The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913Osler, William, Sir
History
The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913
Osler, William, Sir
Medicine -- History
The early years of the century saw the rise of modern clinical medicine
in Paris. In the art of observation men had come to a standstill.
I doubt very much whether Corvisart in 1800 was any more skilful in
recognizing a case of pneumonia than was Aretaeus in the second century
A. D. But disease had come to be more systematically studied; special
clinics were organized, and teaching became much more thorough. Anyone
who wishes to have a picture of the medