed from  the  Mosaic  Code,  the  Occident 
triumphed  over  leprosy.  Guided  by  this 
intellectual  torch,  it  accomplished  the  first 
great  feat  in  direct  prophylaxis:  methodi- 
cal eradication  of  leprosy  by  consistently 
making  the   affected   individuals   harmless 


The  Hygienic  Idea  and  its  Manifestations  in  World  History 


117 


as  carriers  of  the  virus.  Light  from  the  East 
is  transformed  to  pulsating  energy  by  the 
European  peoples,  while  the  disease  swings 
its  lash  unchecked  in  the  Orient. 

The  same  light,  rising  for  Occidental  and 
Mohammedan  physicians  alike,  spent  its 
luminosity  over  a  second  great  battle, 
which  constitutes  an  additional  title  to 
fame  for  the  Middle  Ages:  the  campaign 
against  an  acute  infectious  disease,  which, 
like  the  destroying  angel,  again  coursed 
over  the  Mediterranean  from  the  Orient, 
the  plague.  Stirred  by  the  "Black  Death," 
which  arose  about  the  middle  of  the  four- 
teenth century,  the  public  officials  of  Italy 
and  Southern  France,  during  successive 
decades  into  the  next  century,  with  Venice 
and  Marseilles  as  pioneers,  created  the  whole 
system  of  sanitary  control  of  incoming  ves- 
sels, of  observation  stations,  isolation  hos- 
pitals and  disinfection  procedures.  All  this 
was  adopted  by  the  Renaissance  and  is 
still  practiced  by  modern  hygiene,  in  more 
definite  and  rigorous  form  with  relatively 
few  changes.  An  energetic  attempt  to  es- 
tablish order  in  the  infected  cities  was  made, 
without,  however,  the  consistency  and  pur- 
posefulness  of  the  prevention  of  importa- 
tion. Three  dates  may  be  cited  in  this  con- 
nection :  1 374,  Venice,  being  again  threatened 
by  importation  of  the  plague,  denied  en- 
try to  the  city  of  all  infected  or  suspected 
ships,  travelers  and  freight;  1377,  Ragusa, 
in  Dalmatia,  rejected  all  travelers  from 
plague  districts,  who  had  not  sojourned  for 
a  month  at  one  of  two  designated  points, 
without  developing  the  disease;  1383,  Mar- 
seilles erected  her  first  quarantine  station, 
at  which,  after  rigid  inspection  of  the  ves- 
sels, all  travelers  and  cargoes  from  stricken 
or  suspicious  ships  were  detained  for  forty 
days,  exposed  to  air  and  sunshine.  These 
are  the  principles  of  preventive  medicine 
in  the  Middle  Ages,  created  by  physicians 
and  authorities  in  common  endeavor,  in 
amplification  of  an  idea  called  into  being 
by  the  campaign  against  leprosy. 


Finally,  another  idea  which  can  be 
counted  among  the  great  hygienic  thoughts 
and  contributions  of  the  past,  the  spirit  of 
Christian  mercy,  expressed  in  form  of  hos- 
pitals for  the  poor,  aged,  infirm,  and  sick; 
a  noble  social  blossom  of  young  Christian- 
ity, which  sprouted  on  the  Jewish  tree,  but 
developed  in  self-directed  manner  from  the 
time  of  Basil  the  Great  of  Csesarea.  An 
idea  which,  in  the  early  days  of  Byzan- 
tium, was  in  intimate  sympathy  with  Greek 
medical  science,  as  is  evident  from  regula- 
tions governing  medical  service  in  the  hos- 
pitals, preserved  from  the  period  of  the 
Comnenes,3  while  in  Western  Europe  it 
was  not  until  a  much  later  date  that  heal- 
ing the  sick  by  actual  treatment  became 
the  chief  task  of  hospitals.  Nevertheless, 
their  hygienic  importance  was  tremendous, 
since  hospitals  formed  only  a  fraction  of 
Christian  eleemosynary  institutions  of 
mediaeval  and  modern  times,  and  served 
definitely  as  a  pattern  for  the  wonderfully 
developed  system  of  socially  benevolent 
institutions  which  constitutes  one  of  the 
greatest  claims  of  modern  times  to  recogni- 
tion in  the  field  of  applied  hygiene.  It  holds 
its  own  with  the  scientific  contributions 
of  modern  biologic  medicine  to  hygiene, 
contributions  which  are  the  result  of  orig- 
inal thought  and  independent  development, 
no  matter  how  much  is  unconsciously  re- 
lated to  the  personal  hygiene  of  the  ancient 
Greeks;  while  the  biologic  concept  of  the 
theory  of  infection  itself  must  be  charac- 
terized as  purely  modern,  since,  after  all, 
it  owes  the  first  clear  conception  to  Giro- 
Iamo  Fracastoro  (1546)  finding  in  Ignatius 
Philip  Semmelweis  and  Joseph  Lister  its 
great,  genially  intuitive,  practical  inter- 
preters, while  Louis  Pasteur  and  Robert 
Koch  were  its  master  investigators  along 
purely  scientific  lines  and  thus  the  best 
equipped  to  rede  its  riddles. 

3  Referring  to  the  Byzantine  family  which  oc- 
cupied the  throne  of  Constantinople  during  1057— 
1059  and  1081-1185. 


A   PATRONAL   FESTIVAL   FOR  THOMAS   WILLIS   (1621-1675) 

WITH  REMARKS  BY  SIR  WILLIAM  OSLER,   BART.,    F.R.S. 

By  HENRY  VIETS,     M.D. 

NEWTON",    MASS. 


A  YEARLY  festival  in  honour  of 
a  medical  worthy  is  certainly 
an  occasion  of  note,  especially  if 
it  has  been  held  annually  for 
one  hundred  and  eighty  three  years,  and  is 
still  observed  in  England,  in  spite  of  the 
War.  Last  fall,  news  came  to  Oxford,  Eng- 
land, from  the  little  village  of  Fenny  Strat- 
ford, Buckinghamshire/that  the  exercises  in 


Martin's  Church,  Fenny  Stratford,  Buckinghamshire,  England 
in  1731  in  honor  of  Thomas  Willis  by  his  grandson. 


honor  of  Thomas  Willis  would  be  held  as 
usual  on  November  fourteenth  and  that 
Sir  William  Osier  would  deliver  the  "ora- 
tion" of  the  day.  I  was  fortunately  able  to 
attend  this  exercise  and  I  am  sure  that  a 
short  account  of  the  proceeding  would  be 
of  interest  to  some  of  the  readers  of  the 
Annals  of  Medical  History. 

The  festival  had  its  beginnings  in  1734, 
three  years  after  Browne  Willis  had  built  a 
little-  parish  church  in  his  home  village,  ill 
memory  of  his  grandfather,  and  dedicated 

ri8 


it  to  St.  Martin.  It  was  so  dedicated  be- 
cause Thomas  Willis  had  lived  in  St.  Mar- 
tin's Lane,  London,  had  died  on  St.  Mar- 
tin's Day  and  had  acquired  his  wealth  and 
fame  as  a  seventeenth  century  practitioner 
in  the  Royal  Parish  of  St.  Martin's-in-the- 
Fields.  The  fortune  fell  to  his  grandson. 
During  the  life  of  Browne  Willis,  a  festival 
washeld  annually  in  honor  of  his  grand- 
father. When  he  died  he 
left  the  following  note: 

"...    and  I  do  make 
it  my  request  .    .    .  that 
they  will    with   all  due 
solemnity  ever  keep  up 
and  see  to  the  annual 
celebration   of  S.   Mar- 
tin's  Festival    ...    in 
the  Church    of    Fenny 
Stratford,  in  the  manner 
as    I    have    solemnized 
it  annually     .     .     .    for 
26  years,    in    all   which 
time  1   have  been  con- 
stantly   present    and 
heard    a   sermon." 
He  also  left  for  an  endow- 
ment fund  two  old  houses  near  the  church. 
The  cottages  were  pulled  down  a  few  years 
ago,  being  no  longer  lit  for  occupancy,  and 
the  money  was  invested  in  a  war  loan. 

The  festival  itself,  as  celebrated  last  year, 
has  some  interesting  features,  not  the  hast 
of  which  are  the  "Fenny  Poppers."  The 
poppers  consist  of  six  small  iron  mugs  which 
are  filled  With  powder,  placed  in  a  held  and 
fired  off,  like  a  cannon,  by  a  fuse.  file  1 
inal  poppers  of  Browne  Willis's  time  have 
been  broken,  but  some  thirty  years  ago  six 


Built 


A  Patronal  Festival  for  Thomas  Willis  (1621-1675) 


119 


new  ones  were  made,  modeled  after  the  old 
ones  and  these  are  fired  off  yearly  by  the 
church  wardens  in  strict  accordance  with 
Browne  Willis's  wishes.  Another  feature  is 
the  church  service  which  this  year  was 
held  in  the  little  brick  church  late  in  the 
afternoon  of  November  14,  19 16. 

The  church  stands  on  high  ground  at 
the  cross  roads  of  the  town,  one  of  which  is 
Watling  Street,  the  old 
Roman  road.  The  north 
side  is  the  oldest  part, 
built  in  1726.  Just  inside 
the  door,  the  Fenny  Pop- 
pers are  kept.  Inside  the 
chapel,  most  of  the  inter- 
est falls  on  the  north 
aisle.  The  ceiling  is  ex- 
ceptionally fine,  being 
decorated  in  colors  with 
forty  armorial  shields, 
with  a  "cave"  around  it 
oi  twenty-six  more,  the 
crests  of  all  the  donors 
of  ten  pounds  or  more  to 
the  original  building 
fund.  These  are  beauti- 
fully  executed  and  have 
recently  been  retouched 
under  the  skillful  direc- 
tion of  Dr.  William  Brad- 
brook,  a  local  antiquarian 
with  the  best  interests  of 
medical  history  at  heart. 
The  ceiling  to-day  is  one 
of  the  best  preserved  armorial  ceilings  in 
England.  The  tomb  of  Browne  Willis  stands 
at  the  further  end  of  the  north  aisle.  In 
a  small  room  beside  the  altar  is  hung  an 
engraving  of  Doctor  Thomas  Willis,  dated 
1742,  under  which  Browne  Willis  has  writ- 
ten— 

In  Honour  to  thy  memory,  blessed  shade, 
Was  the  foundation  of  this  Chapell  laid. 
Purchased  by  thee,  thy  son  and  I,  their  heir 
Owe  these  three  mannours  to  thy  art  and  care. 
For  this,  may  all  thy  race,  thanks  ever  pay, 
And  yearly  celebrate  St.  Martin's  Day. 


<St.    .Jflartin's    parish, 

FENNY       STRATFORD. 

Patronal  Festival 

(183rd  Yw^cr  thereabouts) 

Tuesday,  14  November,  1916. 


BROWNE     WILLIS.   OCX.,  F.S.A 


REV.  .1.   H,  FIRMIXGER,  M.A 
W.   E    COOKE.  \    -., 

E.  R.   RAMSBOTHA.M.     I      " 


The  Bishop  of  Buckingham  preached  a 
short  sermon.  Some  sixty  good  church  mem- 
bers were  there  with  twenty  medical  men 
from  Fenny  Stratford  and  the  surrounding 
country.  It  was  an  impressive  service.  The 
bishop  had  an  appropriate  text,  "The  old 
is  good,"  and  one  felt  that  under  the 
guidance  of  the  Church,  such  an  annual 
festival  spirit  would  never  relinquish. 

After  the  service,  we 
wandered  across  the 
street  to  a  comfortable 
old  English  tavern  and 
about  thirty  sat  down  to 
a  jolly  dinner.  Later,  in 
the  town  hall,  coffee  was 
served  by  the  ladies  of 
the  parish.  There  was  an 
exhibition  of  a  number 
of  old  engravings  of  the 
church,  some  old  books 
and  other  objects  of  in- 
terest. 

When  Sir  William  Osier 
was  called  upon  to  speak 
the  hall  was  crowded  with 
the  villagers  from  miles 
around.  His  presence  in 
Fenny  Stratford  was  a 
red  letter  day  for  this 
little  country  town.  Sir 
William  Osier  was  at  his 
best  in  his  talk  on  "Willis 
the  Anatomist,"  not  a  bit 
of  which  was  lost  on 
these  simple  country  folks  and  honest  prac- 
titioners. The  spirit  of  medical  history  is 
dear  to  the  heart  of  many  English  physi- 
cians and  most  of  them  pride  themselves 
on  being  antiquarians.  As  Sir  William  Os- 
ier's talk  was  not  written,  I  can  only  give  it 
as  it  appeared  in  the  local  paper. 

REMARKS  OF  SIR  WILLIAM  OSLER 

"As  Fenny  Stratfordians,  you  do  well  to 
cherish  the  memory  of  the  distinguished 
family  to  which  the  parish  is  so  much  be- 


120 


Annals  of  Medical  History 


holden.  It  is  not  always  easy  to  find  en- 
thusiasm for  an  annual  festival,  but  St. 
Martin  of  Tours  is  a  jovial  host  whose 
name  is  associated  with  all  sorts  of  good 
living  and  better  company.  That  the  an- 
nual dinner  preceded  and  did  not  follow 
the  oration  suggests  a  wise  provision  on 
the  part  of  the  Saint  to  whom  a  personal 
reference  stirs  my  blood  when  I  think  of 
some  far-awa\r  ancestor  whose  hostelrie 
was  so  good  and  whose  hospitality,  I  hope, 
was  so  free  that  his  guests,  in  gratitude, 
called  him  by  the  name  of  his  house;  the 
name  from  which  my  own  name  is  obvi- 
ously derived.  It  is  fitting  that  the  Regius 
Professor  of  Medicine  at  Oxford  should 
come  here  to  honour  a  family  to  which 
Thomas  Willis,  the  anatomist,  grand- 
father of  their  founder,  belonged.  This 
is  the  first  time,  I  believe,  in  the  many 
years  you  have  held  the  festival,  that  my 
chair,  the  University  and  the  College  to 
which  Willis  belonged,  have  been  honoured 
in  this  way.  Another  reason  for  my  pres- 
ence is  that  I  happened  to  be  curator  of 
the  Bodleian  Library  to  which  Browne 
Willis  was  a  very  generous  donor.  Then, 
I  have  the  great  pleasure  to  be  the  friend 
of  Dr.  Brad  brook,  your  townsman,  who 
has  done  so  much  to  keep  alive  the  memory 
of  Browne  Willis.  This  evening  I  wish  to 
speak  of  Willis,  senior,  the  physician, 
whom  you  all  know  in  the  profession, 
and  of  his  circle  at  Oxford.  Thomas  Wil- 
lis took  his  M.B.  in  1646,  and  began  his 
practice  in  a  house,  still  existing,  known 
as  Beam  Hall.  He  had  a  special  interest 
in  the  Church  of  England,  and  during 
the  Cromwellian  occupation  of  the  city, 
the  services  of  the  Church  were  held 
twite  a  day  in  his  house.  One  of  the  most 
famous  pictures  hanging  in  the  hall  in 
Christ  Church  shows  John  Fell,  John 
Dolben  and  Richard  Allestree  with  a 
copy  of  the  Litur^v  open  before  them. 
I  liit  picture  may  have  been  taken  in 
Willis's    house    opposite    Mcrton,    where 


these  three  men,  all  great  friends,  were 
in  the  habit  of  attending  the  service  of 
the  Church  of  England  twice  daily..  Wil- 
lis married  for  his  first  wife  a  sister  of 
John  Fell,  the  Dean  of  Christ  Church. 
Browne  Willis's  devotion  to  the  Church 
was  natural — his  grandfather  had  it  be- 
fore him.  To  \\  illis's  special  circle  in  Ox- 
ford belonged  a  most  interesting  group 
in  the  history  of  science  in  England. 

The  awakening  of  science  in  England 
had  begun  in  the  early  part  of  the  17th 
century,  and  perhaps  the  first  scientific 
work  of  first  rank  to  be  published  in 
Great  Britain,  was  Gilbert's  De  Magneto 
(1600).  Harvey's  memorable  work  on  the 
'Circulation  of  the  Blood'  appeared  in 
1628.  Harvey  was  himself  at  Oxford  dur- 
ingthe  period  in  which  Willis  was  an  under- 
graduate. Whether  they  ever  met  or  not 
is  not  known,  but  whilst  there  he  met 
1  group  of  men  whose  lives  and  works 
as  the  founders  of  the  Royal  Society 
have  had  the  greatest  influence  of  any 
single  group  of  men  on  the  development 
of  science  in  this  country.  Wallis  himself 
told  the  story  of  the  Society's  meetings, 
first  in  London  and  then  in  Oxford. 
Most  of  the  scientific  subjects  they  dis- 
cussed had  been  set  on  foot  really  with- 
in the  previous  thirty  years,  chiefly  by 
the  remarkable  observations  of  Galileo. 
These  men,  who  had  an  important  influ- 
ence on  the  subsequent  development  of 
science  in  this  country,  deserve  to  be 
held  in  remembrance.  Seth  Ward,  who 
was  subsequently  Bishop  of  Exeter  and 
of  Salisbury,  was  the  centre  around 
whom  the  majority  of  these  scientific 
men  resolved.  He  was  'a  profound  states- 
man, but  a  very  indifferent  clergyman.' 
Wallis,  who  was  also  a  Cambridge  man, 
was,  more  than  any  single  man,  the  living 
spirit  in  the  formation  of  the  Royal 
Society.  He  was  a  meat  mathematician, 
and,  in  a  most  astonishing  mathematical 
dream,   extracted  the  figure  root    from 


A  Patronal  Festival  for  Thomas  Willis  (162  i -1625) 


121 


eight  groups  of  figures — and  it  was  cor- 
rect. He  became  Professor  of  Geometry 
at  Oxford,  and  his  reputation  as  a  math- 
ematician extended  throughout  Europe. 


and  became  so  much  interested  in  the 
studies  that  were  in  progress  with  Willis, 
Boyle  and  others  that  at  first  he  studied 
medicine;    and   it   is  a  remarkable    fact 


Sir  William  Oslfr 


Another  man  who  had  quite  a  great  in- 
fluence was  Wilkins,  Warden  of  Wad- 
ham,  a  very  ingenious  man  with  a  good 
mechanical  head,  who  was  afterwards 
Bishop  of  Chester.  In  Wadham  College 
is  still  shown  the  early  meeting  room 
of  the  Royal  Society  in  Oxford.  Perhaps 
the  best  remembered  genius  of  the  group 
is  Christopher  Wren,  who  was  an  un- 
dergraduate at  Wadham  College  in  1649, 


that  the  distinguished  architect  was  the 
first  in  England,  probably  in  Europe,  to 
invent  a  method  for  the  transfusion  of 
blood  from  one  human  being  to  another, 
or  from  one  animal  to  another.  He  is 
also  remembered  as  the  first  man  who 
made  drawings  from  the  microscope.  He 
also  did  many  of  the  drawings  for  Willis's 
works.  Another  remarkable  member  of 
the  group  was  the  Hon.  Robert  Boyle, 


122 


Annals  of  Medical  History 


son  of  the  Earl  of  Cork.  He  was  a  great 
exponent  of  the  experimental  method, 
and  every  elementary  student  of  physics 
still  knows  him  through  Boyle's  law.  It 
is  astonishing  when  one  thinks  how 
much  Boyle  did,  how  little  was  the  im- 
pression he  made.  It  was  probably  due 
to  the  fact  that  he  was  rather  a  rough  ex- 
perimenter; he  had  a  better  mind  than 
hands.  Coordination  of  head  and  hand 
are  necessary  for  a  great  experimenter. 
But  he  did  a  great  work  in  stimulating 
research  and  a  good  deal  of  the  reputa- 
tion of  English  science  on  the  continent 
was  due  to  him.  Another  extraordinary 
character  in  the  group  was  that  genius, 
Sir  William  Petty,  who  made  the  Down 
Survey  in  Ireland,  and  was  the  founder 
of  the  science  of  political  economy.  He 
went  to  sea  at  eight  or  nine  years  of  age, 
and  while  being  nursed  in  France  for  a 
broken  leg  he  began  a  career  of  money- 
making.  He  went  to  Paris  with  no  other 
capital  than  his  native  wit,  became  a  doc- 
tor, and  came  to  Oxford  at  the  time  one  of 
my  predecessors  had  the  fortunate  habit  of 
fainting  whenever  he  saw  a  dead  body,  so 
it  was  impossible  for  him  to  do  dissection. 
Petty  was  made  Professor  of  Anatomy,  and 
joined  this  circle  of  Boyle's,  and  was  a  most 
invaluable  member  of  it.  He  became  well- 
known  throughout  the  country  as  the  resus- 
ciattor  of  Ann  Green,  a  young  woman  who 
was  'hanged  by  the  neck  until  she  was 
dead,'  and  then  handed  over  as  a  perquis- 
ite to  the  Professor  of  Anatomy,  who 
claimed  the  bodies  of  all  criminals  for 
dissection.  In  spite  of  the  fact  that  the 
relatives  had  tugged  at  the  rope,  before 
the  body  was  cut  down  and  had  jumped 
on  her  to  make  sure  she  was  dead,  Petty 
resuscitated  her,  and  she  lived  for  mam 
years  and  became  a  very  respectable 
member  of  the  community.  It  was  a  great 
loss  to  Oxford  when  Petty  went  to  Ire- 
land; he  is  of  interest  to  the  present 
ration  as  the   founder  of  the  Lans- 


downe  family.  Other  remarkable  men  of 
the  circle  were  Sydenham  and  John 
Locke,  the  author  of  the  'Essay  on  the 
Human  Understanding,'  which  even  an 
ordinary  woman  can  read.  There  is  no 
one  in  the  room  who  would  not  be  im- 
proved by  a  careful  study  of  this  book 
over  a  period  of  several  years.  The  last 
man  of  the  circle  is  Lower,  who  did  a 
good  deal  of  work  for  Willis,  whose  name 
is  remembered  by  the  smallest  single 
fragment  in  the  human  body.  It  is 
astonishing  on  how  small  a  cork  a  man 
will  float  down  the  ages.  He  did,  how- 
ever, a  great  deal  of  good  work,  especially 
in  the  dissection  of  the  brain.  These  were 
Willis's  friends  during  the  years  he  was  a 
practitioner  in  Oxford. 

Willis  did  two  things;  he  made  him- 
self a  good  scientific  man  as  far  as  the 
science  of  that  day  went,  and  he  made 
himself  a  first  class  practitioner,  and 
those  two  sides  of  the  man  are  pre- 
sented in  his  works.  It  is  not  possible 
in  a  mixed  audience  to  go  into  the  char- 
acter of  his  work,  but  there  are  one  or 
two  things  that  will  interest  you.  The  first 
of  his  collected  works  was  a  'Study  of  Fer- 
mentation.' From  time  immemorial,  it  had 
been  one  of  the  great  mysteries  how  certain 
bodies  undergo  the  extraordinary  change 
known  as  fermentation,  and  why  at  the 
end  of  the  fermentation  there  was  such  a 
good  change  in  the  liquid.  Willis  studied 
this  mystery  and  made  it  still  greater  in 
the  pages  he  devoted  to  it.  But  he  grasped 
one  very  important  thing,  the  analogy 
between  a  fever  and  fermentation.  He 
made  the  very  Interesting  observation 
that  there  is  no  difference  between  the 
vintner  and  the  physician;  when  the  vat 
becomes  too  lull  in  fermentation  the  vint- 
ner draws  off  some  of  the  liquid,  and  he 
said:  'What   is  that   but   what   we  do  with 

blood  fermenting  in  a  fever?'  That  was  a 
good  reason  lor  phlebotomy.  It  was  not 
until  [857  that  the  problem  of  fermenta- 


A  Patronal  Festival  for  Thomas  Willis  (1621-1675) 


123 


tion  was  solved  by  Louis  Pasteur,  who 
showed  that  fermentation  is  not  a  pure 
chemical  process,  but  due  to  changes  ow- 
ing to  the  growth  of  living  bodies  in  the 
fluid.  That  is  the  greatest  single  dis- 
covery as  far  as  the  welfare  of  humanity 


showed  that  if  one  took  the  tiniest  little 
drop  on  the  point  of  a  needle  from  a  fer- 
menting lluid  and  put  it  into  a  sugary 
solution  it  would  create  fermentation; 
and,  in  just  the  same  way,  the  tiniest  drop 
of  blood  from  an  animal  suffering  from 


Thomas  Willis  (1621-1675) 


is  concerned,  and  it  has  had  the  farthest 
reaching  influence  of  any  single  discovery 
of  the  century.  It  revived  the  parallel 
which  had  been  drawn  300  years  before 
between  fermentation  and  fever.  Fracas- 
torius  had  called  attention  to  it  in  the  1 6th 
century,  and  Boyle  had  said  that  the  man 
who  would  solve  the  problem  of  fermen- 
tation would  solve  the  problem  of  infec- 
tious   fevers.    Pasteur    solved    both.    He 


anthrax  would  cause  identical  changes  to 
occur  in  the  blood  of  another  animal; 
there  would  be  a  multiplication  of  the 
germs,  a  change  in  the  fluid,  and  at  the 
end  of  the  fever  produced  by  the  anthrax 
one  could  not  induce  the  fever  again  by 
inoculation.  That  was  the  foundation  of 
our  modern  treatment  of  infectious  disease 
and  the  antiseptic  treatment  of  wounds. 
Besides  this  subject   of   fermentation, 


124 


Annals  of  Medical  History 


Willis  also  dealt  with  intermittent  fevers 
and  enteric  or  typhoid  fever.  He  was 
one  of  the  first  to  describe  an  epidemic 
in  1643  ^n  tne  army  of  Essex  besieging 
Reading.  He  reported  also  on  an  epidemic 
in  1 66 1.  It  is  interesting  to  see  what  he 
prescribed  for  typhoid.  One  would  not 
care  to  have  typhoid  fever  and  to  be 
treated  by  Willis.  The  patient  would  be 
lucky  if  he  were  not  bled,  dosed  with  all 
the  available  purges  in  the  Pharmacopoeia, 
sweated,  given  two  or  three  active  vomits 
and  blistered  on  the  calves  of  the  legs,  the 
abdomen,  and  probably  the  back.  These 
were  five  articles  of  the  treatment  of 
fever  that  the  public  at  present  is 
spared.  Willis  was  one  of  the  first  to  de- 
scribe typhoid  fever  in  epidemic  form,  and 
one  of  the  first  to  give  an  accurate  descrip- 
tion of  child-bed  fever.  He  was  the  first 
to  give  an  accurate  account  of  the  dis- 
ease known  as  diabetes,  and  he  recog- 
nised the  saccharine  or  sugar  variety 
from  the  ordinary  form.  He  is  better 
remembered  to-day  by  his  big  work  on 
the  brain.  He  did  a  really  fine  piece  of 
study  on  the  human  brain,  and  it  was 
the  best  book  of  its  date  on  the  nervous 
system,  not  only  in  the  description  of 
the  anatomy  of  the  brain,  but  of  the 
anatomy  of  the  nerves,  in  which  he  was 
greatly  helped  by  Lower's  sections  and 
\\  ren's  drawings.  His  classification  of  the 
nerves  of  the  brain  remained  in  England 
until  my  own  generation.  Willis  is  remem- 
bered particularly  by  the  description  of 
certain  blood  vessels  at  the  base  of  the 
brain  known  as  the  circle  of  Willis.  A 
great  part  of  Willis's  book  is  taken  up 
with  a  'Pharmaceutica  rationale.'  It  is  as 
dead  as  Willis.  It  gives  me  a  shudder  to 


think  of  the  constitutions  our  ancestors 
had,  and  of  how  they  withstood  the  as- 
saults of  the  apothecary. 

It  is  really  a  wonderful  age  to  live  in, 
more  for  what  the  human  body  misses 
than  for  what  we  have.  When  I  look 
through  the  list  of  drugs  that  were  given 
and  the  prescriptions  that  were  then  fol- 
lowed, I  feel  that  the  public  has  to 
thank  the  profession  for  having  got  rid 
of  so  many  nauseous  and  horrid  drugs. 
We  still  have  a  fair  number,  not  that 
the  profession  likes  to  give,  but  the  pub- 
lic will  have  them.  In  some  of  Willis' 
prescriptions,  there  were  ten  to  fifteen  dif- 
ferent ingredients — each  worse  than  the 
other — besides  vomits,  purges,  sweatings, 
diuretics,  cordials  and  opiates.  Syden- 
ham and  Willis  probably  owed  much  of 
their  reputation  to  their  knowledge  of 
how  to  use  opium.  Willis  wrote,  amongst 
other  things,  two  discourses  on  the  soul 
of  brutes,  which  would  be  a  very  good 
exercise  for  any  medical  student  or  doc- 
tor. Altogether,  Willis  is  an  interesting 
character  to  contemplate.  I  have  known 
him  for  a  good  while  and  I  have  known 
him  far  better  since  I  had  your  kind 
invitation  and  have  had  to  read  Willis's 
large  book  through,  from  which  I  got  a 
great  deal  of  information  I  did  not  want, 
and  have  refrained  from  giving  to  you.  I 
have  only  picked  out  a  lew  parts  lure  and 
there,  but  it  has  been  a  pleasant  task,  and  I 
feel  a  good  deal  better  lor  it.  Willis  was  a 
great  and  a  good  man,  and  the  i-jth  Psalm 
theChairman  has  read  at  the  service  is  most 
appropriate.  It  just  suited  him.  There  are 
many  good  descriptions  of  the  upright, 
righteous  man,  but  none  better  than  thai 
in  the  [5th  Psalm, which  fits  Willis  toa  't.'" 


MEDICINE  AND   MATHEMATICS   IN  THE   SIXTEENTH 

CENTURY 


By  DAVID  EUGENE  SMITH,  LL.D. 

NEW   YORK    CITY 


NO  one  who  gives  serious  attention 
either  to  the  history  of  medicine 
or  to  the  history  of  mathematics 
can  fail  to  be  struck  by  the  num- 
ber of  physicians  who  have  excelled  in  math- 
ematics and  astronomy,  and  by  the  number 
of  mathematicians  who  have  been  skilled  in 
the  healing  art.  The  cases  are  so  numerous 
as  to  surprise  even  those  who  would  natu- 
rally be  familiar  with  the  connection  be- 
tween the  two  sciences,  and  they  are  by 
no  means  confined  to  any  single  race  or  to 
any  particular  period.  To  enter  into  an  ex- 
haustive study  of  the  matter  would  be  im- 
possible within  the  limits  of  a  paper  of  this 
character,  such  a  study  of  the  Arab  civili- 
zation alone  being  enough  to  fill  a  printed 
volume.1  All  that  can  be  attempted  under 
the  present  circumstances  is  to  consider 
some  of  the  causes  of  the  phenomenon  and 
to  speak  of  its  development  in  the  century 
of  its  greatest  prominence,  namely,  the 
period  from  1500  to  1600. 

When  we  seek  for  the  cause  of  any  oc- 
currence whatever,  as  of  some  disease  or 
of  some  event  in  the  domain  of  astronomy 
or  history,  we  always  find  that  it  is  by  no 
means  unique.  Various  contributing  influ- 
ences enter  into  the  situation,  and  so  it  is 
with  the  close  relationship  between  the 
medical  and  mathematical  sciences. 

1  For  example,  in  Wustenfeld's  list  of  300  Arabian 
physicians  ("Geschichte  der  arabischen  Aerzte  und 
Naturforscher, "  Gottingen,  1840)  there  are  the 
names  of  38  prominent  mathematicians,  while  many 
ol  the  others  were  doubtless  interested  in  the  sub- 
jects of  astronomy  or  mathematics.  In  Suter's  list 
of  528  Arabian  mathematicians  ("Die  Mathemati- 
ker  und  Astronomer  der  Araber  und  ihre  Werke,"  in 
Abbandlungen  zur  Geschichte  der  math.  Wiss.,  Leip- 
zig, 1900),  at  least  85  are  known  to  have  been  phy- 
sicians. 


One  of  the  most  potent  causes  in  this 
case  was  the  general  belief,  both  in  ancient 
times  and  in  the  Middle  Ages,  in  the  influ- 
ence of  the  stars  upon  human  life.  Astrol- 
ogy therefore  became  the  handmaid  of 
medicine  and  was  looked  upon  by  the  in- 
tellectual world  as  part  of  the  equipment  of 
the  man  who  aspired  to  highest  rank  in  the 
medical  profession.  Great  stimulus  was 
given  to  this  idea  through  a  translation  of 
a  passage  in  Hippocrates  in  which  the  mas- 
ter speaks  of  ti  deiov  in  disease,  a  term 
which  the  early  translators  rendered  by 
coeleste  instead  of  diviiium  and  which  was 
thus  thought  to  refer  to  the  influence  of 
the  heavenly  bodies.2  Moreover,  there  was 
much  to  encourage  the  belief  because  of 
the  manifest  curative  powers  of  the  sun,  of 
the  influence  of  the  moon  upon  human 
emotions,  and  of  the  force  of  tradition  de- 
rived from  the  religious  beliefs  of  the  an- 
cients in  the  power  of  the  stars.  To  our 
somewhat  more  scientific  minds  a  little  of 
this  belief  seems  warranted;  but  we  of  the 
present  fail  to  comprehend  the  further  be- 
lief in  horoscopes  or  to  recognize  that  the 
best  scientific  minds  of  a  few  centuries  ago 
failed  as  completely  to  take  our  own  point 
of  view.  That  a  man  like  Caspar  Bartho- 
Iinus  (1585- 1 629),  father  of  the  mathema- 
tico-medical  scholar  Erasmus  Bartholinus 
(1625-1698)  and  professor  of  medicine  at 
the  University  of  Copenhagen,  should  have 
seriously  advocated  the  claims  of  astrology  3 
only  three  centuries  ago  seems  to  us  quite 
beyond  reason,  but  such  cases  were  by  no 

2  E.  Withington  in  Little's  "Roger  Bacon  Essa\-~," 
Oxford,  1914,  page  343. 

3  "Astrologia,  seu,  de  stellarum  natura,"  Witten- 
burg  (?),  1612,  and  his  "De  astrologia,"  Rostoehii, 
1616. 


125 


126 


Annals  of  Medical  History 


means  rare  at  that  time  or  even  up  to  the 
close  of  the  eighteenth  century. 

To  this  belief  in  the  power  of  the  stars  is 
partly  due  the  development  of  the  Greek- 
Alexandrian  sect  of  iatromathematicians,4  a 
sect  that  has  its  origin  in  the  superstitions 
of  the  ancients  long  before  the  period  of 
Hermes  Trismegistos.5  The  beliefs  of  these 
iatromathematicians,  relating  chiefly  to  the 
application  of  astrology  in  the  domain  of 
medicine,  have  been  clearly  set  forth  by 
Sudhoff,  particularly  as  they  showed  them- 
selves in  the  fifteenth  and  sixteenth  centu- 
ries.6 These  beliefs  are  to  be  found  in  the 
writings  of  some  of  the  best  scholars  of  ear- 
lier times,  such  as  the  Rabbi  ben  Esra  of 
Browning's  poem,  who  asserts  that  a  lunar 
eclipse  at  the  beginning  of  an  illness  has  a 
baneful  influence,  that  a  solar  eclipse  pro- 
longs the  period  of  sickness,  and  that  a 
conjunction  of  planets  or  of  the  sun  and 
moon  is  a  very  dangerous  sign.  Another 
such  writer  was  the  Arab  scholar  Alcabitius 
01.  c.  965), "  whose  work  on  astrology  was 
translated  by  Johannes  Hispalensis  and 
commented  upon  by  Johannes  de  Saxonia.8 

Still  another  example,  and  this  from  the 
thirteenth  century,  is  seen  in  the  case  of 
Roger  Bacon.9  This  remarkable  man  touch- 
ed all  branches  of  science  then  known,  and 
in  particular  he  wrote  upon  medicine  as  set 
forth  by  the  school  of  Galen  and  by  the 
Arab  writer  Avicenna.10  Just  as  he  antag- 
onized the  mathematicians  of  the  day,  so 
he    asserted    that    contemporary    medicine 

4   larpo^aOrjiiaTLKoi 

his  'laTponaOriixaTiKa  in  Patricias,  "Nova 
de  Universis  Philosophia"  (1593).  On  his  general 
beliefs  in  the  subject,  see  "Die  Lehren  des  Hermes 
Trismegistos"  by  Josef  Kn.ll  in  the  Beitr&ge  /.ur 
Gescbicbte  der  Pbilosopbie  des  Mittelalters,  Bd.  XII. 
Ilrlt  2  4,  Mtinster  i.  W.,  1014,  pp.  206  seq.  and  ]<>- 
seq. 

• " Jatromathematiker,   vornehmlich   im    15.   und 

16.   fahrhund.,"  in  the  Abbandlungen  zur  Gescbicbte 

der  Medizin,  Breslau,   [902,  Bd.  II.  The  term  has 

also  been  applied  to  those  interested  in  the  general 

i  mathematics  in  medicine. 


abounded  in  error.  He  stated  it  to  be  his 
belief  that  the  antiqui  had  a  sort  of  primi- 
tive medical  revelation  which  endured 
through  the  periods  of  Chaldean,  Greek, 
and  Arab  ascendency,  although  dimmed  by 
the  errors  and  defects  of  the  Latini  rustici. 

Once  the  belief  is  established  that  astrol- 
ogy has  value  in  the  equipment  of  the  phy- 
sician, it  is  evident  that  a  certain  degree  of 
proficiency  in  mathematics  will  be  looked 
upon  as  necessary  in  his  education.  He  must 
know  something  of  angle  measure,  must  be 
able  to  use  astronomical  tables,  and  must 
be  fairly  well  equipped  as  a  computer.  This 
explains  in  part  the  relation  of  mathemat- 
ics to  medicine  in  that  period  in  which 
printing  first  made  learning  really  popular, 
namely,  the  sixteenth  century. 

There  was  also  another  potent  influence 
leading  to  the  development  of  the  iatro- 
mathematicians, namely,  the  universal  an- 
cient belief  in  number  mysticism,  a  belief 
which  had  not  died  out  in  the  seventeenth 
century  and  which  is  not  unknown  even 
to-day.  Deus  imparibus  numeris  gaudet  is  a 
phrase  as  old  as  the  period  of  the  Pythago- 
reans, and  even  to-day  the  belief  that 
"there  is  luck  in  odd  numbers"  is  very 
general.  The  recognition  of  the  influence  of 
the  number  seven  in  medical  literature,  un- 
til recently  almost  universal,  a  recognition 
due  in  large  part  to  a  work  long  attributed 
to  Hippocrates  himself  but  probably  spuri- 
ous, is  an  illustration  of  this  belief.  The 
superstitions  relating  to  numbers  like  three 

7  'Alxlel  'aztz  ibn  'Otman  ibn  'AH,  AM'I-Saqr,  el- 
Qahisi.  Tin'  transliteration  of  Arabic  names  follows 
the  Suter  list. 

8  This  commentary  was  printed  in  Venice  in  1  t^i 
and  again  in   1  i2i. 

9  A.(i.  Little, "Roger  Bacon  Essays," Oxford,  1  «>  1  -4. 
See  the  article  by  the  present  writer,  on  "The  Place 
oi  Rogei  Bacon  in  the  Historj  of  Mathematics," 
page  1,5,  and  the  one  l>\  I..  Withington,  "Roger 
Bacon  and  Medicine,"  page  J37,  from  each  of  winch 
extracts  have  been  freelj  made. 

1,1  EI-Hosein  ibn  Abdallah  ibn  Hosein  ibn  'Air, 
Aim  'Ali,  el-Seich  el-Ra'Is,  Ibn  Sh.a  (980-1037). 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


127 


and  seven,  with  their  squares,  have  all  the 
appearance  of  being  transmitted  from  the 
East,  possibly  through  Pythagoras  himself; 
but  at  any  rate  they  were  powerful  enough 
to  interest  the  medical  profession  for  many 
generations  in  the  mysticism  of  number. 

This  number  mysticism  naturally  led  to 
the  use  of  amulets  such  as  the  Thibetans 
and  others  of  the  East  wear  to-day,  — 
plates  on  which  magic  squares,  the  mystic 
trigrams  of  the  Chinese,  and  the  signs  of 
the  zodiac  are  engraved.  These  are  closely 
related  to  various  instruments  of  divina- 
tion in  which  number  played  a  leading 
part.  This  subject  is  so  extensive  as  to  per- 
mit only  of  brief  mention  at  this  time,  and 
a  single  illustration  will  serve  to  show  its 
importance.11  Tradition  relates  that  the  as- 
trologer Petosiris  dedicated  to  King  Ne- 
chepso,  of  the  seventh  century  B.C.,  a 
sphere  of  wondrous  power.12  To  foretell  the 
outcome  of  the  sickness  of  a  patient  it  was 
only  necessary  to  add  the  numbers  corre- 
sponding to  the  Greek  letters  of  the  name 
of  the  disease,  to  add  to  this  sum  the  num- 
ber corresponding  to  the  day  of  the  month 
on  which  the  invalid  took  to  his  bed,  to  di- 
vide the  result  by  29  (approximately  the 
number  of  days  in  the  lunar  month),  to 
note  the  remainder,  and  then  to  consult  the 
magic  sphere.  This  sphere  was  divided  into 
six  cells,  the  upper  three  being  the  cells  of 
life  and  the  lower  three  those  of  death. 
Whether  the  patient  would  live  or  die  was 
determined  by  the  group  of  cells  in  which 
the  remainder  was  found,  and  whether  the 
recovery  would  be  speedy  or  slow  was  de- 
termined by  the  particular  cell  in  the 
group.13  It  will  at  once  be  seen  that  there 
is  a  connection  between  this  superstition 
and  that  of  gematria,  the  theory  of  finding 

11  For  further  discussion,  see  Wickersheimer,  "  Fig- 
ures Medico-Astrologiques  des  IXe,  Xe,  et  Xle 
Siecles,"  in  Janus,  1914,  Vol.  XIX,  pp.  157-177. 

12  This  sphere  seems,  however,  not  to  be  older  than 
the  second  century  B.C.  For  discussion,  see  Sudhoff, 
loc.  cit. 


the  attributes  of  a  person  from  the  numeri- 
cal value  of  his  name  obtained  by  adding 
the  numerical  values  of  the  letters,  a  sub- 
ject too  extensive  to  admit  of  discussion  at 
this  time. 

A  fourth  reason  why  the  medical  class  in 
the  Middle  Ages  was  led  to  a  study  of 
mathematics  is  found  in  the  imagined  need 
for  the  compounding  of  drugs  in  such  pro- 
portions as  to  bring  out  their  dynamidix. 
This  need  led  the  physician  to  the  study  of 
alligation,  as  the  alchemist  and  the  mint 
master  were  also  led,  and  it  is,  of  course,  even 
more  potent  in  carrying  out  the  scientific 
work  of  to-day.  It  was  very  likely  this  in- 
fluence that  led  a  man  like  Arnaldo  de  Vil- 
Ianova  (1235-C.1313),  or  Arnaldo  Bachuone, 
to  study  mathematics.  Teaching  medicine 
in  Barcelona  and  Paris,  physician  to  Fred- 
erick of  Sicily,  a  prominent  practitioner  in 
Rome,  Bologna,  and  other  great  centers, 
known  chiefly  for  his  writings  on  alchemy, 
Arnaldo  was  the  type  of  man  who  would 
naturally  be  led  to  imagine  a  close  connec- 
tion between  medicine  and  number,  and  be- 
tween alchemy  and  astrology.  So  whether 
the  aspiring  physician,  when  Salerno  began 
to  encounter  serious  rivalry,  went  to  Pa- 
dua, which  leaned  to  the  astrological  doc- 
trines of  Pietro  di  Abano  (c.  1 250-1 3 16), 14 
or  to  Montpellier,  which  favored  the  al- 
chemy of  Arnaldo,  he  was  sure  to  come  in 
contact  with  some  form  of  mathematics. 

A  fifth  influence  to  be  noted,  even  though 
this  is  not  the  place  to  discuss  it  historical- 
ly, is  that  of  the  study  of  optics,  especially 
on  the  part  of  the  physician  who  specialized 
in  the  treatment  of  the  eye.  Upon  this  topic 
there  is  a  large  literature,  beginning  promi- 

13  See  also  "Nechepsonis  et  Petosiridis  fragmenta 
magica,"  in  Pbilologus,  Suppl.  VI  (1891-1893I,  pp. 
382-383. 

14  Also  known  as  Petrus  Aponensis,  professor  of 
Medicine  at  Padua.  His  "Astrolabium  planum"  was 
published  at  Venice  in  1502,  his  "Geomantia"  at 
Venice  in  1556,  and  his  "Opera  artis"  (on  alchemy) 
at  Paris  in  1567.  SudhofT  gives  the  dates  1253- 
1319  (?)• 


128 


Annals  of  Medical  History 


nently  with  the  Arab  scholars  and  spread- 
ing thence  to  the  West,  particularly  in  the 
thirteenth  century,  one  of  the  most  remark- 
able periods  in  the  world's  intellectual  pro- 
gress. 

A  sixth  reason  why  physicians  were  so 
commonly  led  to  the  study  of  mathematics 
is  to  be  found  in  the  general  belief  in  the 
influence  of  comets  upon  human  health. 
This  is  quite  independent  of  the  belief  in 
astrology,  and  it  proved  to  be  so  strong  as 
to  attract  the  attention  of  a  considerable 
number  of  physicians  in  the  sixteenth  cen- 
tury, and  to  lead  them  to  a  sufficient  study 
of  mathematics  to  make  use  of  armillary 
spheres  and  astrolabes  for  locating  the  com- 
ets in  the  heavens.  An  example  of  this  is 
found  in  the  case  of  Fernandez  Raxo  y  Go- 
mez (d.  1695),  a  graduate  in  medicine  at 
Valencia,  physician  to  Philip  II,  and  the 
author  of  a  well-known  work  on  the  influ- 
ence of  comets.15 

It  is  especially  appropriate  in  this  con- 
nection to  mention  one  more  influence  lead- 
ing the  physician  to  the  study  of  mathe- 
matics, since  this  makes  the  mystic  num- 
ber seven,  and  so  I  refer  to  the  fact  that 
medicine  was  a  very  natural  gateway  to 
mathematics  in  the  early  universities.  A 
young  scholar  was  offered  four  great  possi- 
bilities in  the  mediaeval  period,  namely, 
theology,  philosophy,  law,  and  medicine. 
Of  course  he  might  follow  out  his  mental 
bent  without  taking  any  of  these  paths, 
but  these  were  the  enticing  ones.  If  his 
taste  was  for  science  in  any  of  its  branches, 
the  path  of  medicine  was  the  natural  one 
to  follow,  since,  as  we  have  seen,  medicine 
had  as  auxiliary  sciences  astronomy  (which 
was  mathematics  par  excellence  in  those 
days)  and  alchemy,  and  made  not  a  little 
use  of  physics.  Scientific  training,  there- 
lore,  found  its  path  of  least  resistance 
through  medicine. 

u"DeConi<  rtis,  et  prodigiosiseorum  portentis  libri 
quatuor,"  Madrid,  15-8.  A  Spanish  bibliographer  re- 
marks that  "era  mas  bicn  filosofo  que  astronom<>." 


An  illustration  of  this  general  combina- 
tion of  all  the  sciences  under  the  guidance 
of  medicine  is  seen  in  one  of  the  sumptuous 
volumes  that  came  from  the  Aldine  press 
at  the  opening  of  the  sixteenth  century, 
written  by  Georgius  Valla,  the  elaborate 
title  beginning:  "Georgii  Valke  Placentini 
viri  clariss.  de  expetendis,  et  fvgiendis  rebvs 
opvs,  in  qvo  haec  continentvr."  Valla  was 
born  at  Piacenza  in  1430  and  died  at  Ven- 
ice in  1499.  He  lectured  on  physics  and 
medicine  at  Pavia  and  also  at  Venice,  and 
translated  various  writings  of  the  Greeks, 
both  medical  and  mathematical.  His  mag- 
num opus,  above  mentioned,  treated  of 
Boethian  arithmetic  and  music,  of  Eucli- 
dean geometry,  of  medicine  and  optics,  of 
astrology  and  the  astrolabe,  of  rhetoric, 
poetry,  and  law,  and  of  most  of  the  other 
great  branches  of  human  knowledge.  Much 
of  the  work  is  devoted  to  medicine.  Thus 
he  has  "De  Physiologia  libri  .iiii.  .  .  . 
De  Medicina  libri  .vii.  .  .  .  De  Corpo- 
ris commodis,  &  incommodis  libri  .hi.  quo- 
rum primus  totus  de  anima,  Secudus  de 
corpore,  Tertius  uero  de  urinis  ex  Hippo- 
crate,  ac  Paulo  aegineta,  deq;  Galeni  quas- 
tionibus  in  Hippocratem."  Like  all  such 
works,  this  was  merely  a  compendium,  but 
it  established  Valla's  reputation  as  a  phy- 
sician of  great  scientific  learning,  and  it 
serves  to  illustrate  the  point  in  question. 

There  is  much  more  to  say  if  one  desires 
to  enter  fully  into  the  relations  between 
mathematics  and  medicine.  The  story  is 
one  of  interesting  mysticism,  ol  the  Greek, 
Roman,  and  mediaeval  symbols  of  drugs  and 
numbers,  of  tetragrams,  of  exorcisms,  of 
skryers,  and  of  all  that  borderland  between 
the  region  of  superstition  and  that  of 
science.  The  story  is  therefore  a  long  one, 
and  lest  it  might  prove  unprofitable  it  is 
better  to  leave  it  untouched  and  to  men- 
tion a  few  of  the  great  names  in  the  fields 
of  medicine  and  mathematics  in  the  six- 
teenth century. 

This  century  has  been  selected  because 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


129 


it  combines  the  seven  influences  above 
mentioned  more  completely  than  was  the 
case  before  the  year  1500  or  has  been  since 
the  year  1600.  Before  the  sixteenth  cen- 
tury printing  had  not  been  sufficiently  de- 
veloped to  make  it  possible  to  freely  dis- 
seminate thought,  while  after  the  close  of 
that  century  superstition  began  to  give  way 
more  rapidly  than  ever  before  to  scientific 
inquiry. 

Before  considering  the  list  of  sixteenth 
century  mathematico  -  medical  scholars, 
many  of  whom  were  slavish  followers  of 
tradition,  one  name  should  be  mentioned 
as  standing  in  a  class  by  itself.  No  list  of 
medico-mathematical  writers  would  be  com- 
plete without  reference  to  this  remarkable 
genius  who  was  neither  a  medical  man  nor 
a  mathematical  professor,  but  who  knew 
more  of  anatomy  and  of  mathematics  than 
most  of  his  contemporaries  who  were  work- 
ing in  these  fields.  The  works  of  Leonardo 
da  Vinci  (1452-15 19)  in  mechanics,  in  as- 
tronomy, in  the  study  of  the  infinitely  great 
and  the  infinitely  small,  and  his  familiarity 
with  the  writings  of  the  scholars  who  had 
made  mathematical  physics,  all  show  the 
same  remarkable  acumen  that  he  revealed 
in  connection  with  the  study  of  the  heart 
and  the  circulation  of  the  blood.  Had  Leo- 
nardo not  been  one  of  the  world's  greatest 
artists  he  would  have  been  known  as  one  of 
the  world's  greatest  anatomists;  had  not 
the  other  phases  of  his  genius  overshad- 
owed his  work  in  mathematical  physics,  he 
would  have  been  known  as  one  of  the 
world's  greatest  scholars  in  this  important 
field.  The  contributions  of  Dr.  Arnold  C. 
Klebs  to  our  knowledge  of  his  work  on  the 
circulation  of  the  blood  were  a  revelation 
to  most  of  us  who  thought  that  we  knew 
something  of  Leonardo's  scientific  attain- 
ments, while  even  a  brief  consideration  of 
his  fragmentary  work  in  mathematics  will 
convince  anyone  of  his  real  ability  in  this 
field  as  well. 

I  now  propose  to  mention  a  few  of  the 


other  leading  names  among  those  whose 
tastes  led  to  the  study  of  mathematics  as 
well  as  medicine,  and  to  speak  very  briefly 
of  their  labors.  After  that  it  will  be  quite 
enough  to  enumerate,  for  purposes  of  refer- 
ence, the  names  of  others  who,  in  that  cen- 
tury, cultivated  more  or  less  impartially 
the  two  sciences  under  discussion. 

It  usually  happens  that  a  really  great 
man  attains  his  dominant  position  in  one 
line,  his  other  lines  of  interest  being  so  com- 
pletely overshadowed  as  to  be  forgotten. 
Of  course  there  are  exceptions  to  this  rule, 
as  in  the  cases  of  Descartes,  Pascal,  Leib- 
nitz, and  particularly  Leonardo  da  Vinci; 
but  in  general  it  is  a  law  that  is  almost 
axiomatic.  For  this  reason  few  in  the  medi- 
cal profession  will  recall  the  fact  that  Gali- 
leo ( 1 564-1 642)  was  at  least  a  novice  in 
their  guild.  This,  however,  is  the  case,  for 
his  father  withdrew  him  from  the  monas- 
tery of  Vallombrosa,  where  he  had  decided 
to  take  orders,  and  sent  him  to  Pisa  to  study 
medicine.  His  observation  of  the  swinging 
lamp  led  not  only  to  his  study  of  the  law 
of  the  pendulum  but  to  his  use  of  this  de- 
vice for  measuring  the  frequency  of  the 
pulse.16  His  tastes,  however,  were  toward 
applied  mathematics,  and  so  he  secured  his 
father's  consent  to  give  up  the  study  of 
medicine  and  to  endeavor  to  make  a  name 
for  himself  in  his  chosen  field.17 

As  in  the  case  of  Galileo,  so  with  Coper- 
nicus (1473-1543);  it  is  not  generally  re- 
called that  he  was  a  physician,  as  also 
Canon  of  the  Cathedral  at  Frauenburg  in 
East  Prussia.  His  mathematical  and  as- 
tronomical studies  under  Peurbach,  Regio- 
montanus,  Domenico  Maria,  and  Brudzcw- 
ski  led  him  to  devote  his  energies  to  the 
mathematical  side  of  astronomy  with  an 
intelligence  that  made  for  the  success  which 
the  world  has  long  since  recognized. 

16  Paolo  Frisi,  "Elogio  del  Galileo,"  Milano,  1778, 
p.  14. 

17  "Le  Opere  di  Galileo,"  Firenze,  1856,  tomo  xv,  p. 
334- 


130 


Annals  of  Medical  History 


Of  all  those  who  achieved  a  reputation 
in  the  fields  of  mathematics  and  medicine 
in  the  sixteenth  century,  none  was  more 
notorious,  to  say  the  least,  than  Girolamo 
Cardano  18  who  was  born  at  Pavia  in  1501. 
He  was  the  illegitimate  son  of  a  jurist, 
Facio  Cardano,  a  man  who  had  also  taken 
a  degree  in  medicine,  had  given  some  at- 
tention to  mathematics,  and  had  edited 
Archbishop  Peckham's  "Perspectiva  Com- 
munis," and  of  a  mother  who  had  a  repu- 
tation that  was  none  too  good.  Students  of 
heredity  may  find  here  a  fertile  field  for 
speculation,  for  Girolamo  certainly  com- 
bined in  his  nature  some  of  the  highest  and 
some  of  the  lowest  elements.  He  was  at 
once  an  astrologer  (not  a  great  reproach  at 
that  time,  however)  and  a  serious  student 
of  philosophy;  a  gambler  and  a  first-class 
algebraist;  defender  and  father  of  a  mur- 
derer and  at  the  same  time  a  physicist  of 
high  ability;  a  liar  and  at  the  same  time  a 
physician  of  repute;  an  inmate  of  a  poor- 
house  and  a  professor  in  the  University  of 
Bologna;  a  victim  of  blind  superstition  and 
rector  of  the  College  of  Physicians  at  Milan; 
a  heretic  who  ventured  to  publish  the  horo- 
scope of  Christ  and  a  recipient  of  a  pension 
from  the  Pope.  While  only  twenty-one 
years  of  age  he  taught  mathematics  at 
Pavia;  at  the  age  of  twenty-five  he  took  his 
degree  in  medicine  at  Padua,  practicing  for 
seven  years  at  Sacco.  In  1534  he  became 
professor  of  mathematics  at  Milan,  at 
the  same  time  practicing  and  teaching 
medicine.  He  died  in  Rome  in  1576. 

Cardano's  greatest  mathematical  work  is 
the  "Ars  Magna"  (1545),  a  work  in  which 
the  solution  of  the  cubic  equation  first  ap- 
peared in  print,  although  apparently  se- 
cured under  the  pledge  of  secrecy  from 
Tartaglia.  He  wrote,  however,  numerous 
other  works  on  mathematics,  physics,  phi- 
losophy, and  astronomy,  and  a  number  of 
"oposcoli"  on  medicine,  published  and  un- 
published. Among  the  medical  writings  giv- 

11  Jerome  Cardan,  Hieronyraus  Cardanus. 


en  by  him  in  his  own  list,  are  the  following: 
"Delle  cause,  dei  segni  e  dei  Iuoghi  delle 
malattie,"  "Picciola  terapeutica,"  "Degli 
abusi  dei  medici,"  "Delle  orine,  Iibro  quat- 
tro,"  and  "Sulla  medicina  di  Galeno,"  but 
a  careful  modern  edition  of  his  works  has 
not  appeared,  and  a  systematic  search  for 
his  unpublished  manuscripts  has  probably 
not  been  made.  Among  his  works  was  also 
a  commentary  on  the  anatomy  of  Mundi- 
nus. 

Cardano's  own  opinion  of  a  medical  career 
is  familiar  to  all  who  have  looked  into  the 
history  of  medicine,  but  it  may  be  interest- 
ing for  others  to  read.  He  says,  in  his  gar- 
rulous autobiography:  "If  I  had  money  to 
earn,  I  could  earn  it  as  a  doctor,  and  in  no 
other  way.  But  that  calling  of  all  others 
(except  the  glory  that  attends  it)  is  com- 
pletely servile  (tota  servilis  est),  full  of  toil, 
and  (to  confess  the  truth)  unworthy  of  a 
high-spirited  man  (ingenuo  viro  indigna), 
so  that  I  do  not  at  all  marvel  that  the  art 
used  to  be  peculiar  to  slaves."  19 

The  most  popular  writer  on  arithmetic 
in  the  Latin  language  in  the  sixteenth  cen- 
tury was  Gemma  Regnier  or  Rainer  (1508- 
1555).  Having  been  born  at  Dockum,  in 
East  Friesland,  he  was  known  as  the  Fris- 
ian, or  commonly  as  Gemma  Frisius.  He 
was  only  thirty-two  years  old  when  his 
"Arithmetical  Practical  Methodus  Facilis" 
was  published  at  Antwerp  (1540),  and  so 
favorably  did  this  work  strike  the  popular 
taste  that  it  went  through  at  least  fifty-nine 
editions  in  the  sixteenth  century,  not  to 
speak  of  many  later  ones.  He  also  wrote  on 
astronomy  and  geometry,  acquiring  a  high 
reputation  as  an  author  if  not  as  a  mathe- 
matician. Soon  after  publishing  his  arith- 
metic he  took  the  degree  of  doctor  of  medi- 
cine and  then  gave  up  his  mathematical 
studies.  While  nothing  was  published  upon 
medicine  under  his  name  during  his  life- 
time, there  is,  in  a  work  printed  at  Frank- 

"Morley,  "Jerome  Cardan,"  II,  283;  "Opera,"  1, 
131- 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


131 


fort  in  1592,  a  "Consilia  qusedam  de  arthri- 
tide"  attributed  to  him. 

Among  French  physicians  of  the  six- 
teenth century  there  stood  out  prominently 
one  whom  his  admirers  called  the  modern 
Galen,  Jean  Fernel  (1 497-1 558),  who  re- 
ceived his  doctorate  from  the  Faculte  of 
Paris  in  1530.  Four  years  after  receiving  his 
degree  he  became  a  professor  in  Paris,  and 
soon  rose  to  a  position  of  leadership  in  the 
medical  profession.  His  "Universa  Medi- 
cina"  (1567)  went  through  more  than  thirty 
editions.  In  the  field  of  mathematics  he  pub- 
lished two  works,  "De  proportionibus " 
(1528)  and  also  two  in  the  field  of  astron- 
omy, the  "Monalosphoerium"  and  the 
"Cosmotheoria."  His  work  in  geodesy  was 
also  noteworthy,  his  computation  of  the 
length  of  a  degree  of  the  meridian  being 
56,746  toises,  although  it  is  really  57,024 
toises,  —  a  good  approximation  for  the  time. 

Of  the  English  scholars  who  cultivated 
both  mathematics  and  medicine  in  the  six- 
teenth century,  Robert  Recorde  was  the 
most  prominent.  Born  at  Tenby,  Pembroke, 
c.  15 10,  he  studied  at  Oxford  and  Cam- 
bridge, and  received  his  degree  in  medicine 
at  the  latter  university  in  1545.  He  taught 
mathematics  at  Oxford  and  very  likely  at 
Cambridge,  became  royal  physician,  and 
wrote  on  medicine  as  well  as  mathematics. 
It  was  in  the  latter  field,  however,  that  he 
attained  his  chief  prominence.  His  arithme- 
tic, "The  Ground  of  Artes,"  appeared  be- 
tween 1540  and  1542  and  went  through  at 
least  thirty  editions,  being  the  most  popu- 
lar work  that  appeared  in  England  upon  the 
subject  in  the  first  two  centuries  of  print- 
ing. He  wrote  also  "The  Castle  of  Knowl- 
edge" (155 1),  a  work  on  astronomy;  "The 
Whetstone  of  Witte"  (1557),  a  work  chief- 
ly on  algebra,  and  the  one  in  which  the 
present  sign  of  equality  ( = )  first  appeared 
in  print;  and  "The  Pathway  to  Knowledge" 
(155 1 ),  a  work  on  geometry,  written,  like 
the  others  mentioned,  in  catechism  form. 

His  medical  work,  "The  Urinal  of  Phy- 


sic," appeared  in  1548  and  went  through 
several  editions,  being  as  popular  in  medi- 
cal circles  as  were  his  mathematical  works 
in  the  field  of  general  education. 

His  end  was  not  what  one  would  have 
expected  for  a  man  who  had  been  permit- 
ted to  dedicate  one  of  his  works  to  "Prin- 
cesse  Marie,"  over  his  signature  of  "Rob- 
ert Recorde  Physicion;"  who  had  adminis- 
tered to  the  medical  needs  of  Edward  VI 
and  of  Mary  Tudor,  and  who  had  written 
the  most  popular  mathematical  books  that 
England  had  known.  He  was  imprisoned 
for  debt  in  Southwark  Prison,  and  died 
there,  probably  soon  after  June  28,  1558, 
the  date  of  his  will. 

Among  the  physicians  whose  mathemati- 
cal attainments  were  much  above  the  aver- 
age to  be  found  in  those  who  devoted  them- 
selves wholly  to  the  exact  science,  there 
should  be  mentioned  Ludovico  Lilio  (15 10- 
1576)  who  was  one  of  the  astronomers  called 
by  Gregory  XIII  to  consider  the  change  of 
the  calendar.  It  was  substantially  his  sug- 
gestion for  reform  that  was  adopted.  Un- 
fortunately he  died  six  years  before  the  new 
calendar  was  put  into  general  use,  and  so 
he  did  not  live  to  see  the  fruition  of  his 
labors  in  this  important  field. 

In  Belgium,  contemporary  with  Galileo, 
there  lived  the  well-known  Adriaen  van 
Roomen  (1561-1615)  who  divided  his  time 
rather  impartially  between  medicine  and 
mathematics.  He  lectured  on  both  subjects 
at  Louvain  and  upon  mathematics  in  Wiirz- 
burg,  where  he  was  physician  to  the  bishop, 
and  he  was  at  one  time  mathematician  to 
the  king  in  Poland.  He  is  best  known  in 
mathematics  for  his  computation  of  the 
value  of  ir  to  sixteen  decimals,20  but  he 
wrote  also  upon  other  geometric  subjects.21 

20  In  his  "  Ideae  mathematics  pars  prima,"  Ant- 
verpiae,  1593. 

21  In  " Archimedis  circuli  dimensionum  expositio 
et  analysis,"  Wirceburgi,  1597;  "Mathesis  polemica," 
Francofurti,  1605;  "Canon  triangulorum  sphaeri- 
corum,"  Moguntiae,  1609. 


132 


Annals  of  Medical  History 


Interested  in  the  same  line  of  mathematical 
study  was  his  contemporary  Adriaen  Me- 
tius  (1571-1635),  or  Adriaen  Adriaenszoon, 
who  was  a  professor  of  mathematics  and 
medicine  in  the  university  at  Franeker,  but 
whose  writings  were  all  in  the  line  of  mathe- 
matics and  astronomy.  He  also  is  well 
known  for  his  approximation  to  the  value 

Of  7T.22 

Among  those  of  less  importance  in  the 
combined  fields  of  medicine  and  mathe- 
matics in  the  sixteenth  century  was  Jacques 
Peletier  (15 17-1582).  He  was  a  man  of 
some  ability  in  mathematics,23  but  he  was 
too  ready  with  his  pen,  and  this  in  too 
many  lines  of  work,  to  attain  a  high  stand- 
ing. Interested  in  law,  a  voluminous  writer 
in  general  literature,  principal  of  the  Col- 
lege de  Bayeux,  physician  at  Bordeaux, 
Poitiers,  and  Lyons,  teacher  of  arithmetic 
at  Annecy,  author  of  various  textbooks  on 
mathematics — including  algebra,  geometry, 
and  arithmetic — it  will  be  seen  that  he  had 
little  time  for  serious  work  in  any  of  his 
various  fields  of  activity. 

Perhaps  the  most  all-round  dilettante  of 
the  sixteenth  century  to  come  within  our 
field  is  Henricus  Cornelius  Agrippa  (1486- 
1535).  He  posed  as  physician,  lawyer,  sol- 
dier, philosopher,  astrologer,  and  alchemist 
in  various  centers  of  learning,  including 
Cologne,  Pavia,  Freiburg,  Brussels,  Bonn, 
and  Grenoble.  His  "De  Incertitudine  & 
Vanitate  Scientiarum"  went  through  vari- 
ous editions  24  and  shows  at  least  a  super- 
ficial knowledge  of  substantially  every 
science,  mathematics  ranking  equally  with 
medicine  in  his  general  condemnation.26 

Such  were  a  few  of  those  who  added  to 
mathematical  knowledge,  who  were  held  in 


high  esteem  as  healers  of  the  body,  or  who 
made  some  name  in  literary  productions 
which  touched  upon  both  of  the  sciences. 
It  will,  however,  be  more  helpful  to  those 
who  care  to  study  the  intimate  connection 
between  mathematics  and  medicine  if  a  list 
of  some  of  the  others  who  helped  to  estab- 
lish this  connection  is  made  accessible  to 
them,  and  such  a  list,  necessarily  much 
abridged,  is  given  as  a  supplement  to  this 
fragmentary  sketch. 

Although  it  has  been  said  above  that  the 
sixteenth  century  was  par  excellence  the 
century  of  the  iatromathematicians,  it  must 
not  be  thought  that  later  centuries  failed  to 
find  this  same  intimate  relationship  be- 
tween the  two  sciences.  Thus  in  the  cen- 
tury following  we  find  the  great  Boerhaave 
(1668- 1 738),  whose  reputation  as  one  of 
the  greatest  physicians  of  his  time  obscured 
what  would  otherwise  have  been  an  envi- 
able reputation  in  the  field  of  applied 
mathematics.  So  his  contemporaries  Eisen- 
schmid  (1656-17 12)  and  Guglielmini  (1655- 
1710)  represent  the  union  of  the  two  sub- 
jects, since  it  was  the  "Diatribe  de  figura 
telluris  eIIiptico-spha;roide  (1691)"  of  the 
former  that  gave  rise  to  the  dispute  as  to 
the  elongation  of  the  earth,  and  the  latter 
was  a  recognized  authority  on  mathematics 
as  applied  to  hydraulics.  These  facts  are 
apt  to  be  forgotten  both  by  the  historian 
of  mathematics  and  by  the  recorder  of 
medical  progress,  just  as  when  we  see  the 
beautiful  colonnade  of  the  Louvre,  we  for- 
get that  Claude  Perrault  (161 3-1688)  was 
not  merely  an  architect  but  was  also  a  phy- 
sician and  a  mathematician.  Not  many,  too,  ' 
recall  the  fact  that  the  famous  Johann  (I) 
Bernoulli  (1 667-1 748),  one  of  the  two  broth- 


B  His  works  include  "Doctrinae  sphscrioE  Iibri  V," 
Francofurti,  1 591,  and  Franeker,  i5Q8;"Geometriccs 
per  usum  circini  nova  praxis,"  Amstclodami,  1623; 
"Opera  arithmetica  et  geometrica,"  Lugduni  Batavo- 
rum,  1625. 

"Among  his  works  are  "L'AIgcbrc,  d6partie  en 
deux  livres,"  Lyon,  1554;  "  L'Arithmetique,  departie 


en  quatre  livres,"  t6.,  1554;  "Dcmonstrationum  in 
Euclidis  elementa  geometrica  Iibri  six,"   Lu] 
1557. 

u  A  copy  in  the  writer's  library   lias  the  double 
date,  Lugduni  Batavorum,  1643  and  1644. 

24  His  "De  occulta  Philosophia  Iibri  III  "  appeared 
at  Cologne  in  15 10  and  again  in  1533. 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


133 


ers  who  founded  the  celebrated  family  of 
mathematicians  bearing  his  name,  held  a 
degree  in  medicine.  His  dissertation  "De 
effervescentia  et  fermentatione"  (Basilese, 
1690)  gave  little  suggestion  that  he  would 
become  one  of  the  greatest  leaders  in  spread- 
ing the  knowledge  of  the  new  mathemati- 
cal discipline  of  the  calculus  throughout 
continental  Europe;  yet  such  was  the  case, 
and  his  productions  in  mathematics  were 
of  highest  scientific  value. 

Thus  it  has  been  through  all  the  centu- 
ries, particularly  from  the  ninth  to  the  twen- 
tieth, that  mathematics  and  medicine  have 
found  much  in  common,  although  the  two 
periods  in  which  this  has  been  the  most 
noticeable  are  the  era  of  the  Arab  ascend- 
ency and  that  of  the  sixteenth  century,  to 
the  latter  of  which  this  brief  summary  chief- 
ly refers. 

A  PARTIAL  LIST  OF  THOSE  WHO,  IN  THE  SIX- 
TEENTH CENTURY,  WERE  DISTINGUISHED 
IN  MATHEMATICS  AND   IN  MEDICINE  26 

Bernard  Abatia  (1540-C.1590),  physi- 
cian, mathematician,  astronomer,  jurist, 
and  linguist. 

Alessandro  Achillini  (1463-15 1 2  or 
15 18)  was  professor  of  medicine  and  of 
philosophy  in  Bologna  and  in  Padua.  His 
"Opera  Omnia"  (Venetiis,  1508)  contains 
numerous  contributions  to  medicine,  and 
he  wrote  also  on  astronomy  and  physics, 
subjects  so  closely  connected  with  mathe- 
matics as  to  show  the  trend  of  his  interests. 

Johann  Acronius,  or  Atrocianus  (1520- 
1564),  not  only  practiced  medicine  at  Basle 
but  was  also  professor  of  mathematics  and 
of  logic  in  the  university  of  that  city.  His 

26  The  list  is  arranged  alphabetically  either  by  the 
family  name  or  by  the  name  by  which  the  person  is 
commonly  known.  It  includes  the  names  of  many 
prominent  medico-mathematicians  who  were  living 
between  1500  and  1600,  but  the  reader  is  referred 
to  Sudhoff's  list  for  a  considerable  number  of  minor 
names. 

27  His  "Canones  astrolabii  universalis"  appeared 
in  its  second  edition  at  Salamanca  in  1554. 


writings  were  in  the  line  of  mathematical 
astronomy.  His  skill  as  a  physician  could 
not  save  him  from  death  as  a  result  of  the 
plague. 

Adriaen  Adriaenszoon.  See  the  article. 

Agrippa.  See  the  article. 

Juan  Aguilera,  who  flourished  in  Sala- 
manca in  the  middle  of  the  sixteenth  cen- 
tury, was  well  known  as  a  mathematician, 
physician,  philosopher,  and  theologian.27 

Juan  Aleman  practiced  medicine  in 
Spain  in  the  second  half  of  the  sixteenth 
century  and  wrote  on  astronomy  and  as- 
trology.28 

Juan  Almenar,  born  in  Valencia  in  the 
latter  part  of  the  fifteenth  century,  took 
his  degree  in  medicine  and  is  described  as 
"el  primer  espafiol  que  escribio  sobre  el 
mal  venero"  (1502).  He  was  much  interested 
in  astrology,  however,  "en  la  cual  Ilego  a 
adquirir  gran  fama,"  and  he  seems  to  have 
written  a  work  on  astronomy  which  was 
never  printed. 

Johann  Asverus  Ampsing  (c.  1559  - 
1642),  one  of  the  chief  authorities  on  the 
iatromathematics  in  the  seventeenth  cen- 
tury, a  native  of  the  province  of  Upper 
Yssel.  He  was  a  physician  of  prominence  and 
wrote  a  dissertation  on  iatromathematics.29 

Melchior  Ayrer  (1520-1579),  a  physi- 
cian of  Nurnberg,  well  known  in  his  day  as 
a  chemist  and  mathematician,  was  skillful 
in  the  making  of  mathematical  instruments. 

Bernardino  Baldini  (15 15-1600),  pro- 
fessor of  medicine  in  Pavia  and  of  mathe- 
matics in  Milan.  His  writings  were  chiefly 
on  astronomy  and  physics. 

Pierre  Beausard  (d.  1577),  a  physician 
of  Louvain,  and  in  later  life  a  professor  of 
mathematics  in  the  university.  While  not 

28  The  first  edition  of  his  work  appeared  at  Bar- 
celona in  1580,  under  the  title  "Lunari  6  repertori 
del  temps  compost  per  Io  molt  abil  astrolec  Joan 
Alemany." 

29  "Diss,  iatromathica  in  qua  de  medicinese  et  as- 
tronomiae  praestantia  indissolubili  cojugio  disseritur," 
Rostochii,  1629. 


134 


Annals  of  Medical  History 


an  original  genius,  he  is  known  for  two 
works  of  some  merit.30 

Isaac  Beeckman  (1570-1637),  a  physi- 
cian, director  of  the  Latin  school  at  Dor- 
drecht, wrote  "  Mathematico-physicarum 
meditationum,"  Traject.  ad  Rhen.,  1644. 

Lattanzio  Benacci  (1499-1572),  physi- 
cian and  professor  of  astronomy  in  Bologna, 
and  an  astrologer  of  some  repute. 

Michael  Beuther  (1522-1587),  doctor 
of  law  and  also  of  medicine,  professor  of 
poetry  and  also  of  mathematics  in  Greifs- 
wald,  and  finally  professor  of  history  at 
Strasburg.  He  contributed  slightly  to  the 
literature  of  the  circle  and  the  calendar. 

Heinrich  Bruoeus  (c.  1531— 1593),  was 
professor  of  mathematics  in  Rome,  and  af- 
terwards practicing  physician  as  well  as 
professor  of  medicine  and  of  mathematics 
in  the  University  of  Rostock.  He  wrote 
numerous  medical  works  and  at  least  two 
books  on  mathematical  astronomy. 

Olaus  Engelberti  Bure,  or  Bur.^us 
(1578-1655),  was  a  physician  at  the  court 
of  Gustavus  Adolphus,  but  he  was  also 
much  interested  in  mathematics  and  was 
one  of  the  pioneers  in  mechanical  computa- 
tion." 

Baldassare  Capra  (d.  1626)  was  a  prac- 
ticing physician  at  Milan,  but  his  interests 
were  rather  in  mathematical  astronomy.32 
He  was  a  bitter  antagonist  of  Galileo.33 

Facio  Cardano  (1444-1524),  professor 
of  medicine  and  jurisprudence  in  Milan, 
edited  Bishop  Peckham's  "Perspectiva 
communis."  He  was  the  father  of  Cardano 
the  algebraist. 

Girolamo  Cardano.  See  the  article. 

JOHANN    CHESNECOPHERUS    (1581-1635), 

*°"AnnuIi  astronomici  instrument  .  .  .  usus," 
Antvcrpiae,    1553;    "Arithmetices    praxis"   Lovanii, 

i573-( 

n  "Arithmetica  instrumentalis  Abacus  ab  co  ipse 
inventus,"  Helmst..  1609. 

**"Considerazione  astronomica  sopra  la  nuova 
stella  del  1604,"  Padova,  1605;  "Tyrocinia  astro- 
nomica," ib.,  1606;  "Dc  usu  ct  fabrica  circini  cujus- 
dam  proportionis,"  16.,  1607. 


professor  of  medicine  and  anatomy  at  Up- 
sala,  gave  much  attention  to  astronomy 
and  physics,  and  incidentally  to  mathe- 
matics.34 

Federigo  Commanding-  (1509-1575),  a 
physician,  became  mathematician  to  Duke 
Guido  Ubaldi  of  Urbino  and  to  Cardinal 
Ranuccio  in  Rome,  but  his  greatest  contri- 
butions were  in  his  editions  of  the  mathe- 
matical works  of  Ptolemy,  Archimedes, 
ApoIIonius,  Aristarchus,  Euclid,  Pappus, 
and  Heron.  These  were  published  in  Venice, 
Rome,  Bologna,  Pisa,  and  Urbino  between 
1558  and  1592.  His  edition  of  Euclid  is  par- 
ticularly well  known. 

Copermcls.  See  the  article. 

Juan  Baptista  Cursa,  born  in  Valencia 
in  the  second  half  of  the  sixteenth  century, 
a  doctor  of  medicine,  wrote  one  work  on 
mathematical  astronomy.35 

Joachim  Curtius  (1 585-1 742),  a  prac- 
ticing physician  in  Hamburg,  edited  Tycho 
Brahe's  "Oratio  de  disciplinis  mathema- 
ticis"  (Hamb.,  1621)  and  wrote  "De  cert  it  u- 
dine  matheseos  et  astronomic"   (ib.,  1616). 

Cyriaque  de  Mangin  (c.  1 570- 1 642),  a 
Paris  physician,  published  his  "Problemata 
duo  nobilissima,  quorum  nee  analysin  geo- 
metricam  videntur  tenuisse  J.  Regiomon- 
tanus  et  P.  Nonius,"  etc.,  in  Paris  in  161 6. 

Federigo  Delfino  (1477-1547),  a  physi- 
cian in  Venice,  became  professor  of  astron- 
omy in  the  University  of  Padua,  his  native 
town.  His  mathematical  work  is  seen  in  his 
"Annotationes  in  Tabulas  Alphonsinas." 

Joseph  Solomon  Delmedigo  (1591- 
1655),  a  native  of  Candia,  a  graduate  of 
Padua,  a  student  under  Galileo,  a  cabalist 
in  Constantinople,  physician  to  Prince  Rad- 

33  So  we  have  Galileo's  "Difese  contra  alle  ca- 
lumnie  e  imposture  de  Baldassare  Gipra,"  Venezia, 
1607. 

u  E.g.,  in  his  "De  stellis,"  and  his  "De  eclipsi 
solis  et  Iunse,"  Upsala,  1624. 

**"Discvrso  mathematieo  sobrc  la  nat\  rale/a  y 
significacion  dc  Ios  cometas  .  .  .  de  1618;  Com* 
puesto  por  el  doctor  Iuan  Baptista  (ansa,  lilosopho 
y  Medico  Valenciano,"  Valencia,  1619. 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


135 


ziwill  at  Vilna,  a  Rabbi  at  Hamburg,  a 
physician  in  Amsterdam,  and  a  prolific 
writer  on  medicine  and  mathematics.36 

Johann  Dryander,  or  Eichmann  (1500- 
1560),  was  professor  of  medicine  and  mathe- 
matics at  the  University  of  Marburg  (1535). 
He  wrote  several  works  on  mathematical 
astronomy. 

Thaddaus  Dunus,  or  Taddeo  Duno 
(1523-1613),  was  a  Zurich  physician,  born 
in  Locarno,  but  he  is  known  only  for  his 
two  rather  obscure  mathematical  works.37 

Lorenz  Eichstadt  (1596- 1 660),  profes- 
sor of  medicine  and  mathematics  in  the 
Gymnasium  at  Danzig,  published  several 
works  on  mathematical  astronomy. 

Samuel  Eisenmenger,  known  also  as 
Siderokrates  (1 534-1 585),  a  practicing  phy- 
sician, was  professor  of  mathematics  at  the 
University  of  Tubingen.38 

Paul  Fabricius  (1529  or  15 19-1588),  a 
physician  of  high  standing,  a  professor  in 
the  University  of  Vienna,  was  known  chief- 
ly for  his  mathematical  tables  for  use  in 
astronomy.39 

Jean  Fernel.  See  the  article. 

Auger  Ferrier  (1513-1588),  physician 
to  Catharine  de  Medici,  queen  of  Henri  II 
of  France,  was  quite  as  much  interested  in 
mathematics  and  astrology  as  in  medi- 
cine.40 

Fienus,  or  Fyens  (1567-1631),  professor 
of  medicine  at  Louvain,  writer  upon  medi- 
cal matters,  was  also  known  as  an  astrono- 


36  For  example,  the  "Refuath  Tealah"  (Healing 
medicine);  "Or  Shibat  Ha-yamim"  (the  Light  of 
the  Seven  Days)  including  some  discussion  of  op- 
tics; "Bosmat  Bat  Schelomoh"  (Bosmat,  daughter 
of  Solomon),  on  mathematics  and  related  subjects; 
and  "Elim" (Amsterdam,  1629),  a  work  containing  an- 
swers to  various  scientific  questions  propounded  by 
Zerakh  ben  Nathan  and  seventy  mathematical  para- 
doxes. 

37  "Arithmetices,  practices  methodus,"  Basileae, 
1546;  "De  nonis,  idibus  et  calendis,"  16.,  1546. 

38  "De  usu  partium  cceli  in  commendationem  as- 
tronomiae,"  Argentorati,  1567. 


Thomas  Finke,  or  Finck  (1561-1656), 
was  court  physician  to  the  Duke  of  Schles- 
wig-HoIstein,  and  afterward  professor  of 
medicine  (1591),  of  mathematics  (1602), 
and  of  rhetoric  in  the  University  of  Copen- 
hagen. His  mathematical  work  also  led  him 
into  the  field  of  astronomy.42 

Jacob  Flach  (1537-1611)  was  professor 
of  medicine  and  of  mathematics  at  the  Uni- 
versity of  Jena,  but  he  seems  to  have  con- 
tributed nothing  to  the  literature  of  either 
science. 

Erasmus  Flock  (15 14-1568),  a  physician 
of  Nurnberg,  was  for  a  short  time  (1543- 
1545)  professor  of  philosophy  and  mathe- 
matics in  the  University  of  Wittenberg. 
Among  his  other  activities  he  edited  Ptol- 
emy's "Almagest"  (Norimb.,  1550). 

Simon  Forman  (1552-1611),  a  physician 
and  an  astrologer  in  London  and  the  author 
of  various  works  on  alchemy,  magic,  and 
astrology. 

Geronimo  or  Girolamo  Fracastoro 
(1483-1553),  a  physician  in  Verona,  was 
afterwards  Papal  physician.  He  wrote  on 
medicine,  but  also  was  interested  in  the 
mathematics  of  optics  and  seems  to  have 
had  some  idea  of  the  telescope.43 

Jean  Franco  (c.  1 550-1 610),  a  physician 
of  Brussels,  wrote  an  ephemeris  of  astrolog- 
ical character,  in  Flemish,  and  this  was  pub- 
lished at  Antwerp  in  1594. 

Lorenz  Fries  (c.  1485-1531),  a  promi- 
nent iatromathematician,  author  of  the 
"Spiegel  der  Arznei"  (15 18)  and  of  a  work 
on  the  astrolabe.  He  remarks  that  "medi- 


39  "Tabula?  astronomicae,"  Vienna,  1558. 

40  "De  diebus  decretoriis  secundum  Pythagori- 
cam  doctrinam  et  astronomicam  observationem," 
Lugduni  Batavorum,  1541. 

41  "De  cometa  anni  1618,"  Antv.,  1619. 

42  "De  constitutione  philosophise  mathematicae," 
Hafniae,  1591;  "  Geometries  rotundi  Iibri  XIV,"  Basi- 
leae, 1583;  "De  hypothesibus  astronomicis,"  etc., 
Hafniae,  1593,  etc. 

43  This  is  in  his  "  Homocentricorum  seu  de  stellis, 
liber  unus,"  Venet.,  1538. 


ll6 


Annuls  of  Medical  History 


cus  sine  astrorum  cognitione  perfectus  esse 
non  potest." 

Galileo.  See  the  article. 

Gemma  Frisius.  See  the  article. 

Cornelis  Gemma  Frisius  (i  535-1 577), 
son  of  the  better  known  Gemma  Rainer 
(Gemma  Frisius),  was  professor  of  medicine 
and  also  of  astronomy  at  Louvain.  His  "De 
arte  cyclognomica  tomi  III,  philosophiam 
Hippocratis,  Galeni,  Platonis  et  Aristotelis 
in  unam  methodi  speciem  referentes" 
(Antv.,  1569)  is  well  known,  and  he  also 
wrote  two  astronomical  works. 

Simon  GryNjEUS  the  Younger  (1539- 
1582)  was  professor  of  medicine  and  of 
mathematics  at  Heidelberg.  His  father 
published  the  first  Greek  edition  of  Ptol- 
emy's "Almagest"  (Basil.,  1538),  and  was  a 
friend  of  Luther  and  Melanchthon.  Simon 
the  Younger  wrote  a  work  on  astronomy,44 
published  in  Basle  in  1580. 

Isaak  Habrecht  (d.  1633)  was  a  doctor 
of  philosophy  and  of  medicine.  In  his  later 
years  he  became  an  assistant  in  mathe- 
matics in  the  University  of  Strasburg.  He 
published  various  works  of  an  astronomical 
nature. 

Thaddaus  Hagek  (1525  - 1600),  also 
known  as  Hajek,  or  Hagecius  ab  Hayek, 
and  as  Thaddaeus  Nemicus,  was  for  a  long 
time  professor  of  mathematics  in  the  Caro- 
Iinum  at  Prague,  but  later  was  physician  to 
Maximilian  II  and  to  Rudolph  II.  He 
wrote  several  works  on  geometry  and  as- 
tronomy.46 

Muhammed  ibn  IbrahIm  ibn  Jusuf, 
RadI  ed-din  Abu  'Abdallah  (d.  1563), 
known  as  Ibn  el-Hanbalt,  a  native  of  Alep- 
po, a  man  well  versed  in  medicine,  law,  and 
mathematics,  wrote  various  works  on  geom- 
etry and  arithmetic. 

Johann     Hartmann     (1568-1631)    was 

44  "De  cometis  dissertationes  nova." 

"Among  them,  "Oratio  de  Iaudibus  gcometriae," 
Pragse,  1557;  "Apodoxis  physica  et  mathematica  de 
cometis  turn  in  genere,  turn  imprimis  de  eo,  qui 
1580.     .     .  aflulsit,"  Gorlicii,  1581. 


professor  of  mathematics  in  the  University 
of  Marburg  (1592)  and  later  took  his  de- 
gree there  in  medicine  (1606),  then  becom- 
ing professor  of  chemistry  (of  "Chymia- 
trie").  He  was  physician  at  the  court  of 
the  Kurfiirst  of  Hesse.46 

Sixtus  ab  Hemminga  (1533-1581)  was 
a  physician  and  mathematician  of  some 
prominence  in  Belgium.  He  studied  in  Gro- 
ningen,  Coin,  Louvain,  and  Paris.47 

Georg  Henisch  ( 1 549-1 61 8),  of  Hun- 
garian birth,  was  a  physician  and  after- 
wards taught  logic  and  mathematics  at 
Augsburg.  He  wrote  numerous  works  on 
mathematics,48  philology,  and  medicine. 

David  Herlicius  (1557-1636),  also 
known  as  Herlick  and  Herlitz,  a  physician, 
was  professor  of  mathematics  in  the  Uni- 
versity of  Greifswald  from  1585  to  1598. 
He  wrote  upwards  of  fifty  works,  chiefly 
on  astronomy. 

Joachim  Jung  (1 587-1 657),  professor  of 
mathematics  at  Giessen  (1609-1614),  of 
medicine  at  Padua  (1618),  of  mathematics 
at  Rostock  (1624-1625),  of  medicine  at 
Helmstadt  (a  few  months),  and  again  of 
mathematics  at  Rostock,  alternated  as  few 
men  do  between  his  two  favorite  sciences. 
His  writings  cover  a  wide  range,  including 
mathematics,49  astronomy,  physics,  and  bot- 
any. 

Lilio.  See  the  article. 

Johann  Marcus  Marci  de  Kronland 
(1595-1667),  for  more  than  forty  years  pro- 
fessor of  medicine  at  Prag,  physician  to  Em- 
peror Ferdinand  III,  wrote  quite  as  much, 

44  His  sole  printed  work  on  mathematics  was  his 
"Disputatio  elementorum  geometricorum,"  G\ssel, 
1600,  but  he  wrote  on  medicine  and  chemistry. 

47  He  wrote  "Astrologiae  ratione,  et  cxpericntia 
refutatae  liber,"  Antverpiae,  1583. 

48  "Dc  numcratione  multiplied  vetcrc  et  recenti," 
Aug.  Vind.,  1605;  "Arithmetica  perfecta  et  demon- 
strata,"  ib.,  1605;  "Commentarius  in  sphaeram  Pro- 
di," ib.,  1609;  and  others. 

4'"Geometria  empirica,"  Rostochii,  1627,  with 
later  editions;  "Disputatio  dc  Stoecheosi  geometrica," 
Hamb.,  1634. 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


137 


in  a  somewhat  heterodoxical  fashion,  on 
mathematics  as  on  medicine.50 

Philips  van  Lansberg  (1561-1652),  a 
physician  and  priest  at  Antwerp  and  else- 
where, devoted  his  energies  chiefly  to 
mathematics 51  and  astronomy.  His  "Opera 
omnia"  appeared  at  Middelburg  in  1663. 

Wilhelm  Lauremberg  (1547-1612)  was 
professor  of  mathematics  and  medicine  at 
Rostock  and  wrote  on  both  sciences.62 

Peter  Lauremberg  (1585-1639),  son  of 
Wilhelm,  was  even  more  versatile  than  his 
father,  for  he  studied  medicine  in  Leyden, 
was  professor  of  philosophy  in  Montauban, 
of  medicine  in  Montpellier,  of  physics  and 
mathematics  in  Hamburg,  and  of  poetry 
at  Rostock.  He  wrote  on  astronomy,  mathe- 
matics, physics,  and  various  other  disci- 
plines, and  his  influence  was  what  would  be 
expected  from  one  who  scattered  his  ener- 
gies so  recklessly. 

Johann  Wilhelm  Lauremberg  (1590- 
1658),  a  younger  brother  of  Peter,  divided 
his  interests  almost  as  disastrously.  He  re- 
ceived his  doctor's  degree  in  medicine  at 
Rheims  in  16 16,  was  professor  of  poetry 
and  mathematics  at  Rostock  (161 8)  and  of 
mathematics  in  the  Ritteracademie  at  So- 
roe  (1623).  His  writings  were  chiefly  if  not 
wholly  mathematical,  but  not  of  a  high 
character.53 

Heinrich  Lavater  (1560— 1623),  a  phy- 
sician, was  professor  of  physics  and  mathe- 
matics in  Zurich,  the  city  of  his  birth.  His 
writings  were  chiefly  on  physics  and  as- 
tronomy and  were  of  no  particular  merit. 

50  For  example,  "De  proportione  motus,"  Pragae, 
1639,  "De proportione  motus  figurarum  rectilinearum 
et  circuli  quadratura  ex  motu,"  ib.,  1648;  "De  Iongi- 
tudine  s.  differentia  inter  duos  meridianos;  una  cum 
motu  vero  Iunae  inveniendo  ad  tempus  datae  obser- 
vationis,"  ib.,  1650;  "Labyrinthus  in  quo  via  ad  circuli 
quadraturam  pluribus  modis  exhibetur,"  ib.,  1654. 

61  "Triangulorum  geometriae,  Iibri  quatuor"  Lug- 
duni  Batav.,  1591  and  Amstelod.,  1631;  "Cyclome- 
triae  novae  Iibri  duo,"  Middelb.,  1616-1628. 

62  Among  other  works  he  wrote  a  "Breviarium  geo- 
metricum  et  geodaeticum." 


Leonardo  da  Vinci.  See  the  article. 

Adam  Lonicerus,  or  Lonitzer  (1528- 
1586),  was  professor  of  mathematics  at 
Niirnberg  in  1553  and  the  following  year 
he  received  his  doctor's  degree  in  medicine 
at  Mainz.  He  wrote  on  botany,  medicine, 
and  mathematics.64 

Mangin.  See  Cyriaque  de  Mangin. 

Simon  Marius,  or  Mayer  (1570-1624), 
studied  astronomy  under  Tycho  Brahe  and 
Kepler  and  then  took  a  course  in  medicine 
at  Padua.  His  contributions  were  all  in  the 
line  of  mathematics,  including  astronomy.61 

Mayer.  See  Marius. 

Metius.  See  the  article. 

Christoph  Meurer  (1558-16 16),  a  mem- 
ber of  the  medical  faculty  and  professor  of 
mathematics  at  the  University  of  Leipzig.59 

Jacob  Milich  (1501-1559),  or  Milichius, 
professor  of  medicine  in  the  University  of 
Wittenberg,  also  taught  mathematics  there. 
His  commentary  on  Pliny  contains  more  or 
less  of  astronomy. 

BURCKHARD     MlTHOB     (15O4-I565)     was 

professor  of  mathematics  and  of  medicine 
in  the  University  of  Marburg.67 

Antoine  Mizauld  (c.  1520-1578),  a  prac- 
ticing physician  in  Paris,  wrote  a  number 
of  works  on  mathematical  astronomy. 

Henry  de  Monantheuil,  or  Monantho- 
lius  (1536-1606),  professor  of  medicine 
(1574)  and  later  (1585)  of  mathematics  in  the 
College  royal  of  France,  at  Paris.  He  was  a 

o3"Logarithmus,"  Lugduni  Batav.,  1628;  "Lusus 
et  recreationes  ex  fundamentis  arithmeticis,"  Havn., 
1634;  "Arithmetica  et  algebra,"  Soroe,  1643;  "In- 
strumentum  proportionum,"  etc.  Rostochii. 

64  "Arithmetices  brevis  introductio,"  Francof., 
1551. 

55  Among  his  works  were  "Die  ersten  sex  Biicher 
elementorum  Euclidis,"  Niirnberg,  1610;  "Hypothe- 
ses de  systemate  mundi,"  1596. 

56  He  wrote  "Analysis  arithmetics  et  geometriae  ta- 
bulis  succinctis,"  Lipsiae,  1607,  and  edited  the  arithme- 
tic of  Psellus  and  the  optics  and  catoptrics  of  Euclid. 

67  He  wrote  "Annuli  cum  sphaerici,  turn  mathe- 
matici  usus  et  structura,"  Marp.,  1536;  "Stereo- 
metria,"  Francof.,  1544. 


i38 


Annals  of  Medical  History 


pupil  of  Ramus's.  He  wrote  various  works 
on  mathematics  and  iatromathematics.58 

Jean  Baptiste  Morin  (1583-1656),  phy- 
sician to  the  Bishop  of  Boulogne  and  other 
notables,  became  professor  of  mathematics 
at  the  College  royal  in  Paris  in  1630.  He 
was  a  voluminous  writer,  his  interests  includ- 
ing geology,  astronomy,  theology,  astron- 
omy, and  mathematics.59 

Joannes  Morisotus,  a  physician  of 
about  the  middle  of  the  sixteenth  century, 
wrote  among  other  works  four  books  on 
arithmetic.60 

Jacob  Muller  (1 594-1 637)  was  pro- 
fessor of  mathematics  (161 8)  and  of  medi- 
cine (1620)  in  the  University  of  Giessen, 
and  later  of  both  mathematics  and  medi- 
cine at  Marburg.  He  wrote  chiefly  on  mathe- 
matics.61 

Muller.  See  also  Mulerius. 

Nicolaus  Mulerius  (1564-1630),  also 
known  as  Mulierius,  Muliers,  and  Muller, 
a  Dutch  physician,  was  professor  of  mathe- 
matics at  the  University  of  Groningen 
(1614-1621).  He  wrote  a  number  of  works 
on  mathematical  astronomy. 

Pieter  Mulerius  (1599-1647),  son  of 
the  preceding,  was  a  physician  and  became 
professor  of  physics  and  botany  at  Gronin- 
gen (1629).  He  wrote  on  mathematical  as- 
tronomy, continuing  the  Ephemeris  begun 
by  his  father. 

Michael  Neander  (1 529-1 581)  was  pro- 
fessor of  mathematics  and  Greek  (1551)  in 
the  University  of  Jena,  and  later  (1560) 
professor  of  medicine.62 

Nemicus.  See  Hagek. 

**  "Oratio  pro  mathematicis  artibus,"  Parisiis, 
1574;  "Ludus  iatromathematicus,"  16.,  1597;  "De 
puncto,  primo  geometric  principio,"  Lugduni  Bat., 
1600,  etc. 

*'  "Trigonometric  canonical  Iibri  tres,"  Parisiis, 
1633. 

*°  Heilbronner,  "Historia  Matheseos  Universal," 
Lipsiae,  1742,  p.  789,  quoting  Vossius. 

""Compendium  geometricum,"  Gissae,  1620; 
"Praxis  geometric  universalis,"  ib.,  1621;  "Arith- 
metices  compendium,"  Lipsiae,  163 1. 


Gerard  de  Neufville  (d.  1648),  pro- 
fessor of  mathematics  and  physics  (161 1) 
in  the  Gymnasium  at  Bremen,  and  later 
(1624)  of  medicine,  wrote  on  mathematics,63 
astronomy,  and  physics. 

Augustinus  Niphus  (1473-1546),  a  phy- 
sician and  astrologer  in  Suessa,  Calabria, 
published  in  1504,  in  Venice,  an  astrological 
work  in  which  he  endeavored  to  combine 
the  observations  of  the  physician  with 
those  of  the  astronomer. 

Antonio  Nunez  de  Zamora,  a  native  of 
Salamanca  or  Zamora,  born  in  the  second 
half  of  the  sixteenth  century,  lectured  at 
the  University  in  that  city  on  medicine, 
mathematics,  and  astrology.64 

Pedro  Nunez  Salaciense  (1492-1577) 
studied  medicine  in  Lisbon,  but  gave  his 
attention  thereafter  entirely  to  mathemat- 
ics. He  became  one  of  the  leading  Portu- 
guese mathematicians  of  the  sixteenth  cen- 
tury, writing  several  treatises  of  consider- 
able merit.65 

Hermann  Obermeyer  (1588-1655),  a 
Basle  physician,  became  professor  of  mathe- 
matics in  the  University  of  Basle  in  1630. 
His  writings  were  astrological  and  astro- 
nomical and  were  of  no  value. 

Peletier.  See  the  article. 

Kaspar  Peucer  ( 1 525-1 602)  was  pro- 
fessor of  mathematics  (1554)  and  then 
(1560)  of  medicine  in  the  University  of  Wit- 
tenberg. His  position  as  son-in-law  of  Me- 
Ianchthon  probably  gave  him  more  stand- 
ing than  would  otherwise  have  been   his. 

6J  His  "Synopsis  mensurarum  et  ponderum  pon- 
derationisque  mensurabilium  secundum  Romanos, 
Athenienses,"  etc.,  was  published  at  Basle  in  1555. 
He  also  wrote  "Elementa  sphaericae  doctrina\"  i/>., 
1561. 

"  "Arithmetica  theoretica  et  practica,"  Bremae, 
1624. 

M  He  published  two  works,  the  first  being  "Prog- 
nostico  del  eclipse  del  sol  que  se  hizo  en  ano  de  1600," 
Salamanca,  1600. 

M  Among  them,  "Libro  de  algebra  en  Arithmetica 
y  Gcometria,"  Ambercs,  1564- 1567;  "Tratado  de 
sphera,"  Lisboa,  1537- 


Medicine  and  Mathematics  in  the  Sixteenth  Century 


139 


He  was  also  physician  at  one  of  the  small 
courts.  He  wrote  various  works  on  medi- 
cine and  mathematical  astronomy.66 

Juan  Martin  Poblacion,  a  native  of 
Valencia,  took  high  rank  as  a  physician  and 
astrologer  in  the  sixteenth  century.  He 
wrote  two  works  on  the  astrolabe,  one  of 
which  exists  only  in  manuscript.67 

Cristobal  Ponce  de  Leon  (d.  1598)  was 
professor  of  medicine  and  also  of  mathe- 
matics in  Alcala.68 

Rainer  or  Rainier.  See  Gemma  Frisius 
in  the  article. 

Recorde.  See  the  article. 

Regnier.  See  Gemma  Frisius  in  the  ar- 
ticle. 

Ambrosius  Rhodius  (1577-1633),  pro- 
fessor of  mathematics  in  the  University  of 
Wittenberg  (1608)  and  author  of  various 
works  on  optics,  astronomy,  and  geome- 
try,69 gave  also  much  attention  to  medi- 
cine. There  seems  to  have  been  another  of 
the  same  name,  a  contemporary,  who  was 
also  interested  in  medicine  and  mathe- 
matics. 

Giovanni  Antonio  Roffeni  (d.  1643),  a 
doctor  of  medicine,  became  professor  of 
mathematics  in  Bologna,  but  his  works 
were  astronomical  and  astrological  only.70 

Adriaen  van  Roomen.  See  the  article. 

66  Among  the  latter,  "Elementa  doctrinae  de  cir- 
culis  ccelestibus  et  primo  motu,"  Viteb.,  1551,  with 
various  editions;  "De  dimensione  terras  et  geome- 
trice  numerandis  locorum  particularium  intervallis 
ex  doctrina  triangulorum  sphaericorum,"  ib.,  1554, 
with  later  editions. 

67  The  published  work  was  entitled  "De  vsv  as- 
trolabi,"  and  appeared  in  Paris  in  1526  and  1527. 
later  editions  in  1546,  1547,  1550,  1553,  1554,  and 
1556.  The  unpublished  manuscript  is  a  "Tratado  y 
uso  del  astrolabio"  and  is  in  the  Biblioteca  Nacio- 
nal  at  Madrid. 

68  He  wrote  "Libro  de  la  ciencia  natural  del  cielo," 
Alcala,  1598. 

'•  "Euclidis  elementorum  Iibri  XIII,"  Viteb.,  1609, 
1634. 

70  "Contra  cacam  cujusdam  Martini  Horckii," 
Bononise,  161 1;  "De  Iaudibus  verae  astrologiae,"  ib., 
1614. 


Peter  Ryff  (1 552-1 629)  was  a  practic- 
ing physician  in  Basle  and  became  professor 
of  mathematics  (1586)  in  the  university.  He 
wrote  several  works  on  mathematics.71 

Francisco  Sanchez  (1550-1623),  born 
at  Tuy  in  the  diocese  of  Braga,  a  Spanish 
physician,  lived  for  some  time  in  Mont- 
pellier  where  he  was  engaged  in  the  prac- 
tice of  his  profession,  finally  settling  in 
Tolosa.  He  wrote  one  work  on  mathe- 
matics 72  and  one  on  astronomy.  He  should 
not  be  confused  with  the  great  humanist 
of  the  same  name,  who  was  born  at  Brozas 
in  1523. 

Giuseppe  Scala  (1556-1585),  a  Sicilian 
physician,  composed  a  set  of  astronomical 
tables  which  was  published  four  years  after 
his  death.73 

Victorin  Schonfeld  (1525-1591)  re- 
ceived the  degree  of  doctor  of  medicine  at 
Marburg  in  1557,  became  professor  of 
mathematics  in  the  same  university  in  1557, 
and  in  1566  became  professor  of  medicine. 
He  wrote  on  medicine,  mathematics,  and 
astrology.74 

Jacob  Schonheinz,  one  of  the  earliest 
iatromathematicians  of  Germany,  and  the 
earliest  in  the  sixteenth  century,  published 
his  "Apologia  astrologiae,"  at  Niirnberg, 
in  1502. 

Johann  Schroter  (1513— 1593),  a  Vien- 
nese practitioner,  physician  to  the  Imperial 
and  Saxon  courts,  wrote  various  mathe- 
matical works.76 

Miguel  Serveto  (c.  1511-1553),  one  of 

71  Among  them,  "Questiones  geometricas  in  Eucli- 
dis elementa,"  Francof.,  1600;  "Compendium  arith- 
meticae  Vrstisii,"  Oxoniae,  1626;  "Elementa  sphaerae 
mundi,"  ib.,  1627. 

72  "Objectiones  &  erotemata  super  Geometricas 
Euclides  demonstrationes  ad  Christopherum  Cla- 
vium." 

73 "  Ephemerides  ex  tabulis  Magini,"  Venetiis, 
1589. 

74  Among  his  works  are  a  treatise  on  epilepsy 
(Marburg,  1577)  and  the  "Prognosticon  astrologi- 
cum,"  which  appeared  for  various  years. 

75  Among  them,  "De  arte  numerandi." 


140 


Annals  of  Medical  History 


the  best  educated  young  men  of  Spain  in 
the  sixteenth  century,  well  trained  in  Latin, 
Greek,  Hebrew,  philosophy,  theology, 
mathematics,  and  medicine,  fell  under 
the  ban  of  the  authorities  because  of  his 
opinions  and  was  executed  in  his  forty- 
fourth  year.  He  wrote  on  geography  and 
astrology.76 

Olaus  Martin  Sten  (i  598-1 650)  was 
professor  of  astronomy,  physics,  and  medi- 
cine at  the  University  of  Upsala. 

Georg  Tanstetter  von  Thannau 
( 1 482-1 535)  was  physician  to  the  Emperor 
Maximilian  I,  and  became  professor  of  as- 
tronomy in  the  University  of  Vienna.  He 
edited  Peurbach's  "Tabulae  eclipsium," 
Regimontanus's  "Tabulae  primi  mobilis," 
Proclus's     "Libellum     de     sphaera,"     and 

74  "Apologetica  disceptatio  pro  astrologia." 


the  works  of  Albertus  Magnus,  Vienna 
1523. 

Jeronimo  Torella,  a  physician  to  Fer- 
dinand the  Catholic,  to  Juana  of  Naples, 
and  to  other  dignitaries  in  the  sixteenth 
century,  was  much  interested  in  astrology 
and  wrote  two  works  on  the  subject. 

Bartolome  del  Valle,  a  doctor  of  medi- 
cine in  Salamanca,  wrote  two  treatises  on 
astrology,  published  in  1619. 

Vespasieno  Jeronimo  de  Vargas  y  He- 
redia,  a  physician  and  mathematician,  pub- 
lished a  "Tratado  de  cometas"  in  Granada 
in  1619. 

Victoriano  Zaragozana  (1545- 1 602),  a 
Spanish  physician,  was  much  interested  in 
the  mathematics  of  astronomy,  and  wrote 
several  works  on  the  subject,  all  printed  at 
Zaragoza,  1 583-1 599. 


STRUCTURE  FOLLOWS  FUNCTION 


Thus  man  is  the  most  intelligent  of  all 
animals,  thus  the  hands  are  proper  instru- 
ments for  an  intelligent  being,  since  man  is 
not  wiser  than  the  animals  because  be  has 
bands  (as  Anaxagoras  maintains),  but  as 
the  judicious  Aristotle  asserts,  he  has  hands 
precisely  because  he  is  the  ivisest.  It  is  not  by 
means  of  his  hands,  in  fact,  but  through  his 
reason  that  man  learned  the  arts:  the  hands 
are  an  instrument  like  the  lyre  to  the  musician, 
like  the  tongs  to  a  blacksmith.  .  .  IJ  we 
examine  newly-born  creatures  that  strive  to 
act  before  the  parts  of  the  body  are  fully  formed, 
it  becomes  clear  that  it  is  not  the  parts  of  the 
body  which  excite  the  soul  to  be  cowardly, 
courageous  or  wise.  For  example,  I  have  often 


seen  a  calf  try  to  gore  before  its  homs  bad 
developed,  a  chicken  try  to  spur  although  its 
feet  were  soft,  and  a  little  pig  tryring  to  defend 
itself  with  its  snout,  although  it  had  no  tusks; 
even  a  little  dog  trying  to  bite  ivithout  teeth; 
for  every  animal  has  i?i  himself,  ivithout  any 
previous  instruction,  an  instinctive  feeling  of 
the  faculties  and  functions  of  bis  body.  .  . 
It  is  7iot  through  iristruction,  I  opine,  that  the 
eagle  soars,  the  duck  swims  and  the  snake 
glides  into  a  hole,  for  as  Hippocrates  says: 
Animal  natures  are  untaught.  Whence  it 
seems  to  me,  for  the  rest,  that  animals  practice 
certain  arts  more  by  instinct  than  through 
reason. 

Galen  De  usu  partium,  1,  ?. 


HISTORICAL  DEVELOPMENT  OF  OUR   KNOWLEDGE  OF 
THE  CIRCULATION  AND   ITS  DISORDERS1 

By  PHILIP  S.  ROY,  M.D. 


WASHINGTON,    D.    C. 


THE  earliest  account  of  the  struc- 
ture of  the  heart  is  that  contained 
in  the  Hippocratic  writings.  It  is 
probably  pseudo  -  Hippocratic, 
but  admittedly  a  work  of  great  antiquity. 
The  heart  is  described  as  a  strong  muscle;  the 
pericardium  as  a  smooth  tunic,  containing  a 
little  fluid  resembling  urine;  the  auricles, 
the  ventricles,  the  sigmoid  valves  and  the 
origin  of  the  veins  from  the  heart  are  men- 
tioned. The  heart  is  described  as  the  foun- 
tain-head irrigating  all  parts  of  the  body, 
and  the  left  ventricle  is  held  to  be  the  seat 
of  understanding. 

The  first  great  master  dealing  with  the 
circulation  of  whom  we  have  a  record  is 
Aristotle,  and  we  constantly  find  Harvey 
referring  to  him  in  his  great  work.  Indeed, 
Harvey's  mind  seems  to  have  been  so  im- 
pressed by  the  great  masters  of  antiquity 
that  in  his  old  age  he  bade  a  young  student, 
"Go  to  the  fountain-head  and  read  Aris- 
totle, Cicero  and  Avicenna." 

From  John  G.  Curtis's  great  book,  "Har- 
vey's Views  on  the  Use  of  the  Circulation 
of  the  Blood,"  we  learn  in  concise  language 
what  Aristotle  knew  of  the  circulation. 

"When  an  ancient  observer  looked 
with  the  naked  eye  at  the  very  early  em- 
bryo of  the  fowl,  he  distinguished  at  first 
only  a  blood-red  point,  which  pulsated, 
or  'leapt.'  This,  Aristotle  judged  to  be 
the  heart  containing  blood,  before  any 
blood-vessel  had  shown  itself  and  before 
blood  was  visible  in  any  other  part.  Very 
soon,    however,    two    vessels    containing 

1  Read  to  the  Medical  History  Club  of  Washing- 
ton, D.  C,  January  27,  19 17. 


blood  were  seen,  according  to  him,  to  ex- 
tend from  the  rudimentary  heart  to- 
wards the  periphery.  From  these  and 
other  considerations,  Aristotle  inferred 
that  both  the  blood  and  all  its  contain- 
ing vessels  owe  their  first  origin  to  the 
heart;  and  that  throughout  life  the  liquid 
made  elsewhere  from  the  food,  enters 
the  heart,  there  to  be  perfected  into 
blood  by  the  action  of  the  vital  innate 
heat,  of  which,  as  we  have  seen,  he  held 
the  fiery  central  hearth  to  be  within  the 
heart.  Naturally,  therefore,  he  believed 
the  blood  not  to  be  hot  of  itself,  but  to  ac- 
quire its  vivifying  heat  at  the  heart,  the 
pulsation  of  which  he  held  to  be  caused 
directly  by  the  seething  of  the  blood 
within.  When  thus  perfected  and  charged 
with  heat,  the  blood,  according  to  him, 
is  distributed  from  the  heart  through  the 
vena  cava  as  well  as  the  aorta.  These 
great  vessels  and  their  subdivisions,  Aris- 
totle distinguished  anatomically,  but  he 
made  no  serious  physiological  distinction 
between  what  we  call  the  veins  and  the 
arteries;  and,  himself,  applied  the  word 
"artery"  to  the  windpipe  only.  As  to  the 
cavities  and  contents  of  the  heart,  even 
as  to  the  number  of  its  cavities,  he  had 
obscure,  complex,  and  erroneous  ideas, 
and  of  the  valves  he  knew  nothing.  He 
recognized  no  essential  differences  be- 
tween the  matters  distributed  by  way  of 
the  vena  cava  and  by  way  of  the  aorta, 
all  being,  alike,  one  thing, — blood; 
though  the  blood  was  hotter  or  cooler, 
thinner  or  thicker,  purer  or  cruder,  in 
different  regions  or  parts  of  the  body,  in 
different  sets  of  vessels,  in  different  cavi- 


141 


142 


Annals  of  Medical  History 


ties  of  the  heart,  or  at  different  times, 
in  the  same  place."2 

Aristotle,  like  Plato,  knowing  nothing  of 
the  nerves,  judges  the  blood-vessels  to  be 
sensory  paths;  and  blood-vessels  connect, 
not  only  the  sensitive  flesh,  but  all  the 
most  special  sense  organs,  with  the  heart. 
Such  is  an  outline  of  the  reasons  why  Aris- 
totle held  the  heart  to  be  the  life-long  seat, 
not  only  of  the  "nutritive  soul"  but  of  the 
"sensory  soul"  as  well.  During  the  Alexan- 
drian period,  Erasistratus  (300  B.C.)  recog- 
nized the  valves,  both  arterial  and  auricu- 
lar, and  believed  that  they  ventilated  the 
heart.  This  was  more  than  four  centuries 
before  Galen  and  more  than  nineteen  cen- 
turies before  Harvey. 

Passing  from  Aristotle  to  the  next  great 
period  of  medicine,  we  learn  from  Curtis 
the  views  that  Galen  held  about  the  heart, 
blood-vessels    and    the    circulating    blood. 

"According  to  the  more  detailed  views 
of  Galen  and  his  school,  the  blood  was 
perfected  and  had  its  central  source  not 
in  the  heart  but  in  the  liver,  to  which  the 
portal  vein  brought  a  cruder  liquid  de- 
rived from  the  products  of  digestion.  In 
the  liver,  the  veins  also  originated,  while 
the  arteries  originated  at  the  heart.  The 
blood  left  its  source  in  the  liver,  by  way 
of  the  roots  of  the  venous  system,  that 
is,  by  the  hepatic  veins  of  modern  anat- 
omy. From  these  it  entered  the  great 
venous  trunk,  the  vena  cava,  a  vessel 
which  comprised  the  inferior  vena  cava, 
the  right  auricle,  and  the  superior  vena 
cava  of  our  present  nomenclature.  Upon 
leaving  the  liver,  the  blood  at  once  di- 
vided into  two  sharply  diverging  streams, 
one  flowing  directly  downward  through 
the  vena  cava,  the  belly,  and  the  lower 
extremity;  the  other  flowing  directly  up- 
ward through  the  vena  cava  to  the  chest, 
the    upper    extremities,    and    the    head. 

1  J.  G.  Curtis:  "Harvey's  Views  on  the  Use  of 
the  Circulation  of  the  Blood,"  New  York,  1915,  48. 


Therefore,  that  part  of  the  vena  cava 
which  we  call  the  right  auricle  simply 
formed  a  part  of  the  upward  pathway  of 
the  blood,  at  a  place  where  some  of  the 
blood  left  its  upward  pathway  and  flowed 
through  a  side  opening  into  the  right 
ventricle.  Of  the  fraction  of  the  blood 
that  entered  the  right  ventricle,  a  part 
went  to  the  lungs  simply  for  their  nutri- 
tion, by  the  "arterial  vein" — the  pul- 
monary artery  of  modern  parlance — and 
a  part  percolated  in  a  refined  condition 
through  the  pores  of  the  septum,  from 
the  right  ventricle  to  the  left,  to  be 
worked  up  there  with  the  vital  spirits 
and  thus  become  the  basis  of  the  spiritu- 
ous blood  of  the  arteries.  From  the  left 
ventricle,  this  spirituous  blood  went  to 
the  body  at  large  by  way  of  the  arteries. 
There  is  no  evidence  that  Galen  believed 
any  blood  to  pass  from  the  right  to  the 
left  ventricle  otherwise  than  through  the 
pores  of  the  septum.  As  he  says,  how- 
ever, the  branches  of  the  'venous  ar- 
tery' (our  pulmonary  vein)  'transmit 
thin  and  pure  and  vaporous  blood  in 
abundance'  to  the  lungs  for  their  nutri- 
tion, we  may  infer  that  he  held  this  sup- 
ply to  be  derived  from  the  left  ventricle, 
like  that  of  the  rest  of  the  body."  3 

Galen  seems  to  have  been  the  first  writer 
who  positively  proved  that  the  blood-ves- 
sels, both  veins  and  arteries,  carry  blood. 

Galen  had  maintained  that  the  blood 
passes  from  the  right  to  the  left  ventricle 
by  means  of  certain  hypothetical,  invisible 
"pores."  Vesalius,  in  1543,  treated  this 
statement  in  a  skeptical  or  half-credulous 
manner.  Servetus,  in  1553,  reasoned  that 
the  blood  is  mixed  with  air  from  the  lungs 
before  passing  into  the  heart.  Columbus, 
in  1559,  showed,  in  his  vivisections  of  ani- 
mals, that  the  pulmonary  veins  contain 
blood,  denied  the  existence  of  Galen's  pores, 
and  also  held  that  the  blood  is  cooled  and 

*  Curtis:  op.  cit.,  56-58. 


Historical  Development  of  Our  Knowledge  of  the  Circulation 


H3 


rendered  spirituous  by  mixture  with  air  in 
the  lungs.  Sir  Michael  Foster  and  others 
maintain  that  Columbus  derived  his  knowl- 
edge from  the  works  of  Servetus,  and  that 
the  honor  of  discovering  the  pulmonary  cir- 
culation belongs  to  Servetus  and  not  to 
Columbus. 

The  circulation  was  but  dimly  under- 
stood by  physiologists  until  William  Har- 
vey on  his  fiftieth  birthday,  1628,  in  a 
master-stroke,  gave  to  the  world  a  treatise 
which  he  entitled  "An  Anatomical  Disser- 
tation Upon  the  Movements  of  the  Heart 
and  Blood-vessels  in  Animals."  We  can  not 
help  regretting  that  Harvey  did  not  dedicate 
this  great  work  to  a  great  man,  but  we  find 
it  dedicated  to  Charles  I,  and  this  dedica- 
tion concluding  with  the  following  words: 

"Accept,  therefore,  I  most  humbly  be- 
seech you,  most  serene  King,  with  your 
wanton  kindness  and  forbearance,  this,  my 
new  treatise  upon  the  heart — you  who  are 
yourself  the  new  light  of  this  age  and  in- 
deed its  true  heart,  a  prince  abounding 
with  virtue  and  grace,  to  whom  we  will 
gladly  refer  all  the  blessings  which  England 
enjoys,  all  the  pleasures  in  our  lives." 

Aristotle  established  what  Curtis  calls 
"The  primacy  of  the  heart,"  regarding  it 
as  the  seat  of  life  and  the  soul,  the  hearth 
of  animal  heat.  Harvey  gave  this  primacy 
to  the  blood  and  viewed  the  heart  as  only  a 
force-pump  to  keep  the  blood  in  motion. 

It  would  not  be  possible  in  the  length  of 
this  paper  to  give  all  of  Harvey's  disserta- 
tion on  the  circulation  of  the  blood,  prov- 
ing that  it  is  "a  movement,  as  it  were,  in  a 
circle."  Harvey  said  he  became  convinced 
that  "the  veins  on  the  one  hand  would  be- 
come drained,  and  the  arteries  on  the  other 
ruptured  through  excessive  charge  of  blood 
unless  the  blood  should  somehow  find  its 
way  from  the  arteries  into  the  veins  and  so 
return  to  the  right  side  of  the  heart."  He 
continues, 

"I  finally  saw  that  the  blood,  forced 

by  the  action  of  the  left  ventricle  into 


the  arteries,  was  distributed  to  the  body 
at  large  and  its  several  parts,  in  the 
same  manner  as  it  is  sent  through  the 
lungs,  impelled  by  the  right  ventricle 
into  the  pulmonary  artery;  and  that  it 
then  passed  through  the  veins  and  along 
the  vena  cava,  and  so  round  to  the  left 
ventricle  in  the  manner  already  indi- 
cated. And  similarly  does  it  come  to  pass 
in  the  body,  through  the  movement  of 
the  blood,  that  the  various  parts  are 
nourished,  cherished,  quickened  by  the 
warmer,  more  perfect,  vaporous,  spiritu- 
ous, and,  I  may  say,  alimentive  blood; 
which,  on  the  other  hand,  owing  to  its 
contact  with  these  parts,  becomes  cooled, 
coagulated,  and,  so  to  speak,  effete.  It 
then  returns  to  its  sovereign,  the  heart, 
as  if  to  its  source,  or  to  the  inmost  home 
of  the  body,  there  to  recover  its  state  of 
excellence  or  perfection.  Here  it  renews 
its  fluidity,  natural  heat,  and  becomes 
powerful,  fervid,  a  kind  of  treasure  of 
life,  impregnated  with  spirits,  it  might 
be  said  with  balsam." 
Harvey  then  proceeds  with  mathemati- 
cal precision  to  demonstrate  his  circulation 
theory.  He  says: 

"Let  us  assume,  either  arbitrarily  or 
from  experiment,  the  quantity  of  blood 
which  the  left  ventricle  of  the  heart  will 
contain  when  distended,  to  be,  say  two 
ounces,  three  ounces,  or  one  ounce  and 
a  half — in  the  dead  body  I  have  found 
it  to  hold  upwards  of  two  ounces.  Let  us 
assume  further,  how  much  less  the  heart 
will  hold  in  the  contracted  state  than  in 
the  dilated  state;  and  how  much  blood  it 
will  project  into  the  aorta  upon  each  con- 
traction;— and  all  the  world  allows  that 
with  the  systole  something  is  always  pro- 
jected; a  necessary  consequence,  and  ob- 
vious from  the  structure  of  the  valves; 
and  let  us  suppose  as  approaching  the 
truth,  that  the  fourth  or  fifth  or  sixth,  or 
even  the  eighth  part  of  its  charge  is 
thrown  into  the  artery  at  each  contrac- 


144 


Annals  of  Medical  History 


tion;  this  would  give  either  half  an  ounce, 
or  three  drachms,  or  one  drachm  of  blood, 
as  propelled  by  the  heart  at  each  pulse 
into  the  aorta;  which  quantity,  by  rea- 
son of  the  valves  at  the  root  of  the  ves- 
sel, can  by  no  means  return  to  the  ven- 
tricle. Now  in  the  course  of  half  an  hour, 
the  heart  will  have  made  more  than  one 
thousand  beats,  in  some  as  many  as  two, 
three,  or  even  four  thousand.  Multiply- 
ing the  number  of  drachms  propelled  by 
the  number  of  pulses,  we  shall  have 
either  one  thousand  half-ounces,  or  one 
thousand  times  three  drachms,  or  a  like 
proportional  quantity  of  blood,  accord- 
ing to  the  amount  which  we  assume  as 
propelled  with  each  stroke  of  the  heart, 
sent  from  this  organ  into  the  artery;  a 
larger  quantity  in  every  case  than  is 
contained  in  the  whole  body!  Upon  this 
supposition,  therefore,  assumed  merely  as 
a  ground  for  reasoning,  we  see  the  whole 
mass  of  blood  passing  through  the  heart 
from  the  veins  to  the  arteries,  and  in  like 
manner,  through  the  lungs.  But  let  it  be 
said  that  this  does  not  take  place  in  half  an 
hour,  but  in  an  hour,  or  even  in  a  day;  any- 
way it  is  still  manifest  that  more  blood 
passes  through  the  heart  in  consequence  of 
its  action,  than  can  either  be  supplied  by 
the  whole  of  the  ingesta,  or  than  can  be  con- 
tained in  the  veins  at  the  same  moment." 

If  Harvey  had  expressed  these  facts  in 
terms  of  algebra,  the  scientific  world  would 
have  soon  come  around  to  our  own  view 
that  his  experiments  led  him  to  a  mathe- 
matical or  quantitative  demonstration  of  the 
circulation.4  But  Smith  shows  that  the  plus 
and  minus  signs  were  first  introduced  in 
the  arithmetic  of  the  Bohemian  physician 
Johann  Widman  (i489),B  and  Cajori  tells 
us  9  that  these  did  not  come  into  general 
use  before  the  time  of  Vieta  (1540- 1603), 

'Garrison:  "History  of  Medicine,"  Phila.,  2  ed., 
191 7,  234- 
'Smith:  "Rara  Arithmetica,"  Boston,  1908,  39. 


who  also  popularized  the  use  of  letters  to 
denote  algebraic  quantities.  The  sign  of 
equality  was  devised  by  Robert  Recorde  in 
"The  Whetstone  of  Witte"  (1557),  the  first 
English  treatise  on  algebra;  the  sign  of  divi- 
sion was  not  employed  in  England  before 
1668,  and  the  sign  of  inequality  much  later. 

In  1640,  Harvey's  discovery  was  given  a 
hydrodynamic  proof  in  the  celebrated  "ex- 
periment of  Walaeus,"  viz.,  that  incision  in 
a  Iigated  femoral  vein  causes  the  blood  to 
spurt  in  streams  from  the  distal  opening  and 
to  ooze  in  drops  from  the  proximal  opening. 

In  1660,  Malpighi  demonstrated  the  cap- 
illary circulation.  Of  his  discovery  of  the 
capillaries,  Fraser  Harris  has  well  said, 
"Harvey  made  their  existence  a  logical 
necessity,  Malpighi  made  it  a  histological 
certainty." 

ANATOMY    AND    PHYSIOLOGY 

Leonardo  da  Vinci  made  the  most  accu- 
rate and  beautiful  drawings  of  cardiac  struc- 
ture of  his  time.  As  with  Henle,  many  of 
his  drawings  are  architectural  in  charac- 
ter, bringing  out  the  idea  of  plan  and  ele- 
vation. The  valves  are  drawn  from  many 
angles,  from  above  downwards  and  other- 
wise, and  their  relations  in  three  dimen- 
sions are  clearly  shown.  In  one  drawing,  the 
whole,  valve  is  dissected  from  the  underly- 
ing muscle  and  unrolled  in  a  single  plane, 
showing  its  finer  structure  in  a  sort  of 
Mercator's  projection  (Arnold  Klebs).7 
Leonardo  understood  clearly  that  "the 
heart  is  a  muscle,  the  first  in  strength  and 
the  most  potential  among  the  other  mus- 
cles." His  drawings  and  physiological  in- 
vestigations of  the  heart  were  far  superior 
to  those  of  Vesalius.  He  was  the  first  to  de- 
lineate the  muscular  bands  which  pass  from 
the  ventricular  walls  to  the  septum,  now 

•  F.  Cajori:  "History  of  Mathematics,"  New 
York,  1897,  150-151. 

7  A.  C.  Klebs:  Boston  Med.  &  Surg.  Jour.,  1916, 
CLXXV,  1 ;  45,  with  many  illustrations. 


Historical  Development  of  Our  Knowledge  of  the  Circulation 


145 


described  as  "moderator  bands,"  structures 
which  contain  branches  of  the  auriculo- 
ventricular  bundle  of  His. 

In  1733,  Stephen  Hales,  an  English 
clergyman,  invented  the  first  manometer 
or  tonometer — a  long  glass  tube  fastened 
inside  a  horse's  artery;  and  with  this  rude 
instrument  made  the  first  measurements  of 
blood  pressure  in  connection  with  the  ca- 
pacity of  the  heart  and  the  velocity  of  the 
blood  current.8  The  next  step  was  taken  by 
Poiseuille,  who  in  1828  invented  the  hemo- 
dynamometer,  with  which  he  showed  the 
relation  of  blood  pressure  to  respiration, 
and  measured  the  degree  of  arterial  dilata- 
tion at  each  heart  beat.  In  1847  Carl  Lud- 
wig  connected  Poiseuille's  instrument  with 
a  revolving  cylinder  and  thus  invented  the 
kymograph  and  introduced  the  graphic 
method  into  physiology.  In  1840  Poiseuille 
stated  the  celebrated  mathematical  law  or 
formula  for  estimating  the  viscosity  of  the 
blood  and  invented  the  viscosimeter  for 
this  purpose.  The  inhibitory  power  of  the 
vagus  nerve  was  discovered  by  the  Weber 
brothers  in  1845,  but,  in  1870-71,  Ludwig 
and  Schmiedeberg  showed  that  the  vagus 
contains  accelerator  as  well  as  inhibitory 
fibers.  Nearly  all  our  recent  knowledge  of 
the  physiology  of  the  circulation  came  orig- 
inally from  the  laboratory  of  Ludwig,  who 
was  once  defined  as  "the  only  physiologist 
who  ever  did  anything."  He  invented  the 
graphic  method,  the  kymograph,  the  blood 
pump  and  the  Stromuhr  or  blood  current 
clock,  and  devised  the  method  of  perfusion 
of  excised  organs,  which  has  played  such  a 
prominent  part  in  physiological  experimen- 
tation up  to  the  time  of  Carrel.  In  1848, 
Ludwig  discovered  the  ganglionic  cells  in 
the  auricular  septum.  In  1850,  with  Noll, 
he  showed  that  the  lymph  is  produced  by 
the  diffusion  of  fluids  from  the  blood 
through  the  walls  of  the  capillary  vessels 
into    the   surrounding   tissues.    In    1857-8, 

8  Garrison:  "History  of  Medicine,"  2  ed.,  Phila., 
1917,  317. 


with  Lothar  Meyer,  he  investigated  the 
gases  of  the  blood.  In  1866,  with  Cyon,  he 
investigated  the  effect  of  temperature  on 
the  heart  beat,  discovered  the  depressor 
nerve  of  the  heart  and  the  erector  nerves  of 
the  peripheral  vessels.  In  1867,  with  Do- 
giel,  he  measured  the  movement  of  blood 
passing  in  a  unit  of  time,  by  means  of  the 
current-clock  (Stromuhr).  In  1869-70,  he 
had  Brunton  and  Schmiedeberg  study  the 
effects  of  drugs  upon  the  circulation,  which 
was  the  starting  point  of  the  pharmacologi- 
cal careers  of  these  two  distinguished  men. 
In  1 87 1,  his  pupil,  Bowditch  of  Boston,  de- 
duced "the  all  or  nothing  law,"  viz.,  that 
the  heart  muscle  will  always  give  a  maxi- 
mal contraction,  or  none  at  all.  In  the  same 
year  Kronecker  showed  that  the  heart 
muscle  can  not  be  tetanized.  In  1871-73, 
with  Dittmar,  Ludwig  located  the  vasomo- 
tor center  in  the  medulla.  In  1875,  with 
von  Kries,  he  measured  the  blood  pressure 
in  the  capillaries.  In  1880,  with  Schmidt 
Mulheim,  he  inaugurated  the  study  of  the 
effect  of  the  injection  of  peptones  into  the 
blood.  In  1883,  his  pupil  Wooldridge  be- 
gan the  study  of  the  chemistry  of  coagula- 
tion of  the  blood.  In  1884,  another  pupil, 
Gompertz,  studied  the  arrangement  of  the 
muscular  fibers  in  the  heart.9 

The  most  important  work  of  recent  times 
on  the  physiology  of  the  circulation  is  that 
of  Gaskell,  who,  in  1882-85,  investigated 
the  vasomotor  nerves  of  the  blood  vessels, 
in  Ludwig's  laboratory.  This  research  was 
the  starting  point  of  Gaskell's  great  work 
on  the  vagus  nerve,  which  he  showed  to  be 
quiescent  rather  than  inhibitory  in  its  ef- 
fects upon  the  heart.  The  researches  of  Gas- 
kell and  Engelmann  brought  out  the  im- 
portant fact  that  the  heart  muscle  is  auton- 
omous and  automatic  in  its  action,  its 
contractions  being  regulated  to  some  ex- 
tent by  the  nerves  but  not  caused  by  them. 
Gaskell  invented  the  term  heart-block,  pro- 

9  Garrison:  "History  of  Medicine,"  2  ed.,  Phila., 
1917,  590-591- 


146 


Annals  of  Medical  History 


duced  it  experimentally  and  explained  its 
causes.  Around  the  name  of  Gaskell  we 
naturally  group  Waller,  Kent,  Keith  and 
Flack,  His  and  Tawara.  It  was  Gaskell 
who  explained  the  significance  of  the  cele- 
brated "experiment  of  Stannius,"  viz.,  that 
a  ligature  at  the  junction  of  the  auricle  and 
the  sinus  venosus  will  stop  the  heart,  while 
a  second  ligature  applied  to  the  auriculo- 
ventricular  groove  will  cause  the  ventricle 
to  beat  again.  By  means  of  the  polygraph 
and  the  string  galvanometer  Sir  James  Mac- 
kenzie, Thomas  Lewis  and  other  clinicians 
have  made  many  obscure  diseases  of  the 
heart  stand  out  as  individualities.  Cushny 
used  electrocardiograms  in  checking  up 
the  effects  of  digitalis,  and  it  is  now  well 
recognized  that  this  drug  is  a  positive  dan- 
ger in  certain  conditions  of  the  heart. 
Among  these  may  be  mentioned  angina 
pectoris,  due  to  changes  in  the  coronary 
arteries,  and  heart-block,  unless  complete. 

The  elucidation  of  the  vasomotor  mech- 
anism was  one  of  the  great  triumphs  of 
Claude  Bernard  (185 1-3).  The  anatomical 
studies  of  the  heart's  innervation  were 
made  by  Henle  (1841),  by  Bidder  who  dis- 
covered the  ganglionic  cells  at  the  auriculo- 
ventricular  juncture  (1852),  and  by  Bezold 
who  demonstrated  the  accelerator  nerves  and 
their  origin  in  the  spinal  cord.  The  sphygmo- 
graph  was  invented  by  Marey  (i860). 

The  first  correct  investigation  of  the  true 
nature  of  coagulation  of  the  blood  was 
made  by  William  Hewson  in  1771.  He 
showed  that,  when  coagulation  is  delayed 
by  chemical  means,  coagulable  plasma  can 
be  separated  from  the  corpuscles  and 
skimmed  off,  and  that  this  contains  an  in- 
soluble "coagulable  lymph,"  which  is  our 
present  fibrinogen.  This  discovery  was  con- 
firmed by  Andrew  Buchanan,  who  extract- 
ed fibrin  ferment  in  1845.  This  name  was 
given  to  the  substance  by  Alexander 
Schmidt,  who  supposed  that  coagulation 
was  due  to  the  combination  of  fibrinogen 
and   serum   globulin.   This   error   was   cor- 


rected by  Hammaersten,  who  showed  that 
coagulation  is  caused  by  the  splitting  up  of 
the  fibrinogen  and  other  substances  (1875). 
The  role  of  the  hormones,  antithrombin  and 
thromboplastin,  in  the  coagulation  of  the 
blood,  was  investigated  by  Howell  of  Bal- 
timore in  191 1  and  subsequently.  Howell 
has  also  investigated  the  effect  of  increased 
venous  pressure  of  the  heart  (1881),  the 
life  history  of  the  blood  corpuscles  (1890), 
and  other  problems  connected  with  the  cir- 
culation. His  teacher,  Newell  Martin,  also 
specialized  in  the  circulation,  and  studied 
the  effect  of  variations  of  blood  pressure 
and  temperature  upon  the  rate  of  heart 
beat.  Two  other  American  physiologists, 
Stewart  of  Cleveland,  and  Porter  of  Har- 
vard, have  also  made  extensive  investiga- 
tions in  the  circulation.  In  1880,  Sidney 
Ringer  of  Norwich,  England,  began  to  ex- 
periment with  the  effects  of  mixtures  of 
the  chlorids  of  sodium,  potassium,  calcium 
and  magnesium  in  keeping  the  heart  beat- 
ing outside  the  body  for  a  long  period  of 
time.  These  experiments  evolved  the  ideal 
Ringer's  "solution"  for  this  purpose,  and 
showed  the  importance  of  calcium  salts  in 
the  maintenance  of  tissue  activity,  and 
gave  Carrel  the  means  for  his  remarkable 
work  in  experimental  surgery,  in  particular 
his  investigations  of  the  latent  life  of  ar- 
teries (1910),  the  preservation  of  portions 
of  blood-vessels  in  cold  storage  for  long 
periods  before  using  them  in  transplanta- 
tion, and  the  vast  improvements  in  the 
surgery  of  the  vascular  system  which  re- 
sulted from  this  technic. 

HEART   SOUNDS  10 

Harvey  thought  that  the  ebullition  of 
hot  blood  distends  the  auricle,  and  that 
the  distention  of  the  ventricle  through  con- 

10  The  history  of  the  heart  sounds  has  been  inves- 
tigated by  G.  Joseph  in  the  older  Janus  (Got  ha, 
1853,  II,  1;  345;  565)  and  latterly  by  Leonard  Hill 
in  Schafer's  "Text-Book  of  Physiology,"  Edinl).  iv 
Lond.,  1900,  II,  28-33. 


Historical  Development  of  Our  Knowledge  of  the  Circulation 


147 


traction  of  the  auricle  causes  the  heart- 
beat. He  said  further  that,  "When  there  is 
the  delivery  of  a  quantity  of  blood  from 
the  veins  to  the  arteries,  a  pulse  takes  place 
and  can  be  heard  within  the  chest."  He 
compared  this  sound  to  the  noise  made  by 
a  horse  swallowing.  This  view  was  natural- 
ly opposed  by  all  the  opponents  of  Har- 
vey's theory  of  the  circulation,  and  one  of 
these,  ^Emilius  Parisanus,  a  Venetian  phy- 
sician, declared  that  the  sound  described 
could  not  be  heard  at  all,  or  at  least  "only 
in  London."  Lancisi,  Senac,  Haller  and 
others  refer  to  a  pulsus  cardis,  however, 
which  could  be  heard  as  well  as  felt,  but 
even  Corvisart  made  no  distinction  what- 
ever between  the  sound  and  the  impulse, 
since  he  only  approached  his  ear  to  the 
chest  when  he  could  not  sufficiently  distin- 
guish the  beats  by  laying  his  hand  upon 
the  thorax.  Laennec  was  the  first  to  note 
that  the  heart  sounds  can  be  heard  in  the 
vicinity  of  the  heart,  that  there  are  two 
successive  sounds,  the  first  dull  and  longer, 
the  second  shrill  and  shorter,  separated  by 
a  momentary  rest,  in  the  musical  sense  of 
the  term.  He  ascribed  the  first  sound  to  the 
ventricular  contraction,  the  second  to  the 
auricular  contraction,  and  he  compared  the 
latter  to  the  sound  made  by  a  dog  in  lap- 
ping up  water.11  In  1829,  A.  Turner  point- 
ed out  that  the  second  sound  occurred  not 
at  the  end  but  at  the  beginning  of  the  di- 
astolic pause,  and  hence  could  not  be  de- 
rived from  the  auricular  systole.12  From  this 
date,  a  perfect  flood  of  opinions  and  con- 
troversies arose  as  to  the  cause  of  the  heart 
sounds.  Corrigan,  Burdach,  Magendie, 
Piorry,  C.  J.  B.  Williams,  Bouillaud,  Skoda, 
Cruveilhier,  Barth,  Roger,  Purkinje,  Valen- 
tin, Hamernik,  Canstatt — to  mention 
only  a  few  outstanding  names — all  venti- 
lated opinions  more  or  less  erroneous.  Dun- 

11  Laennec:  "De  I'auscultation  mediate,"   Paris, 
18 19,  II,  210.  Cited  by  Leonard  Hill. 

12  Turner:  Tr.  Med.-Cbir.  Soc,  Edinb.,  1829,  226. 
Cited  by  Leonard  Hill. 


glison,  in  1856,  tabulated  the  views  ex- 
pressed up  to  his  time  in  order  to  show 
what  bewildering  discordance  of  opinion 
existed.13  Sandborg,14  in  1881,  tabulated  no 
less  than  forty  different  theories.  Before 
the  time  of  Skoda,  the  French  clinicians 
made  no  distinction  whatever  between 
heart  sounds  and  heart  murmurs,  describ- 
ing either  indifferently  as  "bruit."  Skoda 
cleared  up  much  obscurity  by  making  a 
clean-cut  distinction  between  a  "sound" 
and  a  "murmur."  C.  J.  B.  Williams,  in 
1836,  showed  that  the  first  sound  can  be 
heard  in  the  excised  heart,  even  if  the  auric- 
uloventricular  valves  be  held  open  with 
the  fingers.16  Ludwig  and  Dogiel,  in  1868, 
found  that  the  first  sound  continued,  al- 
most unaltered,  after  successive  ligation  of 
the  venae  cavae,  the  pulmonary  artery  and 
vein,  and  the  aorta.16  This  experiment  en- 
tirely overthrew  the  view  that  the  first 
sound  was  of  simple  valvular  origin.  Schae- 
fer  says  that  the  valves  can  be  held  back 
by  hooks  or  the  finger,  yet  a  systolic  sound 
continues.  A  large  number  of  physiological 
experiments  of  this  kind  produced  the  most 
conflicting  views  as  to  the  origin  of  the  first 
heart  sound,  but  the  difficulty  was  settled 
when  Einthoven  and  Geluk,  in  1894,17  reg- 
istered the  effect  of  the  heart  sounds  on  a 
microphone  circuit,  by  means  of  a  capillary 
electrometer;  the  movements  of  the  elec- 
trometer being  photographed  on  a  moving 
sensitized  plate.  These  photographs  showed 
clearly  that  the  sounds  are  compounded  of 
several  tones,  each  sound  giving  rise  to  a 
succession    of   vibrations    of   the    mercury 

l3DungIison:  "Human  Physiology,"  Phila.,  1856, 
I,  140.  (Leonard  Hill.) 

"Sandborg:  "Resume  des  etudes  sur  Ies  bruits 
du  coeur,"  Christiania,  1881,  6  (Leonard  Hill). 

16  Williams:  Rep.  Brit.  Ass.  Adv.  Sc,  Lond.,  1836, 
269  (Leonard  Hill). 

16  Ludwig  and  Dogiel:  Ber.  d.  k.  s'acbs.  Gesellscb.  d. 
Wissenscb.  Matb.-Nat.  CI,  Leipz.,  1868,  XX,  89 
(Leonard  Hill). 

17  Einthoven  and  Geluk:  Arcb.  J.  d.  ges.  Pbysiol., 
Bonn,  1894,  LVII,  617  (Leonard  Hill). 


Annals  of  Medical  History 


meniscus.  The  same  method  has  been  ap- 
plied to  the  second  sound  of  the  heart,  and 
the  conclusion  is  that  neither  sound  is  sim- 
ple, but  each  is  formed  of  many  component 
tones  caused  by  the  sudden  tension  and 
vibration  of  the  cardiac  muscles  of  the  auric- 
uloventricular  valves,  and  of  the  blood, 
augmented  by  the  stroke  of  the  heart  beat- 
ing against  the  chest  wall.  The  constit- 
uent tones  of  the  second  sound  of  the 
heart  arise  from  vibrations  of  the  valves 
and  of  the  blood  columns  and  the  arterial 
walls. 

A  third  sound  of  the  heart  was  noted  by 
E.  Barie  in  1893,  again  by  A.  S.  Hirsch- 
felder  (1907),  and  elucidated  by  Einthoven, 
A.  J.  Gibson  and  William  S.  Thayer  in 
1907. 

CLINICAL    AND    PATHOLOGICAL    INVESTI- 
GATIONS 18 

Up  to  the  time  of  Hippocrates  (460-377 
B.C.)  it  was  held  that  the  heart  could  not 
be  diseased.  Herophilus  and  Erasistratus,  of 
the  Alexandrian  school  (300  B.C.),  showed 
the  synchronism  of  the  pulse  and  the  heart 
beat,  and  likened  the  heart  to  a  pump. 
Galen  (131-210  A.D.)  expanded  the  pump 
analogy,  showed  that  the  arteries  contained 
blood,  not  air,  and  made  special  experi- 
ments to  demonstrate  the  motor  power  of 
the  heart. 

Aretaeus  says:  "If  the  heart  suffers  pri- 
marily, death  is  not  far  off."  In  Celsus  ap- 
pears, for  the  first  time,  a  mysterious  dis- 
order called  by  the  Greeks  kardiakon,  and 
by  t..e  Romans  Cardiacus  or  Morbus  Car- 
diacus.  This  consisted  of  an  indefinable  and 
incoordinated  group  of  symptoms — pro- 
fuse sweating,  fever  with  thin,  weak  pulse 
and  short,  panting  respiration,  great  bodily 
weakness  with  cold  extremities — various- 
ly attributed  to  the  heart  or  stomach. 
Aretaeus  calls  it  "syncope"  and  regards  it 

M  See  the  historical  sketches  in  Ziemssen's  Cyclo- 
pedia 0/  the  Practice  oj  Medicine,  N.  Y.,  1876,  VI, 
passim. 


as  a  definite  cardiac  affection.  Galen  re- 
gards it  as  a  general  weakening  disease  af- 
fecting both  heart  and  stomach.  Alexander 
Trallianus  and  Aetius,  the  last  to  mention 
it,  describe  it  as  a  gastric  disorder.  The 
treatment  was  roborant,  and  wine  the  uni- 
versal remedy,  in  all  the  old  authors.  After 
Alexander  Trallianus  (6th  century  B.C.)  all 
trace  of  it  disappears  for  six  centuries. 
Huxham  thought  it  a  nervous  fever  with 
colliquative  sweating  and  chills.  Bonet  de- 
scribes a  case  (from  Zacutus  Lusitanus)  of 
syncope  cardiaca  from  a  worm  or  polyp  in 
the  heart.  Hecker,  in  his  treatise  on  the 
English  sweating  sickness  (1834)  regards  it 
as  an  analogue  of  this  disease  (miliary 
fever).  In  1835,  Seidlitz,  of  St.  Petersburg, 
identified  it  with  "exudative  pericarditis." 
Landsberg,  in  his  study  of  1847,  regards  it 
as  a  secondary  anemia.  The  symptoms  he 
enumerates  also  bear  some  resemblance  to 
those  of  leukemia.19  At  all  events,  it  was 
not  an  idiopathic  disease  of  the  heart. 

In  1555,  Vesalius  diagnosed  aortic  aneu- 
rism of  the  abdominal  and  thoracic  aorta  in 
the  living,  and  proved  by  opening  the  chest 
of  a  strapped  animal  that  a  quiescent 
heart  may  be  resuscitated  by  the  use  of 
bellows.  In  1534  Massa  described  cardiac 
dilatation  and  hypertrophy  as  aneurism.  In 
1679,  Bonet  described  fatty  infiltration  or 
degeneration  of  the  heart  muscle.  In  1672, 
Vieussens  surmised  that  heart  disease  was 
the  cause  of  most  of  the  symptoms  which 
the  physicians  of  his  day  grouped  as  hydro- 
thorax  or  otherwise  described  as  asthma, 
palpitation,  etc.  In  1673  ne  noted  dropsy  of 
the  pericardium,  again  in  1675  (with  autop- 
sies), and  a  little  later,  a  case  of  pericarditis 
(with  autopsy).  In  1685,  Vieussens  noted  a 
case  of  stenosis  of  the  left  ostium  with  dis- 
ease of  the  mitral  valve,  and  hypertrophy 
of  the  heart.  The  quality  of  the  pulse  was 
"small,  weak  and  entirely  irregular."  This 
description  of  the  pulse  of  mitral  stenosis  is 
classic.    These    contributions    an'    all    con- 

'•  Landsberg:  Janus,  Brcslau,  1847,  II,  53-124. 


Historical  Development  of  Our  Knowledge  of  the  Circulation 


149 


tained  in  his  treatise  of  1715.20  In  1695  ne 
described  a  case  of  aortic  regurgitation 
which  remained  unnoticed  until  the  time 
of  Hodgkin  and  Corrigan.21  Albertini  was 
the  first  to  employ  palpitation  in  order  to 
ascertain  the  cardiac  impulse.  In  1707,  Lan- 
cisi  associated  asthma  with  cardiac  disease, 
saw  hypertrophy  and  dilatation  as  a  com- 
mon cause  of  sudden  death,  and  described 
palpitation,  difficult  respiration  and  other 
symptoms  of  the  disorder;  also  described 
aneurism  due  to  syphilis.  He  indicated  the 
turgescence  of  the  veins  of  the  neck  as  a 
characteristic  symptom  of  hypertrophy  of 
the  left  ventricle,  which  is  not  necessarily 
true.22  In  1761,  Auenbrugger  introduced 
percussion  in  diagnosis,  which  was  taken 
up  by  Corvisart  (1818)  and  extensively  em- 
ployed in  the  diagnosis  of  heart  disease. 
Auenbrugger  in  his  book  on  percussion 
pointed  out  the  increased  areas  of  dullness 
in  pericardial  effusion  and  cardiac  hyper- 
trophy (1761).  Corvisart  in  his  revival  of 
Auenbrugger's  method  diagnosed  pericar- 
ditis and  separated  hypertrophies  from  dil- 
atations by  percussion. 

The  first  definite  treatise  on  disease  of 
the  heart  was  that  of  Senac  (1749)  which 
was  followed  by  the  splendid  books  of  Cor- 
visart (181 8),  Laennec  (1819-26),  James 
Hope  (1832),  Bouillaud  (1835),  and  Stokes 
(1854).  The  invention  of  the  stetho- 
scope by  Laennec  in  1819  revolutionized 
the  diagnosis  of  diseases  of  the  chest,  in- 
cluding cardiac  disorders,  as  shown  in  the 
first  edition  of  his  work  (181 9).  The  second 
edition  (1823)  is  not  only  the  greatest  work 
on  thoracic  diseases  ever  written,  but  also 
a  wonderful  collection  of  original  descrip- 
tions of  new  diseases.  Hypertrophy  and  dil- 
atation of  the  heart  were  referred  to  in 
Senac's    treatise    (1749).     Endocarditis    is 

20Vieussens:  "Traite  nouveau  de  la  structure  et 
des  causes  du  mouvement  naturel  du  cceur,"  Paris, 
1715. 

21  J.  J.  Philipp:  Janus,  1847,  II,  582-598. 

22  Ibid.,  1848,  111,316-326. 


mainly  associated  with  the  great  name  of 
Bouillaud,23  who  introduced  the  term,  and 
to  whom  we  owe  our  fundamental  knowl- 
edge of  the  condition.  He  showed  the  rela- 
tion between  endocarditis  and  acute  ar- 
ticular rheumatism,  sepsis  and  anemia;  also 
its  relation  to  valvular  lesions  and  its  oc- 
currence after  the  development  of  such 
lesions;  also  the  frequent  complication  of 
myocarditis  with  endocarditis  and  pericar- 
ditis. Virchow  investigated  the  pathological 
histology  of  carditis  (1856-62),  and  bac- 
teriology made  it  possible  to  investigate 
the  causes  of  the  mycotic  and  malignant 
forms  of  the  disease.  Albertini  (1 661- 1738) 
showed  that  the  left  ventricle  is  prone  to 
hypertrophy,  the  right  ventricle  to  dilata- 
tion. Auenbrugger,  and  after  him  Cor- 
visart, applied  the  term  aneurism  to  hy- 
pertrophy and  dilatation.  The  two  con- 
ditions were  first  distinguished  by  Laen- 
nec and  Bertin.  Bright  first  noted  en- 
largement of  the  heart  in  renal  disease 
(1827)  and  Traube  (1856)  investigated  it 
in  detail. " 

Atrophy  of  the  heart  was  first  described 
by  Senac  (1749).  Laennec  (18 19)  regarded 
it  as  a  secondary  disease.  Bouillaud  (1835) 
divided  it  into  the  simple,  eccentric  and 
concentric  varieties. 

Benivieni  first  noted  induration  of  the 
heart  (1529).  Rota  (1555),  Massa  (1559), 
and  Fernelius  (1656)  described  "ulcers  of 
the  heart."  In  1761  Morgagni  gave  de- 
tailed accounts  of  inflammation,  induration, 
ulcers,  and  rupture.  Senac  (1749)  pointed 
out  the  base  of  the  heart  as  the  frequent 
site  of  abscess  and  induration,  and  assigned 
adjacent  disease  (pericarditis)  as  the  cause. 
Laennec  (18 19)  studied  myocarditis  very 
closely,  and  first  described  true  fatty  de- 
generation, and  external  deposits  of  fat 
causing  atrophy  of  the  muscular  substance 

23  See  the  "Historic  Notes"  of  Th.  von  Jiirgen- 
sen  in  his  memoir  on  endocarditis  in  Nothnagel's 
"Practice"  ("Diseases  of  the  Heart"),  Phila.,  1908, 
178. 


150 


Annals  of  Medical  History 


by  pressure.  Boufllaud  (1835)  showed  the 
independence  of  myocarditis  from  endocar- 
ditis and  pericarditis.  Hamernik  (1844") 
and  Dubini  (1844)  gave  simultaneously  the 
first  microscopical  reports  on  inflammation 
of  the  papillary  muscles.  Latham  (1846) 
and  Craigie  (1848)  described  purulent  myo- 
carditis. Rokitansky  pointed  out  the  rela- 
tion of  myocarditis  to  aneurism  of  the 
heart,  and  Virchow  described  parenchy- 
matous inflammation.  Thomas  Bevill  Pea- 
cock, in  his  "Croonian  Lectures"  of  1851, 
described  overstrain  of  the  heart.  J.  M.  Da 
Costa  described  "irritable  heart"  in  sol- 
diers of  the  Civil  War  (1862-71).  Sir  Clif- 
ford Allbutt  elucidated  the  effects  of  over- 
work and  overstrain  of  the  heart  in  those 
engaged  in  occupations  requiring  great  ex- 
ertion (1869-71).  Fragmentation  of  the 
heart  fibers  was  first  described  by  Renaut 
in  1877.  Sir  John  and  Sir  William  Henry 
Broadbent  have  devoted  especial  study  to 
pericardial  disease,  particularly  adherent 
pericardium  (1895). 

Rupture  of  the  heart  was  first  noted  by 
Harvey  in  his  second  letter  to  Riolanus 
(1649).  Morgagni  (1761)  said  it  can  only 
occur  when  the  muscular  tissue  is  diseased. 
It  is  interesting  to  note  that  Morgagni  him- 
self died  of  this  condition.  Corvisart  first 
described  rupture  of  the  chordae  tendineae 
and  "verrucose  vegetations"  of  the  valves, 
which  he  regarded  as  of  venereal  origin. 
This  view  was  opposed  by  his  pupil 
Laennec. 

The  first  great  contribution  to  the  heart's 
pathology  was  made  by  Morgagni  (1761), 
who,  in  his  autopsies,  found  most  of  the 
valvular  lesions,  and  connected  them  with 
the  clinical  manifestations.  The  mitral  le- 
sion is  particularly  associated  with  his 
name.  Morgagni  was  also  the  first  to  de- 
scribe heart-block  (1761),24  which  attained 
its  present  status  through  the  classical 
papers'  of  Robert  Adams  (1826)26  and  Wil- 

"  Morgagni:  "De  scdibus,"  Venice,  1761,  I,  70 
(Osier). 


Ham  Stokes  (1846),26  and  the  memoir  of 
\Y.  H.  Gaskell  (1881),27  who  produced  the 
condition  experimentally.  It  was  Huchard 
who  called  the  affection  "Stokes-Adams' 
disease."  Laennec  fully  described  the  sounds 
and  murmurs  of  the  heart  in  different  dis- 
eases, and  Skoda  clearly  differentiated  the 
sounds  from  the  murmurs.  The  second  edi- 
tion of  Laennec  (1826)  accounts  for  dila- 
tation, hypertrophy,  hardening,  softening, 
atrophy,  gangrene,  displacement,  abnormi- 
ties, intercommunication,  rupture,  fatty 
degeneration,  ossification,  tubercle,  cancer, 
serous  cysts,  valvular  lesions,  polyps  and 
neuralgia  of  the  heart.  The  clinical  minutiae, 
which  now  make  up  the  pictures  of  these 
diseases  in  our  textbooks,  were  added  grad- 
ually through  the  labors  of  Stokes,  Graves, 
Adams,  Bouillaud,  Hope,  Corrigan,  Sibson, 
Andral,  Piorry,  and  many  others,  followed 
by  the  new  era  of  Gaskell  and  Mackenzie. 
What  we  know  of  the  earlier  history  of  val- 
vular disease  is  contained  in  Laennec's 
treatise  on  mediate  auscultation  (second 
edition,  1826).  Aortic  regurgitation  was 
noted  by  Vieussens  (1695),  Cowper 
(1705); 28  in  more  detail,  by  Hodgkin 
(1829),29  and  in  classical  form  by  Corrigan 
(1832),30  with  a  superb  plate  showing  the 
pathological  appearances.  John  Mayow,  in 
1669,  described  mitral  stenosis;  Vieussens 
gave  a  good  account  in  1685;  Morgagni,  in 
1 76 1,  gave  several  autopsies  with  clinical 
findings,  and  with  the  description  of  Scnac, 
in  1749,  this  lesion  became  familiar  to  clin- 
icians. King,  in  1837,31  first  individualized 
tricuspid  insufficiency,  which  was  first  noted 
by     Morgagni     in     his     autopsies     (1761). 

"Adams:  Dublin  Hosp.  Rep.,  1827,  IV,  396. 

*  Stokes:  Dublin  Quart.  Jour.  Med.  Sc.,  1846. 

"  Gaskell:  Phil.  Tr.,  1881.  Lond.,  1882,  CL.WIII, 
933-1033. 

"Cowper:  Pbil.  Tr.,  Lond.,  May,  1705,  No.  299. 

B  Hodgkin:  London  Med.  Gaz.,  1828-9,  II,  433-443. 

,0  Corrigan:  Edinb.  Med.  &  Surg.  Jour.,  1832, 
WWII,  225-245,  1  pi. 

■  T.  W.  King:  Guy's  Hosp.  Rep.,  Lond.,  1837,  II, 
132-148,  3  pi. 


Historical  Development  of  Our  Knowledge  of  the  Circulation 


151 


George  Whitley,  in  1857,32  gave  the  earliest 
complete  account  of  disease  of  the  pulmo- 
nary valves.  Laennec  said  that  Corvisart 
was  the  first  to  distinguish  by  percussion 
the  purring  or  cat-like  thrill  (Jremissement 
cataire)  in  valvular  disease.  Austin  Flint,  in 
1862,  showed  that  a  presystolic  murmur 
can  be  produced  in  cases  of  aortic  insuffi- 
ciency without  mitral  lesion.33  Laennec,  in 
spite  of  the  stethoscope,  did  little  to  clarify 
the  diagnosis  of  mitral  disease,  which  be- 
gan to  assume  accuracy  in  the  treatise  of 
James  Hope  (1832).  The  early  history  of 
pulse-counting  (Cusanus,  Kepler,  Sancto- 
rius,  Sir  John  Floyer)  has  been  given  by 
Weir  Mitchell  in  his  "Early  History  of  In- 
strumental Precision  in  Medicine"  (1892). 
The  use  of  the  watch  in  timing  the  pulse 
was  due  to  Louis,  Graves  and  Stokes. 

In  1632  the  Earl  of  Clarendon  in  his 
Memoirs,  described  a  case  of  angina  pecto- 
ris in  his  own  father.  Morgagni  again  de- 
scribed it  in  1 76 1  and  in  1772,  William  He- 
berden  gave  his  classical  account,34  which 
was  followed  by  the  investigations  of  Jen- 
ner  and  Parry.  John  Hunter  suffered  from 
the  disease  for  twenty  years  (1773-93)  an<^ 
died  from  it.  At  the  autopsy  Edward  Jen- 
ner  found  calcification  of  the  coronary  ves- 
sels. The  use  of  amyl  nitrite  in  the  treat- 
ment of  angina  pectoris  was  introduced  by 
Sir  Lauder  Brunton  (1867).36 

In  1881  Gaskell  first  investigated  the 
electrical  condition  of  the  heart  with  a  gal- 
vanometer.36 In  1889,37  Augustus  D.  Waller 
first  measured  and  figured  the  action  cur- 
rents of  the  heart  by  means  of  electrodes  in 
contact  with  the  wet  skin  and  connected 

32  Whitley:  Guy's  Hosp.  Rep.,  Lond.,  1857,  3  s., 
Ill,  252-260,  2  pi. 

33  Flint:  Am.  Jour.  Med.  Sc,  Phila.,  1862,  n.  s., 
XLIV,  29:  1886,  XCI,  35. 

34  Heberden:  Med.  Tr.  Coll.  Phys.,  Lond.,  1768-70, 
II,  59-67. 

36  Brunton:  Lancet,  Lond.,  1867,  II,  97. 

36  Gaskell:  Pbil.  Tr.,  1881,  Lond.,  1882,  CLXXIII, 

933-1033- 
"  Waller:  Ibid.,  1889,  CLXXX,  169. 


with  a  galvanometer  or  a  Lippmann  elec- 
trometer. This  led  to  the  invention  of  the 
ink-polygraph  of  Sir  James  Mackenzie, 
Jaquet's  cardiosphygmograph  and  the  string 
galvanometer  of  Einthoven  (1903).38  With 
this  instrument  and  the  electrocardiograms 
obtained  from  it  such  conditions  as  heart- 
block,  auricular  fibrillation,  paroxysmal 
tachycardia,  pulsus  alternans  and  pulsus 
bigeminus  were  closely  analyzed  and  de- 
fined by  Sir  James  Mackenzie,39  James 
Lewis,  A.  W.  Hewlett  and  others.  Mackenzie 
and  Cushny,  with  its  aid,  elucidated  the 
uses  and  limitations  of  digitalis.  The  English 
periodical  Heart,  founded  in  London  in 
1909,  and  edited  by  Thomas  Lewis,40  con- 
tains most  of  these  important  investiga- 
tions. 

Before  the  latter  half  of  the  nineteenth 
century,  patients  with  heart  disease  were 
usually  required  to  rest  and  keep  quiet.  In 
his  treatise  of  1854,  William  Stokes  pointed 
out  that  "the  symptoms  of  debility  of 
the  heart  are  often  removable  by  a  regu- 
lated course  of  gymnastics,  or  by  pedestrian 
exercise,  even  in  mountainous  countries, 
such  as  Switzerland  or  the  Highlands  of 
Scotland  and  Ireland."  Gradually  the  Swed- 
ish movements  of  Ling  and  the  mechanical 
contrivances  of  Zander  were  applied,  to  be 
followed  by  the  slow  "resistance  gymnas- 
tics," breathing  exercises  and  protein  diet 
of  M.  J.  Oertel  (1884),  and  the  combined 
exercises,  rest  and  carbonated  baths  (Nau- 
heim  treatment)  of  Schott  (1880).41 

The  modern  doctrine  of  embolism  is  al- 
most entirely  the  work  of  Rudolph  Virchow 
(1846-56),  which  was  followed  by  the  later 

38  Einthoven:  K.  Akad.  v.  Wetenscb.  te  Amst.  Proc. 
Sect,  sc,  1903-4,  VI,  107-115,  2  pi. 

39  Sir  James  Mackenzie:  "The  Study  of  the  Pulse," 
London,  1902;  "Diseases  of  the  Heart,"  London, 
1908. 

40  Thomas  Lewis:  "The  Mechanism  of  the  Heart 
Beat,"  London,  191 1;  "Lectures  on  the  Heart," 
London,  1915. 

"Schott:  Berl.  klin.  Wocbenscbr.,  1880,  XVII, 
357-359- 


Is2 


Annals  of  Medical  History 


researches  of  Cohnheim,  Bernhard  Cohn, 
Welch  and  others.  Up  to  Virchow's  time, 
John  Hunter  and  Cruveilhier  had  firmly  es- 
tablished the  doctrine  that  phlebitis  is  the 
cause  of  thrombosis.  In  1856  Virchow 
turned  this  about  by  showing  that  coagu- 
lation and  other  mechanical  obstructions  of 
the  blood-current  may  initiate  thrombosis 
with  subsequent  phlebitis.  Bacteriology  es- 
tablished the  fact  that  pathogenic  micro- 
organisms may  set  up  a  phlebitis,  in  which 
case  thrombosis  is  again  secondary. 

A  case  of  malformation  of  the  heart  was 
reported  to  the  Royal  Society  by  Wilson  in 
1798.  Meckel  studied  the  resemblances  be- 
tween these  congenital  malformations  and 
the  hearts  of  reptiles,  amphibians  and  crus- 
taceans (1802).  In  1858  Thomas  Bevill  Pea- 
cock published  the  first  systematic  treatise 
on  the  malformations  of  the  human  heart, 
an  outstanding  work  which  was  reissued  in 
1866,42  and  followed  by  the  great  memoir 
of  Rokitansky  on  defects  of  the  cardiac 
septa  (1875)  and  the  fine  study  of  Maude 
Abbott  on  "Congenital  Cardiac  Disease" 
(1908).43 

Aneurism  was  not  known  to  Hippoc- 
rates, but  Galen  knew  of  aneurism  from 
dilatation  and  traumatic  aneurism, recogniz- 
ing the  thrill  in  the  former.  Galen  recog- 
nized arteriovenous  aneurism  "as  a  se- 
quel of  careless  vivisection  and  cured  a  case 
of  it"  (Osier).44  William  Hunter  described 
it  in  classic  form  in  1757.45  In  1555,  Vesalius 
diagnosed  aneurism  of  the  thoracic  and 
abdominal  aorta  (case  of  Leonard  Velser) 
and  confirmed  his  diagnosis  at  the  post- 
mortem (1557).  Fernelius,  in  his  Patbologia 
(1592),  first  noted  that  "aneurism  likewise 

"Peacock:    "On    Malformations   of  the    Human 

,"  London,  1858. 
"Abbott:  "Mod.  Med."  (Osier),  Phila.,  1908,  IV, 

323-425- 

44  Osier:  "Syst.  Med."  (Allbutt),  Lond.,  1909,  VI, 
630-621. 

46  Hunter:  "Med.  Obs.  and  Inq.,"  Lond.,  1757,  I, 
323;  1762,  II,  390. 


happens  sometimes  in  the  internal  arteries, 
especially  under  the  breast,  about  the 
spleen  and  mesentery,  where  the  venous 
pulsation  is  often  observed"  (Osier).46  Am- 
broise  Pare  recognized  aneurism  by  anasto- 
mosis, erosion,  rupture  and  injury.  "He 
was  the  first  to  suggest  the  relation  of 
aneurism  to  syphilis,  and  he  described  the 
noise  or  blowing  sound  associated  with  the 
tumor,  and  the  frequency  of  thrombosis  in 
the  sac  and  the  occasional  calcification" 
(Osier).  Modern  pathologists,  while  recog- 
nizing mechanical  disturbances  of  the  cir- 
culation as  an  accessory  factor  in  the  pro- 
duction of  stagnation  thrombi,  regard  a 
phlebitis  as  beginning  in  the  outer  coat  of 
the  vein  and  proceeding  inwardly  until  en- 
dophlebitis  is  established,  so  that  throm- 
bosis is  usually  secondary  to  lesions  of  the 
veins,  the  old  Hunter-Cruveilhier  view.  The 
syphilitic  causation  of  aneurism  was  later  es- 
tablished by  Lancisi  (1728)  and  Morgagni 
(1761),  who  also  gave  Valsalva's  mode  of 
treatment.47  William  Hunter,  in  his  account 
of  arteriovenous  aneurism  (1775),  first 
separated  the  true,  spurious  and  mixed 
forms.  The  pathology  of  aneurism  was  later 
investigated  by  Scarpa  (1804),  Cruveilhier 
(1849-64),  Rokitansky  (1850),  Hemstedtcr 
(1873),  Koster  (1875)  and  others.  Dilation- 
aneurism  of  the  aorta  was  clearly  described 
in  1815  by  Joseph  Hodgson,48  who  differen- 
tiated it  from  ordinary  aneurism,  observed  its 
frequency  in  the  arch,  its  misleading  cardiac 
symptoms,  and  its  association  with  aortic 
insufficiency.  Trousseau  called  the  latter 
variety  "maladie  <T Hodgson."  In  1507  An- 
tonio Benivicni  first  noticed  cardiac  thrombi 
as  "polyps"  (fibrinous  clots)  in  the  heart 
(Welch).  William  Wood  of  Edinburgh  de- 
scribed ball  thrombi  in  the  hit  auricle 
(1814).  Recklinghausen,  in  1893,  described 
agglutinative  (hyaline)  thrombi.  Trousseau 

48  Osier:  Ibid.,  621. 
"Osier:  Unci,  621-622. 

48  Hodgson:    "Diseases   of   Armies    and    Wins," 
London,  1815. 


Historical  Development  of  Our  Knowledge  of  the  Circulation- 


's 


and  Werner,  in  i860,  first  pointed  out  the 
association  of  thrombosis  with  chlorosis  in 
young  women.  A  detailed  history  of  em- 
bolism and  thrombosis  is  given  in  the  ex- 
haustive memoirs  of  Professor  William  H. 
Welch  (1909).49 

Of  diseases  of  the  blood,  chlorosis  was 
described  by  Johann  Lange,  in  one  of  his 
Consilia,  as  "morbus  virgineus"  (1520), 50 
Virchow  described  the  form  with  aortic  hy- 
poplasia and  contracted  heart  in  girls 
(1870).51  Hemophilia  was  first  described  by 
John  C.  Otto,  of  New  Jersey  (1803),  splenic 
anemia  by  Guido  Banti  (1882),  aplastic 
anemia  by  Ehrlich,  leukemia  by  Hughes 
Bennett  (1845)  and  Virchow  (1845),  pur- 
pura hsemorrhagica  by  Werlhof  (1735), 
pernicious  anemia  by  Addison  (1849-55) 
and  Biermer  (1872),  peliosis  rheumatica  by 
Schonlein  (1837),  infantile  infectious  pur- 
pura bjr  Henoch  (1874),  multiple  telangi- 
ectases by  Sir  William  Osier  (1901),  ery- 
thremia or  polycythemia  by  Henri  Vaquez 
(1892)  and  Sir  William  Osier  (1903). 

Of  the  vasomotor  affections,  symmetrical 
gangrene  was  described  by  Maurice  Ray- 
naud (1862),  erythromelalgia  by  Sir  James 
Paget  and  Weir  Mitchell  (1872-8),  angio- 
neurotic edema  by  H.  Quincke  (1882). 

Of  diseases  of  the  blood-vessels,  phlebitis 
was  described  by  John  Hunter,  periar- 
teritis nodosa  by  Kussmaul  and  Maier 
(1866),  gouty  phlebitis  by  Sir  James  Paget 
(1875),  obliterative  arteritis  by  Friedlander 
(1876).  The  modern  theory  of  arteriosclero- 
sis owes  its  origin  to  the  memoir  of  Sir 
William  Gull  and  Henry  G.  Sutton  on  ar- 
teriocapillary  fibrosis  (1872).52  Allbutt 63 
says  that  Galen  noted  degrees  of  hardness 

49  Welch:  "Svst.  Med."  (Allbutt),  Lond.,  1909, 
VI,  691-821. 

50  Lange:  Medicinalium  epistolarum  miscellanea, 
Basel,  1554,  74-77-  Translated  in  E.  T.  Withington's 
Medical  History,  Lond.,  1894,  290. 

51  Virchow:  "Ueber  die  Chlorose,"  Berlin,  1872. 

62  Gull  and  Sutton:  Med.  Cbir.  Tr.,  Lond.,  1871-2, 
LV,  273-326,  2  pi. 


or  softness  in  the  coats  of  the  blood-vessels 
and  that  Asclepiades  ascribes  "certain 
hemorrhages  to  decay  and  rupture  of  the 
arterial  coats."  Morgagni  and  Haller  initi- 
ated the  pathological  study  of  the  arterial 
walls.  Bichat  found  arterial  disease  in  seven 
out  of  every  ten  men  over  60.  Scarpa  men- 
tions "steatomatous  arteries,"  Matthew 
Baillie,  coronary  atheroma.  Peter  Frank, 
Broussais  and  Bouillaud  mistook  cadaveric 
staining  of  the  great  vessels  for  an  arteritis. 
The  name  "arteriosclerosis"  was  intro- 
duced by  Lobstein  (1833).  Bright  associ- 
ated atheroma  with  chronic  renal  disease. 
Gull  and  Sutton  showed  that  the  red  con- 
tracted kidney  of  "Bright's  disease"  is 
only  part  of  a  general  arteriocapillary  fi- 
brosis, and  so  established  the  concept  of 
"arteriosclerosis."  The  introduction  of  the 
sphygmomanometers  of  von  Basch  (1887), 
Riva  Rocci  (1896),  Leonard  Hill,  (1897) 
and  others  revolutionized  the  diagnosis  of 
arteriosclerosis  and  Bright's  disease.  Pa- 
tients were  found  who  had  arterial  hyper- 
tension without  Brightic  symptoms  or  al- 
buminous urine,  and  this  was  supposed  to 
be  due  to  idiopathic  hypertrophy  of  the 
heart.  Von  Basch  called  this  condition  "an- 
giosclerosis,"  Huchard  "presclerosis,"  All- 
butt "hyperpiesis,"  Volhard  and  Fahr  "be- 
nign essential  hypertension,"  Janeway  calls 
it  "primary  hypertensive  cardiovascular 
disease,"  M  and  states  that  its  recognition 
is  entirely  due  to  the  sphygmomanometer. 
Huchard  actually  regarded  arteriosclerosis 
as  a  "clinical  entity"  and  described  what 
he  regarded  as  its  clinical  forms  (1909).  It 
is  now  looked  upon  as  a  simple  pathological 
lesion  incident  to  various  conditions.  "To 
call  arteriosclerosis  a  'disease,'"  says  All- 
butt,  "is  not  pathology  but  necrology."55 

53  This  history  of  arteriosclerosis  is  derived  from 
Sir  Clifford  Allbutt's  splendid  work  on  "Diseases  of 
the  Arteries,"  London,  1915,  I,  3-18,  and  passim. 

54  Janeway:  Tr.  Assoc.  Am.  Pbvs.,  Phila.,  1915, 
XXX,  34- 

65  Allbutt:  op  cit.,  14. 


154 


Annals  of  Medical  History 


The  earliest  blood  pressure  observations  on 
a  large  scale  were  made  by  Richard  C. 
Cabot  in  58  cases  (1903).  Joseph  Erlanger, 
Potain,  Janeway  and  others  have  done 
much  in  this  field.  Janeway  says  there  were 
only  twelve  references  to  blood  pressure  in 
1886;  in  1915  he  had  over  a  thousand.56 
The  advantage  of  the  sphygmomanometer 
over  the  fingers  and  the  sphygmograph  has 
been  well  brought  out  in  Allbutt's  work  on 
"Diseases  of  the  Arteries"  (1915).  He 
points  out  that  every  new  instrument  of 
precision  has  been  ridiculed  by  conserva- 
tive, old-fashioned  physicians  as  "pauper- 
izing the  senses."  But  the  truth  is  that 
these  instruments,  "far  from  pauperizing 
our  clinical  perceptions,  have,  on  the  con- 
trary, enriched,  enlarged  and  corrected 
them."  57  Gibson  of  Edinburgh  said  "the 
sphygmomanometer  had  taught  him  how 
fallacious  the  finger  may  be."  So,  too,  the 
polygraph  and  the  string-galvanometer 
have  given  us  records  of  the  heart's  condi- 
tion which  are  to  the  clinician  what  the 
printed  notes  on  the  musical  staff  are  to 
the  musician.  As  any  one  with  a  good  musi- 
cal ear  can  whistle  or  hum  a  tune  he  has 

64  Janeway:  op  cit.,  29. 
67  Allbutt:  op  cit.,  61. 


heard,  so  the  internist  can  trust  much  to 
his  senses ;  but  as  the  musician  gets  to  know 
a  complex  composition  b}r  associating  it  sub- 
consciously with  the  printed  notes,  so  we 
can  best  educate  our  clinical  senses  by  the 
electrocardiograms  and  blood-pressure  rec- 
ords. 

In  preparing  this  paper,  it  has  struck  me 
forcibly  that  a  large  part  of  our  knowledge 
of  the  circulation  is  of  English  origin.  From 
Harvey's  time,  the  heart  alone  has  been  a 
sort  of  specialty  with  English  physicians. 
In  reviewing  the  history  of  the  circulation 
we  can  not,  however,  like  the  lawyers,  re- 
gard this  part  of  our  science  as  broadening 
"slowly  down,  from  precedent  to  prece- 
dent;" its  development  has  been  fitful  and 
irregular. 

Let  us  neither  lean  too  heavily  upon  the 
past  for  precedent,  nor  be  too  confident 
about  the  present  or  the  future.  Let  eternal 
vigilance  in  studying  and  caring  for  our 
clinical  cases  be  our  watchword;  for  some 
of  our  present  errors  may  be  corrected  by 
the  accurate,  if  empirical  judgments  of 
physicians  of  the  past,  even  as  the  experi- 
ences of  the  past  can  best  be  understood 
and  its  errors  condoned  in  the  light  of  the 
present. 


THE  SONS  OF  SYDENHAM 


Conspicuous  among  the  physicians  of  the  seven- 
teenth century,  great  among  those  of  all  time,  is  Syden- 
ham. In  early  life  an  officer,  one  of  five  brothers  who 
jougbt  in  the  army  of  Parliament,  be  remained  loyal  to 
the  memory  of  the  Protector,  and  bis  doctor's  garb  covered 
through  life  a  soldier's  love  oj  action  and  decision.  He 
brousbt  us  back  to  the  near  study  of  nature,  taught  us  to 
look  at  it  clearly,  to  derive  our  knowledge  wholly  from  it, 
and  be  stands  out  in  history  the  very  embodiment  of  the 
insight  and  practical  character  oj  bis  race.  He  bad  but 
little  respect  for  mere  authority,  and  it  is  to  be  feared 
that,  bad  be  'ived  a  hundred  years  before  tbe  time  be  did, 


be  would  have  been  cited  with  Gcynes  before  tbe  Royal 
College  of  Physicians  for  impugning  tbe  infallibility  of 
Galen,  and  would  not  have  recanted.  To  bim  everything 
was  observation,  experiment.  He  pointed  tbe  way  for 
advance  in  our  science,  and  happy  would  be  have  been 
if  be  could  have  seen  tbe  sons  of  oi.<  intellect  and  endeavor 
who,  following  in  bis  path,  have  made  Medicine  what  it 
is;  for  these  sons  are  Jenner  and  Bright  and  Addison, 
and  Corvisart  and  Andral,  and  Skoda  and  Frericbs, 
and  tbe  eloquent  Trousseau,  whose  delight  it  was  to 
quote  bim,  and  our  own  trutb-loving  Flint. 

J.  M.  Da  Costa  (1891) 


THE  JETONS  OF  THE  OLD  PARIS  ACADEMY  OF  MEDICINE 

IN  THE  NUMISMATIC  COLLECTION  IN  THE 
ARMY   MEDICAL  MUSEUM  AT  WASHINGTON,  D.  C 

By  ALBERT  ALLEMANN,  M.D. 


DURING  the  early  years  of  the 
Library  of  the  Surgeon  General's 
Office,  a  number  of  medical  med- 
als were  presented  to  it  by  pri- 
vate parties.  This  led  Col.  Billings,  the 
creator  of  the  Library,  to  the  idea  of  estab- 
lishing a  collection  of  medical  medals.  He 
went  to  work  with  his  usual  energy  so  that, 
in  1888,  he  had  gathered  more  than  1500 
medals  and  jetons.  In  that  year  he  gained 
the  services  of  Dr.  William  Lee  of  Wash- 
ington, a  man  well  versed  in  medical  his- 
tory and  numismatic  lore,  to  arrange  the 
collection.  Dr.  Lee  made  a  card  catalogue, 
describing  and  interpreting  each  medal  on 
a  separate,  numbered  card.  As  Col.  Billings 
had  charge  of  the  Medical  Museum  as  well 
as  the  Library,  he  placed  the  medals  in  the 
Museum,  where  they  are  now  exhibited. 
After  Billings  left  the  Library  in  1895  the 
collection  was  continued  from  year  to  year 
by  his  assistant,  Mr.  Myers,  so  that  at  pres- 
ent it  contains  more  than  3000  medals. 
After  Mr.  Myers'  death,  the  addition  of 
new  medals  to  the  collection  by  purchase 
was  discontinued  for  a  long  time,  but  Col. 
William  O.  Owen,  the  present  officer  in 
charge  of  the  Army  Medical  Museum,  has 
taken  a  renewed  interest  in  the  subject  and 
has  added  a  number  of  valuable  pieces,  in- 
cluding those  struck  off  by  the  Paris  mint. 
One  of  the  most  interesting  series  of 
medals  in  the  Washington  collection  com- 
prises the  jetons  of  the  old  Academy  of 
Medicine  of  Paris.  They  range  from  1638 
to  1793,  when  the  corporation  was  dis- 
solved by  the  Government  of  France.  It 
was  a  very  old  custom  of  the  Paris  Medical 
Faculty  that  whenever  a  new  Dean  was 
elected,  which  took  place  every  two  years, 


silver  or  bronze  jetons  were  presented  to  all 
the  members  of  the  Faculty.  The  Dean  was 
not  a  professor.  He  had  exclusive  charge  of 
the  administrative  business  of  the  Faculty. 
But  he  also  kept  the  minutes  of  the  Trans- 
actions of  this  learned  corporation,  and 
these  minutes,  from  1395  to  1792,  still  exist 
in  manuscript  and  form  a  complete  history 
of  the  Medical  Faculty  of  Paris. 

When  the  practice  of  striking  jetons  at 
the  election  of  a  new  Dean  was  initiated  is 
not  known.  The  Transactions  of  the  Fac- 
ulty mention  a  jeton  as  early  as  1398,  but 
the  older  jetons  are  now  all  lost  and  it  is 
probable  that  the  custom  was  not  regularly 
followed  until  1638,  when  the  Faculty  de- 
cided to  strike  jetons  regularly  on  a  uni- 
form model  at  every  election  of  a  new  Dean. 

Jetons  are  not  medals  in  the  full  sense  of 
the  word.  They  differ  from  them  in  that 
their  imprint  is  flat  like  that  of  a  coin.  Med- 
als are  cast  while  jetons  are  struck.  Jetons 
are  usually  of  small  size,  rarely  larger  than 
our  silver  half  dollar.  The  French  jetons 
have  all  a  diameter  of  1%  inches. 

These  jetons  of  the  old  French  Academy 
of  Medicine  are  now  very  rare.  Many  are 
entirely  lost.  The  most  complete  collection 
is  in  the  possession  of  the  Bibliotheque 
nationale  at  Paris.  The  Academy  of  Medi- 
cine of  Paris  possesses  108  pieces.  Next  in 
completeness  is  probably  the  collection  in 
the  Army  Medical  Museum  at  Washington 
which  has  no  less  than  91  of  these  rare  je- 
tons. 

From  1638  to  1793  there  were  in  all  65 
Deans.  Philippe  Harduyn,  who  was  Dean 
from  1636  to  1638,  was  the  first  to  be  hon- 
ored with  a  jeton  of  the  new  model.  The 
jeton   shows   on    the   obverse   the   coat   of 


i55 


156 


Annals  of  Medical  History 


arms  of  Harduyn  with  the  legend :  Decano 
M.  Philip.  Harduyno  de  Sainct  Jacque.  On 
the  reverse  is  the  coat  of  arms  of  the  Medi- 
cal Faculty  of  Paris,  viz. :  three  storks  in  a 
row  turned  to  the  left,  each  one  with  a 
laurel  branch  in  his  beak.  The  inscription  is : 
Urbi  et  Orbi  Salus.  In  exergue:  Facult. 
Medic.  Paris.  1638.  AH  the  early  jetons 
show  merely  the  coat  of  arms  of  the  retir- 
ing Dean  on  one  side  and  on  the  other  the 
coat  of  arms  of  the  Medical  Faculty. 

Guy  Patin  (1602- 1672)  was  the  first  to 
place  his  own  effigy  on  the  obverse  instead 
of  his  coat  of  arms.  He  was  Dean  from  1650 
to  1652.  The  jeton  shows  Patin's  head  to 
the  right  with  the  legend:  M.  Guy  Patin 
Doien.  1652.  In  exergue:  Felix  Qui  Potuit. 


The  M.  stands  for  Maitre  (Magister).  In 
the  Middle  Ages,  the  Medicinae  Doctores 
called  themselves  "Magistri  in  medicina" 
and  the  Deans  of  the  Paris  Medical  Fac- 
ulty retained  this  ancient  title  long  after  it 
had  been  abandoned  by  the  medical  pro- 
fession. "Felix  Qui  Potuit"  is  the  begin- 
ning of  a  passage  in  Virgil's  Georgics.1 

The  reverse  shows  the  usual  three  storks 
of  the  Paris  Medical  Faculty.  Patin  is 
chiefly  known  by  his  Letlres,  which  were 
published  in  1 7 1 3.  He  was  not  an  originator 
of  new  ideas, — he  even  opposed  Harvey's 
great  discovery, — but  he  was  a  man  of  an 
independent  mind,  he  despised  the  hollow- 
ness  and  formalism  of  his  time  and  merci- 
lessly exposed  the  weaknesses  of  his  con- 
temporaries. 

'Felix  qui  potuit  rcrum  cognoscere  causas 
Atque  mctus  omnes  et  inexorabile  fatum 
Subjecit  pedibus,  strepitumque  Achcrontis  avari. 


The  five  Deans  who  succeeded  Patin  re- 
verted to  the  old  custom  of  placing  their 
coats  of  arms  on  the  obverse  of  their  jetons. 
Antoine  Morand,  who  was  Dean  from  1662 
to  1664,  again  placed  his  own  effigy  on  the 


obverse  of  his  jeton.  From  now  on  the  je- 
tons regularly  show  the  image  of  the  re- 
tiring Dean,  and  the  coat  of  arms  of  the 
Medical  Faculty  on  the  reverse  is  frequent- 
ly replaced  by  other  designs. 

Francois  Le  Vignon  was  Dean  from  1664 
to  1666.  The  obverse  of  his  jeton  bears  the 
inscription:  M*  Fr.  Le  Vignon.  Con-  d'Es- 
et  Doien.  As  he  carries  the  title  Con- 
seiller  d'etat,  Moehsen 2  supposes  that  he 
was  body  physician  to  the  queen.  The  re- 
verse of  the  medal  shows  a  bare  arm  thrust 
forth  from  the  clouds,  the  hand  throttling 
three  serpents.  The  legend  is:  Contero  Mon- 
stra.  This  refers  to  the  decree  of  the  French 
Parliament  of  1666  which  decided  the  long 


controversy  among  the  French  physicians 

about  antimony  in  favor  of  those  who  ad- 
vocated its  value  in  medicine. 

From  1666  to  1668  the  Deanship  was 
held  by  Jean  Armand  de  Mauvillain.  His 
jeton  shows  on  the  obverse  his  effigy  by 
Du  Four.  The  reverse  presents  the  giant 

•Moehsen,  Bcschreibung  einer   Berl.   Medaillen- 

samml.  Bed.  &  Leipz.,  1773- 


French  Medical  Jetons 


157 


Polyphemus  lying  prostrate,  while  Ulysses 
puts  out  his  eye  with  a  burning  torch.  The 
circumscription  reads:  Vero  Lumine  Ccecat. 
Polyphemus   represents    Francois   Blondel, 


who  was  one-eyed.  Blondel  was  one  of  the 
chief  opponents  of  antimony  but  lost  his 
lawsuit  against  the  Medical  Faculty.  Mau- 
villain  is  chiefly  known  by  the  enmity  he 
bore  to  Moliere.  He  fell  out  with  Moliere's 
wife  and  the  latter  took  revenge  by  incit- 
ing her  husband  to  ridicule  the  haughty 


physician  in  L Amour  Medecin,  in  which 
one  of  the  four  physicians  is  supposed  to 
represent  Mauvillain. 

From  1696  to  1700,  the  Deanship  was 
held  by  Jean  Boudin.  The  obverse  of  his 
jeton  shows  his  bust  to  the  right.  The  re- 
verse represents  the  centaur  Chiron  leading 
young  ^sculapius  to  a  distilling  apparatus. 
The  inscription  is:  Servat  et  Docet.  In  ex- 
ergue: Facult.  Medic.  Paris.  Anno  1700. 
Boudin  was  the  first  Dean  to  hold  the  po- 
sition for  two  successive  terms. 

Francois  Vernage  was  Dean  from  1702 
to  1704.  His  jeton  does  not  show  his  own 
image  but  that  of  Guido  Fagon,  body  phy- 
sician of  Louis  XIV.  The  obverse  with  Fa- 
gon's  bust  carries  the  legend:  Scholae  Tutela 
Prsesens.  The  reverse  shows  the  arms  of 
the  Paris  Medical  Faculty  and  the  inscrip- 
tion: M.  Fr.  Vernage.  Paris.  Fac.  Med.  Paris. 


Decano.  Below  are  the  words:  Preesed.  Ord. 
M.  Guid.  Cresc.  Fagon.  Archiat.  Com.  Ult. 
Ma.  1703.3  It  seems  Fagon  owed  the  honor 
of  having  his  bust  on  Vernage's  jeton  to 
the  fact  that  he  was  at  that  time  President 
of  the  Medical  Faculty.  Fagon  was  in  1703 
66  years  old  and  Vernage,  who  was  then 
scarcely  forty,  honored  his  older  colleague 
by  placing  the  Iatter's  effigy  on  the  jeton  of 
his  administrative  term. 

While  a  Dean  was  usually  elected  only 
once  for  a  term  of  two  years  quite  a  num- 
ber held  the  position  for  two  terms.  Be- 
sides Jean  Boudin,  mentioned  above,  Ar- 
mand  Doute  (1716-  1720),  Francois  Geof- 
froy  (1726 -1730),  Jean  -  Baptiste  Boyer 
(1756  -  1760),  Louis  Alleaume  (i774  -  1778). 
and  several  others  were  elected  twice  suc- 
cessively. Rene  Le  Thuillier  (1768- 1774) 
and  Claude  Bourru  (1788  -  1793)  were  eIec1> 
ed  for  three  successive  terms. 

None  of  these  men  of  the  old  Paris  Medi- 
cal Faculty  gained  eminence  in  medicine. 
While  England,  during  the  same  period, 
produced  such  men  as  Harvey,  Sydenham, 
Willis  and  Mayow,  French  medicine  was 
barren.  "The  physician  had  become  a  sterile 
coxcomb,"  says  Garrison,4  "red-heeled, 
long-robed,  big-wigged,  pompous  and  dis- 
dainful in  manners.  Among  themselves  the 
physicians  were  narrowly  jealous  of  their 


rights  and  privileges,  regarding  their  fra- 
ternity as  a  closed  corporation  yet  eternal- 
ly wrangling  about  theories  of  disease  and 

3  Prasedente   Ordinario    Magistro    Guidone   Cre- 
scentio  Fagon.  Archiatrorum  Comite.  Ultimo  Mail. 

x703- 

4  Garrison,  History  of  Medicine,  Phila.,  1913- 


158 


Annals  of  Medical  History 


current  modes  of  treatment."  The  facsim- 
iles of  the  jetons  accompanying  this  article 
afford  a  striking  illustration  of  this  fact. 

Claude  Bourru  was  the  last  Dean  of  the 
old  Medical  Faculty  of  Paris.  In  1793  the 
Revolutionary  government  of  France,  which 
swept  away  so  many  mediaeval  spiderwebs 
but  in  its  mania  for  reforms  also  did  away 
with  manj"  useful  and  salutary  institutions, 
abolished  all  scientific  corporations  and  so- 
cieties, among  them  the  Academy  of  Medi- 
cine of  Paris.  The  practice  of  medicine  was 
freed  from  all  restriction.  It  was  soon  found, 
however,  that  the  country  could  not  get 
along  without  a  recognized  medical  pro- 
fession and  in  1795  tne  three  so-called 
Ecoles  de  sante  of  Paris,  Montpellier  and 
Strasbourg  were  established.  Napoleon  I, 
the  heir  of  the  Revolution,  did  not  restore 
the  Academy  of  Medicine.  The  old  corpo- 
ration had  enjoyed  great  freedom  and  many 
privileges  and  had  always  been  very  jeal- 
ous of  governmental  interference  in  its  in- 
ternal affairs.  This,  of  course,  did  not  suit 
an  autocratic  mind  like  that  of  Napoleon. 
It  was  not  until  1823,  under  Charles  X, 
that  the  Academy  of  Medicine  of  Paris  was 
reestablished.  But  the  old  custom  of  strik- 
ing jetons  at  the  election  of  a  new  Dean 
was  not  renewed.  This  is  perhaps  to  be  de- 
plored. It  was  certainly  a  beautiful  custom, 
which  was  imitated  by  many  European 
scientific  societies.6 

While  the  old  Faculty  of  Medicine  of 
Paris  was  barren  of  men  distinguished  in 
medical  science,  the  new  Academy  at  once 
opened  up  with  a  galaxy  of  illustrious 
names.  In  looking  over  a  collection  of  medi- 
cal medals  Billroth  once  remarked  that  "not 

6  It  would  certainly  not  be  out  of  place  if  the 
American    Medic  tion    would    strike   such 

medals  at  the  biennial  election  of  its  presidents. 
These  medals  would  form  a  history  <>f  the  Associa- 
tion in  metal. 


a  single  one  of  them  had  been  struck  of!"  to 
commemorate  anything  more  than  respect- 
able mediocrity."  6  This  was  true  of  former 
centuries  when  men  of  merit  in  medical 
science  were  rare  and  when  positions  of 
power  and  influence  were  entirely  due  to 
birth  and  wealth.  It  is  not  true  to-day,  for 
at  no  time  have  merit  and  true  wor^h  been 
more  recognized  than  in  our  democratic 
age.  Of  this  the  French  medals  stmck  in 
honor  of  medical  men  during  the  19th  cen- 
tury give  ample  proof.  The  Washington 
collection  includes  a  large  number  of  these 
medals,  which  have  beside  their  medico- 
historical  importance  great  artistic  value. 
Among  the  men  thus  honored  are  Corvisart, 
Dupuytren,  Larrey,  Pinel,  Bernard,  Chau- 
veau,  Oilier,  Pasteur  and  many  others.  " 

BIBLIOGRAPHY 

Corlieu — L'ancienne  Faculte  de  medecine  de 
Paris,  1900. 

Kluvskens — Des  hommes  celebres  dans  Ies 
sciences  et  Ies  arts.  Gand,  1859. 

Moehsen — Beschreibung  einer  Berliner  Medail- 
Iensammlung.  Berlin  u.  Leipzig,  1773. 

Nivelet — Moliere  et  Guy  Patin.  Paris,  1880. 

Prevost — La  Faculte  de  medecine  de  Paris.  Paris, 
1900. 

Roubaud — Histoire  et  statistique  de  I'Academie 
nationale  de  medecine.  Paris,  1852. 

Rudolphi — Index  numismatum.  Berolini,  1823. 

Corlieu — Les  jetons  des  doyens  de  l'ancienne 
Faculte  de  medecine  de  Paris.  Paris  medical,  1 887, 
XII,  213. 

Lacroniql'E — Etude  historique  sur  les  medaiiles 
et  jetons  de  I'Academie  royale  de  chirurgie,  1 73 1- 
1793.  Bull.  Soc.  franc,  d'hist.  de  la  mid.,  Paris,  1003, 
II.  23-79- 

•Garrison,  Med.  Pickwick,  Saranac  Lake,  1915, 
L  2. 

7  The  photoprints  accompanying  this  article, 
slightly  enlarged,  are  taken  from  copper  engravings 

in  Moehsen's  "Beschreibung  einer  Berliner  Medail- 
[ensammlung,"  as  it  was  impossible  to  make  good 

photographs  from  the  actual  medals,  though  most 
of  them  are  still  well  preserved. 


THE   HISTORY  OF   INFECTION1 


By  ARNOLD  C.  KLEBS,  M.D., 


WASHINGTON,   D.   C. 


NOT  only  among  the  Greeks  and 
Romans  who  still  are  our  princi- 
pal schoolmasters,  but  long  be- 
fore them  there  existed  in  human 
language  a  term  to  designate  the  process  of 
infection.  It  did  not  always  have  exactly  the 
same  significance  which  it  now  has.  Tradi- 
tion preserved  for  it  a  certain  basic  mean- 
ing; and  convention,  according  to  varying 
necessities  and  changing  interests,  modified 
its  application.  This  is  only  the  natural  vari- 
ation to  which  all  terms  are  subject  and  one 
of  the  reasons  why  it  is  so  difficult  for  us 
to  enter  into  the  thoughts  and  activities  of 
former  generations  and  fully  profit  by  their 
experiences. 

When  the  Roman  used  the  verb  "infi- 
cere"  it  conveyed  to  him  not  only  the  lit- 
eral sense  of  putting  one  thing  into  another, 
but  with  the  qualification  that  the  "in- 
fected" object  is  altered  in  appearance  or 
effect  and  chiefly  so  as  to  render  it  unpleas- 
ing,  harmful  or  corrupted.2  Now,  this  cor- 
responds in  general  to  our  own  use  of  the 
word  and  indeed  one  might  think  that  we 
chose  it  for  that  very  reason,  making  it 
only  more  precise  and  limited.  As  a  matter 
of  fact  we  had  no  choice.  The  term  came 
down  to  us  gradually  through  all  the  in- 
tervening generations,  even  preserving  its 
Latin  form.  It  is  evidently  the  importance 
of  the  underlying  idea  which  it  expresses 

1  Subject  of  an  address  delivered  before  the  Bio- 
logical Club  of  the  University  of  Chicago  and  the 
Historical  Society  of  Washington  University,  St. 
Louis,  in  December,  191 6. 

2  The  adjective  and  noun  (injectus  and  injectio) 
had  more  the  sense  of  our  "ineffective,"  while  "in- 
Jectivus,"  at  least  in  Vitruvius,  is  the  thing  altered, 
infected,  particularly  dyed  or  colored. 


intelligibly  that  has  preserved  it,  and  this 
idea  is  neither  Roman  nor  Greek,  but  sim- 
ply human.  It  offers  an  appropriate  word- 
picture  for  something  of  daily  incidence 
and  vital  importance.  It  relates  the  cause 
with  the  effect  and  thus  becomes  the  word- 
symbol  of  a  primitive  aetiologic  concept. 
Words  of  this  kind  have  a  much  greater 
vitality  than  the  more  artificial  nomencla- 
ture of  philosophy  and  science. 

Since  we  have  become  acquainted  with 
microorganisms  and  their  role  in  diseases, 
setiologic  research,  because  of  its  tangible 
object,  has  exerted  a  determining  influence 
on  medicine.  It  has  gone  almost  to  the  ex- 
treme of  making  aetiology  and  bacteriology 
synonymous  terms.  Infection  to-day  means, 
if  we  take  it  in  the  broad  definition  of  Hek- 
toen,  "the  entrance  into  the  body  of  living 
agents,  capable  of  multiplication,  most 
commonly  microbes,  which  then  cause  dis- 
ease." The  microorganism  as  the  deter- 
mining factor  of  infectious  diseases,  the 
specificness  of  the  infection  and  the  invari- 
ability of  microbic  species  make  this  the 
dominant  theory  of  the  day  in  medicine. 
Its  profound  influence  is  felt  in  private  and 
public  life  to  a  degree  unparalleled  in  the 
annals  of  human  society.  So  dominant  is 
this  doctrine  that  the  question  is  hardly 
ever  asked:  might  there  not  be,  apart  from 
the  microbe,  pathogenic  influences  of  equal 
if  not  of  greater  importance? 

Even  those  who  vindicate  for  modern 
scientific  research  its  freedom  from  dogma 
(Hamilton)  adhere  to  the  all-importance  of 
the  living  agent  in  the  causation  of  disease. 
The  others,  the  followers  of  Koch,  whose 
labors,  they  say,  have  brought  the  question 
to  "a  certain  and  unequivocal  conclusion," 


159 


i6o 


Annals  of  Medical  History 


proclaim  proudly  that  the  doctrine,  even 
in  its  most  restricted  sense,  ought  to  have 
been  long  ago  "established  as  a  fixed  dog- 
ma" on  the  basis  of  historical  tradition 
and  by  every-day  observation.3  Here  we 
have  in  modern  times  a  contrast  between 
empiricism  and  dogmatism  which  in  the 
past  has  led  to  so  many  wasteful  and  ster- 
ile conflicts.  It  is  immaterial  whether  the 
basic  theory  on  which  both  are  agreed  was 
obtained  by  syllogistic  reasoning  or  by  ex- 
perimental demonstration,  neither  is  con- 
cerned with  the  continuous  reality  as  it 
appears  to  immediate  intuition;  for  prac- 
tical purposes  this  is  broken  up  into  ele- 
ments, and  fixed  by  verbal  symbols  (or 
images  of  objects)  later  to  be  artificially 
reconnected.4 

Most  of  the  historical  surveys  of  the  doc- 
trine of  infection  are  nothing  but  panegy- 
rics of  the  current  doctrine,  showing  past 
errors  or  an  assumed  evolution  from  vague 
unconscious  gropings  towards  that  final 
perfection  represented  by  modern  achieve- 
ments. While  entirely  legitimate,  this  kind 
of  historiography  can  give  only  an  inade- 
quate understanding  of  human  thought  in 
the  past  and  no  clear  outlook  into  the  fu- 
ture. The  higher  task  of  history  is  to  study 
critically  the  ideas  of  man  about  living 
nature,  in  the  same  way  that  the  biologist 
studies  the  various  phenomena  of  the  or- 
ganism itself,  to  promote  the  understand- 
ing of  basic  principles.  If  we  study  the 
records  of  the  past  with  this  aim  before  us, 
we  perceive  that  the  concept  "infection," 
although  assuming,  from  time  to  time,  for 
practical  purposes  a  varying,  transitory  sig- 
nificance, tenaciously  retains  a  fundamen- 
tal and  primordial  relation  to  disease,  pos- 
sibly identical  to  the  one  ingestion  holds  to 
growth  and  sustenance,  or  fertilization  to 
the  propagation  of  the  species.  Such  gen- 
eralization may  be  deemed  unscientific  and 

*  KoIIc  in  "Handbuch  der  Mikroorganismcn"  by 
KoIIc  and  Wasscrmann,  2nd  cd.  I,  869,  872. 

*  See  Bergson:  Mind  and  Matter.  Lond.,  191 1. 


contrary  to  the  admonition  that  the  his- 
torical student  should  record  rather  than 
interpret.  But  there  can  be  no  doubt  that 
the  endeavor  to  disentangle  from  history 
the  leading  and  connecting  threads  adds 
zest  and  vitality  to  the  search  and  no  harm 
is  done  provided  true  facts  are  given  with- 
out distortion. 

The  Annals  have  brought  in  the  last 
number  an  illuminating  study  by  Dr.  and 
Mrs.  Singer  on  Fracastoro,  the  first  clear 
exponent  of  the  theory  of  infection  as  we 
now  understand  the  term.  The  essay  shows 
very  well  how  the  mind  of  a  cinquecento 
scholar,  unaided  by  the  microscope  and 
bacteriologic  technique,  could  formulate 
what  we  believe  has  now  been  determined 
as  a  scientific  fact.  But  there  can  be  no 
question  that  the  same  idea  was  in  the 
minds  of  uncounted  generations  before  Fra- 
castoro. To  analyze  some  expressions  in 
available  literature  that  seem  suggestive  in 
this  direction  is  the  task  I  have  set  for  my- 
self in  the  following. 

BABYLONIA    AND   ASSYRIA 

Civilizations  which  have  endured  for 
such  long  periods  as  did  those  of  the  ancient 
Babylonians  and  Egyptians  must  have  been 
founded  and  advanced  bjr  very  practical 
people.  Their  efforts  and  thoughts,  while 
in  form  differing  from  ours,  must  have  been 
directed  to  the  realization  of  very  similar 
aims.  Their  evident  success,  if  nothing  else, 
must  command  our  attention,  although 
some  are  inclined  to  dismiss  as  supersti- 
tions most  of  the  ideas  we  encounter  among 
them.  Perhaps  it  would  be  more  profitable 
if  we  used  the  word  "superstitions"  in 
Lowell's  sense  as  marking  the  world's  "un- 
finished business."  Are  we  not  apt  to  over- 
look the  fact  that  the  primitive  man,  when 
he  tries  to  promote  his  understanding  of 
the  world  by  attaching  a  name  or  some 
figurative  symbol  to  the  invisible  power 
which  he  feels  affects  him  in  some  way, 


The  History  of  Infection 


161 


does  nothing  essentially  different  from  what 
we  are  doing  all  the  time?  "Seeing  is  know- 
ing" guided  him  as  it  guides  us,  and  the 
superstitious  awe  of  which  we  hear  so  much 
blinded  him  far  less  than  is  usually  thought. 
Beneath  the  complex  texture  of  his  myth- 
ology we  find,  if  we  only  look  for  it,  fre- 
quent evidence  of  most  minute  observation 
and  the  utilization  of  experiment.5 

Theurgic  and  numinal  concepts  form  the 
basis  of  the  nosological  nomenclature  of  the 
ancient  Babylonians  and  Assyrians.  The 
study  of  cuneiform  inscriptions  has  opened 
our  eyes  to  a  new  world.  The  texts  which  deal 
with  incantations,  divinations,  conjurations 
(exorcisms)  and  the  like  contain  a  great  deal 
of  information  on  medical  subjects.  The 
priest,  who  filled  the  place  of  the  physician, 
as  so  often  in  history,  used  these  texts  as  a 
sort  of  practical  guide  book  in  his  daily  rou- 
tine. They  were  to  lead  him  to  diagnosis, 
prognosis,  prophylaxis  and  treatment  of  hu- 
man ills.  The  compilation  of  the  most  im- 
portant ones  can  be  traced  to  the  non-semi- 
tic  priests  and  magicians  who  practiced  their 
craft  before  the  advent  of  the  Semitic  Baby- 
lonians (dated  variously  between  5000  and 
4000  B.C.,  or  roughly,  before  3000  B.C.). 
The  excavations  of  the  great  library  of 
Asurbanipal  (668-626  B.C.)  at  Nineveh 
brought  copies  of  them  to  light. 

For  infectious  diseases  the  most  impor- 
tant series  is  that  of  incantations  against 
the  special  disease  demons  and  fever  sick- 
ness (ekimmu  and  asakki  marsuti)  or  the 
"incantations  against  the  appearance  of  the 
dead."  Consciousness  of  regret  and  fear, 
evoked  by  the  memories  of  those  that  have 
passed  away,  sublimized  by  the  mystery 
of  death,  these  are  the  principal  sources  of 
the  belief  in  the  troublesome  ghost.  The 
idea  of  the  entrance  of  the  demon  into  his 
victim  is  not  always  clearly  expressed.  The 
incantation,  which  is  really  the  prayer  of  a 

6  Thus  we  see,  for  instance,  on  various  Assyrian 
monuments  some  divinities  depicted  in  the  act  of 
fertilizing  manually  the  flower  of  the  date  palm. 


troubled  soul,  has  the  sense:  "Let  them 
accept  this  offering  and  leave  me  in 
peace." 

In  the  divination  series  the  same  ideas 
prevail.  They  form  a  minutely  worked  out 
system  of  prognostics,  based  partly  on  ob- 
servation, partly  on  hypothesis,  intended  to 
serve  individuals  as  well  as  the  king  or 
state.  The  elaborate  descriptions  of  the 
birth  omina  and  liver  omina  have  evoked 
great  medical  interest  because  they  re- 
vealed an  unexpected  knowledge  of  ana- 
tomical detail.  From  one  of  the  liver-texts 
we  learn  of  the  mangu-disease,  an  infection 
of  the  throat  which  seems  to  have  appeared 
as  an  epidemic,  something  like  diphtheria, 
and  another  of  the  face  which  has  been 
identified  as  erysipelas.6  There  is  naturally 
a  great  deal  of  arbitrariness  in  this  nomen- 
clature of  diseases  in  which  it  is  often  diffi- 
cult to  distinguish  whether  the  demon  or 
the  disease  that  he  is  supposed  to  have  pro- 
duced, is  intended.  Still,  whether  demon 
or  disease,  we  have  quite  a  number  of 
names  which  are  thought  to  specify  infec- 
tious diseases  as,  for  instance :  Bennu,  sassa- 
tu,  sakikku,  hatu,  mursu,  si-ib-tu,  ummu, 
huntu,  li'bu  and  in  a  class  by  themselves 
sidanu  and  miktu.7 

While  religious  cult,  just  as  scientific  re- 
search, produces  a  large  and  somewhat 
mysterious  nomenclature,  the  language  used 
to  define  personal  property  in  sale  or  pur- 
chase strives  towards  clearness  and  circum- 
scribed precision.  The  right  of  the  pur- 
chaser of  a  slave  to  return  the  same  to  the 
seller  at  the  original  price  after  a  certain, 
stipulated  period,  in  case  of  an  illness  or 
defect  which  was  not  obvious  at  the  time 
of  sale,  was  recognized  in  the  famous  law 

6  Cuneiform  Texts,  Part  xxviii,  43 ;  and  for  many 
further  details  the  works  by  Jastrow:  "The  Civiliza- 
tion of  Babylonia  and  Assyria,"  and  "Religion 
Babyloniens  and  Assyriens,"  in  three  volumes,  which 
contains  translations  and  discussions  of  numer- 
ous texts  (incantations  and  divinations).  Phila., 
1915. 


1 62 


Annals  of  Medical  History 


code  of  Hammurabi.7  Slave  contracts  based 
on  this  law  have  come  down  to  us  in  great 
number  not  only  from  Babylonian,  but  also 
from  Assyrian,  Persian,  near-Asiatic  and 
finally  Greek  times.  Since  the  diseases  are 
usually  stipulated  by  a  name  in  these  con- 
tracts and  their  most  striking  traits  de- 
fined by  the  practical  exigencies  of  the 
contract,  it  was  hoped  that  their  stud}' 
would  perhaps  bring  out  more  precise  de- 
tails about  the  ancient  knowledge  of  a  cir- 
cumscribed group  of  diseases.  As  a  matter 
of  fact  it  was  found  that  also  here  accurate 
identification  offered  great  difficulty  and  that 
it  was  much  wiser  to  be  satisfied  with  the 
general  information  obtained. 

It  is  fairly  generally  agreed  among  ex- 
perts that  the  two  names  bennu  and  sibtu 
which  are  found  most  frequently  in  these 
contracts  were  meant  to  designate  those 
diseases  or  defects  whose  occurrence  could 
invalidate  the  sale.  Non-medical  Assyriolo- 
gists  were  quick  to  identify  them  in  vari- 
ous ways.  Fever  and  ague  (Harper,  Jen- 
sen), syphilis  (Ungnad)  and  lepra  were  in 
turn  proposed 8.  Sudhoff,  by  a  very  inter- 
esting and  ingenious  argument  based  upon 
a  mass  of  corroborative  evidence,  has  come 
to  the  rather  startling  conclusion  that  both 
terms  together  were  meant  to  indicate  a 
seizure  of  epilepsy.  This  would  put  the 
subject  apparently  out  of  consideration  in 
this  place.  But  epilepsy  and  other  psychotic 
and  neurotic  affections  have  been  regarded 
through  long  epochs  as  caused  by  infection, 
and  the  term  psychic  infection  is  occasion- 
ally heard  in  our  own  day,  so  that  we  may 
be  permitted  to  devote  a  little  time  to  Sud- 
hofFs  translation  of  bennu  and  sibtu,  inas- 
much as  the  material  he  adduces  allows 
possibly  a  different  interpretation. 

'2267-2213  B.C.  See  SudhofF,  Arcb.  J.  Gescbicbte 
d.  Med.  1910-n,  iv,  353.  cf.  Johns,  C.  H.  W.: 
Assyrian  deeds  and  documents  on  transfer  of 
property,  3  vols.  Cambridge,  1901,  iii,  394. 

•See  Kohlcr  and  Ungnad:  Assyrische  Rechtsur- 
kundcn,  Leipzig,  1913. 


Assj'riologists  derive  the  word  bennu  from 
a  Sumerian  ideogram  which  stands  for 
muscle  or  tendon,  and  hence  they  give  as 
the  literal  translation  "the  disease  of  the 
muscles."  In  later  contracts,  made  by 
Greeks  in  Asia  Minor,  Sudhoff  found  the 
word  tepd  vocros  ("sacred  disease")  in  the 
same  place  inserted  with  one  or  two  other 
names  of  diseases.  This  he  considers  defi- 
nitely identified  with  epilepsy  and  hence 
he  concludes  that  in  the  Babylonian  con- 
tracts the  word  bennu  also  is  meant  to 
designate  a  disease  characterized  by  spas- 
modic attacks  which  incapacitate  the  vic- 
tim and  by  periods  of  latency  might  de- 
ceive the  purchaser.  This  is  quite  plausible, 
but  it  might  be  objected  that  the  muscle 
spasm  would  not  necessarily  be  the  most 
striking  symptom  of  the  attack  so  as  to 
impose  the  special  name,  also  that  we  have 
no  evidence  that  epilepsy  occurred  fre- 
quently enough  to  make  a  special  legal  pro- 
vision against  it  desirable.  However  this 
may  be,  only  Assyriologists  assisted  by 
medical  men  can  decide  the  matter.  There 
is,  however,  a  disease  the  enormous  fre- 
quency of  which  in  antiquity  is  abundant- 
ly demonstrated  by  paIa?o-pathologicaI  find- 
ings and  which,  so  far  as  I  know,  has  never 
been  mentioned  in  connection  with  bennu — 
I  mean  osteo-artbritis  deformans.  From  the 
findings  in  Egyptian  mummies  we  know 
that  it  led  to  marked  deformity,  such  as 
we  see  no  more,  and  also  that  it  attacked 
already  relatively  young  individuals.  That 
it  might  have  appealed  as  a  "rheumatic" 
muscle  disease  any  modern  sufferer  of  the 
trouble  will  readily  testify,  and  thus  the 
terms  bennu  and  rbeuma  are  about  on  a 
par  as  regards  aetiologic  lucidity. 

Whether  the  word  sihtu  stands  for  a  dif- 
ferent disease  from  bennu,  or  whether  it 
simply  means,  as  Sudhoff  thinks,  "seizure" 
or  "attack,"  derived  from  the  verb  sabatu 
"to  grab,  to  seize,"  is  still  an  open  ques- 
tion. Undoubtedly  it  has  been  used  in  va- 
rious senses,  but  it  seems  quite  established 


The  History  of  Infection 


163 


that  it  designates  rather  a  general  concept 
than  a  special  object  and  that  this  corre- 
sponds to  the  Latin  inficere  is  more  than 
likely.  Very  similarly  the  Greek  eira<pri  is 
used  later  in  connection  with  lepra,  the 
verbal  derivative  of  which  Thucydides  em- 
ploys to  designate  the  infection,  in  his  fa- 
mous account  of  the  Attic  plague,  so  that 
Sudhoff  considers  the  Greek  word  a  literal 
translation  of  the  Assyrian  term.  The  He- 
brew word  nega  very  similarly  determines 
saraath  and  the  two  together  are  translated 
in  our  Bible  as  "the  plague  of  the  lep- 
rosy." 

A  series  of  Babylonian  tablets  is  devoted 
to  lists  of  animals  and  plants  showing,  not 
only  a  considerable  knowledge  of  fauna  and 
flora,  but  also  that  degree  of  careful  obser- 
vation necessary  for  a  systematic  classifi- 
cation. The  latter  does  not  always  corre- 
spond with  ours  but  that  need  not  disturb 
us  unless  we  are  ready  to  assume  that  our 
classification  will  survive  the  next  5,000 
years.  The  Babylonian  recognized  perfectly 
well  the  role  which  certain  of  the  smaller 
animals  played  in  those  diseases  which  for 
some  reason  or  other  we  consider,  as  para- 
sitic, different  from  the  other  infectious 
diseases. 

Dr.  F.  von  Oefele  has  made  a  special 
study  of  Babylonian  entomology  and  with 
great  courtesy  he  has  put  his  notes  on  the 
subject  at  my  disposal.9  The  texts  begin 
with  the  large  class  of  zumbu,  the  fly,  in 
which  are  enumerated  several  diptera  and 
hymenoptera.  Their  names  are  determined 
by  those  of  their  various  hosts  and  also  by 
water,  stone  and  other  objects,  or  foods  for 
which  they  showed  a  predilection.  The  fly 
as  the  symbol  of  the  god  of  destruction  and 
pestilence,  Nergal,  appears  quite  often  in 
pictorial  representation  as  a  special  em- 
blem, so  for  instance  on  a  seal  cylin- 
der in  the  collection  of  the  late  J.  P.  Mor- 

9  See  Cuneiform  Texts,  Part  xiv,  London, 
1902. 


gan.10  The  next  class  is  formed  by  the 
various  bugs  which  as  hemiptera,  with 
some  50,000  species,  threatens  to  drown 
the  modern  entomologist.  Under  the  name 
kalamatu,  18  different  lice  are  recorded. 
Some  of  them  figure  as  worms,  which  need 
not  astonish  us,  because  even  quite  close 
to  our  time  they  have  been  frequently 
described  as  such.11  These  lice  are  again 
named  by  their  habitat  beginning  with 
kalamatu  kakkadi,  the  "head  louse."  There 
are  three  hypothetical  kalamates  which  are 
said  to  produce  internal  disease;  they  are: 
mikkana,  tultu  and  mubattira.  Tultu  is  the 
best  known.  It  is  the  worm  cause  of  dental 
caries  and  toothache  and  as  such  became 
the  object  of  a  great  Babylonian  incanta- 
tion. This  setiologic  concept  we  can  follow 
in  an  enormous  literature  way  into  the 
1 8th  Century.  Dr.  von  Oefele  also  calls 
my  attention  to  the  fact  that  in  the  texts 
of  the  North  American  Dakota  Indians  the 
same  concept  is  found.12 

BIBLICAL    PEOPLES 

Many  cultural  streams  have  crossed  each 
other  in  the  lands  of  the  easternmost  corner 
of  the  Mediterranean  basin  with  which  the 

10  Nergal  is  represented  in  the  company  of  14  de- 
mons over  which  he  has  command.  They  represent 
various  evil  influences,  some  of  which  surely  are 
diseases,  especially  fevers.  Ungnad  in  Gressmann: 
Altorientalische  Texte  und  Bilder,  I.  p.  69  gives 
their  names  as  follows:  4.  mutabriku,  5.  sarabdu, 
6.  rabisu,  7.  dirit,  8.  ibitu  (?),  9.  bennu,  10.  sidanu, 
11.  mikit,  12.  bel-ubri  (?),  13.  ummu,  14.  libu.  Bennu 
here  heads  five  others  which  all  stand  for  various 
degrees  of  heat,  indicating  possibly  feverish  diseases. 
(See  Sudhoff,  op.  cit.,  note  7.) 

11  "A  Ious  is  a  worme  with  many  fete  &  it  com- 
meth  out  of  the  filthi  and  onclene  skynne  .  .  ." 
Book  of  the  Quinte  Essence  (ed.  Furnival)  p.  19. 

12  He  adds:  "It  is  Mongolian  in  common;  from 
the  time  prior  to  the  separation  of  Mongolian  and 
Indian.  It  entered  Babylonian  medicine  through  the 
Hittites,  whom  I  consider  with  the  Etruscans  and 
other  peoples  as  Mongolian,  split  off  from  them 
somewhat  like  the  Huns." 


164 


Annals  of  Medical  History 


Bible  has  acquainted  us.  Of  course  it  has 
been  intensively  studied,  but  still  many 
puzzles  remain  to  be  solved.  It  was  a  reve- 
lation when  not  long  ago,  in  Crete,  traces 
of  a  very  high  (Minoan)  culture  were 
found,  one  which  antedated  considerably 
that  of  Mycenae,  Troy  and  of  classic  Greece. 
We  have  also  not  yet  found  out  about  the 
Hittites,  and  much  remains  equally  uncer- 
tain about  the  Philistines  who  seem  to  have 
come  from  Crete.  It  is  in  the  accounts  of 
the  wars  between  the  Jews  and  the  Philis- 
tines that  we  find  an  early  reference  to  our 
subject.  (11  Sam.  ii  3.)  When  the  Israel- 
ites were  hard  pressed  by  the  Philistines 
they  sent,  as  a  last  resort,  for  the  Ark  of 
the  Covenant  to  be  brought  from  Shiloh 
to  the  front.  The  Philistines  speedily  cap- 
tured it  and  took  it  in  triumph  to  Ashdod 
where  it  was  exhibited  in  the  temple  of 
Dagon.  The  result  was  that  the  statue  of 
Dagon  fell  down  and  broke  its  hands.  Then 
the  plague  broke  out  in  the  town  and  spread 
along  the  coast.  This  "plague  of  emerods" 
is  usually  identified  with  the  bubonic 
plague.  The  subsequent  spread  of  the  plague 
is  expressly  connected  with  the  arrival  of 
the  ark  in  those  three  places  to  which  it  was 
in  turn  removed.  During  its  sojourn  of 
seven  months  in  Philistia  it  must  have 
done  a  great  deal  of  harm,  and  at  Ekron, 
its  last  station,  it  was  finally  decided  on 
the  advice  of  the  "priests  and  diviners" 
(vi,  2)  to  send  the  ark  back  to  the  Israelites 
with  an  appropriate  trespass  offering.  This 
was  to  consist  of  five  golden  emerods  and 
five  golden  mice  "according  to  the  number 
of  the  lords  of  the  Philistines."  These 
offerings,  the  text  states  (vi,  5),  were  to 
represent  "images  of  your  emerods  and 
images  of  your  mice  that  mar  the  land 
.  .  .  to  lighten  his  hand  from  off  you, 
and  from  off  your  Gods,  and  from  off  your 
land."13  These  offerings  were  to  be  placed 

"This  is  the  only  passage  from  which  a  concur- 
rent plague  of  mice  might  be  inferred,  (cf.  Macalis- 
ter:  The  Philistines,  London,  1914,  p.  47.) 


into  a  separate  coffer  beside  the  ark, 14  and 
to  be  delivered  at  the  frontier  to  "those  of 
Beth-shemesh."  Here  once  more  the  ark 
proves  troublesome,  killing  some  50,000 
people  "because  they  had  looked  into  the 
ark"  (vi,  19).  This  last  outbreak  of  the 
plague  among  the  Israelites  themselves 
would  seem  to  emphasize  the  authenticity 
of  the  story.  It  was  a  plain  and  recognized 
case  of  infection  per  jomitem,  independent 
of  theurgic  influence. 

Another  epidemic,  several  hundred  years 
later,  is  also  briefly  mentioned  in  the  Bible 
(1 1  Kings  xix,  36).  This  time  the  "Angel  of 
the  Lord"  smote  13,000  Assyrians  of  the 
invading  army  of  Sennacherib  (705-681  ).16 
Herodotus  (ii,  141)  gives  more  details  about 
this  plague  and  connects  it  somehow  with 
mice.  According  to  an  Egyptian  tradition, 
the  Assyrians  were  decimated  through  the 
intervention  of  the  God  Ptah  in  the  role  of 
a  pestilence  deity.  This  Ptah  had  a  temple 
at  Thebes  where  he  was  represented  hold- 
ing a  mouse  in  his  hand.  We  see  in  all  these 
tales,  the  mouse  creep  in  somehow.  Offord  w 
states  also  that  votive  mice  modeled  in 
silver  were  found  in  a  river  on  the  Syrian 
coast,  near  Sidon,  and  that  mice  are  carved 
on  Phoenician  and  Punic  monuments.  A 
deity  of  the  latter,  Esbmun,  was,  it  appears, 
equated  by  the  ancients  with  /Esculapius 
and  that  his  cult  was  very  similar  to  that 
of  the  "Smintheus"  who  inflicts  the  pesti- 
lence upon  the  Greeks  before  Troy  (Iliad, 
i>  53)-  Smintheus  is  the  "mouse-god" 
alternative  of  Apollo.  Other  gods  with  mice 
attached  to  their  images  or  receiving  offer- 
ings of  mice  were  ATM,  the  associate  of  the 
hawk-headed  sun  god  RA  of  Egypt,  the 
Resepb  (Dagon?)  of  the  Philistines,  Phoeni- 
cians and  Cypriotes,  according  to  Offord, 
worshiped  also  by  Hittite  and  Syrian 
tribes. 

14  Cf.  OfTord  in  Science  Progress,  London,  19 16,  x, 
570. 

11  Isaiah  xxxvii,  36:  "when  they  arose  early  in  the 
morning,  behold,  they  were  all  dead  corpses." 


The  History  of  Infection 


i65 


One  should  think  that  the  correlation  of 
plague  and  mice,  evidently  noticed  in  such 
remote  ages,  would  have  impressed  the 
bacteriologist  earlier,  inasmuch  as  we  can 
follow  it  to  the  threshold  of  our  times  as  a 
historical  common-place.  When  Nicolas 
Poussin  in  his  famous  painting,  now  in  the 
Louvre,  of  the  "Pest  of  the  Philistines," 
has  rats  among  the  crowd  of  victims  in 
front  of  Dagon's  temple,  he  found  more 
justification  for  doing  this  in  practically  all 
the  accounts  of  plague  that  he  might  have 
consulted,  than  in  the  rather  meager  evi- 
dence of  the  Bible.  But  it  would  not  be 
sound  reasoning  to  conclude  that  all  this 
historical  evidence  must  be  taken  as  vague 
anticipations  of  present  conceptions.  Even 
the  use  of  mice  or  rats  as  emblems  of  plague 
divinities,  or  their  models  as  votive  offer- 
ings is  not  necessarily  conclusive.  One  must 
not  forget  that  all  these  divinities  were  the 
controlling  forces  of  all  kinds  of  destructive 
calamities,  for  the  prevention  or  removal  of 
which  they  were  implored.  The  mouse,  all 
by  itself,  represented  one  of  the  most  dread- 
ed plagues  to  an  agricultural  people  and 
thus  may  have  been  symbolized  without 
any  reference  to  the  plague  in  man.  Aschoff 
(Jaiius,  1900,  v)  tried  to  get  to  the  bottom 
of  the  question  why  the  mouse  should  have 
symbolized  the  plague.  From  a  comparison 
of  the  passages  in  the  Vulgate  and  the  Sep- 
tuagint  he  suggested  that  the  votive  offer- 
ing might  simply  have  attempted  to  repro- 
duce the  size  and  shape  of  the  bubo. 
But  from  the  passage  in  1  Sam.  vi,  5  it 
is  quite  clear  that  models  of  both  bubo 
(emerod)  and  mouse  were  offered,  each  ap- 
parently for  a  specific  purpose.  The  custom 
of  offering  in  sacrifice  to  a  deity  models  of 
organs  or  of  symbols  of  disease  is  also  very 
ancient  and,  as  is  well  known,  persistent  in 
our  day.  It  is  of  great  interest  and  has  an 
indirect  bearing  on  our  subject  because 
these  models  were  probably  thought  to  draw 
away,  specifically,  the  anger  of  the  deity 
from  that  part  of  the  patient's  anatomy. 


The  Hebrew  "scapegoat"  and  the  Greek 
"pharmakos"  are  simply  variations  in  form 
of  the  underlying  idea. 

More  important  than  the  decision  of  the 
question  whether  the  Hebrew  recognized 
the  relation  between  mice  or  rats  and  the 
plague  is  the  very  clear  account  given  of 
the  transmission  by  fomites  and  the  com- 
parative silence  about  direct  transmission 
from  individual  to  individual.  From  the 
sanitary  point  of  view  the  decision  of  the 
relative  importance  of  these  two  factors  has 
a  definite  significance  and  as  it  is  still  under 
discussion  it  is  interesting  to  note  that  the 
ancient  Hebrew  apparently  decided  it  in 
favor  of  those  moderns  who  oppose  the  ex- 
treme contagionist  stand-point  in  plague 
prophylaxis.16 

The  concepts  of  the  insect  pests  among 
the  Biblical  people  are  largely  derived  from 
the  Babylonians.  Thus  the  fly,  the  mos- 
quito and  other  diptera  play  also  with  them 
a  role  in  cult  and  elsewhere.  Ekron,  which 
we  have  already  mentioned  as  one  of  the 
stations  of  the  Ark  in  Philistia,  held  an 
ancient  and  famous  shrine  dedicated  to 
Baal-zebub,  which  name,  literally  translated, 
means  the  "Lord  of  flies."  Macalister 
identifies  Ekron,  not  with  Akir  as  is  usually 
done,  but  with  the  modern  Dhikerin  far- 
ther south,  near  which  still  exists  Deir  edh- 
Dhubban,  "the  convent  of  the  fly."  The 
shrine  of  Baalzebub  was  so  famous  for  its 
oracles  that  the  Jewish  king  Ahaziah,  when 
ill,  sent  to  consult  it,  disregarding  thereby 
the  general  prejudice  of  the  orthodox 
against  foreign  divinities  (11  Kings  i).  This 
Baalzebub,  who  only  later  in  official  demon- 
ology  became  one  of  the  gubernators  of 
the  Infernal  Kingdom  of  Lucifer,  repre- 
sents, as  fly-averter,  a  very  ancient  and 
widely  prevalent  anthropomorphic  concep- 
tion. He  is  surely  a  Babylonian  importa- 
tion, probably  even  older.  He  and  his  fe- 
male counterpart  Asbtoreth   (Astarte,   Ish- 

16  See  G.  Sticker.  Wien.  klin.  Rundscb.,  1898  and 
his  exhaustive  monograph  "Die  Pest,"  Giessen,  1908. 


1 66 


Annals  of  Medical  History 


tar),  so  popular  among  Assyrians,  Phoeni- 
cians and  Canaanites,  proved  very  tempting 
to  the  Jews  whose  leaders  painted  them  so 
black  that  their  devilish  reputation  has  long 
survived.  The  deep  appeal  which  these,  we 
may  call  them  aetiological,  divinities  exert- 
ed upon  the  human  soul,  is  a  very  interest- 
ing fact  to  note,  as  well  as  the  opposition 
which  they  encountered  from  the  learned. 
It  is  also  known  that  Hippocrates  had  to 
warn  his  pupils  against  the  demoniacal 
theory  of  disease.  Baalzebub  of  Ekron 
and  the  BaalBerek  (Berith)  of  Shechem 
(in  the  Talmud)  was  known  to  the  Greeks 
as  the  Baa\  /Ivlau  and  probably  directly 
transmitted  into  their  own  cult  as  the  Olym- 
pian Zeus  Apomuios,  of  whom  Pliny  speaks 
in  his  Natural  History  (xxxix,  34),  where  he 
also  mentions  the  use  of  fly  ashes  in  the 
treatment  of  alopecia  "to  drive  away  the 
fly."17  All  these  are  only  echoes  of  the  Ela- 
mite  and  Babylonian  rites,  brought  out  by 
the  French  excavations  at  Susa,  fixed  by 
the  fly-emblem  already  alluded  to.  The  cu- 
rious persistency  of  the  popular  association 
of  health  and  fly  is  illustrated  by  a  pretty 
story  Macalister  (I.  c.)  tells  about  the  heal- 
ing spring  of  St.  Michael  in  Kirkmichael 
(Banffshire)  which,  in  popular  tradition, 
had  always  been  presided  over  by  a  fly  and 
the  neglect  of  which  as  late  as  1820  was 
deplored  by  an  old  man  who  "in  the  days 
of  his  youth  enjoyed  the  pleasure  of  seeing 
the  guardian-fly."  Deeply  rooted  in  the 
folk  soul  is  this  old  and  ever-young  con- 
cept of  this  relation  of  fly  and  health;  and 
as  we  watch  the  "burnt-offerings"  of  heca- 
tombs of  trapped  flies  rising  to  the  skies 
from  the  camp  fires  of  the  U.  S.  Army  we 
do  not  seem  to  be  so  very  far  from  Baby- 
Ionia.18 

More  closely  in  concordance  with  our 
views  on  infection  are  the  prophylactic  laws 
against  the  saraatb  (the  collective  name  for 
lepra  and  similar  diseases)   which  are  re- 

17  See  M.  Hocfler:  Die  volksmedizinische  Or- 
ganotherapie.  Stuttgart,  1908. 


corded  in  the  famous  chapter  xiii  of  Levit- 
icus, a  book  which  is  known  to  date  from 
the  Babylonian  phase  of  the  Jewish  people. 
It  became  the  prototype  for  similar  sani- 
tary legislation  close  to  our  own  times  and 
led  to  the  provision  of  institutions  which 
we  have  every  reason  to  admire.  It  is  in- 
deed the  current  opinion  that  the  wide 
distribution  of  the  Ieproseries  throughout 
Europe  was  mainly  responsible  for  the 
gradual  disappearance  of  lepra  toward  the 
end  of  the  Middle  Ages.  It  is  difficult  to 
understand  how  again  and  again  the  opin- 
ion can  find  utterance  that  these  measures 
were  not  based  on  the  fundamental  recog- 
nition of  the  infectiousness  and  transmissi- 
bility  of  the  disease,  because  of  the  demo- 
nial  prepossessions  in  the  minds  of  the  Jew- 
ish law-givers.  It  is  not  my  intention  to 
enter  into  this  subject  fully  although  in 
the  concatenation  of  facts  it  is  one  of  the 
strongest  links.  My  desire  is  to  bring  out 
facts  which  are  not  so  clearly  self-evident. 
Morris  Jastrow,  Jr.,  has  recently  discussed 
the  subject  (Jewish  Quarterly  Rev.  IV,  357). 
His  view  is  that  the  laws  are  mainly  based 
on  the  demonistic  theory  of  disease  which 
must  not  be  confounded  with  our  own  bac- 
terial theories  and  that  the  remedies  were 
not  used  against  the  disease  but  against 
the  demons  to  whom  they  were  distasteful 
—  pharmacology  gradually  evolving  out  of 
demonology.  This  is,  of  course,  one  way  of 
looking  at  the  matter,  but  it  fails  to  go  to 
the  core  of  it.  J.  H.  Alexander,  on  the  other 
hand  (Med.  Press  and  Circular,  London), 
following  Clerk  Maxwell's  famous  example, 
substitutes  in  certain  ancient  accounts  bac- 
teriologic  terms  for  the  demonistic  ones. 
Finding  them  to  fit  well,  he  asks  whether 
this  is  due  to  mere  chance  or  whether  the 
Ancients  did  not  anticipate  to  some  extent 

18  That  in  our  days  grave  pathogenic  possibilities 
of  the  fly  are  recognized  is  clear  from  a  large  special 
literature  which  has  been  admirably  reviewed  by 
Henry  G.  Beyer:  The  dissemination  of  dtseaac  by 
the  fly.  N.  Y.  Med.  J.,  1910. 


The  History  of  Infection 


167 


in  their  crude  ideas  and  beliefs  the  theories 
of  modern  science. 


The  views  the  ancient  Egyptians  enter- 
tained about  diseases  and  their  causes  are 
much  better  known  than  those  of  the  peo- 
ples we  have  just  discussed.  The  differences 
are  in  form  rather  than  in  substance.  I 
shall  content  myself  to  select  only  a  very 
few  examples  out  of  the  rich  harvest  of 
archeologic  research.19 

The  disease-making  possibility  of  the 
worm  seems  to  have  been  uppermost  in  the 
Egyptian  mind  in  all  times.  Worm  diseases 
being  very  prevalent,  this  cannot  astonish. 
But  that  the  relation  of  worm  and  disease 
should  have  been  established  in  ancient 
time  in  those  cases  where  only  the  minutest 
examination  can  reveal  the  parasite,  would 
seem  remarkable  indeed.  Herodotus  gives 
an  account  of  a  regulated  inspection  of  the 
meat  which  was  destined  for  sacrifices.  It 
shows  among  other  things  that  the  inspect- 
or, the  priest,  was  on  the  look-out  for  such 
small  invaders  as  the  cysticercus.  When 
only  parts  of  the  animal  were  sacrificed, 
the  rest  was  available  for  consumption  and 
so  the  inspection  may  have  had  a  direct 
hygienic  intent.  But  meat  was  not  the  main 
diet  of  the  Egyptian.  Cereals,  vegetables 
and  fruits  were  the  staple  foodstuffs,  but 
to  them  must  be  added  as  of  considerable 
importance  the  air-dried  fish,  at  least  for 
the  early  Egyptian.  This  latter  fact  allows 
us  to  identify  a  tape-worm  for  which  there 
is  a  hieroglyphic  sign: 

8   ^=^- 


i.e.,  the  pend-worm,  with  tolerable  proba- 
bility as  the  botriocephalus  latus,  whose 
cysticercus  lives  in  freshwater  fishes.  The 

19  For  further  detail  see  the  brilliant  articles  by  F. 
von  Oefele:  Studien  iiber  die  altaegyptische  Para- 
shologie.  Arcb.  de  parasitology  Paris,  1901  and  1902, 
iv  and  v. 


taenia  solium  and  other  cestodes  may  of 
course  have  occurred  also,  but  for  the  for- 
mer this  is  not  very  likely  since  pork  as  a 
whole  was  despised  as  food. 

The  Egyptian  anaemia,  still  very  fatal, 
seems  to  have  been  known  to  the  ancient 
Egyptian.  At  least  a  description  in  the 
Papyrus  Ebers  has  been  interpreted  in  this 
sense.  Here  it  is  stated  that  the  fatal  dis- 
ease was  sent  by  the  God  of  Death,  aaa.  by 
name,  to  both  sexes,  causing  abdominal 
and  other  pains,  bloody  discharges.  As 
its  immediate  cause  the  worm  Neltu  is 
named.  Scheuthauer,  Joachim,  Finlayson 
identified  this  aaa-disease  with  the  fatal 
anaemia  caused  by  the  ankylostoma  or  un- 
cinaria  duodenalis,  i.e.,  our  hookworm  dis- 
ease. This  restricted  identification  has  late- 
ly been  disputed  on  very  interesting 
grounds.20  Pfister  opposes  very  rightly  the 
tendency  of  identifying  too  closely  with 
modern  concepts  those  ancient  descriptions 
which  covered  broad  complexes  of  symp- 
toms and  not  pathologic  entities.  He  dem- 
onstrates that  very  similar  symptoms  are 
caused  by  the  schistosoma  haematobium  in 
that  equally  fatal  disease  Bilharziosis,  which 
attacks  in  some  places  as  many  as  70  to  80 
per  cent  of  the  population  (as  against  25 
per  cent  of  ankylostomiasis).  That  Bilhar- 
ziosis most  likely  entered  into  the  concept 
of  the  aaa-disease,  Pfister  sees  in  the  fact 
that  in  the  hieroglyphic  sign  for  the  aaa- 
disease,   the  phallus  is  the  determinative: 


If  this  is  so,  it  would  indeed  be  good  evidence, 
for  as  he  shows  in  typical  pictures,  the  ure- 
thritis with  subsequent  enormous  tumefac- 
tion of  the  penis,  as  the  most  striking  symp- 
tom, would  have  amply  justified  the  use  of 
this  determinative.  No  other  than  these  two 
worm  diseases  seem  to  have  been  considered 

20  E.  Pfister:  Ueber  die  aaa-Krankheit  der  Papy- 
ri Ebers  und  Brugsch.  Arcb.  J.  Gescb.  d.  Med.,  1912, 
vi,  12. 


i68 


Annals  of  Medical  History 


and  around  this  of  course  hinges  the  whole 
question  as  to  what  diseases  are  comprised  in 
the  aaa-disease,  a  question  which  only  the 
Egyptologists  are  competent  to  decide.21  If 
the  Egyptians  could  detect  the  worm  as  the 
cause  of  the  disease,  it  is  astonishing  in- 
deed, given  its  small  size  (about  10  mm. 
length,  the  schistosoma  being  a  little  long- 
er than  the  ankylostoma)  and  the  fact  that 
it  is  not  readily  observed  in  the  excretions. 

CLASSICAL    ANTIQUITY    AND    AFTER 

As  we  leave  the  era  of  these  remote  peo- 
ples and  approach  the  one  we  know  better 
and  recognize  as  the  basis  of  our  culture, 
we  seem  to  notice  the  gradual  development 
of  circumscribed,  almost  tangible,  notions 
about  the  subjects  which  have  occupied  us. 
There  we  saw  man  apparently  satisfied 
with  the  vague  connection  of  primordial 
ideas,  apprehended  more  by  feeling,  by  in- 
tuitive perception,  than  by  reasoning.  Here 
he  seems  to  have  discovered  systematized 
thinking  as  a  new  instrument  by  which  he 
could  with  certainty  approach  the  riddles 
of  the  material  universe  and  of  life,  in  order 
to  satisfy  that  new  craving  for  knowledge 
which  had  come  over  him.  We  saw  how  the 
Babylonian  had  already  begun  to  classify 
his  observations.  Now  Greek  and  Roman 
begin  to  classify  their  thoughts  and  to 
write  them  out;  not  any  more  as  a  solemn 
religious  rite,  but  for  the  dissemination  of 
what  they  regard  as  a  record  of  their  wider 
and  more  conscious  experience.  This,  broad- 
ly speaking,  marks  the  principal  distinction 
of  that  epoch  which  we  call  classical,  as  the 
prototype  of  our  own  civilization.  All  be- 
comes very  complex  suddenly.  Fixed  con- 
cepts based  on  intricate  reasoning  multiply 
with  the  individualities  of  the  thinkers.  And 
as  we  project  ourselves  into  that  life,  we 

51  It  is  of  some  interest  that  Ruffer  in  his  micro- 
scopic examinations  of  Egyptian  mummies  found 
the  encapsulated  or  calcified  schistosoma  haemato- 
bium, and  so  demonstrated  with  certainty  the  oc- 
currence of  Bilharziosis  in  ancient  Egypt. 


see  the  analogies  and  resemblances  with 
our  own,  passing  over  the  essential  differ- 
ences determined  by  their  closer  relationship 
to  and  dependence  on  the  older  cultures;  and 
we  see  only  the  dawn  of  our  civilization  and 
the  birth  of  our  science,  of  progress. 

What  profound  differences  between  these 
two  "classics."  The  Greek,  in  his  gay, 
cheerful  attitude  towards  life,  exquisitely 
receptive  to  the  beauty  of  form,  of  color 
and  of  thought,  casts  the  forces  of  nature 
into  beautiful  anthropomorphic  shapes.  The 
same  sense  for  proportion  and  harmony 
which  we  admire  in  the  artistic  products  of 
his  hand  characterize  equally  those  of  his 
mind.  Of  much  sterner  stuff  the  prac- 
tical Roman.  He  takes  himself  and  life 
more  seriously,  he  has  a  purpose:  action 
and  power;  art  and  thought  are  there  only 
to  serve  it,  they  have  to  be  fixed  and  codi- 
fied, made  into  law.  Disease  for  the  Greek 
is  a  disturbance  of  the  beautiful  harmony 
of  health,  he  thinks  it  out  on  those  lines 
and  tries  to  reestablish  the  harmony. 
Hence  hygiene  is  the  keynote  of  his  medi- 
cine. The  Roman  proudly  refuses  to  con- 
sider disease  except  when  its  palpable  ex- 
istence forces  him  to  it.  Then  only  and  re- 
luctantly he  takes  the  most  necessary  steps. 
There  is  no  such  thing  as  scientific  Roman 
medicine  and  what  was  brought  in  from 
abroad  had  soon  to  adapt  itself  to  Roman 
ways.  But,  in  general,  thought  on  somatic 
needs,  on  medicine,  formed  only  a  small 
fraction  of  the  philosophy  which  was  en- 
grossed with  seemingly  higher  ideals,  ses- 
thetical,  logical,  and  religious  in  turn.  And 
in  that  small  place  left  for  medicine  the 
concept  of  infection  was  not  apt  to  thrive. 

To  enter  into  details  here  would  lead  us 
far  astray.  And  details  do  not  help  us  much, 
considered  by  themselves,  outside  of  that 
connection  which  links  them  as  intellectual 
phenomena  to  primordial  concepts.  That  is 
a  task  for  future  historians.  But  one  curi- 
ous fact  becomes  apparent  already,  as  we 
glance  over  the  period:  in  times  of  greater 


The  History  of  Infection 


169 


emergencies  such  as  wars  and  pestilence, 
the  idea  of  infection  asserts  itself  in  its 
state  of  original  simplicity.  What  share  has 
the  classical  medical  thought,  with  its  fund 
of  analyzed  observation  and  experience,  in 
this  phenomenon?  In  the  Hippocratic  writ- 
ings, in  those  of  the  Alexandrian  school,  we 
still  detect  the  influence  of  the  primitive 
concepts,  but  gradually  they  separate  and 
follow  different  channels.  Along  with  the 
roaring  and  sometimes  turbid  main  stream 
of  scientific  thought  runs  the  babbling,  lim- 
pid brook  of  popular  tradition,  in  which  we 
readily  detect  the  intuitive  sources.  Here 
and  there  they  approach  each  other  and 
sometimes  a  little  runs  from  one  into  the 
other,  but  on  the  whole  they  proceed  apart. 
The  poet,  the  playwright,  the  philosopher, 
those  spokesmen  of  folk  medicine,  the  medi- 
cal writer  less  and  less,  re-affirm  the  eternal 
validity  of  the  primitive  idea  of  infection 
whenever  they  dwell  on  times  of  grave 
danger.22 

The  history  of  infection  is  usually  begun 
with  the  period  when  the  animate  contagium 
became  demonstrated  to  the  satisfaction  of 
exacting  scientists.  The  cornerstones  plant- 
ed are  Fracastoro  in  the  sixteenth,  Athana- 
sius  Kircher  in  the  seventeenth  century.23 
In  a  certain  sense  this  is  true,  in  another 
it  may  be  shown  that  the  history  of  infec- 
tion as  a  broad  concept  of  pathogenesis 
ended  when  the  attempt  was  made  to  con- 
vert medicine  into  an  exact  science.  The 
supreme  effort  in  this  direction  is  centered 
in  Galen,  the  most  industrious  and  ingeni- 
ous prototype  of  the  modern  medical  scien- 
tist. Whenever  one  examines  his  great  work, 
and  analyzes  the  reasons  for  the  aggressive 

22  From  a  review  of  Sir  Bampfylde  Fuller's  new 
book  ("Man  as  he  is,"  London,  Murray,  1916),  in  the 
Times  Literary  Supplement  of  Nov.  23,  1916,  which 
I  receive  as  I  am  reviewing  my  Mss.  I  find  that  he 
has  come  to  similar  conclusions:  "With  man  as  we 
know  him,  living  in  an  artificial  state,  recollections 
of  his  experience  count  for  more  and  more,  and  the 
primitive  impulses  for  less  and  less.  They  are  by  no 
means  dead.  In  certain  circumstances  of  strain  and 


and  contemptuous  attitude  he  assumed 
against  all  other  thinkers  in  medicine, 
methodists,  empirics  and  pneumatists,  one 
is  impressed  by  the  logical  sequence  of  his 
arguments,  by  his  evident  eagerness  for 
objective  examination  in  the  solution  of  his 
problems,  but  one  can  not  fail  to  see  that 
he  juggles  with  his  premisses  and  assorts 
his  facts  just  to  show  the  stupidity  of  the 
others  and  especially  that  of  the  "ass  of 
Thessalos,"  his  chief  abomination,  and  that 
he  is  not  above  a  feeling  of  jealousy  towards 
those  successful  practitioners. 

The  differences  between  the  opposing 
schools  were  formal  rather  than  real,  in  the- 
ory at  least,  but  the  methodists  were  more 
ready  to  adapt  themselves  to  Roman  pecul- 
iarities which  Galen  scorned.  This  is  brought 
out  very  well  by  Meyer-Steineg  in  his  essay 
on  Thessalos  of  Tralles  24  where  he  shows 
how  the  Roman  always  favored  popular  as 
against  scientific  medicine,  and  how  clever- 
ly this  was  exploited  by  Thessalos  and  his 
methodist  confreres.  Also  how  strong  this 
Roman  preference  was  so  that  even  Galen 
had  to  submit  to  it  in  turn.  Both  parties  in 
the  conflict  derived  their  knowledge  from  a 
study  of  the  body  and  its  functions,  but 
both  in  different  ways,  wherefore  they  de- 
nied scientific  consideration  to  each  other. 
In  common  they  neglected  a  broader  aeti- 
ology. True,  Galen  had  evolved  logically 
an  aetiologic  system,  but  based  it  almost 
entirely  on  an  elaboration  of  Hippocratic 
humoral  concepts  and  the  theory  of  innate 
qualities.  He  was  too  much  absorbed  by 
the  variegated  phenomena  in  the  body  and 
too  much  opposed  temperamentally  to  the 
superstitious  nature  of  external  forces,  to 

stress  they  start  into  life  and  take  command.  Dumb 
and  invisible,  some  are  yet  our  masters  in  all  criti- 
cal times." 

23  For  the  details  of  this  period  see  the  painstaking 
review  by  Charles  and  Dorothea  Singer:  The  De- 
velopment of  the  Doctrine  of  the  Contagium  Vivum, 
1500-1750,  Int.  Med.  Congr.  Sect.  Hist.  Med.,  1913, 
pp.  187-207. 

24  Arcb.  j.  Gescb.  d.  Med.,  191 1,  iv,  89. 


170 


Annals  of  Medical  History 


ever  clearly  see  and  admit  the  fact  of  in- 
fection, or  at  least  its  importance.  "Who 
does  not  know,  he  exclaims,  that  brine  and 
seawater  preserve  meat  and  keep  it  un- 
corrupted  (aseptic,  aarjTTa),  whilst  all  other 
water — the  drinkable  kind — readily  spoils 
and  rots  it"  (dicupdelpei  re  xai  ariirei) ,25  But 
this  did  not  suggest  to  him  any  exter- 
nal origin  of  this  corruption.  To  him  it  is  a 
spontaneous  process,  apt  to  occur  also  in- 
side the  body,  just  as  the  innate  heat, 
which  according  to  him  has  no  outside 
source,  as  Erasistratos  thought.  Such  facts 
as  he  notes  them  down  serve  him  only  to 
support  ingeniously  his  humoral  theory.  For 
sixteen  hundred  years  scientific  medicine 
speculated  and  experimented  on  very  simi- 
lar lines. 

The  lay  writers  Celsus,  Cato,  Varro, 
Columella,  Pliny,  Vergil,  Vitruvius  and 
others  note  the  fact  of  infection  as  a  com- 
monplace that  needs  no  argument.  Could 
any  one  express  it  more  clearly  than  Lucre- 
tius in  his  famous  poem,  de  rerum  natura, 
which  had  such  a  great  influence  on  the 
thought  of  the  Middle  Ages? 

Primum,  multarum  semina  rerum 
Esse  supra  docui,  quae  sint  vitalia  nobis: 
Et  contra,  quae  sint  morbo  mortique,     .     .     . 26 

Had  Galen  seen  in  this  and  in  Lucretius' 
morbidus  ser  and  pestilitas  anything  else  but 
a  poet's  license,  we  would  surely  have  a 
long  treatise  from  him  on  the  subject,  and 
not  only  his  casual  references  to  the  con- 
tagiosity of  certain  diseases.  And  still,  in 
spite  of  Galen's  science  which  was  triumph- 
antly to  conquer  the  world,  we  find  Ammi- 
anus  Marcellinus,  last  but  not  least  of  Roman 
historians,  telling  that  the  Antoninian  plague 
was  caused  bysoldiers  breaking  into  the  tem- 

25  Galen:  On  the  natural  faculties,  B.  II.  120, 
translation  by  A.  J.  Brock.  London,  Heinemann. 
N.  Y.,  Putn.-im,  [916.  Loeb'a  "Classic.  Lib." 

"  First,  as  I  have  said  before,  seeds  of  many 
things  are  vital  to  us;  and  again  others  that  bring 
disease  and  death     .     .     . 


pie  of  Apollo  where  Chaldean  priests  hid  the 
morbific  virus.  Nergal,  the  god  from  Meso- 
potamia, still  wants  his  voice  heard  in  the 
matter! 

This  voice  arises  again  and  again  as  we 
traverse  the  coming  centuries.  Hardly  per- 
ceptible in  the  scientific  writings  of  the 
Middle  Ages,  though  always  traceable,  it 
becomes  more  and  more  subdued  by  the 
one  eager  interest  of  Christian  aspiration 
to  use  the  knowledge  of  the  world  for  the 
understanding  of  the  Bible.  Science  be- 
comes the  handmaiden  of  theology:  "Non 
potest  intellegi  sacra  Scriptura  sine  aliarum 
scientiarum  peritia,"  wrote  Bonaventura.27 
And  when  modern  historians  claim  that  the 
turn  of  the  tide  came  in  those  times  with 
the  introduction  of  the  experimental  meth- 
od, hailing  Roger  Bacon  and  his  "experi- 
mental science  which  neglects  argument" 
as  a  sort  of  savior  of  science,  it  can  not 
appeal  to  one  who  has  heard  the  far  cry  for 
observation,  experience  and  experiment 
from  the  dawn  of  human  thought.  It  cer- 
tainly is  difficult  to  understand  how  such 
evaluation  could  ever  be  deduced  from 
Bacon's  naive  belief  in  the  powers  of  this 
"new  science"  and  its  master,  Pierre  de 
Maricourt.28  Infinitely  more  important  it 
is  to  recognize  in  those  times  the  profound 
social  reorganization  which  is  taking  place, 
leading  to  powerful  and  multiple  organiza- 
tions of  corporate  interests,  the  mediaeval 
townships  and  universities.  This  is  more 
significant  even  than  the  setting  free  of  the 
purer  classical  spirit  after  tin-  capture  of 
Constantinople,  and  its  influence  on  arts 
and  sciences,  because  for  the  first  time  an 
organized  popular  will  asserts  itself  which 
henceforth  cannot  be  neglected.  Already  it 
shows  its  creative  possibilities  in  the  meas- 
ures for  the  protection  of  the  public  health. 
No  careful  student  of  the  decrees  of  this 

27  "Epist.  de  irihus  qiuestionibus." 

28  See   Henry  Osborn   Taylor's   brilliant    article  OH 

Roger  Bacon  in  his  "Medieval  Minil,"  London, 
Macmillan,  1914,  vol.  ii,  514. 


The  History  of  Infection 


171 


time  providing  sanitary  legislation,  quar- 
antine measures  and  disinfection  against 
various  diseases  and  especially  plague,  lep- 
rosy and  phthisis,  can  fail  to  see  how  much 
all  this  is  based  on  the  fundamental  con- 
cept of  infection.  Imperfect  as  are  all  hu- 
man institutions  these  measures  were  often 
excessive  and  unnecessarily  severe.  Because 
of  this  inherent  defect,  which  our  own 
measures  share,  they  hardly  merited  being 
held  up  to  ridicule  by  Koehler  at  the  Inter- 
national Conference  on  Sanitary  Legisla- 
tion in  1897.  It  is  characteristic  of  the  pre- 
vailing historical  shallowness  that  he  cited 
the  mediaeval  decrees  against  cholera,  a  dis- 
ease which  first  appeared  in  Europe  only 
100  years  ago.29 

Many  instances  might  be  cited  to  show 
how  often  the  lay  mind,  grasping  a  funda- 
mental principle,  drew  instinctively  and 
spontaneously  the  necessary  consequences 
and  it  is  somewhat  depressing  to  have  to 
acknowledge  that  so  very  often  this  oc- 
curred without  the  aid  of  the  scientist  and 
sometimes  against  his  protests.  But  only 
the  recognition  of  the  fact  can  indicate  the 
road  to  improvement.  I  shall  not  try  to  cite 
many  instances  but  I  cannot  refrain  from 
alluding  to  that  last  event  in  the  history  of 
infection,  sufficiently  remote  to  permit  crit- 
ical analysis,  which  shows  the  extraordinary 
viability  of  the  primordial  concept  and  its 
application.  I  mean  the  great  experiment  of 
prophylactic  variolation  during  the  period  of 
from  1 72 1  to  1840.  It  is  almost  forgotten  over 
vaccination  although  neither  the  one  nor 
the  other  owed  its  origin  to  scientific  medi- 
cine. I  shall  merely  repeat  what  I  said  be- 
fore about  the  work  of  Angelo  Gatti  in 
which  he  gave  expression  to  the  thoughts 
underlying  the  movement,  against  the  op- 
position of  the  Medical  Faculty  of  Paris: 
First  he  discusses  the  aetiology  of  smallpox 
and  turns  sharply  against  such  futile  terms 
as   "fermentation,   Ieven,   humores,   ebulli- 

29See  G.  Sticker  in  Heft  2,Zur  historischen  Biologie 
der  Krankheitserreger,  Giessen,  19 10. 


tion,  effervescence,  germ,  etc."  On  the 
meaninglessness  of  such  terms  a  mass  of 
physicians  base  their  therapeutic  proce- 
dures; they  use  them  even  in  such  cases 
where  a  Sydenham  or  Boerhaave  would 
have  been  content  to  observe  and  describe. 
For  Gatti  variola  is  produced  by  a  foreign 
body  that  has  entered  the  organism  from 
without.  Transmission  takes  place  by  con- 
tact, or  through  the  organs  of  respiration  or 
digestion.  The  "virus"  reproduces  and  mul- 
tiplies itself.  Smallpox  is  the  constant  and 
definite  effect  of  it,  strictly  specific.  Vario- 
lation is  the  transmission  of  the  disease 
controlled  by  intelligence  instead  of  acci- 
dent. For  the  purpose  of  inoculation  the 
virus  must  be  modified.  Gatti's  purposeful 
attempts  at  attenuation  might  still  be  read 
with  profit  by  modern  experimenters.30 

CONCLUSIONS 

We  are  too  near  our  own  time  to  form  a 
broad  judgment  of  our  methods  and  con- 
cepts. When  we  review  the  many  fertile 
applications  made  by  microorganic  biology 
in  every-day  life,  the  advances  of  a  pur- 
poseful prophylaxis  and  of  sanitary  sciences 
generally,  to  doubt  the  correctness  and 
utility  of  these  efforts  would  require  a  hy- 
percritical and  entirely  objectionable  atti- 
tude of  mind.  And  also  as  regards  our  mod- 
ern methods  of  laboratory  investigation, 
we  must  agree  with  Welch,  when  he  said 
here  at  the  University  of  Chicago  in  1907, 
that  "we  cannot  foresee  a  time  when  pure- 
ly observational  and  descriptive  biological 
studies,  which  to-day  hold  the  first  place, 
shall  not  continue  to  have  their  value."31  It 
is  probably  better  in  the  interest  of  our 
aims    that   we   should    rather   over-    than 

30  A.CKIebs,  Heft  7.  Hist.  Biologie  d.  Krankheits- 
erreger. Giessen,  1914,  also  The  historic  evolution 
of  variolation,  Johns  Hopkins  Hosp.  Bull.,  1913, 
xxiv,  69. 

31  Welch:  The  Interdependence  of  medicine  and 
other  sciences  of  nature.  Science,  1908,  Jan.  10. 


172 


Annuls  of  Medical  History 


under-estimate  the  absolute  value  of  our 
methods  and  achievements.  In  the  wider 
realm,  just  as  in  individual  life,  an  insidious 
dwelling  on  the  past  may  lead  to  paralyz- 
ing speculation,  self-depreciation  and  hesi- 
tation. Here  as  there,  such  tendencies  must 
be  discountenanced.  But,  on  the  other  hand, 
it  can  not  be  denied  that  the  taste  for  self- 
exaltation,  rampant  to  no  small  extent, 
merits  equal  attention,  as  it  may  easily  lead 
to  overindulgence  and  mental  indigestion. 

Viewed  with  this  general  proviso  it  may 
perhaps  not  be  unprofitable  to  picture 
the  impressions  a  future  historian  might 
gather  from  a  perusal  of  our  bulky  litera- 
ture. Would  he  see  that  the  elaboration  of 
the  doctrine  of  the  specificity  of  cause  and 
effect  in  infectious  diseases,  which  "de  tout 
Ie  temps  toutes  Iangues  ont  dit"  as  Bret- 
toneau  put  it,  already  in  1855,  has  led  us  to 
a  deeper  and  more  correct  comprehension 
of  these  diseases?  May  he  not  conclude 
that  we  have  not  drawn  from  it  the  full 
logical  consequences,  that  we  have  persist- 
ently disregarded  our  negative  findings  and, 
in  overestimating  the  importance  of  the 
positive  ones  have  come  to  a  sterile  gener- 
alization of  contagionism?  Will  he  admire 
with  Sticker  the  courage  of  Pettenkofer 
when  he  insisted,  in  his  famous  cholera 
doctrine,  less  on  what  he  had  determined 
and  knew,  than  on  what  he  did  not  know 
and  what  needed  to  be  brought  out?  Or, 
will  he  brand  him,  with  Liebermeister,  as 
"a  subtle  and  sometimes  humorous  dialec- 
tician," notwithstanding  the  solid  results 
obtained  as  a  consequence  of  Pettenkofer's 
and  others'  sanitary  reforms? 

It  is  worthy  of  serious  reflection  whether 
the  day  is  not  likely  to  come  when  those  ef- 
forts now  occupying  the  center  of  the  scienti- 
fic stage,  that  is,  the  search  after  the  specific 
microorganism,  its  minute  identification  by 
complex  experimentation  and  the  prophy- 
lactic and  therapeutic  application  derived 
therefrom,  will  be  relegated  to  a  less  con- 
spicuous   place.    We    admit    contributory 


causes,  but  by  their  very  subordination  we 
show  how  difficult  it  is  for  us  to  see  in  them 
anything  but  unimportant  influences.  And 
we  forget  that  it  is  only  the  obviousness  of 
one  factor  and  the  lacking  clearness  of  the 
other  which  determine  the  artificial  subor- 
dination. Pettenkofer's  x  we  have  found 
but  the  equally  important  y  and  z  have  yet 
to  be  supplied  in  the  aetiologic  formula. 

Shall  we  desist  from  this  deeper  aetiologic 
search  because  of  intrinsic  difficulties?  The 
reserved  position  of  Virchow  and  Cohn- 
heim  toward  it  will  be  recalled.  To  them 
aetiology  seemed  too  vast  a  subject,  involv- 
ing too  many  different  factors  and  techni- 
cal methods  which  could  not  all  be  fitted 
into  one  scientific  garment.  Hence  they  per- 
sisted in  observational  and  descriptive 
methods.  Koch  and  his  school  of  technical 
artists,  without  any  such  restraint  but  also 
without  the  broad  outlook  of  their  prede- 
cessors, were  heralded  as  the  founders  of  a 
new  medicine.  Their  historian,  Abel,  de- 
scribes the  final  triumph  in  these  eloquent 
words:  "Laboriously,  slowly  and  late,  but 
at  last  with  certainty,  the  pure  contagionis- 
tic  theory  has  attained  to  the  sole  rulership 
in  science."  All  this  in  barely  forty-five 
years  and  based  almost  entirely  on  techni- 
cal and  instrumental  improvements.  The 
"sole  ruler"  is  difficult  to  please,  a  failure 
to  solve  some  particular  problem  is  invari- 
ably put  to  faulty  or  inadequate  technic, 
never  to  a  wrong  direction  of  effort,  and  the 
object  of  research,  may  it  be  the  infecting 
organism  or  its  carrier,  must  remain  unal- 
terably the  same.  We  look  down  upon  the 
mediaeval  scholar  who  attempted  the  solu- 
tion of  similar  problems  by  syllogistic  struc- 
tures of  thought  based  upon  insufficient 
facts.  We  have  undoubtedly  more  facts, 
but  can  we  prove  their  sufficiency  by  sub- 
tleties of  experimental  research,  so  often 
unrelated  to  actual  exigencies?  Multiple 
facts  brought  out  by  inductive  research  do 
not  combine,  as  Francis  Bacon  expected  they 
would,  infallibly  leading  to  really  useful  gen- 


The  History  of  Infection 


173 


eralization.  Never  yet  in  the  world's  his- 
tory has  a  great  progress,  a  discovery  of 
fundamental  importance,  been  achieved  by 
this  method. 

There  are  some  signs  of  a  reaction  against 
the  present  concepts  and  methods  of  path- 
ology. It  is  no  more  a  cellular  pathology 
in  Virchow's  sense.  The  doctrine  of  the  cell 
as  the  vital  unit,  one  of  the  most  useful  gen- 
eralizations in  biology,  does  not  rule  path- 
ology any  longer.  The  limits  of  cellular 
autonomy  and  the  interdependence  of  the 
units,  only  dimly  admitted  by  Virchow,  are 
becoming  better  defined.  The  concept  of 
the  organism  as  an  entity  (also  in  its  path- 
ological phenomena)  and  of  its  essentially 
fluid  constitution  opens  a  wide  outlook 
through  the  work  of  W.  Roux,  Jacques  Loeb 
and  Albrecht.  In  accord  with  these  modern 
concepts,  it  was  one  of  the  pioneers  of  seti- 
ologic  research,  Edwin  Klebs,  who  defined 
infectious  disease  as  the  resultant  from  the 
interaction  of  different  bodies,  yielding  dif- 
ferent products  and  phenomena.  And  he  al- 


ready postulated,  as  of  prime  importance, 
that  all  processes  within  the  sphere  of  liv- 
ing bodies  just  the  same  as  in  that  of  the 
non-living,  must  take  place  according  to  the 
same  fundamental  laws;  that,  therefore,  also 
in  pathology,  there  is  no  room  left  for  a 
special  vital  force. 

In  all  these  newer  tendencies  the  inter- 
dependence of  medicine  and  the  other  natu- 
ral sciences  becomes  ever  more  clearly  visi- 
ble. It  will  need  the  work  of  genius  to  bring 
about  the  needed  efficient  interaction.  We 
may  have  to  wait  long  for  such  an  one. 
Meanwhile  the  common  ground  might  be 
prepared,  and  we  believe  that  nothing  can 
do  it  so  well  as  organized  historical  research 
in  science,  because,  in  George  Sarton's 
admirable  words:  "Science,  divided  into 
water-tight  compartments,  makes  us  feel 
uneasy; — a  world  split  into  selfish  and 
quarrelsome  nations  is  too  narrow  for  us. 
We  need  the  full  experience  of  other  coun- 
tries, of  other  races;  we  need  also  the  full 
experience  of  other  ages.  We  need  more  air ! " 


MARSHALL  HALL'S  PROOF  OF  REFLEX  ACTION 


You  observe  this  living  frog:  its  sentient  and  volun- 
tary functions  are  obvious.  I  divide  tbe  spinal  marrow, 
below  tbe  occiput,  with  these  scissors:  all  is  still. 
There  is  not  a  trace  oj  spontaneous  motion.  The  ani- 
mal would  remain  in  this  very  jorm  and  position, 
without  change,  until  all  signs  oj  vitality  were  extiiict. 
But  now  I  pinch  a  toe  ivitb  tbe  forceps.  You  see  bow 
both  posterior  extremities  are  moved.  All  is  now 
still  again;  there  is  no  spontaneous  motion,  no  sign 
of  pain  from  tbe  wound  made  in  tbe  neck.  It  is  with- 
out sensibility — without  volition;  tbe  power  to  move 
remains — tbe  will  is  extinct.  I  now  pinch  tbe  integu- 
ment. You  observe  tbe  result — tbe  immediate  recur- 
rence of  excito-motory  phenomena. 


I  now  destroy  tbe  whole  spinal  marrow  with  this 
probe.  It  is  in  vain  that  I  pinch  tbe  toes;  tbe  animal, 
tbe  limbs  are  motionless! 

Could  tbe  former  excited  motions  be  tbose  of  irrita- 
bility? I  will  fry  tbe  truth  of  this  suggestion  by  seeing 
whether,  now  that  tbe  axis  of  tbe  excito-motory  system 
is  destroyed,  with  its  phenomena,  tbe  application  of  a 
slight  galvanic  shock  will  prove  tbe  subsistence  of  irrita- 
bility. You  see  bow  instantaneously  and  forcibly  tbe 
muscles  are  simulated  to  contraction. 

Is  not  tbe  proof,  from  these  experiments,  of  tbe 
distinction  between  tbe  motions  of  volition,  of  tbe 
excito-motory  system,  and  of  these  from  tbose  of  irrita- 
bility perfectly  and  unequivocally  complete? 


TEXT  OF  WILLIAM  SHIPPEN'S  FIRST  DRAFT  OF  A  PLAN  FOR 

THE  ORGANIZATION   OF  THE   MILITARY   HOSPITAL 

DURING  THE   REVOLUTION 


[Through  the  courtesy  of  Colonel  William  O.  Owen,  U.  S.  Army,  Curator,  Army  Medical 
Museum,  Washington,  D.  C,  we  are  able  to  print  from  No.  22,  folio  99,  papers  of  the  Continental 
Congress,  William  Shippen's  first  draft  of  a  plan  for  the  organization  of  the  Military  Hospital 
Service  during  the  Revolution.  This  document,  by  Shippen  and  John  Cochran,  was  written  out 
in  Shippen's  own  handwriting  and  transmitted  to  Congress  February  14,  1777.  The  committee 
report  on  the  same,  written  out  in  the  handwriting  of  Benjamin  Rush,  was  then  submitted  to 
Congress  on  February  27,  1777.  The  heading  of  the  page  given  in  facsimile,  "For  the  flying 
Hospitals,"  would  look  at  first  as  if  it  were  an  anticipation  of  the  innovation  of  Baron  Larrey. 
But,  as  the  text  shows,  camps  and  hospital   wagons  only  are  meant;  in  other  words,  the  plan 

Eroposed  was  a  sort  of  precursor  of  our  present  field  hospital,  but  not  the  rapidly  moving  field 
ospkal,  with  litter-bearers,  which  Larrey  and  Percy  made  accomplished  fact. — Editor.] 


THREE  Districts  Northern,  middle 
and  Southern. 
To  each  one  Director  General — 
His  duty,  with  the  advice  of 
the  general  or  Commandr-in-Chief,  in  his 
respective  Department. 

To  establish  a  sufficient  number  of  Hos- 
pitals at  proper  places  for  receiving  the 
sick  &.  wounded  of  the  army  &  to  dispose 
of  the  same  as  he  shall  think  proper —  To 
provide  &  prepare  medicines  Instruments 
&  dressings;  Bedding,  &  other  necessary 
furniture,  proper  Diet  &  every  thing  neces- 
sary for  the  subsistance  &  comfort  of  the 
sick  &  wounded  Soldiery  &  the  officers  of 
the  hospital  &  to  pay  the  salarys  of  the 
latter  agreeable  to  establishment  of  Con- 
gress, together  with  all  other  expences  of 
the  hospital.-.  To  execute  which  He  shall 
be  allowed  the  following  officers  to  be  ap- 
pointed &  discharged  by  him  in  such  num- 
bers as  the  necessity  of  the  army  may  re- 
quire &  the  General  approve  an  authentick 
report  of  which  to  be  immediately  trans- 
mitted to  Congress. 

Assistant  Directors — to  superintend  the 
Hospitals  to  the  care  of  which  they  shall 
be  appointed  &.  see  that  ye  same  are  pro- 
vided as  before  specified  agreable  to  ye 
instructions  of  the  Director  Gen1 

An  Apothecary  General  whose  Duty 
shall  be  recieve,  prepare  &  deliver  medi- 
cines and  other  articles  of  his  department 


to  the  Hospital  &  ye  Army  as  shall  be  or- 
dered by  ye  Dir.  Gen.  Apothecarjr  and 
mates  to  obey  ye  Apoth.  gen1. 

A  Commissary — whose  duty  shall  be  to 
procure  store  and  deliver  provisions,  for- 
age such  other  articles  as  the  Director  shall 
judge  necessary  for  ye  use  of  ye  hospitals 
in  the  purchase  of  wch  he  shall  frequently 
consult  with  &.  be  regulated  by  the  prices 
of  the  Quartermastr  and  Commissr  gener- 
als. 

Adjutants  to  ye  Commissary  &  Store- 
keeper, a  Steward  for  every  100  sick  who 
shall  recieve  from  ye  commissary  provi- 
sions, distribute  them  agreable  to  ye  or- 
ders of  the  Genl.  or  Physician  &  surgeon 
genl.  of  his  dept.  &  be  accountable  to  ye 
commissary  for  ye  same. 

a  matron  to  every  100  sick  who  shall 
see  the  provisions  are  properly  prepared, 
the  Wards,  Beds,  <x  Utensils  shall  be  kept 
in  neat  order,  c^  that  ye  greatest  Ocono- 
my  be  observed  in  her  department.  A  nurse 
to  every  15  sick  at  the  direction  of  ye 
matron. 

An  Hostler  or  Stabler  to  receive  ye  for- 
age from  the  commissary  and  to  take  care 
of  ye  Waggon  &  other  horses  belonging  to 
the  Hospital  agreeable  to  orders  he  shall 
recieve  from  the  Dr.  genl.  or  such  other 
officer  of  ye  Hospital  he  shall  appoint. 

A  Secretary  whose  Business  shall  be  to 
keep  the  accounts  of  the  Hospitals,  shall 


«74 


tf^uJn^  ^h^^  ^^r  T*,  ; 


.   _  .    y     s  ',    jt sis'     zA*; 


4  ■fjU./s*^^*,**^??*"*?. 


^w  *■  ~»**  <^fz  *~r?„  <&i 


Specimen  Page  of  Shippen  Text. 


176 


Annals  of  Medical  History 


recieve  and  deliver  ye  monies  agreable  to 
ye  orders  of  the  Directr  Genl. — 

Clerks  for  the  same. — 

Such  officers  &  soldiers  as  the  general 
shall  think  proper  to  guard  ye  hospitals  & 
to  conduct  such  as  shall  be  weekly  dis- 
charged ye  Hospital  to  their  respective 
regiments  &  who  shall  obey  the  directions 
of  the  Direct-  Genl.  or  the  Physician  and 
Surgeon  Genl.  while  on  this  duty. 
There  shall  be  also 

Two  Physician  and  Surgeon  Generals — 
who  must  superintend  &  regulate  the  prac- 
tice of  Physic  c\  Surgery  in  such  Hospitals 
as  the  Dir.  Genl.  shall  appoint  them  to,  & 
in  his  absence  they  shall  appoint  the  Phy- 
sicians Surgeons  and  other  officers  of  said 
Hospital  to  such  dutys  as  they  shall  think 
proper  &  shall  report  weekly  to  ye  Dir.  genl. 
or  in  his  absence  to  ye  ass.  Dir.  the  state 
eV  number  of  the  sick  &  wounded  of  their 
Hospital  c\  the  delinquent  officers  of  ye 
same.  They  shall  also  see  that  those  who 
are  lit  shall  be  delivered  every  week  to 
the  officer  of  the  Guard  to  be  conducted  to 
ye  army. 

Senior  Physicians  &  Surgeons  who  shall 
attend,  prescribe  for  &  operate  upon  and 
see  properly  treated  such  sick  &  wounded 
as  shall  be  allotted  them  by  ye  Dir.  genl. 
or  either  of  the  Physician  &  Surgeon  genl. 

Second  Surgeons  to  assist  ye  senior  Sur- 
geon and  be  under  ye  same  direction. 

Mates  who  shall  attend  the  physicians 
and  Surgeons  when  they  prescribe  and  op- 
erate, shall  dress  ye  wounded,  recieve  from 
the  apothecary,  mate  of  ye  Hospital  &.  put 
up  the  medicines  l\  see  that  they  are  regu- 
larly *.V  properly  administered  to  ye  pa- 
tients. 

A  suitable  number  of  covered  and  other 
Waggons  to  be  supplied  by  ye  G.  M.  G. 


For  the  Flying  Hospital 

There  shall  be  A  Director  and  Surgeon 
Genl.  whose  Duty  in  subordination  to  ye 
Dir.  Genl.  shall  be  to  superintend  &  re- 
cieve from  him  a  suitable  number  of  large 
strong  Tents — Beds,  Beddfing,]  Medicine,  & 
Hospital  Stores  for  such  sick  &  wounded  per- 
sons as  cant  be  transported  to  ye  general 
Hospital  with  safety  or  may  be  rendered 
fit  for  duty  in  a  few  days — He  shall  also 
see  that  the  sick  &  wounded  while  in  his 
hospital  are  properly  attended  &  dressed 
and  when  able,  to  be  conveyed  to  ye  genl. 
Hospital  for  which  last  purpose  he  shall  be 
supplied  by  ye  Dir.  Genl.  with  a  proper 
number  of  convenient  Waggons  and  Driv- 
ers.— He  shall  see  that  the  regimental  Sur- 
geons and  mates  attend  their  regiments. 
Those  who  refuse  to  obey  his  or  ye  Dir. 
Genl.'s  directions  shall  be  tried  and  pun- 
ished as  Congress  shall  direct. 

He  shall  have  under  him 

Stewards  to  recieve  and  properly  dis- 
pense such  articles  of  diet  as  ye  Director 
General  shall  give  or  order  to  be  given  him 
by  the  Corny  of  ye  Army  or  Hospital. 

Brigade  Surgeons — who  shall  superintend 
the  medical  department  in  their  respective 
Brigades,  report  the  state  thereof  to  the 
Director  of  ye  Hying  Hospital  &  see  that 
the  sick  &  wounded  are  sent  in  proper  time 
&  in  a  proper  manner  to  ye  Hying  Hospitals 
— they  shall  also  attend  &  prescribe  for  j  e 
sick  and  wounded  in  ye  Hospital  under  ye 
Direction  of  ye  Surgeon  Genl. 

A  suitable  number  of  mates  to  dress,  c\ 
of  Nurses  and  orderly  men  ye  number  to 
be  determined  and  they  appointed  and  paid 
by  ye  Dir. 

All  the  above  officers  to  be  appointed  & 
recieve  such  Salarys  as  the  Congress  shall 
please  to  direct. 


THE   BEGINNINGS  OF   INTRAVENOUS   MEDICATION 


By  HORACE  MANCHESTER  BROWN,   M.D.,  F.A.C.S. 


MILWAUKEE,    WIS. 


ARISTOTLE  (B.C.  384-322)  saw 
the  blood  of  a  fish  flow  from  its 
heart  into  its  gills.  ("De  Part. 
Animalium,"  III.)  Undoubted- 
ly many  men  who  have  had  the  taste  and 
disposition  for  wandering  in  the  sinuous 
paths  of  medical  investigation,  or  who  have 
found  joy  in  philosophizing  with  the  an- 
cients, have  dreamed  dreams  of  speculation 
as  to  what  might  have  been  the  position 
of  the  theory  and  art  of  medicine  and  our 
civilization  and  religious  thought,  had  Aris- 
totle but  had  sufficient  imagination  to  have 
gone  a  step  farther  and  have  thought  of 
the  possibility  of  the  way  of  the  return  of 
the  blood  to  the  heart. 

There  is  no  limit  to  the  horizon  toward 
which  such  dreams  might  lead;  and  to 
speculate  upon  the  possibilities  of  such  a 
conception  is  almost  to  wander  away  among 
the  djinn  of  an  Arabian  tale,  or  to  intoxi- 
cate oneself  with  musings  among  the  Sepi- 
roth  of  the  Kabbalah. 

Whatsoever  might  have  been  the  result 
that  must  of  necessity  have  been  the  out- 
come of  such  a  discovery  at  a  period  al- 
most 2000  years  before  the  time  of  Harvey, 
it  is  not  beyond  the  realm  of  reason  to  be- 
lieve that  the  world  would  have  been  spared 
the  degradation  of  the  ignorance  of  the 
Dark  Ages,  and  the  erroneous  philosophy 
of  St.  Thomas  Aquinas,  founded  upon  the 
physiology  of  Aristotle,  the  controversies 
of  the  scholastic  and  dogmatic  theologians, 
the  proposition  of  "two  kinds  of  truth:  the 
Philosophical,  founded  upon  proof,  and  the 
Theological,  founded  upon  faith"  (See  Mat- 
thieu  Paris.  "Hist.  Maj.,"  p.  541,  and 
Mosheim.  "Eccl.  Hist.,"  Part  II,  Cap.  3.), 
the  futile  discussions  as  to  the  nature  of 
and  location  of  the  soul,  the  problems  of 
generation,  metabolism  and  nutrition:  the 


nature  and  functions  of  the  liver,  spleen, 
lungs,  and  heart,  and  a  thousand  other 
things  which  are  but  common-places  to- 
day, but  which  were  insurmountable  ob- 
structions to  true  knowledge  up  to  the 
middle  of  the  seventeenth  century,  would 
never  have  been  considered,  or  would  many 
centuries  ago  have  been  cleared  away. 

The  reader  may  well  ask,  What  has  all 
this  to  do  with  the  subject  upon  which  this 
paper  is  supposed  to  treat?  The  answer  is 
not  difficult. 

Nothing  that  can  result  from  philoso- 
phizing is  ever  of  any  value,  until,  like  the 
result  of  any  other  form  of  mental  activity, 
it  finds  its  application  ad  bominem.  The 
study  of  the  history  of  medicine  is,  in  the 
most  intense  degree,  the  study  of  the  de- 
velopment of  civilization,  not  only  as  ap- 
plied to  community  life  but  as  well  when 
applied  to  the  development  of  the  individ- 
ual. It  is  a  study  of  the  great  struggle  of 
mankind  as  led  by  its  teachers,  against  the 
destructive  forces  of  nature,  and  in  so  far 
as  the  teachers  have  failed  in  their  grasp  of 
the  meaning  of  things  and  phenomena  about 
them,  in  so  much  has  man  failed  in  the 
speed  of  his  journey  toward  better  health, 
better  mentality,  better  living  and  better 
appreciation  of  the  things  of  life. 

Throughout  the  world,  up  to  the  time  of 
William  Harvey,  mankind  was  struggling 
blindly  in  a  fog  of  theory,  superstition  and 
fear,  toward  the  light,  the  first  glimmerings 
of  which  came  with  the  coming  of  the  great 
anatomist  Vesalius,  the  controversialist  Ser- 
vetus,  the  keen  observer  Fabricius;  a  glim- 
mering which  was  to  burst  into  a  full  efful- 
gence which  should  illumine  the  path  that 
science  might  tread,  when  Harvey  by  his 
discovery  of  the  circulation  of  the  blood, 
illumined  the  leaders  of  the  world  of  philos- 


177 


i78 


Annals  of  Medical  History 


ophy  and  science,  and  through  them  gave 
to  the  human  race  those  facts  which  have 
made  all  exact  medical  knowledge  possible 
since  his  time. 

It  has  seemed  to  me  in  view  of  the  great 
interest  that  the  medical  profession  has 
taken  in  the  matter  of  intravenous  medica- 
tion since  the  introduction  of  salvarsan, 
that  a  short  account  of  the  early  history  of 
that  method  of  treatment  may  not  be  with- 
out interest,  and  therefore  I  have  to  offer 
a  somewhat  incomplete  review  of  the  rec- 
ords relating  to  infusion  of  medicaments 
and  transfusion  of  blood,  during  the  period 
between  1490  and  1680. 

It  will  be  necessary  to  glance  first  at  the 
conditions  of  knowledge  in  our  profession 
in  relation  to  the  physiology  of  the  blood 
and  its  movement  during  the  centuries  pre- 
vious to  the  discovery  of  the  circulation  by 
Harvey  in  the  year  16 13,  and  his  announce- 
ment of  his  discovery  by  the  publication  of 
his  book  in  Frankfort  in  1628. 

In  the  year  201  A.D.,  there  died  a  man 
in  Rome,  a  physician,  who  had  had  seven 
emperors  as  his  patients  and  who  left  be- 
hind in  his  writings,  an  accumulation  of 
the  knowledge  of  his  predecessors,  and  a 
system  of  medicine,  which  was  perfect  in 
its  kind,  logical  in  its  reasonings,  complete 
and  well  proportioned  in  its  form  and  which 
ruled  the  medical  world  for  1400  years;  in- 
fluencing not  only  the  writers  on  medicine 
as  no  other  man  had  inllucnccd  them,  not 
only  as  to  the  physical  welfare  of  the  entire 
world,  but  also  furnishing  the  Christian 
world  with  a  basis  for  a  complete  system 
of  theology,  although  but  little  of  it  was 
founded  upon  anything  more  than  specu- 
lation, w  hile  those  parts  of  it  which  seem  to 
be  demonstrations  of  facts  were  but  false- 
hoods and  erroneous  conclusions  due  to  er- 
ror in  observation.  This  man  was  (  ralen. 

II  we  but  stop  to  consider  our  own  sur- 

roundings  and  relations  to  our  own  pa- 
tients, v.e  are  brought  to  realize  that  his 
influence  extends  even   to  ourselves,   and 


that  on  every  hand  and  every  day  the 
medical  profession  here,  now,  is  forced  to 
contend  with  the  erroneous  conceptions 
that  were  handed  down  through  the  years 
from  Galen,  and  which  still  hold  not  only 
in  the  minds  of  the  laity,  but  also  in  the 
acts  and  thoughts  of  many  men  within  the 
profession  of  medicine  itself. 

Erasistratos,  of  the  School  of  Alexandria, 
had  established  the  belief  in  the  minds  of 
medical  men  and  philosophers  that  the  ar- 
teries contained  only  air.  Galen  by  his  fa- 
mous experiment  with  the  hollow  reed  or 
a  bronze  tube  (Liber,  "An  Sanguis  in  Ar- 
teriis  Contineatur,"  Cap.  8)  had  proved 
the  folly  of  this  belief. 

For  Galen,  the  liver  was  the  source  of 
the  blood  and  the  natural  spirit,  and  the 
heart  was  the  seat  of  the  essential  heat  and 
of  the  vital  spirit,  while  the  blood  mixed 
with  air  in  the  left  ventricle  of  the  heart 
and  passing  to  the  brain  through  the  ca- 
rotid arteries  became  perfected  in  the  lateral 
ventricles,  so  as  to  produce  the  animal 
spirit,  which  was  the  food  of  the  soul. 

The  soul  was  looked  upon  as  a  sort  of  a 
triad.  The  concupiscent  soul,  the  epithu- 
mos,  resided  in  the  liver.  This  was  the 
passive  or  feminine  element,  the  desiring  or 
acquiring  element  in  the  triad.  In  the 
heart  resided  the  acting  soul,  the  tbumos, 
the  active,  masculine  element  of  the  triad 
which  produced  the  vital  heat  and  sent  it 
throughout  the  body,  and  which  when  re- 
fined became  part  of  the  governing  soul, 
the  begemonOS,  which  was  the  controlling 
element  of  the  triad.  The  natural  spirit  was 
in  the  liver  and  veins,  the  vital  spirit  was 

in  the  heart   and  arteries,  the  animal  spirit 
w  as  in  the  brain  and  ner\  es. 
A  certain   movement   of  the  blood  was 

recognized,  and  had  been  since'  the  time  of 
Hippocrates;  but  this  movement  was  in 
nowise    recognized    as    a    circulation    but 

rather   as   a    perioidos   Inuinatus,  a   tide-like 

movement  which  was  compared  to  the  tides 
of  Eripos,  in  the  strait  of  that  name  in 


The  Beginnings  of  Intravenous  Medication 


179 


Greece.  The  blood  was  produced  from  the 
chyle  in  the  liver  and  then  moved  back 
and  forth  in  the  veins  until  it  was  con- 
sumed, a  new  supply  always  being  pro- 
duced by  the  liver. 

Some  of  the  blood  oozed  through  certain 
foveae,  or  supposed  porosities  in  the  intra- 
ventricular septum  of  the  heart,  from  the 
right  to  the  left  ventricle  there  to  form  the 
vitalized  blood,  which,  mixed  with  air,  was 
sent  out  through  the  arteries  up  to  their 
finer  filaments  which  were  supposed  to  be 
nervous  in  character.  Some  of  this  vitalized 
blood  went  to  the  brain  for  further  per- 
fection, but  none  returned,  in  a  circulating 
sense,  to  the  heart.  That  blood  that  went 
to  the  lungs  was  sent  to  them  to  nourish 
them,  or  to  be  cooled  by  them. 

It  is  necessary  that  we  should  recall  these 
things  in  order  to  understand  that  which 
occurred  after  the  discovery  of  the  circula- 
tion of  the  blood. 

Wm.  Harvey  of  Folkstone  and  London, 
England,  lectured  to  the  students  upon  his 
discovery  of  the  circulation  at  St.  Bar- 
tholomew's Hospital,  in  the  year  161 3;  this 
date  should  be  kept  in  mind.  In  the  year 
1628  his  book  "De  Motu  Cordis"  was  pub- 
lished in  Frankfort.  His  discovery  was 
quickly  accepted  in  England,  Holland  and 
in  Germany;  but  such  was  the  temper  of 
the  time,  the  respect  paid  to  and  the  fas- 
cination of  the  opinions  of  the  ancients, 
that  almost  an  hundred  years  elapsed  be- 
fore it  was  admitted  in  Italy,  the  southern 
part  of  France  or  by  the  acknowledged 
master-teachers  in  medicine  of  the  Univer- 
sity of  Paris;  for  we  find  a  certain  Vigerius, 
professor  of  medicine  at  Montpelier,  still 
teaching  the  Galenic  ideas  as  late  as  1694, 
while  his  colleague  of  the  same  faculty, 
Dionis,  was  demonstrating  its  truth  at  the 
Royal  Garden  in  Paris,  by  command  of 
Louis  XIV  and  at  the  same  time  it  was 
being  denied  in  the  same  city,  under  the 
lingering  influence  of  Riolan,  by  the  Fac- 
ulty of  Medicine  of  that  center  of  learning. 


In  view  of  the  absence  of  any  speedy  means 
of  communication  between  nations  at  the 
time  when  this  discovery  was  published,  it 
is  with  astonishment  that  we  observe  how 
quickly  information  in  regard  to  it  was 
transmitted  throughout  Europe. 

Its  acceptance  by  the  master  minds  of 
medicine,  with  but  few  exceptions,  was  very 
rapid.  The  foundations  of  medical  belief 
were  shaken  as  they  had  never  been  shaken 
before,  and  on  every  side  men  arose,  armed 
with  this  first  of  physiological  facts,  who 
were  only  too  ready  to  use  it  for  the  pur- 
pose of  clearing  away  the  banked  clouds  of 
theory  which,  up  to  that  time,  had  obscured 
the  vision  of  the  medical  world  from  any 
sane  perception  of  rational  methods  of 
treatment  of  disease. 

Hope  was  high  in  every  breast  that 
through  this  knowledge  disease  and  its 
cure  might  be  approached  with  confident 
tread.  Alas!  these  hopes  were  to  be  dashed 
to  the  ground  because  of  too  sanguine  an- 
ticipations, the  result  of  the  lack  of  other 
facts  that  were  to  be  learned  only  through 
experience,  or  by  the  gradual  evolution  of 
instruments  of  precision,  used  as  aids  to 
the  acquirement  of  collateral  and  related 
knowledge. 

No  discovery  or  discoverer  is  great 
enough  to  be  beyond  the  range  of  shafts  of 
doubt  or  envy,  and  it  was  so  in  the  case  of 
Harvey.  Hardly  had  his  discovery  been 
noised  abroad,  before  there  arose  a  num- 
ber of  detractors  whose  purpose  it  was  to 
prove  by  what  seemed  to  them  sufficient 
evidence  that  the  knowledge  of  the  circu- 
lation was  as  old  as  civilization. 

An  attempt  was  made  to  show  by  the 
testimony  of  a  work  by  Pere  Halde,  put 
into  Latin  by  Michael  Boym  and  published 
by  Andreas  Cleyer  of  Cassel,  and  Batavia 
in  Java,  that  the  circulation  was  under- 
stood by  the  Chinese  at  a  time  4000  years 
before  the  Christian  era,  and  later  Cleyer 
wrote  a  book  ("Specimen  Medicae  Sinicae," 
Frankfort,  1682)  in  one  chapter  of  which, 


i8o 


Annuls  of  Medical  History 


"Tractatus  de  Pulsibus,"  this  claim  is 
maintained.  It  will  not  be  without  interest 
for  any  one  desiring  to  go  further  into  this 
matter,  that  the  article  on  Chinese  medi- 
cine by  Neuburger,  Vol.  I,  and  Renouard 


V 


*  tor  brflrcoIt4tcm  anfjeliow  et  co:bi4C4  4c 
.  „  ohmiaut  ft  quw  fputum  ipftae  fumpfe^ 
ntcntp:opcmo:aj  fiattquir»4pcUS  bibertt.cteros 
tora  eft  pono  |rmtragt>u  ^.ubewbe  mtrare  co:p  "  at 
rtuite  qiwbropcbt  magrmvt  eft  boe  4fTmw:wfrm^ 
W8  »d  equus  M  rataarc  dlob  Oarrtx  Bn4C4.j.ii.bibe 
Kftaoebcjoartfllrtpiaimtcrtaw  mcapitc  bufFots 
<j"|£PJ*  l4pib4rio«  vwrttur  bojrw  w»lg<mtcr  W 


b 


©  mmw  colcricc  rufjj  (rnigtratw  cttracttw 

tgc  rtrc  fue  vd  funjjie  04tue  cm  m  potu  (u 

enulle  poactur  furojca  moitw  ct  pmira* 

^  mm  mteUcctos  ct  irrurrccunbu  banbc  paalacun  eric 

<4b;tur.ct  due  atra  eft  bibcrc  4qu,i  cucumera  p4kp 

tonetnMftuarcgraruipfius  ctbcgluorc|iKcum  ec 

potart  ftatpam  natufonrtanuct  em  bejow  eft  trc- 
o|cu»rnu6bcttr*.  ,     _ 


<!^P»diffcW^.i5c/4rt^Krri«jirtW4utJ«j)fu      >     £  English 

«^3r««g^4«lcpjc^qu<M>trrc  humble, 


•Ik^dHturciJcpijfrigtatJia  ct  tumjocus 
rrwlcficwtus  «  oblmwflw.  et  raw  cur4  e|| 
P0t4«iri4r34rit4aoft46.}4.cu4qi»4meli)]i  etbaP 
ntari  m  4qii4  tepib4.ee  coire  cu  pijdUjmiigei  Jt  co 
ucrfan  ct  4inplef4n  cimt  putUte  ct  wuertculw.ct  cats 
bej04reftc<>ineb«rtfcrportcoqnibwc4Ub<  •?C4pit4 
per  p4lmom  ftgt  4bfa|f4. 


Specimen  Page  from  "  De  Vcnenis" 

("Hist,  de  la  Medicine,"  Tome  I.,  fol.  46 
et  seq.)  should  be  investigated. 

Again:  Conrad  Victor  Schneider  ("Diss. 
cle  Catarrhis,"  1664,  Cap.  2)  and  Johannes 
Schmidius  in  his  work  ("Dcscriptio  Senec- 
tutis  Regis  Salomon  is")  endeavored  to  show 
that  King  Solomon,  among  the  other  evi- 
dences of  his  great  w  isdom,  was  acquainted 
with  the  mystery  of  the  circular  movement 
ol  the  blood,  taking  as  proof  of  that  propo- 


sition the  meaning  of  the  text  as  it  appears 
in  the  Douai  version  of  the  Vulgate,  "Be- 
fore the  silver  cord  be  broken,  and  the 
golden  fdlet  shrink  back,  and  the  pitcher  be 
crushed  at  the  fountain,  and  the  wheel  be 

broken   upon  the  cistern."    (Eccl. 

^*%    xii,6.) 

To  the  writer  it  would  seem  that 
these  men  must  have  been  possessed 
with  most  marvelous  capacity  for 
engendering  conceptions  based  up- 
on unwarranted  imaginings. 

In  investigating  this  matter  it 
seemed  so  far  beyond  possibility 
that  such  deductions  should  be 
drawn  from  this  text,  that,  fearing 
that  a  misprint  may  have  led  me 
astray,  I  took  pains  to  discover 
what  might  have  been  written  in 
the  book  of  Ecclesiasticus,  of  Jesus 
Son  of  Sirach,  which  appears  in  the 
Vulgate  but  not  in  the  St.  James 
The  citation  as  given  in 
reads:  "Do  good  to  the 
and  give  not  to  the  un- 
godly: hold  back  thy  bread,  and 
give  it  not  to  him,  lest  thereby  he 
over-master  thee."  Which  seems  to 
be  very  good  practical  advice,  but 
hardly  applicable  to  the  problem  of 
the  knowledge  of  the  circulation. 

It  would  take  too  much  time  for 
the  reader  to  enter  upon  the  various 
claims  for  the  discovery,  on  behalf 
of  Cesalpinus  and  Sarpi,  nor  is  such 
a  digression  desirable  in  this  article, 
but  it  may  not  be  without   Interest 
at  this  point  to  note  some  of  the  ideas  enter- 
tained among  the  ancients  as  to  the  use  of 
blood  as  a  remedy,  or  as  to  the  effects  of  the 
abuse  of  the  blood,   as   in   certain  cases   of 
pen  ersion. 

I  quote  from  Petro  de  Abano  ("De  \<- 
nenis,"  circa  1250-13 16,  Editio  Jacobus 
Thanner,  Liptzcn,  1498,  Cap.  74,  "De  San- 
guine Menstruo  aut  I.cprosi.") 

"He  who  drinks  of  menstrual  blood  or 


The  Beginnings  of  Intravenous  Medication 


181 


of  that  of  a  leper,  will  be  seen  to  be  dis- 
tracted and  lunatic,  evil  minded  and  for- 
getful, and  his  cure  is  to  drink  of  daisies, 
powdered  and  mixed  with  water  of  honey, 
and  to  bathe  in  tepid  water,  and  to  copu- 
late with  girls  according  to  the  law  natu- 
ral, and  to  play  with  pretty  girls  and 
young  boys:  and  the  antidote  (bezoar)  is 
to  eat  serpents  whose  heads  and  tails 
have  been  cut  off  with  the  edge  of  a  palm 
frond." 

Pliny  ("Natural  History,"  fol.  498,  v.  9) 
describes  the  drinking  of  the  flowing  blood 
of  gladiators  in  the  arena  "as  if  out  of  liv- 
ing cups,"  for  epilepsy. 

Again  Pliny  states  that  "a  man's  own 
blood  rubbed  upon  himself  will  relieve  him 
of  pain."  (Fol.  501,  v.  2.) 

Again  Pliny,  as  does  Diodorus  Siculus, 
describes  the  employment  of  baths  of  hu- 
man blood  by  the  Egyptian  kings  as  a 
cure  for  elephantiasis.  (Fol.  469,  v.  49.) 

The  use  of  blood  as  a  remedy  is  men- 
tioned in  many  other  places  in  Lib.  XXII. 
In  Thomas  Bartholin's  famous  book,  "De 
Sanguine  Vetito"  (Frankfort,  1673),  we 
shall  find  numberless  instances  of  the  use 
of  blood  as  a  remedy,  many  of  the  stories 
being  not  without  humor  as,  for  instance, 
in  that  portion  in  which  he  treats  of  the 
use  of  the  blood  of  cats,  doves,  turtles  and 
other  animals  in  the  treatment  of  epilepsy, 
he  tells  of  a  certain  girl,  an  epileptic,  at 
Breslau,  who,  after  taking  cats'  blood,  was 
quickly  endowed  with  the  characteristics  of 
a  cat.  She  climbed  upon  the  roofs  of  the 
houses,  imitating  the  manners  of  cats  in 
voice,  jumping,  scratching,  yowling,  and 
even  sitting  for  hours  gazing  into  a  hole  in 
the  floor. 

Ettmiiller  gravely  informs  us,  upon  the 
authority  of  Hildesheim  ("Spicilegium," 
VII,  p.  609)  that  if  a  black  cat's  tail  be  cut 
off  at  the  distal  third,  and  the  first  three 
drops  of  blood  that  exude  be  given  to  an 
epileptic,  it  will  prove  a  powerful  means 
for  cure,  but  he  considers  the  blood  from  a 


wild  cat  to  be  more  potent.  However,  blood 
from  the  ear  of  a  black  cat  is  most  valu- 
able in  the  treatment  of  erysipelas. 

The  ancient  pagans  advocated  the  use 
of  the  blood  not  only  of  brutes,  but  also  of 
human  beings  in  the  treatment  of  epilepsy. 

Scribonius  Largus  (Comp.  XVI)  says: 
"A  simple  woman,  one  of  the  common  peo- 
ple, sold  as  a  valuable  remedy  and  a  secret 
one,  the  mixed  blood  of  a  turtle  and  a 
pigeon  —  as  much  as  would  flow  out  —  as 
a  certain  cure  for  this  disease  (epilepsy), 
which  seems  to  have  been  as  mysterious  a 
malady  then  as  it  is  to-day." 

Paulus  ^Egineta  ("De  Re  Medica,"  Lib. 
VII,  Cap.  3)  advises  the  use  of  the  mixed 
blood  of  many  animals  for  this  disease  and 
Galen  and  Dioscorides  also,  the  drinking  of 
the  blood  of  a  weasel,  or  the  blood  of  a 
dog  for  the  cure  of  the  bite  of  one  that  was 
rabid. 

Caelius  Aurelianus  (Lib.  I,  Chronic, 
Cap.  4,  Editio  Amsterdam,  1722,  fol.  314) 
ridicules  the  use  of  the  mixed  blood  of  men, 
seals  and  turtles  for  the  cure  of  epilepsy, 
and  says,  "from  this  remedy  none  reaches  a 
cure."  Among  the  Norwegians  from  time 
immemorial  the  blood  of  seals  and  whales 
has  been  used  as  a  remedj-  for  fits  and 
scurvy,  and  the  blood  of  the  reindeer  is 
used  in  Lapland  for  the  same  purpose. 

Artseus  (Lib.  I,  "De  Cur.  Diut.  Morb.," 
Cap.  4)  describes  the  manner  of  filling  a 
vial  with  the  blood  flowing  from  the  wounds 
of  the  soldiers,  that  it  might  be  drunk  as  a 
remedy,  and  says:  "Oh  what  a  mighty 
necessity,  that  any  one  should  be  forced  thus 
to  cure  one  evil  by  the  use  of  a  greater." 

Nicolaus  Marepsus  (Sect.  I,  "De  Anti- 
dotis,"  c.  439)  advised  the  use  of  the  mixed 
blood  of  kids,  geese,  and  male  and  female 
ducks  for  a  number  of  diseases  affecting 
the  "spirits."  Celsus  (Lib.  Ill,  Cap.  23) 
deplores  the  custom  of  the  people  who 
rushed  into  the  arena  at  the  time  of  the 
gladiatorial  games  to  drink  the  blood  fresh- 
flowing  from  the  jugular  veins  of  the  dying 


1 82 


Annals  of  Medical  History 


victims,  and  TertuIIian  ("Apolog.",  IX) 
asks,  "Where  are  those  who  at  the  shows  in 
the  Arena,  where  men  are  slaughtered, 
drank  the  flowing  blood  (but  not  that  from 
the  throat)  with  eager  thirst,  that  they 
might  be  cured  of  epilepsy?"  Here  we 
have  a  reference  to  the  danger  of  taking  in 
any  portion  of  the  "spirit"  of  the  bleeding 
man  in  the  froth  of  his  blood.  There  can 
be  but  little  doubt  of  the  use  of  distillates 
from  the  blood,  for  we  shall  find  in  the 
"De  Distillatione "  of  Hieronymus  Rubasus 
(1585)  a  full  description  of  its  use  on  pages 
123-127  et  seq.,  and  the  distillate  of  blood 
was  often  employed  combined  with  the 
waters  and  oils  extracted  by  distillation 
from  human  and  other  feces  for  many 
diseases. 

One  might  well  quote  from  Dioscorides, 
Galen,  Alexander  of  Trales,  Benedictus  Vic- 
torius,  Mizaldus,  Levinius  Lemnius,  Avi- 
cenna  and  a  long  list  of  others,  but  what 
has  gone  before  is  quite  enough  to  prove  a 
multitudinous  use  of  blood  as  a  remedy. 

About  the  use  of  blood  hung  always  the 
idea  that  it  was  the  container  of  the  vari- 
ous spirits,  and  that  therefore  it  might  be, 
if  rightly  chosen  or  confected,  of  use  as  a 
restorative  in  cases  of  maladjustment  of 
those  mythical  factors  when  they  were  dis- 
arranged. Indeed  we  may  well  imagine  that 
in  its  use,  as  well  as  in  the  employment  of 
the  crushed  testicles  of  goats,  asses,  rab- 
bits and  cocks,  there  was  some  sort  of  fore- 
shadowing of  the  organotherapy  of  to-day. 
What  could  be  more  convincing  (if  prece- 
dent were  a  proof)  of  the  value  of  goats' 
lymph  in  the  treatment  of  diminished  viril- 
ity, than  the  grave  and  serious  statements 
of  the  ancients  as  to  these  things  of  ap- 
plied medicine  being  arcana  or  specifics. 

INFUSIONAL   SURGERY 

There  can  be  but  little  doubt  that  the 
original  conception  of  the  possibility  of  in- 
troducing remedies  into  the  blood  stream 


was  the  result  of  reasoning  from  the  knowl- 
edge that  the  vessels  might  be  injected 
after  death,  as  was  done  by  Mondinus  in  a 
certain  degree,  as  early  as  13 16,  at  Bologna. 
This  process  was  developed  to  a  greater  ex- 
tent by  Silvius,  Eustachius  and  Vesalius. 
It  is  difficult  to  believe  that  the  theories 
of  Servetus  as  to  the  lesser  circulation  were 
the  outcome  of  a  correct  knowledge  of  the 
anatomy  of  the  vessels  of  the  lungs,  derived 
from  an  examination  of  injected  vessels,  al- 
though at  the  time  he  was  a  fellow  student 
with  Vesalius  at  Louvain  under  the  teach- 
ings of  Guinter  of  Andernach  he  must  have 
known  something  of  the  method  of  exhibit- 
ing them. 

Whatever  may  be  the  truth  of  this  opin- 
ion it  is  certain  that  the  first  record  of  a 
suggestion  of  any  such  method  or  attempt 
is  to  be  found  recorded  as  originating  in 
England  in  the  year  1657. 

In  the  transactions  of  the  Royal  Society 
of  England,  Vol.  I,  page  96,  there  is  a 
statement  by  Robert  Boyle,  the  celebrated 
physicist  and  chemist  of  the  seventeenth 
century,  to  the  effect  that  early  in  the  year 
1657  the  idea  of  the  intravenous  introduc- 
tion of  medicines  was  proposed  to  him  by 
Sir  Christopher  Wren,  the  famous  architect 
of  the  St.  Paul's  Cathedral  in  London.  This 
suggestion  seems  to  have  remained  with- 
out fruition  up  to  the  year  1664  when  Jo- 
hannes Daniel  Major,  physician  and  pro- 
fessor of  anatomy  and  botany  at  the  Uni- 
versity of  Kiel,  a  man  who  was  pronounced 
by  his  contemporaries  as  "perquam  erudi- 
tius,  sed  perquam  ctiam  vagus,"  published 
his  "Prodromus  a  se  invents  chirurgiffi 
infusoria?,"  in  which  he  narrates  the  follow- 
ing experiments.  (Cap.  1,  Sec.  4.) 

Major  s  Experiments 

1.  A  large  dog  was  infused  with  liquid  ex- 
tract of  opium  one  ounce.  After  half  an 
hour  he  became  stupid  and  torpid,  then  he 
fell  asleep  and  would  permit  needles  to  be 


The  Beginnings  of  Intravenous  Medication 


183 


thrust  through  his  tongue  without  resist- 
ing, hardly  noticing  them,  and  after  having 
slept  for  two  days  and  one  night  he  recov- 
ered. 

2.  A  dog  was  infused  with  (Croci  metal- 
Iorum)  oxidised  sulphuret  of  Antimony  gr. 
16,  in  one  ounce  of  water,  not  filtered.  This 
brought  on  vomiting  and  the  following  day 
he  died. 

3.  In  another  large  dog  (a  mastiff)  a 
very  small  quantity  of  the  same  medicine 
was  infused.  Nothing  unfortunate  hap- 
pened, and  afterwards  the  same  medicine  to 
the  ordinary  dose,  namely,  one  ounce  was 
given;  the  dog,  like  the  other,  vomited  vio- 
lently. 

4.  Then  with  acids  a  large  number  of  in- 
fusions were  made,  but  it  was  observed 
that  all  these  coagulated  the  blood  and 
death  quickly  supervened;  but  a  few  grains 
of  oil  of  tartar  (liquor  potassii  subcarbona- 
tis)  produced  only  a  bright  and  very  red 
condition  of  the  blood. 

5.  When  a  decoction  of  arsenic  in  com- 
mon water  was  infused  up  to  one  ounce, 
into  a  dog,  death  was  brought  on. 

6.  In  the  same  manner,  when  a  solution 
of  one  half  drachm  of  corrosive  sublimate 
dissolved  in  water  was  injected  into  the 
crural  vein  of  a  strong  dog,  the  dog  after  a 
short  time  passed  away. 

7.  Another  dog  was  injected  in  the  crural 
vein  with  nitre  (potassium  nitras),  and 
nothing  happened. 

Major  made  note  of  the  fact  that  if  the 
dog  were  injected  in  the  jugular  vein  he 
died,  but  that  if  a  common  vein  were  used 
for  the  infusion  he  usually  survived.  (Were 
these  deaths  by  air  embolism?) 

A  large  number  of  experiments  were 
made  upon  dogs,  cats  and  other  animals  for 
the  purpose  of  finding  out  how  far  this 
method  of  medication  might  be  of  use  for 
the  benefit  of  mankind.  Although  some- 
what intoxicated  by  his  enthusiasm  for  his 
newly  discovered  method,  Major  (or  Meyer) 
was  in  the  end  obliged  to  admit  that  his 


experiments  had  proved  to  be  of  but  little 
value,  and  that  the  danger  of  their  action 
was  greater  than  any  benefit  derived  from 
them. 

Further  experiments  were  made  by  many 
investigators,  and  among  others  a  certain 
physician  of  Danzig  named  Fabricius  in- 
jected seven  grains  of  resin  of  scammony, 
dissolved  in  three  drachms  of  the  essence 
of  guaiac,  into  the  median  cephalic  vein  of 
a  soldier  suffering  with  lues,  having  indo- 
lent ulcers  on  both  legs,  a  tumor  of  the 
right  arm,  horrible  pains  in  the  head,  as 
well  as  laboring  with  gummata  or  nodes 
upon  the  bones.  "Although  the  medicine 
was  injected  with  the  greatest  care  and 
success,"  the  effect  of  all  these  things  was 
that  vomiting  supervened  and  the  soldier 
died. 

After  the  time  of  the  suggestion  by  Sir 
Christopher  Wren  and  before  the  appear- 
ance of  the  book  of  Major  a  number  of  prop- 
ositions in  regard  to  infusion  were  made  in 
England  by  Dr.  Clark,  afterward  Physician 
to  King  Charles  the  Second,  which  are  fre- 
quently noted  in  the  transactions  of  the 
Royal  Society. 

In  the  year  1665  appeared  the  three  let- 
ters of  Carolus  Fracassatus  of  Pisa,  written 
to  Malpighi,  in  which  are  related  his  ex- 
periments having  in  view  the  renewal  of 
the  blood  after  removal  of  a  certain  amount 
of  it,  for  the  purpose  of  "preventing  its 
fermentation,  or  the  depression  of  its  qual- 
ity," by  means  of  infusion  of  medicinal  sub- 
stances. This  series  of  letters  was  published 
at  Bologna.  It  is  clear  that  Fracassatus  was 
seeking  for  a  specific  for  epilepsy  and  that 
he  was  greatly  hampered  in  his  work  by 
the  fact  that  when  he  injected  spirit  of 
vitriol  (sulphuric  acid),  for  some  strange 
reason,  the  blood  of  his  victim  always  co- 
agulated and  the  aforesaid  victim  died,  and 
post-mortem  —  mirabili  dictu — the  blood 
was  not  found  to  be  entirely  concreted,  but 
in  the  lungs  was  frothy  and  slimy,  and  as 
the  dog  died  with  symptoms  of  suffocation 


1 84 


Annals  of  Medical  History 


and  with  frothing  at  the  mouth,  as  well  as 
with  ululations,  it  was  thought  that  these 
symptoms  confirmed  the  idea  that  epilepsy 
was  induced  by  a  natural  concretion  of  the 
blood  similar  to  that  induced  by  the  vitrio- 
lic spirit  injected. 

In  the  year  1661,  Johannes  Sigmund  EIs- 
holz,  physician  in  ordinary  to  the  Elector 
of  Brandenburg,  as  the  result  of  a  dissec- 
tion (for  the  purpose  of  proving  the  theory 
of  the  circulation  of  the  blood)  of  the  body 
of  a  woman  who  had  been  drowned,  came 
to  the  conclusion  that  intravascular  injec- 
tions of  medicines  ought  to  be  of  the  great- 
est and  most  certain  value  for  the  treat- 
ment of  all  diseases.  (His  book  containing 
his  observations,  "Chlysmatica  Nova,"  was 
published  in  1667.) 

The  same  year,  Mauritz  Hoffmann,  Doc- 
tor of  Medicine  and  Public  Professor  of 
Anatomy  and  Botany  at  Altdrof,  taught 
that  in  cases  of  melancholia,  epilepsy  and 
other  hypochondriacal  diseases,  the  cure 
lay  in  the  injection  of  the  blood  of  a  "florid 
youth"  into  the  veins  of  the  patient. 

A  curious  story  is  related  by  EttmuIIer 
of  a  certain  nobleman  who  lived  in  upper 
Lusatia  (Lausitz  in  Austria)  in  the  year 
1642.  Being  a  great  huntsman  and  hav- 
ing a  large  number  of  dogs,  the  kennel- 
master  found  great  sport  in  filling  his 
mouth  with  Spanish  wine  and  then  inject- 
ing or  blowing  it  into  an  opened  vein  in  the 
leg  of  one  of  his  dogs  through  a  quill.  At 
other  times  he  used  spirits  of  wine.  The 
wounded  vein  being  then  tied,  the  dogs 
were  made  drunk,  and  afforded  great  amuse- 
ment to  the  owner  by  their  inebriated  howl- 
ings  and  actions,  and  they  after  a  time,  like 
the  porter  in  Macbeth,  were  "cozened  into 
a  sleep"  to  recover  from  their  unwilling 
bacchanalia.  Whether  it  was  his  practice 
when  his  dogs  were  sick  to  treat  them  for 
their  diseases  in  the  same  way  with  vari- 
ous medicaments,  I  do  not  know. 

As  an  evidence  of  the  tendency  of  the 
minds  of  men  to  run  in  the  same  general 


direction,  it  is  of  interest  to  note  the  simi- 
larity of  method  and  material  employed  in 
the  prosecution  of  the  investigations  made 
by  experimenters  far  removed  from  each 
other,  at  a  time  when  communication  was 
slow,  and  in  the  absence  of  any  postal  or 
telegraphic  arrangements  that  were  in  the 
least  degree  comparable  to  those  of  our  era. 

We  find  that  even  before  the  book  of 
Major  was  sent  to  the  press,  dogs  and  cats 
seem  to  have  been  almost  invariably  the 
victims  of  the  inquisitive  surgeon  or  pri- 
vate investigator,  for  there  were  many  such. 

In  Elsholz'  book  is  given  an  account  of 
a  gentleman — "curiousus  in  sciencia" — 
who  injected  the  crural  vein  of  a  large  dog 
with  one  ounce  of  plain  water  and  who  re- 
ported that  for  the  space  of  half  an  hour 
the  dog  licked  the  wound,  and  then  ran 
about  without  apparent  disturbance. 

Elsholz  injected  one  ounce  of  Spanish 
wine  into  the  veins  of  a  dog,  and  reported 
that  even  a  large  dose  did  not  seem  to  pro- 
duce any  other  effect  than  to  cause  a  short 
period  of  drunkenness. 

Schottus  infused  a  much  larger  amount 
and  states  that  "after  a  few  minutes  the 
dog  staggered  about  in  a  drunken  manner, 
and  then  fell  flaccid  upon  his  side  and  slept 
for  many  hours,  snoring  like  a  drunken 
man";  and  when  he  injected  one  ounce  of 
spiritum  vitae  aureum  (tincture  of  gam- 
boge) as  much  as  would  be  sufficient  for  a 
man,  the  dog  was  seen  to  be  feeling  badly, 
to  wander  about  in  a  state  of  confusion  and 
then  after  a  lapse  of  seven  hours,  to  have 
two  very  copious  dejections. 

Elsholz  himself  infused  a  large  dose  of 
yellow  antimonial  emetic  into  a  large  dog 
at  noon  of  a  certain  day.  The  poor  beast 
had  hiccough  and  frothing  at  the  mouth, 
was  greatly  depressed,  and  lay  torpid  with 
snoring  respiration,  and  the  second  hour 
after  the  infusion  vomited  severely,  wan- 
dered from  one  corner  of  the  room  to  an- 
other, and  when  the  night  was  past  was 
found  dead;  but  in  another  dog,  when  two 


The  Beginnings  of  Intravenous  Medication 


185 


ounces  were  infused  "the  dog  vomited  up 
both  soul  and  body."  Daniel  Boyle  inject- 
ed one  ounce  of  liquid  extract  of  opium  into 
a  mastiff.  The  dog  slept,  anesthetic,  for  two 
days  and  nights,  and  then  recovered. 

In  the  course  of  these  experiments  it  was 
noted  that  the  effect  of  a  drug  upon  one 
animal  was  different  from  its  effect  upon 
another.  Thus  Boyle  the  English  scientist 
discovered  that  the  amount  of  the  tincture 
of  opium  enough  for  a  dose  for  a  man,  was 
enough  to  drive  a  cat  into  a  condition  of 
violent  madness  like  that  of  rabies;  while 
the  same  dose  given  to  a  dog  had  but  little 
effect  other  than  to  soothe  him  into  a  pro- 
longed slumber,  and  that  afterward  the 
dog  grew  fat. 

The  injection  of  a  watery  solution  or  di- 
lution of  nitromuriatic  acid  into  the  jugu- 
lar and  crural  veins  of  a  dog  quickly  caused 
death,  and  as  we  might  expect,  the  body 
being  opened,  the  blood  was  found  to  be 
coagulated  throughout  the  body  in  the 
veins,  while  in  the  heart  the  valves  were 
found  to  be  lacerated  or  ruptured,  and 
apoplexy  of  the  lungs  was  seen  to  have 
occurred. 

Other  experiments  were  made  with  spiri- 
tus  nitri  (nitric  acid)  and  spiritus  vitreoli 
sulphuric  acid)  by  Fracassatus  and  Mal- 
pighi,  as  well  as  with  oleum  sulphuris  (sul- 
phuretted oil)  with  the  same  result.  Hel- 
mont  then  began  a  process  of  deligation  of 
an  area  or  a  limb  of  a  dog,  and  experiment- 
ed with  acids  for  the  purpose  of  watching 
the  effect  of  permitting  a  slow  invasion  of 
the  body  with  the  acid.  In  Helmont's  work 
appears  a  long  account  of  the  post-mortem 
findings  in  these  cases,  but  it  is  hardly 
worth  while  for  us  to  go  into  them  at 
length.  It  is  sufficient  to  say  that  the  total 
picture  in  all  these  cases  is  the  same  in 
general,  as  that  of  the  dog,  dead  of  the  in- 
fusion of  the  nitromuriatic  acid. 

Alkalies  were  then  tried  and  an  ounce  of 
the  oleum  tartari  (liquor  potassii~subcar- 
bonatis)  was  infused  into  a  large  dog.  Im- 


mediately he  became  furious  and  with 
whining  testified  to  his  pain.  The  abdomen 
became  inflated  and  then  the  subcutaneous 
tissues,  after  which  he  died.  An  autopsy 
showed  that  there  was  a  general  coagula- 
tion of  the  blood  analogous  to  that  found 
in  the  case  of  the  injection  of  the  acid. 

An  experiment  was  made  to  try  if  by 
drawing  off  a  certain  portion  of  the  blood, 
and  substitution  for  it  of  a  solution  of  a 
drug,  better  results  might  be  obtained. 

With  this  object  in  view,  a  portion  of 
blood  was  drawn  from  a  large  dog  and  an 
equal  amount  of  decoction  of  arsenic  in 
water  was  substituted.  "The  poor  dog  died 
in  the  greatest  misery,  with  grave  symp- 
toms; coughing,  vomiting  and  with  a  mul- 
titude of  dejections  both  from  the  bladder 
and  rectum,  and  with  violent  convulsions 
of  the  body  and  contortions  of  the  eyes." 

A  certain  German  named  Garmannus  ex- 
perimented with  the  desire  to  see  what 
might  be  the  possibilities  of  use  of  the 
method  as  a  means  of  introducing  antido- 
tal remedies.  First  he  infused  a  big  cat 
with  a  small  portion  of  the  spirits  of  Rhen- 
ish wine,  and  as  usual  the  cat  was  made 
drunk.  Shortly  afterward  a  certain  number 
of  drops  of  liquor  narcotici  (probably  liquid 
extract  of  opium)  were  superinfused;  when, 
oh,  horror!  the  cat  fell  down  in  a  stupor  as 
if  dead.  A  short  half-hour  elapsed  during 
which  the  cat  had  a  continuous  discharge  of 
a  fluid  from  the  rectum,  then  a  large  fluid 
evacuation  took  place,   and  the  cat  died. 

One  might  prolong  the  description  of  the 
many  experiments  upon  animals,  through 
many  pages.  But,  Quid  moror? 

At  the  end  of  his  chapter  upon  animal 
experimentation  in  infusional  surgery,  an 
old  writer  of  the  period  has  said,  "These 
are  those  attempts  to  acquire  knowledge 
which  were  carried  on  by  the  investigators 
for  the  benefit  of  man,  upon  those  martyrs 
of  the  anatomists,  the  dogs  and  cats." 

In  Belgium  many  experiments  were  made 
with  infusional  surgery  for  the  purpose  of 


1 86 


Annals  of  Medical  History 


establishing  methods,  not  of  medication, 
but  of  means  of  feeding  through  the  ves- 
sels, for  improving  nutrition,  and  for  sus- 
taining life  by  the  introduction  of  nutri- 
ment into  the  blood.  None  of  these  was 
fortunate. 

The  first  methodical  efforts  at  the  treat- 
ment of  disease  in  man  were  made  by  EIs- 
holz  in  1664-5. 

He  treated  three  soldiers,  with  their  con- 
sent (I  suspect  from  the  context,  that  it 
was  forced),  by  infusion.  The  first  had  an 
ulcer  of  the  leg.  The  crural  vein  was  opened 
at  a  place  near  the  ulcer  and  by  means  of 
a  syphon  a  small  quantity  of  aqua  planta- 
ginis  was  injected. 

The  next  was  a  man  suffering  from  a 
continued  fever.  After  having  been  bled 
from  the  median  vein,  while  the  vein  was 
still  open,  a  teaspoonful  of  the  distilled 
water  of  Carduis  Benedictus — our  old  friend 
— was  introduced. 

The  third  suffering  from  a  "scorbutic 
corruption  of  the  humours,"  was,  in  the 
same  manner  as  the  second,  infused  with  a 
portion  of  the  "water  of  Cochlearia."  The 
results  in  these  cases  has  not  yet  been  re- 
ported. Fabricius,  before  mentioned,  in- 
jected the  soldier  whose  case  of  syphilis 
has  already  been  mentioned.  Also  he  treat- 
ed a  servant  girl  of  uncertain  age,  who  was 
a  victim  of  epilepsy,  with  an  infusion  made 
of  six  grains  of  jalap  dissolved  in  the  spirit 
of  Iillium  convallium.  After  a  period  of 
severe  vomiting  she  seemed  to  be  other- 
wise unaffected,  and  for  a  number  of 
months  remained  free  from  fits.  In  his  re- 
port of  the  experiment,  Fabricius  says, 
"  Whether  or  not  she  was  entirely  cured,  I 
do  not  know." 

The  discussion  of  the  value  of  this  means 
of  medication  raged  among  the  medical 
authorities  of  the  world  for  more  than  a 
quarter  of  a  century,  and  we  find  as  many 
names  ranged  upon  the  one  side  of  opinion 
as  upon  the  other. 

A  list  of  the  names  of  the  men  who  in 


the  two  decades  from  1657  to  1677  argued 
the  question  pro  and  con,  reads  like  a  roll- 
call  of  the  great  lights  of  medicine  in  the 
age  when  experimental  medicine  was  in  its 
infancy.  All  wrote  and  each  called  to  his 
aid  for  authority  upon  the  ancients,  Aris- 
totle, Hippocrates,  Celsus,  Galen  and  the 
Alexandrians,  but  as  it  were,  among  the 
clash  of  the  many  weapons  of  words,  a 
sudden  "silence  fell  upon  the  multitude." 

Infusorial  surgery  fell  into  a  state  of 
innocuous  desuetude,  and  was  almost  for- 
gotten, or  was  considered  as  one  of  the 
curiosities  of  medical  history. 

TRANSFUSIONAL   SURGERY 

It  has  been  shown  that  the  English  were 
the  first  to  suggest  the  investigation  of  the 
merits  of  infusional  treatment,  and  it  was 
but  natural  that  the  next  step,  transfusion, 
but  a  modification  of  the  former,  as  a  re- 
medial measure  should  follow,  transfusion 
being  but  the  child  of  infusion.  In  this  the 
English  were  the  leaders. 

Perhaps  no  subject  in  the  history  of  the 
progress  of  our  profession  has  caused  so 
much  discussion  as  that  of  the  priority  of 
the  venture  of  the  transfusion  of  blood.  I 
shall  endeavor  to  cover  the  ground  as  con- 
clusively as  may  be  in  as  few  words  as  pos- 
sible. 

We  have  vague  references  to  what  may 
have  been  attempts  at  transfusion  in  the 
writers  of  the  Augustan  period  of  Roman 
civilization.  Pliny  vaguely  mentions  it,  and 
a  passage  of  Ovid,  m  the  eighth  book  of 
the  "Metamorphoses,"  seems  to  indicate 
that  something  of  the  kind  was  conceived 
of,  but  there  is  nothing  definite  about  it, 
as  it  may  also  be  taken  to  mean  that  the 
blood  vessels  of  the  recipient  were  to  be 
filled  by  the  drinking  of  blood.  I  cannot 
believe  anything  that  was  said  by  Roussel 
in  his  citations  as  to  there  having  been  true 
transfusions  in  the  old  days,  for  those  of 
them  that  I  have  investigated  are  not  in 


The  Beginnings  of  Intravenous  Medication 


187 


the  least  proofs  of  any  such  operation  hav- 
ing been  done;  therefore  we  may  pass  over 
his  pronunciamentos  as  to  the  cure  of 
Naaman,  the  writings  of  Herophilus,  the 
case  of  Tanquilla  in  the  time  of  Tarquinius 
Priscus,  or  those  which  he  finds  in  Celsus 
and  Pliny,  Eubages  and  Apollo  (sic)  for 
they  are  not  there.  We  may  safely  start  in 
the  month  of  June,  1490,  or  1492  at  Rome, 
when  blood  is  said  to  have  been  transfused 
by  a  Jewish  physician,  named  Abraham 
Meyre  of  Balmes,  into  the  veins  of  Pope 
Innocent  VIII. 

The  blood  was  taken — according  to  the 
story — from  the  veins  of  three  boys  of  ten 
years  of  age,  to  each  of  whom  a  ducat  was 
paid.  It  was  introduced  into  the  veins  of 
the  Pontiff  and  he  either  died  or  recovered, 
accordingly  as  you  read  the  history  of  his 
life  in  (Enuphrius,  or  De  Cormenin.  The 
fact  is  that  about  the  year  1490,  two  years 
before  the  death  of  the  Pope,  he,  apparent- 
ly suffering  from  Bright's  disease,  fell  into 
a  stupor,  and  became  breathless  and  pulse- 
less. He  was  pronounced  dead,  and  the  Car- 
dinals gathered  together  to  elect  a  new 
Pope.  However,  the  good  man  could  not 
permit  this,  and  after  about  70  hours,  re- 
covered consciousness  and  continued  to 
rule  the  Church  for  a  period  of  two  years, 
dying  in  1492. 

It  may  be  well  for  us  to  enter  a  short 
distance  into  a  review  of  what  has  been 
written  upon  this  subject.  The  testimony  is 
most  conflicting. 

Rafael  Sabatini  in  his  "Life  of  Caesar 
Borgia,"  states  that  the  blood  was  drawn 
from  three  boys.  Too  much  was  taken. 
They  all  died.  The  Pope,  hearing  of  this, 
was  horrified  and  the  Jewish  physician  fled. 
De  Cormenin  ("History  of  the  Popes") 
states  that  it  was  "a  frightful  beverage" 
and  given  in  the  year  1492. 

Raynaldus  states  that  the  blood  was 
taken  "in  order  that  the  quack,  from  this 
(the  blood)  might,  by  chemical  art,  prepare 
a  distillate  for  a  draught  for  the  Pontiff." 


Frederic  Baron  Corvo  believed  it  to  have 
been  a  drink  of  a  prepared  distillate. 

In  Leo's  "Geschichte  von  Italien,"  Vol. 
IV,  p.  618,  the  historian  considers  it  to 
have  been  a  transfusion,  as  does  also  Pas- 
quale  Villari.  ("Life  of  Savonarola.") 

Ciaconius  and  (Enuphrius  Panvinus,  fol- 
low Steven  Infessura,  a  contemporary  of 
the  Pope,  whose  statement  will  be  seen  in 
a  later  paragraph. 

Gregovorius  ("Geschichte  der  Stadt  Rom 
im  Mittelalter,"  Vol.  VII,  p.  279)  states 
that  the  blood  was  transfused. 

All  of  the  beforementioned  writers  refer 
in  one  way  or  another  to  Infessura.  Let  us 
see  exactly  what  he  says. 

Steven  Infessura  in  his  "Diaria  Rerum 
Romanorum"  (quoted  in  "Fonti  per  la 
Storia  d' Italia,"  pages  275-6): 

"Interea  in  Urbe  nunquam  cessaverunt 
tribulationes  et  mortes;  nam  primo  tres 
pueri  decern  annorum.e  venis  quorum  Ju- 
daeus  quidam  medicus  qui  papam  sanum 
reddi  promiserat  sanguinem  extraxit,  in- 
continenti  mortui  sunt.  Dixerat  namque 
Judaeus  se  ville  sanare  pontificem,  dum- 
modo  habere  posset  certam  quantitatem 
sanguinis  humani  et  quidem  juvenis; 
quern  propterea  extrahi  jussit  a  tribus 
pueris,  quibus  post  flebotomiam  unum 
ducatum  pro  quodlibet  donavit;  et  paulo 
post  mortui  sunt.  Judaeus  quidem  aufu- 
git,  et  papa  sanitus  non  est." 

This,  in  English,  is   about   as  follows: 

"Nevertheless  the  deaths  and  distress 
in  nowise  ceased;  for  three  boys  of  ten 
years  of  age  from  whose  veins  a  certain 
Jewish  physician,  who  had  promised  to 
save  the  Pope's  life,  drew  the  blood,  died 
incontinently.  For  the  Jew  said  that  in 
order  to  cure  the  Pontiff,  it  was  necessary 
to  have  a  certain  quantity  of  blood,  and 
that  it  must  be  drawn  from  young  peo- 
ple, for  which  reason  it  was  ordered  to 
be  drawn  from  the  veins  of  three  boys,  to 


Annals  of  Medical  History 


each  of  whom,  after  the  phlebotomy,  a 
ducat  was  given,  and  shortly  after  they 
all  died.  The  Jew,  of  course,  fled,  and 
the  Pope  was  not  cured." 

There  is  no  assurance  that  the  Holy  Fa- 
ther ever  received  either  the  transfusion  or 
the  drink.  There  is  nothing  in  regard  to 
any  new  instrument,  no  account  of  any  air 
embolism,  nothing  whatever  from  which 
either  conclusion  may  with  certainty  be 
drawn. 

It  may  be  that  whatever  was  done  was 
at  the  time  when  the  Pope  was  in  the  state 
of  uremic  coma,  in  1490. 

It  only  remains  to  investigate  as  to  what 
was  really  accomplished.  It  is  hardly  prob- 
able that  there  was  any  interchange  of 
blood  between  the  boys  and  the  Pontiff. 
The  following  facts  seem  to  stand  out  of 
the  jumble  of  reports.  There  was  a  Pontiff. 
There  was  a  quack  doctor,  a  Jewish  phar- 
macus.  There  were  three  boys  who  were 
bled,  and  who  were  paid  a  ducat  apiece  for 
their  blood.  They  died  before  they  had  time 
to  spend  the  money.  The  "Judaeus  aufu- 
git"  before  the  Pope  had  a  chance  to  get 
his  drink  (or  was  it  a  transfusion?),  for  the 
pharmacus  did  not  tarry  to  confect  it.  The 
Pope  died.  The  reader  may  take  his  choice 
as  to  what  it  was. 

An  hundred  and  twenty  years  elapse  be- 
fore we  come  to  anything  that  seems  defi- 
nite as  to  transfusion,  and  that  instance  is 
found  in  a  rather  satirical  collection  of 
statements  derived  from  a  thousand  sources 
by  a  certain  Andreas  Libavius  (1  546-1616), 
who,  having  written  an  extensive  book 
upon  chemistry  and  chemical  medicine, 
sought  to  defend  his  postulates,  against  his 
critics,  by  gathering  together  the  various 
curiosities  of  theory  in  regard  to  cures, 
from  every  source,  and  in  the  course  of 
this  process  introduces  a  perfect  descrip- 
tion of  a  transfusion,  at  a  period  even  be- 
the  announcement  of  the  discovcr\  <>l 
the  circulation  by  Harvey. 


This  book  of  Libavius  was  published  at 
Frankfort  in  1615,  hence  it  must  have 
been  before  that  date  that  the  transfusion 
described  took  place,  ij  it  was  done  at  all. 

It  is  to  be  remembered  that  Harvey  first 
lectured  to  his  students  at  St.  Bartholo- 
mew's Hospital  upon  his  theory  as  to  the 
circulation,  in  the  year  16 13.  (Dezeimeris, 
Diet.,  Tome  3,  Part  1,  fol.  56.)  The  book 
of  Libavius,  "Syntagma  Arcanorum  Medi- 
corum,"  was  somewhat  of  a  firebrand  to 
the  Galenists,  the  Hermetics  and  the  fol- 
lowers of  Paracelsus,  and  was  at  once  at- 
tacked most  virulently,  especially  by  Scheu- 
nemann,  and  in  reply  to  this  attack  he 
published  his  "Defensio  Syntagmatis,"  in 
which  the  passage  occurs.  After  reciting  a 
number  of  the  ridiculous  methods  of  the 
Paracelsians,  and  citing  the  miracles  of 
Elisha  and  Elijah,  as  well  as  the  story  of 
David  and  the  young  woman  who  was  sent 
to  him  to  restore  his  vitality  (I  Kings  i, 
3),  he  says: 

"Sed  RYuv  et  EIisa?i  potcntia  non  suc- 
cessit  MEZENTIO,  qui  mortuos  non 
restituit  applicatis  vivis,  sed  hos  occidit. 
I  He  vero  noster  quo  qua?so  remedio  puta- 
bat  se  ista  insperata  consequi  posse?  As- 
sit  juvenis  robustus,  sanus,  sanguine 
spirituoso  plcnus.  Astet  exhaustus  viri- 
bus,  tenuis,  macilentus,  vix  animam  tra- 
hens.  Magister  artis  habeat  tubulos  ar- 
genteos,  inter  se  congruentes.  Aperiat 
arteriam  robusti  ct  tubulum  inseral  mu- 
niatque:  mox  et  segroti  arteriam  findat, 
et  tubulum  foemineum  infigat.  Jam  duos 
tubulos  sibi  mutuo  applied,  et  ex  sano 
sanguis  arterialis,  calens,  et  spirituosus 
saliet  in  segrotum,  unaque  vita  Content 
afferet,  omnemque  languorem  pellet.  Sed 
quomodo  ille  robustus  non  languescet? 
Danda  ei  sunt  bona  confortantia  et  cibi: 
medico  vero  hellcborum." 

\\  hich  being  put  into  English  is  as  follows: 

"But  the  powers  of  Elisha  and   Elijah 

did  not  descend  to  MAZENTIUS,  since 


8       Dcfcnfio  Syntagmatisarcan.Chym. 

f'tphUtU-  |3aico  pounce  extinctura  Philufophorum  ccs  przmunucr.  Alius  Chiniiirrm Mtlftlbltilim 
•&&""  mmmeadt\iit:PntalfiaEtix1rtxfift<mii4naiKgaidua  tmnm  vim  ir'nn  ptriua  melon  wgail: 
mBmpbi.  j,crt;j„,j„4/,^4,)gcyj?;/;i„nyf,fll(:j,msgianique  totam  quid  non  promiuuntiQuidnoatriUiit 
tut  ami-  '  Crclltui  mniwidt tftri,  &  im-ignnriomintcnfa:  hominis  i  Gixci  UufUtdUtu  affcc'tus  duccbant.quo 
i»m.  volebant.  NonnulliVJ/uiHM^wiini/iBjiiiBiliibluaconftellationeciaroviiicmuraiitanimoi, 

vtfi.nitlupini.bouini.tclini.&c.AiamwMiJ/a'ni^fw&liccafflliumintsiauJjtnalii.  Quidam  fta- 
««>««»  tuur;ir.«iOHiji(iim,^<i4ni/?^«iBt(>jriiBi»/'o»«infJ,vnun-.  faKj^i  ,aluiuraa'gm'um,itavt  radii  ex 
unfmrnM.  6noillapfiin«grotaB)hancafficiant)ac<jucitaexillBiioliiincraiiirateniin£  lantdireclc.  Opoi- 
tct  autctn  vtruinquc  animum  fonitet  intcndctc&auidumdlc  bunc  i.«p'en'larianitatis, ilium 
com municindajiinagiuaiionelubcercolydeiumpofiru  interna.  Qui  J  enim  crt  quod  per  (ydera 
iroaginaiionc  foiti  deducia  ,•& quail esc<rloraptaaeqacant.cffi<:eie,fi con fallaoior;  Quid  /a- 
cilius  quam  per  mumum  ranquam  pet  centrum  ex  vnoinaliurDtransferrcpnncipnimfamtacis? 
An  non  fdgt  lie  vruntui beniu  tcull ;  Aonon^rJfu/ucramplantarrtlKroolbiexparuo  mnndoin 

Quidni  iui!   s  magnt  raundi  fclubntas  in  liommcm  inucharut-  Saga  &  fon 

rebusamaiisvtuutot,necratofudoribnsatKpiis,&C«ri»^fcM>6V"&^^«B«,8ec-IiKiii«f'ijrf<ai 

eUm" '«'.'  AtlifturroiKiiumfitit  cxfdliui  UU:;,M>.i;ndu mtUcmijI*.  VtPdtilx  &  Efi/iic  4.  Reg.  +.  ;4.  appii- 

17.  %.ii.  ^  carumfemortu  s,  .\:lpiritum,ca!otemquevira:emeisreiliiuciuut,ita8r::rgtoiantibus  poll:  vi- 

dentut  laiv.  In  o  v:  c .vai\i Ik (clcs olutm in [t  trdc>fituit,iti  viles  peifonzanubilibus  potetanr. 

D.-.uidim  tcfocillabat  puichta,  iuuen;s,cjlcr.rquc,&  IpirituoraSnBiiBiirtr.qujIi  renigdioquislcnex 


TrdnfpUn- 


Mitdlili  t 


Ttfirs  1 


Ingidus  pullet  mcalelcere.cumidScmuenes  petantTSed  Hid  Si  Eli/iupuicr.'anonluccgflit  Me- 
ttmis.quimomijsnonicitiiuit.ipplicatisvmis  JeaTiosocciJit.  Ulevero Holier  quo  quar'o  re- 
medioputajjatfcilcainlperata  conlcqui  pollc  ■  Aftt  imitnu  rebul'.m ,  f.i<uu  ,[■,•  :ui  :i '} r.itiefoplaiui. 
AJititxluvJl*iviiibiu,ttnu!ijr.i:d!nm,viX4nim*mt7ahms.Mj?ijltrirtulijbiit;i!  ..'at  ergentas  iaitr  ft 
iawgmtiitts.  Aaa:A;dr:iT:^;r,TolHlUicrtubiilumin[a*t,miiniatifui:iilo\^'dgro:.4r'.:r.  \w fiv.ijt ,fr tuhu- 
lum  famtr.cuvi  inji^dj.  I  :m  duti tubules fibi  mmue  dppticu ,  &exfditofdnytn  aruri^.u , talcn> ,  c~  (p-ritucfa 
fdlitliidi!ioium,r::j,;-.  •■.ttjoMtm  jffjra,fmntmqui  Itvsiitrtmptllit.  Scdquumod  oil1  cumulus  nun 
languefcct:  Panda  ei!.inc  bona  confortantia,cVcibi:  medico  verohcllebotL  rrin  Caput  1 1  J.  P10- 


Udfitdm 


Ctn/1,1 

Jvwui 


::i  in^t 


J>  unJdt 
nfJad  fit. 


rmdoru  n  ^r.-.n-.iun-.i.  lMats<iuip:!iis»:drimttltiap.ttrutr)txtliummji't,&:  in  alias  ccitas  illati  ioi 
tarn  viui6.  wgc'i  1.  ."juaro  iomari,quin&perr.iancanr,propagcniat,cV:  mentis  ioferuiant.Si 
etiam  luntH.iuiatiltSLCitaruni  tegionum  qoalcsfuntin  DaaubtdHtf/£jfa,&c. )  :i  po.Tunt  omni 
loco, & carlo  co:nn u!ies  fieti.  Hoc  med  j  fUteigt,  ibomli ,felit , dfclli,C. hi ,  8«:«,  rwgri 
<;:  >'.  nut  •  .'/iiijA'iimiliiaquaiiliacxmati, autlhgnismarinispuliunt  transfciri  (kicacuiari, 
ijuntfaporc,  vircuteque&fubltanoaalia  quam-£xiccataiila,  (alia  ,  &aliicr  condit.i. 
I  r.loco':  Inioomnibus.Eiic&comaioditas,iacilitT)aquciatiof:'ifj  nuelii  to: 

&  •  '  1  tc.r.?ord[rr<iinii> quo  lamas  veniant  in  cuSuin,  maiote  copia,&  \  iliotc precio  quc- 

.  Iintpiatflo.  Ecquidplacet  ptomillbtjMinimclaltimentariis;  ApicuscV  cupcdinariis1, 
■    piag  sinultum.^^wifliotiar.siettipirccsaliquandoiDfgionespctegiinas  pol- 
11  1  b  iBtTiflhm/,5cDjiiitbti&Miubi*tegc  olira  in  viiiai  aStbtmu  tjlatuscli. 
■   ari  inviuanauiaimiTiiliC  i'.-iBjmi».  Piifii Enriw>  nuuis  in  pifciuac coece- 
1  .  'nanosauratiu.  •.  rcnuniain  lacuvmcditcitaneiis  inucxide.  Nuiu  !\z 

pollinra:lnlcccs,p-,:Vt-tts,arelli,&:c.incc:v.pcicuni  eft.  Caput  IV.  Mcdicum  lttriinicft:  Vulc 
•■J.t>  fa'.u '.  i-/t".  e:lquc  pol^ctut  media  rirjgularia,^  exopta:  ■.  .u  cdo  intet  pctlbnas 
nulla  lit  a  tipauiia.  Quid?  Numctiamcxoli  ris^cmottnjsvuluissEthis  qtioquc(iue  maribus, 
liucla   iinis.Hicenia]r<iiMurw«a  .idnini:tiUi'.iut.ic. crlcnd.i.vt licet ar  -Dcnviiibus 

lint  iiiueinlts.pollintque  pioctcatc.  Sane  ft  ileum  [ir^m  cjpiriiiu.tumd 
ftrianiit  1.1  ftmlu <e?perd imffiu fucnt .aliquid .'pcieflc polli: ,  nilitallit  raedm. . 
di:  Non  tamtam  vtPHvbmKiMM.quiliatcc  Mididfc\  heiliaicoclas,gignr.n: ,  !;d&  mmrbitrdiu 
mafiulus,  nlfamtid  concipiatur,  Itgenerctm^t bote utiuzprweienuptu  fit: ; 
niiiuirq-ieobno'tius.TT.'ciioDibuf,  roorbis.pctegtinikjiic  cupiditatibus .  i..l . 

•4  r.iiultofanguineexfa-minaprotcrmui^.cxni.iiibusii  1  -....,    r  . ■■■:•■. 
jLe,*caiiimoroeliot,&f.!icior,eiiam  vltra  media  con  cc  pi.t  .imp.   1 
■    1  ;  ita.  Elto-'profufiorptomilTis.  Vtcnim(i«i»i)liatj..' ;.       .  1 
ctiatn  maiote  vanita'c  Icripfir ;  &  vtdeg.it  Cum; ,  Grtu midia ptr  fuel [ilti,  fVatici  dc  Rcfea  ctuce 
tbrceperiaj  iiuruni  ,qu.^:  rcriouatoiiusclt,  obtineripoflepmant.  5:diilcnoftct 

roachiHani.iiuc  in!tii[neniumfab:icit.-potell,cuiuscpc  piruatxvtmlibtitiiu  qu.i:i- . 
f.JJiJtd.     Cptatdata  i-s  pto  virginibus  imtlujiia-is  ,nc  .it  opu*  (iltu  llippoetarico ,  atlt  pnthoricis.)Cur 
illud? Quia ginctbliiCt fata pendctecxaliiorum moment ikX'ii'n a natiuic-tij  dicunt.  Ft  agetidf- 
CdturinjdXuptimdtor.jiiUauent.Mni  inlUumcnium  clliccre  pcliit.  U.lfern.vel  acceletai 
eodem  valet.  Sed  num  etiam  fcecundas  fcit  (tctiles teddere ,  vt  riant  limiles  Gcllia:  spud  Martia- 
lem,<jua:colludcte  vicis,  I  -d  non  paretc  \  olcbat  t  Quidm !  Ignorata«a  Blicvfqiic  ratio  eft,  fitque 
tantummedicammibustam  vtiliter,^rieccHario>;uamnci:c:raiiafuntcaliduni,l.iin-!.  : 
dom.liccum,»ddi«ioii{lubtra6tioluistempoiibu\delidecata.  Quicunqnc  etgovitin  . 
nerio  languct.&impotcm  le  agnolcit^quartceiHtiuignaucleruitlibiuini  ,.ul  hunc  a 
adeflo.  Alactitcr  lalciune  c^  hucite  difccnt,  liue  ifaHHua  fit  impoientia  .  (iue/i/nM.  ( 
m,jltaptomittnntfiduciatinciura;riia;pliyfica,>&acc3niantimon.itamp..i    mgaTita, quam te- 

'■.cdexemplafunttumtaM,  vt  putentu:  nulla  tfl'e.cum  Ikipji ptflcgirtt «tmi 
liuhineiijumf-.iv.  Alia rf«ii(*f»7(4 eft Pijlmi  io).qjaniD.-us  piobaui:  \a  AiTdb-i;HtxSdtd 


Page  From  the  Writings  of  Libavius. 


190 


Annals  of  Medical  History 


he  could  not  restore  the  dead  to  life  by 
application  of  the  living  to  the  dead,  but 
on  the  contrary  he  killed  them.  Was  he 
not  that  man  among  us  who  thought 
that  by  employing  the  following  most 
unusual  procedure  he  might  bring  about 
that  result?  'Let  there  be  a  young  man, 
robust,  full  of  spirituous  blood,  and  also 
an  old  man,  thin,  emaciated,  his  strength 
exhausted,  hardly  able  to  retain  his  own 
soul.  Let  the  performer  of  the  operation 
have  two  silver  tubes  fitting  into  each 
other.  Let  him  open  the  artery  of  the 
young  man  and  put  into  it  one  of  the 
tubes,  fastening  it  in.  Let  him  immedi- 
ately after  open  the  artery  of  the  old 
man,  and  put  the  female  tube  into  it, 
and  then  the  two  tubes  being  joined  to- 
gether, the  hot  and  spirituous  blood  of 
the  young  man  will  pour  into  the  old 
one,  as  if  it  were  from  a  fountain  of  life, 
and  all  of  his  weakness  will  be  dispelled. 
"  'Now,  in  order  that  the  young  man 
may  not  suffer  from  weakness,  to  him 
are  to  be  given  good  care  and  food,  but 
to  the  Doctor,  hellebore.')" 

(I  cannot  imagine  why  the  Medicus 
should  need  hellebore,  but  perhaps  it  was  on 
the  principle  that  a  veratrum  cock-tail 
might  reduce  his  blood-pressure  after  his 
exciting  experiment.) 

Contrary  to  what  has  been  advanced  by 
many  historians  of  medicine,  I  cannot  find 
in  any  of  this  the  slightest  intimation  that 
Libavius  either  advocated  or  performed 
this  operation  of  transfusion.  A  certain  Ma- 
zentius  seems  to  have  been  the  man  who 
suggests  the  method.  It  will  be  noted  that 
two  arteries  are  to  be  used.  This  alone  would 
indicate  that  Mazentius  had  no  conception 
of  the  circulation,  and  that  his  idea  was 
that  the  blood  would  rush  into  the-  old 
man  because  of  the  greater  pressure  ol  tin- 
spirits  in  the  young  man.  I  cannot  believe 
with  Dr.  Garrison  ("History  of  Medicine," 
p.  144)  that  Libavius  was  an  advocate  of 


transfusion.  Rather  he  seems  to  be  casting 
ridicule  upon  the  experiment. 

Now  who  was  this  man  Libavius  whose 
statement  has  been  a  sort  of  stumblino- 
block  to  the  solution  of  priority  in  the  per- 
formance of  transfusion.  One  writer  speaks 
of  him  as  being  "vir  scribendo  prolixus, 
sed  insignis  scopticus  et  scepticus."  As  to 
his  prolixity — I  show  you  a  page  of  his 
writings  whereon  appears  the  extract  above 
translated.  He  surely  Mas  energetic  and 
learned,  as  well  as  skeptic,  and  a  very  good 
business  man  withal,  for  we  learn  from  Gar- 
rison ("Hist,  of  Medicine,"  p.  144)  that  he 
had  at  Coburg  a  large  establishment,  a 
private  laboratory,  and  his  quarters  were 
furnished  with  rooms  for  patients,  a  gym- 
nasium, baths,  enclosed  corridors  for  exer- 
cise in  cold  weather,  and  a  well-stocked 
wine-cellar.  He  was  the  great  chemist  of 
his  time  and  was  the  discoverer  of  stannic 
chlorid.  His  nomenclature  of  many  chemi- 
cals remains  in  use  to  this  day. 

It  is  certain  that  Johannes  or  Giovanni 
CoIIe,  of  Belluno,  in  Italy,  who  was  Pro- 
fessor of  Medicine  at  Padua,  Physician  to 
Cosimo  II  of  Florence,  and  who  wrote  ex- 
tensively upon  Morbus  Gallicus,  described 
a  method  of  transfusion  in  a  medical  trac- 
tate at  a  period  anterior  to  the  year  1628, 
as  his  book,  in  chapter  seven  of  which  he 
gives  the  account,  "Methodus  Facile  Pro- 
curandi  Tuta,  et  Nova  Medicamenta,"  ap- 
peared at  Venice  in  that  year. 

There  was  a  little  book  published  about 
1660,  in  Italy,  that  hears  the  title — when 
put  into  English — "A  Pair  of  Medical 
Scales,  in  Which  Are  Weighed  Not  Only 
the  Infusion  of  Medicines  and  Other  Novel- 
ties, but  also  the  Favorable  and  Unfavor- 
able Opinions  as  to  the  Transfusion  of 
Blood." 

This  book  was  written  by  one  Francesco 
FoIIi,  a  native  of  Poppi,  born  in  1624.  He 
practiced  medicine  in  various  cities  and 
provinces  of  Italy  and  was,  about  1650, 
called  to  Florence  to  become  body-physi- 


The  Beginnings  of  Intravenous  Medication 


191 


cian  to  the  daughter  of  the  Duke,  Cosimo 
II.  In  his  book  he  shows  that  he  was  famil- 
iar with  the  theory  of  the  transfusion  of 
blood,  that  he  had  developed  a  technique 
of  his  own  and  had  had  instruments  made 
for  that  purpose.  He  states  that  he  demon- 
strated the  operation  of  transfusion  in  the 
year  1654  in  the  presence  of  the  Grand 
Duke  Frederick  II.  This  would  have  been 
1 1  years  before  the  operation  was  done  by 
Richard  Lower,  the  English  surgeon.  In  the 
year  1766,  a  book  was  published  in  Flor- 
ence entitled  "A  Series  of  Portraits  of 
Distinguished  Tuscan  Men."  In  this  pub- 
lication there  appears  a  portrait  of  FoIIi 
and  a  pictorial  reproduction  of  the  instru- 
ments invented  by  him. 

FoIIi  proposed  to  employ  a  silver  tube 
inserted  into  the  artery  of  the  donor,  and  a 
cannula  of  boneinto  the  vein  of  the  recipient, 
and  to  connect  the  two  by  means  of  a  hol- 
low pipe  made  from  a  blood-vessel  taken 
from  an  animal.  This  tube  was  provided 
with  a  lateral  branch  that  permitted  the 
escape  of  the  air  as  the  blood  poured 
through  it  from  the  artery  toward  the  vein. 
It  would  seem  that  but  for  his  lack  of 
knowledge  of  hemolysis,  FoIIi  was  practi- 
cally as  well  prepared  to  do  the  operation 
as  we  are  to-day. 

I  now  quote  from  Roussel. 

"In  France  they  had  not  dared  to  at- 
tempt arterial  transfusion,  for  the  reason 
that  in  opening  the  carotid  artery  of  the 
donor,  his  life  was  inevitably  sacrificed. 
In  1653  Robert  des  Gabets,  a  monk  of 
Cluny,  demonstrated  the  possibility 
of  performing  intravenous  transfusion, 
which  he  designated  'communication,' 
by  means  of  two  little  tubes  of  silver 
which  he  had  manufactured  at  Macon  in 
1 65 1  under  the  direction  of  another 
monk,  Dom  Eloy  Pichot.  These  tubes 
were  connected  by  a  leather  ball  the  size 
of  a  walnut,  and  each  contained  a  valve 
to   regulate  the  flow  of  the  blood.   By 


compressing  the  ball  the  necessary  force 
was  communicated  to  the  venous  blood 
to  make  it  penetrate,  and  the  quantity 
of  blood  could  be  measured.  The  ideas 
incorporated  in  the  construction  are  the 
same  as  are  demonstrated  in  the  most 
modern  apparatus  for  direct  transfusion 
to-day."  (1! 


We  are  now  approaching  the  date  of  the 
first  visual  demonstration  of  the  actual  flow 
of  the  blood  from  the  arterial  into  the 
venous  side  of  the  circulatory  system,  for  it 
was  not  until  1661  that  Malpighi  saw  the 
passage  of  the  corpuscles  of  blood  through 
the  capillaries  in  a  frog's  foot,  and  by  that 
vision  supplied  the  final  link  to  the  chain  of 
evidence  proving  the  truth  of  Harvey's 
theory. 

You  will  remember  what  I  have  said  in 
an  earlier  portion  of  this  paper  as  to  the 
first  suggestion  of  the  infusorial  surgery  by 
Sir  Christopher  Wren  in  1657.  During  the 
period  following  that  suggestion  the  ex- 
periments along  that  line  were  followed,  as 
I  have  shown  you,  for  a  period  of  eight 
years  before  any  attempt  was  made  to 
transfuse  blood  from  one  animal  to  an- 
other. Then  "in  the  year  1665,  toward  the 
end  of  February,"  as  says  the  author  of 
"The  Gold  Headed  Cane,"  "Richard  Lower 
made  this  experiment  at  Oxford;  by  means 
of  long  tubes,  the  blood  of  the  vertebral 
artery  of  one  dog  was  made  to  pass  into 
the  jugular  vein  of  another,  and  it  appeared 
proved  that  there  was  no  reason  to  fear 
any  mischief,  and  that  the  character  or 
nature  of  one  animal  was  not  likely  to  be 
changed  by  injecting  into  its  veins  the 
blood  of  another." 

Whatever  may  have  gone  before,  whether 
it  be  the  work  of  Abraham  Meyre  of 
Balmes,  the  operation  described  by  Liba- 
vius,  the  efforts  of  FoIIi,  or  the  instruments 
of  the  Monks  of  Cluny,  the  date  of  the 
demonstration  by  Lower  is  the  starting 
point  of  the  long  series  of  transfusional  ex- 


192 


Annals  of  Medical  History 


periments  upon  animals,  by  a  multitude  of 
learned  men  all  over  Europe,  leading  up  to 
the  triumphant  experiment  of  Dionis  of 
the  Faculty  of  Montpelier,  in  Paris,  of  di- 
rect transfusion  of  the  blood  of  an  animal 
into  man. 

But  before  we  go  into  the  matter  it  will 
be  well  to  quote  once  more  from  "The 
Gold  Headed  Cane"  and  tell  a  little  story 
that  is  not  without  interest.  ("The  Gold 
Headed  Cane,"  p.  97.) 

Dr.  Mead  is  made  to  say,  "So  late  as 
the  middle  of  the  seventeenth  century, 
about  the  time  when  Lower  was  making 
at  Oxford  the  daring  and  original  experi- 
ment of  transfusion  (of  the  blood),  a  grave 
dispute  arose  in  Germany  as  to  the  posi- 
tion of  the  heart  itself.  The  contest  was 
terminated  at  length  by  the  Professors  of 
Heidelberg,  where  the  question  was  agi- 
tated: having  recourse  to  the  delicate  ex- 
periment of  killing  a  pig  in  the  presence  of 
the  Margrave  of  Baden-Durlach,  and  clear- 
ly proving  to  His  Highness,  who  then  la- 
bored under  palpitation  of  the  heart,  that 
it  really  was  situated  on  the  left  side  of 
the  thorax. 

"The  result  of  this  important  discovery 
was  fatal  to  the  fortunes  of  His  Highness' 
physician,  who,  though  he  stoutly  main- 
tained by  a  refinement  of  courtly  flattery 
that  the  heart  of  his  master  could  not  have 
a  position  similar  to  that  of  a  pig,  was  dis- 
missed in  disgrace." 

In  Samuel  Pepys'  Diary,  under  date 
"Nov.  the  14th,  1666,"  we  find  the  follow- 
ing reference  to  the  work  of  Lower: 

"Dr.  Croone  told  me  that  at  the  meet- 
ing at  Gresham  College  to-night  (which, 
it  seems,  they  now  have  every  Wednes- 
day  again),  there  was  a  pretty  experi- 
ment of  the  blood  of  one  dog  let  out  (till 
he  died)  into  the  body  of  another  on  one 
side,  while  all  his  own  run  out  on  the 
other  side.  The  first  died  upon  the  place, 
and  the  other  very  well,  and  likely  to  do 


well.  This  did  give  occasion  to  many 
pretty  wishes,  as  of  the  blood  of  a  Quaker 
to  be  let  into  an  Archbishop,  and  such 
like;  but,  as  Dr.  Croone  says,  may  if  it 
takes,  be  of  mighty  use  to  man's  health, 
for  the  amendment  of  bad  blood  by  bor- 
rowing from  a  better  body." 

It  will  be  seen  that  the  experimental 
forms  of  transfusion  took  three  classifica- 
tions. 

First,  From  brutes  to  brutes. 

Second,  From  brutes  to  man. 

Third,  From  man  to  man. 

The  particular  objects  that  were  be- 
lieved to  be  worthy  of  an  effort  at  trans- 
fusion were  as  follows.  (I  quote  from  an  old 
authority,  EttmuIIer): 

"To  correct  a  vicious  condition  of  the 
blood. 

To  prolong  the  lives  of  the  aged. 

The  cure  of  Melancholy  delirium. 

The  eradication  of  Scurvy. 

The  cure  of  Consumption. 

The  mitigation  of  Arthritis. 

The  removal  of  Epilepsy. 

The  amelioration  of  Scabies  and  Lep- 
rosy. 

The  restitution  of  diminished  strength, 
as  well  in  the  young  weakened  by 
disease,  as  in  the  aged  worn  out  with 
years. 

For  the  alteration  of  the  habits  of  peo- 
ple of  evil  disposition. 

For  the  solution  of  calculi  produced  by 
a  tartarous  state  of  the  blood." 

It  is  needless  to  say  that  none  of  these 
objects  was  accomplished.  Pierre  Dionis, 
one  of  the  surgeons  to  the  Dauphin  of 
France,  son  of  Louis  XIV,  after  a  multi- 
tude of  experiences  made  in  the  transfusion 
of  blood  from  animal  to  aninal,  with  vary- 
ing results,  in  the  month  of  June,  1667,  made 
the  following  experiment.  This  was  the  first 
instance,  properly  recorded,  of  the  transfer- 
ence of  blood  directly  into  the  veins  of  a 


The  Beginnings  of  Intravenous  Medication 


193 


human  being  from  the  arteries  of  an  ani- 
mal. 

Thanks  to  the  willingness  of  a  certain 
strong  and  robust  porter,  Dionis  was  al- 
lowed, first  to  remove  from  the  median 
vein  of  the  man  10  ounces  of  blood,  and 
immediately  afterward  the  vein  was  con- 
nected by  means  of  a  tube  with  the  crural 
vein  of  a  Iamb  and  twenty  ounces  of  blood 
was  poured  into  the  circulation  of  the  por- 
ter. Dionis  paid  the  man  and  he  at  once 
went  to  an  inn  and  ate  and  drank. 

The  experiment  was  repeated  upon  the 
man  a  number  of  times  without  harmful 
result.  It  is  to  be  noted  that  the  man  was 
in  good  health. 

The  next  instance  of  transfusion  was 
that  of  the  introduction  of  blood  into  a 
sick  man,  the  result  not  being  as  fortunate. 
The  case  is  well  worthy  of  complete  re- 
hearsal. 

"In  Paris  there  was  a  boy  of  ten  years 
of  age  who  was  suffering  from  a  long 
continued  tertian  fever,  weakened  by 
continuous  clysters  and  a  vast  number 
of  bleedings,  brought  to  a  state  of  com- 
plete lethargy  by  the  depauperation  of 
the  spirits,  and  whose  life  and  intellect 
were  reduced  to  the  lowest  ebb.  For  the 
relief  of  these  conditions,  and  to  im- 
prove the  thickness  of  the  blood  and  to 
increase  its  spirituosity,  transfusion  was 
attempted,  but  the  boy  being  corrupted 
by  his  feverishness  and  his  diarrhea, 
three  ounces  of  thick,  coarse  and  black- 
ish blood  were  taken  from  him,  and  then 
eight  ounces  of  blood  from  the  carotid 
artery  of  a  Iamb  were  transfused  into 
the  vein.  The  boy  soon  felt  better,  took 
food,  moved  about  and  slept  during  the 
middle  of  the  day;  but  after  24  hours  he 
was  again  attacked  with  diarrhea  and 
coma,  and  died." 

In  the  month  of  December,  1667,  Dionis 
transfused  five  ounces  of  the  blood  of  a  calf 
into  the  veins  of  a  man  suffering  from  mania 


and  melancholia,  after  he  had  been  bled  to 
the  amount  of  three  ounces.  This  seems  to 
have  had  a  good  effect  upon  the  patient, 
but  we  do  not  learn  that  his  improvement 
was  permanent. 

On  November  23rd,  1667,  Lower  had  at- 
tempted the  same  thing  at  Arundel  House, 
upon  Mr.  Arthur  Coga,  "a  mildly  melan- 
choly insane  man,"  with  the  blood  of  a 
Iamb,  without  mishap,  but  without  any 
specially  favorable  result.  The  experiment 
was  to  have  been  repeated,  but  for  some 
reason  not  stated,  it  never  was.  After  the 
operation,  Coga  stated  that  he  felt  himself 
better. 

There  is  no  doubt  that  Lower  would 
have  gone  on  with  his  work  to  the  final 
test  to  transfusion  of  blood  from  man  to 
man,  but  that  the  law  and  local  prejudice 
prohibited  such  an  operation. 

The  work  begun  by  Lower  and  Boyle 
attracted  the  attention  of  many  philoso- 
phers and  physicians  in  England  and  on 
the  Continent,  and  we  find  them  being  re- 
peated with  many  variations  by  King,  Coxe 
and  others  in  England,  by  Dionis  and  Gayen 
in  France,  by  Graaf  and  others  in  Germany 
and  Cassini  in  Bologna. 

Reports  of  all  these  efforts  are  to  be 
found  in  the  Transactions  of  the  Royal  So- 
ciety. 

Similar  experiments  were  carried  on  in 
Italy  at  Rome,  by  Guillelmus  Riverius  or 
Riva,  of  Montpellier.1  The  following  case, 
reported  by  him,  is  not  without  interest, 
in  that  it  is  probably  the  first  instance 
recorded,  possibly,  of  hemolysis. 

It  is  not  to  be  wondered  at  that, 
since  these  experiments  in  infusion  and 
transfusion  were  in  progress  at  a  time 
when  there  was  no  possible  chance  that 
there  could  be  any  true  knowledge  of  the 

1  The  context  in  the  report  of  this  case  makes  it 
rather  doubtful  as  to  the  city  at  which  it  was  done, 
but  it  would  seem  that  it  was  done  either  by  Guillel- 
mus Riva,  who  was  a  well  known  surgeon  at  Rome, 
or  by  Dionis  at  Paris. 


194 


Annals  of  Medical  History 


histology  of  the  blood,  there  should  have 
been  accidents  of  this  kind,  and  that 
through  the  occurrence  of  a  number  of 
them  the  method  of  treatment  fell  into  dis- 
repute. The  case  is  as  follows: 

"There  was  living  at  that  time  in 
Paris  a  certain  Swedish  Baron  named 
Bond,  who  was  sick  with  a  peculiar  con- 
tinued miliary  fever  of  a  light  form, 
which  was  complicated  by  a  colliquative 
diarrhea  with  bloody  discharges  from 
the  bowels,  indicating  an  hepatic  com- 
plication. 

"The  man  had  been  bled  32  times,  but 
nevertheless  his  strength  was  failing  and 
he  was  approaching  death,  the  disease 
being  so  long  drawn-out. 

"Now  when  he  was  in  an  half-dead 
condition,  a  transfusion  of  a  great  num- 
ber of  ounces  of  blood  from  a  calf  was 
made  into  his  veins. 

"The  pulse  immediately  became 
stronger  to  the  touch,  and  after  two  days 
he  was  so  much  improved  that  he  was 
able  to  speak,  but  after  the  lapse  of  two 
more  days  he  suddenly  died.  An  autopsy 
having  been  made,  it  was  found  that  in 
the  whole  of  his  body  and  vessels  there 
was  not  to  be  found  blood  to  the  amount 
of  a  teaspoonful." 

Was  this  a  case  of  hemolysis  from  the 
use  of  a  blood  that  was  lytic  to  that  of  the 
recipient?  The  intervening  time  between 
the  immission  of  the  blood  and  the  death 
would  seem  to  be  too  long,  yet  the  possi- 
bility of  hemolysis  having  taken  place  is 
not  improbable. 

As  to  the  question  of  priority  of  transfu- 
sion from  animal  to  animal,  and  animal  to 
man,  the  matter  is  made  clear  in  the  fol- 
lowing table. 

It  is  very  likely  that  experiments  both 
in  infusion  and  transfusion  were  made  as 
early  as  1660  by  Wren,  Richard  Lower  and 
Boyle,  at  Oxford. 

It  is  certain  that  transfusion  from  ani- 


mal to  animal  was  done  by  Lower  and 
Boyle  at  that  city  in  February,  1665. 

On  May  17th,  1665,  Lower  made  his 
demonstration  of  transfusion  by  means  of 
quills,  from  dog  to  dog,  before  the  Royal 
Society  in  London. 

Pierre  Dionis,  at  Paris,  had  been  experi- 
menting in  infusional  surgery  during  the 
year  1665  and  1666,  and  his  letter  in  re- 
gard to  his  experiments  appears  in  the 
Transactions  of  the  Royal  Society,  No.  25, 
May  6th,  1667.  He  had  also  done  some 
work  in  the  way  of  transfusion  on  animals, 
as  for  instance  the  transfer  of  the  blood  of 
four  goats  into  the  veins  of  a  26-year-old 
horse,  with  success. 

In  the  month  of  June,  1667,  Dionis  made 
his  first  transfusion  from  an  animal  to  a 
healthy  man.  This  experiment  was  repeat- 
ed either  in  July  or  August  of  the  same 
year  by  him,  the  recipient  being  a  sick  boy. 

In  November  23d,  1667,  Lower  trans- 
fused the  blood  of  a  sheep  into  the  veins  of 
one  Arthur  Coga. 

In  December,  1667,  Dionis  transfused 
the  blood  of  a  calf  into  the  circulation  of 
man  suffering  from  mania  and  melancholy. 

The  correct  description  of  the  method 
employed  by  Lower  in  his  epoch-making 
demonstration  is  taken  from  the  records  of 
the  Royal  Society  of  London  (Philosophical 
Transactions,  Vol.  I,  Monday,  Dec.  17th, 
1666,  page  353). 

"The  method  observed  in  transfusing 
the  blood  out  of  one  animal  into  another. 
It  was  first  practised  by  Doctor  Lower  in 
Oxford,  and  by  him  communicated  to  the 
Honorable  Robert  Boyle,  who  imparted 
it  to  the  Royal  Society  as  follows: 

"First  take  up  the  carotidal  artery  of 
the  dog  or  other  animal  whose  blood  is 
to  be  transfused  into  another  of  the 
same  or  a  different  kind,  and  separate  it 
from  the  nerve  of  the  eighth  paire,  and 
lay  it  bare  above  an  inch. 

"Then  make  a  strong  ligature  on  the 


The  Beginnings  of  Intravenous  Circulation 


195 


upper  part  of  the  artery,  not  to  be  untied 
again;  but  an  inch  below,  videlicet,  to- 
wards the  heart,  make  another  ligature  of 
a  running  knot,  which  may  be  loosened 
or  fastened  as  there  shall  be  occasion. 
Having  made  these  two  knots,  draw 
two  threads  under  the  artery  between 
the  two  ligatures,  and  then  open  the  ar- 
tery and  put  in  a  quill,  and  tie  the  ar- 
tery upon  the  quill  very  fast  by  those 
two  threads,  and  stop  the  quill  with  a 
stick.  After  this  make  bare  the  jugular 
vein  in  the  other  dog  about  an  inch  and 
a  half  long,  and  at  each  end  make  a  liga- 
ture with  a  running  knot,  and  in  the 
space  betwixt  the  two  running  knots 
draw  under  the  vein  two  threads  as  in 
the  other.  Then  make  an  incision  in  the 
vein,  and  put  into  it  two  quills,  one  into 
the  descendent  part  of  the  vein  to  re- 
ceive the  blood  from  the  other  dog  and 
carry  it  into  the  heart,  and  the  other 
quill  put  into  the  other  part  of  the  jugu- 
lar vein  which  comes  from  the  head  (out 
of  which  the  second  dog's  own  blood 
must  run  into  dishes). 

"These  two  quills  being  put  in  and 
tyed  fast,  stop  them  with  a  stick  till  there 
is  occasion  to  open  them. 

"All  things  being  thus  prepared,  tie 
the  dogs  on  their  sides  towards  one  an- 
other, so  perfectly  that  the  quills  may 
go  into  each  other  (for  the  dogs'  necks 
cannot  be  brought  so  near  but  that  you 
must  put  two  or  three  several  quills  more 
into  the  first  two  to  convey  the  blood 
from  one  to  another). 

"After  that  unstop  the  quill  that  goes 
down  into  the  first  dog's  jugular  vein 
and  the  other  quill  coming  out  of  the 
other  dog's  artery,  and  by  the  help  of 
two  or  three  other  quills  put  into  each 
other  according  as  there  shall  be  occasion, 
insert  them  into  one  another.  Then  slip 
the  running  knots,  and  immediately  the 
blood  runs  through  the  quills  as  through 
an   artery,   very   impetuously.   And   im- 


mediately as  the  blood  runs  into  the 
dog  unstop  the  other  quill,  coming  out 
of  the  upper  part  of  the  jugular  vein  (a 
ligature  being  first  made  about  his  neck, 
or  else  his  other  jugular  vein  being  com- 
press'd  by  one's  finger),  and  let  his  own 
blood  run  out  at  the  same  time  into 
dishes  (yet  not  constantly,  but  accord- 
ing as  you  perceive  him  able  to  bear  it, 
till  the  other  dog  begins  to  cry  and  faint 
and  fall  into  convulsions,  and  at  last  dye 
by  his  side). 

"Then  take  out  both  the  quills  out  of 
the  dog's  jugular  vein  and  tye  the  run- 
ning knot  fast  and  cut  the  vein  asunder 
(which  you  may  do  without  any  harm  to 
the  dog,  one  jugular  vein  being  sufficient 
to  convey  all  the  blood  from  the  head 
and  upper  part  by  reason  of  a  large  an- 
astomosis, whereby  both  the  jugular  veins 
meet  about  the  larynx).  This  done,  sew 
up  the  skin  and  dismiss  him  and  the  dog 
will  leap  from  the  table  and  shake  him- 
self and  run  away  as  if  nothing  ailed  him. 

"There  are  many  circumstances  neces- 
sary to  be  observed  in  the  performing  of 
this  experiment.  .  .  .  Secondly,  that 
you  constantly  observe  the  pulse  beyond 
the  quill  in  the  dog's  jugular  vein  (which 
it  acquires  from  the  impulse  of  the  ar- 
terious  blood).  For  if  that  fails,  then  'tis 
a  sign  the  quill  is  stopt  by  some  con- 
gealed blood,  so  that  you  must  draw  out 
the  arterial  quill  from  the  others,  and 
with  a  probe  open  the  passage  again  in 
both  of  them,  that  the  blood  may  have 
its  free  course  again.  For  this  must  be 
expected  when  the  dog  that  bleeds  into 
the  other  hath  lost  much  blood  his  heart 
will  beat  very  faintly,  and  then,  the  im- 
pulse of  the  blood  being  weakened,  it 
will  be  apt  to  congeal  the  sooner,  so  that 
at  the  latter  end  of  the  work  you  must 
draw  out  the  quill  often  and  clear  the 
passage.     .     .     . 

"The  most  probable  use  of  this  experi- 
ment may  be  conjectured  to  be  that  one 


196 


Annals  of  Medical  History 


animal  may  live  with  the  blood  of  an- 
other, and  consequently  that  those  ani- 
mals that  want  blood  or  have  corrupt 
blood  may  be  supplyed  from  others  with 
a  sufficient  quantity,  and  of  such  as  is 
good,  provided  the  transfusion  be  often 
repeated,  by  reason  of  the  quick  expense 
that  is  made  of  the  blood." 

Here  the  scientific  Air.  Boyle  comes  into 
the  matter  with  certain,  "Tryals  proposed 
by  Mr.  Boyle  to  Dr.  Lower  to  be  made 
by  him  for  the  improvement  of  transfusing 
blood  out  of  one  live  animal  into  another." 
(Philosophical  Transactions,  Monday,  Feb- 
ruary 11,  1667,  page  385,  Vol.  I.) 

"The  following  quaeries  and  tryals 
were  written  long  since,  and  read  about 
a  month  ago  in  the  Royal  Society,  and 
so  now  come  forth  against  the  author's 
intention,  at  the  earnest  desire  of  some 
learned  persons,  and  particularly  the 
worthy  doctor,  to  whom  they  were  ad- 
dressed, who  thinks  they  may  excite  and 
assist  others  in  a  matter  which  to  be  well 
prosecuted  will  require  many  hands.  At 
the  reading  of  these  the  author  declared 
that  of  divers  of  them  he  thought  he 
could  foresee  the  events,  but  yet  judged 
it  fit  not  to  omit  them,  because  the  im- 
portance of  the  theories  they  may  give 
light  to,  may  make  the  trials  recompense 
the  pains,  whether  the  success  favours 
the  affirmative  or  negative  of  the  ques- 
tion, by  enabling  us  to  determine  the 
one  or  the  other  upon  surer  grounds  than 
we  could  otherwise  do.  And  this  adver- 
tisement he  desires  may  be  applied  to 
those  other  papers  of  his  that  consist  of 
quaeries  or  proposed  tryals." 

The  queries  themselves  follow: 

"1.  Whether  by  this  way  of  transfus- 
ing blood  the  disposition  of  individual 
animals  of  the  same  kind  may  not  be 
much  altered  (as  whether  a  fierce  dog, 
by  being  often  quite  new  stocked  with 


the  blood  of  a  cowardly  dog  may  not 
become  more  tame,  or  vice  versa). 

"2.  Whether  immediately  upon  the  un- 
binding of  a  dog,  replenisht  with  ad- 
ventitious blood,  he  will  know  and  fawn 
upon  his  master,  and  do  the  like  custo- 
mary things  as  before;  and  whether  he 
will  do  such  things  better  or  worse  at 
some  time  after  the  operation. 

"3.  Whether  those  dogs  that  have  pe- 
culiarities will  have  them  either  abol- 
ished or  at  least  much  impaired  by  trans- 
fusion of  blood. 

"4.  Whether  acquired  habits  will  be 
destroj^ed  or  impaired  by  this  experi- 
ment. 

"5.  Whether  any  considerable  change 
is  to  be  observed  in  the  pulse,  urine,  and 
other  excrements  of  the  recipient  animal 
by  this  operation,  or  the  quantity  of  his 
insensible  transpiration. 

"6.  Whether  the  emittent  dog  being 
full  fed  at  such  a  distance  of  time  before 
the  operation  that  the  mass  of  blood  may 
be  supposed  to  abound  with  chyle,  the  re- 
cipient dog  being  before  hungry  will  lose 
his  appetite,  more  than  if  the  emittent 
dog's  blood  had  not  been  so  chylous. 

"7.  Whether  a  dog  may  be  kept  alive 
without  eating  by  the  frequent  injection 
of  the  chyle  of  another,  taken  freshly 
from  the  receptacle  into  the  veins  of  the 
recipient  dog. 

"8.  Whether  a  dog  that  is  sick  of  some 
disease  chiefly  imputable  to  the  mass  of 
blood  may  be  cured  by  exchanging  it  for 
that  of  a  sound  dog;  and  whether  a  sound 
dog  may  receive  such  diseases  from  the 
blood  of  a  sick  one  as  are  otherwise  of 
an  infecting  nature. 

"9.  What  will  be  the  operation  of  fre- 
quently stocking  (which  is  feasible 
enough)  an  old  and  feeble  dog  with  the 
blood  of  young  ones  as  to  liveliness,  dul- 
ness,  drowsiness,  squeamishness,  &c,  and 
vice  versa? 

"10.  Whether  a  small  young  dog  by 


The  Beginnings  of  Intravenous  Medication 


197 


being  often  fresh  stockt  with  the  blood  of 
a  young  dog  of  a  larger  kind  will  grow  big- 
ger than  the  ordinary  size  of  his  own  kind. 

"11.  Whether  any  medicated  liquors 
may  be  injected,  together  with  the  blood, 
into  the  recipient  dog.  And  in  case  they 
may,  whether  there  will  be  any  consider- 
able difference  found  between  the  sepa- 
rations made  on  this  occasion  and  those 
which  would  be  made,  in  case  such  medi- 
cated liquors  had  been  injected  with  some 
other  vehicle,  or  alone,  or  taken  in  at 
the  mouth. 

"12.  Whether  a  purging  medicine  be- 
ing given  to  the  emittent  dog  a  while 
before  the  operation,  the  recipient  dog 
will  be  thereby  purged,  and  how. 

"13.  Whether  the  operation  may  be 
successfully  practised  in  case  the  inject- 
ed blood  be  that  of  an  animal  of  another 
species,  as  of  a  calf  into  a  dog,  and  of 
cold  animals  as  of  a  fish,  or  frog,  or  tor- 
toise, in  the  vessels  of  a  hot  animal,  and 
vice  versa. 

"14.  Whether  the  colours  of  the  hair 
or  feathers  of  the  recipient  animal,  by 
the  frequent  repeating  of  this  operation 
will  be  changed  into  that  of  the  emittent. 

"15.  Whether  by  frequently  transfus- 
ing into  the  same  animal  of  another 
species,  something  further  and  more  tend- 
ing to  some  degree  of  a  change  of  species 
may  be  effected  at  last  in  animals  near  of 
kin  (as  spaniels  and  setting  dogs,  &c). 

"16.  Whether  the  transfusion  may  be 
practised  upon  pregnant  bitches,  at  least 
at  certain  times  of  their  gravitation,  and 
what  effect  it  will  have  upon  the  whelps.'' 

In  Paris,  Dionis  was  arrested  and  brought 
before  a  court,  accused  of  murder  of  one  of 


his  transfused  patients,  but  he  proved  him- 
self innocent,  and  the  court,  while  it  ac- 
quitted him,  prohibited  further  experi- 
ments with  human  beings  as  subjects,  ex- 
cept with  the  consent  of  the  Faculty  of  the 
University,  and  then  they  were  to  be  done 
only  by  a  registered  physician  of  that 
city. 

The  many  accidents  and  deaths  that  fol- 
lowed these  experiments  and  the  divided 
opinion  of  the  Faculties  of  the  various 
countries  of  Europe  quickly  attracted  the 
attention  of  the  different  governments  to 
the  work  being  done  by  the  experimenters, 
and  in  France,  transfusion  was  prohibited 
by  an  edict  of  the  Parisian  Parliament. 
However,  experiments  upon  dogs  or  other 
animals  were  not  frowned  upon  in  that 
country. 

Further  progress  in  the  investigation  of 
the  transfusional  surgery  was  brought  to  a 
stand-still  in  almost  all  parts  of  Europe  by 
a  special  edict  of  the  Pope  at  Rome  about 
the  year  1678. 

One  might  go  deeply  into  a  consideration 
of  the  various  conclusions  arrived  at  by 
the  wise  ones  of  that  generation  as  to  the 
value  of  this  method  of  treatment. 

There  seems  to  have  been  as  many  opin- 
ions as  there  were  investigators,  and  no 
common  opinion  among  them.  This  was 
but  natural  at  a  period  when  so  much  was 
yet  to  be  learned  as  to  the  physiology  of 
the  blood,  chyle  and  lymph, — their  circula- 
tion and  purposes. 

The  whole  proposition  fell  into  oblivion 
and  almost  a  century  and  a  half  elapsed 
before  interest  was  again  awakened  in  the 
question.  But  that  is  a  matter  beyond  the 
meaning  of  the  title  of  this  essay.  I  leave  it 
for  others  to  investigate. 


THE   LEGISLATIVE  AND  ADMINISTRATIVE  HISTORY  OF  THE 

MEDICAL  DEPARTMENT  OF  THE  UNITED  STATES  ARMY 

DURING  THE   REVOLUTIONARY   PERIOD   (1776-1786) 

By  COLONEL  WILLIAM  O.  OWEN,  U.  S.  ARMY 

CURATOR,    ARMY    MEDICAL   MUSEUM,    WASHINGTON,    D.  C. 


SO  far  as  I  have  been  able  to  acquire 
it,  the  original  method  of  caring  for 
the  sick  and  wounded  in  the  Revo- 
lutionary War,  which  is  the  begin- 
ning of  our  medical  history,  was  to  employ 
individual  medical  men  wherever  they  might 
be  found  to  take  care  of  the  sick  or  wounded 
who  happened  to  fall  in  some  particular  fight 
in  their  locality. 

Little  by  little  the  generals  in  command, 
the  Provincial  Congresses  of  the  colonies, 
and  the  Continental  Congress  of  the  Uni- 
ted Colonies  had  medical  matters  forced 
upon  their  attention  by  the  numerous  bills 
coming  in  from  doctors,  here,  there,  and 
everywhere  that  there  had  been  a  battle. 
The  Provincial  Congresses  and  the  Conti- 
nental Congress  had  a  number  of  medical 
men  in  their  memberships,  and  in  looking 
over  the  histories  of  this  date  we  find  con- 
stant references  to  them.  Among  those  who 
were  found  in  the  legislative  bodies  of  Mas- 
sachusetts was  Dr.  Benjamin  Church.  He 
was  afterwards  sent  as  a  member  to  the 
Continental  Congress  itself.  He  and  three 
other  doctors  formed  the  first  Army  Medi- 
cal Examining  Board  of  which  we  can  get 
any  history,  for  I  find  in  the  Journal  of 
the  Provincial  Congress  of  Massachusetts, 
'775»  P-  203,  that  on  May  8th,  1775,  this 
Congress 

"Ordered,  That  the  President  pro  tempore,  Doct. 
Church,  Doct.  Taylor,  Doct.  Helten  and  Doct. 
Dunsmore,  be  a  committee  to  examine  such  per- 
sons as  are,  or  may  be,  recommended  for  surgeons 
for  the  army  now  forming  in  this  colony." 

and  they, 

"Resolved,  That  the  persons  recommended  by 
the  commanding  officers  of  the  several  regiments,  be 


appointed  as  surgeons  to  their  respective  regiments 
provided  they  appear  to  be  duly  qualified  upon  ex- 
amination." 

In  Thacher's  Military?  Journal,  1 775-1 783, 
on  pages  34-35,  we  read: 

"On  the  day  appointed,  the  medical  candidates, 
sixteen  in  number,  were  summoned  before  the  board 
for  examination.  This  business  occupied  about  four 
hours;  the  subjects  were  anatomy,  physiology,  sur- 
gery and  medicine.  It  was  not  long  after,  that  I  was 
happily  relieved  from  suspense,  by  receiving  the 
sanction  and  acceptance  of  the  board,  with  some 
acceptable  instructions  relative  to  the  faithful  dis- 
charge of  duty,  and  the  humane  treatment  of  those 
soldiers  who  may  have  the  misfortune  to  require 
my  assistance.  Six  of  our  number  were  privately 
rejected  as  being  found  unqualified.  The  examina- 
tion was  in  a  considerable  degree  close  and  severe, 
which  occasioned  not  a  little  agitation  in  our  ranks. 
But  it  was  on  another  occasion,  as  I  am  told,  that  a 
candidate  under  examination  was  agitated  into  a 
state  of  perspiration  and  being  required  to  describe 
the  mode  of  treatment  in  rheumatism,  among  other 
remedies  said  that  he  would  promote  a  sweat,  and 
being  asked  how  he  would  effect  this  with  his  pa- 
tient, after  some  hesitation  he  replied,  'I  would  have 
him  examined  by  a  medical  committee.' 

Thacher  was  so  fortunate  as  to  obtain 
the  office  of  surgeon's  mate  in  the  provin- 
cial hospital  at  Cambridge,  the  senior  sur- 
geon being  Dr.  John  Warren,  brother  and 
pupil  of  the  gallant  General  Joseph  Warren, 
who  was  slain  in  the  memorable  battle  on 
Breed's  Hill. 

"This  gentleman  has  acquired  great  reputation  in 
his  profession,  and  is  distinguished  for  Ins  humanity 
and  attention  to  the  sick  and  wounded  soldiers,  and 
for  his  amiable  disposition.  Having  received  my  ap- 
pointment by  the  Provincial  Congress,  I  commenced 
my  duty  in  the  hospital,  July  15th.  Several  private, 
but  commodious  houses  in  Cambridge  are  occupied 
for  hospitals,  and  a  considerable  number  of  soldiers 


History  of  the  Army  Medical  Department  During  the  Revolution 


199 


who  were  wounded  at  Breed's  Hill,  and  a  greater 
number  of  sick  of  various  diseases,  require  all  our 
attention.  Dr.  Isaac  Foster,  late  of  Charlestown,  is 
also  appointed  a  senior  hospital  surgeon;  and  his 
student,  Mr.  Josiah  Bartlet,  officiates  as  his  mate; 
Dr.  Benjamin  Church  is  Director  General  of  the 
hospital." 

I  find  in  Thacher's  Military  Journal, 
1 775-1 783,  on  page  294,  the  following: 

"January  1st,  1781. — On  this,  the  first  day  of  the 
new  year,  an  arrangement  of  our  army  takes  place, 
according  to  the  late  resolve  of  Congress.  The  su- 
pernumerary regiments  are  to  be  incorporated  with 
those  which  continue  on  the  new  establishment  fixed 
by  Congress,  and  are  to  be  entitled  to  the  same 
privileges  and  emoluments,  which  are  to  be  allowed 
to  those  who  continue  to  the  end  of  the  war.  It 
being  optional  with  me,  either  to  retire  or  to  con- 
tinue in  service,  I  shall  retain  my  commission  as 
surgeon  to  Colonel  H.  Jackson's  regiment.  We  are 
encouraged  to  anticipate  more  favorable  circum- 
stances, and  more  liberal  compensation,  Congress 
having  at  length  passed  several  resolves,  entitling 
all  officers  who  shall  continue  in  service  till  the  end 
of  the  war,  or  shall  be  reduced  before  that  time,  as 
supernumeraries,  to  receive  half  pay  during  life,  and 
a  certain  number  of  acres  of  land,  in  proportion  to 
their  rank.  Besides  these  pecuniary  considerations, 
we  are  actuated  by  the  purest  principles  of  patriot- 
ism; having  engaged  in  the  mighty  struggle,  we  are 
ambitious  to  persevere  to  the  end.  To  be  instru- 
mental in  the  achievement  of  a  glorious  Independ- 
ence for  our  country,  and  posterity,  will  be  a  source 
of  infinite  satisfaction,  and  of  most  grateful  recol- 
lection, during  the  remainder  of  our  days.  Notwith- 
standing the  unparalleled  sufferings  and  hardships, 
which  have  hitherto  attended  our  military  career, 
scarcely  an  officer  retires  without  the  deepest  re- 
gret and  reluctance.  So  strong  is  the  attachment, 
and  so  fascinating  the  idea  of  participating  with 
our  illustrious  commander  in  military  glory,  that  a 
separation  is  like  a  relinquishment  of  principle,  and 
abandonment  of  the  great  interest  of  our  native 
country." 

The  successive  steps  in  the  legislative 
history  of  our  Army  Medical  establish- 
ment during  the  Revolution  will  be  found 
in  the  following  pages,  which  I  have  care- 
fully excerpted,  from  the  Journals  of  each 
Provincial  Congress  of  the  Colony  of  Mas- 
sachusetts Bay,  and  from  the  twenty  odd 
volumes  of  the  Journals  of  the  Continental 


Congress.  Buried  as  they  are  in  these 
lengthy  archives,  such  records  are  valueless 
for  medico-historical  purposes.  Presented 
here,  as  purely  archivistic  material,  they 
are  but  the  crude  ore  of  medical  history. 
Yet  this  record  is  undoubtedly  the  basic 
material  upon  which  future  historians  must 
rely  in  their  work,  which  is  my  reason  for 
presenting  it.  To  the  medical  officer,  these 
records  are  of  exceptional  interest;  to  the 
patriot  they  will  not  seem  dry  and  unin- 
spiring. 

Our  military  medical  history  began,  as 
we  have  seen,  in  the  Colony  of  Massachu- 
setts Bay.  In  the  Journals  of  the  Continen- 
tal Congress,  we  trace  the  prehistory  of 
our  present  Army  Medical  Corps,  from  the 
appointment  of  Dr.  Benjamin  Church  as 
Director  General  and  Chief  Physician  of 
our  first  Army  Hospital,  at  a  salary  of  four 
dollars  a  day,  to  the  final  acts  relating  to 
the  reduction  of  the  army  in  1783.  The 
subsequent  act  of  June  2,  1784,  practically 
disbanded  the  U.  S.  Army,  but  it  was  im- 
mediately followed  by  acts  of  June  3,  1784, 
April  7,  1785,  October  20,  1786,  and  October 
3,  1787,  providing  for  the  levying  of  troops 
and  officers  to  guard  our  Northwestern 
frontier  and  other  localities.  These  were, 
however,  only  militiamen.  The  U.  S.  Army 
proper  was  still  non-existent.  Following  the 
appointment  of  Major-General  Henry  Knox 
as  Secretary  of  War,  on  March  8,  1785,  an 
act  of  September  29,  1789,  authorized  the 
formation  of  a  corps  of  700  men,  rank  and 
file,  to  guard  the  western  posts.  This  force 
had  a  medical  complement  of  one  surgeon 
and  four  surgeon's  mates.  These  forces  were 
enlarged  up  to  their  disband ment  in  the 
fall  of  1 79 1,  and  on  March  5,  1792,  our 
military  forces  were  reorganized  as  a  "Le- 
gion" by  Congressional  enactment,  with 
Richard  Allison,  as  "Surgeon  to  the  Le- 
gion," or  Chief  Medical  Officer  on  the  Gen- 
eral Staff,  at  seventy  dollars  per  month, 
the  pay  of  regimental  surgeons  (surgeon's 
mates)    being    forty-five   dollars    monthly . 


200 


Annals  of  Medical  History 


Major  General  Anthony  Wayne  command- 
ed the  whole  Legion,  and  in  August,  1794, 
fought  the  decisive  battle  of  Maumee  Rap- 
ids against  the  hostile  Indians.  The  Medi- 
cal Department  was  enlarged  by  the  acts 
of  May  28,  1798,  and  March  2,  1799,  which, 
at  the  earnest  request  of  Washington,  pro- 
vided for  the  appointment  of  James  Craik 
of  Virginia  as  Physician  General  to  both 
the  Army  and  the  Navy.  Craik  served  in  this 
capacity  from  July  19,  1798,  to  June  15, 
1800,  when  he  was  mustered  out  by  dis- 
bandment  of  these  forces.  On  March  3, 
1813,  in  the  midst  of  the  War  of  181 2,  the 
office  of  Physician  and  Surgeon  General  was 
created,  and  on  June  11,  James  Tilton  of 
Delaware  was  appointed  to  this  position. 
With  Tilton's  appointment,  the  history  of 
the  Medical  Corps  of  our  Army,  as  we  now 
know  it,  begins. 

In  the  pages  immediately  following,  one 
may  find  the  legislation  relating  to  the 
treasonable  action  of  Church,  his  trial  and 
confinement,  the  appointment  of  John  Mor- 
gan as  his  successor,  the  famous  act  of  July 
17,  1776,  limiting  and  defining  the  author- 
ity of  medical  officers,  Morgan's  dismissal, 
through  his  disputes  with  Shippen  and  the 
unsoldierly  neglect  of  duty  of  Stringer,  the 
appointment  of  Shippen,  Rush,  and  others, 
Shippen's  trial  for  malfeasance  in  office,  his 
acquittal  and  the  resignation  of  Dr.  Wil- 
liam Brown,  Shippen's  resignation,  the  ap- 
pointment of  Cochran  as  Director  General, 
and  his  services  up  to  the  disbandment  of 
the  Army  in  1783.  In  the  different  plans 
considered  for  organization  and  reorgani- 
zation of  medical  service,  in  such  things  as 
the  bits  of  legislation  bearing  upon  pre- 
ventive inoculation  against  small-pox,  we 
get  a  clear  idea  of  what  Congress  was  act- 
ually doing  for  the  medical  establishment 
of  the  Continental  Army. 

The  main  source  books  for  the  early  his- 
tory of  our  Army  Medical  establishment 
have  been  James  Tilton's  "Observations  on 
Military    Hospitals"    (181 3),   the    Military 


Journal  of  James  Thacher  (1826),  James 
Mann's  "Military  Sketches  of  the  Cam- 
paigns of  181 2-14"  (1816),  and  "The  Medi- 
cal Department  of  the  United  States  Army 
from  1775  to  1873"  by  Harvey  E.  Brown 
(1873).  It  is  m  the  hope  of  stimulating  fur- 
ther interest  and  research  that  I  add  the 
subjoined  record. 

I.    FROM  THE  JOURNALS  OF   THE  PROVINCIAL 
CONGRESSES    OF   MASSACHUSETTS    BAY 
(1775) 
April  27,  1775  (A.  M.)  160 

Ordered,  That  Capt.  Kingsbury,  Doct.  Holten 
and  Deacon  Stone,  are  appointed  to  enquire,  and 
endeavor  to  get  an  exact  account  of  the  men  killed, 
and  wounded,  and  murdered,  in  the  late  scene  on 
the  19th  instant. 

May  8,  1775,     203. 

Ordered,  That  the  president  pro  tempore,  Doct. 
Taylor,  Doct.  Holten  and  Doct.  Dunsmore,  be  a 
committee  to  examine  such  persons  as  are,  or  may 
be,  recommended  for  surgeons  for  the  army  now 
forming  in  this  colony. 

Resolved,  That  the  persons  recommended  by  the 
commanding  officers  of  the  several  regiments,  be 
appointed  as  surgeons  to  their  respective  regiments, 
provided  they  appear  to  be  duly  qualified  upon  ex- 
amination. 

May  16,  1775.    232 

The  committee  reported,  that  Doct.  Benjamin 
Church  was  chosen. 

May  17,  1775-    236 

Resolved,  That  Doct.  Church  be  allowed  one  ser- 
vant to  attend  him  in  his  journey  to  Philadelphia. 

June  2,  1775.    290 

Ordered,  That  Doct.  Whiting  and  Doct.  Bailies, 
be  added  to  the  committee  which  was  appointed  by 
the  last  Congress,  to  examine  those  persons  who 
might  be  nominated  for  surgeons  of  the  Massachu- 
setts army. 

June  12,  1775.    321 

Ordered,  That  Doct.  Whiting,  Doct.  Taylor  and 
Mr.  Parks,  be  a  committee  to  consider  some  method 
of  supplying  the  several  surgeons  of  the  army  with 
medicines. 

(Afternoon) 

The  committee  appointed  to  consider  some  meth- 
od for  supplying  the  surgeons  in  the  army  with 
medicine,  reported:  the  report  was  read  and  accept- 
ed, and  is  as  follows,  viz.: 

The  committee  appointed  to  take  into  considera- 
tion a  complaint  that  the  surgeons  in  the  army  are 
not  properly  furnished  with  medicines,  have  at- 
tended that  service,  and  beg  leave  to  report:  that 
whereas,  it  appears  that  there  is  not,  as  yet,  a  suffi- 


History  of  the  Army  Medical  Department  During  the  Revolution      201 


cient  number  of  medicine  chests  provided,  to  fur- 
nish each  regiment  with  a  distinct  chest;  and  where- 
as, the  committee  of  supplies  are  making  provision 
for  the  supplying  of  each  regiment  with  such  medi- 
cine chests  as  soon  as  possible:  therefore,  Resolved, 
That  the  committee  of  supplies  be,  and  hereby  are 
directed,  immediately  to  furnish  the  surgeon  of  the 
first  regiment  at  Cambridge,  and  also  the  surgeon 
of  the  first  regiment  at  Roxbury,  each  of  them, 
with  a  medicine  chest,  for  the  present;  and  that  all 
the  other  surgeons  in  the  army  at  Cambridge  and 
Roxbury,  have  free  recourse  to  the  said  chests,  and 
be  supplied  from  them,  from  time  to  time,  as  they 
shall  find  occasion,  until  more  ample  provision  shall 
be  made  for  them:  all  which  is  humbly  submitted, 
and  the  committee  beg  leave  to  sit  again. 

William  Whiting,  per  order. 
Ordered,  That  the  same  committee  be  appointed 
to  examine  into  the  medical  stores,  and  make  a  list 
of  what  is  necessary  for  the  supplying  each  regi- 
ment, that  the  same  may  be  laid  before  the  com- 
mittee: and  that  the  same  committee  consider  what 
medicines  are  necessary,  and  bring  in  a  list  of  what 
medicines  are  in  the  medical  store:  and  that  they 
be  directed  to  report  what  instruments  are  neces- 
sary for  the  surgeons  of  the  army. 

June  16,  1775.    341 

Doct.  Hall  and  Doct.  Jones  were  added  to  the 
committee  to  examine  surgeons  for  the  army.  Re- 
solved, That  any  three  of  said  committee  shall  be  a 
quorum. 

June  19,  1775.  355,  357,  360-1 

Doct.  Hall,  Doct.  Jones  and  Mr.  Bigelow,  were 
appointed  a  committee  to  consider  the  expediency 
of  establishing  another  hospital  for  the  sick  and 
wounded  of  the  army,  and  ordered  to  sit  forthwith. 

The  committee  appointed  to  consider  the  expedi- 
ency of  establishing  another  hospital  for  the  army, 
reported,  that  a  house  belonging  to  Doct.  Spring, 
of  this  place,  may  be  had  for  that  purpose,  where- 
upon, 

Resolved,  That  said  committee  be  directed  to  in- 
quire at  what  rate,  per  month,  Doct.  Spring  will  let 
the  same. 

Doct.  Gunn  was  appointed  to  report  a  resolve  on 
the  proposal  made  by  the  committee  of  safety,  rela- 
tive to  the  killed  and  wounded  in  the  late  battle. 

Upon  a  motion  made,  Resolved,  that  the  house  of 
Mr.  Hunt,  at  Cambridge,  be  hired  for  a  hospital, 
and  that  the  committee  appointed  to  treat  with 
Doct.  Spring,  be  a  committee  to  hire  the  same. 

Ordered,  That  Doct.  Church,  Doct.  Taylor,  and 
Doct.  Whiting,  be  a  committee  to  consider  what 
method  is  proper  to  be  taken  to  supply  the  hospi- 
tals with  surgeons:  and  that  the  same  gentlemen  be 
a  committee  to  provide  medicines,  and  all  other 
necessaries  for  the  hospitals. 

The  committee  appointed  to  confer  with  Doct. 
Spring,  relative  to  the  use  of  his  house  for  another 
hospital,  reported:  the  report  was  read  and  accept- 
ed, and  is  as  follows,  viz.: 

The  committee  appointed  to  consider  of  the  ex- 
pediency of  establishing  another  hospital  for  the  sick 
and  wounded  of  the  army,  having  attended  that  ser- 


vice, beg  leave  to  report,  that  they  judge  it  is  really 
expedient  to  have  another  established,  and  they 
judge  that  the  house  of  Doct.  Spring,  in  Watertown, 
is  convenient  for  that  purpose;  and  that  he  is  will- 
ing said  house  should  be  improved  by  the  province 
for  that  use,  but  that  he  cannot  at  present  ascertain 
the  damage  it  may  be  to  him,  but  is  willing  to  sub- 
mit that  matter  to  the  judgment  of  a  committee  to 
be  hereafter  appointed  by  this  honorable  Congress 
or  the  house  of  assembly. 

June  22,  1775.  374,  375,  377 

Ordered,  That  Doct.  Francis  Kittridge  be  desired 
to  attend  the  hospital,  as  a  surgeon,  till  the  further 
order  of  Congress,  and  that  Mr.  Kendall  be  desired 
to  inform  Doct.  Kittridge  of  his  appointment. 

Ordered,  That  the  colonels  of  the  several  regi- 
ments in  the  Massachusetts  army,  be  directed  to 
recommend,  immediately,  suitable  persons  for  sur- 
geons and  surgeons'  mates. 

Ordered,  That  a  hospital  be  provided  for  the 
camp  at  Roxbury,  and  that  Col.  Davis,  Doct.  Tay- 
lor and  Doct.  Whiting,  be  a  committee  to  provide 
one  accordingly,  and  to  supply  the  same. 

Resolved,  That  (the  colonels ')  in  the  Massachu- 
setts army,  be  and  they  are  hereby  directed,  imme- 
diately to  inform  the  committee  appointed  by  Con- 
gress to  examine  the  surgeons  for  said  army,  whom 
they  recommend  for  the  surgeons  and  surgeon's 
mates  of  their  respective  regiments,  and  send  them 
to  said  committee  for  examination,  without  delay; 
except  such  as  have  been  examined. 

June  23,  1775.  378 

The  committee  appointed  to  provide  a  hospital 
for  the  camp  in  Roxbury,  reported  as  follows:  That 
they  have  appointed  the  house  belonging  to  Joshua 
Loring,  in  said  Roxbury,  for  a  hospital,  and  for  the 
use  of  said  camp.  The  report  was  accepted. 

June  24,  1775.  383,  384,  387 

Voted,  That  there  shall  be  two  surgeons  and  two 
mates  appointed  for  each  hospital,  and  commis- 
sioned accordingly. 

Ordered,  That  the  committee  appointed  to  exam- 
ine the  surgeons,  be  desired  to  report  an  establish- 
ment for  surgeons  of  hospitals. 

The  committee  appointed  to  consider  an  estab- 
lishment for  the  surgeons  of  hospitals,  reported:  the 
report  was  accepted,  and  is  as  follows,  viz.:  that  it  is 
their  opinion,  that  the  establishment  of  the  chief 
surgeons  should  be  at  the  rate  of  eight  pounds  per 
month,  and  each  mate,  four  pounds,  ten  shillings, 
per  month. 

The  committee  appointed  to  hire  a  house  of  John 
Hunt,  Esq.,  for  a  hospital,  reported  the  following 
proposal,  which  was  accepted,  viz.: 

Gentlemen: — With  respect  to  the  hire  of  the  house 
belonging  to  John  Hunt,  Esq.,  for  a  hospital,  the 
proprietor  only  expects  such  a  consideration  from 
the  colony,  as  will  be  a  satisfaction  for  the  necessary 
damage  to  the  house,  expecting  proper  care  will  be 
taken  that  the  out-houses,  &c,  be  kept  in  good 
order. 

W.  Hunt,  in  behalf  of  the  proprietor. 

1  (each  colonel). 


Annals  of  Medical  History 


June  2-%  1775.  406 

Ordered,  That  the  committee  appointed  to  pro- 
vide hospitals  for  the  army,  be  directed  to  provide 
another  hospital,  to  be  appropriated  solely  for  such 
of  the  army  as  may  be  taken  with  the  small  pox, 
and  to  consider  what  measures  can  be  taken  to  pre- 
vent the  spreading  of  that  distemper,  and  that 
Doct.  Rand,  and  Doct.  Foster,  be  added  to  the  com- 
mittee. 

June  28,  1775.  415 

The  form  of  a  warrant  for  the  surgeons  was  read 
and  accepted,  and  is  as  follows,  viz. : 

Tbe  Congress  oj  the  Massachusetts  Bay,  to  A.  B. 
Greeting. 

Being  informed  of  your  skill  in  surgery,  and  re- 
posing especial  trust  and  confidence  in  your  ability 
and  good  conduct,  we  do,  by  these  presents,  consti- 
tute and  appoint  you  the  said  A.  B.,  to  be  surgeon 

of  the  regiment  of  foot,  whereof is  colonel, 

raised  by  the  Congress  aforesaid,  for  the  defence  of 
said  colony.  You  are,  therefore,  carefully  and  dili- 
gently to  discharge  the  duty  of  a  surgeon  to  the 
said  regiment,  in  all  things  appertaining  thereunto, 
observing  such  orders  and  instructions  as  you  shall, 
from  time  to  time,  receive  from  the  colonel  of  said 
regiment,  according  to  military  rules  and  discipline 
established  by  said  Congress,  or  any  your  superior 
officers,  for  which  this  shall  be  your  sufficient  war- 
By  order  of  the  Congress, 

President. 

Dated  at  Watertown. 

June  30,  1775.  423,  4 

The  committee  appointed  to  consider  some  mea- 
sures to  prevent  the  spreading  of  the  small  pox, 
were  directed  to  sit  forthwith. 

The  form  of  a  warrant  for  surgeons  of  the  hospi- 
tal, was  read  and  accepted,  and  is  as  follows,  viz. : 

Tbe  Congress  oj  tbe  Colony  oj  tbe  Massachusetts 
Bay,  to Greeting. 

Being  informed  of  your  skill  in  surgery,  and  re- 
posing special  trust  and  confidence  in  your  ability 
and  good  conduct,  (we)  do  by  these  presents,  con- 
stitute and  appoint  you,  the  said to  be  a 

surgeon  of  the  hospital,  established  by  order  of  the 

Congress,  in  ,  for  the  sick  and  wounded  of  the 

colony  army.  You  are,  therefore,  carefully  and  dili- 
gently to  discharge  the  duty  of  a  surgeon  of  said 
hospital,  in  all  things  appertaining  thereto,  observ- 
ing such  orders  and  instructions  as  you  shall,  from 
time  to  time,  receive  from  any,  your  superior  offi- 
cers, according  to  the  rules  and  discipline  estab- 
lished by  said  Congress,  for  which,  this  shall  be 
your  sufficient  warrant. 

By  order  of  Congress, 

I  feted  the day  of A.  D.  1775. 

Ordered,  That  warrants  be  made  out  to  the  fol- 
lowing  officers,    viz.:    Doct.    Lemuel    Cushing,    sur- 
geon; Doct.  Gad  Hitchcock,  Burgeon's  mate;  .     .     . 
Doct.    Lemuel    Howard,    surgeon   to   the    Roxburv 
rtal. 

July  1,  i~,-.  436,  7 

Ordered,   I  raylor,  Mr.  Fox,  and  Capt 

Bragdon,  be  a  committee  to  bring  in  a  resolve,  di- 


recting how  the  sick  and  wounded  shall  be  removed 
to  the  hospitals. 

The  committee  appointed  to  devise  means  for  the 
better  accommodation  of  the  sick  and  wounded  of 
the  colony  army,  reported.  The  report  was  accepted, 
and  is  as  follows,  viz.:  In  order  that  all  the  sick  and 
wounded  in  the  army  may  be  provided  for,  and 
taken  care  of,  in  the  best  way  and  manner  possible, 
Resolved,  and  it  is  hereby  Ordered,  that  when  any 
person  in  the  army  is  so  ill,  either  by  a  wound  or 
otherwise,  that  the  surgeon  of  the  regiment,  to 
which  the  sick  or  wounded  person  belongs,  finds 
the  sick  or  wounded  as  abovesaid  cannot  be  prop- 
erly taken  care  of  in  the  regiment  to  which  he  be- 
longs, said  surgeon  shall  send  the  sick  or  wounded 
as  abovesaid,  to  the  hospital  provided  for  the  use  of 
the  camps  to  which  they  belong,  and  a  certificate 
of  the  man's  name,  and  the  company  and  regiment 
to  which  he  belongs;  and  in  that  case,  the  surgeon 
of  the  said  hospital  shall  receive  said  sick  or  wound- 
ed under  his  care;  and  in  case  said  hospital  shall  be- 
come too  full,  in  that  case,  the  surgeon  of  said  hos- 
pital shall  send  such  of  his  patients  as  may  with 
safety  be  removed,  to  the  hospital  in  Watertown 
and  a  certificate  setting  forth  the  man's  name,  what 
company  and  regiment  each  belongs  to;  and  in  that 
case  the  surgeons  of  the  Watertown  hospital  shall 
receive  said  sick  or  wounded  under  his  care. 

July  4,  1  ~,-.  445,  446,  448 

Ordered,  That  Mr.  Pickering,  Mr.  Partridge,  and 
Mr.  Goodwin,  be  a  committee  to  prepare  a  letter  to 
General  Washington,  informing  him  of  the  provi- 
sion this  Congress  has  made  for  the  sick  and  wound- 
ed of  the  army. 

Ordered,  That  Doct.  Taylor,  Doct.  Church,  and 
Mr.  Johnson,  be  a  committee  to  bring  in  a  resolve 
appointing  Doct.  (Andrew)  Craigie,  a  commissary 
of  medical  stores,  and  that  said  committee  be  di- 
rected to  consider  what  is  a  proper  establishment 
for  his  pay. 

The  committee  appointed  to  bring  in  a  resolve 
for  appointing  Mr.  Craigie,  medical  commissary,  re- 
ported. (The  report)  was  read,  and  is  as  follows, 
viz. : 

Resolved,  That  Mr.  Andrew  Craigie  be,  and  he  is 
hereby  appointed  a  medical  commissary  and  apothe- 
cary for  the  Massachusetts  army,  and  that  said 
Craigie  be  allowed  live  pounds  per  month,  for  his 
services  as  abovesaid. 

Ordered,  That  the  committee  for  making  out  com- 
missions make  out  a  warrant  for  Mr.  Craigie,  medi- 
cal commissary. 

July  5,  1775-  449.  45<>,  455- 

A  list  of  surgeons  who  have  been  examined  ami 
approved  of,  by  a  committee  of  this  Congress,  was 
laid  before  the  Congress,  and  read,  and  is  as  follows: 

Doct.   David  Jones,   surgeon;  Samuel   Blanchard, 
mate,   in  Col.   Gerrish's   regiment;    Aaron    Putnam, 
mate,  in  Col.  Fry's  regiment;  Joseph  Hunt,  it 
Doct.  Joseph   foster,   in  Cambridge  hospital;  Jacob 
Bacon,    matt'    in    Col.    Scammon's    regiment;    Mains 

Clary  Fridges,  mate;  Edward  Durant,  surgeon,  Col. 

Mansfield's    regiment;    Josiah    llarve\,    mate.    Col. 
fellow's  regiment;  Abraham  Watson,  Jr.  surgeon, 


History  of  the  Army  Medical  Department  During  the  Revolution      203 


William  Vinal,  mate,  Col.  Gardner's  regiment;  Doct. 
John  Georges,  mate,  General  Heath's  regiment; 
Doct.  Isaac  Spafford,  surgeon,  Col.  Nixon's  (regi- 
ment) ;*  Doct.  John  Crooker,  surgeon  in  Col.  Scam- 
mon's  regiment;  Doct.  Walter  Hastings,  surgeon  in 
Col.  Bridges'  (regiment) ;  Doct.  Timothy  Child,  sur- 
geon, in  Col.  Patterson's  (regiment) ;  Doct.  Levi 
Willard,  surgeon,  in  Col.  Reed's  (regiment);  Doct. 
Daniel  Parker,  surgeon,  in  Col.  Walker's  (regiment) ; 
and  Doct.  Thomas  Kittridge,  surgeon,  in  Col.  Fry's 
regiment. 

Thereupon,  Ordered,  That  warrants  be  made  out 
for  them  agreeably  thereto. 

Resolved,  That  the  order  of  Congress  relative  to 
the  date  of  the  warrants  for  the  staff  officers,  be  so 
far  reconsidered,  as  that  the  warrants  for  the  sur- 
geons be  dated  the  28th  June,  ultimo. 

A  form  of  a  warrant  for  a  medical  commissary, 
was  read  and  accepted,  and  is  as  follows,  viz.: 

The  Congress  0/  the  Colony  0/  the  Massachusetts 
Bay,  to Greeting. 

We,  being  informed  of  your  skill  in  medicine,  and 
reposing  especial  trust  and  confidence  in  your  abil- 
ity and  good  conduct,  do,  by  these  presents,  con- 
stitute and  appoint  you  the  said ,  to  be 

medical  commissary  and  apothecary  to  the  army 
raised  by  the  Congress,  for  the  defence  of  this  col- 
ony. You  are,  therefore,  carefully  and  diligently  to 
discharge  the  duty  of  a  medical  commissary  and 
apothecary  in  all  things  appertaining  thereto,  ob- 
serving such  orders  and  instructions  as  you  shall, 
from  time  to  time,  receive  from  any  your  superior 
officers,  according  to  the  rules  and  discipline  estab- 
lished by  said  Congress,  for  which  this  shall  be  your 
sufficient  warrant. 

By  order  of  Congress, 

,  President. 

The  committee  appointed  to  prepare  a  letter  to 
General  Washington,  enclosing  a  resolution  of  Con- 
gress relative  to  the  sick  and  wounded,  reported. 
The  report  was  accepted,  and  is  as  follows,  viz.: 
(To  bis  Excellency  General  Washington:) 

This  Congress  ordered  the  enclosed  resolution  to 
be  prepared,  and  sent  to  Generals  Ward  and  Thom- 
as; but  by  the  agreeable  event  of  your  excellency's 
appointment  to  the  chief  command  of  the  Ameri- 
can army,  and  arrival  at  camp,  the  propriety  of  that 
step  ceases.  We  mean  not  to  dictate  to  your  excel- 
lency, but  presume,  that  to  secure  the  health  of  the 
army,  and  (to  afford)  relief  for  the  sick,  will  natur- 
ally engage  your  attention.  Every  thing  in  the 
power  of  this  Congress  (to  do)  to  enable  you  to  dis- 
charge, with  ease,  the  duties  of  your  exalted  and  im- 
portant station,  will  be,  by  us,  attended  to,  with  the 
greatest  alacrity.  If  the  enclosed  resolution  has  that 
tendency,  we  attain  the  end  intended  by  transmit- 
ting to  you  the  same,  and  are,  with  respect, 

Your  Excellency's  most  humble  servants. 

July  7,  1775.  464 

Ordered,  That  a  warrant  be  made  out  for  Doct. 
Isaac  Foster,  as  surgeon  of  the  hospital  at  Cam- 

*  Material  in  parentheses  was  placed  in  brackets  in  the 
original  mss. 


bridge,  and  another  to  Doct.   Isaac  Rand,  as  sur- 
geon of  the  hospital  at  Roxbury. 

July  8,  1775.  470,  472,  476 

A  list  of  surgeons  examined  by  a  committee  ap- 
pointed for  that  purpose,  was  exhibited  to  Con- 
gress, and  warrants  ordered  to  be  made  out  agree- 
ably thereto. 

Resolved,  That  three  o'clock,  in  the  afternoon,  be 
assigned,  to  consider  the  expediency  of  appointing 
a  surgeon  general  for  the  Massachusetts  forces. 

Resolved,  That  eight  o'clock  to-morrow  morning 
be  assigned  for  the  consideration  of  the  expediency 
of  appointing  a  surgeon  general  of  the  Massachu- 
setts army. 

July  11,  1775.  488,  489 

Ordered,  That  Mr.  Crane,  and  Mr.  Fox,  make  out 
warrants  for  several  surgeons  and  surgeons'  mates, 
agreeably  to  a  list  this  day  exhibited  by  Doct.  Tay- 
lor, and  that  such  warrants,  when  made  out,  be 
transmitted  to  the  committee  of  safety. 

Resolved,  That  Doct.  Church,  Doct.  Taylor,  and 
Doct.  Whiting,  be  a  committee  to  take  into  their 
custody  all  the  medicines,  medical  stores  and  in- 
struments, which  are,  or  may  be  provided  for  the 
use  of  the  army,  by  this  colony,  and  to  distribute 
them  at  their  best  discretion,  so  that  no  peculation 
or  needless  waste  be  made  of  the  medicinal  stores 
belonging  to  the  public. 

December  20,  1774.  506 

Voted,  unanimously,  that  Doct.  Warren,  Doct. 
Church,  and  the  Hon.  John  Hancock,  Esq.,  be  a 
committee  to  inspect  the  commissaries'  stores,  in 
Boston,  and  report  what  surgeon's  stores  and  stores 
of  other  kind  are  there. 

February  21,  1775.  509 

Voted,  That  Docts.  Warren  and  Church  be  a  com- 
mittee to  bring  in  an  inventory  of  what  is  necessary 
in  the  way  of  their  profession,  for  the  above  army 
to  take  the  field. 

February  24,  1775.  512 

Voted,  That  Doct.  Warren,  Doct.  Church,  Mr. 
Gerry,  Mr.  Cheever,  Col.  Orne  and  Mr.  Devens, 
make  inquiry  where  fifteen  doctor's  chests  can  be 
got,  and  on  what  terms,  and  report  at  the  next 
meeting. 

March  7,  1775.  512 

Voted,  That  the  committee  of  supplies  be  direct- 
ed to  make  a  draft  on  Henry  Gardner,  Esq.,  the  re- 
ceiver general,  in  favor  of  Doct.  Joseph  Warren  and 
Doct.  Benjamin  Church,  for  five  hundred  pounds, 
lawful  money,  to  enable  them  to  purchase  such  ar- 
ticles for  the  provincial  chests  of  medicine  as  can- 
not be  got  on  credit,  to  be  deducted  from  the  pro- 
vincial tax  payable  by  the  town  of  Boston. 

April  18,  1775.  517 

Voted,  That  two  medicinal  chests  still  remain  at 
Concord,  at  two  different  parts  of  the  town;  three 
of  said  chests  at  Sudbury,  in  different  parts  of  the 
town;  six  do.  at  Groton,  Mendon,  and  Stow,  two  in 
each  town,  and  in  different  places;  two  ditto  in 


204 


Annals  of  Medical  History 


Worcester,  one  in  each  part  of  the  town;  and,  two 
in  Lancaster,  ditto;  that  sixteen  hundred  yards  of 
Russia  linen  be  deposited  in  seven  parts,  with  the 
doctor's  chests;  that  the  eleven  hundred  tents  be 
deposited  in  equal  parts  in  Worcester,  Lancaster, 
Groton,  Stow,  Mendon,  Leicester,  and  Sudbury. 

April  21,  1775.  521 

Voted,  That  Major  Bigelow  be  applied  to,  to  fur- 
nish a  man  and  horse  to  attend  the  surgeons,  and 
convey  medicines  agreeably  to  their  directions. 

April  29,  1775.  527 

Voted,  That  Doct.  Isaac  Foster  be  directed  and 
empowered  to  remove  all  the  sick  and  wounded, 
whose  circumstances  will  admit  of  it,  into  the  hos- 
pital, and  to  supply  proper  beds  and  bedding,  cloth- 
ing, victuals,  and  furniture,  with  every  other  article 
he  shall  judge  proper  for  said  hospital,  and  that  this 
be  a  sufficient  order  for  him  to  draw  on  the  com- 
missary for  such  articles  as  he  can  supply,  and  to 
draw  orders  upon  the  commissary  for  the  payment 
of  whatever  expenses  are  necessary  for  procuring 
the  above  mentioned  articles. 

April  30,  1775.  530 

Voted,  That  Andrew  Craigie  be  appointed  to  take 
care  of  the  medical  stores,  and  to  deliver  them  out 
as  ordered  by  this  committee;  and  that  the  secre- 
tary make  out  his  commission  accordingly. 

May  7,  1775-  538 

Whereas,  it  appears  to  this  committee,  that  great 
uneasiness  may  arise  in  the  army,  by  the  appoint- 
ment of  surgeons  who  may  not  be  agreeable  to  the 
officers  and  soldiers  in  their  respective  regiments, 
therefore,  Voted,  that  it  be  recommended  to  the 
Congress,  to  allow  the  colonel  of  each  regiment  to 
nominate  the  surgeon  for  his  regiment;  said  surgeon 
to  nominate  his  mate;  and  unless  there  is  some  ma- 
terial objection  made  against  them,  that  they  be  ac- 
cordingly appointed. 

May  13,  I775-  544 

Voted,  That  General  Thomas  be  desired  to  deliver 
out  medicines  to  such  persons  as  he  shall  think 
proper,  for  the  use  of  the  sick  soldiers  at  Roxbury, 
until  the  surgeons  for  the  respective  regiments  are 
regularly  appointed. 

Voted,  That  the  provisions  and  chest  of  medicines 
belonging  to  Madam  Vassal,  now  under  the  care  of 
Col.  Starks,  be  stored  as  Col.  Starks  may  direct,  till 
further  orders:  and  that  the  other  packages  may 
pass  into  Boston  or  elsewhere. 

May  14,  1775.  545 

Mr.  Andrew  Craigie,  commissary  of  the  medicinal 
,  &c,  was  directed  and  empowered  to  impress 
beds,  bedding,  and  other  necessaries  for  the  sick,  as 
they  may  be  wanting,  giving  the  owners  a  receipt 
for  such  articles  as  he  may  take  for  the  purpose 
aforesaid. 

June  13,  1775.  566 

The  committer  earnestly  recommend  to  the  hon- 
or.il.lt:  Congress  that  the  representations  from  the 
quarter   master  general,   be  taken   into  immediate 


consideration,  especially  as  the  committee,  from 
their  own  knowledge,  find  the  rooms  too  much 
crowded,  and  the  healths  and  lives  of  the  soldiers 
thereby  greatly  exposed;  and  if  tents  cannot  be  im- 
mediately furnished,  that  some  barracks  be  forth- 
with erected.2 

June  14,  1775.  566 

Whereas,  this  committee  are  informed,  that  Doct. 
How,  of  Andover,  is  prepared  to  receive  (insane  pa- 
tients,) and  is  well  skilled  in  such  disorders  as  Dan- 
iel Adams,  of  Boston,  sent  on  the  13th  instant,  to 
the  town  of  Woburn,  is  affected  with,  therefore,  Re- 
solved,  that  the  selectmen  of  the  town  of  Woburn, 
be,  and  they  hereby  are  released  from  keeping  said 
Daniel  Adams  in  the  town  of  Woburn,  and  they  are 
required  to  provide  a  horse  and  carriage,  with  pro- 
visions, to  forward  the  said  Adams  to  Andover,  the 
expense  of  which  will  be  paid  by  this  colony. 

Resolved,  That  Daniel  Adams,  a  lunatic,  now  at 
\\  oburn,  be  carried  to  the  town  of  Andover,  and 
committed  to  the  care  of  Doct.  How,  and  the  said 
Doct.  How  is  hereby  desired  to  take  proper  care  of 
the  said  lunatic,  at  the  expense  of  this  colony. 

June  19,  1775.  571 

Resolved,  That  the  house  of  the  Rev.  Samuel 
Cook,  of  Menotomy,  be  improved  as  a  hospital  for 
the  colony  army;  and  that  Mr.  William  Eustis  be, 
and  hereby  is  appointed,  to  the  care  of  the  sick  and 
wounded  in  said  hospital,  till  the  further  order  of 
this  committee. 

Ordered,  That  Doct.  Isaac  Foster  be,  and  he  here- 
by is  directed,  to  take  up  and  improve  as  hospitals, 
so  many  houses  in  Menotomy,  as  he  may  find  nec- 
essary for  the  safety  of  the  sick  and  wounded  of 
the  colony  army,  and  that  he  employ  such  person 
or  persons  as  may  be  necessary  to  carry  such  pro- 
visions and  other  necessaries  as  may  be  wanted  for 
the  use  of  the  aforesaid  sick  and  wounded;  and  fur- 
ther, that  he  take  such  precautions,  respecting  the 
small  pox  hospital,  as  may  be  necessary  for  the  pre- 
vention of  the  spreading  of  that  epidemical  disorder 
in  the  camp  or  elsewhere. 

June  26,  1775.  578 

Whereas,  this  committee  find  the  public  hospital 
in  this  town  has  been  much  neglected,  to  the  great 
injury  of  the  patients  in  said  hospital,  occasioned 
by  the  want  of  some  suitable  person  being  placed 
there  as  surgeon,  therefore,  Resolved,  that  Doct. 
John  Warren,  be,  and  he  hereby  is  appointed,  to  tin- 
oversight  of  said  hospital,  and  that  tie  take  proper 
care  such  provision  be  made  as  may  lx'  nee. 
for  the  comfortable  support  of  the  patients  in  said 
hospital  until  further  orders. 

July  15,  1775.  597 

Complaint  having  been  made  to  this  committee 
by  the  honorable  General  Ward,  and  other  officers 
in  the  army,  that  several  men  are  dangerously  sick, 
and  their  lives  would  be  greatly  hazarded,  except 

1  Tho  nuartenmwtiT  Kcnonil  rcpriscnti-d,  that  tlu-ro  wan  (treat 
want  <.f  tanti  and  banaoks,  and  thai  the.  leas)  delay  in  maldnj 

provision  for  tl("  ihaltat  of  flic  troops,  woiilil  l»'  attended  with 
injurious  consequences. 


History  of  the  Army  Medical  Department  During  the  Revolution      205 


immediate  application  of  medicine  be  made  to  them, 
and  that  the  surgeons  of  some  of  the  regiments  had 
applied,  but  could  not  obtain  any;  a  sub-committee 
was  therefore  chosen  to  visit  the  hospital,  and  to 
see  the  surgeons,  and,  upon  inquiry,  found  that 
there  were  no  such  medicines  as  are  immediately 
wanted:  therefore,  Resolved,  that  as  the  lives  of  some 
part  of  the  army  are  in  great  danger,  for  want  of 
medicines,  notwithstanding  the  commission  of  the 
committee  of  safety  does  not  admit  of  direction  in 
this  matter,  that  Mr.  Commissary  Craigie  be  de- 
sired to  procure,  at  the  expense  of  the  colony,  such 
medicines  as  may  be  immediately  and  absolutely 
necessary;  in  consequence  of  which,  the  following 
order  was  given  Mr.  Commissary  Craigie: 

Sir: — You  are  hereby  desired  immediately  to  sup- 
ply the  store  under  your  care,  with  such  medicines 
as  are  absolutely  necessary  for  the  present  relief  of 
the  sick  in  the  army.3 

Report  of  the  Committee  sent  to  Ticonderoga, 

Cambridge,  July  6,  1775. 

Your  committee,  being  of  opinion,  that  a  major 
should  be  appointed  under  Col.  Easton,  and  one 
surgeon  to  the  battalion,  and  having  inquired  into 
the  disposition  of  the  officers  and  men  who  have 
engaged,  have  appointed  John  Brown,  Esq.,  as  ma- 
jor, and  Mr.  Jonas  Fay,  as  surgeon. 


All  which  is  humbly  submitted, 
WALTER  SPOONER,  by  order. 

II.    FROM    JOURNALS    OF    THE    CONTINENTAL 
CONGRESS    (1774-83) 

June  2,  1775.  76 

The  President  laid  before  the  Congress  a  letter 
from  the  Provincial  Convention  of  Massachusetts 
which  was  read  and  was  as  follows: 

In  prov.  Congress,  Watertown,  May  16,  1775. 

Resolved,  That  Docf.  Benjamin  Church  be  ordered 
to  go  immediately  to  Philad".  and  deliver  to  the  presi- 
dent of  the  Hon*"».  American  Congress  there  now  sit- 
ting, the  following  application  to  be  by  him  com- 
municated to  the  members  thereof:  and  the  s? 
Church  is  also  directed  to  confer  with  the  s*  Con- 
gress, respecting  such  other  matters  as  may  be 
necessary  to  the  defence  of  this  colony  and  particu- 
larly the  state  of  the  army  therein.     .     .     . 

July  19,  1775.  19I 

Resolved,  That  a  Committee  of  three  be  appointed 
to  report  the  method  of  establishing  an  hospital. 

The  committee  chosen,  Mr.  (Francis)  Lewis,  Mr. 
(Robert  Treat)  Paine,  and  Mr.  (Henry)  Middleton. 

July  24,  1775.  203 

The  Committee  for  that  purpose  app(oin)t*  bro't 
in  a  report  for  establishing  a  hospital.  Ordered  to 
lie  on  the  table. 

July  25,  1775.  203. 
Report  read: 

3  Although  the  sessions  of  the  committee  continued  after  the 
fifteenth  day  of  July,  1775,  the  journal  is  not  preserved  to  a  later 
date. 


July  27,  1775.  209-211 

The  Congress  took  into  consideration  the  report 
of  the  committee  on  establishing  an  hospital,  and 
the  same  being  debated,  was  agreed  to  as  follows: 

That  for  the  establishment  of  an  hospital  for  an 
army,  consisting  of  20,000  men,  the  following  offi- 
cers and  other  attendants  be  appointed,  with  the 
following  allowance  or  pay,  viz. : 

One  Director  general  and  chief  physician,  his  pay 
per  day,  4  dollars.4 

Four  surgeons,  per  diem  each,  one  and  one  third 
of  a  dollar. 

One  apothecary,  one  and  one  third  of  a  dollar. 

Twenty  (surgeons')  mates,  each,  two  thirds  of  a 
dollar. 

One  clerk,  two  thirds  of  a  dollar. 

Two  storekeepers,  each  four  dollars  per  month. 

One  nurse  to  every  10  sick,  one  fifteenth  of  a  dol- 
lar per  day,  or  2  dollars  per  month. 

Labourers  occasionally. 

The  duty  of  the  above  officers:  viz.: 

Director  to  furnish  medicines,  Bedding  and  all 
other  necessaries,  to  pay  for  the  same,  superintend 
the  whole,  and  make  his  report  to,  and  receive  or- 
ders from  the  commander  in  chief. 

Surgeons,  apothecary  and  mates.  To  visit  and  at- 
tend the  sick,  and  the  mates  to  obey  apothecary  and 
the  orders  of  the  physicians,  surgeons  and  apothecary. 

Matron:  To  superintend  the  nurses,  bedding,  &c. 

Nurses:  To  attend  the  sick,  and  obey  the  ma- 
tron's orders. 

Clerk:  To  keep  accounts  for  the  director  and  store 
keepers. 

Storekeeper:  To  receive  and  deliver  the  bedding 
and  other  necessaries  by  order  of  the  director.    .  .    . 

The  Congress  then  proceeded  to  the  choice  of 
officers  for  the  Hospital,  when, 

Benjamin  Church  was  unanimously  elected  as  di- 
rector of,  and  chief  physician  in,  the  hospital. 

Resolved,  That  the  appointment  of  the  four  sur- 
geons and  the  Apothecary  be  left  to  Docf.  Church. 

That  the  Mates  be  appointed  by  the  Surgeons; 

That  the  number  do  not  exceed  twenty;  and 

That  the  number  be  not  kept  in  constant  pay,  unless 
the  sick  and  wounded  should  be  so  numerous  as  to 
require  the  attendance  0/  twenty,  and  to  be  diminished 
as  circumstances  will  admit;  jor  w^  purpose,  the 
pay  is  fixed  by  the  day,  that  they  may  only  receive  pay 
jor  actual  service. 

That  one  Clerk,  two  storekeepers,  and  one  nurse 
to  every  10  sick,  be  appointed  by  the  Director. 

September  14,  1775.  249 

5th,  sundry  letters  from  General  Schuyler,5 

The  same  being  taken  into  consideration, 

On  motion  made,  Resolved,  That  Samuel  Stringer, 
Esq'  be  appointed  director  of  the  Hospital,  and 
chief  Physician  and  surgeon  for  the  Army  in  the 
Northern  department. 

That  the  pay  of  the  sd  Samuel  Stringer,  as  Director, 
Physician,  and  Surgeon,  be  four  Dollars  per  day. 

4  The  original  plan  provided  for  a  Director  General  and  a  Phy- 
sician, each  to  receive  four  dollars  a  day. 

6  Letters  dated  July  26,  27,  28,  and  August  6,  read  in  Congress 
on  this  day,  are  in  Papers  of  the  Continental  Congress,  No.  153, 
folios  63,  71,  77,  102. 


206 


Annds  of  Medical  History 


That  he  be  authorized  and  have  power  to  appoint 
a  number  of  surgeon  mates  under  him,  not  exceed- 
ing four. 

That  the  pay  of  said  mates  be  2,  3  of  a  dollar  per 
day. 

*[Tbat  tbe  number  be  not  kept  in  constant  pay, 
unless  the  sick  and  wounded  be  so  numerous  as  to 
require  tbe  constant  attendance  0/  jour,  and  to  be 
diminished  as  circumstances  uill  admit,  jor  ubicb 
reason  tbe  pay  is  fixed  6y  tbe  day,  that  tbey  may  only 
receive  pay  Jor  actual  service.] 

That  the  deputy  Commissary  general  be  directed 
to  pay  Doctr.  Stringer  for  the  Medicines  he  has  pur- 
chased for  the  use  of  the  army,  and  that  he  purchase 
and  forward  such  other  medicines  as  General  P. 
Schuyler  shall,  by  his  warrant,  direct,  for  the  use  of 
said  army. 

That  M*  (Eliphalet)  Dyer,  Mr  (.Thomas)  Lynch, 
Mr  (John)  Jay,  Mr  (John)  Adams,  and  M?  (Fran- 
cis) Lewis,  be  a  Committee  to  devise  ways  and 
means  for  supplying  the  continental  army  with 
Medicines. 

September  23,  1775.  261 

On  motion  Ordered,  That  the  Committee  appoint- 
ed to  devise  ways  and  means  of  supplying  the  Army 
with  Medicines,  do  buy  a  parcel  of  Drugs  in  the 
hands  of  Mr.  Rapalje,  which  he  offers  at  the  prime 
cost. 

October  14,  1775.  294-295 

On  motion  made, 

Resolved,  That  a  director  general  and  chief  physi- 
cian of  the  Hospital  in  Massachusetts  bay,  be  ap- 
pointed in  the  room  of  Doct'  (Benjamin)  Church, 
who  is  taken  into  custody  for  holding  a  correspond- 
ence with  the  enemy. 

Resolved,  That  the  Congress  will,  on  Monday  next, 
proceed  to  the  election  of  a  director  general  and 
chief  physician  of  the  Hospital,  in  the  room  of  Doctr 
Church. 

October  17,  1775.  297 

The  Congress  proceeded  to  the  election  of  director 
general  and  chief  physician  of  the  Hospital,  in  the 
room  of  Doct^  (Benjamin)  Church,  and  the  ballots 
being  taken  and  exam'd, 

Doctf  (John)  Morgan,  (of  Philadelphia,)  was  elect- 
ed. 

November  7,  1775.  334 

Resolved,  That  Dr.  Church  be  close  confined  in 
some  secure  gaol  in  the  colony  of  Connecticut,  with- 
out the  use  of  pen,  ink,  and  paper,  and  that  no  per- 
son be  allowed  to  converse  with  him,  except  in  the 
presence  and  hearing  of  I  Magistrate  of  the  town, 
or  the  sheriff  of  the  county  where  he  shall  be  con- 
fined, and  in  the  English  language,  until  farther 
orders  from  this  or  a  future  Congress. 

November  10,  i~75-  344 

lived.  That  the  medicines  purchased  in  this 
11  the  army  at  Cambridge,  be  sent  thither  by 
land. 

*  M  ilorial  placed  in  brackets  is  crossed  out  in  original  mss. 


December  8,  1775.  416 

On  motion,  Resolved,  That  a  surgeon  be  allowed 
to  each  regiment,  (in  the  service  of  the  United 
Colonies;) 

That  the  pay  of  a  regimental  Surgeon  be  25  Dol- 
lars per  (calendar)  month. 

\\  illiam  Barnet,  jun.  was  unanimously  elected 
surgeon  of  the  first  or  eastern  battalion  raised  in  New 
Jersey. 

December  21,  1775.  442 

Doctor  James  Holmes  was  chosen  surgeon  to 
Colonel  Maxwell's  regiment. 

January  8,  1776.  38 

Resolved,  That  the  provisions  heretofore  made  for 
an  hospital  in  the  northern  army,  when  it  was  more 
numerous  than  it  is  now,  is  sufficient. 

January  17,  1776.  61 

A  Petition  from  Benjamin  Church  was  presented 
to  Congress,  and  read : 6 

Ordered,  That  the  same  be  referred  to  a  commit- 
tee of  three. 

January  18,  1776.  65 

The  committee  on  the  petition  of  Dr.  Church, 
brought  in  their  report,  which  being  taken  into  con- 
sideration, 

Resolved,  That  Governor  Trumbull  be  desired  to 
give  order  for  the  removal  of  Dr.  Church  to  some 
more  comfortable  place  of  confinement  than  that 
where  he  now  is,  if  such  can  be  found  in  that  colony; 
and  that,  for  the  advancement  of  his  health,  the 
said  Dr.  Church  be  permitted  to  ride  out,  at  proper 
seasons,  under  a  trusty  guard,  who  will  be  careful 
to  prevent  his  earning  on  any  correspondence,  or 
doing  any  act  prejudicial  to  the  safety  and  welfare 
of  the  United  Colonies. 

A  letter  from  the  committee  of  Frederic  town, 
(Maryland,)  enclosing  sundry  intercepted  letters  of 
Connolly,  taken  on  Dr.  John  Smith,  (one  of  Con- 
nolly's associates,)  and  brought  by  the  guard  who 
had  the  charge  of  bringing  down  said  Smith,  was 
laid  before  Congress  and  read: 

Resolved,  That  it  be  recommended  to  the  commit- 
tee of  safety  of  Pennsylvania,  to  take  the  examina- 
tion of  Dr.  Smith,  and  then  commit  him  to  safe 
and  close  confinement. 

January  25,  1776.  87-8 

A  letter  from  Richard  Huddleston,    .     .    .     .' 

The  same  Committee  on  considering  Dr.  Ilud- 
dlestone's  Letter,  are'  of  Opinion, 

That  he  be  immediately  set  at  Liberty  on  the 
Terms  he  mentions.  And  that  a  verbal  Proposition 
be  sent  by  him  to  General  Carleton,  to  enter  into  a 
Stipulation  on  both  sides,  not  only  to  release  all 
Physicians  and  Surgeons;  but  that  if  In  the  For- 
tune of  War,  the1  Hospital  of  either  Army  should 
fall  into  the  Power  of  the  other,  the  same'  Sulisist- 
encc  and  Supplies  should  be  afforded  to  the  Sick 

•This  petition  Is  in  ill"  Paper!  of  the  Continental  Congreti,  No. 
41,  II.  Mi"  •'.. 

'The  Urtter  of  Mill. II. si, ,n  is  in  tlii-  /'<i;wr«  of  the  Continental 
Congre*:  N"    7s,  XI,  folk)  13. 


History  of  the  Army  Medical  Department  During  the  Revolution      207 


and  Wounded  as  if  Friends;  and  that  neither  they 
nor  the  Attendants  of  the  Hospitals  should  be  con- 
sidered or  detain'd  as  Prisoners.  And  it  is  farther 
the  Opinion  of  the  Committee,  that  if  Govr.  Carle- 
ton  should  not  agree  to  the  mutual  Release  of  Sur- 
geons, Dr.  Huddlestone  is  to  be  on  his  Parole,  to  re- 
turn immediately  hither.8 

January  30,  1776.  10 1 

Resolved,  That  Dr.  Cadwalader  and  Dr.  W.  Ship- 
pen,  JunT  be  desired  to  inspect  the  room  of  the  gaol 
where  General  Prescot  is  confined,  and  enquire  into 
the  state  of  his  health,  and  report  to  Congress. 

January  31,  1776.  105 

Dr.  Cadwalader  and  Dr.  Shippen  returned  their 
report  respecting  the  room  where  General  Prescot 
is  confined,  and  the  state  of  the  general's  health, 
which  was  read. 

March  1,  1776.  180 

Resolved,  That  the  Secret  Committee  be  empow- 
ered to  treat  with  the  owners  of  some  medicines 
lately  imported,  and  purchase  the  same  on  the  most 
reasonable  terms  for  the  use  of  the  continent. 

March  7,  1776.  188 

Resolved,  That  the  Committee  appointed  to  pro- 
vide medicine  chests  be  directed  to  supply  the  first 
and  third  New  Jersey  batallions  with  proper  medi- 
cine chests  and  instruments. 

March  11,  1776.  197 

Resolved,  That  the  committee  on  applications  and 
qualifications  &c.  be  directed  to  provide  6  medicine 
chests  for  the  6  Virginia  batallions. 

March  22,  1776.  225 

A  petition  from  Thorowgood  Smith,  and  others, 
was  presented  to  Congress,  and  read,  setting  forth, 
that  they  have  procured  a  vessel,  and  raised  money 
to  fit  her  out  as  a  privateer,  in  order  to  guard  and 
cruise  on  the  coast  of  Virginia,  and  praying  that  a 
commission  be  granted  to  William  Shippen,  to 
whom  they  propose  to  give  the  command  of  said 
vessel;  and  that  the  Congress  will  grant  them  a 
small  quantity  of  powder,  upon  their  making  satis- 
faction for  the  same: 

Resolved,  That  a  commission  be  granted  to  Wil- 
liam Shippen,  as  captain  of  the  above  mentioned 
vessel,  for  the  purposes  aforesaid. 

Resolved,  That  Captain  William  Shippen  be  sup- 
plied with  three  hundred  weight  of  powder  by  the 
Secret  Committee,  he  paying  for  the  same. 

8  This  report,  in  the  writing  of  Benjamin  Franklin,  i3  in  the 
Papers  of  the  Continental  Congress,  No.  19,  III,  folio  215.  The  fol- 
lowing notes  in  the  writing  of  Franklin  are  in  No.  78,  XIX,  folio  7. 

"Agreed  to  set  Dr.  Huddlestone  at  Liberty  on  the  Terms  he 
mentions.  And  send  by  him  a  Proposition  to  Gen.  Carleton,  that 
it  be  Stipulated  on  both  Sides,  not  only  to  release  all  Surgeons; 
but  that  if  by  the  Fortune  of  War,  the  Hospital  of  either  Army 
should  fall  into  the  Power  of  the  other,  the  same  Care  should  be 
taken  of  the  Sick  and  Wounded  as  of  Friends,  and  that  neither 
they  nor  the  Attendants  of  the  Hospital  should  be  considered  as 
Prisoners.  And  if  Gov'  Carleton  should  not  agree  to  the  mutual 
release  of  Surgeons,  Dr.  Huddleston  is  to  be  on  his  Parole  to 
return  immediately.     .     . 


March  23,  1776.  229 

The  Committee  of  Claims  reported  that  there  is 
due, 

To  Dr.  Jonathan  Potts,  for  attendance  on  the 
second  and  fourth  Pennsylvania  batallions,  the  sum 
of  125.6.9=67.6  dollars. 

March  30,  1776.  242-3 

Resolved,  That  each  regimental  surgeon  be  allow- 
ed a  mate: 

Resolved,  That  the  pay  of  a  surgeon's  mate  be  18 
dollars  per  month. 

Resolved,  That  (suitable  chirurgical)  instruments 
be  purchased  with  each  medicine  chest. 

April  1 1,  1776.  271 

To  Dr.  Jonathan  Potts,  for  attending  the  prison- 
ers at  Reading,  the  sum  of  £28.15.0  (=76.6  dollars); 
and  for  sundry  medicines,  &c.  provided  for  the  mid- 
dle department,  the  sum  of  £50.9.1  (=134.6  dollars,) 
amounting,  together,  to  the  sum  of  £79.4.1=211.2 
dollars. 

April  29,  1776.  317 

A  letter  from  Thomas  Bullit  and  a  petition  from 
Dr.  J.  Potts,  was  presented  to  Congress  and  read.9 

Resolved,  That  they  be  referred  to  the  foregoing 
committee. 

May  6,  1776.  330 

Resolved,  that  the  convention,  or  committee  or 
council  of  safety  of  Virginia,  be  empowered  to  ap- 
point surgeons  to  the  batallions  raised  in  said  col- 
ony, for  the  service  of  the  continent. 

May  10,  1776.  344 

G.  6.  That  Dr.  Potts  be  taken  into  the  Pay  of  the 
Continent  and  be  employed  in  the  Canada  Depart- 
ment or  at  Lake  George  as  the  GenI  Schuyler  shall 
think  fit.  But  that  this  Recommendation  be  not 
considered  so  as  to  supersede  Dr.  Stringer.  That  the 
Pay  of  Dr.  Potts  be  Dollars  per  Mo. 

May  1 1 ,  1 776.  348 

Resolved,  That  two  sets  of  trepanning  instruments 
be  sent  to  Virginia  for  the  use  of  the  surgeons  of  the 
continental  troops  there;  and  that  two  sets  of  tre- 
panning instruments,  and  100  lb.  of  Peruvian  bark, 
be  sent  to  North  Carolina,  for  the  use  of  the  conti- 
nental troops  in  that  colony. 

May  13,  1776.  350 

Sundry  petitions  were  presented  to  Congress  and 
read,  viz.:  One  from  Benjamin  Church,  accompanied 
with  one  from  Benjamin  Church,  Samuel  Church 
and  Edward  Church,  and  a  certificate  from  three 
Doctors  (respecting  the  health  of  Dr.  B.  Church;) 
one  from  John  Connolly  and  John  Smith,  accom- 
panied with  a  letter  from  Dr.  (Thomas)  Cadwala- 
der:10 

' .  .  .  The  petition  of  Dr.  Potts  is  in  the  Papers  of  the  Con- 
tinental Congress,  No.  78,  XVIII,  folio  56.     .     .     . 

10  The  petition  of  Connoly  is  in  the  Papers  of  the  Continental 
Congress,  No.  78,  V,  folio  39.  That  of  Smyth  is  in  No.  78,  XX, 
folio  29.  That  of  Cadwalader  is  in  No.  78,  V,  folio  43. 


208 


Annals  of  Medical  History 


May  14,  1776.  352 

The  committee  to  whom  the  petition  of  Dr.  Ben- 
jamin Church,  now  confined  in  gaol  in  Norwich,  in 
the  colony  of  Connecticut,  and  also  a  petition  from 
Benjamin,  Samuel,  and  Edward  Church,  together 
with  a  certificate  from  physicians,  respecting  the 
dangerous  state  of  the  aforesaid  Dr.  Church,  were 
referred,  brought  in  their  report,  which  was  read 
and  agreed  to:  \\  hereupon, 

Resolved,  That  Dr.  Benjamin  Church  be  sent  to 
the  colony  of  Massachusetts  bay,  and  that  the  coun- 
cil of  the  said  colony  be  requested  to  take  a  recog- 
nisance from  him,  with  two  good  sureties,  in  such 
penalty  as  they  shall  think  sufficient,  not  being  less 
than  one  thousand  pounds,  lawful  money,  for  his 
appearance  before  such  court  as  shall  be  erected  for 
his  trial,  and  at  such  time  and  place  as  such  court 
shall  direct,  and  to  abide  the  judgment  of  the  same; 
and  that  they  be  farther  requested,  to  take  his 
parole,  not  to  hold  any  correspondence  with  the 
enemies  of  the  United  Colonies,  or  at  any  time,  to 
depart  out  of  the  same  colony,  without  their  license; 
and  that,  upon  the  performance  thereof,  the  said 
Dr.  Benjamin  Church  be  set  at  liberty. 

May  16,  1776.  358 

A  letter  from  General  Washington,  of  May  (15), 
enclosing  a  letter  (to  him)  from  Dr.  Stringer.11 

Resolved,  That  the  letter  from  Dr.  Stringer  to 
General  Washington,  be  referred  to  the  committee 
appointed  to  prepare  medicine  chests: 

May  18,  1776.  284 

That  a  continental  Hospital  be  established  in  Vir- 
ginia, and  a  director  to  the  same  be  immediately 
appointed  by  Congress. 

May  22,  1776.  378 

15.  That Surgeons  and mates  be  added 

to  the  Hospital  in  Canada  and  that  DoctT  Stringer 
be  directed  to  procure  them.12 

June  5,  1776.  419 

That  the  pay  of  the  regimental  surgeons  be  aug- 
mented to  thirty  three  dollars  and  one  third  of  a 
dollar  a  month. 

June  6,  1776.  424 

Resolved,  That  doctor  Jonathan  Potts  be  em- 
ployed as  a  physician  and  surgeon  in  the  Canada 
department,  or  at  Lake  George,  as  the  general  shall 
direct;  but,  that  this  appointment  shall  not  super- 
sede Dr.  Stringer. 

June  17,  1776.  449,  453 

U.  6." 

R.  8.  That  the  committee,  appointed  to  provide 
medicines,  be  directed  to  send  a  proper  assortment 
of  medicines  to  Canada:  M 

"  Tin-  letb  r  "f  \\  nihineton  is  in  the  Papers  of  the  Continental 
Congress,  No.  163,  I.  folio  08C  i  in  Writings  of  Wash- 

ington (Ford).  IV,  80. 

"Against  thin  paragraph  i-i  written:  "Befarx'd  to  to-morrow." 
11  TUl  paragraph,  relating  to  the  appointment  of  Dr.  Jonathan 

Jeffenoo  report,  hawing  been  printed 

und<  r  June  0,  p.  434,  ante. 

'*  In  Iht  J> ■:>•  iMl  paragraph  read:  "Resolved,  That 

■f  medicinefl  be  sent  to  Canada."  Against  it 
ii    has    written   "Com*?   already    appointed    to    provide 
medicine*." 


June  1 8,  1776.  460-461,  463 

A  memorial  from  Dr.  (John)  Morgan,  director 
general  and  chief  physician  of  the  Hospital,  was  laid 
before  Congress,  and  read: 15 

Resolved,  That  it  be  referred  to  the  committee 
appointed  to  provide  medicines. 

Resolved,  That  Mr.  (Thomas)  Heyward  (Jr.),  and 
Mr.  (Lyman)  Hall  be  added  to  the  committee  for 
providing  medicines. 

June  19,  1776.  466 

To  Mary  Thomas,  for  nursing  and  boarding  two 
of  Captain  Benezet's  men,  in  the  small  pox,  the 
sum  of  £4.10.0=12  dollars: 

Ordered,  That  the  said  accounts  be  paid. 

Resolved,  That  the  committee  for  preparing  medi- 
cine chests,  be  directed  to  send  a  chest  of  medicines 
to  the  surgeon  of  said  batallion. 

A  memorial  from  the  mates  of  the  Hospital  was 
laid  before  Congress  and  read:16 

Resolved,  That  it  be  referred  to  the  committee  for 
providing  medicines. 

June  20,  1776.  469 

To  Abraham  Mills,  for  nursing  and  boarding  six 
soldiers  in  the  small  pox,  the  sum  of  £12.14.8= 
33  36/90  dollars: 

Resolved,  That  a  committee  of  five  be  appointed 
to  consider  what  provision  ought  to  be  made  for 
such  as  are  wounded  or  disabled  in  the  land  or  sea 
service,  and  report  a  plan  for  that  purpose: 

The  members  chosen,  Mr.  (Robert  Treat)  Paine, 
Mr.  (Francis  Lightfoot)  Lee,  Mr.  (Lyman)  Hall, 
Mr.  (William)  EUery,  and  Mr.  (Francis)  Lewis. 

July  8,  1776.  528 

Resolved,  That  the  committee  for  providing  medi- 
cines, be  directed  to  supply  the  militias  aforesaid, 
with  a  sufficient  quantity  of  suitable  medicines. 

July  12,  1776.  556 

The  committee  appointed  to  take  into  considera- 
tion the  memorial  of  the  director  general  of  the 
American  hospital,  brought  in  their  report,  which 
was  read: 

Ordered,  To  lie  on  the  table. 

July  15,  1776.  562 

Resolved,  That  a  chief  physician  be  appointed  for 
the  flying  camp,  and  that  his  pay  be  four  dollars 
per  day : 

The  ballots  being  taken  (and  examined,) 

William  Shippen,  JunT  was  elected. 

July  17,  1776.  568-571 

The  Congress  took  into  consideration  the  report 
of  the  committee  on  the  memorial  of  the  director 
general  of  the  American  hospital;  Whereupon, 

[Resolved,  For  the  better  Government  of  the  gen- 
eral Hospital  of  the  American  Army,  for  explaining 
and  ascertaining  more  fully  the  duties  of  the  Direct- 
or-General, the  directors  of  Hospitals,  the  Surgeons 
and  Mates,  both  Hospital  and  Regimental:] 

"  This  memorial  is  in  the  Papers  of  the  Continental  Congreet, 
No.  41.  VI.  folio.). 

"  This  memorial  is  in  tho  Papers  of  the  Continental  Congreet, 
No.  41,  III,  folio  107. 


History  of  the  Army  Medical  Department  During  the  Revolution      209 


Resolved,  That  the  number  of  hospital  surgeons 
and  mates  be  increased,  in  proportion  to  the  aug- 
mentation of  the  army,  not  exceeding  one  surgeon 
and  five  mates  to  every  five  thousand  men,  to  be 
reduced  when  the  army  is  reduced,  or  when  there  is 
no  further  occasion  for  so  great  a  number: 

That  as  many  persons  be  employed  in  the  several 
hospitals,  in  quality  of  store  keepers,  stewards,  man- 
agers, and  nurses,  as  are  necessary  for  the  good  of 
the  service,  for  the  time  being,  to  be  appointed  by 
the  directors  of  the  respective  hospitals: 

That  the  several  regimental  chests  of  medicines, 
and  chirurgical  instruments,  which  now  are  or  here- 
after shall  be,  in  the  possession  of  the  regimental 
surgeons,  be  subject  to  the  inspection  and  enquiry 
of  the  respective  directors  of  hospitals,  and  the  di- 
rector general;  and  that  the  said  regimental  surgeons 
shall,  from  time  to  time,  when  thereto  required,  ren- 
der account  of  the  said  medicines  and  instruments 
to  the  said  directors,  or  if  there  be  no  director  in 
any  particular  department,  to  the  director  general; 
the  said  accounts  to  be  transmitted  to  the  director 
general,  and  by  him  to  this  Congress;  and  the  medi- 
cines and  instruments  not  used  by  any  regimental 
surgeon,  to  be  returned  when  the  regiment  is  re- 
duced, to  the  respective  directors,  and  an  account 
thereof  by  them  rendered  to  the  director  general, 
and  by  him  to  this  Congress: 

Resolved,  That  an  Additional  Apothecary  with 
such  Number  of  Mates  as  the  Service  may  require, 
be  allowed,  under  the  Title  of  Apothecary  to  the 
Army,  and  in  subordination  to  the  [General  Hospital] 
Apothecary  of  the  General  Hospital.17 

That  the  several  directors  of  hospitals,  in  the  sev- 
eral departments,  and  the  regimental  surgeons, 
where  there  is  no  director,  shall  transmit  to  the  di- 
rector general  regular  returns  of  the  number  of  sur- 
geons' mates,  and  other  officers  employed  under 
them,  their  names  and  pay;  also,  an  account  of  the 
expences  and  furniture  of  the  hospital  under  their 
direction;  and  that  the  director  general  make  report 
of  the  same,  from  time  to  time,  to  the  commander 
in  chief,  and  to  this  Congress: 

That  the  several  regimental  and  hospital  sur- 
geons, in  the  several  departments,  make  weekly 
returns  of  their  sick  to  the  respective  directors  in 
their  departments: 

That  no  regimental  surgeon  be  allowed  to  draw 
upon  the  hospital  of  his  department,  for  any  stores 
except  medicines  and  instruments;  and  that,  when 
any  sick  person  shall  require  other  stores,  they  shall 
be  received  into  the  said  hospital,  and  the  rations 
of  the  said  sick  persons  be  stopped,  so  long  as  they 
are  in  the  said  hospitals;  and  that  the  directors  of 
the  several  hospitals  report  to  the  commissary  the 
names  of  the  sick,  when  received  into,  and  when 
discharged  from  the  hospital,  and  make  a  like  re- 
turn to  the  Board  of  Treasury: 

That  all  extra  expences  for  bandages,  old  linen, 
and  other  articles  necessary  for  the  service,  incurred 
by  any  regimental  surgeon,  be  paid  by  the  director 
of  that  department,  with  the  approbation  of  the 
commander  thereof: 

That  no  more  medicines  belonging  to  the  conti- 

17  A  paragraph  that  was  not  retained. 


nent  be  disposed  of  [by  sale  till  the  army  is  fully 
supplied]  till  further  order  of  Congress: 

Resolved,  that  no  Surgeon  or  Surgeon's  Mate  shall 
receive  a  Commo  as  such  in  the  Army,  without  hav- 
ing first  undergone  an  Examination  by  the  director, 
of  the  hospital  of  the  Department  in  which  he  may 
desire  employment  or  the  director  GenI  and  ob- 
tained a  Certificate  from  the  Commdr  and  director 
of  that  department,  or  the  Director  GenI,  of  his 
Abilities  and  knowledge  in  his  business.18 

That  the  pay  of  the  hospital  surgeons  be  increased 
to  one  dollar  and  two  thirds  of  a  dollar  by  the  day; 
the  pay  of  the  hospital  mates  be  increased  to  one 
dollar  by  the  day;  and  the  pay  of  the  hospital 
apothecary  to  one  dollar  and  two  thirds  of  a  dollar 
by  the  day;  and  that  the  hospital  surgeons  and 
mates  take  rank  of  regimental  surgeons  and  mates: 

Resolved,  that  the  Storekeepers  of  the  several 
Hospitals  be  paid  by  the  month,  and  the  Stewards 
and  Managers  of  the  said  Hospitals  be  paid  by  the 
Month  a  sum  not  exceeding  dollars.18 

Resolved,  That  the  duties  and  privileges  of  the 
Surgeons  and  Mates,  not  heretofore  particularly  as- 
certained, be  conformable  to  the  established  Usage 
of  other  well  regulated  Armies,  as  far  as  is  consist- 
ent with  the  Good  of  the  Service,  until  otherwise 
settled  and  directed  by  this  Congress.18 

Resolved,  that  the  Appointments  of  Surgeons  (Sur- 
geons Mates)  Storekeepers,  Stewards,  Managers  and 
Nurses,  heretofore  mentioned,  shall  be  made  by  the 
Director  General  in  the  Northern  and  Eastern  De- 
partments; and  of  the  Middle  department  by  the 
Director,  which  may  hereafter  be  app'd_  in  that 
dep't;  and  in  the  Southern  Dep't  by  the  director  of 
that  dep't  with  the  approba.  of  the  Commandr  of 
the  respect  departments.19 

Resolved,  that  it  be  recommend  to  Congress  to 
purchase  the  Medicines  (now  in  Phila)  belonging  to 
Doctor  Morgan.19 

Resolved,  that  in  all  levies  of  Troops  hereafter 
to  be  raised  for  the  Service  of  the  Continent  a  stop- 
page of  out  of  the  month's  pay  of  each  Man  be 
made  for  the  Use  and  support  of  the  several  Conti- 
nental Hospitals.19 

That  the  director  general,  and  the  several  direct- 
ors of  hospitals,  be  empowered  to  purchase,  with 
the  approbation  of  the  commander  of  the  respective 
departments,  medicines,  and  instruments  for  the 
use  of  their  respective  hospitals,  and  draw  upon  the 
pay  master  for  the  same,  and  make  report  of  such 
purchases  to  Congress.20 

July  20,  1776.  595 

Resolved,  That  Dr.  Senter  be  recommended  to 
Dr.  Morgan;  who  is  desired  to  examine  him;  and  if, 
(upon  examination,)  he  finds  him  qualified,  to  em- 
ploy him  in  the  hospital  as  a  surgeon. 

July  26,  1776.  612 

Resolved,  That  an  order  for  2,000  dollars  be 
drawn  on  the  treasurers  in  favor  of  Dr.  W.  Shippen; 
he  to  be  accountable. 

18  A  paragraph  that  was  not  retained. 

19  A  paragraph  that  was  not  retained. 

20  This  report,  in  the  writing  of  Thomas  Stone,  is  in  the  Papers 
of  the  Continental  Congress,  No.  19,  IV,  folio  181. 


210 


Annals  of  Medical  History 


July  31,  1776.  622 

Resolved,  That  the  committee  for  providing  medi- 
cines be  directed  to  provide,  and  send  forward,  such 
a  quantity  of  medicines  as  may  be  necessary  for  the 
Hospital  in  the  northern  army: 

That  the  said  committee  be  directed  to  procure 
and  send  forward  such  a  quantity  of  medicines  as 
may  be  necessary  for  the  hospital  in  the  southern 
department. 

August  6,  1776.  633 

Resolved,  That  the  committee  for  procuring  medi- 
cines be  directed  to  supply  the  director  general  of 
the  Hospital  with  such  medicines  as  he  may  want. 

August  7,  1776.  636 

Resolved,  That  Dr.  (Benjamin)  Rush  be  added  to 
the  committee  for  procuring  medicines. 

August  16,  1776.  661 

A  petition  from  Dr.  Samuel  Stringer,  was  present- 
ed to  Congress  and  read: 

Resolved,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

Resolved,  That  the  Medical  Committee  be  em- 
powered to  purchase  such  medicines  as  they  judge 
proper  and  useful  for  the  army. 

August  20,  1776.  673 

The  committee  to  whom  was  referred  the  peti 
tion  of  Dr.  Stringer  brought  in  their  report,  which 
was  taken  into  consideration;  whereupon, 

Resolved,  That  Dr.  Morgan  was  appointed  direct- 
or general  and  physician  in  chief  of  the  American 
hospital: 

That  Dr.  Stringer  was  appointed  director  and 
physician  of  the  hospital  in  the  northern  depart- 
ment only. 

That  every  director  of  a  hospital  possesses  the  ex- 
clusive right  of  appointing  surgeons  and  hospital 
officers  of  all  kinds,  agreeable  to  the  resolutions  of 
Congress  of  the  17  of  July,  in  his  own  department, 
unless  otherwise  directed  by  Congress: 

That  Dr.  Stringer  be  authorized  to  appoint  a  sur- 
geon for  the  fleet  now  fitting  out  upon  the  lakes: 

That  a  Druggist  be  appointed  in  Philadelphia 
whose  business  it  shall  be,  to  receive  and  deliver  all 
medicines,  instruments,  and  shop  furniture  for  the 
benefit  of  the  United  States: 

That  a  salary  of  thirty  dollars  a  month  be  paid  to 
the  said  druggist  for  his  labour. 

Congress  proceeded  to  the  election  of  a  druggist, 
and,  the  ballots  being  taken,  Dr.  William  Smith  was 
elected. 

August  26,  1776.  705 

Provided,  that  all  such  officers  and  soldiers  that 
may  be  entitled  to  the  aforesaid  pension,  and  are 
found  to  be  capable  of  doing  guard  or  garrison  duty, 
shall  be  formed  in  a  corps  of  invalids,  and  subject 
to  the  said  duty;  and  all  officers,  marines,  and  sea- 
men of  the  navy  who  shall  lie  entitled  to  the  pen- 
sion aforesaid,  and  shall  be  found  capable  <>f  doing 
any  duty  on  board  the  navy,  or  any  department 
thereof,  shall  be  liable  to  be  so  employed: 

Ordered,  That  the  above  be  published.21 

■  Mahd  in  tho  Pennsylvania  Gautie,  4  September,  1776. 


The  Medical  Committee,  to  whom  Dr.  M'Henry's 
petition  was  referred,  brought  in  their  report:  Where- 
upon, 

Resolved,  That  Congress  have  a  proper  sense  of 
the  merit  and  services  of  Dr.  M'Henry,  and  recom- 
mend it  to  the  directors  of  the  different  hospitals 
belonging  to  the  United  States,  to  appoint  Dr. 
M'Henry  to  the  first  vacancy  that  shall  happen,  of 
a  surgeon's  berth  in  any  of  the  said  hospitals. 

August  29,  1776.  717 

That  the  said  committee  be  directed  to  import 
the  medicines  ordered  by  the  Medical  Committee. 

September  7,  1776.  742 

Resolved,  That  Mr.  (Gustavus)  Risberg,  the  as- 
sistant to  Colonel  Biddle,  be  directed  to  take  proper 
measures  for  providing  the  sick  soldiers  in  Philadel- 
phia, with  proper  lodgings  and  attendance. 

September  18,  1776.  781 

That  the  Medical  Committee  send  an  assortment 
of  proper  medicines  to  the  northern  army:  a 

September  24,  1776.  812-813 

Resolved,  That  a  committee  of  five  be  appointed 
to  devise  ways  and  means  for  effectually  providing 
the  northern  army  with  provisions  and  medicines, 
and  supplying  their  other  necessary  wants: 

The  members  chosen,  Mr.  (Benjamin)  Rush,  Mr. 
(Lyman)  Hall,  Mr.  (Samuel)  Chase,  Mr.  (Thomas) 
Johnson  and  Mr.  (Richard)  Stockton. 

Resolved,  That  the  Medical  Committee  be  direct- 
ed to  apply  to  the  council  of  safety  of  Pennsylvania, 
for  a  quantity  of  medicines;  to  be  repaid  in  kind  or 
in  cash,  as  they  shall  chuse. 

September  25,  1776.  822,  823,  826 

The  committee  appointed  to  devise  ways  and 
means  for  providing  the  northern  army  with  pro- 
visions, medicines  and  other  necessaries,  brought 
in  a  report,  which  was  taken  into  consideration; 
Whereupon,     .     .     . 

That  the  committee  be  empowered  to  make  regu- 
lations for  the  hospitals  in  the  northern  depart- 
ment, and  to  remove  or  suspend  any  person  em- 
ployed therein,  and  to  employ  such  as  they  may 
think  necessary  and  proper;  and  that  they  report 
to  Congress  the  state  and  condition  of  the  army, 
and  any  further  regulations  which  they  may  think 
necessary,  for  the  better  government  anil  supplying 
the  said  army: 

That  the  committee  consist  of  [three]  two,  ami 
that  to  Morrow  be  assigned  for  electing  the  said 
committee. 

To  the  steward  of  the  Pennsylvania  hospital,  for 
boarding  William  Whiting,  a  wounded  soldier,  four 
wicks,  by  order  of  Congress,  5  30/90  dollars: 

September  30,  1776.  836-837 

That  it  be  recommended  to  tin-  legislatures  of 
the  United  States,  to  appoint  gentlemen  in  their  re- 
spective states,  skilful  in  physic  and  surgery,  to  ex- 

n  Thin  report,  dnted  "at  a  board  of  war,  Soptr.  14tli,  1776"  and 
in  the  writing  of  Hirhard  Peters,  it  in  the  FajMN cf  fkt Cotlttnm* 
tnl  Conarett,  No.  147, 1,  folio  5.  It  laendormd:  "iMirtly  agrood  to. 
Two  paragraphs  pontpon'd,  Sept'.  18,  1776." 


History  of  the  Army  Medical  Department  During  the  Revolution      211 


amine  those  who  offer  to  serve  as  surgeons  or  sur- 
geons' mates  in  the  army  and  navy;  and  that  no 
surgeon  or  mate  shall  hereafter  receive  a  commis- 
sion or  warrant  to  act  as  such,  in  the  army  or  navy, 
who  shall  not  produce  a  certificate  from  some  or 
one  of  the  examiners  so  to  be  appointed,  to  prove 
that  he  is  qualified  to  execute  the  office: 

That  all  regimental  surgeons  and  mates,  as  well 
as  those  of  the  hospitals,  be  subject  to  the  direction 
and  controul  of  the  directors  in  the  several  depart- 
ments: 

That  no  soldier  be  discharged  from  the  service  as 
disabled,  unless  the  certificate  of  disability  be  coun- 
tersigned by  the  director,  assistant  physician,  or 
first  surgeon  of  the  hospital,  nor  be  excused  from 
duty  for  sickness,  unless  the  certificate  of  sickness 
be  countersigned  by  one  of  those  persons,  where  ac- 
cess may  be  had  to  them. 

Resolved,  That  the  remainder  of  the  said  report  be 
postponed. 

October  7,  1776.  852-3 

.  .  .  .  Three  Camp  Kettles  for  the  use  of  the 
Hospital,  to  W.  V.  Wimple  Surgeon;     .     .     . 

That  said  Nicholson  delivered  five  Camp  Kettles, 
to  Colo.  Hazen,  3  ditto  to  Doctr.  Lynn  for  the  Gen- 
eral Hospital,  and  3  ditto  for  the  red  hospital  at  St. 
Foys. 

October  9,  1776.  857-8,  9 

Congress  resumed  the  consideration  of  the  report 
of  the  committee  who  went  to  the  camp;  M  Where- 
upon, 

Resolved,  That  no  regimental  hospitals  be,  in  fu- 
ture, allowed  in  the  neighbourhood  of  the  general 
hospital: 

That  John  Morgan,  Esq?  provide  and  superin- 
tend a  hospital,  at  a  proper  distance  from  the  camp, 
for  the  army  posted  on  the  east  side  of  Hudson's 
river. 

That  William  Shippen  (Jun.),  EsqT  provide  and 
superintend  an  hospital  for  the  army,  in  the  state 
of  New  Jersey: 

That  each  of  the  hospitals  be  supplied  by  the  re- 
spective directors  with  such  a  number  of  surgeons, 
apothecaries,  surgeons'  mates,  and  other  assistants, 
and  also  with  such  quantities  of  medicine,  bedding, 
and  other  necessaries,  as  they  shall  judge  expedient: 

That  they  make  weekly  returns  to  Congress  and 
the  commander  in  chief,  of  the  officers  and  assist- 
ants of  each  denomination,  and  also  the  number  of 
sick  and  deceased  in  their  respective  hospitals: 

That  the  regimental  surgeons  be  directed  to  send 
to  the  general  hospitals  such  officers  and  soldiers  of 
their  respective  regiments,  as,  confined  by  wounds 
or  other  disorders,  shall  require  nurses  or  constant 
attendance,  and,  from  time  to  time,  to  apply  to  the 
quarter  master  general,  or  his  deputy,  for  conve- 
nient waggons  for  this  purpose;  also,  (that  they  ap- 
ply to  the  directors  in  their  respective  departments, 
for  medicines  and  other  necessaries:)  24 

That  the  wages  of  nurses  be  augmented  to  one 
dollar  per  week: 

a  See  note  under  October  3,  p.  844,  ante. 

M  This  sentence  is  in  the  writing  of  John  Hancock. 


That  the  commanding  officer  of  each  regiment  be 
directed,  once  a  week,  to  send  a  commission  officer 
to  visit  the  sick  of  his  respective  regiment  in  the 
general  hospital,  and  report  their  state  to  him : 

That  for  the  promoting  health  in  the  army,  the 
commissary  general  be  directed  to  cause  the  same 
to  be  well  supplied  with  Indian  meal  and  vegetables. 

October  14,  1776.  869 

A  letter  ....  One  from  General  Washington, 
of  the  7,  enclosing  a  letter  from  Dr.  Morgan,  were 
laid  before  Congress,  and  read. 

Resolved,  .  .  .  That  the  letter  from  Dr.  Morgan, 
enclosed  in  General  Washington's  letter,  be  referred 
to  the  Medical  Committee. 

November  4,  1 776.  92 1 

It  being  represented  that  some  of  the  marines  in 
the  barracks  are  sick, 

Resolved,  That  Doct?  Rush  be  desired  to  take 
them  under  his  care,  and  see  them  properly  provided 
for. 

November  12,  1776.  940 

A  letter,  .  .  .  and  one,  of  the  9,  from  Dr.  Ship- 
pen,  were  read.25 

November  13,  1776.  948 

To  Doctor  Samuel  Wilson,  for  board,  attendance, 
and  medicine,  to  sick  soldiers  of  the  6  Virginia  regi- 
ment, 33  60/90  dollars: 

That  there  should  be  paid  to  Thomas  Armer,  on 
account  of  Elizabeth  Robinson,  for  so  much  short 
paid  on  settlement  of  her  account,  the  14th  October 
last,  for  board,  &c.  of  sick  soldiers  belonging  to  Cap- 
tain Grier's  company,  10  dollars: 

That  there  should  be  paid  to  the  Pennsylvania 
hospital,  for  the  support  and  cloathing  of  John 
Hughes,  a  wounded  soldier,  36  54/90  dollars: 

November  19,  1776.  965 

That,  on  any  sick  or  disabled  non-commissioned 
officer  or  soldier,  being  sent  to  any  hospital  or  sick 
quarters,  the  captain  or  commandant  of  the  troop 
or  company  to  which  he  belongs,  shall  send  to  the 
surgeon,  or  director  of  the  said  hospital,  or  give  to 
the  non-commissioned  officer  or  soldier,  so  in  the 
hospital  or  quarters,  a  certificate,  (countersigned  by 
the  pay  master  of  the  regiment,  if  he  be  with  the 
regiment,)  of  what  pay  is  due  to  such  sick  non-com- 
missioned officer  or  private,  at  the  time  of  his  enter- 
ing the  hospital  or  quarters;  and  the  captain  or  com- 
mandant of  the  troop  or  company,  shall  not  receive 
the  pay  of  the  said  soldier  in  hospital  or  quarters, 
or  include  him  in  any  pay  abstract  during  his  con- 
tinuance therein.  And,  in  case  any  non-commis- 
sioned officer  or  soldier  shall  be  discharged  from 
the  hospital  or  quarters,  as  unfit  for  farther  service, 
a  certificate  shall  be  given  him,  by  the  surgeon  or 
director,  of  what  pay  is  then  due  to  him;  and  the 
said  non-commissioned  officer  or  soldier,  so  dis- 
charged, shall  be  entitled  to  receive  his  pay  at  any 
pay  office,  or  from  any  pay  master  in  the  service  of 
the  United  States;  the  said  pay  master  keeping  such 
original  certificate,  to  prevent  impositions,  and  giv- 

25  The  letter  of  Dr.  Shippen  is  in  the  Papers  of  the  Continental 
Congress,  No.  78,  XX,  folio  75. 


212 


Annals  of  Medical  History 


ing  the  non-commissioned  officer  or  soldier  his  dis- 
charge, or  a  certified  copy  thereof,  mentioning,  at 
the  same  time,  his  having  been  paid: 

November  26,  1776.  983 

That  the  committee,  who  are  sent  to  the  camp, 
be  directed  to  make  particular  enquiry  into  the 
abuses  in  the  medical  department  in  the  army,  and 
report  thereon  to  Congress. 

November  28,  1776.  989 

The  Medical  Committee,  to  whom  Dr.  Shippen's 
letter  was  referred,  brought  in  a  report,  which  was 
taken  into  consideration;  Whereupon, 

Resolved,  That  Dr.  Morgan  take  care  of  such  sick 
and  wounded  of  the  army  of  the  United  States,  as 
are  on  the  east  side  of  Hudson's  river,  and  that  Dr. 
Shippen  take  care  of  such  of  the  said  sick  and 
wounded  as  are  on  the  west  side  of  Hudson's  river; 
and  that  they  both  be  directed  to  use  the  utmost 
diligence  in  superintending  the  surgeons  and  mates 
of  the  army,  so  that  the  sick  and  wounded  may  be 
effectually  provided  with  everything  necessary  for 
their  recovery. 

November  29,  1776.  990-991 

Resolved,  That  Mr.  Mease  be  directed  to  supply 
the  sick  soldiers,  in  the  House  of  Employment  in 
Philadelphia,  with  one  shirt  apiece. 

Resolved,  That  the  Medical  Committee  be  directed 
to  provide  sufficient  quantities  of  antiscorbutics  for 
the  use  of  the  hospitals  in  the  northern  army: 

That  the  hospital  at  Fort  George  be  continued 
for  the  reception  of  soldiers  labouring  with  con- 
tagious diseases,  and  that  there  be  a  general  hospi- 
tal erected  on  Mount  Independence: 

That  a  suitable  spot  of  ground  for  a  garden  be 
enclosed  in  the  neighbourhood  of  the  general  hospi- 
tal, to  supply  the  army  with  vegetables;  and  that 
labourers  be  hired  to  cultivate  it,  under  the  direc- 
tion of  an  overseer,  to  be  appointed  by  the  general 
or  commanding  officer: 

That  the  general,  or  commanding  officer,  in  each 
of  the  armies,  cause  strict  enquiries  to  be  made  into 
the  M  conduct  of  the  directors  of  the  hospitals,  and 
their  surgeons,  officers,  and  servants,  and  of  the 
regimental  surgeons,  that  if  there  has  been  any  just 
grounds  of  complaint  in  those  departments,  the  of- 
fenders may  be  punished: 

That  the  colonel  or  commanding  officer  of  every 
regiment,  make  frequent  enquiry  into  the  health  of 
the  men  under  his  command,  and  report  the  state 
thereof,  with  any  negligence,  mal-practice,  or  other 
misconduct  of  the  surgeons  or  others,  to  the  general, 
and  to  Congress,  delivering  copies  of  such  reports 
to  all  persons  therein  accused: 

December  1,  1776.  998 

Resolved,  .  .  .  That  the  Medical  Committee  be 
directed  to  take  such  steps,  as  they  shall  judge 
proper,  for  the  accommodation  of  the  sick  of  the 
army. 

December  5,  1776.  1006 

Resolved,  That  it  be  and  is  earnestly  recommend- 
ed to  the  council  of  safety  of  Pennsylvania,  to  pro- 
■  The  original  report  here  contained  "past  as  well  as  future.'} 


cure  the  Pennsylvania  hospital,  for  the  purpose  of 
accommodating  the  sick  belonging  to  the  continen- 
tal army. 

Resolved,  That  the  Medical  Committee  be  em- 
powered to  procure  suitable  persons  to  take  care  of 
the  sick,  and  to  remove  them  to  such  convenient 
places  in  the  country,  as  they  shall  think  proper. 

December  12,  1776.  1024 

That  5,000  dollars  be  advanced  to  Dr.  Nicholas 
Way,  (of  Wilmington,)  for  the  public  service;  he  to 
be  accountable. 

Resolved,  That  the  continental  apothecary  be  di- 
rected immediately  to  pack  up  all  the  continental 
medicines,  and  send  them  to  the  quarter  master 
general : 

That  the  quarter  master  general  be  directed  to 
remove  all  the  medicines  belonging  to  the  continent 
in  this  city  to  a  place  of  security: 

STANDING  COMMITTEES 

1 775-1 776 

Medicines  p.  1065 

14  September,  1775.  Eliphalet  Dyer 
Thomas  Lynch 
John  Jay 
John  Adams 
Francis  Lewis 
18  June,  1776.  Thomas  Hey  ward,  Jr. 

Lyman  Hall 
7  August,        1776.  Benjamin  Rush 

January  3,  1777.  13 

Resolved,  That  Dr.  (Jonathan)  Elmore  and  Dr. 
(Nathan)  Brownson  be  added  to  the  Medical  Com- 
mittee. 

January  9,  1777.  24-5 

Congress  resumed  the  consideration  of  the  report 
of  the  Medical  Committee;  Whereupon, 

Resolved,  That  Dr.  John  Morgan,  director  general, 
and  Dr.  Samuel  Stringer,  director  of  the  hospital  in 
the  northern  department  of  the  army  of  the  United 
States,  be,  and  they  are  hereby,  dismissed  from  any 
farther  service  in  said  offices: 

That  the  directors  of  the  military  hospitals 
throughout  the  army,  with  the  assistance  of  the  hos- 
pital and  regimental  surgeons  in  each  department! 
make  returns  to  Congress,  as  soon  as  possible,  of 
the  kind  and  quantity  of  medicines,  instruments, 
and  hospital  furniture  that  remain  on  hand. 

January  14,  1777.  34 

Resolved,  .  .  .  That  the  Medical  Committee 
provide  a  suitable  assortment  of  medicines,  and 
send  them  to  the  hospital  in  the  northern  army, 
witli  all  possible  despatch,  together  with  other  nec- 
essaries for  tlu-  sick;  and  that  the  list  mentioned  by 
Dr.  Stringer,  in  a  paper,  No.  1,  enclosed  in  General 
Schuyler's  letter,  be  committed  to  them: 

That  Dr.  Potts  be  directed  to  repair  to  Ticon- 
deroga  without  delay: 

That  Dr.  Stringer  be  directed  to  deliver  to  Dr. 
Potts,  such  medicines,  and  other  medical  stores,  as 
may  be  in  his  hands  belonging  to  the  Continent. 


History  of  the  Army  Medical  Department  During  the  Revolution      213 


January  17,  1777.  44 

A  letter  with  a  number  of  papers,  from  Dr.  Mor- 
gan, were  laid  before  Congress,  and  referred  to  the 
Medical  Committee. 

January  18,  1777.  48 

To  Dr.  J(ohn)  Witherspoon,  for  wood  supplied 
the  troops  at  Princetown;  for  the  expences  of  sick 
soldiers;  and  the  allowance  due  to  John  M'Kinzie, 
a  prisoner  from  North  Carolina,  from  the  18th  Oc- 
tober to  the  10th  January,  inclusive,  being  12  weeks, 
105  78/90  dollars:  " 

Ordered,  That  the  said  accounts  be  paid. 

January  29,  1777.  70 

Resolved,  That  Dr.  Mackenzie,  who  has  the  care 
of  the  sick  in  the  hospital  in  Baltimore,  be  empow- 
ered to  appoint  a  mate  to  assist  him. 

January  31,  1777.  79-80,  81 

Resolved,  That  a  committee  of  four  be  appointed 
to  consider  what  honours  are  due  to  the  memory  of 
General  Warren,  (who  fell  in  the  battle  of  Bunker's- 
Hill,  the  17th  of  June,  1775;)  and  of  the  late  Gen- 
eral H.  Mercer,  who  died  on  the  12th  instant,  of 
the  wounds  he  received  on  the  3d  of  the  same 
month,  in  fighting  against  the  enemies  of  American 
liberty,  near  Princetown: 

The  members  chosen,  Mr.  (Benjamin)  Rush,  Mr. 
(Thomas)  Heyward,  Mr.  (Mann)  Page,  and  Mr. 
S(amuel)  Adams. 

To  Dr.  Samuel  Mackenzie,  for  sundry  medicine 
purchased  by  him  for  the  use  of  the  hospital  in  Bal- 
timore, 86  74/90  dollars: 

To  Dr.  John  Hindman,  for  sundry  medicine  sup- 
plied by  him  for  the  use  of  Colonel  Richardson's 
batallion  of  Maryland  forces,  20  6/90  dollars: 

February  4,  1777.  87 

A  memorial  from  Dr.  Thomas  Young  was  read, 
and  referred  to  the  medical  committee. 

Resolved,  That  Dr.  (Thomas)  Burke  be  added  to 
the  Medical  Committee;  and  that  he  be  appointed 
a  member  of  the  Marine  Committee,  in  the  room  of 
Mr.  (William)  Hooper,  who  has  leave  to  return 
home  for  some  time. 

February  5,  1777.  91 

Ordered,  That  the  Board  of  War  digest  the  said 
conference,  and  bring  in  a  proper  report  on  the 
several  matters  mentioned,  saving  what  relates  to 
medicines. 

Resolved,  That  the  Medical  Committee  be  empow- 
ered to  employ  a  suitable  person  in  each  of  the 
states,  to  purchase  such  medicines  as  they  shall  di- 
rect, for  the  use  of  the  army,  which  can  be  procured 
at  any  reasonable  rates. 

||  Ordered \\  That  the  said  committee  enquire  what 
is  become  of  the  medicines  which  Dr.  Morgan  took 
from  Boston,  and  which  Dr.  Stringer  bought  for  the 
northern  army,  and  take  measures  to  have  them 
secured,  and  applied  to  the  use  of  the  army. 

February  12,  1777.  no 

Ordered,  That  the  Medical  Committee  write  to 
General  Washington,  and  consult  him  on  the  pro- 

"  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
132,  I,  folio  17. 


priety  and  expediency  of  causing  such  of  the  troops 
in  his  army,  as  have  not  had  the  small  pox,  to  be 
inoculated,  and  recommend  that  measure  to  him,  if 
it  can  be  done  consistent  with  the  public  safety,  and 
good  of  the  service. 

February  20,  1777.  139 

To  Dr.  Frederick  Phile,  for  the  amount  of  his  ac- 
count for  medicine  and  attendance  to  the  German 
batallion,  in  Philadelphia,  (£74  16  6=)  199  48/90 
dollars:  .     .     . 

Ordered,  That  the  said  accounts  be  paid. 

At  a  Board  of  War,  20th  Feb".,  1777. 
Agreed  to  report  to  Congress:  .... 
That  the  Assembly  of  the  State  of  Maryland  be 
requested  to  deliver  to  Doctor  McKensie  so  much 
Medicines   of  the   following   Denominations   as   he 
shall  want  and  they  can  spare,  to  enable  him  to 
inoculate  the  Continental  Troops  in  this  Town,  in 
the  following  Proportions  for  one  hundred  Men. 
Six  ounces  Calomel 
Two  Pounds  Jallop 
Three  Pounds  Nitre 

EIixr  Vitriol 
One  Pound  Peruvian  Bark 
One  Pound  Virginia  Snake  Root.28 

February  22,  1777.  143 

Resolved,  .  .  .  That  1,500  dollars  be  paid  to  Dr. 
Samuel  M'Kinzie,  for  the  use  of  the  hospital  in  Bal- 
timore; he  to  be  accountable. 

February  25,  1777.  155,  156 

Two  officers  of  the  2d  and  7th  Virginia  batallions, 
who  were  left  to  bring  up  the  baggage  of  their  re- 
spective batallions,  and  a  surgeon's  mate  belonging 
to  the  2d  batallion,  of  the  Virginia  forces,  being  ar- 
rived in  Baltimore,  applied  for  two  months'  pay 
(for  themselves  and  the  men  with  them,)  to  enable 
them  to  proceed  with  their  companies. 

Resolved,  That  they  be  referred  to  Mr-  Jonathan 
Hudson,  who  is  directed  to  pay  the  said  officers  and 
[their]  men  [one]  two  months'  pay;  [and  to  the  sur- 
geon two  months'  pay];  and  return  an  account  to  the 
General,  and  to  the  pay  master  general. 

Doctor  (John)  Witherspoon,  having  represented 
to  Congress  that  the  situation  of  his  private  affairs 
requires  his  returning  home  for  a  short  time,  desires 
leave  of  absence. 

Resolved,  That  leave  be  granted. 

To  Dr.  Benjamin  Rush,  for  sundry  medicine  and 
attendance  to  sick  soldiers  and  prisoners,  the  sum 
of  (£177.9=)  473  18/90  dollars: 

To  Richard  Stockton,  Esq.  and  to  be  paid  to  Dr. 
Benjamin  Rush,  for  the  hire  of  two  horses,  a  sulky, 
&c.  for  his  journey  to  Ticonderoga  last  fall,  by  order 
of  Congress,  151  30/90  dollars: 

February  27,  1777.  161-4 

The  Medical  Committee,  to  whom  the  report  on 
the  hospital  was  re-committed,  brought  in  a  report, 
which  was  read: 

The  Medical  Committee  having  taken  into  their 

28  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
147,  I,  folio  85. 


214 


Annals  of  Medical  History 


consideration  a  plan  M  for  establishing  Military  Hos- 
pitals, [transmitted  to  Congress  by  General  Wash- 
ington], agree  to  report — 

Section  i.  That  the  Continent  be  divided  into 
three  districts.  The  Middle  to  extend  from  Hudsons 
river  to  Potomac.  The  Southern  to  extend  from 
Potomac  to  Georgia,  and  the  Northern  from  Hud- 
sons river  to  Quebec  or  Crown  Point. 

2.  That  there  be  a  Surgeon  and  Physician  Gen1- 29, 
with  a  suitable  number  of  Senior  physicians,  Senior 
Surgeons  and  mates  to  each  district.  That  the  sick 
be  taken  care  of  by  the  physicians,  and  the  wound- 
ed by  the  Surgeons  in  different  apartments. 

3.  That  there  be  a  physician  and  Surgeon  General 
with  the  main  army  whose  business  it  shall  be  to 
attend  the  general  and  principal  Officers  of  the 
Army,  to  enquire  into  the  quality  of  the  food  of  the 
Soldiers,  to  superintend  the  regimental  Surgeons  and 
Mates,  and  to  attend  when  called  upon  in  consulta- 
tion with  them  in  all  extraordinary  cases. 

4.  That  there  be  an  Apothecary  General  whose 
business  it  shall  be  to  purchase  such  medicines  and 
instruments  as  shall  be  judged  necessary  by  the 
Surgeons  and  physicians  general  of  the  Army.  That 
he  have  the  liberty  of  appointing  three  assistant 
Apothecaries  in  different  parts  of  the  United  States, 
in  order  to  supply  with  the  more  convenience  the 
several  hospitals,  and  regimental  and  Naval  Sur- 
geons with  medicines  and  instruments. 

5.  That  there  be  an  Inspector  General  of  the 
Army  of  the  United  States  whose  business  it  shall 
be  to  visit  the  Military  hospitals  and  Apothecaries 
Shops  in  every  part  of  the  Continent;  to  examine 
the  medicines  and  instruments  belonging  to  the 
States;  to  enquire  into  the  conduct  of  the  several 
Officers  in  the  medical  department  and  report  to 
the  Congress,  and  Commander  in  chief  at  least  once 
a  month. 

6.  That  the  Surgeons  and  Physicians  General  of 
the  hospitals  have  the  liberty  of  appointing  hospital 
Apothecaries,  senior  Physicians,  and  Surgeons, 
Mates,  Purveyors,  Clerks,  Commissaries,  Wardmas- 
ters,  Servants,  Washerwomen,  Nurses,  Cooks,  and 
all  such  Officers  as  shall  be  necessary  for  the  accom- 
modation of  the  sick  and  wounded  in  the  hospitals. 

7.  That  the  business  of  the  Commissaries  shall  be 
to  provide  provisions,  and  liquors,  also  straw,  hay 
and  fuel  for  the  hospitals.  Also  to  bury  the  dead. 
He  shall  likewise  provide,  and  superintend  the  wag- 
gons employed  in  transporting  the  sick,  and  wound- 
ed, and  the  baggage  of  the  hospitals. 

The  business  of  the  Purveyors  shall  be  to  take 
care  of,  and  distribute  the  provisions,  and  other  Ar- 
ticles provided  by  the  Commissaries  for  the  sick  and 
wounded  both  in  the  camp  and  hospitals. 

8.  The  business  of  the  Wardmaster  shall  be  to 
take  care  of  the  Arms,  Accoutrements,  and  cloathes 
of  the  sick  and  wounded,  and  to  take  care  that 
proper  attention  is  paid  to  the  cleanliness  of  the 
patients,  and  their  respective  wards,  rooms,  or  tents. 

9.  That  one  Clerk  be  allowed  to  every  general 
hospital,  and  one  Nurse  to  every  ten   sick.  That 

"Thin  plan,  in  tbe  writing  of  William  Shippcn,  is  in  tho  Papert 
of  (As  Continental  Conaru;  No.  22.  (0U0  '.».  It  TCI  prepared  by 
Doctor*  i    John   Cochran,   ami   won   transmitted   to 

Congress  by  Washington,  February  14,  1777. 


each  military  hospital  be  furnished  with  a  number 
of  shirts,  sheets,  blankets  and  cases  for  straw  for 
the  accommodation  of  the  sick. 

That  each  regiment  be  furnished  with  a  number 
of  hospital  tents  according  to  their  number  of  men, 
a  full  regiment  not  to  have  more  than  six  tents. 

10.  That  the  pay  of  the  Surgeons  and  physicians 
Generals,  be  four  dollars  and  six  rations  a  day. 
That  the  inspector  General  have  five  dollars  and  12 
rations  a  day.  That  the  pay  of  the  Apothecary 
General  be  3  dollars,  and  4  rations  a  day.  That  tiie 
assistant  Apothecaries  appointed  by  the  Apothecary 
General  have  one  dollar  and  1  3  per  day.  That  the 
Purveyors  of  the  hospitals  have  2  dollars  and  3 
rations  per  day,  and  that  the  pay  and  rations  of  the 
hospital  Apothecaries,  senior  Surgeons  and  Mates 
of  the  hospital  be  the  same  as  formerly  established 
by  Congress.  That  the  pay  and  rations  of  the  senior 
physicians  of  each  hospital  be  the  same  as  those  of 
a  senior  Surgeon. 

11.  That  the  pay  and  rations  of  the  commissaries 
of  the  hospitals  be  the  same  as  the  deputy  com- 
missaries in  the  Army. 

12.  That  the  pay  and  rations  of  the  Wardmasters 
be  the  same  as  that  of  a  Commissary. 

13.  That  the  pay  of  the  Clerks,  Cooks,  Nurses, 
Washerwomen,  Servants,  &c,  be  regulated  by  the 
Physicians  and  Surgeons  General. 

14.  That  the  pay  and  rations  of  a  regimental  Sur- 
geon be  the  same  as  those  of  a  Captain  and  the  pay 
and  rations  of  a  Mate  be  the  same  as  those  of  a 
Ist  Lieutenant. 

15-16.  That  no  senior  Physician,  or  Surgeon,  no 
hospital  Mate,  nor  shall  any  regimental  Surgeon  or 
Mate  be  appointed  in  the  Army  who  has  not  previ- 
ously undergone  an  examination  before  one  or  more 
of  the  Physicians  and  Surgeons  General,  or  before 
the  Inspector  General  of  the  medical  department. 

17.  That  a  Sergeants  guard  be  constantly  placed 
at  each  general  hospital  to  prevent  the  unnecessary 
visits  of  Strangers,  and  the  desertion  of  convalescent 
patients,  and  to  assist,  if  necessary  in  inforcing  the 
rules,  and  orders  of  the  Surgeons,  and  physicians  of 
the  hospitals. 

18.  That  the  Officers  of  the  several  regimental 
companies  to  which  the  sick  and  wounded  belong  be 
ordered  to  concur  by  means  of  their  Authority  with 
the  Surgeons  and  physicians  in  taking  care  of  their 
respective  Soldiers. 

19.  That  the  physicians  and  Surgeons  General 
with  the  Inspector  General  of  the  medical  depart- 
ment be  authorized  to  make  such  further  improve- 
ments in  this  plan  for  regulating  the  medical  <le- 
partment  as  the  exigencies  and  situation  of  the 
Army  may  make  necessary,  and  that  they  report  the 
same  when  made  to  Congress  for  their  Approbation. 

20.  That  it  he  recommended  to  each  of  the  States 

to  make  suitable  provision  for  the  maintainanec  of 
such  maimed,  and  incurable  Soldiers  and  Seamen  as 
shall  he  discharged  from  the  service  of  the  united 
States.10 

Ordered,  To  lie  on  the  table. 

10  Thin  report,  in  ill''  writing  ^f  Benjamin  Rush,  >•>  in  the  Papert 

0/  the  Continental  Congrest,  No,  S3,  folk)  1  Af*4mrl  paragraphs 
1,  2,  and  4  is  written  "Query  if  necessary." 


History  of  the  Army  Medical  Department  During  the  Revolution      21 


March  15,  1777.  180 

Resolved,  That  as  Congress  proceeded  to  the  dis- 
mission of  Doctor  Stringer,  upon  reasons  satisfac- 
tory to  themselves,  General  Schuyler  ought  to  have 
known  it  to  be  his  duty  to  have  acquiesced  therein: 

Resolved,  That  the  suggestion  in  General  Schuy- 
ler's letter  to  Congress,  that  it  was  a  compliment 
due  to  him  to  have  been  advised  of  the  reasons  of 
Doctor  Stringer's  dismission,  is  highly  derogatory  to 
the  honour  of  Congress;  and  that  the  president  be 
desired  to  acquaint  General  Schuyler  that  it  is  ex- 
pected his  letters,  for  the  future,  be  written  in  a 
stile  more  suitable  to  the  dignity  of  the  representa- 
tive body  of  these  free  and  independent  states,  and 
to  his  own  character  as  their  officer. 

March  19,  1777.  186 

Resolved,  That  the  extract  of  Mr.  Deane's  letter, 
relative  to  Dr.  Williamson,  be  referred  to  a  com- 
mittee of  five,  who  are  empowered  to  send  for  Dr. 
Williamson  and  examine  him: 

The  members  chosen,  Dr.  (John)  Witherspoon, 
Mr.  (Jonathan  Bayard?)  Smith,  Mr.  (George)  Cly- 
mer,  Mr.  (James)  Wilson,  and  Mr.  (Thomas)  Hey- 
ward. 

March  22,  1777.  193 

The  report  of  the  Medical  Committee  was  taken 
up  and  considered;  (and,  after  debate,)  Whereupon, 

Resolved,  That  said  report,  together  with  Dr. 
Shippen's  plan,  be  recommitted. 

Resolved,  That  a  committee  of  five  be  appointed 
to  devise  ways  and  means  for  preserving  the  health 
of  the  troops,  and  for  introducing  better  discipline 
into  the  army: 

The  members  chosen,  Mr.  (Oliver)  Wolcott,  Mr. 
(Daniel)  Roberdeau,  Dr.  (John)  Witherspoon,  Mr. 
S(amuel)  Adams,  and  Mr.  (Abraham)  Clark. 

March  24,  1777.  197-200 

The  Medical  Committee,  to  whom  the  plan  of  the 
general  hospital  was  recommitted,  brought  in  a  re- 
port, which  was  read: 

The  Medical  Committee,  having  taken  into  their 
consideration  the  establishment  of  the  medical  de- 
partment in  the  Army,  Report  as  follows: 

i8t,  That  to  each  regiment  there  be  appointed 
one  Surgeon  and  one  Surgeon's  Mate,  who  shall 
constantly  attend  the  Regiment,  to  afford  present 
relief  to  the  sick  and  wounded,  and  take  care  of 
such  as  it  may  be  proper  to  remove  to  the  hospital. 

2nd,  That  Senior  Surgeons  of  approved  Abilities 
in  Physick  and  Surgery  be  appointed  to  each  Brig- 
ade or  a  greater  number  of  Regiments  as  the  Gen- 
eral commanding  in  each  department  or  grand  divi- 
sion of  the  Army  shall  judge  necessary;  whose  busi- 
ness shall  be,  to  Superintend  the  Regimental  Sur- 
geons and  Mates,  see  that  they  do  their  duty,  ad- 
vise and  direct  them  in  all  difficult  cases,  and  direct 
or  perform  all  Capital  Operations,  give  Assistance 
to  the  director  of  the  hospital  when  such  assistance 
is  necessary;  direct  the  Commissary  of  the  Sick  in 
the  Articles  Necessary  to  be  procured  for  the  Sick 
and  wounded  out  of  the  hospital,  and  see  that  the 
Commissary,  purveyor  and  Nurses  Regularly  per- 
form  their   respective   duties,   and   provide   proper 


Nurses  to  attend  the  sick  when  Necessary;  and  also 
from  Time  to  Time  furnish  the  Regimental  Surgeons 
with  such  Medicines  and  instruments  as  they  may 
have  Occasion  for  out  of  those  furnished  them  by 
the  Apothecaries,  taking  receipts  for  the  same,  and 
render  Accounts  of  all  medicines  and  instruments 
by  them  received  or  delivered  out  when  required 
thereto  by  Congress. 

3rd,  That  a  Commissary  for  the  Sick  be  appoint- 
ed to  attend  each  grand  division  of  the  Army,  who 
shall  appoint  one  or  more  assistants  if  necessary, 
whose  business  it  shall  be  to  purchase  and  deliver 
to  the  purveyor  all  such  Provisions,  Liquors,  and 
other  necessaries  for  the  Sick  and  wounded  as  di- 
rected by  the  Senior  Surgeons,  and  keep  accounts  of 
and  take  receipts  for  the  same:  he  shall  provide 
Straw,  hay  and  fuel  for  the  hospitals,  and  have  the 
care  of  burying  the  Dead:  he  shall  furnish  the  hos- 
pital with  such  a  number  of  shirts,  sheets,  blankets, 
and  cases  for  straw  for  the  Accommodation  of  the 
Sick  as  the  General  commanding  in  such  grand  divi- 
sion of  the  Army  shall  direct:  he  shall  likewise  pro- 
vide or  obtain  from  the  Quarter  master  general  a 
proper  number  of  hospital  tents  for  the  Sick  in  case 
the  Army  is  likely  to  be  stationed  in  places  where 
houses  convenient  cannot  be  obtained  for  that  pur- 
pose: and  also  provide  and  Superintend  the  Wag- 
gons necessary  to  be  employed  in  removing  the  Sick 
and  wounded,  the  number  of  hospital  tents  and 
Waggons  necessary  for  the  above  purposes  to  be 
fixed  and  ascertained  by  the  Generals  commanding 
each  division,  and  certified  under  their  hands  re- 
spectively: of  all  which  Articles  above  enumerated, 
when  provided,  the  Commissary  shall  take  proper 
receipts  and  vouchers  proving  that  the  same  were 
furnished,  which  he  shall  lay  before  Congress  when 
required. 

4th,  That  one  Purveyor  be  appointed  to  attend 
each  grand  division  of  the  Army,  with  one  or  more 
Assistants  if  necessary:  whose  duty  it  shall  be  to  re- 
ceive from  the  Commissary,  take  care  of  and  dis- 
tribute the  provisions  and  other  necessaries  provid- 
ed for  the  sick  and  wounded  in  such  manner  as  the 
Senior  Surgeons  shall  direct:  which  provisions  and 
necessaries  are  to  be  delivered  in  lieu  of  well  rations. 

5th,  That  the  General  commanding  in  each  De- 
partment or  grand  division  of  the  Army,  direct  one 
hospital  to  be  provided  in  some  Convenient  place 
contiguous  to  the  Army  consisting  of  different  or 
separate  houses,  if  such  can  be  had,  in  order  that 
the  wounded  may  be  kept  apart  from  the  sick,  and 
also  that:  he  sick  may  be  properly  divided,  as  may 
be  most  conducive  to  their  recovery:  to  which  hos- 
pital all  such  sick  and  wounded  are  to  be  sent  as 
the  Senior  Surgeons  may  think  proper,  and  whose 
circumstances  will  admit  being  removed,  which  hos- 
pital shall  be  supplied  by  the  Commissary  for  the 
sick,  with  such  provisions  and  other  necessaries  for 
the  use  of  the  sick  and  wounded,  as  the  director 
shall  require  in  lieu  of  well  rations. 

6th,  That  one  director  of  approved  skill  in  Phy- 
sick and  Surgery  be  appointed  for  each  hospital, 
who  shall  have  the  liberty  of  appointing  one  assist- 
ant Surgeon  and  four  mates;  a  purveyor  and  such  a 
number  of  Washerwomen  and  Nurses  as  he  shall 


2l6 


Annals  of  Medical  History 


judge  necessary  for  the  comfortable  accommodation 
and  attendance  of  the  sick  and  wounded  under  his 
care,  always  observing  that  no  more  than  necessary 
are  employed.  Also  that  the  director  May  call  to  his 
assistance  one  or  more  of  the  Senior  Surgeons  when 
the  number  of  sick  and  wounded  in  the  hospital  re- 
quires such  assistance.  Also  that  the  director  take 
an  Account  of  each  of  the  sick  and  wounded  under 
his  care,  with  the  Time  of  their  coming  to  the  hos- 
pital, and  when  discharged,  or  deceased:  and  also  of 
the  Number  of  attendants  employed  in  Nursing  and 
taking  care  of  the  sick:  and  make  due  returns  there- 
of every  month  to  the  general  commanding  in  each 
grand  division  of  the  Army  to  be  by  him  transmit- 
ted to  Congress. 

7th,  That  there  be  two  Apothecaries,  one  in  the 
middle,  and  one  in  the  eastern  department,  whose 
business  it  shall  be  to  receive  all  sucli  Medicines  and 
instruments  as  shall  be  procured  by  the  Secret  Com- 
mittee, and  to  purchase  such  others  as  they  shall  di- 
rect. That  the  Apothecaries  prepare  and  put  up  such 
medicines  and  instruments  for  each  hospital,  and  for 
each  Regimental  Surgeon,  and  also  for  each  Senior 
Surgeon  to  be  used  by  them  or  dealt  out  to  the 
Regimental  Surgeons  when  needed,  as  the  medical 
committee  shall  direct,  and  forward  the  same  with 
Supplies  from  Time  to  Time  agreeable  to  their  or- 
ders, keeping  exact  accounts  and  taking  proper  re- 
ceipts for  the  same  to  be  laid  before  Congress  when 
required.  Each  Apothecary  to  be  allowed  one  mate. 

8th,  That  the  sick  and  wounded  as  well  in  the 
Army  as  in  the  hospital  be  kept  separate  from  each 
other,  when  circumstances  will  admit  thereof;  and 
that  the  sick  be  always  placed  at  such  a  distance 
from  those  in  health  as  to  prevent  the  spread  of  in- 
fection in  the  Army. 

9th,  That  the  pay  of  the  medical  department  be 
as  follows — 

The  director  of  the  hospital  dollars  per  month 
and         rations  per  day. 

The  Senior  Surgeons  and  assistants  to  the  direc- 
tors dollars  per  month  and  rations  per  day 
each. 

The  Apothecaries         dollars  per  month  and 
rations  per  day  each. 

The  Regimental  Surgeons  dollars  per  month 

and        rations  per  day  each. 

The  directors  Apothecaries  and  Surgeons  mates 
dollars  per  month  and         rations  per  day  each. 

The  Commissary  of  the  sick  dollars  per  month 
and        rations  per  day  each. 

The  Purveyors  dollars  per  month  and  ra- 

tions per  day  each. 

The  Assistant  Commissaries  and  Assistant  Pur- 
veyors dollars  per  month  and  rations  per  clay 
each.31 

Ordered,  That  it  be  referred  for  consideration  to 
morrow  morning. 

report,  in  (In:  writing  ol  Abraham  Clark,  is  in  tho  Pa- 

•     '  •   si,  Miu  15, 


March  27,  1777.  206 

Congress  resumed  the  consideration  of  the  report 
of  the  Medical  Committee  on  the  hospital; 

Resolved,  That  it  be  [referred  to  a  Committee  of 
the  Whole.  Congress  then  resolved  itself  into  a 
Committee  of  the  Whole,  to  take  into  consideration 
the  report  of  the  Medical  Committee,  and  after 
some  time,  the  President  resumed  the  chair,  and 
Mr.  (Daniel)  Roberdeen  reported  ]  re-committed. 

April  2,  1777.  219 

Congress  resumed  the  consideration  of  the  report 
of  the  (medical)  committee  on  the  hospital,  and, 
after  debate, 

Ordered,  That  the  said  report  lie  on  the  table  (for 
farther  consideration). 

Resolved,  That  a  committee  of  three  be  appointed 
to  revise  Dr.  Shippen's  plan  for  the  regulating  the 
hospital,  and  report  thereon. 

The  members  chosen,  Mr.  (Elbridge)  Gerry,  Mr. 
(Thomas)  Burke  and  Mr.  J(ohn)  Adams. 

April  4,  1777.  225 

The  Committee  on  the  hospital,  brought  in  a  re- 
port, which  was  taken  into  consideration,  and  after 
debate, 

Resolved,  That  the  farther  consideration  thereof 
be  postponed  till  to  morrow. 

April  5,  1777.  227 

Congress  resumed  the  consideration  of  the  report 
on  hospitals,  and,  after  debate, 

Resolved,  That  the  farther  consideration  be  post- 
poned till  Monday  next. 

April  7,  1777.  231-7 

Congress  resumed  the  consideration  of  the  report 
on  the  hospital;  Whereupon, 

Resolved,  That  there  be  one  director  general  of  all 
the  like  weekly  returns  to  their  respective  directors, 
mutatis  mutandis: 

That  the  deputy  directors  general  cause  the  like 
returns  to  be  made,  once  every  month,  to  the  di- 
rector general,  together  with  the  names  and  de- 
nominations of  all  the  officers  in  the  respective  hos- 
pitals: 

And  that  the  director  general  shall  make  a  like 
return  for  all  the  hospitals  and  armies  of  the  United 
States,  once  every  month,  to  the  Medical  Commit- 
tee: 

That  the  Medical  Committee  have  power  to  ap- 
point any  of  their  members  to  visit  and  inspect  all 
or  any  of  the  medical  departments,  as  often  as  they 
shall  think  proper,  to  enquire  into  the  conduct  of 
such  general  officers  of  the  hospital  as  shall  be  delin- 
quent in  this  or  any  parts  of  their  duty,  and  to  re- 
port their  names  to  Congress,  with  the  evidence  ol 
the  charges,  which  shall  be  brought  against  them.3' 

Resolved,  That  the  farther  consideration  of  the  re- 
port be  postponed  till  to  morrow. 

"  This  report,  in  the  writing  of  Thomas  Hurko,  is  in  the  Paptrt 

of  the  Continental  Congress,  No.  22,  folio  19. 


(.Continued  in  tbe'next  issue.) 


EDITORIAL 


Through  the  courtesy  of  Colonel  Wil- 
liam O.  Owen,  Curator,  Army  Medical 
Museum,  Washington,  D.  C,  we  are  able 
to  print,  in  this  number,  the  first  install- 
ment of  the  complete  procedure  of  Con- 
gress in  regard  to  the  organization  of  medi- 
cal service  during  the  War  of  the  Revolu- 
tion (1775-83)-  As  archival  material  of 
greatest  value  for  the  earlier  medical  his- 
tory of  our  country  and  of  interest  to  all 
American  physicians  of  colonial  extraction, 
we  regard  it  as  a  privilege  to  print  this 
record,  lengthy  as  it  is.  It  shows  exactly 
what  Congress  did  or  did  not  do  for  mili- 
tary medicine  in  the  most  crucial  period  of 
our  history.  In  this  connection,  however, 
it  would  seem  apposite  to  specify  our  in- 
tention in  regard  to  the  printing  of  ma- 
terial of  this  kind  in  future.  Any  archivis- 
tic  material  of  exceptional  national  and 
historical  importance,  if  not  too  extensive, 
will  be  most  welcome  in  these  pages.  Real- 
ly valuable  material  of  this  kind  is  exces- 
sively rare  in  this  country.  We  cannot, how- 
ever, engage  to  print  the  archival  histories 
of  medicine  for  separate  states,  counties, 
cities  or  smaller  localities.  This  we  con- 
ceive to  be  the  proper  function  of  the  jour- 
nals of  the  state  medical  societies,  the  city 
and  county  journals,  and  the  local  period- 
icals devoted  to  medical  history.  Moreover, 
these  separate  histories  have  already  been 
very  well  taken  care  of  for  some  of  the  sev- 
eral states,  cities  and  counties,  whether  in 
book  or  periodical  form.  Dr.  Stephen  Wickes, 


for  instance,  wrote  the  medical  history  of 
New  Jersey  (1879);  Dr.  Samuel  Abbott 
Green,  the  medical  history  of  Massachusetts 
(1881),  andofGroton,  Mass.  (1890)  in  par- 
ticular; Dr.  Eugene  F.  Cordell,  the  "Medical 
Annals  of  Maryland,  1799-1899"  (1903). 
Drs.  Samuel  C.  Busey  and  Daniel  S.  Lamb 
have  covered  the  medical  history  of  the  Dis- 
trict of  Columbia  in  several  volumes;  Dr. 
Frederick  P.  Henry  wrote  the  medical  history 
of  Philadelphia  ( 1 897) .  Dr.  Otto  Juettner  has 
given  an  exhaustive  history  of  medical  Cin- 
cinnati in  his  "Daniel  Drake"  (1909).  Old 
medical  New  York  has  been  the  theme  of 
memoirs  by  John  W.  Francis  (1858),  and 
Francke  Huntington  Bosworth  (1898). 
Early  medical  Chicago  has  been  treated  by 
James  Nevins  Hyde  (1879)  with  subse- 
quent material  in  the  earlier  numbers  of 
the  Bulletin  of  the  Medical  History  Society 
of  Chicago.  The  story  of  the  Boston  Society 
for  Medical  Improvement  was  given  by  the 
late  Dr.  James  G.  Mumford  (1901).  Old 
medical  Boston  is  in  the  hands  of  Mr. 
James  F.  Ballard  of  the  Boston  Medical 
Library.  Medical  histories  of  all  our  impor- 
tant states  and  cities  will  undoubtedly  ap- 
pear in  course  of  time,  andTit  should  be  a 
matter  of  local  pride  and  patriotism  to 
have  them  completed  and  printed  in  each 
particular  locality.  We  cannot  engage  to 
cover  this  extensive  field,  but  we  would 
particularly  solicit  such  archival  material 
as  unpublished  letters  of  great  physicians 
and  surgeons— particularly  those  of  which 


217 


Annals  of  Medical  History 


the  content  is  of  historical  and  biograph- 
ical importance — brief  autograph  letters  of 
medical  celebrities  for  reproduction  in  fac- 
simile, rare  photographs  of  eminent  physi- 
cians not  heretofore  reproduced,  rare  en- 
gravings and  prints  of  the  same  description, 
and  other   medical  curiosities   which   may 


stimulate  interest  in  our  subject  or  serve 
as  basic  material  for  future  historians. 
We  realise  that  this  is  a  new  departure, 
and  in  the  absence  of  such  old  medical 
manuscripts  as  Europe  abounds  in,  we 
solicit  the  help  of  our  subscribers  and 
contributors. 


MEMORIAL  NOTICE  SIR   MARC   AMAND   RUFFER 

KT.,    C.   M.   G.     (1859-I917) 


Original  investigation  in  medical  history 
of  late  years  has  been  furthered  in  remark- 
able ways  by  archae- 
ologists, anthropolo- 
gists, numismatists, 
antiquarians,  collec- 
tors of  engravings, 
sinologists,  Egyptolo- 
gists, and  particularly 
by  travellers  and  ex- 
plorers. Indeed,  the 
journey  method  of 
Sudhoff  goes  to  show 
that  he  who  enjoys  the 
advantages  of  travel  is 
much  more  likely  to 
turn  up  new  facts  than 
the  stationary  investi- 
gator. One  of  the  most 
prominent  exponents 
of  this  new  tendency 
was  Sir  Marc  Amand 
Ruffer,  late  President 
of  the  Sanitary  Coun- 
cil of  Egypt,  who  died 
at  sea  cl  uring  t  he 
spring  of  [917  on  his 
return  from  Salonika, 
w  hither  he  had  gone  to 
reorganize  the  sanitar\ 
service  of  the  Greek  Provisional  Govern- 
ment. Hi'  made  his  mark  in  the  medical 
history  of  ancient  Egypt  In  his  contribu- 
tions  to   its  paleopathology,  in  particular 


Sir    Marc    Amand 


the  paleohistology  of  the  pathological 
lesions  found  in  mummies  of  the  XVIII- 
XXVII  dynasties. 
He  was  born  at 
Lyons,  France,  in 
1859,  the  son  of  the 
late  Baron  Alphonse 
Jacques  de  Ruffer.  His 
mother  was  a  German. 
He  was  educated  at 
Brasenose  College, 
Oxford,  where  he  took 
his  B. A.  degree  in  1883, 
and  at  University  Col- 
lege, London,  becom- 
ing bachelor  of  medi- 
cine and  surgery  in 
1887  and  M.D.  in 
1889.  He  then  became 
a  pupil  of  Pasteur  and 
Metehnikolf  at  the 
Pasteur  Institute,  de- 
voting special  study 
to  the  then  novel  sub- 
ject ol  phagoey  tosis. 
In  his  papers  of  [890, 
he  gave  an  cai'K  and 
timeh     exposition    of 

MetchnikofFs  concept 
Ruffer   ( 1859— 1917J  r   ■    u 

ol   inflammation  as  a 

protective  mechanism  against  infection, 
particularly  in  the  intestinal  canal.  He 
described  tin-  diphtheritic  membrane  as  "a 

battlefield,"    in    which    pathogenic    bacteria 


Sir  Marc  Amand  Ruffer 


219 


and  ameboid  leucocytes  contend  for  mas- 
tery. In  1 89 1,  Ruffer  became  the  first 
director  of  the  British  Institute  of  Preven- 
tive Medicine,  his  assistant  being  Professor 
Henry  G.  Plimmer.  At  Metchnikoff's  in- 
stance, Ruffer  and  Plimmer  took  up  the 
study  of  cancer  and  established  the  provi- 
sional status  of  the  quasi-parasitic  forma- 
tions in  cancer  cells.  While  testing  the 
new  diphtheritic  serum  at  the  Institute, 
both  Ruffer  and  Plimmer  fell  victims  to 
the  disease,  and  Ruffer  was  so  severely 
smitten  with  the  paralytic  sequelae  that 
he  felt  compelled  to  resign  his  directorship. 
He  then  went  to  Egypt  for  recuperation 
and  subsequently  took  up  his  permanent 
residence  at  the  Villa  Menival,  Ramleh. 

Ruffer  was  one  of  the  ablest  organizers 
of  medical  administration  in  recent  times. 
He  did  much  to  make  the  present  Lister 
Institute  what  it  is  to-day,  became  pro- 
fessor of  bacteriology  in  the  Cairo  Medical 
School  (1896),  which  he  reorganized,  and 
was  the  president  of  the  Sanitary,  Mari- 
time and  Quarantine  Council  of  Egypt 
( 1 901-17),  in  which  office  he  was  instru- 
mental in  ridding  Egypt  of  cholera  by  rig- 
orous hygienic  policing  of  the  routes  of  pil- 
grimage at  the  Tor  Station  and  elsewhere. 
In  this  work,  he  enjoyed  the  confidence  and 
support  of  both  Lord  Cromer  and  Lord 
Kitchener.  He  served  on  the  Indian  Plague 
Commission,  was  Egyptian  delegate  to  san- 
itary conferences  of  1903,  1907  and  191 1, 
and  from  the  outbreak  of  the  present  war, 
was  highly  efficient  as  head  of  the  Red 
Cross  in  Egypt.  He  was  the  recipient  of 
many  honors  and  decorations,  and  was 
knighted  in  19 16.  A  man  of  the  world  in 
the  widest  sense,  he  was  a  remarkable  lin- 
guist, a  talented  violoncellist,  and  an  ex- 
pert at  his  favorite  game  of  billiards. 

In  December  1908,  in  connection  with 
the  excavations  made  in  Nubia  by  Elliot 
Smith,  Wood  Jones  and  Derry  prior  to 
the  flooding  of  the  country  by  the  raising 
of  the  Assuan  dam   (1907),   Ruffer  began 


to  exhibit  microscopic  sections  of  patho- 
logical lesions  in  mummies  at  the  Cairo 
Scientific  Society.  In  this  field,  Fouquet  was 
the  pioneer  (1889),  but  Ruffer  made  it  his 
own  by  his  expert  skill  in  microtomic  tech- 
nique and  staining  methods.  To  overcome 
the  hard,  brittle  and  friable  character  of 
the  tissues,  before  cutting  with  a  Minot 
microtome,  he  softened  them  in  a  solution 
of  alcohol  and  sodium  bicarbonate,  with 
subsequent  hardening  in  alcohol.  For  this 
new  branch  of  pathological  histology  he  de- 
vised the  term  "paleopathology."  His 
"preliminary  note"  of  1909  (Brit.  Medical 
Journal,  1909  I,  1905)  was  followed  by  a 
striking  series  of  papers  on  the  presence  of 
Bilharzia  hematobia  in  Egyptian  mum- 
mies of  the  XX  dynasty,  1250-100  B.C. 
(Ibid.,  1910,  I,  16),  on  a  varioloid  eruption 
in  the  skin  of  a  mummy  of  the  same  period 
(J.  Path.  &  Bad.,  Cambridge,  1910-11,  XV, 
1-3,  1  pi.),  on  arterial  lesions  in  mummies 
of  1580  B.C. — 525  a.d.  (Ibid.,  453-462, 
3  pi.),  on  the  osseous  lesions  in  Egyptian 
skeletons,  ranging  from  2980  B.C.  to  the 
Greek  period  (Ibid.,  1911-12,  XVI,  439- 
495,  9  pi.)  on  dental,  osseous  and  articular 
lesions  in  Coptic  bodies  of  400-500  a.d. 
(Ibid.,  1913-14  XVIII,  149-162,  6  pi.)  on 
a  tumor  of  the  pelvis  from  the  catacombs 
of  Komel  Shougafa,  250  a.d.  (Ibid.,  480- 
484,  2  pi.)  and  a  monograph  on  "Histolog- 
ical Studies  in  Egyptian  Mummies"  (Cairo, 
191 1).  In  1910,  Elliot  Smith  and  Ruffer 
described  a  case  of  Pott's  disease  in  a 
mummy  of  the  XXI  dynasty,  circa  1000 
B.C.  (Giessen,  1910),  perhaps  the  earliest 
landmark  we  have  in  the  history  of  tuber- 
culosis. In  these  studies,  Ruffer  showed  the 
presence  of  calcified  Bilharzia  eggs  in  the 
kidneys  of  two  mummies,  a  common  cause 
of  prehistoric  hematuria,  as  shown  in  the 
hieroglyphs  and  medical  papyri;  also  the 
common  occurrence  of  arthritis,  spondy- 
litis deformans,  dental  caries,  rarefying  peri- 
odontitis, pyorrhoea  alveolaris,  Bouchard's 
nodes,  malarial  enlargement  of  the  spleen, 


220 


Annals  of  Medical  History 


biliary  calculi  and  particularly  arteriosclero- 
sis (atheroma)  which  was  found  even  in 
the  aorta  of  Rameses  II,  and  was  as  fre- 
quent 3000  years  ago  as  it  is  to-day.  Its 
causation  RufFer  leaves  an  open  question, 
since,  in  his  view,  alcohol,  tobacco,  meat 
diet,  strenuous  exercise  and  "wear  and 
tear"  could,  none  of  them,  have  availed  to 
produce  it.  His  final  studies  of  dental  and 
osseous  lesions  in  specimens  dug  up  at 
Faras  (100  B.c-300  a.d.)  and  at  Merawi 


(750-500  B.C.)  in  the  Sudan  (Sudhoff's 
Mittb.,  1914,  XIII,  453)  lead  him  to  the  con- 
clusion that  these  people  were  short-lived, 
dying  before  50.  The  war  interrupted  Ruf- 
fer's  work,  which  was  cut  short  forever  by 
his  untimely  death,  but  he  had  already 
prepared  a  volume  of  antiquarian  studies" 
for  the  press  which  will  probably  be  a  per- 
manent record  of  his  unique  and  memorable 
discoveries  in  paleopathology. 

F.  H.  Garrison. 


ANTYLLUS  ON  ANEURISM 


There  are  tivo  kinds  of  aneurysm.  In 
the  first  the  artery  has  undergone  a  local  dila- 
tation; in  the  second  the  artery  has  been 
ruptured.  The  aneurysms  which  are  due  to 
dilatation  are  longer  than  the  others.  The 
aneurysms  by  rupture  are  more  rounded. 
To  refuse  to  treat  any  aneurysm,  as  the 
ancient  surgeons  advised,  is  unwise;  but  it  is 
also  dangerous  to  operate  upon  all  of  them. 
We  should  refuse,  therefore,  to  treat  aneur- 
ysms which  are  situated  in  the  axilla,  in  the 
groin  and  in  the  neck,  by  reason  of  the  volume 
of  the  vessels  and  the  impossibility  and  danger 
of  isolating  and  tying  them.  We  should  not 
touch  an  aneurysm  of  large  volume  even  when 
it  is  situated  in  some  other  part  of  the  body. 
We  operate  in  the  following  manner  upon 
those  which  are  situated  upon  the  extremities 
and  the  bead:  If  the  aneurysm  be  by  dilata- 
tion, make  a  straight  incision  through  the 
skin  in  the  direction  of  the  length  of  the  vessel, 
and,  drawing  open  by  the  aid  of  hooks  the  lips 
of  the  wound,  divide  with  precautions  the 
membranes  which  cover  the  artery.  With 
blunt  books  we  isolate  the  vein  from  the 
artery,  and  lay  bare  on  all  sides  the  dilated 
part  of  this  last  vessel.  After  having  intro- 
duced beneath  the  artery  a  probe,  we  raise  the 
tumor  and  pass  along  the  probe  a  needle  armed 
with  a  double  thread  in  such  a  manner  that 


this  thread  finds  itself  placed  beneath  the 
artery;  cut  the  threads  near  the  extremity  of 
the  needle,  so  that  there  will  be  two  threads 
having  four  ends;  seizing,  then,  the  tivo  ends 
of  one  of  these  threads,  we  bring  it  gently 
toward  one  of  the  two  extremities  of  the 
aneurysm,  tying  it  carefully;  in  like  manner 
also  we  bring  the  other  thread  toward  the 
opposite  extremity,  and  in  this  place  tie  the 
artery.  Thus  the  whole  aneurysm  is  between 
the  two  ligatures.  We  open  then  the  middle 
of  the  tumor  by  a  small  incision:  in  this 
manner  all  which  it  contains  will  be  evacuated, 
and  there  will  be  no  danger  of  hemorrhage. 

To  tie,  as  it  has  been  advised,  the  artery  on 
both  sides  the  vein,  and  then  to  extirpate  the 
dilated  part  which  finds  itself  betiveen,  is  a 
dangerous  operation;  frequently,  in  fact,  the 
violence  and  tension  of  the  arterial  pneuma 
push  off  the  ligatures. 

If  the  aneurysm  owes  its  origin  to  the 
rupture  of  the  artery,  we  isolate  with  the 
fingers  as  much  of  the  tumor  as  we  can,  in- 
cluding the  skin,  after  which  we  pass  under- 
neath the  isolated  part  the  needle  with  the 
double  thread  and  proceed  as  before;  after 
which  the  tumor  rnay  be  opened  at  its  summit 
and  the  superfluous  portion  of  the  skin  cut 
away. 

Oribasius. 


BOOK   REVIEWS 


Finch  and  Baines,  A  Seventeenth  Century 
Friendship.  By  Archibald  Malloch,  B.A. 
(Queen's);  M.D.  (McGill);  Temporary  Captain, 
Canadian  Army  Medical  Corps.  Cambridge,  at 
the  University  Press,  1917. 

This  is  a  large  quarto  volume  well  illus- 
trated with  nine  full-page,  halftone  pictures 
of  Finch  and  Baines  and  of  things  associated 
with  them.  Dr.  Malloch,  the  author,  has 
done  an  interesting  piece  of  work,  and  made 
a  contribution  to  medical  history  which  will 
be  much  prized  by  those  interested  in  the 
humanities  of  medicine.  He  has  put  Doc- 
tors Finch  and  Baines,  so  to  speak,  "on  the 
map,"  for  neither  of  them  is  mentioned  in 
the  standard  histories  of  medicine. 

Doctors  Finch  and  Baines  were  two  Eng- 
lishmen born  in  the  early  part  of  the  seven- 
teenth century.  They  studied  at  Cambridge 
and  graduated  there — or  at  Oxford — in  arts. 
Having  formed  a  warm  friendship,  they  then 
went  together  to  Italy  and  took  up  the 
study  of  medicine  at  Padua  at  the  sugges- 
tion, it  is  said,  of  Dr.  Harvey,  whose  niece 
was  married  to  Finch's  elder  brother.  Dur- 
ing the  trip,  and  while  at  Padua,  Finch  kept 
a  journal,  and  wrote  frequent  letters  to  his 
much  beloved  sister,  Viscountess  Anne  Con- 
way, a  learned  woman,  who  was  an  invalid, 
and  a  patient  of  Dr.  William  Harvey. 

Finch,  in  his  journal,  gives  some  interest- 
ing notes  of  the  hospitals  and  sanitary  con- 
dition of  Paris,  whose  streets  were  "more 
durty"  but  better  paved  than  those  of 
London.  (Finch  could  not  spell.)  "At  the 
Hotel  Dieu,"  he  says,  "there  were  eight  in 
a  bed,  but  at  the  Hotel  Charite  everyone 
has  his  own  bed." 

Finch  and  Baines  finally  reached  Padua 
and  began  the  study  of  medicine.  This  was 
about  1652.  The  letters  of  this  period  throw 


little  light  on  the  life  and  methods  of  study 
at  that  time.  Finch  is  interested  in  his  sister's 
headaches,  and  writes  about  a  Universal 
Medicine  and  the  cures  of  Van  Helmont. 
He  also  sends  his  sister  long  discourses  on 
philosophy  and  natural  history,  and  inci- 
dentally does  not  think  much  of  Descartes. 
He  refers  to  only  one  of  his  teachers,  Moli- 
netti,  who  succeeded  Vestigius  in  the  chair 
of  anatomy.  Baines  wrote  a  very  lauda- 
tory poem  on  Molinetti's  skill,  much  in 
the  line  of  the  canticles  and  eulogies  to  the 
anatomists  of  those  and  earlier  days. 

"Ne  dissecas,  Molinette,  sed  adornas  cor- 
pora: 


sic  non  Te  Anatomicum 
Praestas  sed  id  quod  abunde   magis   est, 
Deum." 

During  the  next  years  Finch  was  especial- 
ly interested  in  anatomy.  In  1656,  he  was 
made  Pro-rector  of  the  University  and  in 
1657  the  friends  took  their  degrees  in  Medi- 
cine. Two  years  later  they  went  to  Pisa 
and  Finch  was  made  Professor  of  Anatomy 
in  the  University,  although  he  had  been 
graduated  but  a  short  time  and  was  about 
33  years  old.  At  Pisa  they  had  as  associates 
Malpighi  and  Borelli,  and  they  made  studies 
in  comparative  anatomy  and  natural  history. 

In  1660  they  returned  to  England,  where 
Finch  was  made  physician  to  the  Queen 
and  Baines  a  professor  of  music.  Both  be- 
came Fellows  of  the  Royal  College  of  Phy- 
sicians and  Finch  was  knighted,  an  honor 
which  Baines  received  later. 

In  1665  Finch  with  Baines  attending  re- 
sumed his  lectures  on  Anatomy  at  Pisa. 
Three  years  later  he  was  made  ambassador 
at  the  court  of  the  Grand  Duke  of  Tus- 
cany and  began  to  get  into  politics. 


222 


Annals  of  Medical  History 


Finch  kept  a  note  book  and  would  now 
and  then  write  in  it  some  rather  melancholy 
and  entirely  non-compromising  poems. 

About  this  time  Finch  took  a  trip  to 
Rome  and  Naples  with  his  nephew,  leaving 
behind  for  the  first  time  poor  Dr.  Baines, 
who  was  suffering  from  stone  and  also 
from  a  tremor  which  prevented  his  writing 
very  much.  In  1670,  the  doctors  gave  up 
Italy  and  returned  to  England,  living  at  the 
Inner  Temple  with  Sir  John's  elder  brother, 
Chancillor  Heneage  Finch. 

Most  of  the  writing  quoted  in  this  book 
was  done  by  Dr.  Finch.  We  suspect  that 
Dr.  Baines  was  the  cleverer  man,  and  the 
more  important  of  the  two;  but  he  did  not 
have  quite  the  social  connections  of  Dr. 
Finch.  Dr.  Malloch  thinks  that  perhaps  he 
had  paralysis  agitans,  as  he  had  a  tremor 
all  his  life,  but  this  is  unlikely  for  he  could 
not  have  lived  with  it  to  such  an  age. 

In  1673  Finch  was  made  ambassador  to 
Turkey,  and  he  and  Baines  sailed  for  Con- 
stantinople. While  there  he  wrote  often  to 
his  sister;  and  his  journal  contains  notes  of 
persons  met,  and  of  discussions,  mostly 
religious  in  character.  The  friends  had 
dropped  out  of  medicine. 

Baines  died  in  1681,  aged  57,  of  a  ter- 
tian ague.  Sir  John  Finch  has  a  touch  of 
superstition,  and  he  makes  this  curious  note 
regarding  the  demise  of  his  friend: 

"Two  things  I  cannot  omitt.  The  first  is 
that  Sir  Thomas  and  I  sitting  at  table  in  our 
gallery  at  Pera,  after  supper,  about  a  year 
before  his  death,  there  was  a  loud  knocking 
upon  the  round  table  wee  sat  at,  for  near 
the  space  of  a  quarter  of  an  hour.  We 
called  in  three  servants,  my  secretary,  Der- 
ham,  and  Zacar,  which  last,  astonished  at 
the  thing  threw  off  the  carpet  (i.e.  the 
table  cover)  and  crept  under  the  table; 
and  then  the  knocking  seemed  to  be  above 
the  table:  as  it  seemed  to  us  to  be  under- 
neath it. 

"The  second  was  thai  about  foure  dayes 
before  Sir  Thomas  his  sieknesse,  one  of  my 
dentes  incisores  dropt  out  of  my  head  with- 


out any  pain  whilst  wee  dined  together; 
which  seemes  to  confirm  the  interpretation 
of  those  who  make  the  dreaming  of  the 
Iosse  of  a  tooth  to  be  the  prediction  of  the 
Iosse  of  a  friend. " 

Sir  John  and  Sir  Thomas  lived  together 
for  36  years,  and  in  very  intimate  friend- 
ship for  26  years.  At  the  time  of  Baines's 
death  Sir  John  wrote  a  "dedication"  to 
him.  It  is  a  touching  and  eloquent  tribute 
to  his  friend  and  to  friendship. 

"But  lastly  Sir  when  I  consider  that  of 
the  twenty-six  years  wee  spent  together 
since  wee  first  left  England,  that  wee  never 
have  been  separated  two  months  from  each 
other  unlesse  it  were  in  the  exercising 
some  act  of  kindnesse  though  two  and 
twenty  of  them  spent  in  foreign  parts: 
.  when  I  consider  your  inimitable 
as  well  as  unrequitable  friendship  though 
you  were  wracked  with  stone  and  torment- 
ed by  the  gout,  inspiring  you  with  courage 
to  accompany  me  in  your  declining  years 
and  strength  all  this  length  of  time  and 
voyage:  the  greatest  temporall  blessing 
could  have  befallen  me — so  that  I  may  say 
as  truly  of  you  as  Aneas  did  Anchiscs,  and 
I  doe  say  more  affectionately, 

Ille   meum    Comitatus   iter   maria   omnia 

mecum 
Atque    omnes    Pelagique    minas    coelique 

jerebat 
Invalidus  vires  ultra  sortemque  Senectae. 

When  dear  Sir  I  consider  all  this,  I  find 
that  under  all  the  ties  of  honour,  friend- 
ship, gratitude  and  justice,  you  are  entitled 
to  this  dedication.     .     .     ." 

Finch  did  not  long  survive  his  friend.  He 
died  of  pleurisy  in  1682. 

Charles  L.  Dana. 

Dr.  Lyman  Spalding,  the  Originator  of  the 
United  States  Pharmacoiheia;  Co-laborer  with 
Dr.  Nathan  Smith  in  the  founding  of  the  Dart- 
mouth College  Medical  School  and  its  Inst 
Chemical  Lecturer;  President  and  Professor  of 
Anatomy  and  Surgery  of  the  College  of  Physi- 
cians and  Surgeons  of  the  Western  District,  al 
Fairfield,  N.  Y.  By  his  Grandson,  Dr.  James 
Alfred  Spalding.  W.  M.  Leonard,  Boston,  mid. 
8vo,  pp.  379- 


Book  Review 


223 


This  book  tells  the  story  of  the  life  and 
achievements  of  an  interesting  character 
who  lived  a  hundred  years  ago.  The  book  is 
full  of  letters  and  reminiscences  connected 
with  the  prominent  physicians  of  New  Eng- 
land, and  of  New  York  and  Philadelphia 
during  that  time.  To  those  who  are  inter- 
ested in  the  customs  and  habits  of  life  of 
medical  men  of  America  during  this  period, 
and  in  the  teachings  of  the  professors  and 
in  the  development  of  medical  and  scien- 
tific education,  the  book  will  afford  in- 
struction and  very  great  entertainment. 
The  names  and  doings  of  Drs.  Nathan 
Smith,  Shattuck,  Warren,  Ramsay,  Mit- 
chell and  Waterhouse  are  most  frequently 
mentioned,  but  there  is  hardly  a  notable  of 
that  period  who  is  not  referred  to.  Dr. 
Spalding  evidently  mingled  with  and  knew 
well  the  Fathers  of  American  Medicine. 

He  gives  many  interesting  notes  of  lec- 
tures by  famous  surgeons  and  physicians. 

Here  is  one: 

"At  a  lecture  by  Dr.  V.  Physick  a  pa- 
tient with  unreduced  dislocation  of  the  fe- 
mur was  brought  in  for  reduction.  After 
counterextension  and  rotation,  the  neck  of 
the  femur  broke  to  the  confusion  of  the 
surgeons  and  the  amazement  of  the  class. 
'  I  go  next,  said  Dr.  Physick  without  ap- 
parent interruption,  'I  go  next  to  speak  of 
strangulated  hernia  in  which  a  high  enema 
of  tobacco  is  better  than  tobacco  smoke.'" 

The  book  contains  several  illustrations 
including  a  portrait  of  the  hero  of  the 
Pharmacopoeia,  and  reproductions  of  auto- 
graph letters  by  eminent  physicians. 

Chas.  L.  Dana. 


An  Introduction  to  the  History  of  Medicine, 
with  Medical  Chronology,  Suggestions  for  Study 
and  Bibliographic  Data.  By  Fielding  H.  Gar- 
rison, A.B.,  M.D.,  Principal  Assistant  Librarian, 
Surgeon-General's  Office,  Washington,  D.C.  Sec- 
ond Edition,  Revised  and  Enlarged,  Illustrated. 
W.  B.  Saunders  Company,  Philadelphia  and 
London,   1917.     Octavo,  pp.  905.     Cloth. 


We  welcome  with  much  satisfaction  this 
second  edition  of  Dr.  Garrison's  popular 
"Introduction  to  the  History  of  Medicine," 
no  doubt  the  best  history  of  any  substantial 
length,  which  has  been  published  in  English. 
Such  a  work,  we  need  hardly  say,  of  very 
solid  labor,  can  only  be  accomplished  by  an 
exceptional  combination  of  diligence  and 
zeal.  Indeed,  the  term  "zeal"  is  too  faint; 
we  might  substitute  enthusiasm  or  self- 
sacrifice  and  yet  not  go  beyond  the  mark. 

The  American  physician  has  only  just 
discovered  as  it  were,  new  veins  of  gold, 
opened  up  by  Sudhoff,  Neuburger,  Sticker, 
Wickersheimer,  Allbutt,  Curtis,  Singer  and 
others  in  the  study  of  the  history  of  medi- 
cine, and  the  mine  is  being  eagerly  worked. 
Dr.  Garrison  is  a  sympathetic  writer  who 
grasps  the  leading  features  of  medical  history 
and  delivers  his  impressions  with  clearness 
and  ease,  never  losing  sight  for  a  moment  of 
his  main  theme.  One  is  astonished  to  find 
within  the  covers  of  a  single  volume  the 
exhaustive  and  rich  amount  of  material  given 
in  such  a  brief  manner. 

In  the  preface  he  quotes  from  a  private 
letter  of  Dr.  Charles  Singer  (Oxford),  who 
says:  "The  history  of  medicine  is  a  history 
of  ideas,  and  biography  is  only  of  value  in 
so  far  as  it  bears  on  ideas.  The  history  of 
medicine  is  not  concerned  with  tattle  about 
the  lives  of  the  great,  nor  with  the  absurdi- 
ties of  ancient  error,  nor  with  the  quaintness 
of  antique  expression."  The  time  is  not  yet 
very  long  past  when  a  historical  work,  es- 
pecially an  elementary  and  popular  work, 
was  scarcely  anything  but  an  endless  series 
of  names,  dates  and  facts  arranged  in  regu- 
lar succession.  Now,  however,  our  concep- 
tion is  changed.  We  ask  of  the  historian,  not 
to  load  our  memory  with  facts  but  to  recall 
the  dead  past  to  life,  to  give  us  a  vivid,  ani- 
mated, and  truthful  picture  of  the  times  that 
are  no  more.  We  require  him  to  make  us  live 
the  life  of  our  medical  forefathers;  to  initiate 
us  into  their  ideas,  their  beliefs,  their  pas- 
sions; to  disclose  to  us  all  the  motives  good 


224 


Annals  of  Medical  History 


or  evil,  on  which  they  acted;  to  reveal  to  us 
their  virtues  and  vices;  and  we  thus  say  of 
the  historian,  what  used  to  be  said  only  of 
the  poet,  that  he  must  be  a  painter.  No 
small  part  of  the  charm  of  the  literary  excel- 
lence of  the  book  is  duetothe  character 
painting  which  our  author  indulges  in. 

Not  only  in  the  case  of  a  long  and  de- 
tailed history,  made  as  complete  as  possible, 
but  even  of  a  summary,  an  elementary  book, 
the  object  of  which  is  to  narrate  briefly  in  one 
short  volume  the  whole  history  of  medicine, 
we  do  not  accept  a  simple  record  of  dry  and 
lifeless  facts,  but  require  the  author  to 
present  us  a  picture  addressing  the  imagina- 
tion as  much  as  the  memory,  and  enabling 
us  to  understand  what  were  at  various 
periods  the  manners,  the  intellectual  con- 
ditions, the  character,  the  tendencies  of 
periods,  which  is  the  subject  of  his  work. 

Such,  then,  is  the  end  which  the  author 
of  this  "Introduction  to  the  History  of 
Medicine"  has  kept  in  view,  and  this  end 
he  seems  to  us  to  have  attained.  Drawing 
his  inspirations  from  Osier,  Baas,  Pagel, 
Sudhoff,  Neuburger,  and  other  authorities, 
he  has  composed  a  scholarly  and  delightfully 
entertaining  account  of  the  development  of 
medicine  from  the  ancient  and  primitive 
period  to  the  present.  He  has  composed  an 
attractive  story,  which,  while  easy  reading, 
is  fully  adequate  to  instruct  the  readers  for 
whom  it  is  intended,  and  to  prepare  for 
more  complete  studies  those  who  wish  a 
more  minute  acquaintance  with  a  special 
period  or  subject.  For  this  purpose  Dr. 
Garrison  has  added  three  appendices,  viz.. 
medical  chronology,  hints  on  the  study  of 
medical  history  and  bibliographic  notes  for 
collateral  reading. 

The  composition  of  such  a  book  needs 
much  art,  and  also  really  scientific  knowl- 
edge; the  author  possesses  both  qualifica- 
tions and  has  acquainted  himself  with  the 
most  recent  works  as  shown  in  his  account 
of  Assyro-Babylonian  medicine  by  Pro- 
fessor Morris  Jastrow  of  the  University  of 


Pennsylvania.  The  medical  features  of  the 
cuneiform  inscriptions  of  the  Ass}rrians  and 
Babylonians  have  not  been  very  generally 
studied  and  the  first  good  account  of  Assyro- 
Babylonian  medicine  was  given  by  Pro- 
fessor Jastrow.  Although  not  a  physician, 
he  has  paid  much  attention  to  the  subject, 
and  students  of  medicine  are  indebted  to 
him  for  some  clever  discoveries  therein.  We 
admire  his  patience  and  learning  displayed 
in  collecting  and  arranging  in  an  under- 
standable order  the  facts  which  he  has 
gleaned  from  the  broken  fragments  of  the 
clay  libraries  of  Nineveh  and  Babylon.  It  is 
hardly  necessary  to  say  that  this  crude  ma- 
terial needs  interpretation  of  the  kind  Jas- 
trow has  given.  Many  other  investigations 
not  accessible  in  the  first  edition  are  also 
considered.  In  particular,  the  researches  in 
ancient  medicine  of  Erwin  Rohde,  Max 
Holler  and  Max  Wellman,  those  in  mediaeval 
medicine  by  Karl  Sudhoff,  Neuburger,  Wick- 
ersheimer  and  Singer,  the  investigations  in 
epidemiology  of  Georg  Sticker,  the  history 
of  pharmacy  of  Tschirch  and  Schelenz,  the 
paleopathology  of  ancient  Egypt  of  Elliot 
Smith  and  Wood  Jones  are  very  accurately 
rendered.  These  are  only  some  of  the  points 
of  interest  touched  upon  in  this  entertaining 
and  delightful  book. 

Dr.  Garrison  has  been  extremely  fortu- 
nate in  his  position  as  Principal  Assistant 
Librarian  in  the  Surgeon-General's  Office 
which-  enables  him  to  take  freely  from  its 
unlimited  resources  and  treasures.  Few 
English  writers,  moreover,  are  so  well 
qualified  in  a  scholarly  way  for  the  task  of 
using  these  references.  We  are  grateful  to 
Dr.  Garrison  for  having  taken  up  and 
brought  to  so  happy  a  conclusion  the  labo- 
rious work  which  he  had  begun  in  his  first 
edition.  It  remains  to  say  that  in  course  of 
reading  steadily  through  large  consecutive 
portions  of  the  book,  we  have  been  led  to 
view  it  not  only  as  an  utilitarian  book  of 
reference  but  as  a  source  of  genuine  literary 
pleasure.  Mortimer  Frank. 


VOLUME    I 


NUMBER    3 


ANNALS    OF 

MEDICAL  HISTORY 


FRANCIS  R'PACKARD'M'D'EDITOR  [PHILADELPHIA] 
PUBLISHED  QUARTERLY  BY  PAUL  <  B  *  HOEBER 
67-69  EAST  FIFTY-NINTH  STREET  <  NEW  YORK  CITY 


It 





s 


ANNALS  OF  MEDICAL  HISTORY 


Volume  i 


Fall  1917 


Number  3 


FIGURATIONS  OF  SKELETAL  AND  VISCERAL  ANATOMY 

IN  THE  BOOKS  OF  HOURS 

By 

WILFRID  M.  DE  VOYNICH  &  FIELDING  H.  GARRISON,  M.D. 


HE  memorable  essay 
of  Lessing  (1769) 
and  subsequent 
studies  have  fairly 
well  proven  that  the 
ancients  represented 
death  in  art  in  a  se- 
rene and  beautiful 
way.  Parkes  Weber  has  latterly  shown 
that  "during  the  best  period  of  Greek 
art  the  realistic  representation  of  skel- 
etons and  corpses  was  avoided,"  although, 
in  the  later  Roman  and  Grseco-Roman 
figurations,  skeletons  and  shrivelled  corpses 
of  skin  and  bone  sometimes  occur,  as 
a  whimsical  memento  mori  device,  on 
gems,  vases,  wine  cups,  etc.1  In  these,  for 
instance  in  the  figures  of  skeletons  or 
shades  of  dead  philosophers  on  the  Graeco- 
Roman  silver  wine  cups  of  the  Boscoreale 
treasure    in    the    Louvre,2    the    device    is 

1  F.  Parkes  Weber:  "Aspects  of  Death  in  Art  and 
Epigram,"  2.  ed.,  London,  1914,  15-21. 


humorous,  signifying,  Parkes  Weber  main- 
tains, a  degraded  Epicureanism.  But  the 
ancients  never  used  the  skeleton  or  the 
shrivelled  skin-and-bone  larva  as  a  symbol 
of  Death  itself.  This,  as  Parkes  Weber 
insists,  was  an  innovation  of  the  Middle 
Ages.  Mediaeval  figurations  of  dancing  and 
tipsy  skeletons  occur  in  plenty,  it  is  true, 
but,  by  the  time  of  Holbein,  the  skeleton 
had  become  the  sign  and  symbol  of  Death 
as  the  King  of  Terrors. 

The  question  arises:  Were  these  skeletal 
symbols  of  Death  a  survival  of  the  Epi- 
curean Graeco-Roman  figurations,  or  were 
they  derived  from  the  drawings  in  the 
manuscript  illustrations  of  anatomy  of  the 
Middle  Ages?  That  the  artists  of  the  Mid- 
dle Ages  should  have  figured  Death  as  a 
skeleton,  with  scythe  or  drum,  is  easy  of 
explanation.  Death  was  at  hand  every- 
where. The  long  succession  of  devastating 
wars  and  epidemics  following  the  downfall 

2  Ibid.,  p.  18. 


225 


226 


Annals  of  Medical  History 


of  the  Roman  Empire  had  paralyzed  hope 
and  human  endeavor,  and  the  thoughts  of 
mankind  were  constantly  turned  towards 
mortality.  But  the  very  character  of  some 


upon  anatomy,  Streeter  infers  that  these 
artists  acquired  their  interest  in  dissecting 
in  precisely  this  way: 

"How  these  easy  intimacies  arose  be- 


of  the  early  medieval  figurations  of  Death 
suggest  kinship  with  the  MS.  anatomical 
drawings  of  the  same  period,  and  it  is  pos- 
sible that  the  medieval  artists  may  have 
acquired  this  peculiar  type  of  decorative 
scheme  not  beautiful  in  itself,  from  associa- 
tion with  physicians  who  were  studying 
anatomy  by  means  of  dissection.  In  his 
interesting  study  of  the  influence  of  the 
Florentine   painters   of   the   Quattrocento 


tween  physic  and  thcligurative  arts  would 
be  hard  to  explain  in  any  other  way  than 
the  one  I  shall  attempt  to  use,  simple 
and  obvious  as  it  is!  It  was  by  the  haz- 
ard of  association  in  one  and  the  same 
guild  that  the  anatomists  and  artists  of 
Florence  made  their  magnetic  contacts. 
The  painters  formed  a  sub-membrum  of 
the  'Guild  of  Physicians  and  Apotheca- 
ries.' They  all  belong* d— Giotto,  Masac- 


Skeletal  and  Visceral  Anatomy 


227 


cio,  Castagno,  Ucello,  Verrocchio— to  the 
membrum  pictorum  of  the  Guild  of 
Physicians  and  Apothecaries.  Masaccio 
joined   the  guild   first  as  an   apothecary 


together  in  all  the  multiform  guild  func- 
tions; they  sat  together  in  the  guild 
Council;  walked  together  under  the  same 
banner  in  pageants.   It  cannot,  therefore, 


facit  rectos  co:dejOcus  (udejt  iuftus  foztts  et  parens; 

[  nunquid  irafcirur  per  finguloo  Dies^r^ficoiiuerfi  fucri= 

rts  g!adtumtHumvib:3uit:arcum  fuimvtefendit  et  para= 

uit  fllum£Jt  ii  eoiMrauft  vafa  moms:  fagittas  fuas  ar 

dcnttbus  elfccir.  Of.ce  parturit  iniufticiam  concepit  00 

lozem: «  pcperit  (niqmtatettutj^cujnapcrutt  et  olfodit 

eum :  ct  incidit  in  fouca  quatn  fccit4DK'"ucrtetur  bolo: 

ejus  in  camiuiusxt  in  verticem  ipfius  iniquitas  cms  be 

fcendetiOjonfiteboz  Domino  fecudum  iufticiam  eiusrct 

pfallam  nomint  om  altiiTinif^f^Fquie  cternam  .5n.  lRe= 

quando  rapiat  vt  leo  animam  mca  oum  no  eft  q"  redimat 

neq?  q  faluum  faciat.*.3  po:ta  infcri;fy.t£r\ie  one  aias 

CQZum.^atcrnofter.Ctncnos.^cdlibera.      TLcc.i. 

Srce  mt'cbi  otic:  ntcbil  cni  funt  Dice  met.  Quid  eft 

bomo  quia  maguificas  eum:  aut  quid  apponis  cr= 

r  ga  eum  co:  tuu;  Sil.fitas  eu  DiIucuIo:ct  fubitop:obas  iU 

I  Ium  .^Slfquequb  non  parcis  mkbi.-nec  Dimittis  mevt  glu 

"'  tta  faliua  mca'  l^eccaui.  Quid  facia  tibi  0  cuftos  borm's 

ml:'  Quarc  pofuifti  me  contrariu  tibi :  et  factus  fum  mu 

cbimet  pfi  graufec'Cur  non  tollis  pcccatum  m«l:et  qua 

W  re  non  aufers  iniquitate  mcaY/Ecce  nunc  fit  pulucre  Do> 

j^J  mio:et  fi  mane  me  quefiens  non  fubfifta.rv.  Credo  q>  re 

SjOf]  dcptoz  me9  viuit  z  in  nouiflimo  Die  pe  terra  furrccturus 

1  fum.i£t  in  came  meavideboocu  faluato:e  mcfi.*.  Que 

^  vifurus  fum  egoipfe  ct  no  aliuc.-et  oculimci  confpecruri 

funtj^tin  came  mea  v;debo  ocu  faluatoze  incu.2Lcc.ij. 

j^|/£detanimamea  vitcmee:  Dimittaaduerfum  me 

J  lAeloqutu  meu.Hoquarinamaritudineanimemee: 

oica  oeo.lRolimecodemnarcindica  micbi  cur;me(ta  iu= 

dices^lHuquid  bonQ  tibi  vidctur  fi  calumnicris  et  oppji 

mas  me  opus  manuu  tuaru :  et  confiliu  impiomm  adm= 

uesHRunquid  oculi  carnei  tibi  fuut:aut  ficutvidet  bomo 

et  tuvidcbis^lRunquid  ficut  Dies  bominis  Dies  tui  et  an 

ni  tui  ficut  bumana  funt  tempos.'  ©t  qucras  iniquitate 


(in  142 1,  at  the  age  of  19) ;  then  he  matric- 
ulated under  the  membrum  pictorum  (in 
1423).  You  see,  the  apothecaries  included 
color  handlers,  the  'spetiarii,  qui  emunt, 
vendunt  et  operant  colores  et  alia  ad 
membrum  pictorum  spectantia  memora- 
tum'  (apothecaries  who  buy,  sell  and 
deal  in  colors  and  other  materials  needed 
by  the  artists).  By  virtue  of  this  affilia- 
tion the  artists  and  doctors  were  thrown 


be  a  matter  of  surprise  to  learn  that 
Giotto  was  a  friend  of  Dino  del  Garbo 
and  Torrigiano,  or  that  Luca  della  Rob- 
bia  (almost  200  years  later)  was  a  friend 
of  the  founder  of  pathological  anatomy, 
Benivieni,  although  the  latter  was  al- 
most half  a  century  (49  years)  younger 
than  Luca."3 

3  E.  C.  Streeter:  Johns  Hopkins  Hosp.  Bull., 
Bait.,  1916,  xxvii,  118. 


228 


Annals  of  Medical  History 


Some  light  upon  this  question  is  afforded 
in  the  skeletal  and  other  anatomical  figura- 
tions in  the  illuminated  and  printed  "Books 
of  Hours,"  from  which  the  pious  recited  their 


of  the  "Books  of  Hours,"  and  the  best  in 
artistic  merit,  particularly  the  illuminated 
mss.,  are  of  French  design,  tasteful  and 
charming    in    conception    and    execution. 


JWBI  nict4n.2Defufcepit, 

yMSf'r\  E-ue  ocus  meusrad  te  oe  luce  vigiio<$Tmjit(n  te 
'  %d  ^r*~Jwxm  mca:cj5multipliciter  tibi  caro  meaj^7fTe>ra 
Sri 0c^crta  *l,u'3  z  ln3cluofa  fie  in  fancto  apparulnbi^tvidc  a 
M  rem  virtutc  warn  et  glo:ia  warn  Qugnia  melio:  eft  mfal^ 
j>  'jj  tua  fuper  vitas:labia  mea  laudabut  tc.j^ic  benedicatef 
m  vita  mea:et  in  nomine  ruo  leuabo  manus  mMaGjkaa 
adipeetpiiiguedine  repkaturaiamea  :etlabiisejculta=| 
|  nonis  laudabit  00  mefi.j^ic  memo:  fui  tui  fuper  ftraru  I 
in  matutinis  meditabo:  te :  q:  fuifti  adiuto:  meus 
in  velamento  alaru  tuarum  ejculrabo  adbefit  anima  Ij 
mea  poft  te:me  fufcepit  ocjetera  toOEjR  vero  inuanum 
queficrunt  aiam  mcam  introibuntfn  inferior  tcrre:  tra= 
I  dentur  in  manus  gladi/  partes  vulpiu  erunt^F^cje  vero 
letabitur  in  oeo  laudabutur  oes  qui  turat  in  co:qz  obftru= 
ctum  eft  os  loquenriu  iniqua  Ocus  mifcrcaf  noftri  z  be. 
nedic3tnpt}is:  illuminet  vultu  fuu  fuper  nos  et  mifere3f 
noftnCTtcognofcamusiii  terra  viam  nil : in  omnibus 
sentibus  falutare  tuuOfonfucatur  tibi  populi  ocus:  co 
ntcantur  tibi  populi  ocs^fletetur  et  ejeultcnt  gctes  quo 
ruam  iudicas  populos  inequitatc.-et  gentes  in  terra  oiri= 
gis.Cfcnfiteanrur  tibi  populi  ocus:  confitcantur  tibi  po , 
pult  oes  terra  oedit  fructfi  fuS0enedicat  nos  oe''  ocus  I 
nofter  bndicat  nos  oerfs:et  mctuant  eum  oes  fines  terrc. 
uiem  eternam  oonajis  one  et  luje  perpetua  luceat 
,XOc  fufcepit  oeprera  tua  oomie.an.2l  potf  a  inferi 

ar  |_pf&ralmus«  I 

(60  of|ci  in  oimidio  oicru  meomm:  vadam  ad  po:=  F^^T^j 
tas  inferi.  CJiefiuirefiduumannommme^'m 
oijci  nou  videbo  oominum  oeum  in  terra  viuentii! 
afpiciambomtncvltra:etbabitato:cm  quietis.  <3Citcr 
no  mea  ablata  eft  ct  conuoluta  eft  a  me:quafi  tabernacu^ 
lum  paftozumOttcifa  eft  velut  a  tejeente  vita  mea  oum 
adbuc  o:direfTuccidit  me:oc  manevfep  advefpera  fiuics  J 
rt  me/^erabamvfq3admanc:quafileo  ficcontriuitoiaj 


wire- 


m 


matins,  lauds,  vespers,  and  the  other  daily 
exercises  of  prayer  and  devotion.  There  arc 
many  different  varieties  of  skeletons  in  these 
beautiful  medieval  manuals  which  we 
hope  at  some  future  time  to  study.  For 
the  present,  it  may  suffice  to  describe  a 
pages  photographed  from  a  manual 
oi  the  borx  canonicse  printed  at  Paris  in 
1501     by    Pigouchet   (Plates    I-IV).     Most 


In  the  plates  herewith  presented,  it  will 
strike  upon  the  sense  of  any  one  that  the 
marginal  figurations  of  death  as  a  half- 
dissected  corpse,  as  a  figure  covered  with 
syphilitic  or  leprous  sores,  or  as  a  shrivelled 
Hautskelett  (Sudholf's  Lemurengestalt)  were, 
in  all  probability,  conceived  from  some 
other    viewpoint    than    the    purely    artistic. 

In  the  shrivelled  figure  of  Death  subscribed 


Skeletal  and  Visceral  Anatomy 


229 


"le  pape"  in  the  right-hand  margin  of 
Plate  I,  the  abdomen  is  opened,  suggesting 
dissection.  In  the  lower  right-hand  corner 
of  the  center-piece  is  a  leper,  with  Lazarus- 


covered  with  syphilitic  sores,  with  a  spade, 
threatening  a  newly-married  wife  ("nouvelle 
marie"),  and  Death  jeering  at  a  pregnant 
woman  ("la  feme  grosse").  At  the  bottom 


rattle  and  wallet,  a  dog  licking  the  sores 
on  his  left  foot.  The  skeleton  in  the  lower 
right-hand  corner  of  Plate  II  ("le  medecin"), 
grins  mockingly  at  a  doctor  who  is  uphold- 
ing a  urine  glass.  At  the  top  ("le  moyne"), 
grinning  Death  shoulders  a  spade.  The 
right-hand  marginal  ornamentation  of  Plate 
III  shows  an  eviscerated  Death  arm  in 
arm   with  a  nun    ("la  theologiene"),  Death 


of  the  page,  a  dead  eviscerated  king,  covered 
with  luetic  sores,  lies  with  his  crown  beside 
him.  In  the  center  of  Plate  IV  is  a  corpse 
astride  a  jester,  the  abdominal  viscera 
being  dissected  out,  with  lines  extending 
from  the  heart,  liver,  stomach  and  other 
viscera  to  legends  in  the  margin  indicating 
the  planets  influencing  these  separate  parts, 
a  decorative  device  plainly   derived   from 


230 


Annals  of  Medical  History 


the  old  zodiacal  diagrams  for  bloodletting 
and  purgation,  in  which  an  exposition  of 
planetary  influences  was  frequently  com- 
bined with  schemata  of  the  viscera.  That 
these  grotesque  figurations  should  be  em- 
ployed as  decorative  devices  in  the  other- 
wise beautiful  "Books  of  Hours,"  plainly 
suggests  affiliation  of  the  miniature  painter 
with  medical  men  who  did  dissecting  and 
made  anatomical  illustrations  in  mss.  This 
will  seem  clear  to  any  one  who  compares 
these  shrivelled  and  eviscerated  skeleton- 
larvse   with  the  twelve  anatomical   minia- 

4  Sudhoff :  "Studien  zur  Geschichte  der  Medizin" 
(Puschmann  Stiftung),  Heft  4,  Leipzig,  1908,  pi. 
xxiv. 


tures  of  Henri  de  Mondeville  (1314),  which 
Sudhoff  has  reproduced,4  or  the  shrivelled 
skeletal  larva?,  with  jesters  between  their 
outstretched  legs,  from  the  Shepherd's  Cal- 
endars (Calendrier  des  Bergiers)  of  1495  and 
1500  5  or  the  Nuremberg  skeleton  of  Rich- 
ard Helain  (1493), 6  or  the  Brunswick  skele- 
ton of  Griininger  (1497).7  That  there  is 
some  connection  between  these  early  ana- 
tomical figurations  and  the  decorative  de- 
vices in  the  "Books  of  Hours"  seems  clear, 
and  we  hope  to  trace  this  connection  further 
back  at  some  future  opportunity. 

5  Sudhoff:  Ibid.,  pi.  ix. 

6  Ibid.,  p.  46. 

7  Ibid.,  p.  48. 


THE  EXPERIMENT  OF  WALAEUS 

[Job  Walaeus.    Epistolae  dux  (1640)] 


//  we  open  a  vein  in  a  ligated  arm  arid 
compress  or  ligate  the  distal  portion  near  the 
opening,  riot  a  drop  0/  blood  comes  out:  from 
ivbich  we  may  conclude,  apparently,  that  when 
blood  does  flow  from  the  openiiig,  it  comes 
from  the  direction  oj  the  band.  Again,  when 
blood  is  drawn  in  quantity  to  the  extent  that 
it  could  not  have  come  jrom  the  lower  part  oj 
the  brachial  veins,  it  must  have  come  Jrom  ar- 
teries not  closed  by  the  ligature,  and  above  the 
opening  as  the  pulse  itselj  indicates.  But  in 
order  to  make  this  plainer,  we  have  sometimes 
separated  the  tissues  Jrom  a  large  vein  and  ar- 
tery lying  above  the  muscles  in  a  dog's  groin 
so  that  both  were  completely  exposed.  On  lig- 
ating  this  vein  ivith  a  thread  we  have  noticed 
that  the  part  nearer  the  vena  cava  emptied  and 
contracted,  while  the  lower  parts  swelled  ex- 
tremely towards  the  leg,  so  that  by  reason  oj 
its  Jullness  it  seemed  harder  than  the  artery 
itselj.  But  directly  the  ligature  was  relaxed, 
the  Ulood  mounted  upwards  on  the  instant  and 
the  hardness  and  Jullness  oj  the  vein  was  vast- 
ly diminished;  when  the  artery  was  ligated, 
the  part  near  the  aorta  swelled  marvelously 


while  the  distal  part  was  correspondingly  dim- 
inished; at  the  same  time,  ij  the  vein  ivas  lig- 
ated, it  did  not  swell  perceptibly.  This  has 
been  our  common  experience.  But  in  order 
that  there  might  be  no  manner  oj  doubt,  and 
that  ive  might  know  what  goes  on  inside  the 
vein,  we  have  elevated  the  detached  vein  and 
artery  a  little,  and  have  jastened  the  leg  tight- 
ly underneath,  so  that  the  blood  could  not  be 
carried  up  or  down  by  any  other  vein  than  the 
one  so  lijted.  Then,  having  suspended  and 
elevated  the  vein  with  a  thread  as  represented 
in  the  figure,  we  made  a  little  opening  above 
and  below  the  ligature:  Instantly  the  blood 
Jrom  the  part  Jarthest  Jrom  the  heart  spurted 
out  in  an  abundant,  impetuous  jet;  while  the 
part  beyond  the  thread  and  nearer  the  heart 
oozed  out  only  drop  by  drop.  From  ivbich  it 
seems  evident  that  the  blood  does  not  descend 
Jrom  the  greater  vessels  but  ascends  Jrom  the 
smaller  to  the  larger  veins;  especially  since 
having  ligated  the  same  vein  farther  Jrom  the 
heart  we  have  seen  that  not  a  drop  came  Jrom 
the  opening  jrom  which  it  had  previously  jet- 
ted jorth  with  such  impetuosity. 


BABYLONIAN-ASSYRIAN  MEDICINE1 


By  MORRIS  JASTROW,  JR.,  Ph.D.,  LL.D. 

University  of  Pennsylvania 
PHILADELPHIA,    PA. 


MEDICINE  among  the  Babylo- 
nians and  Assyrians  takes  its 
rise  from  popular  experience 
or  perhaps,  we  should  say, 
from  necessity,  and,  therefore,  rests  upon 
popular  beliefs  as  to  the  cause  of  disease. 
That  cause  forms  part  and  parcel  of  a  most 
primitive  Weltanschauung  which  seeks  to  ex- 
plain the  universe  in  terms  of  life.  Life  is  the 
onephenomenon  which  man  finds  everywhere, 
in  himself  and  about  him.  He  recognizes  life 
in  trees  and  plants,  in  wells  and  streams,  in 
the  heavens  above — in  the  sun  and  moon,  in 
the  rain  and  the  storms  which  come  from 
above — and  as  a  matter  of  course  also  in  the 
animals  that  he  sees  or  with  which  he  comes 
into  contact.  Whatever  moves  must  have 
life,  and  so  he  assigns  life  to  the  clouds  and 
to  the  running  brooks.  Whatever  grows  and 
gives  fruit  has  life,  and  so  there  is  life  in  the 
trees  and  plants;  whatever  has  power  is  en- 
dowed with  life,  and  so  there  is  life  in  the 
sun  and  moon  as  in  animals  and  in  himself. 
Whether  we  call  this  theory  animism  or 
prefer  some  other  designation,  it  represents 
an  early  and  natural  phase  of  man's 
thought,  closely  entwined  with  his  religion 
and  involved  in  most  of  the  rites  which  we 
find  to  be  a  part  of  primitive  culture. 

It  is  a  part  of  this  early  and  naive  philos- 
ophy to  identify  all  forms  of  life  as  of  the 
same  quality,  or  rather  as  one  may  also 
put  it,  not  to  differentiate  between  the 
various   forms   and   manifestations  of  life. 

1  The  article  is  based  in  large  measure  upon  my 
monograph  "The  Medicine  of  the  Babylonians  and 
Assyrians,"  published  in  the  Proc.  Roy.  Soc.  Med., 
Section  for  the  History  of  Medicine,  1914,  vii, 
109-176,  which  is  an  enlargement  of  a  paper  read 
before  the  Royal  Society  in  October,  1913.  In  the 
present  article,  enlarged  from  a  paper  read  before 
the  Chicago  Society  for  the  History  of  Medicine, 


It  is  the  same  life  that  manifests  itself 
everywhere.  So  far  as  plants  and  the  ani- 
mal world  are  concerned,  this  identification 
of  all  forms  of  life,  though  set  up  in  an  en- 
tirely unscientific  spirit,  would  not  be  in 
contradiction  to  modern  biological  theories 
which  recognize  some  connecting  link  be- 
tween the  lowest  form  of  animal  life 
and  the  highest  form  of  plant  life,  but 
primitive  man  extends  the  analogy  to 
inanimate  nature — to  stones,  streams  and 
the  heavenly  bodies.  All  life  is  of  the 
same  kind  and,  therefore,  the  primitive 
philosophy  assumes  the  possibility  of  one 
form  of  life  passing  on  to  another  form — a 
point  of  view  that  is  illustrated  in  the  folk 
tales  and  myths,  so  widespread,  of  men 
being  changed  into  animals  or  trees,  and 
vice  versa.2  This  theory  survives  in  ad- 
vanced forms  of  religious  thought  in  the 
doctrine  of  the  transmigration  of  souls,  as 
in  Buddhism,  where  the  same  vital  es- 
sence, it  is  assumed,  may  appear  succes- 
sively in  a  tree,  in  an  animal  or  in  man;  in 
another  direction  it  leads  to  the  belief  of 
the  incarnation  of  a  deity  in  human  form — 
a  belief  found  in  many  religions. 

The  primitive  theory  of  animism  has  a 
bearing  on  the  earliest  view  as  to  the  cause 
of  disease.  Since  physical  suffering  is  an  at- 
tack upon  the  vital  essence  in  man,  pre- 
senting itself  as  a  conflict  waged  between 
man  and  some  hostile  power,  that  power 
is  likewise  viewed  under  the  aspect  of  life. 

May  5,  1917,  I  have  treated  the  subject  from  a  some- 
what different  point  of  view  and  have  added  some 
new  material,  to  bring  the  subject  up  to  date. 

2  For  instance,  in  the  Jatakas  or  the  Buddha  birth 
tales,  coming  down  to  us  as  the  "Fables  of  Bidpai, " 
"/Esop's  Fables"  and  in  various  other  forms. 
The  "Metamorphoses"  of  Ovid  and  the  "Golden 
Ass"  of  Apuleius  also  rest  on  this  popular  belief. 


231 


232 


Annals  of  Medical  History 


The  germ  theory,  so  popular  in  these  days 
of  advanced  pathology,  has  an  ancient  heri- 
tage. It  forms  the  starting  point  of  medi- 
cine everywhere,  for  sickness  is  pictured 
by  primitive  man  as  being  due  to  some 
active  living  force  that  has  found  its  way 
into  the  bod}-.  The  conclusion  is  a  very 
natural  one.  In  the  case  of  a  violent  or  a 
shooting  pain,  the  sensation  is  very  vivid 
that  there  is  something  inside  which  pro- 
duces the  picture,  something  that  must  be 
forced  or  coaxed  out  if  one  is  to  be  relieved 
— and  in  many  cases  this  is  no  doubt  true. 
A  cure,  therefore,  involves  the  expulsion 
of  the  hostile  power.  Medical  treatment  is 
essentially  exorcism.  This  primitive  germ 
theory  has,  in  fact,  a  great  advantage  over 
the  modern  successor,  for  to  the  imagina- 
tion of  primitive  man  the  germ  is  obliging 
enough  to  take  on  tangible  shape.  It  does 
not  hide  itself,  as  the  modern  germ  insists 
upon  doing,  so  as  to  be  discernible  only 
when  isolated  and  under  the  gaze  of  a 
powerful  microscope,  nor  must  its  exist- 
ence be  hypothetically  assumed.  The  an- 
cient germ  was  not  ashamed  of  itself;  it 
showed  its  teeth  and  even  its  tail  and  its 
horns.  The  germ  was  a  demon,  an  evil  spir- 
it that  was  sufficiently  accommodating  to 
sit  for  its  portrait,  and  so  we  have  in  early 
art,  pictures  of  these  demons  that  by  their 
terrifying  aspect 3  suggest  the  mischief  that 
they  were  capable  of  inflicting. 

Let  me  add  a  description  of  these  de- 
mons as  found  in  Babylonian  literature: 

Evil  Rabisu  *  are  they 
From  the  lower  world  they  come  forth. 
Messengers  of  Enlil,6  the  lord  of  the  lands  are 
they. 


The   evil    Utukku,6   who    in    the   open    attacks 

the  living; 
The  evil  AIu  covering  one    like  a    garment;7 
The  evil  Etimmu,8  the  evil  Gallu  who  seizes  the 

body. 
Labartu,  Labasi,  bringing  sickness  to  the  body; 
Lilu,9  wandering  about  in  the  open, 
Approaching  the  side  of  the  wandering  man, 
Imposing  wasting  disease  on  his  body, 
Bringing  an  evil  ban  on  his  body, 
Bringing  an  evil  pest  into  his  body, 
Bringing  evil  poison  into  his  body, 
Bringing  the  evil  curse  into  his  body. 

******* 

Ashakku10  has  approached  the  head  of  the  man. 

Namtar  ll  has  approached  the  throat  of  the  man. 

The  evil  Utukku  has  approached  his  neck. 

The  evil  AIu  has  approached  his  breast. 

The  evil   Etimmu  has  approached  his  stomach. 

The  evil  Gallu  has  approached  his  hand. 

The  evil  god  has  approached  his  foot. 

The  seven  together  have  seized  him; 

They  have  burned  his  body  like  a  glowing  fire.118 

The  Babylonians  and  Assyrians  thus  rec- 
ognized an  entire  faculty  of  demons.  The 
age  of  specialization  had  set  in  which  as- 
signed a  special  function  to  each  "germ," 
though  the  professional  ethics  of  demon- 
ology  did  not  bar  the  demons  from  en- 
croaching on  the  domain  of  a  colleague. 

Medical  treatment,  therefore,  was  di- 
rected towards  exorcising  the  demon  as  the 
cure.  It  remained  on  this  level  among  the 
Babylonians  and  Assyrians,  despite  consid- 
erable progress  made  in  the  direction  of 
prophylaxis.  Sickness  continued  to  the  lat- 
est period,  in  the  long  stretch  of  several 
thousand  years  covered  by  Babylonian-As- 
syrian history,  to  be  viewed  as  a  struggle 
between  the  patient  and  the  demon.  The 
theory  persisted  that  the  patient  was  cured 
when  the  demon  hae!  been  thrust  out. 


'See  the  illustrations  in  Jastrow,  "Civilization  of 
Babylonia  and  Assyria,"  PI.  xxxii. 

4  Name  of  a  class  of  demons,  meaning  "the  one 
who  lies  in  wait." 

*  The  chief  deity  of  Nippur  and,  in  the  older  period, 
the  head  <>f  the  pantheon. 

'Another  class  of  demons,  meaning  "the  strong 
one." 


7  A  demon  that  clouds  one's  vision. 

8  A  class  of  demons  identified  with   the  "shade" 
of  the  departed. 

9  A  storm  demon. 

'"The-  demon  of  wasting  disease. 

11  The  demon  of  plague. 

11 '  I  hat  1-,,  with  a  level,  which  is  regularly  spoken 

of  ill   these  texts  as  a   lire. 


Babylonian-Assyrian  Medicine 


233 


II 

An  interesting  trace  of  this  point  of  view 
is  to  be  found  in  the  Sumerian12  name  for 
physician  which  also  passed  over  into  Ak- 
kadian and  thence  into  other  Semitic  lan- 
guages. He  is  called  A-Su  composed  of  two 
signs,  conveying  the  idea  of  "one  who 
knows  water" — a  water  expert.  The  term 
rests  on  the  prominent  part  played  by  water 
in  the  exorcising  of  disease.  The  water-cure 
is,  in  fact,  the  starting  point  of  medical 
treatment  among  the  Babylonians. 

In  the  Babylonian-Assyrian  incantation 
texts,  of  which  we  have  a  large  number,13 
the  two  elements  of  nature  which  play  the 
most  prominent  part  in  the  exorcising  of 
disease  are  water  and  fire.  Water  is  viewed 
under  the  aspect  of  a  sacred  element,  sym- 
bolizing, as  water  does  in  primitive  and  an- 
cient cults  in  general,  purification  from 
ritualistic  uncleanness.  Fire  is  also  a  sacred 
element,  contact  with  which  purifies,  but 
in  Babylonian-Assyrian  texts  its  function  is 
to  destroy  the  demon  or  the  sorcerer  as  the 
cause  of  the  disease. 

Disease  as  due  to  the  presence  of  a  harm- 
ful demon  is  regarded  as  a  form  of  unclean- 
Iiness.  The  association  of  ideas  involved  in 
this  symbolism  is  very  natural.  Water  is 
looked  upon  as  a  gift  of  the  gods,  suggested 
by  the  rain  that  comes  from  above.  Streams, 
filling  up  and  overflowing  during  the  rainy 
season,  therefore  acquire  a  special  degree  of 

12  Sumerian  is  the  designation  of  the  non-Semitic 
speech  represented  by  the  earliest  records  of  the 
Euphrates  Valley;  Akkadian  is  the  Semitic  speech 
that  became  predominant  after  2000  b.  c.  While 
the  Akkadians  may  have  been  the  earlier  settlers, 
the  Sumerians,  coming  to  the  Valley  as  conquerors 
from  a  mountain  home,  imposed  their  authority  and 
their  language  on  the  valley  till  circa  2500,  when  the 
Akkadians  came  to  the  front,  and  about  2000  B.C. 
obtained  definite  control  of  the  region,  though  some 
Sumerian  centers  continued  to  flourish  after  that 
date.  The  cuneiform  syllabary  appears  to  be  of 
Sumerian  origin.  See  further  Jastrow,  "Civilization 
of  Babylonia  and  Assyria,"  Chapter  iii. 

13  Translations  of  many  of  these  texts  will  be  found 
in  R.  C.  Thompson,  "Devils  and  Evil  Spirits  of 


sacredness.  The  Nile,  the  Euphrates  and 
Tigris,  the  Ganges,  the  Jordan,  the  Tiber 
and  the  Rhone,  as  indeed  large  streams 
everywhere,  are  sacred.  To  this  day  pious 
pilgrims  bathe  in  the  Ganges  and  in  the 
Jordan  to  free  themselves  from  sin.  Baptism 
as  a  rite  of  initiation  into  the  covenant  of 
the  church  is  in  the  direct  line  of  succession 
to  the  use  of  water  as  a  purifying  element. 
The  novice  must  be  freed  from  uncleanliness 
before  entering  upon  a  new  life.  Hygiene 
and  religion  thus  converge  in  the  early 
stages  of  human  culture. 

An  incantation  to  be  recited  while  sprink- 
ling the  patient  with  water  or  pouring  it 
over  him  reads: 

The  holy  14  water, 

The  water  of    the    Euphrates,    flowing    in    a 

holy  place, 
The  water  that  is  preserved  in  the  deep,15 
The  pure  water  that  is  purified  by  Ea,16 
Seven  sons  of  the  deep  17  are  they, 
Who  have  purified   it  and   made  it  clean  and 

glisten 
Before  your  father,  Ea, 
Before  your  mother  Damkina  18 
May  he  (i.e.,  the  victim  or  diseased  one)  become 

resplendent,  pure,  clean. 

Or  again  in  an  incantation  to  the  god 
Marduk,  the  son  of  Ea,  and  who  as  the 
chief  god  of  the  city  of  Babylon  becomes  the 
head  of  the  later  Babylonian  pantheon: 

Marduk,  son  of  Ea. 

With  holy,  streaming  water, 

With  clear,  shining  water, 

Babylonia,"  London,  1904;  and  in  German,  K.  L. 
Tallquist,  "Die  Assyrische  Beschworungsserie  Maq- 
Iu, "  Leipzig,  1894,  and  Zimmern,  "Beitrage  zur 
Kenntniss  der  Babylonischen  Religion, "  Leipzig, 
1 90 1,  Part  i. 

14  Or  "pure."  The  two  terms  are  synonymous  in 
Babylonian. 

16  That  is,  by  the  spirit  or  god  who  resides  in  the 
waters. 

16  The  god  of  the  waters — more  particularly  of 
the  Persian  Gulf. 

17  Seven  minor  water  gods,  who  are  the  attendants 
of  Ea. 

18  Consort  of  Ea. 


234 


Annuls  of  Medical  History 


Seven  times  and  again  seven  sprinkle,  purify, 

cleanse ! 
May  the  evil  Rabisu  pass  out! 
May  he  step  to  one  side, 
May  the  good  Shedu,19  may  the  good  Lamassu19 

attach  themselves  to  his  body! 20 
By  heaven,  be  ye  exorcised! 
By  earth,  be  ye  exorcised! 

The  A-Su  or  "water  expert"  is,  there- 
fore, the  one  qualified  b}r  his  knowledge  to 
drive  the  demon  away  through  the  use  of 
water  as  the  purifying  element.  From  the 
circumstance  that  he  rather  than  the  fire 
expert  should  have  been  the  one  to  acquire 
the  general  qualities  of  the  physician,  we 
may  conclude  that  the  water-cure  was  prob- 
ably the  older  and  certainly  the  most  aus- 
picious method  of  driving  out  the  demon 
of  disease. 

In  accord  with  this,  we  find  the  deity 
most  prominently  associated  with  the  large 
mass  of  Babylonian-Assyrian  incantations 
to  be  the  god  Ea,  the  god  who  has  his  hab- 
itat in  the  deep  that  surrounds  the  earth 
and  on  which,  according  to  Babylonian 
views,  the  earth  floats  like  a  rubber  ball. 
The  name  Ea  is  written  with  two  signs  con- 
veying the  idea  of  "water-house,"  which 
points  to  the  character  of  the  deity,  and 
also  shows  that  the  name  was  originally  a 
designation  of  the  "deep."  21  The  Persian 
Gulf  as  the  largest  body  of  water  was  more 
particularly  regarded  as  the  seat  of  Ea,  and 
the  old  city  of  Eridu,  situated  on  the  Gulf, 
was  the  oldest  center  of  his  cult.  That  city 
is  represented  by  the  mound  Abu  Shahrein,22 
which  has  not  yet  been  excavated.  When 
that  shall  have  been  done,  we  will  be  in  a 
position  to  solve  many  a  problem  connected 
with   the  origin  of  this  deity  and  will  no 

19  A  protecting  spirit. 

10  As  bodyguards. 

21  We  must,  therefore,  assume  that  the  god  was 
designated  as  the-  "god  of  Ea,"  i.e.,  "the  god  <>!  the 
water-house"  <»r  the  god  of  the  deep.  The  older  nam- 
ing of  the  deity  was  En-Ki,  "lord  of  the  land"  or 
of  tin-  fixed  abode.  As  the  deity  <>f  the  Sumeriana 

living  in  a  mountainous  country,   I'nki   is  a  god  of 


doubt  come  across  the  original  incantation 
ritual  of  Eridu,  which  is  frequently  referred 
to  in  the  later  texts  at  our  disposal.  "Recite 
the  incantation  of  Eridu,"  we  read  in  these 
texts,  time  and  again. 

The  most  common  conception  attached 
to  Ea  next  to  that  of  "king  of  the  deep" 
is  that  of  god  of  humanity.  He  is  depicted 
as  saving  man  when  other  gods  are  angry 
and  irreconcilable.  It  is  Ea  who  reveals 
to  a  favorite  that  the  gods  intend  to  bring 
on  a  deluge,  and  tells  him  to  build  a  ship. 
Ea  endeavors  even  to  secure  immortality 
for  man,  though  he  fails  to  do  so.  This 
aspect  of  Ea  as  the  friend  of  humanity  is 
due,  largely  if  not  exclusively,  to  the 
function  of  water  as  the  element  of  Ea  in 
exorcising  the  demon  of  disease.  Ea  is  the 
real  physician  and  in  a  sense  the  only 
healer.  The  Asu  or  "water  expert"  is 
merely  his  human  servitor,  who  knows  how- 
to  secure  the  cooperation  of  the  god  in 
effecting  a  cure.  One  of  the  forms  in  which 
Ea  was  portrayed  was  that  of  a  huge-sized 
man — the  gods  were  always  pictured  as 
supermen — with  fish  scales  hanging  down 
from  the  back  of  the  head  to  the  feet,  the 
latter  being  an  appropriate  symbol  for 
a  water  god.  The  priests  of  Ea,  when  per- 
forming their  exorcising, ritual,  similarly 
clad  themselves  in  robes  resembling  fish 
skins,23  to  indicate  that  they  were  the  god's 
representatives,  and  that  their  power  was 
due  to  the  supposed  transfer  of  the  god's 
qualities  to  his  vicars.  The  masquerade  was 
to  suggest  the  transfer. 

No  doubt  the  Asu  also  made  use  of  other 
forms  of  treatment  besides  the  water-cure, 
and  it  may  be  worth  while  before  passing 
on   to  give  a  specimen   from   Babylonian- 

terra  firma,  who  becomes  a  "water  god"  when  the 
Sumerians  reached  the  Euphrates  Valley — where 
water  is  the  most  prominent  element. 

"See  the  map  in  Jastrow,  "Civilization  of  Baby- 
lonia and  Assyria. " 

23  See  the  illustrations  in  Ward,  "Seal  Cylinders  of 
Western  Asia,"  p,  2  2<>  el  seq. 


Babylonian-Assyrian  Medicine 


235 


Assyrian  incantation  texts  in  which  fire  is 
introduced  as  the  exorcising  element, 
though,  as  already  suggested  from  a  dif- 
ferent point  of  view.  We  have  two  long 
series  of  exorcising  formulas  with  accom- 
panying rites,  which  were  known  as  Sburpu 
and  Maklu.24  Both  terms  convey  the  idea 
of  "burning,"  and  the  designation  is  due  to 
the  prominence  given  in  the  incantations 
to  the  burning  of  images  made  of  wax  or  some 
other  substance.  These  are  effigies  either  of 
the  demons  of  disease,  or  of  the  sorcerer  or 
witch  who  has  control  of  the  demons,  and 
through  them  bewitches  the  victim.  The 
burning  of  the  images  is  supposed  by  the 
familiar  process  of  sympathetic  magic  to 
destroy  the  demon  or  sorcerer  (or  witch) 
as  the  immediate  or  mediate  cause  of  the 
disease.  One  of  the  incantations  in  the 
Maklu  series  reads: 

I  raise  the  torch,  their  images  I  burn. 

The    images    of   the    Utukku,    Shedu,    Rabisu, 

Etimmu, 
Of  Labartu,  Labasi,  Akhkhazu, 
Of  Lilu,  Lilitu  and  Ardat  Lili,25 
And  all  evil  that  seizes  hold  of  men. 
Quake,  melt,  vanish! 
Your  smoke  rise  to  heaven! 
May  Shamash,26  destroy  your  limbs! 
May  the  arch-exorciser,  the  son  of  Ea, 
(i.e.,  Marduk)  check  your  strength! 

The  water  treatment  by  pouring  or 
sprinkling  water  over  the  victim  is  direct, 
the  fire  treatment  is  purely  symbolical.  The 
former  method  was  supposed  to  drive  away 
the  demon  by  purifying  the  victim  of  the 
uncleanliness  marked  by  the  presence  of  the 
demon,  the  latter  to  destroy  the  demon  by 
a  process  of  sympathetic  magic,  resting  on 
the  hope  that  the  symbolic  burning  of  the 
image  would  bring  about  the  hoped-for 
reality. 

24  See  note  13  above. 

25  These  are  all  names  for  the  various  classes  of 
demons  of  disease.  See  above,  p.  232,  Lilitu — 
the  feminine  form  of  Lilu — is  the  female  "storm 
demon";  Ardat  Lilu  "maid  of  Lilu"  is  similarly  the 


III 

This  burning  of  an  image  of  a  demon  or 
sorcerer  or  witch  introduces  a  new  thought 
in  the  primitive  treatment  of  disease  which 
was  not  implied  in  the  appeal  to  the  water- 
god  Ea,  or  of  his  son  Marduk,  to  whom,  as 
the  head  of  the  later  pantheon,  the  at- 
tributes and  powers  of  the  father  are  trans- 
ferred. This  thought  is  that  certain  in- 
dividuals have  the  power  to  superinduce  the 
entrance  of  demons  into  the  bodies  of  those 
singled  out  as  victims.  The  belief,  while 
widespread  in  antiquity,  would  appear  to 
be  a  stratum  superimposed  upon  the  older 
and  more  primitive  belief  that  the  demons 
are  lurking  everywhere,  and  are  at  all 
times  ready  to  strike  whomsoever  and 
wheresoever  they  can.  They  act  independ- 
ently. The  thought  of  their  being  under 
control  strikes  one  as  a  later  development, 
though  still  falling  within  the  circle  of  primi- 
tive notions.  The  "fire"  ritual  would,  there- 
fore, be  a  later  procedure  than  the  water 
cure.  At  all  events,  while  the  sorcerer  as  the 
ultimate  source  of  disease — because  of  his 
supposed  power  to  direct  the  entrance  of 
the  demon  into  the  body — is  the  logical 
complement  of  the  exorciser  as  the  one 
who  drives  the  demon  out,  the  real  starting 
point  of  medical  treatment  among  the 
Babylonians  and  Assyrians  is  the  water- 
cure  through  the  Asu,  in  which,  to  be 
sure,  sympathetic  magic  also  enters  but  as 
a  subsidiary  factor,  whereas  in  the  case  of 
the  "fire"  ritual,  the  symbolical  rite  is  the 
dominating  factor.  An  illustration  will  make 
this  distinction  clearer,  and  will  also  show 
the  further  steps  in  the  development  of  the 
fire  ritual. 

In  the  fifth  and  sixth  tablets  of  the 
above-mentioned  Shurpu  series,  we  have  a 
long  list  of  exorcising  formulae   in    which 

designation  of  a  demon  that  makes  its  attack  like  a 
storm,  or  comes  with  the  storm. 

26  The  sun  god  whose  rays  dissipate  the  shadows 
and  the  specters  of  the  night — the  favorite  time  for 
the  activity  of  the  demons. 


236 


various  substances  like  onions,  dates,  palm 
clusters,  bits  of  sheep's  hide  and  goat  skins 
and  colored  wool  are  introduced  to  be 
peeled  or  to  be  torn  to  pieces,  and  as  each 
bit  is  thrown  into  the  fire  an  incantation  is 
recited.  The  rite  is,  again,  purely  symbolical. 
The  incantation  in  the  case  of  the  onion 
is  the  following: 

As  this  onion  is  peeled  and  thrown  into  the  fire, 
Consumed  by  the  glowing  fire-god, 
Never  to  be  planted  again  in  a  garden, 
Never  to  be  harrowed,  never  to  take  root, 
Will  never  again  be  placed  in  the  ground, 
Its  stalk  will  never  grow,  will  never  see  the  sun- 
light again, 
\\  ill  never  come  on  the  table  of  a  god  or  king, 
So  may  the  ban,  curse,  pain  and  woe, 
Sickness,  groans,  injury,  sin,  misdeed  and  trans- 
gression, 
So  may  the  sickness  in  my  body,  in  my  flesh,  in 

my  limbs, 
As  this  peeled  onion,  be  consumed  by  the  glow- 
ing fire-god. 

The  same  incantation,  with  merely  a 
change  in  the  substance,  is  prescribed  for 
the  other  materials  when  selected  for  burn- 
ing. 

Here  there  is  no  treatment  prescribed  for 
the  patient.  The  burning  of  the  image  of 
the  sorcerer  or  of  the  demon  suggests  as  a 
further  step  the  destruction  of  some  sub- 
stance, the  burning  of  which  is  to  sym- 
bolize the  "destruction"  of  the  demon  as 
the  cause  and  source  of  the  suffering.  Sins 
and  transgressions  are  placed  in  the  same 
category  as  bodily  tortures,  for  sin  shows 
itself  in  suffering.  The  advance  signaled  by 
this  synonymity  is  along  the  line  of  primi- 
tive- thought,  but  the  new  idea  added  is 
the  punishment  for  wrongdoing  by  the  en- 
trance of  a  demon  into  the  body  of  a  victim. 
Sin  is  thus  a  form  of  uncleanliness,  and  the 
sin  can  only  be  removed  by  exorcising  the 
evil  spirit  which  has  secured  its  hold  over 
the  victim.  The  fire  ritual  thus  forms  a 
bridge  leading  to  an  entirely  different 
province  than  the  direct  treatment  of  dis- 
ease, lire-  is  not  viewed  as  a  purifying  ele- 


Annals  of  Medical  History 

ment,  contact  with  which  removes  unclean- 
liness, but  as  a  symbol  of  the  hoped-for 
destruction  of  the  demon  as  a  means  of 
ridding  oneself  from  the  clutches  of  the 
evil  one. 


IV 

It  is  only  in  connection  with  the  water- 
treatment  that  we  pass  on  to  genuine  medi- 
cal treatment.  The  Asu,  or  "water  expert," 
passes  over  into  the  physician.  He  takes  on 
this  function  because  the  use  of  water  in 
the  exorcising  ritual  is  regarded  as  a  puri- 
fying element,  acting  directly  on  the  vic- 
tim, whereas  the  use  of  fire,  though  at  its 
start  also  viewed  under  the  aspect  of  a 
purifying  element,  passes  over  into  the  do- 
main of  sympathetic  magic  and  becomes 
associated  with  a  symbolism  that  takes  us 
outside  of  the  sphere  of  medical  treatment 
altogether. 

Bearing  this  distinction  between  the 
water  and  fire  incantations  in  mind,  we 
will  be  prepared  to  find  actual  medical 
remedies  introduced  into  the  Ea  ritual, 
supplemental  to  the  sprinkling  of  the  sa- 
cred element  over  the  body  of  the  victim. 
But  while  the  Asu,  from  being  merely  an 
exorciser  by  the  use  of  water,  thus  becomes 
the  physician,  the  association  of  incantations 
with  direct  medical  treatment  is  indissolu- 
ble in  Babylonian-Assyrian  medicine.  The 
two  aspects  are  never  disassociated  from 
each  other,  despite  the  considerable  prog- 
ress made  in  the  course  of  time  in  the 
treatment  of  bodily  ills.  Both  are  essential 
to  effect  a  cure — the  medical  prescription 
and  the  incantation— and  as  an  interesting 
survival  of  this  strange  partnership,  one 
may  point  to  the  custom  reported  by  trav- 
elers which  prevails  among  the  fellahs  of 
Egypt  of  swallowing  not  merely  the  drug 
prescribed  by  a  native  physician,  hut  the 
prescription  as  well.  The  prescription  takes 
the  place  of  the  ancient  incantation;  and  it 
is  perhaps  not  unnatural  that  even  the  mod- 
ern  prescription,   with   its  queer  cabalistic 


Babylonian-Assyrian  Medicine 


237 


signs  so  mysterious  to  the  uninitiated,  should 
be  looked  upon  as  a  mystic  formula.  It  is 
possibly  also  a  fair  inference  that  the  swal- 
lowing of  a  prescription  drawn  up  by  a 
modern  herb-doctor  or  quack — the  direct 
heir  of  the  ancient  Asu  or  exorciser — is  in 
many  instances  as  effective  as  the  taking 
of  the  drug. 

Let  me  now  turn  to  an  illustration  of  the 
manner  in  which  in  Babylonian-Assyrian 
literature  medicinal  drugs  are  introduced 
in  connection  with  incantation  formulae.  In 
a  tablet  of  the  Maklu  series — in  which  the 
water  and  fire  rituals  are  combined — we 
find  a  long  series  of  plants  enumerated 
which  are  precisely  the  ones  that  are  fre- 
quently encountered  in  medical  texts  prop- 
er. They  are  here  enumerated  with  plays 
upon  the  name  of  the  plants — genuine  puns, 
but  serving  a  most  serious  purpose.  The 
hope  is  expressed  by  means  of  these  plays 
that  the  plants  may  bind,  pierce  and  lacer- 
ate the  demons  of  disease,  may  cause  them 
to  scream,  strike  them  blind,  strangle  them, 
and  the  like. 

Like  the  ninu  plant  (i.e.,  ammi)  may  her 
enchantment27  be  weakened,"8 

Like  the  sapru  plant,  may  her  enchantment 
cause  her  to  scream,29 

Like  the  sikhlu  plant,30  may  her  enchantment 
pierce  her,31 

Like  the  sammu  plant,  may  her  enchantment 
blind  her,32 

Like  the  kasu  plant  (i.e.,  cassia),  may  her  en- 
chantment pierce  her.33 

Like  the  kbaltappanu  plant  may  her  enchant- 
ment startle  her.34 

Like  the  kitmu  plant  may  her  enchantment 
cover  her.35 

27  The  reference  is  throughout  to  the  enchantment 
of  the  victim  through  a  witch. 

28  Li-nu-sbu  with  a  play  upon  ninu,  the  name  of 
the  plant. 

29  Lisappiru  with  a  play  upon  sapru. 

30  A  thorn  plant. 

31  Liskhulu  with  a  play  upon  sikhlu. 

32  Lisammu  with  a  play  upon  sammu. 

33  Liksu  with  play  upon  kasu. 

34  Likbashsbu  with  play  upon  kbaltappanu  (for 
kbasbtapanu). 


Like  the  araru  plant  may  her  enchantment  curse 

her.36 
Like  the  nukhurtu  plant  may  it  cut  her  lips.37 

The  significant  feature  of  such  a  list  is 
the  underlying  idea  that  the  medicinal 
plants  are  supposed  to  have  their  effect  on 
the  demon,  here  pictured  as  a  witch  who 
has  cast  a  spell  on  her  victim.  The  plants 
are  supposed  to  have  the  power  of  destroy- 
ing the  vitality  of  the  witch  (or  demon),  to 
weaken  her  hold,  to  cause  her  discomfort, 
to  torture  her — all  in  the  hope  that  the  de- 
mon may  be  forced  to  make  an  exit  out  of 
the  body  of  the  sufferer.  There  is  no  sharp 
dividing  line  between  the  witch  controlling 
the  demon  and  the  demon  itself.  The  one 
is  bound  up  with  the  other,  and  it  is  of  the 
essence  of  ancient  witchcraft  that  the  witch 
is  at  one  and  the  same  time  the  de- 
mon and  the  controller  of  the  demon,  in- 
duced by  her  to  enter  the  body  of  the 
victim. 

Each  plant  is  supposed  to  have  some 
specific  effect  on  the  witch  or  demon.  The 
name  of  the  plant,  in  accordance  with  the 
significance  attached  to  names  3S  throughout 
antiquity  as  bound  up  with  the  essence  of 
the  thing  designated  by  the  name,  becomes 
an  omen.  While  we  must  not  press  such 
plays  or  names,  as  revealed  by  this  text, 
too  hard,  yet  the  point  of  view  is  important 
for  an  appreciation  of  an  essential  feature 
of  Babylonian-Assyrian  medicine  that  the 
purpose  of  the  medicinal  drug  is  to  have  an 
effect  on  the  demon,  and  only  in  this 
indirect  manner  to  affect  the  patient.  The 
patient  is  merely  the  accidental  subject. 
The  chief  factor  is  the  demon,  and  if  the 

35  Liktumu  with  play  upon  kitmu. 

36  Liruru  with  play  upon  araru. 

37  Littakhkira    (for    lintakbiru)    with    play    upon 

yiukhurtu. 

38  The  name  of  an  object  is  part  of  the  essence 
of  the  object.  To  have  a  name  is  the  synonym  of 
"to  exist."  The  meaning  of  the  name,  therefore, 
also  involves  the  quality  of  an  object.  What  we 
regard  as  a  "play"  on  the  name  is  for  the  ancients 
an  indication  of  what  the  thing  itself  is. 


238 


Annals  of  Medical  History 


Asu  succeeds  in  driving  the  demon  away, 
his  part  is  fulfilled,  no  matter  what  happens 
to  the  patient,  though  the  implication  of 
course  is  that  the  patient  is  cured  if  the 
demon  is  driven  out.  If  nevertheless  the 
sick  man,  contrary  to  what  he  ought  to  do, 
dies,  it  is  the  equivalent  to  a  "successful" 
operation  in  our  days,  to  which  the  patient 
inconsiderately  succumbs. 


The  transition  from  such  an  enumeration 
of  medicinal  plants,  bound  up  with  the 
exorcising  formulae,  to  actual  prescriptions 
is  a  simple  step.  Accordingly,  we  find  in  a 
text  in  which  the  basis  is  an  incantation 
in  the  name  of  Ea  and  his  son  Marduk,  a 
genuine  prescription,  prescribed  for  a  patient 
suffering  with  chills  and  fevers.  It  runs  as 
follows : 

Against  fever  and  chills,  which  is  not  good  for 
the  flesh,  fill  a  shukburratu  jar  with  water  from 
a  cistern,  untouched  by  hand.39  Add  tamarisk 
wood,  mashtakal-plant,  shalalu-reed,  ukhkhuli 
(perhaps  alkali),  cummin,  pressed  date  wine. 
Add  thereto  a  sparkling  ring.  Pour  the  water 
over  that  man.  Pluck  makkanu-root,  pour  pure 
salt  with  pure  ukbkbulu  plant,  and  sweet  oil 
brought  from  the  mountain.  Seven  times  rub 
the  bod}'  of  that  man. 

That  the  liniment  is  to  be  associated  with 
the  magic  power  of  a  ring  is  not  to  be 
regarded  as  an  incidental  factor,  but 
inherent  in  the  semi-magical  treatment 
prescribed.  The  actual  remedy,  however,  pre- 
dominates. The  rubbing  of  the  patient  with 
a  liniment  made  of  water  mixed  with  oil, 
salt,  cummin,  some  roots  and  other  in- 
gredients  (the  exact  nature  of  which  escapes 
us)  is  evidently  intended  to  bring  about  a 
stimulation  of  the  blood  circulation,  as  a 
countereffect  to  the  chills  and   fever  pro- 

"That  is,  the  water  is  to  be  drawn  in  a  pail,  with- 
out allowing  one's  hand  to  come  into  contact  with 
the  water. 


duced  by  an  irregular  circulation.  The 
introduction  of  the  various  ingredients 
rests,  it  may  reasonably  be  supposed,  upon 
actual  experience,  but  the  point  of  view, 
it  is  equally  evident,  is  the  hope  that  by 
manipulating  the  patient  in  the  way  indi- 
cated the  demon  of  chills  and  fevers  will 
be  driven  out  of  the  body. 

\\  e  have  a  large  number  of  such  texts 
in  which  medical  prescriptions  are  closely 
entwined  with  incantations  and  also  with 
purely  magic  rites.  At  times,  the  formula? 
predominate  and  again  the  actual  treat- 
ment; and  according  as  this  is  the  case, 
the  text  still  falls  within  the  category  of 
incantations,  or  is  to  be  regarded  as  a  medi- 
cal text,  though  the  two  aspects,  as  already 
indicated,  are  not  sharply  separated  from 
each  other. 

For  rheumatism,  which  is  called  "fever 
of  the  muscles  and  joints, "  we  find  in  such 
a  mixed  text  the  following  treatment  pre- 
scribed ;40 

(i)  Around  water  taken  from  the  Euphrates, 
place  in  a  circle  flour  made  of  putrid  grain. 
Place  within  the  circle  sbasbur-reed.  Take  a 
measure  of  grain,  place  it  on  the  sbasbur- 
reed  and  let  the  sick  man  sit  on  it. 
(2)  Fill  a  Ka  measure  with  the  decayed  grain 
and  put  it  on  the  sbasbur-recd.  Place  the 
foot  of  the  sick  man  on  it,  and  cover  the 
foot  with  putrid  dough,  made  of  the  decayed 
grain. 

Two  remedies  are  here  combined,  the 
former  of  which  has  a  more  distinct  touch 
of  a  magic  rite  in  the  direction  to  pour 
some  holy  water  on  the  ground,  or  perhaps 
in  a  receptacle,  and  to  surround  it  with  a 
wall  of  putrid  grain.  The  aim  of  the  treat- 
ment is  to  drive  the  demon  out  of  the  body 
and  to  drown  him  in  the  water  which  is 
under  the  protection  of  Ea,  and  out  of 
which  he  cannot  escape  by  virtue  of  the 
wall  around  it.  The  reed  placed  in  the 
water  with  a  measure  of  grain  is  to  form  a 

40  The  text  will  be  found  in  "Cuneiform  Texts  from 
Babylonian  Tablets,"  etc.,  in  the  Miitisli  Museum, 
xxiii,  Plate  i,   1    1. 


Babylonian-Assyrian  Medicine 


239 


kind  of  poultice  to  drive  the  demon  out, 
by  having  the  patient  sit  on  it.  In  the  sec- 
ond prescription  the  poultice  is  more  defi- 
nitely indicated,  as  is  also  the  localization  of 
the  rheumatism  in  the  foot. 

What  the  modern  layman  would,  there- 
fore, describe  as  "drawing  out  the  inflam- 
mation," the  ancient  Asu  regarded  as  the 
endeavor  to  drive  out  the  demon  and  then, 
if  possible,  to  catch  him,  drown  him  or  im- 
prison him.  This  purpose  of  the  treatment 
is  even  more  explicitly  indicated  in  the  con- 
tinuation of  the  text,41  where  further  direc- 
tions are  given  how  to  catch  the  demon 
after  having  driven  him  out  of  the  body. 

Recite  this  incantation  while  covering  the 
thigh.  Place  the  putrid  food  in  a  room  facing 
the  west.  Close  up  the  door  with  earth  taken 
from  the  Pu-plant,  seal  the  door  with  shubu 
and  gunu  stones.  Then  fasten  a  torch  to  the 
man's  thigh,  take  hold  of  his  hand  and  let  him 
pass  seven  times  and  again  seven  times  across 
the  encircled  water  taken  from  the  Euphrates. 
After  he  has  crossed  it,  recite  in  a  clear  voice 
the  incantation: 

Ea  has  made,  Ea  has  released. 

Exorcise  the  evil,  ease  the  pain  (  ?  ). 

Loosen  the  evil  enchantment!  Ea  be  with 
thee! 

The  heat  of  the  torch  is  to  act  as  an  ad- 
ditional means  of  forcing  the  demon  out  as 
the  patient  crosses  and  recrosses  the  pool 
of  water,  which  is  under  the  protection  of 
Ea.  The  room  is  to  be  tightly  closed  so  as 
to  preclude  the  possibility  of  the  demon  es- 
caping through  any  opening.  Ea  is  to  catch 
him  and  put  an  end  to  him  once  for  all. 

VI 

Now  if  Babylonian-Assyrian  medicine  had 
remained  in  this  stage,  it  would  have  little 
interest  for  us  except  as  a  curiosity.  We 
find,  however,  that  though  medicine  in  the 
Euphrates  Valley  never  cut  loose  from  the 
fundamental  principle  of  exorcising  the  de- 

41  Op.  cit.,  xxiii,  Plate  i,  9-14. 


mon,  considerable  progress  was  made  in  the 
remedies  applied  on  the  basis  of  actual  ex- 
perience. 

By  the  side  of  incantation  texts  in  which 
medical  prescriptions  are  introduced — but 
viewed  either  entirely  or  mainly  from  the 
angle  of  magical  rites — we  have  medical 
texts  in  the  proper  sense  of  the  term,  in 
which  incantations  play  a  subsidiary  role 
and  impress  one  as  a  survival,  retained  by 
virtue  of  the  conservative  instinct  which 
preserves  the  old  by  the  side  of  the  new. 
The  British  Museum  possesses  in  the  great 
collection  of  tablets  found  by  Layard  in 
the  ruins  of  the  palace  of  King  Ashurbana- 
pal  of  Assyria  (668-626  B.C.),  about  fifty 
years  ago,42  a  large  number  of  medical  texts 
dealing  with  various  diseases  and  prescrib- 
ing a  large  number  of  distinctly  medical 
remedies.  Of  these  texts — some  four  hun- 
dred— only  a  few  have  as  yet  been  pub- 
lished.43 Dr.  R.  C.  Thompson  has  had 
ready  for  some  time  a  large  volume,  em- 
bodying most  of  these  texts,  the  publication 
of  which  has  been  delayed  by  the  war. 
These  texts  are  all  copies  made  from  the 
library  which  Ashurbanapal  through  his 
scribes  had  made  from  originals  in  the 
temple  collections  of  Babylonian  cities. 
The  prominent  part  played  by  the  Asu,  or 
physician,  in  the  Hammurawi  code  (circa 
2086  B.C.),  where  the  fees  for  the  surgeon's 
operations  are  regulated  and  fines  and 
punishments  imposed  for  unsuccessful  treat- 
ment, justifies  us  in  carrying  back  these 
originals  to  the  third  millennium  before  this 
era. 

A  few  years  ago  the  Berlin  Museum,  ac- 
cording to  published  reports,  acquired  a 
collection  of  about  one  thousand  medical 
tablets — presumably  from  Kaleh  Shergat — 
the  ancient  capital  of  Assyria  some  forty 

42  See  Jastrow,  "Civilization  of  Babylonia  and 
Assyria,"  p.  21,  et  seq. 

43  By  Friedrich  Kuchler,  "Beitrage  zur  Kenntniss 
der  Assyrisch-Babylonischen  Medizin,"  Leipzig, 
1904. 


240 


Annals  of  Medical  History 


miles  south  of  Nineveh.  These  too  may 
turn  out  to  be  copies  of  older  originals.  A 
medical  tablet  of  about  the  seventh  cen- 
tury B.C.  from  Kaleh  Shergat  was  obtained 
through  a  dealer  by  the  College  of  Physi- 
cians of  Philadelphia.44  There  are  also  two 
medical  texts,  one  from  the  late  Neo-Baby- 
Ionian  period,  i.e.,  about  the  fifth  century 
B.C.,  the  other  of  the  Hammurawi  period 
c.  2000  B.C.,  in  the  Museum  of  the  University 
of  Pennsylvania.45  There  are  also  a  consid- 
erable number  of  letters  from  Assyrian  phy- 
sicians of  the  seventh  century  B.C.  included 
in  the  great  corpus  of  "Assyrian  and  Baby- 
Ionian  Letters,"  edited  by  the  late  Robert 
Francis  Harper,46  which  throw  an  interest- 
ing light  on  medical  practice  in  Assyria. 
However,  until  the  two  large  collections — 
the  one  in  the  British  Museum  and  the  other 
in  the  Berlin  Museum — shall  have  been 
placed  at  the  disposal  of  students,  we  must 
resign  ourselves  to  a  considerable  amount 
of  uncertainty  as  to  the  exact  scope  of 
medical  knowledge  and  treatment  in  an- 
cient Babylonia  and  Assyria.  Yet  the  ma- 
terial published  is  sufficient  to  give  us  a 
bird's-eye  view  of  the  methods  adopted  in 
the  treatment  of  disease  and  to  show  us 
the  extent  to  which  a  genuine  science  of 
medicine,  based  on  experience,  developed, 
despite  the  very  serious  limitation,  due  to 
the  persistence  of  the  primitive  theory  of 
disease  and  to  the  confirmed  combination 
of  medical  treatment  with  magic  rites  and 
the  recital  of  incantations. 

VII 

The  diseases  most  commonly  referred  to 
in  the  texts  are  stomach  and  intestinal 
troubles,  liver  complaints,  fevers,  colds, 
and  eye  diseases.  The  diagnosis  is,  as  one 

44  Published  by  me,  Tr.  College  oj  Physicians, 
ip.  565-400. 

*Thc>  have  been  copied  by  Dr.  II.  F.  Lutz  and 
will  ere  long  l«-  published.  The  one  of  the]  tammuravt  1 
period  is  particularly  rmportanl  as  being  the  oldest 

medical  1  < - x t  1.1   Bal>\  lom.'i  at   present  known    to  us. 


might  expect,  the  weakest  feature,  being 
purely  empirical  and  devoid  of  any  scien- 
tific principle.  For  purposes  of  treatment, 
the  physicians  prepared  elaborate  hand- 
books in  which  they  entered  very  briefly 
the  symptoms  of  the  various  diseases  that 
had  come  under  their  notice,  together  with 
a  variety  of  remedies  to  be  used,  given  in 
the  form  of  prescriptions.  The  number  of 
such  prescriptions  for  one  and  the  same 
diagnosis  varies.  The  aim  evidently  was  to 
gather  as  many  as  possible,  so  that  if  one 
failed  another  might  be  tried,  or  it  was  left 
to  the  judgment  of  the  Asu  which  one  to 
use.  Not  infrequently  as  many  as  a  dozen 
remedies  are  enumerated,  with  only  occa- 
sional indications  of  the  stage  of  the  disease 
in  which  any  particular  one  is  to  be  used. 
The  treatment  being  wholly  empirical,  the 
general  procedure  must  have  been  for  a 
physician  to  try  one  remedy  after  the  other 
until  the  demon  was  exorcised,  or  until  the 
patient  succumbed  to  the  remedies. 

Let  me  quote  a  few  examples.  In  a  tablet 
dealing  with  stomach  and  intestinal  troubles 
we  read: 

If  a  man's  inside47  is  sick,  compound  sbi-shi 
plant  in  wine  at  the  rising  of  a  star  (i.e.,  in  the 
evening).  Let  him  drink  it  without  food.  Grind 
a  stick  of  Shi-Nub  plant,  mix  with  finely  pow- 
dered flour,  stir  with  cassia  juice,  spread  on  a 
cloth  and  bind  around   his  stomach  and  loins. 
If  ditto,  boil  leak  and  puttati  and  let  him  drink 
it    with    milk.     x/i    Ka  48   of   thorn,    '  ■>    Ka    of 
turnip,  kneaded  with  milk,  spread  on  a  cloth 
and  attach. 
We   have   here   two   series   of  remedies, 
each  one  of  which  consists  of  a  potion  to 
ease  the  pain  or  cramp,  and  of  an  exterior 
application — a  poultice.  The  first  is  a  cold 
potion  to  be  taken  with  wine,  which  is  very 

*  Thirteen  volumes  (Luzac  &  Co.,  London, 
1914).  A  bibliography  of  Babylonian-Assyrian 
medicine  till  1902  will  be  found  in  von  Oefele 
"Keilschriftmedizin"  (Breslau,  1902),  in  "Abhand- 
[ungen  zur  Geschichte  der  Medizin,"  I  left  iii. 

47  A  general  term,  libbu,  meaning  "inner"  (also 

"heait"  as  that  which  is  "within")  is  used. 

48  A  common  measure. 


Babylonian-Assyrian  Medicine 


241 


frequently  introduced  as  an  ingredient,  the 
second  a  hot  one.  The  purpose  of  the  poul- 
tice is  apparently  to  produce  heat,  and  thus 
by  stimulating  the  circulation,  to  afford 
relief.  The  vagueness  of  the  term  used  to 
diagnose  the  seat  of  the  trouble  makes  it 
impossible  to  determine  the  nature  of  the 
disease,  which  may  have  been  a  simple  case 
of  indigestion. 

Somewhat  more  specific  is  the  descrip- 
tion of  a  disordered  stomach  as  follows : 

If  a  man's  inside  is  swollen  and  inflamed,  and 
he  is  nauseated,  then  for  his  life  (i.e.  to  cure 
him),  mix  onion  with  cumin  seed,  let  him  drink 
it  in  wine  without  food  and  he  will  recover.  If 
ditto,  take  the  green  rind  of  the  II  plant,  mix 
with  pig's  fat,  let  him  drink  it  with  Du-Zab, 
unmixed  wine  and  sweetened  water,  and  he 
will  recover. 

Aggravated  cases  of  inability  to  retain 
food  are  described  as  follows: 

If  a  man  has  a  pain  inside,  food  and  drink 
coming  back  to  his  mouth,  bandage  his  head 
and  breast.  Boil  .  .  . 49  let  him  eat  it  with 
honey,  Iamb  fat  and  butter.  Let  him  refrain 
from  eating  onions,  white  onions  and  kidnu 
for  three  days,  and  not  wash  himself  with  water 
and  he  will  recover. 

Here  we  have  at  last  a  diet  prescribed. 
The  honey,  fat  and  butter  are  intended  to 
soothe  the  irritation,  while  avoiding  onions 
seems  equally  rational.  Presumably,  the  di- 
rection not  to  wash  for  three  days  has  refer- 
ence to  bathing,  which  should  be  avoided 
to  prevent  the  patient  from  catching  cold. 

For  a  similar  case  of  inability  to  retain 
food,  pounded  tamarisk  seed  is  prescribed, 
likewise  to  be  taken  with  honey  and  butter 
and  without  any  other  food. 

For  a  case  of  constipation  with  gas  in 
the  stomach,  a  laxative  mixture  is  ordered 
with  very  specific  directions. 

If  a  man's  inside  is  full  of  gas,  to  cure  him 
take  sweet-smelling  reed,  Balluku-plant,  cypress, 
oleander  (?)...  put  into  wine,  boil,  strain, 

49  Text  defective. 


let  it  cool,  mix  with  oil  and  honey,  let  him  drink 
it  without  food,  and  he  will  have  a  passage.  The 
next  morning,  mix  honey,  fine  oil,  unmixed 
wine,50  let  him  gulp  it  down  without  food  and 
without  touching  his  tongue,  and  he  will  have 
a  passage. 

In  addition  to  poultices  and  drugs  in- 
tended to  mollify  irritated  membranes,  to 
reduce  swellings,  to  open  the  bowels,  to  get 
rid  of  wind,  we  come  across  such  curious 
remedies  as  pouring  concoctions  over  a  pa- 
tient's head,  on  his  stomach  and  on  his 
anus,  though,  presumably,  in  some  cases 
rubbing  of  the  affected  parts  with  liniment 
is  intended. 

If  a  man  has  cramps,51  let  that  man  sit  down, 
with  his  feet  under  him,  pour  boiled  .  .  . 
and  cassia  juice  over  his  head  and  he  will 
recover.  If  ditto  let  him  kneel  and  pour  cold 
water  on  his  head. 

The  choice  is  here  again  between  a  warn 
and  cold  douche.  If  the  one  afforded  no  re- 
lief, the  other  could  be  tried.  A  variation 
of  the  treatment  includes  massage  to  stim- 
ulate circulation. 

If  ditto,  place  his  head  downwards  and  his 
feet  [under  him?],  manipulate  his  back  with 
the  thumb,  saying  "be  good,"  manipulate  his 
arms  14  times,  manipulate  his  head  14  times, 
rolling  him  on  the  ground.   .    .   . 

The  address  to  "be  good"  appears  to  be 
directed  to  the  demon,  and  in  view  of  the 
underlying  theory  of  disease,  it  would  be  a 
reasonable  conclusion  that  the  aim  of  the 
manipulation  is  to  push  the  demon  out  of 
the  body.  If  this  be  correct,  we  would  have 
in  such  treatment  another  illustration  of 
the  manner  in  which  the  theory  would  ac- 
cord with  the  result  of  experience.  Massage 
must  have  been  recognized  as  beneficial  in 
certain  cases,  but  the  point  of  view  neces- 
sarily was  that  what  was  good  for  the  pa- 
tient was  bad  for  the  demon.  The  drugs, 
the  poultices,  the  hot  and  cold  douches  and 
the  massage  all  were  supposed  to  act  not 

60  That  is,  strong  fermented  wine. 

61  Literally  "tying"  or  "contraction  of  the  inside." 


242 


Annals  of  Medical  History 


on  the  patient  but  on  the  demon,  who  was 
in  this  way  to  be  forced  out  or  to  be  coaxed 
out. 

It  is  hard  for  us  at  the  present  stage  of 
medical  knowledge  to  reconstruct  so  strange 
and  distorted  an  attitude  towards  the 
results  of  medical  treatment,  and  yet  it  is 
perhaps  fair  to  assume  that  the  average 
lay  person  today  when  he  hears  of  an  anti- 
toxin to  kill  the  germ  that  is  the  cause  of  a 
particular  disease,  has  in  mind  a  picture  of 
something  that  by  the  treatment  passes 
out  of  the  body.  At  all  events,  the  popular 
(not  necessarily  the  scientific)  notion  of  the 
"germ"  theory  should  help  us  to  understand 
the  point  of  view  which  looked  upon  any 
relief  from  pain  as  due  to  an  influence 
exercised  upon  the  demon.  The  removal  of 
an  irritation  was  always  realistically  inter- 
preted as  a  consequence  of  getting  the 
demon  away  from  the  affected  spot.  The 
drug  was  supposed  to  be  disagreeable  or 
harmful  to  the  demon  and,  similarly,  the 
poultice — hot  or  cold — was  unpleasant  to 
him,  and  the  bandage  around  the  head  or 
breast  or  stomach  was  supposed  to  strangle 
him. 

The  use  of  an  enema,  which  is  frequently 
referred  to  in  the  medical  texts,  would 
strengthen  the  belief  that  a  cure  actually 
involved  driving  the  demon  out  of  the  body. 
Prescriptions  of  this  character  read  as 
follows: 

If  a  man  has  a  stomach  ache,  he  cannot 
retain  food  which  comes  back  through  his 
mouth,  his  .  .  .  is  pierced  and  he  has  diarrhoea, 
Ins  flesh  is  flabby  ( ? ),  and  wind  (i.e.,  gas) 
moves  about  in  his  anus  ...  to  cure  him  take 

1  a  Ka  of  date  juice,  Yi  Ka  cassia  juice,  oil  and 
sweetened   water,   3   shekels  '*  of  clarified   oil, 

2  shekels  of  honey,  10  shekels  of  pounded  mint 
added  thereto,  at  night  before  the  rise  of  the 

62  A  standard  silver  coin,  worth  about  40  cents, 
but  here  used  as  a  weight. 
UA  general  phrase  equivalent  to  "evening." 
M  Literally,  "mountain  salt." 
"Literally,   "salt  of  Amanus"   from   which  our 


goat  star  M  and  in  the  morning  without  food  let 
him  drink.  Then  let  him  take  x/2  of  Shi-Ka 
through  his  mouth  and  anus,  sprinkle  him 
with  it  and  he  will  recover.  If  ditto,  mix  rock 
salt  w  and  ammonia  ■  with  unmixed  wine,  let 
him  take  it  without  food  through  his  mouth  and 
his  anus,  sprinkle  him  with  it  and  he  will 
recover. 

Or  again: 

If  a  man  has  cramps,  compound  green  onions, 
chicory  rind  with  unmixed  wine  and  let  him 
drink  it  without  food.  (For  his  diet)  let  him 
eat  dates  either  in  pig's  fat  or  in  oil  .  .  .  .If 
ditto,  take  Shi-Shi  plant,  Shi-.Makh,  tarmush 
(a  kind  of  bean),  root  of  male  namtar  (some 
bitter  root),  moistened  with  unmixed  wine  at 
the  rise  of  the  star  (i.e.,  in  the  evening)  and  in 
the  morning,  let  him  drink  one-third  of  it  with- 
out food,  and  two-thirds  let  him  direct  into  his 
anus,  and  he  will  recover. 

As  the  last  example  of  a  disordered  stomach 
I  quote  a  most  realistic  description  of  what 
we  would  call  a  case  of  "jag,"  but  which 
the  Babylonian  Asu  sets  forth  in  most 
serious  fashion: 

If  a  man  has  drunk  unmixed  wine  and  has 
a  severe  headache,  he  forgets  his  words,66  his 
speech  is  heavy,  his  mind  is  clouded,  his  eyes 
are  set,  take  (eleven  plants  are  enumerated) 
mix  them  with  oil  and  wine,  let  him  drink 
before  the  approach  of  Gula,67  and  in  the  morn- 
ing before  any  one  has  kissed  him. 

Did  the  Asu  add  the  last  touch  from  a 
sense  of  humor? 

Now  taking  all  these  and  other  descrip- 
tions with  the  prescribed  remedies  together, 
we  obtain  not  only  an  extensive  pharma- 
copoeia but  also  a  rather  large  variety  of 
treatment  as  well  as  dietary  precautions, 
bandages,  poultices,  douches,  massage,  ene- 
mas and  even  indications  of  a  rest  cure. 

term  sal  ammoniac  is  directly  derived.  Amanus  is 
the  name  of  a  mountain  range  in  northern  Syria. 
The  common  derivation  from  the  temple  of  Anion 
in  Egypt  is  erroneous,  and  rests  upon  a  phonetic 
coincidence.  The  substance  appears  to  have  been  in- 
troduced into  Egypt  through  Babylonian  influences. 

66  That  is,  does  not  know  what  he  is  talking  about. 

"Another  expression  meaning  "evening." 


Babylonian-Assyrian  Medicine 


243 


VIII 

When  we  turn  to  other  diseases,  the 
list  of  drugs  and  the  methods  of  treatment 
can  be  still  further  extended.  Liver  troubles 
are  particularly  frequent  in  hot  moist 
regions  like  the  Euphrates  Valley,  and  our 
medical  texts  give  many  specimens  both  of 
diagnosis  and  treatment.  A  clear  case  of  a 
disordered  liver  is  described  as  follows  with 
an  interesting  emphasis  on  the  character  of 
the  excrements: 

When  a  man  has  sharp  pains  in  his  head, 
gall 5S  is  mixed  with  his  excrements,  his  bowels 
are  disordered,  he  cannot  retain  onions,  leek, 
beef,  pig's  meat  and  unmixed  wine,  for  his  cure 
take  (prescription  of  some  20  plants)  with  oil 
and  flour,  strain  it,  stir  with  wine,  spread  on  a 
cloth,  attach  it  for  three  days  and  remove  it  on 
the  fourth  day.  If  his  excrements  are  white,  he 
is  improving,  if  red  the  fever  69  is  still  there,  if 
green,  he  will  shortly  die  (?)...  if  black, 
he  will  grow  worse  and  die;  he  will  not  recover. 
If  (the  excrements)  are  long,  take  dough  and 
kurbannu  of  the  field,  mixed  and  pounded  with 
mud  .  .  .  knead  with  cassia  juice  and  let  him 
drink  it  with  wine.  After  he  has  drunk  it,  let 
him  wash  himself  with  sAunu-juice,  Ag-ut  and 
Dilbat  plants. 

The  general  aim  of  the  treatment  in  gall 
troubles  appears  to  have  been  to  superin- 
duce a  free  movement  of  the  bowels. 

If  a  man  is  seized  60  with  gall  trouble,  pound 
cassia,  let  him  drink  it  with  unmixed  wine  and 
he  will  have  a  passage. 

Among  other  remedies  prescribed  to  move 
the  bowels  are  drinking  salt  water,  or  salt 
with  wine,  or  onions  in  water.  For  jaundice 
designated  as  "yellow"  sickness61  we  have 

68  The  Babylonian  term  marru  means  "bitter." 

69  Literally  "fire." 

60  The  verb  used  is  interesting  as  an  indication 
that  a  demon  has  got  hold  of  him.  Our  modern 
usage  of  the  term  to  be  "seized"  with  a  sickness  is 
a  survival  of  this  view. 

61  amurrikanu. 

62 The  term  used  lishan  kalbi,  "dog's  tongue," 
is  the  source  of  our  cynoglosson — a  direct  derivative, 


a  large  number  of  remedies.  The  diagnosis 
is  simple  up  to  the  point  of  naivete. 

If  a  man's  body  is  yellow,  his  countenance  is 
yellow,  the  flesh  swollen  (  ?  ) — that  is  amur- 
rikanu (i.e.,  yellow  disease). 

Among  the  remedies  prescribed  are  drink- 
ing a  mixture  of  cypress  with  wine,  crushed 
myrrh  or  cynoglosson62  or  chicory63  or  the 
same  ingredients  (and  other  drugs)  taken 
with  milk. 

A  more  detailed  description  of  jaundice 
in  an  advanced  stage  reads: 

If  a  man  has  yellowness  of  the  eye,  the  dis- 
ease having  extended  to  the  eye,  so  that  the 
water  of  the  eye  is  green  as  copper  .  .  .  his 
inside  is  swollen,  he  cannot  retain  food  or  drink 
and  the  sickness  has  dried  up  his  entire  body — 
that  man  will  die. 

Or  again  most  graphically: 

If  a  man  has  yellowness  of  the  eye,  his  head, 
his  face,  his  whole  body  even  to  the  root  of  his 
tongue  is  affected,  it  is  fatal  (  ?  ).M  He  will  die. 

A  distinction  is  made  between  the  disease 
which  gives  the  face  a  yellowish  appearance 
and  when  the  skin  becomes  dark,  in  which 
case  it  is  called  akbkhazu,  i.e.,  "seized" 
from  the  name  of  the  demon,65  regarded 
as  the  cause  of  the  disease. 

If  a  man's  body  is  yellow  and  his  face  is 
yellow  and  black,  the  root  of  his  tongue  is 
black — that  is  akbkazu.  Bake  large  Mush-Dim- 
guruna  66  of  the  field,  let  him  drink  it  with  wine 
and  the  akbkhazu  will  be  quieted.67 

As  in  the  case  of  jaundice,  also  cypress, 
myrrh  or  chicory  is  prescribed  to  be  taken 
in  wine  or  milk,  as  well  as  a  paste  made  of 
powdered  mountain-stone,  mixed  with  oil 
and  wine. 

The  term  used   for  "colds"   is  used  as 

therefore,  like  cassia,  from  Babylonian  medicine. 

63  Kukru,  the  origin  of  our  "chicory." 

64  Or  perhaps  "incurable." 
66  See  above,  p.  235. 

66  The  name  of  a  basilisk,  but  here  presumably 
the  designation  of  a  plant. 

67  The  verb  again  rests  on  the  picture  of  the  demon 
who  is  subdued  through  the  treatment. 


244 


Annals  of  Medical  History 


vaguely  as  the  modern  one  is  in  general 
parlance.  A  tablet,  dealing  in  detail  with 
such  troubles,  begins: 

If  a  man  has  a  cold  which  has  developed 
pains  in  his  stomach,  let  him  compound  nam- 
tar  root  and  liquorice  root  and  beans  (  ?  )  and 
darnel,  Shi-Man,  Tu-me  and  "tongue"  plant — 
these  seven  drugs  with  wine  let  him  drink  as 
the  star  rises  (i.e.,  in  the  evening)  and  in  the 
morning,  and  he  will  recover. 

As  a  last  example  from  the  medical  texts, 
I  choose  some  remedies  prescribed  for  fever, 
appropriately  called  "fire,"68  taken  from  a 
tablet  which  is  particularly  interesting,  be- 
cause it  once  formed  part  of  a  library  be- 
longing to  a  physician  whose  name  was 
Nabu-zer-kitti-Iishir,69  the  son  of  Afardi, 
grandson  of  Apia.  The  tablet  dates  from  the 
late  Assyrian  period — somewhere  in  the 
seventh  century  B.C.,  and  represents  an 
extract  from  a  larger  series  of  medical 
texts,  prepared  by  the  physician  for  his  own 
guidance  and  use.  It  is  the  only  specimen 
so  far  published  of  a  physician's  handbook.70 

If  a  fever  seizes  a  man,  localized  in  the 
nerves  of  his  head  (i.e.,  produces  a  severe 
headache),  and  it  affects  his  eyes  so  that  his 
vision  is  clouded,71  and  inflammation  sets  in, 
and  his  eyes  water,  pound  one-third  Ka  of 
powdered  "thorn"  root  with  khaltappanu  stone, 
take  one-third  of  it  for  the  head  that  pains, 
knead  with  cassia  juice,  wrap  it  around  the 
head,  attach  it  (i.e.,  by  a  bandage),  and  for 
three  days  do  not  remove. 

The  physician  includes  in  his  extracts 
other  remedies  for  headaches  which  are  not 
accompanied  by  a  fever: 

68  In  the  Talmud  the  question  is  asked,  "what  is 
fever,"  to  which  the  answer  is,  "a  fire  of  the  bones." 

••  The  name  signifies  "O,  Nabu,  may  the  legitimate 
offspring  Sourish." 

70 The  one  referred  to  above,  p.  240,  inthepossession 
of  the  College  of  Physicians  of  Philadelphia.  For  a 
complete  translation  and  discussion  of  its  contents, 
see  my  article,  Tr.  College  0/  Physicians,  191 3,  pp. 
365-400. 


If  a  man's  head  burns,  his  head  oppresses  him, 
particularly  the  veins  of  his  temple,  compound 
.  .  .  with  oil,  wrap  it  around  his  head,  press  it 
on  tight  and  do  not  remove  for  three  days. 

A  poultice  of  a  more  complicated  char- 
acter to  be  used  as  a  compress  consists  of: 

Y2  Ka  of  powdered  juniper  wood,  10  shekels 
of  powdered  cypress,  10  shekels  of  cypress,  10 
shekels  of  chicory,  10  shekels  of  powdered 
cassia,  10  shekels  of  large  Tig  flour,  io1^ 
shekels  of  small  Tig  flour,  10  shekels  of  good 
standing  wine,  10  shekels  of  powdered  radish, 
mix  them  together,  knead  with  wine  into  a 
solid  paste,  strain,  take  one-third  for  his  head 
which  pains,  mix  with  cassia  juice,  wrap  it 
around  and  for  three  days  do  not  remove. 

He  also  prescribes  an  eye  wash  of  alkali 
with  which,  it  is  directed,  his  eyes  are  to  be 
washed  until  the  tears  cease  to  flow.  Then 
the  eyes  are  to  be  bandaged,  and  the  pa- 
tient to  be  put  into  a  closed  room,  and  the 
patient's  head  is  to  be  rubbed  with  boiled 
juice  of  kiptu  every  evening  and  morning, 
alternating  with  poultices  of  various  in- 
gredients and  oil  liniment — the  treatment 
to  continue  as  usual  for  three  days. 

Our  physician,  despite  the  late  period  in 
which  he  flourishes,  holds  to  the  belief  in 
demons  as  strongly  as  do  his  patients,  and 
so  he  does  not  hesitate  to  copy  on  his  tablet 
the  following  purely  magic  rite  to  drive  the 
demon  out  in  case  all  other  methods  fail. 

If  a  man's  head  is  affected  and  the  demon  7! 
in  the  man  cries  out,73  but  comes  not  out,  is 
not  caught  by  bandage  or  incantation,  then  kill 
a  captured  kurku  bird,  squeeze  its  blood  out,74 

71  A  blinding  headache. 

72 There  is  a  special  demon  of  headache,  who  is 
known  as  Ti'u. 

"One  is  reminded  of  the  passage  in  Mark  1,  26  = 
Luke  14,  33,  of  the  unclean  spirit  (i.e.,  demon)  in 
a  man  that  cries  out  and  issues  from  the  body  at 
the  command  of  Jesus.    See  also  the  incident   in 

I. like  0,  27. 

74  Note  a  similar  rite  of  using  the  blood  of  a 
bird  as  part  of  the  rite  to  exorcise  the  demon  ol 
sara'  alb,  a  skin  disease  (not  our  leprosy)  in  Leviticus, 
Chap.   13,  for  the  explanation  of  which  consult  the 


Babylonian-Assyrian  Medicine 


245 


take  its  .  .  .  its  fat  and  the  skin  of  its  crop  (?  ), 
burn  it  in  the  fire,  mix  cedar  with  the  blood,  and 
pronounce  the  incantation  "evil  finger  of  man" 
three  times. 

These  examples  will  suffice  as  illustrations 
of  the  general  character  of  the  medical  texts 
of  the  Babylonians  and  Assyrians,  showing 
both  the  method  followed  and  the  decided 
limitations  in  this  method.  Medical  treat- 
ment, being  based  solely  on  popular  ex- 
perience, never  reached  even  to  the  border- 
land of  a  science.  It  developed  no  new 
theory  of  disease;  on  the  contrary,  it  clung 
to  the  old  one.  The  Asu  was  as  steeped  in 
superstitious  regard  for  the  value  of  in- 
cantations and  magic  rites  as  his  patient. 
Both  stood  on  the  same  platform,  and  the 
manner  in  which,  even  in  genuine  medical 
texts,  incantations  and  magic  rites  are  pre- 
scribed shows  the  persistence  of  the  primi- 
tive theory,  and  the  impossibility  of  any 
genuine  advance  in  medical  science  beyond 
prescribed  bounds.  We  not  infrequently  find 
the  incantations  to  be  recited  taking  up 
more  space  than  the  remedies  prescribed. 
Even  such  trifles  as  that  a  medical  potion 
should  be  held  in  the  left  hand  while  drink- 
ing it  seemed  worthy  of  mention.  The  in- 
cantations— a  jumble  of  phrases,  often 
meaningless — are  set  forth  in  detail. 

Wind  of  the  glowing,  wind,  wind  close  to  the 

gods 
Wind  that  went  forth  between  excrements  and 

urine, 
And  whose  throne  is  set  up  with  the  gods,  thy 

brothers. 

This  incantation  for  one  suffering  from 
an  inflated  stomach  is  to  be  recited,  while 
the  patient  is  being  rubbed  with  a  salve  of 
cynoglosson  and  oil. 

Or  in  another  instance  the  incantation 
reads : 

writer's  article,  "The  So-called  Leprosy  Laws,"  in 
the  Jewish  Quarterly  Review,   New  Series,  vol.   iv, 
191 3,  pp.  336  et  seq. 
76  Play  upon  libbu  "heart"  and  the  "insides." 


The  "heart"  plant  grew  in  the  mountain  and 
I  tore  it  out — the  "inside" 75  became  affected — 

The  god  Sin  76  [plucked  it  out]. 

I  commanded,  and  the  "heart"  of  Shamash  77 
was  affected;  Shamash  [plucked  it  out] 

I  commanded,  and  the  "heart"  of  heaven  and 
earth  became  affected. 

And  so  on  ad  infinitum  et  ad  nauseam. 
Such  incantations  may  well  represent  older 
elements  than  the  prescriptions  proper,  but 
their  retention  in  that  case  by  the  side  of 
genuine  remedies  is  as  significant  a  feature 
as  their  greater  age. 

IX 

Turning  now  to  the  pharmacopoeia  of  the 
Babylonians  and  Assyrians,  the  large  di- 
mensions that  it  assumed  in  the  course  of 
time  will  have  become  apparent  from  the 
examples  quoted.  This  conclusion  is  con- 
firmed by  the  long  lists  of  plants  that  have 
come  down  to  us  in  the  later  copies  of  Ashur- 
banapal's  library,73  and  also  in  texts  dating 
from  much  earlier  periods.  These  lists  were 
prepared  in  the  temple  schools  of  Babylonia 
where  all  instruction  was  imparted,  in- 
cluding, therefore,  the  training  of  priests  to 
act  as  physicians.  The  evident  aim  was  to 
make  these  texts  as  inclusive  as  possible 
so  as  to  cover  all  the  plants  and  woods  and 
shrubs  that  grew  in  fields,  gardens,  orchards 
and  in  the  mountains.  The  medical  charac- 
ter of  these  lists  is  indicated  by  the  use  of 
the  determinative  Sham,  signifying  "drug," 
and  which,  like  Asu,  has  made  its  way  from 
the  Sumerian  into  the  Semitic  languages. 
Moreover,  in  addition  to  the  names,  the 
lists  often  contain  indications  of  the  use  to 
which  the  drugs  are  to  be  put,  or  in  what 
way  they  are  to  be  compounded  with  other 
drugs  or  with  ingredients  other  than  drugs. 
Finally,  we  have  the  proof  for  the  medical 
character  of  these  lists  in  the  circumstance 

76  The  moon  god. 

77  The  sun  god. 

78  Many  specimens  of  such  lists  in  "Cuneiform 
Texts,"  Part  xiv. 


246 


Annals  of  Medical  History 


that  many  of  the  "plants"  mentioned  are 
precisely  the  drugs  occurring  in  the  medical 
texts.  No  doubt  when  the  two  large  collec- 
tions of  medical  texts  in  London  and  Ber- 
lin, which  have  been  above  referred  to,79 
shall  have  been  published,  we  will  find  that 
most  if  not  all  the  plants,  trees,  and  shrubs, 
of  the  extensive  lists  served  some  purpose 
in  medical  treatment. 

A  rough  estimate  shows  that  the  ingre- 
dients used  in  medical  prescriptions  mount- 
ed high  in  the  hundreds. 

The  lists  also  reveal  attempts  at  a  classi- 
fication of  plants,  thorny  plants  being 
placed  together  in  one  group,  a  series  of 
shrubs  in  another,  plants  of  which  the  roots 
are  used  in  a  third,  and  so  on.  The  classifi- 
cation is  of  course  not  based  on  any  scien- 
tific principle  but,  in  agreement  with  the 
purely  empirical  character  of  Babylonian- 
Assyrian  medicine,  suggested  by  external 
features.  So  we  have  lists  grouping  various 
kinds  of  Ammi  plants  (?miu),  of  cynoglosson, 
of  juicy  and  sweet-smelling  plants  together. 
Again,  drugs  are  placed  together  which 
are  to  be  used  in  the  case  of  the  same  dis- 
ease. So,  for  example,  we  have  a  list  of  six 
plants  or  drugs  that  are  to  be  used  for  dis- 
eases of  the  teeth  and  to  be  placed  in  the 
mouth,  and  again  a  series  to  be  used  for 
compresses  around  the  head  or  for  poultices 
to  be  placed  on  the  stomach  or  the  anus,  or 
as  ingredients  for  enemas.  In  other  cases, 
drugs  are  enumerated  to  be  used  for  dog 
or  serpent  bites. 

Indications  are  added  in  other  cases  of 
the  manner  in  which  the  drugs  are  to  be 
taken,  mixed  with  oil  or  taken  in  wine  and 
the  like. 

Unfortunately  only  a  small  proportion  of 
the  drugs  have  up  to  the  present  been  iden- 


7*  Sec  p.  239. 

80  The    splendid     work    of    Low,     "Aram&ische 

I'll.iii/rrm.'imcii,"   Leipzig,    1881,   has   been   of  great 

service  in  this  respect.    Recently,  a  young   Finnish 

'l'>Kist,   Ilarri   Holma,   has  made  a  valuable 


tified.  The  difficulties  involved  in  such  iden- 
tifications are  very  great.  In  the  first  place 
the  plants  often  have  fanciful  names,  and 
unless  we  are  able  to  determine  the  character 
of  these  names,  we  reach  an  impasse.  It 
seems  hopeless  to  solve  such  a  puzzle  as  is 
involved  in  a  name  like  "plant  of  tears" 
from  the  fancied  resemblance  of  some  part 
of  the  plant  to  tears.  A  "star"  plant  is 
evidently  suggested  by  the  shape,  but  what 
is  it?  A  name  like  "sword"  plant  tells  us 
that  the  plant  has  a  sharp  cutting  edge,  but 
the  term  again  is  too  general  to  admit  of  a 
definite  identification.  If  we  knew  the  folk- 
lore of  ancient  Bab}  Ionia  we  might  be  sure 
of  an  identification  for  the  "birth"  plant. 
As  it  is  we  are  confined  to  a  guess  that  it 
may  be  a  species  of  "mandrake,"  associated 
so  commonly  with  sexual  fertility.  In  quite 
a  number  of  cases,  we  have  the  comparison 
with  plant  names  in  other  Semitic  languages 
— notably  the  Aramaic — to  help  us,80  and 
sometimes  the  signs  with  which  the  plants 
are  written  furnish  a  means  of  identifica- 
tion. A  study  of  the  flora  of  the  Euphrates 
Valley  and  Mesopotamia  in  general  with 
the  present  names  in  use  by  the  natives, 
many  of  which  reflect  popular  points  of 
view,  will  probably  yield  important  results, 
for  traditional  lore  has  a  way  of  clinging  to 
the  soil  that  is  often  surprising. 

Summing  up  the  results  so  far  gleaned 
from  these  various  sources,  we  have  quite  a 
number  of  the  ingredients  used  in  Baby- 
lonian-Assyrian medicine  that  may  be  Iden- 
tified with  certainty.  Among  these  are  (as 
already  indicated)  kasu,  from  which  our  own 
"cassia"  is  directly  derived;  lisban  kalbi, 
"cynoglosson";  sbilim,  "darnel";  ninu, 
"fennel";  kurkanu,  "crocus"  (or  saffron), 
which  appears  likewise  to  revert  to  the 
Babylonian  term,  kukru,  identical  with  our 

contribution  to  the  identification  of  Babylonian 
plants  and  drugs,  embodied  in  his  "Kleine  Bertrttge 
7.11m  Assyrischen'  Lexikon,"  Leipzig,  1912,  pp. 
57-94.  See  also  some  suggestions  in  Stuckcn,  "As- 
tralmytlun,"  I,  p.  5,  note. 


Babylonian-Assyrian  Medicine 


247 


"chicory"  (cicborium) ;  sbusbi,  "liquorice 
root";  karashu,  "leak";  gingiru,  "rocket" 
(eruca  sativa);  tarmush,  a  "bean"  of  some 
kind;  girgishshu,  "strawberry  tree"  (ar- 
butus unedo) — native  in  Mesopotamia  and 
Palestine;  silbanu,  "liquorice  wood";  bu- 
rashu,  "cypress";  laptu,  "turnip"  (brassica 
rapa);  puglu,  "radish";  zuziratu,  "por- 
tulac";  sapru,  "straw  flower"  (helichry- 
sum);  lardu,  identical  with  "nard"  (by  a 
common  interchange  between  I  and  n); 
sapandu,  which  has  passed  over  into  Persia 
and  Arabia  as  sipandu,  and  is  our  white 
mustard  (sinapis  alba);  kulkulanu,  "cassia- 
tora";  kaman,  identical  with  our  "cinna- 
mon"; kamtu,  "truffle";  khazilatu,  "colo- 
cynth";  sagilatu,  "jasmin";  sbisbbanu, 
"vitex  agnus  castris";  kharubu,  "St.  John's 
wort."  The  terms  for  "coriander"  and 
"caraway  seed"  seem  also  to  have  been  de- 
termined with  considerable  certainty. 

Among  trees  of  which  the  leaves,  bark, 
sap,  roots  and  seeds  were  used  for  medical 
purposes  we  have  urbatu,  "willow";  binu, 
"tamarisk";  tittu,  "fig";  asu,  "myrtle"; 
sarpatu,  "elm";  as  well  as  the  terms  for 
olive  and  cypress.  Among  salts,  we  have  at 
least  two  which  are  quite  certain  "moun- 
tain salt"  which  is  our  rock  salt,  and  "salt 
of  amanus"  which,  as  pointed  out,81  is  our 
ammoniac.  Other  mineral  substances, 
crushed  and  compounded,  were  used  in 
considerable  number,  and  it  should  be  noted 
that  just  as  in  medical  texts  and  in  lists, 
the  sign  for  "plant,"  Sham,  is  used  in  a 
general  way  for  all  organic  substances,  so 
the  sign  for  stone  (Sumerian  Na  =  Akka- 
dian abnu)  is  used  in  general  fashion  for 
inorganic  substances. 

Before  leaving  the  subject,  attention 
should  be  directed  to  a  feature  of  the  lists 
of  plants  and  drugs  drawn  up  by  the  scribes 
for  medical  instruction  and  guidance.  We 
find  a  large  number  of  substances  enumer- 
ated that  are  conspicuous  for  their  nasty 

81  See  above,  p.  242. 


and  ill-smelling  qualities.  These  drugs  con- 
stitute a  Dreckapotbeke,  to  use  the  expressive 
title  for  a  general  compilation  of  such 
strange  remedies'2  and  which,  as  is  well 
known,  were  in  general  use  in  all  countries 
until  well  into  the  nineteenth  century,  and 
no  doubt  still  survive  as  "lay"  prescrip- 
tions— "housewife  remedies" — in  many  a 
nook  and  corner  of  Europe.  In  the  Baby- 
Ionian-Assyrian  Dreckapotbeke,  we  encoun- 
ter such  examples  as  a  "green  frog"  to  be 
mixed  with  chicory,  the  claw  of  a  black  dog 
with  "pestilence"  root,  the  dust  from  a 
man's  foot  to  be  added  to  powdered  "thorn" 
plant.  Pig's  fat,  dog's  dung,  fat  of  a  viper, 
neck  of  a  dog,  the  excrements  of  man  and 
swine,  the  hair  taken  from  a  virgin  goat, 
a  hair  from  the  pudenda  of  an  old  woman, 
and  much  more  of  the  like  are  included  in 
the  lists. 

Such  remedies  represent,  as  I  venture  to 
suggest,  a  natural  outcome  of  the  primitive 
theory  of  disease  upon  which  Babylonian- 
Assyrian  medicine  rests.  Their  purpose  is  to 
have  a  direct  effect  on  the  demon  by  dis- 
gusting him  through  their  nasty  smell — to 
lead  him  to  fly  to  regions  where  the  air  is 
more  agreeable,  and  thus  to  relieve  the  un- 
fortunate victim  after  being  obliged  to  sub- 
mit to  an  ordeal  that  must  often  have 
seemed  worse  than  the  disease.  The  genuirie 
remedies  represent,  of  course,  the  result  of 
experience,  but  it  was  easy  to  apply  the 
fundamental  principle — that  what  was  good 
for  the  patient  was  bad  for  the  demon — to 
remedies  that  were  intended  to  bear  on  the 
demons,  without  reference  to  any  medicinal 
character  of  the  substances  employed. 

When  with  the  advance  of  medical  knowl- 
edge of  a  more  rational  kind  the  value  of 
genuine  remedies  acting  on  the  patient 
increased,  the  value  of  the  Dreckapotbeke 
was  forced  into  the  background,  without, 
however,  altogether  disappearing.  The  nasty 

82  K.  F.  PauIIini:  "Heilsame  Dreckapotheke," 
1714  (reprinted,  Stuttgart,  1847). 


248 


Annuls  of  Medical  History 


substances  acquired  the  power  of  a  charm, 
and  from  this  point  of  view  the  old  Baby- 
lonian-Assyrian Dreckapotheke  was  carried 
along  the  ages,  gathering  new  ingredients 
on  the  way  and  surviving  to  the  threshold 
of  modern  times.  The  substances  which  the 
witches  in  "Macbeth"  throw  into  the  caul- 
dron53 to  produce  a  charm  to  enable  them 
to  peer  into  the  future  bear  a  close  family 
resemblance  to  the  ingredients  of  the 
"magic"  aspect  of  Babylonian-Assyrian 
medicine  that  is  hardly  accidental.  The 
usage  in  both  instances  rests  ultimately 
on  the  same  association  of  ideas,  though  the 
purpose  differs. 

Fillet  of  a  fenny  snake 
In  the  cauldron  boil  and  bake 
Eye  of  newt  and  toe  of  frog, 
Nose  of  bat  and  tongue  of  dog, 
Adder's  fork  and  blind-worm's  sting, 
Lizard's  leg  and  owlet's  wing, 
For  a  charm  of  powerful  trouble, 
Like  a  hell-broth  boil  and  bubble. 

The  substances  represent  drugs  that  con- 
tinued to  form  part  of  the  popular,  as  also 
part  of  the  professional  pharmacopoeia  in 
Shakespeare's  days  and  beyond.  The  charm 
passes  over  into  the  amulet,  and  the  wearing 
of  bits  of  animals  or  trinkets  in  the  shape 
of  substances  supposed  to  have  magical 
power  is  merely  another  expression  of  the 
same  idea  that  such  substances  as 

Scale  of  dragon,  tooth  of  wolf 
Witches'  mummy,  maw  and  gulf 
Of  the  ravin'd  salt-sea  shark, 
Root  of  hemlock,  digg'd  i'  the  dark  M 
I  i\  ir  of  blaspheming  Jew, 
Gall  "I  goat  and  slips  of  yew, 
Sliver'd  in  the  moon's  eclipse, 
Nose  of  Turk  and  Tartars  lips, 
Finger  of  birth-strangled  babe, 
Ditch-delivered  by  a  drab. 

M  Act  iv,  i,  lines  14-40. 

MThc  direction  not  to  pluck  a  medicinal  root 
while  the  sun  shines  is  specifically  given  in  the  Baby- 
Ionian-Assyrian  lists  of  medicinal  drugs;  e.g.,  "Cunei- 
form Texts,   from   Babylonian  Tablets,"  xiv,  Plate 

25  (K  259). 


are  supposed  to  have  the  power  of  disgust- 
ing the  demons  and  of  driving  them  away. 
Lastly,  we  have  included  in  the  lists, 
compiled  by  the  Babylonian-Assyrian 
scribes  for  use  in  the  medical  courses  given 
in  the  temples,  actual  prescriptions,  the 
form  of  which  is  very  simple.  The  drugs  to 
be  compounded  are  enumerated,  together 
with  the  indication  of  the  disease  against 
which  they  are  to  be  used.  In  this  way,85  we 
have  nine  drugs  set  forth,  as  a  remedy  for 
stomach  trouble,  five  drugs  to  be  com- 
pounded for  the  advanced  stage  of  jaundice 
— known  as  akhkazu,S6  a  formula  of  six 
drugs  for  the  ordinary  form  of  jaundice, 
and  so  on. 

X 

A  direct  natural  result  of  medical  treat- 
ment among  the  Babylonians  and  Assyri- 
ans was  to  lead  to  the  study  of  the  human 
body  and  to  some  extent  also  of  animal 
anatomy.  An  elaborate  anatomical  nomen- 
clature was  evolved  which,  passing  far  be- 
yond the  obvious  subdivisions  of  the  body 
to  minute  details,  furnishes  the  evidence 
that  the  general  structure  of  the  human 
body  was  actually  studied  by  the  medical 
students  of  the  Euphrates  Valley  thousands 
of  years  ago.  Long  lists  of  parts  of  the 
body  were  drawn  up  by  the  scribes  which 
show  the  richness  of  the  anatomical  nomen- 
clature developed  in  the  endeavor  to  sub- 
divide the  organs  and  members  of  the  body 
into  their  component  parts.87  Let  me  take 
as  an  illustration  the  designations  of  the 
parts  of  the  male  and  female  genital  organs. 
A  common  term  for  both  is  ba'ultu  which  has 
the  force  of  "pudenda."  The  most  frequent 
term  for  the  penis  is  birku,  literally  "knee," 

85  "Cuneiform  Texts,"  xiv,  Plate  48  (Rm  328). 
M  See  above,  p.  243. 

87  The  most  comprehensive  study  of  the  subject 
is  embodied  in  the  monograph  by  Harri  Holma,  "Die 

Namcn  der  KorpcrU-ilc  im  Assyi  ieli-Bal>\  loniselien," 
Helsingfors,  191 1,  in  Annales  Acad.  Scientiarum  Fen- 
nicae.  Ser.  B,  Tome,  vii,  i. 


Babylonian-Assyrian  Medicine 


249 


and  which  suggests  that  birku  is  a  euphem- 
ism just  as  we  find  in  other  languages  some 
part  of  the  body  suggesting  the  penis  as 
"hand,"  "foot,"  "leg,"  "tail"  used  euphe- 
mistically for  the  male  organ.  The  "testi- 
cles" are  ishku,  the  "foreskin"  uruldti,  and 
the  "prostate  gland"  perhaps  sapsapu. 
For  the  female  organ,  the  number  of  terms 
is  very  large — so  large  indeed  as  to  suggest 
that  specific  parts  of  the  womb  were  in- 
tended— though  each  term  was  used  also  for 
the  female  organ  in  general.  We  find  among 
others  uru  from  a  stem  indicating  "naked- 
ness, "  bissuru,  perhaps  the  "clitoris, "  rubsu, 
the  "uterus,"  remu  or  remtu  the  "womb," 
kuzbu,  perhaps  the  "mons  veneris,"  libish- 
shatu,  probably  the  "hymen,"  silitu,  "after- 
birth," and  such  fanciful  names  as  E-tur, 
"house  of  the  child,"  and  pirisbtu, 
"secret,"88  besides  a  number  of  more  defi- 
nitely euphemistic  terms. 

It  is  entirely  natural  and  not  indicative 
of  technical  knowledge  to  find  in  such  lists 
terms  for  leg  (ishdu  literally  "pillar"  or 
"support"),  knee  (birku),  flank  (kuritu), 
shin-bone  (kimsu),  leg  (puridu,  literally 
"advance"),  foot  (shepu),  sole  (bud  shepi), 
heel  (ikbu),  toe  (ubdnu)  and  nail  (supru),  or 
that  for  the  upper  part  of  the  body  we 
should  have  names — and  in  some  cases 
several  names — for  the  eye,  ear,  lip,  nose, 
nostrils,  mouth,  teeth,  gums,  tongue,  throat, 
beard,  breast,  nipple,  etc.;  but  when  we 
find  in  the  case  of  the  eye  such  subdivisions 
as  iris  (burmu — literally  "many  colored"), 
eyelid  (kappu,  "wing"),  nakabtu,  "corner 
of  the  eye,"  eye-ball  (gaggultu),  pupil  (libbu, 
"inside"),  arku,  "white  of  the  eye,"  salmu, 
"dark  of  eye,"  or  when  in  connection  with 
the  throat  and  neck,  the  differentiation  ex- 
tends from  kishadu,  "neck,"  to  labariu, 
"nape,"  tikku,  "back  of  neck,"  napishtu, 


"jugular  vein,"  girru,  girdnu,  and  gangu- 
ritu,  "gurgle,"  with  further  subdivisions, 
kharurtu,  "larynx,"  urudu,  "windpipe," 
kbamuritu  perhaps  "vocal  chords,"  and  sub- 
divisions of  the  back  into  "spinal  column" 
(esensiru — literally,  "bone  of  the  back"), 
shoulder  (budu),  shoulder  blade  (rapasbtu), 
and  varous  other  terms,  and  similarly  for  the 
stomach  (karshu),  such  divisions  as  takaltu, 
"stomach  net, " pappan  libbi,  " navel," 'butnu 
"belly  "(?),  we  may  reasonably  conclude  that 
medical  practice  superinduced  such  de- 
tailed analysis.  We  have  in  all  about 
four  hundred  terms  for  the  various  organs 
and  members  and  subdivisions  of  the  hu- 
man body.  This  extensive  nomenclature, 
which  will  no  doubt  be  further  increased 
as  new  texts  are  made  accessible,  is  a  sig- 
nificant testimony  to  the  attention  that 
must  have  been  paid  to  the  study  of  anat- 
omy, though  to  be  sure,  in  a  purely  empir- 
ical and  unscientific  fashion. 

We  may  go  a  step  further  in  tracing  the 
origin  of  this  study  which,  curiously  enough, 
takes  its  start  not  with  medicine  but  with 
divination;  and,  what  is  still  stranger,  it  was 
the  attention  paid  in  the  interest  of  divina- 
tory  lore  to  the  liver  of  the  sheep,  the  sac- 
rificial animal  par  excellence,  that  furnished 
the  stimulus  to  the  study  of  anatomy. 

Among  the  various  methods  of  divination 
developed  by  the  Babylonians  and  Assyri- 
ans, the  endeavor  to  read  the  future  in  a 
sheep's  liver  appears  to  be  the  oldest,  as 
it  is  certainly  the  most  widespread  of  prim- 
itive methods  to  ascertain  the  disposition 
of  the  gods  at  any  critical  juncture  in  af- 
fairs. In  various  publications  I  have  en- 
larged upon  this  subject  of  liver  divination, 
or  hepatoscopy,89  and  of  its  spread  under 
Babylonian-Assyrian  influence,  so  that  I 
may  content  myself  here  with  a  brief  ref- 


88 One  might  compare  our  use  of  "privates." 
89  See  my  monograph,  "Babylonian-Assyrian  Birth 
Omens  and  Their  Cultural  Significance,"  Giessen, 
1914,  p.  1,  where  a  list  of  articles  of  mine  on  the 


subject  is  given;  and  for  a  general  survey  of  the  field 
of  Babylonian-Assyrian  divination,  see  Jastrow, 
"Civilization  of  Babylonia  and  Assyria,"  pp.  254- 
269. 


250 


Annuls  of  Medical  History 


erence.  The  method  rests  upon  the  belief 
that  the  liver  as  the  bloodiest  organ  in  the 
body  was  also  the  seat  of  life.  The  associa- 
tion of  ideas  between  blood  and  life  was  as 
natural  as  it  was  obvious.  Early  specula- 
tions about  what  we  in  common  parlance 
call  the  soul  or  the  vital  essence  always  take 
on  a  materialistic  turn.  Life  was  looked  upon 
not  as  a  condition,  but  as  connected  with 
some  substance  and,  accordingly,  the  at- 
tempt was  made  to  localize  the  seat  of  life 
in  some  part  of  the  body.  Blood  being  re- 
garded as  identical  with  life,  the  organ 
which  seemed  to  be  the  center  and  seat  of 
the  blood,  whence  it  was  distributed 
throughout  the  frame,  was  also  the  seat  of 
life.  The  primitive  observation  was  correct 
to  this  extent — that  the  liver  contains  a 
considerable  proportion  of  the  blood  of  the 
body,  about  one-sixth  in  the  case  of  many 
animals,  and  even  more  than  this  in  the 
case  of  man. 

The  ordinary  sacrificial  animal  in  Baby- 
Ionia  and  Assyria  was  the  sheep,  and  in  or- 
der to  ascertain  the  disposition  of  a  deity 
at  any  given  moment,  a  sheep  was  killed 
and  its  liver  examined.  According  to  symp- 
toms found  on  the  liver  conclusions  were 
drawn  as  to  whether  the  signs  observed 
portended  a  favorable  answer  to  a  question 
put,  or  whether  one  had  better  defer  an 
undertaking  till  a  more  favorable  moment. 
The  sacrificial  animal  offered  to  a  deity 
and  accepted  by  him  became  attuned,  as 
it  were,  to  the  deity.  The  soul  of  the  animal 


00  The  general  principle  underlying  the  system  was 
the  significance  attached  to  any  deviation  from  the 
normal — an  abnormally  large  or  abnormally  small 
lobe,  a  peculiar  form  of  the  appendix  pvramidalis 
or  of  the  appendix  ca]>illaris,  an  unusually  large  or 
thick  or  unusually  short  or  thin  gall-bladder,  the 
shape  of  the  hepatic  duct  and  the  like.  The  in- 
Urprrt.it inn  varied  according  as  the  abnormality 
appeared  on  the  right  or  on  the  left  side  of  any  part 
of  the  liver.  In  general,  a  sign  on  the  right  side 
portended  something  favorable,  on  the  left  side 
something   unfavorable.     If  favorable   to   you,   the 


and  the  soul  of  the  god  became  for  the  time 
being  in  perfect  accord.  The  liver  as  the 
soul  of  the  animal  reflected  the  disposition 
of  the  deity  as  in  a  mirror.  If  one  could 
read  the  signs  on  the  liver,  one  could  be 
certain  of  what  the  god  had  in  mind — 
whether  he  was  favorably  disposed  to  the 
questioner  or  unfavorably  minded — just  as 
in  the  higher  form  of  astronomical  divina- 
tion, the  reading  of  the  stars  revealed  the 
frame  of  mind  of  the  gods  in  heaven. 

This  curious  method  of  liver  inspection 
had,  however,  the  result  of  leading  to  a 
study  of  the  sheep's  liver,  for  in  the  course 
of  time  as  the  signs  noted  on  examined 
livers  increased — and  no  two  livers  \\  ere 
ever  exactly  alike — liver  divination  became 
a  pseudoscience  for  which  specialists  had 
to  be  trained. 

The  experience  of  the  past  was  gathered 
in  handbooks  which  formed  the  textbooks 
for  training  the  priestly  augurs — the  pre- 
cursors of  our  modern  meat  inspectors.  By 
means  of  a  natural  or  artificially  developed 
association  of  ideas  between  signs  observed 
on  the  liver  and  what  they  portended,  and 
further  on  the  basis  of  actual  experience 
that  on  an  occasion  when  an  inspected  liver 
showed  certain  signs,  an  event  of  a  favor- 
able or  unfavorable  character  occurred, 
an  elaborate  system  of  liver  interpretation 
was  built  up  that  continued  in  force  till  the 
end  of  the  Babylonian  empire  and  spread 
to  other  lands.90 


sign  was  a  bad  one  for  the  enemy,  if  unfavorable  to 
you  then  it  was  Favorable  to  the  enemy.  To  the 
markings  on  the  liver— due  to  the  traces  of  the 

subsidiary  ducts  on  the  surface  great  attention  was 
paid, and  all  kinds  of  fanciful  objects  were  seen  in  the 
combination  of  these  markings.  The  general  prin- 
ciple was  always  subject  to  modification  through  tin- 
observation  that  on  a  former  occasion  certain  signs 
wire  followed  by  certain  occurrences,  favorable  or 
unfavorable.  The  ramifications  of  the  system  of 
interpretation  that  thus  grew  up  were  nigh  endless, 
just  as  the  field  of  divination  in  astrology  and  in 
birth  omens  was  boundless. 


Babylonian-Assyrian  Medicine 


251 


The  study  thus  given  to  signs  on  the  liver 
included  the  appearance  of  the  gall,  of  the 
various  lobes  of  the  gall-bladder  and  of  the 
gall-ducts,  of  the  larger  and  smaller  ap- 
pendices to  the  liver  and  of  the  veins. 
Names  for  these  subdivisions  were  devised, 
some  of  which  passed  over  into  the  anatom- 
ical nomenclature  of  other  lands  or  which 
influenced  that  nomenclature.  Since  this 
curious  system  of  hepatoscopy  was  devised 
as  early  at  least  as  2500  b.  c,  we  may  safely 
assume  that  the  inspection  of  the  sheep's 
liver  marks  the  very  begijviings  of  the  study 
of  animal  anatomy  anywhere.  The  impetus 
thus  given  by  liver  divination  reacted  on 
the  natural  curiosity  of  man,  and  was  no 
doubt  a  factor  in  leading  to  a  closer  ob- 
servation of  the  human  body  as  part  of 
the  medical  training  of  the  Babylonian- 
Assyrian  Asu,  with  the  result  of  producing 
the  very  extensive  anatomical  nomencla- 
ture that  forms  one  of  the  surprises  in  the 
study  of  cuneiform  literature.  The  proof 
that  this  study  was  undertaken  in  connec- 
tion with  the  endeavor  to  drive  out  the 
demons  of  disease  by  incantations  and 
medical  treatment  is  again  furnished 
through  the  occurrence  of  the  anatomical 
nomenclature  in  incantation  and  medical 
texts,  as  well  as  in  divination  texts  that 
form  a  supplement  to  incantations  and 
medical  prescriptions. 

XI 

By  way  of  further  illustration  of  the  use 
of  anatomical  terms  in  Babylonian-Assyrian 
medicine,  supplemental  to  the  occurrence 
of  these  terms  in  the  specimens  from  the 

91  See  above,  p.  240. 

92  Letters  almost  invariably  begin  with  a  greeting 
of  this  kind  in  the  name  of  some  god  or  some  gods. 
In  the  case  of  medical  letters,  Ninib,  who  is  the  god 
of  healing,  and  his  consort,  Gula,  are  always  invoked; 
in  the  case  of  divination  and  omen  texts,  Shamash 
(the  sun-god)  and  Adad  (the  storm-god)  who  are 
the  gods  of  divination  are  addressed.  Otherwise,  the 
ordinary  greeting  introduces  Nebo  and  Marduk  in 


medical  texts  already  given,  let  me  quote 
some  passages  from  letters  from  Assyrian 
physicians  that  have  come  down  to  us.  These 
letters  form  part  of  the  royal  library  at 
Nineveh  which  has  been  mentioned. 91  In- 
cidentally, they  also  shed  a  further  light 
on  medical  diagnosis  and  medical  treatment 
in  ancient  Assyria. 

One  of  these  letters  written  by  a  court 
physician,  Arad-Nana,  in  the  days  of  King 
Ashurbanapal  (668-626  b.  c.)  deals  with 
the  case  of  one  of  the  royal  princes  who  is 
suffering  from  an  injury  to  the  eye.  The 
physician  reports  to  the  king  as  follows: 

To  the  King,  my  lord:  thy  servant  Arad- 
Nana!  Hearty  greetings  to  the  King  my  lord! 
May  Ninib  and  Gula92  grant  happiness  and 
health  to  the  King,  my  lord. 

Hearty  greetings  to  the  little  fellow  whose 
eyes  cause  him  trouble.  I  put  a  bandage93  on  his 
face.  Yesterday,  towards  evening,  I  took  the 
bandage  off,  removing  also  the  dressing  below. 
There  was  blood  on  the  dressing  as  much  as 
the  point  of  the  little  finger.  To  which  one  of 
the  gods  this  is  due,  his  order  has  surely  been 
carried  out.  Hearty  greetings!  Let  the  King,  my 
lord,  rest  assured.  In  seven  or  eight  days  he  will 
be  well. 

The  nature  of  the  injury,  unfortunately, 
is  not  stated,  nor  the  ingredients  in  the 
dressing.  The  injury — perhaps  a  wound — 
had  resulted  in  hemorrhages  and  the  doctor 
reports  that  the  eye  was  almost  healed. 
The  flow  of  blood  had  almost  stopped.  In 
accordance  with  the  pious  belief  of  the  day, 
the  physician  ascribes  the  improvement  to 
the  gods,  though  he  does  not  know  which 
one  of  them  has  come  to  the  rescue. 

Assyrian  and  Babylonian  letters,  though  not  in- 
frequently others  are  added.  So  in  Assyrian  letters 
one  finds  Ashur  and  his  consort,  Belit,  or  Nebo  and 
his  consort,  Nana,  invoked.  In  the  subscripts  to 
the  literary  collection  of  Ashurbanapal  the  divine 
pair  Nebo  (the  god  of  wisdom  and  writing)  and  his 
consort,  Tashmitu,  are  introduced,  except  in  the 
case  of  divination  and  omen  texts  which  substitute 
Shamash  and  Adad. 

93  No  doubt  a  dressing  with  a  salve. 


252 


Annals  of  Medical  History 


If  the  "son  of  the  king"  mentioned  in 
another  letter  of  Arad-Nana  is  the  same 
prince,  it  would  appear  that  the  young 
fellow  was  also  suffering  from  hemorrhages 
of  the  nose.  Arad-Nana  reports,  after  the 
customary  greeting,  that  the  treatment 
prescribed  by  some  one  else  to  stop  the 
bleeding  was  not  correct,  and  proposes  a 
different  one: 

In  regard  to  the  bleeding  of  his  nose  (i.e.,  of 
the  prince)  about  which  the  Rab-Mugi  (a  high 
official)  has  reported  to  me  that  yesterday 
towards  evening  there  was  much  bleeding,  these 
dressings  are  not  properly  applied.  They  have 
been  placed  on  the  alae  of  the  nose,  obstructing 
the  breathing,  while  at  the  same  time  the  blood 
flows  down  into  the  mouth.  Let  the  nose  be 
plugged  up  at  the  back,  so  that  air  will  be  held 
out,  and  the  bleeding  will  cease.  If  it  please  the 
king,  I  will  come  to  look  at  it  to-morrow. 
Meanwhile  may  I  hear  good  news. 

A  third  letter  of  this  same  physician 
deals  with  an  aggravated  case  of  rheumatic 
fever  from  which  the  king  is  suffering.  The 
royal  patient  has  grown  restive,  and  in 
human  fashion  places  the  blame  for  the 
failure  of  the  remedies  prescribed  on  the 
doctor.  He  raises  the  question  whether  the 
latter  understands  the  case,  and  the  doctor 
confesses  that  perhaps  the  treatment  was 
not  right. 

The  King,  my  lord,  continues  to  declare, 
"the  state  of  this  sickness  of  mine  thou  dost  not 
recognize,  thou  dost  not  bring  about  a  cure." 
Now,  I  confess  that  hitherto  I  did  not  under- 
stand this  rheumatism,94  but  now  I  seal  this 
letter  and  send  it  to  the  King,  my  lord.  Let  it 
be  read  to  the  King  and  properly  understood. 
When  it  reaches  the  King,  my  lord,  let  a  phy- 
sician .  .  .  carry  out  the  accompanying  direc- 
tions. Let  the  King  apply  this  liniment.  If  the 
King  docs  this,  this  fever  will  soon  leave  the 

94  Literally:  "sickness  of  the  muscles." 

"  A  massage. 

MThis  appears  to  be  the  correct  reading  of 
the  name  of  the  writer,  as  Prof.  D.  D.  Luckcnbill 
has  pointed  out,  Jour.  Am.  Orient.  Soc,  PI.  37, 
pp.  250-253. 


King,  my  lord.  A  second  and  a  third  time  this  oil 
liniment  should  be  .applied  to  the  King,  my 
lord.  Let  the  King  see  to  this.  If  it  please  the 
King,  let  it  be  done  in  the  morning.  This  disease 
is  in  the  blood.  Let  them  bring  the  King  a  sil- 
banu 95  as  was  twice  done,  and  let  it  be  vigorously 
applied.  I  shall  come  to  inform  myself  and  as 
soon  as  the  perspiration  flows  freely  from  the 
King,  my  lord,  I  will  send  to  the  King  something 
to  apply  to  the  King's  neck.  With  a  salve  which 
I  shall  send  to  the  King,  my  lord,  let  the  King, 
my  lord,  be  rubbed  at  the  appointed  time. 

XII 

In  conclusion,  let  me  summarize  the  ref- 
erences to  the  Asu  in  the  famous  Ham- 
murawi96  Code,  promulgated  c.  2080  b.  c, 
toward  the  close  of  the  King's  reign.97 
There  are  eleven  paragraphs  (§§215-225) 
in  the  code  dealing  with  the  fees  to  the 
Asu,  and  with  fines  for  unsuccessful  opera- 
tions. Both  fees  and  fines  are  regulated  ac- 
cording to  the  class  to  which  the  patient 
belongs.  The  mar  ameli,  equivalent  to  our 
well-born  gentleman,  pays  ten  shekels  for 
an  operation  for  an  eye  wound,  made  with 
a  bronze  lancet,  while  a  plebeian  gets  a  re- 
duction of  fifty  per  cent,  and  a  slave  is 
charged  only  two  shekels  to  be  paid  by  the 
owner.  If  a  slave,  in  consequence  of  an  op- 
eration, dies,  the  physician  must  supply 
another  slave.  If  the  slave  loses  an  eye,  the 
physician  pays  half  the  value  of  the  slave, 
but  if  the  Asu  is  unfortunate  enough  to 
destroy  the  eye  of  a  gentleman  or  of  a 
plebeian,  or  if  a  patient  of  either  of  these 
two  ranks  dies,  the  physician's  hand  is  cut 
off — in  order  to  render  him  harmless  for 
the  future.  For  setting  a  broken  bone  or 
for  the  cure  of  an  injured  limb,  the  fee  is 
five  shekels  for  the  well-born,  three  shekels 
for  the  plebeian  and  two  shekels  for  a  slave. 

97  See  the  translation  in  R.  W.  Rogers,  "Cuneiform 
Parallels  to  the  Old  Testament,"  New  York,  1912, 
pp.  398-405.  For  a  survey  of  the  Code,  see  Jastrow, 
"Civilization  of  Babylonia  and  Assyria,"  pp.  283- 
3'5- 


Babylonian-Assyrian  Medicine 


253 


Now  the  point  of  interest  in  these  some- 
what strange  regulations  is  that  they  all 
fall  within  a  subdivision  of  the  code  dealing 
with  injuries.  Hence,  the  only  phase  of  the 
Asu's  activities  referred  to  in  the  code  is 
surgery.  Nothing  is  said  of  general  medical 
treatment,  and  no  doubt  for  the  reason 
that  such  treatment  still  fell  entirely  within 
the  category  of  religious  rites,  bound  up 
with  incantations.  The  Asu  as  surgeon, 
however,  is  not  dealing  with  demons,  but 
with  injuries98  to  some  member  or  organ 
of  the  body.  The  treatment  of  injuries  is, 
therefore,  logically  dealt  with  in  the  part 
of  the  code  devoted  to  assault  and  battery, 
to  blows  and  wounds  inflicted  accidentally 
or  intentionally  on  someone  by  a  fellow 
being;  and  it  is  worth  noting  that  this  sub- 
division of  the  code  (§§196-233)  is  intro- 
duced by  the  lex  talionis,9*  as  the  funda- 
mental principle  regulating  the  punish- 
ment. In  its  original  form,  this  lex  talionis 
read  as  follows: 

If  a  man  destroys  the  eye  of  another, 

His  eye  shall  be  destroyed. 

If  he  breaks  the  bone  of  another, 

His  bone  shall  be  broken. 

ff  he  knocks  out  the  tooth  of  another, 

His  tooth  is  to  be  knocked  out. 

Supplementary  to  this  primitive  law  of 
direct  punishment  for  injuries,  paragraphs 
are  added,  reflecting  a  later  stage  of  society 
when  fines  take  the  place  of  bodily  tor- 
tures. If  the  injured  party  is  a  plebeian, 
one  mana  10°  is  imposed  for  an  eye  or  bone, 
and  one-third  of  a  mana  for  a  tooth,  whereas 
in  the  case  of  a  slave  one-half  of  the  price 
of  a  slave  is  the  compensation  to  the  owner 
for  the  loss  of  an  eye  or  a  broken  bone, 
rendering  the  slave  by  so  much  less  valuable. 
Nothing  is  said  about  the  broken  tooth  of 
a  slave,  because  the  injury  does  not  affect 
the  value  of  the  slave.  The  old  lex  talionis 
is  limited  to  the  case  of  an  injury  done  to 


an  individual  by  an  equal.  The  Asu  as  sur- 
geon inflicts  an  injury  in  case  his  treat- 
ment is  unsuccessful,  and  therefore  must 
pay  a  fine.  But  while  he  thus  cuts  loose  from 
the  physician  as  an  exorciser,  the  surgeon 
passes  from  the  Babylonian-Assyrian  point 
of  view  to  a  lower  plane.  He  is  taken  out  of 
the  priestly  class  and  degraded  to  that  of  a 
mechanic  or,  let  us  say,  a  butcher.  The 
Asu  as  surgeon  does  not  appeal  to  Ninib 
and  Gula  for  aid  in  driving  out  a  demon. 
He  has  no  recourse  to  incantations  and 
magic  rites,  supplemental  to  the  medicinal 
remedies,  supposed  to  have  their  effect  on 
the  demon  as  the  cause  of  the  disease.  The 
operator  depends  solely  on  his  knife— the 
Babylonian  would  say  merely  on  his  knife — 
which  is  generally  of  bronze.  The  Asu  as 
physician  is  the  instrument  of  the  gods, 
but  the  moment  he  takes  an  instrument 
into  his  own  hands  he  is  only  an  ordinary 
man  who  becomes  subject  to  the  law  of 
injuries.  The  Asu  as  surgeon  is  responsible 
for  the  result  of  his  work,  whereas  if  in  his 
treatment  of  disease  the  demon  worsts  the 
Asu  and  the  patient  dies,  it  is  a  misfortune 
for  the  patient  for  which  the  Asu  is  not 
to  blame.  The  attitude  of  the  Hammurawi 
Code  towards  surgical  operations  was  med- 
icus  caveat — the  surgeon  must  not  risk  fail- 
ure. If  the  eye  is  destroyed,  it  is  due  to 
the  Asu  who  ought  to  have  done  better. 
With  cruel  logic,  the  code  refused  to  recog- 
nize an  operation  as  successful  if  the  pa- 
tient succumbs,  though  we  have  noted  the 
inconsistency  that  in  the  case  of  medicinal 
treatment  the  death  of  the  patient  was  re- 
garded in  a  different  light.  The  surgeon 
had  to  pay  a  fine  in  case  of  an  unsuccessful 
operation,  just  as  the  code  provides  (§  5) 
that  if  a  judge  renders  a  wrong  decision, 
it  is  not  the  decision  that  is  reversed  but 
the  judge,  by  being  removed  from  the 
bench,  in  addition  to  paying  a  heavy  fine. 


98 The  term  used  is  zimmu  kabtu,  "heavy  blow"  or 
wound. 


69  §§196-201. 
100  Sixty  shekels. 


254 


Annals  of  Medical  History 


The  lower  dignity  accorded  to  the  sur- 
geon as  against  the  "medicine  man"  left 
its  trace  on  medicine  up  to  a  late  period. 
The  barber's  pole— his  symbol  as  a  surgical 
operator — survives  as  evidence  for  the  small 
value  attached  to  the  functions  of  the  sur- 
geon, which  were  in  many  cases  committed 
to  the  barber,  though  generally  limited  to 
bleeding,  cupping  and  extracting  teeth. 
Modern  surgery,  which  takes  its  rise  with 
Ambroise  Pare  (1517-1590),  has,  of  course, 
changed  this  and  given  to  the  surgeon  his 
present  high  standing,  but  I  venture  to 
raise  the  question  whether  the  distinction 
still  made  in  England  between  the  physician 
who  is  called  "Doctor"  and  the  surgeon 
who  is  addressed  as  "Mr."  may  not  in  the 
last  analysis  be  a  survival  from  the  older 
days  when  the  surgeon  stood  on  a  lower 
level  than  his  colleague,  the  medical  prac- 
titioner. 

The  attitude  towards  the  surgeon,  as 
exemplified  in  the  regulations  of  the  Ham- 
murawi  Code,  accounts  for  the  fact  that  in 
the  medical  texts  of  Babylonia  and  Assyria, 
as  in  the  lists  of  letters  supplemental  to 
these  texts,  we  encounter  no  reference  what- 
soever to  the  surgeon  but  only  to  medical 
treatment  through  drugs,  liniments,  salves, 
massage  and  diet — all  with  the  one  object 
of  effecting  a  cure  by  driving  the  demon 
out  of  the  body.  On  the  other  hand,  it  is 
interesting  to  note  that  as  early  as  the  days 
of  the  Hammurawi  Code,  surgery  had  ad- 
vanced to  the  stage  of  differentiation  be- 
tween the  surgeon  and  the  veterinarian. 
The  latter  was  called  the  Asu  for  the  ox 
or  ass  (§§224-225).  This  is  probably  the 
earliest  instance  of  specialization  in  med- 
icine, though  the  fact  that  the  distinction 
was  made  was  due  again  to  the  lower  grade 
assigned    to    the    surgeon    as    against    the 

101  Sec  the  proof  in  the  author's  monograph, 
"Babylonian-Assyrian  Birth  Omens  and  Their 
Cultural  Significance,"  pp.  3-4,  and  more  fully 
in  his  "Religion  Babylonicns  and  Assyriens"  ii, 
320,  el  seq.  and  741-741;. 


medical  practitioner,  who  as  an  exorciser 
of  demons  would  have  considered  it  beneath 
his  dignity  to  treat  animals.  He  was  hide- 
bound by  the  theory  that  demoniac  posses- 
sion was  limited  to  human  beings. 

XIII 

A  rapid  survey  of  the  influence  exerted 
by  Babylonian-Assyrian  medicine  upon  the 
ancient  world  may  close  this  article.  That 
influence  runs  parallel  with  the  wide  spread 
of  Babylonian-Assyrian  methods  of  divina- 
tion. Babylonian-Assyrian  hepatoscopy  and 
astrology  passed  beyond  the  bounds  of  the 
Euphrates  Valley  to  find  their  way  to  the 
Hittites,  Hebrews,  Greeks  and  Romans;101 
and  the  medical  methods  developed  in  the 
Euphrates  Valley  similarly  spread  to  the 
cultural  nations  of  antiquity,  as  supple- 
mental to  divination  lore.  We  can  trace 
that  influence  in  the  medicine  of  the  Jews 
of  the  Talmudic  period.  In  the  great  legal 
compilation  of  the  Jewish  rabbis  known  as 
the  Talmud,102  we  come  across  general 
points  of  view  and  details  in  treatment  that 
can  be  carried  back  directly  to  Babylonian- 
Assyrian  prototypes.  The  advanced  mono- 
theism of  the  Jews  did  not  succeed  in  driv- 
ing out  the  popular  belief  in  demons,  hob- 
goblins, vampires  and  all  manner  of  semi- 
divine  beings  of  a  sinister  character,  just 
as  early  and  medieval  Christianity  found 
room  by  the  side  of  the  Trinity  for  devils 
and  angels.  Popular  beliefs  are  too  deeply 
imbedded  to  yield  to  metaphysical  specu- 
lations as  to  the  method  of  divine  govern- 
ment of  the  universe  by  a  single  spiritual 
power.  The  Talmud  furnishes  us  with  magic 
incantations  to  be  recited  as  a  means  of 
driving  off  the  evil  demons.  The  stimulus 
given  to  medical  treatment  of  a  more 
scientific  character  through  the  contact  of 

102  See    l.bstein,    "Die    Mcdizin    ini    Ncucn    I  <■■-.!. .- 

ment  und  im  Talmud,"  Stuttgart,  1903,  and  Preuss, 

"Biblisch- Talmudischc  Mcdizin,"  Berlin,  191 1. 


Babylonian-Assyrian  Medicine 


*55 


the  Orient  with  Greek  civilization  that  had 
given  birth  to  the  medical  schools  of  Hip- 
pocrates and  Galen  led  to  the  practical 
abandonment  of  the  theory  of  demoniac 
possession  as  the  cause  of  disease,  but  med- 
ical treatment  in  the  Talmud  remained  on 
the  same  level  as  in  Babylonia  and  Assyria. 
As  late  as  the  days  of  Josephus  we  come 
across  beliefs  in  the  power  of  individuals 
to  drive  demons  out  of  the  body  by  means 
of  certain  roots  attached  to  a  ring  placed 
in  the  nostrils  of  a  victim.  Josephus,  "An- 
tiquities," viii,  2,  5,  tells  us  also  of  a  root 
baaras  that  was  supposed  to  have  the 
power  when  brought  to  a  sick  person  of 
driving  the  demon  away.  This  crude  man- 
ner of  affecting  the  demons  is  an  indication 
of  the  fading  belief,  reflecting  a  period  when 
it  was  no  longer  regarded  as  plausible  that 
by  taking  a  medical  prescription  the  cure 
involved  the  departure  of  a  demon  out  of 
the  body.  Demoniac  possession  becomes 
limited  to  abnormal  mental  manifestations 
like  insanity  and  hallucinations.  In  this 
form  it  appears  in  the  New  Testament,103 
but  for  all  that  the  remedies  themselves 
that  are  set  forth  in  Talmudic  passages 
parallel  the  pharmacopoeia  of  Babylonia  and 
Assyria,  including  a  Dreckapotheke.104  Such 
a  detail,  as  that  medicines  should  be  taken 
in  wine,  forms  too  close  a  parallel  to  what 
we  so  frequently  find  in  Babylonian-As- 
syrian texts  to  be  an  accident.  We  have 
the  proof  also  that  in  Syria  the  Babylonian- 
Assyrian  methods  of  medical  treatment  re- 
mained in  popular  usage  long  after  the  more 
scientific  Greek  medicine  had  made  its 
way  throughout  the  ancient  world.  Attached 
to  an  elaborate  Syriac  '  'Book  of  Medicines," 
published  a  few  years  ago  by  E.  A.  Wallis 
Budge,105  embodying  for  the  larger  part  a 

103  See  the  passage  quoted  above,  p.  244,  note  73. 

104  See  examples  in  Preuss,  "Biblisch-Talmudische 
Medizin,"  p.  509. 

105  "Syrian  Anatomy,  Pathology  and  Therapeu- 
tics" or  "The  Book  of  Medicines,"  2  vols.,  text, 
transIation  and  introduction,  Oxford,  191 3. 


transcript  of  Greek  medicine,  is  a  chapter 
of  "native  prescriptions,"106  and  here  we 
encounter  the  familiar  remedies  of  Baby- 
Ionian-Assyrian  medicine  as,  for  example, 
for  a  disease  of  the  heart: 

Burn  the  bones  of  partridges  (  ?  )  until  they 
become  a  fine  powder.  Pour  this  powder  into 
olive  oil  and  warm  the  mixture  and  smear  it  on 
the  head  and  sprinkle  vinegar  on  the  head. 

Or  again: 

Pound  the  insides  of  walnuts  with  garlic 
and  apply  to  the  head. 

For  eye  trouble,  the  following  is  pre- 
scribed: 

Take  30  drachmas  of  juice  of  anethum  foeni- 
culum  and  10  drachmas  of  honey  and  30 
drachmas  of  sweet  pomegranates,  mix  together. 
Set  the  mixture  on  a  fire  and  boil.  Take  it  off 
the  fire,  keep  it  in  a  glass  vessel  and  pour  onto 
the  eyes  when  the  belly  is  empty.107 

Still  closer  to  the  style  of  Babylonian- 
Assyrian  prescriptions  are  the  following:108 

For  insides  109  which  will  not  retain  food,  boil 
thorns  in  water  and  let  the  patient  drink  it. 

For  wind  on  the  stomach,  pound  peppercorn 
and  cinnamon  reed.  Work  into  a  paste  with 
honey  and  let  the  patient  eat  3  drachmas  for 
two  days. 

For  a  very  sick  person,  give  him  to  drink  of 
the  sweat  of  his  feet  mixed  with  excrements. 

For  one  who  has  been  poisoned,  let  him 
drink  the  urine  of  a  child,  mixed  with  wine  or 
gall  of  a  gazelle  in  goat's  milk. 

Among  other  ingredients  of  the  "native" 
Dreckapotheke,  clearly  intended  to  disgust 
the  demons  as  well  as  the  patient,  we  have 
such  substances  as  the  testicles  of  a  fox 
for  breasts  too  full  of  milk,  or  the  gall  of  a 

106  Vol.  ii,  pp.  656-714. 

107  A  parallel  to  the  frequent  injunction  in  Baby- 
Ionian-Assyrian  texts  to  take  a  mixture  "without 
food. " 

108  Budge,  II,  pp.  674-675. 

109  The  word  leb  (Babylonian  libbu)  is  used  to 
designate  the  "insides"  in  a  general  and  vague  way. 


2^6 


Annals  of  Medical  History 


pig  to  be  burnt  under  a  person  who  has  a 
sore  in  the  arms,  or  the  fat  of  a  black  ser- 
pent with  a  red  neck  and  the  gall  of  a  pig 
to  be  applied  to  the  anus,  or  the  dung  of  a 
white  dog.  The  person  who  has  gas  in  the 
stomach  should  drink  this  mixed  with  sugar 
and  water  "and  his  insides  will  be  loosened 
and  he  will  have  relief." 

Such  remedies  are  clearly  remnants  of 
Babylonian-Assyrian  medicine,  preserved 
perhaps  for  centuries  by  oral  tradition  until 
they  were  embodied  in  the  collections  made 
by  native  "quacks,"  who  continued  to 
flourish  by  the  side  of  the  better  educated 
physicians. 

The  rival  of  Babylonian-Assyrian  med- 
icine in  point  of  age  is  Eg}-ptian  medicine, 
of  which  we  now  know  a  great  deal,  thanks 
to  the  discovery  and  publication  of  several 
medicinal  papyri  of  various  periods.110  The 
possible  relations  between  the  two  systems 
is  a  question  which  must  be  left  to  a  fur- 
ther paper.111  That  the  drugs  used  in  the 
Euphrates  Valley  should  have  passed  to 
Egypt  at  an  early  period,  and  rice  versa,  is 
exactly  what  we  should  expect  to  have  hap- 
pened at  an  early  date,  now  that  we  have 
ascertained  that  the  intercourse  between 
these  two  regions  reverts  to  the  second 
millennium  before  this  era.  In  the  plant  and 
drug  lists  drawn  up  by  Babylonian- Assyrian 
scribes,  we  find  specific  mention  of  sub- 
stances brought  from  other  countries — 
Canaan,  Magan,  Elam,  etc.  I  have  pointed 
out 112  that  ammonia  was  probably  intro- 
duced into  Egypt  through  intercourse  with 
Babylonia.  Beyond  such  interchange,  how- 
ever, it  may  be  questioned  whether  the 
Egyptian  medicine  had  anything  to  learn 
from   Babylonia,   for  medical  practice  ap- 


pears to  have  reached  a  much  higher  plane 
in  Egypt.  The  oldest  medical  papyrus  of 
Egypt — the  Papyrus  Ebers — dates  back  to 
the  16th  century  b.  c.  and  is  remarkably 
free  from  magic  rites  and  incantations, 
though  we  do  find,  as  in  Babylonia-Assyrian 
medicine,  substances  like  dung,  the  uterus 
and  vulva  of  various  animals  introduced 
as  drugs — which  suggests  that  the  purpose 
of  such  drugs  was  originally,  likewise,  to 
drive  the  demon  out  of  the  body.  No  doubt 
Egyptian  medicine  started  out  from  the 
same  primitive  theory  of  demoniac  posses- 
sion, but  it  appears  to  have  cut  itself  loose 
from  the  theorj-  to  a  large  extent  at  an  early 
age.  Strangely  enough  in  medical  papyri  of 
the  new  kingdom,  magic  practices  and  the 
recital  of  incantations  reappear  as  promi- 
nent factors  in  the  treatment  of  disease. 
It  is  tempting  to  conclude  that  this  recru- 
descence of  primitive  methods,  in  striking 
contrast  to  the  more  rational  manner  in 
which  diseases  are  handled  in  the  papyri 
of  older  date,  was  due  to  the  influence  of 
Babylonian-Assyrian  culture,  whereas  the 
advance  to  more  scientific  methods  in  Baby- 
Ionian-Assyrian  medicine,  so  far  as  this  is 
to  be  noted,  may  be  ascribed  to  Egyptian 
influence  as  a  factor,  by  the  side  of  the 
natural  progress  which  must  also  be  as- 
sumed. 

At  all  times,  however,  and  despite  the 
recrudescence  of  magic  incantations,  Egyp- 
tian medicine  appears  to  have  been  far 
more  scientific  in  character,  and  if  in  the 
case  of  Greek  medicine,  which  marks  the 
foundation  of  medical  treatment  on  a  basis 
more  closely  approaching  that  of  modern 
days,  we  are  to  seek  for  any  outside  influ- 
ence, we  must  turn  to  Egypt  as  a  possible 


110  The  latest  publication  of  them  by  Wreszinski 
(a)  "Papyrus  Ebers,"  Berlin,  1913;  (b)  "Berlin 
Papyrus,"  Berlin,  1909;  "London  Papyrus,"  Leipzig, 
10.12.  To  these  i->  to  be  added  "The  Hearst  Medical 
Papyrus,"  edited  by  Reisner,  Univ.  of  California 
Publications  (1905).  See  also  Budge's  Introduction 
to  his  edition  of  the  Syriac  "Book  of  Medicines," 


pp.  cxxx-cxliii,  for  a  general  survey  of  Egyptian 
medicine  and  the  further  references  there  given. 

"'  I  reserve  lor  a  special  article  to  be  prepared  for 
the  Bull.  Soc.  Med.  Hist.  0/  Chicago  a  fuller  discussion 
of  the  relations  between  Babylonian-Assyrian  Medi- 
cine and  that  of  the  Jews  and  Egyptians. 

l"  See  above,  p.  242,  note  $5. 


Babylonian-Assyrian  Medicine 


257 


factor.  Homer,  it  is  interesting  to  note, 
refers  to  Egyptian  physicians,  and  we 
find  Egyptian  herbs  mentioned  in  the 
pharmacopoeia  of  Greek  physicians.  With 
Hippocrates,  however  (460-375  b.  a),  an 
entirely  new  epoch  in  medicine  is  ushered 
in,  and  no  doubt  in  the  first  instance  it  was 
the  native  scientific  spirit  of  Greece  that 
had  manifested  itself  even  before  the  days 
of  Hippocrates,  in  mathematics  and  astron- 
omy and  in  the  development  of  philosophical 
thought  that  brought  about  the  systematic 
study  of  human  anatomy  and  philosophy 
and  laid  the  foundations  for  the  rational 
treatment  of  disease  as  against  purely  em- 
pirical methods,  based  on  tradition  and 
crude  popular  beliefs. 

But  popular  beliefs  and  time-bound  tra- 
ditions have  a  tenacious  life  and  survived 
even  in  Greece  long  after  the  attempt  was 
made  to  convert  medical  treatment  into  a 
science.  Just  as  we  have  down  to  the  thresh- 
old of  modern  science,  astrology  flourish- 
ing by  the  side  of  astronomy  and  the  exor- 
ciser  plying  his  trade  side  by  side  with 
the  spiritual  guide,  so  we  have  the  Baby- 
Ionian-Assyrian  Asu  surviving  by  the  side 
of  the  Greek  iatros.  Indeed,  in  our  own 
days  we  still  have  the  astrologer  as  the 
successor  of  the  Babylonian-Assyrian 
baru,113  and  likewise  the  medicine-man  and 
the  herb  doctor  and  "quack"  as  the  direct 
descendant  of  the  Asu,  supplying  remedies 
that  have  been  handed  down  from  a  hoary 
antiquity,  dealing  with  disease  in  purely 
empirical  fashion  and  introducing  all  kinds 
of  hocus-pocus  that  suggest  the  old  theory 

113  The  "seer,"  used  for  the  one  who  inspects  the 
liver,  equally  with  the  priest  who  searches  the  skies 
for  omens. 


of  demoniac   possession    as   the   source   of 
disease. 

It  is  an  observation  that  may  frequently 
be  made,  that  after  a  civilization  passes 
away,  its  weaker  aspects  continue  to  exer- 
cise a  more  or  less  pronounced  influence. 
There  is  a  strange  fatality  in  the  manner 
in  which  "the  evil  that  men  do  lives  after 
them,  the  good  is  oft  interred  with  their 
bones."  Babylonian-Assyrian  civilization 
can  point  to  great  achievements  in  art, 
literature,  trade  and  government  that 
exerted  a  strong  and  wide  influence  for  good 
in  the  ancient  world;  but  after  it  passed 
away — leaving  scarcely  any  visible  traces 
until  the  spade  of  the  explorer  dug  up  the 
remains  of  the  civilization  out  of  the 
mounds  that  formed  over  the  places  where 
once  great  cities  stood — the  beliefs  and 
theories  of  a  purely  primitive  character, 
which  were  carried  along  in  the  waves  of 
influence  that  flowed  from  the  Euphrates 
Valley,  continued  their  sway.  These  beliefs 
and  theories  became  in  the  course  of  time 
unofficial  appendages  to  astronomy,  re- 
ligion and  medicine;  they  were  degraded  to 
the  rank  of  superstitions;  they  were  finally 
denounced  as  heterodox,  but  their  vitality 
remained  unimpaired.  And  so  the  Baby- 
Ionian-Assyrian  Asu  may  still  be  found  in 
the  by-ways  of  American  and  European 
cities.  In  these  times  when  we  are  living 
under  the  sign  of  the  germ  theory  of  disease, 
there  would  be  a  certain  poetic  justice  in 
the  apparition  of  an  old  Asu  of  Babylonia- 
Assyria  rising  out  of  his  grave,  and  ex- 
claiming with  his  bony  finger  directed  to 
the  ultramodern  pathologist,  "There,  I 
told  you  so  thousands  of  years  ago — it's  all 
due  to  the  demons." 


ON  A  GREEK  CHARM  USED  IN  ENGLAND  IN  THE 
TWELFTH  CENTURY 

By  CHARLES  SINGER,  M.D. 

OXFORD,    ENGLAND 


IN  the  Library  of  St.  John's  College, 
Oxford,  is  a  large  folio  volume  (MS. 
i~  .  containing  an  encyclopaedia  of 
secular  knowledge,  perhaps  the  earli- 
est mediaeval  work  of  its  kind  that  has  yet 
come  to  light.  It  is  composed  under  the 
strong  traditional  influence  of  Bede.  We 
have  described  the  MS.  elsewhere  and  have 
shown  that  it  was  written  between  iuo 
and  1 1 12  by  an  English  speaking  monk 
who  was  ignorant  of  Norman  French.1  The 
MS.  contains  numerous  glosses  nearly  all 
of  which  are  in  the  same  hand  as  the 
text. 

A  rather  surprising  feature  of  this  en- 
cyclopaedia is  the  acquaintance  with  Greek 
that  it  betrays  especially  in  the  medical 
sections.  The  knowledge  of  Greek  is,  it  is 
true,  little  more  than  vestigeal,  but  even 
that  degree  was  unusual  in  Western  Europe 
during  the  profound  intellectual  depression 
of  the  ioth,   nth,  and  early  12th  centuries. 

The  interest  in  the  Greek  language  taken 
by  the  author,  or  rather  the  compiler,  is 
shewn  in  various  ways.  Thus  there  are  sev- 
eral Greek  alphabets  scattered  through  the 
volume.  Again,  derivation  from  the  Greek 
had  the  same  fascination  for  the  English 
monk  as  was  exhibited  by  St.  Isidore  <>l  Se- 
ville and  by  Bede.  He  tells  us,  for  instance, 
that  the  name  of  the  month  April  is  derived 
from  Aphrodite.  "Aprilis  pro  uenere  elicit  or 
quasi  afrodis  grece  enim   uenus  dicrtur."' 

1  Charles  Singer:  "A  Review  of  the  Medical  Liter- 
ature of  the-  Dark  Ages  with  a  New  Text  ofaboul 
mo,"  Proc.  Roy.  Soc.  Med.,  London,  [917,  vol.  \ 
m  of  History  of  Medicine,  pp.  [07-160)  and 
"A  Medical  Compendium  of  the  First  Half  of  the 
1  ■  nturj  "  in  the  Hull.  Soc.  Med.  Hist. 
Chicago,  /917. 


"April  is  named  after  venery  or  Aphrodis 
for  Venus  is  called  in  Greek  Aphrodis." 
Afrodis  is  for  aqjpwS-rjc,  an  adjective  formed 
from  iypoc  =  foam.  Again  "Eliotropium  id 
est  intuba  a  grecis  sive  solsequia  uel  sponsa 
solis."  "The  heliotrope  of  the  Greek,  that 
is  intuba,  either  the  sweetheart  or  the  bride 
of  the  sun."3  In  one  instance,  also,  the 
Greek  script  is  used,  namely  for  the  legends 
of  a  circle  of  Petosiris.'1 

In  the  medical  section  the  author  has 
borrowed  largely  from  the  contemporary 
Salernitan  writings,  and  from  them  he  may 
have  derived  a  number  of  medical  terms  of 
Greek  origin,  such  as  anastomo,  plagiotimo, 
anacarsis,  malanma,  dissentericus,  emotoi- 
cus,  cephalica.  In  some  cases,  however,  there 
is  a  suggestion  of  a  more  intimate  contact 
with  Greek  sources,  and  a  correspondingly 
greater  degree  of  misunderstanding  of  them. 
Thus  in  a  section  on  bloodletting  we  read: 

Inciditur  autera  de  Hebotomo  optimo  rectam 
percussuram  catatixin.  habet  hoc  est  in  iussum 
primere  flebotomum  rectum.  &  sursum  leuare. 
Quod  si  male  incisa  fuerit.  collectionem  in 
altum  tacit.  &  uulnera  insaniosa  tacit,  insan- 
iamque  plurimam.  &  spissa  nutril  uulnera.  & 
deduch  ad  omnem  perniciem." 

"[The  vein]  is  best  incised  with  the  lancet 
catatixin,  that  is  with  a  direct  cut,  and  it 
is  the  practice  to  raise  the  lancet  with  the 
[joint  passing  it  straight  and  upwards.  For  il 

1  Fol.  1 76  recto  column  l>. 
/  liotropium  is.  "I  course,  f.X'.oTpixtov.  Intuba 
is  the  Virgilian  intibum,  endive  or  some  such  plant. 
The  interpretation  of  solsequia  is  more  difficult.  I 
have  regarded  sequia  as  equal  t<>  secia  a  medieval 
form  of  sexa.  Possiblj  it  is  falselj  derived  from 
sequor. 

•  Folio  S  K\  tn. 

I  olio  a  recto  col.  !>■ 


258 


On  a  Greek  Chai 


259 


it  should  be  badly  cut,  a  deep  gathering  is 
formed  which  makes  the  wound  extremely 
unhealthy,  generates  chronic  lesions  and 
gives  rise  to  all  kinds  of  trouble." 

This  catatixin  is  clearly  the  xax'  Y^tv  of 
Hippocrates  who  uses  it  as  describing  the 
same  side  and  distinguished  from  the  op- 
posite side.  Hippocrates6  says  that  if  a  person 
with  enlarged  spleen  has  haemorrhage  from 
the  same  (that  is  the  left)  nostril,  it  is  a 
good  sign,  but  if  dvdxaXcv  from  the  opposite 
(that  is  the  right)  nostril,  it  is  bad,  an  idea 
which  afterwards  gave  rise  to  the  famous 
controversy  as  to  "derivation"  or  "re- 
vulsion." Galen  uses  the  expression  xax'  i£tv 
in  a  commentary  on  this  very  passage  of 
Hippocrates.7  He  there  takes  the  view  that 
venesection  should  be  performed  /.ai'  Iqtv  on 
the  same  side  as  the  disease.  The  author  of 
our  MS.  has  misunderstood  Galen's  phrase 
and  takes  him  to  mean  that  venesection 
should  be  performed  with  a  straight  up  and 
down  cut*  The  error  may  have  arisen  from 
the  use  of  the  ambiguous  Latin  word  recte, 
to  translate  xar't^tv. 

The  most  interesting  point  of  contact  with 
the  Greek  language  in  the  MS.  is,  however, 
in  a  marginal  gloss  by  the  same  hand  as  the 
rest  of  the  volume.  It  occurs  in  the  course 
of  a  section  on  the  preparation  of  plasters 
and  runs  as  follows  (Fig.  1): 

Wi39  blod  rine  of  nosu  wriht  on  his  for- 
heafod  on  Xpistis  mel. 


Stor 


calcos  .  +  . 


6  Prorrhetics,  I,  125,  Littre,  Vol.  v,  p.  554. 

7  The  passage  in  question  is  in  Galen's  "De 
curandi  ratione  per  venae  sectionem"  cap.  XV. 
kiihn's  edition  xi,  295-6,  and  runs  as  follows: 

«-'j  ii  y.ax'  TSjivoTUtar'  euSuXeys',  xaacvwiioXoYTjTataafti^auTou 
xs^pTJ^vou  TCoXXax.ii;  exi  xouoe  tou  aT)[iaiovou.Evoit  Tf)  xcru'  V^tv  yu>vn. 
-ri  '.'  ivixaXtva!|j.oppa7oGvTa[j.7)SJV(ifeXetvY)  x«l  {IXdxTetv  evoke  T(7> 
y.xtxX'jaxt  t9jv  Buvauuv  Sveu  tou  to  xorflo?  xouipfaai.)) 


The  top  line  in  Anglo-Saxon  may  be 
translated  "If  blood  run  from  the  nose 
write  on  his  forehead  in  a  Christ's  cross," 
and  then  follows  the  charm. 

As  regards  the  charm  itself,  it  is  nothing 
else  than  a  quotation  from  the  Greek  Lit- 


■ 


Jtomen    ||    cAcof  -f 
a 


Jr 

urgy  of  St.  John  Chrysostom  still  in  use 
by  the  Orthodox  Church.  The  passage  oc- 
curs in  the  most  solemn  part  of  the  service 
before  the  distribution  of  the  sacred  ele- 
ments, the  priest  reciting 

2twu.sv  xaAwq'  ctcojasv  [Asra  9660  if  xpor/w^sv 
ty)v  dycav  ava^opav  sv  stpTjvt)  xpoa«pepetv. 

"  Let  us  stand  seemly,  let  us  stand  in  awe; 
let  us  accept  the  holy  memorial  which  is 
o tiered  in  peace." 

STOMEN    CALCOS    STOMEN    META 
FOFU 

was  read  for 

STQMEN  KAAQ2  STOMEN  META 
'POBOT 

The  scribe  has  transliterated  the  Greek 
with  two  exceptions.  He  has  written  calcqs 
for  kalos  and  fo/u  for  iobou.  How  did  these 
errors  arise?  There  is  a  complete  explanation 
for  them. 

8 1  have  to  thank  my  friend  Dr.  E.  T.  Withington 
for  drawing  my  attention  to  Galen's  true  meaning 
and  for  pointing  out  to  me  some  errors  in  my 
previous  interpretation  of  this  passage. 

9  [Folio  175  recto.]  As  will  be  seen  from  Fig.  i 
the  MS.  gives  \\  id.  We  have  restored  the  cross  stroke 
to  the  d,  as  seems  required  by  the  context. 


260 


Annals  of  Medical  History 


In  early  MSS.,  the  letter  kappa  often 
takes  a  form  something  like  IC,  the  stem 
of  the  k  being  completely  separated  from 

TiYiNAnoicnfcHMWNiwANN^ 
"kpyimuionflVUv^KicTANj^ 

No^no\c-wc^oyxr^cocrroM 

6  f  MH  N  f  I A  € IS  'TO  I  <  \t\m  AT-t-A*! 


TOY  GNATIOIC  n(«)p(o)G  HMGON  IG3ANNOY 

APxienicKonoY  kconctanti  „ 

NOYnOAGCOC  TOY  XPYCOCTOM 
GPMHNGIA  GIC  TO  KATA  MAT0AI 
ON  eYAITGAION  BIBAION  B  :  -x. 

the  rest  of  the  letter.  We  give  here  (Fig.  2) 
a  facsimile  with  transcription  from  the 
title  of  a  9th  century  MS.  of  the  sermons 
of  St.  John  Chrysostom10  which  illustrates 
well  this  tendency.  The  second  line 
of  this  facsimile  shows  two  kappas 
either  of  which  could   easily   be  read   IC. 

10  The  facsimile  is  from  a  MS. found  in  a  secret  crypt 
in  the  Monastery  of  the  Transfiguration  at  Meteora. 
It  is  the  earliest  dated  Greek  MS.  that  has  yet  come 
to   light   and   is  described    in    "Un    Manuscrit    des 


The  third  line  of  the  same  facsimile  sim- 
ilarly shows  an  co  that  can  be  mistaken 
by  a  careless  reader  for  CO.  Thus  KAAQ2  in 
the  original  became  CALCOS  in  transcrip- 
tion. The  passage  of  <£»OBOY'  into  FOFU  is 
equally  simple.  The  F  as  a  representative 
of  the  letter  beta  is  by  no  error  but 
is  a  true  presentation  of  the  Byzantine 
pronunciation.  The  U  of  the  word  FOFU  is 
an  ignorant  error  for  the  usual  MS. 
method  of  writing  the  diphthong  OU  (cp. 
Fig.  2,  line  3). 

We  thus  have  the  very  remarkable  phe- 
nomenon of  a  passage  in  the  Communion 
Service  of  the  Greek  Church  in  actual  use 
as  a  charm  in  England  in  the  12th  century 
and  probably  earlier.  The  source  of  this 
remedy  for  nosebleeding  was  doubtless  un- 
known to  the  scribe  who  has  preserved  it 
for  us.  The  fact  may,  however,  suggest  to 
the  folklorist  a  new  field  of  research  into 
the  origin  of  other  apparently  gibberish 
charms  and  folksayings,  and  to  the  medical 
historian  further  reflexion  on  the  continuity 
of  Greek  influence  during  the  darker  age 
of  his  science. 

Meteores  de  I'an  86 1  2"  in  the  Revue  des  Etudes 
Grecques  xxvi,  p.  -53,  Paris,  1913.  Our  fig.  2  is  taken 
from  this  work. 


SORANUS  OF  EPHESUS  AND  MARION  SIMS 


In  the  brilliant  reign  of  Hadrian  Hied  So- 
ranus,  who  had  been  the  tutor  of  Alliens.  He 
devoted  himself  chiefly  to  the  diseases  of  the 
jemale  sex,  and  wrote  the  only  complete  treat- 
ise on  the  subject  which  has  come  to  us  from 
antiquity.  His  work,  remarkable  for  its  ful- 
ness of  knowledge,  slums  him  to  have  been 
something  of  an  enthusiast;  and  we  can  think 
of  him  in  his  evening  walks  near  the  splendid 
walls  of  bigb-turreted  Rome,-  the  altx  mania 
Ronue  that  \irgil  loved, or  returning  from 
the  Atbenseum,  as  wondering  what  were  to  be 
the  developments  following  his  labors  and  the 
instruments    he    had    invented.    I  lad    bis    eye 


penetrated  into  the  future,   there   would  have 
appeared  to  him,  standing  on  a  platform  in 

what  would  have  seemed  a  most  singular  garb, 
but  with  features  similar,  because  as  regular 
in  outline  as  those  to  ubicb  be  was  accus- 
tomed, a  youth  with  a  roll  in  his  hand,  and, 
attracted  by  the  look  of  genius  in  bis  face,  be 
might  well  have  wished  him  strength  to  unn 
out  resolves  that  were  to  lead  to  immortality: 
Made  nova  virtute  puer;  sic  itur  «</  astra. 
And  that  wish  would  have  been  fulfilled  in 
the  citation  of  a  science  that  oivcs  everything 
to  him,     to  him,  Marion  Sims. 

J.  \l.  DaCosta  I  x8gi). 


THE  LEGISLATIVE  AND  ADMINISTRATIVE  HISTORY  OF  THE 

MEDICAL  DEPARTMENT  OF  THE  UNITED  STATES  ARMY 

DURING  THE   REVOLUTIONARY   PERIOD   (1776-1786) 

By  COLONEL  WILLIAM  O.  OWEN,   U.  S.  ARMY 

CURATOR,  ARMY  MEDICAL  MUSEUM,  WASHINGTON,  D.  C. 

SECTION  II 


SINCE  the  first  section  of  this 
valuable  archivistic  material  has 
already  been  prefaced  by  Colonel 
Owen's  salient  cullings  from  the 
records,  these  few  words  of  recapitulation 
will  suffice. 

From  unorganized  beginnings,  the  forma- 
tion of  official  medical  service  may  be  traced 
in  the  scattered  items  of  the  Journals  of  the 
Provincial  Congress  of  Massachusetts 
(1775),  supplemented  by  excerpts  from  the 
Military  Journal  of  Thacher,  who,  as  sur- 
geon's mate  to  the  senior  surgeon,  Dr.  John 
Warren,  was  active  in  these  early  days.  In 
the  Journals  of  the  Continental  Congress 
from  June  2nd,  1775  to  April  7th,  1777,  the 
story  is  carried  through  the  appointment 
and  dismissal  of  Benjamin  Church,  the 
Director  General  and  Chief  Surgeon  of  our 
first  Army  Hospital,  and  of  Dr.  Stringer 
whose  conduct  was  pronounced  "highly 
derogatory  to  the  honor  of  Congress."  The 
office  of  Surgeon  General  and  less  important 
positions  under  revolutionary  medical  service 
were  destined  to  be  stumbling  blocks  for  many. 
At  this  point,  the  excerpts  in  this  second 
installment  take  up  the  account  with  the  ig- 
nominious dismissal  of  Church's  successor, 
Dr.  John  Morgan  on  August  3rd,  1777.  Dr. 
Rush,  Chief  Physician  in  the  Middle  Dis- 
trict, is  forced  to  resign  his  commission  to 
Dr.  Jonathan  Potts  at  about  the  same  time. 
By  June  10th,  1778,  this  worthy  gentleman 
is  charged  with  "exorbitant  expenditure" 
and  indeed  the  numerous  successive  entries 
in  the  Journal  of  requisitions  for  fifty  and 
one  hundred  thousand  dollars,  "for  which 


Dr.  Potts  is  to  be  held  accountable"  would 
perhaps  need  more  explanation  than  the  de- 
preciated value  of  Continental  paper  then 
obtaining. 

In  the  light  of  modern  war  reconstructive 
work,  the  provision  for  an  I  nvalid  Corps  under 
date  of  May  27th,  1777,  to  be  composed  of 
men  disabled  for  rigorous  war  service  but 
capable  of  acting  in  the  capacity  of  military 
instructors  and  garrison  guards,  is  illuminat- 
ing. Interest  also  centers  around  the  unfor- 
tunate circumstances  at  the  Alexandria  in- 
oculation camp  in  which  the  conscientious 
Dr.  Rickman  was  involved.  His  work  was 
later  exonerated  by  tracing  the  cause  of 
the  unsuccessful  results  to  incompetent  as- 
sistants and  the  malarial  breeding  swamps 
through  which  the  men  were  taken  on  forced 
march  immediately  before  inoculation. 

The  beginnings  of  our  present  pension  sys- 
tem, odd  means  of  disciplining  those  con- 
tracting venereal  disease,  unusual  reports 
of  the  extravagance  at  the  Yellow  Springs 
Hospital  under  a  certain  Alexander  McKal- 
Iaher,  "allowed  to  do  so  by  Congress  or  Dr. 
Shippen,  the  informant  is  not  certain 
which,"  and  the  complaints  about  food  and 
clothing, — all  these  rather  modern  problems 
are  interwoven  with  the  many  entries  which 
group  themselves  around  the  story  of  Dr. 
Shippen's  court-martial.  From  June  4th, 
1 778,  when  Shippen  was  accused  of  malfeas- 
ance in  office  by  the  counter-charges  of  the 
deposed  Dr.  Rush,  until  his  acquittal  August 
1 8th,  1780,  the  machinations  of  Dr.  Morgan 
and  other  derogators  are  but  slightly  hidden 
in  the  record  which  follows. — Editor. 


261 


262  Annuls  of  Medical  History 

II.    FROM  JOURNALS   OF   THE    CONTINENTAL  geons  general  of  the  military  hospital,  and  the  physi- 

/            o   \    is*     .•          j\  cians  and  surgeons  general  of  the  respective  armies, 

congress  ( 1 774-83)  (Continued)  and  that  the  election  be  on  the  day  f0iiowing. 

April  8,  1777.  243,  244-6  April  11,  1777.  253-5 

That  the  eldest  son  of  General  Warren,  and  the  Congress  then  proceeded  to  the  election  of  the 

youngest  son  of  General  Mercer,  be  educated,  from  officers  in  the  hospital  department;  and  the  ballots 

this  time  at  the  expence  of  the  United  States.33  being  taken, 

Congress  resumed  the  consideration  of  the  report  Dr.  William   Shippen,  Jun*    was  chosen,  by  the 

on  the  hospital;  Whereupon,  unanimous  vote  of  the  thirteen  states,  director  gen- 

Resolved,  That  in  time  of  action  and  on  any  other  era|  of  all  the  military  hospitals  for  the  armies  of  the 

emergency,  when  the  regimental  surgeons  are  not  United  States. 

sufficient  in  number  to  attend  properly  to  the  sick  Dr.  Walter  Jones,  was  elected  physician  general  of 

and  wounded,  that  cannot  be  removed  to  the  hos-  the  hospital  in  the  middle  department, 

pitals,  the  director,  or  deputy  director  general  of  Dr.  Benjamin  Rush,  was  elected  surgeon  general 

the  district,  be  empowered  and  required,  upon  the  °f  the  hospital  in  the  middle  department, 

request  of  the  physician  and  surgeon  general  of  the  Dr.  John  Cochran,  was  elected  physician  and  sur- 

army,  to  send,  from  the  hospitals  under  his  care,  to  geon  general  of  the  army  in  the  middle  department, 

the  assistance  of  such  sick  and  wounded,  as  many  Dr.  Isaac  Forster,  deputy  director  general  of  the 

physicians  and  surgeons  as  can  possibly  be  spared  hospital  in  the  eastern  department, 

from  the  necessary  business  of  the  hospitals.  Dr.  Ammi  Ruhamah  Cutter,  physician  general  of 

That  the  director,  deputy  directors  general,  as-  the  hospital  in  the  eastern  department, 

sistant  deputy   directors,   physicians  and   surgeons  Dr.  Philip  Turner,  surgeon  general  of  ditto. 

general,   be  and  they  are  hereby  required  and  di-  Dr.  William  Burnet,  physician  and  surgeon  (gen- 

rected  to  employ  such  parts  of  their  time,  as  may  eral)  of  the  army  (in  the  eastern  department  >. 

conveniently  be  spared  from  the  duties  before  point-  Dr.  Jonathan  Potts,  was  elected  deputy  director 

ed  out  to  them,  in  visiting  and  prescribing  for  the  general  of  the  hospital  in  the  northern  department. 

sick  and  wounded  of  the  hospitals  under  their  care.34  Dr.  Malachi  Treat,  physician  general  of  ditto. 

That  the  establishment  of  the  medical  department  Dr.  Forgue,  surgeon  general  of  ditto. 

be  as  follows:  Dr.  John  Bartlett,  physician  and  surgeon  general 

1  director  general 6  dollars  a  day  and  9  rations.  °'  ditto. 

3  deputy  directors  gen-  The  Board  of  Treasury  reported, 

eral 5      do.                         6     do.  That  there  is  due  to  Dr.  J.  Ramsey,  and  to  be  paid 

Indeterminate     assist-  to  the  honorable  Jonathan  Elmer,  Esq-   for  sundry 

ant  deputy  director. 3     do.                       6     do.  medicine  supplied  the  New  Jersey  troops,  the  sum 

4  physicians    general  of  £9  3  6  equal  to  24  42/90  dollars; 

and  4  surgeons  gen-  That  there  is  due  to  Dr.  James  Tilton,  for  sundry 
eral  each                     5      do.                         6     do.  medicine  supplied  the  batallion  of  the  state  of  Dela- 
1  to  each  army,  physi-  ware,  the  sum  of  £10,  equal  to  26  60/90  dollars; 
tian     and     surgeon  That  there  is  due  to  Dr.  William  Currie,  for  sun- 
general  of  the  army .  5      do.                         6     do.  dry  medicine  supplied  the  5,  or  Colonel  Johnston's 

Senior  surgeons 4      do.                         6     do.  Pennsylvania  batallion,  the  sum  of  £50  17  2  equal 

Second  surgeons 2     do.                       4     do.  to  135  56/90  dollars. 

Surgeons' mates ij^do.                        2     do.  .      ., 

Apothecaries  general..  3     do.                       6     do.  April  12,  1777.  257 

Mates 1 Y2  do.                       2     do.  Resolved,  That  100,000  dollars  be  advanced  to  Dr. 

Commissary 2      do.                         4     do.  Shippen,  director  general,  for  the  use  of  the  hospi- 

Qerk,    who    is    to    be  tals;  he  to  be  accountable. 

paymaster 2     do.                       4     do.  Resolved,  That  the  surgeons  general  and  physi- 

Assistant  clerks 2/3  do.                        1     do.  cians  general  of  the  hospitals,  shall,  each  of  them 

Stewards 1     do.                     2     do.  regulate  the  practice  of  both  physic  and  surgery,  and 

Matron Yi   do.                        1     do.  do  the  duty  of  physician  and  surgeon  general  in  the 

Nurses 24-90                          1     do.  hospitals  respectively  committed  to  their  charge,  and 

Stabler 1      do.                       1     do.  that  the  director  and  deputy  directors  general  take 

Regimental  surgeons..  2     do.                    4    do.  proper  care  to  keep  the  sick  and  wounded  in  separate 

Do.        mates..    .11/3                            2     do.  departments. 

Ordered,  That  the  regulations  respecting  hospitals  Aoril  17    1777   274-5 

be  published.  '         .         .      ,             ~.      xxr„-        c    •  i_ 

That  there  is  due  to  Dr.  William  Smith,  conti- 

April  9,  1777.  247  nental  druggist,  for  sundry  medicine  purchased  by 

Resolved,  That"  to-morrow  be  assigned  for  nomi-  llin?  ffor  Public  UM  V,Ik'  M,m  V1  J'?20,  ?"  ?°  J?""8' 

natina  gentlemen  for  the  offices  of  director  and  dep-  a"d.for. sunc  rv  ,milK"u:  suppbed  by  him  for  the  use 

uty  I                 ,  ral,  physicians  general  and  sur-  of  thc  br,«  ^gton,  the  sum  oi  131  58  90  dollars, 

both  sums  making  2,<)$2  28  90  dollars; 

report,  in  the  writing  >>f  Benjamin  Kuan,  i.t  in  the  Pa-  "TIh-ho  two  puruiaapli*,  i»  tin-  writing  of  Jamei  WiUon,  tie 

prrt  t,J  Ih.    (  nntm.ulal  CqUQMU,    \,,     ]').    V,  f.,li.,   I..I  in  tin'  l'til„r«  of Ou  I  \mlim  tit.il  ConffTUI,   Nn.  22,  folio  '-'0   1/2. 


History  of  the  Army  Medical  Department  During  the  Revolution        263 


That  there  is  due  to  Dr.  William  Currie  for  sun- 
dry medicine  supplied  the  sick  of  the  4th  and  6th 
Virginia  regiments,  the  sum  of  99  66/90  dollars. 

April  22,  1777.  288-90 

Resolved,  That  a  Corps  of  Invalids  be  formed  con- 
sisting of  eight  Companies,  each  Company  to  have 
one  Captain,  two  Lieutenants,  two  Ensigns,  five  Ser- 
jeants, six  Corporals,  two  Drummers,  two  fifers  and 
one  hundred  Men.  This  Corps  to  be  employed,  in 
Garrisons  and  for  Guards,  in  Cities  and  other  Places, 
where  Magazines  or  Arsenals  are  placed;  as  also  to 
serve  as  a  Military  School  for  Young  Gentlemen, 
previous  to  their  being  appointed  to  marching  Regi- 
ments, for  which  purpose,  all  the  Subaltern  Officers, 
when  off  Duty,  shall  be  obliged  to  attend  a  Mathe- 
matical School,  appointed  for  the  purpose  to  learn 
Geometry,  Arithmetick,  vulgar  and  decimal  Frac- 
tions and  the  extraction  of  Roots.  And  that  the 
Officers  of  this  Corps,  shall  be  obliged  to  contribute 
one  day's  pay  in  every  Month,  and  Stoppages  shall 
be  made  of  it  accordingly,  for  the  purpose  of  pur- 
chasing a  Regimental  Library  of  the  most  approved 
Authors  on  Tacticks  and  the  Petite  Guere. 

That  some  Officers  from  this  Corps  be  constantly 
employed  in  the  Recruiting  Service,  in  the  Neigh- 
bourhood of  the  places  they  shall  be  stationed  in, 
that  all  Recruits  so  made,  shall  be  brought  into  the 
Corps,  and  drilled  and  afterwards  draughted  into 
other  Regiments  as  occasion  shall  require.35 

Inform  General  Washington  that  Surgeons'  Mates 
are  appointed  and  their  Pay  fixed.  Pay  and  Rations 
of  Regimental  Surgeons  and  Mates  same  as  second 
surgeons  in  the  Hospital.36 

Resolved,  That  the  farther  consideration  of  the 
report  be  postponed. 

Resolved,  That  the  director  and  deputy  directors 
general,  shall  constantly  publish  in  the  news-papers, 
the  names  of  the  places  in  which  their  military  hos- 
pitals are  respectively  kept;  and  the  several  com- 
manding officers  of  parties,  detachments,  or  corps, 
on  their  march  to  or  from  the  camp,  shall  send  to 
the  said  hospitals,  such  of  their  officers  and  soldiers, 
as,  from  time  to  time,  are  unable  to  proceed,  together 
with  certificates  to  the  director  or  deputy  director 
general,  mentioning  the  names  of  the  said  officers 
and  soldiers  and  particular  regiments  to  which  they 
belong;  unless,  from  the  distance  of  the  hospitals, 
or  other  causes,  it  shall  at  any  time  be  necessary  to 
deliver  them  to  the  care  of  private  physicians  or 
surgeons,  in  which  cases,  such  physicians  and  sur- 
geons, and  also  the  respective  commanding  officers, 
are  forthwith  to  report  their  names  and  regiments 
to  the  director  or  deputy  directors  general  as  afore- 
said, who  shall  give  the  necessary  orders  for  removing 
them  to  the  hospitals  as  soon  as  may  be,  and  dis- 
charge the  reasonable  demands  of  the  physicians  and 
surgeons  conducting  agreeable  to  this  resolve. 

That  the  director,  deputy  directors  general  and 
assistant  deputy  directors,  have  power  to  order  to 
their  respective  hospitals,  the  sick  and  wounded  of 

36  See  under  June  20,  1777,  post. 

36  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
147,  I,  folio  147. 

*'  This  report,  dated  April  29,  is  in  the  Papers  of  the  Continen- 
tal Congress,  No.  136,  I,  folio  141. 


the  army,  wherever  found,  in  their  own  or  other 
departments,  provided  such  other  departments  are 
not  supplied  with  any  of  the  officers  aforesaid. 

April  23,  1777.  292 

Resolved,  That  Dr.  James  Tilton  be  authorized  to 
repair  to  Dumfries,  in  Virginia,  there  to  take  the 
charge  of  all  continental  soldiers  that  are  or  shall 
be  inoculated,  and  that  he  be  furnished  with  all 
necessary  medicines:  that  the  commanding  officers 
in  that  department  be  directed  to  afford  every  as- 
sistance in  their  power,  and  that  all  commissaries 
and  quarter  masters  on  whom  the  doctor  shall  have 
occasion  to  call,  be  directed  to  provide  quarters  and 
everything  requisite  for  this  business. 

April  25,  1777.  300 

Resolved,  That  the  physician  or  surgeon  general 
of  the  hospital  in  the  middle  department,  be  directed 
to  send  a  proper  person  or  persons  in  the  medical 
department,  to  visit  all  the  hospitals  betwixt  this  city 
and  the  town  of  Annapolis,  in  Maryland,  with  direc- 
tions to  order  all  such  soldiers,  as  shall  be  deemed 
capable  of  service,  to  join  immediately  their  respec- 
tive corps  under  proper  officers. 

April  30,  1777.  317 

Resolved,  That  Major  General  Schuyler  be  di- 
rected to  send  a  proper  officer,  to  hasten  the  march 
of  the  Carolina  continental  troops,  supposed  to  be 
now  on  their  way  to  head-quarters;  that  they  halt 
at  Dumfries,  Colchester  and  Alexandria,  in  Virginia, 
there  to  pass  through  inoculation;  which  the  hospi- 
tal surgeons,  lately  despatched  from  this  city  to  Dum- 
fries, are  directed  to  see  effected,  with  the  greatest 
despatch. 

May  2,  1777.  321-2 

That  there  is  due  to  Christopher,  jun.  and  Charles 
Marshall,  for  sundry  medicine  and  chirurgical  in- 
struments supplied  by  them  for  the  use  of  different 
batallions  of  continental  forces,  the  sum  of  £1,556 
16  6,  equal  to  4, 151  48/90  dollars: 

That  there  is  due  to  Dr.  George  Glentworth,  for 
sundry  medicine  supplied  the  sick  of  Captain  Doyle's 
company  in  continental  service,  the  sum  of  28  48/90 
dollars: 

That  there  is  due  to  Dr.  Frederick  Phile,  for  sun- 
dry medicine  administered  by  him  to  several  batal- 
lions of  continental  forces,  the  sum  of  £492  2  9, 
equal  to  1,312  33/90  dollars.37 

Ordered,  That  the  said  accounts  be  paid. 

May  8,  1777-  335 

A  letter,  from  Governor  Livingston,  to  Dr.  Wither- 
spoon,  dated  Haddonfield,  May  7,  was  laid  before 
Congress  and  read,  wherein  he  requests  a  guard  of 
25  or  30  continental  troops,  for  purposes  therein 
mentioned;  Whereupon,38 

May  20,  1777.  371 

A  letter  ...  of  the  19th,  from  Dr.  W. 
Shippen,  director  general;     .     .     -39 

38  This  letter  is  in  the  Papers  of  the  Continental  Congress,  No. 
68,  folio  255. 

39  The  letter  of  Shippen  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  78,  XX,  folio  403. 


264 


Annals  of  Medical  History 


May  27,  1777.  389-90 

Resolved,  ...  by  the  resolutions  of  Congress 
of  the  26th  day  of  August,  1776,  to  make  provision 
for  the  maintenance  of  disabled  wounded  soldiers, 
belonging  to  their  respective  States,  and  to  keep  a 
regular  account  of  the  expence  attending  the  same, 
that,  at  a  future  day,  the  Continent  may  be  charged 
therewith: 

May  28,  1777-  394 

A  letter,  of  the  27th,  from  Dr.  B.  Rush,  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

June  20,  1777.  482 

Resolved,  That  a  corps  of  invalids  be  formed. 
.  .  .  This  corps  to  be  employed  .  .  .,  and 
for  guards  in  cities  and  other  places  where  .  .  ., 
or  hospitals  are  placed;     .     .     . 

June  23,  1777.  490 

A  .  .  .  letter  of  the  20th,  from  Dr.  W.  Ship- 
pen,  informing  that  Dr.  Walter  Jones,  for  weighty 
reasons,  cannot  accept  the  honour  Congress  did  him 
in  appointing  him  physician  general  of  the  hospitals 
of  the  middle  department;  and  that  he  gives  this 
information  at  the  desire  of  Doctor  W.  Jones; 
.40 

July  1,  1777.  517,  518 

Resolved,  That  there  be  advanced  to  Dr.  \\ . 
Shippen,  director  general  of  the  military  hospitals, 
25,000  dollars,  for  which  he  is  to  be  accountable.41 

Congress  proceeded  to  the  election  of  a  physician 
general  of  the  hospital  in  the  middle  department,  in 
the  room  of  Dr.  Jones,  who  declines,  and,  the  ballots 
being  taken, 

Benjamin  Rush  was  elected. 

July  2,  1777.  525 

Congress  proceeded  to  the  election  of  a  surgeon 
general  of  the  hospital  in  the  middle  department,  in 
the  room  of  Dr.  Rush;  and,  the  ballots  being  taken, 

Dr.  William  Brown  was  elected. 

July  3,  1777-  527 

A  letter  ...  of  the  22  June,  from  Jonathan 
Potts,  at  Ticonderoga;    .    .     . 

Ordered,  .  .  .  that  the  letter  from  Dr.  Potts, 
be  referred  to  the  Medical  Committee. 

July  5,  1777.  532. 

The  said  Board  farther  reported  that  a  warrant 
should  be  drawn  by  the  president  on  Benjamin  Har- 
rison, Junr,  Esq',  deputy  pay  master  general  of 
the  southern  department,  in  favour  of  Colonel  Will- 
iam Aylett,  deputy  commissary  general  in  the  said 
department,  for  54,000  dollars,  for  which  the  said 
Commissary  General  is  to  be  accountable.42 

July  7,  1777.  538 

That  there  is  due  to  Messrs.  Caldwell  &  Co.  for 
sundry  medicine  delivered  William  Smith,  conti- 
nental druggist,  for  the  use  of  the  United  States, 
the  sum  of  666  60/90  dollars: 

(Ordered,  That  the  said  account  be  paid.) 

"The  latter  »f  BUppea  h  in  the  Papam  afQlt  Continental  Con- 
gress, No.  78,  XX.  foil..  II.',. 

■  Tliii  report  11  in  the  /"'i/xt»  of  the  Continental  Congress,  No. 
IM,  I.  f..li,,  27L 

"  Thin  paragraph  formed  part  of  a  report,  dated  July  2,  which 
contained  two  other  paragraphs,  both  of  which  were  ordored"  to 


July  12,  1777.  547 

That  there  be  advanced  to  Dr.  William  Shippen, 
director  general  of  the  hospitals,  8,000  dollars,  for 
which  he  is  to  be  accountable: 

July  16,  1777-  554-6 

Resolved,  That  the  pay  and  subsistence  of  sur- 
geons in  the  navy,  be  equal  to  the  pay  and  subsis- 
tence of  the  lieutenants  of  the  vessels  to  which  they 
shall  respectively  belong. 

Resolved,  That,  for  carrying  into  execution  the  re- 
solve respecting  Colonel  Nicola's  corps  of  invalids, 
the  following  plan,  for  raising  one  company,  be 
adopted  for  raising  the  whole  of  the  said  corps : 

1.  That  the  director  general  of  the  continental 
hospital  be  desired  to  give  directions  to  the  Phy- 
sicians and  surgeons,  in  the  different  departments 
at  a  reasonable  distance  from  Philadelphia,  that,  be- 
fore they  discharge  any  Serjeants,  corporals,  or  pri- 
vate men  from  the  hospitals  as  unfit  for  service, 
they  consider,  whether  such  men  are  actually,  or 
likely  soon  to  be  capable  of  doing  garrison  duty; 
and,  if  thought  so,  to  mention  it  in  the  discharge, 
that  they  may  not  be  entirely  discharged  from  the 
service,  but  transferred  from  the  regiment  to  which 
they  actually  belong,  to  that  of  invalids;  and  that 
in  case  such  men  are  at  a  distance  from  their  re- 
spective regiments,  that  the  director  or  steward  of 
each  hospital  send  such  men  to  Philadelphia,  in  the 
best  manner  circumstances  will  admit : 

2.  That  notice  be  sent,  by  the  Board  of  War,  to 
the  generals  commanding  the  armies,  of  the  raising 
a  corps  of  invalids,  and  that  they  be  desired  to  give 
orders  to  the  officers  commanding  regiments,  that, 
in  case  they  have  any  Serjeants,  corporals,  drum- 
mers, or  private  men,  deemed  incapable  of  doing 
field  duty,  such  men  should  be  examined  by  the  di- 
rector of  the  hospital  or  some  other  physician  or 
surgeon,  and,  if  judged  fit  for  garrison  duty,  that 
they  be  not  discharged,  but  transferred  to  the  in- 
valid corps,  and  sent  to  Philadelphia  as  soon  as  pos- 
sible. 

Men  having  only  one  leg  or  arm  each,  if  otherwise 
capable  of  doing  garrison  duty,  are  to  be  deemed 
proper  recruits  for  this  corps. 

3.  That  the  following  advertisement  be  published 
in  the  several  newspapers  as  soon  as  possible,  viz. 

"War-Office,  June,  1777:  The  Congress,  beinji;  de- 
sirous to  make  provision  for  such  men  as  suffer  in 
the  military  service  of  the  United  States,  have  di- 
rected a  regiment  of  invalids  to  be  immediately 
raised  for  the  reception  of  such  as  have  already 
been,  or  may,  in  future,  be  rendered,  by  wounds  or 
disorders,  incapable  of  doing  Geld  duty,  but  are  yet 
fit  for  garrison  service.  Notice  is  hereby  given,  that 
all  persons  in  Philadelphia,  or  within  twenty  miles 
round,  who  are  under  continental  half-pay,  on  ac- 
count of  incapacities  contracted  in  the  service,  must, 
within  fifteen  days,  repair  to  Philadelphia  and  show 
themselves  to  Colonel  Nicola,  in  Front  Street,  four 
doors  below  the  Coffee  house,  that,  if  judged  capable 

lie."  Than  paragraph!  wit.  '.it  .ill  Badding,  Blan- 

keta,  Shirts  unci  Shift*  which  limy  !«•  necessary  f"r  tho  use  of  the 
QoapKall  bo  purchased  and  supplied  by  tlm  Clothier  Gen- 
eral.    ..." 

Tin'  raparl  i*  in  tho  Papers  of  the  Continental  Congress,  No. 
130,  I,  folio  283. 


History  of  the  Army  Medical  Department  During  the  Revolution        265 


of  duty,  they  may  be  put  on  full  pay.  All  other  per- 
sons, who  have  served  in  the  armies  of  the  United 
States,  within  the  above  description,  though  not  on 
half-pay,  may  present  themselves,  and,  if  judged 
capable,  they  will  be  immediately  received.  All 
such  as  are  above  twenty  miles  from  Philadelphia 
must  apply  to  the  nearest  continental  general,  field 
officer,  physician  or  surgeon,  who  are  desired  to  for- 
ward such  as  they  judge  fit  for  the  corps  of  invalids. 
Officers  who,  from  wounds  or  disorders  contracted 
in  the  service,  are  rendered  unfit  for  field  duty, 
must  signify  their  pretensions,  with  certificates  from 
continental  physicians  or  surgeons  to  the  Board  of 
War.  As  this  corps  is  intended,  not  only  as  a  pro- 
vision for  disabled  officers  and  soldiers,  but  as  a 
school  for  propagating  military  knowledge  and  dis- 
cipline, no  officers  need  apply  but  such  as  produce 
ample  certificates  of  their  having  served  with  repu- 
tation, and  having  supported  good  characters,  both 
as  citizens  and  soldiers.  Officers  and  soldiers  who 
have  engaged  during  the  war  will  be  preferred." 

Resolved,  That  Enoch  Welsh  be  appointed  an  en- 
sign in  the  corps  of  invalids.43 

July  17,  1777.  560 

Resolved,  That  in  lieu  of  the  advance  ordered  on 
the  12  instant  to  be  made  to  Dr.  William  Shippen, 
director  general  of  the  hospitals,  an  order  be  drawn 
on  the  loan  officer  of  Connecticut,  in  his  favour,  for 
8,000  dollars,  for  which  the  said  Dr.  Shippen  is  to 
be  accountable.44 

July  22,  1777.  570 

A  letter,  of  the  5,  from  Dr.  W.  Rickman  to  Mr. 
(Benjamin)*  Harrison,  was  laid  before  Congress  and 
read:44a 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

July  31,  1777-  593 

A  .  .  .  letter  and  memorial  from  Dr.  J.  Mor- 
gan, were  read: 44b 

Ordered,  .  .  .  that  the  memorial  of  Dr.  Morgan 
be  referred  to  the  Medical  Committee. 

August  5,  1777.  608,  609  _ 

.  .  .  That  there  are  sick  in  the  Hospitals  and 
Army  3,745  soldiers,  the  number  of  which  has  been 
greatly  increased  by  the  use  of  bad  Bread,  and  the 
Want  of  Vinegar,  Vegetables  and  Soap  as  particu- 
larly set  forth  in  General  Washington's  Letter  to  the 
Committee  .... 

In  the  Hospital  Department  from  the  Want  of 
Authority  in  the  Director  and  Deputy  Directors 
General  to  draw  Supplies  from  the  Commissary's 
Stores. 

That  the  General  officers  as  well  as  the  Staff  com- 
plain of  their  not  receiving  regularly  the  resolutions 
of  Congress  relative  to  their  several  offices. 

That  the  Complaint  of  the  General  upon  the  be- 

13  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
147.  I,  folio  237. 

44  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
136.  I,  folio  305. 

«a  This  letter  is  in  No.  78,  XIX,  folio  97. 

44bThe  letter  of  Morgan,  in  No.  63,  folio  113;  and  the  me- 
morial in  No.  41,  VI,  folio  19. 

*  Material  placed  in  parenthesis  appeared  in  brackets  in  the 
original  MSS. 


stowing  of  rank  on  the  inferior  officers  of  the  civil 
Departments  of  the  Army,  corresponds  with  the 
Opinion  of  the  Officers  in  general,  and  there  is  too 
much  Reason  to  apprehend  great  inconveniences 
from  such  Measures  if  not  rectified  in  future.  .  .  . 
That  the  Director  and  each  of  the  Deputy  Direc- 
tors General  be  severally  authorized  to  empower  the 
Surgeon  and  Physician  General  of  the  Army  within 
his  respective  District,  to  draw  on  the  issuing  Com- 
missaries for  such  Articles  of  Provision  in  gross 
Quantities  as  the  said  Surgeon  and  Physician  Gen- 
eral Shall  require  for  supporting  the  Sick  in  the  fly- 
ing and  temporary  Hospitals;  and  the  said  issuing 
Commissaries  are  respectively  directed  to  charge 
such  Provisions  to  the  Director  or  Deputy  Director 
General  of  the  District,  and  to  keep  the  Vouchers  in 
separate  Files  in  order  for  Settlement  with  the 
Officers  aforesaid.     .     .     . 

August  6,  1777.  618 

Resolved,  That  there  be  advanced  to  Dr.  William 
Shippen,  Jr.  director  general  of  the  hospitals,  the 
sum  of  fifty  thousand  dollars,  for  the  use  of  the  hos- 
pitals, for  which  he  is  to  be  accountable: 

August  8,  1777.  623 

A  petition  from  William  West,  major,  James 
M'Henry  and  Hugh  Hodge,  surgeons  of  the  4th  and 
6th  regiments  of  || Pennsylvania  forces, ||  commanded 
by  Colonels  Magaw  and  Cadwallader,  prisoners  on 
parole,  praying  to  be  informed,  whether,  as  conti- 
nental officers  holding  commissions  only  revocable 
by  this  or  a  future  Congress,  they  are  not  entitled 
to  pay  while  on  parole,  as  well  as  when  in  the  hands 
of  General  Howe: 45 

Ordered,  To  lie  for  consideration  to  Monday  next. 

The  Medical  Committee,  to  whom  the  memorial 
from  Dr.  J.  Morgan  was  referred,  brought  in  a  re- 
port.46 

August  9,  1777.  626-7 

Congress  took  into  consideration  the  report  of 
the  Medical  Committee  which  was  read,  as  follows: 

"The  Medical  Committee  to  whom  the  memorial 
of  Dr.  John  Morgan  to  Congress  was  referred,  beg 
leave  to  report,  that  they  find  from  the  journals  of 
Congress,  that  Dr.  Morgan  was  appointed  director 
general  and  chief  physician  of  the  hospital,  in  the 
room  of  Dr.  B.  Church,  October  17,  1775;  that,  on 
the  9  January,  1777,  he  was  dismissed  from  said  ap- 
pointment; that  though  no  cause  is  assigned  for  his 
discharge,  yet,  your  committee  on  enquiry,  find, 
that  the  general  complaints  of  persons  of  all  ranks 
in  the  army,  and  not  any  particular  charges  against 
him,  together  with  the  critical  state  of  affairs  at 
that  time,  rendered  it  necessary  for  the  public  good 
and  the  safety  of  the  United  States,  that  he  should 
be  displaced,  and  were  the  reasons  of  his  dismission; 
that  the  doctor's  memorial  appears  to  your  commit- 
tee to  be  a  hasty  and  intemperate  production;  not- 
withstanding which,  as  he  conceives  himself  injured, 
and  requests  an  enquiry  into  his  conduct,  your  com- 
mittee are  of  opinion  that  he  ought  to  be  heard,  and 

45  This  petition  is  in  the  Papers  of  the  Continental  Congress,  No. 
42,  VIII,  folio  167. 

48  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
19,  IV,  folio  177.  It  is  summarized  on  August  9,  post. 


266 


Annals  of  Medical  History 


that  a  committee  of  Congress  should  be  appointed 
for  that  purpose:" 

Resolved,  That  Congress  concur  in  the  said  report. 

The  Medical  Committee,  to  whom  was  referred 
the  letter  from  Dr.  William  Rickman,  also  report, 
"that  as  the  establishment  of  the  military  hospital 
in  Virginia,  by  a  resolution  of  Congress  of  the  1 8th 
of  May,  1776,  is  entirely  distinct  from,  and  inde- 
pendent of,  the  general  establishment  of  hospitals 
in  the  other  States,  they  are  of  opinion,  the  same 
was  not  affected  by  the  new  regulations  of  the  7th 
day  of  April  last,  and  that  Dr.  Rickman  still  con- 
tinues director  of  that  hospital;" 

Resolved,  That  Congress  concur  with  the  foregoing 
report.47 

Ordered,  That  a  copy  of  the  foregoing  report  and 
concurrence  of  Congress  be  sent  to  Dr.  Shippen,  and 
that  he  be  directed  to  withdraw  from  Virginia  such 
physicians,  surgeons,  or  assistants,  as  he  may  have 
sent  thither. 

August  25,  1777.  670 

A  letter,  ...  of  the  16,  from  Dr.  Shippen,  were 
read: 48 

Ordered,  That  .  .  the  letter  from  Dr.  Shippen,  be 
referred  to  the  Medical  Committee. 

August  30,  1777.  699 

The  Medical  Committee  brought  in  a  report 
which  was  taken  into  consideration;  Whereupon, 

Resolved,  That  the  several  issuing  commissaries 
be  directed  to  furnish  the  director  general,  or  any  of 
the  deputy  directors,  or  their  assistants,  with  such 
provisions  as  any  of  them  shall,  from  time  to  time, 
demand  by  an  order  in  writing,  for  the  use  of  any 
temporary  hospital  which  shall  be  established,  which 
order,  with  the  receipt  of  the  steward  endorsed 
thereon,  shall  be  a  sufficient  voucher  for  such  issu- 
ing commissary,  who  is  also  required  to  keep  such 
vouchers  separate,  and  make  a  separate  entry  of  the 
same  in  his  books,  charging  the  director  who  ordered 
the  same  therewith. 

September  10,  1777.  727,  728-9 

A  letter,  .  .  of  the  9,  from  Dr.  Shippen,  director 
general  of  the  hospital,     .     .     . 

Ordered,  That  the  letter  from  Dr.  Shippen,  .  . 
be  referred  to  the  Board  of  Treasury.     .     .     . 

That  there  is  due  to  Dr.  John  Morgan,  late  direc- 
tor general  of  the  American  hospitals,  the  balance 
of  his  account  current  as  adjusted  by  the  commis- 
sioners of  accounts  at  Hartford,  the  12  July  last,  the 
sum  of  613  40/90  dollars,  and  the  farther  sum  of 
200  dollars  which  he  advanced  to  Dr.  Warren,  sur- 
geon of  the  general  hospital,  to  defray  cxpences,  &c. 
which  sum  was  stolen  from  the  said  Warren,  as  per 
certificates  taken  on  oath  before  the  commissioners 
at  Stamford,  and  which  the  Board  of  Treasurj 
Mould  be  allowed  to  Dr.  Morgan; 

Also  the  pay  of  director  general  from  the  31  De- 

r,  1776,  to  the  12  July,  1777,  being  194  days, 

at    6  dollars   per   day,    which    time    he   employed   in 

■  accounts,  and   delivering   up  the   medicines, 

note  tmdaf  \ 

■  latter  of   BMppeil,    -  Die   Continental 

78,  XX.  folio  1 17. 
'•  Wordl  in  parontbonoa  were  in  Leun  HI 


hospital  stores,  &c.  settling  accounts  with  the  sur- 
geons, mates,  &c.  attending  the  commissioners  at 
Hartford,  1,164  dollars;  for  1,179  rations  from  31 
December,  1776,  to  10  May,  at  8/90  dollar,  104 
72  90  dollars,  and  for  567  rations,  from  10  May  to 
12  July,  at  10  90,  63  dollars,  making  in  the  whole 
2,145  22/90  dollars: 

September  13,  1777.  739 

Ordered,  That  the  President  issue  his  warrant  on 
the  commissioners  of  the  loan  office  for  the  State  of 
Pennsylvania,  in  favour  of  Dr.  Shippen,  director 
general  of  the  hospital,  for  fifty  thousand  dollars, 
for  the  use  of  that  department;  and  for  which  he 
shall  be  accountable: 

September  18,  1777.  754 

Resolved,  That  establishments  be  made  for  the 
hospital  in  the  respective  departments,  and  chap- 
lains appointed,  and  that  their  pay  be  each  60  dol- 
lars a  month,  three  rations  a  day,  and  forage  for 
one  horse: 

The  Rev.  Mr.  Noah  Cook  was  elected  chaplain  of 
the  hospitals  in  the  eastern  department. 

October  18,  1777.  821 

A  letter  from  William  Shippen,  director  general, 
to  the  Medical  Committee,  was  laid  before  Con- 
gress and  read: 

Ordered,  That  it  be  referred  to  the  Board  of  War. 

October  20,  1777.  823 

Resolved,  That  General  R.  Howe's  letter  of  the 
29  August  last,  relating  to  the  general  hospital  in 
South  Carolina,  be  referred  to  the  Medical  Commit- 
tee. 

October  24,  1777.  838 

Resolved,  That  a  warrant  issue  on  the  treasurer  for 
500  dollars,  in  favour  of  William  Shippen,  Junr  di- 
rector general  of  the  hospital,  which  is  to  be  charged 
to  the  said  W.  Shippen,  and  for  which  he  is  to  be 
accountable;  this  being  to  indemnify  the  treasurer 
for  so  much  advanced  by  him  to  the  said  Dr.  Ship- 
pen  on  account  of  the  military  hospitals,  as  appears 
by  his  receipt,  dated  15  October,  1777. 

November  6,  1777.  870 

Resolved,  That  the  unremitted  attention  shewn 
by  Dr.  Potts,  and  the  officers  of  the  general  hospi- 
tal in  the  northern  department,  (as  represented  in 
General  Gates's  letter  to  Congress,  of  the  20  Octo- 
ber,)49  to  the  sick  and  wounded  under  their  care, 
is  a  proof  not  only  of  their  humanity,  bul  of  their 
zeal  for  the  service  of  the  United  States,  so  deeply 
interested  in  the  preservation  oi  the  health  and  lives 
..I'  tin-  gallant  asserters  of  their  country's  cause;  and 
that  Congress,  therefore,  cannot  but  ascertain  a 
high  sense  of  the  services  which  they  have  Ten- 
dered, during  this  campaign,  by  a  diligent  discharge 
of  their  respective  functions.60 

November  12,  1777.  894 

Ordered,  That  a  warrant  issue  on  Nathaniel  Ap- 
pleton,  E.sq'  commissioner  of  the  continental  loan 
office  of  the  State  of  Massachusetts  bay,   in   las  our 

*°  Thin  report,  dated  November  1.  i-<  i"  tin-  Papers  «/  the  Conti- 

nmtal  ConareHH,  No.  117.  I.  folio  881.  The  members  ol  the  Board 
nniml    were:    Praneii    Ughtfoot    1 William    Dust,   Joaapb 

hones,  William  Williams  and  John  Sarvie, 


History  of  the  Army  Medical  Department  During  the  Revolution 


267 


of  Dr.  William  Shippen,  director  general  of  the  hos- 
pitals, for  sixty-seven  thousand  dollars,  for  the  use 
of  his  department,  and  for  which  he  is  to  be  ac- 
countable: 

November  19,  1777.  941 

The  Medical  Committee  brought  in  a  report, 
which  was  taken  into  consideration;  Whereupon, 

Resolved,  That  the  cloathier  general  be  directed  to 
deliver  to  the  director  general  of  the  military  hospi- 
tals, the  deputy  directors  general,  or  their  assistants, 
for  the  use  of  the  sick  and  wounded  of  the  several 
departments,  a  proportionable  share  of  the  blankets, 
shirts,  shoes,  and  stockings,  he  shall,  from  time  to 
time,  procure  for  the  supply  of  the  army: 

That  the  director  general  of  the  hospitals  be  au- 
thorized to  cause  stoves  to  be  erected  in  the  differ- 
ent hospitals,  in  case  he  shall  think  such  a  measure 
will  conduce  to  make  up  for  the  present  scarcity  of 
blankets  and  cloathing,  or  to  the  greater  comfort  of 
the  sick;  and  that  the  waggons  annexed  to  the  hos- 
pital department  be  employed,  as  much  as  possible, 
in  the  transportation  of  fuel  for  the  respective  hos- 
pitals. 

November  29,  1777.  980 

A  letter,  of  the  16,  from  General  Gates,  .  .  . 
also  a  letter  of  the  24,  from  W.  Shippen,  director 
general,  at  Bethlehem,  were  read: 5l 

December  1,  1777.  983 

Ordered,  That  a  warrant  issue  on  Thomas  Smith, 
Esq^  commissioner  of  the  loan  office  for  the  State 
of  Pennsylvania,  in  favour  of  Dr.  William  Shippen, 
director  general  of  the  hospitals,  for  fifty  thousand 
dollars,  for  the  use  of  his  department;  the  said  direc- 
tor general  to  be  accountable: 

Ordered,  That  a  warrant  issue  on  the  treasurer,  in 
favour  of  Dr.  William  Shippen,  director  general  of 
the  hospitals,  for  fifty  thousand  dollars,  for  the  use 
of  his  department,  the  said  director  general  to  be 
accountable: 

December  10,  1777.  10 16 

Resolved,  That  two  members  be  added  to  the 
Medical  Committee: 

The  members  chosen,  Mr.  (Francis)  Lewis  and 
Mr.  (John)  Penn. 

Congress  having  received  information  that  the 
inoculation  of  recruits  in  the  hospital  in  the  State 
of  Virginia  has  of  late  been  attended  with  much  ill 
success; 

Resolved,  That  the  Medical  Committee  make  strict 
enquiry  into  the  truth  of  this  information,  and  re- 
port to  Congress,  with  all  possible  despatch. 

December  13,  1777.  1024 

A  return  of  the  number  and  names  of  the  wound- 
ed men,  distinguishing  such  as  are  fit  for  the  corps 
of  invalids,  and  such  as  are  totally  unfit  for  service; 

December  20,  1777.  1039 

The  Medical  Committee,  to  whom  it  was  referred 
to  enquire  into  the  conduct  of  the  director  of  the 


hospitals  at  Alexandria,  reported,  "That  from  the 
information  of  several  officers  in  the  Virginia  and 
North  Carolina  regiments,  which  are  annexed,  it 
appears  obvious  to  the  committee  that  Dr.  Rick- 
man,  director  of  the  said  hospitals,  has  been  guilty 
of  great  neglect  in  not  giving  proper  attendance  to 
the  officers  and  soldiers  under  inoculation  at  Alex- 
andria:" The  said  report  and  the  informations  being 
read, 

Resolved,  That  Dr.  Rickman  be  immediately  sus- 
pended, and  that  he  attend  the  Medical  Committee, 
to  answer  the  several  complaints  exhibited  against 
him. 

Ordered,  That  the  Medical  Committee  transmit 
to  Dr.  Rickman  a  copy  of  the  complaints  against 
him,  and  direct  his  attendance: 

That  the  said  committee  write  to  Dr.  Shippen, 
director  general,  and  direct  him  to  send  immediate- 
ly a  skilful  physician  to  take  care  of  the  sick  and 
superintend  the  inoculation  of  the  soldiers  at  Alex- 
andria. 

January  1,  1778.  p.  9 

A  letter,  of  the  8,  and  one,  of  the  13  December, 
from  Dr.  B.  Rush  to  Mr.  (William)  Duer,  were  laid 
before  Congress,  and  read: 52 

Resolved,  That  the  said  committee  be  fully  au- 
thorized to  take  every  measure,  which  they  shall 
deem  necessary,  for  the  immediate  relief  of  the  sick, 
and  report  such  alterations  in  the  medical  depart- 
ment, as  they  shall  deem  best  adapted  to  answer 
the  end  of  its  institution. 

January  6,  1778.  p.  23,  24 

The  committee  to  whom  the  letters  from  Gover- 
nor Livingston  and  Dr.  Rush  were  referred,  brought 
in  a  report,  which  was  taken  into  consideration; 
Whereupon, 

Resolved,  That  the  cloathier  general  be  directed 
to  deliver  to  the  order  of  the  director  general  as 
much  linen  and  as  many  blankets  as  can  be  spared, 
to  be  retained  in  the  hospital  for  the  use  of  the  sick: 

That  the  cloathier  general  be  directed  to  supply 
the  convalescents  with  necessary  cloathing,  in  order 
that,  when  properly  recovered,  they  may  join  the 
army: 

That  a  member  of  Congress  be  forthwith  appoint- 
ed to  visit  the  hospitals  in  the  middle  department: 
the  member  chosen,  Mr.  (John)  Penn. 

That  a  recommendation  be  sent  to  the  clergy  of 
all  denominations  in  the  said  [  middle  ]  district,  to 
solicit  charitable  donations  of  woolens  and  linen, 
made  or  unmade,  for  the  sick  soldiers  in  the  hospi- 
tals; and  to  send  the  same  to  the  Board  of  War,  or 
any  hospital,  as  may  be  most  convenient. 

That  Dr.  Shippen  and  Dr.  Rush  be  directed  to 
attend  Congress  on  the  26  day  of  January  inst.  to 
be  examined  touching  certain  abuses  said  to  prevail 
in  the  hospital. 

Resolved,  That  the  farther  consideration  of  the  re- 
port be  postponed  (to  the  afternoon.)     .     .     . 

Congress  resumed  the  consideration  of  the  report 
under  debate  this  morning;  Whereupon, 


51  The  letter  of  Shippen  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  78,  XX,  folio  163. 


52  These  letters  are  in  the  Papers  of  the  Continental  Congress,  No. 
78,  XIX,  folios  173  and  181. 


268 


Annals  of  Medical  History 


Resolved,  That  the  sum  of  ten  dollars  shall  be  paid 
by  every  officer,  and  the  sum  of  four  dollars  by 
every  soldier,  who  shall  enter,  or  be  sent  into  any 
hospital  to  be  cured  of  the  venereal  disease;  which 
sums  shall  be  deducted  out  of  their  pay,  and  an  ac- 
count thereof  shall  be  transmitted  by  the  physician 
or  surgeon  who  shall  have  attended  them,  to  the 
regimental  pay  master  for  that  purpose;  the  money 
so  arising  to  be  paid  to  the  director  general,  or  his 
order,  to  be  appropriated  to  the  purchasing  blan- 
kets and  shirts  for  the  use  of  sick  soldiers  in  the 
hospital. 

January  19,  1778.  60 

A  letter,  of  the  18th,  from  W.  Shippen,  Jun, 
.     .     .  was  read:     .     .M 

January  26,  1778.  92 

A  letter,  of  the  25,  from  Dr.  Rush,  was 
read:     .     .     .M 

January  27,  1778.  93 

A  letter  from  Dr.  Shippen,  director  general  of  the 
hospital,  and  one  from  Dr.  Brown,  (both  directed) 
to  the  Medical  Committee,  were  laid  before  Con- 
gress, (and  read:)  55 

Ordered,  That  the  same,  together  with  the  letters 
some  time  since  received  from  Dr.  Shippen  and  Dr. 
Rush,  and  Governor  Livingston,  relative  to  the  hos- 
pital department,  be  referred  to  a  committee  of  five, 
and  that  the  committee  be  instructed  to  confer  with 
Dr.  Shippen  and  Dr.  Rush,  and  report  specially: 

January  30,  1778.  100 

Resolved,  That  a  warrant  issue  on  the  treasurer 
in  favour  of  Dr.  Jonathan  Potts,  deputy  director 
general  of  the  hospitals  in  the  northern  department, 
for  twenty  thousand  dollars  for  the  use  of  his  dis- 
trict; the  said  deputy  director  general  to  be  ac- 
countable. 

A  letter,  of  this  day,  from  Dr.  Rush,  requesting 
leave  to  resign,  was  read: 56 

February  6,  1778.  128-13 1 

Congress  took  into  consideration  the  report  of  the 
committee  to  whom  the  letters  from  Dr.  Shippen, 
Dr.  Rush,  and  others  were  committed;  and  there- 
upon came  to  the  following  resolutions: 

For  the  better  regulating  the  hospitals  of  the 
United  States, 

Resolved,  That  there  be  a  deputy  director  general 
for  the  hospitals  between  Hudson  and  Potomack 
rivers;  and  that  the  superintending  care  of  the  di- 
rector genera]  be  extended  equally  over  the  hospi- 
tals in  every  district,  and  that  he  be  excused  from 
the  duty  of  providing  supplies,  [and  from  "particu- 
larly" superintending  the  said  hospitals]*  when  the 
deputy  director  general  shall  be  ready  to  enter  upon 
tin-  office: 

That  the  several  officers  of  the  hospitals  shall 
ucfa  of  their  former  powers  as  are 
herein  ;i     l-m  d  to  oilier  officers  thereof: 

uTlii'  letted  <.f  Shippen  ll  Is  tli«>  Paper*  nf  the  Continental  Con- 

8  X.  folio  171. 
"  TIk-  letter  of  Dr.  Rmh  ll  in  the  Papers  of  the  Continental  Con- 
r«i.  No.  7s,  XIX,  folio  107. 

*  This  letter  is  in  tho  Papers  0/  the  Continental  Congress,  No. 


That  in  the  absence  of  the  director  general  from 
any  district,  the  physician  general  and  surgeon  gen- 
eral shall  hereafter  determine  the  number  of  hospi- 
tals to  be  provided  by  the  deputy  director  general 
for  the  sick  and  wounded,  and  shall  superintend 
and  controul  the  affairs  of  such  hospitals: 

That  the  director  general  shall  consult  with  the 
physician  general  and  surgeon  general  in  each  dis- 
trict, about  the  supplies  necessary  for  the  hospitals, 
and  shall  give  orders  in  writing  to  the  deputy  direc- 
tor general  thereof  to  provide  the  same;  and,  in  the 
absence  of  the  director  general,  the  physician  gen- 
eral and  surgeon  general  shall  issue  such  orders: 

That  each  deputy  director  general  shall  appoint 
one  or  more  of  the  assistant  deputy  directors,  under 
him,  to  the  sole  business  of  providing  beds,  furni- 
ture, utensils,  hospital  cloathing,  and  such  like  arti- 
cles; and  shall  appoint  one  or  more  to  provide  medi- 
cines, instruments,  dressings,  herbs,  and  necessaries 
of  a  similar  kind: 

That  the  director  general  shall  frequently  visit 
the  hospitals  in  each  district,  and  sec  that  the  regu- 
lations are  carried  into  effect;  shall  examine  into  the 
number  and  qualifications  of  the  hospital  officers, 
report  to  Congress  any  abuses  that  may  have  taken 
place,  and  discharge  the  supernumerary  officers,  if 
there  be  any,  that  all  unnecessary  expence  may  be 
saved  to  the  public;  and  when  the  director  general 
is  in  any  particular  district,  the  physician  general 
and  surgeon  general  in  that  district  shall  not  ap- 
point any  officers  without  his  consent: 

That,  on  the  settlement  of  hospital  accounts,  the 
officers  entrusted  with  public  money  shall  produce 
vouchers  to  prove  the  expenditure,  and  receipts  from 
the  proper  officers  of  the  hospitals,  specifying  the 
delivery  of  the  stores  and  other  articles  purchased; 
and  the  apothecaries,  mates,  stewards,  matrons,  and 
other  officers,  receiving  such  stores  and  other  arti- 
ticles,  shall  be  accountable  for  the  same,  and  shall 
produce  vouchers  for  the  delivery  thereof  from  such 
officers,  and  according  to  such  forms  as  the  physi- 
cians general  and  surgeons  general  have  directed,  or 
shall,  from  time  to  time,  direct;  which  forms  and 
directions  the  physicians  and  surgeons  general  shall 
report  to  the  Board  of  Treasury: 

That  the  director  general,  or,  in  his  absence  from 
the  district,  the  physician  general,  and  surgeon 
general,  shall  appoint  a  ward  master  for  each  hos- 
pital, to  receive  the  arms,  accoutrements  and 
cloathing  of  each  soldier  admitted  therein,  keeping 
entries  of,  and  giving  receipts  for  such  articles, 
which,  on  the  recovery  of  the  soldier,  shall  be  re- 
turned to  him,  or,  in  case  of  his  death,  the  arms  and 
accoutrements  shall  be  delivered  to  the  commissary 
or  deputy  commissary  of  military  stores,  and  re- 
ceipts be  taken  for  the  same;  and  the  ward  master 
shall  receive  and  be  accountable  for  the  hospital 
cloathing;  and  perform  such  other  services  as  the 
physician  general  or  the  surgeon  general  shall  di- 
rect: 

That  the  physicians  general  and  surgeons  general 
shall  hereafter  make  no  returns  to  the  deputy  direc- 

78,  xx.  folio  it;.. 

"Tliin  letter  in  in  tin'  Paper*  of  the  Continental  Conor* 
7s.  XIX.  folio  205. 

*  Material  in  brackots  was  cancelled  in  tho  original  MS9. 


History  of  the  Army  Medical  Department  During  the  Revolution        269 


tors  general,  but  the  returns  shall  be  made  by  the 
said  officers  respectively  to  the  director  general, 
who  shall  carefully  transmit  copies  of  each  with  his 
monthly  return  to  Congress,  and  suspend  such  of 
the  officers  aforesaid  as  neglect  this  or  any  other 
part  of  their  duty,  and  shall  report  their  names  to 
Congress: 

That  the  director  and  deputy  directors  general 
forthwith  prepare  their  accounts,  and  adjust  them 
with  the  commissioners  of  claims,  at  the  Board  of 
Treasury. 

That  four  dollars  a  day,  and  the  former  allowance 
of  rations,  be  hereafter  allowed  to  each  assistant 
deputy  director  and  the  commissary  of  the  hospitals 
in  each  district;  and  one  dollar  a  day,  and  two  ra- 
tions, to  each  ward  master: 

Resolved,  That  Dr.  Potts  be  called  from  the  north- 
ern district,  and  appointed  to  act  as  deputy  director 
general  in  the  middle  district. 

Resolved,  That  the  eldest  assistant  deputy  director 
in  the  northern  district  shall  execute  the  office  of  the 
deputy  director  general  in  the  said  district,  until  the 
further  orders  of  Congress: 

That  the  salaries  of  the  hospital  officers  and  debts 
contracted  for  the  hospitals  of  the  middle  district 
to  the  time  of  Dr.  Potts's  entering  upon  the  office  of 
deputy  director  general  therein,  shall  be  adjusted 
and  paid  by  the  director  general,  who  shall  deliver 
all  the  public  stores  in  his  possession  to  the  deputy 
director  general  or  his  order,  taking  duplicate  re- 
ceipts for  the  same,  and  transmitting  one  of  each  to 
the  Board  of  Treasury;  and  the  same  rule  shall  be 
observed  by  Dr.  Potts  with  respect  to  the  salaries 
and  debts  of  the  hospitals  of  the  northern  district, 
and  the  public  stores  thereof,  which  are  to  be  de- 
livered to  his  successor  in  office  in  that  district. 

Congress  proceeded  to  the  election  of  a  physician 
general  in  the  middle  district,  in  the  room  of  Dr. 
Rush,  [  resigned  ]  and  the  ballots  being  taken, 

Dr.  William  Brown  was  elected. 

February  10,  1778.  p.  142 

Resolved,  That  another  chaplain  be  chosen  for 
the  hospitals  in  the  middle  department: 

The  ballots  being  taken,  the  Rev.  Mr.  (James) 
Sproat  was  elected. 

February  13,  1778.  p.  157,  158 

That  there  is  due  to  Dr.  John  Witherspoon,  for 
hay  for  the  army,  and  wood  for  the  hospital  at 
Princeton,  as  appears  by  the  certificate  of  Enos  Kel- 
sey,  acting  in  the  quarter  master's  department,  the 
sum  of  429  30/90  dollars: 

Resolved,  That  Mr.  Nathaniel  Scudder  be  added 
to  the  Medical  Committee, 

February  21,  1778.  p.  186,  187 

A  letter  of  21,  from  Dr.  W.  Shippen,  was  read;  " 
Whereupon, 

Resolved,  That  a  surgeon  general  be  appointed 
for  the  hospital  in  the  middle  department,  in  the 
room  of  Dr.  Brown,  promoted;  the  ballots  being 
taken, 

67  This  letter  is  in  the  Papers  of  the  Continental  Congress,  No. 
78.  XX,  folio  193. 

68  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
136,  II,  folio  101. 


Dr.  Charles  M'Knight  was  elected. 

Whereas,  the  duty  of  the  person  who  executes  the 
office  of  secretary  and  pay  master  of  the  hospital  in 
the  middle  department,  is  important  and  difficult: 

Resolved,  That  the  pay  of  the  person  who  exe- 
cutes those  offices  in  the  hospital  in  the  middle  de- 
partment, be  augmented  to  three  dollars  a  day. 

That  a  warrant  issue  on  the  treasurer  for  the  sum 
of  forty  thousand  dollars,  in  favour  of  William  Ship- 
pen,  Jun.  director  general  of  all  the  military  hospi- 
tals, for  the  use  of  the  middle  district;  for  which 
the  director  is  to  be  accountable: 

February  23,  1778.  p.  191 

That  a  warrant  issue  on  the  treasurer  in  favour  of 
Dr.  Jonathan  Potts  .  .  .  for  one  hundred  thou- 
sand dollars  .     .     .  he  is  to  be  accountable.58 

March  7,  1778.  p.  230 

The  Medical  Committee  report,  "That  they  have 
carefully  examined  and  considered  the  several  alle- 
gations and  testimonies  for,  and  against,  Dr.  Wil- 
liam Rickman,  deputy  director  general  in  the  south- 
ern department;  that,  notwithstanding,  it  appears 
the  North  Carolina  and  Virginia  troops,  inoculated 
by  the  said  Dr.  Rickman  at  Alexandria,  suffered,  in 
general,  more  in  the  course  of  the  disease  than  is 
usual,  and  that  a  number  of  them  did  die;  yet,  as 
the  committee  are  convinced  that  it  was  impracti- 
cable for  the  director  to  obtain,  in  season,  a  variety 
of  articles  for  their  due  accommodation  in  the  hos- 
pitals, as  many  of  them  were  badly  cloathed,  and 
all  had,  immediately  before  the  operation,  under- 
gone a  long  and  fatiguing  march  at  a  season  of  the 
year  when  putrid  diseases  generally  prevail  most;  as 
from  a  regular  return  it  appears  that  most  of  those 
who  were  lost,  died  of  a  putrid  fever;  as  the  director 
really  had  not  sufficient  assistance,  and  lastly,  as 
one  of  the  assistants,  of  the  name  of  Parker,  who 
was  employed  from  the  necessity  of  the  case,  ap- 
pears to  have  greatly  abused  the  confidence  and 
trust  reposed  in  him  by  the  director;  whence  a  great 
part  of  the  evils  complained  of  by  the  patients  may 
have  arisen;  the  committee  are  of  opinion,  that  Dr. 
Rickman  ought  to  be  acquitted  of  the  charges  ex- 
hibited against  him;  that  the  resolution  of  the  20th 
day  of  December  last,  for  his  suspension,  be  re- 
pealed, and  that  Dr.  Rickman  be  directed  to  repair 
immediately  to  his  department,  and  resume  the  ex- 
ercise of  his  duty  there:"  59 

March  9,  1778.  235 

A  letter,  of  the  2,  from  Captain  W.  Nichols,  was 
read,  praying  for  leave  to  resign  his  commission. 
.  .  .  A  letter  from  Dr.  A(mmi)  R(uhamah)  Cut- 
ter to  Mr.  (George)  Frost,  praying  for  leave  to  re- 
sign, were  read: 60 

Ordered,  That  Dr.  Cutter  have  leave  to  resign; 
that  the  letter  from  Captain  Nichols  be  referred  to 
the  Board  of  War; 

March  11,  1778.  243 

That  a  warrant  issue  on  the  treasurer,  in  favour 
of  Joseph  Nourse,  pay  master  to  the  Board  of  War 

69  This  report,  in  the  writing  of  Nathan  Brownson  (?),  is  in  the 
Papers  of  the  Continental  Congress,  No.  19,  V,  folio  249. 

60  The  letter  of  Nichols  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  78,  XVII,  folio  37. 


270 


Annals  of  Medical  History 


and  ordnance,  for  50,000  dollars,  to  be  by  him  trans- 
mitted to  Doct.  Isaac  Forster,  deputy  director  gen- 
eral of  the  military  hospital  in  the  eastern  depart- 
ment, at  Danbury,  in  Connecticut,  for  which  the 
said  doctor  is  to  be  accountable: 

March  26,  1 — 8.  284, 

A  letter,  of  the  24  February,  from  the  council  of 
Massachusetts  bay,  respecting  allowances  to  be 
made  to  sick  and  wounded  soldiers,  was  read.  61 

April  3,  1778.  p.  303 

A  letter,  of  21  March,  from  General  Washington, 
enclosing  a  copy  of  a  letter  to  him  from  Dr.  Rush, 
dated  Princeton,  25  February,  was  read;  also  a  let- 
ter of  9  March,  with  a  postscript  of  19,  from  Dr. 
Rush  to  Mr.  (Daniel)  Roberdeau,  was  laid  before 
Congress: 62 

April  17,  1778.  p.  361 

That  30,000  dollars  be  advanced  to  Dr.  Potts, 
and  that  a  warrant  issue  in  his  favour  on  Thomas 
Smith,  Esq.  commissioner  of  the  continental  loan 
office  in  the  State  of  Pennsylvania,  for  the  farther 
sum  of  70,000  dollars,  for  the  use  of  the  hospital  in 
the  middle  district;  for  which  sums  the  said  Dr. 
Potts  is  to  be  accountable: 

April  18,  1778.  p.  365,  366 

Resolved,  That  a  Warrant  issue  on  the  Treasurer 
On  question,  in  favour  of  Dr.  William  Shippen,  .  . 
negatived  for  Forty  thousand  Dollars,  .  .  . 
for  which  he  is  to  be  accountable. 

Resolved,  That  Mr.  G(ouverneur)  Morris  be  add- 
ed to  the  Medical  Committee. 

May  16,  1778.  p.  504 

Ordered,  That  100,000  dollars  to  be  paid  to  Dr. 
Thomas  Bond,  Jun.  to  be  by  him  delivered  to  Dr. 
Jonathan  Potts,  deputy  director  general,  for  the  use 
of  the  hospitals  of  the  middle  district;  the  said  Dr. 
J.  Potts  to  be  accountable: 

May  23,  1778.  p.  525,  526,  527 

.  .  .The  Board  will  lay  before  Congress  the  facts 
which  they  have  collected  from  Major  Wilson,  com- 
manding at  Carlisle  during  the  residence  of  Major 
Stockton  and  other  officers  of  his  party  in  the  goal 
of  that  place;  from  M.'  T.  Peters,  Deputy  Commis- 
sary of  prisoners,  who  has  had  the  charge  during  the 
winter  of  the  prisoners  at  Carlisle  and  York;  from 
Doctor  Henry,  employed  to  attend  the  British  pris- 
oners when  sick;     .     .     . 

.  .  .  But  the  goal  at  Carlisle  not  being  secure, 
the  deputy  Commissary  of  prisoners  removed  them 
to  the  prison  of  this  place,  wherein  was  also  confined 
Doctor  John  ConoIIy,  for  the  same  causes  which  in- 
duced and  continued  their  present  imprisonment, 
and  for  other  reasons  of  policy  and  prudence.  Doc- 
tor ConoIIy  having  also  sundry  times  behaved  amiss 
while  on  parole. 

"  This  Inter  if  in  the  Paper*  of  the  Coni  te.  No. 

66,  I.  [1  ire  do  resolution!  "f  Con- 

Kreaa  respecting  soldiers  in  any  of  tin-  airoumstanoi  1  mentioned 

■  The  letter  "f  Washington  is  In  the  Paper*  0/  the  Continental 
Conor—,  No,  163,  V,  folio  ill;  thai  of  Bush  to  Washington  is 
78,  XIX,  foHo  211;  and  that  of  Rush  to  Bobardeao,  In 
the  samo  volume,  folio  215. 


.  .  .  There  was  some  time  ago  an  apprehension 
in  a  part  of  the  goal  distant  from  the  officers'  apart- 
ments that  a  contagious  fever  had  broke  out  among 
the  soldiers,  but  the  diseased  were  immediately  re- 
moved to  hospitals,  and  a  Surgeon  and  nurses  pro- 
vided for  them,  and  every  assistance  afforded  them 
the  nature  of  our  affairs  would  admit.     .     .     . 

M'  ConoIIy,  altho'  indulged  with  every  thing  a 
prisoner  could  reasonably  wish,  has  repeatedly  rep- 
resented his  own,  and  the  situation  of  the  goal,  in 
similar  terms  with  the  letter  now  under  considera- 
tion, and  the  former,  and  this  Board,  have  often 
had  consequent  examinations,  in  all  of  which  they 
found  the  complaints  groundless.  Once  particularly, 
when  M!'  ConoIIy  represented  himself  as  at  the 
point  of  death  from  the  severity  of  his  confinement, 
the  board  directed  Doctor  Shippen  to  visit  him,  who 
reported  that  his  situation  was  directly  opposite  to 
his  representation,  his  indisposition  slight  and  mere- 
ly of  an  Hippochandriac  Nature.     .     .     . 

Richard   Peters.63 

May  25,  1778.  p.  531 

Resolved,  That  the  auditor,  together  with  Mr. 
Milligan,  one  of  the  commissioners  of  claims,  be  au- 
thorized and  directed  to  examine  and  pass  upon  the 
accounts  of  Dr.  Isaac  Forster,  deputy  director  gen- 
eral of  the  eastern  department. 

May  28,  1778.  p.  546 

That  755  42/90  dollars  be  advanced  to  the  Com- 
mittee of  Commerce,  to  enable  them  to  pay  Andrew 
and  James  Caldwell  the  freight  of  sundry  medicines 
imported  in  their  sloop  from  Martinico,  on  public 
account;  the  said  Committee  to  be  accountable." 

June  4,  1778.  p.  568 

A  letter,  of  20  April,  from  Dr.  Rush  to  Messrs. 
(William  Henry)  Drayton,  (Samuel)  Huntington, 
and  (John)  Banister,  committee  appointed  on  3d  of 
that  month  to  inquire  into  Dr.  Rush's  charge  against 
Dr.  Shippen,  (was  read:)  M 

June  9,  1778.  p.  580,  582 

Ordered,  That  50,000  dollars  be  advanced  to  Dr. 
Isaac  Forster,  .  .  .  for  the  use  of  his  department; 
and  for  which  he  is  to  be  accountable.     .     .     . 

Resolved,  That  the  deputy  director  general  of  the 
hospital  in  the  eastern  department  shall,  as  hereto- 
fore, in  the  absence  of  the  director  general,  superin- 
tend the  medical  affairs  of  that  department  till  the 
further  order  of  Congress. 

June  10,  1778.  p.  582 

Ordered,  That  200,000  dollars  be  advanced  to  Dr. 
Jonathan  Potts,  deputy  director  general  for  the 
middle  district,  for  the  use  of  his  department;  he  to 
be  accountable. 

N.  B.  Dr.  Potts  applies  for  300,000  Dollars;  but 
as  he  lias  already  had  that  sum  advanced  him  since 
February  last,  and  as  the  Treasury  is  at  present 
very  low,  your  Committee  judged  it  improper  to 
report  so  large  a  sum.  They  beg  have  further  to 
inform  Congress,  that  from  an  examination  ol  the 

"This  report  is  in  the  Papers  a/ (As  Continental  Congrats,  No. 

117.  II  folio  .".7. 

"  This  re|„.rt  is  in  the  I'n/ters  of  the  Continental  Congress,  No. 
I  18,  II.  folio  831. 

•This  letter  is  in  the  /'.i/>rr«  of  the  Continental  Congress,  No. 
78,  XIX.  folio 388. 


History  of  the  Army  Medical  Department  During  the  Revolution         271 


estimates  given  them  by  Dr.  Potts,  they  conceive 
the  expences  that  accrue  in  his  Department  are  ex- 
orbitant; they  have  therefore  laid  them  before  Con- 
gress for  their  Inspection.66 

June  15,  1778.  p-  607 

The  auditor  general  and  commissioners  of  claims 
having,  in  consequence  of  the  resolution  of  the  25 
May,  reported  upon  the  accounts  of  Dr.  Forster, 

Ordered,  That  it  be  referred  to  the  Board  of  Treas- 
ury, and  that  the  accounts  of  Dr.  Forster  be  adjust- 
ed agreeably  to  the  said  report,  when  he  shall  pro- 
duce vouchers  shewing  the  expenditure  of  the  stores 
by  him  procured  and  charged  in  the  said  account. 

July  13,  1778-  P-  686 

The  Committee  for  Foreign  Affairs  laid  before 
Congress  a  letter  from  Dr.  Edward  Bancroft,  dated 
31  March  last  which  was  read,  and  returned  to  the 
Committee. 

August  4,  1778.  p.  746 

Ordered,  That  a  warrant  issue  on  the  treasurer 
for  one  hundred  thousand  dollars,  in  favour  of  Jona- 
than Potts,  Esq.,  .     .     .he  to  be  accountable. 

August  11,  1778.  775 

That  a  warrant  issue  on  the  treasurer  in  favour  of 
Dr.  Isaac  Forster,  .  .  .for  the  use  of  his  depart- 
ment, .  .  .  he  to  be  accountable;  and  that  the 
same  be  paid  to  John  Delamater,  as  requested  by 
the  doctor. 

August  14,  1778-  787 

A  letter,  of  the  1  August,  from  Mr.  (Samuel) 
Huntington,  one  of  the  delegates  of  that  State  in 
Congress,  was  laid  before  Congress,  and  read,  set- 
ting forth  sundry  evils  and  abuses  in  the  hospitals 
in  the  eastern  district:  Whereupon,67 

Resolved,  That  the  resolution  of  Congress  of  the 
9  of  June  last,  authorizing  the  deputy  director  gen- 
eral of  the  hospital  in  the  eastern  department,  in 
the  absence  of  the  director  general,  to  superintend 
the  medical  affairs  of  that  department,  be,  and  it  is 
hereby  repealed;  and  that  the  said  hospital  for  the 
future  be  under  the  same  regulations  as  the  hospi- 
tals in  the  other  departments. 

Resolved,  That  the  director  general  be  directed  to 
enquire  into  the  state  of  the  hospital  in  the  eastern 
department,  and  give  proper  orders  for  the  good 
government  and  economy  thereof,  and  discharge  un- 
qualified and  supernumerary  officers,  if  any  there 
be. 

August  20,  1778.  816 

A  letter,  of  19,  from  Major  General  Arnold,  was 
read: 

Ordered,  That  it  be  referred  to  the  Board  of  War, 
and  that  the  Board  be  directed  to  report  their  opin- 
ion on  the  necessity  of  an  additional  number  of 
troops  to  the  corps  of  invalids,  for  the  purpose  of 

66  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
136,  II,  folio  349. 

67  The  letter  of  Huntington  is  in  the  Papers  of  the  Continental 
Congress,  No.  78,  XI,  folio  309. 

68  This  report,  dated  August  20,  is  in  the  Papers  of  the  Conti- 
nental Congress,  No.  136,  II,  folio  471. 


guards  in  the  city  of  Philadelphia;  and  if  an  addi- 
tional number  is,  in  their  opinion,  necessary,  how 
many  and  for  what  purposes. 

August  2i,  1778.  p.  825 

That  there  is  due  to  the  officers  and  privates  of 
the  invalid  regiment,  for  pay  and  subsistence  for  the 
months  of  May  and  June  last,  the  sum  of  937  54/9° 
dollars:68 

Ordered,  That  the  said  accounts  be  paid. 

September  3,  1778.  p.  863 

That  a  warrant  issue  on  the  treasurer  in  favour 
of  Dr.  Jonathan  Potts,  deputy  director  general  for 
the  middle  district,  for  70,000  dollars,  of  which 
40,000  is  for  the  use  of  the  hospitals  thereof,  and 
30,000  to  be  transmitted  to  Dr.  Johnston,  assistant 
director  of  the  northern  department;  the  said  Dr. 
Potts  to  be  accountable: 

September  7,  1778.  p.  887 

A  letter,  of  28  August,  from  Dr.  (I.)  Forster,  dep- 
uty director  general  of  the  hospital  in  the  eastern 
department,  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

September  16,  1778.  p.  918 

That  Dr.  John  Warren,  Executor  of  the  late  Ma- 
jor General  Warren  be  authorized  and  requested  to 
superintend  their  Education,  and  to  make  quarter- 
ly Drafts  on  the  Treasury  of  the  United  States  for 
the  Expences  incident  to  the  same,  transmitting  to 
the  Board  the  necessary  Accounts. 

September  18,  1778.  925 

A  letter  and  memorial  from  Dr.  J.  Morgan,  were 
read:69 

Ordered,  That  the  foregoing  letter  and  memorial 
be  referred  to  the  said  committee. 

September  23,  1778.  946 

Resolved,  That  Mr.  (Samuel)  Holton  be  added  to 
the  Medical  Committee. 

October  9,  1778.  p.  993 

That  there  is  due  to  the  officers  and  privates  of 
the  invalid  regiment,  commanded  by  Colonel  L. 
Nicola,  for  pay  and  subsistence  for  the  month  of 
August  last,  the  sum  of  1558  25/90  dollars: 

October  10,  1778.  997 

A  letter,  of  4,  from  Dr.  W.  Shippen,  director  gen- 
eral, enclosing  a  return  of  the  sick  in  the  hospital, 

was  read:  »*■_»• 

Ordered,  That  the  same  be  referred  to  the  Medi- 
cal Committee. 

October  20,  1778.  1031 

Whereas  by  a  resolution  of  Congress  of  the  22 
April,  1777,  it  is  provided,  that  the  several  com- 
manding officers  of  parties,  detachments  or  corps  on 
their  march  to  or  from  the  camp,  shall  send  to  the 
military  hospitals  such  of  their  officers  and  soldiers 
as  from  time  to  time,  are  unable  to  proceed,  unless 
from  the  distance  of  the  hospitals  or  other  causes, 

69  This  position,  dated  September  17,  is  in  the  Papers  of  the 
Continental  Congress,  No.  41,  VI,  folio  51.  The  letter  is  in  No.  63. 
folio  117. 


272 

it  shall  at  any  time  be  necessary  to  deliver  them  to 
the  care  of  private  physicians  or  surgeons,  in  which 
cases  the  deputy  director  general  shall  discharge  the 
reasonable  demands  of  the  physicians  and  surgeons 
conducting,  agreeably  to  the  said  resolve. 

And,  whereas,  no  provision  is  therein  made  for 
discharging  the  accounts  of  other  persons  who  have 
been  or  may  be  employed  by  proper  officers  for 
taking  care  of  and  providing  for  such  officers  and 
soldiers: 

Resolved,  That  the  deputy  directors  general  be 
respectively  authorized  and  instructed  to  discharge 
such  of  the  said  accounts  as  shall  appear  to  be  rea- 
sonable and  just,  provided  that  each  person  who 
may  hereafter  be  employed  to  provide  for  officers 
and  soldiers  as  aforesaid,  shall  give  the  earliest  no- 
tice thereof  to  the  deputy  director  general,  or  the 
physician  or  surgeon  general  of  the  district,  in  order 
for  their  speedy  removal  to  the  military  hospitals. 

October  22,  1778.  p.  1038 

A  memorial  from  the  regimental  surgeons  and 
surgeons'  assistants  of  the  Army  or  the  United 
States  of  America,  was  read: 

Ordered,  That  it  be  referred  to  a  committee  of 
three: 

The  members  chosen,  Mr.  (Nathaniel)  Scuddcr, 
Mr.  (Samuel)  Holton,  and  Mr.  (Josiah)  Bartlett. 

October  26,  1778.  p.  1062,  1064. 

A  letter,  of  21,  from  Major  General  Lord  Stirling, 
enclosing  a  letter  to  him  from  Dr.  Griffith,  with  sun- 
dry affidavits  relative  to  the  massacre  of  Colonel 
Bayler's  regiment,  on  27  September  last,  was  read: 

.  .  .  Ordered,  That  Mr.  (Josiah)  Bartlett  be 
added  to  the  Medical  Committee: 

October  30,  1778.  p.  1079 

That  there  is  due  to  the  officers  and  privates  of 
Colonel  Lewis  Nicola's  regiment  of  invalids,  for  ra- 
tions and  parts  of  rations  retained  from  their  first 
establishment  to  the  31  of  May,  1778,  a  balance  of 
six  hundred  and  eighty-eight  50/90  dollars,  as  more 
fully  appears  by  a  particular  state  filed  with  the  ac- 
counts: 

November  3,  1778.  p.  1101 

That  a  warrant  issue  on  Thomas  Smith,  commis- 
sioner of  the  continental  loan  office  in  the  State  of 
Pennsylvania,  in  favour  of  Jonathan  Potts,  deputy 
director  general,  for  one  hundred  and  thirty  thou- 
sand dollars,  for  the  use  of  his  department;  he  to  be 
accountable: 70 

A  motion  being  made  respecting  the  medical  de- 
partment, 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

November  9,  1778.  p.  1 1 13 

An  extract  from  the  journals  of  the  assembly  of 
South  Carolina,  purporting  to  be  "a  report  of  the 
committee  on  tin-  president's  message,  relative  to 
the   hospital   establishment  and   military   arrangc- 

"'  TUl  report  is  in  tlio  Papert  of  the  Continental  Congress,  No. 
130.  II.  f..li..  • 
"TUi  iiKiu'.ririi.  dated  November  is,  i<  in  the  Paptr$  of  the 
llal  congress,  No.  41,  VI,  folio  7.1. 


Annals  of  Medical  History 


ments  of  this  State,  as  agreed  to  by  the  House," 
was  laid  before  Congress: 

Ordered,  That  so  much  thereof  as  relates  to  the 
hospital,  be  referred  to  the  Medical  Committee,  and 
the  remainder  to  the  Board  of  War. 

November  12,  1778.  p.  1124 

Ordered,  That  a  warrant  issue  on  the  treasury  for 
seventy-five  thousand  dollars,  in  favour  of  Jonathan 
Potts,  deputy  director  general,  and  another  warrant 
in  his  favour  on  Derick  Ten  Broek,  Esq.  commis- 
sioner of  the  continental  loan  office  in  the  State  of 
New  York,  for  seventy-five  thousand  dollars,  .  .  . 
for  use  in  hospitals  in  the  northern  department; 
.  .  .  said  deputy  director  general  is  to  be  account- 
able. 

November  28,  1778.  p.  11 70,  11 74 

That  another  warrant  issue  on  the  treasurer  in 
favour  of  Isaac  Forster,  Esq.,  .  .  .  for  twenty-five 
thousand  dollars,  to  be  paid  to  James  Davison, 
.  .  .  said  deputy  director  general  to  be  account- 
able:    .     .     . 

A  memorial  from  the  magistrates  and  the  over- 
seers of  the  poor  of  the  city  of  Philadelphia,  was 
read,  praying  for  a  compensation  for  the  use  of  the 
house  of  employment,  occupied  for  continental  hos- 
pital: 71 

Ordered,  To  lie  on  the  table. 

December  5,  1778.  p.  1192 

The  committee  to  whom  was  referred  the  memo- 
rial of  the  regimental  surgeons  and  assistants, 
brought  in  a  report,  which  was  read,  and  after  de- 
bate, 

Ordered,  That  it  be  committed  to  the  Medical 
Committee,  who  are  directed  to  take  into  considera- 
tion the  case  of  the  hospital  as  well  as  regimental 
surgeons,  and  report  thereon. 

December  28,  1778.  p.  1259 

Resolved,  That  a  member  in  the  place  of  Mr. 
(John)  Harvie  be  added  to  the  committee  on  the 
memorial  from  Dr.  Morgan: 

The  member  chosen,  Mr.  M(eriwethcr)  Smith. 

February  6,  1778.  p.  1282 

Resolutions  on  Hospitals. 

199.  Rules  and  directions  '  for  the  better  regulat- 
ing the  Military  Hospital  of  the  United  States:  In 
consequence  of  a  Resolve  of  the  Honourable  the 
Continental  Congress,  the  6th  of  February,  1778; 
to  be  punctually  observed  by  the  Officers,  Nurses, 
&c.   of  the        Eastern    Department.7"1 

(Signed)    P.  Turner,  Surg.  Gen.  M.  H.  E.  D. 
F"  Broadside. 

September  25,  1778.  p.  1287 
Provision  for  disabled  officers  and  privates. 
226.  In  Congress,  August  26,  1776  ....    In  Con- 
gress September  25,  1778     .     .     .7lb 

December  3,  1778.  p.  1289 
Health  of  Soldiers. 

"*  A  oopy  in  in  the  Library  "f  Oongraa.  Papers  of  the  Con- 

titU  ntaJ  Congress,  No.  7S,  wii,  folio  867.  It  DMMUTM  40  J  -■'>  0BM< 
"b  800  Pennsylvania  Archives,  vi,  765. 


History  of  the  Army  Medical  Department  During  the  Revolution        273 


235.  Directions  /  For  Preserving  /  The  Health  of 
/  Soldiers:  /  recommended  to  /  The  Consideration 
of  the  /  Officers  /  Of  the  Army  of  the  United  / 
States.  /  By  Benjamin  Rush,  M.  D.  /  Published  by 
Order  of  the  Board  /  of  War.  /  Lancaster:  Printed 
by  John  Dunlap,  /  In  Queen-Street.  /  M.DCC.LXX- 
VIII.  120  pp.  8. 

January  12,  1779.  51 

A  letter,  of  10,  from  Doctor  Shippen,  Director 
General,  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

Ordered,  That  two  members  be  added  to  the  said 
committee. 

The  members  chosen,  Mr.  (Thomas)  Burke  and 
Mr.  T(homas)  Adams. 

January  16,  1779.  73 

That  a  warrant  issue  on  the  treasurer,  in  favour 
of  Nathaniel  Eustis,  upon  the  application  of  Doctor 
Isaac  Forster,  deputy  director  general  of  the  eas- 
tern district,  agreeable  to  his  letter  of  the  28  Decem- 
ber last,  for  twenty-five  thousand  dollars;  and 

That  another  warrant  issue  on  Nathaniel  Apple- 
ton,  Esq.  commissioner  of  the  continental  loan  office, 
in  the  State  of  Massachusetts  bay,  in  favour  of  the 
said  Doctor  Isaac  Forster,  for  fifty  thousand  dol- 
lars; .  .  .  said  deputy  director  general  is  to  be 
accountable;  .     .     .    for  the  use  of  his  department. 

January  23,  1779.  no-ill 

Resolved,  That  the  director  general  (of  the  medi- 
cal department)  be  authorized  and  instructed  to  en- 
join the  several  deputy  directors,  physicians,  and 
surgeons  general  and  other  officers  under  his  super- 
intendence, to  attend  and  perform  such  duties  at 
any  post  or  place,  as  a  change  of  the  position  of  the 
army,  or  other  circumstances,  may,  from  time  to 
time,  make  necessary,  and  shall  be  required  by  the 
Commander  in  Chief,  notwithstanding  such  deputy 
director,  physician,  or  surgeon  is,  by  the  general  ar- 
rangement of  the  hospitals,  attached  to  a  particu- 
lar department;  and  that  in  case  of  any  dispute  con- 
cerning their  seniority  or  precedence,  the  director 
general  shall  determine  the  same  in  the  first  instance, 
the  party  supposing  himself  aggrieved  being  at  lib- 
erty to  appeal  for  redress  to  the  Medical  Committee. 

Resolved,  That  the  director  general  be  authorized 
and  instructed  to  supply,  for  the  use  of  the  regi- 
mental surgeons,  such  medicines  and  refreshments 
as  may  be  proper  for  the  relief  of  the  sick  and 
wounded  before  their  removal  to  a  general  hospital, 
and  to  be  dispensed  under  the  care  and  at  the  dis- 
cretion of  the  physician  and  surgeon  general  of  the 
army.72 

February  8,  1779.  151 

A  memorial  from  W.  Shippen,  director  general,  in 
behalf  of  himself  and  the  medical  officers  of  the  gen- 
eral hospital  in  the  middle,  eastern  and  northern 
districts,  was  read: 


Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

February  26,  1779.  255 

That  agreeable  to  the  application  of  the  Medical 
Committee  a  warrant  issue  on  the  treasurer,  in 
favour  of  Doctor  Jonathan  Potts,  ***  for  one  hun- 
dred and  fifty  thousand  dollars,  ***  he  to  be  ac- 
countable. 

March  6,  1779.  287 

Resolved,  That  a  warrant  issue  on  the  treasurer, 
in  favour  of  Dr.  Jonathan  Potts,  ***  on  the  applica- 
tion of  the  Medical  Committee,  for  one  hundred 
and  fifty  thousand  dollars,  .  .  .for  which  he  is 
to  be  accountable. 

March  10,  1779.  301 

That  a  warrant  issue  on  the  treasurer  in  favour  of 
Doctor  Jonathan  Potts,  .  .  .for  one  hundred  and 
fifty  thousand  dollars,  .    .    .  he  is  to  be  accountable. 

March  13,  1779.  313 

The  committee,  to  whom  was  referred  the  memo- 
rial of  Doctor  J.  Morgan,  late  director  general  and 
physician  in  chief  in  the  general  hospital  of  the 
United  States,  brought  in  a  report,  which  was  read: 73 

Ordered,  To  lie  on  the  table  for  the  perusal  of  the 
members,  to  be  taken  into  consideration  on  Thurs- 
day next. 

April  12,  1779.  440 

That  John  Nixon  Esqr.  Col.  Shee,  Andrew  Doz 
have  been  recommended  by  Francis  Hopkinson  Esq. 
Treasurer  of  Loans;  Hugh  Montgomery  by  Doctor 
Witherspoon,  and  John  Miller  Esq.  by  Doctor 
Ewing,  as  proper  persons  to  be  appointed  Commis- 
sioners for  destroying  the  Bills  to  be  taken  out  of 
circulation. 

April  15,  1779.  455 

A  memorial  from  the  staff  officers  of  the  general 
hospital  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

April  16,  1779.  460 

That  a  warrant  issue  on  the  treasurer,  in  favour 
of  Doctor  Jonathan  Potts,  deputy  director  general 
of  the  military  hospitals  for  the  middle  department, 
upon  the  application  of  the  Medical  Committee,  for 
one  million  of  dollars,  for  the  use  of  his  department, 
and  for  which  he  is  to  be  accountable. 

April  27,  1779.  515,  523-524 

That  a  warrant  issue  on  the  treasurer,  in  favour 
of  Isaac  Forster,  Esq.  ***  for  one  hundred  thousand 
dollars,  to  be  paid  agreeable  to  his  request  to  John 
Adams,  ***  the  said  Doctor  Forster  to  be  account- 
able.74 

The  Committee  on  the  Treasury  report, 

That  information  has  been  given  to  the  Board  of 
Treasury  that  Alexander  McKallaher,  the  deputy 
commissary  of  the  hospital  at  the  Yellow  Springs, 
has  made  a  practice  of  exchanging  the  hospital  stores, 
such  as  sugar,  molasses,  &c.  for  butter,  poultry,  eggs, 


72  This  report,  in  the  writing  of  James  Duane,  is  in  the  Papers 
of  the  Continental  Congress,  No.  33,  folio  277. 


73  See  under  June  12,  "post." 

74  Based  upon  Forster's  letters  of  March  9  and  10,  1779. 


274 

&c.  for  his  own  and  the  doctors'  table:  That  he  keep 
a  blooded  horse  in  the  guard  house,  and  a  mare  and 
colt;  and  a  hostler  at  his  quarters,  and  another  at 
the  hospital,  that  he  entertains  all  people  who  come 
to  the  hospitals  with  wine  and  toddy,  alledging  that 
he  is  allowed  to  do  so  by  Congress  or  Doctor  Ship- 
pen,  the  informant  is  not  certain  which. 

That  those  circumstances  have  given  occasion  to 
great  clamours  among  the  inhabitants  in  the  neigh- 
bourhood. 

That  it  is  convalescent  hospital:  That  they  have 
repaired  the  Farmer's  houses  in  the  neighbourhood 
for  their  own  convenience  at  the  public  expence; 
Whereupon, 

Ordered,  That  the  information  from  the  Commit- 
tee on  the  Treasury,  relative  to  Alexander  McKalla- 
her  be  referred  to  the  Medical  Committee,  and  that 
they  take  such  measures  for  ascertaining  the  facts; 
and  if  properly  supported  for  bringing  him  to  a  tryal, 
as  they  shall  judge  expedient.75 

May  5,  i?79-  549 

That  a  warrant  issue  on  the  treasurer,  in  favour 
of  Doctor  George  Smith,  for  the  sum  of  thirteen 
hundred  seventy  six  dollars  22  90,  equal  to  five  hun- 
dred and  fifty  pounds  ten  shillings,  New  York  cur- 
rency, reported  by  John  Welles  and  Edward  Chinn, 
Esquires,  commissioners  of  accounts,  at  Albany,  to 
be  due  to  him  for  cattle  and  forage  taken  by  order 
of  General  Schuyler  for  the  immediate  subsistance 
of  the  militia  and  other  troops  assembled  at  Fort 
Edwards  on  the  evacuation  of  Ticonderoga,  his  de- 
mand of  recompence  for  the  loss  of  fencing  being  re- 
jected.76 

May  17,  1779.  599 

Resolved,  That  a  warrant  issue  on  the  treasurer 
in  favour  of  John  Gibson,  auditor  general,  for  four- 
teen thousand  dollars,  being  the  sum  he  so  paid  to 
the  said  Scott,  on  the  order  of  the  said  Nathan 
Brownson,  on  the  1  September,  1777,  on  account  of 
the  State  of  Georgia,  and  for  which  the  said  State  is 
to  be  accountable.77 

May  28,  1779.  66 1 

A  petition  from  Isaac  Forster  and  others,  officers 
of  the  hospital  in  the  eastern  department,  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

June  5,  1779.  689 

A  letter,  of  this  day,  from  John  Morgan  was 
read;78  Whereupon, 

Resolved,  That  Saturday  next  be  assigned  for 
considering  the  report  of  the  committee  on  the 
memorial  of  Doctor  J.  Morgan. 


Annals  of  Medical  History 


June  12,  1779.  722>  723,  724 

That  upon  the  application  of  the  Medical  Com- 
mittee, a  warrant  issue  on  the  treasurer,  in  favour 
of  Doctor  Isaac  Forster,  deputy  director  general 
of  the  eastern  department,  for  one  hundred  and 
fifty  thousand  dollars,  .  .  .he  is  to  be  account- 
able.    . 

That  there  is  due  to  the  officers  and  privates  of 
Colonel  Lewis  Nicola's  invalid  regiment,  their  pay 
and  subsistance  for  the  month  of  April  last,  two 
thousand  three  hundred  and  seventy  three  dollars 
and  6  cjoths.     .     .     . 

Congress  took  into  consideration  the  report  of  the 
committee  to  whom  was  referred  the  memorial  of 
Doctor  John  Morgan,  late  director  general  and  phy- 
sician in  chief  of  the  general  hospitals  of  the  United 
States,  and  thereupon  came  to  the  following  resolu- 
tion: 

Whereas  by  the  report  of  the  Medical  Committee, 
confirmed  by  Congress  on  the  9th  of  August,  1777, 
it  appeared  that  Dr.  John  Morgan,  late  director 
general  and  chief  physician  of  the  general  hospitals 
of  the  United  States,  had  been  removed  from  office 
on  the  9th  of  January,  177",  by  reason  of  the  gen- 
eral complaint  of  persons  of  all  ranks  in  the  army, 
and  the  critical  state  of  affairs  at  that  time;  and 
that  the  said  Dr.  John  Morgan  requesting  an  in- 
quiry into  his  conduct,  it  was  thought  proper  that 
a  committee  of  Congress  should  be  appointed  for 
that  purpose:  and,  whereas,  on  the  18th  day  of 
September  last,  such  a  committee  was  appointed, 
before  whom  the  said  Dr.  John  Morgan  hath  in  the 
most  satisfactory  manner  vindicated  his  conduct  in 
every  respect  as  director  general  and  physician  in 
chief,  upon  the  testimony  of  the  Commander  in 
Chief,  general  officers,  officers  in  the  general  hospi- 
tal department,  and  other  officers  in  the  army,  shew- 
ing that  the  said  director  general  did  conduct  him- 
self ably  and  faithfully  in  the  discharge  of  the  duties 
of  his  office:  therefore, 

Resolved,  That  Congress  are  satisfied  with  the 
conduct  of  Dr.  John  Morgan  while  acting  as  director 
general  and  physician  in  chief  in  the  general  hospi- 
tals of  the  United  States;  and  that  this  resolution 
be  published.79 

June  15,  1779- "33 

A  letter,  of  this  day,  from  Dr.  J.  Morgan,  was 
read,  charging  Dr.  William  Shippen,  Jun.  in  the 
service  of  the  United  States,  with  mal-practices,  and 
misconduct  in  office,  and  declaring  hi^  readiness  to 
give  before  the  proper  court  having  jurisdiction,  the 
necessarv  evidence  in  the  premises  against  the  said 
Dr.  William  Ship} 

On  motion  of  Sir.  (Henry)  Laurens,  seconded  by 
Mr.  (William  Henry)  Drayton, 


71  The  committee's  recomnn-ndution  ma  that  "an  enquiry 
ought  to  ho  mad-  into  tin-  truth  of  the  aaid  churn.*,  without  de- 
lay; and  that  on  proof  thereof  the.  partial  charged  ought  to  be 
:••!  and  brought  to  trial."  The  resolution  adopted  waa  an 
anModmeat  offered  by  [Abridge  Oeny,  t"  be  found  In  hit  writing 
on  loho  260  1  -'  The  name  b  written  MoKaUaster  in  the  X 

ulnl  Mi  Kiilhi)n  r  in  the  nfflllimltttH  "I1"'1 

"Tin  I   May  :(.  it  iii  the  /'n;xrr»  of  the  Contim  nfcW 

No   1  10,  m   toUo  287 
"  This  report,  dated  May  17,  is  in  the  Papert  of  the  Continental 


Conantt,  No.  130,  III.  folio  .'ill.    The  account  with  the  - 
Georgia  ii  on  f ■  ■  1  •  • »  -'.it. 

letter  i-  In  tin-  Pupm  of  the  Conltnentai  Congress,  No. 
08,  folio  135 

7,Thi»  report,  In  the  writing  of  William  Henrj  Drayton,  la  In 
tin   Papers  of  tin  Contmmlai  Conor—,  No,  19,  IV.  folio  I 
was  piwontori  March  18,  t77'.».  aforgan'a  "Vindication,' 
In  No.  08,  folio  184. 

,0  Thi*  tetter  it  in  tho  Papert  of  th>  Continental  Cangnu,  No. 
63,  folio  120, 


History  of  the  Army  Medical  Department  During  the  Revolution         275 


Resolved,  That  a  copy  of  the  said  letter  be  trans- 
mitted to  the  Commander  in  Chief,  and  that  he  be 
directed  to  cause  such  proceedings  to  be  had  there- 
on, as  that  the  charges  alluded  to  in  it  be  speedily 
enquired  into,  and  justice  done. 

Ordered,  That  an  extract  of  the  letter,  with  the 
above  resolution,  be  transmitted  to  Dr.  Shippen. 

June  21,  1779.  754 

A  petition  from  the  surgeons  of  the  American 
navy  was  read: 

Ordered,  That  it  be  referred  to  the  Marine  Com- 
mittee. 

June  29,  1779.  782 

That  a  warrant  issue  on  the  treasurer,  in  favour 
of  Doctor  John  Warren,  for  seventeen  hundred  and 
forty  three  dollars  and  60/90,  in  full  of  his  account 
for  the  support  and  education  of  Joseph  Warren,  son 
of  the  late  Major  General  Warren,  to  April,  1779,  as 
allowed  by  the  council  of  Massachusetts  bay,  and 
that  the  said  sum  be  paid  to  David  H.  Conyngham 
authorised  to  receive  the  same.81 

July  19,  1779.  854 

A  letter,  of  19,  from  John  Morgan  was  read,  en- 
closing sundry  papers  relative  to  his  charges  against 
Doctor  Shippen:  82 

Ordered,  That  copies  thereof  be  sent  to  General 
Washington. 

August  3,  1779-  917 

A  letter,  of  28  July,  from  Doctor  W.  Shippen,  was 
read;  M  Whereupon, 

The  Medical  Committee,  to  whom  were  referred 
the  several  papers  and  memorials  from  the  officers 
of  the  Medical  department,  brought  in  a  report, 
which  was  read: 

Ordered,  That  the  same  be  taken  into  considera- 
tion, when  the  report  from  the  committee  on  a  far- 
ther allowance  to  the  officers  of  the  army  is  consid- 
ered. 

August  18,  1779.  978 

Resolved,  That  until  the  further  order  of  Congress, 
the  said  officers  be  entitled  to  receive  monthly  for 
their  subsistance  money,  the  sums  following,  to  wit, 
.     .     .  ensign  and  surgeon's  mate  100  dollars. 

September  3,  1779.  10 18 

A  letter,  of  2d,  from  the  hon*1-8  Sr.  Gerard,  was 
read,  soliciting  leave  for  Mr.  Witherspoon,  a  surgeon 
in  the  service  of  the  United  States  to  go  to  France: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

Resolved,  That  two  members  be  added  to  the  said 
committee. 

The  members  chosen,  Mr.  (Nathaniel)  Peabody, 
and  Mr.  (Frederick  A.)  Muhlenberg. 

September  29,  1779.  11 23 

That  on  the  application  of  the  Medical  Commit- 
tee, a  warrant  issue  on  the  treasurer,  in  favour  of 
Doctor  Jonathan  Potts,  .     .  for  one  hundred  and 

81  Based  upon  an  order  of  the  Council  of  the  State  of  Massa- 
chusetts of  May  3,  1779. 

82  Morgan's  letter  is  in  the  Papers  of  the  Continental  Congress, 
No.  68,  folio  133. 


fifty  thousand  dollars,  for  the  purchase  of  hospital 
stores,  and  for  defraying  the  necessary  expences  of 
his  department,  and  that  another  warrant  issue  on 
Thomas  Smith,  Esq.  commissioner  of  the  continental 
loan  office,  for  the  State  of  Pennsylvania,  in  favour 
of  the  said  Doctor  Jonathan  Potts,  for  seventy  one 
thousand  one  hundred  and  forty  four  dollars,  in  loan 
office  certificates  [for  the  purpose  of  discharging 
a  debt  due  to  Robert  Morris,  Esq.  for  twelve 
boxes  of  surgical  instruments  purchased  of  him  by 
the  said  Dr.  Potts;]  the  said  Doctor  Potts  to  be  ac- 
countable .... 

October  19,  1779.  1187 

Resolved,  That  Friday  next  be  assigned  for  taking 
into  consideration  the  report  of  the  Medical  Com- 
mittee on  the  medical  staff. 

October  22,  1779.  1200-1 

Congress  took  into  consideration  the  report  of  the 
Medical  Committee  on  the  medical  staff,  and  some 
time  being  spent  thereon, 

Ordered,  That  the  farther  consideration  thereof  be 
postponed. 

October  25,  1779.  1208 

A  letter,  of  this  day,  from  Doctor  John  Morgan, 
was  read:  84 

Ordered,  That  it  be  referred  to  a  committee  of 
three: 

October  27,  1779.  121 1 

Sundry  returns  of  the  state  of  the  hospital  in  the 
southern  department,  were  laid  before  Congress  and 
read : 

Ordered,  That  they  be  referred  to  the  Medical 
Committee. 

October  27,  1779.  1213-14 

According  to  order,  Congress  took  into  consider- 
ation the  report  of  the  Medical  Committee  and  af- 
ter debate, 

On  motion  of  Mr.  (Nathaniel)  Scudder,  seconded 
by  Mr.  (Samuel)  Holton, 

Resolved,  That  the  farther  consideration  thereof 
be  postponed. 

On  motion  of  Mr.  (Nathaniel)  Scudder,  seconded 
by  Mr.  (William  Churchill)  Houston, 

Resolved,  That  the  director  general,  each  of  the 
deputy  directors  general,  each  physician  and  sur- 
geon general,  each  senior  physician  and  surgeon, 
each  junior  surgeon,  each  apothecary  general,  each 
chaplain  and  each  apothecary's  assistant,  in  the 
hospital  of  the  United  States,  [to  the  north  ward  of 
the  river  Potomac  ]  shall  be  entitled  to  draw  clothing 
annually  from  the  stores  of  the  clothier  general,  in 
the  same  manner,  and  under  the  same  regulations  as 
are  established  for  officers  of  the  line,  by  a  resolu- 
tion of  the  twenty-sixth  day  of  November,  1777. 

Resolved,  That  until  the  further  order  of  Con- 
gress, the  said  officers  of  the  military  hospital  shall 
also  be  entitled  to  subsistence,  in  like  manner  as  is 
granted  to  officers  of  the  line,  to  be  estimated  in  the 
following  ratio: 

83  The  Shippen  letter  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  78,  XX,  folio  435. 

84  The  Morgan  letter  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  63,  folio  137. 


276 


Annals  of  Medical  History 


1st.  The  director  general  to  receive  the  same  sub- 
sistence as  a. colonel  in  the  line: 

2d.  The  deputy  directors  general,  the  physicians, 
surgeons  and  apothecaries  general,  the  same  as  lieu- 
tenant colonels: 

3d.  The  senior  physicians  and  surgeons  the  same 
as  majors: 

The  junior  surgeons  and  apothecaries'  assistants 
the  same  as  captains:  and  the  chaplains,  the  same 
as  chaplains  of  brigades  are  entitled  to  by  a  resolu- 
tion of  the  1 8th  day  of  August  last,  and  to  com- 
mence from  the  said  18th  day  of  August. 

Resolved,  That  the  mates  of  the  military  hospital 
shall,  during  service,  be  entitled  to  the  same  sub- 
sistence as  is  given  to  regimental  surgeon's  mates,  by 
the  resolution  of  the  18th  day  of  August  last. 

October  28,  1779.  12 16 

Resolved,  That  the  resolutions  of  yesterday,  re- 
specting the  officers  of  the  hospital  department  of 
the  United  States,  be  re-considered;  and  together 
with  the  report  of  the  xMedical  Committee  on  the 
hospital  department,  be  re-committed. 

Novembers  1779.  1237 

A  letter,  of  26  October,  from  Thadeus  Benedict, 
was  read,85  respecting  the  conduct  of  Dr.  Forster: 

Ordered,  That  it  be  referred  to  the  Commander 
in  Chief,  and  that  he  be  directed  to  cause  such  pro- 
ceedings to  be  had  thereon,  as  that  the  charges  al- 
luded to  in  it  be  speedily  enquired  into  and  justice 
done. 

Ordered,  That  the  Medical  Committee  transmit 
to  the  Commander  in  Chief  the  memorial  of  Thadeus 
Benedict  and  others,  against  Dr.  Forster,  and  such 
other  papers  as  they  may  have  respecting  that 
matter. 

November  5,  1779.  1240 

A  letter,  of  4,  from  Doctor  Forster,  was  read,  re- 
questing that  a  court  of  enquiry  may  be  appointed 
to  examine  into  his  conduct.86 

Ordered,  That  it  be  transmitted  to  the  Com- 
mander in  Chief. 

November  16,  1779.  1277 

The  Medical  Committee,  to  whom  were  referred 
the  resolutions  of  27  October  respecting  the  officers 
of  the  hospital  department,  together  with  the  re- 
port of  the  said  committee  on  the  said  department, 
which  was  re-committed,  brought  in  a  report: 

Ordered,  That  the  same  be  taken  into  considera- 
tion on  Friday  next. 

The  committee  to  whom  was  referred  the  letter  of 
25  October  last,  from  Dr.  J.  Morgan,  brought  in  a 
report;  Whereupon, 

Resolved,  That  it  be  recommended  to  the  execu- 
tive authority  of  the  respective  states,  upon  the  ap- 
plication of  the  judge  advocate  for  that  purpose,  to 
grant  proper  writs  requiring  and  compelling  the  per- 
son or  persons  whose  attendance  shall  be  requested 
by  the  said  judge,  to  appear  and  give  testimony  in 
any  cause  depending  before  a  court  martial;  and 
that  it  be  recommended  to  the  legislatures  of  the 
several  stab  try  powers  for  the 

•  ThU  Irttor  U  in  the  Washington  Papers,  No.  02,  folio  312. 


purposes  aforesaid  in  their  executive  authorities,  if 
the  same  be  not  already  done. 

November  19-20,  1779.  1293,  4-6 

Resolved,  That  the  report  of  the  Medical  Com- 
mittee on  the  hospital  staff  be  postponed  till  to- 
morrow, and  that  the  same  be  taken  into  consider- 
ation immediately  after  reading  the  journal. 

Congress  took  into  consideration  the  report  of 
the  Medical  Committee  on  the  hospital  staff;  Where- 
upon, 

Resolved,  That  the  director  general,  deputy  di- 
rectors general,  the  assistant  deputy  directors,  the 
physicians  and  surgeons  general  of  the  hospitals  and 
army,  the  senior  surgeons,  the  second  or  junior  sur- 
geons, the  apothecaries  general  and  apothecaries' 
mates  or  assistants,  the  hospital  chaplains,  regimen- 
tal surgeons  and  mates,  mates  of  the  military  hos- 
pitals, commissaries,  assistant  commissaries,  pay 
masters  and  stewards  of  the  hospital,  who  shall  have 
been  in  the  service  for  the  space  of  one  year,  and  are 
at  present  employed  in  the  same,  shall  each  be  en- 
titled annually  to  draw  cloathing  from  the  stores  of 
the  cloathier  general,  in  the  same  manner  and  under 
the  same  regulations  as  are  established  for  officers 
of  the  line  by  a  resolution  of  Congress  of  the  26  day 
of  November,  1777. 

Resohed,  That  until  the  further  order  of  Con- 
gress, the  following  officers  of  the  military  hospital 
shall  be  entitled  to  subsistence,  in  like  manner  as  is 
granted  to  officers  of  the  line  by  a  resolution  of  the 
1 8th  day  of  August  last,  and  in  the  following  pro- 
portions, viz.  each  deputy  director  general,  500  dol- 
lars per  month;  each  assistant  deputy  director,  400 
dollars;  each  physician  general  and  surgeon  general, 
500  dollars;  each  phy-sician  and  surgeon  general,  500 
dollars;  each  senior  surgeon,  400  dollars;  each  junior 
surgeon,  300  dollars;  each  apothecary  general,  400 
dollars;  each  apothecary's  assistant  or  mate,  100 
dollars;  each  commissary,  300  dollars;  each  commis- 
sary's assistant,  200  dollars;  each  clerk,  who  is  to 
be  pay  master,  200  dollars;  each  steward,  100  dol- 
lars; each  chaplain,  400  dollars; 

The  same  to  commence  from  the  18  day  of  August 
last. 

[Resolved,  That  all  the  said  officers  of  the  military 
hospital  and  all  regimental  surgeons  and  their  mates 
who  shall  continue  in  the  service  to  the  end  of  the 
present  war,  shall  be  entitled  to  quotas  of  lands 
respectively,  in  like  manner  as  is  stipulated,  in  favour 
of  officers  of  the  line  by  the  resolution  of  the 
day  of  ,  which  quotas  shall  be  ascertained  and 

apportioned   according  to   the   rate  of  subsistance 
above  granted.  ] 

Resohed,  That  all  mates  necessarily  employed  in 
the  military  hospital  or  army  shall,  dining  service, 
be  entitled  to  the  same  subsistence  as  is  raven  to 

regimental  mates,  viz.  100  dollars  per  month. 

Resolved,  That  the  remainder  of  the  report  be  re- 
committed. 

November  22,  1779.  ,297 

A  letter,  of  19th,  from  George  Morgan,  was  read: 

Resolved,  That  the  Medical  ( ommittee  be  instruct' 

ed  to  revise  the  several  resolutions  passed  respecting 

"  The  Forater  letter  in  in  the  Wathington  Papers,  92,  folio  311. 


History  of  the  Army  Medical  Department  During  the  Revolution        277 


the  hospital  department,  and  to  digest  and  arrange 
them  with  such  amendments  as  may  make  the  whole 
consistent  with  and  conformable  to  the  alterations 
made  by  Congress  in  the  original  system,  and  re- 
port the  same  to  Congress. 

November  24,  1779.  1303 

A  letter,  of  22d,  from  Doctor  J.  Morgan,  was 
read: 87 

Ordered,  That  the  same  be  transmitted  to  the 
Commander  in  Chief,  Doctor  Shippen  being  first 
furnished  with  a  copy  thereof. 

November  25,  1779.  13 10 

That  on  the  application  of  the  Medical  Commit- 
tee, the  following  warrants  issue  in  favour  of  Doctor 
Isaac  Forster,  deputy  director  general  of  the  eastern 
department,  amounting  to  one  hundred  and  fifty 
thousand  dollars,  for  the  use  of  his  department;  for 
which  he  is  to  be  accountable,  viz: 

December  10,  1779.  1366 

A  letter,  of  8,  from  D(avid)  Jackson  and  a  memo- 
rial from  the  officers  in  the  hospital  department, 
were  read:  88 

Ordered,  That  they  be  referred  to  the  Medical 
Committee. 

December  13,  1779.  1373 

The  director  general,  to  whom  was  referred  the 
report  of  the  commissioners  on  the  memorial  of 
Lewis  Weiss  in  behalf  of  the  single  brethren  of  Beth- 
lehem, having  reported  thereon,  and  the  said  re- 
port being  read:  89 

Ordered,  That  a  warrant  issue  on  the  treasurer,  in 
favour  of  Lewis  Weiss,  attorney  of  John  Bonn,  war- 
den of  the  single  brethren  of  Bethlehem,  for  three 
thousand  and  seventy  seven  dollars  and  60/90  for 
the  use  of  the  said  brethren,  being  in  full  of  their 
account  for  evacuating,  repairing  and  re-entering 
their  house,  which  was  used  as  a  general  hospital 
for  the  space  of  eight  months,  in  lieu  of  rent  and  all 
other  demands.90 

December  22,  1779.  1400 

A  letter,  of  20,  and  one  of  22d,  from  Doctor  Mor- 
gan, were  read:  91 

Ordered,  That  they  be  referred  to  a  committee  of 
three: 

December  24,  1779.  1409 

The  committee  to  whom  was  referred  the  letter 
of  20,  from  Dr.  Morgan,  brought  in  a  report,  which 
was  taken  into  consideration;  and  thereupon, 

Resolved,  That  on  the  trials  of  cases  not  capital 
before  courts  martial,  the  depositions  of  witnesses 
not  in  the  line  or  staff  of  the  army,  may  be  taken 
before  some  justice  of  the  peace,  and  read  in  evi- 
dence, provided  the  prosecutor  and  person  accused 
are  present  at  the  taking  the  same,  or  that  notice 
be  given  of  the  times  and  places  of  taking  such  de- 
positions to  the  opposite  party  four  days  previous 

87  The  Morgan  letter  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  63,  folio  143. 

88  Letter  of  Jackson  and  enclosures,  in  the  Papers  of  the  Con- 
tinental Congress,  No.  78,  XIII,  folio  125-33. 

88  Shippen's  letter,  dated  this  day,  is  in  the  Papers  of  the  Con- 
tinental Congress,  No.  19,  VI,  folio  513. 


thereto,  where  the  witness  resides  within  the  dis- 
tance of  thirty  miles  from  such  party,  and  six  days 
where  the  witness  resides  above  the  distance  of 
thirty,  and  not  exceeding  eighty  miles,  and  a  reason- 
able time  for  a  greater  distance. 

P-  1435 
SUMS  ADVANCED   IN  THE  HOSPITAL  DE- 
PARTMENT 
Feb.      26.  To  Jonathan  Potts,  deputy  di- 
rector    150,000 

March  10.  To  do 150,000 

April     16.  To  do 500,000 

Sep.       29.  To  do 221,144 

Jan.       16.  To  doctor  Isaac  Forster,  dep- 
uty director  eastern  district .        75,000 

April     27.  To  do 100,000 

June      12.  To  do 150,000 

Nov.     25.  To  do 150,000 

June     29.  To  S.  Kennedy  for  rent  of  hos- 
pital at  Yellow  Springs    .     .  5,000 
Dollars  1,501,144 
p.  1440 
FARTHER  SUMS  ADVANCED  IN  THE  PAY- 
OFFICE   DEPARTMENT 

Jan.        9  and  20 3857    5-90 

Feb.        9 2102  26-90 

March  30 2275    5-90 

April     12 2152  70-90 

May      13 2300    4-90 

June      12 2373    6-90 

January  1,  1780.  1 

A  letter,  of  30  December,  from  Doctor  J.  Morgan, 
was  read,  requesting  to  be  furnished  with  copies  of 
the  following  letters  and  returns  of  Doctor  W.  Ship- 
pen,  viz:  92 

Letters  previous  to  October  9,  1776,  on  which 
were  founded  the  resolves  of  that  day;  of  November 
1,  1776,  including  the  return  of  the  sick;  November 
9,  1776;  November  24,  1777,  and  return  of  the  sick, 
also  return  of  the  hospital  officers;  January  19,  1778, 
with  the  return  of  the  hospital  officers,  &c,  also 
Governor  Livingston's,  to  which  it  refers;  January 
26,  1778,  to  Francis  Lewis,  Esquire;  Whereupon, 

Ordered,  That  Doctor  Morgan's  request  be  com- 
plied with  and  that  those  of  the  papers  which  are  in 
the  possession  of  the  Medical  Committee  be  lodged 
in  the  Secretary's  office  for  that  purpose. 

January  3,  1780.  10-12 

According  to  order,  Congress  took  into  considera- 
tion the  report  of  the  Medical  Committee,  viz. 

That  each  and  every  officer  hereafter  mentioned 
and  described  in  this  resolve,  belonging  to  the  medi- 
cal department  in  the  hospitals,  or  army,  who  is 
now  in  the  service  of  the  United  States,  and  shall 
continue  therein  during  the  war,  and  not  to  hold 
any  office  or  profit  under  the  United  States,  or  any 
of  them,  shall  after  the  conclusion  of  the  war,  be 
entitled  to  receive,  annually,  for  the  term  of  seven 
years,  if  they  shall  live  so  long,  viz;  the  physicians 

90  This  report,  dated  December  4,  is  in  the  Papers  of  the  Con- 
tinental Congress,  No.  136,  III,  folio  873. 

91  Morgan's  letter  of  the  20th  is  in  the  Papers  of  the  Continental 
Congress,  No.  63,  folio  165. 

82  This  letter  is  in  the  Papers  of  the  Continental  Congress,  No. 
158,  folio  305. 


278 


Annals  of  Medical  History 


general,  surgeons  general,  the  physician  and  surgeon 
general  of  the  army,  the  deputy  directors  general, 
each,  a  sum  equal  to  the  half  pay  granted  and  ex- 
tended to  a  colonel  in  the  line  of  the  army  by  a  re- 
solve of  Congress,  of  the  15  of  May,  1778;  the  senior 
surgeons  and  physicians,  assistant  deputy  directors, 
and  the  apothecary  general,  each,  a  sum  equal  to  the 
half  pay  of  a  lieutenant  colonel,  granted  and  ex- 
tended by  the  resolve  aforesaid;  the  junior  or  sec- 
ond surgeons  of  the  hospitals  and  the  regimental 
surgeons,  each,  a  sum  equal  to  the  half  pay  of  a  ma- 
jor in  the  line,  granted  and  extended  as  aforesaid; 
the  mates  of  the  regimental  surgeons,  the  apothe- 
cary's mates,  or  assistants,  each  a  sum  equal  to  the 
half  pay  granted  and  extended  to  a  lieutenant  in 
the  line  of  the  army,  by  the  resolve  aforesaid;  the 
whole  of  the  foregoing  allowances  are  to  be  subject 
in  every  respect  to  the  same  rules,  restrictions  and 
limitations,  upon  which  the  half  pay  of  the  afore- 
mentioned officers  of  the  line  was  granted  and  ex- 
tended by  the  said  resolve,  of  the  15  of  May,  1778. 

That  each  of  the  aforementioned  and  described 
officers  in  the  medical  department,  or  their  legal 
representatives,  respectively,  shall  be  entitled  to  the 
like  quantity  of  lands  with  the  aforementioned  and 
described  officers  of  the  line,  in  due  proportion  to 
the  sums  granted  to  them  respectively  by  the  pre- 
ceding resolve,  upon  the  same  conditions,  and  sub- 
ject to  the  same  rules,  restrictions  and  limitations, 
as  the  grants  of  lands  to  the  aforementioned  officers 
of  the  line,  by  a  resolve  of  Congress  of  the  16  Sep- 
tember, 1776. 

On  the  question  to  agree  to  the  first  proposition 
for  granting  half  pay,  the  yeas  and  nays  being  re- 
quired by  Mr.  (Roger)  Sherman, 

So  it  passed  in  the  negative. 

On  the  question  to  agree  to  the  second  proposition 
for  granting  lands,  the  States  were  equally  divided, 
and  the  question  lost. 

January  27,  1780.  99 

That  the  Medical  Committee,  as  soon  as  they 
shall  judge  convenient,  give  directions  for  removing 
the  hospitals  in  or  near  Philadelphia,  to  some  other 
place,  where  wood  and  other  necessaries  may  be 
procured  on  more  reasonable  terms  than  in  the  city 
aforesaid : 

That  the  issuing  commissaries  be  respectively  di- 
rected not  to  deliver  rations,  or  parts  of  rations,  to 
any  hospital  commissary,  unless  on  returns  signed 
by  him  and  countersigned  by  the  principal  physician 
or  surgeon  of  the  respective  hospitals,  specifying  the 
nanus  and  stations  of  the  persons  for  whom,  and  for 
what  time,  the  rations  are  drawn;  and  that  the  hos- 
pital commissary  be  also  required  to  annex  to  each 
return  the  receipts  of  the  persons  to  whom  lie  shall 
have  delivered  the  provisions  drawn  on  the  last  re- 
turn: 


"  TMl  report,  in  Hi"  \iritinn  of  EQbricLge  <!■  rry,  is  in  the  Papers 

olio  123. 
MTHi  manorial,  dated  January  :t.  1780,  i->  in  il»'  Papers  0} 
.  No    11,  X,  folio  l-.'i;  tin-  letter  fr nih- 
il.•■  hoapttal  department!  dated  February  7,  1780,  La  in  the 

/  •    7s.  \X.  f,.1 

•'  Tlii*  report  li  in  the  Papon  0/  the  Continental  Congrats,  No. 
,  .  .  folio  79. 


That  the  commissary  general  of  issues  direct  the 
form  of  the  returns  and  receipts  aforesaid.93 

February  7,  1780.  130 

A  letter  from  sundry  officers  in  the  hospital  de- 
partment was  read: 

Ordered,  That  it  be  referred  to  the  Board  of  War, 
to  take  order. 

A  memorial  from  President  Wheelock,  of  Dart- 
mouth college,  was  read:  91 

Ordered,  That  the  same,  together  with  the  report 
of  the  committee  on  a  memorial  from  the  late  Doc- 
tor Wheelock,  be  referred  to  the  Board  of  War. 

February  9,  1780.  143 

That  on  the  application  of  the  Medical  Commit- 
tee, a  warrant  issue  on  the  treasurer,  in  favour  of 
Jonathan  Potts,  purveyor  general  in  the  middle  dis- 
trict, for  sixty  thousand  dollars,  to  defray  the  neces- 
sary expences  of  the  department;  and  for  which  sum 
he  is  to  be  accountable.95 

February  14,  1780.  166 
The  Board  of  Treasury  beg  leave  to  report 
That  a  warrant  issue  on  Thos.  Smith  Esq'  Com- 
missr  of  the  Continental  Loan  Office  for  the  State 
of  Pennsylvania  for  Thirty  six  thousand  nine  hun- 
M  ■  1  dred  dollars  in  Loan  Office  Certificates 
Negatived  m  favor  of  J0nathan  Potts  Purveyor 
General  of  the  Hospitals,  or  order,  for  which  sum 
the  said  Purveyor  General  is  to  be  accountable.96 

March  1,  1780.  220 

Two  letters,  of  February  4th  and  14,  from  Philip 
Turner,  were  read: 

Ordered,  That  they  be  referred  to  the  Medical 
Committee. 

March  18,  1780.  260 

That  on  the  application  of  the  Medical  Commit- 
tee, the  following  warrants  issue  in  favour  of  Jona- 
than Potts,  purveyor  general  of  the  hospitals,  for 
the  use  of  his  department;  and  for  which,  amount- 
ing to  forty  six  thousand  nine  hundred  dollars,  he  is 
to  be  accountable;  viz 

March  30,  1780.  317 

A  letter,  of  n,  from  Doctor  I.  Forster  to  the 
Medical  Committee  was  laid  before  Congress  and 
read. 

Ordered,  That  it  be  referred  to  the  Board  of 
Treasury. 

April  4,  1780.  326 

A  letter,  of  28  March,  from  Doctor  J.  Morgan, 
was  read.*' 

April  5,  1780.  330 

That  on  the  application  of  the  Medical  Commit- 
tee of  the  third  instant,  a  warrant  issue  on  Henry 

"This  report  in  in  the  Papers  of  A»  Continental  Congrtu, 
No.  13(1,  IV.  folio  01. 

"  Morgan'!  letter  i*  in  the  Papon  ../  tin-  Continental  Congress, 
No,  88,  folio  LOO. 

(Note)  \  letter  from  W.  EUekman,  dated  Iprfl  38,  I7sn.  :,,,- 
pean  to  have  been  read,  it  i*  in  Hi'-  Papon  «./  </,.  Continental 
Conor—,  No.  7s,  xix,  folio  811. 


History  of  the  Army  Medical  Department  During  the  Revolution        279 


Gardiner,  treasurer  of  the  State  of  Massachusetts 
bay,  in  favour  of  Isaac  Forster,  deputy  director  gen- 
eral of  the  hospitals  in  the  eastern  department,  for 
forty  thousand  dollars,  being  part  of  the  monies 
raised  in  the  said  State,  for  the  use  of  the  United 
States,  and  for  the  use  of  that  department;  for  which 
the  said  deputy  director  general  is  to  be  accountable. 

May  4,  1780.  412 

Ordered,  That  a  member  be  added  to  the  Medical 
Committee. 

The  member  chosen,  Mr.  (James)  Henry. 

May  10,  1780.  417 

A  letter,  of  this  day,  from  Doctor  J.  Morgan  was 
read,  requesting  "to  be  indulged  with  an  authenti- 
cated copy  of  his  Excellency  General  Washington's 
letter  to  Dr.  Shippen,  referred  to  in  the  General's 
letter  to  him  (Dr.  Morgan),  of  January  6,  1779, 
dated  about  the  beginning  of  November,  1776,  and 
enclosed  to  the  President  of  Congress  in  Doctor 
Shippen's  letter,  dated  9th  November,  1776:" 

Ordered,  That  Doctor  Morgan  be  furnished  with 
a  copy  of  the  said  letter,  agreeably  to  his  request. 

May  12,  1780.  425 

The  Board  having  considered  the  letter  of  William 
Rickman  Deputy  director  general  of  the  hospitals 
in  Virginia  referred  to  them  by  Congress  report 

That  the  said  William  Rickman  is  not  charged 
with  any  monies  in  the  Treasury  books,  [and  that  if 
he  has  received  any  monies  that  he  is  accountable 
to  the  Director  General  who  is  to  account  with  the 
United  States.] 

May  16,  1780.  430 

The  Board  on  the  references  relative  to  the  Chil- 
dren of  the  late  General  Warren  Report, 

That  the  accounts  for  the  Education  of  Joseph 
Warren  his  eldest  son  have  been  paid  to  Doctor 
John  Warren  up  to  April  1779  and  that  no  accounts 
have  Since  been  rendered, 

That  they  know  of  no  resolution  of  Congress  mak- 
ing provision  for  the  education  of  any  other  cf  the 
Children  of  the  said  late  General  Warren.98 

May  20,  1780.  442 

On  motion  of  the  Medical  Committee, 

Resolved,  That  on  the  application  of  the  Medical 
Committee,  the  Commercial  Committee  be  author- 
ised to  furnish  Doctor  Potts,  the  purveyor  general, 
with  two  hogsheads  of  sugar,  for  the  use  of  the  hos- 
pitals in  the  middle  district,  the  said  purveyor  gen- 
eral to  be  accountable. 

Resolved,  That  on  the  application  of  the  Medical 
Committee,  the  commissary  general  of  purchases  be 
directed  to  furnish  the  purveyor  general  with  two 
hogsheads  of  spirits,  for  the  use  of  the  hospitals  in 
the  middle  district,  the  said  purveyor  general  to  be 
accountable.99 

May  23,  1780.  447 

Congress  took  into  consideration  the  report  of  the 

88  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
136,  IV,  folio  303. 

w  This  report,  in  the  writing  of  Frederick  A.  Muhlenberg,  is 
in  the  Papers  of  the  Continental  Congress,  No.  22,  folio  89. 

100  This  report,  in  the  writing  of  Frederick  A.  Muhlenberg,  is  in 
the  Papers  of  the  Continental  Congress,  No.  22,  folio  87. 


Medical  Committee,  to  whom  was  referred  the  let- 
ter from  Governor  Trumbull,  of  the  ist  inst.;  and 
thereupon, 

Resolved,  That  the  director  general,  or  in  his  ab- 
sence, deputy  director  general,  of  the  hospitals  in 
the  eastern  district,  be  and  he  is  hereby  directed  to 
hire  a  suitable  house  at  or  near  the  port  of  New 
London,  in  the  State  of  Connecticut,  for  the  recep- 
tion of  such  sick  American  prisoners  as  shall,  from 
time  to  time,  be  exchanged  and  landed  in  that 
neighbourhood;  and  that  one  senior  surgeon  or  phy- 
sician, and  a  suitable  number  of  mates,  be  occasion- 
ally employed  therein,  as  the  number  of  sick  shall 
increase  or  diminish.100 

June  26,  1780.  562 

That  on  the  application  of  the  Medical  Commit- 
tee, a  warrant  issue  on  Abraham  Yates,  commission- 
er of  the  continental  loan  office  for  the  State  of  New- 
York,  in  favour  of  Robert  Johnson,  assistant  direc- 
tor of  the  hospitals  in  the  northern  department,  on 
account  of  Jonathan  Potts,  purveyor  general  of  the 
military  hospitals,  for  the  sum  of  fifty  thousand  dol- 
lars, one  half  of  which,  payable  in  loan  office  cer- 
tificates, and  the  other  half  in  current  money  of  the 
United  States,  to  be  applied  in  the  department  afore- 
said; and  for  which  the  said  Jonathan  Potts  is  to  be 
accountable.101 

July  1,  1780.  581 

A  letter,  of  this  day,  from  the  Board  of  War  was 
read: 

Ordered,  That  the  same  be  referred  to  the  Medi- 
cal Committee,  and  that  they  take  order  thereon. 

July  6,  1780.  589 

Ordered,  That  on  the  application  of  the  Medical 
Committee,  a  warrant  issue  on  the  treasurer,  in 
favour  of  Jonathan  Potts,  purveyor  of  military  hos- 
pitals, for  twenty  thousand  dollars  for  the  purpose 
of  purchasing  necessaries  for  the  hospitals  in  the 
middle  department;  and  for  which  the  aforesaid 
Jonathan  Potts  is  to  be  accountable.102 

July  7,  1780.  592 

Resolved,  That  a  member  be  added  to  the  Medi- 
cal Committee,  in  the  room  of  Mr.  J(ames)  Henry, 
who  is  absent: 

The  member  chosen,  Mr.  (Abraham)  Clark. 

July  18,  1780.  638 

Another  letter,  of  15,  from  General  Washington 
was  read,  enclosing  the  proceedings  and  sentence  of 
a  general  court  martial  on  the  trial  of  Doctor  W. 
Shippen,  Junr,  director  general  of  the  military  hos- 
pitals: 

Ordered,  That  the  consideration  thereof  be  as- 
signed for  to  morrow. 

Another  letter,  of  15,  from  General  Washington 
was  read,  respecting  the  hospital  department. 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee.103 

101  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
136,  IV,  folio  367. 

102  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
136,  IV,  folio  409. 

105  Washington's  letters  are  in  the  Papers  of  the  Continental  Con- 
gress, No.  152,  IX,  folios  25  &  19. 


280 


Annals  of  Medical  History 


July  19,  1780.  646 

According  to  the  order  of  the  day,  Congress  took 
into  consideration  the  proceedings  of  the  court  mar- 
tial on  the  trial  of  Doctor  W.  Shippen,  director  gen- 
eral of  the  hospitals,  and  some  time  being  spent 
therein; 

Ordered,  That  the  farther  consideration  thereof 
be  postponed  till  to  morrow. 

July  20,  1780.  648 

Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  court  martial  on  the  trial  of  Doctor 
Shippen;  and  having  made  some  farther  progress, 

Ordered,  That  the  farther  consideration  thereof 
be  postponed  till  to  morrow. 

July  21,  1780.  648 

The  Medical  Committee,  to  whom  was  referred 
the  letter  of  15,  from  General  Washington,  brought 
in  a  report,  which  was  read;  Whereupon, 

The  Medical  Committee  to  whom  was  referred 
the  letter  of  the  Commander  in  Chief  of  July  15th 
beg  leave  to  report, 

That  they  have  conversed  with  D.  Cochran  and 
other  gentlemen  of  the  Hospital  department  by 
whom,  and  the  many  distressing  accounts  the  Com- 
mittee almost  daily  receive  from  every  quarter,  it 
appears  that  the  department  is  in  want  of  almost 
every  article  necessary  for  the  comfortable  suste- 
nance of  the  sick  and  wounded  soldiery.  They  are 
therefore  clearly  of  opinion  that  a  sum  of  two  hun- 
dred thousand  dollars  is  immediately  necessary  to 
put  the  department  on  such  a  footing,  that  the  dan- 
ger the  General  apprehends  in  his  letter  may  be 
avoided.  They  beg  leave  to  refer  to  the  enclosed 
estimate  and  submit  the  following  resolution. 

Ordered,  That  a  warrant  issue  on  the  treasurer,  in 
favour  of  Jonathan  Potts,  purveyor  of  the  hospitals 
in  the  middle  district,  for  two  hundred  thousand 
dollars,  for  the  use  of  the  hospitals  in  the  middle 
district,  to  be  applied  as  the  Medical  Committee 
shall  direct;  the  said  purveyor  to  be  accountable.104 

The  Medical  Committee,  to  whom  was  referred 
the  letter,  of  15,  from  Doctor  Brown,  brought  in  a 
report,  which  was  read;  Whereupon, 

The  Medical  Committee  to  whom  D.  Will, 
Brown's  letter  of  July  15th  was  referred,  beg  leave 
to  report: 

That  thej'  have  conversed  with  D.  Brown  and 
find  that  his  circumstances  will  no  longer  permit  his 
continuance  in  the  service,  and  as  it  appears  to 
them  that  he  has  been  a  faithful  and  diligent  officer 
they  submit  the  following  Resolution. 

Resolved,  That  Congress  entertain  a  high  opinion 
of  the  abilities,  integrity  and  past  services  of  Doctor 
William  Brown,  physician  general,  but  as  his  pres- 
ent circumstances  will  no  longer  permit  his  continu- 
ance in  the  service,  his  resignation  he  accepted.105 

July  22,  1780.  654 

Congress  resumed  the  consideration  of  the  pro- 
ceeding of  the  court  martial  on  the  trial  of  Doctor 
Shippen,  and  having  made  some  farther  progress, 

Adjourned  to  10  o'clock  on  Monday. 

■   in  tin-  wniiiiK  nl  Frederick  A  MnhlantMg,  i<  in 
•  I  Ctmgrm,  No-  IV,  VI.  [oUo  187 
***  Tlii-  report,  la  tha  irritini  of  Fkadatiok    \    kfuhlanbafg,  is 


July  27,  1780.  676 

Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  court  martial  on  the  trial  of  Doctor 
W.  Shippen,  Junior;  and  some  farther  progress  be- 
ing made 

July  28,  1780.  677-8 

Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  general  court  martial  on  the  trial  of 
Doctor  W.  Shippen;  and  some  farther  progress  be- 
ing made  therein, 

Ordered,  That  the  farther  consideration  thereof  be 
postponed. 

July  29,  1780.  680 

Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  general  court  martial  on  the  trial  of 
Doctor  W.  Shippen;  and  some  farther  progress  be- 
ing made, 

July  31,  1780.  684 

Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  court  martial  on  the  trial  of  Doctor 
Shippen,  director  general;  and  some  farther  prog- 
ress being  made  therein, 

August  7,  1780.  708 

Ordered,  That  the  Medical  Committee  report  as 
soon  as  may  be,  the  state  of  the  military  hospitals 
within  the  State  of  Pennsylvania,  specifying  partic- 
ularly the  number  of  physicians,  surgeons,  mates, 
matrons  and  attendants  residing  in  Pennsylvania, 
and  the  places  they  are  employed  in,  and  also  the 
number  of  the  sick. 

August  10,  1780.  716 

W™  Shippen,  D.  G.  H.,  628,200  dollars,  Ren- 
dered accounts. 

August  16,  1780.  737,  8. 

A  letter,  of  15,  from  Doctor  W.  Shippen  was  read.10* 
Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  court  martial  on  the  trial  of  Doctor 
Shippen,  director  general,  and  having  gone  through 
the  evidence,  defence  and  judgment  of  the  court, 

August  18,  1780.  744,  5,  6 

Congress  resumed  the  consideration  of  the  pro- 
ceedings of  the  court  martial  on  the  trial  of  Doctor 
Shippen,  director  general,  when  a  motion  was  made 
by  Mr.  (Timothy)  Matlack,  seconded  by  Mr.  (Wil- 
liam  Churchill)  Houston,  as  follows: 

That  the  court  martial  having  acquitted  the  said 
Doctor  \\  .  Shippen,  the  said  acquittal  be  confirmed. 

A  motion  was  made  by  Mr.  (Abraham)  Clark, 
seconded  In  Mr.  (Nathaniel)  Folsom,  to  amend  the 
motion,  by  inserting  after  W.  Shippen,  these  words, 
"excepting  that  part  of  the  2d  charge  relating  to  his 
speculating  in  hospital  stores,  on  which  the  court 
judge  him  highly  reprehensible." 

The  court  martial  having  acquitted  the  said  Doc- 
tor \V.  Shippen,  Ordered,  that  he  be  discharged  from 
arrest. 

So  it  was  resolved  in  the  affirmative, 

in  tha  Paper*  aftlu  Contmmtal  Congrtu,  No.  19,  1.  folic  ■ 
M Shippan'a  latter  i^  in  tha  Paptn  a/tkt  Continmtal  Congrett, 
\\.  foUo  641. 


(Concluded  in  the  next  issue) 


MILITARY  SANITATION  IN  THE  SIXTEENTH,  SEVENTEENTH 

AND    EIGHTEENTH   CENTURIES1 

By  COLONEL  CHARLES  L.  HEIZMANN 

U.  S.  A.,  Retired 
SAN    FRANCISCO,    CAL. 


PART  I. THE  SIXTEENTH   CENTURY 

The  Siege  of  Metz,  1552 

THE  1 6th  century  was  eminently  one  of 
sieges,  from  which  date  the  origin  of 
modern  fortifications.  In  the  preceding  cen- 
tury the  proportion  of  sieges  to  battles  was 
nearly  as  1  to  1 ;  in  the  16th,  as  2  to  1 ;  and 
in  the  17th,  about  4  to  3.  Political,  econom- 
ical or  strategic  reasons  may  be  given  for 
these  differences,  but  underlying  them  will 
be  found  a  sufficient  explanation  in  the 
history  of  the  development  of  fire-arms. 
The  ramparts  of  a  town  became  the  best 
defensive  armor  against  the  gradually  in- 
creasing number  and  effectiveness  of  arque- 
buses and  cumbrous  pieces  of  siege  guns, 
few  of  which  could  be  brought  into  action 
in  the  field  on  account  of  the  crude  means 
of  transportation.  It  is  true  that  the  smaller 
fire-arms  were  not  in  general  use  until  the 
following  century.  As  late  as  1553  the  lance 
was  the  favored  weapon  of  the  French, 
the  pike  of  the  Swiss,  the  two-hand  sword 
of  the  Poles,  bows  of  the  English,  sword 
and  poignard  of  the  Italians,  halberd  of 
the  Germans,  pistols  of  the  Danes  and 
arquebuses  of  the  Spaniards.  Yet  one-third 
of  the  entire  force  of  40,000  fighting  men, 
gathered  by  Henry  II.  of  France,  March, 
1552,  to  invade  Germany,  possessed  arque- 

1  This  article,  which  appeared  in  the  Journal  of 
the  Military  Service  Institution  of  the  United  States, 
Vol.  xiv,  No.  Txiv,  July,  1893,  has  been  reprinted 
by  permission. 

2  One  fourth  of  the  remainder  of  Henry's  army 
had  pistols,  and  from  1200  to  1500  mounted  harque- 
busiers  had  guns  three  feet  long,  slung  to  the  saddle- 
bows. Slings,  long  disused,  were  said  to  carry  from 
500  to  600  paces,  and  ancient  Roman  machines  700 
yards;  crossbows  killed  point  blank  at  from  40  to 
50  yards,  elevated  at  from  120  to  160  yards. 


buses,  and  Montluc  relates  the  equipment, 
in  the  same  year,  of  twenty  men  of  each 
company  with  arquebuses  that  carried  400 
paces  from  point  to  point.2  Field  artillery 
was  comparatively  rare  during  the  whole  of 
this  period.  Rabutin,  who  details  the  ar- 
mament of  Henry's  army,  mentions  forty- 
three  cannon,  nearly  all  siege  guns.  On  the 
other  hand,  cities  of  any  importance  were 
provided  with  large  cannon,  and  as  these 
were  eventually  opposed  by  artillery  of 
similar  calibre,  more  numerous  because 
made  more  movable,  further  means  of  de- 
fense were  invented,  which  proved  a  tem- 
porary advantage  over  besieging  armies  in 
the  first  years  of  the  17th  century. 

Forts  and  arms,  however,  did  not  always 
determine  the  result.  Famine  and  disease 
were  just  as  fatal.3  Knowledge  of  the 
means  of  prevention  of  epidemics  and  of 
precautions  against  their  spread  was  very 
extensive  in  this  century.  Municipal  and 
royal  ordinances  regulating  the  police  of 
cities  in  time  of  peace  were  very  common.4 

The  application  of  them  in  a  besieged 
town  by  military  authority  ought  to  have 
been  easy,  yet  the  memoirs  of  the  time  are 
full  of  recitals  of  suffering  and  destruction 
due  to  their  neglect.  There  was  excuse  for 
the  absence  of  sanitary  measures  from  ar- 
mies in  the  field,  in  their  transitory  charac- 
ter, lack  or  weakness  of  medical  organiza- 
tion, and  general  ignorance  of  the  subject 

3  Of  57  besieged  towns,  24  were  carried  by  assault, 
20  capitulated  and  13  were  relieved  or  the  siege  aban- 
doned. 

4  The  Archives  curieuses  de  Vhistoire  de  France 
depuis  Louis  XI — Louis  XVIII,  par  L.  Cimbcr, 
Paris,  1834,  contain  (9th  vol.  1st  series)  a  valuable 
and  interesting  document  on  the  subject,  by  Claude 
de  Rubys,  being  the  history  of  the  pest  in  Lyons, 
1577- 


281 


282 


Annals  of  Medical  History 


as  affected  by  the  changed  condition  of 
living.5  Hence  the  dissipation  of  armies  was 
frequent,  on  account  of  the  want  of  food, 
the  appearance  of  disease  and  consequent 
desertions. 

The  gallant  array  of  Henry  II.  met  with 
this  fate  in  less  than  four  months,  although 
it  encountered  no  serious  military  obstacle, 
nor  fought  a  single  battle.  Its  historian  says 
that  the  camp  followers  outnumbered  the 
troops  proper,  a  common  occurrence  of 
those  days,  and  together  with  the  soldiers 
loaded  the  wagons  with  plunder  from  aban- 
doned houses,  thus  causing  disorder  and 
famine  in  the  camp.  Summer  approaching, 
on  account  of  the  great  heat  some  started 
to  march  at  2  a.m.,  and  remained  on  horse- 
back until  noon  before  they  were  lodged; — 
the  foot  soldiers  generally  began  the  march 
first  so  as  to  reach  their  destination  at  the 
same  time,  and  were  overcome  by  thirst; 
they  eagerly  filled  themselves  with  cold 
water  and  many  "fell  into  great  diseases, 
pleurisies  and  fevers,"  a  large  number  dying. 
Toul,  Metz  and  Verdun  were  the  trophies, 
but  France  was  exhausted  when  it  became 
known  in  July  that  the  Emperor  Charles  V. 
was  collecting  a  force  to  recapture  these 
places. 

Among  the  Emperor's  many  inheritances 
from  his  predecessor,  Maximilian  I.,  not  the 
least  were  regulations  for  military  organiza- 
tion and  discipline,  so  that  his  armies  were 
considered  in  these  respects  the  best  in 
Europe.  Leonhard  Fronsperger  in  1555 
wrote  a  work  on  Imperial  courts-martial, 
etc.,  in  which  are  found  sanitary  disposi- 

5  I  can  find  only  one  treatise  on  hygiene  specially, 
printed  in  the  16th  century, — Anton  Schneeberger, 
De  bona  militum  valetudine  conservanda,  1564,  a  copy 
of  which  is  in  the  Library  of  the  Surgeon-General's 
office,— and  a  chapter  in  a  surgical  work  by  N. 
Godin,  1558.  Occasional  orders  enjoining  cleanli- 
ness were  issued,  presumably  after  their  necessity 
became  manifest;  thus,  the  statute  of  the  English 
V.  in  the  early  15th  century,  at  Mans,  and 
one  of  Henry  VIII.,  in  1,-44,  prohibiting  "carrion, 
filth,  or  other  unwholesome  or  infectious,  stinking 


tions  for  the  Landesknecbte.  It  is  not  known 
how  far  or  often  these  were  carried  out,  but 
it  has  been  justly  said,  by  Froelich,  that  the 
instructions  for  physicians  and  surgeons  are 
the  origin  and  basis  of  the  present  medical 
regulations  of  the  German  army,  because 
no  such  existed  in  Germany  before,  and  be- 
cause there  is  so  great  a  resemblance  be- 
tween them  and  those  of  to-day; — indeed, 
the  latter  are  very  little  better  than  those 
that  an  enlightened  past  had  brought  to  a 
high  grade  of  perfection.  Another  authority6 
asserts  that  Charles  drew  physicians  and 
surgeons  from  all  sides  for  his  campaigns, 
and  that,  not  satisfied  with  garrison  hos- 
pitals, he  instituted  field  hospitals,  following 
the  example  of  his  grandmother,  Isabella  of 
Spain. 

The  custom  in  camp  was  to  send  the  sick 
and  wounded  to  the  baggage  train,  where 
they  were  cared  for  in  tents  by  the  physi- 
cian or  barber  and  nursed  by  women,  who 
then  constituted  a  large  following  of  armies. 
On  breaking  camp  the  light  sick  were 
transported  in  wagons  and  the  dangerously 
sick  sent  to  hospitals  in  the  nearest  towns. 
The  Landesknecbte  selected  from  among 
their  number  and  paid  in  common  a  Spital 
meister,  or  hospital  superintendent,  who 
looked  after  their  sick  in  hospital  or  on  the 
march,  providing  necessaries  and  waiting 
on  the  physician,  barber  and  women.  The 
meanest  duties  were  performed  by  women 
and  children. 

A  field  physician-in-chief  and  a  field- 
barber  were  attached  to  the  staff  of  the 
commanding  officer  of  each  Hauffen, — 5,000 

thing  to  be  near  lodgings,  and  the  same  to  be  bin  led." 
\ItOgether  there  were  printed,  mostly  after  Pare's 
I  it  ion,  4-j  works  or  parts,  011  militar\  surgery 
by  both  physicians  and  surgeons,  most  of  whom  had 
field  experience, — 1  on  military  pharmacy,  and  11 

on  various  military  diseases. 

8  L.  Thomas,  Lectures  mi  Fbistoire  de  la  medicine, 
Paris,  1885.  He  mentions  particularly  the  celebrated 

anatomist  Vcsalius  and  a  distinguished  Spanish  sur- 
geon, Daca  Chacon. 


Military  Sanitation 


283 


to  10,000  infantrymen;  a  physician  to  the 
field-marshal  of  cavalry,  and  a  field-barber 
and  assistant  to  the  chief  of  artillery.  All 
of  these  had  rank  and  pay  assimilated  to 
superior  officials.  To  each  independent 
troop,  each  infantry  company — about  200 
men,  and  each  squadron  was  assigned  a 
field-barber.  His  place  during  battle  when 
not  in  the  ranks,  was  with  the  rear  guard, 
and  he  ranked  between  clerk  and  halber- 
dier, according  to  Fronsperger,  after  the 
quartermaster  sergeant  and  before  a  cor- 
poral, according  to  others.  He  received  a 
salary  and  could  charge  a  soldier  for  special 
services. 

"The  physician-in-chief  must  have  been 
a  doctor,  or  one  who  had  recently  charge  of 
surgeons  or  field-barbers  by  State  authority; 
he  must  be  a  well-known,  skilful,  experi- 
enced and  cautious  man,  of  the  proper  age, 
upon  whom  all  barbers,  cutlers,  wounded, 
sick  and  stricken  could  rely  for  help  and 
counsel  in  time  of  need,  particularly  when 
they  are  shot,  cut,  bruised  or  broken,  or 
are  suffering  from  any  accidental  or  dis- 
abling diseases,  such  as  scalds,  fluxes, 
fevers,  and  similar  affections  that  occur 
among  soldiers.  His  duties  are  even  more 
extensive  in  that  he  should  inspect,  both 
when  the  regiment  is  organized  and  later 
at  monthly  muster,  the  instruments  and 
everything  pertaining  thereto,  and  when  he 
finds  anything  lacking  or  lost,  such  shall  be 
charged  to  the  field-barber,  to  make  up  the 
deficit.  When  this  cannot  be  done,  he  shall 
find  other  means  to  meet  emergencies.  On 
the  march  he  will  closely  attend  his  com- 
manding officer.  When  exigency  or  peril 
impends  from  the  enemy,  in  battle  array 
or  skirmishes  and  such  like,  he  shall  remain 
in  the  neighborhood  of  his  superior  military 
officer; — but  he  will  also  oversee  as  much  as 
possible  the  other  physicians,  surgeons  and 
the  like,  wherever  wounded,  etc.,  are  to  be 
attended,  and  he  shall  devote  his  care,  ad- 
vice and  skill  to  all  others,  particularly  be- 
cause he,  above  others,  is  ready  with  instru- 


ments, apothecaries  and  medicines  for  both 
internal  and  external  wounds  and  sickness. 

"He  should  also  with  all  diligence,  advise 
whether  a  leg,  arm  or  such  should  be  am- 
putated or  preserved  by  other  means. 
Further,  he  should  give  his  attention  to  the 
severely  wounded,  that  they  may  not  be 
left  too  long  on  the  lines  or  in  the  companies, 
but  immediately  carried  to  the  surgeons  and 
aided  by  beneficial  dressings.  On  the  march, 
when  it  becomes  important  to  have  a  field- 
barber  near  at  hand  or  available,  it  is  his 
business  to  see  that  one  is  stationed  between 
the  cavalry  and  infantry,  with  his  instru- 
ments. On  other  occasions,  in  camp  and 
quarters,  each  barber  remains  with  the 
troop  in  which  he  has  been  assigned  for 
duty.  Whenever  a  question  arises  between 
barbers  and  cured  soldiers  or  others,  as  to 
the  payment  to  be  made,  he  shall  settle  it, 
seeing  that  neither  too  much  nor  too  little 
is  given. 

"As  it  is  necessary  that  a  field-barber  or 
surgeon  serve  with  each  troop,  so  should 
each  Captain  be  careful  to  select  a  well- 
versed,  skilful,  experienced  and  trained  man, 
and  not  a  poor  beard-shaver  or  bath-boy 
as  often  happens  by  reason  of  favor;  thus, 
the  killing  or  maiming  of  good  soldiers  may 
be  prevented.  The  field-barber  should  be 
supplied  with  all  necessary  medicines  and 
instruments  in  a  field  wagon,  and  the  Cap- 
tain should  see  that  it  is  done.  He  should 
be  a  capable  Knecht,  to  help  in  necessity. 
His  duty  is  to  render  assistance  first,  when 
there  is  need,  to  those  of  his  own  troop, 
not  to  exact  too  much  from  anyone,  but  to 
treat  men  at  reasonable  and  like  rates.  He 
shall  have  his  lodging  at  night  at  the  com- 
pany pennant,  so  that  he  may  be  found  in 
necessity,  and  it  is  best  that  one  barber 
should  be  accessible  to  each  lodging  house, 
on  account  of  the  sick  and  wounded.  He 
shall  serve  with  his  troop  in  all  else  like  an 
ordinary  soldier,  and  he  shall  receive  double 
pay." 

The  greater  part  of  the  Imperial  army 


284 


Annals  of  Medical  History 


on  this  occasion  consisted  of  Landesknechte,1 
14  regiments  of  143  bands  or  companies, 
and  it  is  presumed  that  some  such  medical 
organization  obtained  among  them,  for 
Fronsperger  speaks  of  it  as  well  known,  not 
as  having  been  recently  introduced;  and  in 
1557  at  the  siege  of  St.  Quentin,  an  analo- 
gous arrangement  of  medical  officers  for 
the  English  ordnance  existed,  evidently 
copied  from  Maximilian's,  and  usually  cited 
by  English  authors  as  the  first  attempt  at 
the  formation  of  a  regular  medical  staff. 
The  remainder  of  120,000  men  was  made 
up  of  27  Spanish  companies,  16  Italian, 
more  than  10,000  cavalry  and  7,000  pioneers. 
There  were  140  pieces  of  artillery.  This 
army  was  said  to  have  been  larger,  by  15,000 
men,  than  any  army  gathered  by  Charles, 
and  twice  as  large  as  any  army  collected 
under  one  chief  afterwards  for  more  than 
one  hundred  years.  There  is  no  record  of  a 
medical  organization  other  than  the  Ger- 
man, but  it  is  probable  that  a  surgical  ser- 
vice existed  among  the  Spanish  troops, 
such  being  mentioned  in  1554  with  Daca 
Chacon  as  head,  and  among  the  Italians, 
who  employed  surgeons  for  campaigns  as 
early  as  the  13th  century,  and  combined 
them  in  bodies  for  sieges  in  the  previous 
century  and  even  before. 

To  meet  this  formidable  array  the  Duke 

7  Salignac  says  they  were  levied  in  the  manner 
and  numbers  of  the  Germans,  and  that  the  companies 
were  not  complete,  coming  recently  from  their 
country.  It  was  the  custom  to  enlist  Knechts  by  vol- 
untary engagement  for  the  war  only; — a  fixed  pay 
was  agreed  upon,  and  they  were  permitted  to  pillage 
and  demand  ransom.  There  arose  from  this  condot- 
lieri,  who  had  at  their  call  bodies  of  men,  of  varying 
numbers  according  to  the  price  paid,  which  were 
placed  at  the  disposition  of  princes  about  to  engage 
in  war.  There  was  no  medical  examination  of  a  re- 
cruit, and  when  a  Knecbl  was  permanently  disabled, 
lie  dragged  himself  to  his  home  as  best  he  could. 

1 P  curious:  biscuit,    fresh    beef,   salt 

■  ins;    salt     fish,    as 

cod,  marline,  salmon,  shad,  tunny,  anchovy,  sar- 
dines, herring;  al  ins,  rice,  garlic,  onions, 
prunes,  cheeses,  butter,  oil  and  salt;  pepper,  ginger, 


of  Guise  and  other  nobles  occupied  Metz, 
and  formed  and  drilled  in  guard  exercises 
12  companies,  in  all  4,500  to  4,600  foot,  444 
horse,  and  920  gendarmes  in  3  companies. 
The  military  student  ought  to  read  Sa- 
lignac for  the  particulars  of  preparation 
for  defense  made  by  the  active  genius  of 
this  young  man,  with  very  inadequate 
means; — the  repairs  to  the  fortifications 
with  the  aid  of  women  and  children,  making 
serviceable  old  and  badly  cast  cannons, 
construction  of  powder  mills,  razing  of 
suburban  gardens,  pleasure  resorts,  mills, 
etc.;  the  storing  of  grains  and  provisions, 
purchasing  in  his  own  credit  animals,  salt 
meats,  fish,  butter,  oil,  salt,  cheese,  rice, 
etc.,  enough  to  last  a  year8  purging  the  city 
of  superfluous  persons  and  things,  retaining 
and  organizing  1,200  artisans,  including 
carpenters,  masons  and  blacksmiths  to 
help  in  the  ramparts  and  artillery,  and 
armorers,  farriers,  bakers,  shoemakers  and 
hosiers,  a  limited  number  of  the  most  ex- 
pert and  best  provided  with  materials  to 
meet  the  necessities  of  the  soldiers; — the 
means  of  defense  adopted  in  the  event  of 
breaches,  or  in  case  the  walls  were  taken; 
the  rules  for  the  effective  guard  of  the 
walls,  for  cavalry  raids  in  large  parties  (100 
to  120  men),  and  in  small  (20  to  30  men) 
on  the  enemy's  supply  trains,  for  ambushes, 

cardamon  and  other  spices  "to  put  in  our  pastries, 
the  principal  ingredient  of  which  was  horse  meat, 
and  these  would  have  tasted  badly  without  them." 
Turnips,  carrots,  leeks,  etc.,  were  buried  in  the 
gardens  and  reserved  for  extreme  necessity.  Sir 
James  Turner  furnishes  even  a  larger  list  ol  articles 
to  be  provided  for  an  English  army  in  the  Held  in 
Elizabeth's  time,  including,  besides,  almonds,  chest- 
nuts and  hazelnuts,  honey  and  tobaccol  The  ordi- 
nary daily  ration  was  2  lbs.  of  bread,  I  lb.  of  llesli, 
or,  in  lieu  of  it,  1  lb.  of  cheese,  1  bottle  of  wine  or 
1  of  beer.  An  ensign  got  4  rations,  a  colonel  12.  "  'It 
is  enough,'  cry  the  soldiers,  'we  desire  no  mine.' 
It  is  enough  in  conscience;  but  this  allowance  will 
not  last  very  long; — they  must  be  contented  to 
march  sometimes  one  whole  week  and  scarce  get 
two  pounds  of  bread  all  the  while,  and  the  officers 
as  little  as  they." 


Military  Sanitation 


285 


for  the  interior  police  defining  the  relation 
of  citizen  and  soldier,  the  duties  of  the 
former  during  an  alarm  of  fire,  etc.,  and 
of  the  latter  to  suppress  disorder  at  any 
hour. 

Rabutin  visited  Metz  after  the  siege  was 
raised,  and  inspected  the  numerous  con- 
trivances hastily  made  to  meet  every  step 
of  the  enemy's  advance.  He  also  speaks  of 
them  somewhat  in  detail,  and  in  the  most 
admiring  terms,  especially  of  the  pyrotech- 
nical  inventions  of  M.  de  St.  Remy,  who 
was  among  the  besieged. 

The  energy  and  foresight  of  Guise  did 
not  stop  here.  Some  soldiers  of  Rodemar, 
who  had  joined  the  garrison  before  the  city 
was  invested,  were  taken  sick  with  a  con- 
tagious disease; — they  were  at  once  isolated, 
and  after  having  been  mustered,  were  or- 
dered to  rejoin  the  camp  of  M.  de  Chatillon, 
their  colonel.  To  the  surgeon  barbers  of  the 
city  he  advanced  money  to  provide  them- 
selves with  means  to  treat  wounds.  The 
pioneers,  under  the  provost,  were  ordered 
to  clean  the  city  often,  horses  and  carts 
being  supplied,  to  throw  carrion  and  all 
other  filth  out  of  the  city,  and  to  keep  the 
streets  always  clean.  When  a  soldier  was 
wounded  or  taken  sick,  especially  during 
the  night  watch  or  work  that  had  to  be 
done  in  the  rain  or  extreme  cold,  it  was 
ordered  that  he  be  carried  at  once  to  the 
hospital  and  then  treated  with  everything 
necessary;  and  the  pioneers,  when  taken 
sick  or  wounded  while  engaged  on  the 
ramparts,  were  to  be  sent  to  another  hos- 
pital. 

The  siege  began  October  20th,  but  the 
defense  was  so  well  conducted  that  a  breach 
was  not  effected  before  November  26th, 
by  means  of  a  constant  battery  of  40 
double  cannons  for  many  days.  It  was  as 
large  as  a  front  of  fifty  men.  The  besiegers 
found  behind  it  another  new  and  stronger 
rampart.    The    weather     now    became    so 

9  Frequent  mention  is  made  in  those  days  of  charla- 
tans following  in  the  train  of  an  army  to  practice 


cold  that  sentries  were  found  frozen  stiff, 
lance  in  hand.  The  wounded  in  both 
armies,  partly  on  this  account,  did  not  do 
well.  Some  of  the  imperial  officers  be- 
came dissatisfied  with  the  treatment  and 
sent  many  of  their  disabled  soldiers  to 
springs  of  their  native  country.  A  quack 
appeared  in  one  of  the  three  besieging 
camps,  named  Doublet,  who  met  with  such 
success  by  the  use  of  simple  water  dressing 
that  his  fame  spread.9  After  the  manner 
of  the  time  Guise  suspected  poison  in  the 
drugs  used  in  the  city,  and  sent  a  message 
to  the  king,  November  8th,  requesting  a 
new  supply.  Ambrose  Pare  was  intrusted 
with  the  commission,  and  repairing  to 
Verdun,  was  smuggled  into  the  city,  him- 
self, an  assistant  and  a  medical  outfit,  at 
midnight  on  December  8th,  by  an  Italian 
captain,  whose  services  were  purchased  by 
1,500  ecus,  an  easy  matter,  it  appears,  since 
the  Emperor  had  failed  to  keep  his  prom- 
ises of  payment. 

Pare's  reception  and  presentation  by 
Guise  to  the  princes  and  officers  on  the 
breach  are  historical,  and  his  recital  of  his 
labors  and  observations  is  classical. 

From  his  account  and  other  sources  it  is 
learned  that  at  this  period  in  France,  at 
least,  surgeons,  like  physicians,  in  armies 
were  not  obliged  to  attend  the  soldiers. 
A  few  men  of  considerable  merit  were  at- 
tached to  the  persons  of  captains  or  nobles, 
whom  they  followed,  and  upon  whom  they 
depended.  Pierre  Aubert,  in  his  capacity  of 
surgeon,  thus  served  the  Duke  of  Guise. 
When  a  campaign  ended,  usually  in  autumn, 
they  passed  the  winter  in  the  cities,  in  the 
pursuit  of  their  customary  civil  practice. 
However,  royal  ordinances  were  beginning 
to  be  issued  establishing  more  uniformity. 
In  1550  Coligny  inspired  a  decree  respecting 
infantry,  which  was  remarkable  in  that  it 
created  in  each  company  a  surgeon,  who 
was  to  take  care  of  its  sick  and  wounded 

on  soldiers  who  had  been  abandoned  by  their  com- 
rades. 


286 


Annals  of  Medical  History 


in  garrisons  and  campaign;  his  pay  was 
not  to  come  from  the  royal  treasury,  but 
from  a  tax  on  the  sum  total  of  the  pay  of 
the  company.  The  company  baker,  one  to 
each  company,  was  paid  in  the  same  way. 

The  obstinacy  and  cleverness  of  Guise 
irritated  the  Emperor  into  an  expressed 
determination  to  capture  the  city  by  force 
or  famine  at  the  cost  of  his  entire  army. 
This  becoming  known,  it  was  ordered  that 
no  one  in  the  city  should  eat  fresh  fish  or 
venison  or  game  birds,  for  fear  that  they 
might  be  pestiferous.  The  prescribed  rations 
must  suffice,  and  they  were  carefully  dis- 
tributed by  weight  and  measure  according 
to  the  quality  of  the  persons.  At  first  each 
soldier  received  two  pints  of  wine  and  two 
loaves  of  bread,  each  of  12  ounces; — from 
these  were  gradually  taken  J^  and  '  o  ounce. 
Pare  says  that  the  rations  were  diminished 
in  such  a  manner  that  what  had  been  given 
to  three  was  divided  among  four  persons, 
and  it  was  forbidden  to  sell  or  barter  any 
remnants. 

During  the  siege  prisoners  were  treated 
with  unusual  consideration.10  The  Emperor 
learning  from  some  of  his  own  soldiers 
returned  from  the  city  on  parole,  the  ex- 
treme measures  taken  by  Guise,  watered 
his  wine,  as  Pare  puts  it.  His  battery  of 
forty-five  days  had  not  advanced  and  his 
mines  had  all  been  successfully  met  by 
countermines.  The  intensely  cold  weather 
persisted  and  was  the  cause  of  crowding  in 
the  tents,  huts  and  holes  dug  in  the  ground 
and  covered  with  stubble.  Food  became 
scarce;  the  surrounding  country,  having 
been  previously  devastated  by  Henry's 
expedition  and  by  Guise's  orders,  furnished 
no  resources,  and  much  of  the  imperial 
supplies  had  been  ruined  by  rain  and  snow. 
Clothing  was  s<»  scarce,  bj  reason  of  raids 
on  the  trains,  thai  the  greater  part  of  the 
soldiers    were    barefoot.     In    consequence, 

10  At  the  Biege  of   Metz   in    14441  according  to 

Mat!,  1         ■         .,  the  besieged  amused  themselves 

owning  the  prisoners,  and  the  besieging  French 


congelations,  dysentery  and  scurvy  were 
soon  followed  by  typhus  fever,  and  the 
mortality  became  frightful.  The  least  esti- 
mate places  the  loss  in  the  imperial  army 
from  all  causes  at  20,000  men. 

On  the  sixty-fifth  day,  December  26th, 
the  retreat  was  ordered  and  begun.  It  was 
done  so  hurriedly  and  covered  so  badly  by 
the  Marquis  Albert  of  Brandenburg  that 
some  dead  were  left  unburied  and  many 
sick  and  wounded  were  abandoned  in  their 
tents.  Still,  part  of  the  disabled  were  car- 
ried away  in  carts,  but  the  roads  having 
been  made  impassable  by  the  advance  of 
cavalry  and  heavy  cannon,  a  number  of 
them  were  left  at  a  neighboring  abbey.  To 
these  Guise  sent  provisions  arid  ordered 
Pare  and  several  other  surgeons  to  attend 
to  their  wants.  A  sallying  party  came  across 
a  number  of  sick  Spaniards  in  wagons  and 
let  them  pass  unmolested.  Considering  these 
circumstances  Guise  departed  from  the 
custom  of  setting  fire  to  the  camps;  he  col- 
lected all  the  sick  and  sent  more  than 
three  hundred  to  the  hospital  in  the  city, 
where  many  lost  limbs  by  amputation;  he 
ordered  that  all  be  fed  and  treated,  and  he 
buried  the  dead.  After  a  few  days  he  sent  a 
trumpet  to  Alva,  the  imperial  general,  prom- 
ising safe  conduct  to  such  persons  as  he 
might  send  to  care  for  and  carry  the  sick 
and  wounded  prisoners  to  Thionville,  the 
objective  point  of  the  retreat,  stating  that 
he  would  gladly  supply  them  with  well 
covered  boats  for  the  purpose.  Alva  sent 
wagons  and  carts,  but  not  enough,  and 
Guise  supplied  the  deficiency.  Most  re- 
markable of  all,  the  imperial  general  asked 
that  a  sick  Spanish  officer  of  his  command 
be  permitted  to  enter  the  city  for  treat- 
ment, and  the  request  was  granted.  The 
demoralization  of  the  defeated  army  was 
so  great  that  the  French  cart  drivers,  on 
their  return,  found  the  roads  filled  with 
the  dead   bodies  of  those  who,   before  cx- 

followed  the  example,  l»>th  parties  disdaining  ran- 
som. 


Military  Sanitation 


287 


piring,  had  been  thrown  there  by  the 
Spanish  teamsters,  who  remarked  that  they 
were  not  paid  to  carry  dead  men. 

The  clemency  of  Guise  proved  a  disaster, 
which  would  have  been  averted  had  the 
same  precaution  been  taken  as  at  the  be- 
ginning of  the  siege.  No  serious  disease  had 
been  in  the  city  during  the  siege; — once 
it  was  raised,  the  importation  of  prisoners 
created  an  epidemic  of  typhus,  which 
spread  to  the  adjoining  villages. 

The  defense  of  Metz  became  the  marvel 
of  Europe; — it,  without  doubt,  saved 
France  from  destruction,  and,  in  many 
ways,  besides  political,  its  effects  were 
lasting.  Wounded  soldiers  were  afterwards 
better  treated,  as  at  the  siege  of  Thionville, 
1558,  and  after  the  capture  of  Havre,  1563, 
when  the  project  of  an  Invalides  originated 
with  the  queen  mother,  though  it  was  not 
carried  out  for  many  years.  The  humanity 
of  Guise  towards  both  well  and  sick  was 
remembered  at  the  siege  of  Therouanne, 
1553,  by  the  Spanish,  who,  on  being  re- 
minded of  it  by  the  French,  courteously 
saved  all  prisoners,  says  Brantome.  After 
this  the  custom  of  massacring  prisoners 
who  were  not  reserved  for  ransom,  gradually 
declined,  and  this  was  the  germ  from 
which  arose  the  spirit  that  culminated,  in 
a  little  over  300  years,  in  the  articles  of 
the  Geneva  Convention. 

It  was  noteworthy  also  in  the  prepara- 
tions made  for  it,  other  than  purely  mili- 
tary, of  food,  medicines,  hospitals; — in  the 
organization  of  artisans  and  surgeons;  in 
the  police  and  guard  regulations  and  pre- 
cautions against  disease.  The  first  sugges- 
tion of  transporting  wounded  soldiers  in 
numbers  by  water  was  made  here.  It  was 
the  first  occasion  when  the  services  of  the 
"father  of  modern  surgery"  were  univer- 
sally recognized  in  an  army,  by  soldiers  as 
well  as  officers,  services  that,  in  the  fol- 
lowing year,  rendered  his  opinion  of  such 
importance,  that  he  was  called  in  the  coun- 
cil of  war  to   determine  whether   Hesdin 


should  be  surrendered.  Only  a  few  months 
before  it,  at  the  siege  of  Damvilliers,  Pare 
first  tied  an  artery  after  amputation,  dis- 
carding the  cautery.  On  his  return  to  Paris 
from  Metz,  he  was  appointed  surgeon  to 
the  King,  the  highest  position  he  could 
covet,  and  about  this  time  his  surgical  dis- 
coveries began  to  spread  throughout  Eu- 
rope. 

PRINCIPAL  AUTHORITIES 

Salignac,  Le  siege  de  Metz  par  I'empereur  Charles  V. 
en  I'an  1552.  Carloix,  Memoires  sur  Vielleville.  Rabu- 
tin,  Commentaires  des  dernieres  guerres  en  la  Gaule 
Belgique.  Bourdeille,  abbe  de  Brantome,  Vies  des 
grandes  capitaines,  etc.  Pare,  Apologia  et  voyages. 
Fronsperger,  Von  kayserlichen  Kriegsgericbten,  Male- 
fitz  und  Schuldbandler,  etc.  Froelich,  Geschichte  des 
Konig.  Sachs.  Sanitdtskorps.  Montluc,  Commen- 
taires. 

PART  II. THE  SEVENTEENTH  CENTURY 

The  Last  Campaign  of  Gustavus  Adolphus 

Sully,  the  great  Minister  of  Henry  IV., 
under  date  of  1604,  wrote  in  his  Memoirs: 
"It  is  difficult  to  conceive  that,  in  a  na- 
tion, which  from  its  establishment  has  been 
engaged  in  war  and  has  indeed  pursued  no 
other  trade  than  that  of  arms,  no  care 
should  have  been  hitherto  taken  to  form 
and  methodize  them.  Whatever  related  to 
the  soldiery  of  France  was  offensive  and 
disgusting;  the  foot  soldiers  were  enlisted 
by  violence  and  made  to  march  by  a  cudgel ; 
their  pay  was  unjustly  withheld;  they 
heard  of  nothing  but  a  prison  and  had 
nothing  before  their  eyes  but  a  gibbet; 
their  treatment  drew  them  into  all  meth- 
ods of  desertion,  which  was  prevented  only 
by  the  prevots,  who  kept  them  in  the  camp 
like  men  besieged;  the  officers  themselves 
being  ill-paid  had  some  kind  of  right  to 
violence  and  plunder.  .  .  .  The  regulation 
(prompt  payment)  was  followed  by  another 
equally  just  and  equally  proper  to  recon- 
cile the  mind  to  the  trade  of  arms ;  by  this 
there  was  a  provision  made  for  the  relief 


288 


Annals  of  Medical  History 


of  soldiers  who,  by  wounds  or  sickness  con- 
tracted in  the  service,  were  unable  to  live 
either  by  war  or  labor;  things  were  man- 
aged so  that  in  their  state  of  misery  they 
wanted  nothing  either  for  their  maintenance 
or  care." 

By  the  establishment  of  the  Maison 
rovale  de  la  Cbarite  Chretienne  in  1600,  the 
droit  d'oblat  was  practically  abolished.  In 
virtue  of  this  right  the  kings  attached  dis- 
abled and  aged  officers  and  soldiers  to  con- 
vents as  lay  brothers,  who  rendered  service 
by  ringing  the  bells  and  sweeping  the 
chambers.  It  had  been  exercised  since  the 
beginning  of  the  Carlovingian  race  (752- 
987).  The  conception  of  a  house  in  common 
for  infirm  soldiers  is  older  than  Sully's 
institution.  Philip  Augustus  of  France 
(1 165-1223),  St.  Louis  in  1260,  the  charter 
of  the  chevaliers  de  I'Etoile  in  1352,  contem- 
plated it;  Mary  of  England  left  a  pro- 
vision in  her  will,  1558,  for  such  a  retreat, 
but  no  attention  was  paid  to  it,  and  the 
mother  of  Henry  III.  of  France  in  1563 
promised  it.  Many  private  individuals  fol- 
lowed the  example,  among  them  Sir  Thomas 
Coningsby,  who  founded  a  relief  for  worn- 
out  soldiers  in  Hereford  in  1614.  The 
Maison  decayed  insensibly  under  Louis 
XIII.,  a  pension  of  100  Iivres  was  substi- 
tuted in  place  of  the  oblat,  and  after  an- 
other ineffectual  attempt  by  the  organization 
of  the  Commandery  of  St.  Louis  in  1633, 
the  Invalides,  proposed  in  1659,  was  finally 
started  in  1676.  In  England  Chelsea  was 
foreshadowed  by  the  fourth  of  the  Articles 
for  his  Majesty's  Guard,  1663,  and  com- 
menced operations  in  1682;  Kilmainham  in 

"  In  the  time  of  I  lcnr\  II.  and  Francis  II.  disabled 
soldiers  and  widows  went  to  Fontainebleau  to  de- 
mand, not  pensions,  for  these  were  not  vet  in  vogue, 
hut  assistance.  The  cardinal  Minister  Claude  de  Lor- 
raine, for  an  answer,  caused  to  be  trumpeted  that 

who  Came  to  seek  relief  must  lease  in  twenty- 
four  hours,  under  pain  of  being  hanged,  and  he 
actually  had  a  giblx  I  erected  fur  the  purpose  under 
the  window  of  the  king  himself.  (Audoliin,  llistoire 
de  I' administration  de  la  guerre.) 


Ireland  in  1693,  and  Greenwich  for  seamen 
in  1695. 

From  remote  antiquity  disarmed  and 
maimed  soldiers  excited  general  commis- 
eration and  were  provided  for  in  various 
ways,  by  pensions,  assignment  of  lands, 
etc.  The  reasons  for  founding  asylums  for 
them  are  obvious  and  are  often  men- 
tioned; economy,  repression  of  beggary 
and  control  of  vices  that  were  especially 
prevalent  among  discharged  mercenaries.11 
No  permanent  means  were  taken,  however, 
other  than  civil  hospitals,  to  preserve  the 
soldier  temporarily  disabled  in  active  service, 
or  in  time  of  peace,  until  enlistment  became 
universally  established  for  a  period  longer 
than  the  duration  of  a  war,  and  when  offi- 
cers became  irremovable  and  dependent 
on  the  sovereign;  until  a  regular  royal  mili- 
tary service  was  organized  having  greater 
cohesion,  better  discipline  and  administra- 
tive departments,  than  were  possessed  by 
the  so-called  standing  armies  before  the 
17th  century.  For  France,  Richelieu  is 
credited  with  the  first  system  of  sedentary 
hospitals  on  the  frontier  near  the  scene  of 
war,  at  Pignerol,12  (1630)  for  the  army  in 
Italy.  They  were  all  placed  directly  under 
the  superintendence  of  a  cbirurgien-major 
des  cainps  et  armees,  the  first  appearance 
of  this  title.  Other  nations, — Austria,  Prus- 
sia, Denmark  and  Sweden, — continued  to 
furnish  treatment  for  sick  and  wounded 
soldiers  in  quarters  and  tents,  exceptionally 
in  civil  hospitals,  until  the  middle  of  the 
1 8th  century.  The  persistence  of  regimental 
hospitals  in  England  and  America  to  the 
beginning  of  the  present  century,  is  a  relic 
of  the  company  methods  of  the  16th  cen- 

It  was  found  during  the  reign  of  Louis  XIII. 
that  the  soldiers  dissipated  their  pension  and  lived 
in  misery  the  rest  of  the  time.  (Histoire  de  l' hotel 
des  Invalides,  in  Archives  eurieuses  etc.,  par  Danjon, 
2d  series.) 

12  About  70  miles  from  Cassl  the  seat  of  the  hnil 
military  operations.  The  building  was  standing  in 
1858. 


Military  Sanitation 


289 


tury.  Permanent,  or  garrison,  and  port,  or 
naval,  hospitals  soon  followed  the  seden- 
tary in  France  (probably  an  outcome  of 
epidemics),  but  nowhere  else,  and  were 
prominent  among  the  military  reforms  of 
Louvois  undertaken  with  the  aid  of  Mar- 
tinet and  Dumetz,  and  dating  from  1666, 
Vauban  designating  places  for  hospitals 
in  all  the  captured  towns  of  Alsace  and 
Flanders,  which  he  fortified. 

The  crude  field  system  of  the  16th  cen- 
tury was  limited  to  the  company  infirmary 
with  the  occasional  help  of  civil  hospitals. 
Sully's  establishment  at  the  siege  of  Amiens, 
1597,  was  an  improvement  on  this,  but  was 
not,  as  has  been  stated,  the  first  ambulance 
hospital.13  It  had  more  of  the  character  of 
a  field  hospital,  was  supported  by  a  tax 
on  sutlers,  tavern-keepers,  haberdashers, 
tailors  and  shoemakers  in  the  train  of  the 
army,  and  was  so  well  directed  by  Pigray, 
a  pupil  of  Pare  and  the  king's  physician- 
surgeon,  that  officers  preferred  to  be  treated 
there.  This  was,  nevertheless,  the  first  im- 
pulse given  to  a  change  of  former  methods 
and  to  the  development  of  organization,  on 
military  models,  for  the  care  of  sick  and 
wounded  soldiers,  whether  on  the  field  or 
at  sieges. 

Throughout  Europe  the  condition  of  the 
soldier  and  officer  began  to  improve  at  the 
beginning  of  the  century,  and  with  it  the 
quality  and  number  of  surgeons;  though 
medical  attendance  was  not  yet  deemed  a 
soldier's  right  or  even  a  department  of 
State. 

In  England  more  interest  was  taken  in 
military  matters  generally,  and  officers 
were  imported  to  instruct  the  militia,  there 
being  no  standing  army  proper.  Much 
confusion  prevailed   in   sanitation.   A   regi- 

13  A  similar  field  hospital  was  established  at  the 
siege  of  Rouen,  1591,  and  in  the  same  year  an  edict 
was  issued  taxing  wines  and  ciders  of  tavern-keep- 
ers, the  proceeds  to  be  applied  to  the  care  of  wounded 
soldiers. 

14  Another  account  describes  a  regiment  as  con- 


ment  of  2,200  men  sent  by  James  I.,  1620, 
to  the  Palatinate,  was  accompanied  by 
medical  officers,  but  there  was  no  allow- 
ance for  medicines  or  hospitals  in  the  esti- 
mates, though  made  by  experienced  officers, 
and,  consequently,  it  suffered  much  from 
privation.  The  original  plan  for  the  expe- 
dition contemplated  two  physicians,  two 
surgeons  and  two  apothecaries  on  the  staff 
of  the  general;  one  surgeon  to  a  regiment 
of  1,800  men  with  pay  of  captain,  and  one 
surgeon  to  each  company  of  150  men,  with 
pay  of  ensign;  one  surgeon  to  the  general 
of  horse,  one  to  each  cavalry  troop  of  100 
men,  and  one  surgeon  to  the  ordnance 
and  pioneers.14 

The  English  contingent  of  12,000  foot 
and  200  horse  to  Count  Mansfeld's  expedi- 
tion to  the  Netherlands,  1624,  was  likewise 
provided  with  surgeons,  but  owing  to  in- 
competency or  want  of  supplies  it  lost 
one-half  of  its  men  from  contagious  dis- 
eases. The  scarcity  of  surgeons  compelled 
Charles  I.  to  issue  a  mandate,  1628,  to  the 
Surgeon's  Company  to  "impress  sixteen 
able  and  efficient  chirurgeons"  for  the  force 
of  4,000  men  collected  for  the  relief  of 
Rochelle.  In  1630  the  Scotch  troops  in  Swe- 
den, 12,000  men,  had  four  surgeons  to  a 
regiment,  they  being  reckoned  among  the 
staff  officers,  who  took  priority  over  the 
line.  About  this  period  there  was  introduced 
in  the  army  in  Ireland  the  rank  of  physi- 
cian-general, surgeon-general  in  the  East 
India  service,  regimental  surgeon  in  the 
army  and  surgeon's  mate  in  the  navy. 
As  early  as  1614  there  was  improvement 
in  the  navy,  and  to  Woodall,  originally 
an  army  surgeon,  were  due  the  assignment 
of  surgeons  to  the  East  India  ships,  outfits 

sisting  of  13  companies,  one  being  the  colonel's; 
the  12  had  144  privates  each,  the  colonel's  192; 
each  company  had  a  surgeon;  on  the  regimental 
staff  was  a  chief  surgeon,  who  was  also  surgeon  of 
the  colonel's  company;  each  cavalry  troop  had  70 
cuirassiers  and  30  carbineers  with  one  surgeon. — 
Colburn's  United  Service  Magazine,  1836,  part  3. 


290 

of  medicine  chests,  and  the  introduction 
of  lime  juice  for  the  prevention  and  cure 
of  scurvy.  Not  until  1660  do  we  find  a 
purely  military  expression  of  interest  in 
the  hygiene  of  troops,  and  that  by  Sir 
James  Turner.  During  the  civil  war  the 
character  of  the  soldiery  was  necessarily 
of  a  higher  order  than  usual.  In  the  parlia- 
mentary ranks  Sydenham  rose  to  a  captain- 
cy and  subsequently  became  the  greatest 
observer  of  medical  facts  of  modern  times. 
On  the  royal  side  served  Harvey,  the  dis- 
coverer of  the  circulation  of  the  blood,  as 
physician  to  the  king,  and  Wiseman,  the 
best  English  surgeon  of  his  day.  The  pro- 
verbial conservatism  of  the  English  is  no- 
where shown  so  well  as  in  the  retention  of 
crossbowmcn  in  their  armies  as  late  as  1672. 
Among  the  Germans  the  soldiers  of  the 
duchy  of  Brandenburg  (united  with  that 
of  Prussia,  161 1)  were  at  first  in  a  wretched 
condition.  They  were  not  provided  with  a 
commissary,  and  in  1620,  when  Branden- 
burg raised  troops,  they  received  the  privi- 
lege of  begging  through  the  country;  the 
peasantry  were  ordered  to  give  each  sol- 
dier a  farthing  every  time  he  begged  and 
a  good  thrashing  with  a  stout  cudgel,  if  he 
was  not  satisfied.  The  few  permanent 
troops  before  1653, — the  Elector's  body 
guard  of  100  men  and  several  companies 
of  Landesknecbte  distributed  among  various 
strongholds, — grew  in  that  year  to  52 
troops  of  cavalry  and  82  companies  of  in- 
fantry, and  in  1656  to  a  force  of  25,000 
men.  The  system  of  company  field-barbers 
remained;  those  of  the  infantry  were 
equipped  and  armed  like  other  soldiers, 
though  their  rank  was  gradually  raised; 
they  received,  besides  their  pay,  a  small 
sum  I  nun  each  man,  "basin-money," 
lor  shaving  twice  a  week.  Each  regiment 
had  a  physician  on  its  staff  and  a  field- 
barber,  who  ;_r'>t  from  each  soldier  monthly 

u  Eventually  a  genera]  oversight,  only  in  time  of 
war,  was  given  to  the  physicians  of  the  guard,  thus 
malting  the  organization  more  of  a  unit.  These  phy- 


Annals  of  Medical  History 


a  stipulated  amount  to  support  the  regi- 
mental medicine  chest;  both  were  liable  to 
be  called  bjr  the  company  barbers,  the 
physician  only  in  severe  cases.15  During 
the  first  years  of  the  century  this  was, 
likewise,  the  status  in  the  Saxon  army,  in 
which  nursing,  by  the  consent  of  the  com- 
manding officers,  was  still  done  by  camp 
women  who  accompanied  the  soldiers  in 
the  march,  the  regulation  prescribing  that 
they  should  be  neither  "lewd  nor  sus- 
pected." Not  until  1683  was  there  a  head 
to  the  surgical  personnel,  a  staff  physician 
in  the  cortege  of  the  general,  whose  duty 
it  was  to  look  after  the  proper  arrangement 
of  the  hospitals  and  superintend  the  barbers 
and  apothecaries  therein.  There  were  also 
a  staff  field-barber  and  field  apothecary  in 
the  same  body.  The  rank  of  all  these  is 
supposed,  by  Froelich,  from  their  pay  and 
rations,  to  have  been  that  of  ensign.  The 
physicians  and  surgeons  furnished  their 
own  mounts,  and  received  forage;  the 
apothecary  was  allowed  six  horses  and 
two  wagons.  Toward  the  end  of  the  century 
there  appears  a  general  staff  surgeon,  and 
the  regimental  barber's  rank  was  then 
fixed  among  the  officers,  but  that  of  the 
company  barber  was  still  between  quarter- 
master sergeant  and  corporal.  That  the 
social  and  official  position  of  medical  men 
was  then  improved  is  shown  by  the  fact 
that  a  captain  of  horse,  Gehema,  became 
physician  to  the  Brandenburg  Guard.  In 
his  capacity  as  an  officer  of  the  line  he  had 
observed  the  faults  of  the  sanitary  service, 
particularly  manifest  in  the  character  of 
the  field  physician  and  subordinates  and 
of  medical  supplies,  and  he  made  vigorous, 
but  almost  ineffectual,  efforts  to  reform 
them.  Minderer,  a  Bavarian,  was  an  es- 
teemed writer,  [620,  on  military  medicine, 
including  hygiene  of  troops  and  camps,  and 
Purmann,  surgeon-major  in  the  I'randen- 
burg  army,  published  a  celebrated   treatise 

sicians  were  the  first  Prussian  Burgeons-general,  be- 
ginning With  Brandhorst. 


Military  Sanitation 


291 


on  military  surgery  in  1680.  The  medical 
organization  throughout  Germany,  how- 
ever, continued  to  be  so  poor  that  soldiers 
perished  in  numbers;  as  late  as  1685-87,  of 
3,000  men  sent  by  Saxony  to  aid  Venice  in 
the  Morea  only  761  returned. 

It  is  natural  to  infer  from  the  number 
and  variety  of  military  medical  institutions 
in  France,  that  there  was  greater  advance- 
ment in  the  quality  and  numbers  of  the 
personnel.  Before  the  invention  of  seden- 
tary hospitals  for  armies  in  the  field,  Rich- 
elieu began  to  improve  the  field  hospitals, 
first  at  the  siege  of  Rochelle,  1627,  by  at- 
taching to  them  persons  whose  duty  it  was 
to  distribute  bouillons  and  medicines,  even 
to  those  who  could  or  would  not  seek  their 
aid.  There  was  as  yet  no  uniformity  in 
the  assignment  of  physicians  and  surgeons,16 
but  they  became  more  an  official  part  of 
the  army.  In  1638  he  published  an  ordi- 
nance, which  is  considered,  by  Morache, 
as  the  foundation  of  true  ambulances. 
Like  the  system  adopted  at  the  siege  above 
mentioned  it  provided  Jesuits  and  cooks  to 
give  potages  and  bouillons  to  the  sick  who 
did  not  want  to  go  to  the  field  or  sedentary 
hospitals,  and  a  surgeon  and  apothecary; — 
a  large  army  was  to  have  4  priests,  a  lay 
brother  and  a  cook  with  5  assistants,  2 
wagons  with  food  and  six  sheep; — small 
armies,  3  priests,  a  cook  with  3  assistants, 
1  wagon  and  three  sheep.  The  priests  were 
to  look  after  the  spiritual  welfare  of  the 
sick.  The  majority  of  surgeons  of  hospitals 
and  regiments  were  members  of  the  College 
of  St.  Come,  Paris;  and  Percy  says  that  in 


the  latter  half  of  the  century,  there  was  no 
surgeon  of  any  merit  or  reputation,  who  had 
not  served  in  the  armies,  such  service  being 
the  readiest  means  of  obtaining  employ- 
ment. Instances  are  recorded  of  men  from 
the  rank  of  private  rising  to  distinction  in 
science  and  in  medicine  and  surgery,  no- 
tably the  philosopher  Descartes,  whose 
mathematical  and  physical  discoveries  and 
physiological  observations  place  him  among 
the  promoters  of  medical  science,  and 
Jacques  Beaulieu,  a  famous  Iithotomist. 
Richelieu  also  organized  the  administrative 
departments  generally,"  and  the  details  of 
the  edicts  affecting  them  were  admirable, 
though  experimental  and  not  always  suc- 
cessful in  results.  During  the  retreat,  in 
1635,  of  the  army  of  la  Valette  on  the 
Rhine,  the  hospitals  were  still  unorganized 
and  there  was  no  transport  service  for  the 
wounded.  It  was  on  this  occasion  that  the 
young  Turenne  having,  as  was  customary, 
several  carts  loaded  with  personal  baggage, 
plate,  etc.,  ordered  the  contents  to  be  thrown 
away  and  the  carts  filled  with  wounded;  he 
also  picked  up  bodily  a  wounded  soldier  and 
tied  him  on  his  own  horse,  which  he  led  to 
a  place  of  shelter.  The  medical  service  ex- 
cited in  1667  the  personal  interest  of 
Louis  XIV.  so  much  that  he  sent  for  three 
of  the  most  skilled  surgeons  of  Paris  for 
the  army  in  Flanders, — Turbiere,  to  whom 
was  first  given  the  title  of  chirurgien-major 
consultant  des  camps  et  armees,  Bienaise,  re- 
nowned as  the  most  intrepid  operator  of 
the  century,  and  Gayant,  who  was  the 
first  surgeon  to  be  admitted  to  the  Acad- 


16  Thus,  this  year,  2  surgeons  to  the  Chevaux 
Legers, — 212  men;  1  to  a  company  of  Mousquet aires, 
— 343  men;  2  surgeons  and  1  physician  to  the 
guards, — 4,602  men;  1  physician  and  no  surgeon  to 
the  Suisses, — 2,516  men;  1  surgeon  to  the  Gardes  du 
Corps, — 145  men;  many  organizations  had  neither 
physician  nor  surgeon. 

"Troops  in  garrison  were  supplied  with  bread  in 
kind  by  a  contractor,  its  cost  being  withheld  from 
the  pay.  Troops  on  the  march  were  supplied  with 


larger  rations  at  the  expense  of  the  municipalities: 
daily  for  each  man,  2  pounds  of  bread,  1  pound  of 
meat,  salt,  vinegar,  and  one  pint  of  wine,  fuel  for 
light  and  heating,  and  the  loan  of  table  linen,  a 
bowl  and  a  glass; — forage  was  also  to  be  supplied 
to  the  horses.  During  the  campaign  the  system  of 
contracts  on  a  large  scale  was  followed  to  furnish 
everything  including  transports,  the  contractor 
being  represented  by  a  general  des  vivres,  who  had 
under  him  a  large  personnel. 


292 

emy  of  Sciences.18  By  1674  lt  had  so  grown 
and  was  so  well  managed  that  at  the  battle 
of  Seneffe,  the  Intendant  Robert  could  dis- 
tribute in  three  villages  230  military  sur- 
geons assisted  by  nurses,  with  the  necessary 
material  to  care  for  an  exceptionally  large 
number  of  wounded.  In  1683  it  was  ordered 
that  during  a  campaign  the  sick  be  lodged 
before  the  officers. 

The  Thirty  Years'  War  brought  Sweden 
into  prominence  as  a  military  nation,  and 
its  most  brilliant  achievement  was  the  last 
campaign  of  Gustavus  Adolphus,  beginning 
June,  1630,  by  the  landing  in  Pomerania 
of  an  army  of  8,000  men,  reinforced  at  first 
by  six  Scotch  regiments,  about  7,000  men. 
Of  this  force  both  regiments  and  companies 
of  infantry  and  cavalry  varied  in  the  num- 
ber of  men.  The  differences  were  more 
marked  in  the  infantry,19  but  four  surgeons 
were  always  among  the  regimental  staff 
officers  of  both  arms,  as  well  as  a  quarter- 
master (ranking  between  major  and  cap- 
tain), a  provost  (and  his  archers),  a  re- 
corder, two  chaplains,  eight  sutlers  and  a 
drum-major.  All  soldiers  had  swords,  long 
swords  or  sabres.  Two-thirds  of  the  foot 
were  armed  with  matchlock  muskets,  the 
forked  rest  being  suppressed,  and  cartridge 
boxes  instead  of  shoulder  belts;  and  one- 
third  with  pikes  1 1  feet  long,  the  iron  part 
being  2  feet  long  and  4  inches  broad  at 
the  widest  part.  The  cuirasseurs  had  car- 
bines and  two  pistols  each,  the  dragoons, 
or  light  cavalry,  light  muskets  and  axes. 
Armor  was  then  falling  into  disuse,  because 
it  could  be  easily  penetrated  by  the  heavy 
bullets; — the  head  only  was  specially  pro- 
tected by  a  helmet  or  iron  cap,  the  jackets 

18  Gui  Patin,  Lettres,  who  had  no  special  regard 
for  surgeons  as  a  class,  speaks  of  them  in  the  highest 
terms,  and  adds  that  it  was  rumored  that  the  king 
it  the  same  time  had  sent  for  a  good  physician  to 
govern  the  army  hospitals.  It  was  the  custom  then, 
and  it  lasted  many  years  thereafter,  for  physicians 
to  superintend  the  work  of  surgeons,  there  being 
the  greatest  distinction  between  the  two. 


Annals  of -Medical  History 


being  of  sheep-skin,  excepting  those  of  the 
cuirasseurs,  who  had  simple  breastplates. 
The  infantry  company  was  in  six  ranks, 
the  cavalry  in  four  and  two  squadrons. 
The  artillery  pieces  differed  in  calibre,  the 
novel  feature  being  the  field-guns  worked 
by  the  infantry.  These  consisted  of  a  thinly 
beaten  cylinder  of  copper,  the  chamber 
reinforced  by  four  bands  of  iron,  and  the 
whole  wound  by  rope  and  covered  with 
rawhide; — they  were  mounted  on  carriages 
so  light  that  two  men  could  drag  and 
manipulate  a  gun,  and  they  were  very  slow 
in  heating.  The  effects  of  this  artillery  are 
graphically  described  by  Munro,  a  surgeon 
of  McKay's  Scotch  regiment. 

"  It  is  thought  the  invention  of  cannon 
was  first  found  at  Nuremberg  for  the  ser- 
vice of  man;  being  at  first,  for  a  long 
time,  used  for  battering  down  of  walls 
and  cities,  and  for  counter-batteries,  till 
at  last  they  were  used  in  the  field  to 
break  the  squadrons  and  battailles  of 
horse  and  foot;  some  carrying  pieces 
called  spignards,  of  four  foot  and  a  halfe 
long,  that  shot  many  bullets  at  once  no 
greater  than  walnuts;  —  and  how  soon 
the  trumpet  did  sounde,  the  enemy  wore 
thundered  on,  first  with  these  as  with 
showers  of  hailstone,  so  that  the  enemies 
were  cruelly  affrighted  with  them,  men 
of  valour  being  suddenly  taken  away, 
who  before  were  wont  to  light  valiantly 
and  long  with  sword  and  lance,  more  for 
the  honour  of  victory  than  for  any  desire 
of  shedding  of  blood;  but  now  men  were 
martyrised  and  cut  down  at  more  than 
half  a  mile  of  distance  by  these  firearms 
and  thundering  engines  of  great  cannon 
that  sometimes  shote  fiery  bullets  able  to 

19  From  a  note  found  among  tin-  papers  "I    \\>1 
Oxcnstiern,  dated   1632,  it  appears  that  some  regi- 

ments  had  12  companies  and  1,787  men;  others,  ti 

companies    and    1,533    men;   others,    13   companies 

and  i,i)io  men;  others,  1 2  companies  and  1,824  men. 
Since  1614  the  company  had  varied  from  120  to 
140  men. 


Military  Sanitation 


293 


burne    whole    cities,    castles,    houses    or 
bridges,  where  they  chance  to  fall; — and 
if  they  happen  to  light  within  walls  or 
amongst  a  brigade  of  foot  or  horse,  as 
they  did  at  Leipsigh  on  the  grave  Van 
Torne  his  brigadd,  they  spoil  a  number 
at  once,  as  doubtless,  the  devilish  inven- 
tion did  within  Walestine." 
The  opposing  imperial  infantry  regiments 
had  6  companies  of  300  men,  each  company 
having  a  surgeon.20  One  half  of  the  soldiers 
had  very  heavy  matchlocks,  a  forked  rest 

4  feet  long  and  a  sabre  of  the  same  length, 
the  cartridges  being  carried  in  metal  or 
wood  boxes  on  a  leather  shoulderbelt; — 
the  other  half  had  pikes  15  to  18  feet  long 
and  swords; — both  had  helmets,  but  the 
pikemen  had  breastplates  and  mailed 
aprons  as  well.  They  were  in  10  ranks.  A 
cavalry  regiment  had  5  companies  of  100 
men  each,  and  no  surgeon  is  mentioned  in 
its  organization; — the  cuirasseurs  were 
weighted  down  by  complete  armor,  a  long 
sword  and  two  pistols  and  fought  in  8 
ranks; — the  carabineurs  had  pistols,  sabres 
and  carbines,  helmets  and  breastplates,  in 

5  or  6  ranks,  and  the  dragoons,  in  the  same 
number  of  ranks,  were  like  the  infantry, 
except  that  they  were  mounted  and  had 
a  lighter  musket.  Drills  and  exercises  in 
this  army  were  very  minute  and  manoeuvres 
were  very  slow. 

At  this  period  troops  subsisted  mainly  on 
the  country  and  plunder,  but  Gustavus 
Adolphus  made  efforts  to  deprive  his  cam- 
paigns of  the  appearance  of  incursions; — 
he  combined  his  troops  in  marching,  fight- 
ing and  feeding,  established  magazines  and 
distributed  daily  rations  of  bread  and  meat. 
There  was  no  separate  commissary  officer, 
each  general  acting  in  that  capacity.  His 
Articles  of  War  are  very  explicit,  prohib- 
iting pillage  without  leave  under  penalty 

20  Some  writers  assert  that  the  imperial  armies 
had  no  surgeons; — all  seem  to  base  their  opinion 
on  the  anecdote  of  Tilly  being  wounded  at  Leipsic 
and  compelled  to  seek  a  surgeon  at  Halle  in  his 


of  death; — quarrels  over  spoils  were  pun- 
ished by  seizure  of  the  goods,  which  were 
devoted  to  the  "next  hospital"; — civil 
hospitals,  except  when  used  for  offensive 
purposes,  were  expressly  reserved  from 
pillage,  as  also  churches,  schools  and  mills; — 
churchmen,  the  aged,  maids  and  children 
were  shielded;  ordnance,  munitions  of  war 
and  food  were  to  be  left  for  the  use  of  the 
army,  exempted  from  pillage,  and  one  tenth 
of  his  spoil  each  soldier  was  to  give  to  the 
sick  and  wounded  in  the  hospitals. 

Billeting  was  at  its  height,  and  the  custom 
was  to  leave  the  sick,  wounded,  prisoners 
and  heavy  baggage  in  a  captured  town  with 
a  small  garrison,  the  disabled  to  be  treated 
in  the  civil  hospitals.  This  was  often  diffi- 
cult, as  appears  from  an  edict  of  the 
Elector  John  George  of  Saxony,  for  Dres- 
den, after  the  battle  of  Leipsic,  Sept., 
1 63 1,  mentioned  by  Froehlich.  Wagons  were 
used  in  both  armies  for  carrying  the 
wounded,  and  an  instance  is  related  of  a 
badly  wounded  prisoner  being  transported 
to  Pappenheim's  quarters  on  two  pikes.21 

Gustavus  made  it  a  rule  to  gather  the 
enemy's  wounded  and  bring  them  to  camp, 
whence  they  were  sent  to  hospitals  in  the 
neighboring  towns.  He  was  anticipated  in 
this  by  Henry  IV.  of  France  during  his 
campaign  in  Flanders,  where  he  commanded 
besides  that  the  wounded  prisoners  receive 
without  distinction  the  same  treatment  as 
his  own  men.  Indeed,  the  sentiment  of  hu- 
manity toward  an  afflicted  enemy,  though 
far  from  universal,  was  not  uncommonly 
exhibited  during  the  Thirty  Years'  War, 
and  several  instances  are  related  as  antici- 
pating in  a  measure  the  Geneva  Conven- 
tion. At  the  siege  of  Domitz  by  the  Swedes, 
1 63 1,  under  Colonel  Lohansen,  in  the  ar- 
ticles   of   capitulation    there    was    one    to 

flight.  Recent  researches  disprove  this,  for  which  see 
Baas,  Hist,  of  Medicine,  1 7th  century. 

21  This  method  is  mentioned  in  the  Cbronique  de 
Bayart  as  having  been  offered  to  the  chevalier  when 
he  received  his  mortal  wound,  but  was  declined. 


294 

supply  wagons  for  the  transport  of  the 
sick  along  with  the  garrison  retiring  with 
the  honors  of  war.  And  in  1636  there  was 
an  agreement  made  between  John  George 
of  Saxony  and  the  representatives  of  the 
king  of  Sweden  at  the  surrender  of  Magde- 
burg, that  the  sick  were  to  be  left  in  the 
city  and  when  cured  to  be  given  passes 
to  return  to  their  regiments.  The  same 
compact  was  made  at  Gorlitz,  1641,  between 
the  same  parties. 

The  career  of  Gustavus  was  terminated 
at  Liitzen,  1632,  by  a  ball  traversing  his 
breast,  his  arm  having  been  first  broken 
by  a  bullet,  which  fact  he  hid  from  his 
soldiers.  His  military  talents  placed  him 
among  the  greatest  generals  of  this  century 
so  prolific  in  warriors,  and  his  example  in 
caring  for  his  soldiers,  sick  and  well,  had 
their  influence,  no  doubt,  on  his  political 
ally,  Richelieu,  and  others,  and  thus  served 
to  bring  forth  organized  means  for  their 
welfare  when  disabled  in  action. 

Epidemics  of  all  kinds  were  very  frequent 
during  the  century,  though  not  always  in 
the  train  of  its  incessant  wars,  yet  typhus 
and  dysentery  were  often  due  to  the  gen- 
eral misery  of  the  people  consequent  on 
war.  Scurvy  principally  prevailed  in  the 
armies  engaged  in  the  Thirty  Years'  \\  ar. 
Considering  the  opportunities  of  the  period, 
it  has  been  observed,  as  a  curious  fact,  that 
the  century  was  very  unproductive  of 
epidemiological  works;  yet  there  were  pub- 
lished no  less  than  28  first  editions  on 
these  diseases  in  armies,  including  2  naval 
and  10  on  particular  diseases,  by  military 
authors.  It  is  also  remarkable  that  from 
the  beginning  of  the  Thirty  Years'  War 
lor  lifty  years  very  little  military  medical 
literature  of  any  kind  appeared; — only  8 
original  works  on  surgery,  nearly  all  un- 
important, and  9  on  diseases,  out  of  a 
total  for  the  century  of  34  on  surgery,  in 
contrast  with  45  lor  the  1 6th  century; 
2  on  hygiene,  1  on  the  simulation  of  disease 
and  2  on  medical  organization.  Especially 


Annals  of  Medical  History 


toward  the  end  of  the  century  were  sown 
the  seeds  that  made  the  18th  century,  in 
this  and  all  other  respects,  the  most  note- 
worthy of  modern  times. 


PRINCIPAL  AUTHORITIES 

Grimoard,  Histoire  des  conquetes  de  Gustave  AdolJ, 
iy8g.  Gustave  Adolf,  Lettres  et  memoires,  etc.,  iygo. 
Chassignet,  Essai  bistorique  sur  les  institutions  mil- 
itaires,  iS6g.  Morache,  Article,  Service  de  Sante  in 
Diet.  Encyclop.  des  sciences  medical,  1874.  Gore, 
Surg.  Major,  The  story  of  our  services  to  the  Crown. 
Froelich,  Militdrmedicin.  Froelich,  Gescbicbte  des 
Kong.  Sacbs.  Sanitats-korps.  Baas,  Grundniss  der 
Gescbicbte  der  Medicin.  Sieard,  Histoire  des  institu- 
tions militaires  des  Francais.  Daniel,  Histoire  de  la 
milice  Francaise.  Grose,  Military  antiquities. 


PART  III. — THE  EIGHTEENTH  CENTURY 

The  Battle  of  Fontenoy 

The  administrative  services  for  armies 
were  of  very  slow  and  irregular  growth 
prior  to  the  18th  century  in  France,  where 
they  originated,  and  in  other  countries, 
notwithstanding  the  spirit  of  imitation 
and  improvement  which  seems  to  be  so 
universal  even  in  our  day.  They  then  be- 
came an  affair  of  government,  and  before 
its  close,  when  armies  assumed  more  of  a 
national  character,  everything  pertaining 
to  the  life  of  a  soldier  was  of  as  much  con- 
cern to  the  State  as  now.  Popular  interest, 
too,  was  excited  to  such  an  extent  that, 
long  before  the  French  Revolution,  discus- 
sions on  tactical  subjects  were  so  frequent 
and  violent  in  the  salons  of  Paris  that  the 
court  and  fashionable  world  were  divided 
into  two  camps.  Grievous  faults  in  organiza- 
tion and  practice  lasted  through  the  cen- 
tury and  remains  of  the  old,  severely  criti- 
cised and  generally  unsuccessful  methods, 
yet  exist  in  some  armies.  Still,  these  ser- 
vices then  became  to  the  general  of  as  great 
importance  as  his  plans  for  a  campaign. 
The  history  of  their  development  is  volumi- 
nous and  very  interesting  to  the  military 
student.    Two    especially    curious    features 


Military  Sanitation 


195 


are  to  be  observed.  There  is  no  natural 
order  of  time  or  succession  in  the  births 
of  departments,  or  in  the  evolution  of  the 
details  of  each,  particularly  of  the  medical, 
and,  what  appears  to  be  a  good  reason  for 
this,  most  advances  were  made  by  circum- 
stances impelling  individual  endeavor  be- 
fore the  State  acted. 

All  known  methods  of  securing  men  for 
the  ranks  were  tried  at  one  time  or  another. 
Voluntary  enlistment  was  everywhere  en- 
couraged more  than  before,  and,  with  the 
evident  intent  of  making  the  soldier's  po- 
sition more  honorable,  it  was  declared  for 
fixed  periods,  first  by  Venice  in  1766. 
This  had  been  done  at  times  for  certain 
purposes,  as  by  England  in  1755,  for 
three  years,  but  the  understanding  that 
enlistment  was  for  life  or  until  discharge 
by  order,  existed  on  all  other  occasions, 
until  1775.  Marshal  Saxe  was  a  strenuous 
advocate  of  a  limited  period  as  early  as 
1732.  In  the  beginning,  from  whatever 
source  coming,  the  recruit  underwent  the 
inspection  of  his  captain  only,  as  to  phys- 
ical and  other  qualifications,  and,  conse- 
quently, there  was  no  uniformity  in  this 
respect  except  as  to  height  and  age,  which 
were  prescribed  by  law.  From  1726  to  1775 
in  France  a  medical  examination  began  the 
ceremony  of  admitting  a  person  in  the  pro- 
vincial militia,  from  which  the  ranks  of  the 
army  were  filled  according  to  necessity, 
and  in  1763,  to  each  of  thirty-two  regi- 
ments of  recruits  then  organized  was  as- 
signed a  surgeon,  who  was  required  to  in- 
quire into  the  physical  aptitude,  in  the 
presence  of  the  commissary  of  war.  In  1778 
an  inspector-general  of  recruiting  for  for- 
eign service  was  appointed  in  England  but 
there  was  no  medical  examination  until 
1790,  and  then  by  reason,  apparently,  of 
the  complaints  of  regimental  surgeons 
abroad,  and  no  written  attestation  of  it 
before  the  last  year  of  the  century.  As 
early  as  1745  rupture  disqualified,  by  act 
of  Parliament,  no  professional  opinion  being 


exacted.  The  Prussian  regulations  of  1788 
for  the  first  time  order  real  examinations 
by  the  regimental  and  battalion  surgeons; 
before  that  date  violence  and  deceit  noto- 
riously prevailed  to  fill  the  ranks. 

Billeting,  onerous  to  the  civilian  and 
subversive  of  discipline  for  the  soldier,  was 
the  common  usage  until  it  was  so  modified 
that  it  was  practically  abolished  before  the 
end  of  the  century.22  Although  barracks, 
in  rare  instances,  had  been  constructed  in 
France  in  the  previous  century  and  a  uni- 
form type  had  been  designed  by  Vauban 
and  futile  ordinances  issued  for  their  erec- 
tion, they  really  date  from  the  early  years 
of  the  1 8th  century,  the  first,  in  most 
continental  countries  as  well,  having  been 
built  at  the  instance  and  expense  of  munici- 
palities, to  avert  the  charge  of  lodging  from 
the  poor  inhabitants,  the  wealthier  classes 
being  nearly  all  exempted.  The  number  of 
casernes  was  greatly  increased  and  their 
plans  very  much  improved  during  the  reign 
of  Louis  XVI.,  and  in  1818  their  construc- 
tion was  assigned  to  the  engineers.  England 
began  in  1739,  by  erecting  low,  ill- venti- 
lated houses  that  bred  disease,  and  these 
were  used  before  Pitt  interested  the  State 
in  the  matter,  building  large  barracks  to 
such  an  extent  that  the  expense  became  a 
political  issue.  The  obligation  of  cities  to 
shelter  troops  was  in  force  in  Prussia  as 
late  as  1810,  when  the  government  assumed 
it.  Regularly  laid  out  modern  camps,  on 
the  ancient  Roman  model,  and  the  conse- 
quent good  order  of  everything  relating 
thereto,  date  from  Martinet,  whose  plan 
Louis  XIV.  adopted  in  orders,  1667.  The 
habitations  of  soldiers  and  their  accessories 
was  a  favorite  theme  among  writers  on  the 
Art  of  War, — Feuquiere,  Frederick  the 
Great,    Saxe,   etc., — and   the   hygienic   de- 

22  It  is  now  legal  in  France,  in  certain  cases,  as 
during  a  general  mobilization,  when  barracks  would 
be  insufficient.  It  was  prohibited  in  England  in  1745 
except  on  licensed  victualers,  but  lasted  in  Scotland 
as  late  as  1857. 


296 


Annals  of  Medical  History 


tails  were  discussed  by  every  military  med- 
ical writer,  especially  worthy  of  note  being 
Pringle,  1752,  Brocklesby,  1764,  Monro, 
1764,  and  Colombier,  1772. 

Nor  was  the  sanitary  condition  of  the 
soldiers  neglected  in  the  matter  of  clothing, 
the  literature  of  the  subject  being  meagre, 
however,  to  this  day.  The  hair,  hat,  stock- 
ings, shoes,  coats,  breeches  were  all  criti- 
cised in  the  minutest  particular  by  Saxe, 
who  cared  more  for  the  soldier  than  any 
other  general,  and  gradually  reformed  on 
lines  laid  down  by  him,  according  to  Des- 
genettes,  his  commentator.  Uniformity  was 
introduced  in  France  1670-1679,  among 
the  improvements  of  Louvois,  the  soldier 
before  that  time  wearing  a  shoulder  belt 
over  a  steel  breastplate  and  ordinary  dress. 
Its  supply  as  a  source  of  profit  was  taken 
from  the  officers  in  1729,23  yet  in  1779  the 
war  minister,  St.  Germain,  complained 
that  soldiers  were  poorly  clad,  more  for 
theatrical  effect,  and  with  no  reference  to 
health.  The  first  English  regulation  for 
clothing  was  issued  in  1751,  and  Frederick 
William  began  the  reform  in  Prussia.  It 
was  not  until  the  French  Revolution  that 
a  permanent  interest  became  manifest  and 
only  after  that  period,  except  incidentally, 
by  medical  authors. 

Every  commander  who  recorded  his  ex- 
periences or  opinions,  from  Turenne  to 
Napoleon,  including  the  eccentric  Suwar- 
row,24  recognized  the  hygienic  importance 
of  food,  and  has  something  to  say  about  it. 
A  few,  like  Rutowsky  and  Maillebois,  and 

MThe  custom  lasted  in  England  until  1858. 

MA  book,  "Discourse  upon  the  Trigger,"  attrib- 
uted to  him,  was  sent  by  the  Russian  government 
to  every  regiment  in  the  service.  It  contains  these 
rules  for  diet.  "Have  a  dread  of  the  hospital.  Ger- 
man physic  stinks  from  afar,  is  good  for  nothing 
and  rather  hurtful.  A  Russian  is  not  used  to  it;  mess- 
mates know  where  to  find  roots  and  herbs.  A  soldier 
is  beyond  all  price;  take  care  of  your  health,  scour 
the  Stomach  when  it  is  foul;  hunger  is  the  best  med- 
icine. If  loose  bowels  want  food,  at  sunset  a  little 
nourishment;  for  costive  bowels  some  purging  plant 


French  officers  generally,  prescribed,  in 
marching  orders,  rules  to  govern  its  con- 
sumption. The  standard  daily  allowance 
was  24  oz.  wheat  bread,25  1  lb.  of  meat  and 
one  pint  of  wine  or  two  of  beer.  The  bread 
was  sometimes  increased  to  28  oz.  and  the 
cavalryman's  ration  was  one-half  again  as 
large,  as  a  rule.  In  England  bread  seems  to 
have  been  issued  always  by  contractors; 
there  was  a  stoppage  for  it,  however,  while 
other  articles  were  sold  by  officers  at  ad- 
vanced and  often  exorbitant  prices,  and  as 
pay  was  irregular,  the  result  may  be  im- 
agined. Frederick  the  Great  instructed  his 
generals  to  supply  bread  2  lbs.  daily,  and 
meat  2  lbs.  weekly,  free  during  a  campaign. 
In  1799  the  issue  was  made  in  France  at 
the  expense  of  the  government,  and  not 
deducted  from  the  pay  of  the  soldier.  The 
Russian  troops  made  their  own  bread  long 
before  this.  Subsistence  details  were  placed, 
in  Richelieu's  time,  in  the  hands  of  civil- 
ians, who  were  directly  under  the  minis- 
ters, and  it  thus  happened  that  both  mili- 
tary operations  and  generals  were  subject 
to  them.  Guibert  says  that  this  system  of 
brigandage  was  at  its  height  in  1757,  and 
soldiers  in  all  armies  suffered  from  insuffi- 
cient quantity  and  bad  quality.  There  were 
no  regular  commissaries  in  England  before 
1787,  the  contract  system  prevailing,  and 
even  the  great  Marlborough  was  suspected 
of  sharing  profits  obtained  by  fraud  in  the 
supply  of  food.  The  vice  lasted  in  all  coun- 
tries, notwithstanding  the  often  expressed 
wishes  of  the  generals  and  orders  of  govern- 
in  warm  water  or  licquorice  root.  In  high  fevers  eat 
nothing  even  for  twelve  days,  but  drink  small  beer 
as  much  as  you  please.  In  intermitting  fevers, 
neither  eat  nor  drink.  In  hospital  the  first  day  the 
bed  is  soft,  the  second  comes  French  soup,  and 
the  third  you  are  laid  in  your  coffin;  one  dies  and  ten 
of  his  companions  inhale  his  expiring  breath.  For  the 
healthy,  drink,  air  and  food;  for  the  siek,  air,  drink 
and  food." 

24  Rye  bread  was  issued  in  Queen  Anne's  time 
but  discarded  because  of  a  notion  that  it  caused 
dysentery. 


Military  Sanitation 


297 


ment  and  in  spite  of  warnings  by  medical 
officers.  The  work  of  Lind  for  seamen  is  to 
be  especially  commended.  Toward  the  end  of 
the  century  we  find  such  expert  opinion 
more  highly  regarded,  and  physicians  and 
surgeons  appear  on  boards  constituted  to 
inquire  into  the  subject  of  articles  of  diet. 
Special  hospital  diet  did  not  originate  until 
in  the  last  half  of  it. 

The  transport  service,  personal  cleanli- 
ness, marches,  drills  and  exercises  attracted 
the  attention  of  both  military  and  medical 
writers,  special  works  and  orders  appearing, 
and  all  these  subjects  were  treated  more  or 
less  under  the  now  very  common  head  of 
means  of  preserving  the  health  of  soldiers. 

This  growing  general  interest  in  military 
sanitary  matters  greatly  improved  the  con- 
dition of  the  soldier,  and  when  they  became 
a  part  of  the  duty  of  medical  officers  the 
position  of  these  was  more  elevated  and 
respected.  Only  physicians  who  were  Uni- 
versity graduates,  and  surgeons,  were  at 
first  considered  of  sufficient  importance  to 
be  given  the  rank  and  uniform  of  officers, 
but  before  the  beginning  of  the  19th  cen- 
tury, assistants,  mates,  etc.,  were  com- 
missioned, and  surgeons  were  considered 
the  equals  of  physicians.  Officers  of  the  line 
like  Robert  Jackson  transferred  to  the  med- 
ical staff,  and  from  the  medical  staff,  like 
Charles  Bisset,  to  the  engineers.  Hospital 
affairs  began  to  be  governed  like  military, 
the  French  in  1718  setting  the  example  by 
the  adoption  of  medical  regulations  estab- 
lishing discipline,  defining  duties  and  ex- 
acting reports;  then  followed  a  system  of 
inspections  and  the  creation  of  a  depart- 
ment with  a  chief  subordinate  directly  to 
the  minister  of  war.  Probably  the  first 
English  regulations  were  issued  in  1762 
by  Robert  Gordon  at  Winchester  camp 
with  the  approval  of  Brocklesby.  To  meet 
the  demands  of  new  responsibilities  it  soon 
became  apparent  that  a  special  training 
was  needed,  and  schools  were  founded,  in 
France  at  army  and  naval  hospitals,  17 18, 


separate  and  elaborated  amphitheatres, 
1775,  in  Saxony,  1748,  as  a  part  of  the 
Collegium  Medico-Chirurgicum  of  Prussia, 
1719,  distinct  in  1795,  and  in  Austria,  the 
Josephinum,  1784.  How  much  of  this  was 
due  to  individual  effort  is  shown  by  the 
fact  that  Desoteux  established,  with  the 
aid  of  his  colonel,  a  school  of  surgery  in 
his  regiment  that  became  celebrated;  it 
had  regularly  about  sixty  pupils,  many  of 
whom  became  distinguished  surgeons  and 
even  professors  in  the  faculty.  And  in  1766, 
through  the  exertions  of  Richard  de  Haute- 
sierck,  inspector  of  hospitals,  appeared  in 
France  the  first  journal  devoted  exclu- 
sively to  military  medicine,  though  before 
this  Schaarschmidt  and  Henkel,  military 
physicians,  edited  publications  on  medical 
matters  in  general,  the  former  from  1708 
to  1749,  the  latter  from  1747  to  1772.  But 
the  greatest  and  most  beneficial  institution 
of  the  century  was  the  Academie  royale  de 
Chirurgie,  founded  1 73 1 ,  at  the  instigation 
of  de  la  Martiniere.  Five  of  its  seven 
officers,  and  one-half  of  the  forty  members 
nominated  by  the  king,  and  of  the  associate 
members,  were  prominent  military  surgeons 
who  served  in  the  field,  and  more  than  one- 
third  of  the  authors  of  papers  and  observa- 
tions contained  in  4  volumes  of  memoirs, 
1743-68,  were  in  the  army  or  navy. 

With  the  exception  of  the  last  decade, 
which  was  the  most  eventful,  brilliant  and 
fertile  epoch  in  the  entire  history  of  mili- 
tary medicine,  the  most  interesting  period 
of  the  century  is  that  between  the  origin 
of  the  Academy  and  the  publication  of 
the  second  volume  of  its  transactions  in 
1753.  Within  this  period  were  conceived, 
signed  and  operated  the  celebrated  articles 
affecting  the  neutrality  of  hospitals,  be- 
tween Lord  Stair  and  the  Duke  de  Noailles. 
The  official  correspondence  of  the  latter 
with  his  king  and  d'Argenson,  the  minister 
of  war,  credit  the  first  suggestion  to  Stair, 
but  there  is  good  authority  for  the  belief 
that  Pringle,  chief  physician  of  the  English 


298 


Annals  of  Medical  History 


army,  inspired  the  proposition,  many  cir- 
cumstances after  the  battle  of  Dettingen, 
1743,  bringing  about  a  favorable  condition 
of  mind  in  both  armies.  With  the  campaign 
ended  the  agreement; — a  similar  arrange- 
ment for  all  time  was  advocated  by  Monro, 
Peyrilhe,  Percy,  surgeons,  and  Chamousset, 
intendant-general,  and  proposed  on  occa- 
sions, as  by  Moreau  to  the  Austrian  General 
Kray.  In  1820  the  subject  was  revived, 
and  again  in  1864  by  Henri  Dumant,  a 
Geneva  philanthropist,  and  it  resulted  fi- 
nally in  the  adoption  of  the  present  articles. 
During  this  time  the  number  of  permanent 
military  hospitals  in  France  increased  rap- 
idly; there  was  established  the  first  special 
hospital  for  officers  and  soldiers  at  the  hot 
springs  of  Bourbonne;  new  regulations  en- 
couraging the  spirit  of  detail  and  subordina- 
tion in  all  these  institutions  were  promul- 
gated, and  the  selection  of  the  personnel 
and  its  payment  were  first  made  by  the 
State.  In  the  English  army  in  active  ser- 
vice abroad,  hospital  comforts  were  sup- 
plied so  far  beyond  anything  heretofore 
extended  to  the  soldiers  that  there  arose  a 
lengthy  correspondence  between  the  Duke 
of  Cumberland  and  the  home  authorities 
with  reference  to  the  additional  expenditure 
incurred.  Humanity,  Fonblanque  says,  had 
not  yet  become  an  element  in  British  mili- 
tary economy.  Austria,  Prussia,  Denmark 
and  Sweden  attempted  the  introduction  of 
the  French  system  of  hospitals  in  their  ar- 
mies. Questions  in  surgery  began  then  to  be 
discussed  in  a  comprehensive  and  scientific 
manner,  as  never  before,  the  battle-fields 
of  Dettingen  and  Fontenoy  especially  fur- 
nishing ample  material  from  which  practical 
deductions  were  made  by  many  surgeons, 
and  their  differences  brought  to  light  de- 
tails that  single  individual  experience  had 
failed  to  give  to  the  world.  Then,  too,  was 
first  formed  the  germ  of  an  organization 
for  the  prompt  relief  of  wounded  on  the 
field,  that  finally  developed  into  the  pr< 
ambulance  system. 


The  Marquis  de  Feuquiere  has  much  to 
say  concerning  the  administration  of  fixed 
and  movable  hospitals  at  the  beginning  of 
the  century.  He  mentions  nothing  similar 
to  what  took  place,  probably  for  the  first 
time,  at  Fontenoy.  Randby,  the  last  royal 
household  surgeon  to  be  present  with  the 
English  king  in  active  service,  is  credited 
with  the  first  suggestion,  but  he  made  it 
after  Dettingen,  in  the  form  of  a  recom- 
mendation, and  I  can  find  no  such  actual 
organization  in  the  British  army  before 
1748,  when  are  mentioned  flying,  fixed  and 
also  convalescent  hospitals.  The  custom 
was,  as  described  in  Marlborough's  time, 
to  extend  the  order  of  battle  in  front  of  the 
tents,  behind  which  were  placed  the  sur- 
geons to  await  the  arrival  of  the  wounded. 
Both  English  and  French  generals  com- 
plained of  the  sick  and  wounded  interfering 
with  military  movements  during  and  after 
an  engagement.  Randby's  project  was,  that 
when  an  army  was  ranged  for  battle,  the 
surgeon-majors  of  three  or  four  regiments 
posted  side  by  side,  should  unite  with  their 
assistants  under  the  same  tent,  taking  sta- 
tion at  the  rear  guard,  according  to  the 
orders  of  the  general: — the  wounded  were 
to  be  carried  to  these  points,  and  by  these 
means  the  surgeons  could  assist  each  other 
and  do  their  duty  with  diligence  and  ex- 
actitude. He  then  deplores  the  actual 
method  of  carrying  wounded  from  point 
to  point  without  any  system  and  much  to 
their  detriment. 

We  are  indebted  to  Bagieu,  a  distin- 
guished French  military  surgeon,  for  a  few- 
scant  particulars,  which  are  given  casually 
for  the  purpose  of  elucidating  a  surgical 
question.  He  says  that  "in  battles  there  is 
an  ambulance  hospital,  more  or  less  within 
reach  of  the  place  where  an  engagement 
occurs,  where  the  surgeon-major  and  other 
surgeons  hold  themselves  in  readiness.  This 
is  the  fust  depot  when'  wounded  arc  col- 
lected, from  whence  they  arc  carried  to 
hospitals  in  the  nearest   towns,  and  thence 


Military  Sanitation 


299 


to  cities  farther  removed  when  these  be- 
come crowded.  It  is  rare  that  surgical  op- 
erations are  performed  on  the  field  proper, 
that  is,  at  the  place  where  wounds  are  in- 
flicted, and  still  more  rare  are  amputations 
performed.  The  light  wounded  betake  them- 
selves to  the  ambulance  station,  the  dan- 
gerously wounded  are  carried  there  on 
litters." 

The  place  occupied  by  the  ambulance  is 
thus  described:  "Sometimes,  as  at  Fon- 
tenoy,  it  is  in  the  open  field,  commonly 
it  is  in  some  village,  more  rarely  in  the 
cities,  and  nearly  always  sufficiently  distant 
from  the  place  of  combat."  He  also  dis- 
cusses litters,  mentions  a  horse  litter  im- 
provised by  the  great  surgeon,  J.  L.  Petit, 
praises  transportation  by  water,  accom- 
plished on  a  considerable  scale  after  Det- 
tingen,  and  gives  the  detailed  structure  of 
a  wagon  specially  designed  for  carrying 
wounded. 

With  the  aid  of  other  writers  the  ar- 
rangements at  Fontenoy  can  be  pictured. 

The  contending  forces,  allied  English, 
Dutch,  Hanoverians  and  Austrians,  55,000, 
and  the  French,  60,000,  were  organized 
very  much  alike;  foot  battalions  of  five 
companies  containing  100  to  140  men 
each,  two  to  four  battalions  making  a  regi- 
ment numbering  1,000  to  2,700  men,  the 
English  battalions  being  slightly  largest; 
cavalry,  in  squadrons  of  about  100  men 
each.  As  at  this  time  each  infantry  regi- 
ment had  a  surgeon  and  mate  or  assistant, 
it  is  estimated  that  the  allies  had  about 
forty  regimental  medical  officers,  the  French 
as  many;  the  cavalry  of  both  armies  had 
none.  There  was  on  both  sides  a  small 
number  of  physicians,  one  usually  to  a 
garrison  of  about  10,000  men,  and  army 
surgeons.  The  infantry  were  armed  with 
flintlock  muskets  and  bayonets,  the  sword 
having  been  abandoned  about  this  time, 
and  they  worked  the  field  pieces  of  artil- 
lery, the  largest  mentioned  being  a  battery 
of  six  16-pounders  on  the  bank  of  the  River 


Scheldt  opposite  the  field,  to  cover  the  re- 
treat of  the  French  king.  All  arms  were 
engaged  at  one  time  or  another,  the  artil- 
lery opening  the  battle,  and  at  the  critical 
moment,  supported  by  cavalry,  saving  the 
day  for  the  French,  an  occurrence  said  to 
have  been  the  first  combination  of  the  two 
arms  in  history. 

With  the  village  of  Fontenoy  toward  the 
right  of  the  French  centre,  the  length  of  the 
line  that  bore  the  brunt  of  the  battle  was 
about  1,200  yards,  and  the  width,  of  what 
was  practically  a  closed  field,  was  2,000 
yards.  The  point  where  the  English  and 
Hanoverians  massed  their  attack  was  on  the 
left  of  the  village,  including  it  eventually, 
and  it  was  here  that  the  terrible  slaughter 
of  the  French  infantry  nearly  won  a  victory 
for  the  allies.  Surgeons  were  posted  on  the 
first  line,  as  is  proved  by  the  fact  that 
while  the  English  were  advancing  on  the 
regiment  stationed  nearest  Fontenoy,  the 
French  lieutenant-general  Luttaux  was 
wounded,  and  his  aide  implored  him  to 
have  his  wound  first  dressed  before  going 
to  report  to  the  king.  The  regiments  of 
Hainaut  and  Dillon  were,  in  the  beginning, 
on  the  French  left,  and  which  moving  toward 
the  centre  to  stay  the  English  by  an  attack 
in  the  flank,  lost  heavily.  It  is  stated  by 
Boucher  that  on  the  field  itself  amputa- 
tions were  performed  on  wounded  of  these 
regiments,  it  is  inferred,  at  the  ambulance 
hospitals,  which  were,  at  the  furthest,  about 
2,000  yards  from  the  front  line.  After  the 
battle  these  ambulances  were  evacuated 
and  the  wounded  carried  on  caissons  and 
carts  to  cities  in  the  rear,  principally  to 
Lille,  16  miles,  and  Douai,  20  miles  distant, 
where  an  immense  number  of  surgical  op- 
erations were  performed  at  hospitals  estab- 
lished for  the  purpose,  the  civil  hospitals, 
churches  and  private  houses  being  used.26 

26  The  following  members  or  associates,  or  con- 
tributors to  the  transactions,  of  the  French  Academy 
of  Surgery  were  present:  Boucher  at  Lille,  where  his 
conduct  is  mentioned  as  beyond  praise,   Geraud, 


300 

A  battle  begun  with  an  exchange  of  fencing 
master's  compliments  ought  to  have  ter- 
minated by  an  exhibition  of  practical  phi- 
lanthropy, and  Voltaire  says  that  in  these 
hospitals  no  comfort  was  wanting  for  the 
wounded  French  or  their  prisoners.  The 
zeal  of  civilians  and  soldiers  was  such  that 
the  surgeons  were  obliged  to  interfere,  and 
the  hospitals  were  so  well  managed  that 
officers  preferred  to  be  treated  there.  The 
allies  carried  600  wounded  twenty  miles, 
to  Ath,  where  a  hospital  was  established 
in  the  casernes;  they  left  1,200  in  the  hands 
of  the  French,  who  had  of  their  own  4,000. 
Here  then,  at  Fontenoy,  May  11,  1745, 
wounded  soldiers  were  treated  on  the  first 
line  by  regimental  surgeons;  they  were 
collected  at  ambulance  stations,  where  cap- 
ital operations  were  performed,  then  trans- 
ferred to  hospitals  prepared  for  them  in  near 
cities,  and,  when  these  became  over- 
crowded, to  cities  further  away.  A  few 
months  after  this  battle,  Maillebois  con- 
ducted an  army  into  Italy,  his  chief  physi- 
cian being  Baron,  who  was  subsequently 
dean  of  the  Faculty  of  Paris,  and  in  nearly 
every  daily  order  for  marching  and  camping 
is  designated  a  place  for  the  hospital  am- 
bulant, usually  on  the  march  in  rear  of  the 
artillery  with  the  treasure  and  provisions. 
The  day  before  the  battle  of  Bassignano, 
September  27,  1745,  three  ambulance  hos- 
pitals  were   organized,    one   for   each   col- 

Guffroy,  PoIIet,  Guerin,  Vandergracht,  Theri  at 
field  hospitals,  Faure  and  Read  at  Valenciennes. 
Garengeot  was,  I  presume,  with  his  regiment,  du 
Roi,  one  of  those  at  the  centre  of  the  conflict;  An- 


Annals  of  Medical  History 


umn,  and  ordered  to  take  station  at  vil- 
lages, each  about  1,200  yards  in  rear  of  the 
line  of  battle  on  the  river  Tanaro,  where 
an  engagement  was  expected.  Two  of  these 
hospitals  actually  united  opposite  the  centre 
of  the  line,  which  covered  ground  about 
6,000  yards  long.  And  in  the  "Art  of  War," 
by  the  Marechal  de  Puysegur,  published  in 
1749,  a  map  for  illustration  shows  the  am- 
bulance about  2,500  yards  in  rear  of  the 
first  line.  Excepting  an  untried  project  of 
Ravaton,  very  little  improvement,  on  Rand- 
by's  outline  and  Bagieu's  account,  took 
place  subsequently  until  Larry  and  Percy 
made  their  names  immortal,  not  only  for 
the  invention  of  details  to  rapidly  relieve 
and  remove  wounded  soldiers  during  battle 
on  a  scale  never  equalled,  but  for  their  in- 
estimable contributions  to  operative  mili- 
tary surgery. 


PRINCIPAL  AUTHORITIES 

Saxe,  Mes  Reveries.  Frederick  the  Great,  Instruc- 
tions militaires  pour  ses  generaux.  Comte  de  St.  Ger- 
main, Memoires.  Feuquiere,  Memoires.  Noailles, 
Campagne  en  Allemagne.  Maillebois,  Histoire  des 
campagnes.  Puysegur,  Art  de  la  guerre.  Guibert,  De 
Vetat  actuel  de  la  politique  et  de  la  science  militaire. 
Voltaire,  Precis  du  siecle  de  Louis  XV.  Academie 
royale  de  chirurgie,  Memoires.  Delorme,  Traite  de 
chirurgie  de  guerre.  Morache,  Hygiene  militaire. 
Fonblanque,  Treatise  on  the  administration  and 
organization  of  the  British  army.  Audouin,  Histoire 
de  I' administration  de  la  guerre. 

douille  had  charge  of  the  whole  system  of  evacua- 
tion of  wounded  on  cities  of  the  nortli  of  France; 
Ravaton  was  at  one  of  these,  and  La  Peyronie,  its 
President,  operated  on  the  field. 


A  CHECK  LIST  OF  MEDICAL  INCUNABULA 


IN  THE  SURGEON  GENERAL'S  LIBRARY,   WASHINGTON,  D.   C.,    I918 


THE  following  check  list  of  incunabula 
in  the  Surgeon  Generals  Library  is 
compiled  not  only  for  only  for  the  convence 
of  the  library,  to  enable  us  to  state  at  aglance 
what  it  possesses  of  early  printed  books, 
flut  also  in  the  interest  of  the  students  of 
medical  history.  The  list  does  not  make  a 
pretentious  claim  to  bibliography. 

Dr.  Arnold  C.  Klebs  has  in  preparation 
a  bibliography  of  all  medical  incunabula, 
including  those  in  our  library  and  those  in 
other  American  libraries,  in  which  the  en- 
tries will  be  given  in  full. 

As  I  have  already  stated  in  my  paper 
"On  Incunabula,"  published  in  the  Bulletin 
of  the  Medical  Library  Association,  N.  S., 
Vol.  V,  No.  1  (July,  1915),  the  first  attempt 
at  listing  medical  incunabula  was  made  by 
the  late  J.  Stockton  Hough  of  Trenton, 
New  Jersey. 

It  cannot  be  the  aim  of  our  library,  just 
as  it  cannot  be  the  aim  of  any  library,  no 
matter  how  large  its  endowment  or  ap- 
propriation, to  own  all  the  incunabula  in 
existence,  especially  when  one  takes  into 
account  the  fact  that  there  are  about  28,000 
of  these  rare  volumes,  and  that  in  some 
instances  only  a  few  copies  have  been  pre- 
served and  in  some,  only  one.  Prof.  Karl 
Sudhoff,  of  Leipzig,  estimated  the  number 
of  medical  incunabula  at  about  2,000.  We 
are  inclined  to  place  the  number  much  lower, 
but  refrain  from  giving  any  approximate 
figure. 

Early  printed  books  must  be  judged  from 
two  points  of  view;  first,  from  the  standpoint 
of  the  intrinsic  value  of  the  book  itself,  and, 
second,  from  a  bibliographical  standpoint. 
This  must  be  the  guiding  principle  for  a 
special  library  like  ours,  when  making  a 
collection  of  incunabula.  If  possible,  every 
printer  and  every  town  should  be  repre- 
sented by  a  good  specimen  dealing  with  the 
subject  in  which  the  library  in  question  is 
most  interested. 

On  this  principle  the  incunabula  for  the 
library  of  the  Surgeon  General's  Office  were 
collected;  notwithstanding  the  limited 
means  I  have  tried  to  enlarge  our  collection 
of  early  printed  books  and  during  my  ad- 


ministration have  succeeded  in  increasing 
the  number  of  our  incunabula. 

This  list  is  published  in  the  Annals  of 
Medical  History  to  give  the  material  a 
wider  circulation  among  readers  of  medical 
literature.  I  hope  that  other  lists  of  the 
medical  incunabula  available  in  public  and 
private  libraries  may  be  presented  to  the 
public  through  this  medium  so  that  the 
files  of  the  Annals  will  eventually  contain 
a  complete  bibliography  of  the  medical 
incunabula  in  this  country. 

Champe  Carter  McCulloch 

Librarian 

LIST  OF  INCUNABULA 

1.  ABIOSUS,    JOANNES.    Trutina  rerum 

ccelestium    et    terrestrium.      [Venezia, 

Joannes  Rubeus,  a.  5  February,  I4g8.\ 

Quarto. 

Reichling,  IV,  p.  97.     Hain  25. 

2.  ABRAHAM  BEN   EZRA.  De  nativita- 

tibus.  Venezia,  Erhard  Ratdolt,  24 
December,  1485.  Quarto.  Bound  with: 
Prognosticon,  etc.  Venezia,  1485. 
Hain-Copinger  *  2 1 .  Proctor  4407.  Pel- 
Iechet  16.  Walters  p.  2.  Redgrave 
46. 

3.  ABULCASIS.  Liber  servitoris.    Venezia, 

Nicolas  Jensen,  1471.  Quarto. 
Bound  with:  Nicolaus.  Antidotarium. 
Pellechet  411.     Proctor  *  4075. 

4.  ^GIDIUS       CORBOLIENSIS.       De 

pulsibus.     Commentator:  Gentilis  de 

Fulgineo.     Editor:  Avenantius  Mu- 

tius    de    Camerino.      Padova,    Mat- 

thaeus     Cerdonis,     January,     1484. 

Quarto. 

Hain  *   103.      Pellechet    64.      Proctor 

6815. 

5.  ^EGIDIUS     CORBOLIENSIS.       Car- 

men de  urinis  cum  commentario.  Car- 
men de  pulsibus.  Commentator:  Gen- 
tilis de  Fulgineo.  Editor:  Avenan- 
tius de  Camerino.  Venezia,  Bernar- 
dinus  de  Vitalibus,  16  February,  14Q4. 
Quarto. 


301 


302 


Annals  of  Medical  History 


13 


14 


Hain    *    101.     Pellechet    62.     Proctor 

5522. 

Imperfect. 

ALBERTUS  MAGNUS.  Liber  aggre- 
gations de  virtutibus  herbarum.  [Ant- 
werp, Mathias  van  der  Goes,  c.  i486.] 
Quarto. 

Campbell's  Annales  80+Supp.  II,  *8o 
Burger  p.  418. 

ALBERTUS  MAGNUS.  De  animali- 
bus.  Venezia,  Joannes  &  Gregorius 
de  Gregoriis,  21  May,  1495.  Folio. 
Hain  *  547.  Pellechet  341.  Proctor 
4541. 

ALBERTUS  MAGNUS.     Liber  aggre- 
gations     de      virtutibus      herbarum. 
[Speier,  Conrad  Hist,  or  Eichstatt; 
Michael  Reyser.]     Quarto. 
Pellechet  343. 

ALCANIS,     LUIS.     Regiment    preser- 
vatiu  e  curatiu  de  la  pestilencia.     [Va- 
lencia, Nicolaus  Spindeler,  c.  14Q0.] 
Quarto. 
Undescribed. 

ALEXANDER  OF  APHRODISIAS. 
Problemata.  Latin  translation  by 
Georgius  Valla.  Aristoteles: 
Problemata.  Plutarch:  Problemata. 
Venezia,  Antonhjs  de  Strata,  24 
November,  18  December,  1488 — 5-  Jan- 
uary, 1480.     Folio. 

Hain-Copinger  *  658.  Pellechet  439. 
Voullieme  Berlin  3917.     Proctor  4594. 

.  ALFONSUSBONI  HOMINIS.  Libel- 
Ius  arabicus  contra  malos  medicos.  Edi- 
tor: Joannes  Elisius  Neapolitanus, 
1500.     Quarto. 

.  ALMENAR,  JOAN.  De  morbo  gal- 
lico.  Venezia,  1502.  Torrella,  Cas- 
par. De  dolore  cum  tractatu  de  ulceri- 
bus  in  pudcndagra.  Roma,  Johann 
Besicken  with  Martin  of  Amster- 
dam. 31  October,  1500.  Quarto. 
Proctor  4000.  Hain-Copinger  15559. 
Voullieme  Berlin.     3547. 

.  ARCANA.  Arcana  Medicinae.  [Ge- 
nfoe:  Louis  Cruse,  c.  1490.}  Quarto. 
Pellechet  1 105. 

ARCULANUS,     JOANNES.     Exposi- 

tio    in    AvKiitna-    canonis    quart!    Fen 


primam.     Ferrara,  Andreas  Belfor- 
tis.     24  January,  1489.     Folio. 
Hain  1552.     Burger  p.  340.     Reichling 
II,  p.  118. 

15.  ARCULANUS,  JOANNES.  Practica 
seu  expositio  in  IX  Iibrum  Rhazis  ad 
Almansorem.  Venezia,  Bernardinus 
Stagninus,  12  November,  1493.  Folio. 
Hain-Copinger  *  13899. 

16.  ARCULANUS,  JOANNES.  Exposi- 
tio in  Avicennse  canonis  quarti  Fen 
primam.  Venezia,  Bonetus  Locatel- 
lus,  27  October,  1496.  Folio.  Bound 
with  Gian  Matteo  Ferrari  da  Grado, 
1502. 

Hain-Copinger  *  1553.       CoIIijn    Up- 
sala  788. 

17.  ARCULANUS,  JOANNES.  Practica 
seu  expositio  in  IX  Iibrum  Rhazis  ad 
Almansorem.     Venezia,   Bonetus   Lo- 

CATELLUS   for  OCTAVIANUS   ScOTUS,    l8 

September,  1497.     Folio. 
Hain-Copinger  *  13900.    Burger  p.  482. 

18.  ARGELLATA,  PETRUSDE.  Chirur- 
gia.  Venezia,  Benedictus  of  Genova, 
9  August,  1480.     Folio. 

Proctor  4596.  Pellechet  1161.  Hain 
1635.     Reichling  IV,  p.  120. 

19.  ARGELLATA,  PETRUS  DE.  Chirur- 
gia.  Venezia,  [Joannes  &  Gregorius 
Gregoriis],  12  September,  1499.  Folio. 
Bound  with:  Alsaharavius.  Liber 
theoricse  nee  non  practical,  1519. 
Hain  1639.  Copinger  III,  241.  Proc- 
tor 5703.     Reichling  IV,  p.  121. 

20.  ARISTOTELES.  Opera.  [Latin.]  [4 
parts.]  Augsburg,  Ambrosius  Keller, 
IS  September — 21  October,  1479.  Folio. 
Hain  *  1658  [4].  Pellechet  1176. 
British  Museum  Catalogue  II,  361 
[  I — III  ].  Voullieme  Benin  105-197. 
Proctor  1 747- 1 749. 

21.  ARISTOTELES.  Problemata.  Ad- 
dition: De  vita  et  morte  Aristotelis. 
[Coin,  Heinrich  Quentell.  c.  1490- 
1495.]     Quarto.     Woodcut. 

Hain*  1 72 1.  Pellechet  1220.  Proctor 
1410.  Burger  p.  552.  British  Mu- 
seum Catalogue  I,  p.  281. 

22.  ARNOLDUSDEVILLANOVA.  Trac- 
tatus  de  venenis.  Addition:  Valascus 
de  Taranta.     De  epidemia  et  peste. 


A  Check  List  of  Medical  Incunabula 


303 


[Mantova,  Johann  Burster  &  Thomas 
of  Hermannstadt.     1473.]     Quarto. 
Hain-Copinger  *  1805.     Pellechet  1307. 
Proctor  6884. 

23.  ARNOLDUS  DE  VILLANOVA.  Prac- 
tica.  [Pavia,  Antonius  Carcanus,  c. 
1482.]  Folio.  Bound  with:  Antonio 
Guaineri.  Opera  medica.  Pavia. 
Copinger  II,  647.  CoIIijn  Stockholm 
103. 

24.  ARNOLDUS  DE  VILLANOVA.  Prac- 
tica  medicina.     Venezia,  Baptista  de 
Tortis,  21  February,  1494.     Folio. 
Hain  *   1 80 1.     Proctor   4646.     Burger 
p.  614. 

25.  ARNOLDUS  DE  VILLANOVA.  Prac- 
tica.  Venezia,  Otinus  de  Luna,  21 
October,  1497.  Folio.  Bound  with: 
Rhazes.  Opera  varia.  [Venezia,] 
Bonetus  Locatellus,  1497. 

Hain  Copinger  *  1802.  Pellechet  1275. 
Proctor  5606.     Burger  p.  487. 

26.  ARNOLDUS  DE  VILLANOVA.     De 

virtutibus  herbarum.  Venezia.  Simon 
[de  Gabis]  Bevilaqua.  14  December, 
1499.  Quarto.  Numerous  woodcut  il- 
lustrations [colored]. 

Hain*  1807.  Pellechet  13 15.  Proctor 
5415. 

27.  ARNOLDUS  DE  VILLANOVA.  Op- 
era. Letter:  Thomas  Murchius  of 
Genoa.  Venezia,  Bonetus  Locatel- 
lus for  the  heirs  Octavianus  Scotus, 
19  January,  1505.  Folio.  Bound 
with  this:  Dinus  de  Garbo.  Gentilis 
de  Fulgineo,  Gentilis  de  Florentia:  Ex- 
positio  partium  quarti  canonis  Avi- 
cennae.  Additions:  Dinus  de  Garbo. 
Tractatus  de  ponderibus  et  mensuris. 
Compilatio  emplastrorum  et  unguent- 
orum.  Venezia,  Johann  Herzog  for 
Andrea  de  Torresani,  4  December, 
1499.  Folio. 

Hain  *  6168.  Pellechet  4252.  Proctor 
5203. 

28.  ARTICELLA.  Seu  thesaurus  operum 
medicorum  antiquorum.  Editor: 
Franciscus  Argilagnes.  Venezia, 
Baptista  de  Tortis,  20  August,  1487. 
Folio. 

Hain-Copinger   1870.     Pellechet   1378. 


29.  ARTICELLA.  Seu  thesaurus  operum 
medicorum  antiquorum.  Editor: 
Gregorius  a  Vulpe.  Venezia,  Bone- 
tus Locatellus  for  Octavianus  Sco- 
tus. [20  December,  1492.]  Folio. 
Reichling  App.  IV,  p.  124.  Pellechet 
1379.     Hain  1872. 

30.  AUGUSTIS,  QUIRICUS  DE.    Lumen 
apothecariorum.         [  Lyon:    Mathieu 
Husz,  a.  15  November,  1491.]     Folio. 
Hain*  21 16.     Pellechet  1595.     Burger 
p.  442. 

31.  AVENZOAR.  Libri  Theizir  Averroes 
CoIIiget.  Venezia,  Joannes  &  Grego- 
rius, 4  January,  1490.  Folio.  Hain* 
2186.  Proctor  4513.  Pellechet  1952. 
Hain-Copinger  7501.  Pellechet  5003. 
Proctor  4508. 

32.  AVENZOAR.  Libri  Theizir  Averroes 
CoIIiget.  Venezia,  Bonetus  Locatel- 
lus for  Octavianus  Scotus,  31  May, 
1496.     Folio. 

Pellechet  1653.     Hain-Copinger.    2187. 

33.  AVICENNA.  Canonis  medicinse  libri 
V.  Translated  by  Gerard  of  Cre- 
mona. Libellus  de  viribus  cordis. 
Translated  by  Arnold  of  Villanova. 
Padova,  [  Johann  Herbort,]  19  August, 
27  August,  27  October,  6  November, 
1479.     Folio. 

Hain-Copinger  *  2202.     Pellechet  1661. 
Proctor  6800. 

34.  AVICENNA.  Canonis  medicinse  libri 
V.  Translated  by  Gerard  of  Cre- 
mona. Libellus  de  viribus  cordis. 
Translated  by  Arnold  of  Villanova. 
Cantica,  with  commentary  of  Averroes. 
Translated  by  Armengaud  [  Blasius  ] 
of  Monte  Pessulana.  Venezia, 
Pierre  Maufer  with  Nicolaus  de 
Contengo  of  Ferrara.  1482-3. 
Folio. 

Copinger    III,    p.     243.     Hain    2203. 
Pellechet  1662. 

35.  AVICENNA.  Canon.  Venezia,  Pi- 
erre Maufer  cum  sociis,  10  June, 
i486.     Quarto. 

Hain-Copinger  *  2205.      Proctor  4602. 
Pellechet  1664. 

36.  AVICENNA.      De  animalibus  [  Aristo- 

teles  ].     [  Venezia,  Joannes  &  Grego- 
rius de  Gregoriis,  1500.]     Folio. 


304 


Annals  of  Medical  History 


37- 


3* 


Hain-Copinger  *  2220.  Pellechet  1672. 
Proctor  4563. 

AYERROES.  Liber  colliget.  Venezia, 
Laurentius  de  Valentia  [  de  Ru- 
beis,  ]  et  socn,  5  October,  1482.  Folio. 
Hain  *  2i8q.     Burger  p.  570.      Pelle- 


chet 16- 


diff. 


BAGELLARDUS,  PAULUS.     De  in- 
fantium  aegritudinibus.     Padova,  Bar- 

THOLOM.'EUS   DE   VaLDIZOCCHO    &    AIaR- 

tinus  de  Septemarboribus,  21  April, 
14-72.     Quarto. 

Hain  *  2244.     Pellechet  1688.     Proc- 
tor 6756. 

39.  BAGELLARDUS,  PAULUS.  De  aegri- 
tudinibus infantium.     [  Padova,  ]  AIat- 

THEUS       [  CERDONIS  ]       DE       WlNDISCH- 

gretz,  10  November,  1487.     Quarto. 
Reichling  I,  p.  99.     Hain  2245. 

40.  BARTHOLOALEUS  ANGLICUS.  De 
proprietatibus  rerum.  [  Basel,  Ber- 
thold  Ruppel,  Not  ajter  1468.]  Folio. 
Hain-Copinger  *  2499.  Pellechet 
1866.     Proctor  7452.     Burger  p.  574. 

41.  BARTHOLOALEUS  ANGLICUS.  De 

proprietatibus      rerum.         Strassburg, 
[  Printer  of  Jordanus  of  Quedling- 
burg,]  77  August,  14Q1.     Folio. 
Hain-Copinger  *  2509.     Pellechet  1875. 
[  Flach.  ]     Proctor  665.    Burger  p.  329. 

42.  BARTHOLOALEUS  DE  PISIS.  Epi- 
toma  medicinae.  [  Firenze,  Lorenzo 
AIorgiani  &  Johann  Petri.]  Quarto. 
Pellechet   1896.     Hain-Copinger  2531. 

43.  BARZIZIUS,  CHRISTOPHORUS.  In- 
troductorium  ad  opus  practicum  medi- 
cinae, cum  commentario  in  IX  Iibrum 
Rhazis  ad  Almansorem.  Corrector: 
Petrus  Bucius.  Pavia,  Antonius  Car- 
canus,  20  August,  14Q4.     Folio. 

Hain  *  2666.     Pellechet    1975.     Proc- 
tor 7066. 

44.  BAVERIUS  DE  BAVERIIS,  [Joan- 
nes ].  Consilia  medica.  Bologna, 
Franciscus  [  Plato  ]  de  Benedictis, 
5  November,  7489.     Folio. 

Pellechet  2010.     Proctor  6589.     Hain- 
Copinger  2712. 

45-  BENEDICTUS,  ALEXANDER.     De 
rvatione   in   pcstilentia.     Venezia, 


Joannes  &  Gregorius  de  Gregoriis, 
2Q  July,    1493.     Quarto. 
Hain-Copinger  *  807.      Pellechet  456. 
Proctor  4530. 

46.  BENEDICTUS  DE  NURSIA.  De 
natura  rerum  et  valetudine  conservan- 
da.  Roma,  Joannes  Philippus  de 
Lignamine,  14  January,  1475.  Quarto. 
Hain  *  11919.     Burger  p.  478. 

47.  BENEDICTUS  DE  NURSIA.  De 
conservatione  sanitatis.  Bologna, 
Domintcus  de  Lapis,  1477.  Quarto. 
Hain  *  1 1920.  Proctor  6536.  Voul- 
Iieme  Berlin  2735. 

48.  BENEDICTUS  DE  NURSIA.       De 
conservatione  sanitatis.     [  Roma,  Ste- 
phen Plannck.]     Quarto. 
Copinger  II,  4444.     Proctor  3768. 

49.  BEROALDUS,  PHILIPPUS.  Decla- 
matio  an  orator  sit  philosopho  et  medi- 
co anteponendus.  Bologria,  Benedic- 
tus  Hectoris  F.^elli,  73  December, 
1497.     Quarto. 

[  Undescribed  ]. 

50.  BRUNSCHWIG,  HIERONYAIUS. 
Buch  von  der  pest.  Strassburg,  Johann 
Gruninger,  18  August,  7500.  Folio. 
Numerous  woodcut  illustrations. 
Hain  *  4020.  Pellechet  3040.  Proc- 
tor 405. 

51.  CANDIDUS,  PETRUS  DECEM- 
BRIUS.  De  genitura  hominis.  [  Roma, 
Stephanus  Plannck,  c.  7490.]  Quarto. 
Reichling  I,  104.  Proctor  3772, 
Burger  p.  542. 

52.  CASTELLO,  TURAN  DE.  De  bal- 
neis.  San^orso],  Johannes  de  Reno, 
24  March,  i4~$.     Quarto. 

Hain  *  4592=Hain   7571.     Burger   p. 
560. 

53.  CELSUS,  AURELIUS  CORNELIUS. 
De  medicina.     Firenze,  Nicolaus  Lau- 
rentii,  1478.     Folio. 
Hain-Copinger  *  4835.     Proctor  61 16. 
Burger  p.  464. 

54.  CELSUS,  AURELIUS  CORNELIUS. 
De  medicina.  Milano,  Leonardos 
Pachel  &  Uldericus  Scinzenzeler, 
7481.     Folio. 

Pellechet  3465.     Proctor  5940.    Burger 
p.    516.     Hain-Copinger   4836. 


A  Check  List  of  Medical  Incunabula 


305 


55.  CELSUS,  AURELIUS  CORNELIUS. 
De  medicina.  Addition:  Galen.  De 
affectorum  Iocorum.  [  Venezia,  Jo- 
hannes Hamman,  1500.]  Venezia, 
Johannes  Rubeus,  8  July,  1493.  Folio. 
Hain-Copinger  *  4837.  Pellechet  3466. 
Proctor  5134. 

56.  CELSUS,  AURELIUS  CORNELIUS. 
De  medicina.     Venezia,  Philippus  Pin- 
zius,  6  May,  1497.     Folio. 
Hain-Copinger  *  4838.    Pellechet  3467. 
Proctor  5316. 

57.  CHIROMANTIA.  Chiromantia  ex 
divina  philosophorum  academia.  Vene- 
zia, Bernardinus  de  Benalius,  Octo- 
ber, 1493.  Quarto.  Woodcuts. 
Reichling  IV,  p.  188.  Hain-Copinger 
4976. 

58.  Descriptiones  Morborum.  Descrip- 
tiones  morborum  in  corpore  hu- 
manorum.  Addition:  Arnoldus  de 
Villanova.  Tractatulo  de  virtutibus 
quercus.  [  Memmingen,  Albrecht 
Kunne,  ]  1496.     Quarto. 

Hain  *  6096.     British  Museum  Cata- 
logue II,  606.     Proctor  2798. 

59.  DESPARTS,  JACQUES.  Summula 
super  remediis  ex  Mesue  Iibris.  Lyon, 
[Joannes  Trechsel,  c.  1500].  Octavo. 
Copinger,  II,  6609.  Hain  12425. 
Reichling,  III,  p.  132. 

60.  DINUS  DE  GARBO.  Expositio  par- 
tium  quarti  canonis  Avicennse.  Fer- 
rara,  Andreas  de  Belfortis,  27 
October,  1489.     Folio. 

Hain  *  6166.    Pellechet  4250.    Burger 
p.  340. 

61.  DINUS  DE  GARBO.  Compilatio  em- 
plastrorum  et  unguentorum.  Ferrara, 
Andreas  de  Belfortis,  28  October, 
1489.  Folio.  Bound  with  his  Exposi- 
tio. 

Hain  *  6170.     Pellechet  4253.    Burger, 
p.  340. 

62.  DINUS  DE  GARBO.  Tractatus  de 
ponderibus  et  mensuris.  Compilatio  em- 
plastrorum  et  unguentorum.  Venezia 
Johann  Herzog  for  Andrea  de  Tor- 
resani,  4  December,  1499.  Folio. 
Hain  *  6168.  Pellechet  4252.  Proctor 
5203. 


63.  DINUS  DE  GARBO,  GENTILIS  DE 
FULGINEO,  GENTILIS  DE  FLO- 
RENTIA.  Expositio  partium  quarti 
canonis  Avicennse.  Additions:  Dinus 
de  Garbo.  Tractatus  de  ponderibus 
et  mensuris.  Compilatio  emplastrorum 
et  unguentorum.  Venezia,  Johann 
Herzog  for  Andrea  de  Torresani,  4 
December,  1499.     Folio. 

Hain*  6168.  Pellechet  4252.  Proctor 
5203. 

Sillanus  de  Nigris.  Expositio  in  IX 
Librum  Rhazis  ad  Almansorem.  Addi- 
tion: Petrus  de  Tussignano.  Recep- 
ta  Rhazis.  Venezia,  Otinus  de  Luna, 
[21  July,]  1497.  Folio. 
Hain-Copinger*  13897.     Proctor  5605. 

64.  DINUS  DE  GARBO.  Gentilis  de  Ful- 
gineo;  Gentilis  de  Florentia;  Expositio 
partium  quarti  canonis  Avicennse.  Ad- 
ditions: Dinus  de  Garbo.  Tracta- 
tus de  ponderibus  et  mensuris.  Com- 
pilatio emplastrorum  et  unguentorum. 
Venezia,  Johann  Herzog  for  Andrea 
de  Torresani,  4  December,  1499.  Folio. 
Hain*  6168.  Pellechet  4252.  Proctor 
5203. 

65.  DONDI,  GIACOMO  DEI.  Aggrega- 
tor. [Strassburg,  Adolph  Rusch,  c. 
1470.  ]     Folio. 

Hain-Copinger  *  6395.  Pellechet  4435. 
British  Museum  Catalogue  I,  p.  64. 
Proctor  248.     VouIIieme  Berlin  21 19. 

66.  FALCUCCI,  NICCOLO.  Sermones 
medicinales  VII.  [4  volumes.]  Vene- 
zia, Bernardinus  Stagninus,  24  De- 
cember, 1490 — 8  October,  1491.  Folio. 
Hain  *  1 1768. 

67.  FICINO,  MARSILIO.  De  triplici  vita. 

Venezia,  [  Bartholomeo  of  Capod'Is- 
tria.  ]     1498.     Quarto. 
Proctor    5639.     Hain  *  7066.     Burger 
p.  530.     Giinther  Leipzig  31 12. 

68.  FIERA,  BAPTISTA.    Coena  seu  de  ci- 
borum  virtutibus.     [Roma,  Eucharius 
Silber,  c.  1484.  ]     Quarto. 
Reichling  II,  p.  169.     Hain  7084. 
Copy  II. 

69.  GADDESDEN,  JOHN  OF.  Rosa  an- 
glica  practica  medicinse.     Pavia,  Leo- 


306 


Annals  of  Medical  History 
Gerla,    24    January,     1492. 


1 108.    Pellechet    764.         n 


NARDUS 

Folio. 

Hain-Copinger 
Proctor.     7 1 06 

70.  GALEN.     Opera.     Venezia,  Philippus 
Pinzius,   27    August,    1490.    Folio. 
Hain  *  7427.    Pellechet  4975.    Burger 
p.  537.     Giinther  Leipzig  3535. 

71.  GALEN.  De  affectorum  Iocorum  no- 
titia.  [  Venezia,  Johannes  Hamman 
(Hertzog),  1500.]  Folio.  Bound  with: 
Celsus.  De  medicina.  Venezia,  Ru- 
beus,  1493. 

Hain  7428.     Burger  p.  430. 

72.  Gart  der  Gesundheit.  Maintz,  Peter 
Schoffer,  28  March,  1485.  Folio. 
Numerous  colored  illustrations. 

Proctor  123.     Hain  *  8948.    VouIIieme 

Berlin  1542. 

Imperfect. 

73.  GAZIO,  ANTONIO.  Corona  florida 
medicina?.  Venezia,  Joannes  &  Grego- 
rius  de  Gregoriis,  20  June,  14Q1. 
Folio.  Bound  with  this:  Avenzoar. 
Libri  Theizir  Averroes  CoIIiget. 
Venezia,  Joannes  &  Gregorius  de 
Gregoriis,  4  January',  1490.  Folio. 
Hain*  2186.  Proctor 45 13.  Pellechet 
1652. 

Hain-Copinger *750 1.     Pellechet  5003. 
Proctor  4518. 

74.  GEMINIANO,  JOANNES  DE 
SANCTO.  Liber  de  exemplis  et  simili- 
tudinibus  rerum.  Venezia,  Joannes 
et  Gregorius  de  Gregoriis,  12  July, 
1409.     Quarto. 

Hain-Copinger  *  7547.     Proctor  4560. 

75.  GENTILIS  DE  FULGINEO.  Super 
fen  unum  quarti  canonis  Avicenna?  de 
febre  et  de  majoritate  morbi.  Padora, 
Nicolaus  Petri  de  Harlem,  19  Febru- 
ary, 1476.     Folio. 

Pellechet    5025.     Reichling    I,  p.    147. 
Burger,  p.  533.     Hain  7565. 

76.  GENTILIS    DE    FULGINEO.     Con- 
silium  contra    pestilcntiam.         [Colle, 
Bonus  Gallus,    1478-9.  ]     Quarto. 
Pellechet  5021.   Reichling  II,  530. 

77-  GENTILIS  DE  FULGINEO.  Tracta- 
tus  de  febribus.     Padova,  Matth/EUS 


79- 


80. 


83. 


84. 


85. 


Cerdonts  2  December,  i486.  Folio. 
Copinger  II,  2653. 

GERSON,  JOANNES  DE  [  CHAR- 
LI  ER  ].  De  pollutione  nocturna  et 
diurna.  De    cognitione    castitatis. 

Forma  absolutions  sacramentalis. 
[  Coin,  Ulrich  Zell,  c.  1467.  ]  Quarto. 
Hain  7697+Hain  *  7690  [  Hain-Co- 
pinger 7704.]  Pellechet  5212  +  PeIIe- 
chet  5135.     Proctor  806+Proctor  807. 

GERSON,  JOANNES  DE  [  CHAR- 
LIER].  De  pollutione  nocturna  et 
diurna.  De  cognitione  castitatis. 
[  Coin,  Ludwig  of  Renchen.  ]  Quarto. 
Hain*  7701.     Proctor  1275.      Burger 

P-  559- 
Imperfect. 

GORDON,  BERNARDUS  DE.     Prac- 

tica  dicta  Lilium  medicinse.     Ferrara, 

Andreas    Beaufort,    18   May,    i486. 

Folio. 

Hain-Copinger  *  7796.    Pellechet  5274. 

Proctor  5749. 

Addition:  Manuscript. 

GORDON,  BERNARDUS  DE.  Prac- 

tica  dicta  Lilium  medicina?.     Lyon,  An- 
tonius  Lambillon  et  Marinus  Sara- 
sin,  2  May,  1 49 1.     Folio. 
Pellechet  5275.    Burger  p.  461.    Hain- 
Copinger  7797. 

GORDON,  BERNARDUS  DE.    Prac- 

tica  dicta  Lilium  medicina?.      Venezia, 

Joannes  &  Gregorius  de  Gregoriis, 

16  January,   1496.     Quarto. 

Hain  *  7799.  Pellechet  5276.    Proctor 

455  *■ 

GORDON,  BERNARDUS  DE.    Prac- 

tica  dicta  Lilium  medicina?.      Venezia, 

Bonetus    Locatellus,    22    December, 

1498.     Folio. 

Hain  *  7800.     Pellechet  5277.    Proctor 

5095.     VouIIieme  Berlin  4200. 

GRADO,  GIAN  MATTEO  FERRARI 

DA.  Pract ica.  Pavia,  [Joannes  de 
Sidriano,  ]  29  September,  1471.  Folio. 
Reichling  II,  p.   177.     Hain  17836. 

GRADO,  GIAN  MATTEO  FERRARI 
DA.  Super  XXII  fen  tertii  canonis 
Avicenna.  Mikmo,  Jacobus  de  San 
Nazarro,   17  November,    1494.     Folio. 


A  Check  List  of  Medical  Incunabula 


307 


Hain  *  7840.  Pellechet  5286.  Burger 
P-  575- 

86.  GRADO,  GIAN  MATTEO  FERRARI 
DA.  Opera  medica,  seu  practica  cum 
textu  Iibri  noni  Rhazis  ad  Almansorem. 
Venezia,  Bonetus  Locatellus  for  the 
heirs  of  Octavianus  Scotus,  [  12  June,] 
1502.  Folio.  Bound  with  this:  Arcu- 
lanus,  Johannes.  Expositio  in  Avi- 
cennae  canonis  quarti  Fen  primam. 
Venezia,  Bonetus  Locatellus,  27 
October,  1496.     Folio. 

Hain  *  1553.     CoIIijn  Upsala  788. 

87.  GRASSI,  BENEVENUTO.     Deoculis. 

[  Ferrara,  Severinus  de  Ferrara, 
14.74.  ]     Quarto. 

Pellechet  5300.  Reichling  II,  p.  179. 
Burger  p.  398.     Hain  7869. 

88.  GRUNPECK,  JOSEF  VON  BURCK- 

HAUSEN.  De  pestilentiali  scorra  sive 
mala  Franczos.  [  Coin,  Cornelis  de 
Zierikzee.  ]  Quarto.  Two  illustra- 
tions. 

Hain*  8092.  Proctor  1501.  Burger 
p.  655. 

89.  GUAINERI,  ANTONIO.  De  pro- 
priis  mulierum  segritudinibus.  [  Padova, 
Conrad  de  Paderborn.  ]  1474. 
Quarto. 

Reichling  II,  p.  182.  Burger  p.  517. 
Hain-Copinger  8104. 
00.  GUAINERI,  ANTONIO.  Opera  med- 
ica. Addition:  De  febribus.  De  bal- 
neis.  Pavia,  Antonius  Carcanus, 
1 48 1.     Folio. 

Reichling  V,  p.  130.  Burger  p.  371. 
Hain  8097. 

91.  GUAINERI,  ANTONIO.  Opera  med- 
ica. Addition:  Arnoldus  de  Villa- 
nova.  Practica.  [Pavia,  Antonius 
Carcanus.  ]  Copinger  II,  647.  CoIIijn 
Stockholm  103.  Pavia,  Antonius  Car- 
canus, 10  January,  1488.  Folio. 
Hain-Copinger  *  8098.     Proctor  7057. 

92.  GUAINERI,  ANTONIO.  De  febri- 
bus. [  Padua,  Conrad  de  Paderborn.] 
Folio. 

Reichling     II,    p.    183.     Copinger   II, 

2803.     Burger  p.  517. 

Bound  with  2  other  works  of  Guaineri. 

93.  GUY    DE    CHAULIAC.      Chirurgia. 


Venezia,    Nicolaus    Girardengus,    2 
November,  1480.     Folio. 
Copinger  II,    1548.        Reichling  II,  p. 
146.     Burger  p.  417. 

94.  GUY    DE    CHAULIAC.      Chirurgia. 

Venezia,  Bonetus  Locatellus  for 
Octavianus  Scotus,  21  November, 
14Q8.     Folio. 

Hain-Copinger  481 1.  Pellechet  3530, 
Proctor  5093. 

95.  GUY  DE  CHAULIAC.        Chirurgia. 

Venezia,  Simon  of  Lovere,  25  Decem- 
ber, 1499.     Folio. 

Hain-Copinger    *    4812.  Pellechet 

3531.     Proctor    5626. 

96.  GUY  DE  CHAULIAC.  Chirurgia. 
[  Lyon,  ]  [  Vincentius  de  Portonariis, 
14QQ.  ]     Quarto. 

Copinger  i546  =  Peddie  Conspectus: 
Lyon,  1499.     Burger  p.  544. 

97.  HALY  ABBAS.  Liber  regalis.  Vene- 
zia, Bernardinus  Ricius,  25  Septem- 
ber, 1492.     Folio. 

Hain-Copinger  *  8350.  Proctor  4964. 
Burger  p.  563. 

98.  HIPPOCRATES.     De  natura  hominis. 
[  Roma,   Georg   Herolt  or   Stephen 
Plannck.  ]     Quarto. 
Hain-Copinger  *  8669.     Proctor  3943. 
Burger  p.  434. 

99.  HORTUS  SANITATIS.  Ortus  sani- 
tatis.  Mainz,  Jacob  Meydenbach,  23 
June,  1491.     Folio. 

Hain-Copinger  *  8944.  British  Mu- 
seum Catalogue  44. 

100.  HORTUS  SANITATIS.  Ortus  sanita- 
tis.  [  Strassburg,  Johann  Gruninger, 
b.   1497.  ]     Folio. 

Hain-Copinger  *  8942. 

101.  HUG0[BENCIUS1SENENSIS.  Su- 
per  IV  Fen  primi   canonis   Avicennae. 
Venezia,    Andreas    Calabrensis    of 
Pavia,  4  February,  1485.     Folio. 
Hain-Copinger*  9018.     Proctor  4965. 

102.  HUGO[BENCIUS]SENENSIS.  Su- 
per   I   Fen   primi    canonis    Avicennae. 
Ferrara,      Andreas      Belfortis,      73 
August,  1 49 1.     Folio. 
Hain-Copinger  9016.     Proctor  5751. 

103.  HUGO[BENCIUS]SENENSIS.  Su- 


3o8 


Annals  of  Medical  History 


104. 


105, 


106, 


107 


108 


109 


per  aphorismos  Hippocratis  cum  com- 
mento  Galeni.  Ferrara,  Lorenzo  Rossi 
with  Andreas  De  Grassis,  13  Novem- 
ber, 1493.  Folio. 
Hain  *  901 1.     VouIIieme  Berlin  2873. 

HUGO    [  BENCIUS  ]    SENENSIS. 
Consilia   aurea.     Pavia,    [  Leonardus 
Gerla,  ]  14  April.  [  1498.  ]     Folio. 
Reichling  V,  1544. 

Bound  with  another  work  of  Hugo 
Bencius  Senensis. 

HUGO  [BENCIUS]  SENENSIS.  Su- 
per I  Fen  quarti  canonis  Avicennae.  Ad- 
dition: De  regimine  sanitatis.  Pavia, 
[  Andreas  de  Bosco.  ]  Pavia,  An- 
dreas de  Bosco,  29  October,  1498. 
Folio. 
Reichling  VI,  1766. 

HUGO  [  BENCIUS  ]  SENENSIS.  Su- 
per I  &  II  Fen  primi  canonis  Avicennae. 
Addition:  Super  quarta  fen  primi  Avi- 
cennae  cum  annotationibus  Jacobi  de 
Partibus.  Venezia,  Bonetus  Loca- 
tellus  for  Octavianus  Scotus,  6 
August,  1502.     Venezia,    Bonetus  Lo- 

CATELLUS  for  OCTAVIANUS  ScOTUS,  [  2J 

April,]  1408.     Folio. 
Hain-Copinger  *  9017.    VouIIieme  Ber- 
lin 4204. 

JACOBUS  FORLIVIENSIS.    Exposi- 
tio    in    Hippocratis    aphorismos    cum 
Marsilio  di  Sancta  Sophia.     [  b.  1480.  ] 
Folio. 
Hain  7246.     [  diff.  ] 

JACOBUS  FORLIVIENSIS.  Expo- 
sitio  in  Hippocratis  aphorismos  cum 
Marsilii  de  Sancta  Sopnia  super  apho- 
rismos Hippocratis.  Venezia,  Bone- 
tus LOCATELLUS  for  OCTAVIANUS  ScO- 

tus,  10  March,  20  May,  1495-  Folio. 
Hain-Copinger  7251.  VouIIieme  Ber- 
lin 4188.     Copinger  III,  p.  261. 

JOANNITIUS.         Isagogae   in   tegni 
Galeni.  Leipzig,  Wolfgang  [  Stockel  ] 
of    Munch  en,     27    May,  [14]    97. 
Quarto. 
Hain-Copinger  9435. 

,  JUNG,  AMBROSIUS.  Tractatulus 
pcrutilis  de  pestilentia.  Augsburg, 
Johannes  Schonsperger,  20  Novem- 
ber,  14(14.     Quarto. 


Hain  *  9472.     British  Museum  Cata- 
logue II,  p.  368. 

in.  KAMINTUS.     Regimen  contra  pesti- 
Ientiam.     [  Antwerp,  Mathias  van  der 
Goes.  c.  1484.  ]     Quarto. 
Campbell's  Annales  1066.  Copinger  II, 
343 1- 

112.  KAMINTUS.  Regimen  contra  pesti- 
Ientiam.  [  Leipzig,  ]  Arnoldus  von 
Coln,  [  a.  1493.  ]     Quarto. 

Hain  *  9757.      Proctor  3004.      British 
Museum  Catalogue  III,  645. 

113.  KETHAM,  JOHANNES  DE.  Fasci- 
culus medicinae.  Venezia,  Joannes  & 
Gregorius  de  Gregoriis,  13  October, 
1493.  Folio.  Numerous  illustrations. 
Hain-Copinger  *  9775.  Proctor  4550. 
Choulant  Abbildung  p.  20. 

114.  KETHAM,  JOHANNES  DE.  Fasci- 
culus medicinae.  Venezia,  Joannes  & 
Gregorius  de  Gregoriis,  17  February, 
1300.  Folio.  Numerous  illustrations. 
Hain*  9777.  Proctor  4561.  Chou- 
lant Abbildung  p.  22. 

115.  LANFRANCI.  Cirurgia  menor.  Se- 
villa,  Pro  tres  Alemanes  companeros,  13 
May,  1493.     Folio. 

Reichling    I,    p.     162.      Haebler    349. 
Proctor  9523  A. 

116.  LAPIDARIUM.  Lapidarium  medici- 
nae experimenta  complectens.  Wien, 
Johann  of  Winterburg,  [  c.  1493  ]. 
Quarto. 

Copinger  3492. 

117.  LEONICENUS,   NICOLAUS.        De 

Plinii  et  plurimorum  aliorum  in  medi- 
cina  erroribus.    Ferrara,  Lorenzo  Ros- 
si with  Andreas  de  Grassis,  18  De- 
cember, 1492.     Quarto. 
Hain-Copinger    *    10021.  Proctor 

5760.     VouIIieme  Berlin  2872. 

118.  LEONICENUS,   NICOLAUS.        De 
morbo  gallico.     Milano,  Guilelmus  Si- 
gnerre,  4  July,   1497.     Quarto. 
Reichling   V,  p.    172.    Hain   10020. 
Copy  I. 

ii<).  LEONICENUS,   NICOLAUS.        De 
morbo  gallico.     Milano,  Guilelmus  Si- 
gnerre,   ./  Julv,    1497.     Quarto. 
Reichling  V,  p.  172.     Hain  10020. 


A  Check  List  of  Medical  Incunabula 


309 


Copy  II.  With  which  are  bound: 
Mondini.  Anatomia,  7494.  Tra- 
nensis.  De  ingenuis  moribus,  14Q6. 
Savonarola.     Psalm  L.  [  7498  ] 

120.  LEONICENUS,   NICOLAUS.        De 

morbo  gallico.     Venezia,  Aldus  Manu- 
tius,  June,  14Q7.     Quarto. 
Hain-Copinger  *  100 19.     Proctor  5557. 
VouIIieme  Berlin  4493. 

121.  LOCHER,  JACOBUS.  De  partu 
monstroso  carmen.  Ingolstadt,  [  Jo- 
hann  Kachelofen,  a.  26  November, 
i4gg.  ]  Quarto.  Two  woodcuts. 
Hain  *  10162.  Proctor  3165.  British 
Museum  Catalogue  III,  p.  679. 

122.  MACER  FLORIDUS.  De  viribus 
herbarum.  [  Geneve,  Louis  Cruse, 
7483-95.  ]      Quarto. 

Last  leaf  missing. 

123.  MACER  FLORIDUS.  De  viribus 
herbarum.  [  Paris,  Le  Petit  Lau- 
rens, c.  1500.  ] 

Hain-Copinger  104 18.     John  Pierpont 

Morgan  Catalogue  541. 

Imperfect. 

124.  MACER  FLORIDUS.  De  viribus 
herbarum.  [  Paris,  Gui  Marchand.  ] 
Quarto.     Numerous  woodcuts. 

Hain  *  104 17.     VouIIieme  Koln  p.  340. 

125.  MAGNINUS.  Regimen  sanitatis. 
Louvain,     Johann     of     Westphalia, 

1482.  Quarto. 

Campbell's  Annales  *  1 1 88.  Proctor 
9230.  Burger  p.  638.  Hain-Copinger 
10483. 

126.  MAGNINUS.  Regimen  sanitatis. 
Paris,   Udalricus  Gering,   5  March, 

1483.  Quarto. 

Hain  *  10484.     Proctor  7869. 

127.  MAGNINUS.  Regimen  sanitatis.  Ba- 
sel, Nicolaus  Kesler,  [  c.  8  November, 
14Q3.  ]     Quarto. 

Copinger    II,    3756.     Proctor  7701   A. 
Burger  p.   450.     Hain  10486.     British 
Museum  Catalogue  III,  771. 
Variant  I,  ib  is  blank. 

128.  MAGNINUS.  Regimen  sanitatis. 
Basel,  Nicolaus  Kesler.  [  c.  8  No- 
vember, 14Q3.  ]     Quarto. 

Copinger   II,   3756.     Proctor  7701   A. 


Burger  p.  450.     Hain  10486.     British 
Museum  Catalogue  III,  771. 
Variant  II,   ib  contains  Letter. 

129.  MAGNINUS.  Regimen  sanitatis. 
Additions:  Reginaldus  de  Villanova. 
De  phlebotomia.  Hippocrates.  De 
astronomis:  secreta.  Averroes.  De 
venenis.  Nicolaus  Salernitanus: 
Quid  pro  quo.  Avicenna  et  al. 
[  Lyon.  ]     Quarto. 

Hain  *  10482.  Proctor  8705.  Burger 
p.  486. 

130.  MAI  MON  IDES,  MOSES.  De  regi- 
mine  sanitatis.  Firenze,  Sanctus  Ja- 
cobus de  Ripoli.  [  c.  1478.  ]  Quarto. 
Hain-Copinger*  10525.  Proctor  6109. 
Burger  p.  403. 

131.  MAIMONIDES,  MOSES.  Aphorismi 
medici.  Addition:  Johannis  Damas- 
ceni  aphorismi,  Bologna,  Franciscus 
[  Plato  ]  de  Benedictis,  2g  May,  i48g. 
Quarto. 

Hain-Copinger  *  10524.  Proctor  6588. 
VouIIieme  Berlin.     2750. 

132.  MANFREDI,  GERONIMO.  Liber 
de  homine  et  de  conservatione  sanitatis. 
[  Italian  ]  Bologna,  Ugo  Rugerius  & 
Doninus  Bertochus,  /  July,  1474. 
Folio. 

Reichling  VI,  p.  94.  Copinger  II, 
2623.     Proctor  6529.     Hain  10689. 

133.  MANFREDI,     GERONIMO.        De 
peste.     Bologna,   [  Johann  Valbeck,  ] 
3/  December,  I4yg.     Quarto. 
Reichling  VI,  94.     Hain  *  10696. 

134.  MANLIIS,  JOANNES  JACOBUS 
DE.  Luminare  majus.  Pavia,  An- 
tonius  de  Carchano,  9  April,  I4g4. 
Folio. 

Reichling  III,  p.  101.  Proctor  7065. 
Hain  10711. 

135.  MANLIIS,     JOANNES     JACOBUS 

DE.  Luminare  majus.  Venezia,  Bon- 
etus  Locatellus,  28  May,  14Q6.  Folio. 
Hain-Copinger    *      107 12.  Proctor 

5070.      VouIIieme  Berlin  4192. 

136.  MATHEOLUS,  PERUSINUS.  De 
memoria    augenda.     [  Roma,    Johann 

BESICKEN        &        SlGISMUND        MaYR.  ] 

Quarto. 

Hain-Copinger*   10906. 


3Jo  Annals  of 

137.  MESUE.  Opera  medicinalia.  Vene- 
zia, Clemens  Patavinus  Sacerdos, 
18  May,  1471.     Folio. 

cf.     Hain-Copinger     11118.       Proctor 
4142. 

138.  MESUE.  Opera  medicinalia  cum 
additionibus.  Venezia,  Renaldus  of 
Numegen,  31  January',  1479.  Folio. 
Hain-Copinger*   11 108.    Proctor  4432. 

139.  MESUE.  Opera  medicinalis  cum  ad- 
ditionibus. Venezia,  Dionysius  Berto- 
chus,  1484.     Folio. 

140.  MESUE.     Opera  medicinalis  cum  ad- 
ditionibus.      Venezia,    Peregrino   de 
Pasquale,  2  December,  1489,  21  Novem- 
ber, 1490,  18  July,  1491.     Folio. 
Hain  *  1 1 1 10.     Choulant,  p.  354. 

141.  MESUE.  Liber  de  consolatione 
medicinarum  simplicium.  Venezia, 
Petrus  de  Quarengis,  12  December, 
1493.     Folio. 

Reichling  VI,   p.  97.      Hain-Copinger 
1 1 1 16. 

142.  MESUE.  Opera  medicinalis  addi- 
tionibus. Venezia,  Bonetus  Locatel- 
lus  for  Octavianus  Scotus,  31  March, 
1495.     Folio. 

Hain  *  inn.     Proctor  5059. 

143.  METLINGER,  BARTHOLOM/EUS. 
Regiment  der  jungen  Kinder.  [  Augs- 
burg, Gunther  Zainer  c.  7  December, 

1473.  ]     Folio. 

Proctor    1537.     Hain-Copinger    11127. 

144-  METLINGER,  BARTHOLOM/EUS. 

Regiment  der  jungen   Kinder.     Augs- 
burg,    JOHANN     BaMLER,     28     August, 

1474.  Folio. 

145.  METLINGER,  BARTHOLOM/EUS. 
Regiment  der  jungen  Kinder.  Addi- 
tion: Schrick.  Ulm,  1501.  Augs- 
burg, Hans  Schauren,  13  February, 
1500.  Quarto.  Four  illustrations. 
Sudhoff  39. 

146.  MONDINI  DEI  LUZZI.  Anatomia. 
[  Leipzig,  Martin  Landsberg,  c.  1493.} 
Quarto. 

Hain-Copinger  *  1 1633.     Proctor  2994. 
VouIIieme  Berlin  1342. 

147.  MONTAGNANA,   BARTHOLO- 

M  11   S.      Cunsilia    medievi    cum    addi- 


Mcdical  History 

tionibus.  Venezia,  Bonetus  Locatel- 
lus  for  Octavianus  Scotus,  2  August, 
1497.     Folio. 

Hain-Copinger  *  11552.  Proctor  5081. 
VouIIieme  Berlin  4198. 

148.  MONTAGNANA,  BARTHOLO- 
M^US.  [  or  by  Zacharia  de  Fel- 
tre.  ]  De  urinarum  judiciis.  Padova, 
Matthaeus  Cerdonis,  17  February, 
1487.     Quarto. 

Reichling  V,  p.  198.  Proctor  6821. 
Hain-Copinger  11553. 

149.  MULLER,  JOHANN  [  REGIOMON- 
TANUS]  Kalendarium.      Venezia,  Er- 
hard       Ratdolt,    io    October,    148$. 
Quarto.     Numerous  diagrams. 
Hain-Copinger*  13779.     Proctor  4405. 

150.  NICANDER.  Theriaca  et  alexiphar- 
maca.  Venezia,  Aldus  Manutius, 
July,  1499.     Folio. 

Hain-Copinger*  6257.  Proctor  5571. 
VouIIieme  Berlin  4506. 

151.  NICOLAUS  SALERNITANUS.  Anti- 
dotarium.     Quarto. 

Reichling    VI,   p.    97.     Proctor  4076. 

Hain  1 1764. 

Bound   with    this:    Abulcasis:    Liber 

servitoris.     Venezia,  Nicolas  Jensen, 

1471. 

Pellechet  411.    Burger  p.  444. 

152.  NICOLAUS  SALERNITANUS.    An- 

tidotarium   cum   Mesue.     [  Strassburg, 

JOHANN  PRUSS,  C.   1480.  ]      Folio. 

Hain*  11763.     VouIIieme  Berlin  2387. 

153.  ORTOLFF     VON     BAYERLAND. 

Arzneibuch.        Niirnberg,  Anton  Ko- 
burger,   17  March,   1477.     Folio. 
Hain*  121 12.     Proctor  1977.       Voul- 
Ii6me  Berlin  1646. 

154.  ORTOLFF  VON  BAYERLAND. 
Arzneibuch.  Augsburg,  Anton  Sorg, 
11  August,  1479.     Folio. 

Hain  *  121 13. 

155.  ORTOLFF  VON  BAYERLAND. 
Fraucnbiichlcin.     [  Ulm,  c.  149$.  ] 

156.  Pestilentia.  Perutilis  tractatus  de  pes- 
tilentia.  [  Augsburg,  Johann  Keller, 
c.  1480.  ]    Quarto. 

Hain*  12745.  Proctor  1746.  British 
Museum  Catalogue  II,  361. 


A  Check  List  of  Medical  Incunabula 


3ii 


157.  PETRARCA,  FRANCESCO.  Epis- 
tolse  familiares.  Venezia,  Joannes  & 
Gregorius  de  Gregoriis,  13  Septem- 
ber, 1492.  Quarto. 
Hain-Copinger  *  12811.  Proctor  4526. 
Ashley  318. 

158.  PETRUS  DE  ABANO.  Conciliator 
differentiarum  inter  philosophos  et 
medicos.  Tractatus  de  venenis.  Edi- 
tor: Petrus  de  Carariis  de  Monte 
Silice.  De  terminatione  venenorum. 
Venezia,  Gabriele  Petri  for  D. 
Thomas  of  Treviso  [  Corrector  ],  1476. 
Folio. 

Hain-Copinger  *  2.     Pellechet  2.   Proc- 
tor 4196.     Burger  p.  532. 
Imperfect. 

159.  PETRUS  DE  ABANO.  Conciliator 
differentiarum  inter  philosophos  et 
medicos.  Tractatus  de  venenis.  Edi- 
tor: Petrus  de  Carariis  de  Monte 
Silice.  De  terminatione  venenorum. 
Venezia,  Gabriele  Petri  for  D. 
Thomas  of  Treviso  [  Corrector  ],  1476. 
Folio. 

Hain-Copinger  *  2.     Pellechet  2.   Proc- 
tor 4196.     Burger  p.  532. 

160.  PETRUS  DE  ABANO.  De  venenis. 
Padova,  [  LEONARDUS  (Achates)  of 
Basel  ],  1473.     Quarto. 

Pellechet  7.     Hain-Copinger  8.     Proc- 
tor 6775. 

161.  PETRUS  DE  ABANO.     De  venenis. 
Roma,  Joannes  Philippus  de  Ligna- 
mine,  27  January,  1475.     Quarto. 
Pellechet  8.     Hain  9. 

162.  PETRUS  DE  ABANO.  De  venenis. 
Addition:  Arnoldus  de  Villanova. 
De  arte  cognoscendi  venena.  Valesco 
de  Taranta.  De  epidemia  et  peste. 
[  Padova  ],  Matth/eus  Cerdonis,  18 
December,  1487.     Quarto. 

Hain*   12.        Pellechet   10.        Proctor 
6826.     Burger  p.  376. 

163.  PETRUS  DE  ABANO.  De  venenis. 
Emendator:  Wilhelm  Haldenhoff. 
Leipzig,  Jacob  Thanner,  9  November, 
1500.     Quarto. 

Hain*  15.     Burger  p.  608. 

164.  PETRUS  DE  ABANO.  Conciliator 
differentiarum     inter     philosophos     et 


medicos.  Tractatus  de  venenis.  Vene- 
zia, Bonetus  Locatellus  for  Octavi- 
anus  Scotus,  [  15  March,  ]  14Q6.  Folio. 
Woodcuts. 

Hain-Copinger  *  4.     Pellechet  4.   Proc- 
tor 5069. 
Imperfect. 

165.  PETRUS  DE  ABANO.  Conciliator 
differentiarum  inter  philosophos  et 
medicos.  Venezia,  Johann  Herbort, 
9  February,  1483.  Folio. 
Hain-Copinger  *  6.  Pellechet  5.  Proc- 
tor 4689. 

166.  PETRUS  DE  ABANO.  Expositio 
problematum  Aristotelis.  [  Venezia,  ] 
Johann  Herbort,  25  February,  1482. 
Folio. 

Hain-Copinger  *  17.  Pellechet  12. 
Proctor  4686.     Burger  p.  433. 

167.  PETRUS  DE  ARGELLATA.  Libir 
sex  chirurgia.  Venezia,  [  Joannes 
&  Gregorius  de  Gregoriis,  ]  12  Sep- 
tember, 1499.  Folio.  Bound  with 
Abulcasis. 

Copinger  III,  p.  241.     Hain  1639. 

168.  PETRUS  HISPANUS.  Practica 
medicinal  seu  Thesaurus  pauperum. 
[  Firenze,  Bartolomeo  de  Libri,  c. 
1480.  ]     Quarto. 

Reichling  II,  p.  191.  Hain  8713  or 
8714? 

169.  PETRUS  HISPANUS.  Practica 
medicinae  seu  Thesaurus  pauperum. 
Antwerp,  Thierry  Martens,  2  May, 
j  497.     Folio. 

Campbell's  Annales  *  1395.  Proctor 
9453.     Hain-Copinger  8712. 

170.  PEYLIGK,  JOHANNES.  Compen- 
dium philosophise  naturalis.  Leipzig, 
Melchior  Lotter,  12  September,  1499. 
Folio.  Woodcut  illustrations. 
Hain-Copinger  *  1 286 1.  Proctor  3036 
A.     VouIIieme  Berlin  1393. 

171.  PISTOR,  SIMON.  Declaratio  defen- 
siva  positionis  de  mala  franco.  Leip- 
zig, [  Conrad  Kachelofen,  a  5  Janu- 
ary, 1500  ].  Quarto. 
Hain-Copinger*  13021.  Proctor  2878. 
British   Museum   Catalogue   III,   629. 

172.  PLATINA,  BARTHOLOMEWS.  De 
honesta  voluptate.     Venezia,  Lauren- 


312 


Annals  of  Medical  History 


173- 


174. 


TIUS  DE  AQUILA  &  SlBYLLINUS  UMBER, 

13  June,  1475.     Folio. 
Hain  *  1 305 1.     Proctor    4355.     VouI- 
Iieme Berlin  3765. 

PLINIUS  SECUNDUS,  .CAIUS 
[the  elder].  Historia naturalis.  With 
the  corrections  of  Philippus  Beroal- 
dus.  Parma,  Stephanus  Corallus 
[  of  Lyon  ],  14.76.  Folio. 
Hain-Copinger  13091.  Proctor  6842. 
VouIIieme  Berlin  3221.  CoIIijn  Stock- 
holm 873. 

Prognosticon :  Prognosticon  de  muta- 
tione  aeris.  Addition:  Hippocrates: 
Libellus  de  medicorum  astrologia. 
Translator:  Petrus  de  Abano.  Vene-  ^3. 
zia,  Erhard  Ratdolt,  148$.  Quarto. 
Redgrave  56.  Reichling  III,  p.  160. 
Proctor  4401.  Hain-Copinger  13393. 
Copy  I. 

PUFF,  MICHAEL,  OF  SCHRICK.      ^4. 

Von     den     ausgebrannten     Wassern. 

Augsburg,        JOHANN        SCHONSPERGER, 

1484.     Folio. 

Copinger  III,  5320.     Sudhoff  160  a. 

Qua^stiones.  Quaestiones  naturales  an- 
tiquorum  philosophorum.     Coin,  Cor-       185. 

NELIS    DE    ZlERIKEE,    [  I §00  ].      Quarto. 

Copinger,  III,  5004.     Proctor  1500. 

177.  Regimen  Sanitatis.  Regimen  sanita- 
tis  salernitanum  cum  commentario 
Arnoldi  de  Villanova.  Strassburg,  186. 
[  Printer  of  Jordanus  of  Quedling- 
burg  ],  2Q  December,  14QI.  Quarto. 
Hain-Copinger   *    13758.  Pellechet 

1292.     Proctor  666.     VouIIieme  Berlin 
2446. 

178.  Regimen  Sanitatis.  Regimen  sanitatis       187. 
salernitanum  cum  commentario  Arnoldi 

de  Villanova.     Paris,   Felix  Balli- 
gault,  17  November,  14Q3.     Quarto. 
Pellechet  1296.     Proctor  8246.     Hain- 
Copinger  13760. 

Regimen  Sanitatis.  Regimen  sanitatis       188. 
salernitanum    cum    commentario    Ar- 
noldi de  Villanova.    Paris,  Andreas 
Bocard,  17  November,  1403.     Quarto. 

Pellechet   1295.      Copinger  III,  5069. 

Regimen  Sanitatis.  Regimen  sanitatis 
s.ilc  rnitanum    cum    commentario    Ar-       189. 


175 


176. 


179. 


180. 


[Possibly  French, 
■50tI.       Proctor 


noldi  de  Villanova. 
c.  1485.  ]     Quarto. 
Hain-Copinger     III, 
7418. 

Regimen  Sanitatis.  Regimen  sanitatis. 
Ulm,   Conrad   Dinckmut,   5   October, 
1482.     Folio.     Illustration. 
Sudhoff  16.     Hain  13742. 

Regimen  Sanitatis.  Regimen  sanitatis 
salernitanum  cum  commentario  Ar- 
noldi de  Villanova.     [  Louvain,  Jo- 

HANN       OF       PaDERBORN,       a.        1480.  ] 

Quarto. 

Pellechet    1279.     Campbell's    Annales 

1469. 

Regimen  Sanitatis.  Regimen  sanitatis. 
Augsburg,  Hans  Bamler,  23  April, 
1472.     Folio. 

Sudhoff  10.     Hain  *  13736. 
Incomplete. 

Regimen  Sanitatis.  Regimen  sanitatis 
salernitanum  cum  commentario  Ar- 
noldi de  Villanova.  [  Venezia,  Ber- 
nardinus  de  Vitalibus,  a.  1500.  ] 
Quarto.  Woodcut. 
Hain-Copinger  13750. 

RHAZES.  Liber  dictus  Elhavi.  Bres- 
cia, Jacobus  Britannicus,  18  October, 
i486. 

Hain-Copinger*  13901.  Proctor  6984. 
VouIIieme  Berlin  2823. 

RHAZES.  Libri  ad  Almansorem. 
Milano,  Leonhard  Pachel  &  Ulrich 
Scinzenzeler,  14  February,  1481. 
Folio. 

Hain-Copinger  13891.  VouIIieme  Ber- 
lin 3087. 

RHAZES.  Opera  varia.  Addition: 
Arnoldus  de  Villanova.  Practica. 
Venezia,  Bonetus  Locatellus,  7  Octo- 
ber, 14Q7.  [  Venezia  ],  Bonetus  Loca- 
tellus, 7  October,  1407.  Folio. 
Hain-Copinger*  13893.     Proctor  5082. 

RHAZES.  Libri  ad  Almansorem  cum 
additionibus.  Venezia,  [  Bonetus  Lo- 
catellus ]  for  Octavianus  Scotus,  10 
April,  1400.  Folio. 
Hain*  13896.  Proctor  5022.  Chou- 
Iant  p.  344. 
ROLANDO  CAPELLUTI.     Tracta- 


A  Check  List  of  Medical  Incunabula 


3i3 


tus  de  curatione  pestiferorum  aposte- 

matum.     [  Roma,   Stephan   Plannck, 

a.  1480.  ]     Quarto. 

Hain  *  4375.     Pellechet  3228.     Proctor 

*3773- 

190.  ROLEVINCK,  WERNER.  Fascicu- 
lus temporum.  [  Strassburg,  Johann 
Pruss,  not  bejore  14QO.  ]  Folio.  Wood- 
cuts. 

Hain-Copinger  *  6916. 

191.  SALICETO,     GUILIELMUS      DE. 

Chirurgia.  ig  December,  i486.  Quarto. 
Reichling  III,  314. 

192.  SALICETO,      GUILIELMUS     DE. 

Summa  conservationis  et  curationis 
cum  chirurgia.  Venezia,  [  Joannes  & 
Gregorius  de  Gregoriis,  ]  8  May, 
14QO.     Folio. 

Hain-Copinger  14145.  Proctor  4515. 
VouIIieme  Berlin  3862. 

193.  SALICETO,  GUILIELMUS  DE. 
De  salute  corporis.  Addition:  Jo- 
annes de  Turrecremata.  De  salute 
animae.  [  Mantova,  Paulus  Joannes 
de  Butzbach,  c.  1480.  ]  Quarto. 
Woodcut. 

Hain-Copinger  *  14150.  Proctor  4014. 
A.  VouIIieme  Koln  540.  Burger  p. 
365- 

194.  SALICETO,  GUILIELMUS  DE. 
Chirurgia.  Lyon,  Matthieu  Husz,  16 
November,  I4Q2.     Quarto. 

Copinger  III,  5212. 

195.  SALICETO,  GUILIELMUS  DE. 
Summa  conservationis  et  curationis 
cum  Chirurgia.  Piacenza,  25  May, 
1476.     Folio. 

Reichling,  III,  p.  169.  Burger,  p.  539. 
Hain  14144  [  1475  ]  t  Hain  14146. 

196.  SALICETUS,  NICOLAUS.  Antido- 
tarius  animae.  Strassburg,  Johann 
Gruninger,  4  March,  14Q3.  Quarto. 
Hain-Copinger*  14161.     Proctor  463. 

197.  SAVONAROLA,  GIOVANNI  MI- 
CHELE.  Practica  de  oegritudinibus. 
Venezia,  Andreas  de  Bonetis,  10 
May,  i486.  Folio. 
Hain-Copinger  *  14481.  Proctor  4819. 
VouIIieme  Berlin  4036. 

198.  SAVONAROLA,  GIOVANNI  MI- 
CH ELE.  Practica  de  segritudibus.    Ve- 


nezia,   BONETUS    LOCATELLUS    FOR   Oc- 

tavianus  Scotus,  27  June,  I4Q7-  Folio. 
Hain-Copinger  *  14484.  Proctor  5080. 
VouIIieme  Berlin  4197. 

199.  SAVONAROLA,  GIOVANNI  MI- 
CH ELE.  Canonica  de  febribus  et  alii 
tractatus.        Venezia,  Bonetus  Loca- 

TELLUS     for     OCTAVIANUS     ScOTUS,     22 

November,  I4g8.     Folio. 
Hain-Copinger    14489.     Proctor   5094. 
VouIIieme  Berlin  4209. 

200.  SAVONAROLA,  GIOVANNI  MI- 
CH ELE.  De  febribus,  de  balneis,  de 
pulsibus,  urinis,  et  egestionibus.  Vene- 
zia, Christophorus  de  Pensis,  16 
October,  14Q6-10,  February,  14Q7.  Folio. 
Hain-Copinger  *  14491.  Proctor  5240. 
VouIIieme  Berlin  4303. 

201.  SAVONAROLA,  GIOVANNI  MI- 
CH ELE.  De  pulsibus,  urinis,  et  eges- 
tionibus. Bologna,  Henricus  de  Har- 
lem &  Joannes  Walbeck,  8  May,  1487. 
Folio. 

Hain-Copinger*  14490.    Proctor  6559. 

202.  SAVONAROLA,  GIOVANNI  MI- 
CH ELE.  Canonica  de  febribus.  Vene- 
zia, Christophorus  de  Lensis,  16  Oc- 
tober, I4g6.     Folio. 

Hain-Copinger  14488.  Proctor  5238. 
VouIIieme  Berlin  4302. 

Bound  with  2  other  works  of  Savon- 
arola. 

203.  SAVONAROLA.  GIOVANNI  MI- 
CH ELE.  De  balneis.  Ferrara,  An- 
dreas de  Balfortis,  10  November, 
1485.     Folio. 

Hain-Copinger  *  14493.  Proctor  5748. 
VouIIieme  Berlin  2865. 

204.  SALICETO,     GUILIELMUS     DE. 

Summa  conservationis  et  curationis 
cum  chirurgia.  Venezia,  [  Johannes  & 
Gregorius  de  Gregoriis,  ]  8  May, 
i4go.     Folio. 

Hain-Copinger  14 145.  Proctor  4515. 
VouIIieme  Berlin  3862. 

205.  SCHEDEL,  HARTMANN.  Liber 
chronicarum.  Niirnberg,  Anton  Ko- 
berger,  12  July,  14Q3.  Folio.  Nu- 
merous woodcut  illustrations. 
Hain-Copinger  *  14508.  Proctor  2084. 
British  Museum  Catalogue  II,  p.  437. 


3*4 

206.  SCHELLIG,  CONRAD.  Ein  kurz 
Regiment  der  Pestilenz.  [  Speier,  Con- 
rad Hist.,  1502.  ]     Quarto. 

Proctor  1 1605  A? 

207.  SCOTUS,  MICHAEL.  Liber  physi- 
onomiae  et  procreationis.  [  Venezia, 
Jacobus  de  Fivizzano,  ]  1477.  Quarto. 
Hain-Copinger  *  14550.  Proctor  4364. 
VouIIieme  Berlin  3766.     Burger  p.  398. 

208.  SCOTUS,  MICHAEL.  Liber  physio- 
nominae  et  procreationis.  [  Treviso  or 
Venezia?  Joannes  Rubeus,  1483.] 
Quarto. 

Hain-Copinger  *  14546.    Proctor  5128. 
[  Venezia.  ]     Burger  p.  572. 

209.  SERAPION,  "JUNIOR".  Aggrega- 
tor in  medicinis  simplicibus.  Milano, 
Antonius  Zarotus,  4  August,  1473. 
Folio. 

Hain-Copinger  *  14691.     Proctor  5775. 
VouIIieme  Berlin  3028. 

210.  SERAPION,  "JUNIOR".  Aggrega- 
tor in  medicinis  simplicibus.  Addition: 
Serapion,  "senior".  Brevarium  me- 
dicinal. Venezia,  Renaldus  of  Nijme- 
gen,  /  August,  I47Q. 
Hain-Copinger  *  14693.  Proctor  4434. 
Folio.  Venezia,  Renaldus  of  Nijme- 
gen,  1  June,  147Q. 
Hain-Copinger*  14692.     Proctor  4433. 

211.  SILVATICUS,  MATTHEUS.  Liber 
pandectarum  medicinse.  Venezia, 
Philippus  Pinzius  for  Bernardinus 
Fontana,  16  June,  14Q2.  Folio. 
Hain  *  15021.  Proctor  5292.  VouI- 
Iieme Berlin  4343. 

212.  SILVATICUS,  MATTHEUS.  Liber 
pandectarium  medicinse.  Venezia, 
Bernardinus  Stagninus,  27  March, 
14QQ.     Folio. 

Hain-Copinger*  15 199.     Proctor  4840. 
VouIIieme  Berlin  4058. 

213.  SILVATICUS,  MATTH/EUS.  Liber 
pandectarum  medicinse.  [  Strassburg, 
Adolph  Rusch,  the  R  Printer.]  Folio. 
Hain-Copinger  *  15192.  Proctor  251. 
VouIIieme  Berlin  2128. 

214.  SILVATICUS,  MATTHEUS.  Liber 
pandectarum  medicinse.     Venezia,  Jo- 


Annals  of  Medical  History 


HANN    OF    COLN    &   JOHANN    MaNTHEN, 

10  October,  1480.     Folio. 
Hain  *  15 198.     Proctor  4347. 

215.  SIMON  [A  CORDO,  ]  GENUENSIS. 

Clavis  sanationis  seu  synonyma  medici- 
nse.    Milano,    Antonius    Zarotus,    5 
August,  1473.     Folio. 
Hain-Copinger    14747.     Proctor   5774. 
VouIIieme  Berlin  3027. 

216.  SIMON  [A  CORDO,]  GENUENSIS. 
Clavis  sanationis.  Venezia,  Guilel- 
mus  de  Tridino,  12  November,  i486. 
Folio.     Maps. 

Hain-Copinger  *  14749.  Proctor  5109. 
VouIIieme  Berlin  4217. 

217.  SOLDUS,  JACOBUS.  Opus  de  peste. 
Bologna,  Johann  Schreiber,  1478. 
Quarto. 

Hain-Copinger  *  14870.  Proctor  6548. 
VouIIieme  Berlin  2736. 

218.  STEBER,  BARTHOLOM.EUS.  A 
mala  franczos  morbo  gallorum  prse- 
servatio  ac  cura.  [  Wien,  Johann  Win- 
terburg,  14Q--8.  ]     Quarto. 

British  Museum  Catalogue  III,  p.  81  r. 
Proctor  9483.  VouIIieme  Berlin  2684. 
Hain-Copinger  15053. 

219.  STEINHOWEL,      HEINRICH. 
Krankheit  der  Pestilentz.     Vim,  Con- 
rad Dinckmut,  [  c.  1482  ].     Folio. 
Sudhoff    191.     Hain     15057.     Proctor 
2560  A. 

220.  TORNEMIRE,  JEAN  DE.    Clarili- 
catorium  super  nono  Almansoris  cum 
textu  Rhasis.     Lyon,  Johann  Trecii- 
sel,  14QO.     Folio. 
Hain-Copinger*  15551.     Proctor  8598. 

221.  TORRELLA,  CASPAR.  De  dolore 
Addition:  De  ulceribus.  Roma,  Jo- 
hann Besicken  with  Martin  of  Am- 
sterdam, 31  October,  1500.  Quarto. 
Proctor  4000.  Hain-Copinger  15559. 
VouIIieme  Berlin  3547. 

222.  TORRELLA,    GERONIMO.         De 

imaginibus  astrologicis.     Valencia,  Al- 
fonso de  Orto,  [  a.  1  December,  1406.  ] 
Quarto. 
Proctor  9507.    Hain-Copinger  1 5560. 

223.  TUSSIGNANA,  PIETRO  DE.  Trac- 
tatus  de  peste.     Quarto. 

Compare  Hain-Copinger  *  15750  [  diff.] 


A  Check  List  of  Medical  Incunabula 


3i5 


224.  VALASCUS  DE  TARANTA.  Deepi- 
demia  et  peste.  [  Basel,  Martin  Flach 
c.  1470  ].     Folio. 

Hain-Copinger  15244.  Proctor  7552. 
VouIIieme  Berlin  424. 

225.  VALASCUS  DE  TARANTA.     Prac- 
tica  seu  philonium.    Nicolaus  Wollf, 
10  March,  1500.     Quarto. 
Hain-Copinger  *  15252.     [  cliff.]     Gun- 
ther  Leipzig.      1715. 

226.  VALASCUS    DE    TARANTA.      De 

epidemia  et  peste.  Hagenau,  Hein- 
rich  Gran,  25  November,  1497.  Quarto. 
Hain  *  15247.  Proctor  3190.  VouI- 
Iieme Berlin  1178.  British  Museum 
Catalogue  III,  p.  685. 

227.  VALLA,  GIORGIO.    Interpretationes 
varise.     Venezia,  Simon  Bevilaqua,  50 
September,  1498.     Folio. 
Hain-Copinger  11748.       Proctor  5408. 
VouIIieme  Berlin  4410. 

228.  VERSEHUNG.  Versehung,  Leib,  Seel, 


Ehr  und  Gut.    Nurnberg,  [  Peter  Wag- 
ner, 14  ]  89.     Quarto.     Woodcut. 
Sudhoff  230.     Hain-Copinger  *  16019. 
Proctor  2244.     VouIIieme  Berlin  1873. 
British  Museum  Catalogue  II,  p.  463. 

229.  WIDMANN,  JOHANN.  Tractatus 
de  pustulis quae  dicuntur  Mai  de  Franzos. 
[  Strassburg,  Johann  [  Reinhard  ] 
Gruninger,  a.  1  February,  1497.  ] 
Quarto. 

Copinger  III,  6573.  Proctor  478. 
VouIIieme  Berlin  2332.  Hain-Copinger 
16160. 

230.  ZERBI,  GABRIELE.        De  cautelis 
medicorum.    [  Venezia,  Christophorus 
de  Pensis,  n.  b.  149s.  ]     Quarto. 
Hain-Copinger  *  16286.     Proctor  5235. 

231.  ZERBI,  GABRIELE.  Gerontocomia. 
Roma,  Eucharius  Silber,  27  Novem- 
ber 1489.     Quarto. 

Reichling  VI,  p.  181.  Proctor  3840. 
VouIIieme  Berlin  3486.     Hain  16284. 


* 


//  our  young  medical  student  would  take 
our  advice,  and  for  an  hour  or  two  twice  a 
week  take  up  a  volume  of  Shakespeare,  Cer- 
vantes, Milton,  Dryden,  Pope,  Cowper,  Mon- 
taigne, Addison,  Dejoe,  Goldsmith,  Fielding, 
Scott,  Charles  Lamb,  Macaulay,  Jeffrey,  Syd- 
ney Smith,  Helps,  Thackeray,  etc.,  not  to  men- 
tion authors  on  deeper  and  more  sacred  sub- 
jects— they  would  have  happier  and  healthier 
minds,  and  make  none  the  worse  doctors.  If 
they,  by  good  fortune — for  the  tide  has  set  in 


strong  against  the  literae  humaniores — have 
come  off  with  some  Greek  or  Latin,  we  would 
supplicate  for  an  ode  of  Horace,  a  couple  of 
pages  of  Cicero  or  Pliny  once  a  month,  and  a 
page  of  Xenophon.  French  and  German 
should  be  mastered  either  before  or  during  the 
first  years  of  study.  They  will  never  after- 
viards  be  acquired  so  easily  or  so  thoroughly, 
and  the  want  of  them  may  be  bitterly  felt  when 
too  late. 

Horse  Subsecivx,  by  John  Brown. 


NOTES  AND  QUERIES 

[In  the  initial  volume  of  the  Index  Medicus  (1879)  a  department  ot  "Notes  and  Queries,"  relat- 
ing to  medical  history  and  medical  bibliography,  was  established  by  Dr.  Billings,  Dr.  Fletcher, 
Thomas  \\  indsor  and  others,  but  from  lack  of  interest  in  the  readers  of  the  journal,  due  no  doubt 
to  the  backward  state  of  medico-historical  investigation  in  this  country  at  that  time,  the  project 
did  not  take  hold  and  was  soon  abandoned.  In  a  journal  devoted  exclusively  to  medical  history 
it  seems  fitting  and  proper  that  items  of  this  kind  should  be  introduced  from  time  to  time,  with 
the  proviso  that  both  questions  and  answers  be  brief  and  to  the  point.  Those  subjoined  are 
believed  to  be  difficult  of  solution. — Editor.] 


1.  Purposeful  Deformation  of  Chil- 
dren (Chirurgie  au  rebours). — In  Victor 
Hugo's  "L'bomme  qui  rit"  (I,  2;  III,  6), 
considerable  space  is  devoted  to  an  affilia- 
tion of  seventeenth  centur}r  criminals  (los 
compracbicos)  who  bought  and  sold  friend- 
less or  abandoned  children  for  the  purpose 
of  maiming  or  disfiguring  them  by  reversed 
orthopedic  procedure  (chirurgie  au  rebours), 
in  order  to  turn  their  deformities  to  profit. 
Hugo  mentions  a  certain  Dr.  Conquest 
as  the  author  of  a  Latin  treatise  on  this 
variety  of  "reversed  orthopedics, "  and  from 
an  alleged  chapter,  "De  denasatis, "  he 
gives  the  citation  "  Bucca  fissa  usque  ad 
aures,  genzivis  denudatis,  nasoque  murdridato, 
masca  eris,  el  ridebis  semper"  as  the  recipe 
employed  in  the  disfigurement  of  the  un- 
fortunate Gwynplaine.  Did  Conquest  really 
exist,  and  if  so,  what  was  the  title  of  his 
treatise?  When  and  where  was  it  published? 
Or  were  these  chapters  in" L'bomme  qui  rit" 
mere   romancing  and   literary  supercberie? 

2.  Mathilde  Marcard  and  Werlhof's 
Wedding.  —  In  H.  Rohlfs'  biographical 
sketch  of  Werlhof,  it  is  stated  that  Mathilde 
Marcard  wrote,  from  reports  of  eye  wit- 
nesses and  personal  letters,  an  interesting 
account  of  the  ceremonies  of  Werlhof's 
second  marriage,  which  is  described  as  of 
considerable  cultural  value.  Some  pleasant 
details  of  this  account  have-  been  reproduced 
by  Rohlfs  and  arc  again  given,  in  concli 


form,  in  Baas's  "History  of  Medicine." 
Was  the  original  writing  of  Mathilde  Mar- 
card ever  published,  and,  if  so,  where,  when 
and  by  whom? 

3.  Life  of  Alois  Bednar. — Nothing  is 
known  of  the  life  of  the  Viennese  pedia- 
trician, Alois  Bednar,  beyond  the  few  lines 
given  by  Gurlt,  in  Hirsch's  "  Biograpbiscbes 
Lexicon"  (VI,  470),  which  merely  states 
that  Bednar  was  a  Privatdocent  at  the 
University  of  Vienna,  giving  a  list  of  his 
three  treatises  on  diseases  of  infancy  (1850- 
53),  pediatrics  (1856)  and  dietetics  of  in- 
fancy (1857).  Can  the  dates  of  his  birth 
and  death,  with  any  other  biographical 
data  (with  sources)  be  supplied? 

4.  Life  of  Frederick  Corbyn. — Fred- 
erick Corbyn,  a  surgeon  in  the  Indian  Med- 
ical Service  of  Great  Britain,  was  editor  of 
the  India  Journal  oj  Medical  and  Physical 
Science  (Calcutta,  n.s.,  v.  1-7,  1836-42), 
usually  known  as  Corbyn's  Journal,  which 
was  started  by  John  Grant  and  J.  T.  Pear- 
son as  the  India  Journal  0/  Medical  Science 
(Calcutta,  1834-5),  and  is  remarkable  For 
its  outline  portraits  of  prominent  medical 
officers  of  the  Indian  Medical  Service. 
Corbyn  was  also  the  author  of  the  "  Manage- 
ment and  Diseases  of  Infants  under  the 
Influence  of  the  Climate  of  India"  (Calcut- 
ta, 1828),  which  is  the  earliest  treatise  on 
tropical  pediatrics,  and  also  of  "A  Treatise 
on  Epidemic  Cholera  as  It  Has  Prevailed  in 


316 


Notes  and  Queries 


3i7 


India"  (Calcutta,  1832).  No  details  of 
Corbyn's  life  are  given  in  Lieut.  Colonel 
D.  G.  Crawford's  "History  of  the  Indian 
Medical  Service"  (London,  1914)  or  else- 
where. Can  the  dates  of  birth  and  death  be 
supplied,  with  sources? 

5.  John  Bell.— Is  any  portrait  of  the 
artist  surgeon  John  Bell  [1763-1820],  of 
Edinburgh,  extant,  and  if  so,  where  can 
it  be  obtained? 

6.  Emil  Noeggerath  [1847-95]. — Be- 
yond a  brief  memorial  note  in  Virchow's 
Archiv  (1896,  CXLIII,  680),  and  the  per- 
sonalia in  Dr.  Arpad  G.  Gerster's  "Recol- 
lections" (New  York,  19 17,  200),  no  bio- 
graphical data  exist  about  the  late  Emil 
Noeggerath,  a  gynecologist  who  introduced 
the  theory  of  latent  gonorrhea  and  the  op- 
eration of  epicystotomy,  and  was  associated 
with  Jacobi  in  "Contributions  to  Mid- 
wifery, and  Diseases  of  Women  and  Chil- 
dren" (1859)  and  in  the  editorship  of  the 
American  Journal  0/  Obstetrics  (1868-71). 
Can  any  other  facts  be  supplied,  from  per- 
sonal knowledge  or  otherwise?         F.  H.  G. 

7.  Surgical  Instruments. — Satisfactory 
illustrations  of  early  surgical  instruments 
of  the  time  of  the  ancient  Greeks  and  Ro- 
mans are  at  the  present  time  difficult  to  find. 


The  standard  work  of  Overbeck  on  the 
excavations  at  Pompeii  contains  the  same 
old  wood-cuts  published  over  thirty  years 
ago.  The  reproductions,  in  atlas,  of  these 
instruments  by  Vulpes  are  almost  inacces- 
sible, in  the  city  of  New  York,  at  least.  The 
illustrations  used  by  Vedrenes  in  his  trans- 
lation of  Celsus  are  very  clear,  but  they  are 
almost  too  perfect  drawings  to  be  correct 
reproductions.  The  latest  and  most  com- 
plete book  on  this  subject  was  by  the  late 
Dr.  Milne  of  England.  In  the  back  of  his 
book  are  a  series  of  half-tone  reproductions 
of  instruments  from  various  Museums  of 
Europe.  The  half-tones,  however,  are  ex- 
tremely poor  and  do  not  give  a  good  idea  of 
the  character  of  the  instruments.  The  gen- 
eral impression  is  that  the  surgical  instru- 
ments of  ancient  days  have  only  been  found 
at  Pompeii  and  Herculaneum.  As  a  matter 
of  fact,  collections  have  been  made  from 
many  other  sources,  Baden,  Cologne,  Paris, 
for  example.  Perhaps  some  reader  can  tell 
us  whether  there  are  any  better  illustrations 
than  are  mentioned  here,  and  especially 
whether  there  are  any  collections  in  this 
country.  In  France  Dr.  Hamonic,  of  Paris, 
had  a  good  collection,  and  so  I  am  informed, 
had  Dr.  Milne. 


^ 


EDITORIALS 


DR.    STEPHEN"    SMITH,    THE    NESTOR    OF 
AMERICAN    SURGERY 

The  publication  of  Dr.  Smith's  charm- 
ing "History  of  Surgery,"  in  the  con- 
cluding volume  of  Stedman's  "Refer- 
ence Handbook"  (viii,  28-57),  reminds 
us  of  the  debt  of  gratitude  which  the  Ameri- 
can profession  owes  to  this  remarkable 
man  whose  public  activities  have  extended 
over  half  a  century  and,  apart  from  his  own 
specialty,  have  included  the  broadest  and 
most  beneficent  kinds  of  social  service, 
from  hospital  construction  and  the  im- 
provement of  homes  of  the  laboring  and 
tenement  house  population  of  New  York 
City  to  the  sane  and  humane  treatment  of 
the  insane  and  the  advancement  of  public 
hygiene  in  his  own  state. 

On  February  19,  1918,  Dr.  Smith 
attained  the  ripe  age  of  ninety-live. 
On  May  6  following,  Dr.  Jacobi  will  be 
eighty-eight.  One  is  the  Nestor  of  American 
surgery,  the  oldest  living  representative  of 
the  surgical  profession  in  the  United  States; 
the  other  is  the  father  and  founder  of  Ameri- 
can pediatrics,  and  by  the  same  token,  the 
Nestor  of  our  internists.  For  what  is  pedi- 
atrics but  internal  medicine  applied  to 
children?  Both  arc  still  youngish  nun,  out- 
standing examples  of  hi  jeutiesse  c/e  lu  luil- 
lesse,  that  is,  of  those  whose  future  is  "before 
tin  in,  not  behind  them."  Both  are  still  able, 
vigorous  thinkers;  both  have  been  upstand- 
ing champions  of  the  right,  outspoken  in 


318 


criticism  of  the  evils  and  deficiencies 
of  medicine  and  hygiene  in  their  time; 
both  are  universally  beloved  and  respected. 
The  only  difference  is  that  one  is  seven 
years  older  than  the  other. 

Dr.  Stephen  Smith  was  born  in  Onondaga 
County,  New  York,  on  February  19,  1823, 
and  is  a  descendant  of  Job  Smith,  an  officer 
of  the  Fifth  Regiment  of  the  Connecticut 
line  in  the  War  of  the  Revolution.  Brought 
up  on  his  father's  farm  in  the  central  part  of 
the  state,  his  own  native  industry  soon  car- 
ried him  beyond  the  slender  attainments 
possible  in  common  schooling,  and  when, 
at  the  age  of  twenty,  he  was  able  to  attend 
the  Cortland  Academy  (Homer,  New  York), 
he  had  already  taught  himself  Latin,  Greek 
and  the  ordinary  branches  of  the  higher 
mathematics.  Dr.  Smith's  brother  was  the 
celebrated  Dr.  J.  Lewis  Smith,  a  physician 
whose  fame,  as  Billings  said  of  Daniel 
Drake,  "will  probably  be  greater  a  hundred 
years  hence  than  it  is  now."  Although  he 
disliked  and  resented  the  appellation  of 
"specialist,"  J.  Lewis  Smith  and  Jacobi 
were  the  first  in  this  country  to  teach  and  prac- 
tice pediatrics  as  a  distinct  and  separate 
branch  of  internal  medicine.  Wonderful  to 
relate,  when  we  consider  the  period,  Dr. 
Smith's  well-known  textbook,  which  was 
based  mainly  upon  his  own  clinical  and  post- 
mortem experience,  passed  through  no 
less  than  eight  editions  (1869-96).  Dr. 
Lewis  Smith  was  a  man  who  was  so  in- 
trinsically good,  so  unworldly  and  unselfish, 


Editorials 


319 


that,  in  our  time — the  age  of  the  struggle- 
for-Iifer,  the  arriviste  and  the  parvenu — he 
would  need  a  guardian.  Externally  he  was 
only  the  plain,  unassuming  family  doctor 
of  the  old-fashioned  American  type;  but 
in  the  history  of  medicine  he  has  a  place 
with  men  like  Charles  West  and  Jacobi  as 
one  of  the  forerunners  of  humanistic  pedi- 
atrics, the  practice  of  internal  medicine 
among  children,  not  as  a  cold,  lifeless  busi- 
ness or  laboratory  "specialty,"  but  from 
a  peculiar  affection  for  the  children  them- 
selves. When  we  have  named  these  three, 
we  can  think  of  but  few  others  in  the 
same  class:  Chapin,  notably,  among  the 
living,  and  Theophile  Roussel,  among  the 
dead. 

The  two  brothers  Smith  attended  Cort- 
land Academy  together  and  studied  medi- 
cine together.  Their  first  preceptor  was 
Dr.  Caleb  Green,  of  Homer,  New  York, 
formerly  Professor  of  Materia  Medica  at 
the  Geneva  Medical  College,  at  which  in- 
stitution Stephen  Smith  took  his  first  course 
of  lectures,  under  such  masters  as  Frank 
Hamilton  and  Austin  Flint.  Entering  Ham- 
ilton's office,  at  Buffalo,  New  York,  he  at- 
tended his  second  course  of  lectures  at  the 
Buffalo  Medical  College,  and,  in  1849, 
became  interne  or  resident  pupil  in  the 
Buffalo  Hospital  of  the  Sisters  of  Charity, 
where  he  had  considerable  experience  with 
cholera,  which  was  then  epidemic.  In  the 
autumn  of  1849  he  entered  upon  his  third 
course  at  the  College  of  Physicians  and 
Surgeons,  New  York  City,  from  which  he 
was  graduated  in  the  spring  of  1850,  and, 
as  an  earlier  sketch  of  him  relates,  "found 
himself  in  a  strange  city,  with  legalized 
power  to  practice,  and  nobody  to  treat." 
There  happened,  providentially,  to  be  a  va- 
cancy in  the  resident  staff  of  Bellevue  Hos- 
pital at  the  time.  Dr.  Smith  was  one  of 
twelve  applicants  for  the  place.  He  passed 
the  rigid  examination  of  the  Board  success- 
fully and  at  once  entered  upon  his  duties. 

In    this    period,    the    leading    figure    at 


Bellevue  was  the  celebrated  Alonzo  Clark, 
whose  name  is  historically  associated  with 
the  therapeutic  "wrinkle"  of  exhibiting 
large  doses  of  opium  in  puerperal  peritonitis 
(1855)  and  with  several  witty  epigrams. 
One  of  these  completely  reverses  and  ob- 
literates the  poesy  of  the  French  byword: 
Si  jeunesse  savait,  si  vieillesse  pouvait.  As  a 
student,  Clark  wished  to  marry  a  daughter 
of  a  wealthy  man  but  was  rejected  by  her 
parent  on  the  ground  that  there  was  not 
enough  money.  When  Clark  became  a 
celebrity,  the  proposition  of  marriage  was 
revived  by  the  parent  himself.  "Alonzo 
Clark,  the  student,  couldn't;  Alonzo  Clark, 
the  professor,  wouldn't,"  was  the  somewhat 
metallic  reply.  During  his  incumbency  at 
Bellevue,  Dr.  Smith  had  charge  of  the  lying- 
in  wards,  and  was  requested  by  Clark  to 
put  the  opium  treatment  to  the  test  in  the 
cases  of  puerperal  peritonitis,  then  so  fre- 
quent. Clark's  requirement  was  no  less 
than  saturation  of  the  system  with  opium 
to  the  point  of  semi-narcotism,  but  young 
Smith  was  cautious  and,  at  first,  got  no 
results  from  his  administration  of  the  drug. 
Clark  then  took  him  aside,  and  the  follow- 
ing conversation  ensued: 

"Dr.  Smith,  have  you  ever  attended 
a  common  school?" 

"Yes,  sir." 

"Did  you  ever  have  a  teacher  say 
to  you,  '  I  will  whip  you  within  an  inch 
of  your  life?'" 

"Yes  sir,  I  have,  and  I  have  also 
had  it  applied  to  myself." 

"Well,  that  is  the  way  I  wish  you  to 
give  opium  to  these  patients — let  it  be 
to  'within  an  inch  of  their  lives!'" 

This  heroic  treatment  was  then  carried 
out  upon  four  patients,  under  two  reliable 
nurses,  Dr.  Smith  visiting  each  patient 
every  hour,  night  and  day.  One  patient 
yielded  to  treatment  under  two  grains 
of  opium  hourly;  the  second  nearly  suc- 
cumbed under  three  grains;  the  third  re- 


320 

quired  four  grains;  and  in  the  fourth  the 
gigantic  tolerance  of  the  human  system 
for  opium  was  such  that  4^2  grains  hourly 
were  required  to  produce  a  semi-comatose 
condition,  and  no  less  than  1,900  grains 
were  taken,  without  vomiting  or  purging, 
before  the  course  of  treatment  was  com- 
pleted. Yet  all  the  patients  recovered,  and 
through  such  experiences  this  therapeutic 
device  acquired  a  certain  vogue  in  gyne- 
cology, by  reason  of  the  diminution  of  the 
mortality  rate  in  puerperal  peritonitis.  In 
his  early  period  at  Bellevue,  Dr.  Smith  was 
consulted  in  a  medico-legal  case  of  rupture 
of  the  bladder,  from  external  violence,  the 
possibility  of  which  had  been  doubted  in 
the  court  room  evidence  on  account  of  the 
rarity  of  the  condition.  He  was  able  to 
collate  and  tabulate  some  78  cases  from  the 
literature — a  remarkable  piece  of  painstak- 
ing work,  in  the  days  when  medical  bibli- 
ographies, in  Billings'  sense,  were  non- 
existent. This,  his  first  important  paper, 
was  published  in  May,  1851.1  Later,  it 
was  translated  into  German  and  French, 
which  led  to  his  being  made  a  member  of 
the  Surgical  Society  of  Paris. 

On  leaving  Bellevue  Hospital  Dr.  Smith 
commenced  practice  in  New  York  City 
where,  through  his  contributions  to  the 
New  York  Journal  oj  Medicine,  he  came  in 
contact  with  its  editor,  Dr.  Samuel  S. 
Purple,  who  was  one  of  the  earliest  physi- 
cians to  follow  medical  history  and  to  col- 
lect rare  medical  books  in  this  country,  and 
whose  choice  collection  is  now  in  the  Library 
of  the  New  York  Academy  of  Medicine. 
In  1853,  Dr.  Smith  became  joint  proprietor 
and  co-editor  of  the  Journal,  and,  in  1857, 
after  the  retirement  of  Doctors  Purple  and 
Bulkeley,  he  assumed  full  editorship.  In 
i860,  the  New  York  Journal  oj  Medicine 
became  the  American  Medical  Times,  which 
Dr.  Smith  continued  to  edit  until  1864. 

In  1854,  Dr.  Smith  was  elected  one  of 
the  attending  surgeons  at  Bellevue,  where 

'  New  York  J.  M.,  1851,  vi,  336-375. 


Annals  of  Medical  History 


he  made  a  reputation  by  his  ability,  his 
unfailing  self-possession,  his  humane  efforts 
in  behalf  of  the  patients,  and  his  power  of 
concise  expression  in  lecturing.  These  were 
the  early  post-anaesthetic  days,  when  pain- 
less surgery  had  not  yet  become  firmly 
established,  and  when  patients,  writhing 
with  pain,  were  sometimes  lectured  over. 
Although  he  frequently  taught  major  sur- 
gery at  the  operating  table,  Dr.  Smith  would 
never  lecture  during  an  operation,  but  only 
before  or  after  removal  of  the  patient. 
Among  his  earlier  surgical  feats  were  a  liga- 
tion of  the  common  iliac  artery  and  the 
first  Syme  amputation  at  the  ankle  joint 
in  this  country  after  Carnochan's  case.  At 
the  beginning  of  the  Civil  War,  a  number  of 
books  on  military  medicine,  surgery  and 
hygiene  were  published  by  S.  D.  Gross, 
Roberts  Bartholow,  William  A.  Hammond, 
J.  J.  Woodward  and  other  well-known 
American  physicians.  This  characteristic 
tendency  goes  back  to  the  American  Revo- 
lution (John  Jones,  Benjamin  Rush,  Wil- 
liam Brown),  and,  judging  by  the  large 
crop  of  medico-military  manuals  on  hand, 
is  now  in  evidence  in  all  the  warring  coun- 
tries. In  1862,  at  the  suggestion  of  profes- 
sional friends  who  had  entered  the  medical 
staff  of  the  Volunteer  Army,  Dr.  Smith 
published  a  "Hand-book  of  Surgical  Opera- 
tions," designed  as  a  pocket  manual,  for  use 
in  the  field.  Of  the  large  group  of  such  books 
above  mentioned,  this  was  the  only  one 
which  survived  a  first  edition.  The  fifth 
edition  of  Dr.  Smith's  Hand-book  was  pub- 
lished in  1863,  a  triumph  for  that  darling 
of  the  medical  publisher  and  his  clientele, 
the  small-sized  book.  The  reasons  for  its 
success  were  not  only  its  size,  shape  and 
flexible  covers,  but  its  well-arranged,  ex- 
haustive index,  its  useful  illustrations,  the 
large  amount  of  information  compressed 
into  its  274  pages,  and  its  eminently  prac- 
tical tendency.  It  plunges,  at  the  open- 
ing of  Chapter  I,  without  preliminaries, 
into  the  make-up  of  a  surgeon's  pocketcase, 


Editorials 


321 


the  proper  way  to  make  incisions  with 
scalpel  and  bistoury,  and  the  suturing  and 
dressing  of  wounds.  In  this  connection,  we 
are  reminded  of  the  fact  that  the  most  suc- 
cessful and  useful  medico-military  text- 
books published  at  the  present  hour  have 
been  written  in  the  same  concise,  precise 
manner.  The  sentiment  of  the  officer  in  the 
field  would  seem  to  be:  "Long  life  to  the 
small-sized  book!"  Prolixity  at  the  battle- 
front  is  unthinkable. 

During  1861-1865  Dr.  Smith  was  Pro- 
fessor of  Surgery  in  Bellevue  Hospital 
Medical  College,  after  which  he  held  the 
chair  of  anatomy  until  1874,  in  which  year 
he  became  Professor  of  Clinical  Surgery  in 
the  Medical  Department  of  New  York 
University.  In  1865,  he  made  an  investiga- 
tion of  the  sanitary  condition  of  New  York 
and  reported  his  findings  to  the  legislature. 
In  1866,  he  made  a  report  on  hospital  con- 
struction to  the  trustees  of  Bellevue  Hos- 
pital, and  was  one  of  the  five  physicians 
who  submitted  plans  for  the  construction 
of  the  Johns  Hopkins  Hospital  (1875),  the 
award  in  this  competition  being  made  to 
the  late  Dr.  John  S.  Billings.  His  papers  on 
the  improvement  of  the  homes  of  the  tene- 
ment house  population  in  New  York  City 
were  published  in  1 873-1 875.  In  1882,  Dr. 
Smith  was  appointed  State  Commissioner 
in  Lunacy  of  New  York  by  Governor 
Alonzo  B.  Cornell,  and  during  his  incum- 
bency (1882- 1 888)  the  following  reforms 
were  effected:  (1)  the  introduction  of  a 
training  school  for  attendants,  (2)  the  crea- 
tion of  a  State  Commission  in  Lunacy,  (3) 
the  removal  of  the  insane  from  county  to 
state  care — in  other  words,  a  steady  im- 
provement over  the  old  conditions,  in 
which  the  insane  were  pauperized  "in 
filthy  cells  and  stalls,  shackled  hands  and 
feet,  and  fed  like  swine,"  up  to  the  "kindly 
care,  good  food,  clean  sanitary  dormitories 
and  freedom  from  cruel  forms  of  restraint" 
of  the  now  unrivalled  State  hospitals  of  New 
York.    Dr.    Smith's    experiences    are    sum- 


marized in  his  book  "Who  Is  Insane?" 
(19 1 6),  which  is  a  large-minded  considera- 
tion of  "the  illusive  nature  of  insanity,  its 
origin  in  the  derangement  of  the  functions 
of  the  brain-cells,  the  extreme  impressibility 
of  these  cells  and  our  power  to  increase  or 
repress  their  activities,"  a  series  of  piquant 
homilies  on  the  Horatian  "naviget  Anti- 
cyram."  The  book  is  highly  practical,  and 
leaves  one  with  the  humorous  impression 
that  the  whole  world  is  potentially  or  (as  in 
present  Eastern  Europe)  actually  mad.  "A 
mad  world,  my  masters."  We  may  take 
comfort  in  the  observation,  quoted  by  Osier: 
"Every  man  has  a  sane  spot  somewhere." 
As  to  "the  failure  of  the  alienists  to  formu- 
late an  acceptable  definition  of  insanity  for 
the  profession  and  the  courts,"  Dr.  Smith 
is  at  one  with  Shakespeare: 

To  define  true  madness, 
What  is  it  but  to  be  nothing  else  but 
mad  ? 

Among  Dr.  Smith's  other  public  activities 
have  been  his  services  as  member  of  the 
city  and  national  Boards  of  Health,  and 
the  State  Board  of  Charities,  his  work  with 
the  United  States  Sanitary  Commission, 
and  his  Commissionership  to  the  Ninth  In- 
ternational Sanitary  Convention  at  Paris 
(1894).  He  was  one  of  the  founders  and  also 
first  president  of  the  American  Public 
Health  Association  (1873),  nas  published 
many  contributions  to  public  hygiene,  and 
has  done  much  for  the  improvement  of  the 
Department  of  Health  of  New  York  City. 

To  the  literature  of  surgery,  Dr.  Smith 
has  contributed  many  papers,  notably  his 
analysis  of  439  recovered  amputations  in  the 
continuity  of  the  lower  extremity,  one  of 
the  surgical  memoirs  of  the  United  States 
Sanitary  Commission  (1871).  In  1879,  he 
published  a  "Manual  of  the  Principles  and 
Practice  of  Operative  Surgery,"  a  large 
treatise  of  689  pages,  which  was  re-issued, 
enlarged  and  revised  in  1887.  To  the  history 
of  surgery,    he    has    made   two    important 


322  Annuls  of  Medical  History 

contributions,  viz.,  his  monographs  on  "The 
Evolution  of  American  Surgery"  published 
in  Bryant  and  Buck's  "American  Practice 
of  Surgery"  (1906),  and  "The  History  of 
Surgery"  in  Stedman's  "Reference  Hand- 
book" (1917).  These  are  both  able  and 
vigorous  contributions,  worthy  of  a  place 
beside  the  writings  of  Gross,  Billings, 
Pilcher,  Dennis  and  other  Americans  who 
have  worked  in  this  field. 

Personally,  Dr.  Smith  is  a  valiant,  up- 
standing character,  straight,  erect,  and 
self-disciplined  as  an  army  officer,  keen  and 
quick  of  perception,  yet  with  the  genial, 
humorous  "twinkle."  No  one  could  clasp 
his  hand  and  look  into  his  face  without  feel- 
ing impressed  with  his  astonishing  vitality 
and  virility.  Those  of  us  who  heard  his 
vivacious  address  to  the  medical  students 
at  Syracuse,  in  191 5,  were  treated  to  a  cap- 
tivating volley-fire  of  humorous  recollec- 
tions and  anecdotes  which  carried  the 
younger  men  quite  away.  As  we  listened, 
with  shaking  sides,  some  of  us  could  but 
re-echo  the  sentiment  expressed  by  Pro- 
fessor Thayer  at  a  banquet  given  to  another 
distinguished    physician: 


treatment  of  the  larynx  was  first  shown, 
and  here  that  intralaryngeal  surgery  had 
its  birth.  The  art  of  photographing  the 
larynx  was  perfected  by  a  Brooklyn  Iaryn- 
gologist.  The  causes  of  nasal  obstructions 
were  discovered  and  the  methods  of  reliev- 
ing them  devised  by  New  York  surgeons. 
There  followed  from  this  definite  knowledge 
concerning  sinus  diseases.  Intubation  was 
made  a  practical  measure  here.  Graduate 
courses  in  laryngology  and  rhinology  were 
established  in  New  Y'ork,  and  the  first  so- 
ciety of  Iaryngologists  that  was  ever  organ- 
ized was  established  here.  Dr.  Delevan  has 
done  much  to  infuse  a  civic  pride  in  New 
"\  orkers  over  the  work  done  in  laryngology 
in  this  city. 

Charles  L.  Dan  \. 


Long  may  he  live  to  taste  alike 
Of  age  and  youth  the  joys; 
Old,  yes,  in  years,  but  in  his  heart, 
A  bov  among  the  bovs. 

F.  H. 


It  has  been  especially  through  the  indus- 
try zeal  and  historical  activities  of  Dr.  D. 
Bryson  Delevan  that  New  York  City  lias 
been  shown  to  have  unusual  importance  in 
the  history  of  the  development  of  laryngol- 

According  to  Dr.  Delevan,  it  was  in  New 
^  ork  that  attention  was  hrst  especially 
called  to  tin-  diseases  of  the  throat  In  the 
establishment  of  special  public  clinics  and 
<»l  professorships  in  this  branch  of  medicine. 
It  was  here  that  the  possibility  of  topical 


The  history  of  medicine  furnishes  a  sub- 
ject which  can  be  approached  from  several 
points  of  view,  and  it  is  one  that  may  be 
treated  in  various  ways,  excellent  or  dis- 
tressing. No  doubt  the  best  one  is  that  of 
scientific  research,  by  means,  for  example,  of 
a  study  of  original  documents.  Through  this 
we  secure  new  data  and  gain  new  interpre- 
tations. This  kind  of  work  is  essential  to 
progress.  It  is  the  laboratory  method,  and 
justly  acclaimed  by  the  chosen  few,  who 
are  in  the  position  to  follow  it.  Medical  his- 
tory may  also  be  approached  by  the  de- 
scriptive and  literary  nut  hod,  and  it  is 
through  this  method  that  historical  matter 
is  made  vital  and  brought  into  touch  with 
current  life,  contributing  to  education, 
recreation  and  art.  The  descriptive  his- 
toriographer must  have  not  only  literarj 
skill,  but  a  sense  of  the  proportion  of  things; 
he  must  have  some  learning  and  do  some 
research  also.  As  this  kind  of  writing  is 
open  to  any  one  trained  or  untrained,  it 
ma\  be  done  and  often  is  done  stupidlj  and 
verbosely,  with  little  result  of  real  import- 
ance to  the  world.  Medical  history  and 
epidemiology  may  also  be  studied  for  their 


sffr.(jhwo  cJatin  doctor  mcoiciu pai 


//'/, 


mccLau  ct  pro  cjsor  ^Acquis 


P' 


91, 


gi 


Editorials 


323 


use  in  contributing  toward  the  larger  prob- 
lems of  general  history  and  of  human  prog- 
ress, being  drawn  upon  as  an  ancillary  to 
more  serious  and  important  work.  This  has 
been  done  in  efforts  to  explain  the  extinc- 
tion of  the  Grecian  States,  and  the  decline 
of  the  imperial  power  of  Rome. 

Medical  history  is  drawn  upon  to  illus- 
trate social  customs,  criminology,  extraor- 
dinary human  characters,  and  causes,  and 
the  stupidities  of  legislation.  There  is  an 
interesting  form  of  medical  history  which 
is  strictly  biographical,  and  this  is  by  no 
means  the  least  important  of  the  methods 
of  historical  work. 

There  is  thus  a  long  list  of  phases  and 
types  of  medico-historical  writing,  and 
an  application  of  data  obtained  throws  light 
upon  a  number  of  present-day  human  prob- 
lems. It  is  wise  to  encourage  all  kinds  of 
historical  writing  and  to  censure  only  that 
work  which  is  insincere,  careless  and,  per- 
haps, that  which  attempts  to  be  funny. 
The  gods  forgive  everything  but  dullness; 
those  who  are  interested  in  medical  history 
must  sometimes  forgive  even  this.  Let  those 
who  would  avoid  this,  study  the  contribu- 
tions of  Sir  William  Osier. 

Charles  L.  Dana 


Guy  Patin  (1601-1672),  Dean  of  the 
Faculty  of  Medicine  of  the  University 
of  Paris,  Professor  of  Surgery  and,  later, 
of  Medicine,  was  an  important  person  in 
the  medical  life  of  Paris  in  the  seventeenth 
century.  Although  he  contributed  nothing 
to  medical  science,  he  made  a  place  for  him- 
self in  medical  history  and,  to  an  extent,  in 
the  world  of  letters,  through  the  force  of 
his  personality  and  his  gifts  of  erudition, 
eloquence  and  satirical  wit. 

Patin  was  a  reactionary,  a  follower  of 
Hippocrates  and  Galen,  a  hater  of  the 
chemical  school,  and  was  defiant  of  the  value 
of  the  antimony  which  was  then  becoming 
a  substitute  for  bleeding.  He  did  not  believe 


in  innovations  or  that  any  improvement 
could  be  made  in  the  science  and  art  of  medi- 
cine as  laid  down  by  Galen. 

He  was  learned  in  the  classics  and  in  liter- 
ature; he  had  a  ready  and  prodigious  mem- 
ory. He  was  an  eloquent  and  witty  speaker, 
and  his  lectures  were  so  popular  that  the 
laity  crowded  into  his  amphitheater  to 
hear  him. 

He  became  one  of  the  most  popular  and 
successful  physicians  of  his  day,  and  was 
invited  by  the  Queen  of  Sweden  to  be  physi- 
cian at  her  court,  and  by  the  Senate  of 
Venice  to  establish  himself  in  that  city.  He 
was  a  bit  litigious:  he  had  a  serious  law- 
suit against  the  famous  Renardot,  who  tried 
to  start  a  commercial  dispensary,  and  he 
was  sued  by  the  apothecaries  because  he 
publicly  attacked  their  popular  mixtures. 
He  was  one  of  the  first  to  denounce  publicly 
the  secret  and  proprietary  medicine  busi- 
ness, and  he  won  out  in  his  fight. 

Patin  believed  in  bleeding,  senna  and 
ptisanes,  and  he  denounced  the  chemical 
remedies  and  polypharmacy  with  its  mithri- 
dates  and  theriacs  and  benzoar  compounds. 
He  was  even  a  little  doubtful  of  quinine, 
and  was  cautious  in  the  use  of  opium  and 
alcohol. 

He  wrote  a  little  book  on  the  preservation 
of  health,  and  always  maintained  it  was 
easier  to  keep  well  than  to  get  well.  Were 
he  living  now  he  would  have  been  a  zealous 
sanitarian. 

He  had  a  large  acquaintance  and  wrote 
many  letters,  and  he  called  himself  of  the 
"literary  group."  In  those  days  stone  in 
the  bladder  was  considered  the  penalty  of 
being  learned.  Patin  thought  the  best  pre- 
ventative was  vini  privatio,  but  to  make 
additionally  sure  he  gave  himself  "cinq  ou 
six  bonnes  saignees  de  precaution  par  an." 

After  his  death,  his  letters  were  published; 
they  were  eagerly  read,  and  went  through 
several  editions.  They  told  the  gossip  of 
the  town,  and  threw  interesting  side  lights 
on  life  in  Paris  in  the  seventeenth  century. 


324  Annals  of 

Few  medical  men  of  that  century  have 
been  more  written  about  or  had  their  lives 
and  characters  more  frequently  commented 
upon. 

A  very  considerable  literature  has  grown 
up  around  Guy  Patin  and  his  family,  for  he 
had  an  unusually  talented  wife,  and  he  had 
two  sons  who  became  physicians.  One  of 
them,  Charles,  became  a  professor  at  the 
University  of  Padua  and  gained  a  very  con- 
siderable distinction  in  medicine  and  numis- 
matics. The  bons  mots  of  Patin  were  pub- 
lished in  a  book,  entitled  "Patiniana." 

Many  editions  of  his  letters  were  pub- 
lished, and  comments  on  his  life  and  career 
have  appeared  by  various  authors.  Dr. 
Pierre  Pic  published  a  work  on  the  career 
and  character  of  Patin,  Paris,  191 1.  Dr 
Felix  Larrieu  published  a  monograph  on 
"Patin,  His  Life,  His  Work  and  His  Thera- 
peutics," in  1889,  and  a  very  elaborate 
work  was  published  in  1898,  by  L.  Vuil- 
horgue. 

The  comments  on  the  career  and  char- 
acter of  Patin  have  not  always  been  by  any 
means  commendatory.   But  whatever  one 


Medical  History ' 

feels  with  regard  to  the  qualities  of  his  char- 
acter and  the  work  that  he  did — and  he  was 
fiercely  honest,  genuinely  learned,  brilliant 
in  lecture  and  conversation,  true  in  his 
many  friendships  and  devoted  to  his  family 
— one  cannot  help  feeling  kindly  towards 
the  man  who  said: 

"J'aime  bien  Ies  enfants;  j'en  ai  six  et  il 
me  semble  que  je  n'en  ai  point  encore  assez. 
Je  suis  bien  ayse  qu'ayez  une  petite  fille. 
Nous  n'en  avons  qu'une,  Iaquelle  est  si 
gentille  et  agreable  que  nous  I'aimons  pres- 
que  autant  que  nos  cinq  garcons." 

Charles  L.  Dana. 


The  publication  of  this,  the  third  number 
of  the  Annals  of  Medical  History,  has 
been  greatly  delayed  owing  to  the  fact  that 
the  editor  has  been  called  into  service  and 
to  the  fact  that  all  the  gentlemen  connected 
with  the  editorial  work  have  been  very  much 
occupied  by  duties  in  connection  with  the 
war.  The  material  for  the  fourth  number  is 
now  in  hand  and  it  will  appear  with  very 
much  less  delay. 


BOOK   REVIEWS 


Early  History  of  North  Carolina  Medical 
Society.  By  Dr.  Wesley  Long,  M.D.,  Greens- 
boro, N.  C.  A  reprint  of  an  address  delivered  at 
the  sixty-fourth  annual  meeting  of  the  North 
Carolina  Medical  Society. 

The  author  has  spent  two  years  of  hard 
work  in  obtaining  the  data  regarding  the 
organization  about  which  he  writes  and  he 
has  succeeded  in  bringing  to  light  many 
interesting  facts  about  the  pioneer  work  of 
the  North  Carolina  Medical  Society. 

It  seems  that  North  Carolina  was  one  of 
the  first  states  to  have  a  medical  society. 
Such  a  society  was  organized  in  1799,  and 
met  yearly  for  five  successive  years,  when 
it  dropped  out  of  existence,  and  there  was 
then  no  state  organization  until  the  present 
society  came  into  existence  in  1849.  The 
first  society  was  evidently  composed  of 
men  of  intelligence  and  vision.  They  recom- 
mended the  establishment  of  a  board  of 
medical  examiners,  and  the  dividing  of  the 
state  into  districts,  with  meetings  in  these 
various  districts. 

Dr.  Charles  Smith  was  perhaps  the  first 
American  physician  on  record  who  was  sub- 
jected to  examination  by  a  board  of  exam- 
iners. Dr.  Long  suggests  that  he  ought  to 
have  a  monument. 

The  Proceedings  of  the  early  North  Car- 
olina Society  show  that  they  were  a  serious 
as  well  as  an  intelligent  set  of  men,  and 
the  local  paper  states  that  at  the  meeting 
in  1801,  a  "considerable  number  of  respect- 
able physicians"  were  present.  The  presi- 
dential address  contained  "a  cursory  nar- 
rative of  the  progress  of  the  science  of 
medicine  from  the  earliest  ages,"  showing 
that  the  gentlemen  of  those  days  took  an 
interest  in  the  history  of  medicine.  They  also 


appointed  a  committee  to  found  a  botanical 
garden  and  a  medical  library. 

All  together,  from  the  scanty  records  of 
this  pioneer  organization,  we  feel  sorry  that 
it  did  not  go  on. 

The  present  North  Carolina  Medical 
Society  dates  from  1849.  Dr.  Long  gives  a 
brief  summary  of  the  work  of  these  meet- 
ings, year  by  year,  up  to  1861,  and  he  adds 
biographical  notes  of  the  presidents  and 
important  officers  during  that  time.  He 
made  a  careful  search  for  the  portraits  of 
the  officers  of  the  Society  in  the  early  days. 
Dr.  Long  is  a  resourceful  man,  and  when  he 
could  not  get  a  picture  of  an  ancient  father 
he  put  in  a  picture  of  his  grave.  The  oldest 
portrait  is  that  of  Dr.  James  Webb,  who 
was  a  censor  in  1801  and  a  very  handsome 
man. 

The  pictures  of  other  men  who  are  in- 
corporated in  this  monograph  show  them 
to  be  persons  of  intelligence  and  force. 
Undoubtedly  it  required  those  qualities  to 
be  a  successful  physician  in  pioneer  days. 

Dr.  Long  has  made  an  original  and  very 
interesting  contribution  to  American  med- 
ical biography.  ^  T      „ 

0    ^  J  Charles  L.  Dana 

The  Nurse  in  Greek  Life.  By  Sister  Mary  Ro- 
saria,  M.A.,  of  the  Sisters  of  Charity,  Halifax, 
N.  S.  A  dissertation  submitted  to  the  Catholic 
Sisters  College  of  the  Catholic  University  of 
America  in  partial  fulfillment  of  the  require- 
ments for  the  degree,  Doctor  of  Philosophy. 
51  pp.,  1. 1.,  8°.  Boston,  June,  1917. 

This  is  a  beautiful  piece  of  synthetic 
work.  What  purports  to  be  a  dissertation 
in  classified  philology  is,  for  the  physician 
at  least,  a  most  fascinating  study  of  the 
cultural  history  of  Greek  pediatrics. 


325 


326 


Annals  of  Medical  History 


On  the  textual  side,  admirable  analyses 
of  the  Hippocratic  and  post-Hippocratic 
pediatrics  have  been  made  by  Kroner, 
Troitzky  and  others,  but  this  is  the  first 
extensive  handling  of  the  present  theme. 
Hitherto,  the  subject  has  only  been  adum- 
brated in  such  things  as  the  section  on 
"  Kinderpflege, "  in  SudhofPs  Catalogue  of 
the  Dresden  Hygienic  Exhibit  (191 1,  pp. 
138-144)  or  the  charming  pages  in  J.  P. 
Mahaffy's  "Social  Life  in  Greece  from 
Homer  to  Menander"  (London,  1913, 
29-31,  163-168).  Sister  Mary  Rosaria  builds 
up  the  whole  cultural  scheme  of  Hellenistic 
pediatrics  from  citations  from  the  poets, 
dramatists,  orators,  philosophers  and  physi- 
cians of  classical  antiquity. 

Beginning  with  a  short  introductory  chap- 
ter on  the  Greek  terms  used  for  "nurse" 
(Tpo4>6s,  TLdrjvri  /xata,  and  rlrdr)),  the  suc- 
cessive sections  deal  with  the  social  status 
of  the  nurse,  the  nurse  and  the  family, 
including  bathing,  swaddling,  wet-nursing, 
cradling,  fondling,  humoring  and  all  other 
phases  of  "mothering"  the  infant,  also  toys 
and  games,  nursery  tales  and  lullabies, 
closing  with  a  chapter  on  monuments  to 
the  nurse,  and  a  bibliography  of  sources. 
The  high  esteem  in  which  the  nurse  was 
held  in  ancient  Hellas,  even  when  her  tender 
charges  had  grown  up  to  be  men  and  women, 
is  plain.  As  in  Elizabethan  England,  and 
even  later  in  Scotland,  the  nurse  remained 
a  very  important  and  influential  personage 
in  the  household. 

The  poetic  citations — particularly  the 
lullabies  from  Theocritus,  Simonidcs,  Soph- 
ocles and  Euripides  are  beautiful,  and  we 
can  only  regret  that  our  authoress,  who 
commands  a  literary  style  of  such  pleasing 
simplicity,  has  chosen  to  give  them  only 
in  the  Greek.  In  an  essay  intended,  in  the 
first  instance,  for  Greek  scholars,  this  was 
natural  and  to  be  expected.  But  this  is  a 
work  which  can  hardly  be  bettered  of  its 
kind,  one  which  will  be  in  demand  among 
professional  pediatrists  and  students  of  med- 


ical history,  and  no  great  amount  of  fore- 
cast would  be  required  to  predict  a  second 
edition.  When  this  comes  to  pass,  we  hope 
that  Sister  Mary  Rosaria  will  add  transla- 
tions to  the  citations  chosen  with  such  skill, 
if  only  that  busy  physicians  may  be  spared 
the  necessity  of  painfull}-  picking  out  the 
meaning  from  Bohn's  ponies  or  from  the 
bilinguals  in  Loeb's  Classical  Library. 

F.  H.  Garrison 

Leonardo  da  Vinci:  Quaderni  d'Anatomia  V. 
Ventisei  fogli  della  Royal  Library  de  Windsor. 
Vasi-muscoli  cervello  e  nervi — anatomia  topo- 
graphica  e  comparata.  Quaderni  d'Anatomia 
VI.  Ventitre  fogli.  .  .  Proporzioni-funzioni  dei 
muscoli — anatomia  della  superficie  del  corpo 
humano,  pubblicate  da  Ove  C.  L.  Vangensten, 
A.  Fonahn,  H.  Hopstock.  Con  traduzione  inglese 
e  tedesca.  Christiania,  Casa  editrice  Jacob  Dyb- 
wad,  1 91 6. 

We  have  now  before  us  complete  the  gi- 
gantic work  which  began  to  appear  in  191 1. 
If  the  war  has  hindered  the  industrious  co- 
workers in  their  plan  of  issuing  an  annual 
volume  regularly,  in  the  beginning  of  Sep- 
tember of  each  year,  it  has  not  hindered 
them  and  the  doughty  publisher  from  com- 
pleting the  publication  by  the  appearance 
of  the  sixth  and  last  volume  on  September 
2,  1916,  although  the  four  non-Norwegian 
collaborators  have  been  called  to  military 
duty  in  the  warring  nations,  two  in  Ger- 
many and  Austria,  two  in  England  and 
Italy.  We  have,  then,  the  complete  graphic 
and  textual  material  of  Leonardo  on  anat- 
omy at  hand  in  an  exemplary  edition,  as 
far  as  the  Royal  Library  of  Windsor  Castle 
possesses  it.  Unfortunately,  the  original 
material  was  not  accessible,  since  physicians 
have  had  little  opportunity  for  spending 
afternoons  at  Windsor  for  three  years. 
Not  only  these  six  volumes,  which  the  pub- 
lisher, theHeliotype  establishment  at  Chris- 
tiania, the  London  publishers  in  small  part, 
and  the  three  scholars  of  the  northern  uni- 
versity with  their  staff,  have  given  us  in 


Book  Reviews 


327 


such  admirable  and  splendid  style,  but  these 
volumes,    combined   with   the   two   earlier 
volumes  which  Piumati  in  Paris  (1898)  and 
Sabachnikoff  in  Turin  (1901)  published  as 
Feuillets  A  and  B  respectively,  with  Italian 
textual  script  and  English  translation,  make 
up  the  whole.  In  the  Christiania  edition,  the 
Italian  original  text  is  accompanied  by  an 
English  and  a  German  translation,  closely 
following  the  Italian  text.  The  English  ver- 
sion is  the  work  of  W.  Wright.  The  German 
rendition  was  made  through  the  collabora- 
tion of  M.  HoII  and  K.  Sudhoff,  HoII  having 
naturally  and  rightly  supervised  the  ana- 
tomical interpretation  of  the  text.  We  have 
now   a  reasonable   basis   for   utilizing  and 
evaluating  the  material  in  its  relation  to 
the  history  of  anatomy  and  physiology,  a 
field  which  Hopstock  and  Fonahn,  as  well 
as  M.  HoII,  have  made  legitimately  and  pe- 
culiarly their  own.  While  the  sixth  volume 
deals  almost  exclusively  with  surface  anat- 
omy, muscular  function  and  the  theory  of 
proportions,  the  fifth  volume,  made  up  of 
leaves   from   all   of  Leonardo's   periods   of 
anatomical  study,  from  the  Florentine  days 
onward,  contains  great  masterpieces  of  his 
skill  in  the  art  of  anatomical  preparation, 
particularly  his  delineations  of  the  muscles 
and  tendons  of  the  leg  and  foot,  his  original 
injections  of  masses  of  wax  into  the  ven- 
tricles of  the  brain,  to  the  cortex  of  which, 
as  well  as  the  peripheral  nerves,  many  stud- 
ies are  devoted.  The  topographical  anatomy 
of  the  neck  is  set  forth  in  countless  prepara- 
tions;   the    supply    of    muscles,    tendons, 
bloodvessels   and  nerves  of  the  lower  ex- 
tremity is  elucidated  by  serial  sections;  the 
course  of  the  intestines  is  traced  by  occa- 
sional separation  of  the  intestinal  coils  from 
the  omentum.  Physiological  questions,  such 
as  the  action  of  the  heart  and  fetal  respira- 
tion, are  also  attacked.  The  careful  delicacy 
of  the   excellent   reproductions   will   be   a 
constant  source  of  delight  to  the  beholder, 
from  the  very  first  picture  of  the  venous 
system,  which  in  posture  resembles  the  old 


bloodletting  manikin,  but  reveals  exten- 
sive post-mortem  dissection  in  the  delinea- 
tion, of  the  course  of  the  veins,  or  the  won- 
derfully fine  silver-crayon  drawings  of  the 
topographical  anatomy  of  the  neck,  etc.  The 
publisher  has  done  his  part  as  well,  as  thor- 
oughly and  with  the  same  restless  zeal  as 
the  worthy  editors. 

Karl  Sudhoff 

(Translated  from  Miinchen.  med.  Wchnschr., 
1916,  LXIII,  1622.) 

Recollections  of  a  New  York  Surgeon.  By 
Arpad  G.  Gerster,  M.D.  Paul  B.  Hoeber,  New 
York,  1917;  8vo,  Cloth,  347  pages,  10  plates, 
16  illus.  S3. 50. 

There  are  several  types  of  autobiograph- 
ical writing.  In  some  the  writer  pours  out 
his  heart  or  lays  bare  his  soul  to  the  au- 
diences for  which  he  writes.  Of  such  a  kind 
were  the  "Confessions"  of  St.  Augustine 
and  those  of  Rousseau.  Other  autobiogra- 
phies are  not  much  more  than  a  series  of 
literary  or  critical  essays,  of  which  the  most 
interesting  example  is  the  recently  published 
"Recollections"  of  Viscount  Morley.  Some 
autobiographies  are  the  simple,  straight- 
forward, unvarnished  tales  of  the  writer's 
career.  Such  was  the  "Vita  Propria"  of 
Cardan  and  the  story  of  Benjamin  Franklin 
himself. 

Dr.  Gerster  has  written  his  autobiography 
along  the  lines  of  the  last  type.  He  tells  his 
story  with  simplicity,  directness  and  vivac- 
ity. 

The  author  has  had  a  much  more  varied 
experience  than  the  average  surgeon,  who 
has  lived  a  fairly  long  and  very  successful 
life.  Dr.  Gerster  grew  up  in  picturesque 
Hungary;  he  finished  his  education  in 
Vienna;  he  had  an  experience  in  the  Aus- 
trian armj-.  He  made  a  great  adventure  to 
America  and  a  still  greater  one  to  Brooklyn; 
he  had  the  daring  later  to  transfer  himself 
to  Manhattan.  All  of  these  enabled  him  to 
give  picturesqueness  and  a  certain  dramatic 
quality  to  his  story. 


328 


Annuls  of  Medical  History 


Readers  will  be  generally  more  interested, 
we  think,  in  the  story  of  his  home  life  and 
early  education.  This  presents  to  us  in  a 
singularly  direct  and  felicitous  way  the 
kind  of  family  life  which  the  Hungarian 
boy  led.  We  must  say  after  all  that  it  was 
not  very  remote  in  method  and  type  from 
that  of  New  England  of  forty  to  one  hundred 
years  ago. 

We  are  a  little  disappointed  that  the 
author  has  not  given  us  more  gossip  and 
comment  on  the  surgery  of  his  early  days 
in  New  York.  There  were  great  men  in 
those  times  and  some  fierce  controversies 
and  personal  incidents  which  Dr.  Gerster 
could  have  given  with  great  effect.  He  is, 
we  might  say,  almost  too  kind  to  his 
medical  brethren.  The  members  of  that  his- 
toric band  known  as  the  Charaka  Club  are 
given  a  chapter  and  receive  thereby  a  con- 
ditional immortality. 

Those  who  know  the  author  would  know 


that  there  is  nothing  in  his  book  which  ex- 
ploits himself.  We  should  rather  be  in- 
clined to  say  that  the  author  is  almost  too 
shy  in  recounting  his  achievements.  He 
seems  more  interested  in  the  personalities 
about  him.  He  shows  that  he  likes  to  esti- 
mate and  esteem  his  fellow  men,  and  con- 
fesses that  he  has  been  well-treated  by 
those  in  his  profession.  He  shows  himself 
very  keen  and  very  sound  on  problems  of 
education.  He  is  a  lover  of  art,  of  music,  of 
books  and  of  all  the  phases  of  outdoor  life, 
his  own  experience  in  which  he  felicitously 
portrays.  If  the  traveler  from  Mars  should 
pick  up  the  work,  he  would  say,  we  think, 
that  it  tells  a  story  of  a  very  unusual  man, 
progressive,  and  sometimes  aggressive,  tenax 
propositi,  broadly  educated,  widely  endowed 
and  a  mighty  good  fellow.  The  book  is  well 
printed,  and  illustrated  with  some  very  inter- 
esting plates  of  his  family  and  environment. 
Charles  L.  Dana 


VOLUME    I 


NUMBER    4 


ANNALS    OF 

MEDICAL  HISTORY 


m 


r 


FRANCIS  R'PACKARD'M'D'EDITOR  [PHILADELPHIA] 
PUBLISHED  QUARTERLY  BY  PAUL  <  B  <  HOEBER 
67-69  EAST  FIFTY-NINTH  STREET'  NEW  YORK  CITY 


£ 


i 


Entered  as  second  class  matter  June  a,ioi7,  at  the  post  office  at  New  York,  N.  Y„  under  the  Act  of  March  3,  1879. 
Yearlv  Subscription  $6.00.    Single  numbers  Ja.oo. 


3^ 


ANNALS  OF  MEDICAL  HISTORY 


Volume  i 


Winter  1917 


Number  4 


THE  FIRST  PRINTED  DOCUMENTS  RELATING  TO  MODERN 

SURGICAL  ANESTHESIA1 

By  SIR  WILLIAM  OSLER,  M.D.,  F.  R.  S. 

Oxford,  England. 


HE  story  of  surgical 
anaesthesia  illustrates 
how  long  it  takes  an 
idea  to  become  effect- 
ive. The  idea  of  pro- 
ducing insensibility 
to  pain  during  a  cut- 
ting operation  is  of 
great  antiquity,  e.  g.,  in  Chapter  II,  21,  of 
the  Book  of  Genesis.  Nor  is  the  word 
anaesthesia  modern,  as  is  sometimes  said, 
and  invented  by  Oliver  Wendell  Holmes.  It 
occurs,  Withington  tells  me,  first  in  Plato 
(Timaeus)  and  is  used  by  Dioscorides  in 
the  modern  sense. 

The  extraordinary  controversy  which  has 
raged,  and  which  re-rages  every  few  years, 
on  the  question  as  to  whom  the  world  is 
indebted  for  the  introduction  of  anaesthesia, 
illustrates   the   absence   of  true   historical 

1  Remarks  made  on  presenting  Morton's  original 
papers  to  the  Royal  Society  of  Medicine,  London, 
May  15,  19 18. 


perspective  and  a  failure  to  realize  just 
what  priority  means  in  the  case  of  a  great 
discovery. 

Why  do  we  not  give  the  credit  to  Dios- 
corides, who  described  both  general  and 
local  anaesthesia,  or  to  Pliny,  or  Apuleius 
or  to  Hiotho,  the  Chinaman,  who  seems 
to  be  next  in  order,  or  to  the  inventor  of 
the  spongia  somnifera,  or  to  Master  Mazzeo 
Montagna,  in  Boccaccio,  or  to  any  one  of 
the  score  or  more  of  men  in  the  Middle 
Ages  who  are  known  to  have  operated  on 
patients  made  insensible  by  drugs  or  vapors? 
Why  do  we  not  give  the  credit  to  Davy, 
who  had  the  idea,  or  to  Hickman,  who  had 
both  idea  and  practice,  or  to  Esdaile,  who 
operated  on  hundreds  of  patients  in  the 
hypnotic  state,  or  to  Elliotson,  who  did 
the  same;  or  to  Wells,  who,  in  1844,  oper- 
ated under  nitrous  oxide,  or  to  Long,  who 
frequently  practised  ether  anaesthesia? 
Why?  Because  time  out  of  mind,  patients 
had   been ,  rendered   insensible   by   potions 


329 


330 


Annals  of  Medical  History 


or  vapors,  or  by  other  methods,  without 
any  one  man  forcing  any  one  method  into 
general  acceptance,  or  influencing  in  any 
way  surgical  practice. 

Before  October  16,  1846,  surgical  anaes- 
thesia did  not  exist — within  a  few  months 
it  became  a  world-wide  procedure;  and  the 
full  credit  for  its  introduction  must  be 
given  to  William  Thomas  Green  Morton, 
who,  on  the  date  mentioned,  demonstrated 
at  the  Massachusetts  General  Hospital 
the  simplicity  and  safety  of  ether  anaes- 
thesia. On  the  priority  question  let  me 
quote  two  appropriate  paragraphs — "He 
becomes  the  true  discoverer  who  estab- 
lishes the  truth;  and  the  sign  of  the  truth 
is  the  general  acceptance.  Whoever,  there- 
fore, resumes  the  investigation  of  neglected 
or  repudiated  doctrine,  elicits  its  true 
demonstration,  and  discovers  and  explains 
the  nature  of  the  errors  which  have  led 
to  its  tacit  or  declared  rejection,  may 
certainly  and  confidently  await  the  acknowl- 
edgements of  his  right  in  its  discovery." 
(Owen,  "On  the  Archetype  and  Homologies 
of  the  Vertebrate  Skeleton,"  p.  26.)  "In 
science  the  credit  goes  to  the  man  who 
convinces  the  world,  not  to  the  man  to 
whom  the  idea  first  occurs"  (Francis  Dar- 
win, Tbe  Eugenics  Review,  1914).  Morton 
convinced  the  world:  the  credit  is  his. 

Morton's  original  essays  are  among  the 
rarissima  not  existing,  so  far  as  I  can 
ascertain,  in  any  of  the  general  or  special 
libraries  of  this  country.  I  have  been 
looking  for  them  in  vain  for  many  years. 
In  a  parcel  of  his  father's  papers  recently 
received  from  William  J.  Morton  of  New 
York  there  were  duplicates  of  "Letheon" 
and  "Remarks  on  the  Proper  Mode  of 
Administering  Sulphuric  Ether  by  Inhala- 
tion," which  I  have  great  pleasure  in  pre- 
senting to  the  Library.  Also  a  duplicate 
copy  of  Tbe  Boston  Medical  and  Surgical 
Journal  of  November  18,  1846,  which 
contains  the  first  printed  account  of  the 
new  procedure,  by  Dr.  Henry  J.  Bigelow. 


In  the  same  journal  for  December  9th, 
Dr.  J.  Collins  Warren  (Primus)  gives  an 
account  of  the  first  operation  at  the  Massa- 
chusetts General  Hospital.  These  four 
papers  stand  out  in  the  literature  of  sur- 
gical anaesthesia  as  fundamental,  and  truly 
epoch-making. 

Morton  called  the  drug  letheon  and 
applied  for  letters  patent  to  secure  his 
rights — not  an  unethical  procedure  in  the 
dental  profession  of  America.  This  led 
to  the  publication  of  his  first  pamphlet 
called  "Letheon,"  the  bibliography  of 
which  some  one  should  undertake.  "The 
medium  through  which  Dr.  Morton  com- 
municated the  results  of  experiments  on 
etherization  to  the  public,  was  a  'circular' 
which  he  had  printed,  at  his  own  expense, 
almost  every  week.  It  was  at  first,  as  its 
name  imports,  a  mere  letter  of  advice; 
but,  as  it  became  the  receptacle  of  news- 
paper articles,  and  correspondence  from 
every  portion  of  the  Union,  announcing  the 
success  of  etherization,  it  was  necessarily 
enlarged  into  a  large  and  closely-printed 
sheet  of  four  pages.  Soon  this  'Circular' 
became  a  pamphlet,  and  of  this  five  differ- 
ent editions  were  published,  under  Dr. 
Morton's  immediate  supervision,  embody- 
ing a  digest  of  all  the  authentic  information, 
both  from  Europe  and  America,  on 
Anaesthesia."  (Rice,  "Trials  of  a  Public 
Benefactor,"  1859,  p.  114.) 

The  Index  Catalogue  of  the  Surgeon 
General's  Library  only  mentions  a  four- 
teen-page pamphlet,  1846,  printed  by 
Dutton  and  Wentworth,  Boston.  The  early 
form  of  the  circular  may  be  seen  on  the 
back  page  of  Tbe  Boston  Medical  and 
Surgical  Journal,  for  December  9th.  In 
the  number  for  November  1 8th  with  Bige- 
Iow's  paper,  there  is  only  an  advertisement 
of  Morton's  courses  of  instruction  in  dentis- 
try.  The  circular  appeared  first  November 
26th,  and  is  copied  on  pages  14-15  of  the 
Letheon  pamphlet,  fifth  edition.  This 
pamphlet  is  made  up  of  more  than  eighty 


First  Printed  Documents  Relating  to  Modern  Surgical  Anaesthesia        33  j 


short  articles  from  medical  journals  and 
newspapers,  and  is  of  special  value  in 
giving  the  popular  first-hand  impressions 
relating  to  the  great  discovery.  There  is 
very  little  of  Morton's — only  the  circular 
already  referred  to,  and  on  page  16  the 
terms  for  the  "Apparatus,  a  bottle  of  the 
Preparation,  instruction,  etc." 

In  1847  Morton  published  a  forty-four 
page  pamphlet  on  "The  Proper  Mode  of 
Administering  Sulphuric  Ether  by  Inha- 
lation," Boston,  Dutton  and  Wentworth, 
printers,  in  which  the  original  apparatus 
(now  a  treasured  relic  at  the  Massachusetts 
General  Hospital)  is  described.  In  the  early 
part  of  April  he  found  that  a  sponge  would 
serve  the  same  purpose  and  was  less  danger- 
ous. The  greater  part  of  the  pamphlet  is 
taken  up  with  general  directions,  the  out- 
come of  the  author's  experience. 

The  claims  of  Morton  were  very  fully 
stated  in  a  pamphlet  published  in  Paris 
in  1847  with  the  title  "Memoire  sur  la 
decouverte  du  novel  emploi  de  I'ether 
Sulphurique." 

In  1859  he  published  a  small  work 
"On  the  Physiological  Effects  of  Sulphuric 
Ether  and  its  Superiority  to  Chloroform," 
Boston.  So  far  as  I  can  ascertain,  this  is 
his  complete  output  on  the  subject  of 
anaesthesia,  except  a  posthumous  pam- 
phlet on  "The  Use  of  Ether  as  an  Anaes- 
thetic at  the  Battle  of  the  Wilderness." 
(Journal  0/  the  American  Medical  Asso- 
ciation, April  23,  1904.) 

The  third  item  is  No.  16  of  Vol.  xxxv 
of  The  Boston  Medical  and  Surgical  Journal 
(then  as  now,  issued  weekly)  for  November 
1 8th,  which  introduces  to  the  profession 
modern  surgical  anaesthesia.  Henry  J.  Bige- 
Iow,  the  distinguished  surgeon,  had  been 
interested  in  Morton's  private  dental  cases, 
and  read  a  paper  before  the  American 
Academy  of  Sciences,  November  3rd,  and 
at  the  Boston  Society  of  Medical  Improve- 
ment, November  9th.  It  was  called  "Insen- 
sibility during  Surgical  Operation  Produced 


by  Inhalation,"  and  after  referring  to  the 
early  cases  of  Warren  and  of  Hayward  at 
the  Massachusetts  General  Hospital,  he 
gives  fuller  details  of  the  dental  cases  which 
he  had  seen  with  Dr.  Morton.  No  small 
share  of  the  early  confidence  inspired  in 
the  profession  is  due  to  this  temperate 
statement  by  Dr.  Bigelow,  who  fully  realized 
the  enormous  value  of  the  discovery. 

In  the  literature  of  anaesthesia  these  are 
the  three  fundamental  contributions.  With 
them  should  be  placed  Collins  Warren's 
account  of  the  first  operation,  The  Boston 
Medical  and  Surgical  Journal,  December 
9th,  and  Vol.  xxxv  of  this  publication, 
which  contains  some  twenty-two  papers  on 
the  subject,  illustrating  the  rapid  spread  of 
the  practice. 

The  opportunity  here  offers  to  suggest 
the  arrangement  of  certain  subjects  in  our 
libraries  on  an  educational  basis.  For 
example,  why  should  not  the  members  of 
the  Section  on  Anaesthesia  of  this  Society 
undertake  to  collect  and  classify  their 
literature  on  historical  lines?  Start  with 
the  documents  that  magnetized  into  life 
an  antique  practice,  these  pamphlets  of 
Morton,  Bigelow's  paper,  Warren's  paper, 
and  Volume  xxxv  of  The  Boston  Medical 
and  Surgical  Journal.  Put  these  together — 
all  in  vellum  and  lettered  in  gold! — as  the 
blastoderm  from  which  the  enormous  litera- 
ture has  developed,  which  might  be  ar- 
ranged on  the  shelves  in  ten  or  more 
sections.  The  Index  Catalogue  of  the  Sur- 
geon General's  Library  has  a  good  classi- 
fication, but  for  my  own  collection  I  have 
used  the  following: 

I.  The  general  story,  as  given  in  such 
publications  as  the  Jubilee  numbers  of  the 
British  Medical  Journal  and  The  Boston 
Medical  and  Surgical  Journal;  and  the 
text  books  in  which  the  history  of  the 
subject  is  well  given,  as  Snow,  Foy,  and  so 
forth. 

II.  Pre-ether  period.  On  cards,  references 
to  Gurlt's  "Geschichte  der  Chirurgie,"  Bd. 


332 

III,  p.  621;  and  Volume  I  of  Simpson's 
works,  from  which  sources  most  of  the 
textbook  and  other  descriptions  are  taken; 
and  to  Dioscorides,  Pliny,  and  Apuleius, 
to  the  spongia  somnifera,  to  Boccaccio  and 
the  numerous  other  early  writers.  Brief 
descriptions  could  be  written  on  the  cards. 
Then,  in  order,  would  follow  the  words  of 
Days',  of  Beddoes,  the  tragic  story  of 
Hickman,  the  remarkable  documents  relat- 
ing to  anaesthesia  produced  by  compression 
of  arteries,  veins,  and  nerves,  Bartholinus' 
use  of  cold  for  local  anaesthesia,  and  the 
section  would  conclude  with  the  writings 
of  Esdaile  and  of  Elliotson  on  hypnotism 
in  surgery.  What  an  education,  even  to 
glance  at  this  literature  in  due  sequence 
on  the  shelves! 

III.  The  modern  period,  beginning  with 
Morton,  Wells  and  Jackson;  the  story  of 
the  miserable  priority  claims,  the  congres- 
sional reports,  the  publications  of  the 
Morton  association,  the  topical  literature, 
showing  the  introduction  of  the  practice 
into  different  countries,  the  Long  literature, 
and  so  forth. 

IV.  In  chronological  order  the  subject  of 
anaesthesia  in  midwifery,  embracing  every- 
thing from  Simpson's  original  pamphlet  to 
the  latest  popular  magazine  article  on 
twilight  sleep. 

V.  Chloroform  and  its  introduction.  The 
papers  of  the  discoveries,  Guthrie,  and  so 
forth,  the  Simpson  pamphlets — his  famous 
British  Encyclopaedia  article,  dealing  with 


Annals  cf  Medical  History 


the  subject  of  anaesthesia  under  the  word 
chloroform,  which  led  to  the  sharp  Bigelow- 
Simpson  controversy — the  Hyderabad  Re- 
ports, the  B.  M.  A.  and  other  reports  and 
documents. 

VI.  Local  anaesthesia  from  Dioscorides 
and  Bartholinus  to  Kohler,  Corning,  Hal- 
sted,  Cushing,  and  others. 

VII.  Agents  other  than  ether  and  chloro- 
.  form  used  for  inducing  anaesthesia,  arranged 

in  order  of  introduction. 

VIII.  Technique,  including  the  various 
methods  of  administration — intravenous, 
intratracheal — and  the  literature  of  ap- 
paratus. 

IX.  Physiology. 
X.  Pathology. 

I  speak  as  an  amateur.  Doubtless  experts 
could  easily  arrange  a  more  comprehensive 
scheme.  To  separate  in  literature  the  quick 
from  the  dead  is  one  of  the  functions  of  a 
well-ordered  library;  but  much  that  we 
carelessly  regard  as  dead  is  magnetized 
into  life  when  put  in  its  historical  relation. 
The  plan  here  suggested — which  could  be 
applied  in  other  directions — sustains  that 
continuity,  to  the  study  of  which  this 
Section  is  devoted.  You  remember  the  rings 
of  Lucretius — well,  there  is  a  vis  et  vinculo 
librorum,  binding  together  books,  a  force 
just  as  potent  as  the  Vis  et  vinculo,  lapidis, 
which  supports  the  rings,  and  in  the  litera- 
ture of  anaesthesia  tnis  force  is  derived 
from  the  works  here  presented  to  the 
Library. 


* 


BYZANTINE  MEDICAL  FRAGMENTS 
By  CHARLES  SINGER 


OXFORD,    ENGLAND 


UNDER  the  title  of  Byzantine 
Medical  Fragments  we  propose 
to  publish  in  these  pages  a  series 
of  short  texts  in  later  Greek 
dialects.  Each  will  be  accompanied  by 
a  translation  as  literal  as  possible  and  by 
brief  notes. 

Of  late  years  there  has  been  a  wide- 
spread revival  of  interest  in  the  Middle 
Ages,  and  a  considerable  part  of  the  energies 
of  medical  historians  has  been  directed  to 
collecting  the  material  for  a  consecutive  and 
coherent  history  of  mediaeval  medicine. 
Except  for  the  purely  astrological  material, 
Byzantine  sources  have,  however,  been  large- 
ly neglected.  A  great  store  of  medical  frag- 
ments must  still  lie  in  the  monastic  libraries 
of  the  East,  where  enthusiastic  collectors 
have  for  centuries  been  seeking  the  more 
fairly  written  and  valuable  copies  of  known 
writers,  rejecting  those  scribbled  fragments 
of  medical  lore  which  yet  give  us  a  far 
truer  view  of  the  real  contemporary  outlook 
than  the  magnificent  volumes  of  Dioscorides 
or  Galen  that  are  among  the  treasures  of 
the  great  European  libraries.  It  is  to  be 
hoped  that  in  future  more  copies  or 
photographs  of  such  fragments  may  be 
secured. 

The  expert  palaeographer  in  his  just 
scientific  desire  to  demonstrate  continuity 
has  tended  always  to  reproduce  the  hand- 
writing of  the  professional  scribe  rather 
than  the  more  careless  and  less  typical 
work  of  the  monastic  scribbler.  The  read- 
ing and  dating  of  our  fragments  may 
thus  often  present  special  difficulty.  In 
view  of  this  and  of  the  scarcity  of  fac- 
similes of  Byzantine  medical  palaeography, 
we  shall  in  each  case  reproduce  a  photo- 
graph of  the  transcribed  text.  *  *■ 

333 


I.  A  GREEK  FOURTEENTH-CENTURY  PROGNOS- 
TIC FROM  THE  BLOOD 

A  large  part  of  mediaeval  medical  lore, 
both  Eastern  and  Western,  was  made  up  of 
prognosis,  the  methods  of  which  were  drawn 
from  the  most  diverse  sources.  Scraps  of 
the  genuine  science  of  antiquity,  sentences 
and  aphorisms,  frequently  modified  and 
misunderstood,  from  the  writings  of  Hip- 
pocrates and  Galen,  often  stand  side  by 
side  with  astrological  precepts,  with  the 
ridiculous  mechanical  devices  of  Hermetism 
or  with  fragments  of  primitive  folk  medicine. 

Among  the  most  favorite  forms  of  prog- 
nosis were  the  examination  of  the  urine  and 
of  the  blood.  Urinoscopy  and  haematoscopy 
occupied  a  large  part  of  the  attention  of  the 
physician,  and  perhaps  even  more  that  of 
the  partially  trained  or  untrained  pretenders 
to  whose  guardianship  the  people  largely 
trusted  its  health.  Urinoscopy  was  fre- 
quently a  specialist's  occupation  and  figures 
illustrating  it  are  common  enough  in  the 
MSS.  and  have  been  frequently  reproduced. 
Blood-letting  was  no  less  specialized  and  the 
barber,  having  performed  his  venesection, 
was  frequently  called  upon  to  give  an  opin- 
ion as  to  the  patient's  health  and  prospects 
of  life  from  the  appearance  and  behavior 
of  the  shed  blood.  The  formation  of  buffy 
coat,  the  separation  of  serum  and  clot,  the 
distinction  between  arterial  and  venous 
blood,  the  alteration  in  color  after  exposure 
to  and  mixture  with  air,  the  process  of 
Iaking,  the  rate  and  character  of  putrefac- 
tion, all  phenomena  now  easily  distinguished 
from  one  another,  were  then  confused  to- 
gether and  the  resultant  held  to  indicate  the 
present  and  future  nosological  state  of  the 
patient.  Curiously  enough  figures  illustrating 
haematoscopy  appear  to  be  much  rarer  in 


334 

MSS.1  than  figures  of  urinoscopy,  though 
miniatures  of  the  actual  process  of  blood- 
letting are  very  frequently  encountered. 

The  text  here  transcribed  gives  a  fair 
idea  of  the  kind  of  opinion  that  would  thus 
be  formed.  It  consists  of  a  single  page  and 
was  written  in  the  late  fourteenth  or  early 
fifteenth  century,  probably  in  the  monastery 
of  the  Holy  Trinity  in  Chalchis,  whence  it 
was  brought  to  the  Bodleian  Library.  The 
language  is  that  of  a  well-instructed  writer 
but  it  is  sometimes  confused,  and  in  places 
inaccurate.  Thus  x':tj.a  is  written  for  yj.j.y., 
-r/C'.p^y/lov  for  mzvSapax^ov  and  r.zi- 
trnvoc,  ior  xpdcuvoc;.  The  iota  subscript  is 
usually  omitted.  The  handwriting  is  regular 
but  considerably  contracted  and  there  is 
a  peculiar  tendency  to  insert  letters  above 
the  line  without  otherwise  abbreviating. 
\\  e  would  especially  point  to  the  word  cr./.oi 
in  lines  19,  26,  28  and  29  where  the  letters 

01 
are  written  in  three  vertical  rows  thus   t; 

:/., 
although  the  scribe  is  not  pressed  for  space. 

Perhaps  the  only  doubtful  reading  in  the 
MS.  is  in  the  rubricated  title,  in  a  hand 
different  to  that  of  the  text.  The  natural 
reading  of  the  third  word  of  the  title  is  the 
impossible  (7£!ov,  but  the  author  of  the  Bod- 
leian catalogue2  would  seem  correct  in 
giving  coyrr;pi<.jV,  that  is  jUott; jpfwv,  the  p 
having  lost  its  tail. 

At  the  end  of  the  MS.,  in  the  same  hand- 
writing and  red  ink  as  the  title  arc  the 
words  xEkoq  or/:  v.'oj  !  "Don't  think  this 
the  end."  We  are  inclined  to  differ  from 
the  anonymous  scribe  and  to  think  that  this 
is  really  the  end  and  that  the  little  text  is 
complete  in  itself. 

The  initial  letter  of  each  paragraph  has 
been  rubricated,  probably  by  the  scribe  who 
inserted  the  title  and  the  three  final  words. 

'The  only  figure  <>f  a  true  hematoscopj   that  we 

can  recall  is  in  a  fiftrenth-o  ntur\  German  astro- 
logical calendar  in  the  British  Museum,  MS.  addi- 
tional 17987,  folio  101  recto. 


Annals  of  Medical  History 


\\  e  may  conclude  with  a  few  notes  on 
our  English  rendering  of  the  contents  of  the 
MS. 

:-/cop  we  have  left  as  "ichor."  It  refers 
to  a  puslike  appearance  in  the  blood  and 
is  probably  used  to  denote  the  buffy  coat. 

piyoc,  which  here  implies  some  form  of 
continued  fever  with  chills  and  not  a  mere 
rigor,  we  have  here  translated  by  the  in- 
definite term  "ague." 

-/oat;  we  render  "choler"  rather  than  at- 
tribute a  conception  of  modern  medicine  to 
a  writer  immersed  in  the  humoral  pathology 
by  translating  it  as  "bile." 

The  debatable  word  IXkoc,  we  have  ren- 
dered "abscess"  or  "pus,"  according  to 
the  sense  of  the  passage. 

auj.2  IXx&Sec,  on  line  23  we  have  rendered 
"blood  as  though  from  an  abscess,"  and 
x'iyx  piov  ;jlt;  'ix:  IXxwcewc  on  line  12  we 
translate  "blood  running  as  though  from 
an  uncured  abscess." 

Line  9.  x':.\xx  .  .  .  [xaupov  zt//.t6v  C>q  to  tt)<; 
XeXcoVTjc," Blood  black-clotted  like  that  of  the 
tortoise."  In  Greece  there  are  two  species  of 
tortoise,  the  land  tortoise,  Testudo  grseca,  and 
the  fresh-water  tortoise,  Testudo  clemmys  cos- 
pica.  We  have  experimented  with  the  blood 
of  both  these  animals  and  find  that  it  clots 
much  more  rapidly  than  normal  human 
blood.  On  the  other  hand  it  contains  con- 
siderably less  haemoglobin  than  human 
blood  so  that  the  epithet  [laupov,  black  or 
dark,  is  inapplicable.  The  sense  would  there- 
fore be  improved  by  the  Insertion  of  some 
separative  word  such  as  i\\d  giving  the 
meaning  "blood  dark  hut  clotted  like  that 
of  the  tortoise." 

Line  17,  javSipayHiov  must  be  for  javo*- 
zpa/flov.  a  participle  of  a  verb  formed  bom 
JOVOapflbcY),  realgar  (arsenic  disulphide, 
As-jSj),  the  red  color  of  \\  hich  is  comparable 
to  blood. 

IL  mi\  ( ).  Coxe,  " Catalogi  Codicum  Manuscrip- 
torum  Bibliothecae  Bodleianae  Pars  Prima,  Recen- 
sionem  Codicum  Praecorum  continens."  Sec.  469, 
Oxford,  1853. 


I 


6  1         (V-»  .  t  f        '    t  t  '         \  t*  &        ' 

<u*4f v  i  fto*  f  «7  7^  «*  /^y  ?***,  yppr  «*V«*» .  c  >h  «*/•*»/«*  A**?-6*7«W>^  «#,  r ; 

o««f*vuv--.f>ivVv^t^e«tt^^«tTr^^wi,k^VUvQ(r'7V7ri«#^a)V9»>*,f478^ifa.^ 

^Wi,  fx-pvfiMj  v ,  w  j,  nfy  vt*>°'*sit  h^^f  •&*&!, *n*bfi  wVtyi>*it*Qfi4  «w;'<f  SVfkr?  6'iTrfi 


335 


336 


Annals  of  Medical  History 


Lines  18  and  26,  a::jia  u>q  xoyxuXij, 
"blood  like  a  shell,"  refers  doubtless  to  ac- 
cidentally coiled  or  twisted  clots  which  may 
bear  some  resemblance  to  the  spiral  coils 
of  univalve  mollusca. 


Transcription,   Bodleian   Library  MS.,   Roe 
IS,  f.  104V 

77£pl    3K[AGfT(i)V    ff  (<i)Tlj)p{(i)V    "/.a;    6Xs6p((t)V 

'Ext  uiv  tou  TJpoq  fjiapTtoj-  dhcpiXXfou" 
louvfou,  e!  9Ae5oTo;i"r/:7ri  xlqm  v.7.\  pzjar,  a''.';j.a, 
r/ov  hy./  ocaafav  ypoav  o>z  vSjZjz,  tw  to'.ojtm 
Xeiuxovo^  apyoiiivoj,  Oava-ro^  y:v£Ta:-  :w 
0'  ajTW  v.y.:zC>  z:.  ;j.ev  efai  Ta  y'i'xyzx  jtaTaXeu- 
xa,  xa:  r/C)zyz  zyjjz:.  p:y:a  xal  xoixtXa; 
ajfJevela.:  SnXouatv'  (5)  iav  0£  xaOapioc  p£J- 
awai,  7.2::  txwpac  xo:t;:7(.)t:  xat  [xeTptaK  yo'^v 
e'cotcrtv,   'Jy.fjC  iaovrai. 

'Ex:  wXeupfaQV  Be£toO  xa:  iptarepou,  e: 
pi£v  eupeOf,  -ro  a![i.a  (fafverov  r,  xpajrjvov,  t]  (be 
xaxviav  Ov^cxe:'  £:  Be*  Xeuxiv  xa:  xayuoep^ov, 
•/.a:  k':to  [JL^vwv  Btaxjprov,  £x  psu'cto^  xotXtaq 
ato^erat  6  xatxvtov. 

'Eav  Be  Ttq  tayvoq  xa:  iirjpoq  xdvu  clx;  ext 
tg)v  Ixt6ti}x6t(i)v  yXe6oTO[x^<n]  xa:  peuoT)  to  atfjia 
aikou  [xajpov  xt/z.tov  wc  to  tt;;  XsXwvrjg, 
xcc/jstaq  TeXeuxqc. 

'Eav  cs  t:c  (10)  XArjptxtxoq  fh  r;  A7;0ap- 
ytxoc-  rt  veq>piTtx6?  pXe6oTou.f|cnr],  xa:  p£j-r, 
avTt  afywtToq  /oat,  xpatrrjvo.;  wemjyeTa,  -.T/i^z 
TeXe'jTa. 

'Eav  Be  fc'jTf,  aY;i.axaTd:jiaiipov  xat  t'xwpa^ 
xo:Tjo-£'.q,  p:y£a  StjXoI"  et  Be  '"y.wpa  ou  xotTjce: 
aya06v  Scxi. 

A;.';j.a   piov   [jly;   laq   SXxaMietoq,   iicaXXay^v 
ct/ao:   tt(;    ;j.3>.XouaTfjq   voao'J. 

AYfxa  plov  d'atvcTov  oaov  toj  [xtj  yaevouivou 
rYiuctoc.,  Sic!  ofov&ijicoTe  [lipoq  toj  iyyeiou, 
fajXoc  l(.<r//  l§au-i)vta(av,  fj  to  icoXJi  eviauafatev 
£:  ch  xpaj'.vo:  £&pe0e(l]  (15)  T)  8«J"?  toj 
/j.yTo:,  xejMCTaloq,  r,  izz'.yj.vjz  axoOvYj-xer 
xa(   (J)<;   X(I>pca    1x2   toj    xfywtTOS   yo'.r,; 

B6pT)6'j)9(v'    (oT-rp    xoXuxav86Xou    ypau-pval 
xXeupktSa  StjXoc  [iefcfcXTjv  £-!  i:  psjj£:  waxep 

IXxo?,  r(  fop6opw8e<;   :r/>.v  :r/o'.. 

A't'txa:  cavcpy/ilov  ^.ijvo?  vojw  <fa(v£t. 


AYfxa  w?  xoyxuX^,  6avautixov  Ijte'v. 
AYpu  a9pd)0£>;  x£ptxv£'j[j.ov(av    B^Xol   xa: 

Al^ta  p£ujxv,  to  ^jxcau  eXxo?  xat  to  ^[jlcuu 
a'^a,  Tax£iav  6y£:av  StjXoi. 

At[ji.a  6potx6toSeq  xat  (20)  aeuxov  w?  yaXa 
xat  B'jawctav  I'xov,  vsypfinQV  CT]Xot. 

AY^a  [X£Atoxay,u  xa:  SuatSSeq,  Ixov  Xop(a 
djTpaxwCY),  6avaTov  St^aoT  xpovtalov  r;  £^a^.T;- 
v.atov. 

To  axo  yA£6oTo;a.:ac  aY;j.a,  ziv  [xaupov  i": 
xa:  :-/(T)pa  oj  xo:TQa£t£  ptyo^  StjXoI"  e!  Be 
T0'.r,j£:  :x<ipa,  ayaBdv  £jt:v. 

AYjxa  £Axto:£c  ov  axa AAayifjv  otqao!  T"^q 
•jl£aaoj-t;c  v6o,ou"  6a:v£Tov  :i  q;av£v  oaov  xat 
;ju;:6a<i->;  [X£T£Xov  aY[xaToc,  £3a^.r;v:a:oj  xpovo'J 
l,(ot)v  Br^Aot.  E(  Bs  xpaatvo?  yaivo-.To,  t;  'i'^.z 
toj  zij-y-r,-  (25)  X£;jixTa:oc-  T]  icoo^atoq,  6 
ojtok  iywv  axo6vT)ffxei. 

Et  ci  zy.z-r,z  dcpcevtXT)?  X?03:v  ^'X«;.  Oava- 
tov  £xay£: '  e!  Be  xai  w;  x:-ja  peucr;,  exxtx6v 
cr,Ao:. 

Et  Bd  p£jtt;  IXxoq  Xeuxfe?  t;  oopSopwBss 
crrj^tv  StqXoI'  £t  31  xa:  to;  xoyxuX^v;  <pav£:if;, 
Bavaatfxov. 

E!  Be  to  t;[jl:jj  eXxoq  xa:  to  r/x:jj  aY^.a 
jy:a:v£:  Tayjco-;. 

Et  Be  slq  ttjv  airr^v  Xdxxov  r/j:,  OavaTov 
CTyXo:. 

E(  Bl  [JLcXav  xayj  xa:  ;j-o)0£c,  lyov  A(.»p:a 
SaxpaxwBiQ,  Oavarov  ypov:a:ov  t;  i^a^TQVtatov 

Bf]AOt. 

Et  Be  yotvixouv  ypw[Jt.a  (30)  e'xet  ^^PT!- 
voat'av  BtjXot. 

In  a  later  hand 
ts'ao;  i<r/j  Tjyoj. ! 

Translation 

Concerning  sale  and  dangerous  bloods. 

In  Spring,  in  March,  April,  or  June  it  one 
should  hi-  bled  and  the  blood  How,  having 
on  the  surface  a  color  like  to  the  sea,  to 
such  a  one  death  comes  at  the  beginning  of 

the  winter.  At  the  same  season  if  bloods  are 
whitish  and  have  ichors,  they  denote  agues 
and  various  sicknesses.    If  they  should  How 


Byzantine  iMedical  Fragments 


337 


cleanly  and  [then]  form  ichors  and  throw 
out  a  moderate  amount  of  choler,  they  will 
be  healthy. 

In  right  or  left  pleurisy,  if  the  blood  is 
found  purple  or  greenish  or  like  smoke,  he 
dies.  If  whitish  and  with  a  thick  coat,  yet 
remaining  red  within,  the  belly  being  re- 
laxed, the  patient  survives. 

If  any  one  being  thin  and  very  dry,  as 
in  those  who  have  wasted,  should  be  bled 
and  his  blood  run  dark  [but]  clotted  like 
that  of  the  tortoise,  he  quickly  ends. 

If  any  one  should  be  pleuritic,  or  leth- 
argic, or  nephritic,  and  he  be  bled,  and 
greenish  congealed  choler  should  run  in- 
stead of  blood,  he  quickly  ends. 

If  blood  should  run  very  dark  and  should 
form  ichor,  it  is  well. 

Blood  running  from  an  uncured  abscess 
denotes  deliverance  from  the  coming  dis- 
ease. 

Blood  running  all  purple,  not  having  the 
appearance  of  blood  in  any  part  of  the  ves- 
sel, denotes  a  life  of  six  months  or  at  most 
a  year.  If  the  appearance  of  the  blood  should 
be  found  greenish,  in  five  or  seven  days  he 
dies.  If  they  have  found  as  though  streaks 
of  choler  upon  the  blood,  like  branches  of  a 
candelabrum,  it  denotes  a  great  pleurisy. 
But  if  it  run  like  pus  or  is  turbid  it  denotes 
putrefaction. 

Blood  like  realgar — he  goes  for  a  month 
in  disease. 

Blood  like  a  shell  is  fatal. 

Blood  like  foam  denotes  peripneumonia 
and  cough. 

Blood  flowing  half  pus  and  half  blood 
denotes  a  quick  recovery. 

Blood  as  though  clotted  and  whitish  like 
milk  and  having  a  bad  odor  denotes  ne- 
phritis. 

Blood  thick  as  honey  and  malodorous, 
having  streaks  like  an  oyster  shell,  denotes 
a  gradual  death  or  in  six  months. 

The  blood  from  a  phlebotomy,  if  it  is 
dark  and  does  not  produce  ichor,  denotes 
ague.  But  if  it  make  ichor  it  is  good. 


Blood  as  though  from  an  abscess  denotes 
deliverance  from  the  coming  disease.  But 
if  it  appear  purple  and  not  resembling 
blood,  it  denotes  a  life  of  six  months'  time. 
But  if  the  appearance  of  the  blood  should 
seem  to  be  greenish,  he  who  has  it  dies  in 
five  or  seven  days. 

If  it  has  separated  off  a  yellowish  color 
it  brings  forth  death.  But  if  it  should  run 
like  pitch  it  denotes  a  hectic  fever. 

If  pus  should  flow  whitish  and  turbid  it 
denotes  putrefaction.  But  if  it  should  ap- 
pear like  a  shell,  it  is  fatal. 

If  half  pus  and  half  blood,  he  is  quickly 
healed. 

If  it  has  a  cavity  in  the  midst  it  denotes 
death. 

If  dark,  thick  and  malodorous,  having 
streaks  like  an  oyster  shell,  it  denotes  a 
gradual  death  or  in  six  months. 

If  it  has  a  purple  color  it  denotes  a  long 
disease. 

[In  another  hand] 

Don't  think  this  the  end. 

II.    A    LATE    GREEK    NUMERICAL    PROGNOSTIC 

The  text  here  printed  is  from  a  MS.  on 
Mount  Athos  in  the  monastery  of  St.  Greg- 
ory. In  the  catalogue  of  that  monastery  it 
is  numbered  105  (12),  and  it  occupies  folios 
187  verso  to  189  recto.  In  the  catalogue  of 
Professor  Lambros1  it  is  numbered  652.  I 
have  to  thank  the  Abbot  George,  the  present 
f;youu.svoc,  who  with  great  courtesy  pre- 
sented me  with  the  photograph  of  the  MS. 
on  which  I  have  worked.  From  the  character 
of  the  handwriting  and  of  the  paper  there 
can  be  little  doubt  that  it  is  of  the  eight- 
eenth century.  It  was  probably  written  in 
the  monastery  where  it  now  lies. 

The  characteristic  of  Byzantine  science, 
as  of  other  aspects  of  Byzantine  civilization, 
has  been  its  extraordinarily  uniform  char- 

1  S.  P.  Lambros:  "Catalogue  of  the  Greek  Manu- 
scripts on  Mount  Athos,"  vol.  I,  p.  58,  Cambridge 
University  Press,  1895. 


338 


Annals  of  Medical  History 


acter.  From  the  period  when  independent 
Greek  thought  was  finally  submerged  and 
Greek  Orthodox  Christianity  had  been 
irrevocably  set  adrift  from  the  Western 
Church,  the  Greek  intellect  became  prac- 
tically stationary.  There  were,  indeed,  local 
resuscitations  of  learning,  there^were  times 


the  past.  Our  MS.  represents  one  of  these 
disordered  and  incoherent  dreams  of  an- 
tiquity in  the  last  troubled  sleep  of  Hellas 
before  she  awoke  to  reality  and  to  reason 
at  the  voice  of  Adamantios  Koraes.  There 
could  be  no  more  naive  and  childish  pres- 
entation of  the  age-old  belief  in  the  potency 


■  -    -■ 


>  *fifr~  .'■■  :-"■   >■>'-•  .■■:•■>'■  y.*i~-i.'!;y*:^/ 


and  places,  in  the  long  monotonous  history  of 
the  Byzantine  world,  in  which  there  was  a 
better  comprehension  of  the  wisdom  of  the 
ancients;  but  there  were  no  true  intellectual 
revivals  such  as  took  place  in  the  West  in 
the  twelfth  century  with  the  arrival  of  Ara- 
bian science,  in  the  thirteenth  century  dur- 
ing that  long  process  that  resulted  in  the 
erection  of  the  majestic  edifice  of  Scholas- 
ticism, or  in  the  fifteenth  century  with  the 
great  ferment  of  the  Renaissance.  The  out- 
look of  a  Greek  monk  of  the  eighth  century 
was  in  essence  identical  with  that  of  his 
representative  of  the  eighteenth.  Less 
change  was  wrought  by  a  thousand  years  of 
history  in  the  Byzantine  intellectual  world 
than  by  a  hundred  years  in  the  West. 

During  this  long  slumber  of  a  thousand 
years  the  visions  of  Greece  were  always  of 


of  names  and  numbers  than  that  which  is 
here  fathered  on  the  proto-scientist,  Pythag- 
oras. 

Our  MS.  is  illiterate,  sufficiently  illiterate 
to  puzzle  and  shock  one  trained  in  classical 
Hellenic  standards,  yet  not  more  illiterate 
than  is  to  be  expected  in  a  document  of 
the  last  years  of  Greek  degradation,  ema- 
nating from  that  stronghold  of  ignorance 
and  fanaticism,  the  Holy  Mountain,  where 
the  sole  attempt  at  reform— the  foundation 
of  a  monastic  academy2 — so  disturbed  opin- 
ion that  it  was  abandoned  as  too  revolu- 
tionary. But  though  Illiterate,  our  MS.  is 

2  This  event  took  place  in  i~4<>  in  the  monastery  of 
Vathopedi.  A  short  account  of  it  and  of  the  general 
history  and  state  of  the  Holy  Mountain  may  be 
found  in  Alfred  Smidtke,  "Das  KJosterland  des 
Athos,"  Leipzig,  1903. 


Byzantine  Medical  Fragments 


339 


not  without  linguistic  interest.  Thus  for  in- 
stance the  curious  Italianate  word  aou[xaptaov 
(Italian  summare)  reflects  for  us  the  Venetian 
dominance  in  the  fourteenth  century. 

Our  MS.  represents  but  one  of  the  hun- 
dred forms  in  which  the  belief  is  expressed 
that  simple  mathematical  relationships  gov- 


trary  use  of  accents.  The  script  is  difficult, 
and  there  still  remain  one  or  two  doubtful 
readings.  These  I  have  indicated  in  the 
notes.  For  suggestions  with  reference  to 
these  I  have  to  thank  Dr.  E.  T.  Withington, 
Mr.  J.  S.  Scott  of  Emanuel  College,  Cam- 
bridge,  and  Mr.   Peckham,   till  lately  the 


m 


„•    ^  a'  c  <"■>' 

e  *,f  n,j  ... 

e  a  » <  <i  -,  v. 

?  JJT     C>    ■,,: 

£  ij  i  a  5  yi\ 
1  ajV'^'e  "S 


-  ii  ■■•.< 

"'? 

3  ;  v<^« 

em  not  only  the  phenomena  of  nature  but 
also  the  events — both  great  and  small — of 
human  life.  That  idea,  fathered  frequently 
on  Pythagoras,  became  especially  popular 
with  the  spread  of  Hermetic  and  Neo- 
platonic  doctrines.  It  was  very  widely  held 
throughout  the  Dark  and  Middle  Ages  and, 
encouraged  by  all  kinds  of  mystical  and 
cabalistic  writings,  it  is  still  commonly 
encountered  among  the  ignorant  and  super- 
stitious in  every  country.  With  the  Greeks 
such  ideas  have  ever  been  popular,  and  have 
become  associated  with  that  passion  for 
prognosis  that  has  always  characterized 
their  Medical  Systems. 

In  the  transcription  I  have  sought  to  re- 
produce the  document  as  it  stands,  and  the 
original  scribe  is  responsible  for  the  faulty 
grammar  as  well  as  for  the  somewhat  arbi- 


British  vice-consul  at  Uskub.  In  the  trans- 
lation I  have  been  compelled  to  omit  the 
last  sentence  of  the  text.  The  defective 
grammatical  construction  of  that  phrase 
makes  a  faithful  rendering  impossible, 
though  its  general  meaning  is  clear  from  the 
context. 

Transcription,  Monastery  of  St.  Gregory  o?i 

Mt.  Athos,  MS.  105  (12),  folio  187V 
tyriyoc,  xt0ay6pto<;  StayvwaTtxo?  ^(oy)<;  ts  xal 
Gavatou*  u,d6s  xotav  -quipav  xo:t£xXy)6y)  3  6 
daOevrjq,  xal  xoaaq  r]\xipixq  sfysv  i]  aeXrjvq,  xal 
t^Tjtpcaov  auTtov  za  6v6u,aTa,  xa(  tou  dppwffTou 
xp66s<;4  xal  i|njq)ou<;  8lxa,  xaf  auvd^aq 
T}<piXe6,  xaf  ptyov   xaf   ex6aXe   8Xa  td  xpid- 

3  for  x<mxX(8i). 

4  for  xpiaOe?. 

tor  (09j}Xov  from  o^atpw. 


340 

•/.ovtz  xat  Ta  lvaxoXet<?6evTa  xpaTeuov,  xal 
tfXexe  ev  T(I)  opydvto  oxc u  eiva:  ypajxfxevto 
xaT(o6ev,  xai  e!  p£v  eSprjc,  iv  t<J)  yxepyetw  ^f/' 
r(C£  Iv  :m  jxoyelw  dxoGvifjaxer  ttjv  Ik  xpdJ7Y;v 
t;[j.epav  Toj  ippwsrro'j  {jlt;v  ^r^fanj?,  dXXd  ttjv 
Seurlpav  f,  yap  xptoTr;  0  j  voao<;  XeyeTat  aXXd 
xaTaxAucta  6. 


To  opyavov  Oxepyetov 

4>      a  "-,       ta  x      xC 

w      $  6       ty  xa     xyj 

q      y  t       18  xy     tC 


Annals  0/  Medical  History ' 


uxoyetov 


8 

1 

"J 

Xc 

[8 

e 

4 

x£ 

xS 

X 

C 

is 

xS 

x6 

* 

folio  i88r 
Wrfloq  SiayVhWCixoc,  xept  aa6evv;[jiiv(ov 
^•f)9taov  tt)v  f^spav  xa6'  t]v  exXYjOr;  6  dppw- 
cToq,  tj  Tjjxefae'jaev  7  eta  Ttvav  %pelav  auTou, 
t)  lyewijOi),  y)  Breve  tIc,  avGptoxoq  tfouXerai 
xpd£at,  xa!  (|ri)9i<rov  dx6  ty;>;  Tjixepaq  8 
[iTjv6<;  [liXP'  "V"  BoOeorje,  i'Mpzi*  xat  Taq  auva- 
xBeoac.  Tj|iipa<;  aojixaptcov9  dxavTa?, 
xai  fouXov  10  ax6  if,q  XC  xat  Ta<;  Xotxdq 
xpttTt](TOV  ev  -rep  opydvw,  xat  el  jiiv  eupyjq  ev 
T(p  a  Xlav  ayaOiv  iortv,  si  ce  ev  T(p  6  [xeaswq, 
e(  Be  Iv  T(p  y  xaAc*&v  xat  Oavdattlov  xaxd 
xdvTa' 

'  for  xaraxXufa. 

7  The  reading;  of  this  word  is  difficult.  I  have 
regarded  fpi«(s«u«v  as  equivalent  to  fcimumv  derived 
from  a  hypothetical  verb  iiieoeiw  (cp  6|it9oc)  "to  be 
in  urgent  need." 

'The  word  that  I  transcribe  as  f^ipa?  seems  in 
the  original  to  be  ^a?. 


X 

a 

8 

£ 

t 

t7 

tC 

10 

xg 

xe 

X1Q 

Xa 

XS 

P 

P 

e 

I 

ta 

18 

:I 

X 

xy 

xC 

x6 

Xg 

Xe 

T 

T 

C 

e 

«P 

te 

«) 

xa 

xS 

*; 

X 

*Y 

XC 

ei  tfouXei  eupecv,  15  ytvwaxetv  ojrtq  twv 
dyvdxjTwv  aaq  to  ^tjv  exsc  ^  afxetpos  tou  £rjv 
x&puxev.  xotYjaov  outw? — 

Ta  [ih  6v6[JLaTa  auxtov  (J>T/<pt<Jov,  xat  tj>in<p(<jac; 
ex6aXe  Ta  evvea  xdvTa  Ix  twv  ({/rjq)[(i)v  Ttov  6vo- 
jjiaTov,  Ta  Se  e^fiivovTa  twv  Suo  6vo[xdTwv 
4»tj9ta  t'Se  ev  Totq  xpoetpTj^evoK;  oxtaOev  ty-qyl- 
o'.q,  xat  et  6v6(xaTo<;  twv  xaTtoOev  vtxwvTt 
xapaxXr,ff((oq  wv  6  ^90?  *<P  ypd[X[j.aTt  auToq 
tiev  L75,  6  Se  dXXo^  tefivijxev. 

T6  opyavov  eaTtv  oxtjQev  xat  Gewptjov  xa- 
Xm?" 


5  4  Y^^iXuv  (11)  vixi  5 

F 

8    rpea60Tepo? 

'      1 

5    xat 

&    t»    3 

vixi 

p 

xal 

Y     to     Y 

vtxi 

a     xxl 

T     "*>     Y 

v:xi 

p 

xal 

8    ri    5 

vtxa 

a    xal 

¥   to    5 

vixa 

& 

xa! 

e    t4    T 

vtxa 

S    xal 

e     xb     a 

vixa 

p 

xa! 

C  t8    C7 

vtxa 

5    xal 

C     TO      C 

vtxa 

p 

xal 

;   t4   r. 

vtxa 

a    xa) 

;     Tb     a 

vixa 

p 

xa! 

T)       T4       Tj 

vtxa 

a    xal 

r>     TO      T) 

vtxa 

p 

xa! 

5  t4  e 

vtxa 

a    xal 

8     to     9 

vixa 

Y     * 

veoTepo; — 

r 

S 

6 

TaXa:4; 

8 

Y     xal 

6     to     8 

vtxi 

8 

xa! 

7    t4    T 

vtxa 

Y     xal 

I    ro    Y 

vixi 

8 

xa! 

T   t4    "6 

vtxa 

y     xal 

C    TO     C 

vtxa 

8 

xa! 

;  t4  X 

vtxi 

7    xal 

t;  to  ; 

vtxa 

8 

xai 

V     t4     6 

vtxa 

7    xal 

i]     to     if 

vtxa 

8 

xal 

8     t8     9 

v-xi 

7     not 

e   to'   e 

fna 

7    b 

vio«         ? 

V 

6 

Xp<JT6vttX0?      r. 

7    xal 

C     TO       7 

vixi 

( 

xai 

*>     fb     1) 

vtxi 

T    xal 

1;   t6   ; 

vtxa 

5 

xal 

8    t4     8 

vtxi 

s     xal 

T)     t6     "rj 

vixi 

7    xal 

e  to   e 

vtxa 

1) 

4     ■ 
xa! 

:aXatb{    ^ 
6     t4     8 

vtxi 

C  6     xaXatli^  C 

C   xal 

;  to   r. 

v:xi 

C   xal 

1   ti  C 

vtxi 

0 

6      vtOT«pO« 

T    «4. 

1   ri   e 

Nti 

e 

til    9   ri    6   n* 

k 

Note — The  letter  "p"  in  this  article  should  be 
in  the  archaic  form,  but  the  type  is  not  procurable. 
Ed. 

*  oounapioov  doubtless  from  Italian  summarc. 

10  IfouXov  see  note  5  ante. 

11  The  reading  TT)8tX<iv  is  doubtful.  It  is  perhaps 
an  adjective  formed  from  Yfi8o?.   Another  possibility 

IS  vtxaX£>v. 


Byzantine  Medical  Fragments 


341 


Translation 

Pythagorean  Diagnostic  Calculation  of 
Life  and  also  of  Death. 

Ascertain  what  day  the  patient  took  to 
his  bed  and  how  many  days  the  moon  had, 
and  reckoning  [the  numerical  value  of] 
their  names  and  that  of  the  sick  man,  put 
them  together  and  add  ten.  And  having 
summed  them  up,  subtract,  take  away  and 
divide  by  thirty  [lit.  cast  out  all  the  thir- 
ties].12 Then  taking  the  remainder,  look 
where  [the  number]  is  in  the  table  written 
below.  And  if  thou  findest  it  in  the  super- 
terranean  section  he  lives,  but  if  in  the  sub- 
terranean he  dies.  But  do  not  reckon  the 
first  day  of  the  illness  but  the  second;  for 
the  first  is  not  regarded  as  [a  day  of  the] 
disease  but  as  [the  day  of]  taking  to  bed. 


Superterranean  Table 


I 

2 

7 

1 1 

20 

26 

9 

13 

21 

28 

3 

10 

14 

23 

16 

Subterranean 


4 
5 
6 

8 

18 

25 

27 

19 

12 

22 

30 

15 

24 

29 

17 

Diagnostic  calculation  of  those  who  have 
been  taken  sick. 

Reckon  the  day  in  which  the  patient 
took  to  his  bed,  or  fell  into  some  urgent 
need,  or  [on  which]  he  was  born,  or  on 
which  a  man  wishes  to  do  something. 
Reckon  also  [the  number  of  days]  from  the 
first  day  of  the  month  until  the  given  day. 
Then  putting  these  days  together  add  them 

12 1  am  indebted  to  Dr.  Withington  for  this  inter- 
pretation, which  fits  in  well  with  the  tables. 


all  up  and  subtract  from  36,  and  refer  that 
which  remaineth  to  the  table  [below]. 
Now  if  thou  findest  it  in  the  1  it  is  full 
well,  if  in  the  2  of  middling  sort,  but  if  in 
the  3  it  is  ill  and  mortal  above  all. 


I 

1 

4 

7 

10 

13 

16 

19 

22 

25 

28 

3i 

34 

2 

2 

5 

8 

11 

14 

17 

20 

23 

26 

29 

32 

35 

3 

3 

6 

9 

12 

15 

18 

21 

24 

27 

30 

33 

36 

If  thou  wishest  to  find  or  to  know  whether 
one  unknown  to  thee  [still]  walks  in  life 
or  is  without  lot  among  the  living,  do  thus: 

Cipher  out  their  names,  and  having  ci- 
phered them  divide  them  by  nine  [lit.  cast 
out  all  the  nines  from  the  ciphers]  and  seek 
the  remaining  numbers  of  the  two  names 
among  the  aforesaid  ciphers  overleaf  and 

if 

the  one  is  alive,  but  the  other  is  dead. 

The  table  is  overleaf  and  examine  it  well. 

folios  i88v  and  i8gr 


1  the  .  .  (13)  victory  (hath)  I 

2.    The  elder  (is)  2. 

1  and  2.    The  2  (hath)  victory 

2  and  3.    The  3  (hath)  victory 

1  and  3.    The  3  (hath)  victory 

2  and  4.   The  4  (hath)  victory 

1  and  4.   The  4  (hath)  victory 

2  and  5.   The  5  (hath)  victory 

1  and  5.    The  1  (hath)  victory 

2  and  6.   The  6  (hath)  victory 

1  and  6.   The  6  (hath)  victory 

2  and  7.   The  7  (hath)  victory 

1  and  7.   The  1  (hath)  victory 

2  and  8.   The  8  (hath)  victory 

1  and  8.   The  8  (hath)  victory 

2  and  9.   The  9  (hath)  victory 

1  and  9.   The  9  (hath)  victory 

3.     The  younger  (is)  3 

4.     The  ancient  (is)  4 

3  and  4.   The  4  (hath)  victory 

4  and  5.   The  5  (hath)  victory 

3  and  5.   The  3  (hath)  victory 

4  and  6.   The  4  (hath)  victory 

3  and  6.   The  6  (hath)  victory 

4  and  7.   The  7  (hath)  victory 

3  and  7.   The  7  (hath)  victory 

4  and  8.   The  4  (hath)  victory 

3  and  8.   The  8  (hath)  victory 

4  and  9.   The  9  (hath)  victory 

3  and  9.   The  3  (hath)  victory 

5.     The  young  (is)  5. 

7.    The  chief  victor  (is)  7 

5  and  6.   The  6  (hath)  victory 

7  and  8.   The  8  (hath)  victory 

5  and  7.   The  7  (hath)  victory 

7  and  9.   The  9  (hath)  victory 

5  and  8.    The  8  (hath)  victory 

5  and  9.    The  9  (hath)  victory 

8.    The  ancient  (is)  8 

8  and  9.   The  9  (hath)  victory 

6.     The  ancient  (is)  6. 

6  and  7.    The  7  (hath)  victory 

6  and  8.    The  6  (hath)  victory 

9.    The  younger 

6  and  9.   The  9  (hath)  victory 

9  and  9.   The  9  (hath)  victory 

13  See  note  11  to  text. 


THE   LEGISLATIVE  AND  ADMINISTRATIVE  HISTORY  OF  THE 

MEDICAL  DEPARTMENT  OF  THE  UNITED  STATES  ARMY 

DURING  THE   REVOLUTIONARY   PERIOD   (i 776-1 786) 


By  COLONEL  WILLIAM  O.  OWEN,  U.  S.  ARMY 

CURATOR,  ARMY  MEDICAL  MUSEUM,  WASHINGTON,  D.  C. 
SECTION   III 


Introduction 

THIS,  the  third  installment  of  the 
history  of  the  medical  department 
during  the  revolutionary  period, 
deals  almost  entirely  with  the  es- 
tablishment of  hospitals,  their  personnel, 
and  expenditures. 

It  is  interesting  to  compare  the  conditions 
then  existing  with  those  obtaining  in  our 
time.  The  medical  department  does  not 
seem  to  have  been  regularly  incorporated 
with  the  Army  until  May  28,  1781,  when 
the  Medical  Committee  was  discontinued 
and  its  business  handled  by  the  Board 
of  War.  It  was  even  considered  necessary 
as  late  as  September  30,  1780,  to  state 
that  hospital  and  medical  officers  "shall 
be  subjected  to  trial  by  courts-martial  for 
all  offences,  in  the  same  manner  as  officers 
of  the  line  of  the  army." 

Those  acquainted  with  the  organization 
of  the  present  military  hospital,  will  read 
with  interest  the  report  of  the  Medical 
Committee  for  March  22,  1781. 

Even  in  those  days  much  red  tape  was 
required  in  the  procuring  of  medicines  and 
instruments,  as  evidenced  by  the  resolution 
of  July  23,  1782.  However,  the  apothecary 
evidently  held  a  more  important  position 
than  under  the  present  regime. 

A  strong  contrast  is  struck  in  the  salary 
of  the  nurses — four  dollars  per  month  and 
one  ration  per  day.  But  how  familiar  is 
the  motion  of  April  13,  1781,  ordering  that 
a  certain  sum  of  money  be  placed  in  the 
hands  of  one  Nathan  Brownson  "to  pay 


three  months'  salary  and  wages  due  to 
the  officers  and  others  employed  in  the 
hospital  .  .  ." 

The  regulation  under  date  of  September 
28,  1780,  might  well  obtain  in  our  own  time: 
"That  no  person  concerned  in  trade,  on  his 
own  account,  shall  be  suffered  to  act  as 
an  officer  in  the  hospital  or  medical  depart- 
ment of  the  army:" 

Upon  dismissal  of  a  soldier  from  the  hos- 
pital there  seems  to  have  been  difficulty  in 
locating  his  proper  clothing  as  evidenced 
by  the  following  extract:  "The  Steward 
shall  also  receive  the  spare  regimental  arms 
and  accoutrements  and  cloathing  of  each 
soldier  admitted  into  the  Hospital  keeping 
entries  of  and  giving  receipts  for  every 
article  received,  which  when  the  soldier 
shall  be  discharged,  shall  be  accounted  for 
by  the  said  Steward,  with  the  Commanding 
Officer  of  the  regiment  to  which  such 
soldier  belonged,  or  other  proper  person, 
and  shall  also  take  charge  of  the  hospital 
cloathing." 

For  the  sake  of  comparison  we  might 
note  under  date  of  July  24,  1781,  the 
mildness  of  the  enemy's  cruelty  toward 
one  Robert  Henry  who,  on  being  taken 
prisoner  by  the  enemy,  was  only  "stripped 
of  all  his  cloathing." 

Generous  provision  was  made  for  the 
invalided  by  a  resolution  of  May  1,  1783, 
and,  by  the  order  of  September  30,  1780, 
medical  officers  were  entitled  to  grants 
of  land  equal  to  those  of  officers  in  the 
army. 

— Editor. 


342 


History  of  the  Army  Medical  Department  During  the  Revolution        343 


II.     FROM    JOURNALS    OF    THE     CONTINENTAL 

congress  (1774-83)  (Continued) 

August  22,  1780.  755 

A  letter  from  Doctor  W.  Shippen,  director  general, 
was  read: 

Ordered,  That  it  be  referred  to  a  committee  of 
three: 

August  28,  1780.  787-8 

The  committee,  to  whom  was  referred  the  letter, 
of  22d,  from  Doctor  W.  Shippen,  D(irector)*  Gen- 
eral), brought  in  a  report;  Whereupon, 

The  Committee  to  whom,  D.  Shippen  Direc1 
Genls  letter  of  the  22nd  instant  was  referred,  Re- 
port, 

That  that  part  of  the  letter  which  respects  sup- 
plies of  Forage  for  the  Horses  belonging  to  officers 
of  the  Hospital  Department,  together  with  two  let- 
ters received  by  the  Committee  since,  from  the  Di- 
rector General,  be  referred  to  the  Board  of  War  to 
take  order. 

The  Committee  ask  leave  to  sit  again. 

Extract  of  a  letter  of  D.  Shippen  Aug.  22nd  1780 

"I  am  informed  to  day  by  the  Depty'  Quarter 
Master  of  this  State  that  he  will  not  supply  our  de- 
partment with  any  more  Forage,  unless  he  is  au- 
thorised so  to  do  by  an  order  of  Congress,  which 
I  flatter  myself  will  be  given  immediately."  107 

Resolved,  That  that  part  of  the  letter,  which  re- 
spects supplies  of  forage  for  the  horses  belonging  to 
officers  of  the  hospital  department,  together  with 
two  letters  received  by  the  committee  from  the 
director  general,  be  referred  to  the  Board  of  War  to 
take  order. 

September  9,  1780.  814 

The  committee,  to  whom  was  referred  the  letter 
of  22  August,  from  Doctor  Shippen,  director  general, 
brought  in  a  report,  which  was  read: 

Ordered,  That  a  member  be  added  to  the  Medical 
Committee,  in  the  room  of  Mr.  (Samuel)  Holton, 
who  is  absent: 

The  member  chosen,  Mr.  (Theodorick)  Bland. 

September  11,  1780.  819 

Ordered,  That  Wednesday  next  be  assigned  for 
the  consideration  of  the  report  of  the  committee  on 
Doctor  W.  Shippen,  director  general's  letter,  re- 
specting the  hospital  department. 

September  19,  1780.  837 

A  letter,  of  this  day,  from  Doctor  W.  Shippen, 
director  general,  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

September  22,  1780.  847 

Congress  resumed  the  consideration  of  the  report 
of  the  committee  on  the  medical  department,  and 
on  the  consideration  of  the  following  paragraph,  viz. 

"That  the  several  officers  whose  pay  is  estab- 

*  Material  placed  in  parentheses  appeared  in  brackets  in  the 
original  MS. 

107  This  report,  in  the  writing  of  Frederick  A.Muhlenberg,  is  in 
the  Papers  of  the  Continental  Congress,  No.  136,  IV,  folio  641. 


fished  as  above,  except  the  clerks  and  stewards,  shall 
at  the  end  of  the  war  be  entitled  to  a  certain  provi- 
sion of  land  in  the  proportion  following,  viz. 

The  director  to  have  the  same  quantity  as  a  briga- 
dier general.  Chief  physicians  and  surgeons  and 
apothecary  the  same  as  a  colonel.  Physicians  and 
surgeons  and  apothecary  the  same  as  lieutenant 
colonel.  Regimental  surgeons  and  assistants  to  the 
purveyor  and  apothecary,  the  same  as  a  major.  Hos- 
pital and  regimental  surgeons'  mates,  the  same  as  a 
captain." 

A  motion  was  made  by  Mr.  (Frederick  A.)  Muh- 
lenberg, seconded  by  Mr.  (Theodorick)  Bland,  to 
amend  the  paragraph  by  inserting  after  the  words, 
"intitled  to"  the  words  following,  viz.  "half  pay  in 
the  same  manner  and  under  like  restrictions  as  offi- 
cers of  the  line";  and  on  the  question  to  agree  to 
the  amendment,  the  yeas  and  nays  being  required 
by  Mr.  (John)  Fell, 

So  it  was  resolved  in  the  affirmative. 

September  23,  1780.  853 

The  committee,  to  whom  was  re-committed  part 
of  the  report  on  the  hospital  department,  having 
brought  in  a  farther  report,  Congress  resumed  the 
consideration  thereof,  and  made  some  progress. 

Ordered,  That  the  director  general  report  the 
names  of  all  the  officers  in  the  hospital  department 
from  the  director  to  the  junior  surgeons  inclusive, 
with  the  dates  of  their  respective  commissions.108 

September  25,  1780.  854 

The  director  general,  having  made  a  return  of 
the  officers  of  the  hospital ; 109 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

September  28,  1780.  871 

The  Medical  Committee,  to  whom  was  referred 
the  return  made  by  Doctor  Shippen,  delivered  in  a 
report. 

September  30,  1780.  876-88 

Congress  resumed  the  consideration  of  the  report 
on  the  hospital  department,  when  a  motion  was 
made  by  Mr.  (Roger)  Sherman,  seconded  by  Mr. 
(Nicholas)  Van  Dyke,  to  reconsider  that  part  of  the 
report,  viz.  "That  the  several  officers  whose  pay  is 
established,  except  the  stewards  and  ward  masters, 
be  intitled  to  half  pay,  in  the  same  manner  and  un- 
der like  restrictions  as  officers  of  the  line;" 

And  on  the  question  for  reconsideration,  the  yeas 
and  nays  being  required  by  Mr.  (Roger)  Sherman, 


So  it  was  resolved  in  the  affirmative. 

A  motion  was  made  by  Mr.  (John)  Fell,  seconded 
by  Mr.  (William  Churchill)  Houston,  to  strike  out 
the  words,  "half  pay  in  the  same  manner  and  under 
like  restrictions  as  officers  of  the  line." 

And  on  the  question  shall  those  words  stand,  the 

los  Here  were  inserted  the  resolutions  on  the  hospital  service,  but 
Thomson  noted  in  the  margin  "reconsidered  and  amended  30th." 
They  are  printed  under  September  30,  1780,  post,  where  the 
changes  are  noted. 

109  Dr.  Shippen's  letter  transmitting  the  return  is  in  the  Papers 
of  the  Continental  Congress,  No.  78,  XX,  567. 


344 

yeas  and  nays  being  required  by  Mr.  (Roger)  Sher- 
man,. 


Annals  of  Medical  History 


So  it  passed  in  the  negative  and  the  words  were 
struck  out. 

Congress  proceeded  in  the  consideration  of  the 
report,  and  the  same  being  amended,  was  agreed  to, 
as  follows:110 

Whereas,  the  late  regulations  for  conducting  the 
affairs  of  the  general  hospital  are  in  many  respects 
defective;  and  it  is  necessary  that  the  same  be  re- 
vised and  amended,  in  order  that  the  sick  and 
wounded  may  be  properly  provided  for  and  attend- 
ed, and  the  business  of  the  hospitals  conducted  with 
regularity  and  economy;  therefore, 
Resolved,  That  there  be  one  director  of  the  mili- 
tary hospitals,  who  shall  have  the  general  direction 
and  superintendance  of  all  the  hospitals  to  the 
northward  of  North  Carolina;  that,  within  the  afore- 
said limits,  there  be  three  chief  hospital  physicians, 
who  shall  also  be  surgeons;  one  chief  physician,  who 
shall  also  be  a  surgeon,  to  each  separate  army;  fif- 
teen hospital  physicians,  who  shall  also  be  surgeons; 
twenty  surgeons'  mates  for  the  hospitals:  one  pur- 
veyor, with  one  assistant;  one  apothecary;  one  as- 
sistant apothecary;  [and  to  each  hospital  one  clerk 
who  shall  also  be  paymaster,]*  a  steward, matron, 
orderly  men,  and  nurses,  as  heretofore: 

That  the  director,  or,  in  his  absence,  one  of  the 
chief  hospital  physicians,  be  empowered  and  re- 
quired, with  the  advice  and  consent  of  the  Com- 
mander in  Chief,  or  commander  of  a  separate  army, 
to  establish  and  regulate  such  a  number  of  hospi- 
tals, at  proper  places,  for  the  reception  of  the  sick 
and  wounded  of"  the  army,  as  may  be  found  neces- 
sary: 

That  the  director  be  authorised  and  instructed  to 
enjoin  the  several  chief  hospital  physicians,  and 
other  officers  of  the  hospitals  under  his  superintend- 
ance, to  attend  at  such  posts  or  stations  as  he  may 
judge  proper,  and  also  to  attend  and  perform  such 
duties,  at  any  post  or  place,  as  a  change  of  the  posi- 
tion of  the  army,  or  other  circumstances,  may  from 
time  to  time  make  necessary,  and  shall  be  required 
by  the  Commander  in  Chief;  and  that,  in  case  of 
any  dispute  concerning  their  seniority  or  precedence, 
the  director  shall  determine  the  same  in  the  first 
instance,  the  party  supposing  himself  aggrieved  be- 
ing at  liberty  to  appeal  for  redress  to  the  Medical 
Committee: 

That  in  time  of  action,  and  on  any  other  emer- 
gency, when  the  regimental  surgeons  are  not  suffi- 
cient in  number  to  attend  properly  to  the  sick  and 
wounded  that  cannot  be  removed  to  the  hospitals, 
the  director,  or,  in  his  absence,  the  nearest  chief 
hospital  physician,  be  empowered  and  required,  upon 
request  of  the  chief  physician  and  surgeon  of  the 
army,  to  send  from  the  hospitals  under  his  care,  to 
the  assistance  of  such  sick  and  wounded,  as  many 
surgeons  as  can  possibly  be  spared  from  the  aeces- 
sary  business  of  the  hospitals: 

That  the  director,  or,  in  his  absence,  two  of  the 
chief  hospital  physicians,  shall  make  out  and  de- 
liver, from  time  to  time,  to  the  purveyor,  proper  es- 


i  ban  ilif  i-Mricn  are  in  Thomas  Edition's  writing. 
"II  it.  n  J  in  br  wkaU  was  cancelled  in  the  original  MS. 


timates  of  hospital  stores,  medicines,  instruments, 
dressings,  and  such  other  articles  as  may  be  judged 
necessary  for  the  use  of  the  hospitals;  also  direct 
the  apothecary  or  his  assistant,  to  prepare  and  de- 
liver medicines,  instruments,  dressings,  and  other 
articles  in  his  possession  to  the  hospitals  and  sur- 
geons of  the  army  and  navy,  as  he  or  they  may- 
judge  necessary: 

That  the  director  authorise  and  instruct  the  pur- 
veyor and  apothecary  to  supply,  for  the  use  of  the 
regimental  surgeons,  such  medicines  and  refresh- 
ments as  may  be  proper  for  the  relief  of  the  sick  and 
wounded,  before  their  removal  to  a  general  hospital, 
and  to  be  dispensed  under  the  care,  and  at  the  di- 
rection of  the  chief  physician  of  the  army: 

That  the  director,  or,  in  his  absence,  the  chief 
hospital  physicians,  respectively,  be  empowered  oc- 
casionally to  employ  second  mates,  when  the  num- 
ber of  the  sick  shall  increase  so  as  to  make  it  neces- 
sary, and  to  discharge  them  as  soon  as  the  circum- 
stances of  the  sick  will  admit: 

That  the  director,  or,  in  his  absence,  the  chief 
hospital  physicians,  respectively,  shall  appoint  a 
ward  master  for  each  hospital,  to  receive  the  spare 
regimental  cloathing,  arms,  and  accoutrements  of 
each  soldier  admitted  therein,  keeping  entries  of 
and  giving  receipts  for  every  article  received,  which, 
when  the  soldier  shall  be  discharged,  shall  be  ac- 
counted for  by  the  said  ward  master  with  the  com- 
manding officer  of  the  regiment  to  which  such  sol- 
dier belonged,  or  the  officer  directed  to  take  charge 
of  the  convalescents  from  the  said  hospital;  or,  in 
case  of  the  death  of  the  soldier,  shall  be  accounted 
for  with,  and  delivered  to  the  quartermaster  of  the 
regiment  to  which  the  said  soldier  belonged;  and  the 
ward  master  shall  receive  and  be  accountable  for 
the  hospital  cloathing,  and  perform  such  other  ser- 
vices as  the  chief  hospital  physician  shall  direct. 

That  the  director  shall  make  returns  of  all  the 
sick  and  wounded  in  the  hospitals,  once  every 
month,  to  the  medical  committee,  together  with  the 
names  and  ranks  of  all  the  officers  and  others  em- 
ployed in  the  several  hospitals: 

That  the  director  be  required  to  employ  such  part 
of  his  time  as  may  be  spared  from  the  duties  before 
pointed  out  to  him,  in  visiting  and  prescribing  for 
the  sick  and  wounded  of  the  hospitals;  and  that  he 
pay  particular  attention  to  the  conduct  of  the  sev- 
eral officers  in  the  hospital  department,  and  arrest, 
suspend  and  bring  to  trial,  all  delinquents  within 
the  same: 

That  the  duty  of  the  chief  hospital  physician  shall 
be,  to  do  and  perform  all  the  duties  herein  before  en- 
joined them  to  do  in  the  absence  of  the  director;  to 
receive  and  obey  the  orders  of  the  director,  made 
and  delivered  to  them  in  writing,  to  superintend  the 
practice  of  physick  and  surgery  in  the  hospitals  put 
under  their  particular  care  by  the  director,  or  which, 
by  the  order  of  the  commander  in  chief  or  the  com- 
mander of  a  separate  army,  may  be  by  them  estab- 
lished; to  see  that  the  hospital  physicians  and  other 
officers  attending  the  same,  do  their  duty;  and  make 
monthly  returns  to  the  director,  of  the  state  and 
number  of  the  sick  and  wounded  in  the  hospitals 
under  their  care;  and  also  make  to  the  director,  and 
to  the  medical  committee,  of  all  delinquent  officers, 


History  of  the  Army  Medical  Department  During  the  Revolution 


345 


in  order  that  they  may  be  speedily  removed  or  pun- 
ished; and  to  take  measures  that  all  such  sick  and 
wounded  as  are  recovered  and  fit  for  duty  be  deliv- 
ered weekly  to  the  officer  of  the  guard,  to  be  con- 
ducted to  the  army:  when  present  at  any  hospital, 
to  issue  orders  to  the  proper  officers  for  supplying 
them  with  necessaries;  and  generally,  in  the  absence 
of  the  director,  to  superintend  and  controul  the  busi- 
ness of  such  hospitals,  suspend  delinquent  and  re- 
move unnecessary  non-commissioned  officers,  mak- 
ing report  to  the  director;  and,  when  in  their  power, 
to  attend  and  perform  or  direct  all  capital  opera- 
tions: 

That  the  hospital  physicians  shall  take  charge  of 
such  particular  hospitals  as  may  be  assigned  them 
by  the  director:  They  shall  obey  the  orders  of  the 
director,  or  in  his  absence,  of  the  chief  hospital  phy- 
sician: They  shall  have  power  to  suspend  officers 
under  them,  and  to  confine  other  persons  serving  in 
the  hospitals  under  their  charge,  for  negligence  or 
ill-behaviour,  until  the  matter  be  regularly  inquired 
into:  They  shall  diligently  attend  to  the  cases  of  the 
sick  and  wounded  of  the  hospitals  under  their  care, 
administering  at  all  times  proper  relief,  as  far  as 
may  be  in  their  power:  They  shall  respectively  give 
orders,  under  their  hands,  to  the  assistant  purveyor 
or  steward  at  the  hospital,  for  the  issuing  provisions 
and  stores,  as  well  as  for  the  procuring  any  other 
articles  that  the  exigencies  of  the  hospital  may  re- 
quire, and  which  the  store  is  not  provided  with,  hav- 
ing always  a  strict  regard  to  economy,  as  well  as  the 
welfare  of  the  sick  then  to  be  provided  for:  They 
shall  make  weekly  returns  to  the  nearest  chief  hos- 
pital physician,  of  the  state  of  the  hospitals  under 
their  respective  care. 

The  mates  shall  each  take  charge  of  and  attend 
the  patients  assigned  them,  and  perform  such  other 
duties  as  shall  be  directed  by  the  director,  chief  or 
other  physicians  and  surgeons. 

The  chief  physician  and  surgeon  of  the  army  shall 
be  subject  to  the  orders  and  controul  of  the  direc- 
tor: His  duty  shall  be  to  superintend  the  regimental 
surgeons  and  their  mates,  and  to  see  that  they  do 
their  duty:  To  hear  all  complaints  against  the  said 
regimental  surgeons  and  mates,  and  make  report  of 
them  to  the  director,  or,  in  his  absence,  to  the  Com- 
mander in  Chief  or  commanding  officer  of  a  separate 
army,  that  they  may  be  brought  to  trial  by  court- 
martial  for  misbehaviour:  To  draw  for  and  receive 
from  the  purveyor  a  suitable  number  of  large  strong 
tents,  beds,  bedding  and  hospital  stores,  and  from 
the  apothecary,  or  his  assistant,  proper  medicines, 
for  such  sick  and  wounded  persons  as  can  not  be 
removed  to  the  general  hospital  with  safety,  or  may 
be  rendered  fit  for  duty  in  a  short  time.  He  shall 
also  see  that  the  sick  and  wounded,  while  under  his 
care,  are  properly  attended  and  provided  for,  and 
conveyed,  when  fit  to  be  removed,  to  the  general 
hospital;  for  which  last  purpose,  he  shall  be  sup- 
plied by  the  quartermaster  general,  with  a  proper 
number  of  convenient  wagons  and  drivers;  he  shall 
have  a  steward,  which  he  is  to  appoint,  to  receive 
and  properly  dispense  such  articles  of  diet  and  re- 
freshment as  shall  be  procured  for  the  sick;  and  also 
shall  appoint  such  a  number  of  nurses  and  orderly 
men  as  may  be  necessary  for  the  attendance  of  the 


sick  and  wounded  under  his  care.  He  shall  cause 
daily  returns  to  be  made  to  him  of  all  the  sick  and 
wounded  which  have  been  removed  to  the  hospitals, 
all  that  remain  in  the  hospital  tents,  all  that  are  be- 
come fit  for  duty,  all  that  are  convalescent,  and  all 
who  may  have  died,  specifying  the  particular  mala- 
dies under  which  the  sick  and  wounded  labour,  and 
shall  make  a  monthly  return  thereof  to  the  director, 
who  shall  add  it  to  his  general  hospital  returns,  to 
be  transmitted  monthly  to  the  Medical  Committee. 

That  whenever  any  regimental  surgeon  or  mate 
shall  be  absent  from  his  regiment,  without  leave 
from  the  chief  physician  and  surgeon  or  commander 
of  the  army  where  his  duty  lies,  the  said  chief  physi- 
cian and  surgeon  shall  have  power  to  remove  such 
surgeon  or  mate  and  forthwith  appoint  another  in 
his  stead. 

That  the  purveyor  provide,  or  cause  to  be  pro- 
vided, all  hospital  stores,  medicines,  instruments, 
dressings,  utensils,  and  such  other  articles  as  shall 
be  prescribed  by  the  written  order  of  the  director, 
or  two  of  the  chief  hospital  physicians,  and  deliver, 
or  cause  the  same  to  be  delivered,  upon  written  or- 
ders, under  the  hands  of  the  director,  or  chief  hospi- 
tal physician,  or  one  of  the  hospital  physicians,  hav- 
ing the  charge  of  a  particular  hospital,  or  of  a  chief 
physician  and  surgeon  of  the  army,  which,  with  re- 
ceipts thereon  for  delivery  of  the  same,  shall  be  his 
sufficient  vouchers.  He  shall  be  allowed  a  clerk,  and 
as  many  store  keepers  as  occasion  may  require,  and 
the  director  shall  approve  of.  He  shall  also  pay  the 
salaries  of  the  officers,  and  all  other  expences  of  the 
hospitals.  He  shall  render  his  accounts  every  three 
months  to  the  Board  of  Treasury  for  settlement,  and 
make  application  for  money  to  the  Medical  Com- 
mittee, before  whom  he  shall  lay  estimates  of  arti- 
cles necessary,  which  shall  previously  have  been  ap- 
proved and  signed  by  the  director  or  two  of  the 
chief  hospital  physicians;  at  the  same  time  he  shall 
render  to  them  an  account  of  the  expenditure  of  the 
last  sum  of  money  advanced  to  him;  and  the  said 
Medical  Committee  shall  lay  such  estimates  before 
Congress,  with  their  opinion  thereon: 

That  the  assistant  purveyor  shall  procure  such 
supplies,  and  do  and  perform  such  parts  of  the  pur- 
veyor's duty,  as  by  him  shall  be  particularly  as- 
signed to  him. 

That  the  apothecary  and  his  assistant  receive, 
prepare  and  deliver  medicines,  instruments  and 
dressings,  and  such  other  articles  of  his  depart- 
ment, to  the  hospitals  and  army,  on  orders  in  writ- 
ing from  the  director,  or  either  of  the  chief  hospital 
physicians,  or  chief  physician  and  surgeon  of  the 
army;  and  that  he  be  allowed  as  many  mates  as  oc- 
casion may  require,  and  the  director  shall  approve  of: 

That  the  director,  or  in  his  absence,  the  chief  hos- 
pital physician,  shall  appoint  a  steward  for  each  hos- 
pital, whose  duty  it  shall  be  to  purchase  vegetables 
and  other  small  articles,  under  the  direction  of  the 
purveyor,  and  to  receive  hospital  stores  from  the 
purveyor,  and  provisions  from  the  commissary  gen- 
eral, and  issue  the  same  for  the  use  of  the  sick  and 
wounded,  agreeably  to  the  order  of  the  physician 
and  surgeon  attending  such  hospital;  the  steward  to 
account  with  the  purveyor  for  all  such  issues: 

That  the  director,  or,  in  his  absence,  the  chief 


346 


Annals  of  Medical  History 


hospital  physician,  appoint  a  proper  number  of  ma- 
trons, nurses,  and  others,  necessary  for  the  regular 
management  of  the  hospitals,  and  fix  and  ascertain 
their  pay,  not  exceeding  the  sums  heretofore  allowed; 
and  point  out  and  prescribe  their  particular  duties 
and  employments,  in  writing,  which  they  are  en- 
joined to  observe  and  obey: 

That  the  director,  with  two  chief  hospital  physi- 
cians, be  empowered  to  fix  the  pay  of  second  mates, 
and  of  such  clerks,  store  keepers,  and  other  persons, 
as  may  occasionally  be  employed;  and  also  make 
such  regulations,  and  point  out  and  enjoin,  in  writ- 
ing, such  further  particular  duties  for  the  several 
officers  in  the  hospital  department,  as  they  may 
judge  necessary  for  the  regular  management  of  the 
same;  which  duties  shall  always  be  consistent  with, 
and  in  no  wise  contradictory  to  any  of  the  duties 
herein  before  particularly  enumerated,  and  which 
being  reported  to,  and  approved  of  by  the  Medical 
Committee,  shall  thereupon  become  obligatory  to 
all  those  concerned: 

That  the  quartermaster  general  furnish  the  hos- 
pital department,  from  time  to  time,  as  occasion 
may  require,  with  such  a  number  of  horses  and 
wagons  as  may  be  necessary  for  removing  the  sick 
and  wounded,  and  for  transporting  the  hospital 
stores;  but  that  no  other  horses  than  those  belong- 
ing to  the  officers  of  the  department,  for  which  for- 
age may  be  herein  allowed,  be  kept  separately  and 
at  the  expence  of  the  department: 

That  no  person  concerned  in  trade,  on  his  own 
account,  shall  be  suffered  to  act  as  an  officer  in  the 
hospital  or  medical  department  of  the  army: 

That  no  officer  or  other  person  in  the  hospital  de- 
partment, except  the  sick  and  wounded,  be  permit- 
ted to  use  any  of  the  stores  provided  for  the  sick: 

That  the  director,  chief  hospital  physicians,  and 
the  chief  physicians  and  surgeons  of  the  army,  phy- 
sicians and  surgeons,  purveyor,  apothecary,  assist- 
ant purveyor,  and  assistant  apothecary,  be  appoint- 
ed and  commissioned  by  Congress;  the  regimental 
surgeons  and  mates  to  be  appointed  as  heretofore: 

That  the  director,  with  the  advice  and  concur- 
rence of  two  of  the  chief  hospital  physicians,  appoint 
all  hospital  mates,  which  appointments  shall  be  cer- 
tified by  warrants  under  the  hand  of  the  director;  in 
which  appointments  no  person  shall  be  admitted 
under  the  age  of  twenty-one  years: 

That  all  the  officers  in  the  hospital  or  medical  de- 
partments, shall  be  subjected  to  trial  by  courts-mar- 
tial for  all  offences,  in  the  same  manner  as  officers  of 
the  line  of  the  army. 

Resolved,  That  the  pay  and  establishment  of  the 
officers  of  the  hospital  department,  and  medical 
staff,  be  as  follows: 

Director,  one  hundred  and  fifty  dollars  per  month, 
two  rations  for  himself,  and  one  for  his  servant,  per 
day,  and  forage  for  two  horses: 

Chief  physicians  and  surgeons  of  the  army  and 
hospitals,  each,  one  hundred  and  forty  dollars  per 
month,  two  rations  per  day,  and  forage  for  two 
horses: 

Purveyor  and  apothecarv,  each,  one  hundred  and 
thirty  dollars  per  month: 

Physicians  and  surgeons  of  the  hospitals,  each, 


one  hundred  and  twenty  dollars  per  month,  one  ra- 
tion per  day,  and  forage  for  one  horse: 

Assistant  purveyors  and  apothecaries,  each,  sev- 
enty-five dollars  per  month: 

Regimental  surgeons,  each,  sixty-five  dollars  per 
month,  one  ration  per  day,  and  forage  for  one  horse: 

Surgeons'  mates  in  the  hospitals,  fifty  dollars  per 
month,  one  ration  per  day: 

Surgeons'  mates  in  the  army,  forty-five  dollars 
per  month,  one  ration  per  day: 

Steward  for  each  hospital,  thirty-five  dollars  per 
month,  one  ration  per  day: 

Ward  master  for  each  hospital,  twenty-five  dol- 
lars per  month,  one  ration  per  day. 

Resolved,  That  none  of  the  aforesaid  officers,  or 
other  persons  employed  in  any  of  the  hospitals,  be 
entitled  to  rations  of  provisions  or  forage  when  on 
furlough. 

Resolved,  That  the  chief  physician  of  the  army  be 
allowed  a  two  horse  covered  wagon  for  transport- 
ing his  baggage: 

That  the  several  officers  above  mentioned  shall  re- 
ceive their  pay  in  the  new  currency,  emitted  pursu- 
ant to  a  resolution  of  Congress  of  the  18th  day  of 
March  last;  and  that  they  be  allowed  and  paid  at 
the  rate  of  five  dollars  of  said  currency  per  month 
for  every  retained  ration;  and  shall  each  be  entitled 
annually  to  draw  cloathing  from  the  stores  of  the 
cloathier  general,  in  the  same  manner  and  under 
the  same  regulations  as  are  established  for  officers 
of  the  line,  by  a  resolution  of  Congress  of  the  25th 
November,  i~~9: 

That  the  returns  for  cloathing  for  officers  in  the 
medical  staff  (regimental  surgeons  and  their  mates, 
who  are  to  draw  with  the  regimental  staff,  excepted) 
be  signed  by  the  directors,  or  one  of  the  chief  hos- 
pital physicians;  and  such  cloathing  shall  be  deliv- 
ered either  by  the  cloathier  general  or  any  sub- 
cloathier  in  the  state  in  which  the  officer  to  receive 
cloathing  shall  reside,  in  the  same  manner  as  is  pro- 
vided in  the  cases  of  other  staff  officers  not  taken 
from  the  line: 

That  the  several  officers  whose  pay  is  established 
as  above  (except  the  stewards  and  ward  masters) 
shall  at  the  end  of  the  war  be  entitled  to  a  certain 
provision  of  land,  in  the  proportion  following,  viz. 

The  director  to  have  the  same  quantity  as  a  briga- 
dier-general; 

Chief  physicians  and  purveyor,  the  same  as  a 
colonel; 

Physicians  and  surgeons  and  apothecary,  the  same 
as  a  lieutenant  colonel; 

Regimental  surgeons  and  assistants  to  the  pur- 
veyor and  apothecary,  the  same  as  a  major; 

Hospital  and  regimental  surgeons'  mates,  the 
same  as  a  captain; 

That  the  former  arrangements  of  the  hospital  de- 
partment, and  all  resolutions  heretofore  passed 
touching  the  same,  so  far  as  they  art'  inconsistent 
with  the  foregoing,  be  repealed,  excepting  that  the 
hospitals  in  the  southern  department,  from  North 
Carolina  to  Georgia,  inclusive,  be  continued  under 
the  same  regulations  as  heretofore,  until  the  further 
order  of  Congress."1 

111  II.  r.    <  IhmrlM  Thomson  rpmimoH  tho  entries. 


History  of  the  Army  Medical  Department  During  the  Revolution        347 


October  2,  1780.  889 

Congress  took  into  consideration  the  report  of 
the  Medical  Committee  on  the  letter,  of  24  Septem- 
ber, from  the  director  general,  together  with  the  re- 
turns of  the  officers  in  the  hospital  department;  and 
thereupon, 

The  Medical  Committee,  to  whom  the  Director 
General's  letter  of  the  24th  inst.  together  with  the 
Return  of  the  Officers  in  the  Hospital  Department 
was  referred,  beg  leave  to  report: 

That  they  have  conferred  with  the  Director  Gen- 
eral and  other  officers  of  the  Department,  and  have 
made  out  a  new  Return,  of  the  General  Officers,  the 
Senior  and  Junior  Surgeons,  together  with  the  Dates 
of  their  respective  Commissions,  which  they  submit 
to  Congress. 

Resolved,  That  on  Thursday  next  Congress  will 
proceed  to  the  election  of  the  director,  chief  physi- 
cians, purveyor-apothecary  and  their  respective  as- 
sistants, and  the  physicians  of  the  military  hospi- 
tals.112 

October  6,  1780.  908 

Congress  proceeded  to  the  election  of  officers  in 
the  hospital  department,  and  the  ballots  being  taken, 
Doctor  William  Shippen,  jr.  was  elected  director- 
general;  Doctor  John  Cochran,  chief  physician  and 
surgeon  of  the  army;  Doctor  James  Craik,  Doctor 
Malachi  Treat,  Doctor  Charles  M'Knight,  chief  hos- 
pital physicians. 

October  7,  1780.  909-10 

Congress  proceeded  in  the  election  of  officers  in 
the  hospital  department,  and  the  ballots  being 
taken,  Thomas  Bond,  jun.  was  elected  purveyor; 
Isaac  Ledyard,  assistant  purveyor;  Doctor  Andrew 
Craigie,  apothecary;  William  Johonot,  assistant 
apothecary;  Doctors  James  Tilton,  Samuel  Adams, 
David  Townshend,  Henry  Latimer,  Francis  Hagan, 
Philip  Turner,  William  Burnet,  John  Warren,  Moses 
Scott,  David  Jackson,  Bodo  Otto,  Moses  Bloom- 
field,  William  Eustis,  George  Draper,  Barnabas  Bin- 
ney,  hospital  physicians  and  surgeons. 

On  motion  of  the  medical  committee, 

Resolved,  That  Doctor  Matthew  Maus  be  ap- 
pointed surgeon  to  the  regiment  of  invalids  com- 
manded by  Colonel  L.  Nicola,  and  that  Colonel 
Nicola  be  authorised  to  appoint  a  proper  surgeon's 
mate  to  the  said  regiment,  when  the  number  of  sick 
shall  make  it  necessary. 

October  17,  1780.  935 
On  motion  of  the  Medical  Committee, 
Ordered,  That  Doctor  Isaac  Forster  and  Doctor 
Jonathan  Potts  deliver  all  public  stores  in  their  pos- 
session to  Doctor  Thomas  Bond,  purveyor  of  the 
hospitals,  or  his  order,  taking  duplicate  receipts  for 
the  same,  and  transmitting  one  of  each  to  the  Board 
of  Treasury. 

October  21,  1780.  962 

A  letter,  of  4,  from  W.  Rickman,  was  read;  Where- 
upon,113 

112  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
22,  folio  27. 

113  This  letter  is  in  the  Papers  of  the  Continental  Congress,  No. 
78,  XIX.  folio  319. 


Ordered,  That  Dr.  Rickman  be  informed,  that 
pursuant  to  his  former  request,  he  is  left  out  in  the 
new  arrangement  of  the  hospital  department. 

October  30,  1780.  992 

That  as  Major  General  Greene  has  expressed  an 
earnest  desire  to  have  Doctor  James  McHenry  as 
an  aid  de  camp  upon  the  southern  command,  the 
said  Major  General  Greene  be  authorised  to  employ 
the  said  Doctor  James  McHenry  as  one  of  his  aids, 
on  his  command  in  the  southern  department;  and 
that  the  said  Doctor  McHenry  while  so  employed 
be  intitled  to  the  rank  of  major  by  brevet. 

November  1,  1780.  1002 

The  Medical  Committee  delivered  in  a  report; 
Whereupon, 

The  Medical  Committee  beg  leave  to  Report — 

That  they  have  had  under  consideration  an  esti- 
mate of  Hospital  Stores,  laid  before  them  by  the 
Purveyor  by  order  of  the  Director  of  the  Hospital: 
of  which  estimate,  such  parts  as  are  approved  of  by 
the  Committee,  and  in  their  opinion  necessary  to 
be  procured  they  now  lay  before  Congress,  amount- 
ing by  estimation  to  4276  2/3  dollars  in  specie: 
Whereupon  they  offer  the  following  Resolution. 

Ordered,  That  the  sum  of  four  thousand  two  hun- 
dred and  seventy  six  dollars  and  sixty  ninetieths  of 
a  dollar,  in  bills  emitted  pursuant  to  the  resolution 
of  the  1 8th  of  March  last,  be  advanced  to  Thomas 
Bond,  purveyor  of  the  general  hospital,  to  enable 
him  to  purchase  the  stores  mentioned  in  an  esti- 
mate approved  by  the  Medical  Committee;  and  that 
the  Board  of  Treasury  report  a  draught  or  draughts 
for  that  purpose.114 

November  6,  1780.  1024 

Ordered,  That  a  warrant  issue  on  Joseph  Borden, 
commissioner  of  the  continental  loan  office  in  the 
State  of  New  Jersey,  in  favour  of  Thomas  Bond, 
purveyor  of  the  general  hospital,  for  four  thousand 
two  hundred  and  seventy  six  dollars  and  60  90,  in 
bills  of  credit  emitted  pursuant  to  the  act  of  Con- 
gress of  the  18  of  March  last;  for  which  sum  the 
said  Thomas  Bond  is  to  be  accountable. 

November  13,  1780.  1049 

A  letter,  of  5,  from  Doctor  James  Tilton  was  read. 

A  letter  from  Doctor  James  Fallon  was  laid  be- 
fore Congress: 115 

Ordered,  To  lie  on  the  table. 

November  17,  1780.  1066 

The  Board  further  report, 

That  they  have  considered  the  letter  from  Doc- 
tor William  Rickman  of  the  4th  of  October  last  (re- 
ferred to  them  by  Congress)  and  are  of  opinion, 

That  the  medical  committee  only  are  competent 
to  determine  the  expediency  of  accepting  the  resig- 
nation of  Doctor  Rickman.  No  account  is  open  in 
the  public  books  against  Doctor  Rickman,  but  Ben- 
jamin Harrison  Depy  Pay  Master  General  in  the 
Southern  department  has  advanced  considerable 
sums  of  money,  for  the  use  of  the  Hospitals,  and 

114  This  report,  in  the  writing  of  Abraham  Clark,  is  in  the  Pa- 
pers of  the  Continental  Congress,  No.  22,  folio  29. 

115  Letter  of  Fallon,  dated  November  3,  1780,  is  in  the  Papers 
of  the  Continental  Congress,  No.  78,  IX,  folio  347. 


348 


Annals  of  Medical  History 


that  until  the  said  Depy  Pay  Master  General  ren- 
ders his  accounts,  no  account  with  Doctor  Rickman 
can  be  settled  at  the  Treasury-.116 

November  24,  1780.  1 090-1 

The  Medical  Committee  laid  before  Congress  a 
letter,  of  21,  from  Doctor  Shippen,  director  [general], 
which  was  read;  Whereupon, 

[A  motion  was  made  by  Mr.  Duane,  seconded  by] 

Ordered,  That  Doctor  Shippen,  director  of  the  hos- 
pitals, [be  directed  to]  repair  to  head  quarters  and 
put  himself  under  the  orders  of  the  Commander  in 
Chief.117 

November  27,  1780.  1095 

A  letter,  of  this  day,  from  Doctor  Shippen. us 

December  4,  1 780.  1 1 1 8 

A  letter,  of  30  November,  from  B.  Binney,  hos- 
pital surgeon;  and 

One,  of  this  day,  from  M.  Maus,  surgeon  of  the 
invalid  regiment,  were  read: 119 

December  5,  1780.  11 20 

A  letter,  of  4,  from  D(avid)  Jackson,  hospital  sur- 
geon, was  read,  requesting  leave  to  resign: 
Ordered,  That  leave  be  granted. 

December  6,  1780.  1 125-6 

The  Medical  Committee,  to  whom  were  referred 
the  letters  from  Doctor  Binney  and  Doctor  Maus, 
delivered  in  a  report: 

The  Medical  Committee  to  whom  was  committed 
the  letters  from  B.  Binney  and  M.  Maus  beg  leave 
to  report — 

That  on  the  21st  day  of  July  last  a  warrant  issue 
on  the  Treasury  in  favor  of  Dr.  Jonathan  Potts, 
Purveyor  of  the  Hospital  for  200,000  dollars  for  pro- 
curing Hospital  Stores,  and  paying  the  Physicians 
and  surgeons  in  that  Department,  a  part  only  of 
which  Warrant,  owing  to  a  deficiency  of  money  in 
the  Treasury,  hath  been  received — 

That  on  the  6th  November  last  a  warrant  issued 
on  the  Continental  Loan  Officer  of  the  State  of  New 
Jersey  in  favor  of  Thomas  Bond  Jr.  the  present 
Purveyor  for  a  certain  sum  of  money  for  procuring 
supplies  necessary  for  the  hospital,  no  part  of  which 
the  Purveyor  informs  the  Committee  he  hath  been 
able  to  receive.  That  on  account  of  the  failures  in 
obtaining  money,  the  sick  are  in  a  suffering  condi- 
tion; the  physicians  unable  to  proceed  to  their  re- 
spective charges,  and  the  business  of  the  Depart- 
ment greatly  impeeded  in  every  part. 

That  in  order  to  procure  supplies  immediately 
wanted  for  the  relief  of  the  sick  and  to  enable  the 
Physicians  to  perform  their  duty,  it  is  necessary  to 

"•This  report  i-.  in  the  PojMTl  »/  tin  Cimtinental  Congreaa,  No. 
136.  IV,  folio  713a. 

•"TUi  motion,  in  1 1 1«-  writing  of  James  Duanc,  is  in  the  Paper h 
of  the  Continental  Congreta,  No.  36,  IV,  folio  499. 

M,8Mppan'l  letter  1-  in  the  Papers  of  the  Continental  Congreaa, 
\X.  folio  67.1. 

"*  liii.  in  t In-  Papers  of  the  Continental  Congreai, 

No.  78,  IV,  folio  07. 


furnish  the  Purveyor  with  a  sum  of  money.  That  it 
be  referred  to  the  Treasury  to  report  a  Warrant 
without  delay  that  will  insure  a  speedy  supply.120 

December  8,  1780.  11 28 

That  a  warrant  issue  on  Thomas  Smith,  commis- 
sioner of  the  continental  loan  office  for  the  State  of 
Pensylvania,  in  favour  of  Thomas  Bond,  Junior, 
purveyor  of  the  hospitals,  on  the  recommendation 
of  the  Medical  Committee,  for  fifteen  thousand  dol- 
lars, to  be  paid  out  of  the  proceeds  of  a  bill  of  ex- 
change for  two  hundred  dollars,  part  of  those  here- 
tofore ordered  to  be  drawn  on  the  honorable  Benja- 
min Franklin,  minister  plenipotentiary  of  the  United 
States  at  the  Court  of  Versailles,  at  ninety  days' 
sight,  to  be  placed  in  the  hands  of  the  commissioner 
aforesaid,  by  order  of  the  Board  of  Treasury,  to  en- 
able the  said  purveyor  to  make  provision  for  some 
sick  soldiers  in  immediate  want  in  the  barracks  in 
this  city;  for  which  sum  the  said  Thomas  Bond  is  to 
be  accountable.121 

Ordered,  That  it  be  referred  to  the  Board  of 
Treasury,  and  that  they  report  without  delay,  a 
warrant  that  will  ensure  a  speedy  supply  of  neces- 
saries wanted  for  the  sick  and  enable  the  physicians 
to  perform  their  duty. 

December  9,  1780.  1132 

On  motion  of  Mr.  (Theodorick)  Bland,  a  member 
of  the  Medical  Committee, 

Ordered,  That  the  purveyor  and  apothecary  be 
directed  to  issue  medicines  and  refreshments  neces- 
sary for  the  transient  sick  which  may  be,  from  time 
to  time,  under  the  care  of  Doctor  Maus,  as  is  done 
in  the  general  hospital,  he  making  returns  of  such 
sick  in  the  manner  directed  in  the  hospital  regula- 
tions to  the  director,  and  signing  receipts  for  such 
stores  as  are  issued  to  him. 

Ordered,  That  Doctor  Maus  report  to  the  com- 
manding officer  at  the  barracks  such  officers  as  are 
appointed  to  act  under  him  as  surgeon  to  the  tran- 
sient sick,  in  case  of  misdemeanor,  in  order  that 
they  be  tried  for  misconduct  or  neglect  of  duty  by 
a  garrison  court  martial.122 

December  13,  1780.  1149 

A  letter,  of  6,  from  Doctor  Bloomfield  and  Doc- 
tor Scott,  two  hospital  physicians,  was  read,  enclos- 
ing their  commissions,  and  desiring  that  their  resig- 
nations be  accepted.123 

Ordered,  That  their  resignations  be  accepted. 

December  26,  1780.  1194 

A  letter,  of  7,  from  John  Warren  was  read,  signi- 
fying his  acceptance  of  the  office  of  hospital  physi- 
cian. 


*Thta  report,  in  the  writing  of  Abraham  Clark,  la  In  the  Po> 

pan  t,f  tin  Continental  Congreaa,  No.  22,  folio  31. 

1,1  TbJi  report   !■  In  » 1 1 > -  Paper*  Of  thi  Continental  Conyr. 

186,  IV,  folio  746. 

m  Tliis  motion,  in  the  writing  oi  Theodoriok  Bland,  if  in  the 
Papera  of  the  Continental  Congresa,  No   86,  IV,  fdU 

1,1  Tlii*  latter  i*  in  the  Paptrt  a/  tin  Continental  Congn 
78,  IV,  folio  68, 


History  of  the  Army  Medical  Department  During  the  Revolution        349 


EXPENDITURES    FOR  THE   YEAR    1780 ni 

Hospital  Department.  Page  143.  260.  562. 
589.  648.  Jonathan  Potts,  purveyor  gen- 
eral, &c.  accountable: .  376,900 

Page  330.  Isaac  Forster,  deputy  direc- 
tor general  hospitals,  eastern  department, 

accountable: 40,000 

Page  1 128 15,000 

And  Page  1024,  in  new  emission,  4,276 
dollars.  Thomas  Bond,  jun.  purveyor  gen- 
eral, &c.  accountable: 

Total  431,900 

STANDING  COMMITTEES126 

Medical 

4  May,  1780.  James  Henry 

7  July,  1780.  Abraham    Clark     in     place    of 

Henry 
9  September,  1780.  Theodorick   Bland   in   place   of 

Holten 
23  October,      1780.  Isaac  Motte 

January  3,  1781.  15 

A  letter,  of  this  day,  from  Doctor  William  Ship- 
pen,  director  general  of  the  hospital,  was  read,  re- 
questing leave  to  resign:  m 

Ordered,  That  his  resignation  be  accepted. 

Two  papers,  signed  Patrick  Garvey,  were  laid  be- 
fore Congress  and  read: 

Ordered,  That  the  same  be  referred  to  the  Medi- 
cal Committee. 

January  4,  1 781.  20 

.  .  .  .  A  letter,  of  November  29,  from  Doctor 
Forster  to  the  Medical  Committee,  were  read:127 

January  11,  1781.  47-8 

Resolved,  That  Monday  next  be  assigned  for  elect- 
ing a  director  [general]  of  the  hospital,  and  a  paymas- 
ter general  to  the  army. 

Doctor  J.  Cochran  was  nominated  by  Mr.  (James 
Mitchell)  Varnum  for  the  office  of  director  [general]; 

Doctor  Brown,  by  Mr.  (Joseph)  Montgomery; 

Dr.  Craig,  by  Mr.  (Abraham)  Clark. 

January  13,  1 781.  56 

Doctor  J.  Morgan  was  nominated  by  Mr.  (George) 
Walton,  for  the  office  of  director  of  the  hospitals. 

January  17,  1781.  65,  68 

Congress  proceeded  to  the  election  of  a  director 
of  the  military  hospital;  and  the  ballots  being  taken, 
Dr.  John  Cochran  was  elected,  having  been  previ- 
ously nominated  by  Mr.  (James  Mitchell)  Varnum. 

Congress  took   into  consideration  the   report  of 

124  This  Appendix  appears  only  in  the  first  edition  of  the  Jour- 
nals, Vol.  VI.  (Claypoole  imprint:  See  Bibliographical  Notes  No. 
353.)  The  paging  has  been  altered  to  correspond  with  the  pages 
of  the  present  edition. 

115  See  pages  1445-1447  of  Vol.  XV.  I  now  give  such  appoint- 
ments only  as  were  made  in  1780. 

126  This  letter  is  in  the  Papers  of  the  Continental  Congress,  No. 
78,  XXI,  folio  1. 

12'  Forster's  letter  is  in  the  Papers  of  the  Continental  Congress, 
No.  78,  IX,  folio  491. 


the  committee  on  the  letter  of  5  of  November  last, 
from  General  Washington,  enclosing  a  memorial 
from  the  officers  in  the  hospital  department;  and, 
thereupon,  came  to  the  following  resolutions: 

Whereas,  by  the  plan  for  conducting  the  hospital 
department,  passed  in  Congress  the  30th  day  of 
September  last,  no  proper  establishment  is  provided 
for  the  officers  of  the  medical  staff,  after  their  dis- 
mission from  public  service,  which,  considering  the 
custom  of  other  nations  and  the  late  provision  made 
for  the  officers  of  the  army,  after  the  conclusion  of 
the  war,  they  appear  to  have  a  just  claim  to;  for 
remedy  whereof,  and  also  for  amending  several  parts 
of  the  above  mentioned  plan: 

Resolved,  That  all  officers  in  the  hospital  depart- 
ment, and  medical  staff,  hereinafter  mentioned,  who 
shall  continue  in  service  to  the  end  of  the  war,  or 
be  reduced  before  that  time  as  supernumeraries, 
shall  be  entitled  to,  and  receive,  during  life,  in  lieu 
of  half-pay,  the  following  allowance,  viz. 

The  director  of  the  hospital  equal  to  the  half-pay 
of  a  lieutenant  colonel: 

Chief  physicians  and  surgeons  of  the  army  and 
hospitals,  [each  equal  to  the  half-pay  of  major]  and 
hospital  physicians  and  surgeons,  purveyor,  apothe- 
cary, and  regimental  surgeons,  each  equal  to  the 
half-pay  of  a  [lieutenant]  captain:  [and  regimental 
mates  each  equal  to  the  half-pay  of  a]  lieutenant. 

That  there  be  allowed  to  the  purveyor,  apothe- 
cary, and  assistant  purveyors,  each,  forage  for  one 
horse: 

That  the  power  given  in  the  before-mentioned 
plan,  to  the  chief  physician  and  surgeon  of  the  army, 
to  remove  regimental  surgeons  and  mates  in  case  of 
absence  without  leave,  shall  in  future  extend  no  fur- 
ther than  a  power  of  suspension,  until  such  delin- 
quent shall  be  reported  to  a  proper  officer  for  bring- 
ing him  to  trial  by  court  martial: 

That  the  apothecary  may  deliver  medicines,  in- 
struments and  dressings,  and  other  articles  of  his 
department,  to  the  hospitals,  on  orders  in  writing 
from  a  physician  and  surgeon  having  the  care  of 
any  particular  hospital,  where  the  director  or  one 
of  the  chief  physicians  and  surgeons  shall  not  be 
present  to  give  the  same: 

That  the  power  given  to  the  director  and  chief 
hospital  physicians,  with  respect  to  the  appoint- 
ment of  matrons,  nurses,  and  other  persons  neces- 
sary for  the  regular  management  of  the  hospitals,  be 
extended  to  each  of  the  physicians  and  surgeons  of 
the  hospitals,  in  the  absence  of  the  director  and  chief 
physicians  and  surgeons. 

[That  notwithstanding  the  prohibition  against  offi- 
cers of  the  hospitals  using  any  of  the  Stores  provided 
for  the  sick,  the  said  officers  may  occasionally  draw 
out  of  the  hospital  Stores  under  their  particular  di- 
rection by  written  orders  on  the  Stewards  of  the 
same,  such  small  articles  for  their  comfortable  sub- 
Nesatived  s'stence  as  tney  mav  stand  in  need  of, 
provided  such  articles  are  not  imme- 
diately wanted  for  the  use  of  the  sick:  of  which  arti- 
cles so  issued,  the  Stewards  shall  keep  regular  ac- 
counts, charging  each  officer  with  the  articles  drawn 
at  the  current  price  the  same  bears  at  that  time, 
which  shall  be  deducted  out  of  his  pay  in  the  settle- 
ment of  his  account,  copies  of  which  accounts,  each 


350 


Annals  of  Medical  History 


respective  Steward,  under  obligation  of  his  oath  of 
Office,  shall  transmit  every  six  months  to  the  Pur- 
vevor,  Which  being  charged  in  a  general  account  by 
him,  shall  be  lodged  in  the  Treasury  Office — 

That  the  Director,  Chief  Physicians  of  the  army 
and  hospitals,  and  other  Physicians  and  officers  in 
the  hospital  department,  as  well  those  lately  dis- 
missed from  sen-ice,  as  those  re-appointed  in  the 
last  arrangement  who  were  in  office  between  the  first 
day  of  Sept.  1777,  and  the  30th  day  of  September 
last,  shall  have  the  depreciation  of  money  made 
good  to  them  on  their  pay  for  such  part  of  the  above 
mentioned  time  as  they  were  actually  employed  in 
public  service.]128 

January  25,  1781.  86 
A  letter,  from  Doctor  Gould,  was  read: 
Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

February  1,  1781.  103-4 

A  letter,  of  31  January,  from  Doctor  Gould,  was 
read:  ^ 

On  motion  of  the  medical  committee, 

Resolved,  That  the  purveyor  of  the  hospital  be, 
and  hereby  is  empowered  and  directed  to  collect,  or 
cause  to  be  collected  and  secured  under  care,  until 
properly  issued,  all  public  hospital  stores  and  medi- 
cines in  Virginia,  late  under  the  direction  of  Dr. 
Rickman,  or  others  acting  under  the  United  States, 
and  all  persons  in  possession  of  such  public  stores 
or  medicines,  are  hereby  required  to  deliver  the  same 
to  the  said  purveyor,  or  his  order,  upon  demand. 

[That  the  medical  committee  be  authorised  during 
the  absence  of  the  director  to  direct  a  number  of 
the  hospital  physicians  and  mates  to  repair  imme- 
diately to  Virginia  and  take  the  charge  of  the  hos- 
pitals in  that  state.]  l3° 

A  motion  was  made  by  Mr.  (Theodorick)  Bland, 
seconded  by  (Mr.  George)  Walton,  respecting  the 
hospitals  for  the  southern  army: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

February  5,  1781.  115 

A  letter,  of  3,  from  Doctor  B.  Binney,  was  read:131 

February  6,  1781.  118 
On  motion  of  Mr.  (Theodorick)  Bland, 
Resolved,  That  Thomas  Bond,  jun.  purveyor  to 
the  general  hospital,  be,  and  hereby  is,  authorised 
to  settle  the  accounts  for  salaries,  and  pay  the  offi- 
cers of  the  hospital  established  in  Virginia,  under 
the  direction  of  Dr.  Gould,  which  have  accrued 
since  the  new  arrangement  of  the  medical  depart- 
ment; and  that  Dr.  William  Rickman,  late  deputy 
director,  settle  and  return  the  accounts  of  salaries 
due  the  officers  of  the  said  hospital,  prior  to  that 
date,  to  the  present  purveyor. 

'"This  report,  in  tha  writing  of  Abraham  Clark,  is  in  the  Pa- 
per* of  the  Continental  Congress,  No.  19,  VI.  folio  881. 

*•  This  letter  is  in  the  Papers  of  the  Continental  Congress,  No. 

""This  motion,  in  the  writing  of  Abraham  Clark,  h  in  tha  /'"- 
pert  nf  Ihr  Continental  Cimgrmn,  No    SO,   |     f,,|j,,   1_>1. 

1,1  Btnaay'l  lett.-r  is  in  tha  Papers  of  the  Continental  Congress, 
IV.  folio  93. 


February  8,  1781.  130 

A  letter,  of  7,  from  B.  Otto,  physician  and  sur- 
geon, was  read;  Whereupon, 

Ordered,  That  the  letter  of  Doctor  Otto  be  refer- 
red to  the  Board  of  War  to  take  measures  for  pre- 
venting any  interruption  being  given  to  the  hospi- 
tal at  the  yellow  springs,  the  same  being  provided 
solely  for  the  reception  of  proper  hospital  subjects. 

February  16,  1781.  153 

The  Medical  Committee  laid  before  Congress  a 
letter,  of  January  12,  from  Doctor  J.  Browne,  acting 
as  surgeon  general  in  the  southern  army,  which  was 
read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

Ordered,  That  Mr.  (William)  Burnett  be  added 
to  the  Medical  Committee. 

February  19,  1781.  160 

A  letter,  of  3,  from  J.  Cochran,  was  read,  signify- 
ing his  acceptance  of  the  office  of  director  general  of 
the  hospital.132 

A  memorial  of  John  Bartlet  was  read:  1M 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

February  22,  1781.  187 

A  letter,  from  Doctor  B.  Binney,  was  read:  l34 
Ordered,  That  it  be  referred   to    a  committee  of 
three. 

February  24,  1781.  191 
On  motion  of  the  Medical  Committee: 
Ordered,  That  a  warrant  issue  on  Thomas  Smith, 
commissioner  of  the  continental  loan  office  for  the 
State  of  Pensylvania,  in  favour  of  Doctor  Thomas 
Bond,  purveyor  of  the  hospital,  for  forty  thousand 
dollars  of  the  old  emissions,  to  be  applied  towards 
paying  the  officers  of  the  medical  department  in 
part  of  their  salaries  due  since  their  appointment 
under  the  present  arrangement,  for  which  sum  the 
said  purveyor  to  be  accountable. 

February  27,  1781.  199 

A  letter,  of  10,  from  James  Craig,  chief  hospital 
physician,  was  read: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

March  3,  1781.  230 

The  report  of  the  committee  on  the  letter  of  the 
28th  February  from  Dr.  W.  Burnet,  was  taken  into 
consideration ;  Whereupon, 

Ordered,  That  Dr.  James  Craik,  chief  hospital 
physician  and  surgeon,  be,  and  he  is  hereby  ap- 
pointed chief  physician  and  surgeon  of  the  army,  in 
the  room  of  Dr.  J.  Cochran,  elected  director  of  the 
hospital;  and  that  Monday  next  be  assigned  for 
electing  a  chief  hospital  physician  and  surgeon,  in 
the  room  of  Dr.  Craik,  removed  to  the  army.1" 

'"  This  Inter  is  in  the  Papers  of  the  Continental  Congr* 
7s.  VI.  folio  11. 

'"  Bartiett'a  memorial  i-  in  No.  111,  I.  folio  _■  1 1 
'"This  latter,  dated  Pabroarj  80,  1781,  is  in  the  Papers  of  ths 
:•-<  m,  No,  7s.  iv,  (oik  98. 

"*  This  report,  in  tha  writing  of  Abraham  Clark,  is  in  tha 
Papers  of  the  Continental  Congress,  No.  19.  I,  folio  47.'i. 


History  of  the  Army  Medical  Department  During  the  Revolution         351 


March  5,  1781.  233 

According  to  the  order  of  the  day,  Congress  pro- 
ceeded to  the  election  of  a  chief  physician  and  sur- 
geon of  the  hospital,  in  the  room  of  Dr.  Craik,  re- 
moved to  the  army;  and,  the  ballots  being  taken, 
Dr.  William  Burnet  was  elected,  having  been  pre- 
viously nominated  by  Mr.  (John)  Witherspoon. 

March  7,  1781.  237 

A  memorial  of  Francis  Hagan,  a  physician  and 
surgeon  in  the  hospital,  was  read;136 

March  14,  1781.  259 

The  committee  on  Doctor  B.  Binney's  letter,  of 
20  February: 

The  Committee  to  whom  was  referred  the  letter 
of  Doctor  B.  Binney  on  the  22d  Feby.  report,  That 
Doctor  Binney's  services  are  useful  and  necessary 
in  the  medical  department,  and  that  he  ought  to  be 
retained  in  that  department, 

That  it  is  the  opinion  of  the  Committee  Doctor 
Binney  should  immediately  repair  to  the  State  of 
Virginia,  according  to  the  order  he  hath  received 
from  the  Director  General  of  the  hospitals;  and  that 
an  order  issue  to  the  Treasury  to  furnish  on  account 
the  sum  of  forty  thousand  dollars  of  the  old  emis- 
sions of  Congress,  to  enable  him  to  bear  the  expences 
of  himself  and  two  Mates,  and  to  establish  and  fur- 
nish hospitals  in  the  said  State.137 

March  16,  1781.  273 

The  Medical  Committee  also  delivered  in  a  re- 
port for  arranging  the  hospital  for  the  southern 
army. 

The  Medical  Committee,  to  whom  was  referred 
the  memorial  of  Doctor  J.  Bartlet:  delivered  in  their 
several  reports. 

March  19,  1781.  275-7 

The  report  of  the  Medical  Committee  on  the 
memorial  of  Dr.  John  Bartlett,  late  physician  and 
surgeon  general  of  the  army  in  the  northern  depart- 
ment, was  taken  into  consideration;  and  it  appear- 
ing, 

The  medical  committee  to  whom  was  referred  the 
memorial  of  Dr.  John  Bartlett  late  Physic"  and 
Surg"  Gen1  of  the  army  in  the  northern  department, 
beg  leave  to  lay  before  Congress  the  following  State 
of  Facts  respecting  the  memorialist. 

That  on  the  nth  of  April  1777  he  was  appointed 
Physic"  and  Surg"  Gen1  to  the  army  in  the  northern 
department,  to  which  he  repaired  some  time  in  July 
following  and  with  which  he  continued  until  the  23d 
of  October  following  when  he  was  permitted  by  Gen1 
Gates  to  return  home  on  account  of  his  inability  to 
perform  the  duties  of  the  office  by  reason  of  the  in- 
firmities of  age  and  more  especially  on  account  of 
an  accidental  injury  received  in  his  arm,  That  it 
appears  to  your  committee  that  at  the  time  Dr. 
Bartlett  left  the  army  it  was  generally  understood 
that  he  had  no  design  of  returning  to  that  post,  he 

136  Hagan's  memorial  is  in  the  Papers  of  the  Continental  Congress, 
No.  41,  IV,  folio  173. 

1,7  This  report,  in  the  writing  of  Meriwether  Smith,  is  in  the 
Papers  of  the  Continental  Congress,  No.  19,  I,  folio  361.  It  is  in- 
dorsed: "Aug.  24,  1781,  not  to  be  acted  upon." 


having  before  he  received  the  hurt  in  his  arm  de- 
clared repeatedly  to  the  other  officers  of  that  depart- 
ment that  he  was  too  old  and  infirm  to  perform  the 
duties  belonging  to  that  office  and  at  his  particular 
request  exchanged  with  Dr.  Thomas  Tillotson  an 
Hospital  Surgeon,  That  before  he  went  home  he  ob- 
tained a  certificate  from  Dr.  Potts  and  Dr.  Treat 
recommending  him  for  an  appointment  to  any  hos- 
pital that  might  be  established  near  his  own  home. 
That  this  notwithstanding,  he  repaired  to  the  army 
at  the  White  Plains  some  time  in  the  year  1778,  but 
was  not  considered  or  treated  as  Physician  and  Sur- 
geon General  nor  did  he  do  any  of  the  duties  of  that 
office,  Dr.  Tillotson  having  been  appointed  by  Gen1 
Gates  in  his  room  and  being  then  with  the  army  and 
doing  the  duties  of  that  office. 

That  on  the  first  of  July  1779  Dr.  Shippen  the 
late  Director  General  at  the  particular  request  of 
Dr.  Bartlett's  friends  directed  him  to  repair  to  Fish 
Kill  and  superintend  the  Hospital  at  that  place, 
where  lie  accordingly  came  and  the  officers  of  that 
Hospital  refusing  to  do  duty  under  him  he  request- 
ed and  obtained  permission  from  Dr.  Shippen  on 
the  28th  September  1779  to  return  home, 

That  he  received  pay  for  the  time  he  was  with 
the  northern  army  in  1777  and  six  months  pay  be- 
sides after  he  went  home  and  also  that  he  received 
three  months  pay  for  the  time  he  was  at  Fish  Kill 
in  1779.  Since  which  time  your  Committee  cannot 
find  that  Dr.  Bartlett  hath  either  done  duty  or  re- 
ceived pay.  Upon  which  State  of  facts  your  Commit- 
tee beg  leave  to  report, 

That  Dr.  John  Bartlett,  at  his  own  request,  and 
with  the  consent  of  the  commanding  officer  of  the 
department,  and  the  deputy  director  and  other  offi- 
cers thereunto  belonging,  left  the  service  to  which 
he  was  appointed,  in  a  manner  which  clearly  indi- 
cated his  intention  of  relinquishing  his  office;  and 
having  received  pay  for  all  the  time  he  spent  with 
the  army,  and  six  months  while  he  was  at  home, 
cannot  be  entitled  to  any  farther  pay  or  allowance.138 

March  22,  1781.  292-4 

A  letter,  of  January  14,  from  Major  General 
Greene,  was  read,  with  sundry  papers  enclosed: 

Ordered,  That  it  be  referred  to  the  Medical  Com- 
mittee. 

The  report  of  the  Medical  Committee,  delivered 
the  15,  was  taken  into  consideration,  and  it  was 
thereupon  resolved  as  follows: 

Whereas  the  late  regulations  for  conducting  the 
medical  department  and  military  hospitals  passed 
the  30th  day  of  September  last,  and  amended  by 
several  subsequent  acts  of  Congress,  extends  no  far- 
ther southward  than  to  include  the  State  of  Virginia; 
and  whereas  the  present  operations  of  the  war  to 
the  southward,  make  it  necessary  that  the  hospital 
department,  in  that  district,  be  rendered  as  uni- 
form to  that  in  the  northern  army  as  circumstances 
will  permit,  that  no  inconveniences  may  arise  to  the 
army  in  general  from  different  and  opposite  sys- 
tems, as  its  operations  may  eventually  be  inter- 
changeable from  one  district  to  another  in  a  short 
space  of  time;  therefore, 

1,8  This  report,  in  the  writing  of  William  Burnet,  is  in  the  Pa- 
pers of  the  Continental  Congress,  No.  19,  I.  folio  229. 


352 


Annals  of  Medical  History 


Resolted,  That  there  be  one  deputy  director  of 
the  military  hospitals,  [in  the  Southern  district  sub- 
ject to  the  general  control  of  the  director]  who  shall, 
in  the  absence  of  the  director,  have  the  general 
control  and  management  of  all  the  military  hospitals 
that  are  or  may  be  established  [to  the  Southward  of 
Virginia]  under  the  orders  of  the  commander  of  the 
southern  army  for  the  time  being. 

When  the  foregoing  resolution  was  under  debate, 
a  motion  was  made  by  Mr.  (John)  Mathews,  second- 
ed by  Mr.  (Thomas)  Bee,  after  the  words  "the  di- 
rector," to  insert  "for  the  southern  army;"  and  on 
the  question,  shall  those  words  be  inserted?  the 
yeas  and  navs  being  required  by  Mr.  (Thomas) 
Bee,     ........ 

So  it  passed  in  the  negative. 

Resolved,  That  [within  the]  for  the  army  aforesaid, 
[district]  there  shall  be  one  chief  physician  of  the  hos- 
pital, who  shall  also  be  a  surgeon ;  one  chief  physician 
to  the  said  army,  who  shall  also  be  a  surgeon;  two 
hospital  physicians,  who  shall  also  be  surgeons;  and 
four  surgeons'  mates  for  the  hospitals;  one  deputy 
purveyor  with  an  assistant,  one  deputy  apothecary 
with  an  assistant;  and  to  each  hospital,  a  steward, 
matron,  orderly  men  and  nurses  as  is  directed  in  the 
arrangement  of  the  [northern]  hospital,  passed  the  30 
day  of  September  aforesaid. 

That  the  deputy  director,  deputy  purveyor  and 
deputy  apothecary,  have  and  exercise  the  same 
powers  which  are  exercised  by  the  director,  pur- 
veyor and  apothecary  respectively,  agreeably  to  the 
arrangement  above-mentioned: 

That  the  pay  of  the  deputy  director  be  one  hun- 
dred and  forty  dollars  per  month,  that  of  the  deputy 
purveyor  and  deputy  apothecary,  each  one  hundred 
and  twenty  dollars  per  month;  and  they  shall  sever- 
ally be  entitled  to  the  same  emoluments,  and  sub- 
ject to  the  same  regulations  and  restrictions  as  their 
respective  principals  are  entitled  or  subjected  to  by 
the  above-mentioned  arrangement  and  the  amend- 
ments thereto: 

That  all  the  other  officers  of  the  hospital  and  med- 
ical staff  for  the  southern  [district]  army,  exercise  the 
same  powers,  perform  the  same  duties,  receive  the 
same  pay  and  emoluments,  and  be  subject  to  the 
regulations  and  restrictions  laid  down  in  the  afore- 
said arrangement  for  officers  of  like  description: 

Provided  nevertheless,  that  the  powers  therein 
directed  to  be  exercised  by  the  director,  and  any 
two  chief  physicians  and  surgeons  of  the  hospital, 
shall,  in  the  absence  of  the  deputy  director,  be  vest- 
ed in  and  exercised  by  the  next  officer  in  the  hospi- 
tal department  for  the  southern  army,  and  so  on  in 
succession,  in  conjunction  with  the  two  next 
seniors."9 

March  27,  1781.  316 

The  United  States  in  Congress  assembled  pro- 
ceeded to  the  election  of  a  deputy  purveyor  of  the 
hospital  for  the  southern  army,  and,  the  ballots  be- 
ing taken  and  counted,  Dr.  Nathan  Brownson  was 
elected,  he  having  been  previously  nominated  by 
Mr.  (Samuel)  Adams. 

"•  Thin  report,  in  the  writing  of  Theodorick  Bland,  in  in  the 
Papers  of  the  Continental  Congress,  No.  22,  folio  33. 


April  12,  1 78 1.  3_'5 

On  motion  of  the  Medical  Committee: 
Ordered,  That  a  warrant  issue  on  Thomas  Smith, 
commissioner  of  the  continental  loan  office  for  the 
State  of  Pensylvania,  in  favour  of  Thomas  Bond, 
junr,  purveyor  of  the  hospital,  for  thirty  thousand 
dollars  of  the  old  emissions,  twenty  thousand  dol- 
lars of  which  to  be  delivered  to  Nathan  Brownson, 
deputy  purveyor,  to  be  applied  to  the  use  of  the 
hospitals  established  for  the  southern  army  and  the 
remaining  ten  thousand  to  be  applied  by  the  pur- 
veyor towards  the  paying  persons  necessarily  em- 
ployed in  the  general  hospital  northward  of  Virginia, 
for  which  sum  of  thirty  thousand  dollars  the  pur- 
veyor to  be  accountable.140 

April  13,  1 78 1.  388 

On  motion  of  the  Medical  Committee: 
Ordered,  That  a  warrant  issue  on  John  Hopkins, 
commissioner  of  the  continental  loan  office  for  the 
State  of  Virginia,  in  favor  of  Thomas  Bond,  Junr., 
purveyor  of  the  hospital,  for  five  thousand  dollars 
of  the  new  emission,  to  be  by  him  put  into  the 
hands  of  Nathan  Brownson,  deputy  purveyor,  to 
pay  three  months'  salary  and  wages  due  to  the  offi- 
cers and  others  employed  in  the  hospital  established 
for  the  southern  army  and  to  procure  supplies  for 
said  hospital,  for  which  sum  the  said  purveyor  is  to 
be  accountable. 

April  30,  1 78 1.  464 

A  memorial  of  sundry  officers  late  of  the  hospital 
staff  was  read: 141 

Ordered,  That  it  be  referred  to  a  committee  of 
three: 

The  members,  Mr.  (James)  Duane,  Mr.  (William 
Churchill)  Houston,  Air.  (Isaac)  Motte. 

May  2,  1 78 1.  467 

Treasury  Office,  May  ist,  1781 

The  Board  of  Treasury  upon  the  petition  of  Lieu- 
tenant Andrew  Lee  of  Col.  Hazen's  regiment  refer- 
red to  them  27th  ultimo,  beg  leave  to  report  to  the 
United  States  in  Congress  Assembled,  That  for  the 
payment  of  the  said  L\  Lee's  account  (inclosed  in 
the  said  petition)  of  expences  incurred,  from  the 
time  he  was  wounded  at  Springfield  New  Jersey  in 
June  1780  to  the  3rd  of  January  1781  to  the  amount 
of  3820  dollars  old  emissions,  a  warrant  issue  on 
Thomas  Smith  Esq.  Commissioner  of  the  Continen- 
tal Loan  Office  for  the  State  of  Pennsylvania  in 
favour  of  Dr.  Thomas  Bond  purveyor  of  the  Gen- 
eral Hospital  for  3820  dollars  of  the  old  emissions  to 
enable  him  to  pay  the  account  of  the  said  lieut'.  Lee, 
for  which  sum  the  said  Dr.  Thos.  Bond  is  to  be  ac- 
countable.141 

Ordered,  That  a  warrant  issue  on  Thomas  Smith, 
commissioner  aforesaid,  in  favour  of  Thomas  Bond, 
purveyor  of  the  general  hospital,  for  fifty  dollars  and 
eighty-four  ninetieths  of  a  dollar  of  the  new  emis- 

""  This  report,  in  the  writing  of  Abraham  ("lark,  is  in  the  Pa- 
pert  of  the  Continental  Congress,  No.  22,  folio  37. 

"'This  manorial,  dated  April  22,  1781,  is  in  the  Pa  pen  of  tin 
Contmmtal  Congn     ,  No    n    \'II.  folio  292. 

"'  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
13ft,  V,  folio  289. 


History  of  the  Army  Medical  Department  During  the  Revolution 


353 


sion,  to  enable  him  to  discharge  the  account  of  Lieu- 
tenant Lee  for  expences  incurred  from  the  time  he 
was  wounded  at  Springfield,  New  Jersey,  in  June, 
1780,  to  the  3  January,  1781,  for  which  sum  the 
said  Thomas  Bond,  purveyor,  is  to  be  accountable. 

May  4,  1 78 1.  475 

Ordered,  That  Mr.  (John)  Witherspoon  be  added 
to  the  committee  on  the  memorial  of  sundry  officers 
late  of  the  hospital  staff; 

May  23,  1 78 1.  529 

The  report  from  the  Medical  Committee  was  read; 
Whereupon, 

The  Medical  Committee  report, 

That  the  Purveyor  has  certified  to  them  that 
there  is  due  to  Dr.  Peter  Fayssoux  for  his  pay  as 
Physician  and  Surgeon  General  of  the  Hospitals  in 
the  Southern  Department,  a  balance  of  2599  dollars 
therefore  submit  the  following  resolve: 

Ordered,  That  a  warrant  issue  in  favour  of  Thomas 
Bond,  purveyor  of  the  hospitals,  for  one  thousand 
dollars  of  the  new  emission  to  be  by  him  paid  to 
Doctor  Peter  Fayssoux  in  part  of  his  arrearages  of 
pay,  to  enable  the  said  Doctor  P.  Fayssoux  to  re- 
pair to  the  southern  army  [to  take  charge  of  the 
hospital].143 

May  25,  1 78 1.  534 

That  so  much  of  the  letter,  of  25,  from  J.  Coch- 
ran, director  general,  as  respects  the  hospital  sur- 
geons, stores  and  farther  appointments,  be  referred 
to  the  Medical  Committee; 

That  such  parts  of  the  same  as  respects  deprecia- 
tion and  the  pay  of  surgeons  be  referred  to  the 
Board  of  War;  and 

That  such  parts  of  the  same  as  respects  the  post- 
age of  letters  to  and  from  surgeons  be  referred  to 
the  committee  on  the  Post  Office; 

That  the  resignation  of  Doctor  Hagan  be  accept- 
ed;1M 

May  25,  1781.  541 

Resolved,  That  Dr.  James  McHenry  receive  the 
commission  of  major  in  the  army  of  the  United 
States,  to  take  rank  from  the  30th  of  October  last: 

May  26,  1 78 1.  544 

The  Medical  Committee;  delivered  in  their  re- 
spective reports. 

The  Medical  Committee  report  that  from  a  Cer- 
tified account  of  Joseph  Eaker,  Surgeon's  Mate, 
under  the  hands  of  Doctor  William  Shippen,  late 
Director  General  and  Thomas  Bond  Purveyor,  and 
a  letter  from  the  said  Joseph  Eaker,  referred  to 
them,  it  appears  to  your  Committee  that  the  said 
Eaker  has  been  lately  released  from  captivity  where 
he  had  remained  for  seven  months,  that  he  is  in 
much  distress,  and  that  there  is  due  to  him  the  said 
Eaker  on  account  of  pay  and  rations  £444-  13s-  3d 
— Your  Committee  therefore  report,  that  a  warrant 
issue  in  favour  of  EK  Tho8  Bond,  Purveyor  of  Gen- 
eral Hospital  for  a  sum  equal  to  £444-  13s-  3d  to  be 

143  This  report,  in  the  writing  of  Theodorick  Bland,  is  in  the 
Papers  of  the  Continental  Congress,  No.  19,  II,  folio  267. 

144  Copies  of  extracts  from  Cochran's  letter  are  in  the  Papers  of 
the  Continental  Congress,  No.  78,  VI,  folios  33-35. 


paid  to  Joseph  Eaker  late  Surgeons  Mate  to  the 
Hospital  on  discharge  of  the  pay  and  rations  due 
the  said  Eaker  as  appears  by  the  aforesaid  Certified 
acct.145 

May  28,  1 78 1.  570 

Ordered,  That  the  Medical  Committee  be  discon- 
tinued, and  that  the  Committee  lodge  with  the 
Board  of  War  all  the  returns  and  papers  in  their  pos- 
session, and  then  be  discharged;  and  that  the  busi- 
ness heretofore  entrusted  to  them,  and  the  powers 
with  which  they  were  invested,  be  transferred  to  the 
Board. 

July  11,  1 78 1.  624-5 

A  report  from  the  Board  of  War,  on  the  letter  from 
the  director  (of  the  hospitals,  was  read;  Whereupon, 

Ordered,  That  the  sum  of  eight  thousand  five 
hundred  and  forty  five  dollars  and  one-third  of  a 
dollar  in  specie  or  [Bills  of  the  new  Emissions] 
other  money  equivalent,  be  immediately  put  into 
the  hands  of  the  purveyor  of  the  military  hospitals 
in  part  of  the  estimate  laid  before  Congress  by  the 
medical  committee,  to  enable  him  to  purchase  an 
immediate  supply  for  the  use  of  the  sick,  and  to 
prepare  for  the  immediate  exigencies  of  the  cam- 
paign in  the  hospital  department: 

That  the  sum  of  sixteen  thousand  one  hundred 
and  sixteen  dollars,  in  specie  or  [Bills  of  the  new 
Emissions]  other  money  equivalent,  be  advanced  to 
the  said  purveyor,  for  three  months'  pay,  to  be 
paid  by  him  on  account  to  the  officers  of  the 
medical  department: 

That  a  warrant  be  drawn  on  the  treasurer  of  the 
State  of  New  York,  for  six  thousand  dollars,  and 
another  warrant  on  the  treasurer  of  Virginia  for  four 
thousand  dollars,  in  specie  or  [Bills  of  the  new  Emis- 
sions] other  money  equivalent,  in  part  of  the  above 
sum  of  sixteen  thousand  one  hundred  and  sixteen  dol- 
lars, in  favour  of  the  said  purveyor  or  his  order;  and 
that  the  residue,  viz.  six  thousand  one  hundred  and 
sixteen  dollars  be  paid  him  at  Philadelphia,  in  specie 
or  [Bills  of  the  new  Emissions]  other  money  equiv- 
alent: 

That  four  thousand  two  hundred  dollars,  in  specie 
or  [Bills  of  the  new  Emissions]  other  money  equiva- 
lent, be  paid  to  the  said  purveyor,  to  be  put  into 
the  hands  of  stewards  at  established  hospitals,  to 
purchase  milk  and  vegetables  and  discharge  small 
incidental  charges  at  fixed  hospitals).146 

That  the  Treasury  Board  be  and  they  are  hereby 
p  d  directed  to  devise  ways  and  means  for  supply- 
"  ing  the  foregoing  sums  of  eight  thousand  five 
hundred  and  forty  five  and  one  third,  six  thousand 
one  hundred  and  sixteen,  and  four  thousand  two 
hundred  dollars. 

That  all  vacancies  of  regimental  Surgeons  and 
Mates  in  any  regiments  of  the  several  State  Lines 
be  filled  up  by  the  respective  States  in  whose  Lines 
the  vacancies  shall  happen  in  the  same  manner  with 
vacancies  happening  in  the  Line  of  the  State. 

That  all  vacancies  of  regimental  Surgeons   and 

146  This  report,  in  the  writing  of  Theodorick  Bland,  is  in  the 
Papers  of  the  Continental  Congress,  No.  19,  II,  folio  191. 

146  The  portion  in  parentheses  was  entered  in  the  Journal  by 
George  Bond. 


354 


Annals  of  Medical  History 


Mates  happening  in  regiments  or  Corps  not  belong- 
ing to  the  Line  of  any  State  be  filled  up  by  the  Di- 
rector or  Deputy  Director  of  the  Hospitals  with  the 
Army  in  which  such  regiments  or  Corps  shall  serve 
the  said  Director  or  Deputy  Director  reporting  the 
same  to  the  Commander  in  Chief  or  commanding 
General  of  a  separate  Army  that  information  there- 
of may  be  given  to  the  Board  of  War  who  shall 
fill  up  Commissions  accordingly. 

The  filling  up  the  vacancies  in  the  Medical  De- 
partment we  leave  to  the  wisdom  of  Congress  with 
this  observation  that  the  Director  represents  to  us 
that  this  measure  is  necessary.147 

June  1 8,  1 78 1.  668 

Ordered,  That  the  Board  of  War  report  a  plan  of 
succession  to  vacancies  in  the  hospital  and  medical 
lines  of  the  army. 

June  22,  1781.  690 

The  Committee  of  the  Week  report, 

That  the  memorial  of  G.  Glentworth,  W"  Smith 
and  James  Fallon,  supernumerary  senior  physicians 
and  surgeons  of  the  general  hospital  for  themselves 
and  in  behalf  of  other  supernumeraries  praying 
"That  Congress  will  please  to  grant  them,  in  com- 
mon with  supernumerary  judges  advocate,  regimen- 
tal surgeons  and  chaplains,  their  depreciation  and 
half  pav"  ought  to  be  referred  to  a  special  Commit- 
.  tee.1" 

July  3,  1781.  718 

The  committee  of  the  week  made  report ;  Where- 
upon, 

Ordered,  That  a  letter  of  this  day  from  Doctor 
James  Tilton  be  referred  to  the  Board  of  Treasury 
to  take  order  thereon  to  settle  depreciation  and 
grant  a  certificate  as  prayed;  1W 

July  17,  1781.  756 

A  report  from  the  Board  of  War  was  read;  Where- 
upon, 

Resolved,  That  the  Board  of  War  be  authorised  to 
draw  on  the  paymaster  general  in  favour  of  Captain 
Patrick  Cams  of  Lieutenant  Colonel  Lee's  legion, 
for  two  hundred  and  ten  dollars  in  bills  of  the  new 
emission;150  and  of  Doctor  Morris,  surgeon  of  Colo- 
nel Armand's  legion,  for  two  hundred  and  twenty- 
five  dollars  in  bills  aforesaid  in  part  of  their  pay,  and 
for  which  sums  thev  are  respectively  to  be  account- 
able.151 

July  24,  1 78 1.  785 

A  report  from  the  Board  of  War  was  read;  Where- 
upon, 

War  Office,  July  24,  1781 
Sir, 

Robert  Henry,  Surgeon  of  the  2nd  New  Hamp- 

147  This  report  i-  in  the  Paper*  of  the  Continental  Congrttt,  No. 
117  V.  f.,li.i  278.  Ii  i'  indorsed  \utnist  28,  1781.  not  to  be 
acted  upon." 

'"This  report,  in  tin-  writing  <>i  Thomaa  Rodney,  u  in  the  Pa- 

;x-r«  11/  thr  Continental  Congrttt,  No    82,  folio  177 

"•  THl  r-ix.rt.  in  tin-  writing  of  Samuel  Livermorc,  is  in  the 

Paperi  of  th-  nijrr*,.  No.  .')2,  folio  185. 

""  This  clauw  i*  in  the  Papers  nf  the  Continental  Conor. 

•I.  bUo  c 

ul  This  clause  is  in  the  Paperi  of  the  Continental  Congrttt,  No. 
lis.  II.  f..lio65. 


shire  Regiment  hath  represented  to  the  Board,  that 
he  was  taken  prisoner  by  the  enemy  (at  the  time 
Col.  Greene  was  killed)  and  stripped  of  all  his  cloth- 
ing. He  hath  since  obtained  his  parole,  for  a  limited 
time  to  procure  some  necessaries.  He  further  repre- 
sents that  he  hath  received  but  two  months'  pay  in 
twenty,  that  before  he  belonged  to  this  regiment  he 
was  mate  in  the  General  Hospital,  and  there  ap- 
pears due  to  him  by  Doctor  Bond's  certificate  for 
that  service  £101.5.  specie,  which  sum  there  is  no 
provision  made  to  pay,  and  he  further  saith,  that 
he  is  at  this  time  destitute  of  cash.  Upon  consider- 
ing the  foregoing  representation,  the  Board  submit 
the  following  resolution: 

Ordered,  That  the  Board  of  War  draw  on  the  pay- 
master general  in  favour  of  Robert  Henry,  surgeon 
of  the  second  New  Hampshire  regiment  for  one 
hundred  and  ninety-five  dollars  of  the  new  emis- 
sions on  account  of  his  pay; 152  and 

September  20,  1781.  979-81 

The  report  of  the  Board  of  War  respecting  the 
hospital  department  was  taken  into  consideration; 
and  Thereupon, 

At  a  Board  of  War  September  17th,  1 78 1 . 

Present  Mr.  Peters 
Mr.  Cornell 

The  Board  do  themselves  the  honor  to  report  to 
Congress  on  the  medical  department,  and  beg  leave 
to  observe  that  they  have  taken  every  measure  in 
their  power  to  procure  the  necessary  information  to 
enable  them  to  do  justice  to  the  United  States  as 
well  as  individuals. 

First.  For  settling  the  line  of  promotions  in  the 
medical  staff  they  have  obtained  a  plan  fixed  by  a 
Board  of  General  Officers  under  the  orders  of  the 
Commander  in  Chief  with  his  approbation,  Copies 
of  which  No.  1  and  2  are  enclosed,  the  plan  they  beg 
leave  to  recommend  to  be  established  by  Congress 
as  reported  by  the  General  Officers  for  a  rule  of  pro- 
motion in  the  medical  staff  in  future. 

Secondly.  In  consequence  of  General  Greene's  Re- 
quest for  assistance  in  the  Medical  Department, 
they  have  consulted  the  Commander  in  Chief  on  the 
propriety  of  filling  up  the  vacancies  under  the  Di- 
rector General  and  requesting  him  to  send  the  neces- 
sary assistance  to  the  Southern  Army.  He  was  not 
able  to  determine  the  question,  but  on  his  arrival  at 
the  head  of  Elk  he  obtained  Dr.  Craik's  opinion  on 
that  subject  which  is  contained  in  the  enclosed  paper 
No.  3,  but  as  it  appears  from  the  tenor  of  Dr.  Coch- 
ran's letter  to  the  Board  (an  extract  of  which  is  en- 
closed in  No.  4)  that  he  entertains  different  senti- 
ments, the  Board  take  tlu-  liberty  to  recommend  to 
Congress  that  appointments  be  made  agreeable  to 
Dr.  Cochran's  recommendation  contained  in  the  en- 
closed paper  No.  5  to  serve  with  the  main  army  and 
its  dependencies.  And  those  contained  in  Doctor 
Oliphant's  recommendation  contained  m  the  en- 
closed paper  No.  6,  to  be  appointed  for  the  Southern 
Army  under  the  Command  of  General  Greene. 

The  Board  are  the  more  induced  to  recommend 
the  appointment  of  those  Gentlemen  to  the  South- 
ward as   it  appears  to  them  absolutely   necessary 

lM  This  report  is  in  the  Papere  «f  Iht  Continental  Cong  ■ 
148,  II,  folio  85. 


History  of  the  Army  Medical  Department  During  the  Revolution         355 


they  should  be  with  the  army  immediately  and 
could  they  possibly  be  spared  from  their  quarter  a 
considerable  sum  of  money  must  be  advanced  to 
defray  their  travelling  Expences  which  it  is  to  be 
feared  would  cause  a  considerable  delay.153 

Resolved,  That  the  present  vacancies  of  hospital 
physicians  and  surgeons  be  filled  up  by  the  senior 
surgeons  of  the  hospital  lately  deranged,  the  eldest 
hospital  mates  or  regimental  surgeons,  as  shall  be 
recommended  by  the  director  and  chief  physician 
and  surgeon  to  the  army: 

That  all  future  vacancies  of  hospital  physicians 
and  surgeons  be  filled  by  the  eldest  regimental  sur- 
geons and  hospital  mates,  who  shall  be  reckoned  of 
equal  grades,  who  shall  upon  examination  be  found 
qualified  and  obtain  a  certificate  of  recommendation 
from  the  director  and  chief  physician  and  surgeon 
of  the  army,  or  of  the  deputy-director  and  chief 
physician  in  a  separate  department: 

That  the  persons  requisite  to  fill  the  higher  grades 
in  the  hospital  and  medical  departments,  be  ap- 
pointed, from  time  to  time,  by  Congress,  according 
to  merit  and  abilities: 

[That  the  states  shall  nominate  regimental  surgeons 
to  the  regiments  of  their  respective  lines,  who  shall 
be  examined  by  the  director  and  chief  physician 
and  surgeon  to  the  army  and  one  of  the  chief 
hospital  physician  or  of  the  deputy  director  and  of 
the  chief  Physician  in  a  separate  department,  and 
upon  their  certificates  of  approbation  shall  receive 
the  appointment.] 

That  all  surgeons  to  regiments  or  corps  not  be- 
longing to  the  line  of  any  particular  State,  be  nomi- 
nated by  the  director  of  the  hospitals,  and  the  chief 
physician  and  surgeon  of  the  army,  subject  to  the 
approbation  of  the  Commander  in  Chief,  and  shall 
be  equally  entitled  to  promotion  to  hospital  physi- 
cians and  surgeons  with  the  regimental  surgeons  of 
states  lines.164 

On  recommendation  of  the  director  approved  by 
the  Board  of  War: 

Resolved,  That  Dr.  Joseph  Young,  a  deranged 
senior  surgeon,  and  doctors  Goodwin  Wilson,  Daniel 
Jenifer,  Samuel  Edmondson  and  George  Campbell, 
eldest  surgeon's-mates,  be  promoted  to  the  rank  of 
hospital  physicians  and  surgeons,  to  fill  the  vacan- 
cies occasioned  by  the  resignations  of  doctors  Bloom- 
field,  Scott,  Hagan  and  Jackson,  and  the  promotion 
of  Dr.  Burnet. 

On  the  recommendation  of  the  deputy  director, 
approved  by  the  Board  of  War: 

Resolved,  That  doctors  Thomas  Tudor  Tucker, 
and  Vickars,  be  appointed  physicians  and  surgeons 
in  the  hospital  for  the  southern  department: 

That  Daniel  Smith  be  appointed  assistant  deputy 
purveyor,  and  John  Cams  assistant  deputy  apothe- 
cary, in  the  southern  department.155 

153  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
148,  II,  folio  259. 

lM  A  copy  of  this  report  of  the  Board  of  General  Officers,  refer- 
red to,  in  the  Board  of  War  report,  as  No.  2,  is  in  the  Papers 
of  the  Continental  Congress,  No.  148,  II,  folio  269. 

165  A  copy  of  the  recommendation  of  the  director  (John  Coch- 
ran) dated  June  4,  1781,  is  in  the  Papers  of  the  Continental  Con- 
gress, No.  148,  II,  folio  273;  a  copy  of  the  recommendation  of 
the  deputy  director  (David  Olyphant)  is  on  folio  263. 


October  16,  1781.  1055 

Ordered,  That  Thursday  next  be  assigned  for 
electing  a  deputy  purveyor  for  the  military  hospi- 
tal, in  the  room  of  Doct  Brownson,  who  is  elected 
governor  of  Georgia. 

October  25,  1781.  1072 

A  report  from  the  committee  of  the  week  was 
read;  Whereupon, 

The  Committee  of  the  week  report, 

That  a  letter  of  Robt.  Johnson  Deputy  Purveyor 
of  the  Southern  Department  requesting  relief  for 
the  Gentlemen  of  his  Department;  the  Petition  of 
Capt.  Joseph  Traversier  praying  for  the  pay  and 
subsistance  due  to  him;  the  letter  of  R.  G.  Living- 
ston praying  for  so  much  pay  as  will  enable  him  to 
join  his  Reg';  the  Petition  of  Thomas  Bond  and 
others  officers  of  the  medical  Department;  the  Peti- 
tion of  John  Dealy  praying  for  a  discharge  from  the 
army;  the  Letter  from  Doctor  Hailing  requesting 
the  pay  due  to  him,  and  to  know  whether  he  is  con- 
sidered as  retiring  from  the  service;  be  referred  to 
the  Board  of  War. 

November  3,  1781.  1092,  3-8 

A  memorial  and  petition  of  Barn:  Binney  was 
read.156 

The  committee  to  whom  the  letters  from  the  su- 
perintendent of  finance  relative  to  the  hospital  de- 
partment; and 

The  committee  to  whom  the  letters  from  the  Su- 
perintendent of  Finance  relating  to  the  Hospital  De- 
partment was  referred  do  report  that  they  have  fully 
considered  the  present  state  of  the  Hospital  or  Medi- 
cal Department  in  the  Army,  and  the  several  papers 
referred  to  them,  and  having  taken  the  best  advice 
and  information  in  their  power  are  of  opinion  that 
great  economical  advantages  to  the  public  and  very 
useful  alterations  to  the  sick  and  wounded,  may  be 
obtained  by  a  regulation  of  the  said  Department  in 
the  following  principles. 

By  destroying  all  distinctions  between  Hospitals 
and  forming  the  whole  Medical  Department  into 
one  uniform  Corps. 

By  establishing  the  direction  of  practice  and  Pur- 
veyorship  entirely  distinct  and  separate  vesting  it 
in  different  hands. 

By  establishing  the  Superintendance  of  the  De- 
partment in  a  Board  of  Surgeons,  properly  organized 
for  that  purpose  and  not  in  a  single  person. 

By  the  promoting  the  use  of  regimental  Hospitals, 
and  preventing  the  crowding  the  sick  together  in 
General  Hospitals. 

By  preventing  every  person  concerned  in  Hospi- 
tals from  trading  and  speculating  in  any  manner 
whatever  for  private  advantage  and  emolument. 

By  reducing  the  number  of  Surgeons  and  Mates 
of  the  General  Hospitals. 

Under  the  influence  of  these  principles  your  Com- 
mittee beg  leave  to  Report  the  following  Ordinance 
for  constituting  and  arranging  the  Hospital  Depart- 
ment. 

An  Ordinance  for  regulating  the  General  Hospital, 
and  Surgeons  of  the  Army. 

166  This  memorial  and  petition,  dated  November  3,  1781,  is  in 
the  Papers  of  the  Continental  Congress,  No.  41,  I,  folio  375. 


356 


Annals  of  Medical  History 


Be  it  ordained  by  the  United  States  in  Congress 
Assembled,  That  there  shall  be  one  Physician  in 
Chief  to  the  Army  and  Director  of  the  Military  Hos- 
pitals: [Thirteen]  Twelve  Surgeons  and  twenty  [six] 
four  Mates,  for  the  General  Hospital,  a  Surgeon 
and  one  Mate  to  every  regiment;  an  Apothecary  and 
two  Assistants;  and  a  Purveyor  and  one  assistant. 

The  Physician  in  Chief  and  the  hospital  Surgeons 
or  any  three  of  such  Surgeons  shall  make  a  Medical 
Board,  of  which  a  field  Officer  to  be  appointed  in 
the  usual  form  shall  sit  as  President;  it  shall  meet 
regularly  once  a  month,  by  General  order,  or  often- 
er  if  requisite.  They  shall  examine  regimental  and 
examine  and  appoint  all  hospital  Mates;  and  shall 
examine  and  recommend  the  [regimental  and]  hospital 
Surgeons,  [and  none  but  those  recommended  by  the 
Board  shall  be  appointed  by  Congress  to  vacancies,] 
and  no  person  under  the  age  of  21  years  shall  be  ap- 
pointed a  Mate:  It  shall  be  the  special  duty  of  the 
said  Board  from  time  to  time,  to  settle  the  propor- 
tions of  regimental  and  hospital  practice,  and  to 
make  regulations  accordingly.  They  shall  prescribe 
the  measures  for  supplying  the  sick  effectually  with 
medicines,  stores,  provisions  &c.  It  shall  also  be 
their  duty  to  make  out  proper  estimates  for  the 
Purveyor,  inspect  his  accounts  and  transactions, 
and  regulate  his  plan  of  issues  so  as  to  prevent 
waste  and  extravagance.  As  often  as  required,  the 
Director  shall  report  to  the  Board  a  full  state  of  all 
the  Hospitals  under  his  direction,  and  receive  their 
Instructions.  This  Board  shall  enquire  into  all  com- 
plaints brought  against  Officers  of  the  Department: 
and  present  to  a  Court  Martial,  such  as  they  may 
think  deserving  of  censure.  And  this  Board  shall  be 
authorized  to  digest  rules  and  carry  into  execution, 
every  thing  relative  to  the  Medical  Department: 
Provided  nevertheless,  that  no  regulation  of  theirs 
be  valid  and  take  effect  until  issued  in  orders,  with 
the  consent  and  approbation  of  the  Commander  in 
Chief  or  the  Commanding  Officer  of  a  separate  De- 
partment. 

The  Physician  in  Chief  and  Director  shall  have  a 
general  Superintendent  and  direction  of  practice, 
both  in  Camp  and  in  hospitals.  He  shall  always 
maintain  an  office  near  Head  Quarters,  so  as  to  be 
ready,  at  all  times,  to  consult  and  advise  with  the 
Commander  in  Chief:  and  to  distribute  the  neces- 
sary  advice  and  direction  to  the  Surgeons  with  whom 
it  shall  be  his  duty  to  correspond.  With  the  concur- 
rence of  the  Commander  in  Chief  he  may  establish 
such  Hospitals  as  service  requires:  and  he  shall  dis- 
pose of  the  officers  necessary  to  conduct  them.  In 
time  of  engagement  or  any  emergency,  he  shall  call 
into  the  field  as  many  hospital  Surgeons  as  the  occa- 
sion requires;  and  by  order  of  the  General,  may 
have  assistance  in  hospitals,  from  the  regimental 
Surgeons. 

It  shall  also  In-  the  special  duty  of  the  Director, 
frequently  to  inspect  all  the  hospitals  under  his  di- 
ll; to  stc  that  they  are  managed  with  economy 
and  success:  to  cornet  all  abuses;  to  suspend  and 
bring  to  trial,  delinquent  Officers:  and  to  make 
monthly  returns  of  the  sick  to  the  Commander. 

In  the  absence  of  the  Director  from  Camp,  the 
Surgeon  eldest  in  appointment,  who  is  present,  shall 
do  his  duty. 


Every  Surgeon  shall  direct  his  own  hospital  agree- 
able to  the  regulations,  from  time  to  time  adopted 
by  Congress  or  the  Medical  Board,  and  communi- 
cated to  him  by  the  Director.  He  is  hereby  author- 
ized to  order  from  the  Purveyor  or  his  Assistant,  or 
from  the  Commissaries  and  Quarter  Masters  of  the 
Army,  or  to  be  purchased  from  the  neighborhood, 
whatever  is  necessary  and  convenient  for  the  sick: 
and  shall  be  accountable  for  his  conduct  and  success 
in  practice,  to  the  director;  but  shall  not  be  dis- 
missed the  service  without  due  form  of  trial. 

Y\  lien  two  or  more  Surgeons  are  on  duty  in  one 
hospital,  each  shall  act  independently  with  respect 
to  all  matters  relating  to  his  own  particular  charge, 
and  shall  be  accountable  to  the  director  only,  or  the 
Surgeon  presiding  in  his  stead.  In  case  of  dispute, 
with  regard  to  any  matter  respecting  the  whole  hos- 
pital, the  Surgeon  of  senior  appointment  shall  con- 
trol, until  the  matter  in  dispute  can  be  decided  by 
the  Director,  or  in  his  absence,  the  presiding  Sur- 
geon. 

The  regimental  Surgeon  shall  give  diligent  atten- 
tion to  such  regulations  as  may  be  established  re- 
specting their  conduct,  and  shall  manage  the  sick  of 
their  respective  regiments  accordingly:  and  shall  also 
be  accountable  to  the  Physician  in  Chief  as  the  com- 
mon head  of  the  Medical  Department. 

The  Hospital  and  regimental  Mates  shall  observe 
the  director  of  the  Surgeons,  and  shall  diligently  per- 
form all  the  reasonable  duties  required  of  them,  for 
the  recovery  of  the  sick.  They  shall  also  make  out 
returns  of  the  sick,  for  the  Surgeons  respectively, 
agreeable  to  such  forms  as  the  director  shall  re- 
quire. 

The  Apothecary  and  his  Assistants  shall  receive, 
prepare  and  deliver  Medicines,  Instruments  and 
dressings,  and  other  articles  of  his  department,  to 
the  hospitals  and  Army,  on  orders,  in  writing,  from 
the  director  or  Surgeons.  He  shall  appoint  a  proper 
number  of  Mates  to  assist  him  in  his  duty,  and  shall 
furnish  one  to  every  Hospital,  where  one  is  required 
by  the  Director. 

All  the  Instruments  delivered  by  whose  order  so- 
ever obtained,  shall  be  paid  for,  at  prime  cost,  by 
the  Surgeon  or  Mate  receiving  them. 

The  Purveyor  shall  provide  all  necessary  medi- 
cines, utensils  and  stores  of  every  kind,  that  may  be 
ordered  by  the  Medical  Board,  for  the  deliver]  of 
which  a  written  order  from  the  Director  of  a  hospi- 
tal Surgeon  shall  be  his  voucher.  It  shall  also  be  his 
duty  to  pay  all  the  Officers  of  the  Hospital  and  every 
debt  and  expence  of  the  sick  after  being  duly  certi- 
fied. For  these  purposes  he  shall  draw  money  from 
the  Treasury  agreeable  to  the  estimates  given  him 
by  the  Medical  Board.  He  shall  settle  his  accounts 
of  expenditure  in  money  every  three  months,  with 
the  Auditors  of  accounts,  and  once  a  month,  he 
shall  lay  a  state  of  the  expenditure  0/  stores  with  the 
stock  on  hand,  before  the  Medical  Board. 

The  Purveyor  shall  direct  the  conduct  of  his  As- 
sistant, and  by  advice  and  order  of  the  Medical 
Board  shall  appoint  such  other  Assistants,  Store- 
keepers and  Clerks  as  the  service  may  require. 

In  every  hospital  tbe  purveyor  or  bis  Assistant  shall 
appoint  a  steward:  whose  duty  it  shall  be  to  pur- 
chase vegetables,  straw  and  other  small  article-,  to 


History  of  the  Army  Medical  Department  During  the  Revolution        357 


receive  the  stores  and  provisions  for  the  use  of  the 
hospital  and  deliver  them  agreeable  to  the  orders  of 
the  prescribing  Surgeons.  And  although  in  his  pur- 
chases and  Issues  he  is  to  obey  the  orders  of  the 
prescribing  Surgeons:  yet  for  the  faithful  discharge 
of  his  Office,  he  is  to  be  accountable  to  the  Purveyor, 
and  for  this  purpose  he  shall  keep  separate  accounts 
of  all  he  receives  from  the  Purveyors,  Quarter  Mas- 
ters and  Commissaries,  and  of  what  he  purchases 
himself  from  the  country;  and  shall  render  an  ac- 
count of  all  his  Issues  monthly,  with  his  stock  on 
hand,  to  the  Purveyor;  thus  to  enable  the  Purveyor 
to  lay  the  whole  monthly  expence  of  the  hospital, 
before  the  Medical  Board.  The  Steward's  vouchers 
shall  express  not  only  by  whom  ordered,  but  by 
whom  received  also.  The  Steward  shall  also  receive 
the  spare  regimental  arms,  accoutrements  and 
cloathing  of  each  soldier  admitted  into  the  Hospi- 
tal keeping  entries  of  and  giving  receipts  for  every 
Article  received,  which  when  the  soldier  shall  be  dis- 
charged, shall  be  accounted  for  by  the  said  Steward, 
with  the  Commanding  Officer  of  the  regiment  to 
which  such  soldier  belonged,  or  other  proper  person, 
and  shall  also  take  charge  of  the  hospital  cloathing. 
In  every  Hospital,  the  director  or  Senior  Surgeon 
present,  shall  appoint  a  Matron  and  a  proper  num- 
ber of  nurses  to  be  under  the  direction  of  the  pre- 
scribing Surgeons,  and  paid  by  the  Purveyor. 

During  the  summer,  when  the  Army  is  in  the 
field,  the  Director  shall  institute  a  flying  or  field 
Hospital,  in  the  rear  of  Camp,  and  appoint  proper 
Surgeons  to  take  direction  of  it,  considering  it  al- 
ways as  a  branch  of  the  General  Hospital  and  to 
have  one  common  regulation  and  interest  with  it. 

One  Surgeon  at  least,  whom  the  General  may 
choose,  shall  always  reside  near  head  Quarters,  to 
attend  the  General  and  Staff  Officers,  and  to  be  in 
readiness  for  any  emergency  when  a  division  or  de- 
tachment of  the  Army  is  sent  off,  or  in  any  manner 
becomes  a  distinct  and  separate  body  from  the  Main 
Army,  the  Medical  board  shall  nominate  its  propor- 
tion of  Medical  Staff  of  which  the  Surgeon  eldest  in 
appointment  shall  preside,  with  all  the  powers  of 
Physician  in  Chief  and  director;  and  shall  form  a 
Medical  board,  to  be  authorized  as  before  men- 
tioned: and  when  two  Armies  unite,  having  each  a 
separate  Board,  one  shall  dissolve  of  course  by  di- 
rection of  the  Commanding  Officer  of  the  whole. 

When  Officers  of  the  Line  do  duty  in  hospitals, 
the  Medical  board  shall  make  rules  for  their  conduct, 
that  they  may  not  interfere  with  the  Surgeons,  and 
they  shall  receive  their  instructions  by  General 
order. 

That  the  Quarter  Master  General  furnish  the  hos- 
pital Department,  from  time  to  time,  as  occasion 
may  require  with  such  a  number  of  horses  and  wag- 
ons as  may  be  necessary  for  removing  the  sick  and 
wounded  and  for  transporting  the  hospital  stores, 
but  that  no  other  horses  than  those  [allowed  to  be 
kept  by]  for  which  forage  may  be  herein  allowed  to 
the  Officers  of  the  Department,  be  kept  separately 
and  at  the  expence  of  the  Department. 

That  no  officer  or  other  person  employed  in  the 
hospital  or  Medical  Department  shall  on  any  ac- 
count whatever,  be  concerned  in  trade  for  his  pri- 
vate emolument  and  advantage. 


That  no  officer  or  other  person  in  the  hospital  or 
Medical  Department  except  the  sick  or  wounded, 
be  permitted  to  use  any  of  the  stores  provided  for 
the  sick. 

That  the  Physician  in  Chief,  the  Surgeons  of  the 
Hospital,  Purveyor,  Apothecary,  Assistant  Purveyor 
and  Assistant  Apothecary  be  appointed  and  Com- 
missioned by  Congress.  The  Regimental  Surgeons 
and  Mates  to  be  appointed  as  heretofore. 

That  all  the  Officers  in  the  Hospital  or  Medical 
Department  shall  be  subject  to  trial  by  Courts  Mar- 
tial for  all  offences  in  the  same  manner  as  officers  of 
the  Line  of  the  Army. 

That  the  pay  and  establishment  of  the  Officers  of 
the  hospital  Department  and  Medical  Staff  be  as 
follows,  payable  in  silver  Spanish  Milled  dollars  a 
7/6  a  dollar  [or  other  money  equivalent.] 

Physician  in  Chief  and  Director  of  the  Military 
Hospitals  125  dollars  per  month  2  rations  for  him- 
self and  1  for  his  servant  per  day  and  forage  for  2 
horses. 

Surgeons  of  the  General  Hospital  90  dollars  per 
month  and  2  rations  per  day  and  forage  for  two 
horses. 

Purveyor  and  Apothecary  each  100  dollars  per 
month. 

Assistant  Purveyor  and  Apothecary  50  dollars 
per  month  each. 

Regimental  Surgeons  each  60  dollars  per  month, 
1  ration  per  day  and  forage  for  one  horse. 

Surgeons'  Mates  in  Hospitals  40  dollars  per  month 
and  1  ration  per  day. 

Do.  in  the  Army  40  dollars  per  mo.  and  1  ration 
per  day. 

Steward  for  each  Hospital  30  dollars  per  mo.  and 
1  ration  per  day. 

That  none  of  the  aforesaid  Officers  or  other  per- 
sons employed  in  and  of  the  Hospitals  be  entitled  to 
rations  of  provision  or  forage,  when  on  furlough. 

That  the  Physician  in  Chief  be  allowed  a  two 
horse  covered  wagon  for  transporting  his  baggage. 

That  the  same  allowance  be  made  to  the  afore- 
said Officers  for  retained  rations  as  is  allowed  to 
officers  of  the  line  of  the  army;  and  also  that  each 
of  them  be  annually  entitled  to  draw  Cloathing  from 
the  Stores  of  the  Cloathier  General  in  the  same  man- 
ner and  under  the  same  regulations  as  are  estab- 
lished for  Officers  of  the  Line  by  a  resolution  of  Con- 
gress of  the  25  Nov.  1779  and  in  like  manner  as  has 
heretofore  been  used. 

That  the  several  Officers  above  mentioned  (ex- 
cept Stewards)  shall  at  the  end  of  the  War  be  en- 
titled to  a  provision  of  Land  in  the  proportions  fol- 
lowing viz:  Physician  in  Chief  to  have  the  same 
quantity  as  a  Brigadier  General;  the  Surgeons,  Pur- 
veyor and  Apothecary  of  the  Hospital  the  same  as  a 
Colonel;  Regimental  Surgeons  and  assistants  to  the 
Purveyor  and  Apothecary  the  same  as  a  Major;  Hos- 
pital and  regimental  Surgeons'  Mates  the  same  as  a 
Captain. 

That  all  former  arrangements  of  the  Hospital  De- 
partment and  all  resolutions  heretofore  passed  touch- 
ing the  same  be  repealed.167 


167  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
22,  folio  45. 


35* 


Annals  of  Medical  History 


December  20,  1781.  1182 

(Note)  A  memorial  of  George  Glentworth  and 
others,  supernumerary  physicians  and  surgeons  of 
the  general  hospital,  was  presented  this  day  and  re- 
ferred to  the  Secretary  at  War,  as  the  indorsement 
shows.  It  is  dated  December  17,  1781,  and  is  in  the 
Papers  of  tbe  Continental  Congress,  No.  41,  III, 
folio  483. 

December  24,  1781.  1183 

An  ordinance  respecting  the  hospital  department 
was  read  the  first  time: 

Ordered,  That  Wednesday  next  be  assigned  for 
the  second  reading  of  this  ordinance. 

STANDING  COMMITTEES158 

Medical 
16  February,  1781.  William  Burnett 

January  3,  1782.  4-7 

On  a  report  of  the  Secretary  at  War,  to  whom 
was  referred  a  memorial  of  Dr.  Glentworth  and 
others: 

Resolved,  That  it  be,  and  hereby  is  recommended 
to  the  State  of  Pensylvania,  to  settle  the  balance  of 
pay  and  depreciation  due  to  Doctors  G.  Glent- 
worth, W.  Smith,  J.  Fallon,  S.  Duffield  and  S.  Hail- 
ing, late  physicians  and  surgeons  in  the  general  hos- 
pital, on  the  same  principles  they  settled  with  the 
other  physicians  and  surgeons  of  the  army,  citizens 
of  that  State.159 

On  a  report  of  a  committee,  consisting  of  Mr. 
(Abraham)  Clark,  Mr.  (Ezekiel)  Cornell  and  Mr. 
(Isaac)  Motte,  to  whom  was  referred  an  arrange- 
ment of  the  medical  department: 

The  Committee  to  whom  was  referred  the  ordi- 
nance respecting  the  Hospital  Department,  beg 
leave  to  report — 

That  they  have  considered  the  same,  and  are  of 
opinion  that  any  ordinance  for  a  new  establishment 
of  the  hospital,  (on)  the  plan  proposed,  is  unneces- 
sary and  at  this  time  for  many  considerations  im- 
proper they  have  therefore  returned  the  same  in 
the  manner  they  received  it. —  Your  Committee  are 
nevertheless  of  opinion  that  sundry  alterations  and 
amendments  are  necessary  to  be  made  to  the  plan 
for  conducting  the  General  Hospital,  passed  on  the 
30th  day  of  September,  1780,  and  accordingly  have 
herewith  submitted  such  alterations  and  amend- 
ments for  the  consideration  of  Congress,  in  case 
they  shall  be  of  opinion  with  the  Committee,  that  a 
new  regulation  of  the  Hospital  by  an  Ordinance  is 
at  this  time  unnecessary  or  improper. — 

Resolved,  That  for  the  more  regular  conducting 
the  general  hospital,  the  offices  of  chief  physician 
and  surgeon  of  the  army,  and  of  chief  hospital  phy- 
sician,  be,  and  hereby  are  abolished;  and  that  the 
chief  physician  and  surgeon  to  the  army,  eldest  in 
appointment,  be  continued  in  service,  under  the  title 

"*  Sec  pages  1229  aud  1230  of  Vol.  Will.  I  now  give  niofa  »p- 
pointmantl  only  as  were  made  in  1781. 

**"  'I'lii.x  report  11  in  tin-  /\i/>ct«  of  the  Continental  Cony,' 
I  I ''.   I     folio  '■'■    So  fir  as  Hulling  is  concerned  it  wpamded  tbe 
following  r> --.olution   tent    to  Congress  by  the  Secretary   at    War 

I  >ITI-I1|IHT     1-V 


of  physician,  with  the  pay  and  emoluments  hereto- 
fore allowed  to  a  chief  hospital  physician: 

That  the  number  of  surgeons  to  all  the  military 
hospitals  of  the  United  States,  be  reduced  so  as  not 
to  exceed  fifteen: 

That  the  director  have  the  general  superintend- 
ance  and  direction  of  all  the  military  hospitals,  and 
of  practice  both  in  camp  and  in  hospitals: 

That  in  the  absence  of  the  director,  his  duty  de- 
volve on  the  deputy  director  or  physician,  and  in 
their  absence  on  the  hospital  surgeons,  according  to 
seniority: 

That  the  director,  or  in  his  absence  the  senior 
medical  officer,  with  the  approbation  of  the  Com- 
mander in  Chief,  or  commanding  general  of  a  sep- 
arate army,  be,  and  hereby  is  authorized  and  em- 
powered, as  often  as  may  be  judged  necessary,  to 
call  a  medical  board,  which  shah  consist  of  the  three 
senior  medical  officers  then  present;  and  it  shall  be 
the  duty  of  such  board  to  appoint  all  hospital  mates, 
to  examine  all  candidates  for  promotion  in  the  hos- 
pital department,  and  recommend  to  the  Secretary 
at  War  such  as  they  judge  best  qualified;  and  gen- 
erally to  take  cognizance  of,  and  give  their  opinion 
and  advice  on  every  matter  relative  to  the  depart- 
ment, which  may  be  submitted  to  them  by  the 
Commander  in  Chief,  or  commanding  general  of  a 
separate  army:  provided  always,  that  no  regulation, 
plan  or  order  of  the  board,  shall  be  valid  and  take 
effect,  until  approved  by  the  Commander  in  Chief, 
or  commanding  general  of  a  separate  army,  and  is- 
sued in  general  orders: 

That  all  returns  heretofore  ordered  to  be  made 
by  the  director  or  deputy  director,  to  the  medical 
committee,  be  made  to  the  Secretary  at  War: 

That  the  stewards  may,  in  the  first  instance,  w  hen 
the  purveyor  or  his  assistant  is  at  a  distance,  be  ap- 
pointed by  the  director  or  senior  medical  officer,  but 
shall  be  removeable  at  pleasure,  and  others  substi- 
tuted in  their  stead,  by  the  purveyor  or  his  assist- 
ant. And  although  in  their  purchases  and  issues, 
they  are  to  obey  the  order  of  the  prescribing  sur- 
geons, yet  for  the  faithful  discharge  of  their  clut\, 
they  are  to  be  accountable  to  the  purveyor,  who 
shall  in  like  manner  be  accountable  to  the  United 
States.  Wherefore,  the  said  stewards  shall  keep  sep- 
arate accounts  of  all  they  receive,  and  of  what  they 
themselves  purchase;  and  shall  render  an  account 
monthly  of  all  their  issues,  with  their  stock  on  hand, 
to  the  purveyor,  who  shall  render  the  said  accounts, 
together  with  a  particular  account  of  the  supplies 
furnished  by  himself  or  his  assistants  to  each  re- 
spective hospital,  once  every  three  months  to  the 
Superintendant  of  finance: 

That  the  Secretary  of  War  be,  and  he  is  hereby 
empowered  and  directed,  on  or  before  the  first  day 
of  February  next,  and  hereafter,  from  time  to  time, 
as  the  service  may  require,  to  arrange  the  depart- 
ment agreeably  to  the  foregoing  resolutions,  ;i\^\  to 
issue  his  orders  to  such  as  he  thinks  proper  to  re- 
main, paying  a  due  regard  in  his  first  arrangement 
to  such  of  the  chief  physicians  and  surgeons  as  may 

Bi  "' '■"'.  That  tho  Comptroller  bo  and  ho  is  hereby  directed 
to  adjtul  the  aooounta  of  Doctor  Helling  for  pay  end  depreda- 
tion on   the  HUM  principles  as  the  aoOOUntS  of   Dootor   Allison 

were  tettled.    Thii  resolution  in  on  folio  68. 


History  of  the  Army  Medical  Department  During  the  Revolution         359 


choose  to  continue  in  service  in  the  rank  of  sur- 
geons, and  in  his  subsequent  arrangements  to  such 
of  the  senior  officers  as  may  choose  to  remain  in 
service : 

That  such  of  the  officers  as  shall  not  be  called 
into  service  agreeably  to  the  foregoing  resolution, 
be  considered  as  reduced  by  Congress,  and  be  en- 
titled to  the  emoluments  granted  by  the  Act  of  Con- 
gress of  the  1 7  January,  1 78 1 : 

That  when  by  reason  of  vacancies  or  otherwise, 
any  officer  hereafter  to  be  appointed  in  the  hospital 
department,  and  whose  appointment  is  reserved  to 
Congress,  [it  shall  be  the  duty  of  the  secretary  at 
war  to  recommend  the  person  or  persons  best  quali- 
fied, provided  that,  in  the  recommendations  for 
director,  deputy  director  and  physician]  due  regard 
be  paid  to  the  officers  next  in  rank;  and  that  the 
appointment  of  hospital  surgeons  be  from  among 
the  regimental  surgeons  and  hospital  mates;  pro- 
vided that  no  regimental  surgeon  shall  be  so  ap- 
pointed, who  shall  not  have  submitted  himself  to  an 
examination  by  the  medical  board,  and  obtained 
from  them  a  certificate  that  he  is  well  qualified  for 
the  office  of  regimental  surgeon,  by  which  certificate 
the  regimental  surgeon  shall  be  considered  as  sup- 
erior in  rank  to  an  hospital  mate,  but  not  otherwise. 

Resolved,  That  the  director,  deputy  director,  phy- 
sician, surgeons  and  mates,  as  w:ell  hospital  as  regi- 
mental, receive  their  pay  out  of  the  military  chest, 
at  the  same  time  and  in  the  same  manner  as  the 
army  with  which  they  serve;  the  abstracts  to  be 
signed  by  the  director,  deputy  director  or  physician, 
or  in  their  absence  by  the  senior  hospital  surgeon; 
and  the  warrants  to  issue  in  the  same  manner  as  for 
the  pay  of  the  army.160 

February  20,  1782.  81-2 

The  committee,  consisting  of  Mr.  (Abraham) 
Clark,  Mr.  (Ezekiel)  Cornell,  Mr.  (Thomas)  Mc- 
Kean,  to  whom  were  referred  the  report  of  the  Sec- 
retary at  War,  on  a  petition  of  Dr.  Hagan,  and  the 
memorials  of  Dr.  Jackson,  Dr.  Williams,  Dr.  Eaker, 
and  Dr.  Frinke,  delivered  in  a  report;  Whereupon, 

Resolved,  That  the  comptroller  be,  and  he  is  here- 
by, authorized  and  directed  to  adjust  the  accounts 
of  all  the  officers  of  the  late  general  hospital  for  pay 
and  subsistence,  up  to  the  time  the  arrangement  took 
place  in  [October]  September,  1780,  or  for  so  much 
of  the  preceding  time  as  they  continued  in  service, 
upon  their  producing  proper  documents  of  the  time 
of  their  respective  services. 

Resolved,  That  it  be,  and  hereby  is,  recommend- 
ed to  the  legislatures  of  the  several  states,  to  settle 
and  discharge  on  account  of  the  United  States,  the 
depreciation  of  pay  of  such  officers  in  the  late  gen- 
eral hospital  as  are  inhabitants  of,  or  belong  to  their 
respective  states,  who  resigned  their  appointments 
after  the  10th  day  of  April,  1780,  or  became  super- 
numerary by  the  new  arrangement  in  [October] 
September,  1780. 

Resolved,   That   the    comptroller    be,    and   he   is 

lw  Thia  report  ie  in  the  Papers  of  the  Continental  Congress,  No. 
22,  folios  43  and  63.  The  paragraphs  preceding  the  resolutions 
are  in  Abraham  Clark's  writing,  the  rest  is  in  that  of  Charles 
Thomson. 


hereby,  authorized  and  directed  to  settle  the  depre- 
ciation of  pay  of  officers  in  the  late  general  hospital, 
who  resigned  or  became  supernumerary  as  aforesaid, 
and  who  do  not  belong  to  any  particular  State,  in 
the  same  manner  as  hath  been  provided  for  the 
officers  of  the  late  Colonel  Hazen's  regiment. 

Ordered,  That  the  account  of  Dr.  Frinke,  for  tak- 
ing care  of  the  sick  and  wounded  in  the  retreat  from 
Ticonderoga,  in  1777,  and  for  furnishing  supplies  for 
the  same,  be  returned  to  Dr.  Frinke,  and  the  settle- 
ment suspended,  until  authentic  vouchers  shall  be 
produced  respecting  such  services  and  expendi- 
tures.161 

February  26,  1782.  100 

(Note)  On  this  day,  according  to  the  indorsement, 
a  memorial  of  Joseph  Eaker,  of  the  same  date,  was 
read.  It  is  in  the  Papers  of  the  Continental  Congress, 
No.  41,  III,  folio  71. 

April  10,  1782.  179 

That  the  petition  of  Ll  Morris  praying  for  a  set- 
tlement of  his  accounts,  incurred  by  his  being  or- 
dered to  take  the  charge  of  an  hospital  in  Litchfield 
in  Connecticut,  be  referred  to  the  Superintendent  of 
Finance.162 

April  23,  1782.  209 

War  Office,  March  23rd,  1782. 
Sir, 

There  are  frequent  applications  for  the  discharge 
of  soldiers  whose  wounds  and  sickness  incapacitate 
them  for  all  farther  duty  even  in  garrison.  They  pre- 
fer a  dismission  from  the  service,  which  shall  entitle 
them  to  a  pension  equal  to  half  of  their  pay,  to  be- 
ing classed  with  the  invalids  where  full  pay  and 
every  emolument  of  a  soldier  would  be  continued  to 
them. 

Was  public  economy  the  only  consideration  in 
this  matter,  there  would  not  I  think  remain  a  doubt 
respecting  the  propriety  of  adopting  this  mode  of 
discharge  generally.  But  as  it  becomes  necessary 
equally  to  guard  against  future  inconveniences  as  to 

161  This  report,  in  the  writing  of  Abraham  Clark,  is  in  the  Pa- 
pers of  the  Continentetl  Congress,  No.  22,  folio  65. 

Eaker's  memorial,  dated  February  18,  is  in  No.  41,  III,  folio 
69;  Hagan's,  undated,  is  in  No.  41,  IV,  folio  193;  Jackson's,  dated 
January  28,  is  in  No.  41,  IV,  folio  426. 

The  Secretary  at  War's  report  is  in  No.  149,  I,  folio  119,  and 
is  as  follows: 

Wat  Office,  January  16th,  1782. 
Sir, 

On  the  petition  of  Dr.  Francis  Hagan  referred,  the  following 
resolve  is  submitted  to  the  consideration  of  Congress: 

That  the  Comptroller  be  and  he  is  hereby  authorized  and  di- 
rected to  adjust  the  account  of  Dr.  Francis  Hagan  late  Physi- 
cian and  Surgeon  in  the  General  Hospital  for  pay  and  deprecia- 
tion in  the  same  manner  as  have  been  provided  for  the  officers 
of  General  Hazen's  Regiment. 

The  following  report,  without  date,  is  in  No.  149,  I,  folio  117: 

There  being  a  number  of  officers  who  by  former  acts  of  Con- 
gress are  entitled  to  pay  or  additional  pay,  and  who  cannot  ob- 
tain a  settlement  of  the  depreciation  due  thereon  from  the  re- 
spective States  of  which  they  are  Inhabitants. 

Therefore,  Resolved,  That  the  Comptroller  be  directed  to  set- 
tle the  accounts  of  all  such  officers  on  the  same  principles  as  he 
settled  with  the  officers  of  Colonel  Hazen's  Regiment. 

162  This  report,  in  the  writing  of  Joseph  Montgomery,  is  in  the 
Papers  of  the  Continental  Congress,  No.  32,  folio  347.  It  is  un- 
dated but  belongs  to  this  period. 


360 


Annals  of  Medical  History 


accommodate  the  wishes  of  individuals  I  beg  leave 
to  submit  the  following  resolve,  which  as  it  only  re- 
spects those  whose  private  circumstances  will  en- 
able them  when  discharged  to  live  independent  of 
any  other  gratuity  than  their  pension,  I  think  will 
obviate  the  possibility  of  an  imputation  against  the 
public  that  they  have  dismissed  such  of  their  ser- 
vants as  could  be  no  longer  useful  without  provi- 
sion being  made  to  prevent  them  suffering  individ- 
ually or  becoming  burthensome  to  the  societies 
where  they  might  live. 

[Congress  came  to  the  following  resolutions:] 

Resolved,  That  all  such  sick  and  wounded  soldiers 
of  the  armies  of  the  United  States,  who  shall  in  fu- 
ture be  reported  by  the  inspector  general,  or  the  in- 
spector of  a  separate  department,  and  approved  by 
the  Commander  in  Chief,  or  commanding  officer  of 
a  separate  department,  as  unfit  for  farther  duty 
either  in  the  field  or  in  garrison,  and  who  apply  for 
a  discharge  in  preference  to  being  placed  or  con- 
tinued in  the  corps  of  invalids,  [and  who  can  give 
authentic  proof  that  they  either  have  the  means  to 
support  themselves,  or  that  their  friends  will  provide 
for  them  and  prevent  them  becoming  burthensome 
to  the  society  where  they  really  belong  or  reside. 
In  that  case  all  such  persons  shall  be  discharged, 
and  be  entitled  to  receive  as  a  pension,  [the  value  of 
half  their  pay,]  five  dollars  per  month,  in  lieu  of  all 
pay  and  emoluments. 

Resolved,  That  it  be,  and  hereby  is,  recommend- 
ed to  the  several  states  to  discharge  such  pensions 
annually,  and  draw  on  the  Superintendant  of  finance 
for  the  payment  of  the  money  they  shall  advance 

And  that  the  foregoing  resolution  take  effect  so 
soon  as  the  Superintendant  of  the  Finances  shall  sig- 
nify to  the  several  states,  that  he  has  made  provi- 
sion for  answering  such  draughts.163 

May  3,  1782.  235 

On  a  report  from  the  Secretary  at  War: 


Sir, 


War  Office,  May  3rd,  1782. 


To  the  two  companies  of  Artificers  now  in  this 
City  (making  the  whole  about  fifty  men)  there  are 
attached  a  Surgeon  and  a  Surgeon's  mate.  As  part 
of  these  companies  will  be  detained  in  this  town, 
part  are  now  at  Fort  Pitt,  part  will  be  sent  to  Vir- 
ginia and  part  of  them  will  join  the  army  under 
General  Greene,  this  dispersion  will  render  it  un- 
necessary to  retain  the  Surgeon  and  mate  longer  in 
the  service. 

Should  Congress  be  of  this  sentiment,  and  deem 
some  compensation  due  to  their  past  services  they 
will  please  to  resolve, 

Resolved,  That  as  the  dispersed  situation  of  the 
corps  of  artificers  commanded  by  Captain  Wyley, 
will  no  longer  require  the  services  of  Dr.  A.  McCos- 
key,  surgeon,  and  Dr.  W.  McCoskey,  his  mate,  they 
be  considered  as  reduced  and  retiring  from  service 

1M  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
149,  I.  folios  161-163. 
lM  This  report  is  in  the  Papers  of  the  Continental  Con<jr- 

io  :io:i. 
"*  This  report  is  in  the  Papers  of  the  Continental  Conn  ■ 

In  HI     lli.-  indorsement  says  it  was  read  on  thin  data. 
On  June  ID,  MOOtdiof  to  (he  indorsement,  was  read  a  latter  "f 


on  the  10th  instant  and  that  the  surgeon  be  entitled 
[from  that  day  to  receive  the  same  emoluments  as 
heretofore  allowed  to  surgeons  and  mates  retiring 
under  the  resolves  of  the  3d  and  21st  October  1780] 
to  all  the  emoluments  heretofore  allowed  to  reduced 
regimental  surgeons.164 

June  6,  1782.  319 

Congress  proceeded  to  the  election  of  a  deputy 
purveyor  for  the  southern  hospital;  and,  the  ballots 
being  taken,  Dr.  N.  Brownson  was  elected,  having 
been  previously  nominated  by  Mr.  (William)  Few. 

(June  10,  1782.)  322 

(Report  of  Secretary  at  War,  on  the  arrangement 
of  the  Hospital  Department.) 

War  Office,  June  7th,  1782. 
Sir, 

I  have,  in  obedience  to  the  orders  of  Congress, 
conferred  with  the  Superintendant  of  Finance  on  the 
report  of  your  Committee  respecting  the  Hospital 
Department  and  find  it  is  agreeable  to  him — 

As  the  Purveyor  wishes  that  the  Officers  acting 
immediately  under  him  should  be  of  the  same  grade 
— he  requests  that  he  may  be  allowed  to  appoint 
three  clerks,  one  of  whom  will  have  the  charge  of 
the  store  to  be  kept  near  the  Army — 

He  also  requests  that  there  may  be  no  distinct  al- 
lowance of  subsistence  for  himself  and  the  Apothe- 
cary, but  that  the  sum  intended  as  subsistence  be 
added  to  their  pay — 

I  wish  the  Purveyor's  requisitions  may  be  com- 
plied with  and  that  the  system,  as  it  will  then  stand, 
should  be  adopted  165 

July  23,  1782.  408-12 

On  the  report  of  a  committee,  consisting  of  Mr. 
(Joseph)  Montgomery,  Mr.  (Abraham)  Clark,  and 
Mr.  (David)  Ramsay,  to  whom  were  recommitted 
their  report  respecting  the  hospital  department,  and 
the  amendments  and  observations  thereon  by  the 
Secretary  at  War: 

Resolved,  That  in  conducting  the  business  of  the 
general  hospital,  there  shall  be  an  invariable  stand- 
ard of  prices  established  by  which  the  apothecary 
shall  be  charged  with  every  article  (received  into  his 
department,  and  at  which  he  shall  be  credited  for 
every  article) 166  he  shall  issue  the  standard  to  be  es- 
tablished by  the  medical  board,  or  such  person  or 
persons  as  they  shall  appoint,  which  shall  only  be 
considered  as  a  certain  ratio  whereby  to  keep  the 
accounts;  but  that,  in  the  settlement  of  all  accounts 
in  that  department,  all  deficient  articles,  not  issued 
or  returned,  shall  be  accounted  for  at  such  real 
value  as  shall  be  estimated  by  the  medical  board, 
and  approved  of  by  the  Secretary  at  War. 

An  account  shall  be  taken  as  soon  as  possible,  of 
all  the  medicines,  instruments  and  property  in  the 

June  5  from  General  W.  Small  wood,  enclosing  one  of  same  dale 
from  Ueutananf  I..  -\  richer  de  Vniibnin.  taking  fur  a  furlough  to 
visit   France.  They  were  referred  to  the  Bacratar)     it    War    Qan- 

.  r  .1  9maUwood'a  letter  is  in  No.  161,  folio  188,  and  do  Vaubrun'i 
il  in  No.  78,  XXIll.  folio  191, 

Also  a  memorial  dated  June  S  from  Oliver  Hani  licit  wan  re- 
ferred to  the  Secretary  at  War.  It  is  in  No.  149,  I,  folio  447. 

1M  The  words  in   parent heses  are  in   the  report   but  not    in   the 

Journal. 


History  of  the  Army  Medical  Department  During  the  Revolution        361 


apothecary's  department  belonging  to  the  public, 
in  the  hands  of  the  apothecary,  the  deputies,  assist- 
ants, and  mates,  the  surgeons  of  hospitals,  and  sur- 
geons of  regiments,  for  which  they  shall  severally 
be  charged  at  the  standard  value  ascertained  by 
the  board  as  aforesaid,  and  for  all  they  may  here- 
after receive,  but  to  account  for  deficiencies  at  the 
real  value,  to  be  estimated  as  aforesaid. 

The  apothecary  shall  be  accountable  for  all  arti- 
cles in  his  department  to  the  purveyor  throughout 
the  states,  until  they  come  into  the  hands  of  the 
prescribers;  and  all  deputies,  assistants,  and  mates, 
shall  make  returns,  and  be  accountable  to  the 
apothecary  for  the  medicines,  instruments  and  other 
property  belonging  to  the  public  in  the  department, 
now  in  their  hands,  and  of  such  as  they  may  here- 
after be  possessed  of. 

The  apothecary  shall  make  up  his  accounts  at  the 
expiration  of  every  year,  and  settle  them  as  soon 
after  as  possible,  and  before  the  expiration  of  six 
months.  He  shall,  at  the  same  time,  make  out  two 
returns  for  the  director  of  the  hospital,  one  specify- 
ing what  has  been  received  and  issued,  and  the 
amount  of  what  remains  on  hand;  the  other  exhibit- 
ing a  particular  amount  of  the  value  of  the  medi- 
cines, and  other  public  property,  each  prescriber  has 
received  within  the  year. 

All  losses  which  may  happen  by  the  events  of 
war,  and  other  circumstances  unavoidable,  shall  be 
borne  by  the  public.  In  cases  of  losses  by  fraud  or 
neglect  in  any  deputy,  assistant  or  mate,  the  apothe- 
cary shall  not  be  accountable  for  such  losses,  pro- 
vided the  delinquent  be  convicted  thereof  before  a 
court-martial  appointed  to  try  the  same. 

The  hospital  prescribers  shall  be  supplied,  upon 
their  own  application,  with  medicines  and  instru- 
ments necessary  for  the  sick  and  wounded  under 
their  care. 

Every  regimental  surgeon  shall  receive  yearly 
from  the  apothecary,  a  supply  of  medicines  to  such 
amount,  by  the  above  standard,  as  the  medical 
board  shall  judge  necessary. 

Every  prescribing  surgeon  or  physician,  either  in 
hospital  or  with  the  army,  shall  be  supplied  by  the 
apothecary  with  such  a  set  of  capital  instruments 
as  the  medical  board  shall  judge  necessary,  and  shall 
be  accountable  for  all  losses  in  medicines  and  in- 
struments not  arising  from  the  events  of  war  and 
other  circumstances  unavoidable.  Duplicates  of  all 
returns  made  by  the  apothecary  to  the  director,  shall 
be  lodged  in  the  war  office. 

Resolved,  That  in  the  army  of  the  United  States, 
excepting  the  southern  army,  at  present  under  the 
command  of  Major  General  Greene,  the  offices  of 
assistant  purveyor,  and  assistant  apothecary,  and 
the  storekeepers  under  the  purveyor  and  apothecary, 
except  one  storekeeper  under  the  purveyor  to  keep 
a  store  near  the  army,  and  all  the  clerks,  except 

167  The  recommitted  report  had  it: "and  all  the  clerks 

except  two  to  the  purveyor  one  of  whom  to  have  the  care  of  the 
store  near  the  army  and  all  the  mates  of  the  apothecary  except 
three  be  hereafter  discontinued." 

158  The  recommitted  report  allowed  119  dollars  per  month  to 
the  director;  116  75/100  dollars  to  the  deputy  director  and  phy- 
sician; 93  45/90  dollars  to  hospital  surgeons,  three  rations  for 
himself  and  servant  and  15  dollars  for  Bubsistance;  106  60/90 
dollars  for  purveyor  and  apothecary. 


[one]  two  to  the  purveyor,  shall  hereafter  be  discon- 
tinued.167 

[The  committee  to  whom  was  referred  the  letter  of 
the  Secretary  of  War  respecting  the  rank  of  the  sur- 
geons in  the  hospital  department  submit  the  follow- 
ing resolutions:] 

That  all  surgeons  of  the  hospital  shall  take  rank 
after  the  director  of  the  hospital,  deputy  director 
and  physician  to  the  army,  in  the  following  order, 
viz.  those  surgeons  of  the  hospital,  who  have  been 
either  deputy  director,  physician  general,  surgeon 
general,  chief  physician,  or  chief  surgeon  to  the  hos- 
pital or  army,  shall  take  rank  next  to  the  above 
mentioned  officers:  and  their  relative  rank  to  each 
other  shall  be  according  to  the  date  of  their  respect- 
ive appointments  to  either  of  the  above  offices. 

That  all  such  as  were  regimental  surgeons,  when 
appointed  senior  physician  or  surgeon  to  the  hospi- 
tal, shall  take  rank  with  such  senior  physicians  and 
surgeons,  agreeably  to  the  date  of  their  first  appoint- 
ment, whether  to  the  regiment  or  hospital. 

All  surgeons,  the  date  of  whose  first  appointments, 
either  to  regiments  or  hospitals,  shall  have  been  on 
the  same  day,  shall  decide  their  rank  by  lot. 

[That  the  pay  and  subsistance  of  the  officers  of  the 
Hospital  department  and  medical  staff  be  as  fol- 
lows: 

Director  of  the  Hospital  122  dollars  per  month 
four  rations  per  day  for  himself  and  servants,  for- 
age for  two  horses  and  twenty-five  dollars  per  month 
subsistance. 

Deputy  Director  and  Physician  each  117  dollars 
per  month  three  rations  per  day  for  himself  and  Ser- 
vants, and  forage  for  two  horses,  and  twenty  dollars 
per  month  Subsistance. 

Hospital  Surgeons  each  96  5/6  dollars  per  month 
two  rations  for  himself  and  servant  forage  for  two 
horses  and  fifteen  dollars  per  month  Subsistance. 

Purveyor  and  Apothecary  each  105  dollars  per 
month,  one  ration  and  forage  for  one  horse,  and  fif- 
teen dollars  per  month  subsistance. 

Deputy  purveyor  and  Deputy  apothecary  each 
101  5/6  dollars  per  month,  one  ration,  and  forage  for 
one  horse,  and  ten  dollars  per  month  Subsistance. 

Hospital  Mates  each  45  dollars  per  month,  one 
ration  per  day,  and  five  dollars  per  month  Subsist- 
ance. 

Stewards  each  30  dollars  per  month,  one  ration 
per  day  and  five  dollars  per  month  Subsistance. 

Ward  Masters  each  23  dollars  per  month,  one  ra- 
tion per  day  and  three  dollars  per  month  Subsist- 
ance. 

That  all  former  Acts  of  Congress,  so  far  as  re- 
spects the  pay  Subsistance  rations  and  forage  grant- 
ed to  the  before  mentioned  Officers,  shall  be  and 
they  are  hereby  repealed.] 168 

That  for  the  more  convenient  subsistance  of  the 
officers  of  the  hospital  department,  they  be  allowed, 


In  the  Papers  of  the  Continental  Congress,  No.  22,  folio  79,  on 
a  separate  sheet  in  Charles  Thomson's  hand,  is  a  copy  of  this 
part  of  the  report  relating  to  pay  and  subsistence,  with  the  fol- 
lowing variations  in  amounts:  deputy  director  111  dollars  per 
month;  hospital  surgeons  9'iyZ  dollars  per  mouth,  three  rations 
for  himself  and  servant;  purveyor  and  apothecary  106J4  dollars 
per  month;  deputy  purveyor  and  deputy  apothecary  101 XA  dol- 
lars per  month. 


362 


Annals  of  Medical  History 


including  their  former  allowance  of  rations  and  for- 
age as  follows: 

The  director  of  the  hospital,  four  rations  a  day 
for  himself  and  servants,  forage  for  two  horses,  and 
twenty-five  dollars  per  month  subsistance. 

The  deputy  director  and  physician,  each  three  ra- 
tions a  day  for  himself  and  servants,  forage  for  two 
horses,  and  twenty  dollars  per  month  subsistance. 

Hospital  surgeons,  each  two  rations  per  day,  for 
himself  and  servant,  forage  for  two  horses,  and  fif- 
teen dollars  per  month  subsistance. 

Deputy  purveyor  and  deputy  apothecary,  each 
one  ration  per  day,  forage  for  one  horse,  and  ten 
dollars  per  month  subsistance. 

Hospital  mates,  each  one  ration  per  day,  and  five 
dollars  per  month  subsistance. 

Ward  masters,  each  one  ration  per  day,  and  three 
dollars  per  month  subsistance. 

That  the  above  allowance  of  rations,  forage,  and 
subsistance  to  the  officers  of  the  hospital  depart- 
ment, over  and  above  what  they  severally  were  en- 
titled to,  at  the  time  of  passing  this  act,  shall  be 
charged  to  them  respectively,  as  advances  in  part 
of  their  monthly  pay. 

That  in  the  future  the  pay  and  allowance  of  the 
purveyor  and  apothecary  be  the  same  each  as  that 
of  a  hospital  surgeon. 

That  none  of  the  aforesaid  officers,  or  other  per- 
sons employed  in  any  of  the  hospitals,  be  entitled  to 
rations,  forage  or  subsistance,  when  on  furlough. 

That  the  regulation  respecting  officers'  servants, 
contained  in  the  Act  of  Congress  of  the  nth  day  of 
March,  1780,  shall  not  be  construed  to  extend  to  the 
hospital  department.169 

October  II,  1782.  645 

Pursuant  to  the  resolution  of  the  27  of  February 
last,  the  Superintendant  of  finance  reports,  that  he 
has  appointed  Mr.  Edward  Fox,  a  commissioner  for 
settling  the  accounts  of  the  hospital  department, 
desiring  to  be  favoured  with  the  orders  of  Congress 
if  they  should  disapprove  the  appointment.170 

November  12,  1782.  722 

The  Committee  of  the  Week,  (Mr.  Ralph  Izard, 
Mr.  Ezra  L'Hommedieu,  Mr.  William  Hemsley)  re- 
port, That  the  petition  of  Etienne  Halbon  on  behalf 
of  his  wife,  setting  Jortb  that  there  is  £12,  10s  due  to 
ber  from  the  general  hospital  for  wages  as  the  resi- 
due of  her  pay  while  nurse  in  the  hospital  [as  by 
Dr.  Binney's  certificate  directed  to  Dr.  Bond,  Jun., 
doth  appear]  be  referred  to  the  [Superintendant  of 
Finance]  Secretary  of  War.171 

November  25,  1782.  752 

War  Office,  Nov' 23rd,  1782. 
Sir, 

The  request  of  Doctor  Tucker  referred  to  me  in- 
volves three  questions. 

■••  XJiirt  report,  in  the  writing  of  a  olerk,  except  the  part  in 
parentheses  which  is  in  Abraham  Clark's  writing,  is  In  the  Papers 
0/  the  ContinmttaX  Conors**,  No,  2~.  folio*  69  and  »5.  The  report 
was  delivered  May  Id  and  on  May  .'SO  was  referred  to  the  Sec- 
retary at  War  to  oonte  with  the  Superintendent  of  finance  to 

and  recommitted.   A  OOpy  of   the  recommitted  report  is 
iii  No.  22,  folio  7-i.  The  few  changes  made  in  their  report  by  the 

ittee  are  noted.  The  portion  in  parentheeei  ma  nol  in  the 

recommitted  report, 


The  first  is  whether  he  is  entitled  to  half  pay  al- 
lowed to  other  retiring  hospital  officers  of  his  rank 
— the  second  whether  he  is  entitled  to  pay  for  his 
attendance  on  the  hospital  in  Virginia,  and  the  third 
what  allowance  will  be  made  for  his  expences  while 
attending  the  sick  in  Charlestown. 

There  cannot  be  a  doubt  with  respect  to  the  first. 
The  resolves  of  Congress  of  the  17*  of  January  1781 
fully  secure  to  him  the  half  pay  allowed  to  other 
officers  of  his  rank  as  he  was  not  deranged  until  the 
1 5*  of  May  following. 

On  the  second  question  I  would  observe  that  by 
the  resolves  of  Congress  passed  May  151?  1781  it 
is  ordered  that  all  officers  of  the  Medical  depart- 
ment appointed  under  the  directorship  of  Doctor 
Olyphant  who  were  then  in  captivity  in  South  Caro- 
lina and  Georgia,  and  had  the  charge  of  sick  prison- 
ers in  those  States  be  continued  in  their  respective 
offices  as  heretofore — and  be  considered  as  vested 
with  the  same  privileges  and  emoluments  as  they 
had  enjoyed  before  their  captivity,  to  extend  no  far- 
ther than  to  the  troops  and  hospitals  within  the 
enemy's  lines. 

The  Continental  Hospitals  on  the  first  of  July, 
1 78 1,  removed  from  Charlestown  to  Williamsburg 
in  Virginia.  The  hospital  was  there  continued  under 
the  care  of  Doctor  Tucker  by  order  of  the  Marquis 
de  la  Fayette  as  the  sick  could  not  at  that  time  be 
removed  into  the  country.  The  Commander  in  chief, 
on  his  arrival  in  Virginia,  directed  the  gentlemen  in 
the  Medical  Department  from  South  Carolina  to  do 
duty  in  the  general  hospital  at  Williamsburg.  These 
are  facts  which  appear  from  the  enclosed  papers. 

With  respect  to  the  last  question  which  relates  to 
an  allowance  for  the  extraordinary  expences  while 
detained  in  Charlestown  attending  the  hospital,  I 
suppose  they  were  necessarily  great,  but  he  has  not 
rendered  any  account  of  them. 

On  the  whole  of  his  request  I  beg  leave  to  submit 
to  the  consideration  of  Congress  the  following  draft 
of  a  resolve, 

That  Doctor  Thomas  T.  Tucker,  late  a  senior 
Surgeon  of  the  hospital  under  the  directorship  of 
Doctor  Olyphant,  enjoy  all  the  emoluments  of  his 
office  from  the  date  of  his  appointment  to  the  time 
he  retired  from  actual  service  in  the  hospital  in  Vir- 
ginia, and  that  a  reasonable  compensation  be  made 
him  for  his  extra  expences  while  acting  as  senior  Sur- 
geon in  Charlestown  after  its  surrender.17* 

December  3,  1782.  759 

Resolved,  That  after  the  fore-mentioned  period,  in 
lieu  of  the  pay  and  rations  allowed  to  the  officers  of 
the  hospital  department,  including  rations  for  ser- 
vants, they  shall  be  entitled  to  the  following  month- 
ly pay  and  subsistance;  provided  in  like  manner, 
that  where  the  said  subsistance  money  shall  not  be 

170  This  report  is  in  the  Papert  of  the  Continental  Congress,  No. 
137,  I,  folio  817. 

1,1  Thin  report,  in  the  writing  Ol  I(:il|>h  Izard,  is  in  tlic  Papert  of 
the  Continental  Congress,  No.  82,  [olio  418,  It  was  passed  tins  day, 
hh  the  indorsement  shows. 

1,1  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
161,  folio*  89-48.  It  is  indorsed:  Beoommitted  That  the  wantaag 
may  incliido  in  the  resolution  all  th  M  in  limilai  nlniUIIHl mines 

and  to  report   a  reasonable  allowance  f'>r  tt"*"—  while  in 
Charlestown. 


History  of  the  Army  Medical  Department  During  the  Revolution         363 


paid,  they  shall  be  entitled  to  draw  an  equivalent 
number  of  rations,  at  the  rate  of  four  dollars  for 
each  ration  per  month,  viz. 

The  director,  one  hundred  and  two  dollars  pay 
and  sixty  dollars  subsistance. 

The  deputy  director  and  physician,  each  one  hun- 
dred dollars  pay  and  forty-eight  dollars  subsistance. 

The  surgeons,  each  ninety  dollars  pay  and  forty 
dollars  subsistance. 

Apothecary  and  purveyor,  each  ninety-two  dol- 
lars pay  and  thirty-two  dollars  subsistance. 

Deputy  apothecary  and  deputy  purveyor,  each 
fifty-nine  dollars  pay  and  sixteen  dollars  subsist- 
ance. 

Mates,  each  forty-two  dollars  pay  and  twelve 
dollars  subsistance. 

Stewards,  each  thirty-one  dollars  pay  and  eight 
dollars  subsistance. 

Ward  masters,  each  twenty-one  dollars  pay  and 
eight  dollars  subsistance.173 

BIBLIOGRAPHICAL  NOTES 

January  3,  1782.  885 
Hospital  Department. 

375.  By  the  United  States  in  Congress  assembled, 
January  3,  1782. 

4.0  Broadside  in  two  columns. 

Report  of  Clark,  Cornell  and  Motte.  A  copy  is  in  the 
John  Carter  Brown  Library.     It  measures  20.5  x  21  cm. 

July  23,  1782.  887 

Hospital  Department. 

384.  By  the  United  States  /  in  Congress  assem- 
bled, July  23d,  1782.  / 

Resolved,  /  That  in  conducting  the  business  of  the 
General  Hospital,  .     .     . 

F°.  Broadside  of  two  columns. 

Report  of  Montgomery,  Clark  and  Ramsay.  A  copy  is  in 
the  Library  of  Congress,  Washington  Papers.  It  measures 
40.5  x  30.5  cms. 

February  28,  1783. 

The  committee  of  the  week  (Mr.  William  Hemsley, 
Mr.  Benjamin  Hawkins,  and  Mr.  Phillips  White) 
report:  That  the  memorial  of  Charles  Mortimer  of 
Virginia  Doctor  of  Physic,  praying  payment  of  his 
account,  and  the  usual  wages  and  rations  allowed 
to  others;  for  attending  the  hospital  at  Fredericks- 
burg^ for  nine  months  be  referred  to  a  special  com- 
mittee.174 


March  6,  1783. 


Sir, 


War  Office,  March  5*?,  1783. 


There  are  many  officers,  who  have  been  wounded 
in  the  service  of  the  United  States,  who  are  thereby 
rendered  incapable  of  farther  duty  either  in  the  field 
or  in  garrison,  and  who  wish  to  retire  from  the 
army.  No  other  provision  has  been  made  for  such 

"*  This  report,  in  the  writing  of  Alexander  Hamilton,  is  in  the 
Papers  of  the  Continental  Congress,  No.  21,  folio  309. 

174  This  report,  in  the  writing  of  William  Hemsley,  is  in  the  Pa- 
pers of  the  Continental  Congress,  No.  32,  folio  449.  The  indorse- 
ment gives  at  this  date.  The  memorial  is  in  No.  41,  VI,  folio  297. 
It  was  referred,  the  indorsement  states,  to  Mr.  (John  Lewis) 
Gervais,  Mr.  (Hugh)  Williamson,  and  Mr.  (Theodorick)  Bland. 


officers  than  what  they  may  receive  by  annexing 
themselves  to  the  Corps  of  Invalids. 

This  is  distressing  to  the  individuals,  and  expen- 
sive to  the  public. 

I  beg  leave  to  suggest  the  propriety  of  permitting 
those  officers,  who  have  been  wounded  in  service, 
and  who  wish  to  leave  the  army,  to  retire  to  their  re- 
spective homes  with  allowances  proportioned  in 
some  measure  to  their  inability.175 

March  22,  1783. 

That  all  officers  belonging  to  the  hospital  depart- 
ment, who  are  entitled  to  half  pay  by  the  resolution 
of  the  17th  day  of  January,  1781,  may  collectively 
agree  to  accept  or  refuse  the  aforesaid  commutation, 
signifying  the  same  through  the  Commander  in 
Chief  within  six  months  from  this  time:  that  [the 
deranged]  such  officers  [what]  as  have  retired  at  dif- 
ferent periods,  intitled  to  half  pay  for  life,  [shall  be 
intitled  to  the  same  commutation]  may  collectively, 
in  each  State  of  which  they  are  inhabitants,  accept  or 
refuse  the  same;  their  acceptance  or  refusal  to  be  sig- 
nified by  agents  authorised  for  that  purpose,  within 
six  months  from  this  period ;  that  with  respect  to  such 
retiring  officers,  the  commutation,  if  accepted  by 
them,  shall  be  in  lieu  of  whatever  may  be  now  due 
to  them  since  the  time  of  their  retiring  from  service 
as  well  as  of  what  might  hereafter  become  due;  and 
that  so  soon  as  their  acceptance  shall  be  signified, 
the  Superintendant  of  Finance  be  directed  to  take 
measures  for  the  settlement  of  their  accounts  accord- 
ingly, and  to  issue  to  them  certificates  bearing  in- 
terest at  six  per  cent.  That  all  officers  intitled  to 
half  pay  for  life  not  included  in  the  preceding  reso- 
lutions, may  also  collectively  agree  to  accept  or 
refuse  the  aforesaid  commutation,  signifying  the 
same  [by  their  agents  authorized  for  that  purpose] 
within  six  months  from  this  time.176 

March  26,  1783. 

Resolved,  That  Dr.  Charles  Mortimer's  account  be 
settled  for  pay  and  rations  on  the  same  principle  as 
a  junior  surgeon,  for  the  term  of  nine  months,  dur- 
ing which  he  appears  to  have  been  in  the  public  ser- 
vice: 

That  the  director-general  in  the  hospital  depart- 
ment, take  order  for  delivering  to  Dr.  Mortimer  a 
quantity  of  medicines  equal  to  what  he  has  expend- 
ed in  the  public  hospital.177 


March  31,  1783. 


War  Office,  March  27th,  1783. 


Sir, 

On  the  petition  of  the  late  sergeant  Menerson  re- 
ferred to  me,  I  beg  leave  to  report  that  there  are 
more  than  twenty  thousand  men  who  have  similar 
pretensions  to  be  supplied  with  clothing  from  the 

175  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
149,  II,  folio  315.  According  to  the  indorsement  it  was  referred 
on  this  day  to  Mr.  (Alexander)  Hamilton,  Mr.  (Richard)  Peters 
and  Mr.  (Daniel)  Carroll.  See  ante,  December  19.  1782. 

179  This  report,  in  the  writing  of  Alexander  Hamilton,  is  in  the 
Papers  of  the  Continental  Congress,  No.  21,  folios  332  and  315. 
The  vote  was  transcribed  by  Thomson  on  the  report. 

1,7  This  report,  in  the  writing  of  Hugh  Williamson,  is  in  the 
Papers  of  the  Continental  Congress,  No.  19,  IV,  folio  445. 


364 


Annals  of  Medical  History 


United  States,   and   with   whose  claims  it  is  alto- 
gether impossible  to  comply. 

If  it  shall  appear  upon  a  Surgeon's  examining  his 
wounds,  that  he  has  been  thereby  incapacitated 
from  earning  his  bread,  I  would  beg  leave  to  recom- 
mend him  to  the  provision  made  for  disabled  sol- 
diers bv  the  resolves  of  Congress  of  April  22nd, 
i-82.178~ 

April  22,  1  -83. 

On  the  report  of  a  committee,  consisting  of  Mr. 
(Oliver)  Ellsworth,  Mr.  (Hugh)  Williamson  and  Mr. 
(Abraham)  Clark,  to  whom  was  referred  a  letter  of 
22  June,  i~8i,  from  Dr.  George  Gilmer: 

Resolved,  That  the  account  of  Dr.  G.  Gilmer  for 
pay  and  rations,  be  settled  on  the  same  principles  as 
the  accounts  of  other  hospital  surgeons  of  the  same 
rank,  according  to  the  time  he  shall  appear  to  have 
been  employed  in  the  public  service;  and  that  the 
purveyor  general  return  to  Dr.  George  Gilmer  a 
quantity  of  medicine  equal  to  what  he  expended 
out  of  his  private  stores,  for  the  use  of  the  conti- 
nental hospital  under  his  care.179 

April  30,  1783. 

On  a  report  from  the  Superintendent  of  Finance, 
to  whom  was  referred  a  letter  of  the  17th  from 
Darius  Stoddard: 

Ordered,  That  the  commissioner  for  settling  the 
accounts  of  the  hospital  department,  adjust  and 
liquidate  those  of  Dr.  Darius  Stoddard.180 

May  1,  1783. 

Resolved,  That  the  corps  of  Invalids  be  reduced, 
such  officers  as  have  lost  a  leg  or  been  [otherwise]  equal- 
ly disabled  in  service  to  retire  on  full  pay  for  life,  [or 
at  their  option  collectively  to  the  amount  of  seven 
years  full  pay  in  gross]  such  officers  as  may  not  be  in- 
cluded in  this  description  to  retire  on  [half  pay  for  life] 
the  same  principles  with  other  officers  of  the  army, 
such  non  commissioned  officers  and  soldiers  as  be- 
ing strangers  in  the  country  and  having  been  dis- 
abled in  service  are  incapable  of  providing  for  their 
own  subsistence  and  are  proper  subjects  for  a  hos- 
pital, to  be  received  into  some  fixed  hospital,  to  be  ap- 
propriated for  the  purpose,  and  there  supported  dur- 
ing life  on  such  provision  as  may  be  hereafter  deter- 
mined, to  be  entitled  in  the  meantime  to  their  usual 
rations  and  cloathing;  and  such  non  commissioned 
officers  and  soldiers  disabled  in  service  as  may  have 
homes  to  which  they  can  retire,  to  be  discharged  on 
the  principles  of  the  resolution  of  the  23rd  of  April 
last. 

That  the  Secretary  at  War  be  directed  to  take 
proper  measures  previous  to  the  reduction  to  ascer- 

171  This  report  is  in  the  Paper)  of  the  Continental  Cong:- 
I  M    II.  folio  407.  According  to  the  indorsement  it  was  read  on 
this  day. 

,n  This  report,  in  tin-  writing  of  Hugh  WuVamSOn,  is  fag  the 
Papert  of  the  Continental  Cm,  II.  folio  417. 

uo  Thi*  order  is  in  the  Papert  of  the  Continental  Cong:- 
187,  II,  folio  387. 

ul  This  report,  in  the  writing  of  Alexander  Hamilton,  is  in  kht 
Papert  of  the  Continental  Congrett,  No.  31,  folio  27.'t.  The  in. lor-.  - 
''   it   wan  dilivir><l  this  day. 

u*  Thi«  report    in  the  writing  of  Oliver  Ellsworth,  is  in  the  fa- 


tain  the  different  classes  above  described,  ]and  to 
report  a  list  of  them  respectively  to  Congress.] 

That  the  officers  who  shall  retire  on  full  pay,  may 
at  their  option  collectively  accept  in  lieu  of  such 
full  pay  for  life  the  amount  of  years  full  pay  [in 
money  or  securities]  on  the  terms  of  the  resolutions 
of  the  last. 

That  at  the  reduction  of  this  Corps  all  the  officers 
and  men  shall  receive  one  month's  pay  and  shall 
share  in  any  further  payments  which  may  be  made 
to  the  other  parts  of  the  army  when  reduced.181 

May  12,  1783. 

That  the  accounts  of  Doct.  Jonathan  Arnold  be 
liquidated  and  settled  by  the  commissioner  for  set- 
tling the  accounts  of  the  hospital  department,  who 
is  hereby  authorised  to  allow  him  pay  and  rations  as 
an  Assistant  Deputy  Director  General  in  the  said  de- 
partment from  the  -  day  of  Jan  v.  1778  the  time  to 

p_ u~~i     which  his  accounts  were  settled  by 

Recommitted     the  State  of  ^^  .^^  tQ  the  ^ 

of  May  1— '9  when  he  was  discharged,  charging  him 
with  the  monies  advanced  him  for  the  use  of  that 
Department  by  the  State  of  Rhode  Island  and  cred- 
iting the  said  State  for  the  same  in  account  with 
the  United  States. 

That  the  claim  of  the  officers  of  a  Brigade  raised 
in  the  State  of  Rhode  Island  in  Feby.,  1779  for  one 
year,  with  the  approbation  of  Congress,  for  depre- 
ciation of  their  pay,  is  inadmissible,  no  allowance  of 
that  kind  having  been  made  or  approved  by  Con- 
gress to  any  officers  or  soldiers  discharged  from  ser- 
vice before  the  iotb  of  April  1780.182 

May  16,  1783. 

Resolved,  That  the  Commissioner  for  settling  the 
accounts  of  the  Hospital  department  be  and  he  is 
hereby  authorized  and  directed  to  audit  and  settle 
the  accounts  of  Dr.  Jonathan  Arnold,  as  Assistant 
Deputy  Director  in  the  Eastern  Department  from 
7th  January,  1778,  to  May  9th,  1779,  as  well  for 
all  supplies  and  expenditures  as  for  pay  and  rations, 
and  that  he  also  settle  the  accounts  of  all  those  who 
were  necessarily  employed  in  hospital  service  by 
the  said  Dr.  Arnold  within  the  term  aforesaid.  That 
their  pay  and  other  allowances  be  the  same  as  by 
the  resolutions  of  Congress  are  allowed  to  those  of 
similar  stations  in  the  hospital  department.  And 
that  the  said  commissioner  allow  in  such  settlement 
for  depreciation  upon  all  advances  and  sums  due  to 
each  respectively,  with  an  interest  of  six  per  cent. 
per  annum  from  the  times  they  became  due."0 

May  23,  1783. 

That  the  petition  of  William  Stevens  and  others, 
mates  to  the  general  hospital  in  the  Southern  (le- 
per* of  i'  10,  I.  folio  170,  Tin-  indorse- 
menl  ■tatca  thai  it  m  reported  this  day,  and  on  "September, 
9,  l78-r>.  Arimi.1  \  aooounti  referred  to  <U<-  oommittee  for  *,-t- 
t lint;  hospiteJ  aoooants.  Tbii  to  be  Bled."  Baa  poet,  June  10. 

'"This  motion,  in  the  writing  of  Jonathan  Arnold,  is  in  the 
Papert  0/  ttu  Continrntal  Congress,  No,  13,  VI,  Polio  185,  Com- 
mittee Book,  No.  180,  grvei  it  1 1 1  i .-  date,  It  was  relet  red  to  Mr. 
(Oliver)  BUnrorth,  Mr.  (Hugh)  Williamson,  and  Mr.  (John 
Qervala,  Bat  pssi,  Jons  10,  17M. 


History  of  the  Army  Medical  Department  During  the  Revolution         365 


partment,  praying  to  be  allowed  half  pay  or  com- 
pensation be  referred  to  a  special  committee.184 

June  10,  1783. 

Resolved,  That  the  commissioner  for  settling  the 
accounts  of  the  hospital  department  audit  and  set- 
tle the  accounts  of  Doc?  Jonathan  Arnold,  as  as- 
sistant deputy  director  in  said  department  from  the 
7th  day  of  Jany.  1778  to  the  9th  day  of  May  1779, 
as  well  for  all  supplies  and  expenditures  as  for 
pay  and  rations  charging  him  with  the  monies  ad- 
vanced him  for  the  use  of  said  department  by  the 
State  of  Rhode  Island  and  crediting  the  said  State 
for  the  same  in  account  with  the  U.  States,  And  that 
he  also  settle  the  accounts  of  all  those  who  were 
necessarily  employed  in  hospital  service  by  the  said 
Doctor  Arnold  within  the  term  aforesaid,  and  that 
their  pay  and  other  allowances  be  the  same  as  by  the 
resolutions  of  Congress  are  allowed  to  those  of  simi- 
lar stations  in  the  said  department.18'' 

July  4,  1783. 

The  committee  of  the  week,  (Mr.  William  Ellery, 
Mr.  Jacob  Read  and  Mr.  Jonathan  Arnold)  report 
that  the  petition  of  the  Rev?  William  Plumb  late 
chaplain  to  the  Northern  Hospital  praying  for  an 
adjustment  and  payment  of  his  accounts  be  read  in 
Congress  with  the  papers  accompanying  the  same. 

That  the  petition  of  Grace  Mercer  Widow  of 
Richard  Mercer  Esq?,  late  of  Charles  Town  in  the 
State  of  South  Carolina  deceased  Purveyor  to  the 
Hospitals  of  the  army  of  the  United  States  in  the 
said  State  of  South  Carolina  be  referred  to  the  Su- 
perintendent of  Finance  to  report.186 

July  11,  1783. 

The  Superintendent  of  Finance  to  whom  was  re- 
ferred the  petition  of  Grace  Mercer  Widow  of  Rich- 
ard Mercer  Esq?  Purveyor  to  the  Hospitals  of  the 
United  States  in  South  Carolina  begs  leave  to  re- 
port 

That  if,  as  is  alledged,  the  Paper  Money  therein 
mentioned  remained  in  the  Hands  of  the  said  Rich- 
ard Mercer  from  the  time  in  which  he  received  it 
until  his  Death  and  from  that  time  to  the  present 
in  the  Hands  of  his  widow  the  Delivery  of  it  ought 
to  discharge  the  said  Richard  Mercer's  Estate  in 
account  with  the  United  States  from  the  value  which 
so  much  money  was  of  at  the  time  it  was  received 
by  him.  And  the  Delivery  of  the  said  Money  into 
the  State  Treasury  of  South  Carolina  ought  in  like 
manner  to  discharge  the  United  States  from  the  like 
value  in  account  with  the  said  State. 

That  the  Commissioner  for  Settling  the  Hospital 
Accounts  will  therefore  on  proper  Proof  made  to 
him  of  the  Facts  above  stated  receive  the  said  money 
and  credit  the  same  in  the  account  of  the  said  Rich- 
ard Mercer  and  will  transmit  the  money  and  Proof 
to  the  Commissioner  for  Settling  the  accounts  of  the 

,M  This  report,  in  the  writing  of  Thomas  Fitzsimmons,  is  in  the 
Papers  of  the  Continental  Congress,  No.  42,  V,  folio  290.  Stevens' 
petition  is  in  folio  287.  The  indorsement  shows  the  action  taken. 

185  This  report,  in  the  writing  of  Oliver  Ellsworth,  is  in  the 
Papers  of  the  Continental  Congress,  No.  19,  I,  folio  181.  The  in- 
dorsement states  that  it  was  delivered  and  read  this  day. 

186  This  report,  in  the  writing  of  Jacob  Read,  is  in  the  Papers 
of  the  Continental  Congress,  No.  32,  folio  509. 


United  States  with  the  State  of  South  Carolina  who 
will  enter  it  in  those  accounts  to  the  Credit  of  the 
United  States.  Office  of  Finance  8  July,  1783. m 

July  23,  1783. 

On  the  report  of  a  committee,  consisting  of  Mr. 
(Richard)  Peters,  Mr.  (Abraham)  Clark,  and  Mr. 
(Stephen)  Higginson,  to  whom  was  referred  a  report 
of  the  Superintendant  of  finance,  on  a  petition  of 
Mrs.  Grace  Mercer: 

The  Committee  to  whom  was  referred  a  memorial 
of  Mrs.  Grace  Mercer,  relict  of  Mercer,  late 

Purveyor  of  the  hospital  in  South  Carolina,  report, 

That  the  time  when  the  particular  purpose  for 
which  the  said  money  was  received  or  the  reason 
why  the  same  was  not  applied  to  the  use  intended 
do  not  appear;  and  as  a  permission  granted  to  pub- 
lic Officers  to  return  paper  money  received  at  peri- 
ods of  depreciation  would  establish  a  Precedent 
which  may  be  productive  of  many  ill  consequences 
Your  Committee  are  of  opinion, 

Ordered,  That  the  superintendant  of  finance  trans- 
mit to  the  commissioner  for  settling  the  accounts  of 
the  hospital  department,  a  copy  of  the  memorial  of 
Mrs.  Grace  Mercer,  and  in  the  settlement  of  the 
accounts  of  the  late  Mr.  Mercer,  due  enquiry  be 
made  by  the  said  commissioner,  into  the  causes  of 
the  detention  of  the  money  therein  mentioned;  and 
that  the  said  commissioner  report  the  result  of  such 
inquiry  to  the  superintendant  of  finance,  who  is 
hereby  authorised  to  take  order  therein  as  shall  ap- 
pear to  him  just,  on  such  report  being  made.188 

August  5,  1783. 

The  Superintendant  of  Finance  to  whom  was  re- 
ferred the  Petition  of  Grace  Mercer,  widow  of  Rich- 
ard Mercer  Esqr,  Purveyor  to  the  Hospitals  of  the 
United  States  in  South  Carolina,  begs  leave  to  re- 
port. 

That  if,  as  is  alledged,  the  paper  money  therein 
mentioned  remained  in  the  Hands  of  the  said  Rich- 
ard Mercer  from  the  time  in  which  he  received  it 
until  his  Death  and  from  that  time  to  the  present  in 
the  hands  of  his  widow  the  Delivery  of  it  ought  to 
discharge  the  said  Richard  Mercer's  estate  in  ac- 
count with  the  United  States  from  the  value  which 
so  much  money  was  of  at  the  time  it  was  received 
by  him — and  the  Delivery  of  the  said  money  into 
the  State  Treasury  of  South  Carolina  ought  in  like 
manner  to  discharge  the  United  States  from  the  like 
value  in  account  with  the  said  State. 

That  the  commissioner  for  settling  the  Hospital 
accounts  will  therefore  on  proper  Proof  made  to 
him  of  the  facts  above  stated  receive  the  said  money 
and  Credit  the  same  in  the  account  of  the  said  Rich- 
ard Mercer  and  will  transmit  the  money  and  the 
Proof  to  the  commissioner  for  settling  the  accounts 
of  the  United  States  with  the  State  of  South  Caro- 
lina who  will  enter  it  in  these  accounts  to  the  Credit 


187  This  report  is  in  the  Papers  of  the  Continental  Congress,  No. 
137,  II.  folio  007.  The  indorsement  shows  that  it  was  road  this 
day  and  on  July  10  referred  to  Mr.  (Richard)  Peters,  Mr.  (Abra- 
ham) Clark  and  Mr.  (Stephen)  Higginson. 

188  This  report,  in  the  writing  of  Richard  Peters,  is  in  the  Pa- 
lters of  the  Continental  Congress,  So.  19.  IV,  folio  55.  The  in- 
dorsement states  thai  ii  was  passed  on  this  day. 


366 


Annals  of  Medical  History 


of  the  United  States.  Office  of  Finance,   31   July, 
1783.189 

August  12,  1-83. 

The  committee,  consisting  of  Mr.  (James)  Mc- 
Henry,  Mr.  (Hugh)  Williamson  and  Mr.  (Abraham) 
Clark,  to  whom  was  referred  a  petition  of  Dr.  Dirk 
Van  Ingen,  praying  that  depreciation  may  be  al- 
lowed him  in  the  settlement  of  his  account,  report, 

"That  as  Dr.  Van  Ingen,  who  served  for  some 
years  as  surgeon,  in  the  continental  hospital,  ap- 
pears by  his  petition  to  have  [resigned  or  to  have 
been  left  out  of  promotion]  been  reduced  as  a  super- 
numerary before  the  10th  of  April,  i-^o,  [deprecia- 
tion, therefore,  cannot  be  allowed  him  without  de- 
parting from  the  rule  hitherto  adopted  and  opening 
an  account  which  may  occasion  much  trouble  and 
be  a  precedent  for  a  variety  of  claims  of  officers  in 
different  departments,]  and  as  no  depreciation  [to 
officers  in  every  department]  has  been  allowed  to 
officers  who  left  the  service  before  that  period,  [has 
been  constantly  refused,]  Dr.  Van  Ingen's  claim  can 
not  be  admitted  without  infringement  of  the  rule 
established  by  Congress."  190 

September  2,  1783. 

The  committee  of  the  Week  (Mr.  Jacob  Read,  Mr. 
Abiel  Foster  and  Mr.  William  Ellery)  on  considera- 
tion of  the  petition  of  Ebenezer  Augustus  Smith  for- 
merly a  Surgeon  in  the  General  Hospital  praying 
that  depreciation  may  be  allowed  him,  report  as 
their  opinion  that  the  request  of  the  said  Ebenezer 
Augustus  Smith  being  similar  to  that  of  D1  Dirk 
Van  Ingen  lately  determined  by  Congress  can  not 
be  granted  without  infringing  the  rule  established 
by  Congress  of  the  io'!1  day  of  April  1780.191 

September  10,  1783. 

The  same  reason  which  makes  it  proper  to  have 
two  Serjeant  Majors  &c.  in  each  Regiment  of  In- 
fantry, will  make  it  equally  necessary  to  have  two 
Surgeon's  Mates, 

October  23,  1783. 

No  Regiment  to  be  allowed  to  draw  rations  for 
more  than  four  women  to  serve  as  nurses   in  the 
Regimental  Hospitals  and  to  receive  four  dollars  per 
month  in  addition  to  a  ration  per  day. 
General  Hospital 

A  general  hospital  for  the  reception  of  the  inval- 
ids of  the  army  and  navy  will   be  necessary  to  con- 
sist for  the  present  of  the  following  persons: 
1  Director  to  have  at  the  same  time  the  Super- 
intendance  of  the  Regimental  Hospitals  .      .   80 

1  Surgeon 50 

4  Mates each  25 

1  Purveyor  and  Apothecary 50 

1  Steward 15 

4  Nurses each     5 

"*  This  report  in  in  the  Papers  of  the  Continental  Congress,  No. 
K)7.  II.  folio  781.  Aeoordini  to  the  Imlmeeiiiniil  it  wan  delivered 
thin  day.  It  wu  ordered  to  be  Bled  amonn  ohsolcti'  repoita.  Mr 
atereor't  (.<■» n i-.n  1*  or.  folio  786, 

1.0  Thin  report,  In  the  writing  oi  Junei  kioHenryi  li  in  the  Pa- 
ean 0/  the  Continental  f*flllQn*M.  No.   19,  VI.  folio  109. 

1.1  Thix  report,  in  the  writing  ol  Jaoob  Reed,  i*  in  the  Papers 


To  be  entitled  to  draw  each  a  ration  of  provisions 
per  day,  but  to  no  other  allowance. 

The  invalids  to  receive  one  dollar  per  month,  and 
the  provisions  and  cloathing  of  a  common  soldier 
during  life. 

[The  total  expence  of  this  es-     359,530 
tablishment  [if  complete]  as 
Not  quite       reduced    in    peace,    would 

exact  but       amount  to  about     .            .   [531,950] 
very  near  Deduct    the    product    of  the 
the  truth!      manufactories  which  is  esti- 
mated at 131,950 

S22~,58o 
Balance    an    annual    charge 

upon  the  United  States192  .   [400,000] 

October  31,  1783. 

The  Secretary  at  War  reported,  that  the  following 
lines,  corps  and  individuals,  have  agreed  to  accept 
the  commutation  of  five  years'  pay,  in  lieu  of  the 
half  pay  for  ,  as  appears  by  the  papers  ac- 

companying his  report:  .... 

.  .  .  .  hospital  department,  and  Dr.  Tilton, 
Dr.  Bodo  Otto,  Dr.  Frederick  Otto,  Dr.  Martin. 

November  4,  1783. 

The  Committee  to  whom  was  referred  the  letter 
of  Major  General  Lincoln  of  the  have  ex- 

amined the  list  of  bills  drawn  by  him  whilst  com- 
manding in  the  Southern  Department,  and  find  suf- 
ficient vouchers  to  support  charges  against  the  Com- 
missary of  purchases,  the  Quarter  Master,  the  Cloth- 
ier, the  Pay  Master,  Purveyor  of  the  Hospital  and 
the  Navy,  for  five  millions  four  hundred  and  twenty 
four  thousand  one  hundred  and  nine  dollars;  and 
that  bills  to  a  considerable  amount  are  yet  out- 
standing, which  when  presented  for  payment  ought 
also  to  be  charged  to  the  Departments  in  whose 
favor  they  were  respectively  drawn.  Wherefore  your 
Committee  submit  the  following  resolution: 

Resolved,  That  Major  General  Lincoln  be  credited, 
in  the  books  of  the  treasury,  the  sum  of  five  mil- 
lions four  hundred  and  twenty  four  thousands  one 
hundred  and  nine  dollars,  and  that  the  several  de- 
partments be  charged  with  the  amount  of  the  bills 
drawn  in  their  favor.  And  that  all  such  bills  as  may 
hereafter  be  presented  for  payment,  be  charged  to 
the  departments  in  whose  favor,  from  the  face  of 
the  bill,  they  shall  appear  to  have  been  drawn;  and 
that  Major  General  Lincoln  be  credited  for  the 
amount  thereof.193 

June  2,  1785. 

Resolved,  That  those  officers  of  the  hospital  de- 
partment in  the  southern  army,  who  were  detained 
in  Charleston,  alter  its  surrender  to  the  British 
troops,  for  the  purpose  of  attending  the  sick  and 
wounded  of  the  army  of  the  United  States,  which, 
in  consideration  of  the  extra  ezpences  which  they  in- 

of  the  Continental  Conarete,  No.  82,  folio  617.  A< rding  to  the 

mi  m  11  mi  agreed  1 >  tin-*  day,  Bmith'i  petition,  dated 

Wilmington,  April  10,  I7h:i.  il  in  No,  43,  VII,  folio  101. 

"*  Tbii  report,  In  the  writing  of  Alexander  Hamilton,  i«  in  the 
Paperi  ■<!  th.  Continental  Congreet,  No.  88,  folio*  1 1 

1,1  Thin  report,  in  the  writing  of  Samuel  Osgood,  in  in  the  Pa- 
peri of  tin  Continental  Conor***,  N'o.  19,  in,  folio  .r>77. 


History  of  the  Army  Medical  Department  During  the  Revolution        367 


curred  by  the  performance  of  the  said  duty,  be  al- 
lowed the  sums  affixed  to  their  respective  names  con- 
tained in  a  return  deposited  in  the  war-office,  which 
was  transmitted  and  signed  by  David  Oliphant,  dep- 
uty director  of  the  southern  hospital. 

June  20,  1785. 

On  the  report  of  a  committee,  consisting  of  Mr. 
Williamson,  Mr.  Stewart,  and  Mr.  Howell,  to  whom 
was  referred  the  petition  of  Dr.  J.  Morgan, 

Resolved,  That  when  ever  Dr.  J.  Morgan,  shall 
have  accounted  for  the  stores  delivered  to  his  care, 
or  when  the  several  charges  against  his  former  de- 
partment shall  have  been  delivered  in,  and  it  shall 
appear  to  the  commissioner  for  settling  the  hospital 
accounts,  that  the  doctor's  papers  and  books  are  un- 
avoidably destroyed,  or  that  he  has  rendered  the 
best  account  of  the  stores  committed  to  his  care,  of 
which  the  circumstances  of  the  case  would  admit  he 
shall  obtain  a  certificate  for  the  balance  due  him. 

May  8,  1786. 

Resolved,  That  the  powers  and  duties  heretofore 
exercised  by  the  commissioners  for  the  quarter  mas- 
ter's and  the  commissary's  departments  be  exercised 
by  one  commissioner,  and  that  the  powers  and  duties 


of  the  commissioners  for  the  hospital,  marine  and 
clothier's  departments  be  exercised  by  one  other 
commissioner,  to  be  elected  annually  by  Congress: 
and  that  the  salary  of  each  of  the  said  commission- 
ers be  at  the  rate  of  1250  dollars  per  annum. 

June  28,  1786. 

The  commissioner  for  settling  of  the  accounts  of 
Robert  Johnson,  the  commissioner  for  settling  the 
hospital  accounts  &c.  be  directed  to  examine  strict- 
ly into  the  propriety  of  all  extra  expenses  incurred 
in  the  executing  their  duties,  and  where  it  shall  ap- 
pear that  such  expenses  were  necessarily  and  un- 
avoidably incurred,  and  that  the  subsistence  allowed 
was  not  adequate  thereto,  the  surplus  be  allowed. 
That,  as  it  appears  from  the  deposition  of  the  said 
Dr.  Robert  Johnson,  that  the  sum  of  money  and  cer- 
tificates stated  in  his  memorial,  were  public  monies 
stolen  from  him,  without  any  negligence  on  his  part, 
and  that  the  balance  of  money  remaining  in  his 
hands  has  not  been  applied  to  any  use  since  it  came 
into  his  possession,  the  commissioner  for  settling  ac- 
counts of  the  hospital  department,  be  directed  to 
pass  the  amount  of  those  sums  to  his  credit,  on  his 
returning  to  the  commissioner  the  said  balance  and 
a  list  of  the  certificates  so  stolen. 


EXPERIMENTAL  SECTION  AND  HEMI-SECTION  OF  THE  SPINAL  CORD 


When  the  whole  body  experiences  a  loss  of 
junction  in  the  nerves  it  indicates  that  they 
themselves  are  affected,  which  can  be  proved  by 
dissection.  When  all  the  nerves  lose  sensation 
and  motion  at  once,  the  affection  is  called  Ap- 
oplexy. If  one-halj,  whether  the  right  or  the 
left,  is  attacked,  we  call  it  Paralysis  {Hemi- 
plegia) of  the  right  or  left  side.  In  like  man- 
ner, as  it  occurs  in  one  of  the  extremities,  it 
is  a  paralysis  of  that  part.  Paralysis,  in  fact, 
someti7nes  attacks  a  whole  arm  or  leg,  some- 
times only  the  foot  and  the  parts  below  the 
knee  or  the  corresponding  parts  in  the  arm. 
Dissection  has  taught  us  that  for  all  the  parts 
of  an  animal  below  the  neck  which  are  capable 
of  voluntary  motion,  the  corresponding  motor 


nerves  arise  from  the  dorsal  part  of  the  spina 
cord.  .  .  .  You  have  seen  that  the  motor 
nerves  controlling  the  chest  have  their  origin 
from  the  cervical  part  of  the  cord,  and  further 
you  have  been  taught  that  a  transverse  incision 
of  the  entire  cord  deprives  all  parts  of  the  body 
below  it  of  sensation  and  motion,  seeing  that 
the  cord  derives  the  faculty  of  sensation  and  of 
voluntary  motion  from  the  brain.  You  have 
seen  further  in  our  dissection  that  transverse 
hemi-seclions,  which  do  not  cut  deeper  tharx 
the  centre  of  the  cord,  do  not  paralyze  all  the 
inferior  parts  of  the  body  but  only  those  di- 
rectly underneath  the  incision,  the  right  when 
the  right  side  of  the  cord  has  been  cut  and  nee 
versa.  Galen  de  locis  affectibus 


THE  NEW  YORK  MEDICAL  COLLEGE  1782— 1906 
By  ABRAHAM  JACOB  I 


NEW    YORK 


THE  end  of  the  first  half  of  the 
nineteenth  century  saw  wonder- 
ful changes  in  medicine.  Nitrous 
oxide  and  ether  in  America, 
chloroform  in  Great  Britain,  the  break- 
ing away  of  German  medicine  from 
metaphysics  and  nature  philosophy,  the 
Vienna  school,  the  foundation  by  Virchow 
of  the  Archiv  fur  pathologische  Aiiatomie 
und  Pbysiologie,  the  teachings  of  Louis  and 
Broussais  in  France — all  of  them  were 
destined  to  work  what  seemed  the  miracu- 
lous in  our  art  and  science.  Those  of  us 
who  have  lived  at  or  since  that  time,  and 
certainly  those  who  were  fortunate  enough 
to  see  it  all,  have  experienced  evolutions 
and  emotions  which  stirred  the  hearts,  for- 
tified the  minds,  and  roused  hopes  for  the 
future.  Among  the  few,  if  there  be  any, 
advantages  we  older  men  have  over  you 
who  are  our  juniors,  is  the  very  fact  that 
we  have  lived,  and  in  a  measure  partici- 
pated, in  the  revolution  passing  over  these 
five  or  six  or  seven  decades;  it  was  not  al- 
ways a  smooth  revolution. 

I  learn  that  the  first  law  to  prevent  the 
introduction  of  adulterated  pharmacological 
medicines  into  the  United  States  was  passed 
as  late  as  1848.  Dr.  Bailey,  the  first  incum- 
bent of  a  new  office,  in  a  report  to  the  New 
York  Academy  of  Medicine,  stated  that  over 
90,000  pounds  of  false  and  adulterated  drugs 
were  rejected  during  the  first  nine  months 
at  the  single  port  of  New  York.  Forty 
years  later  my  learned  and  revered  friend, 
Squibb,  complained  to  me  of  the  difficulties 
encountered  in  meeting  the  demands  of  an 
honest  and  conscientious  supply  of  drugs. 
An  additional  retrospect,  brief  and  summa- 
ry, may  be  permitted  for  a  few  paragraphs. 
A   medical  school  was  formed  at  Cam- 


bridge on  September  19,  1782.  Two  full 
courses  of  lectures  were  required,  as  at 
Philadelphia.  As  the  course  was  only  one  of 
four  months,  it  was  expected  that  the  re- 
maining sixteen  months  of  the  two  years 
were  to  be  filled  with  private  instruction. 
The  Harvard  School  which  conveyed  a 
degree  of  Bachelor  of  Medicine  only,  which 
might  be  converted  into  Doctor  of  Medi- 
cine after  an  interval  of  three  years,  changed 
its  degree  to  that  of  M.D.  in  181 1.  In  1871, 
Dr.  Francis  Minot  was  given,  in  addition 
to  his  title  of  Assistant  Professor  of  the 
Theory  and  Practice  of  Physic,  that  of 
Clinical  Lecturer  on  the  Diseases  of  Women 
and  Children.  Both  he  and  Dr.  Calvin 
Ellis,  the  Professor  of  Clinical  Medicine, 
aided  pediatrics  by  being  made  special 
instructors.  They,  however,  were  replaced 
by  Dr.  Charles  Pickering  Putnam  who  was 
appointed  Lecturer  on  Diseases  of  Children 
in  1873.  He  retired  from  the  school  in  1878. 
From  time  to  time,  though  rarely,  questions 
referring  to  pediatrics  appeared  on  the  ex- 
amination papers  until  1879,  when  Dr. 
Joseph  Pearson  Oliver  and  Dr.  Thomas 
Morgan  Rotch  were  appointed  clinical  in- 
structors. The  latter  was  placed  in  entire 
charge  of  pediatrics,  teaching  as  Instructor 
in  Diseases  of  Children,  in  1885;  m  '888  he 
was  given  the  title  of  Assistant  Professor 
of  Diseases  of  Children,  and  a  seat  in  the 
faculty.  Dr.  Rotch  asserted  that  this  hap- 
pened only  in  consequence  of  the  strong 
suggestion  expressed  in  the  introduction  to 
the  five  volumes  of  Keating's  "Cyclopedia  of 
the  Diseases  of  Children".  Finally,  in  1893, 
be  was  made  full  professor  of  that  branch. 
A  full  professorship  of  that  branch  had 
meanwhile  been  held,  since  1888,  in  the 
Medical  School  of  Denver  by  Dr.  Herbert 


368 


The  New  York  Medical  College  (i 782-1 906) 


369 


P.  Whitney  who  had  been  an  assistant  at 
Harvard  from  1887  to  1888.  This  latter 
position  has  since  been  filled  by  Edward 
Marshall  Buckingham  until  his  death,  which 
occurred  a  few  years  ago. 

Up  to  1840  there  were  thirty-two  medical 
schools  in  the  whole  country,  with  2,500 
students.  In  1876  there  were  sixty-four 
schools  with  6,650  students.  Sixteen  of 
these,  sixty-four  offered  hardly  anything 
which  looked  like  clinical  instruction. 

Dr.  Harold  C.  Goodwin,  the  Superin- 
tendent of  the  Albany  Hospital,  says: l  "It 
is  recorded  that  the  first  step  taken  by  any 
hospital  toward  teaching  was  in  1762  when 
the  Pennsylvania  Hospital  founded  a  medi- 
cal library.  It  was  not  until  1765  that, 
through  the  efforts  of  Thomas  Bond,  bed- 
side instructions  were  given.  The  New  York 
Hospital,  in  1776,  did  the  same."  The  author 
adds  that  "a  medical  library  is  more  neces- 
sary to  a  student  than  a  stethoscope" — - 
which  would  prove  that  in  the  eyes  of  a 
mere  superintendent,  bedside  instruction  is 
of  a  doubtful  character.  Tastes  differ. 

According  to  Thomas  F.  Harrington,2 
section-teaching  in  clinical  surgery  was  in- 
augurated in  1890  by  Professor  Charles  B. 
Foster  at  Harvard.  The  same  method  of 
systematic  individual  teaching  has  been 
extended  to  clinical  medicine  and  ob- 
stetrics. In  and  after  1902,  the  fourth 
year  of  study  was  left  to  electives  under 
certain  regulations,  so  as  to  enable  a  student 
to  perfect  himself  in  the  "line  of  work  he 
intends  to  practice".  This  doubtful  method 
was  highly  praised  by  many.  Still  all  men 
and  classes  enjoy  the  privilege  of  mistakes 
they  make  and  those  they  find  in  others.  For 
instance:  The  elective  way  of  study  was 
methodically  praised  and  fostered  by  Charles 
Eliot  of  Harvard ;  and  abrogated  by  his  im- 
mediate successor,  Dr.  Lowell.  I  well  remem- 
ber the  almost  comical  impression  caused  by 
the  discrepancy  of  the  happenings  at  thepres- 


idential  celebration  of  1907  of  the  two 
famous  presidents  of  Harvard.  Within  a 
single  hour  Eliot  spent  all  his  eloquence  on 
the  elective  methods  of  study  he  had  ren- 
dered popular  among  the  young  men  of  the 
University,  and  Lowell,  on  the  contrary, 
praised  the  exact  methods  of  restrictive 
teaching  as  the  source  of  correctness  and 
fundamental  solidity. 

At  all  events,  the  official  section-teaching 
of  1890  did  not  arrive  early  and  syste- 
matically, or  uniformly.  It  arrived  thirty 
years  after  that  which  I  shall  now  refer  to  as 
the  systematic  bedside  teaching  of  the  New 
York  Medical  College,  which  was  first  es- 
tablished in  1850.  Now  thirty  years  seems 
to  mean  a  great  deal  in  this  young  country 
of  ours. 

From  the  pages  of  history  and  from  what 
I  personally  know,  and  particularly  from 
"A  Short  Sketch  of  the  New  York  Medical 
College",  by  Edwin  Hamilton  Davis,  A.M., 
M.D.,  New  York,  1883,  I  cull  the  following: 
The  subjects  which  especially  interested 
the  profession  seventy  and  sixty  years  ago 
were  certain  reforms  in  medical  education. 
The  medical  profession  became  more  and 
more  aware  of  the  fact  that  the  medical 
schools  followed  their  old  indolent  methods 
of  instruction.  These  schools  were  private 
enterprises,  being  mostly  founded  and  main- 
tained for  private  purposes  and  gain.  The 
instruction  gathered  in  them  did  not  satisfy 
those  few  men  who  meant  to  become  ac- 
complished physicians;  they  went  abroad, 
no  longer  exclusively  to  Edinburgh,  as  in 
the  eighteenth  century,  but  also  to  France 
where  Broussais  and  Louis  taught  Jack- 
son, Holmes,  Bowditch,  Francis,  and  others. 

County  and  state  medical  societies, 
which  means  the  profession  at  large,  urged 
the  schools  to  change  their  methods  in  re- 
gard to  the  quality  and  quantity  of  their 
teaching,  but  in  vain.  Then  it  was  that  the 
Medical  Society  of  the  State  of  New  York — 


1  Albany  M.  Ann.,  Jan.,  1918. 


2  St.  Paul  M.  J.,  April,  1906. 


Annals  of  Medical  History 


370 

founded  in  1806 — called  a  convention  of  the 
prominent  medical  men  of  the  whole  coun- 
try to  consider  these  defects  and  to  urge 
improvements  in  the  schools.  The  second 
call  proved  successful.  One  hundred  dele- 
gates from  thirteen  states  assembled  in 
New  York  in  1846.  Many  schools,  remember 
the  schools  were  the  organized  schools,  were 
bitterly  opposed  to  the  movement — un- 
fortunately, not  for  the  last  time;  for  even 
when  thirty  and  more  years  afterward  the 
fight  was  up  for  increased  medical  require- 
ments of  matriculation  in  medical  schools 
and  of  state  requirements  before  the  license 
to  practice  should  be  granted,  it  was  the 
organized  schools  that  opposed  it  openly; 
and  when  public  opinion  became  too  strong 
and  demoralized  to  be  openly  thwarted, 
two  of  the  three  great  schools  of  medicine 
in  New  York  City  sent  their  strongest  men 
with  their  influence  to  Albany  for  clandes- 
tine wire-pulling.  They  were,  I  am  sorry  to 
say,  A.  L.  Loomis  and  Austin  Flint,  Jr. 
They  did  not  succeed,  however,  in  their 
endeavors.  It  is  now  conceded  that  the  wis- 
dom of  the  New  York  State  Medical  So- 
ciety, displayed  in  1882  in  its  modification 
of  the  Code  of  Ethics  of  the  American  Medi- 
ical  Association  and  in  cooperation  with  all 
classes  of  legal  graduates  and  practitioners, 
secured  for  us,  and  for  most  of  the  states 
of  the  Union  which  followed  our  example, 
laws  which  raised  the  standard  of  medical 
education,  gave  our  students  greater  facil- 
ities, and  protected  the  public  by  restricting 
ignorance  or  quackery. 

In  the  Convention  of  1846,  committees 
had  been  appointed  to  report  in  1847.  In 
that  year  the  Convention  met  in  Phila- 
delphia; it  was  there  that  the  American 
Medical  Association  was  founded.  For  years 
after,  it  urged  the  schools  to  adopt,  among 
others,  the  following  changes:  1st,  to  in- 
crease the  length  of  the  lecture  term;  and, 
to  increase  the  number  of  professorships; 
3rd,  to  separate  the  granting  of  degrees 
from  the  Board  of  Ollicial  Teachers. 


As  not  a  single  one  of  the  existing  schools 
saw  fit  to  adopt  a  single  one  of  these 
recommendations,  the  reform  element  in 
the  profession  established  a  few  new  schools. 
Dr.  Davis  reports:  "Thus  the  New  York 
Medical  College  was  called  into  existence." 
It  was  chartered  April  8,  1850.  Its  corner- 
stone was  laid  July  31,  1850,  and  the  build- 
ing was  inaugurated  on  the  16th  of  October. 
The  first  Commencement  of  the  new  school 
was  held  in  March,  1851. 

It  was  the  first  to  wholly  conform  to 
the  changes  advised  by  the  American  Medi- 
cal Association.  Its  building,  112  East 
13th  Street,  the  most  convenient  for  the 
comfort  of  the  teachers  and  the  public, 
of  any  in  the  country,  contained  three  large 
lecture  rooms,  so  that  the  classes  were  never 
compelled  to  occupy  the  same  hall  during 
two  consecutive  hours.  The  entire  front 
of  the  building  was  devoted  to  the  chemical 
laboratory  and  museums.  Here  in  1850 
was  founded  the  first  chemical  laboratory 
in  the  United  States  in  connection  with  a 
medical  college  established  for  the  instruc- 
tion of  students  in  medicine  in  analytical 
researches  important  in  medical  practice. 
Each  candidate  for  graduation  was  ex- 
amined before  a  Board  of  Censors. 

The  lecture  term  was  lengthened  and  a 
summer  course  was  established.  The  num- 
ber of  professors  was  gradually  increased  to 
ten,  in  place  of  the  familiar  seven,  or  less. 
The  charter  strictly  separated  the  power 
of  granting  degrees  from  the  Board  of 
Trustees,  as  Section  V.,  "provides  for  the 
appointment  of  a  Board  of  Censors  to  be 
taken  from  the  profession  not  connected 
with  the  College,  without  whose  consent 
no  degree  could  be  conferred". 

To  remove  all  pecuniary  temptation  to 
increase  the  number  of  graduates,  the  same 
section  provided  that  no  fee  should  be 
charged  for  granting  a  degree.  Finally,  the 
Faculty,  realizing  the  vast  importance  of 
combining  more  clinical  with  didactic 
instruction,     procured    a    charter     for     a 


The  New  York  Medical  College  (i  782-1 906) 


37i 


hospital  to  be  located  alongside  of  the 
College. 

While  awaiting  the  raising  of  funds  to 
build,  they  organized  and  opened  a  charity 
ward  in  the  College  itself.  In  that  ward  I 
taught  in  i860  and  after,  until  both  the 
ward  and  the  college  were  discontinued — 
for  discontinued  they  were.  That  is  the 
brief  history  of  theirs*  attempt  at  establishing 
a  regular  daily  bedside  clinic  for  all  branches 
of  instruction  in  the  indispensable  parts  of 
medical  teaching.  The  twenty-seven  beds 
were  ours,  and  in  daily,  almost  hourly,  use. 
This  should  be  recognized  and  remembered 
as  a  new  and  systematic  teaching,  the  first 
one  in  America,  and  should  be  remembered 
as  one  of  the  progressive  steps  in  American 
medical  instruction.  When  it  was  discon- 
tinued in  1864,  it  had  no  successor  until  in 
1898,  when  bedside  instruction  was  estab- 
lished for  the  students  of  the  College  of 
Physicians  and  Surgeons.  In  that  year,  Dr. 
Francis  Huber,  my  friend  and  assistant, 
furnished  to  Columbia  University  a  capital 
the  interest  of  which  enabled  the  College  of 
Physicians  and  Surgeons  to  facilitate  a 
regular  pediatric  clinic  with  exclusive  bed- 
side instruction  in  Roosevelt  Hospital. 

The  nefarious  example  of  rival  schools 
that  kept  on  granting  diplomas  after  two 
short  winter  courses,  and  the  iniquitous 
tendency  of  the  students  to  rush  into  prac- 
tice with  the  least  possible  expenditure  of 
money,  time,  brains,  and  knowledge,  and 
the  additional  disadvantage  of  the  Medical 
College  caused  by  the  fact  that  very  many 
of  our  students  were  Southerners  who  ran 
or  strayed  away  during  the  Civil  War, 
made  the  life  of  the  institution  hard,  and 
finally  impossible.  The  last  class  was  gradu- 
ated in  1864. 

Dr.  Edwin  Hamilton  Davis,  the  Pro- 
fessor of  Materia  Medica,  reports  one  of 
the  ways  in  which  the  small  Medical  College 
was  injured  by  a  combination  of  the  clouds 
and  a  thief.  Our  very  blank  diplomas — 
thirty-odd  in  number — were  stolen.  A  vio- 


lent storm  blew  off  a  skylight  and  soaked  a 
number  of  documents.  When  new  ones  were 
procured,  the  old  ones  were  left  uncanceled 
and  misused.  The  wrinkled  specimens  were 
taken  away  when  the  janitor  was  dismissed 
a  few  months  later.  He  disposed  of  them 
in  this  country  and  also  in  London.  From 
London  a  few  were  sent  to  New  York  for 
certification.  This  caused  an  opportunity 
for  eliciting  the  facts  that  a  number  of  the 
forged  diplomas  appeared  in  the  market. 

In  the  first  faculty  of  1850,  there  sat 
Horace  Green,  Professor  of  Theory  and 
Practice;  Abram  L.  Cox,  of  Surgery;  Edwin 
Hamilton  Davis,  of  Materia  Medica  and 
Therapeutics;  B.  Fordyce  Barker,  of  Mid- 
wifery and  the  Diseases  of  Women  and 
Children;  and  K.  Ogden  Doremus,  of 
Chemistry  and  Toxicology.  In  1851,  John 
Murray  Carnochan  took  the  place  of  Dr. 
Cox,  and  Edward  R.  Peaslee  the  chair  of 
Physiology,  Pathology,  and  Microscopy. 
In  1852,  two  additional  chairs  were  created: 
that  of  Medical  Jurisprudence,  occupied 
by  Judge  Joel  Parker  of  Boston,  and  that  of 
Dental  Pathology  and  Surgery,  for  Dr.  C.  C. 
Allen.  This  was  the  first  dental  chair  in  an 
American  medical  school.  Very  few  changes 
took  place  after  that.  H.  G.  Cox  was  elect- 
ed Professor  of  Theory  and  Practice  in  1855; 
Timothy  Childs,  Professor  of  Anatomy  in 
1856;  Austin  Flint,  Jr.,  Professor  of  Physi- 
ology and  Pathology  in  1859.  I  have  men- 
tioned here  only  such  men  as  before  and 
since  their  appointment  have  made  a  name 
for  themselves  and  have  played  a  prominent 
role  in  American  medicine. 

In  i860  Southern  students  began  their 
exodus  from  New  York.  The  New  York  Med- 
ical College  was  not  persona  grata  with  the 
South  nor  with  the  other  New  York  schools. 
These  had  not  mended  their  ways  during 
the  whole  decade  of  the  existence  of  the 
New  York  Medical  College;  and  the  ma- 
jority of  the  faculty  of  the  college  became 
discouraged. 

A    new     faculty    was    appointed     April 


372 

21,  i860.  In  it  were  Doremus  and  Carno- 
chan  of  the  former  faculty,  I.  Meredith 
Reese,  A.  K.  Gardner,  B.  I.  Raphael,  John 
O.  Bronson,  Charles  A.  Budd,  Bern  L. 
Budd,  R.  K.  Brown,  and  A.  Jacobi.  Two 
thoroughly  new  departments  were  created. 
Toxicology  was  taught  independently  of 
chemistry  by  Bern  L.  Budd,  and  the  posi- 
tion of  Teacher  of  the  Diseases  of  Children 
was  made  a  full  professorship.  It  has  taken 
Harvard  twenty-eight  years,  and  Columbia 
forty  years  to  follow  the  example  of  the 
struggling  little  school  in  East  Thirteenth 
Street.  In  Columbia  even  the  great  names  of 
Otis  and  Agnew  were  permitted  to  add  to,  or 
in  part  to  make,  the  renown  of  the  school  as 
mere  "clinicals"  until  their  death.  The 
"seven",  that  sacred  close  corporation, 
willed  it  so.  Both  in  Harvard  and  Columbia 
the  Diseases  of  Children  are  now,  however, 
taught  by  full  professors.  Rotch  must  not 
be  forgotten  by  either  Harvard  or  America, 
and  Holt's  acknowledged  high  rank  in  his 
profession  and  specialty  will  always  be  re- 
membered. 

During  the  years  1 86 1  and  1863  a  f"ew 
names  were  added,  some  of  which  were  those 
of  then,  or  afterwards,  famous  men.  These 
were  Noeggerath,  S.  R.  Percy,  Frederic  Hol- 
combe,  and  David  S.  Conant.  Of  all  the 
men  whose  names  I  have  mentioned  only 
one  is  alive  to-day — myself.  I  doubt  not, 
or  hope  that  many,  aye  most,  of  the  names 
called  up  before  you  are  well  known  to 
you.  Still  in  these  days  our  historical  inter- 
est in  things  and  men  gone  by,  is  not  well 
developed,  as  yet — neither  in  the  history  of 
science  nor  of  the  country.  That  is  why  we 
meet  with  so  much  immaturity  in  both 
scientific  and  political  life,  and  why  there 
is  so  much  waste  of  industry  and  of  energy 
in  rediscovering  facts  that  could  easily  be 
gathered  from  our  own  or  foreign  literature. 
Still,  names  like  Green,  Barker,  Peaslee, 
Doremus,  Flint,  and  Carnochan  stand  out 
like  so  many  illuminating  lights  on  the  bat- 
tlefields of  American  scientific  labors. 


Annals  of  Medical  History 


Horace  Green  of  Vermont  died  in  1867 
at  Sing  Sing,  at  the  age  of  sixty-five  years. 
He  taught  medicine  in  Castleton  for  several 
years,  and  in  1850  was  one  of  the  founders 
of  the  New  York  Medical  College  in  East 
Thirteenth  Street.  There  he  taught  until 
i860.  When  the  reorganization  took  place, 
he  remained  in  the  faculty  as  emeritus.  It 
was  through  his  presence  in  the  faculty  that 
I  made  his  acquaintance  and  enjoyed  his 
confidence.  He  settled  in  New  York  in 
1835.  As  early  as  1846  he  published  a  treat- 
ise on  "Diseases  of  the  Air  Passages";  in 
1849,  his  "Pathology  and  Treatment  of 
Croup";  in  1852,  the  "Surgical  Treatment 
of  Polypi  of  the  Larynx,  and  OEdema  of  the 
Glottis".  These  books  were  followed  by  a 
few  others,  mainly  one  on  "Pulmonary 
Tuberculosis"  in  1864,  and  a  number  of 
articles  in  journals.  They  might  be  studied 
to  advantage  by  those  who,  because  they 
are  only  half  as  old  as  his  books  and  unac- 
quainted with  them,  prefer  to  rediscover 
part  of  what  was  then  known.  His  studies 
taught  him  that  the  larynx  was  accessible, 
and  this  accessibility  made  him  catheterize 
that  organ.  His  skill  was  such  as  to  tempt 
him  to  make  laryngeal  and  sublaryngeal 
applications  with  nitrate  of  silver  and  other 
substances,  for  croup  and  tuberculosis  of 
the  lungs.  In  the  New  York  Academy  of 
Medicine  he  was  bitterly  attacked.  The 
great  men  of  those  days  proved  to  their  full 
satisfaction  that  the  thing  could  not  be 
done.  Still,  he  exhibited  his  instruments 
and  did  it.  But  the  overwhelming  vote  \\as 
that  it  could  not  be  clone.  Meanwhile,  I 
had  the  privilege  of  seeing  him  do  his  resec- 
tion of  tonsils  and  his  catheterization  of  the 
larynx  in  his  own  office.  I  was  shy  and  bash- 
ful, and  averse  to  raising  my  voice,  but  the 
treatment  of  Horace  Green,  of  whom  the 
profession  in  America  had  every  reason  to 
be  proud,  was  one  of  the  things  that  made 
me  compare  his  fate  with  that  of  Bouehut 
of  Paris  who  was  the  first  intubator  of  the 
larynx  in  croup.  The  latter  was  unfortunate 


The  New  York  Medical  College  (1782-1906) 


373 


enough  to  exaggerate  his  results;  that  was 
why  his  adversaries  in  the  Paris  Academy  of 
Medicine — the  great  Trousseau  among 
them — succeeded  in  postponing  intubation 
until  our  own  O'Dwyer,  without  any 
knowledge  of  what  had  been  accomplished 
twenty-five  years  earlier,  rediscovered  and 
improved  upon  Bouchut's  manipulation. 
It  was  altogether  an  unfortunate  time  for 
great  discoveries.  Bouchut  was  not  appre- 
ciated; Horace  Green  was  suppressed.  For 
instance,  you  also  know  that  Holmes  was 
ridiculed  by  Meigs  and  Hodge;  and  Sem- 
melweiss  was  driven  into  a  lunatic  asylum 
by  Braun  and  Scanzoni. 

Fordyce  Barker  was  born  on  May  2,  181 7, 
in  Maine,  practiced  in  Norwich,  Conn., 
graduated  in  Paris,  France,  in  1844,  and  was 
Professor  of  Midwifery  in  Bowdoin  in  1845 
and  in  New  York  Medical  College  in  1850. 
His  principal  book  is  one  on  puerperal 
diseases.  He  died  in  1886. 

John  Murray  Carnochan  was  born  in 
Savannah,  Ga.,  July  4,  181 7,  and  died  in 
New  York  October  28,  1887.  He  studied  six 
years  in  Paris.  In  1850  he  was  placed  in 
charge  of  the  newly  established  hospital 
for  immigrants  on  Ward's  Island,  and  added 
to  the  surgical  literature  of  the  femur  and 
many  other  subjects. 

Edward  Randolph  Peaslee  was  born  in 
New  Hampshire  January  22,  18 14,  and  died 
in  New  York  on  January  12,  1878.  He  grad- 
uated from  Yale  in  1840,  continued  his  stud- 
ies in  London  and  Paris,  and  became  pro- 
fessor in  Dartmouth  College  in  1 84 1.  He  pub- 
lished "Human  Histology  in  its  Relations  to 
Descriptive  Anatomy,  Physiology,  and  Path- 
ology" in  1857,  the  first  systematic  book  on 
that  subject  in  English;  a  complete  mono- 
graph on  ovariotomy  in  1865;  "Statistics  of 
Ovariotomy  for  the  Years  1860-61,  '62  and 
'63,   Including    150   Cases";    "Retroflexion 


of  the  Unimpregnated  Uterus"  in  1865  and 
1866;  and  in  1872  "The  History  of  Ovario- 
tomy in  This  Country"  and  "Sketch  of  Dr. 
E.  McDowell's  Life".  While  a  Professor  in 
the  New  York  Medical  College  and  during 
his  co-editorship  of  the  American  Medical 
Monthly,  he  published  a  number  of  his  lec- 
tures and  reports.  He  was  one  of  the  most 
erudite  men  in  the  American  profession. 

Austin  Flint,  Jr.,  was  born  March  28, 
1836,  in  Northampton,  Mass.,  and  died  in 
New  York  in  1915.  He  began  the  study  of 
medicine  at  Louisville  in  1856,  and  gradu- 
ated from  Jefferson  in  1857.  At  an  early 
date  he  began  physiology  as  a  special  study, 
experimented  in  and  wrote  on  that  branch 
of  medicine  in  Paris  under  Robin.  In  1859 
he  taught  in  the  New  York  Medical  Col- 
lege, in  i860  at  New  Orleans,  and  in  1863  in 
the  Bellevue  Hospital  Medical  College,  with 
which  he  remained  in  the  same  capacity  for 
many  years  until  he  changed  his  position 
into  that  of  a  consultant  in  medicine  and 
finally  in  psychiatry.  Most  of  his  literary 
work  remained  physiological;  the  study  of 
the  liver  occupied  much  of  his  attention, 
and  his  extensive  text-book  of  physiology 
in  five  volumes — the  last  of  which  appeared 
in  1874 — first  familiarized  the  profession 
with  his  work. 

This  may  suffice.  What  I  want  to  im- 
press upon  you  is  the  knowledge  of  the  fact 
that  one  of  our  small  medical  schools,  the 
New  York  Medical  College,  was  a  principal 
cause  of  our  national  medical  progress. 
This  was  to  a  great  extent  caused  by  the  in- 
itiative in  and  the  gradual  taste  for  bedside 
instruction  in  practical  medicine.  British 
and  American  medicine  has  always  been 
founded  upon  its  practice,  and  the  nation's 
health  and  felicity  is  the  outcome  of  the 
people's  sanitation  based  upon  the  labors 
and  energy  and  successes  of  its  doctors. 


I 


STUDIES  IN  PALEOPATHOLOGY 


I.  GENERAL  CONSIDERATION  OF  THE  EVIDENCES  OF 

PATHOLOGICAL  CONDITIONS  FOUND  AMONG  FOSSIL  ANIMALS 

By  ROY  L.  MOODIE,  Ph.D. 

Department  of  Anatomy,  College  of  Medicine,  University  of  Illinois 
CHICAGO,    ILLINOIS 

DEFINITION  AND  SCOPE  OF  PALEOPATHOLOGY 


THE  study  of  the  evidences  of 
disease  among  ancient  man  and 
fossil  animals  is  known  as  paleo- 
pathology, the  term  having  first 
been  applied  by  Sir  Marc  Armand  Ruffer1  in 
19142  to  methods  he  had  developed  in 
studying  the  pathological  anatomy  of  the 
ancient  Egyptian  mummies.  He  defined  it 
as   follows : 

"Paleopathology  is  the  science  of  the 
diseases  which  can  be  demonstrated  in 
human  and  animal  remains  of  ancient 
times." 

The  significance  of  the  term  has  been 
dwelt  upon  by  Klebs,3  and  a  further  exten- 
sion of  its  meaning  to  include,  not  only  the 
diseases  of  the  ancient  Egyptians  but  those 
of  prehistoric  man  and  fossil  animals  as 
well,  has  been  suggested  by  the  writer.4 
The  field  thus  involved  includes  the  re- 
sources of  anthropology  and  paleontology, 
as  well  as  some  details  contained  in  archeo- 
Iogical  studies. 

1  Sir  Marc  Armand  Ruffer,  distinguished  for  his 
work  in  preventive  medicine  and  for  his  studies 
on  the  pathology  of  the  Egyptian  mummies,  lost 
his  life  while  engaged  in  Red  Cross  work.  See: 
"Memorial  Notice  of  Sir  Marc  Armand  Ruffer," 
by  F.  H.  Garrison,  Ann.  Med.  History,  1917,  vol. 
i,  No.  2,  pp.  218-220,  with  portrait. 

2  Ruffer:  "Studies  in  Paleopathology  in  Egypt," 
J.  Path.  ("  Bacteriol.  1914,  vol.  18,  p.  149. 

3  Klebs:  Johns  llr>i>kins  Hosp.  Bull.  191 7,  vol. 
28,    pp.    261-266. 

*  Moodie:  Am.  J.  Sc.  1916,  vol.  41,  pp.  530-531; 
Science,  N.  S.  1916,  vol.  xliii,  p.  425. 

*  The  term  prehistoric,  of  course,  usually  refers 
to  events  prior  to  the  details  of  recorded  human 
history,  and  is  variously  designated  according  to 


The  present  paper  deals  mainly  with  the 
so-called  prehistoric,5  and  especially  pre- 
human, evidences  of  disease  (prior  to 
500,000  B.C.)  of  the  extinct  vertebrates. 
It  is  interesting  to  note  that  the  history 
of  disease,  from  the  first  geological  evi- 
dences at  present  obtainable  down  to  the 
historical  data  contained  in  August  Hirsch's 
"Handbook  of  Geographical  and  Historical 
Pathology"  (circa  600  B.C.  to  1875  a.d.), 
will  be  seen  as  a  series  of  consecutive 
events  from  the  introduction  of  diseased 
conditions  among  animals  and  plants  down 
to  the  present  time.  There  can  be  no  doubt 
that  many  of  the  diseases  existing  today 
are  of  very  great  antiquity,  having  a  history 
extending  back  into  geological  time  for  many 
millions  of  years. 

It  is  not  necessary  nor  pertinent  to  review 
in  this  place  the  studies  of  Ruffer,  Elliot 
Smith,  Wood  Jones,  Rietti,  Fouquet  and 
other  writers  on  the  pathological  anatomy 
of  the  ancient  Egyptian  mummies,  since 
their  results  are  so  readily  accessible.  Their 

the  region  under  discussion.  Thus  in  Egypt  any 
grave  earlier  than  the  time  of  the  first  dynasty  is 
often  called  prehistoric.  This  implies  an  age  of 
6,000  years  or  more.  In  France  LeBaron  defines 
the  prehistoric  period  as  closing  at  about  222 
B.C.,  and  several  centuries  later  in  Algeria.  To 
the  paleontologist  the  term  is  meaningless.  Klebs 
has  said:  "The  adjective  'prehistoric,'  used  so 
often,  would  seem  a  misnomer,  because  the  dis- 
tinction of  a  history  read  in  written  records  from 
one  seen  and  studied  in  equally  characteristic 
objects,  chronologically  determinable,  is  purely 
arbitrary  and  artificial  and  it  would  do  no  harm 
to  drop  it  altogether." 


374 


Studies  in  Paleopathology 


375 


material  might  be  regarded,  from  a  certain 
standpoint,  as  fossil,  meaning  something 
"dug  up."  The  term  fossil,  however,  as  used 
in  this  paper  refers  to  material  which  is 
thoroughly  petrified,  the  age  of  which  must 
be  reckoned  by  geological  standards.  The 
studies  of  the  above-mentioned  writers  have 
been  briefly  reviewed  and  summarized  by 
Garrison,6  Klebs,7  and  Sudhoff,8  and  will  be 
extensively  referred  to  elsewhere  by  the  writer. 
The  studies  of  Ales  Hrdlicka  and  Lang- 
don9  on  the  pathological  anatomy  of  the 
North  American  Indians,  and  of  Hrdlicka, 
Eaton10  and  other  writers  on  the  ancient 
Peruvians,  must  also  be  neglected,  as 
well  as  the  meager  details  of  fossil  man  as 
they  are  recounted  in  the  various  works  on 
anthropology.  The  subject  of  the  diseases 
of  ancient  human  races  has  never  been 
systematically  studied.  The  writer  will  pre- 
sent a  consideration  of  this  subject  at 
some  future  time. 

PALEONTOLOGICAL  EVIDENCES  OF  DISEASE 

The  study  of  paleopathology  is  still  in  its 
initial  stages,  and  especially  is  the  applica- 
tion of  pathological  methods  to  fossil  lesions 
a  new  field.  But  the  comparative  scanti- 
ness of  facts  so  far  brought  out  and  the 
difficulties  of  research  should  not  hinder  its 
successful  prosecution.  What  the  final  re- 
sults may  be  remains  to  be  seen.  The  imme- 
diate results  are  certain  to  bring  attention 
to  the  presence  of  characteristic  lesions  of 
disease  far  back  in  geological  time,  and  it 
is  very  interesting,  if  not  important,  to 
find   in  past  geological  ages  evidences  of 

'Garrison:  "History  of  Medicine,"  1917,  2nd 
ed.,  p.  50;  Ann.  Med.  History,  1917,  vol.  1,  No. 
2,  p.  219. 

7  Klebs:  Johns  Hopkins  Hosp.  Bull.  19 17,  vol. 
28,  pp.  261-266. 

8Sudhoff:  J.  L.  Pagel's  "Einfiihrung  in  die  Ge- 
schichte  der  Medizin,"  p.  33. 

9  Langdon:  "The  Madisonville  Prehistoric  Ceme- 
tery. Anthropological  Notes,"  J.Cincin.  Soc.  Nat. 
Hist.   1880,   vol.   iii,  p.  40;    1881,   vol.   iv,   p.    250, 


pathological  processes  which  are  so  familiar 
to  us  today.  If  we  can  trace  the  known 
lesions  to  any  definite  cause  among  the  ex- 
tinct animals  it  will  be  a  step  toward  the  erec- 
tion of  the  newest  branch  of  pathology,  deal- 
ing with  the  oldest  aspects  of  that  science. 
In  regard  to  the  importance  of  this  branch 
of  study,  Klebs11  says: 

"We  need  only  consider  what  definite 
influence  diseases  exert  in  our  individual 
lives,  what  profound  social  upheavals 
were  brought  about  through  the  incidence 
of  epidemics,  less  perceptibly  perhaps 
but  none  the  less  strongly,  through  wide- 
spread chronic  ailments,  through  profes- 
sional diseases,  how  whole  districts  and 
countries  are  forsaken  because  disease 
made  them  uninhabitable,  how  disease 
affecting  early  childhood  and  others 
producing  sterility  led  to  the  gradual 
extinction  of  whole  peoples.  .  .  .  For 
the  grasp  of  such  problems,  the  study  of 
disease  as  it  appears  to  us  now  does  not 
suffice;  the  traces  left  during  immense 
periods  of  time  have  to  be  taken  into 
account  and  it  is  in  just  such  questions, 
not  approachable  by  other  methods,  that 
paleopathology  in  time  to  come  may 
furnish  important  solutions." 

The  attitude  of  students  of  paleontology 
toward  this  subject  has  been  negative.  Even 
men  like  Leidy,  a  trained  anatomist  and  an 
eminent  medical  man,  paid  scant  attention 
to  the  subject,  although  he  did  describe  an 
example  of  caries  in  a  mastodon  tooth12 
from  Florida.  Cuvier  too,  eminent  as  he  was 
in  the  field  of  comparative  anatomy,  failed 
to  recognize  the  importance  of  this  phase 

Figs.  1-22.  Good  discussion  of  pathology  of  early 
North  American   Indians. 

10  Eaton:  "The  Collection  of  Osteological  Material 
from  Machu  Picchu,"  Mem.  Connect.  Acad.  Arts  & 
Sc.  May,  19 16,  vol.  v. 

11  Klebs:  Johns  Hopkins  Hosp.  Bull.,  191 7,  vol. 
28,  pp.  261-266. 

12  Leidy:  Proc.  Acad.  Nat.  Sc,  Philadelphia,  1886, 
p.  38. 


376 


Annals  of  Medical  History 


of  paleontology.  His  discussions  of  the  few 
lesions  he  recognized  were  meager  and  in- 
adequate. He  has  described  a  fractured 
skull  of  a  Pleistocene  Hyaena  and  a  frac- 
tured femur  of  Anoplotberium. 

Paleontology  lends  considerable  light  to 
the  study  of  the  antiquity  of  disease.  The 
study  of  the  lesions  so  far  known  among 
fossil  animals  indicates  nothing  new  in  the 
nature  of  pathological  processes  but  simply 
extends  our  knowledge  of  disease  to  a  vast- 
ly earlier  period  than  had  previously  been 
known.  It  seems  quite  probable  that  some 
of  the  diseases  exhibited  by  the  extinct 
vertebrates  went  out  of  existence  with  the 
race  of  animals  which  were  afflicted.  If  this 
proves  to  be  true  it  will  be  an  interesting 
opportunity  to  study  the  details  of  lesions 
of  extinct  diseases.  There  seems  to  be  little 
possibility  of  determining  the  fundamental 
cause  of  disease  other  than  is  already  known; 
for  disease  is  apparently  one  of  the  mani- 
festations of  life,  and  has  followed  the  same 
lines  of  evolution  as  have  plants  and  ani- 
mals, and  is  possibly  directed  by  the  same 
factors.  Such  a  study  as  the  present  may, 
however,  throw  light  on  the  origin  of  many 
of  the  diseases  to  which  the  human  race  is 
a  prey.  A  knowledge  of  the  pathological 
processes  which  have  taken  place  in  animals 
of  geological  antiquity  will  aid  in  an  un- 
derstanding of  the  general  nature  of  disease. 

The  literature  of  vertebrate  paleontology 
contains  a  number  of  incidental  references 
to  the  diseased  nature  of  the  fossilized  bones 
of  fishes,  reptiles,  birds,  and  mammals,  the 
lesions  described  indicating  a  variety  of 
diseases,  some  of  which  are  not  uncommon 
today.  It  is  manifestly  impossible  to  diag- 
nose correctly,  on  the  basis  of  our  modern 

"  Among  diseases  which  have  become  extinct  with- 
in historical  times  may  be  mentioned  the  sweating 
sickness  described  by  Hecker  in  "Epidemics  of  the 
Middle   Ages,"    1846,   pp.    181-353. 

14  The  soft  parts  of  fossil  vertebrates  have  been 
discussed  by  a  number  of  writers.  Our  knowledge 
of  the  entire  subject  is  reviewed  in  the  author's 
paper,  "A  New  Fish  Brain  from  the  Carboniferous 


knowledge  of  recent  diseases,  all  of  the 
lesions  which  are  preserved  in  a  fossil  condi- 
tion. In  the  extinction  of  the  ancient  races 
of  animals,  certain  diseases,  without  doubt, 
became  extinct  with  them,13  and  it  is 
partly  the  purpose  of  this  paper  to  inaugu- 
rate an  inquiry  into  the  nature  of  the  dis- 
eases of  fossil  vertebrates.  No  one  has  yet 
made  a  study  of  the  evidences  of  disease 
among  fossil  animals,  since  these  conditions, 
whenever  noted,  have  been  referred  to  only 
in  an  incidental  way,  by  writers  on  paleon- 
tological  subjects. 

Geological  evidences  of  the  diseased  state 
of  animals  are  necessarily  restricted  to  path- 
ological lesions  on  the  hard  parts  of  fossil 
animal  remains.  Soft  parts14  are  seldom 
fossilized,  and  the  few  specimens  known 
have  not  been  subject  to  disease.  Since  the 
pathological  changes  which  affect  the  hard 
parts  of  animals  today  are  relatively  few 
when  compared  to  the  diseases  which  aillict 
the  body  as  a  whole,  it  is  to  be  supposed 
that  the  paleontological  evidences  of  disease 
are  but  partial  indications  of  the  prevalence 
of  pathological  conditions  in  geological  time. 
The  following  account,  too,  must  be  read  in 
the  light  of  the  paucity  of  evidence  available 
for  discussion.  The  details  are  meager,  but 
since  they  are  all  we  have,  they  may  be 
deemed  worthy  of  consideration. 

It  will  be  clearly  evident,  after  a  consid- 
eration of  geological  matters,  that  all  paleon- 
tological evidence  is  of  relative  value,  since 
such  small  portions  of  the  ancient  faunas 
and  flora  are  preserved  in  the  rocks.  How- 
ever, we  are  safe  in  stating,  from  such 
evidence  as  we  have,  the  probabilities  of  the 
occurrence  of  numerous  diseases  among  ex- 
tinct animals,  just  as  it  is  safe  for  us  to 
state,  on  the  basis  of  a  single  tooth  in  a 

of  Kansas,  with  a  Review  of  Other  Fossil  Brains," 
J.  Comp.  Neurol.,  April,  1915,  vol.  25,  No.  2, 
where  an  annotated  bibliography  of  fifty  papers 
will  enable  the  interested  reader  to  see  just  hot* 
meager  is  our  knowledge  of  the  soft  parts  of  extinct 
vertebrates.  Many  of  the  softer  structures  are 
represented  by  impressions  on  the  itone. 


Studies  in  Paleopathology 


377 


definite  geological  horizon,  that  such  and 
such  an  animal  existed  at  the  time  the  for- 
mation was  being  deposited,  provided,  of 
course,  the  deposit  is  a  primary  one  and  the 
fossil  was  not  moved  by  shifting  in  a  sec- 
ondary deposition. 

All  that  we  know  of  the  earliest  land 
vertebrates,  prior  to  the  Pennsylvanian,  for 
instance,  is  a  single  footprint  from  the 
Devonian,  and  a  few  series  of  footprints 
from  the  Mississippian.  On  the  basis  of 
these  footprints  we  are  able  to  say  definitely 
that  there  existed  in  North  America  a  di- 
versified fauna  of  vertebrates,  probably 
amphibian,  which  preceded  the  well-known 
amphibian  faunas  of  the  great  Coal  Period. 

DEFINITION   OF   DISEASE    AS    USED    IN 
THIS    STUDY 

Disease,  as  the  term  is  used  in  this  study, 
may  be  defined  as  any  deviation  from  the 
healthy  or  normal  state  of  the  body  which 
has  left  a  visible  impress  upon  the  fossilized 
skeleton.  The  evidence  may  take  the  form 
of  broken  bones,  tumors,  necroses,  hyper- 
plasias and  arthritides  of  various  kinds. 
Only  the  diseases  of  animals  have  been 
considered.  This  is  done  with  a  full  realiza- 
tion of  the  enormous  domain  of  phyto- 
pathology and  is  a  confession  of  a  limitation 
to  a  restricted  field.  Some  of  the  paleo- 
botanical  literature  has  been  read,  but  ap- 
parently no  attempt  has  been  made  to 
trace  the  rise  and  progress  of  phytopathol- 
ogy from  fossil  material. 

This  is  doubtless  due  to  the  unsatisfactory 
condition  of  fossil  plant  material  which  is 
usually  quite  fragmentary.  Some  idea  of  the 
nature  of  plant  diseases  of  the  past  may  be 
had  from  the  following  brief  summary15  for 
which  I  am  indebted  to  Professor  Edward 
W.  Berry: 

"Bacterial    and    fungus    activity    are 
known  in  Carboniferous  plants,  and  would 

16  Berry:  Letter  to  author,  Jan.  4,  1918. 

16  Berry:  "Remarkable   Fossil  Fungi,"  Mycologia, 


probably  be  detectable  at  much  earlier 
horizons  if  petrified  material  of  greater 
age  were  available  for  study,  since  the 
bacteria  appear  to  be  among  the  earliest 
forms  of  life.  Material  preserved  as  im- 
pressions at  all  horizons,  more  especially 
the  post- Paleozoic  ones,  show  abundant 
leaf-spot  fungi,  and  such  remains  from  the 
Cretaceous  and  Tertiary  show  abundant 
insect  galls  and  leaf  cutting  by  cater- 
pillars or  bees;  but  this  class  of  material 
is  usually  more  or  less  indefinite.  When- 
ever one  handles  much  petrified  mater- 
ial, one  is  struck  with  traces  of  fungal 
ravages  and  bacterial  action." 

EVIDENCES    OF    DISEASE    IN    FOSSIL    PLANTS 

It  is  often  difficult  to  decide  whether  the 
ravages  of  fungi  and  bacteria  are  pre-  or 
post-mortem.  The  agents  of  decay  are  well 
known  to  have  existed  early  in  geological 
time.  During  the  Carboniferous  there  ex- 
isted conditions  which  were  especially  favor- 
able to  the  growth  of  a  mycological  flora, 
and  much  of  it  was  probably  on  dead 
plant  material. 

Professor  Berry  writes  further16  con- 
cerning the  primitive  fungi: 

"Among  the  relics  of  former  vegetation 
that  carry  the  record  back  many  millions 
of  years  the  remains  of  fungi  are  so  rarely 
found  that  their  presence  is  always  ex- 
ceptional, although  it  is  obvious  that 
many  times  during  the  long  history  of  the 
earth  the  environment  has  offered  opti- 
mum conditions  for  their  abundant  de- 
velopment. To  mention  but  one  such 
occasion,  that  of  the  formation  of  the 
•  Coal  Measures  must  have  witnessed  an 
exceedingly  abundant  mycological  flora. 
That  these  plants  were  present  thus  early 
is  indicated  by  the  abundance  of  hyphas, 
and  other  traces  of  fungal  activity  such 
as  butyric  fermentation,  in  the  tissues  of 

1916,  vol.  8,  No.  2,  pp.  73-78,  plates  180-182,  con- 
taining 16  figures. 


378 


Annals  of  Medical  History 


Carboniferous  vascular  plants,  and  the 
scarcity  of  described  forms  must  be  attri- 
buted to  the  perishable  nature  of  most 
fungal  tissues  and  to  the  lack  of  syste- 
matic work  by  experienced  mycologists 
on  the  more  or  less  obscure  material  avail- 
able. To  be  sure,  quite  a  considerable 
number  of  fossil  forms  referred  to  Fungi 
have  been  recorded  from  various  geologic 
horizons  but  the  vast  majority  of  these 
are  leaf-spot  types  based  upon  real  or 
fancied  resemblances,  and  found  on  im- 
pressions of  foliage  and  without  definite 
botanical  characters.  Some  doubtless  rep- 
resent fungal  ravages,  others  are  due  to 
insects,  some  are  glandular,  and  others 
are  purely  imaginary." 

Professor  Berry  refers  to  A.  Meschinelli's 
"Fungorum  Fossilium  Omnium  Iconograph- 
ia,"  (1902,  144  pp.,  31  plates),  for  a  rather 
complete  illustrated  list  of  all  of  the  forms 
referred  to  down  to  the  year  1900.  Other 
and  more  complete  studies  on  the  bacteria 
and  fungi  of  the  Coal  Measures  of  France 
particularly  have  been  made  by  Van  Tieg- 
hem  and  Renault.  A  fairly  complete  list  of 
their  numerous  papers  is  to  be  found  in 
Smith's  bibliography.17  Other  information 
may  be  gleaned  from  the  memoirs  and  text- 
books dealing  with  Paleobotany. 

17  Erwin  F.  Smith:  "Bacteria  in  Prehistoric 
Times."  In  "Bacteria  in  Relation  to  Plant  Diseases," 
1905,  vol.  1,  p.  262. 

18The  question  of  extinction  is  still  one  of  the 
unsolved  problems  of  paleontology.  The  importance 
of  those  diseases  which  leave  an  impress  on  the 
skeleton  has  been  referred  to  by  the  author  in  the 
following  words: 

"It  is  not  my  intention  to  contend  that  disease 
has  not  been  influential  in  the  extinction  of  races 
(or  species);  it  probably  has  been;  but  those  diseases 
which  have  left  an  impress  on  the  fossilized  skeleton 
certainly  cannot  be  regarded  as  among  those 
diseases  which  would  produce  widespread  extinc- 
tion. Sonic  other  has  been  the  dominant  factor. 
The  present  results  of  the  study  of  fossil  pathology 
indicate  the  early  appearance  in  geological  time 
and   widespread   distribution   of  diseases  of  many 


METCHNIKOFF   ON    DISEASES    IN 
REMOTE    EPOCHS 

The  possible  presence  of  disease  among 
animals  of  remote  epochs  of  the  earth's  his- 
tory was  suggested  by  Elie  Metchnikoff 
in  the  following  words: 

"Diseases  in  general  and  infective  dis- 
eases in  particular  were  developed  on  the 
earth  at  a  very  remote  epoch.  Far  from 
being  peculiar  to  man,  animals  and  the 
higher  plants,  they  attack  inferior  forms 
and  are  widely  distributed  among  uni- 
cellular organism,  Infusoria  and  Algae. 
Diseases  undoubtedly  play  an  important 
role  in  the  history  of  life  on  our  planet,  and 
it  is  very  probable  that  they  have  con- 
tributed in  a  marked  degree  to  the  ex- 
tinction of  certain  species.18  When  we 
observe  the  ravages  produced  by  para- 
sitic Fungi  among  the  young  fish  which 
we  are  trying  to  rear,  or  the  destruction 
of  cray-fish  in  certain  countries  in  con- 
sequence of  the  rapid  increase  of  epizootic 
germs,  we  are  involuntarily  led  to  the 
conclusion  that  pathogenic  micro-organ- 
isms must  have  brought  about  the  dis- 
appearance of  certain  animal  and  vegeta- 
ble species."19 

It  would  be  interesting  in  this  connection 
to  know  Metchnikoff's  sources  of  informa- 
tion relative  to  the  presence  of  diseases  at 
remote   epochs.    Virchow's  studies  on  the 

kinds,  but  none  of  them,  so  far  as  the  fossil  lesions 
may  be  interpreted,  were  sufficiently  severe  to 
have  played  a  part  in  the  extinction  of  any  of  the 
known  groups  of  fossil  vertebrates.  They  are  to  be 
regarded  rather  as  chronic  infectious  or  constitu- 
tional diseases  which  may  have  played  a  part  in 
extinction,  but  there  must  have  been  some  other 
and  more  powerful  ally  which  is  at  present  un- 
known." ("The  Influence  of  Disease  in  the  Ex- 
tinction of  Races,"  Science,  N.  S.,  Jan.  19,  1917, 
vol.   xlv.,   No.    1 151,  pp.  63-64. 

19  Flic  MetchnikofT:  "Immunity  in  Infective 
Diseases,"  1915.  Translated  from  the  French  by 
Francis  G.    Binnie,   p.   8. 


Studies  in  Paleopathology 


379 


cave  bears  of  Europe20  were  well  known, 
and  his  characterization  of  the  arthritic 
lesions  of  the  fossorial  animals  as  the 
"Hohlengicht,"  was  certainly  famous  at  the 
time  Metchnikoff  wrote.  The  studies  of 
Mayer21  on  the  lesions  of  the  cave  bears 
and  cave  lions  of  Europe  as  well  as  the 
writings  of  Cuvier  (1820),  Esper  (1774), 
Goldfuss  (1810),  Walther  (1825),  Schmerl- 
ing  (1835),  Owen  (1842),  Schaafhausen 
(1858),  Newton  and  Parker  (1870),  Graff 
(1885)  and  Leidy  (1886)  may,  any  or  all 
of  them,  have  been  known  to  Metchni- 
koff. They  all  suggest  the  pathology  of 
ancient  times  and  some  deal  entirely 
with  the  pathological  anatomy  of  fossil  re- 
mains. None,  however,  are  studies  which 
deal  with  remains  older  than  the  middle 
Tertiary,  and  to  a  paleontologist  the  term 
"remote  epoch"  hardly  applies,  when  com- 
pared to  lesions  known  from  the  Carboni- 
ferous, for  example.  I  am,  therefore,  forced 
to  conclude  that  Metchnikoff  simply  fore- 
casted what  would  be  discovered,  on  the 
basis  of  what  he  knew  in  modern  plants  and 
animals.  All  of  the  literature  in  paleontology 
dealing  with  pathological  evidences  of  any 
great  antiquity,  prior  to  the  mid-Tertiary, 
has  appeared  since  1900.  The  literature  is 
meager  and  unsatisfactory.  Paleontological 
studies  seldom  deal  specifically  with  dis- 
eased conditions,  so  that  the  field  is  still 
to  be  explored.  The  studies  in  paleontology 
dealing  with  pathological  evidences  among 
fossil  vertebrates  have  been  reviewed  by 

20  Rudolf  Virchow:  "Ueber  einen  Besuch  der 
west-fallischen  Knochenhohle,"  Ztschr.  j.  Etbnol. 
1870,  Bd.  2,  p.  365,  footnote;  "Knochen  vom 
Hohlenbaren  mit  krankhaften  Veranderungen," 
Ibid.,  1895,  Bd.  27,  pp.  706-708,  figs.  1-4;  "Beitrag 
zur  Geschichte  der  Lues,"  Dermat.  Ztschr.,  1896, 
Bd.  3,  p.  4. 

21  Mayer:  "Ueber  krankhafte  Knochen  vorwelt- 
Iicher  Thiere.  In  "Nova  Acta  Leopoldina  (Novorum 
Actorum  Academia  Csesarea?  Leopoldino-Caro- 
Iinae  Naturae  Curiosum)",  Bd.  xxiv,  pt.  II,  pp. 
673-689,  pi.  30. 

22  O.   Abel:   "Grundziige    der    Paleobiologie    der 


Abel,22  and  a  much  fuller  review  is  planned 
for  a  memoir  on  paleopathology,  now  in 
preparation. 

APPARENT  ABSENCE  OF  DISEASE  AMONG 
EARLY   PALEOZOIC   ANIMALS 

A  careful  study  of  the  literature  of  pale- 
ontology shows  that,  so  far  as  present  ob- 
servations are  concerned,  the  animals  of 
the  earlier  periods  of  the  earth's  history 
were  free  from  disease.  Although  bacteria23 
are  known  to  have  occurred  in  the  algal 
deposits  of  the  Newland  limestone,  a  for- 
mation of  the  Beltian  series  of  Algonkian 
rocks  in  central  Montana,  they  are  not 
known  to  have  been  of  a  pathogenic  nature, 
but  rather  are  supposed  to  have  been  active 
in  the  deposition  of  limestones,  together 
with  the  algae  with  which  they  were  as- 
sociated. No  lesions  due  to  accident  or  to 
infection  have  been  described  among  either 
the  vertebrates  or  invertebrates  of  the  early 
geological  periods,  prior  to  the  Carbonifer- 
ous. This  lack  of  knowledge  concerning  the 
evidence  of  disease  may  be  due  to  ignorance 
on  our  part,  for  the  lesions  may  have  been 
seen  but  were  not  deemed  worthy  of  de- 
scription. Or,  it  may  be  due  to  the  fact 
that  the  invertebrates  of  the  Proterozoic 
and  Paleozoic,  which  were  the  predominant 
types  of  animal  life  during  these  periods, 
were  free  from  disease  which  affected  the 
skeleton,  as  are,  in  general,  the  inverte- 
brates   of   today,    although   many  of  the 

Wirbelthiere,"  1912;  "Spuren  von  Kampfen,"  pp. 
88-91;   "Knochenerkrankungen,"  pp.  91-95. 

23  These  bacteria  are  described  and  figured  by 
C.  D.  Walcott  and  H.  F.  Osborn. 

C.  D.  Walcott:  "Discovery  of  Algonkian  Bac- 
teria," Proc.  Nat.  Acad.  Sc,  April  1915,  p.  256; 
"Evidences  of  Primitive  Life,"  Smithsonian  Rep.  Jor 
1915,  pp.  235-255,  illustrated. 

H.  F.  Osborn:  "Origin  and  Evolution  of  Life," 
1917,  p.  153;  Science,  N.  S.,  1917,  vol.  46,  No. 
1 192,  pp.  432-434. 

Their  discovery  was  forecasted  by  Walcott  in 
his  "Pre-Cambrian  Algal  Flora,"  Smithsonian  Misc. 
Collect,  19 14,  vol.  64,  No.  2,  p.  95. 


38o 


Annals  of  Medical  History 


recent  forms  are  highly  parasitized  and  are 
occasionally  subject  to  disease.  It  appears 
probable  that  vertebrates  have  been  more 
liable  to  diseases  which  afflict  the  hard 
parts  than  have  the  invertebrates,  and  this 
liability  to  pathologic  processes  has  been 
increased  with  the  passage  of  geologic  time. 

IMMUNITY    IN    MODERN    INVERTEBRATES 

The  greater  immunity  of  early  Paleozoic 
animals  to  disease,  based  on  the  evidences 
of  paleontological  material,  is  probably  not 
a  true  index  to  actual  conditions,  though  it 
may  be  so.  It  is  probably  not  safe  to  con- 
clude from  present-day  conditions  what  the 
state  of  Paleozoic  animals  may  have  been 
as  regards  disease.  At  any  rate  the  paleon- 
tological evidences  are  not  wholly  sub- 
stantiated by  conditions  found  in  modern 
forms.  Metchnikoff24  has  called  attention 
to  the  occurrence  of  epidemics  of  a  severe 
nature  among  protozoa,  such  as  diseases 
in  Amoebae  caused  by  the  Microspbaera  and 
the  disease  in  Actinophryrs  attributed  to 
Fungi  allied  to  the  genus  Pythium.  Pasteur's 
studies  on  the  pebrine  and  fldcherie  of  the 
silkworms  will  be  remembered  as  instances 
of  severe  epidemics  in  an  invertebrate 
group.  Molluscs,  however,  are  apparently 
largely  immune  to  infection,  and  since  the 
molluscous  animals  formed  such  a  large 
percentage  of  the  preserved  faunas  of  the 
early  periods  of  the  earth's  history  we  may 
attribute  our  ignorance  of  the  presence  of 
disease  to  this  factor,  in  part  at  least.  The 
immunity  of  many   intermediate  hosts  to 

u  Metchnikoff:  "Immunity  in  Infective  Diseases," 
translated  from  the  French  by  Francis  G.  Binnie, 
1905,  p.   18;  also  Chap.  iii. 

25  Edward  Hindle:  "Flies  in  Relation  to  Disease 
(Blood  sucking  Flies),"  1914. 

G.  S.  Graham-Smith:  "Flies  in  Relation  to 
Disease  (Non-Blood  sucking  Flics),"   1914. 

M  Elias  Metchnikoff:  "Die  Lehre  von  den  Phy- 
gocyten  und  dcren  cxperimentellc  Grundlagen." 
In  "Kollc  und  Wassermann's  Handbuch  dcr  patho- 
genen  Mikroorganismcn,"  1913,  Bd.  ii,  erste  Hiilfte, 
pp.  655-731,  with  an  excellent  bibliography. 


infection25  is  well  known,  and  the  classical 
example  of  the  mosquito-borne  infections 
will  suffice,  although  it  is  well  known  that 
insects  of  many  kinds  are  subject  to  fatal 
diseases.  Kowalevsky  has  discussed  the 
anthrax  of  crickets  and  many  other  students 
have  studied  the  problem.  The  entire  ques- 
tion of  immunity  in  its  relation  to  all  forms 
of  extinct  animals  is  of  course  a  new  and 
unsolved,  probably  an  insolvable,  problem. 
But  it  seems  certain  that  if  the  early  ani- 
mals were  diseased,  the  ensuing  pathology 
was  of  such  a  nature  as  to  leave  no  impress 
upon  the  fossilized  part;  or  else  we  have  not 
yet  learned  to  recognize  these  lesions. 

THE   ORIGIN    OF   DISEASE 

Phagocytosis26  doubtless  began  very  early 
in  the  history  of  animal  life,  and  it  is  prob- 
able that  the  natural  immunity  of  the 
early  animals  was  sufficiently  strong  to 
resist  the  invasion  by  any  pathogenic  organ- 
isms in  sufficient  numbers  to  produce  dis- 
ease. The  breaking  down  of  this  immunity 
may  possibly  be  correlated  with  the  develop- 
ment of  senescence27  among  the  early  races 
of  animals,  which  reached  a  climax  in  some 
forms — the  trilobites,  for  instance, — at 
about  the  time  when  we  find  the  first  indi- 
cations of  disease  among  fossil  animals. 
The  breaking  down  of  the  immuity,  due 
to  the  development  of  race  senescence  and 
the  introduction  of  disease,  doubtless  was 
of  very  great  importance  in  the  extinction 
of  the   trilobites   and  other    great  groups 

-7  The  studies  of  Charles  Emerson  Beecher  (1856- 
1904),  an  American  paleontologist,  upon  evolu- 
tionary phases  of  the  early  fossil  brachiopods  and 
trilobites  are  especially  important  to  consider  in 
connection  with  the  question  of  race  senescence  and 
the  extinction  of  animal  groups.  His  papers  have 
been  collected  into  a  volume:  "Studies  in  Evolution," 
New  York,   1901. 

The  entire  subject  of  senescence  in  the  recent 
lower  animals  is  discussed  by  Child  in  "Senescence 
and  Rejuvenescence,"  University  of  Chicago  Press, 
1915. 


Studies  in  Paleopathology' 


381 


of  animals    which    have  disappeared  from 
the  earth.28 

I  do  not  intend  to  assert  that  senility  or 
senescence  is  a  disease,  but  that  age  weakens 
the  organism  and  the  race  and  allows  the 
ingress  of  disease.  Minot  has  stated: 

"Old  age  is  not  a  disease  and  cannot  be 
cured;  it  is  an  accumulation  of  changes 
which  begin  during  earliest  youth  and 
continue  throughout  the  entire  life  of 
the  individual." 

It  may  be  said  that  disease  in  the  past 
has  often  attacked  the  races  of  animals 
which  showed  senescence.  Many  of  the 
virile  races  of  animals  in  the  past  were  also 
subject  to  disease.  The  paleontological  in- 
dications of  senescence  are  the  reduction  in 
size,  the  loss  of  vigor  and  the  production  of 
apparently  useless  spines  as  seen  in  the 
races  of  animals  which  have  become  re- 
duced or  extinct,  such  as  the  crinoids, 
trilobites,  brachiopods,  ammonites  and  the 
dinosaurs.  Other  examples  of  senescence  may 
be  seen  among  some  of  the  Permian  reptiles 
which  assumed  bizarre  forms.  The  tendency 
of  many  races  of  animals  to  acquire  spinous 
and  other  useless  excrescences  of  the  hard 
parts  shortly  before  the  extinction  of  the 
group  is  noteworthy,  and  this  tendency  has 
been  regarded  by  paleontologists  as  an 
indication  of  senescence. 

LESIONS    OF    PARASITISM    IN    CAR- 
BONIFEROUS  CRINOIDS 

Our  knowledge  of  the  history  of  disease, 
as  it  is  based  on  paleontological  evidence, 
begins  with  the  Carboniferous,  when  cer- 

28  This  suggestion  has  been  discussed  by  Rene 
Larger  in  his  paper  "La  contre-evolution  ou  degen- 
eresence  par  I'heredite  pathologique  cause  naturelle 
de  I'extinction  des  groupes  animaux.  Essai  de  pale- 
opathologique  generale  comparee,"  1916,  Bull, 
et  mem.  Soc.  d'antbrop.  de  Par. 

29  Graff:  "Paleontographica,"  1885,  Bd.  31,  pp. 
183-192,  Taf.  xvi. 


tain  crinoids  were  afflicted  in  their  stems 
with  tumor-like  lesions,  possibly  due  to  the 
parasitic  action  of  myzostomids  such  as 
commonly  attack  crinoid  stems  today.  A 
careful  description  of  the  enlarged  stems  of 
recent  crinoids  and  the  parasitic  action  of 
the  myzostomids  is  to  be  found  in  the 
reports  of  the  Challenger  Exploring  Ex- 
pedition. A  comparison  of  the  ancient  and 
recent  lesions  on  the  stems  of  crinoids  leads 
one  to  accept  the  enlargements  of  fossil 
crinoid  stems  as  due  to  the  parasitic  action 
of  the  myzostomids  or  some  similar  form. 

The  evidences  for  such  a  conclusion  are, 
apparently,  incontrovertible,  and  have  been 
established  by  a  number  of  writers  on  fossil 
crinoids.  Parasitized  crinoid  stems  are 
known  from  the  Carboniferous  of  Scotland, 
Germany  (Fig.  1)  and  the  Keokuk  beds 
(Fig.  4)  of  North  America.  Graff29  found 
the  carbonized  remains  of  the  parasite  in 
one  of  the  enlargements  (Fig.  2)  which  he 
studied  and  which  he  referred  to  as  the 
fossilized  integument  of  the  myzostomid. 
The  presence  of  this  soft-bodied  animal  so 
early  in  the  geological  history  of  the  world 
is  not  surprising,  since  from  the  researches 
of  Walcott30  we  know  that  jellyfishes, 
sea  cucumbers,  many  types  of  annulates, 
and  soft-bodied  crustaceans  lived  f  during 
the  Cambrian,  many  millions  of  years 
earlier.  The  parasitism  of  animals  during 
the  Carboniferous  was  preceded  by  partial 
parasitism  or  commensalism  of  the  earlier 
periods,  and  is  known  to  have  occurred 
among  fossil  corals  (Fig.  3)  of  the  Devonian. 
The  intimate  association  of  animals  and  the 
origin  of  parasitism  and  commensalism  dur- 
ing the  early  part  of  the  Paleozoic  has  been 
studied  by  Clarke.31  The  reader  is  referred 
to  his  paper  for  further  details. 

30  C.  D.  Walcott:  "Evidences  of  Primitive  Life," 
Smithsonian  Rep.  for  191 5,  pp.  235-255,  with  plates. 
31  John  M.  Clarke:  "The  Beginnings  of  Dependent 
Life,"  Fourth  Ann.  Rep.,  Director  of  Science  Div., 
New  York  State  Education  Dept.,  1908,  pp.  1-28. 
PI.  1-13. 


382 


Annals  of  Medical  History 


The  remains  of  the  early  vertebrates 
prior  to  the  Permian  have  shown  no  note- 
worthy   pathological    lesions.    There    may 


FiG.  i.  Parasitized  stem  of  a  crinoid,  from  the 
Carboniferous  of  Germany,  showing  the  tumor- 
like mass  produced  by  the  action  of  the  mvzostomid. 
(After  Graff.) 

Fig.  2.  Portion  of  parasitized  crinoid  stem,  show- 
ing carbonized  remains  of  the  myzostomid.  (After 
Graff.) 

Fig.  3.  Section  through  a  fossil  coral,  Pleurodic- 
Ivum  problemalicum  from  the  Lower  Devonian  of 
Fifel,  showing  the  worm  tube  near  the  center. 
An  example  of  ancient  commensalism.  (After 
Stromer  von   Reichenbach.) 

Fig.  4.  An  enlarged  stem  of  a  crinoid  from  the 
Keokuk  bed-,  of  North  America,  showing  that 
the  enlargement  has  involved  the  plates  of  the 
stem.  This  specimen  was  thoroughly  mineralized 
into  a  geode,  so  that  no  evidences  of  the  parasite 
were  seen.  One-half  natural  size. 


have  been  diseases  among  these  early 
forms,  but  the  lesions  have  not  yet  been 
discovered.    We    find,   to    be   sure,    certain 


laterally  compressed  fishes  preserved  in  the 
attitude  of  the  opisthotonos  and  pleuro- 
thotonos  in  horizons  prior  to  the  Permian. 
These  attitudes  may  have  been  due  to 
spastic  distress  induced  by  cerebrospinal 
infections  or  to  some  form  of  poisoning. 
Since  this  subject  will  be  more  fully  treated 
elsewhere  nothing  more  need  be  said  than 
that  these  attitudes  possibly  represent  dis- 
eased conditions  of  the  central  nervous 
sjstem. 

PATHOLOGY  OF  THE  PERMIAN  VERTEBRATES 

Several  pathological  conditions  are  indi- 
cated among  the  vertebrates  of  the  Per- 
mian. Renault32  has  described  cartes  of 
certain  fish  bones  preserved  in  coprolites 
from  the  Autun  basin.  He  concludes  that 
this  type  of  caries  is  due  to  several  types  of 
bacteria  which  he  has  described  and  figured. 
A  left  radius  of  Dimetrodori,  a  primitive 
reptile,  from  the  Permian  of  Texas  shows 
an  incompletely  healed  fracture  (Fig.  j) 
with  abundant  osteosclerosis  and  some  in- 
termediary callus.  This  is  tbe  oldest  known 
case  oj  fracture.  It  was  a  simple  fracture 
cutting  the  bone  at  right  angles,  and  the 
healing  process  has  taken  place  with  very 
little  shortening.  The  bone  has  no  medullary 
cavity,  so  that  attempts  to  study  the  nature 
of  the  fracture  by  means  of  the  x-ray  have 
been  a  failure.  The  Texas  red  beds,  from 
which  the  bone  comes,  are  impregnated 
with  iron,  and  the  radius  reacts  to  the 
x-rays  much  as  a  bar  of  iron  would.  A 
fractured  rib  with  an  old  callus  is  also 
known  from  the  Permian  of  Texas.  A 
description  of  this  lesion  with  illustrations 
is  to  be  found  in  Tbe  Surgical  Clinics  of 
Chicago,  April,  19 18.  Von  Hucne  has  de- 
scribed the  skull  of  a  phytosaur  from  the 
Triassic  of  Germany,  showing  a  fractured 
snout  with  many  necrotic  sinuses. 

■  B.  Renault :  "Microorganismea  des  combustibles 
fossiles,"  Hull.  Soc.  de  r Industrie  mmtralt  ii  Saint* 
Etienne,  1899-1900,  Ser.  Ill,  with  atlas  of  plates. 


Studies  in  Paleopathology 


383 


DISCUSSION  OF  GRAPH  SHOWING  INCREASE 
OF   DISEASE    IN    GEOLOGICAL   TIME 

It  is  not  necessary  at  this  time  to  go  into 
further  details  concerning  the  progress  of 
disease,  since  the  details  are  to  be  given  in  a 
later  paper.  The  accompanying  graph  (Fig. 
6)  will  show  how,  according  to  present 
evidences,  disease  has  progressed  during 
the  geological  history  of  the  earth.  The 
twenty-five  divisions  on  the  base  line  a-d 
(Fig.  6)  represent  as  many  periods  of  the 
earth's  history.  The  divisions  on  the  vertical 
line  d-b  represent  the  approximate  number 
of  diseases  present  in  each  period,  as  indi- 
cated by  the  known  fossil  lesions.  The 
time  intervals  in  the  graph  are  shown  as  of 
equal  value,  but  the  geological  periods  are 
not  at  all  of  equal  duration  nor  of  equal 
character.  This  should  be  kept  in  mind  in 
studying  the  graph. 

At  the  point  "a"  we  may  say  that  organic 
life  is  first  known.  It  will  be  seen  that  the 
line  "a-b,"  representing  the  history  of  dis- 
ease, follows  a  base  level  for  the  first  twelve 
periods   of  the   earth's    history.   Then   the 


curve  gradually  rises  until,  during  the 
Cretaceous,  at  "c,"  diseases  and  accidents — 
such  as  caries,  osteoperiostitis,  deforming 
arthritides,     necroses,     hyperostosis,     oste- 


Fig.  5.  Callus  and  fracture  in  left  radius  of 
Dimetrodon,  a  reptile  from  the  Permian  of  Texas. 
The  specimen  belongs  to  the  Paleontological  Col- 
lections in  Walker  Museum,  University  of  Chicago. 
One-half  natural  size. 


Fig.  6.  Graph  showing  increase  of  disease  in 
geological  time.  The  d  visions  on  the  base  line, 
a-d,  represent  geological  periods,  and  on  the  vertical 
line  prevalence  of  pathological  conditions. 


ophytes,  osteomata,  fractures — and  many 
infective  processes,  reached  a  maximum  of 
development  among  the  dinosaurs,  mosa- 
saurs,  crocodiles,  plesiosaurs,  and  turtles. 
The  curve  suddenly  and  sharply  descends 
from  "c."  For  with  the  close  of  the  Creta- 
ceous and  the  sudden  extinction  of  large 
groups  of  the  giant  reptiles,  the  incidence  of 
disease  also  decreased.  It  seems  quite  prob- 
able that  many  of  the  diseases  which 
afflicted  the  dinosaurs  and  their  associates 
became  extinct  with  them. 

The  mammals  of  the  Cretaceous  and 
early  Tertiary  periods  (Fig.  7)  do  not  seem 
to  have  been  so  generally  afflicted  with  dis- 
ease as  were  the  preceding  groups  of  giant 
reptiles,  nor  as  were  the  later  mammals. 
The  ascending  curve  therefore  is  not  so 
abrupt  as  one  might  expect.  Certain  proc- 
esses of  disease  seem  to  have  been  acquired 
by  the  mammals  from  preceding  forms,  for 
caries  and  other  primitive  diseases  are  evi- 
dent (Fig.  8)  among  early  Tertiary  mam- 
mals. The  curve  rises  rapidly,  however,  and 
reaches  the  highest  point  at  "b,"  indicat- 
ing that  disease  is  much  more  prevalent 
at  the  present  time  than  ever  before  in  the 
history  of  the  world. 


384 


Annals  of  "Medical  History 


The  geological  development  of  disease  has 
certain  curious  characteristics  which  parallel 
facts  in  the  evolution  of  animals  and  plants. 
Huxley    many    years    ago   called    attention 


geological  antiquity  a  few  can  certainly  be 
called  persistent  or  primitive  types  which 
have  remained  the  same  since  the  close  of 
the    Paleozoic.    Other    diseases    arose    and 


Fig.  7.  The  skeleton  or  an  early  Tertiary  mammal,  Titanotherium  robustum, 
from  the  White  River  01  igocene  of  South  Dakota,  as  it  is  mounted  in  the  American 
Museum  of  Natural  History.  The  fifth  rib  on  the  right  side  lias  been  Fractured 
and  has  healed  with  a  pseudarthrosis  and  considerable  callus.  The  details  are 
shown  in  the  enlarged  sketch  in  the  lower  right  hand  corner.  One-sixteenth 
natural  size.     (Courtesy  of  Dr.  W.  K.  Gregory.) 


to  certain  persistent  types  of  animals  which 
had  existed  almost  unchanged  from  early 
geological  periods  down  to  the  present. 
Among  the  known  diseases  (Figs.  9-12)  of 


became  extinct,    but    some  of  them    have 
retained  the  same   characteristics,  as  seen 
in  the  resulting  changes  of  structure. 
According  to  present  evidences,  disease 


FiO.  9.  Two  views  of  the  mandible  of  a  three-toed  horse,  MerycbippuS  campestris,  from  the  Miocene,  about 
one  and  one-half  million  yean  old.  The  figures  show  in  the  absorbed  alveolar  margins  pathological  processes 
similar  to  alveolar  pyorrhea  of  the  present  day.  A  left  premolar  shows  evidences  of  caries,  and  the  swelling  in 
the  left  ramus,  so  evident  in  the  right-hand  figure,  is  indicative  of  a  fistula,  possibly  indicating  the  presence  of 
actinomycosis  in  the  early  stages.     (Courtesy  of  Dr.  \\ .  I).  Mather  I 


Studies  in  Paleopathology 


385 


Fig.  9.  Lateral  view  of  a  dorsal  vertebra  of  a 
saber-toothed  cat,  Smilodon,  from  the  Rancho  la 
Brea  asphalt  beds,  Pleistocene,  of  California,  show- 
ing the  characteristic  lesions  of  spondylitis  defor- 
mans. Natural  size.  About  500,000  years  old. 


Fig.  10.  Posterior  view  of  a  dorsal  vertebra  of 
a  cave  bear,  Ursiis  spelxus,  from  Europe,  showing 
characteristic  lesions  of  spondylitis  deformans.  Nat- 
ural size.   About  250,000  years  old.  (AfterJMayer.) 


Fig.  1 1.  Spondylitis  in  the  lumbar  vertebra  of 
an  ancient  Egyptian.  About  5,000  years  old.  (After 
Ruffer.) 


Fig.  12.  Spondylitis  deformans  in  a  recent  human 
vertebra.  Natural  size. 


These  four  figures  show  the  characteristic  lesions  of  this  osteoarthritis  at  different  periods  of  the  history 
of  animals  and  man.  So  far  as  external  appearances  go  there  has  been  no  change  in  the  pathological  pro- 
cesses producing  these  lesions  since  the  Pleistocene  at  least.  Similar  lesions  of  greater  antiquity  have  not 
yet  been  seen. 


386 


Annals  of  Medical  History 


is,  from  the  geological  standpoint,  of  rela- 
tively recent  origin  and  has  afflicted  the 
inhabitants  of  the  earth  for  only  the  last 
one-quarter  of  the  earth's  history — that 
is,  for  the  last  25,000,000  out  of  a  possible 


Fig.  13.  The  mandible  of  a  cave  bear,  Ursus 
spelxus,  Pleistocene  of  Europe,  showing  the  ravages 
of  disease.  Caries  and  the  absorption  of  alveolar 
processes,  as  well  as  necrotic  sinuses  are  evident 
in  this  mandible.  (After  Mayer.) 

100,000,000  years.  Future  discoveries  will 
doubtless  modify  our  present  conceptions, 
but  the  above  outline  is  a  summary  of  our 
present  knowledge  of  the  rise  and  develop- 
ment of  disease  among  animals. 

TABULATION  OF  GEOLOGICAL  EVIDENCES 

The  table  given  below  will  show  at  a 
glance  the  antiquity  of  pathological  evi- 
dences in  geological  history.  The  estimates 
of  time  are  based  upon  the  relative  thick- 
ness of  the  pre-Cambrian  and  post-Cam- 
brian rocks,  after  Walcott  and  Schuchert, 
as  given  by  Osborn  in  his  "Origin  and 
Evolution  of  Life."33  The  estimates  of  the 
duration  of  the  geological  periods  vary 
greatly.  The  duration  of  the  Proterozoic 
was  as  great,  probably,  as  all  post-Cam- 
brian time,  which  has  been  estimated  as 
high  as  100,000,000  years.  A  study  of  radio- 
active substances  gives  estimates  as  high 
as  1,600,000,000  years  for  the  duration  of 
the  Archeozoic,  although  Walcott  esti- 
mates that  only  70,000,000  years  have 
elapsed  since  the  beginning  of  sedimenta- 
tion. While  authors  vary  greatly  in  their 
estimates,  they  all  agree  that  the  duration  of 
geological  time  has  been  very  great,  run- 
ning   into    many    millions    of   years.    The 

"Osborn:  "Origin  and  Evolution  of  Life,"  p.  1 53. 


estimates  given  in  the  first  column  of  the 
table  are  extremely  conservative.  I  have 
followed  Osborn  in  this  column.  In  the 
second  column  a  much  greater  estimate  is 
given.  The  table  will  show  the  relative 
antiquity  of  various  diseases,  whatever 
values  are  assigned  to  the  time  estimates. 

FOSSIL    PATHOLOGICAL    LESIONS 

The  following  annotated  list  and  illustra- 
tions of  fossil  lesions  will  indicate  the  extent 
of  diseases  among  fossil  vertebrates.  The 
study  of  these  lesions  is  by  no  means  com- 
plete, and  other  pathological  processes  will 
doubtless  be  indicated  as  the  study  of  them 
progresses. 

1.  Caries  is  very  common  among  fossil 
vertebrates  and  has  been  described  by 
Renault  as  occurring  among  Permian  fishes, 
20,000,000  years  ago.  A  large  marine  reptile, 
from  Belgium,  one  of  the  Cretaceous  mosa- 
saurs,  according  to  Abel,  shows  in  the  left 
mandibular  ramus  extensive  evidences  of 
the  ravages  of  this  disease.  In  an  early 
Tertiary  species  of  the  three-toed  horse 
(Fig.  8),  the  mandible  has  been  affected 
by  caries  and  possibly  also  by  actinomycosis, 
as  well  as  some  necrotic  process  which  has 
resulted  in  the  exposure  of  the  roots  of  the 
teeth  and  the  absorption  of  the  alveolar 
margins,  similar  to  the  results  of  pyorrhea 
ahailaris.  Caries  has  been  noted  also  in  the 
tooth  of  a  mastodon,  and  in  the  early  cave 
bears  (Fig.  13)  of  Europe.  The  early  races 
of  men  were  singularly  free  from  this  disease 
as  evidenced  by  the  fossil  remains. 

2.  Pyorrhea  Alyeolaris,  or  some  sim- 
ilar pathologic  process,  is  especially  evident 
in  the  absorbed  alveolar  margins  and  in  the 
loosened  teeth  of  a  three-toed  horse  (Fig.  cS) 
from  the  Miocene  of  North  America.  It  is 
also  extensively  indicated  in  the  mandibles 
of  the  European  cave  bears  (Fig.  13),  and 
in   a   Cretaceous    mosasaur    from    France. 

3.  Deforming  Arthritides  are  fairly 
common  among  fossil  vertebrates  and  indi- 
cate a  variety    of    pathologic    conditions. 


Studies  in  Paleopathology 


387 


GEOLOGICAL    EVIDENCES    OF    PALEOPATHOLOGY 


Millions 
of  Years 

Time 

Eras 

Geological 
Periods 

Chief  Animal 
Groups 

Evidences  of 
Pathology 

3,000,000 

to 

10,000,000 

years 

Ceno- 

ZOIC 

Quaternary 

Age  of  Man 

Abundant  lesions  on  fossil  and  sub- 
fossil  human  remains 

Tertiary 

Age  of  Mam- 
mals 

Numerous  diseases  represented  on 
animal  remains  from  the  deposits  of 
the  period 

5 

6,000,000 
to 

12,000,000 

years 

Meso- 

ZOIC 

Cretaceous 

Age 

of 

Reptiles 

Lesions  on  the  bones  of  mosasaurs, 
dinosaurs,  plesiosaurs,  turtles,  croco- 

Comanchian 

diles,  phytosaurs  and  other  reptiles 
representing  diseases  similar  to  the 
modern  forms  of  periostitis,  hemangi- 

10 

Jurassic 

oma,  necrosis,  caries,  pyorrhea  alveo- 
Iaris,  arthritides,  fracture  with  cal- 
lus, pachyostosis,  osteoma,  opisthot- 

Triassic 

onos  and  other  lesions  which  cannot 
be  interpreted. 

'5 

12,000,000 

to 

19,000,000 

years 

Paleo- 
zoic 

Permian 

Age 
of 

Amphibians 

The  lesions  known  represent  dental 
caries,  pyorrhea  alveolaris,  fracture, 
callus  and  parasitism.  These  peri- 
ods witnessed  the  beginnings  of  dis- 
ease. Bacteria  and  fungi  were  abun- 
dant. 

Pennsylvanian 

20 

Mississippian 

Devonian 

Age 

of 

Fishes 

No  evidences  of  disease  are  known 
from  these  periods.  Beginning  of 
dependent  life. 

25 

Silurian 

30 

Ordovician 

Age 

of 

Invertebrates 

Cambrian 

31,000,000 

to 

50,000,000 

years 

Protero- 

ZOIC 

Keweenawan 

First 
known 
fossils 

Bacteria  (non-pathogenic) 

Animikian 

35 

Huronian 

Algomian 

40 

Sudburian 

45 

45,000,000 

to 

1,600,000,000 

years 

Archeo- 
zoic 

Laurentian 

No  life  known 

50 

55 

60 

Paleolauren- 
tian 

Annals  of  Medical  History 


Arthritides  are  especially  common  in  Pleis- 
tocene mammals.  The  most  prominent  case 
of  a  deformed  joint  is  the  case  of  two  caudal 
vertebrae  (Fig.  14)  of  a  large  dinosaur,  the 
interarticular  surfaces  of  which  have  been 
extensively  deformed  and  surrounded  by  a 
huge  exostosial  growth. 


the  middle  of  the  tumor-like  mass  is  38.5 
cm.  The  lesion  has  involved  a  length  of 
12  cm.  Its  surface  generally  is  rather  deeply 
pitted.  There  is  an  unusual  ventral  growth, 
which  is  shown  in  its  normal  condition  in 
Fig.  15  at  "A."  This  bony  process,  "the 
chevron,"  which  served  to  protect  the  cau- 


Fig.  14  Two  caudal  vertebra;  of  a  sauropodous  dinosaur,  possibly  Apatosaurus, 
ex  In  biting  a  pathological  lesion  which  may  be  interpreted  as  a  hemangioma, 
as  a  callus,  as  due  to  osteomyelitis  or  some  unknown  cause.  This  is  one  of  the 
most  interesting  evidences  of  disease  among  fossil  animals  so  far  studied.  A 
detailed  account  of  it  will  be  given  later.  Other  lesions  of  a  similar  nature  are 
fairly  common  among  the  dinosaurs  of  North  America  and  Europe.  One-half 
natural  size.  The  specimen  is  from  the  Como  Beds,  Comanchian,  of  Wyoming, 
and  is  the  property  of  the  Kansas  University  Museum  of  Natural  History. 


The  mass  resembles  closely  the  tumor- 
like masses  seen  on  oak  trees.  It  entirely 
encircles  the  vertebrae  and  has  involved 
fully  half  of  the  two  bones.  The  dark  line 
running  vertically  in  the  middle  of  Fig. 
14  indicates  the  point  where  the  normal 
union  of  the  two  vertebne  would  occur, 
but  all  evidences  of  separate  structures  are 
obliterated,  and  the  two  vertebrae  are  fused 
into  a  single  mass.  The  specimen  has  a 
length  ol  26.5  cm.  and  a  weight  of  5.1  kg. 
The  circumference  of  the  normal  articular 
surface  of  one  of  the  vertebrae  measures 
27  cm.,  and  the  same  measurement  around 


dal  vein  and  artery,  is  commonly  present  in 
the  tail  of  these  reptiles.  The  growth  of  the 
diseased  portion  is  unequal  and  has  in- 
volved more  of  the  vertebra  on  one  side 
than  on  the  other;  likewise,  the  growth 
has  attained  greater  lateral  dimensions  on 
one  side. 

The  enlargement  is  somewhat  suggestive 
of  the  lesion  of  chronic  osteomyelitis.  It 
may  be  a  callous  growth,  possibly  due  to 
a  fracture  of  the  caudal  vertebrae;  or  it 
may  be  a  bone  tumor.  The  character  of  the 
lesion  is  naturally  problematic,  but  it  is 
interesting  that  pathological  growths  in  the 


Studies  in  Paleopathology 


389 


early  geological  periods  so  closely  resemble 
the  lesions  of  today.  Section  of  the  tumor 
mass  shows  the  presence  of  numerous  vascu- 
lar spaces,  so  that  in  this  respect  it  re- 
sembles a  hsemangioma.  Microscopic  study 
of  the  periphery  (Fig.  16)  shows  the  pres- 
ence of  well-developed  Haversian  systems 
of  osseous  lamellae. 


Fig.  15.  Outline  sketch  showing  normal  appear- 
ance of  the  two  vertebrae,  based  on  Diplodocus  and 
Apatosaurus.  A = chevron.  This  process  in  the 
pathological  specimen  has  been  shoved  far  ventral- 
ward  and  involved  in  the  tumor-like  mass. 


t »  t 


Fig.  16.  This  figure  will  show  the  possibilities  in 
the  microscopic  study  of  fossil  bones.  The  drawing, 
300  diameters,  shows  the  osseous  lacunae,  with  short 
canaliculi  arranged  around  a  large  vascular  opening, 
thus  simulating  an  Haversian  system.  The  lacunae 
of  dinosaur  bones  are  much  smaller  than  are  the 
lacunae  in  other  extinct  forms.  The  dark  areas 
are  due  to  the  staining  of  iron  with  which  the 
bones  are  infiltrated.  The  section  was  taken  from 
the  periphery  of  the  specimen  shown  in  Fig.  14. 


The  bones  exhibiting  these  interesting 
indications  of  Mesozoic  pathology  are  the 
caudal  vertebrae  of  a  huge  land  reptile,  one 
of  the  sauropodous  dinosaurs,  possibly  Apa- 
tosaurus. The  position  of  these  bones  in  the 
body  of  the  animal  is  indicated  by  the 
arrow  in  Fig.  17.  The  sauropodous  dino- 
saurs were  the  most  gigantic  of  all  land 
vertebrates,  although  not  nearly  so  large 
as  some  of  the  modern  whales.  The  largest 
of  these  reptiles  attained  a  length  of  nearly 
70  feet  and  an  estimated  weight  of  39  tons. 
The  head  was  approximately  the  size  of 
that  of  a  modern  draft  horse  and  the  con- 
tained brain  was  no  larger  than  one's  fist. 
The  lumbar  intumescence,  however,  was  ten 
times  the  size  of  the  cephalic  portion  of  the 
nervous  system,  or  at  least  the  subdural  space 
was.  Whether  the  nervous  material  filled 
the  entire  cavity  or  not  is  unknown.  The 
animals  lived,  possibly,  in  the  swamps  and 
low-lying  rivers,  feeding  on    the   succulent 


vegetation,  and  are  said  to  have  been  ca- 
pable of  attaining  the  ripe  age  of  1,000  years. 
Diseases  are  rarely  seen  on  fossil  dinosaur 
bones,  in  spite  of  the  great  abundance  of 
their  remains. 

i  The  tail  in  some  of  these  large  animals  was 
very  long  and  slender,  and  it  may  have 
been  used  in  swimming,  as  a  muskrat  uses 
his  today.  The  terminal  caudals  in  some 
species  were  reduced  to  mere  slender  rods 
of  bone,  so  that  a  fracture  or  an  injury  of 


Fig.  i_.  Outline  figure  with  skeleton,  of  Bron- 
tosaurus,  showing  at  the  arrow  the  location  of  the 
vertebrae  shown  in  Fig.  14.  This  animal  attained  a 
length  of  nearly  70  feet,  a  height  of  15  feet  and  a 
weight  of  many  tons.  (Based  on  a  figure  by  Mat- 
thew.) 


390 


Annals  of  Medical  History 


any  kind  in  this  region  could  easily  occur. 
Aside  from  possible  blows  from  the  head, 
the  dinosaur  to  which  the  above  described 
vertebrae  belonged  was  entirely  defenseless. 
The  tail,  for  example,  might  be  seized  by 
one  of  the  carnivorous  dinosaurs  and  vig- 
orously chewed  for  some  time  before  the 
owner  of  the  tail  was  able  to  turn  his  huge 
body  and  knock  the  offender  away. 

Lesions  of  a  similar  nature,  but  not  so  well 
developed,  are  known  to  occur  in  the  tail  of 
Cetiosaurus  Leedsi,  an  English  dinosaur;  and 
Hatcher  has  described  the  same  lesions  in 
the  tail  of  Diplodocus.  A  fuller  discussion  of 
these  lesions  is  reserved  for  another  time. 

The  nature  of  the  above-described  lesion 
is  such  that  it  may  have  been  due  to  bac- 
terial activity,  and  suggests,  at  any  rate, 
the  presence  of  pathogenic  bacteria  in  the 
early  part  of  the  Cretaceous  period.  Bacteria 
and  primitive  fungi  have,  indeed,  been 
described  from  much  older  periods.  The 
best  account  of  their  occurrence  is  con- 
tained in  "Microorganismes  des  combusti- 
bles fossiles,"  by  B.  Renault.34  Renault  has 
described  and  figured  many  forms  of  bac- 
teria and  fungi  in  the  fossilized  feces 
(coprolites)  of  fishes,  in  fossil  wood,  and  in 
coal.  He  has  also  discovered  in  the  teeth 
of  some  ancient  fishes  what  he  regards  as 
indications  of  the  activity  of  organisms 
which  have  produced  results  similar  to 
caries.  He  shows  in  one  of  his  plates  photo- 
micrographs of  fossil  bone  from  the  petrified 
feces  in  which  the  ravages  of  the  bacteria. 
Micrococcus  are  evident  in  the  canaliculi 
and  the  bone  corpuscles,  which  appear  in 
various  stages  of  destruction. 

Other  deforming  arthritides  are  repre- 
sented by  the  arthritic  condition  sometimes 
spoken  of  as  rheumatoid  arthritis  which  has 
been  noted  by  Virchow  in  the  cave  bears, 
by  nt lur  observers  in  certain  fossil  human 

u  B.  Renault:  "Microorganismes  <l<s  combustibles 
fossiles,"  Hull.  Soc.  de  I' Industrie  minerale  Saint- 
Etienne,  Paris,  [899-1900,  Tomes  15-14,  with  f<>li" 
atlas  of  20  plates  <>(  photomicrographs. 


skeletons,  in  the  famous  Lansing  man  of 
Kansas,33  and  it  is  probably  indicated  in 
the  Cretaceous  mosasaurs,  where  a  well- 
developed  osteoma  accompanied  the  arthri- 
tic inflammation. 

4.  Osteomyelitis  is  probably  indicated 
in  the  dinosaurian  caudals  figured  herewith 
and  i  n  certain  phalangeal  elements  of  a  gian 
wolf  from  the  Pleistocene  of  California. 

5.  Eosxtoses  due  to  trauma,  indicated 
as  callous  growths  around  fractures  of  ribs 
and  limb  bones,  or  as  outgrowths  due  to 
chronic  irritation  or  infection,  are  fairly 
common  among  fossil  vertebrates.  Healed 
fractures  (Fig.  7)  are  very  common  among 
mammals  and  are  occasionally  seen  among 
fossil  reptiles.  Dinosaurs  exhibiting  broken 
ribs,  vertebrae,  and  horn  cores  attest  the 
accidents  or  lights  which  caused  these 
traumatic  conditions,  and  has  led  Abel  to 
infer  that  the  males  of  these  animals  con- 
tested during  the  breeding  season  for  the 
female.  An  exostosis  which  is  especially 
clearly  marked  is  evident  on  the  inner  or 
visceral  surface  of  a  dinosaur  scapula,  where 
it  takes  the  form  of  a  hook-like  process, 
evidently  due  to  chronic  irritation.  An 
exact  duplicate  of  this  lesion  may  be  seen 
on  a  recent  human  femur.  One  of  the  most 
perfect  exostoses  is  seen  in  a  mosasaur  from 
the  Cretaceous  of  Kansas  where  there  is  a 
decided  lump  at  the  articular  surface  be- 
tween the  third  and  fourth  dorsal  vertebrae, 
resulting  in  what  is  probably  the  only  known 
fossil  osteoma.  Curious  exostoses  which  are 
bilaterally  symmetrical  occur  on  the  radii 
of  an  Oligocene  dog,  the'  skeleton  of  which 
is   in  the  Carnegie   .Museum  of  Pittsburgh. 

7.  Osteosarcoma  1  \  have  not  been  posi- 
tively identified  among  extinct  animals,  but 
the'  condition  is  suggested  in  several  in- 
stances. Esper,  in  [774,  described  what  he 
thoughl  was  an  osteosarcoma  in  the  femur 
of  a  cave  bear,   but    Mayer,  who  studied 

35  Charle's  A.  Parker:  "Evidences  of  Rheumatoid 
Arthritis  In  the  Lansing  Man,"  Amer.  Geol.,  mm, 

vol.   xwiii.   |>|).    5'>-t--   ' 'K-    '■ 


Studies  in  Paleopathology 


39i 


the  specimen  later,  suggested  that  it  might 
have  been  a  fracture  with  callus  and 
necrosis. 

8.  Fistula  are  evident  in  the  lower  jaw 
of  an  ancient  and 

primitive  whale 
from  the  Eocene  of 
Egypt,  and  an  en- 
largement of  the 
mandible  of  a 
three-toed  horse 
from  the  Miocene 
of  North  America 
indicates  the  pres- 
ence of  a  fistula, 
possibly  due  to 
actinomycosis,  i  n 
its  early  stages. 
Dental  fistulse  are 
occasionally  seen 
among  the  known 
remains  of  fossil 
man,  often  result- 
ing in  the  loss  of 
teeth. 

9.  Rickets  is  in- 
dicated, according 
to  Abel,  among  the 
apes  which  are 
found  mummified 
in  the  old  Egyptian 
graves. 

10.  Necroses, 
due  possibly  to  a 
variety  of  causes, 
and  attributed  by 
certain  French 
writers  to  tuber- 
culosis, are  fairly 
common  among 
fossil  vertebrates. 
A  marked  necrosis 
of  the  ilium  of  a 

large  dinosaur,  accompanied  by  expansion 
and  thickening  of  the  bone,  is  evident 
in  the  mounted  skeleton  of  Campto- 
saurus    on     exhibition     at    the     National 


Fig.  18.  The  arm  bones  of  a  mosasaur  from  the  Cretaceou 
of  Kansas,  showing  lesions  resembling  osteoperiostitis.  The 
Ia'ge  bone  is  the  humerus,  the  other  probably  a  radius. 
The  rough  surface  of  the  bone  indicates  its  pathology. 
Normal  well-preserved  specimens  of  these  bones  are  quite 
smooth.  The  lesions  have  an  arthritic  nature  also,  though 
they  are  not  confined  to  the  articular  surfaces,  x  J^. 

The  specimens  are  the  property  of  the  University  of 
Kansas  Museum  of  Natural  History. 


Museum  in  Washington.  A  mosasaur  bone 
from  the  Cretaceous  of  Kansas  and  certain 
crocodile  limb  bones  from  the  Jurassic  of 
England  show  lesions  of  a  necrotic  nature. 
The  assignment  of 
any  of  the  lesions 
to  a  definite  cause 
is  manifestly  im- 
possible, and  while 
tuberculosis  has 
been  suggested  as 
a  possible  cause, 
the  diagnosis  is  so 
uncertain  as  to  be 
nearly  worthless. 
In  the  crocodile 
skeleton,  above 
referred  to,  there 
is  abundant  evi- 
dence that  the  in- 
fection, the  focus 
of  which  was  in 
the  pelvis,  was 
carried  by  metas- 
tasis to  the  bones 
of  the  palate  which 
were  also  involved, 
as  well  as  other 
parts  of  the  body. 
1 1 .  Hyperosto- 
sis  or  PACHYOSTO- 

sis,  which  is  similar 
to  the  enlargement 
of  the  bones  in 
Gigantism,  is  indi- 
cated as  thickened 
and  enlarged  por- 
tions of  the  skel- 
eton. This  condi- 
tion has  been  de- 
tected in  certain 
fossil  Paleozoic 
fishes  and  Mesozoic 
reptiles,  some  of  them  of  great  geological 
antiquity.  A  genus  of  fossil  whales,  known 
as  Pachycanthus,  has  the  neural,  vertebral 
spines  very  greatly  enlarged  and  swollen. 


392 


Annals  of  Medical  History 


- 


Fig.  19.  Microscopic  section  of  one  of  the  lesions 
from  the  surface  of  the  humerus,  Fig.  IS,  showing 
bundles  of  perforating  fibers  of  Sharpey,  osseous 
lacuna?,  and  vascular  openings.  The  large  clear 
space  at  the  upper  portion  of  the  picture  is  a  vascu- 
lar opening  filled  with  calcite  crystals.  300  diameters. 


A  similiar  condition  is  seen  in  the  skeleton 
of  a  Triassic  nothosaur.  Wre  are  not  justified 
in  stating  on  these  evidences  the  presence  of 
pituitary  disturbances  in  ancient  animals, 
but  further  studies  in  this  line  may  add 
very  interesting  data. 

1 2.  Osteoperiostitis  or  some  similar  dis- 
turbance is  the  result  seen  in  the  arm  bones 
of  a  mosasaur  from  the  Cretaceous  of 
Kansas  (Fig.  18).  The  articular  surfaces 
are  very  greatly  roughened  and  the  surfaces 
of  the  bones  are  covered  with  smooth, 
somewhat  flattened  excrescences,  possibly 
due  to  a  subperiosteal  irritation.  The  lesions 
have  been  observed  in  no  other  instances, 
so  that  no  comparative  statements  can  be 
made.  Microscopic  study  of  the  peripheral 
lesions  reveals  many  interesting  histological 
details.  One  area  shows  typical  osteoid  tis- 
sue,   similar    in    all    essential    respects    to 

"This  subject  lias  been  discussed  at  length  by 
the  writer,  in  "Opisthotonos  and  Allied  Phenomena 
anions    Fossil    Vertebrates,"    .American    Naturalist, 


osteoid  tissue  developed  in  a  human  humer- 
us in  a  case  of  osteomyelitis.  Other  areas, 
such  as  the  one  figured  (Fig.  19),  show  per- 
forating fibers  of  Sharpey,  as  seen  in  the 
dark  bundles,  and  the  nature  of  the  osseous 
lacunae.  The  whole  section  is  filled  with 
vascular  spaces.  An  especially  large  one, 
filled  with  calcite  crystals,  is  seen  in  the 
upper  portion  of  the  picture.  There  are  no 
apparent  Haversian  systems  or  canals. 
\\  hether  this  is  due  to  the  pathology  of  the 
bone  or  whether  it  is  an  occurrence  in  nor- 
mal bone  of  the  mosasaurs  will  be  deter- 
mined later  by  microscopic  study  of  the 
normal  tissues. 

13.  Opisthotonos  and  the  allied  phe- 
nomena, pleurothotonos  and  emprostho- 
tonos,  are  quite  frequently  seen  among 
fossil  vertebrates.  It  has  been  suggested 
elsewhere  that  these  attitudes  represent 
possible  cerebrospinal  infections  or  other 
neurotoxic  conditions,  and  they  must  be 
considered  in  connection  with  the  study 
of  disease  among  fossil  animals.36  The  skele- 
ton of  the  small  dinosaur,  Struthiomimus 
alius  (Fig.  20),  described  by  Osborn,37 
shows  a  very  well-developed  condition  of 
opisthotonos,  with  the  head  thrown  sharply 
back,  the  tail  strongly  Hexed,  and  the  toes 
contracted  and  appressed.  The  whole  atti- 
tude strongly  suggests  a  spastic  distress, 
possibly  brought  on  by  some  form  of 
poisoning  of  the  central  nervous  system, 
from  infection  or  the  deglutition  of  some 
poisonous  substance. 

14.  Osteomalacia  is  evidently  the  cause 
of  the  hypertrophy  of  the  bones  of  Lim- 
nocyron  potens,  an  early  carnivore  from  the 
Washakie  Eocene  of  Wyoming,  nearly 
3,000,000  years  old. 

MATERIALS    AND    METHODS 

The  material  described  in  the  present 
paper  has  been  loaned  the  writer  lor  de- 
scription by  the  Field  Museum  of  Chii 

"Osborn:  Hull.  Amcr.  \lus.  Natl.  Hist.,  1917, 
vol.  35.  !>•  733.  P>-  28. 


Studies   in   Paleopathology 


393 


by  the  American  Museum  of  Natural  His- 
tory of  New  York  City,  by  Walker  Museum 
of  the  University  of  Chicago,  and  by  the  Uni- 
versity of  Kansas  Natural  History  Museum. 


made  by  the  well-known  petrographic  meth- 
ods so  common  in  all  geological  labora- 
tories. The  diagnoses,  where  they  are  at- 
tempted, arc  made  from  comparisons  of  the 


Fig.  20.  The  skeleton  of  Strutbiomimus  altus,  a  small  dinosaur  from  the  Beliy 
River  series  (Cretaceous),  Red  Deer  River,  Alberta,  Canada,  now  regarded  as  of 
approximately  the  same  age  as  the  Judith  River  series.  The  unique  feature  of 
the  skull  is  the  total  absence  of  teeth,  with  a  size  of  skull  one-third  larger  than 
the  ostrich  and  a  length  of  body  of  about  fifteen  feet.  The  position  of  the  skeleton 
is  decidedly  that  of  the  opisthotonos  which  may  be  regarded  as  an  indication  of 
disease.      (After  Osborn). 


A  beautiful  specimen  of  an  osteoma,  the 
only  one  known  so  far,  on  the  vertebra  of  a 
Kansas  Cretaceous  mosasaur,  was  given  the 
writer  by  Dr.  J.  M.  Armstrong  of  St.  Paul. 
The  writer  expresses  his  obligations  to  the 
gentlemen  connected  with  the  above-men- 
tioned institutions  and  to  Dr.  Armstrong. 
The  methods  used  are  a  combination  of 
procedures  in  the  various  lines  involved. 
Microscopic  sections,  which  can  be  made 
thin  enough  for  immersion  lens  study,  are 


material  with  similar  lesions  in  recent  hu- 
man material;  but  strict  diagnosis  has  not 
been  attempted.  We  must  have  some  name 
for  the  lesions,  so  the  terms  used  must  be 
regarded  as  suggestive  rather  than  an  ac- 
curate statement  of  conditions.  The  inter- 
pretation of  the  lesions  in  the  fossil  material 
is  a  matter  of  experience  with  fossil  remains. 
The  author  feels  that  twelve  years  experi- 
ence in  the  study  of  fossils  should  be  suffi- 
cient to  avoid  most  of  the  usual  pitfalls. 


PLAGUE  TRACTATES 

By  DOROTHEA  WALEY  SINGER  AND  REUBEN  LEVY 

Oxford,  England 


I.  Introduction By  Dorothea  Waley  Singer 

II.  Sir  John  Mandeville,  Jean  d'Oultremeuse  and  the  Physi- 
cian, Bearded  John  of  Burgundy By  Dorothea  Waley  Singer 

III.   Translation  of  Hebrew  Versions  of  John  oj  Burgundy's 
Tractate  in  Bibl.  Nat.  Fonds  hebreu  1191  (VIII)  and 
Bibl.  Nat.  Fonds  hebreu  1124  (Via).   With  Notes       By  Reuben  Levy 
Appendix    I.    References  to  Tomb  of  John  of  Burgundy  in  Liege. 

Appendix  II.  Text  of  Hebrew  Versions  of  John  of  Burgundy's  Tractates.  Bibl.  Nat. 
Fonds  hebreu  1 191  (VIII)  and  Bibl.  Nat.  Fonds  hebreu  1124  (Via) 
with  facsimiles  from  both  MSS. 


I.  Introduction 

DURING  the  later  middle  ages 
and  earlier  renaissance,  and 
especially  during  the  one  hun- 
dred and  fifty  years  that  suc- 
ceeded the  visitation  of  the  Black  Death  of 
1348,  Europe  was  repeatedly  devastated  by 
waves  of  pestilence  that  swept  over  the 
continent,  usually  in  the  direction  from  the 
East  and  South  towards  the  West  and 
North.  These  terrible  epidemics  left  deep 
their  stamp  on  the  literature  of  the  period- 
theological,  political,  and  medical.  The  con- 
temporary medical  writings  on  the  plague 
consist  mainly  of  short  treatises  or  tractates.1 
They  are  to  be  found  in  every  European 
language  and  several  of  them  have  been 
translated  into  Hebrew.1 

Among  the  most  influential  and  widely 
circulated  of  the  plague  tractates  was  one 

1  Cf.  K.  SudiiofF  "  Pestschriften  aus  den  ersten  150 
Jahren  nach  der  Epidemie  des  Schwarzen  Todes 
1348,"  in  Arcb.  J.  Gescb.  d.  Med.,  Leipzig,  1909-16 
(in  progress), vols.  ii-ix;and  Dorothea  Waley  Singer 
"Some  Plague  Tractates  (14th  and  15th  centuries)" 
in  Proc.  Ray.  Sue.  Mid.,  London,  1916,  vol.  i.\. 
(Section  of  the  History  of  Medicine). 

s  Besides  the  plague  tractate,  of  which  the  Hebrew 

version   forms  the  subject  of  this   paper,    Hebrew 

versions  of  the  plague  writings  of  Antonio  Cermisone, 

■     gnili,  Gentile  da  Foligno,  Antonio 

Guainerio  and  Pietro  de  Tussignano  an-  noted  by 


written  in  1365,  which  professes  to  be  the 
work  of  John  of  Burgundy,  otherwise  known 
as  John  a  la  Barbe.3  This  has  been  printed 
several  times,  and  recently  a  French  version 
has  been  published  from  a  manuscript  dated 
1 37 1 — only  six  years  after  the  original  issue 
of  the  work.4 

The  tractate  professes  to  be  the  third  by 
its  author  on  the  same  subject.  He  gives 
the  "incipit"  and  subject  matter  of  his 
previous  works  on  the  plague,  which  he 
describes  as  well  known,  but  so  far  they 
have  not  been  satisfactorily  identified,  if, 
indeed,  they  ever  existed  outside  the  imag- 
ination of  the  old  physician. 

After  an  astrological  introduction  to  the 
work,  the  author  describes  himself  as  "Jo- 
han  de  Bourgogne,  otherwise  called  a  la 
Barbe,  citizen  of  Liege  and  professor  of  the 
art  of  medicine,  though  the  least  of  all 
physicians".  This  last  tribute  to  modesty 

M.  Steinschneider  in  "Die  Hebr&ischen  Uebersetz- 
ungen  des  Mittelalters  und  die  Juden  als  Dolmet- 
scher",  Berlin,  1893,  PP-  790-i>  799-800,  804,  818, 
etc.;  and  in  //  Buonarotti,  Rome,  1876,  vol.  xi, 
pp.  113-114.  Doubtless  an  examination  of  tlie  man- 
uscripts of  the  great  libraries  would  reveal  more  of 
these   Hebrew   versions  and  translations. 

*  Not  to  be  confused  with  Giovanni  Borgondio  of 
Pisa  (died  1190),  who  translated  Galen's  "De 
Regimine  Sanitatis". 

4  Dorothea  Waley  Singer,  loc.  cit.,  Appendix. 


394 


Plague  Tractates 


395 


he  takes  care  to  discount  by  frequent  allu- 
sions to  his  success  and  long  experience. 
The  influence  of  this  text  may  be  traced 
directly  and  indirectly  in  many  fourteenth 
and  fifteenth  century  works  on  the  plague. 
One,  that  was  immensely  popular  through- 
out England,  bears  in  most  versions  the 
name  "John  of  Bordeaux,  a  noble  physi- 
cian". 6  This  "John  of  Bordeaux"  is  often 
confused  with  the  above-mentioned  "John 
of  Burgundy",  whose  work  appears  to 
constitute  his  sole  source. 

Five  Hebrew  texts  have  been  described 
as  versions  of  the  tractates,  either  of  John 
of  Burgundy  or  of  John  of  Bordeaux.  Be- 
fore examining  these  texts  we  will  sum- 
marize for  the  reader  the  evidence  as  to  the 
identity  of  John  of  Burgundy,  who,  it  will 
be  shown,  had  almost  certainly  a  share  in 
the  authorship  of  the  "Travels  of  Sir  John 
Mandeville". 

II.  Sir  John  Mandeville,  Jean  Despreis 

Dit  d'Oultremeuse,  and  the  Physician, 

Bearded  John  of  Burgundy 

From  the  fifteenth  to  the  eighteenth  cen- 
tury the  identity  of  the  author  of  the  famous 
"Travels  of  Sir  John  Mandeville",  with  a 
certain  Liege  physician  described  as  Bearded 
John,  Joba7ines  ad  Barbara,  or  Jehan  a  la 
Barbe,  was  too  universally  accepted  to 
excite  discussion.   In  the  Guillelmite  mon- 

6This  work,  arranged  in  four  chapters,  was  cur- 
rent in  England  about  the  year  1390,  when  the 
country  was  attacked  by  plague.  It  is  based  entirely 
on  our  text,  and  the  problem  remains  unsolved 
whether  "John  of  Bordeaux"  was  indeed  the  au- 
thor's name  or  was  a  version  of  the  name  "John  of 
Burgundy".  But  the  incipit  and  subject  matter 
described  in  our  text  do  not  quite  correspond  with 
those  either  of  this  work  or  of  a  further  abbreviated 
version  in  the  form  of  an  attractive  little  "  Epistle 
on  the  Plague"  from  about  the  same  date,  of  which 
copies  are  only  known  to  exist  in  England.  See  D. 
Waley  Singer,  loc  cit.,  p.  172  et  seq. 

6  The  evidence  for  the  existence  of  this  tomb  is 
summarized  in  Appendix  I. 


astery  at  Liege  (completely  destroyed  in 
1798),  there  existed  indeed  a  tombstone, 
bearing  the  following  inscription: 

"Hie  iacet  vir  nobilis  Dominus  Joannes 
de  Mandeuil  alias  dictus  ad  Barbam, 
miles,  Dominus  de  Campdi,  natus  in 
Anglia,  Medicinae  Professor,  devotis- 
simus  Orator  et  bonorum  suorum  Iargis- 
simus  pauperibus,  erogator  qui  toto 
quasi  orbe  Iustrato,  Leodii  vitse  sue 
diem  clausit  extremum  Anno  Domini 
1372,  Mensis  Novembris  die  17" 

and  around  the  coat  of  arms  were  inscribed 
the  words: 

"Vos  Ki  passeis  sor  mi,  pour  Iamour 

Deix  proi  pour  mi."  6 
The  evidence  from  the  tombstone  is  sup- 
plemented by  an  extract  from  a  fourteenth 
century  manuscript  of  the  "Myreur  des  His- 
tors"  of  Jean  des  Preis,  dit  d'Oultremeuse, 
clerk  and  notary  at  Liege,  and  Audencier 
in  the  Court  of  Justice  (born  1338).  It  is 
here  recounted  that  on  his  death-bed  the 
physician,  Jean  de  Bourgogne  called  a  la 
Barbe,  revealed  himself  to  d'Oultremeuse, 
declaring  that  he  was  none  other  than  Sir 
John  Mandeville,  the  famous  English  trav- 
eler, and  that  he  had  left  his  native  land 
owing  to  having  "had  the  misfortune"  to 
kill  a  nobleman.  The  passage  cited  is  from 
the  fourth  part  of  the  "Myreur  des  Histors", 
now    unluckily    lost.7 

7"L'  an  MCCCLXXII  mourut  a  Liege,  Ie  12 
Novembre,  un  horame  fort  distingue  par  sa  nais- 
sance,  content  de  s'y  faire  connoitre  sous  Ie  nom  de 
Jean  de  Bourgoyne,  dit  a  la  Barbe.  II  s'ouvrit  nean- 
moins  au  lit  de  la  mort  a  Jean  d'Oultremeuse,  son 
compere  et  institue  son  executeur  testamentaire.  De 
vrai  il  se  titra  dans  Ie  Precis  de  sa  derniere  volonte 
Messire  Jean  de  Mandeville,  chevalier,  comte  de 
Montfort  en  Angleterre  et  seigneur  de  I'isle  de  Camp- 
di et  du  Chateau  Perouse.  Ayant  cependant  eu  Ie 
malheur  de  tuer,  en  son  pays,  un  comte  qu'il  ne 
nomme  pas,  il  s'engagea  a  parcourir  Ies  trois  parties 
du  monde.  Vint  a  Liege  en  1343.  Tout  sortie  qu'il 
etoit  d'une  noblesse  tres  distinguee,  il  aima  de  s'y 
tenir  cache.  II  etoit,  au  reste,  grand  naturaliste,  pro- 


396 


Annals  of  Medical  History 


Further  circumstantial  evidence  seems 
to  be  offered  by  the  "Travels"  themselves. 
In  the  final  chapter  of  the  earliest  Latin 
version  we  find  a  curious  story  which  may 
be  translated  here: 

"In  the  year  1355  of  the  birth  of  the 
Lord  Jesus  Christ  I  was  staying  in  the 
city  of  Liege,  and  owing  to  the  severity 
of  my  arthritic  gout  I  lodged  then  in 
the  street  called  Bassesauenyr.  And  I 
consulted  various  doctors  of  the  town 
as  to  my  convalescence,  and  it  hap- 
pened by  the  will  of  God  that  there 
came  one  physician  more  venerable 
than  the  others  by  reason  of  his  age 
and  grey  hairs,  and  evidently  expert 
in  his  art.  He  was  known  there  as 
Master  Johannes  ad  Barbam.  And 
when  I  would  have  spoken  also  with 
him  he  intervened,  and  after  some 
words  he  at  length  renewed  the  acquain- 
tance that  we  previously  had  at  Cairo 
in  Egypt,  at  [the  court  of]  the  Soldan 
Calalxlich  as  I  mentioned  above,  in 
Chapter  VII  of  this  book.  And  when  he 
had  most  excellently  demonstrated  up- 
on me  his  experience  in  his  art,  he  urged 
me  and  did  most  instantly  entreat  me 
that  I  should  set  down  in  writing  some- 
what of  those  things  that  I  had  seen 
during  my  travels  throughout  the  world, 
that  they  might  be  read  and  heard  for 
the   benefit   of  posterity.    So   that    at 

fond  philosophe  et  astrologuc,  y  joint  en  particulier 
unc  connoissance  ties  singuliere  de  la  physique  se 
trompanl  rarement  [orsqu'il  disort  son  sentiment  a 
ide,  s'il  reviendrort  mi  pas.  Mori 
enlin,  on  l'enterra  aux  F.  F.  Guillelmins,  au  fau- 
bourg d'Avroy,  comme  vous  avez  vu  plus  amplement 
au  dessus. " 

See  S.  Bormans  in  La  Bibliophile  Beige,  Brussels, 
vol.  i,  i).  2}6,  and  in  the  "Chroniqueel  <  <■  sfc 

ile  Jean  (lis  Preis  clit  d'Oultrenieuse",  Brussels,  [887, 
vol.  i.  Intr.  p.  cxxxn,  it  seq. 

The  passage  is  derived  from  a  complete  manu- 
script of  the  "Myreur  des  Histors",  written  by 
Jean  de  Stavelot,  a  friend  of  d'OuItremeuse  and  monk 
of  the  Abbe  de  St.   Laurence  at   Liege,   where  this 


length,  thus  urged  and  with  [his]  help 
this  treatise  was  composed.  Nor  indeed 
did  I  propose  to  write  aught  of  it  until 
at  least  I  should  have  reached  my 
native  England. 

"And  I  believe  that  by  the  providence 
and  grace  of  God  I  attained  that  which 
was  ordained  for  me.  For  from  the  time 
that  I  wrote  it  down  our  two  kings  of 
England  and  France  have  not  ceased 
each  in  turn  to  perpetrate  great  destruc- 
tions, depredations,  ambuscades  and 
slaughter,  so  that  unless  defended  by 
God  I  should  never  have  passed  over 
without  death  or  danger  of  death  and 
many  accusations.  And  now  behold  in 
the  thirty-third  year  since  my  depar- 
ture I  am  established  in  the  city  of 
Liege  which  is  but  two  days'  journey 
from  the  English  sea,  and  I  hear  that 
the  hostile  words  of  our  rulers  are  by 
the  grace  of  God  reconciled.  Wherefore 
I  hope  and  propose  for  the  rest,  as  belits 
my  ripe  age,  to  be  enabled  to  turn  to 
my  own  land  for  the  ease  of  my  body 
and  the  health  of  my  soul." 

If  we  turn  to  Chapter  VII  of  the  work  we 
find  a  description  of  the  first  meeting  be- 
tween Mandeville  and  the  physician  in 
Cairo,  and  we  are  assured  "Long  after- 
wards and  in  a  far  distant  place,  viz.,  the 
town  of  Liege,  exhorted  by  this  venerable 
man   and   with   his   help,    I    composed   the 

manuscript  was  known  to  exist  as  late  as  1-^0.  Our 
extract  was  first  made  from  the  manuscript  by  Louis 
d'Abry  (1643  '~-n  •  Herald  and  Archaeologist  of 
Liege  who,  however,  modernized  the  langi 
Hoi  mans  states  that  this  modernized  version  of 
d'Abry  is  to  be  found  in  the  Library  of  Count 
d'Outremcnt,  where  it  hears  the  number  "66".  It 
was  copied  l>y  Jean  (lilies  I.el'ort,  Herald  of  Liege 
from  1682  until  1718  or  perhaps  by  Jean  Henri  Le 
Fort  who  OCCUpied  the  office  until  his  death  in    [75I, 

The  passage  is  cited  by  Bormans  from  the  "Le  I  "it 
Manuscripts",  Series  ii,  vol.  xxvii,  p.  102,  forming 
part  of  the  Liege  archives.  For  details  ol  the  Lefort 

family,  see  S.  Bormans  in  Bull,  de  flnst.  Anlno- 
logique  Liegois,  vol.  iv,  Liege,  i860,  |>.  511). 


Plague  Tractates 


397 


present  treatise  as  I  will  narrate  fuller  at 
the  end  of  this  work.8" 

With  the  exception  of  a  few  medical 
recipes  at  Heidelberg  and  in  the  Bodleian 
Library,  the  only  work,  besides  the  "Trav- 
els," hitherto  known  as  bearing  the  name 
of  "Sir  John  Mandeville"  is  a  lapidary.9 

In  the  Amiens  fifteenth  century  manu- 
script of  the  "Travels",10  this  "Lapidary" 
is  given  as  a  sort  of  postscript  under  the 
name,  not  of  "Mandeville",  but  of  "Johans 
a.  la  Barbe".  Thus  immediately  after  the 
Explicit  of  the  "Travels"  we  find: 

"Chy    comenche    Ie    Iapidare    maistre 
Johans  a  la  Barbe", 
while  the  explicit  at  the  end  of  the  whole 
codex  runs: 

"Chis  Iibre  est  appelleis  Ie  Livre  Johans 
de  Mande  Ville,  chevalier  qui  fut  fait, 
escrit,  copileit  et  extrais  hors  d'une 
aultre  en  la  ville  de   Hotton,   par  Ie 

8  These  quotations  are  translated  from  folios  i.vii. 
recto  and  verso,  chap.  1  and  folio  b.iii,  verso,  chap,  vii 
of  the  printed  Latin  version  (Brit.  Mus.  66,700) 
described  in  a  manuscript  note  on  its  first  page  as 
the  first  printed  Latin  edition,  dating  probably  from 
about  1480.  Cf.  G.  W.  Warner.  "The  Duke  of 
John  Mandevill,  Knight,  1 322-1 356,  a  hitherto  un- 
published English  version  from  the  unique  copy 
(Egerton  MS.  1892)  in  the  British  Museum,  edited 
together  with  French  texts,  notes  and  introduc- 
tion." Pub.  by  Roxburgh  Club,  Westminster,  1889, 
p.  vii.  Warner  mentions  12  manuscripts  and  5 
printed  editions  of  this  Latin  version. 

Henaux,  Bull,  de  I'lnst.  Archeologique  Liegois, 
Liege,  i860,  vol.  iv,  p.  159,  quotes  a  similar  passage 
from  a  French  manuscript  since  lost  (No.  360  of 
Liege  University  Public  Library,  fol.  118).  This 
French  version  described  the  physician  as  "maistre 
Johans  de  Bourgogne  dit  ale  barbe".  It  gives  1356 
for  the  year  of  the  composition  of  the  "Travels,"  "in 
the  34th  year  of  my  wandering".  Henaux  also  cites 
a  Latin  version  of  Martins  de  Alost,  of  the  year  1491, 
as  describing  the  same  incident.  The  story  appears 
again  in  a  fifteenth  century  French  manuscript 
version  of  the  "Travels"  in  the  Public  Library  of 
Amiens,  manuscript  Fonds  Lescalopier  94  (5200). 
Our  physician  is  here  described  as  "uns  venerable 
homme  et  discreit,  maistre  Johans  a.  la  Barbe,  phi- 
sechiens",  and  the  same  dates  are  given  for  Mande- 


main  Lambert  Ie  clers,  pour  et  on  nora 

de  mon  tres  vailliant  et  tres  honoreis 

signour  mon  damoysiaux   Lovuy,  sig- 

neurs  de  Rochefort  et  d'Agymont,  etc., 

sur  I'an  de  graace  de  la  sainte  nativiteit 

Nostre    Signeur    Jhesu    Criste    milhe 

quatre    cens    et   sissante   et    unck,    en 

moy  de  may,  etc."  u 

The    manuscript    thus    supplements    the 

already-known  evidence  that  in  the  fifteenth 

century  Sir  John  Mandeville  and  John  a  la 

Barbe  were  regarded  as  one  and  the  same 

person. 

In  the  latter  part  of  the  nineteenth  cen- 
tury the  long-forgotten  belief  in  Bearded 
John's  authorship  of  the  "Travels"  was 
again  brought  forward  by  Bormans,12  Nich- 
olson,13 Warner,14  and  later  writers.15  Re- 
cently the  subject   has   been  carefully   in- 

ville's  flight  from  England  and  for  the  composition 
of  the  "Travels".  We  have  not  had  the  opportunity 
of  examining  this  manuscript,  and  these  passages 
are  cited  from  the  Catalogue  General  des  Manuscrits 
des  Bibliotheques  Publiques  de  France,  Departements, 
"Amiens"  by  E.  Coyeeque,  Paris,  1893,  Tome  xix, 
p.  493. 

9"Le  Lapidaire  en  francovs",  compose  par 
messire  jehan  de  Mandeville  (?)  Lyons  (?),  1531; 
Paris,  1 561;  s.  Let  d.,  probably  before  1580,  and 
"Le  Grand  Lapidaire,"  Paris,  1561.  This  latter 
edition  was  republished  with  notes  by  Y  del  Sotto, 
"Le  lapidaire  du  quatorzieme  siecle.  Descriptions 
des  pierres  precieuses  et  de  Ieurs  vertus  magiques 
d'  apres  Ie  traite  du  Chevalier  Jean  de  Mandeville", 
Vienne,  1862. 

10  Amiens  Public  Library.  Manuscripts  Fonds  Les- 
calopier 94  (5200). 

11 E.  Coyeeque,  loc.  cit. 

12  S.  Bormans,  loc.  cit. 

13  E.  W.  B.  Nicholson  and  Sir  Henry  Yule.  Article: 
"Sir  John  Mandeville",  in  " Encyclopaedia  Britan- 
nica",  1883  ed.  Cf.  E.W.B.  Nicholson  in  Academy, 
xxv,  p.  261,  12  April,  1884. 

14  G.  F.  Warner:  loc.  cit.  See  also  G.  F.  Warner 
in  the  "Dictionary  of  National  Biography",  art.: 
"Sir  John  Mandeville." 

15  Cf.  A.  Bovenschen  in  Ztscbr.  d.  Gelsellscb.  J.  Erd- 
kunde,  xxiii,  p.  194,  Berlin,  1888,  and  "Quellen  fur 
die  Reisebeschreibung  des  Johann  von  Mandeville", 
Berlin,  1888. 


398 


Annals  of  Medical  History 


vestigated  by  Professor  Paul  Hamelius,16 
whose  weighty  opinion  supports  the  sugges- 
tion first  made  by  Warner,  that  Jean  des 
Preis,  dit  d'OuItremeuse,  was  himself  largely 
responsible  for  the  "Travels".  Professor 
Hamelius  concedes,  however,  that  the  tomb- 
stone in  the  Guilelmite  monastery  can 
hardly  have  been  erected  to  a  wholly  ficti- 
tious character,  and  he  accepts  the  hypoth- 
esis that  most  probably  our  physician, 
Bearded  John,  collaborated  in  the  produc- 
tion with  his  friend  and  fellow  townsman, 
Jean  d'OuItremeuse.  This  hypothesis  per- 
haps gains  further  support  by  the  fact  that 
d'OuItremeuse  was  himself  the  author  of  "Lc 
tresorier  de  philosophic  Naturelle  des  pierres 
preeieuses".17  At  the  end  of  this  work  is  a 
list  of  philosophers  in  which  wc  read,  in 
almost  the  same  words  used  in  the  "Myreur 


des  Histors"  of  the  "noble  homme,  seigneur 
Jehan  de  Mandeville,  chevalier,  seigneur  de 
Montfort,  de  Castelperouse  et  de  Pisle  de 
Campdiis  qui  fut  en  Orient  et  es  parties 
par  della  par  Iongtemps,  si  en  fist  unq 
Iappidaire  selon  I'oppinion  des  Indois". 
May  we  not  perceive  the  Liege  notary 
enjoying  a  quiet  chuckle  as  he  penned  these 
lines? 

It  would  be  interesting  to  compare  the 
two  manuscripts  of  the  Lapidaire  d'OuItre- 
meuse with  the  "Lapidary  of  Mandeville", 
with  a  view  to  ascertaining  whether  the 
internal  evidence  for  common  authorship, 
as  well  as  common  sources,  is  as  strong  in 
the  case  of  the  "Lapidaries"  as  in  that  of 
the  "Travels"  and  the  "Myreur  des 
Histors".  Professor  Hamelius19  suggests  that 
the    joke    of   d'OuItremeuse    was    perhaps 


16  Prof.  P.  Hamelius:  "Transactions,  Bibliographic 
Society",  London,  1916,  xiii,  p.  193,  and  Quart.  Rev., 
1917. 

17  The  "Lapidary"  of  d'OuItremeuse  survives  in  a 
fifteenth  or  sixteenth  century  manuscript  in  Paris, 
Bibliotheque  Nationale,  Fond  Francais  12,326,  pub- 
lished by  A.  Michelant  in  "Notice  sur  un  manuscrit 
de  Jean  d'OuItremeuse",  in  Bull,  de  I'Inst.  Archeolo- 
gique  Liegois,  Liege,  1870,  x,  39.  Another  sixteenth 
century  copy  formed  Barrois  ccclxviii  in  the  Ash- 
burnham  Collection.  (See  Sotherby.  "Auction  Cata- 
logue", 1901,  Item  439.1 

18  No  such  places  as  Campdi  or  Chateau  Perouse 
have  been  traced,  but  as  regards  the  title  "Comte  de 
Montfort",  Warner  makes  the  ingenious  suggest  ion 
that  perhaps  this  was  a  misinterpretation  for  "du 
Comte  de  Hertford".  Mandeville  calls  himself  in 
the  prologue  to  the  "Travels"  a  "chiualer  .  .  .  neez 
es  norriz  Denglaterre  de  la  villc  Seint  Alban".  The 
monastery  of  St.  Albans  in  Hertfordshire  used  to 
show  precious  jewels  which  it  claimed  to  have  re- 
ceived from  the  author  of  the  "Travels"  and  ol 
the  "L-ipidarium".  Early  records  of  the  monastery 
claim  "Johannis  de  Mandevilla,  miles  Anglicus,  in 
villa  Sancti  Albani  oriundus"  (E.  A.  Bond,  "Chron- 
ica Monasterii  de  Melsa  a  fundatione  usque  ad 
annum    1 3</>   auctore   Thorns    de    Burton    abbate 

aCCedH  ad  annum    1406",   London,    1868,  vol.   iii,  p. 
158),  and  "  Dominus  Johannis  de  Maudes  ille,   Miles, 

pervagatoi  poene  totius  orbis  .  .  .  hie  in  villa  de 

Sancto  Alliano  materno  utero  Insns  est".   (II.  T. 


Riley,  "Chronica  Monasterii  S.  Albano  a  Johanne 
Amundesham  monacho",  London,  1871,  vol.  ii, 
p.  306.  Appendix  E  from  a  number  of  tracts,  probably 
by  Thomas  Walsingham  who  continued  the  Chron- 
icon.  Both  the  works  of  Bond  and  Riley  form  part  of 
the  "Chronicles  and  Memorials  of  Great  Britain  and 
Ireland  during  the  Middle  Ages",  published  by 
the  Master  of  the  Rolls.) 

In  the  seventeenth  century  John  Weever,  while 
recording  the  claim  and  setting  down  the  St.  Albans 
epitaph,  remarks  of  Mandeville  "That  he  was  born 
here  in  this  towne  I  cannot  much  deny;  but  I  am 
sure  that  within  these  few  yeares,  I  saw  his  tombe 
in  the  City  of  Leege,  within  the  church  of  the  reli- 
gious house  of  the  "Guilliamites.  .  ."  (John  Weever 
"Ancient  Funeral  Monuments  within  the  United 
Monarchic  of  Great  Britain,  Ireland  and  the  Islands 
adjacent",  London,  1631,  p.  56-.)  Speaking  ap- 
parently of  St.  Albans,  Weever  adds:  "The  church- 
men will  shew  you  here  his  knives,  the  furniture  "I 

his  horse,  and  his  spines,  which  he  used  in  his 
trauells".  F.  I  lenaus,  /or.  lit.,  tells  us  on  the  other 
hand  that  the   knight's  trophies  of  travel   had   been 

treasured  and  exhibited  at  their  convent  by  the  Guil- 

lelmite  brothers. 

We  may  indeed  concur  with  the  opinion  of  Chailes 

Ellis,  who  wrote  in  1699:  "At  Lrige  is  Sir  John 
MandeuiFsTomb,  whose  Epitaph  is  also  at  St.  Albans 

with  us,  which  may  be  hard  to  be  reconciled"  (PbiL 
Tr.  Hoy.  Soc.  1-05.,  vol.  wiii,  No.  286,  p.  1418). 
18  Quart.  Rev.,  Inc.  tit. 


Plague  Tractates 


399 


taken  seriously  by  pious  descendants  of 
our  Liege  physician,  who  may  have  erected 
the  Guillelmite  tombstone  in  a  mistaken 
belief   in    their  exalted  ancestry.20 

Are  we  then  to  place  no  credence  in  the 
"knight's"  romantic  story  of  his  flight  from 
England?  Perhaps  it  may  have  at  least 
been  suggested  by  the  experience  of  John 
of  Burgundy  himself. 

The  internal  evidence  of  the  "Travels" 
indicates  a  certain  knowledge  of  the  middle 
English  language  of  the  period.21  More- 
over, it  is  remarkable  that  a  certain  "Johan 
de  Burgoyne,  chamberlain"  (to  John  de 
Mowbray),  does  figure  in  the  civil  dis- 
turbances in  England  during  Edward  II's 
reign,  and  that  the  pardon  previously 
granted  to  him  was  revoked  in  May,  1322,22 
the  very  year,  according  to  the  "Travels", 
of  the  author's  departure  from  England. 
The  author  of  the  "Travels"  speaks  of 
"1355,  anno  egressionis  mee  33". 

On  referring,  however,  to  the  records  in 
the  Parliamentary  Writs,  we  find  a  curious 
coincidence.  Among  the  list  of  those  whose 
pardon,  granted  in  August,   1321,  was  re- 

20  It  has  even  been  surmised  that  possibly  the 
name  "Mandeville"  was  suggested  to  the  authors 
of  the  "Travels"  by  the  contemporary  work  of 
Jean  du  Pin,  "Mandevie, "  which  describes  a  voyage 
of  exploration  through  the  moral  world,  somewhat 
parallel  to  Sir  John  Mandeville's  journeyings  over 
the  terrestrial  globe. 

21  Warner,  loc.  cit.,  p.  71;  British  Museum  MSS. 
Egerton  1892,  fol.  60;  Harley  No.  4383;  chap,  xv, 
Cotton  MSS.,  Titus,  cxvi,  fol.  60. 

22  "Parliamentary  Writs,"  vol.  2,  div.  2,  Part  2, 
Appendix  pp.  167,  168,  London,  1830;  and  vol.  2, 
div.  3,  p.  619,  London,  1834.  "Parliamentary  Writs", 
vol.  2,  div.  2,  Part  2,  Appendix  p.  69;  vol.  2,  div. 

3»  P-  1 138. 

23  Thus  in  a  list  of  horses  and  their  owners,  in  1298, 
we  find  "Johannes  de  Maundevill  .  .  .  habet  unum 
badium, "  and  "Dominus  Johannes  Bourdun  habet 
3  equum"  (H.  Gough,  "Scotland,  in  I2g8",  Paisley, 
1888,  p.  163).  But  if  we  identify  this  "Johann  de 
Mandeville"  with  the  bearer  of  that  name  recorded 
in  other  contemporary  documents,  we  find  that  he 
could  hardly  have  survived  until  1372.  (Cf.  C.  Rob- 
erts: "Calendarium  Genealogicum",  London,  1865, 


voked  in  May,  1322,  there  occur  the  follow- 
ing three  names:  "Johan  Ie  Barber  de  Cat- 
thorp,"  "Johan  Mangevilayn  .  .  .  ",  and 
"Johan  de  Burgoyn,  Chamberlayn".  These 
and  similar  names  indeed  dog  one  another 
in  English  annals  of  the  period  as  though 
for  our  special  confusion.23 

But  on  the  whole,  the  great  balance  of 
evidence  does  point  to  a  real  John  of  Bur- 
gundy, otherwise  known  as  La  Barbe,  as 
having  shared  with  d'OuItremeuse  in  the 
authorship  of  the  work  attributed  to  Sir  John 
Mandeville,  while  it  seems  not  improb- 
able that  this  physician  of  Liege  did  origin- 
ally hail  from  England.  It  is  not  without 
interest  to  recall  that  it  was  during  the  latter 
half  of  the  fourteenth  century  that  Queen 
Philippa's  weavers  were  established  in  Eng- 
land. Already  we  may  observe  industry 
sharing  with  scholarship  in  the  slow  task 
of  pioneering  international  amenity,  and 
during  the  years  when  our  physician  was  a 
figure  of  some  little  importance  in  the  town 
of  Liege,  the  Low  Countries,  on  their  part, 
were  laying  the  foundation  of  a  new  industry 
in  Great  Britain. 

vol.  1,  p.  240,  and  Morant:  "History  and  Antiquities 
of  Essex",  London,  1768,  vol.  2,  p.  123.) 

J.  Hutchins:  "History  of  Dorset",  1864,  p.  261, 
etc.  "Inquisitiones  Post  Mortem",  vol.  1,  pp.  59, 
81,  126  and  202;  vol.  2,  p.  219.  "Patent  Rolls",  pp. 
142,  361;  "Parliamentary  Writs",  vol.  2,  div.  2,  part 
i,  p.  727;  part  2,  pp.  380,  82,  vol.  2,  div.  3,  p.  1 138). 

We  do  not  give  details  of  the  later  confusion  of 
"Mandeville"  with  "John  Manduith",  fellow  of 
Merton  College,  Oxford.  The  source  of  this  error  is 
probably  the  entry  under  Mandeville's  name  in 
J.  A.  Fabricius  Bibliotheca  Latina  Mediae  et  Infimx 
etatis,  Hamburg,  1734,  vol.  iv,  p.  289,  and  subsequent 
editions.  Three  works  of  Manduith  are,  probably  by 
a  printer's  carelessness,  here  attributed  to  Mandevill : 

tabulae  astronomical 

de  chorda  recti  et  umbra 

de  doctrina  theologica. 

There  is  a  quite  separate  entry  for  Manduith  him- 
self and  the  three  works  are  duly  given  in  it  as  his 
productions.  Subsequent  copyists  overlooked  the 
entry  under  "Manduith"  and  attributed  the  works 
to  Mandeville.  The  error  is  perpetuated  by  Bormans. 


400 


Annals  of  Medical  History 


III.    Hebrew    Versions,    now     in    the 

BlBLIOTHEQUE  NaTIONALE,  OF  THE  PLAGUE 

Tractate  of  Bearded  John  ;4 

Paris  Bibliotheque  Natioiiale,   Fonds  hebreu 

ngi    (nil)   and  Fonds  hebreu   1124 

(vi  a) 

Both  the  manuscripts  here  translated  are 
now  in  the  Bibliotheque  Nation- 
ale,  at  Paris.  Though  each  con- 
tains only  a  fragment  of  John 
of  Burgundy's  Treatise,  it  will 
be  seen  that  the  two  combined 
present  an  almost  complete  ver- 
sion of  the  work.  We  have  been 
unable  to  obtain  any  informa- 
tion as  to  R.  Benjamin  ben 
Isaac  of  Carcassonne,  described 
as  the  translator  of  MS.  1191 
(viii).  Both  manuscripts  are 
on  paper.  Zotenberg  ascribes 
MS.  1 191  (viii)  to  the  fifteenth 
century,  and  MS.  1 124  (vi  a)  to 
the  sixteenth  century.  We  re- 
produce the  first  page  of  each: 


that  the  air  becomes  corrupt  in  its  essence — 
for  it  is  an  elementary  substance — but  it  is 
because  of  vapours  which  are  mingled  there- 
with that  the  air  is  called  corrupt.  Plague 
results  therefrom  in  many  countries,  and 
in  many  places  there  still  remain  traces  of 
the  Plague.  And  this  is  clear  from  the  fact 
that  many  men  die,  being  full  of  evil  humors. 


f'vipj.-'ih  -nil  ij.'jj, 
vjn  vV" -aj<>3  -»•»>;'  T^P^"'  t?)V 

i^Jjo  6juw  '"V&6  -*•»*  '-»'?  ^»*'>    •-»!*» 


I 


1  i&pfl»p  I*™  *i)  o^u^i^i) -,•>•#.  Vt 
o  ?9fr6  *pmr*o Op  <j*-»t£  J*>  ^yyJ  yap  toJ 


>\yiP 

Ojrr  U»W  pft 

fain  7>,p,<' 


p  »?  •  tiysyJ  ptJ*S)»ir»r»  ri£»  «v  t>>  quo  p>r 
_»r»i>»»)  »'6j>p  t»r»'  •!2^'J>  :»•»>?>  PT>'&  viph 


%t™ 


/"'/ 

*»«! 


;  i»»  nfurl'JStOhp  r>v*rp  oto  r»»^»  u»>i> 


Paris     Bibliotheque     Nationale 

Fonds    hebreu     1191     (viii) 

[Ancien   Fonds  404]   folio 

141  Verso 

A    Very  Noble  Treatise  on  Cor- 
ruption 0/  the  Air  and  on  the 
Pestilence  (Fol.  141,  Verso) 

GENERAL    INTRODUCTION 

(Fol.  07,  recto  line  13)*  In  25 
the  course  of  time  air  is  cor- 
rupted, and  it  becomes  plague- 
stricken.  However,  I  do  not  say 

MA  copy  of  our  extract  from  Paris  Bib.  Nat. 
Fonds  Hebreu,  Ms.  1  124,  as  well  as  of  the  next  item 
in  the  MS.,  appears  to  exist  in  Vienna,  Kon.-Kais.- 
Hof-Bibliothek,  Heb.  MS.  158  (iii,  while  a  copy  of 
our  extract  from  Paris  Bib.  Nat.  Fonds  hebreu, 
1191,     is    cited     by     Steinsehneider    as     belonging 

Then  to  the  original  manuscript  which  appear  in  this  article  in  italics  are  to  the  French  version 

<.f  tin  Treatise,  dating  from  1 371,  published  in  Proc.  Roy.  Soc.  Med.,  loc.  cit.    The  references  in  low 
letters  are  to  the  Hebrew  MSS. 


Plate  I. 


trr$  'tr> 

Facsimile   from    Bibliotheque 
Hebreu    1191    (VIII)  fol. 


Nationale, 
141,  verso. 


MS.   Fonds 


first  to  Dr.  Berliner,  then  to  Gunzburg.  A.  Neubauer 
(Israelitiscbe  Letterbode,  vol.  ii,  pp.  84),  suggests 
thai  there  is  al  Leeuwarden  another  copj  of  this 
work,  but  this  we  have  been  unable  to  identify,  in 
spin-  of  the  kind  help  of  Dr.  V.  F.  BUchner,  ol  the 
Leyden  University  Library. 


Plague  Tractates 


401 


The  corrupt  air  alone  is  not  the  cause  of 
pestilence,  but  it  is  the  mixture  of  hu- 
mours which  fill  the  men  that  die.  And  Galen 
testifies  thereto  in  his  Book  of  Fevers,  his 
words  being:  "know  that  the  air  receives 
no  corruption,  if  the  matter  of  the  body  be 
not  prepared  for  the  corruption  or  if  it  be 
not    subjected    to    any    corruptible    thing. 


'\J3V  orw/W 

tjcvnjw  at*'  aeovi&wvi 
tofton*  1^0  ft*7'  ?<">'  9(> '  "** 

4j  *?fa  A»  nr^  a£  awn**  t|W  eH  »/nfl6W9H»  p> 


I 


Plate  II. 


Just  as  fire  does  not  burn  any  matter  save 
that  which  is  prepared  for  burning,  so  the 
plague-stricken  air  does  not  harm  the  body 
unless    it    finds    the    matter    prepared    for 
corruption;  so  that  bodies  which  are  clean 
and   have  not  neglected  purging  continue 
healthy.    So,    too,    they    continue    healthy 
whose  complexion  26  is  contrary  to  that  of 
the  affected  air.   For  if  it  were 
not  so,  the  people  would  sicken 
and    die    wherever    the    air    is 
plague-stricken.    For  the   air  so 
corrupted  generates  various  dis- 
eases according  to  the  variety  of 
humours,  for  the  agents  always 
work  according  to  the  disposi- 
tion of  matter  in  the  patient." 

Now  there  are  many  physicians 
who  wrork  with  abstract  wisdom 
( neon )  but  are  little  skilled  in 
practice  and  are  innocent  and 
bare  of  the  science  of  astrology, 
that  science  (Fol.  gy,  verso)  being 
of  supreme  importance  to  the 
physician.  As  Hippocrates  says 
in  the  book  on  Epidemics: 
"The  physician  that  is  innocent 
of  astrology  is  worthless,  [Fol. 
142,  recto]  and  no  man  should 
trust  himself  to  be  healed  at  his 
hands. "  For  in  a  man  possessing 
both  the  science  of  astrology 
and  the  art  of  healing,  the  one 
corrects  the  other  and  each 
science  derives  much  support 
from  the  other,  for  not  every- 
Facsimile  from  Bibliotheque  Nationale,  MS.  Fonds  thing  can  be  explained  in  the 
Hebreu  1124  (Via)  fol.  133,  verso.  same  way. 


For  further  references  to  these  manuscripts  see 
Zotenberg,  "Catalogue  des  MSS.  Hebreux  et  Samari- 
tains  de  la  Bibliotheque  Imperiale",  Paris,  1866;  M. 
Steinschneider,  "Die  Hebraischen  Uebersetzungen 
des  Mittelalters",  pp.  803  et  seq.;  M.  Steinschneider, 
Navorscher,  1862,  Part  ii,  p.  50;  M.  Steinschneider, 
"Jewish  Literature",  pp.  198,  368,  note  41;  M. 
Steinschneider,  Magazin  fur  die  Wissenschaft  des 
Judenthums,  Berlin,  1885,  xii,  p.  183;  M.  Stein- 
schneider,   II  Buonarotti,    1876,   p.    114;  M.  Stein- 


schneider, Hebrdiscbe  Bibliograpbie,  v.  69,  xvii, 
57,  xxi,  98;  M.  Steinschneider,  Zeitscbrift  der  deut- 
scben  Morgenlandiscben  Geselhcbaft,  vol.  \xix,  p.  165; 
A.  Krafft  &  S.  Deutsch,  "Katalog  der  Handschrif- 
ten  der  Hebraischen  Werke  der  K.  K.  Hof.  Bibl. 
Wien",  Vienna,  1847,  p.  167. 

25  Our    Hebrew   translation   starts   just   after  the 
opening  of  the  Introduction,  omitting  the  astrology. 

26  Complexio  —  mixture  of  humours   =  tempera- 
ment (temperare — to  mix). 


402 


Annals  of  Medical  History 


And  I  have  proved,  having  been  occupied 
in  physic  for  forty  years  or  more,  that  a 
remedy  administered  under  an  adverse 
constellation,  even  though  it  be  according 
to  the  art  of  medicine  and  correctly  com- 
pounded and  ordered,  will  not  act  according 
to  the  purpose  of  the  practitioner  nor  to 
the  benefit  of  the  patient.  A  case  in  point  is 
that  if  a  remedy  be  given  as  a  laxative,  the 
patient  will  vomit  it  even  though  in  the 
ordinary  course  he  would  not  reject  the 
remedy. 

So  that  he  that  has  not  drunk  fully  of  the 
waters  of  astrology  cannot  help  a  sufferer, 
especially  not  against  pestilential  diseases. 
As  the  prince  of  physicians  says:  "How  can 
I  heal  when  I  know  not  the  cause  of  the 
illness?"  So,  too,  Avicenna  in  his  "Cures 
of  Fevers"  says:  "He  that  is  ignorant  of 
the  cause  cannot  use  the  correct  remedy." 

This,  too,  is  what  Averroes  intends  when 
he  says  in  his  "Physica"  that  knowledge 
is  the  recognition  of  near  and  remote  causes. 
That  being  so,  since  the  heavenly  matters 
are  amongst  the  primary  causes,  one  must 
endeavour  to  acquire  knowledge  of  them; 
and  it  will  therefore  be  plain  that  with- 
out astrology  the  healing  process  will  be 
inadequate.  For  this  reason  many  are  de- 
feated  owing  to   lack  of  counsel.27 

PERSONAL    INTRODUCTION 

(Fol.  g8,  recto)  Therefore  I,  Giovanni  of 
Bourgogne,  of  the  province  of  Liege,28  pro- 
fessor of  the  lore  of  medicine  and  the  least 
among  physicians,  in  the  days  at  the  begin- 
ning of  this    Plague   which  came  about  in 

27  Our  Hebrew  translator  here  omits  a  passage  in 
which  Bearded  John  recommends  the  recipe  of  a 
certain  Lie^e  pharmacist. 

**  imik'^  =  Leuvensis  or  Leodicensis  (Licgc  not 
Lyons).  See  H.  Gross;  "Gallia  Judaica",  Paris, 
1897,  p.  J06. 

"M.  Stcinschneider:  "Die  Hebrfiischen  Ucber- 
sctzungen  des  Mittclaltcrs  unci  die  Juden  als  Dol- 
mctschcr",  Berlin,  1889-1893,  |>.  804,  suggests  that 
"22"  may  be  a  copyist's  error  for  "  122  of  the  Short 


the  year  22  of  the  Short  Era,29  when  it  came 
on  our  borders,  wrote  a  short  treatise  on 
astrology,  together  with  this  treatise  of 
mine  concerning  the  causes  and  the  nature 
of  this  Plague,  and  many  took  copies  of  it. 
It  begins  thus:  "My  God,  my  God,  etc."  30 

31And  when  I  saw  that  this  Plague  returned 
anew  and  was  destined  in  course  of  time  to 
appear  again  continually — for  no  end  of  it 
had  been  reached,  and  being  grieved  at  the 
dying  of  people  and  eager  to  make  some 
attempt  for  their  benefit,  I  composed  (Fob 
142,  verso)  this  work  and  called  it  "Ezer 
Elohim"  [the  Help  of  God]. 31 

My  aim  is  to  set  out  the  prevention  and 
cure  of  these  diseases  with  completeness,  so 
that  scarcely  any  man  may  need  a  physician 
and  that  each  may  be  his  own  physician, 
protector,  guardian  and  guide. 

First  then  we  will  speak  of  the  fitting 
treatment. 

He  that  desires  to  know  my  meaning 
with  regard  to  the  inlluence  of  the  Heavenly 
matters  and  also  of  the  terrestrial  condi- 
tions let  him  see  the  aforementioned  treatise 
which  has  been  composed  for  these  tilings. 

And  I,  the  least  in  quality  and  impor- 
tance, Benjamin  son  of  Isaac  of  Carcas- 
sonne,32 the  translator,  when  I  saw  this 
treatise  hidden  away  and  sealed  up  in  their 
stores,  though  tried  and  proved   by  noble 

Era".  This  emended  reading  would  give  the  year 
1362  A.D.  The  Latin  versions  of  the  treatise, 
however,  usually  bear  the  date  136-;  and  we  have 
encountered  no  other  MS.  of  this  text  bearing  an 
earlier  date  (except  perhaps  the  Hebrew  versions  in 
Vienna),  cf.  Page  405,  note  $5. 

30  Original  has  "Dens  Deorum";  hence  MS.  here 
probably  for   d'^h  ^k    or    D»rr>*  i|r>K. 

31Latin  and  French  versions  omit  this  sentence 
but  describe  a  second  work  in  addition  to  the  present 
treatise. 

1. H>ss  "Gallia  Judaica",  declares  tins  MS.  con- 
tains the  only  known  mention  of  this  persona 
too  the  "Jewish  Encyclopedia",  vol.  iii,  p.  28.  Car- 
cassonne   is    not    far    from    Marseilles    and    near 

Narbonne  and  Montpellier. 


Plague  Tractates 


403 


physicians,  applied  all  my  energies  to  re- 
deem it  from  their  hands  and  to  translate  it 
from  their  tongue  into  the  Holy  Tongue 
that  it  might  be  a  help  and  glory  to  us  and 
to  them  that  follow  us.  Praise  be  to  the 
Helper.  Amen.33 

PROPHYLAXIS 

(Fol.  g8,  recto  line  24.)  I  will  begin  by 
setting  out  the  treatment  as  follows:  It  is 
good  to  guard  against  plethora  of  food  and 
drink,  to  avoid  baths  and  all  such  things 
that  desiccate  the  body  and  open  the  pores; 
for  the  corrupt  air  enters  by  way  of  the 
open  pores  and  so  penetrates  the  body  and 
corrupts  it.  For  this  reason  also  it  is  abso- 
lutely necessary  to  avoid  coitus  and  to  be- 
ware of  eating  fruits — if  they  are  eaten  they 
should  be  exiguous  in  quantity  except  they 
be  sour  fruits.  It  is  good  to  partake  only  of 
easily  digestible  foods  and  wine  of  good 
flavour  well  diluted. 

Every  confection  of  honey  must  be 
avoided  and  every  dish  should  be  seasoned 
with  vinegar. 

In  rainy  and  misty  weather  a  fire  should 
be  made  in  the  bed-chamber,  and  before  he 
leaves  the  house  in  the  morning  or  goes  into 
an  airy  place  the  patient  should  use  some 
fragrant  medicament  such  as  diambra,  dia- 
musk,  or  dianthus  with  musk  philaris  arqu- 
ticon,  together  with  musk  or  the  like.  If  he 
is  too  poor  for  this  he  should  use  cloves, 
maris,  nux  muscada,  zedoary  and  other 
substances.  He  should  take  .  .  .  34 
Paris,   Bibliotheque  Nationale.    Fonds  He- 

breu    1124    (Via)    [Ancien    fonds   417] 
fol.  133,  verso  35 
Counsel  by  Maestro  Giovanni  de  Cenobarba 
Concerning  the  Plague  (Fol.  133,  verso) 

Blessed  be  the  Lord.  Amen.  He  hath 
ordained  times.36 

33  This  passage  is  not  in  the  original  French  or 
Latin. 

34  The  text  breaks  off  here  and  is  followed  on  the 
next  folio  by  a  series  of  recipes  written  in  the  same 
hand. 


PATHOLOGICAL   THEORY,    ETC. 

(Fol.  gg,  redo,  line  ig).  If  anyone  fall 
into  the  sickness  of  the  plague  through  the 
ill  manner  of  his  living,  it  is  necessary 
speedily  to  give  him  some  remedy  because 
such  epidemic  sicknesses  become  confirmed 
after  twenty-four  hours.  It  is  therefore 
necessary  speedily  to  give  some  remedy 
and  medicine. 

You  know  that  there  are  three  principal 
organs  in  man's  body,  namely  the  heart, 
the  brain,  and  the  liver.  Each  of  these,  as 
you  know,  has  an  emunctory  through  which 
it  discharges  its  superfluities;  that  of  the 
brain  is  behind  the  ears,  that  of  the  heart 
is  the  arm-pit,37  and  that  of  the  liver  in  the 
groin. 

You  also  know  that  the  property  of  poison 
is  to  distress  man's  nature,  as  you  know  you 
can  see  in  the  bite  of  poisonous  creatures. 
This  poisonous  air  becomes  mingled  with 
the  blood  and  with  the  vital  spirit  which  is 
in  the  body  and  then  immediately  makes 
for  the  heart  which  is  the  foundation  of 
our  nature,  in  order  to  destroy  and  exhaust 
it.  When  the  heart  perceives  this,  it  exerts 
itself  violently  to  empty  out  the  poisonous 
blood  at  its  emunctory,  and  nature  again 
attempts  to  send  it  into  closed  passages 
that  it  may  not  reach  the  heart.38  And 
sometimes  it  labours  to  discharge  it  and  to 
send  it  on  to  the  liver,  which  is  the  funda- 
mental source  of  all  the  natural  spirits; 
whereby   nature   would    be   exhausted   and 

35  This  version  starts  in  the  middle  of  the  work  and 
finally  reveals  the  part  of  the  beginning. 

36  "He  it  is  who  has  ordained  times";  i.e.,  times 
of  sickness  and  also,  no  doubt,  times  of  healing.  But 
the  author  is  thinking  of  the  plague  and  lias  in  mind 
msa  mnjr  of  Psalms  9  and  10. 

37k^»b«b,  Ditellus  or  Titillium  of  the  Arahists 
Joseph  HyrtI:  Das  Arabische  und  Hebriiische  in 
der  Anatomie,  Wien,  1879.  p.  64L 

38  This  and  the  following  sentence  are  rather  dif- 
ferently turned  in  the  French  version,  which  omits 
the  characterization  of  the  liver  as  "the  fundamental 
source  of  all  natural  spirits". 


404 


Annals  of  Medical  History 


destroyed.  The  liver  too  discharges  it  into 
the  groin.  So  also  does  the  brain  [to  its 
emunctory]. 

THERAPEUSIS 

(Fol.  gg,  verso.)  By  these  following  symp- 
toms the  physician  may  recognize  these 
diseases  and  whence  they  arise.  If  the  symp- 
tom is  seen  in  the  arm-pit  the  cure  is  to 
bleed  speedily  from  that  vein  of  the  heart 
which  is  called  median39  on  the  same  side 
and  not  the  one  opposite.  For  through 
bleeding  on  the  opposite,  two  incon- 
veniences40 arise;  the  first  that  it  empties 
out  the  good  blood  which  has  not  yet  been 
harmed,  and  the  second  that  the  poisoned 
blood41  crosses  over  by  the  sound  channels 
and  poisons  the  sound  parts.42 

If  it  be  in  the  liver,  then  bleed  the  basilic43 
vein  of  the  right  arm;  that  is  from  the  vein  of 
the  liver  or  from  the  vein  of  the  arm  which 
is  called  salvatella,4*  and  which  lies  between 
the  little  finger  called  Zeretb  and  the  ring- 
finger  called  Qemisab. 

If  these  superfluities  travel  within  the 
body  towards  the  groin  "  and  the  mem- 
brum  virile — that  is  the  male  member — 
and  towards  the  glandular*'  surfaces  of 
the  groin,  then  bleed  the  vein  of  the  foot 
on  the  same  side  —that  is  between  the  big 
toe  and  the  next.  For  if  you  bleed  from  the 
arm  on  that  side  you  bring  up  the  poison 
to  the  noble  organs,  that  is  the  upper  organs. 
And  this  would  be  a  grievous  error,  for  you 
would  increase  and  not  abate  the  plague. 

(Fol.  134,  recto.)  But  if  the  symptom  is 
far  removed  from  the  membrum  virile,  then 

*'  ijusip  transliterating  commune. 

40  ■«,;., «>;';•-;<«   transliterating   inconveniences. 

41  IB*"?    perhaps  transliterates  issue. 

"The    explanatory    passage    lines     \(,    [Q    <if    the 

French  version  is  omitted  in  our  translation. 

"•"    transliterating   basilica. 
"H-.-z   transliterates  saluila. 
44  'r,;:K  transliterates  inguila  for  inguina. 
•»  r»:L._,    transliterates  glandula.   Perhaps    mean- 
ing inner?  Cf.  French  vers.  fol.  oov.,  line  21. 


open  the  vein  of  the  foot  which  is  called 
saphena,46'1  near  to  the  little  toe  and  the  next. 
Or  else  apply  cupping-glasses  to  the  legs 
close  to  the  ankle. 

If  [the  symptoms]  appear  in  the  parts  be- 
longing to  the  brain,  at  the  back  of  the  ear 
or  at  the  throat,  bleed  on  the  same  side 
from  the  cephalici6h  vein,  which  is  above  the 
middle  or  medianwc  [vein],  or  in  the  hand 
between  the  thumb  and  the  first  finger. 

Make  deep  (?)  scarifications  and  [apply] 
cupping  glasses  in  order  to  remove  the 
poison  from  the  principal  members.  (Fol. 
100,  recto.)  Strengthen  nature  with  cold 
cordial  electuaries,  such  as  the  following: 
Take  powder  of  diarrbodonre,  abbatis, 
dragagantb,  triasandal  and  powder  of  [?] 
litharge*1  together  with  sucrum  rosarum. 
The  powders  to  be  taken  day  and  night.48 

The  diet  must  be  meager  and  the  patient 
\'ccd  on  small  fowl  and  occasionally  eat 
small  fish  roast  on  a  griddle,49  and  also 
green  grapes.  Tisane,49 '  too,  is  beneficial.  If 
there  is  severe  thirst  give  cold  water  and 
vinegar  well  mixed,  and  occasionally  it  is 
good  to  give  a  little  more  food  and  some 
pure  white  wine  well  mixed.50  On  the  af- 
fected spot  put  this  unguent:  Take  trimi- 
tina60*  4  ounces,  seed  of  riuiM  '  1  ounce,  root  of 
calamintl.r'"''  and  samhucusb0'1  of  each  1 
drachm,  root  of  sernerion60" — which  is  a  kind 
of  parsley — 5  drachms.  Pound  them  all  to- 

46a  to'str  transliterates  sapbvna. 
46b  hk'TO  transliterates  cepbalica. 
46C  np-'E-j  transliterates  media. 

47  k'-ikib'1:  transliterates  litburia  for  litharge. 

48  A  second  recipe  is  omitted  in  the  Hebrew  trans- 
lation. 

49  n---'-jkt.i  transliterates  graticula. 
491  n:Kr'r  transliterates  tissue  tisane. 

60  The  Hebrew  translator  omits  the  contingency: 
"If  the  patient  presses  with  instancy  for  wine."  The 
recipe  again  is  not  identical  in  the  various  versions. 

W)l  «:':n:n'j  transliterates  trimitina. 
1    lwn  transliterates  ruUi. 

500  -.u:'-:--  transliterates ealaminta. 

::  transliterates  sunhucu  for  sumliuats. 
w1'  piovjo  transliterates  senerion  for  scmiiiun. 


Plague  Tractates 


405 


gether  with  oil  of  camomile*'0  and  a  little 
wax,  pitch  (here  iwki  of  the  text  is  left 
untranslated)  and  resin.™*  Make  a  little  stiff 
unguent  and  apply  to  the  spot  three  or  four 
times  a  day.  This  plaister  draws  out  the 
poisoned  matter  from  the  humours  so  that 
they  do  no  harm  to  the  principal  members. 
Sometimes  galbanum™1'   is   added. 

There  is  another  tried  and  excellent  pow- 
der for  this,  and  one  which  is  of  greater 
benefit  than  theriac.b0'  It  is  (Fol.  100,  recto, 
line  jo)  called  amongst  the  infidels  51  "the 
Emperor's  powder",  which  the  Arabian 
emperors  used  in  times  of  plague  and  also 
against  all  venom  and  poison  and  against 
snake  bite  and  against  any  poison  in  the 
world.  It  is  called  in  Arabic,  Zinwar  5iamean- 
ing  "  The  Deliverer  from  Death."  This  pow- 
der is  compounded  of  the  herb  palamenon,51 
that  is  [?]  tigice'"1'',  from  another  herb  called 
philadia*1  (some  call  it  osilla  nigra,51*  others 
call  it  [?]  gentian^2  and  still  others  clove53) — 
some  suggest  turmintella53*  or  (here  id'bbk  h 
of  the  text  is  left  untranslated)  latipha- 
rcm,53l>or  bola  armenic,530  or  terra  sigillata.  It 
can  be  said  of  all  these  herbs  that  they  are 
most  beneficial'o3<i;  they  repel  all  poisons  inju- 
rious to  mankind  and  against  snake  bite,  also 
(Fol.  134,  verso)  they  are  helpful.  If  they  are 

50  16'Biop  transliterates  camomila. 
sob  ..,-.,  transliterates  resin. 

s°h  1;;?;  transliterates  galbana. 
501  npK»na«    transilterates     atbriaca,     the     Arabic 
form  of  tberiaca. 

51  i^TSi's  transliterating  infidels.  The  French 
version  describes  the  powder  as  used  by  "Ii  imperial 
des  pay  (n)s",  the  emperor  of  the  pagans. 

5ia  iKiau 

5lb  pjuDi7>a  transliterates  Palamenon. 
sic  k>3<:i<b  transliterates  tigice. 
5ld  nKHK^'B  transliterates  philadia. 
5ie  NV.-ip  K7U1K  transliterates  osilla  cruda. 
6*ruRicj«.a  transliterates  gentiana. 
M  K77»tM'OTB  transliterates  girofiata  =  giroflee. 
63a  r?7'bJ'0"ikb  transliterates  tormentilla. 
53d  p-pBijaN1?  transliterates  latipharon. 
530  ip'j'aiK  i7i:  transliterates  bola  armenica. 
68d«a>D'DiR'D«nj    r>di;i  transliterates  gracia,  gracio- 
cissimo. 


taken  internally  or  applied  to  the  affected 
spot  they  draw  out  the  poison  as  blood  is 
drawn  out  by  bleeding.  This  has  been 
proved  often  and  by  many  people;  and 
although  the  men_who  understand  these 
herbs  have  died  out,  there  are  said  to  be 
some  people  still  in  Leotida53"  (Liege)  who 
understand  the  herbs.54 

ASTROLOGICAL    EPILOGUE 

(Fol.  100,  verso,  line  15.)  Others  say  that 
the  cause  of  the  pestilence  is  the  conjunction 
of  Saturn  with  Jupiter  and  other  planets 
which  came  into  conjunction  in  the  past 
year.  But  the  real  cause  is  the  conjunction 
which  occurred  in  the  year  22  ;55  from  which 
there  are  still  effects  remaining.  For  in  the 
course  of  time  many  evils  will  still  be  brought 
about  by  these  stars,  such  as  famines, 
plagues  and  dearth. 

POSTSCRIPT  56 

(Fol.  10 1,  recto,  line  8.)  The  remedy  men- 
tioned should  be  carried  out  speedily  and 
there  should  be  no  delays  after  the  time  we 
have  mentioned,  and  the  bleeding  should 
be  done  from  the  places  mentioned. 

If  it  be  impossible  to  carry  out  the  bleed- 
ing immediately,  at  least  do  it  within  six 
hours,  that  the  poison  may  not  penetrate 
and  strengthen  its  hold.  The  patient  must 
refrain  from  food  and  drink  until  the  phle- 
botomy is  performed,  but  after  it  they  must 
be  taken  together  with  cordial  remedies 
that  he  may  gain  strength. 

(Fol.  101,  verso,  line  13.)  We  have  noticed, 
and  it  is  a  fact  proved  by  our  experience 

636  rvbir'?  transliterates  Leotida,  cf.  Latin  Leodia. 

54  Cf.  in  French  version  the  "apothecary  in 
Liege". 

55  A  marginal  gloss  in  the  same  hand  as  text 
emends  "22"  to  "52".  This,  without  Stein- 
schneider's  emendation  would  give  the  year  1292. 
See  above,  note  29. 

56  Both  the  Astrological  Epilogue  and  the  Post- 
script are  shortened  in  the  Hebrew  translation  and 
vary  somewhat  from  the  Latin  and  French  versions. 


406 


Annals  of  Medical  History 


over  a  long  period  of  more  than  twenty 
years  in  which  this  change  [in  the  position 
of  the  planets]  has  taken  place  in  these 
[pestilential]  districts,  that  a  great  number 
of  cases  are  cured  by  phlebotomy  alone. 
For  the  poisonous  matter  is  by  this  method 
expelled,  the  vitality  aiding  to  evacuate  the 
evil  matter;  and  the  heart  also  endeavours 
to  evacuate  the  evil  from  the  body.  This 
evacuation  of  the  poisonous  matter  relieves 
him  [the  patient]  and  he  is  thereby  delivered 
from  the  pestilence.5644 

PROPHYLAXIS  57 

(Fol.  g8,  recto,  line  23.)  It  is  necessary  to 
be  sparing  in  food  and  drink,  avoid  frequent 
bathing  and  heavy  labour  and  all  such 
things  that  open  the  pores  in  the  body.  For 
vi  hc-n  they  are  open  the  heated  5S  air  easily 
penetrates,  and  so  the  vital  and  the  natural 
and  the  animal  spirits  are  dissipated  and 
decayed.  Fruits  must  be  avoided  except 
they  be  acid,  and  at  all  costs  coitus  must  be 
avoided,  for  it  weakens  the  heart. 

Take  easily  digestible  foods  and  aromatic 
wines.  Avoid  confections  and  particularly 
such  that  contain  honey,  and  all  dishes 
should  be  seasoned  59  with  strong  vinegar. 

In  cold  weather  and  on  rainy  days  a  fire 
should  be  lighted  in  the  bed-chamber.  In 
summer  the  patient  should  eat  something 
in  the  morning  before  rising  and  afterwards 
go  out  into  the  open  air.60  He  should  take 
aromatic  (Fol.  g8,  verso)  remedies  such  as 

68aA  marginal  gloss  in  the  same  hand  as  text 
gives  •-•e:'k,  which  Dr.  Cowley  suggests  is  perhaps 
a  transliteration  of  injetto. 

-7  We  here  revert  to  the  passage  on  Prophylaxis, 
with  which  this  version  closes.  It  will  be  observed 
that  it  is  a  portion  of  this  passage  of  which  MS. 
Fondsllebreu  ntji  (viii)  provides  a  version. 

M  ODino    no     doubt     copyist's     error     for    DD1M 
"poisoned." 
■•fBHaip  transliterates  conditi  =  prepared.      Cf. 
=  conditum,  spiced  wine  or  spice  to  put  into 
ondimenl  I. 

tence  does  nol  occur  In  the  French  or 
Latin  versions. 


diabra,  diamusk  and  [  ?  ]  diacodi.  If  he  is 
poor  let  him  use  cloves,  nux  muscata  and 
mace,  and  once  or  twice  a  week  some 
theriac.  He  should  carry  in  his  hand  a 
pomander  or  other  (Fol.  135,  recto)  fragrant 
substance  and  smell  it  frequently. 

In  the  evening  61  he  must  return  home 
speedily  and  go  close  to  the  fire,  throwing 
upon  the  coals  some  fragrant  wood  or  of 
the  following  powder:  Take  of  olibanum 
and  storax  1  ounce,  of  storax  and  mint  2 
drachms,  of  aloe-wood  1  drachm.  Put  it 
on  the  coals  and  it  will  produce  a  smoke. 
Let  him  do  this  also  when  he  perceives  an 
evil  odour.  And,  by  the  help  of  God,  if  he 
act  in  this  wise.  .  .62  In  summer  he  must 
take  much  vinegar  and  green  grapes — he 
must  not  use  hot  spices.  If  in  the  morning  he 
is  warm  or  perceives  an  evil  odour,  then  let 
him  make  a  practice  of  smelling  roses, 
violets,  cloves,  sandal-wood  and  aloes.  Also 
he  should  hold  a  sponge  dipped  in  vinegar 
to  his  nostrils  when  the  weather  is  hot.63 

61  French  version  "a  Ientree  du  lit." 

62  The  copyist  has  omitted  a  line  here,  probably 
through  "homoioteleuton".  It  no  doubt  began: 
"in  time  of  cold",  as  in  the  French  which  runs 
(Fol.  gS  verso,  line  ij  []■):  "alaide  de  dieu  en  temps 
froit  bruyneus,  on  corru(m)pu  effect  de  mauvais 
accide(n)t  pourra  estre  preseruez". 

63  This  passage  is  briefer  than  in  the  French  and 
Latin  versions  which,  however,  do  not  mention  the 
sponge  dipped  in  vinegar.  The  use  of  this  device 
was  common.  Our  translator  may  have  util- 
ized here  the  popular  plague  treatise  of  Bengt 
KnutSSOn  (two  Latin  editions  of  this  work  are  be- 
lieved to  have  been  printed  by  Gheen,  Antwerp, 
1485  and  a  third  by  Amaldus  de  Colon  ia,  Leipzig, 
1495).  Two  English  translations  arc  ascribed  to 
Machlin,  London,  14S0,  another  to  the  same  pub- 
lisher dating  from  1485  1  reprinted  In  Jan  van  Dois- 
bosih,  Antwerp,  early  in  the  16th  century)  while 
another  was  published  by  Wvnkin  de  W'orde,  about 
1510.  Many  of  these  editions  have  survived  only  in 
fragmentary  copies,  but  one  of  the  Machlin  editions 

of  1480  has  been  reprinted  from  a  copy  in  the  John 

Rvlands  Library  at  Manchester:  Guthrie  Vine  "A 
I  itel  boke  .  .  .  for  .  .  .  the  .  .  .  Pestilence":  John 

Rvlands  Facsimile  5,  Manchester,  [OH.  Sec  also 
Dorothea  Walcy  Singer,  loC.  <i'.,  pp.   1S3-185. 


Plague  Tractates 


407 


He  must  avoid  onions,  garlic  and  leek, 
but  parsley  and  cinnamon  are  allowed  him, 
for  they  are  not  excessively  hot.  (Fol.  gg, 
recto.)  It  is  good  to  drink  cold  water  with 
vinegar  and  also  to  drink  tisane,  for  it  is  of 
great  benefit  to  people  of  a  hot  dry  nature.04 

The  house  should  be  sprinkled  several 
times  a  day  with  cold  water  mixed  with 
vinegar  and  rose-water.  Pills  of  Rhazes  too 
are  of  great  good  taken  once  a  week.  They 
are  beneficial  to  all  complexions  of  men  and 
at  all  seasons.  Avicenna  and  all  the  other 
authors  praise  them  greatly.  They  disperse 
all  corrupt  matter  and  their  formula  is: — 

Take  cicotri  aloes  3  drachms;  myrrh  and 
saffron  of  each  1  drachm;  make  into  a  paste 
with  syrup  of  fumo  terra  \Yi  drachms,  and 
form  into  pills  which  should  be  taken  in  the 
evening  before  sleeping. 

translator's  epilogue 

And  if  a  man,  with  God's  help,  employ 
the  means  which  I  have  set  forth  he  will 
stand  secure  in  a  season  of  pestilence. 

This  treatise  was  completed  here,  in  the 
year  65  one  thousand  three  hundred  and 
ninety-nine  by  Maestro  Giovanni  of  Ceno- 
barba.  And  this  reckoning  is  according  to 
the  reckoning  of  the  Nazarenes. 

Appendix  I 

Early  Evidence  for  the  Former  Existence 

at  Liege  of  the  Tomb  of  the  Author  of 

The  Travels  of  Sir  John  Mandeville 

The  epitaph  from  the  Liege  tomb  is  trans- 
cribed by  Abraham  Ortellius  and  Joannis 
Vivianus,  "  Itinerarium  per  nonnullas  Gal- 
Use  Belgicx  partes,"   Antwerp,  1584,  p.  15, 

64  The  Hebrew  version  here  omits  the  warning 
that  a  sensation  of  "pricking  or  motion  in  the  blood 
should  be  treated  by  instant  phlebotomy"  "on  the 
same  side  and  in  the  nearest  vein." 

66  No  other  version  we  have  encountered  gives 
this  date.  The  usual  date  is  1365.  The  treatise  "in  4 
chapters"  of  "John  of  Bordeaux"  especially  current 
in  England,  usually  bears  the  date  1390. 


and  in  the  poem  addressed  to  the  Arch- 
duchess iMechtild  of  Austria  in  1462  by 
Jacob  Puterich  and  published  from  a  six- 
teenth century  manuscript  of  Herzogenburg 
by  Moriz  Haupt,  in  Zeitscbrift  Jiir  deutsches 
Altertbum,  Leipzig,  1848,  p.  55.  Both 
Ortellius  and  Puterich  give  detailed  de- 
scriptions of  the  tomb  and  of  the  coat 
of  arms  which  it  bore.  These  arms  have 
been  traced  by  G.  F.  Warner  to  two 
families,  the  Lamonts  and  the  Tyrells 
or  Tyrrells,  of  counties  Somersetshire,  Here- 
fordshire and  Hertfordshire.  Possibly  our 
hero  had  seen  the  arms  of  the  Hertfordshire 
family  at  St.  Albans.  The  epitaph  on  the 
tombstone  is  also  quoted  by  Pits,  who 
says  it  was  sent  to  him  by  the  English 
priest  Edmundus  Lewknerus,  who  saw  it 
before  his  death  in  Liege.  See  John 
Pits,  "Relationum  Historicarum  de  Re- 
bus Anglicis",  Paris,  1619,  vol.  1,  p.  511. 
John  Weever,  "Ancient  Funeral  Monu- 
ments within  the  United  Monarchic  of 
Great  Britain,  Ireland  and  the  Islands 
Adjacent",  London,  163 1,  found  (p. 
567)  an  epitaph  to  Mandeville  in  the 
church  of  St.  Albans,  and  a  legend  current 
of  his  burial  there.  He  explains  that  he  has 
himself  seen  the  tomb  at  Liege  with  the 
epitaph.  The  epitaph  in  our  text  is  here 
given  verbatim  from  Pits.  Ortellius  and 
Weever  give  the  date  1371,  but  almost 
all  later  references  confirm  the  "1372" 
of  Pits  and  Puterich.  Puterich,  however 
has  also  modified  the  name  and  title  to 
"Monteuilla"  and  "Compredi".  The  only 
other  differences  in  the  versions  of  the 
epitaph  that  we  have  seen  are  the  omission 
by  Ortellius  and  Weever  of  the  word 
"suorum"  after  "bonorum".  The  various 
abbreviations,  etc.,  in  spelling  we  have 
ignored. 

Mandeville  is  mentioned  as  an  eminent 
physician  and  great  traveller,  buried  in  the 
Guillelmite  convent  at  Liege,  by  so  early  a 
writer  as  Radulpho  de  Rivo,  Dean  of  Ton- 
gres   (ten   miles  from  Liege),  who  died   in 


4o8 


Annuls  of  Medical  History 


1403.  See  Joannes  Chapeauville,  "Gesta 
Pontificum  Leodiensium,  scripserunt  auc- 
toris  precipui",  Liege,  1616,  vol.  3,  p.  i. 
(For  the  life  of  Rivo  see  P.  C.  Mohlberg, 
"Radulph  de  Rivo:  der  Ietzte  Vertreter 
der  altromischen  Liturgie",  Louvain,  Paris 
and  Brussels,  191 1.)  De  Rivo  gives  the 
date  of  the  tomb  as  1367,  a  mistake  ex- 
plained by  Warner  as  probably  due  to 
the  easy  confusion  between  a  Latin  X  and 
V,  supposing  the  real  date  to  have  been 
1372.  Similar  references  to  our  author 
are  given  by  Cornelius  Zantlliet,  monk  at 
the  convent  of  St.  Jacques  at  Liege,  in  his 
"Chronicon  ab  anno  1230  ad  1461  ",  edited 
by  de  Louvron  and  published  by  Martene 
and  Durand,  "Veterum  script um  et  Monu- 
mentorum,  documentorum,  moralium,  am- 
plissima  collectis",  vol.  5,  p.  67;  John  Bale, 
"Illustrium  Maioris  Britannica?  Scrip- 
torum"  (Ipswich?),  1548,  Centurion  iii,  p. 
149b;  Jacob  Meyer,  "Commentarii  sive  An- 
nales  rerum  Flandricarum",  Antwerp,  1561, 
Lib.  xiii,  p.  165;  Lodovico  Guicciardini, 
"  Descrittione  Di  Tutti  i  Paese  Bassi  Altri- 
menti  detti  Germania  inferiorc",  Antwerp, 
[567,  p.  281c;  F.  X.  de  Feller,  "Dictionnaire 
Historiquc",  Liege,  1781,  vol.  4  p.  329 
(quoted  by  Henaux;  we  have  ourselves 
seen  only  the  edition  of  Paris  and  Lyon, 
1822,  vol.  8,  p.  395);  P.  Lambinet 
"  Recherches  sur  L'Origine  de  I'lmprimerie 
Brussels,  ann.  VII  de  I'ere  francaise",  p.  299. 

J.  Leland,  "Commentarii  de  Scriptoribus 
Britannicis",  Oxford,  1709,  p.  366,  has  a 
lengthy  notice  of  Mandeville.  He  does  not 
give  the  name  "ad  Barbam"  but  describes 
the  knight  as  "ex  fano  Albani  orhindus". 
ivs  that  he  studied  first  theology,  then 
medicine,  and  that  finally,  owing  to  his 
thirst  for  knowledge,  he  became  a  great 
traveler.  Leland  devotes  much  space  to 
praise  of  this  latter  pursuit. 

R.  P.  Fotillon,  "Historia  I.codiensis  .  .  . 

ab    origine    populi    usque    ad    Ferdinandi 

ii  tempora",  I  lege,  1735,  vol.  I,  pars. 

2,  lib.  5,  |).  436,   mentions  "  Mande\  illium, 


Equestris  Ordinis  Anglum  nobilem,  vivis 
excessisse  Leodii,  Sepulcrumque  in  Subur- 
bana  Guilielmitarum  Aede  elegisse,  scribit 
Radulfus".  He  corrects  both  Rivo  and  Ortel- 
lius  as  to  the  date,  commending  the  greater 
accuracy  of  Guicciardini;  also  he  notes  the 
sentence  carved  "in  the  dialect  of  Liege  as 
used  to  this  day". 

Appendix  II 

Paris,  Bibliotheque  Nationale  Fonds  he- 
breu  1 191  (VIII),  (Ancien  Fonds  404)  folio 
141,  verso 

tBHByn  nsc  -22:  icso 

.-mm  v,sn 

cm  c^d"1  naava  "vwn    nanon  12s 

t»ik  rwyai  »Bijna  Kin 
pbjwv  "pi*ww  icis  ,:\s  c:cs    /sac        5 
minxya 
iaiyna»  d^tkh  maya  :2s  bi»b  -m  s--  »a 
naina  ns:D  nna  7:1::;   .jpbijw  v:x  tnpa 
'n  mapp  n",c:pD  rmr;2  ikbo  pi)?i  rrwrB 
"\vh  lniD"1  c-j-js  na-in  'a  ntna»  102  nsaon 
tPBiyon  r\sn  nt  -r  mjn  nin1^  csrc  en       10 
'ljnn  mrrtn  cjvrxa  :2s  ----  nao  -2? 

nana  z-y-:  -'>•--■  ma  avion  D'trawi 
'lrnpn 
tr.sy  dw  vwn  top"1  n't  t  jn  iautf  mi 

ttf  CS 

nana  rww  i«  Bnsjft  pic  qian  now  nw» 
ep*i»i  s?  VHTW  ma    .rsiytan  lain  nnn      15 

"eaon  v.n-  ja  :c2    .nanirt  pion  -itann 

.cnBjft  pm  -f--  ^:■J.•'.:,   s-  2s  t|iaa   -■•• 

p   DM 

.-■--inn  CM3D  mton  D«pan  'an  D^Bian 

D^TDIJJ 
-•:\s    DMMW1    l'S'I;    D'TDlp   pi      .OWia 

CJTD 

mwa  p  sr  cxr  nanwan  v.s-  -•:-  D^asn      20 
mi  .*•.  2,,:,:s-  v>m  "natan  nun  nw»  Dlpo 
nin^n  mrmnn  »b5  raiyta  1a  -pikm  »a 

tr-irv 


Plague  Tractates 


onyis  Dnyisn  oto/)  'a   .catonn  D^nn 

onv  ''flto    .tyennn  -iDinn  nmn  ""s^ 

naMtoai  nnana  onyisn  cxsnn  can      25 

icdi  n^coy  rmann  noanoi   •mftnin  tayo 

to^  imd  rv^rnan  twin  ncann  "o  .on1? 

KB11 

'»  ""D^TSKn  nana  cnpiaM  "IDKtf  1D3  lp"»B«B 

ptti  njiann  toicon  Ksnn  Dito  nw  WKff 

(fol.  142,  recto) 

ncsn  en1?  "a  it  to  Mamtr  dim1?  ^sn        1 
ruisnn 
neanm  nr  ns  nr  ants^o  nMia-rn  nastoi 

'nsn 
in  to  t  mn«n  nnanno  nmn  nann  nmio 
vuna  mi   .onain  too  •nton1'  m1?  on3 
pDyno 
ruvwi  nannn  to  vm  im  njtt>  'e  nMians        5 

02 
"mDKton  mm  trn»  """eya  "aan  Da 
mama 
Msnn  mia  ■'s^  ntois  nmn  ttf  pina  rrmoDi 
|n:n  dm  ny-ft  n«r    .nftnn  ntyin1?  Mm 

'trann 
k^>  iyao3tt>  '•"ayM  m^  rfnnn  nan  to/to^ 

DW 

n:iann  icd  nna>  Mto>  •'d  p  dm    .nsisin      10 

tansai 
'dmb>  idb  .nin^>  miy1?  tor  m1?  d^bjch  o^nna 
naD  yiM  «^  dm  nKBn^  toiM  tm  D^MBi-in  nc 

'n 
*d  'dm  mmpn  nsisia  ^d  p  d:i   .nmn 

Mto 

.^inn  riMisna  nMisnn  11?  y:DJ  naon  ym 
noiMtr  yotya  mn  p«  nxm  p  dj  nn      15 

p  dm  jvipirnm  nianpn  maD  man  s^n 
WK-in  'udhd  r»m  D^D-'Dcn  nnannty  nnsn 
n«r   .nnn  onann  man  5>m  Ma?  -i"itas"»  nu 

DM 

nt^i  nMisnn  mn  nw>  m5>  ruiann  n^raty  p 

'a 
••jm  j  3  5>  1   .D^ai  inm,>  nxyn  pona      20 
noana  jdim  mutf  tsnano  trwnn  jmi'j 
d,|d,«  1^  nt  o-'MBnac  pp  mrn\n  nsisnn 

n^nna 
mn  p"B^>  a"a  rw  nrpnv  nstn  nsjon 
lannoa 
maono  nt  ••man  oy  raiano  ]ap  man  vwy 


i:dd  pens  inp^>  D^ani  ns;Dn  hmtd  yaom 

hmt  'a  •'niMnai    .'iai  ^m  ^k  p  ^nnoi 

nrny  )Din  i^onai  tinno  natr  nsjon 

ijmi  .ni^  nsp  y;n  k^  'a  ays  nnM  dj>b  z-z-i 

nrnaa  c]mai  d'wkh  nn^o  to  atma 

't  "»man  cnto*n 

(fol.  142,  verso) 
ia  iM3^  Tiyi  .,|n;7M  nny  lvitnpi  nann  nr 

m^  ayoa  |y  mode's  c^nn  n?MD  "nairn 

ncn^ 
iDsy1?  MBin  nvn1?  toi"1  dim  toi  Man  cim^> 

vtr\ 

njnjnno  i3na  nton  p  dm  .jinjoi  nnrr,  no 

'n  nyscn  ^  Tijia  yr1?  nsTtr  ■•d"  .n^mn 

D^snMn  Di^^yno  dji  d^d-'dc-  cTn;n 

■•  3  m  1    -nr  to  n3 inon  -iar:n  -idmds 

pnx^  'na  po^s  n?yDai  ma^Ma  jnpn 

"iud  D-njipn  n»  »m*na  p^nyon  uiiypnp 

'mm 

'naa:  CMsn  'T  to  odimdi  nouo  tmmttta 

am  nnno  lK^sin^  Tiitorurn  to  TiDtr 

lpviyn^i 

bd^i  nry^  1:^  mm  |y  enpn  p»^  ^m  cjicto 

.]dm  iny1?  n'jnnm  "imnM  CMa^  c;i  mx 

..noiMi  n:n:nn  mata  ^nn«i 
pi    .nntrom  toMDn  -"ito  p  nnrn^  n  m  n 
on  cnain  toi  ^mon  pining  'isn 
on  mi»n  Dja^  ^a  D^apjn  o^nniBi  rp;n  c:bd 
tysyDi  ejian  apui  cmnsn  D^ap:n  -jm  a-siy 
n^aso  notyn^i  ^»dd  p^mn^  ~md  v,mt  pi 
m1?  dm  Dyo  mm  nnn  toM"1  dmi  mmen 
'lTflfm 
toayn  *to  D^^y  ^nnft>  'itm    .csionn 

|«i 
ti'ain  mpn  to  p^nmi   -viMna  jitd  nnn  aio 
•m  )Dtai   .foina  o^pino  cnyoon  to  i»mi 
npasi    -ua^D  mna  trM  ntyy  "im  «awa 

iDipa 
miMn  Dipos  noy^  im  n^no  iomx  did 

^am 
Mn  M13DM  Mn  1D3  mmcan  nisnnn 

'1   pCID 

oy  pp^DipiM  tt'nn^B  pt'io  oy  b^d^m  Mn 

pcio 
nisiMnj  ^jm  n:tro  im  ps  dmi   .an^m 
np"1!   .on^iti  nMnv  npcio  ^ou  i^cmd 

ays 

1  Read  n^>^iyn. 


409 
25 


10 


13 


20 


25 


4io 


Annals  of  Medical  History 


Paris  Bibliotheque  Nationale,  Fonds 
hebreu  1124  (Via)  (Ancien  Fonds  417) 
fol.  133,  verso 

p:y  by  Karwa'ia'n  pna  'bc^kb  "b  fy  nxy        1 

pi  Kin  nny  tffD    .nain 
manan  yn  nno^  wri  •■'rina  ^.s'1  *nr»K  ck 

nn1?  tix  nine  -->x 
Y'a  ins  c^na-rn  crtinn  h^M  nw«  ttb  fi 

qua  »a  nyTe*  nn«i  •mnerii  ttb  nn^  mnn 

'«&»Nn  onsK  ':  c"1  ciKn 
tf  ts»  cna  ins  'bai   .Taam  mem  afci  V'n       5 
nrm  u  lira  nyT:r  ids  Team 
■nwK  men  p  wm  naKn  p  nnmon 
K^Bn  a^na-,   .c^rsn 
•,nr,;c2  ensn  ^a  y-rv  nn«i  .c',uaKn  naana': 

ntrsa  wann  yaa  -w? 
-•s-  nr  «bt»  n"a  nrc:  mm  nnK  nyr 

Din  cy  amya  "D"wn 
td"1  K',na»  3^  y;B  td  rp;ac  wnri  mini 

WTO  ick  late  pen 
'baa  yyuna  td  "p  n«n  afrwai    .inta'i      10 

"DTOtn  DTPI  p*Vfi  ln^ 

onuD  c^atra  ipnrr>  jdbti  irnDi  ip-na1? 
>dj?s^    .3%  yp  K^C  »T3 
^>3  to  Kinc  naa1?  irrtwi  lprmfr  tys^ 
yaan  rroi  itoi  nryaan  mrrnn 
neny  pi    .c^urtf'  lnrrp  3":  "nam 
KBinn  TO  caacn  tf«3i   .n*,an 
p^cn  nKT  ck  .vfrw  prim  c^inn  ^kd 

km  nK*,snn  l^BPna 
^"•aip  ^xdk  'pan  a^n  ttb  vpnb  mna      15 
k^>i  TBI  *n*,KD  'y'ba 
'a  it)«jt  twi  isn1?  pprti  *a   .naaar* 
'«n  VDancwaipaw 
^a  '2    .ptio  v^a  nsac  aian  Din  p^-in  ^a 
'y^o  it?"1?  caiocn  cm 
maipan  CDD,,•;  nwisn  nnayoa  TDjy> 

.tit  Dtn    .niKnan 
■^cn  ynrna  Kp^can  rip*"  m  naan  »eta 
naan  ttd  u«m 
paxttn  ra  Kins*  n^Ki^a  'pan  th  ttd  in      20 

psi  mt  'pan  |Bpn 
nnmon  \bn  cki   .nx^op  'pin  njjaBn  ys^K 

•"B'i'D  ci^n  -pm  idt 
nrotn  V'i  ^nv  Bnattn  -c-r-  <Vi"awi 

Ttn  ttiikd  ^>nn  tt  r>pn  r«  ^iuwotb 
^nno  ^nan  pa  u«m 


n:n  yntno  rpn  c«  ^  nxav  yax«n  rai 

'''p'm'?  on«n  n?yo  nns 
^a  njn  nja»  iTnm  n^i^yn  y-i  onaajn 
bki   .lain  nenn  «^>i  Tun 


25 


(fol.  134,  recto) 
Tni  nne  t«  i^ti  cnaxno  pmn"1  pen  b«i 

11DD  RT£W  'pin  frlTI 

moo  D^piB'a  cb'  in   .nn«m  ppn  yax«^ 

naianK^  anp  nepson 
pi33  is  B^rsn  i-iins  n'.on  *p^na  ist1  csi 
wi  imsD  T^pn  tn 
rPtPTn  n^yxDKHD  n^yo^  iprw  sp^exa 
pa  T3  is  'y^a 
niDiDi  D^prn  rami  ncyi    .nnsm  ^run        5 

dikh  p^mni  ns^son 
Dy  ysan  pirn  p^wnn  cnsKna  «onKK 
i:"m  D33^  enp  o^mpn 
BiJ^nK11-  c'DKaK  irrnntrn  paK  np 
Knmis^  pas  ^ijd  nKna 
.n'ji'jai  EV3  c^paKn  ottw  ikcii  npir  cy 

npn  n\nn  rurunn 
D^apn  D^nna  '-"ays^  o^ap  msiy  ;inn 

K^p^Btnas  ^^s 
tk  NBxn  prnn  cki  rUKy>Bri  ^yn  noun  cy      10 
}*cin  cy  cip  cc  |n 
nnv  aye  )ua  nn^  »T3  c'ays^i  3iB3  jitb 
aiaa  ana  ^Vs  p^  p  pi 
np   .nrnnnn  nr  cv  Kc-nan  epe  'jyi 
y-ir  'vpxw  'i  sra^ana 
'k  'kb  lpiaao  "iBra^p  <Kn»  f,paiK  'k  nan 

pa  sin  jiKn^o  'vw  'am 
cyi  K^ciap  jaa»  cy  c^a  ripw  'cm  'n  csia 

Kc^tn  nsr  myc  aya 
cipcn  ^y  cci  ncp  nciann  aya  wjn  ivdi      15 

sa  era  '^cys  'a  ik  1 
ciKnc  "cik  'a-.nn  -jican  'un  n^BDKn 

'"CKnn  cnaK^  ipv  k^» 
nana  p3K  nr^  my  .  -ua^a  cb'dib  ''Bye^i 

nr\v  ^yv  -ick  K^fiii 
ncpn  paK  ^iTorKn  pa  'npn  .TpKnasna 

enc^pn  icK 
^a  in  cai  nann  ]cta  c^nc  w  c^anyn 

'D^cna  naa  4dik^  cd 
tsb  nsun  ^a-iya  'pan  c^yac  oik  ^a  naai      20 

nr  nprpi  man  p 
K^ra  u«m  iirai^s  'pan  ae*y  cy  paKn 

nsn^B  'pan  nnK  atrya 
c^K-np  cnnsi  KTinp  k^tik  rt  imp  cnnKi 
c>nnKi  njK'cra  ^ 


'  Supply  Din. 
»  Read  i*. 


•Read  di»i  . 

*  Read  cbto. 


Plague  Tractates 


411 


'din  D"nriMi  MDM^siMnMJ  1*7  pip 

N7H  ID^DSMn  (?)  IN  N^DrmiD 
■"D  ,D17  7DT>1  Dinn  D'D  IpTDnN  171D  JIT^D 

on  'un  ^Dtsnnn  7D 

pTtf  DIN  7D  lpWl  iQ',D',DlN,DNn:  N'^Di:         25 

Di»mn  pU7i  DnN7 

(fol.  134,  verso) 

Dipon  by  db>w  in  dhd  nntyt?  in  l^yp        1 
nrpma  Din  thpd*»  idd  dimh  "vupd"1 

"•p  S"JJN1  □",D1I71  >DVB  HDD!  HDD  nDlJ  iW 

'*T3wn  D^atpyn  D'Toon  ino 

D^TDDtP    NTDIN^D    jmy    1NXDJ    ""D    'DIN 

'din  DinnNi    .onDun  o^Dtyyn 

D'DDIDI  piX  DJ?  '•NriDty  TIDn  1D1H  DDD  *3 

rmyty  nj^D  imnnjc  '"nnN 

'"•ddidhd  piy  iwn  ty  nnnio 
nrjiDjj-i  d-uddd  p?n  piND  niDi  my-i 

'tan  nKunsn   .-ipn  msjoi 
}dtd  nvyxonn  uw  ">7Di  mno  ntrynt?  ^ni 

lilDMty  IDD   TpW  ^NT 
7D  niB>y7  7Din  N7  DNl     .inDNB>  niDipDHDI 

nt?y  mns7  mno  td 
pmmi  djd11  N7  DnNnty  hd  niytr  tw  mip 
nftnn  pmmi   .d">:sd 
m  nnNi  rnpnn  ncyntr  ly  nna>Di  7Dndd      10 

pmo  ni"07  niND-i  ay 
m  |ot  mn  id  "ma  Mim  wn-i  rum   .n?inn 

Drntryo  iriT'  Nin  nni 
nND  nnni  m^^n  17nd  ">utpn  mnt?  ruts' 
m7D  ntpriD  iNsnn:^  uw 
nDn  •'D  ns1*  -pin  m  7y  ^n«n  noinn  »a 
.jnn  'onn  tsna7  yviDD 
pn  itudi  span  jd  yin  tsna7  pi  pmno  37m 
7  riynb  finD  nosan  dinh 
vm-i  run  arm    .mtn  jd  l^snVi  ioxy      15 
p-'mn'ri  nncoDi  7Dndd  mnniy 
•opa  cnmsn  7Di  ronon  rniitam  pmon 

"Wttt  id  span 
mini  na'as  DJD1  oDino  miNn  .T?p:D  inns' 
"tpaani  ij?DDm  wnn 
id1?  ipnrp  d"7d  rumen   .»eymi  DDDom 
pnvwi  o^ion  mms  im»  dn 

6  Read  D'nB»yn. 

6a  Marginal  gloss  in  same  hand  as  text;    mpi. 
6b  Marginal  gloss  in  some  hand  as  text:  z":. 
See  note  29  and  55  of  the  translation. 

7  Marginal  gloss  in  same  hand  as  text:    ib'bj'k. 
See  note  56a  of  the  translation. 


l'iuiv    .dSt  b^pp  »a  cjs  ^d  ^j;  ^tyon 

wn  j«i    .toynn^  D^p  ctdnd 
chd  djd'b'  cn",Ni  8mKisnn  ipnrp    .7;^:,       20 

T»m  I'^trann  ^d    .terain 
moiDi  nipn  jdtd    .pm  }»Din  cy  'on:ip 
mnD  cn  nB'y  o^Dwn 

^DN11  mDDD  mpiC  DTip  "IpDD  f^pDl     .ntSDH 
"pi  "inNI  IDT  nT'M 

^"•DDnM  niMiann  ^jt1!  c^iyn  n,,,N^ 

nMn   IpDID   MH   N1DNH 

mpDiD  tun  »ton»a  ^n^  ijy  Nin  cni  mpN 

nnN  nysi    .B«XKai 
men  \T2  ybm    .npKna  jnara  c^ntr  in      25 

D":m    DT^yDI    NnDDND 

(fol.  135,  recto) 

n"o^>  mno  -mm  DnyD   .mon  nn^i  n«jnn        1 

ty  -ji^ii  c«n  ^sn  -]^i 
'n  np  pDNn  nto  in  n«:nn  c^xy  c^nan 

B^B'NIIDB'N  iJND^-iND  '<p31S 

.'Dm  'n  'ni^n  XV  'D*n  '3  'n'd  narDN^p 

pi  )wy  ntryi  D^run  ^y  can 
mtyai  .yn  nn  b^jt1  v^'nd  -[iin  nr  ^y  nry 
'nDin  n'i'ND  rwy  dn  ctrn 

tWP  M^     -nDIDl  fDin  DT  ^JT  fpn  |DTD1  5 

□n  Nin  "IpDD  DNl    .D^on  d^ditd 

D^rnn  nnn^  ^ar  tn  nnn  jn  tik  :n 

••ni^n  i^i:d  ^bit»j  tP^iKrwm 

.Dinn  ptD  di-i^jd  pnm  pin  dj;  ;isdi 
•D^Ditym  D^xan  pTIT 
niDyD  D^jnn^  ^dii  jiojpm  osnDn  w:ni 

ninte^    -nND  D'cn  dj'n 
mnty1?  didi    .d">diq  pain  oy  onp  D^en 

i^yD^  ^jm  nDin  »a  naKtyon 
onp  d^d  djj  n^Dn  ^s'i  t^D^n  onn  nddh       10 

D'DJJS   HDD   D'TII   ""D1   pim 
D'^nn1?  7ND  D'DID  '^XM"I  ^l^BTI  D;i     -DVD 

tt  i^j?t»i  yiDt^D  nnN  dj;s 

1NB'  ^Dl  D"DN1  pi  'JD1?  D^DID  Dm  DINn  JTD 

oniN  d^dcd  D^Dnon 
DnnDj  itt'N   .idsj  noin  ^d  i^ty'jc   .rann 

noip'o  sni^n  np  nr 
isiitt'  dj;  tt'i^1  'dit  'nd  ddid  nmo   .'Dm  ': 

'Dm  'N  NmDIDIST 

.\\tfvf  Dnp  DnyD  inpri  tr^i^s  ntryi  'xm       15 

n"y3  nr  mry  nt^MDi 
.imn  ptn  lay*?  top  •'niDTty  Dy^ayn  oy 
is  by  D'xtri  c]^n  n:tyD  'DNDn  nr  ns  d^ot 

NDnDli'DT  'JNi:  'Dtt'^ND 

.onxiin  pa»n^  Nin  paarnn  nti 

8  Read  ninipnn. 


THE  MEDICAL  PHRASES  OF  VICTOR  HUGO* 
By  HUBERT  ASHLEY  ROYSTER,  M.D. 

RALEIGH,    NORTH    CAROLINA 


LITERATURE  is  not  lacking  in  medi- 
cal characters:  many  great  writers 
of  drama  and  fiction  have  intro- 
^#  duced  doctors  into  their  narratives. 
The  doctors  of  Shakespeare  and  of  Dickens 
have  furnished  themes  for  interesting 
studies,  while  much  of  Moliere's  satire  is 
heaped  upon  the  doctor  and  his  foibles. 
In  the  stories  of  innumerable  lesser  writers 
of  fiction  may  be  found  physicians  as 
major  or  minor  characters;  some  play 
the  parts  of  heroes,  others  the  parts  of 
villains.  In  each  instance  the  authors  dis- 
play more  or  less  knowledge  of  doctors  and 
familiarity  with  their  work,  according  as 
they  have  had  opportunity  for  personal 
observation  of  or  association  with  them. 
Usually  scant  justice  is  done  the  doctor  in 
his  attitude  and  service,  but,  on  the  other 
hand,  much  effort  at  mock  heroics  is 
wasted  in  attempts  to  give  him  more  than 
he  deserves.  The  average  fictionist  is  glar- 
ingly ignorant  of  medical  men  and  their 
ways  and  even  more  so  of  medical  science 
itself.  The  hero  or  heroine  is  still  dying 
of  "brain  fever,"  and  peculiar  pathology 
is  often  developed  from  sensational 
injuries. 

Conversely  the  comparatively  few  phy- 
sicians who  have  gone  in  for  literature  rarely 
use  their  works  for  displaying  their  profes- 
sional learning.  It  appears  certain  that 
Keats  and  Goldsmith  actually  avoided  med- 
ical ideas,  if,  indeed,  they  had  many;  and 
very  little  of  the  best  thought  of  Holmes 
and  Mitchell  contains  medical  allusions. 

In  lay  literature  one  author — Victor  Hugo 
— stands  forth  supreme  in  his  medical 
knowledge.  Yet  not  one  of  Hugo's  leading 
characters  is  a  physician.  He  makes  no 
attempt  to  portray  the  personality  of  the 
•  Read  at  a   meeting  of  the   Harvard   Medical 

412 


doctor.  He  merely  writes  into  his  works 
his  wide  and  accurate  knowledge  of  the 
whole  science  of  medicine.  An  astounding 
mastery  was  his  of  every  branch  of  science 
as  it  existed  both  before  and  during  his 
day;  his  books  fairly  teem  with  evidences 
of  it.  Most  of  his  medical  expressions  are  in 
the  form  of  figures  of  speech. 

It  is  not  uncommon,  however,  for  speak- 
ers and  writers  to  employ  medical  similes; 
now  and  then  they  add  strength  to  the 
ordinary  discourse  and  enliven  the  usual 
occasion.  The  ability  to  use  such  expres- 
sions wisely  and  well  constitutes  an  art, 
even  if  it  does  not  attest  a  profound  knowl- 
edge of  medical  subjects.  But  when  one 
illumines  one's  pages  over  and  over  again 
with  deep-rooted  ideas  of  all  that  pertains 
to  a  great  science,  as  Hugo  does,  it  is 
nothing  short  of  genius.  And  genius  he  was 
in  the  truest  measure  of  the  term. 

There  was  apparently  nothing  in  Victor 
Hugo's  early  life  or  his  education  to  give 
him  such  knowledge,  except  that  in  the 
year  181 8,  in  a  general  yearly  competition  of 
all  French  scholars  for  University  prizes, 
he  obtained  fifth  place  for  physics.  At  six- 
teen he  left  the  school  for  good,  determined 
not  to  try  for  admission  to  the  Ecole  Poly- 
technique  or  to  be  a  soldier,  as  was  his 
father  before  him.  Instead,  he  began  to 
write.  We  know  also  that  he  began  to  read 
widely;  only  omnivorous  reading  can  ac- 
count for  his  omniscient  writing.  At  least 
I  shall  claim  that  he  read  greedily  and  re- 
membered tenaciously  all  science,  and  medi- 
cal science  in  particular,  for  without  this 
preparation  he  could  hardly  have  set  down 
the  wonderfully  true  and  interesting  scien- 
tific observations  which  enrich  all  his  works. 
Whether  in  figure  of  speech,  running  illus- 
History  Club,   Boston,   Mass.,  April  4,    1917. 


The  Medical  Phrases  of  Victor  Hugo 


413 


tration  or  homely  simile,  the  details  are  per- 
fectly presented  and  the  meaning  is  exact. 

My  purpose,  then,  will  be  to  pass  in 
review  the  phrases  which  give  evidence  of 
the  profound  medical  knowledge  of  this 
man  of  letters  and  of  his  artistic  perception 
in  weaving  this  knowledge  into  his  narra- 
tive. Let  me  hope  that  my  account  may  not 
be  a  tiresome  catalogue  of  quotations. 

Beginning  with  the  fundamentals,  let  us 
first  find  the  anatomical  references.  With 
his  wonderful  power  of  description  Hugo 
refers  to  "a  row  of  great  piles  set  upright  in 
the  sand  against  a  wall"  as  "dry,  gaunt, 
knotty  logs  resembling  an  array  of  leg 
bones  and  knee-caps  afflicted  with  anky- 
losis." Indeed  he  carries  the  figure  further 
and  suggests  that  "revery  .  .  .  might 
inquire  to  what  race  of  men  these  three- 
fathom  tibias  had  belonged."  One  of  his 
philosopher  characters  (Combeferre  in  "Les 
Miserables")  is  said  to  have  been  "enrap- 
tured with  a  lecture  in  which  Geoffroy  Saint- 
Hilaire  had  explained  the  double  function 
of  the  exterior  carotid  artery  and  the 
interior  carotid  artery,  one  of  which  supplies 
the  face,  the  other  the  brain."  This  same 
philosopher  was  said  to  believe  in  "the 
suppression  of  suffering  in  surgical  opera- 
tions." Anatomical  figures  are  vividly  set  out 
in  the  experience  of  children  hidden  in  the 
elephant  of  the  Bastile:  "Above  a  long  dusty 
beam,  from  which  projected  at  regular  dis- 
tances, massive  encircling  timbers  repre- 
senting the  vertebral  column  with  its  ribs, 
stalactites  of  plaster  hung  down  like  the 
viscera,  and  from  one  side  to  the  other 
huge  spider  webs  made  dusty  diaphragms." 
Similar  anatomical  description  is  seen  in 
this  passage  from  "The  Toilers  of  the  Sea": 
"Over  his  head  was  a  roofing  not  unlike  the 
insides  of  a  vast  skull;  the  vault  was  the 
cranium;  the  arch  was  the  mouth;  the  eye 
sockets  were  lacking.  .  .  .  The  vault  with 
its  cerebral  lobes,  and  its  crawling  ramifi- 
cations, similar  to  outspreading  nerves,  had 
a  tender  reflection  of  the  chrysoprase."  In 


one  of  his  letters  he  calls  the  Strait  of  Mau- 
musson  "one  of  the  navels  of  the  sea";  and 
in  proving  how  divinity  adheres  to  the 
"rough  draught"  he  shows  "how  the  solar 
ray  is  an  umbilical  cord,"  how  the  "disfig- 
ured becomes  transfigured."  Walking  the 
corridor  of  a  dungeon  gives  rise  to  a  com- 
parison: "This  gut  made  circuits;  all  entrails 
are  tortuous,  those  of  a  prison  as  well  as 
those  of  a  man.  .  .  .  The  stone  pavement 
of  the  corridor  had  the  viscousness  of  an 
intestine." 

Hugo  exhibits  his  peculiar  talent  in  no  way 
better  than  in  his  strictures  upon  the  de- 
struction of  the  marvelous  art  of  the  Middle 
Ages  by  modern  architects.  "They  have," 
he  says,  "audaciously  adjusted,  in  the  name 
of  'good  taste,'  mounds  of  Gothic  architec- 
ture, their  miserable  gewgaws  of  a  day,  their 
ribbons  of  marble,  their  pompons  of  metal, 
a  veritable  leprosy  of  egg-shaped  ornaments. 
.  .  .  Three  sorts  of  ravages  today  disfigure 
Gothic  architecture.  Wrinkles  and  warts  on 
the  epidermis;  this  is  the  work  of  time. 
Deeds  of  violence,  brutalities,  contusions, 
fractures;  this  is  the  work  of  the  revolutions 
from  Luther  to  Mirabeau.  Mutilations,  am- 
putations, dislocations  of  the  joints,  restora- 
tions; this  is  the  Greek,  Roman  and  bar- 
barian work  of  professors."  Bemoaning  the 
fate  of  the  "charming  little  bell  tower"  of 
the  Cathedral,  he  tells  us  that  "an  architect 
of  good  taste  amputated  it  and  considered 
it  sufficient  to  mask  the  wound  with  a  large, 
leaden  plaster,  which  resembles  a  pot  cover." 

Our  author's  familiarity  with  physiology, 
pathology,  chemistry  and  allied  subjects  is 
striking.  Here  is  a  contrast  between  pathol- 
ogy and  anatomy:  "The  simplicity  which 
is  short-winded  is  a  case  for  pathology.  A 
hospital  ticket  suits  it  better  than  a  ride 
on  the  hippogriff.  ...  I  admit  that 
the  hump  of  Thersites  is  simple;  but  the 
pectoral  muscles  of  Hercules  are  simple 
also.  I  prefer  this  simplicity  to  the  other." 
How  does  the  logic  of  the  following  physio- 
logical chemico-pathological  study  appeal  to 


4i4 


Annals  of  Medical  History 


you?  It  is  selected  from  the  postprandial 
remarks  of  a  reveller:  "Now  listen  atten- 
tively! Sugar  is  a  salt.  Every  salt  is  desic- 
cating. Sugar  is  the  most  desiccating  of  all 
salts.  It  sucks  up  the  liquids  from  the  blood 
through  the  veins;  thence  comes  the  coagu- 
lation; then  the  solidification  of  the  blood; 
thence  tubercles  in  the  lungs;  thence  death. 
And  this  is  why  diabetes  borders  on  con- 
sumption. Crunch  no  sugar,  therefore,  and 
you  shall  live."  In  1862  through  the  mouth 
of  Grantaire,  who  is  "perfectly  boozy," 
Hugo  gives  vent  to  this  strange  physiology 
of  the  nations:  "If  I  do  not  admire  John  Bull 
shall  I  admire  Brother  Jonathan  then?  I 
have  little  use  for  this  brother  with  his 
slaves.  Take  away  'time  is  money,'  and 
what  is  left  of  England?  Take  away  'cotton 
is  King,'  and  what  is  left  of  America? 
Germany  is  the  lymph;  Italy  is  the  bile. 
Shall  we^go  into  ecstasies  over  Russia? 
Voltaire  admired  her.  He  admired  China 
also.  I  confess  that  Russia  has  her  beauties, 
among  others  a  strong  despotism;  but  I 
am  sorry  for  the  despots.  They  have  very 
delicate  health."  Did  this  keen  observer 
have  any  inkling  then  of  the  greatest  world 
crisis  now  at  its  acme?  Speaking  in  "Les 
Miserables"  of  the  grosser  interests  of  cer- 
tain states,  he  hits  the  nail  squarely:  "Some- 
times the  stomach  paralyzes  the  heart.  The 
grandeur  and  the  beauty  of  France  are  that 
she  cares  less  for  the  belly  than  other 
people;  she  knots  the  rope  about  her  loins 
more  easily."  The  physiology  of  digestion 
was  a  favorite  theme  of  illustration  with 
Victor  Hugo.  Of  a  shipwreck  scene  he  says 
that  "the  deck  underwent  the  convulsions 
of  a  diaphragm,  which  is  seeking  to  vomit." 
Ursus  cries:  "I  have  toiled  today,  empty 
stomach,  plaintive  throat,  my  pancreas  in 
distress,  my  bowels  ruined,  far  into  the 
night  my  recompense  is  to  watch  another 
eat."  Gringoire,  the  impecunious  man  of 
letters,  thus  figures  the  King:  "He  is  a 
sponge,  to  soak  money  raised  from  the  peo- 
ple.   His   saving   is   like   the  spleen   which 


swelleth  with  the  leanness  of  all  the  other 
members."  Then  there  is  this  illuminating 
antithesis:  "The  foreign  war  is  a  scratch  one 
gets  on  the  elbow;  civil  war  is  the  ulcer 
which  eats  up  the  liver." 

Hugo's  chemistry  comes  in  for  its  share 
in  his  figures  of  speech.  He  is  not  very  com- 
plimentary to  the  products  of  the  metropolis 
when  he  writes:  "The  mud  of  Paris  is  par- 
ticularly stinking;  it  must  contain  a  great 
deal  of  volatile  and  nitric  salts."  Then  a 
glimpse  of  cloacal  chemistry:  "Death  in  the 
mire  under  a  cover!  the  slow  stifling  by  the 
filth,  a  stone  box  in  which  asphyxia  opens 
its  claws  in  the  slime  and  takes  you  by  the 
throat;  fetidness  mingled  with  the  death 
rattle;  mire  instead  of  sand,  sulphuretted 
hydrogen  instead  of  the  hurricane;  ordure 
instead  of  the  ocean."  The  grandeur  of 
scenery  is  used  to  bring  out  further  details : 
"The  oxides  of  the  rock  had  placed  here  and 
there  upon  the  cliffs  red  patches  resembling 
pools  of  clotted  blood."  The  toxicology  of 
character  is  expressed  when  he  makes 
Gilliatt  say:  "I  test  the  quality  of  a  scoun- 
drel as  a  doctor  will  test  a  poison." 

For  true  science  this  great  man  had  the 
profoundest  respect,  but  he  could  not  con- 
ceal his  utter  disdain  for  all  spurious  and 
quasi-forms  of  learning.  Satire  and  ridicule 
were  effective  weapons  in  his  hands.  All 
through  his  monograph  on  Shakespeare,  in 
which  he  hales  into  court  the  world's 
greatest  men,  of  whatever  branch  of  learn- 
ing, he  gives  examples  which  prove  his  re- 
markable acquaintance  with  the  history  of 
science,  the  real  and  the  sham.  He  believed 
that  long  advances  had  been  made,  and 
quite  as  confidently  looked  for  more.  "Look 
at  the  point,"  he  states,  "at  which  sperma- 
tology  and  ovology  have  already  arrived  and 
recall  Mariana  reproaching  Arnaud  de  Vil- 
leneuve  (who  discovered  alcohol  and  the 
oil  of  turpentine)  with  the  strange  crime  of 
having  attempted  human  generation  in  a 
pumpkin."  This  is  vivi-genesis  with  a  ven- 
geance.  Were  there  other  "antis"  in  those 


The  Medical  Phrases  of  Victor  Hugo 


415 


days  besides  Mariana?  In  the  following 
passage  one  can  hardly  decide  whether  the 
author  is  serious  or  satirical.  At  any  rate 
here  is  an  unusual  cause  of  death:  "Chrysip- 
pus  of  Tarsus  forms  an  era  in  science.  This 
philosopher  (the  same  who  died — actually 
died — of  laughter  caused  by  seeing  a  donkey 
eat  figs  out  of  a  silver  basin)  had  studied 
everything,  gone  to  the  bottom  of  every- 
thing. .  .  .  He  condensed  in  his  brain  all 
human  knowledge."  But  we  do  definitely 
perceive,  further  on,  the  insight  Hugo  had 
into  the  scientific  pretense  of  his  day.  "Five 
hundred  years  before  Jesus  Christ  it  was 
perfectly  scientific,  when  a  King  of  Meso- 
potamia had  a  daughter  possessed  of  the 
devil,  to  send  to  Thebes  for  a  god  to  cure  her. 
It  is  not  exactly  our  way  of  treating  epi- 
lepsy. In  the  same  way  we  have  given  up 
expecting  the  Kings  of  France  to  cure 
scrofula."  Substituting  "eminent  specialist" 
for  "god"  and  remembering  that  most  cases 
possessed  of  the  devil  are  afflicted  with 
hysteria,  these  words  have  a  very  familiar 
sound  at  this  day.  Neither  have  we  by  lapse 
of  time  or  more  diffuse  education  entirely 
outlived  those  who  still  believe  in  the  Royal 
Touch  and  the  laying  on  of  hands — except 
that  the  Royal  Touch  is  now  frequently 
given  by  a  famous  physician;  we  have 
places  of  pilgrimage,  too. 

Hugo  draws  on  his  knowledge  of  digestion 
and  dietetics  for  an  argument  against  for- 
mal, stilted  writing.  This  is  his  point:  "It 
seems  that  the  only  question  [with  the 
'serious'  school]  should  be  to  preserve  liter- 
ature from  indigestion.  Formerly  the  device 
was  'fecundity  and  power';  today  it  is 
barley  gruel.'  .  .  .  Be  of  the  temper- 
ance society.  A  good  critical  book  is  a 
treatise  on  the  dangers  of  drinking.  Do  you 
wish  to  compose  the  Iliad,  put  yourself  on 
diet."  Again:  "He  does  not  stop,  he  does 
not  feel  fatigue,  he  is  without  pity  for  the 
poor  weak  stomachs  that  are  candidates  for 
the  Academy.  The  gastritis  called  'good 
taste'  does  not  afflict  him."  In  describing 


the  choice  of  subjects  for  writing  by  a  genius, 
he  asks:  "What  is  the  Iliad?  A  collection 
of  plagues  and  wounds — not  an  artery  cut 
which  is  not  complacently  described." 

In  the  realm  of  internal  medicine  and 
diagnosis  we  find  the  great  author  demon- 
strating the  same  capacity  for  critical  illus- 
tration. What  an  observant  attitude  is  pic- 
tured in  this  passage:  "The  pedestrian 
bathed  in  sweat  finds  in  this  vault  [tower 
rock  on  the  road  to  the  Rigi]  an  abundance 
of  chilling  shade,  and  a  little  cool  water 
failing  all  about  him;  a  treacherous  bench 
has  been  placed  there,  and  on  it  pleurisies 
are  in  wait!"  General  manifestations  of 
disease  are  thus  brought  into  service:  "The 
revolutionary  fever,  however,  was  increas- 
ing. No  point  of  Paris  or  of  France  was 
exempt  from  it.  The  artery  pulsated  every- 
where. Like  those  membranes  which  are 
born  of  certain  inflammations  and  formed 
in  the  human  body,  the  net-work  of  the 
secret  societies  spread  over  the  country." 
In  this  connection,  when  the  young  men, 
enthusiastic  over  the  Revolution,  were  sent 
about  to  organize  their  several  branches, 
Joly,  the  medical  student,  was  to  "go  to 
Dupuytren's  clinique  and  feel  the  pulse  of 
the  medical  school."  Joly,  by  the  way,  was 
a  typically  latter-day  neurasthenic.  He  is 
depicted  as  a  "young  malade  imaginaire. 
What  he  had  learned  in  medicine  was  rather 
to  be  a  patient  than  a  physician.  At  23  he 
thought  himself  a  valetudinarian  and  passed 
his  time  in  looking  at  his  tongue  in  a  mirror." 

Discriminating  knowledge  of  special  dis- 
eases is  constantly  exhibited:  "There  is 
something  of  the  cholera  in  that  sort  of 
tempest";  and,  "The  breath  of  the  cholera 
was  felt  in  those  winds" — evidently  the 
prevailing  idea  of  the  epidemiology  of  chol- 
era in  those  days.  With  the  same  figure  in 
mind,  Hugo  finds  the  origin  of  storms: 
"Tempests  are  nervous  attacks  and  fits  of 
delirium  on  the  part  of  the  sea.  The  sea  has 
its  sick  headaches."  A  similar  figure  is 
employed   to   explain   an   unobserved   leak 


4i6 


Annals  of  Medical  History 


during  shipwreck:  "They  had  not  noticed 
it  amid  the  convulsive  violence  of  the  wind 
which  had  shaken  them.  In  a  fit  of  tetanus 
one  does  not  feel  a  prick."  Describing  the 
condition  of  a  little  child,  he  thought  "a 
nurse  would  have  reckoned  her  five  or  six 
months  old,  but  she  was,  perhaps,  a  year  old, 
for  in  poverty  growth  undergoes  heart- 
breaking reductions  which  sometimes  ex- 
tends to  the  rickets."  The  etiology  is  some- 
what mixed,  as  is  the  metaphor,  but  the 
kernel  of  knowledge  is  there.  Further  along 
Ursus  "listened  to  the  other  child  eating," 
and  exclaimed:  "It  will  be  a  task,  if  I  must 
henceforth  nourish  this  glutton  who  is  get- 
ting his  growth.  He  will  be  a  tapeworm 
which  I  shall  have  in  the  belly  of  my  indus- 
try." I  dare  say  that  no  one  could  express 
more  clearly  the  relation  of  certain  degen- 
erative diseases  to  the  life  we  live  than  is 
found  in  the  following  paragraph:  "His 
rheumatism  came  to  him  about  the  time 
when  he  had  gotten  into  easy  circumstances. 
These  two  products  of  labor  are  fond  of 
keeping  one  another  company.  At  the  mo- 
ment when  one  becomes  rich,  one  is  paral- 
yzed. This  crowns  life."  The  sclerosis  of  age 
is  well  presented  in  the  personification  of 
the  cathedral  door  which  yielded  but  slowly 
to  the  attack  of  the  vagabonds;  one  of  them 
said:  "It  is  old,  and  its  gristles  have  become 
bony."  The  following  gives  his  diagnosis  in 
the  crowd:  "Persons  who  wore  cravats  that 
hid  their  chins  were  called  the  scrofulous." 
A  really  remarkable  excerpt  is  the  one  I 
am  now  about  to  quote.  Well  might  we  ask, 
did  Victor  Hugo  know  of  gall-stones  and 
duodenal  ulcer?  Portraying  a  man  in  the  full 
vigor  of  life,  he  says:  "This  vision  is  splendid 
and  astounding;  but  a  little  gravel  in  the 
liver  or  an  abrasion  of  the  pylorus — six  feet 
of  earth,  and  all  is  over."  Not  less  remark- 
able is  his  broad  prophecy  of  fecal  infection 
contained  in  a  longer  extract.  Did  Hugo  an- 
ticipate MetchnikofPs  theory  and  foresee 
Lane's  operation  when  he  wrote:  "The 
belly  being  the  centre  of  matter  is  our  grati- 


fication and  our  danger;  it  contains  appe- 
tite, satiety,  and  putrefaction.  The  devotion, 
the  tenderness  which  seize  us  are  liable  to 
death.  .  .  .  The  belly  is  to  humanity 
a  formidable  weight;  it  breaks  at  every 
moment  the  equilibrium  between  the  soul 
and  the  body.  It  fills  history;  it  is  responsible 
for  nearly  all  crimes;  it  is  the  matrix  of  all 
vices.  .  .  .  It  is  perhaps  obesity,  per- 
haps dropsy.  .  .  .  The  large  intestine  is 
king;  all  that  old  world  feasts  and  bursts; 
and  Rabelais  (doctor  and  priest)  enthrones 
a  dynasty  of  bellies." 

On  a  lonely  journey  through  the  Alps, 
Hugo  wrote  letters  to  his  wife.  During  one 
of  these  tramps  he  had  an  opportunity  to 
indulge  his  fancy  in  speculation  on  the 
etiology  of  goitre.  The  following  quotation 
is  worth  reading:  "There  was  one  witness 
in  reality,  only  one.  .  .  .  In  a  cleft  in 
the  crag,  seated  on  a  huge  stone  with 
legs  hanging  down,  was  an  idiot  with  a 
goitre,  his  body  slim  and  his  face  enormous, 
laughing  with  a  stupid  laugh.  .  .  .  The 
Alps  were  the  spectacle,  the  spectator  was 
an  idiot.  I  forgot  myself  in  this  frightful 
antithesis.  .  .  .  Nature  in  her  superbest 
aspect,  man  in  his  most  miserable  de- 
basement. What  could  be  the  significance 
of  this  mysterious  contrast?  What  was  the 
sense  of  this  irony  in  a  solitude?  Have  I  the 
right  to  believe  that  the  landscape  was 
designed  for  him — the  cretin,  and  the  irony 
for  me — the  chance  visitor?  However,  the 
goitrous  idiot  paid  no  attention  to  me.  .  .  . 
At  this  height  the  convexity  of  the  globe 
confuses  to  a  certain  extent  all  lines  and  de- 
ranges them.  The  mountains  take  extraor- 
dinary postures.  .  .  .  The  landscape 
is  crazy.  With  this  inexpressible  spectacle 
before  your  eyes  you  begin  to  understand 
why  Switzerland  and  Savoie  swarm  with 
stunted  minds.  The  Alps  make  many  idiots. 
It  is  not  granted  to  all  intelligences  to 
cohabit  with  such  marvels  and  to  keep  from 
morning  till  evening,  without  intoxication 
and  without  stupor,  turning  a  visual  radius 


The  Medical  Phrases  of  Victor  Hugo 


417 


of  fifty  leagues  across  the  earth  around  a 
circumference  of  three  hundred." 

Materia  medica  and  therapeutics  form  the 
basis  of  certain  comparisons  which  were  the 
beliefs  of  the  times.  Some  of  these  reflected 
the  serious  side  of  the  author.  Witness: 
"Many  will  remember  that  great  epidemic 
of  croup  which  desolated,  thirty-five  years 
ago,  the  quarters  bordering  on  the  Seine  at 
Paris,  and  of  which  science  took  advantage 
to  experiment  on  a  large  scale  as  to  the 
efficacy  of  insufflations  of  alum,  now  so 
happily  replaced  by  the  tincture  of  iodine 
externally  applied."  On  the  other  hand  he 
takes  occasion  at  times  to  berate  the 
ignorance  both  of  the  physician  and  of  the 
layman.  The  archdeacon  showed  the  in- 
scription, "Medicine  is  the  daughter  of 
dreams,"  to  his  doctor,  who  immediately 
had  his  ire  aroused  and  exclaimed:  "Medi- 
cine a  dream!  I  suspect  that  the  pharmacop- 
olist  and  the  master  physician  would  insist 
upon  stoning  you  if  they  were  here.  So  you 
deny  the  influence  of  philters  upon  the 
blood,  and  unguents  on  the  skin!  You  deny 
that  external  pharmacy  of  flowers  and 
metals,  which  is  called  the  world,  made 
expressly  for  that  eternal  invalid  called 
man!"  The  cleric  replied:  "I  deny  neither 
pharmacy  nor  the  invalid.  I  reject  the 
physician."  "Then  it  is  not  true,"  replied 
the  doctor  hotly,  "that  gout  is  an  internal 
eruption;  that  a  wound  caused  by  artillery 
is  to  be  cured  by  the  application  of  a  young 
mouse  roasted;  that  young  blood,  properly 
injected,  restores  youth  to  aged  veins;  it 
is  not  true  that  two  and  two  make  four  and 
that  emprosthotonos  follows  opisthotonos." 
Which  being  said,  the  debate  ended  in  surli- 
ness on  the  part  of  the  priest  and  anger  on 
the  part  of  the  physician.  But,  "Ursus,  in 
his  capacity  of  physician  healed,  because, 
or  in  spite  of.  He  made  use  of  aromatics. 
He  was  versed  in  simples.  He  took  advan- 
tage of  the  profound  power  which  is  con- 
tained in  a  mass  of  disdained  plants, — 
hazel  twigs,  white  alder,  guelderrose,  the 


wayfaring  tree,  slatern,  viburnum,  buck- 
thorn. He  treated  phthisis  with  sundew;  on 
appropriate  occasions  he  used  the  leaves  of 
the  tithymal,  which  plucked  from  the  root 
are  a  purgative,  and  plucked  from  the  top 
are  an  emetic;  he  took  away  your  sore 
throat  by  means  of  the  vegetable  excres- 
cence called  'Jew's  ear';  he  knew  which 
rush  cures  the  ox  and  which  mint  cures  the 
horse;  he  was  acquainted  with  the  beauties 
and  virtues  of  the  herb  mandragora,  which, 
as  every  one  is  aware,  is  both  male  and 
female.  He  had  receipts.  He  cured  burns 
with  the  wool  of  the  salamander,  of  which 
Nero,  according  to  Pliny,  had  a  napkin." 
A  more  modern  example  of  botanical  super- 
stition may  be  recalled.  An  old  woman, 
(whether  male  or  female  I  do  not  know) 
once  asked  the  celebrated  Abernethy :  "Doc- 
tor, do  you  believe  that  poplar  bark  scraped 
'up  the  tree'  is  an  emetic  and  scraped 
'down  the  tree'  is  a  purgative?"  "Certainly," 
replied  the  doctor,  "and  don't  ever  take 
any  scraped  around  the  tree,  for,  if  you  do, 
it  will  fly  through  your  ribs  and  kill  you." 
Hugo  tells  us  that  Ursus  "correctly  pre- 
ferred Galen  to  Cardan;  Cardan,  learned 
man  as  he  is,  being  only  a  worm  of  the  earth 
in  comparison  with  Galen."  But  in  his 
"Shakespeare"  he  violently  asserts  that  "a 
country  horse-doctor  would  not  inflict  on 
horses  the  remedy  with  which  Galen  treated 
the  indigestions  of  Marcus  Aurelius."  What 
the  remedy  was  we  are  left  to  conjecture. 
Obstetric  references  are  few  but  pointed. 
The  family  of  nations  is  thus  to  be  nour- 
ished: "France  bears  within  her  the  sublime 
future.  This  is  the  gestation  of  the  nine- 
teenth century.  That  which  was  sketched 
for  Greece  is  worth  being  finished  by 
France."  The  channel  islands  are  described 
as  the  "puritanical  archipelago,  where  the 
Queen  of  England  has  been  blamed  for  vio- 
lating the  Bible,  because  she  gave  birth 
while  under  influence  of  chloroform."  When 
Dom  Claude  rails  at  a  fellow  by  shouting, 
"What  means  of  safety  have  you  found, 


4i8 


Annals  of -Medical  History 


knave?  Must  your  idea  be  extracted  with 
forceps?",  one  is  at  a  loss  to  know  whether 
to  classify  this  metaphor  with  obstetrics  or 
with  dentistry.  Idiopathic  Cesarean  section, 
amid  rather  warm  surroundings,  is  thus 
described:  "Under  Mary  Tudor  a  mother 
and  two  daughters  were  burned.  .  .  . 
One  of  the  daughters  was  with  child.  She 
brought  forth  the  child  in  the  coals  of  fagots. 
The  chroniclesays :  'Her  belly  burst.  A  living 
child  came  forth;  the  new  born  infant  rolled 
out  of  the  fiery  furnace;  a  certain  House 
picked  it  up.  [The]  bailiff  .  .  .  caused 
the  child  to  be  flung  back  into  the  fire.'  " 
Maternal  impressions  are  hinted  at  when 
the  populace  hoots  the  hunchback  of  Notre 
Dame:  "The  monster!  a  face  to  make  a 
woman  miscarry  better  than  all  the  drugs 
and  medicines.  .  .  .  'Twas  you  that 
made  my  wife,  simply  because  she  passed 
near  you,  give  birth  to  a  child  with  two 
heads!  And  my  cat  bring  forth  a  kitten  with 


six  paws 


Two  or  three  figures  of  speech  must  suf- 
fice to  convince  us  of  Hugo's  knowledge  of 
the  eye  and  its  diseases.  Hardly  could  there 
be  expressed  a  more  beautiful  figure  than 
this:  "The  pupil  dilates  at  night,  and  at  last 
finds  day  in  it,  even  as  the  soul  dilates  in 
misfortune  and  at  last  finds  God  in  it." 
Another  is  keenly  suggestive:  "He  suffered 
the  strange  pangs  of  a  conscience  suddenly 
operated  upon  for  the  cataract.  He  saw  what 
he  revolted  at  seeing."  Ocular  therapeutics 
is  brought  into  play  upon  literary  diseases: 
"Let  us  not,  then,  be  surprised  ...  at 
the  poultices  applied  by  a  certain  school 
of  criticism  to  the  chronic  ophthalmy  of 
academies." 

It  may  not  be  surprising  to  realize  that 
the  great  Frenchman  was  well  versed  in 
surgical  science  and  practice.  He  certainly 
writes  of  times  when  surgery  was  often  in 
demand  and  when  the  average  citizen  was 
necessarily  familiar  with  its  practices.  His 
exact  knowledge  of  surgical  pathology  is 
evident.  As  an  introduction  Hugo  regretted 


that  "we  are  deprived  of  the  progress  which 
the  executioner  caused  surgery  to  make," 
for  "by  cutting  the  limbs  of  living  men,  by 
opening  their  bellies  and  tearing  out  their 
entrails,  they  [of  the  olden  days]  caught 
phenomena  in  the  very  moment,  and  made 
discoveries."  Hearing  this,  let  the  women 
rage  and  the  anti-vivisectionists  imagine  a 
vain  thing.  Hugo's  phrases  on  wounds  are 
interesting.  Combating  the  idea  that  "emo- 
tion grows  dull"  he  argues  that  "it  is  as 
though  one  were  to  say  a  wound  is  assuaged 
and  become  calm  beneath  nitric  acid  falling 
drop  by  drop."  The  wounds  of  Marius  af- 
forded ample  opportunitj-  for  descriptive 
talent:  "The  doctor  examined  Marius  and, 
after  having  determined  that  the  pulse  beat, 
that  the  sufferer  had  no  wound  penetrating 
his  breast,  and  that  the  blood  at  the  corners 
of  his  mouth  came  from  the  nasal  cavities, 
he  had  him  laid  flat  upon  the  bed,  without 
a  pillow,  his  head  on  a  level  with  his  body, 
and  even  a  little  lower,  with  his  chest  bare, 
in  order  to  facilitate  respiration.  .  .  . 
The  head  .  .  .  was  covered  with  hacks; 
what  would  be  the  result  of  these  wounds 
on  the  head?  Did  they  stop  at  the  scalp? 
Did  they  affect  the  skull?"  Does  not  the 
following  observation  show  marked  dis- 
crimination? "He  had  for  several  weeks  a 
fever,  accompanied  with  delirium,  and  seri- 
ous cerebral  symptoms  resulting  rather  from 
the  concussion  produced  by  the  wounds  in 
the  head  than  from  the  wounds  themselves." 
And  this  also:  "The  suppuration  of  large 
wounds  always  being  liable  to  re-absorption 
and  consequently  to  kill  the  patient  under 
certain  atmospheric  influences."  Further, 
"the  dressings  were  complicated  and  dif- 
ficult, the  fastening  of  cloths  and  bandages 
with  sparadrap  not  being  invented  at  that 
period"  .  .  .  "they  used  for  lint  a  sheet 
'as  big  as  a  ceiling'  "...  and  "it  was 
not  without  difficulty  that  the  chlorurettcd 
lotions  and  the  nitrate  of  silver  brought  the 
gangrene  to  an  end."  The  convalescence 
was  delayed  "on  account  of  the  accident 


The  Medical  Phrases  of  Victor  Hugo 


419 


resulting  from  the  fracture  of  the  shoulder 
blade.  There  is  always  a  last  wound  like 
this  which  will  not  close,  and  which  pro- 
longs the  dressings,  to  the  great  disgust  of 
the  patient."  Can  it  be  doubted  that  the 
author  of  these  lines,  only  a  part  of  which 
I  have  transcribed,  had  himself  seen  and 
attended  such  wounds?  Even  the  King  had 
pretensions,  for  we  are  told  that  he  was 
"something  of  a  doctor;  he  bled  a  postilion 
who  fell  from  his  horse;  Louis  Phillipe  no 
more  went  without  his  lancet  than  Henry 
III  without  his  poniard." 

Of  wounds  in  special  regions  we  note  an 
instance  here  and  there.  "There  was  a 
wound  in  the  shoulder  blade  .  .  .  but  as 
the  lungs  were  not  touched  she  might  re- 
cover." "Wounds  in  the  breast  demand 
silence."  Surgical  diseases  are  the  particular 
care  of  Ursus,  who  thus  addresses  the  popu- 
lace: "I  think  and  I  dress  wounds.  Chirurgus 
sum Almost  all  our  local  in- 
flammations and  sufferings  are  issues  and, 
if  well  cared  for,  rid  us  gently  of  other  ills 
which  are  worse.  Nevertheless  I  would  not 
counsel  you  to  have  an  anthrax,  otherwise 
called  a  carbuncle.  'Tis  a  stupid  malady 
which  serves  no  end.  One  dies  of  it  and  that 
is  all."  He  also  gives  a  much  needed  caution: 
"An  awkward  movement,  a  fright,  and  there 
you  have  a  rupture  of  aneurysm.  I  have 
seen  instances  of  it."  Arterial  ligation  was 
evidently  much  in  Hugo's  mind.  Over  and 
over  again  he  indulges  his  imagination  in 
this  sort  of  figure.  For  example:  "It  was 
time  that  the  artery  should  be  bound  up. 
He  had  suffered  a  loss  of  virtue  .  .  .  and 
he  felt  something  like  a  generous  transfus- 
ion in  his  veins."  A  geographical  reference 
is  inspiring:  "French  blood  is  largely  mixed 
with  Spanish  blood.  .  .  .  The  Pyrenees 
are  simply  a  ligature  efficacious  only  for  a 
time."  History  furnished  this:  "Revolu- 
tions such  as  the  revolution  of  July  are 
arteries  cut;  a  prompt  ligature  is  necessary." 
Other  affections  appeal  to  the  figurative 
nature   within   him:   "The   bulging  of  the 


canvas  became  larger.  It  grew  more  and 
more  distorted  like  a  frightful  abscess  ready 
to  burst."  The  diagnosis  in  the  following 
case  is  not  plain,  but  the  plan  of  treatment 
admits  of  no  uncertainty:  "One  day  .  .  . 
a  man  was  dying,  choked  by  a  tumor  in 
his  throat,  a  horrible  fetid  abscess,  possi- 
bly contagious  and  which  had  to  be  emptied 
at  once.  .  .  .  [The  priest]  applied  his 
mouth  to  the  tumor,  sucked  it,  spitting 
out  as  his  mouth  filled,  emptied  the  abscess 
and  saved  the  man's  life."  Physical  dis- 
ability has  always  furnished  a  plea  for  clem- 
ency in  crime.  "The  old  punishment," 
writes  Hugo,  "which  our  ancient  laws  of 
torture  called  'extension'  and  which  Car- 
touche escaped  because  of  a  hernia,  this  Prom- 
etheus undergoes."  The  question  is  how  did 
Hugo  find  that  Cartouche  had  a  hernia. 

Nor  does  our  observant  genius  overlook 
the  question  of  anaesthesia.  Referring  to  the 
time  of  Queen  Anne  he  recalls  "that  even 
at  that  day  the  means  of  putting  a  patient 
to  sleep  and  of  suppressing  pain  was  known. 
Only  at  that  epoch  it  was  called  magic. 
Nowadays  it  is  called  anaesthesia."  He 
speaks  at  another  place  of  "a  stupefying 
powder  .  .  .  which  suppressed  pain," 
and,  whether  accurately  or  not,  thus  relates 
its  history:  "This  powder  has  always  been 
known  in  China  and  it  is  still  employed 
there  at  the  present  day.  China  had  all  our 
inventions  before  us,  printing,  artillery, 
aerostation,  chloroform.  Only  the  discovery 
which  in  Europe  immediately  acquires  life 
and  growth,  and  becomes  a  prodigy  and  a 
marvel,  remains  an  embryo  in  China,  and 
is  there  preserved  in  a  dead  condition. 
China  is  a  jar  of  foetus." 

Victor  Hugo  was  certainly  not  ahead  of 
his  times  in  sanitary  science.  What  would 
our  trained  public  health  officers  think  of 
his  ideas  on  the  following  question?  He 
says  "that  strong  mental  excitement  is  a 
preservative  against  all  ailments.  In  times 
of  pestilence,  while  sanitary  and  hygienic 
measures  should  not  be  neglected,  the  people 


420 

should  be  entertained  by  grand  fetes,  grand 
performances,  noble  impressions.  If  no  one 
troubled  about  the  epidemic  it  would  dis- 
appear." At  least  he  knew  the  value  of  the 
nurse  and  paid  her  this  tribute:  "It  is  the 
physician  who  prescribes,  it  is  the  nurse 
who  saves." 

Humor  at  the  expense  of  the  doctor  is 
found  in  spots.  It  is  not  biting.  "A  funeral 
is  passing.  There  is  a  doctor  in  the  proces- 
sion. 'Hullo!'  shouts  a  gamin,  'how  long  is 
it  since  the  doctors  began  to  take  home 
their  work?'"  And  the  physician  to  Louis XI 
is  spoken  of  as  "the  brave  man  [who]  had 
no  other  farm  than  the  King's  bad  health. 
He  speculated  on  it  to  the  best  of  his  ability." 
After  obtaining  from  his  Majesty  in  one 
day  an  appointment  for  his  nephew  and  a 
new  roof  for  his  house,  the  doctor  had 
applied  to  the  royal  loins  "the  great  de- 
fensive cerate  composed  of  Armenian  bole, 
white  of  egg,  oil,  and  vinegar"  and  retired 
followed  by  the  raillery  of  the  attendants: 
"  'tis  easy  to  see  that  the  King  is  ill  today; 
he  giveth  all  to  the  leech."  Louis'  retort  to 
the  barber  closed  the  scene:  "The  physician 
has  more  credit  than  you.  'Tis  very  simple; 
he  has  taken  hold  upon  us  by  the  whole 
body,  and  you  hold  us  only  by  the  chin." 
Below  the  rank  of  royalty  a  bit  of  dialogue 
between  notables  may  bring  a  smile:  "Good 
morning,  Marat,"  said  Chabot.  "You  rarely 
attend  our  meetings."  "My  doctor  has 
ordered  me  baths,"  answered  Marat.  "One 
should  beware  of  baths,"  returned  Chabot, 
"Seneca  died  in  one."  The  following  refer- 
ence includes  the  social  problem  along  with 
its  grim  humor:  "If  he  is  rich,  let  him  have 
a  doctor.  If  he  is  not  rich,  let  him  not  have 
any.  If  he  doesn't  have  a  doctor,  he  will  die. 
And  if  he  does  have  one,  he  will  die." 

I  lugo  was  hard  on  the  quack.  He  knew  the 
brand  instantly.  Of  Gilliatt  he  relates: 
"Peasants  came  with  fear  and  trembling,  to 
tell  him  about  their  maladies.  This  fear 
begets  confidence;  and  in  the  country  the 
more  the  physician  is  suspected  of  magical 


Annals  of  Medical  History 


powers,  the  more  efficacious  the  remedy. 
Gilliatt  had  prescriptions  of  his  own,  which 
he  had  inherited  from  the  old  dead  woman; 
he  bestowed  them  upon  those  who  asked 
and  would  take  no  pay.  He  cured  whitlow 
by  the  application  of  herbs,  the  liquor  from 
one  of  his  phials  cut  short  the  course  of  a 
fever;  the  chemist  .  .  .  thought  that  it 
was  probably  a  decoction  of  cinchona.  .  .  . 
Gilliatt  was  a  very  good  fellow  for  sick 
people  where  his  ordinary  remedies  were 
concerned.  ...  He  absolutely  refused  to 
perform  miracles,  which  was  ridiculous 
in  a  sorcerer.  Do  not  be  a  sorcerer;  but 
if  you  are  one  fulfill  your  profession." 
Do  we  not  now  meet  those  of  this  kind? 
And  is  it  not  all  true  to  our  own  life  and 
times — except  the  "no  pay"  feature?  Ursus, 
the  man,  represents  the  peripatetic  patent 
medicine  vendor  in  all  his  glory,  and,  with- 
out doubt  is  one  of  the  cleverest  and  queer- 
est characters  in  fiction.  "Regarded  as  a 
good  mountebank  and  a  good  physician" 
he  was  everything  else  that  it  was  necessary 
to  be.  He  describes  himself:  "I  am  neither 
an  Englishman  nor  a  man,  having  the  honor 
to  be  a  doctor.  That  goes  together.  Gentle- 
men, I  teach.  What?  Two  sorts  of  things; 
those  which  I  know  and  those  which  I  do 
not  know.  I  sell  drugs  and  I  give  away 
ideas."  That  stamps  Ursus  as  an  out-and- 
out  quack.  The  real  physician  sells  his 
ideas,  and  may  or  may  not  give  away  his 
drugs.  Being  a  quack  he  proceeds  to  de- 
nounce other  quacks:  "Gentlemen,"  says 
he,  "distrust  false  savants  who  speculate 
upon  the  briony  root  and  white  adders,  and 
who  make  eye  salves  from  honey  and  cock's 
blood.  Learn  to  see  clearly  through  his  lies. 
.  .  .  It  is  not  true  that  Adam  had  a 
navel.  .  .  .  Oh,  gentle  friends  who  listen 
to  me,  if  any  one  tells  you  that  whoever 
smells  of  the  herb  valerian  will  have  a 
lizard  born  in  his  brain,  .  .  .  that  a  man 
weighs  more  dead  than  alive,  that  buck's 
blood  dissolves  the  emerald,  .  .  .  that 
the  falling  sickness  is  cured  by  means  of  a 


The  Medical  Phrases  of  Victor  Hugo 


421 


worm  which  is  found  in  the  brain  of  a 
kid,  believe  it  not;  these  are  errors.  But  here 
are  truths:  The  skin  of  a  sea-calf  is  pre- 
servative against  lightning;  the  toad  is 
nourished  upon  earth,  which  makes  a  stone 
grow  in  his  head;  .  .  .  the  elephant  has 
no  joints  and  is  forced  to  sleep  standing 
erect  against  a  tree;  make  a  toad  hatch  a 
cock's  egg,  and  you  will  have  a  scorpion 
which  will  make  you  a  salamander;  a  blind 
man  recovers  sight  by  placing  one  hand  on 
the  left  of  the  altar  and  the  other  on  his 
eyes.  .  .  .  Good  people,  feed  yourselves 
on  these  evidences." 

Hugo's  interest  in  deformities  is  shown  by 
his  creation  of  these  two  freaks  in  human 
shape — Gywnplaine  and  Quasimodo.  No 
other  writer  in  our  knowledge  has  succeeded 
in  producing  such  hideous  and  repulsive 
deformities — the  one  artificial,  the  other 
natural.  Much  has  been  brought  against 
Hugo  for  giving  these  characters  sentiment, 
one  critic  going  so  far  as  to  say  that  he  has 
made  "fatherhood  sanctifying  physical  de- 
formity; motherhood  sanctifying  moral  de- 
formity." Marzials  says  of  the  "Laughing 
Man" :  "To  me  it  is  simply  a  preposterous, 
an  impossible  book."  Assuredly  it  is  a  weird 
conception.  But  the  details  are  admirably 
worked  out.  Very  briefly  the  method  of 
producing  the  deformity  of  Gywnplaine 
may  be  stated  by  Hugo  himself:  "This 
artificial  production  of  teratological  cases 
had  its  rules.  It  was  a  complete  science.  Let 
the  reader  imagine  orthopedy  reversed. 
Where  God  had  placed  a  glance,  they  put 
strabismus.  Where  God  had  placed  har- 
mony, they  put  deformity.  .  .  .  It  seemed 
evident  that  a  mysterious  science,  probably 
occult,  which  was  to  surgery  what  alchemy 
was  to  chemistry,  had  chiselled  that  flesh, 
assuredly  at  a  very  early  age,  and  de- 
liberately created  this  visage.  This  science, 
skilful  in  cuttings,  obtusions  and  ligatures, 
had  split  that  mouth,   opened  those  lips, 


bared  the  gums,  distended  the  ears,  removed 
the  partitions  of  the  cartilages,  disarranged 
the  eyebrows  and  the  cheeks,  enlarged  the 
muscles  of  the  cheek  bones,  softened  down 
the  seams  and  scars,  brought  the  skin  back 
over  the  wounds,  still  maintaining  the  face 
in  the  gaping  state,  and  from  that  powerful 
and  profound  sculpture,  that  mask,  Gywn- 
plaine, had  emerged."  A  full,  if  not  clear, 
exposition  of  the  principles  of  plastic  surgery ! 

Quasimodo  I  do  not  attempt  to  explain. 
He  might  be  dismissed,  according  to  one 
reviewer,  as  follows:  "An  animal  with  a  turn 
for  bell-ringing  and,  apart  from  his  deform- 
ity and  deafness,  not  entitled  to  much 
sympathy."  But  whatever  the  classification 
of  his  misshape,  it  was  congenital,  not 
acquired.  My  feeling  is  that  Hugo  must 
have  received  the  impression  of  this  monster 
through  a  bad  dream.  At  any  rate  he  put 
down  no  figure  of  speech  in  which  Quasi- 
modo is  involved. 

Hugo  has  been  accused  of  being  theatri- 
cal, of  straining  after  effect.  Perhaps  so,  but 
he  got  the  effect.  Poet,  dramatist,  novelist, 
publicist;  he  stood  apart — the  great  French- 
man. His  espousal  of  the  Republic  and  the 
Revolution  was  his  absorbing  passion.  He 
came  down  and  remained  close  to  the 
people — a  circumstance  that  caused  him  to 
study  them  deeply,  to  live  with  them  in- 
timately. This  naturally  may  have  directed 
him  to  those  homely  medical  illustrations, 
of  which  he  was  so  full.  Coppee's  estimate 
is  not  wide  of  the  mark:  "Among  all  the 
poets  of  mankind  Victor  Hugo  is  the  one 
who  has  invented  the  greatest  number  of 
similes,  and  those  the  best  carried  out,  the 
most  striking,  the  most  significant."  What 
need  to  tell  his  life  story?  Study  the  man  in 
his  writings — there  he  reveals  himself.  A 
characteristic  piece  of  his  imagery  may 
form  a  fitting  close  to  our  study:  "An  idea 
is  a  balm;  a  word  may  be  a  dressing  for 
wounds;  poetry  is  a  physician." 


EDITORIALS 


Franciscus  Dela  Boe  Sylvius  was  a  physi- 
cian whose  character  and  career  have  an 
unusual  interest.  He  was  a  famous  and 
original  teacher;  and  while  holding  a  chair  in 
medicine,  he  was  an  industrious  student  of 
chemistry  and  anatomy,  particularly  that 
of  the  brain.  In  this  latter  line  of  work, 
his  descriptions  were  so  vivid  and  accurate 
that  his  name  became  identified  with  four 
different  portions  of  the  nervous  system. 

Sylvius  was  a  handsome  man  and  has  left 
us  an  unusually  fine  engraving  of  himself, 
done  by  C.  van  Dalen.  This  is  one  reason, 
perhaps,  why  we  celebrate  his  memory  here. 

Of  recent  years  we  have  been  made  famil- 
iar with  his  work  through  an  article  by 
Prof.  Frank  Baker  in  the  Johns  Hopkins 
Bulletin  of  November  1909,  and  one  by  Dr. 
Smith  Ely  Jelliffe  in  The  Charaka  Club 
Book,  Vol.  III. 

Sylvius  was  born  in  161 4  of  French  par- 
ents in  Hanau,  Germany.  He  studied  in 
several  universities,  took  his  medical  de- 
gree in  Basle,  Switzerland,  went  to  Paris 
for  a  time,  settled  in  practice  in  Amster- 
dam, till  he  was  called  to  be  Professor  of 
Medicine  in  the  University  of  Leyden  in 
1658,  when  he  was  44  years  old.  He  made  a 
definite  success  there  as  a  lecturer,  teacher, 
investigator,  and  practitioner.  Here  he  first 
instituted  bedside  instruction. 

Sylvius  had  admirable  powers  of  descrip- 
tion with  a  gift  to  see  things  correctly  and 
to  individualize  what  he  saw.  He  had,  one 
might  say,  a  synthetic  and  epitomic  mind. 


He  saw  the  fissure  of  Sylvius  as  an  anatom- 
ical entity  and  described  it  so  definitely 
that  it  received  his  name.  He  called  the  iter 
e  tertio  ad  quartam  rentriculam  an  aqueduct, 
and  it  became  the  aqueduct  of  Sylvius. 
He  discovered  or  rediscovered  the  fifth  ven- 
tricle, sometimes  called  the  ventricle  of  Syl- 
vius. Naturally,  the  artery  of  the  Sylvian 
fissure  became  the  Sylvian  artery.  So, 
through  his  power  of  perceiving  acutely, 
describing  clearly,  and  emphasizing  his 
units,  the  name  of  Sylvius  dominates  all 
others  in  cerebral  nomenclature.  Herophe- 
Ius,  Galen,  Varolius,  Viessens,  and  Rolan- 
do have  each  one  part,  but  Sylvius  has  four. 
By  his  happy  art,  Sylvius  has  made  him- 
self anatomically  immortal;  though  he  was 
not  a  great  discoverer  or  a  man  of  the  very 
highest  type,  but  an  able  "runner-up"  of 
greatness.  Indeed,  Prof.  Frank  Baker  as- 
serts that  he  was  one  of  the  great  original 
thinkers  of  the  seventeenth  century. 

He  was  interested  in  chemistry  and  phys- 
iology, and  he  had  a  chemical  theory  of 
vital  action  and  disease,  but  it  had  no  more 
merit  than  other  theories  of  those  and 
later  days.  However,  he  was  a  masterly 
clinical  teacher  and  his  greatest  real  achieve- 
ments were  along  this  line. 

Sylvius  was  a  man  of  handsome  presence, 
fine  personal  qualities;  benevolent,  sincere, 
and  kindly;  making  and  retaining  friend- 
ships. He  was  a  serious-minded  person  and 
seemed  rather  to  court  than  shun  contem- 
plation  upon  death.    Before  he  was   fifty 


422 


ft 


FRANCISCUS     DELEBOE    SYLVIUS  ,  ME  D  I  C  IN.E 
PRACTIOE  IN  ACADEMIA  LUGDLTN  O-BATAVA  PROFESSOR 


Editorials 


423 


years  old,  he  prepared  a  sepulchre  for  him- 
self in  the  choir  of  St.  Peter's  Church  at 
Leyden,  and  had  a  very  modest  inscription 
placed  on  it. 

FRANCISCUS    DELEBOE    SYLVIUS 

MEDICINE    PRACTICE    PROFESSOR, 

TAM    HUMAN/E    FRAGILITATIS 

QUAM        OBREPENTIS        PLERISQUE        MORTIS 

MEMOR, 

DE       COMPARANDO      TRANQUILLO       INSTANTI 

CADAVERI 

SEPULCHRO 

AC      DE      CONSTITUENDA      RUENTI      CORFORE 

DOMO 

JEQUE    COGITABAT    SERIO. 

LUGDUNI    BATAVORUM 

MDCXLV 

Franciscus  de  Ie  Boe  Sylvius, 
Professor  of  the  Practice  of  Medicine, 

■ 

ERRATA 


and  of  the  often  stealthy  approach  of  death, 
bethought  him  to  prepare  against  that  time 
a  quiet  sepulchre  for  his  remains, 
a  house  for  his  mortal  body. 
At  Leyden, 
1665. 
It  would  be  interesting  to  know  what -de-  <W»t.-»cti 
•Gtruction  Sylvius  had  in  mind  when  he  pre- 
pared this  "sepulchrum"  for  his  "instans 
cadaver"  and  a  "domus"  for  his  "ruens 
corpus."   I  should  guess  that  he  believed 
the  house  was  to  hold  the  body  for  the 
resurrection. 

When  taken  ill  with  a  fever  in  1672,  Syl- 
vius said  to  a  friend:  "I  know  the  gravity 
of  this  disease.  I  escaped  three  years  ago; 
this  time  I  shall  die."  His  prediction  proved 
true.  His  death  occurred  November  14, 
1672. 


1+  iv 


Page  422.     First  column,  last  line,  epitomic  should  read  eponymic. 

Page  423.     Second  column,  seventh  line,  destruction  should  read  distinction. 

Page  424.     Second  article,  first  column,  sixth  line,  1501  should  read  1561. 


presence  of  an  aberrant  cusp  which  occurs 
often  on  the  upper  molars  is  perhaps  not 
so  well  known,  but,  according  to  Jeanselme,1 
treatment  for  congenital  syphilis  has  often 
been  made  on  the  basis  of  such  a  diagnosis. 
Jeanselme  points  out  that,  since  this  cusp  is 
present  in  molar  teeth  of  man  from  the 
neolithic,  paleolithic  and  later  periods,  there 
is  no  basis  for  using  such  a  condition  in 
the  diagnosis  of  congenital  syphilis.  The 
case  is  of  even  wider  import  than  Jeanselme 
suggests. 

1  E.  Jeanselme:  "De  l'existence  du  tubercle  de 
Carabelli  aux  epoques  paleolithique  et  neolithique, 
dans  I'antiquite  classique  et  au  moyen  age."  Bull, 
et  mem.  Soc.  mid.  de  hop.  de  Par.,  24  Janvier,  1918, 
pp.  51-52. 


at  any  one  of  three  places  along  the  lingual 
margin  of  the  molar,  there  has  often  been 
confusion  in  the  proper  identification  of 
the  tubercle  of  Carabelli.  The  fact  that  this 
cusp  occurs  more  frequently  in  children 
than  in  adults  and  in  primitive  races  more 
frequently  than  in  civilized  races  is  of  great 
importance. 

This  tubercle  is  often  seen  in  neolithic 
and  in  paleolithic  man.  Gorjanovic-Kram- 
berger3  says  that  it  occurs  in  nearly  all  of 

2  George  C.  Carabelli:  "Systematisches  Hand- 
buch  der  Zahnheilkunde,"  1842,  Bd.  II,  Anatomie 
des  Mundes,  p.  107. 

3  Gorjanovii-Kramberger:  "Die  Kronen  und 
Wurzeln  der  Mahlzahne  des  Homo  primigenius  und 
ihre  genetische  Bedeutung."  Anat  Anz.,  1907,  Bd. 
31.  pp.  1 18-120,  Fig.  13. 


424 

the  first  and  second  upper  molars  of  the 
fossil  human  skeletons  from  Krapina,  which 
represent  a  race  of  men  who  lived  about 
75,000  years  ago.  He  has  given  an  excellent 
photograph  of  the  tubercle  of  Carabelli  on 
the  molar  of  a  fossil  man,  and,  for  com- 
parison, similar  cusps  on  the  molars  of  a 
native  of  Java  are  shown.  Batujeff4  has 
shown  that  the  presence  of  this  cusp  in  the 
primitive  races  of  man  and  many  genera 
of  apes  is  of  wide  distribution.  I  do  not 
doubt  that  a  careful  study  of  the  upper 
molars  of  fossil  primates  would  reveal  the 
presence  of  similar  cusps. 

This  cusp  arises  from  the  cingulum  near 
the  hypocone  and  may  be  regarded  as  of 
phylogenetic  significance.  Gorjanovic- 
Kramberger  says:  "Den  Carabellischen 
Mocker  kann  man  als  ein  in  Entwickelung 
begriffenes  Gebilde,  welches  beim  rezenten 
Menschen  bereits  in  hoheren  Masse  ausge- 


Annals  of  Medical  History 


bildet  ist,  als  phyletisch  wichtig  bezeichnen 
und  fiiglich  filr  ein  den  Homo  primigenius 
mit  dem  H.  sapiens  verbindendes  Merkmal 
ansehen."  Adloff  and  others  have  taken 
exception  to  this  view.  The  entire  subject 
of  the  evolution  of  the  primates,  of  which 
the  question  of  the  tubercle  of  Carabelli  is 
a  part,  has  been  recently  reviewed  by 
Gregory.5 

Since  the  tubercle  of  Carabelli  has  such 
an  ancient  history,  being  demonstrable 
many,  many  thousands  of  years  prior  to 
the  knowledge  of  the  presence  of  syphilis, 
it  is  difficult  to  see  that  the  two  have  any- 
thing to  do  with  each  other.  The  presence 
of  this  tubercle  may  be  regarded  as  the 
persistence  of  an  ancient  character,  and, 
while  it  is  often  said  to  be  hereditary,  it 
seems  improbable  that  it  has  any  connec- 
tion whatever  with  congenital  syphilis. 

Roy  L.  Moodie 


THE  ANATOMIE  UNIVERSELLE  OF  AMBROISE  PARE 


The  early  works  of  the  Father  of  French 
Surgery  were  in  the  vernacular,  and  so 
popular  that,  like  school  books,  they  were 
"thumbed"  away,  and  few  copies  remain. 
Among  the  rarest  is  the  "Anatomie  Uni- 
verselle"  of  1561,  of  which  Malgaigne  knew 
of  only  two  copies — one  imperfect  in  the 
St.  Genevieve  Library  and  the  other  at 
Bar-le-duc  in  private  hands.  The  St.  Gene- 
vieve Library  is  the  fortunate  possessor  of 
six  of  the  nine  works  which  preceded  the 
great  surgery  of  1575;  but  the  Anatomie  is 
not  at  Washington,  nor  in  the  British  Mu- 
seum or  Bodley,  nor,  so  far  as  I  can  ascer- 
tain, in  any  of  the  special  collections,  ex- 
cept the  Hunterian  at  Glasgow.  Dr.  Hahn 
writes  (1918)  that  it  is  not  in  the  Biblio- 


4N.  BatujefT:  "Carabelli's  HOckerchen  und 
andere  unbcstandige  Hocker  dcr  oberen  M.ihlzahnc 
bei  dem  Menachen  und  Affen."  Bull.  Acad.  im)>.  des 
Sc,  St.  Petersburg,  T.  5,   1896  No.    1,  pp.  93-109. 


theque  Nationale  or  in  the  library  of  the 
Ecole  de  Medicine. 

Not  long  ago  in  a  Paris  catalogue,  a 
copy  was  advertised,  and  after  a  hurried 
look  at  Malgaigne  and  the  Index  Catalogue 
of  the  St.  Genevieve  Library,  I  sent  a  tele- 
gram and  was  delighted  to  get  the  book 
within  forty-eight  hours.  The  provenance  is 
uncertain.  It  had  come  in  with  a  number  of 
unbound  volumes  and  was  sent  to  Cham- 
boIIe-Duru,  in  whose  famous  morocco  and 
unmatched  gilding  it  is  now  adorned — a 
small  octavo  of  277  pages.  The  work  must 
have  been  a  boon  to  the  surgical  students 
of  St.  Corne,  very  few  of  whom,  like  Pare 
himself,  had  had  a  classical  training.  Both 
editions  of  the  great  "Fabrica"  had  been 
published,  and  the  text  and  plates,  particu- 
larly the  latter,  are  largely  Vesalian. 

6  VV.  K.  Gregory:  "Studies  on  the  Evolution  of 
the  Primates."  Bull.  Amer.  Mus.  Nat' I  Hist.,  1916, 
vol.  xxxv,  pp.  239-355- 


Editorials 


425 


The  gem  of  the  book  is  a  copper  engrav- 
ing, the  earliest  known  portrait  of  Pare  at 
the  age  of  forty-five,  a  wood-cut  of  which, 


LABOR  1MPROBVS'    OMNIA.  VINCIT  • 
A.PAN  •  ^T>  +S  •       -B-- 


an  oval  medallion,  appeared  a  few  months 
later  in  "La  methode  curative  des  playes, 
etc."  Both  bear  the  legend  Labor  improbus 
omnia  vincit;  in  the  latter  work,  encircling 
the  picture,  not  at  the  base.  It  was  repro- 
duced in  the  "Dix  Iivres  de  la  Chirurgie," 
1564,  with  the  figure  5  changed  to  8.  It  is 
by  far  the  most  pleasing  picture,  and  I 
have  not  found  in  the  Hope  and  other  col- 
lections available  a  reproduction.  The  im- 


pression is  unusually  clear,  much  more  so 
than  the  copies  from  "La  methode  cura- 
tive" and  the  "Dix  Iivres. . ."  just  referred  to. 

tsiNtJT       IE 

VNIVERSELLE  DV 

Corps  huinain,compofee  pat  A  Pare" 
Chirurgien  ordinaire  du  Roy  ,&  lure  a 
Paris :  reueue  &  augmenrce  par  ledit  au- 
theur  auec  I.  Roftaingdu  Bignofc  Pro- 
uen$al  aufsi  Chirurgien  lure  a  Paris. 


Ve?tmpTimcrie  de  lehdn  ie  R?yer,  Imprimeur  du  T^y  is 
M<tthcm*tiqUct ;  dtmeuTttnt  en  Ltrue  S.  Uques,  a 
tenfeigne  du  fray  potier,pres  les  Matkurins. 

JLVEQ  P\iriLEGE  DVK^Y. 

\\6l. 

The  great  surgeon  is  here  seen  in  his  prime, 
and  one  may  read  in  the  face  "The  gentle 
masterly  and  true  man"  (Albutt). 

The  fitness  of  things  demands  that  this 
copy  should  return  ultimately  to  France,  to 
the  great  collection  of  the  Ecole  de  Medi- 
cine. William  Osler. 


HISTORICAL  NOTES 


Early  Instruction  in  Bacteriology  in 
the  United  States. — Following  the  publi- 
cation by  Pasteur  of  the  results  of  his  in- 
vestigations on  the  relations  of  the  bacteria 
to  fermentation  and  to  disease,  several 
scientists  in  this  country  took  up,  indepen- 
dently, the  study  of  bacteria  by  Pasteur's 
methods.  These  men  were  interested  in 
the  bacteria  from  either  the  broad  biological 
standpoint  or  from  the  standpoint  of 
pathology. 

Probably  the  first  name  in  the  list  of 
early  teachers  is  that  of  the  late  Dr.  T  J. 
Burrill  who  introduced  the  study  of  the 
bacteria  into  his  course  on  the  fungi, 
during  the  "seventies."  He  discovered  the 
organism  of  pear  blight  in  1879,  and  in 
the  following  years  conducted  extensive 
inoculation  experiments  with  this  organism 
on  a  large  orchard  of  young  pear  trees, 
thereby  definitely  establishing  the  etio- 
logical relation  of  the  organism  to  the 
disease. 

The  late  Surgeon  General  George  M. 
Sternberg,  whose  investigations  on  the 
causation  of  yellow  fever,  malaria,  syphilis 
and  other  diseases  are  well  known,  also 
discovered  the  pneumococcus  in  normal 
sputum,  and  laid  the  foundations  for  our 
knowledge  of  the  value  of  a  large  number  of 
chemical  substances  as  disinfectants. 

Dr.  William  H.  Welch  from  1878  on  was 
interested  in  the  bacteria  and  their  relation 
to  disease.  On  returning  from  Europe  in 
1885  Dr.  Welch  became  the  head  of  the 
Pathological  Institute  at  Johns  Hopkins 
University,  and  had  for  his  assistant  in  the 
instruction  in  bacteriology  Dr  .A.  C.  Abbott, 
who  had  been  Dr.  Sternberg's  assistant  in 


the  Biological  Laboratory  the  previous 
year.  Later  on  Dr.  George  H.  F.  Nuttall 
also  became  his  assistant,  and  was  asso- 
ciated with  Dr.  Welch  in  the  discovery 
and  study  of  the  "gas"  bacillus. 

Dr.  T.  Mitchel  Prudden  at  the  College 
of  Physicians  and  Surgeons  in  New  York 
also  taught  the  staining  of  bacteria  in 
sections  of  tissues  and  in  sputum,  to  his 
students  in  pathology,  and  commenced  the 
cultivation  of  bacteria  on  solid  media 
about  1883.  Dr.  Prudden,  aside  from  his 
interest  in  the  pathological  action  of  bac- 
teria, also  very  early  interested  himself 
in  the  relation  of  bacteria  to  air,  water, 
and  ice,  which  were  subjected  to  critical 
study,  the  results  forming  the  basis  of 
valuable  monographs. 

Beginning  about  1879,  Dr-  D.  E.  Salmon 
commenced  his  important  studies  on  the 
relation  of  bacteria  to  animal  diseases  in 
the  Bureau  of  Animal  Industry  at  Wash- 
ington, and  while  Dr.  Salmon  is  not  known 
generally  as  a  teacher  of  bacteriology,  there 
is  every  evidence  that  he  was  the  instructor 
of  assistants  in  the  Bureau  and  was  the 
leading  inspiration  for  many  of  the  early 
discoveries  made  by  the  Bureau  stall; 
notably  the  epoch-making  work  which  he 
did  in  association  with  Dr.  Theobald  Smith 
on  Texas  cattle  fever,  work  which  in  a 
broad  sense  can  be  included  here,  even 
though  the  organism  responsible  for  the 
disease  is  not  a  bacterium,  but  a  protozoon. 

In  addition  to  those  early  teachers  the 
following  also  deserve  special  mention: 
Dr.  Henry  Formad,  at  the  University  of 
Pennsylvania;  Dr.  W.  T.  Councilman, 
known   particularly  as  a  pathologist;   Dr. 


426 


Historical  Notes 


427 


Herman  M.  Biggs,  in  charge  of  the  Carnegie 
Laboratory  when  that  was  attached  to  the 
Bellevue  Hospital  Medical  College;  Dr.  E. 
A.  Birge,  who  inspired  some  of  our  noted 
biologists  who  studied  under  him;  Dr.  C.  T. 
Cheesman,  who  began  the  first  systematic 
instruction  in  bacteriological  technique;  Dr. 
John  E.  Weeks,  at  the  Ophthalmic  and 
Aural  Institute;  Dr.  Harold,  at  the  Harvard 
Medical  School  in  1885;  Dr.  Theobald 
Smith;  Dr.  L.  H.  Pammel,  in  the  veterinary 
school  at  the  Iowa  State  College  of  Agri- 
culture; Dr.  Bayard  Holmes,  at  the  Chicago 
Medical  College  in  1888  and  later  at  the 
Post  Graduate  Medical  School  at  Chicago 
and  at  the  College  of  Physicians  and 
Surgeons;  Dr.  Victor  C.  Vaughn  and  Dr. 
F.  G.  Novy,  at  the  University  of  Michigan 
in  1889;  Dr.  H.  W.  Conn,  who  has  directed 
his  interest  principally  to  the  activities  of 
the  bacteria  of  milk  and  soil  in  their  bearing 
on  agriculture;  Dr.  W.  T.  Sedgwick,  at  the 
Massachusetts  Institute  of  Technology  in 
1 888-1 889;  Dr.  Joseph  MacFarland,  at  the 
Medical  School  of  the  University  of  Penn- 
sylvania in  1892  and  following  years;  and 
Dr.  William  H.  Park,  at  Bellevue  Hospital 
Medical  College  in   1895. 

From  these  simple  beginnings  the  teach- 
ing of  bacteriology  has  come  in  a  com- 
paratively brief  time  to  play  a  very  impor- 
tant part  in  the  scientific  education  of 
many  persons,  and  bacteriology  is  to-day 
being  taught  in  a  large  number  of  educa- 
tional institutions  in  this  country.  Courses 
are  given,  not  only  in  elementary  bac- 
teriology to  general  science  students  but 
to  students  in  domestic  science,  agriculture, 
dairying,  water  and  sewage  purification, 
public  hygiene  and  sanitation,  medicine, 
dentistry,  veterinary  medicine,  pharmacy, 
brewing  and  fermentation  industries,  food 
production  and  preservation  and  plant 
pathology. 

David  H.  Bergey, 

Major  M.  R.  C,  U.  S.  Army, 

University  of  Pennsylvania 


The  Evolution  of  Dermatology — The 
impulse  to  specialization  during  the  last 
quarter  of  the  nineteenth  century  grew  so 
strong  that  the  intercommunicating  bonds 
among  the  various  fields  of  medicine  be- 
came obscured.  Dermatology  suffered  with 
the  rest.  The  apostles  of  the  newer  creed 
worshipped  most  devoutly  in  Vienna  at  the 
shrine  of  Hebra.  A  scientific  priesthood 
evolved,  speaking  a  language  incomprehen- 
sible to  other  physicians,  and  often  vague 
enough  to  the  anointed.  A  technical  vul- 
gate  flourished  at  the  expense  of  scientific 
dermatology.  Thereupon,  the  latter  entered 
its  dark  ages,  but  the  renaissance  is  at 
hand. 

It  was  the  thundering  of  the  Southern 
Teutonic  school  that  effected  the  division 
between  dermatology  and  general  medi- 
cine. In  France  and  England,  although  un- 
noticed in  the  general  din,  the  influence  of 
Willan  and  of  his  disciples  still  sustained 
the  substantial  principle  that  the  anatomical 
envelope  of  the  human  body  was  an  inte- 
gral physiological  part  thereof,  and  not  a 
vestment  that  could  be  taken  off,  mended, 
laundered,  and  replaced.  In  northern  Ger- 
many Unna  and  his  pupils  opposed  the 
Viennese  orthodoxy  by  attempting  to  bring 
the  study  of  cutaneous  maladies  in  line 
with  Virchow's  ideas  of  cell  pathology. 
Thus,  the  Hamburg  faction,  upon  a  basis 
of  microscopy  and  microchemistry,  made  a 
definite  contribution  to  dermatology  as  a 
biological  science  rather  than  a  dialect.  In 
the  late  eighties  America  was  invaded  by 
alien  votaries  of  all  cults,  and  Americans 
themselves  returned  from  abroad,  having 
studied  at  the  various  centers,  some  hav- 
ing studied  at  all  of  them.  Thus,  without 
bias,  American  dermatologists  founded  an 
eclectic  school  upon  the  best  that  Europe 
could  offer. 

Europe  is  now  understanding  that  Amer- 
ica is  to  be  regarded  seriously.  So  far  as 
Americans  are  concerned,  Europe  has  ceased 
to  be  Mecca  in  dermatology,  and  such  pil- 


428 


Annals  of  Medical  History 


grimages  as  they  may  deign  to  make  in  the 
future  will  not  be  with  the  idea  of  obei- 
sance, but  with  the  full  knowledge  that  they 
will  bring  abroad  at  least  as  much  as  they 
receive.  In  general,  European  medical  op- 
portunities excel  ours,  because  the  clinical 
material  is  concentrated,  and  is  more  read- 
ily employed  for  investigation.  This  stimu- 
lated medical  research  in  the  old  world  ear- 
lier than  here,  but  now  we  are  fast  closing 
the  gap.  Considering  Europe's  research  ad- 
vantages, and  this  holds  particularly  true 
in  Germanic  countries,  there  has  been  vir- 
tually no  creative  dermatology  abroad.  In 
our  country,  on  the  other  hand,  and  against 
the  utmost  opposition  and  with  the  scanti- 
est of  equipment,  very  earnest  original  work 
has  been  attempted.  That  it  has  not  yet  led 
to  anything  definite  is  due  almost  entirely 


to  the  newness  of  the  work,  and  the  fact 
that  we  must  embark  timidly  upon  un- 
charted seas.  In  Teuton  Europe  dermatolo- 
gists are  still  classifying,  labelling  and  mak- 
ing histological  studies  in  order  to  create  an 
illusion  of  science.  In  America  a  small  but 
ever  increasing  group  of  men  is  studying 
metabolism,  the  endocrinous  glands,  ana- 
phylaxis, and  clinical  medicine  in  relation 
to  skin  diseases.  It  is  the  object  of  this  ex- 
position to  set  forth  the  little  that  has  been 
accomplished,  but  that  little  is  the  result  of 
scarcely  ten  years  of  effort  and  a  genera- 
tion of  dermatological  independence.  This 
seems  most  encouraging  to  those  of  us  who 
do  not  believe  that  the  royal  road  to  der- 
matology is  Alserstrasse. 

Walter  James  Heimann,  M.  D. 
New  York  City 


THE  CHARMS  OF  PRECEDENCE 


Such  is  my  theme,  which  means  to  prove, 
That  though  we  drink,  or  game,  or  love, 
As  that  or  this  is  most  in  fashion 
Precedence  is  our  ruling  passion. 

When  college-students  take  degrees, 
And  pay  the  beadle's  endless  fees, 
What  moves  that  scientific  body, 
But  the  first  cutting  at  a  gaudy? 
And  whence  such  shoals,  in  bare  conditions 
That  starve  and  languish  as  physicians, 
Content  to  trudge  the  streets,  and  stare  at 
The  fat  apothecary's  chariot? 
But  that,  in  Charlotte's  chamber — see 
Moliere's  Medecin  malgr6  Iui — 
The  leech,  howe'er  his  fortunes  vary, 
Still  walks  before  the  apothecary. 

William  Sbenstone  {1714-176}). 


BOOK   REVIEWS 


Studies  in  the  History  and  Method  of  Sci- 
ence. Edited  by  Charles  Singer,  Oxford,  at  the 
Clarendon  Press,  1917.  40,  304  pp.,  41  plates,  23 
illustrations. 

This  impressive  and  beautifully  illus- 
trated book  opens  with  an  introduction  by 
Sir  William  Osier,  who  presents  a  lucid  and 
interesting  explanation  of  the  object  of  the 
work.  This  is  to  contribute  to  the  story  of 
how  human  knowledge  was  gained,  and 
how  scientific  methods  were  evolved  and 
their  results  sytematized.  (We  just  venture 
to  say  passim  that  we  do  not  believe  Sir 
William  could  construe  his  first  sentence.) 

The  volume  is  made  up  of  a  series  of  his- 
torical and  critical  studies,  which  are  richly 
illustrated  and  which,  for  the  most  part, 
represent  the  results  of  original  investiga- 
tions. It  is  not  at  first  apparent  why  the 
title  "Studies  in  the  History  and  Method 
of  Science"  should  be  given  to  such  a  col- 
lection, for  most  of  the  articles  deal  with 
persons  who  did  not  follow  scientific  meth- 
od as  we  know  it  to-day.  We  infer,  how- 
ever, that  the  subjects  dealt  with  represent 
various  historical  examples  in  which  knowl- 
edge was  sought  for  by  means  of  rational 
observation,  rather  than  accepted  as  from 
inspiration  or  tradition. 

The  Editor  opens  with  a  very  elaborate, 
original  and  beautifully  illustrated  article 
on  the  scientific  views  and  interpretative 
visions  of  St.  Hildegarde.  The  author  has 
used  the  Saint  and  her  activities  as  a  me- 
dium for  describing  the  condition  of  natu- 
ral knowledge  at  the  period  in  which  she 
lived,  1098-1180.  He  depicts  Hildegarde's 
schemes  of  the  Universe,  her  allegorical 
conception  of  "The  Soul  pervaded  by  the 
Godhead,"  and  again  of  this  God-pervaded 
Soul  "embracing  the  macrocosm  and  mi- 


crocosm." There  are  wonderful  reproduc- 
tions in  color  showing  "The  Celestial  influ- 
ences on  men,  animals  and  plants";  "The 
Fate  of  the  elements  at  the  last  judgment," 
"The  relationships  of  human  and  cosmic 
phenomena,"  "The  birth  of  the  soul,  its 
trials  and  departure  after  death."  There  is 
also  an  impressive  colored  illustration  of 
"The  Fall  of  the  Angels"  which  is  sugges- 
tive of  William  Blake,  or  whatever  form  of 
most  modern  art  it  is  that  aims  to  tell  a 
story  by  means  of  weird  symbolisms.  It  is 
better  than  the  Picassoes,  and  Matisses,  and 
Cezannes  of  New  York  shops.  In  fine  we 
are  shown  that  in  the  dark  days  of  the 
good  Saint,  there  were  definite  attempts 
made,  out  of  the  scriptures,  and  legends 
and  visions  and  some  serious  thinking,  to 
explain  the  plan  of  the  universe  and  man's 
relation  to  it  and  his  Maker. 

Dr.  J.  W.  Jenkenson  has  a  well-written 
essay  on  "Vitalism"  in  which  he  does  not 
believe.  He  touches  only  briefly  on  the 
newer  physiological  interpretation  of  vital 
phenomena;  hence  his  argument  and  arti- 
cle do  not  seem  complete  or  convincing. 

Dr.  Singer  contributes  a  study  in  "  Early 
Renaissance  Anatomy  with  a  new  Text: 
The  Anothomia  of  Hieronymo  Manfredi 
(1490)."  It  contains  much  original  and  in- 
teresting material  with  many  illustrations. 
Manfredi  (1430- 1493)  was  Professor  of 
Medicine  in  Bologna  and  wrote  a  good 
many  treatises  on  astrology  and  medicine. 
A  manuscript  copy  of  a  short  treatise  on 
anatomy  is  in  the  Bodleian  Library.  This  is 
reprinted  and  parts  of  it  are  translated  in 
the  present  article.  Dr.  Singer  states  that 
Manfredi's  Anatomy  is  more  complete  than 
that  of  Saliceto  or  that  of  Mondino. 

"The  Blessing  of  Cramp-rings — a  chap- 


429 


430 


Annals  of  Medical  History 


ter  in  the  History  of  the  Treatment  of 
Epilepsy,"  by  Raymond  Crawford  is  an  in- 
teresting and  well-illustrated  story  of  the 
blessing  of  rings  for  the  cure  of  epilepsy  by 
the  kings  and  queens  of  England. 

The  article  on  Dr.  John  Weyer  and  the 
Witch  Mania  by  Dr.  E.  T.  Wellington  is  a 
careful  historical  study  of  this  abnormal 
phase  of  human  deviation.  Witches  and 
witchcraft  form  a  curious  phase  of  life 
among  savages  and  early  civilizations.  Prob- 
ably witchcraft  added  somewhat  to  the  pic- 
turesque and  dramatic  side  of  savage  and 
semi-civilized  life.  In  early  mediaeval  times 
witchcraft  was  a  harmless  and  unimportant 
factor,  but  in  the  fifteenth  and  sixteenth 
centuries  Europe  became  obsessed  with  fear 
of  witches  and  a  zeal  to  destroy  them.  It 
seems  incredible  to  us  now  that  in  those 
years  so  many  persons  should  have  been 
tortured  and  burned  as  this  account  avers. 
The  real  number  is  not  even  approximately 
known.  It  ranged  from  40,000  to  over  a 
million,  and  we  are  told  that  the  mania  for 
burning  supposed  witches  caused  more 
deaths  than  the  wars  or  pestilence  of  those 
two  centuries.  The  author  might  have  light- 
ened his  article  by  inserting  some  of  the 
old  cuts  which  filled  Reynard's  book  on 
this  same  subject — published  twenty  odd 
years  ago.  Reynard  took  the  matter  less 
seriously  and  more  journalistically.  As  we 
read  Dr.  Wellington's  article  and  its  de- 
scriptions of  epidemic  fear,  we  realize  that 
even  civilized  countries  to-day  often  get 
touches  of  this  same  outrageous  obsession. 
More  often,  now  the  fear  is  of  some  disease 
like  tuberculosis  or  influenza,  or  in  wartime, 
of  enemy  spies. 

We  have  not  space  specially  to  discuss  Dr. 
Levy's  brief  but  learned  article,  "Tractatus 
de  Causis  et  Indiciis  Morborum."  He 
shows  that  the  tractate  was  not  written  by 
Maimonides. 

F.  C.  S.  Schitler's  contribution,  "Scien- 
tific Discovery  and  Logical  Proof,"  is  de- 
voted to  showing  the  limitations  of  formal 


logic.  Many  years  ago  Macaulay  in  an  Es- 
say on  Mill's  Theory  of  Government,  at- 
tacked the  validity  of  logic  in  a  less  elabo- 
rated but  more  winsome  way  than  does  Dr. 
Schitler,  but  Dr.  Schitler  pursues  the  meth- 
od of  science,  and  he  is  more  convincing  if 
less  readable  than  Macaulay. 

Charles  L.  Dana 


The  Old  Physiology  in  English  Literature. 
By  P.  Ansell  Robin,  D.  Litt.  A  thesis  submitted 
to  the  University  of  London  for  the  degree,  Doc- 
tor of  Literature.  J.  M.  Dent  &  Sons,  Ltd.,  Lon- 
don, and  E.  P.  Dutton  &  Co.,  New  York,  191 1. 
8vo,  cloth,  183  pages.  S3.00. 

This  essay  is  delightful  reading  for  those 
conversant  with  the  older  physiology.  It 
recalls  the  four  elements  of  Empedocles 
(470  B.C.) — air,  earth,  fire  and  water,  each 
of  which  was  compounded  with  two  of  the 
properties,  hot,  cold,  wet  or  dry.  Galen 
(a.d.  200)  in  Medical  Definitions  says: 
"The  elements  of  medicine,  as  some  of  the 
ancients  thought,  are  hot  and  cold,  moist 
and  dry,"  and  also  "Of  what  are  our  pass- 
ive bodies  composed?  Of  four  things,  blood, 
phlegm,  bile  and  melancholy  humour,  which 
some  also  call  passive  elements.  Or  (put- 
ting the  question  in  another  way)  of  what 
do  our  material  bodies  consist?  Of  the  four 
elements,  fire,  air,  earth  and  water." 

Chaucer's  doctor,  from  this  ancient  in- 
formation, knew  the  causes  of  diseases: 

"He  knew  the  cause  of  every  malady, 
Were  it  of  cold  or  hot  or  moist  or  dry 
And  where  engendered  and  of  what  humour, 
He  was  a  very  perfect  practisour." 

And  this  tradition  persisted  despite  the 
warning  of  Hippocrates,  the  Father  of 
Medicine  (c.  B.C.  430),  "Whoever  having 
undertaken  to  speak  or  write  on  medicine 
have  first  laid  down  for  themselves  some 
hypothesis  to  their  argument  such  as  hot 
or  cold  or  moist  or  dry  or  whatever  else 
they  choose  (thus  reducing  their  subject 
within   a    narrow   compass   and   supposing 


Book  Reviews 


43i 


only  one  or  two  original  causes  of  disease 
or  of  death  among  mankind)  are  clearly 
mistaken  in  much  that  they  say." 

Moliere  satirizes  physicians  who  are  his 
contemporaries  as  follows: 

"First  doctor:  'Do  you  eat  well,  sir?' 

"Pourceaugnac:  'Yes  and  drink  still  bet- 
ter.' 

"First  Doctor:  'So  much  the  worse!  This 
great  craving  for  cold  and  moist  is  an  indi- 
cation of  heat  and  dryness  within.'" 

Phlegm  is  described  by  Galen  as  "cold 
and  moist,  applied  by  nature  to  the  swal- 
lowing of  food  and  the  movements  of  the 
limbs."  Phlegm  included  saliva,  mucus  of 
the  respiratory  tract  and  the  synovial  fluid. 
Thus  Pope  speaks  of  the  stomach  after  ex- 
cessive eating  as: 

"A  tomb  of  boiled  and  roast,  and  flesh  and 
fish, 
Where  bile  and  wind  and  phlegm  and  acid 

jar 
And  all  the  man  is  one  intestine  war." 


In  the  fourteenth  century  medical  stu- 
dents at  the  University  of  Cambridge  still 
attended  two  full  courses  of  lectures  on 
Galen's  "Commentaries  on  Hippocrates." 
The  author  believes  that  the  Galenic  physi- 
ology was  currently  known  among  educated 
people  of  the  sixteenth  century.  He  states 
"In  the  case  of  Shakespeare,  however,  the 
number  and  accuracy  of  his  illusions  war- 
rant the  belief  that  he  had  made  acquaint- 
ance with  medical  writings  at  first  hand." 
He  does  not  believe  that  Shakespeare  an- 
ticipated Harvey's  discovery  in  1620,  of 
which  Dryden  speaks: 

"The  circling  streams,   once  thought   but 
pools  of  blood, 
(Whether  life's  fuel  or  the  body's  food) 
From  dark  oblivion  Harvey's  name  shall 
save." 

These  few  selected  fragments  are  taken 
as  illustrative  of  a  scholarly  and  interest- 
ing effort. 

Graham  Lusk. 


CORRESPONDENCE 


To  the  Editor: — 

Bibliographical  Notes  on  Plague 
Tractates. — The  article  "Plague  Trac- 
tates" appearing  in  this  issue  of  the  Annals, 
by  Dorothea  Singer  and  Reuben  Levy  has 
interested  me  very  much  as  a  welcome  con- 
tribution to  a  much  neglected  branch  of  me- 
diaeval Jewish  literature.  Aside  from  some 
publications  of  medical  works  of  Maimon- 
ides  by  Kroner  nothing  has  been  done  in  this 
field  since  the  death  of  Steinschneider,  and 
it  is  seldom  that  competent  medical  students 
favor  us  with  the  edition  and  interpretation 
of  Hebrew  texts.  May  I  be  permitted  to  add 
a  few  bibliographical  notes  which  occurred 
to  me  when  reading  the  article. 

In  amplification  of  Note  2,  I  would 
mention  that  of  Hebrew  tracts  on  the 
plague,  two  are  printed.  A  translation  of 
Valesus  de  Taranta  "de  peste"  (a  part 
of  his  Philonium),  appeared  in  Constan- 
tinople circa  15 10  under  the  title  "naun. 
i:nni?:7'E:?,  9  leaves  4,  see  Steinschneider 
"Hebraeische  Uebersetzungen",  p.  819.  (A 
copy  of  this  extremely  rare  booklet  as 
well  as  the  MS  formerly  belonging  to 
Steinschneider  may  be  found  in  the  library 
of  the  Jewish  Theological  Seminary  of 
America,  New  York.)  An  original  treatise 
by  Isaac  ben  Todros,  written  at  Avignon 
after  1373,  was  published  by  David  de 
Giinzburg  from  a  MS  in  his  possession 
in  the  "Jubelschrift  zum  neunzigsten 
Geburtstag  des  Dr.  L.  Zunz",  Berlin,  1884, 
Hebrew  part,  pp.  104-26;  compare  D.  Kauf- 
mann  in  "Goettingische  gelehrte  Anzeigen", 
1885,  pp.  451-56,  Histoire  Iittcraire  de  la 
France,  XXXI,  pp.  699-700.  An  interesting 


passage  on  the  plague  in  Moses  Narboni's 
medical  work  "o^n  nm«„,  written  in  1350, 
was  published  with  the  omission  of  the 
technical  medical  points  by  Steinschneider 
in  the  Hebrew  periodical  tonan,  VII, 
p.  no— 11.  (See  further  on  this  book,  of 
which  the  same  library  possesses  two  MSS 
representing  different  versions,  in  Stein- 
schneider, Ioc.  cit.  746-47;  Histoire  Iitte- 
raire,  Ioc.  cit.  676-78.)  The  treatise  on 
this  subject  by  Abraham  Caslari,  which 
precedes  that  of  John  of  Burgundy  in  the 
Paris  MS  1191,  reads  almost  like  a  trans- 
lation according  to  Steinschneider,  "Cata- 
Iogus  codicum  hebraeorum  bibliothecae  aca- 
demiae  Lugduno  Batavae",  Leyden  1858, 
p.  159. 

Concerning  the  identity  of  the  two  MSS 
which  is  discussed  in  Note  24,  it  should  be 
noticed  that  the  beginning  of  Vienna  MS 
in  "Hebraeische  Bibliographic"  XVII,  57, 
note  1,  shows  the  identity  with  Paris  MS, 
1 1 24,  but  omits  the  three  puzzling  words 
which  are  rather  arbitrarily  interpreted  in 
Note  36.  The  Berliner-Giinzburg  MS  of 
the  other  version  while  literally  agreeing 
with  the  Paris  MS,  1191,  as  can  be  seen 
from  the  extracts  in  Magazin  XII,  183, 
has  a  complete  ending  before  the  astrological 
epilogue  (fol.  134  verso  line  1  of  MS  n  24) 
with  the  variant  Montpcllier  for  Liege. 
The  title  of  the  other  tract  of  John  on  the 
subject  (deus  deorum)  reads  here  also 
ok  >■?«;  in  consequence  the  correction  in 
Note  30  becomes  rather  doubtful,  the  trans- 
lator possibly  having  chosen  this  term. 

Cod.  Hebr.  2  of  the  Leeuwarden  library 
contains,  according  to  DeGoejc,  "Catalogus 
432 


Correspondence 


433 


Cod.  Orientalium  Bibliothecse  Academiae 
LugdunoBatavae"  Vol.  V.  p.  305,  as  the  last 
piece  a  treatise  on  dietetics  by  Isaac  Israeli! 
Neubauer,  however,  when  examining  the 
MS  found  instead  three  tracts  on  the  plague, 
see  Letterbode  II,  p.  84.  Of  these  the 
third  by  John  of  Tornamira  is  written  in 
Spanish  with  Hebrew  characters,  the  other 
two  are  Hebrew;  the  first  is  ascribed  to  a 
still  unidentified  Paul  of  n»fv  (Sophia? 
Steinschneider,  "Hebraeische  Uebersetzun- 
gen",  p.  816);  the  second,  which  is  anony- 
mous, Neubauer  thinks  might  be  identical 
with  that  of  John  of  Burgundy,  Paris  MS, 
1 191.  A  glance  at  the  first  words  which  he 
communicates  permits  us  now  to  definitely 
deny  this  identity.  The  text  accordingly 
requires  further  investigation. 

The  articles  by  Renan-Neubauer  in  the 
"Histoire  Iitteraire  de  la  France",  XXXI, 
pp.  723-25  and  by  Moise  Schwab,  "Revue 
des  Etudes  Juives",  XLI,  pp.  154-55,  should 
be  noted  as  giving  some  data  about  Ben- 
jamin of  Carcassone,  who  is  described  as 
translator  of  MS  1191,  (viii). 

As  to  the  anonymous  translator  of  MS 
1 1 24,  Steinschneider's  hypothesis  that  it 
might  be  the  same  Joshua  of  Bologna  who 
translated  another  tract  on  the  subject 
following  ours  in  the  Paris  and  Vienna 
MSS  deserves  mention.  A  linguistic  exami- 
nation of  the  names  of  medicaments  in  the 
text  might  show  whether  the  translator 
was  an  Italian. 

In  conclusion  a  few  remarks  may  be  added 
about  the  Hebrew  texts. 

The  copyist  of  MS  1191  frequently  di- 
vides the  words  if  he  lacks  the  space  at  the 
end  of  a  line  to  finish  them,  a  very  uncom- 
mon procedure  in  Hebrew  texts.  For  the 
convenience  of  the  reader  these  cases  might 
have  been  indicated  by  a  hyphen.  The 
practice  to  fill  the  empty  space  at  the  end 
of  a  line  by  the  first  one  or  two  letters  of 
the  next  word  is  very  common.  The  line 
on  top  of  these  letters  is  not  an  abbreviation 
mark  but  stands  for  "deleatur."  The  same 


is  the  case  with  the  line  overan  fol.  141  verso 
line  18;  the  copyist  began  to  write  '"''a-  when 
he  noticed  that  he  had  omitted  a  word. 
All  such  letters  might  just  as  well  have 
been  omitted  in  the  edition. — Fol.  141 
verso  line  26  read  n-ony  for  d'odv  ;  see  facsimile. 
— Fol.  142  recto  line  1  perhaps  no1)  ought  to 
be  read  for  mj^. 

MS  1 124  is  corrupt  in  many  places.  In 
addition  to  the  corrections  proposed  by  the 
editors  the  following  may  be  suggested: 
Fol.  133  verso  line  8  read:  rwiwa  nxn  nn* 
ivHz  d»oi«  rva;  16  line  22  and  134  recto 
line  1  read  ■h^m  -cm;  fol.  134  recto  line  5-6 
read  ininn  for  "d-ikk  d-ik.-i  (comp.  line  16  and  134 
verso  line  13);  "d-ikh  ib.  line  6  for  0::^  perhaps 
d»sS  (comp.  ni'31?  134  verso  line  10)  ib.  line 
25  h'dij  seems  to  be  dittography  from  the 
following  word;  fol.  134  verso  line  9  for 
psnn-i  better  inn;  ib.  line  10  for  pirn  perhaps 
pmS;  ib.  line  14  read  idbjh  o-w  for  c-mn;  the 
marginal  glose  "Infetto"  probably  refers  to 
inn;  line  15  add  in»  after  n-nne-;  fol.  135  recto 
line  9  read  aits  There  still  remain  some 
passages  in  need  of  emendation. 

Alexander  Marx. 

Translation  of  Galen's  Entire  Works 
into  English — Cataloguing  Scientific 
Manuscripts. — The  following  extract  from 
a  letter  of  Dr.  Charles  Singer  to  Dr.  Dana 
should  greatly  interest  students  of  medical 
history. 

There  are  two  projects  that  we  have  in 
hand  which  I  think  would  interest  you  and 
other  American  scholars,  and  to  which  I 
should  like  to  call  your  attention. 

1.  The  first  is  a  scheme  for  complete 
translation  into  English  of  the  entire  works 
of  Galen.  The  Germans  are  gradually  bring- 
ing out  the  Corpus  Medicorum  Graecorum, 
which  will  include  Galen  in  his  entirety. 

As  they  come  out,  volume  by  volume, 
we  hope  to  have  them  rendered  into  English. 
With  this  end  in  view,  we  propose  to  found 
a  Galen  Society,  in  which  we  hope  to  include 
American  men. 


434 


Annals  of  Medical  History 


The  services  of  Dr.  Withington  are  avail- 
able for  the  purpose.  Dr.  Withington,  I 
may  say,  is  an  absolutely  first  class  Greek 
scholar  and,  for  reasons  of  health,  is  entirely 
unavailable  for  military  purposes.  I  believe 
the  Oxford  University  Press  could  be  per- 
suaded to  publish  the  translation,  and  the 
only  burden  on  the  Galen  Society  would 
be  some  recompense  to  the  translator  for 
his  time  and  trouble. 

I  should  be  glad  to  hear  what  your 
view,  and  that  of  other  Americans,  may  be 
on  the  subject,  and  should  you  be  interested 
I  would  let  you  know  of  the  progress  of  our 
scheme. 

2.  The  other  undertaking  which  I  would 
like  to  mention  to  you  is  the  Catalogue  of 
Scientific  MSS  in  the  libraries  of  Great 
Britain  and  Ireland,  which  is  in  process  of 
preparation  by  Mrs.  Singer  and  by  myself, 
or  rather  by  Mrs.  Singer,  for  she,  with 
several  helpers,  has  been  responsible  for 
the  whole  work  in  my  absence. 

It  is  our  hope,  when  the  Catalogue  reaches 
a  serviceable  stage,  which  should  be  by  the 
end  of  the  summer,  that  it  will  place  the 
worker  who  cares  to  use  it  in  quite  as  favor- 
able a  position  for  the  study  of  medical  and 
scientific  MSS  as  those  of  us  who  are  living 
in  touch  with  the  great  European  libraries. 

The  Catalogue  will  include  all  MS  ma- 
terial up  to  the  year  1500.  It  will  be  in  card 
form,  and  will  be  classified  according  to 
the  subject,  Anatomy,  Astronomy,  and  so 
forth.  It  will  contain  about  40,000  entries. 

By  its  means  a  worker,  in  the  United 
States  for  instance,  will  be  able  to  see  at 
a  glance  what  MSS  there  are  that  are  of 
interest  to  him,  and  he  could  procure  roto- 
graphic  or  photographic  copies  of  them  by 
communicating  with  the  library  where  they 
are  to  be  found. 

Yours  sincerely, 
Charles  Singer 


CATALOGUE  OF  MANUSCRIPTS  OF  SCIENTIFIC  INTER- 
EST, Up  to  the  Year  1500,  in  the  British  Isles. 
Edited  by  Charles  and  Dorothea  Singer.  On 
press. 

The  Catalogue  will  be  arranged  primarily 
under  subjects,  and  subdivided  chronologi- 
cally, by  centuries,  and  by  the  localities 
in  which  the  MSS  are  found. 

There  will  be  a  very  brief  excursus  on 
each  text  so  far  as  is  possible. 

There  will  also  be  two  indices. 

Index  i. — Alphabetical  combined  list  of: 
authors;  places;  scribes;  languages  (giving 
subject,  collection,  MS  number  and  folia- 
tion, and  catalogue  page). 

Index  2. — Alphabetical  list  of  manuscript 
collections  with  the  MSS  arranged  in  nu- 
merical order,  and  giving  the  library1  in 
which  each  collection  is  preserved,  the 
subject  and  the  catalogue  page. 

headings  of  the  catalogue 


Alchemy 

Chemistry 
Anatomy 

Aristotle  (Secretum 
Secretorum  Aris- 
totle to  Alexander) 
Arts  and  Crafts 
Astrology 

Menology 
Astronomy 
Bestiaries 

Monstrosities 

Fables 
Calendar 
Computus 
Charm 

Magic 
Children 
Cosmology 

De  Rerum  Natura 

De  Elementis 
Diet 
Fermentation  and 

Generation 
Fevers 
Geography 

Travel 
Gynaecology 


H.ematoscopy 

Blood-inspection 
Herbaria 
Hospitals 
Husbandry 
Lapidaries 
Mathematics  (Pure) 
Measures  and  Weights 
Medicine  (General) 
Melothesia 
Miscellaneous 
Music 
Harmony 

(Scientific  Aspects) 
Ophthalmology 
Pestilence 

Contagion 

Epidemic 

Plague 

Infection 
Phlebotomy 

Blood-letting 
Physics 
Physiognomy 

Chiromancy 
Physiology  (Four 

temperaments,  etc.) 
Prognostics 


1  Under  Bodleian  Library,  it  will  be  necessary  to 
print  also  a  list  of  the  MSS  in  numerical  order 
according  to  the  old  numbers  (retained  in  the  New 
Summary  Catalogue)  giving  the  present  pressmark, 
i.  e.,  collection  and  number. 


Correspondence 


435 


catalogue  headings  (cont.) 

Pulses 

Recipes 

Regimen  (Other  than  Secretion) 

Science  (General) 

Encyclopaedias  of  General 

Knowledge,  (e.  g.,  Bartholomaeus) 
Surgery 
Urine 
Veterinary 

Colors  of  Cards 

White British  Museum 

Yellow Others 

Red Oxford 

Blue  Cambridge 

Grey Cathedrals 

Sunset Foreign 

Purple Cross  Reference2 

CONTENTS    OF    CARDS    OF    SKELETON    CATA- 
LOGUE OF  HAND-LIST 

(This  should  be  ready  by  about 
September,  191 8) 

The  cards  will  give: 

On  Left  Hand  Side — 

Above  line. — Collection  and  number  of 
MS  (Roman  figures  in  brackets  signify  the 
number  of  the  item  in  the  MS).  On  Bodley 
cards,  ordinary  figures  in  brackets  signify 
the  numbers  in  the  summary  and  1697 
catalogues. 

Below  line. — Foliation,  i.  e.,  number  and 
side  of  first  and  last  sheet.  (Nomenclature: 
"recto"  and  "verso"  of  sheets.) 

In  Centre — 

Above  line. — Subject,  in  bold  letters,  and 
under  subject,  author,3  if  known. 

Below  line. — Language,  if  not  Latin,  and 
below  language,  short  title,  if  any. 

On  Right  Hand  Side — 

Above  line. — Date  and  place  of  MS. 
(Leave  space  above  for  exact  size  and 
material.) 

Below  line. — List  of  works  in  which  the 

2  Cross  reference  to  every  author  and  scribe  and 
place,  giving  subject,  library,  collection,  MS  number 
and  foliation. 

3  When  citing  any  printed  work,  be  sure  to  give 
all  initials,  or,  when  known,  Christian  names,  of 
authors. 


MS  is  cited  (and  in  brackets  their  Bodley 
pressmarks,  if  known,  otherwise  leave  space 
for  pressmarks).    If  the  Catalogue   is  the 
only  work,  it  need  not  be  cited. 
On  Body  of  Card — 

1.  If  the  work  is  printed,  in  bold  letters 
printed,  followed  by  a  list  of  works  in 
which  the  MS  is  printed  (and  in  brackets 
their  Bodley  pressmark,  if  known;  other- 
wise leave  space  for  pressmark). 

2.  Followed  by  name  of  Scribe  and  any 
important  note  or  remark. 

3.  Any  figures  or  illustrations  will  be  noted 
in  bold  letters. 

4.  Followed  by  full  title,  incipit,  explicit, 
and  any  other  quotation  given  in  Catalogue. 

To  the  Editor: — 

A  Modernist'sView  of  Medieval  Science 
— I  should  hate  you  to  misunderstand  my 
attitude  towards  Mediaeval  Science.  I  al- 
ways feel  towards  it  as  Huxley  did  towards 
Ghosts.  He  used  to  say,  you  know,  that 
"he  didn't  believe  in  ghosts  because  he 
had  seen  too  many  of  them."  I  don't  think 
there  are  many  medievalists  who  feel  less 
mediaeval  than  I  do.  But  the  Middle  Ages, 
like  the  Germans,  are  there,  and  we  have 
just  got  to  consider  them.  The  important 
question  is,  to  my  mind,  not  whether 
mediaeval  science  made  any  advance  on 
knowledge,  for  it  clearly  did  not,  but 
whether  the  point  of  view  and  the  intellec- 
tual processes  which  gave  rise  to  the  Middle 
Ages  have  or  have  not  had  a  deep  and  lasting 
effect.  To  my  mind  they  have.  To  my  mind 
modern  thought  is  the  descendant  of  mediae- 
val and  not  of  classical  thought.  To  my 
mind  the  classics  have  never  been,  and  can- 
not now  be  studied  from  the  inside  by  the 
Western  nations.  If  the  men  of  the  Middle 
Ages  were  children,  then  the  men  of  Greece 
were  foreigners.  It  is,  of  course,  possible 
to  appreciate  the  beauties  and  the  meaning 
of  the  Greek  and  Roman  writers,  but  to 


436 


Annals  of  Medical  History 


look  at  the  classics  from  within  and  feel 
with  the  heart  of  a  Greek,  or  think  with 
his  mind,  is  a  task  of  excessive  difficulty 
and  one  seldom  accomplished  even  by  the 
rarest  of  scholars. 

To  understand  how  our  science  is  what 
it  is,  we  must  go  back  to  the  point  of  view 
of  our  veritable  intellectual  ancestors,  the 
men  of  the  Dark  Ages,  of  whom  Greece 
and  Rome  were  not  the  parents  but  only 
the  schoolmasters.  That  is  my  chief  plea 
for  the  study  of  the  Middle  Ages. 

But  further,  and  apart  from  this,  I  would 
urge  that  the  mere  fact  that  in  a  thousand 
years  no  new  scientific  method  was  intro- 
duced, no  progress  was  made,  and  that 
the  history  of  the  knowledge  of  the  outside 
world  may  be  summed  up  by  saying  that 
it  was  a  progressive  misunderstanding; 
that  fact,  I  say,  is  one  of  prodigious  impor- 
tance in  the  history  of  the  human  mind. 
Shall  it  then  be  passed  over  in  any  history 
of  human  thought,  medical  or  other?  The 
intellectual  barrenness  of  the  Middle  Ages 
had,  like  other  phenomena,  its  efficient 
causes.  Those  causes  are  surely  worth 
study.  They  are  specially  worth  analysis 


by  an  age  such  as  this,  when  the  first 
intellectual  stimulus  of  scientific  discovery 
has  gone  by.  To  avoid  the  danger  of  any- 
thing in  the  nature  of  a  scientific  hierarchy, 
it  is  necessary  to  analyse  the  basis  of  scien- 
tific belief  and  the  character  and  conditions 
of  scientific  achievements.  The  Middle 
Ages  provide  the  Pathology  of  Science, 
the  study  of  which  may  throw  light  on  the 
growth  of  the  healthy  organism.  I  agree 
with  what  you  say,  that  in  medicine  it  is 
not  till  recent  times  and  then  comparatively 
suddenly  that  science  has  come  by  its  own, 
but  then  the  same  may  be  said  of  science 
itself  as  applied  to  all  technical  subjects 
in  greater  or  less  degree.  To  my  mind  these 
xMiddle  Ages  were  the  period  of  gestation 
of  science,  and  that  period  has  been  longer 
for  medicine  than  for  most  technical  sub- 
jects. Therefore  I  look  upon  myself  as  an 
embryologist  of  science,  and  though  embry- 
ology may  be  less  important  than  anatomy 
or  pediatrics,  it  may  yet  throw  light  on 
both.  The  ovum  is  utterly  different  from 
the  adult  organism,  but  it's  worth  study 
for  all  that. 

Charles  Singer 


INDEX  TO  VOLUME   I 


A  cademy  of  Medicine,  the  old  Paris,  Jetons  of,  in 
the  numismatic  collection  in  the  Army  Medical 
Museum  at  Washington,  D.  C,  Albert  Allemann, 
155. 

Allemann,  Albert,  Jetons  of  the  old  Paris  Academy 
of  Medicine  in  the  numismatic  collection  in  the 
Army  Medical  Museum  at  Washington,  D.  C,  155. 

Anaesthesia,  modern  surgical,  The  first  printed  docu- 
ments relating  to,  William  Osier,  329. 

"Anatomie  Universelle"  (The)  of  Ambroise  Pare, 
William  Osier,  Editorial,  424. 

Anatomy,  skeletal  and  visceral,  Figurations  of,  in 
the  Books  of  Hours,  Wilfrid  M.  de  Voynich  and 
Fielding  H.  Garrison,  225. 

Ancient  Medicine,  The  Greek  cult  of  the  dead  and 
the  Chthonian  deities  in,  Fielding  H.  Garrison,  35. 

Aneurism,  Antyllus  on,  Oribasius,  220. 

Announcement  of  Catalogue  of  manuscripts  of  scien- 
tific interest,  edited  by  Charles  and  Dorothea 
Singer,  434. 

Antyllus  on  aneurism,  Oribasius,  220. 

Arbuthnot,  John,  Tvudi  Xeavrdv  (Verse),  no. 

Archival  histories  of  medicine.  Editorial,  217. 

Army  Medical  Museum  at  Washington,  D.  C, 
Jetons  of  the  old  Paris  Academy  of  Medicine  in 
the  numismatic  collection  in  the,  Albert  Allemann, 

Army,  the  United  States,  Legislative  and  adminis- 
trative history  of  the  medical  department  of,  dur- 
ing the  revolutionary  period  (1776-1786),  William 
O.  Owen,  198,  261,  342. 

13  abylonian-Assyrian  medicine,  Morris  Jastrow,  Jr., 
231. 

Bacteriology  in  the  United  States,  Early  instruction 
in,  David  H.  Bergey,  422. 

Bailey,  Pearce:  Voltaire's  relation  to  Medicine,  54. 

Bednar,  Alois,  Life  of.  In  "Notes  and  Queries,"  316. 

Beginnings  of  intravenous  medication,  Horace 
Manchester  Brown,  177. 

Bell,  John  [1763-1820].  In  "Notes  and  Queries,"  317. 

Bergey,  David  H.:  Early  instruction  in  bacteriology 
in  the  United  States,  422. 

Bibliographical  notes  on  "Plague  tractates."  Corre- 
spondence, Alexander  Marx,  432. 

Billings,  Dr.  John  Shaw,  Eulogy  of,  Abraham 
Jacobi,  109. 

Book  Reviews: 

Dana,  C.  L.:  "Dr.  Lyman  Spalding,  Originator  of 
the  United  States  Pharmaccepia"  by  J.  A.  Spald- 
ing, 222. 

— "Early  History  of  North  Carolina  Medical 
Society"  by  Wesley  Long,  325. 

— "Finch  and  Baines,  a  Seventeenth  Century 
Friendship"  by  Archibald  Malloch,  221. 

— "Recollections  of  a  New  York  Surgeon"  by  A.  G. 
Gerster,  327. 

— "Studies  in  the  History  and  Method  of  Science" 
by  Charles  Singer,  429. 

Frank,  Mortimer:  "History  of  Medicine"  by  F.  H. 
Garrison,  223. 


Garrison,   F.   H.:  "The  Nurse  in  Greek  Life"  by 

Sister  Mary  Rosaria,  325. 
Lusk,   Graham:   "The  Old   Physiology   in   English 

Literature"  by  P.  A.  Robin,  430. 
McCrae,  Thomas:  "Growth  of  Medicine"  by  A.  H. 

Buck,  106. 
Packard,    F.    R.:    "Anatomical   Names"   by   A.    C. 

Eycleshymer  et  al,  108. 
— "The  Cures  of  the  Diseased"  by  Charles  Singer, 

106. 
— "Poetry  and  the  Doctors"  by  C.  L.  Dana,  106. 
Sudhoff,     Karl:     "Leonardo    da    Vinci,    Quaderni 

d'Anatomia  V  e  VI"  by  K.  Sudhoff  and  M.  Hall, 

326. 
Books  of  Hours,  Figurations  of  skeletal  and  visceral 

anatomy  in  the,  Wilfrid  M.  de  Voynich  and  Field- 
ing H.  Garrison,  225. 
Bronze  ecorche,  An  unpublished,  Edward  C.  Streeter, 

Brown,    Horace    Manchester:    The    beginnings    of 

intravenous  medication,  177. 
Brown,  John:  An  excerpt  from  "Horae  Subsecivae," 

315- 

Burke  and  Hare  and  the  psychology  of  murder, 
Charles  W.  Burr,  75. 

Burr,  Charles  W.:  Burke  and  Hare  and  the  psy- 
chology of  murder,  75. 

Byzantine  medical  fragments,  Charles  Singer,  333. 

(^arabelli,  The  tubercle  of,  and  congenital  syphilis, 

^*  Roy  L.  Moodie,  Editorial,  423. 

Catalogue  of  manuscripts  of  scientific  interest,  up 
to  the  year  1500,  in  the  British  Isles.  Edited  by 
Charles  and  Dorothea  Singer.  An  announcement, 

434- 
Charm,  On  a  Greek,  used  in  England  in  the  twelfth 

century,  Charles  Singer,  258. 
Charms  of  precedence  [Verse],   William   Shenstone 

(1714:1763).  428. 
Check  list  (A)  of  medical  incunabula  in  the  Surgeon 

General's  Library,  Washington,  D.  G,  1918,  301. 
Children,   Purposeful  deformation  of  (chirurgie  au 

rebours).  In  "Notes  and  Queries,"  316. 
Chthonian  deities  in  ancient  medicine,  The  Greek 

cult  of  the  dead  and,  Fielding  H.  Garrison,  35. 
Circulation    (The)     and    its    disorders,     Historical 

development    of    our    knowledge    of,    Philip    S. 

Roy,  141. 
Colonial  times,  Laryngology  and  otology  in,  Stanton 

A.  Friedberg,  86. 
Congenital  syphilis,  The  tubercle  of  Carabelli  and, 

Roy  L.  Moodie.  Editorial,  423. 
Corbyn,  Frederick,  Life  of.  In  "Notes  and  Queries," 

316. 
Cordus,  Enricus  (1486-1535),  The  three  characters 

of  a  physician  [Verse],  53. 

Correspondence : 

Marx,  Alexander:  Bibliographical  notes  to  "Plague 

tractates,"  432. 
Singer,  Charles:  A  modernist's  view  of  mediaeval 

science,  435. 


437 


438 


Annals  of  Medical  History 


Criminology: 

Burke  and   Hare   and   the   psychology   of  murder, 

C.  W.  Burr,  75. 
Purposeful  deformation  of  children.  In  "Notes  and 

Queries,"  316. 
Cult,  The  Greek,  of  the  dead  and  the  Chthonian 

deities  in  ancient  medicine,  Fielding  H.  Garrison,  35. 

T~\aCosta,  J.  M.  [1891]:  The  sons  of  Sydenham, 

154- 
— Soranus  of  Ephesus  and  Marion  Sims,  260. 
Dana,  Charles  L.:  Contribution  to  laryngology  of 

Dr.  D.  Bryson  Delavan.  Editorial,  322. 
— Franciscus  Dela  Boe  Sylvius.  Editorial,  422. 
— Guy  Patin  (1601-1672).  Editorial,  323. 
— Methods    of   treating   the    history    of   medicine. 

Editorial,  322. 
— Review  of  "Dr.  Lyman  Spalding,  the  Originator 

of  the  United  States  Pharmacopoeia"  by  James 

Alfred  Spalding,  222. 
— Review   of   "Early    History   of  North    Carolina 

Medical  Society"  by  Wesley  Long,  325. 
— Review   of  "Finch   and    Baines,   a   Seventeenth 

Century  Friendship"  by  Archibald  Malloch,  221. 
— Review  of  "  Recollections  of  a  New  York  Surgeon  " 

by  Arpad  G.  Gerster,  327. 
— Review  of  "Studies  in  the  History  and  Method 

of  Science"  by  Charles  Singer,  433. 
Dead,  Greek  cult  of  the,  and  the  Chthonian  deities 

in  ancient  medicine,  Fielding  H.  Garrison,  35. 
Deities,  the  Chthonian,   in  ancient  medicine,  The 

Greek  cult  of  the  dead  and,  Fielding  H.  Garrison, 

Delevan,   Dr.   D.   Bryson  and  his  contribution  to 

laryngology,  C.  L.  Dana.  Editorial,  322. 
Dermatology,    The    evolution    of,    Walter    James 

Heimann,  427. 
Development,  Historical,  of  our  knowledge  of  the 

circulation  and  its  disorders,  Philip  S.  Roy,  141. 
Documents  relating  to  modern  surgical  anaesthesia, 

The  first  printed,  William  Osier,  329. 

T^corche,    bronze,    An    unpublished,    Edward    C. 
Streeter,  73. 

Editorials: 

The    "Anatomie    Universelle"    of  Ambroise    Pare, 

William  Osier,  424. 
Approaching  the   history  of  medicine,   Charles   L. 

Dana,  322. 
Archival  histories  of  medicine,  217. 
Dr.  D.  Bryson  Delevan's  contribution  to  Iargyngol- 

ogy,  Charles  L.  Dana,  322. 
Dr.  Stephen  Smith,  the  Nestor  of  American  surgery, 

F.  H.G..318. 
Franciscus  Dela  Boe  Sylvius,  Charles  L.  Dana,  422. 
Guy  Patin  (1601-1672),  Charles  L.  Dana,  323. 
Introductory  note,  102. 
Legend  of  the  Mandxagora,  102. 
The  tubercle  of  CaraSelli   and  congenital  syphilis, 

Roy  L.  Moodic,  423. 
Eulogy  of  Dr.  John  Shaw  Billings,  Abraham  Jacobi, 

109. 
Excerpt  from  Hone  Subsccivae,  John  Brown,  315. 
Experiment  (The)  of  Walacus.  [Job  Walacus.  Epis- 

tolse  duae  (1640)]  230 


"pestival,   A   patronal,   for   Thomas  Willis   (1621- 
1675)  witn  remarks  by  Sir  William  Osier,  Bart., 

F.  R.S.,  Henry  Viets,  118. 
Figurations  of  skeletal  and  visceral  anatomy  in  the 

Books   of   Hours,    Wilfrid   M.    de  Voynich   and 

Fielding  H.  Garrison,  22$. 
First  printed  documents  relating  to  modern  surgical 

anaesthesia,  William  Osier,  329. 
Fracastoro,    Girolamo    [14787-1553],    The   scientific 

position  of,  Charles  and  Dorothea  Singer,  1. 
Franciscus   Dela    Boe   Sylvius,    Charles    L.    Dana. 

Editorial,  422. 
Frank,  Mortimer:  Review  of  "An  Introduction  to 

the  History  of  Medicine"  by  Fielding  H.  Garrison, 

223. 
Friedberg;  Stanton  A.:  Laryngology  and  otology  in 

colonial  times,  86. 

{"lalen,   De  usu   partium    I,   3:  Structure  follows 

^-*  function,  140. 

Garrison,    Fielding    H.:    Dr.    Stephen    Smith,    the 

Nestor  of  American  surgery,  Editorial,  318. 
— Greek  cult  of  the  dead  and  the  Chthonian  deities 

in  ancient  medicine,  35. 
— Memorial  notice  Sir  Marc  Amand  Ruffer  (1859- 

1917),  218. 
— Review  of  "The  Nurse  in  Greek  Life"  by  Sister 

Mary  Rosaria,  325. 
— and  Voynich,  Wilfrid  M.  de:  Figurations  of  skel- 
etal and  visceral  anatomy  in  the  Books  of  Hours, 

225. 
Girolamo    Fracastoro    (14787-1553),    The   scientific 

position  of,  Charles  and  Dorothea  Singer,  1. 
Greek  charm  used  in  England  in  the  twelfth  century, 

Charles  Singer,  258. 
Greek  cult  of  the  dead  and  the  Chthonian  deities 

in  ancient  medicine,  Fielding  H.  Garrison,  35. 
Guy  Patin  (1601-1672),  Charles  L.  Dana.  Editorial, 

323. 

TJall,  Marshall:  Proof  of  reflex  action,  173. 

Hare,  and  Burke,  and  the  psychology  of  murder, 
Charles  W.  Burr,  75. 

Hebrew  prayers  for  the  sick,  C.  D.  Spivak,  83. 

Heimann,  Walter  James:  The  evolution  of  derma- 
tology, 427. 

Heizmann,  Charles  L. :  Military  sanitation  in  the 
sixteenth,  seventeenth,  and  eighteenth  centuries, 
281. 

Historical  development  of  our  knowledge  of  the  cir- 
culation and  its  disorders,  Philip  S.  Roy,  141. 

Historical  Notes: 

Early    instruction    in    bacteriology    in    the    United 

States,  David  H.  Bergey,  426. 
Evolution    (The)    of   dermatology,    Walter    James 

Heimann,  427. 
Histories  of  medicine,  Archival,  Editorial,  z\~. 
History  of  infection  (Tin',  Arnold  G  Klebs,  159. 
— of  medicine,  Approaching,  and  methods  of  treating 

the,  Charles  L.  Dana.  Editorial,  322. 
— of  the  medical  department  of  the  United  States 

Army,  Legislative  and  administrative,  during  the 

revolutionary    period    (1776- 1786),    William    O. 

Owen,  198,  261,  342. 
Horse  Subsecivos  (Excerpt  from),  John  Brown,  315. 


Index 


439 


Hospital,  military,  during  the  Revolution,  Text  of 
William  Shippen's  first  draft  of  a  plan  for  the  or- 
ganization of,  174. 

Hugo,  Victor,  The  medical  phrases  of,  Hubert 
Ashley  Royster,  412. 

Hygienic  idea  (The)  and  its  manifestations  in  world 
history,  Karl  Sudhoff,  1 1 1 . 

Tncunabula,  medical,  A  check  list  of,  in  the  Surgeon 
General's  Library,  Washington,  D.  C,  1918,  301. 

Infection,  The  history  of,  Arnold  C.  Klebs,  159. 

— Scientific  position  of  Girolamo  Fracastoro  with 
especial  reference  to  the  source,  character,  and 
influence  of  his  theory  of,  Charles  and  Dorothea 
Singer,  1. 

Intravenous  medication,  The  beginnings  of,  Horace 
Manchester  Brown,  177. 

Introductory  note  to  the  Annals  of  Medical  History. 
Editorial,  102. 

Jacobi,  Abraham:  Eulogy  of  Dr.  John  Shaw  Billings, 
**    109. 

— The  New  York  Medical  College,  1782- 1906,  369. 
Jastrow,  Morris,  Jr.:  Babylonian-Assyrian  medicine, 

23*- 

Jetons  of  the  old  Paris  Academy  of  Medicine  in  the 
numismatic  collection  in  the  Army  Medical 
Museum  at  Washington,  D.  C,  Albert  AJIemann, 
155- 

I/'Iebs,  Arnold  C. :  The  history  of  infection,  159. 

T  aryngology  and  otologv  in  colonial  times,  Stanton 

■L'  A.  Friedberg,  86. 

Laryngology,  Dr.  D.  Bryson  Delevan's  contribution 

to,  Charles  L.  Dana.  Editorial,  322. 
Legend  of  the  Mandragora.  Editorial,  102. 
Legislative  and  administrative  history  of  the  medical 

department   of  the   United  States   Army   during 

the  revolutionary  period  (1776- 1786),  198,  261,  342. 
Levy,  Reuben,  and  Singer,  Dorothea  Waley:  Plague 

tractates,  394. 
Library  of  the  Surgeon  General,  Washington,  D.  C, 

Check  list  of  medical  incunabula  in,  19 18,  301. 
Lusk,  Graham:  Review  of  "The  Old  Physiology  in 

English  Literature"  by  P.  A.  Robin,  430. 

V/TcCrae,   Thomas:  Review   of  "The  Growth   of 
^*  Medicine"  by  Albert  H.  Buck,  106. 
McCuIIock,  Champe  Carter,  Check  list  of  medical 

incunabula    in    the    Surgeon    General's    Library, 

Washington,  D.  C,  1918,  301. 
Mandragora,  Legend  of  the.  Editorial,  102. 
Manuscripts  of  scientific  interest,   up  to  the  year 

1500,  in  the  British  Isles,  Catalogue  of,  edited  by 

Charles  and  Dorothea  Singer.  An  announcement, 

434- 

Marcard,  Mathilde,  and  Werlhof's  Wedding.  In 
"Notes  and  Queries,"  316. 

Marion  Sims,  Soranus  of  Ephesus  and,  J.  M.  Da 
Costa  (1891),  260. 

Marshall  Hall's  proof  of  reflex  action,  173. 

Marx,  Alexander:  Bibliographical  notes  on  "Plague 
tractates."  Correspondence,  432. 

Mathematics,  Medicine  and,  in  the  sixteenth  cen- 
tury, David  Eugene  Smith,  125. 


Mediaeval  science,  A  modernist's  view  of,  Charles 
Singer.  Correspondence,  435. 

Medical  College,  The  New  York,  1782- 1906,  Abra- 
ham Jacobi,  369. 

— department  of  the  United  States  Army  during 
the  revolutionary  period  (1776- 1786),  The  legis- 
lative and  administrative  history  of,  William  O. 
Owen,  198,  261,  342. 

— fragments,  Byzantine,  Charles  Singer,  333. 

— incunabula,  Check  list  of,  in  the  Surgeon  General's 
Library,  Washington,  D.  C,  1918,  301. 

— phrases  of  Victor  Hugo,  (The),  Hubert  Ashley 
Royster,  412. 

Medication,  intravenous,  The  beginnings  of,  Horace 
Manchester  Brown,  177. 

Medicine,  ancient,  The  Greek  cult  of  the  dead  and 
the  Chthonian  deities  in,  Fielding  H.  Garrison,  35. 

— Archival  histories  of.  Editorial,  217. 

— and  mathematics  in  the  sixteenth  century,  David 
Eugene  Smith,  125. 

— Babylonian-Assyrian,  Morris  Jastrow,  Jr.,  231. 

— Methods  of  treating  the  history  of,  Charles  L. 
Dana.  Editorial,  322. 

— -Voltaire's  relation  to,  Pearce  Bailey,  54. 

Memorial  notice  Sir  Marc  Amand  Ruffer,  F.  H. 
Garrison,  218. 

Military  hospital  during  the  Revolution,  Text  of 
William  Shippen's  first  draft  of  a  plan  for  the 
organization  of,  174. 

— sanitation  in  the  sixteenth,  seventeenth,  and 
eighteenth  centuries,  Charles  L.  Heizmann,  281. 

Modern  surgical  anaesthesia,  The  first  printed  docu- 
ments, relating  to,  William  Osier,  329. 

Moodie,  Roy  L.:  Studies  in  paleopathology,  3-5. 

— The  tubercle  of  Carabelli  and  congenital  syphilis. 
Editorial,  423. 

Murder,  Burke  and  Hare  and  the  psychology  of, 
Charles  W.  Burr,  75. 

Nestor  of  American  surgery,  Dr.  Stephen  Smith, 
the,  F.  H.  G.  Editorial,  318. 
New  York  Medical  College  (The)  1782- 1906,  Abra- 
ham Jacobi,  369. 
Noeggerath,     Emil    [1847- 1895].     In    "Notes    and 
Queries,"  317. 

Notes  and  Queries: 

Emil  Noeggerath  [1847- 1895],  317. 

John  Bell  [1763- 1820],  317. 

Life  of  Alois  Bednaf,  316. 

Life  of  Frederick  Corby n,  316. 

Mathilde  Marcard  and  Werlhof's  Wedding,  316. 

Purposeful    deformation    of  children    (chirurgie   au 

rebours),  316. 
Surgical  instruments,  317. 
Numismatic  collection   (the)   in  the  Army  Medical 

Museum  at  Washington,  D.  C,  Jetons  of  the  old 

Paris  Academy  of  Medicine  in,  Albert  Allemann, 

155- 

r\n  a  Greek  charm  used  in  England  in  the  twelfth 

^  century,  Charles  Singer,  258. 

Organization    of  the   military    hospital   during   the 

revolution.  Text  of  William  Shippen's  first  draft 

of  a  plan  for,  1 74. 
Oribasius:  Antyllus  on  aneurism,  220. 


44° 

Osier,  Sir  William,  Bart.,  F.  R.  S.,  A  patronal  festival 
for  Thomas  Willis  ( 162 1- 1675)  with  remarks  by, 
Henry  Viets,  118. 

— The  "anatomie  universelle"  of  Ambroise  Pare, 
Editorial,  427. 

— The  first  printed  documents  relating  to  modern 
surgical  anaesthesia,  329. 

Otology,  and  Laryngology,  in  colonial  times,  Stanton 
A.  Friedberg,  86. 

Owen,  William  O.:  The  legislative  and  administra- 
tive history  of  the  medical  department  of  the 
United  States  Army  during  the  revolutionary 
period  (1776- 1786),  198,  261,  342. 

Dackard,   Francis  R. :  Review — "Poetry   and  the 

*■     Doctors"  by  Charles  L.  Dana,  106. 

— "Anatomical  Names,  especially  the  Basle  Nomina 

Anatomica"  by  Albert  C.  Eycleshymer,  108. 
— "The  Cures  of  the  Diseased.  In  Forraine  Attempts 

of  the  English  Nation,  London,  1598"  by  Charles 

Singer,  106. 
Paleopathology,  Studies  in,  Roy  L.  Moodie,  375. 
Pare,    Ambroise,    anatomie  universelle  of,  William 

Osier.  Editorial,  427. 
Paris  Academy  of  Medicine,  the  old,  Jetons  of,  in 

the  numismatic  collection  in  the  Army  Medical 

Museum  at  Washington,  D.  C,  Albert  Allemann, 

l55-  ,.      . 

Patin,  Guy  (1601-1672),  Charles  L.  Dana.  Editorial, 

323- 

Patronal  festival  (A),  for  Thomas  Willis  (1621-1675) 
with  remarks  by  Sir  William  Osier,  Bart.,  F.  R.  S., 
Henry  Viets,  118. 

Phrases,  Medical,  of  Victor  Hugo,  Hubert  Ashley 
Royster,  412. 

Physician  (A),  The  three  characters  of,  Enricus 
Cordus  (i486- 1 535),  53. 

Plague  tractates,  Dorothea  Waley  Singer  and 
Reuben  Levy,  394. 

— Bibliographical  notes  on,  Alexander  Marx.  Corre- 
spondence, 432. 

Poetry : 

Arbuthnut,    John    (1675-1743-5),    ["What    am    I? 

How  produced?  And  for  what  end?"],  1 10. 
Enricus  Cordus  (1486-1535):  The  three  characters 

of  a  physician,  53. 
Shenstone,    William    (1714-1763):    The    charms    of 

precedence,  428. 
Prayers,  Hebrew,  for  the  sick,  C.  D.  Spivak,  83. 
Proof  of  reflex  action,  Marshall  Hall's,  173. 
Psychology  of  murder,  the,  Burke  and  Hare  and, 

Charles  W.  Burr,  75. 

Deflex  action,  Marshall  Hall's  proof  of,  173. 

*  *•  Revolution,  Text  of  William  Shippen's  first  draft 
of  a  plan  for  the  organization  of  the  military 
hospital  during  the,  174. 

Revolutionary  period  (1776-1786),  Legislative  and 
administrative  history  of  the  medical  department 
of  the  United  States  Army  during  the,  William 
O.  Owen,  198,  261,  342. 

Roy,  Philip  S.:  Historical  development  of  our  knowl- 
edge of  the  circulation  and  its  disorders,  141. 

Royster,  Hubert  Ashley:  The  medical  phrases  of 
Victor  Hugo,  412. 


Annals  of  Medical  History 


Ruffer,  Sir  Marc  Amand  (1859-1917),  Memorial 
notice,  F.  H.  Garrison,  218. 

Canitation,  Military,  in  the  sixteenth,  seventeenth 
^  and  eighteenth  centuries,  Charles  L.  Heizmann, 

281. 
Science,  mediaeval,  A  modernist's  view  of,  Charles 

Singer.     Correspondence,  435. 
Scientific  position  of  Girolamo  Fracastoro  [1478?- 

'5531  Charles  and  Dorothea  Singer,  1. 
Shenstone,    William    (1 714- 1763):    The    charms   of 

precedence  (Verse),  428. 
Shippen,  William,  Text  of  first  draft  of  a  plan  for 

the  organization  of  the  military  hospital  during 

the  revolution,  174. 
Sick  (the),  Hebrew  prayers  for,  C.  D.  Spivak,  83. 
Sims,  Marion,  Soranus  of  Ephesus  and,  J.  M.  Da 

Costa  (1891),  260. 
Singer,  Charles:  Correspondence,  433. 
— A  modernist's  view  of  mediaeval  science.  Corre- 
spondence, 435. 
— Byzantine  medical  fragments,  333. 
— On  a  Greek  charm  used  in  England  in  the  twelfth 

century,  258. 
Singer,  Charles  and  Dorothea:  Catalogue  of  manu- 
scripts of  scientific  interest,  up  to  the  year  1500, 

in  the  British  Isles.  An  announcement,  434. 
— The   scientific   position   of  Girolamo    Fracastoro 

[14787-1553],  1. 
Singer,  Dorothea  Waley,  and  Levy,  Reuben:  Plague 

tractates,  394. 
Singer,  Dorothea  [Waley],  See  also  Singer,  Charles 

and  Dorothea. 
Sixteenth   century,   Medicine  and   mathematics   in 

the,  David  Eugene  Smith,  125. 
Skeletal  and  visceral  anatomy,  Figurations  of,  in  the 

Books   of   Hours,    Wilfrid   M.   de   Voynich   and 

Fielding  H.  Garrison,  225. 
Smith,  David  Eugene:   Medicine  and   mathematics 

in  the  sixteenth  century,  125. 
Smith,  Dr.  Stephen,  the  Nestor  of  American  surgery, 

F.  H.  G.  Editorial,  318. 
Sons  of  Sydenham,  The,  J.  M.  Da  Costa  (1891),  154. 
Soranus  of  Ephesus  and  Marion  Sims,  J.  M.   Da 

Costa  ( 1 89 1 ) ,  260. 
Spivak,  C.  D. :  Hebrew  prayers  for  the  sick,  83. 
Stockman,  Frank  J.  (translator):  The  hygienic  idea 

and  its  manifestations  in  world  history  by  Pro- 
fessor Karl  Sudhoff,  III. 
Streeter,  Edward  C. :  An  unpublished  bronze  ecorche, 

73- 

Structure  follows  function,  De  usu  partium  I,  3, 
Galen,  140. 

Studies  in  paleopathology,  Roy  L.  Moodie,  375. 

Sudhoff,  Karl:  The  hygienic  idea  and  its  manifesta- 
tions in  world  history,  translated  by  F.  S.  Stock- 
man, 1 1 1. 

— Review  of  "  Leonardo  da  Vinci :  Quadcrni  d'Anato- 
tnica  V  e  VI,"  M.  Hall  and  K.  Sudhoff,  326. 

Surgeon  General's  Library,  Washington,  D.  G: 
Check  list  of  medical  incunabula  in,  1918,  301. 

Surgical  anaesthesia,  modern,  The  first  printed  docu- 
ments relating  to,  William  Osier,  329. 

Surgical  instruments,  Early.  In  "Notes  and  Queries," 
317- 

Sydenham,  The  sons  of,  J.  M.  Da  Costa  (1891),  154. 


Index 


441 


Sylvius,  Franciscus  Dela  Boe,  Charles  L.  Dana.  Edi- 
torial, 422. 

Syphilis,  congenital,  The  tubercle  of  Carabelli  and, 
Roy  L.  Moodie.  Editorial,  423. 

""Text  of  William  Shippen's  first  draft  of  a  plan  for 
the  organization  of  the  military  hospital  during 

the  revolution,  174. 
Three  characters  of  a  physician,   Enricus  Cordus 

(i486- 1 535),  53. 
Tractates,    Plague,    Dorothea    Waley    Singer,    and 

Reuben  Levy,  394. 
Tubercle  (The)  of  Carabelli  and  congenital  syphilis, 

Roy  L.  Moodie.  Editorial,  423. 

rjnited  States  Army,  Legislative  and  administrative 
history  of  the  medical  department  of,  during  the 
revolutionary    period     (1776- 1786),    William    O. 
Owen,  198,  261,  342. 


Wictor    Hugo,    The   medical   phrases   of,    Hubert 

Ashley  Royster,  412. 
Viets,  Henry:  A  patronal  festival  for  Thomas  Willis 

(1621-1675),  with  remarks  by  Sir  William  Osier, 

Bart.,F.  R.  S.,  118. 
Voltaire's    relation    to    medicine,     Pearce    Bailey, 

54. 
Voynich,  Wilfrid  M.  de,  and  Garrison,  Fielding  H.: 

Figurations  of  skeletal  and  visceral  anatomy  in 

the  Books  of  Hours,  225. 

\A/aIaeus,  The  experiment  of,  Job  Walaeus,  Epis- 
tolae  duae  (1640),  230. 

Willis,  Thomas  (1 621- 1675),  A  patronal  festival  for, 
with  remarks  by  Sir  William  Osier,  Bart.,  F.  R.  S., 
Henry  Viets,  118. 

World  history,  The  hygienic  idea  and  its  manifes- 
tations in,  Karl  Sudhoff,  translated  by  F.  J. 
Stockman,  in. 


A  WORD  FROM  THE  PUBLISHER 


WITH  the  completion  of  Volume 
one  of  the  Annals  of  Medical 
History,  the  publisher  desires  to 
express  his  appreciation  of  the  cooperation 
received  from  members  of  the  profession, 
whose  watch-word  is  "sacrifice,"  and  who,  in 
these  times  of  stress  have  added  new  lustre 
to  their  history  by  maintaining  the  best 
health  record  in  the  history  of  the  armies 
of  the  world. 

The  fact  that  the  first  number  of  the 
Annals  appeared  synchronously  with  the 
entrance  of  the  United  States  into  the  war 
was  due  entirely  to  the  hard  work  and 
enthusiasm  of  the  Editor,  Captain  Francis 
R.  Packard.  His  last  efforts  before  leaving 
for  duty  with  Base  Hospital  No.  16  in 
France  were  devoted  to  the  preparation 
of  the  first  number.  This  appeared  after 
he  had  entered  upon  the  arduous  duties 
which  he  is  still  carrying  on  at  the  front. 
To  suggestions  that  material  would  not  be 
forthcoming  and  that  subscriptions  would 
lag  on  account  of  the  war,  Dr.  Packard 
lent  a  deaf  ear.  The  four  numbers  now 
published  are  submitted  as  a  vindication 
of  his  judgment. 

Lieutenant  Colonel  Garrison  edited  the 
second  number.  Of  his  kindly  help  and 
suggestions  the  publisher  has  had  many 
opportunities  to  avail  himself  and  too  much 
credit  and  thanks  cannot  be  given  him. 

Beginning  with  the  third  number,  Dr. 
Charles  L.  Dana  of  New  York  City  assumed 
editorial  charge  of  the  Annals,  pending 
the  return  of  Dr.  Packard.  For  Dr.  Dana's 
willingness  to  add  to  his  duties  and  respon- 
sibilities at  this  time,  the  publisher  extends 
his  thanks  and  bespeaks  those  of  the  sub- 
scribers. 


To  the  Associate  Editors  thanks  are  due 
for  their  helpfulness  and  encouragement 
and  special  mention  must  be  made  of  Sir 
William  Osier,  who  has  found  time  not 
only  to  write  articles,  but  to  procure  them 
from  others. 

Captain  Charles  Singer  and  his  wife  have 
rendered  assistance  that  we  feel  will  be 
appreciated  not  only  by  the  readers  of  the 
Annals  of  Medical  History  but  by  all 
medical  men  of  both  America  and  England. 
Their  contributions  will  serve  to  cement 
further  the  bond  of  friendship  in  the  pro- 
fession of  the  two  countries. 

To  all  who  have  unselfishly  contributed 
their  papers  to  the  first  volume  of  the 
Annals  and  made  possible  its  completion, 
and  to  those  whose  subscriptions  have 
given  the  encouragement  necessary  for 
successfully  carrying  on  the  Annals,  the 
publisher  extends  his  heartiest  thanks. 
The  courtesy  and  patience  of  subscribers 
will  not  be  forgotten,  for  despite  delays  in 
publication,  they  have  had  nothing  but 
encouraging  words  for  the  Annals. 

With  the  return  of  peace,  it  is  hoped 
that  the  usefulness  of  the  publication  will 
be  demonstrated  in  such  a  fashion  that 
the  workers  whose  efforts  have  been  so 
generously  and  unostentatiously  given  will 
be  more  than  recompensed. 

Number    i    of  Volume  II   is  already  in 
hand  and  for  its  future,  the  publisher  so- 
licits the  continuation  of  that  collaboration 
which  has  made  Volume   I   possible. 
Paul  B.  Hoeber, 

Publisher. 

New  York, 

November,  Ninteen  Hundred  Eighteen. 


74S  -h 


BINDING  SECT.  APR     5  1966 


R 

11 
A85 

v.l 
Bioi.j 

-  dical 
Serials 


Annals  of  medical  history 


PLEASE  DO  NOT  REMOVE 
CARDS  OR  SLIPS  FROM  THIS  POCKET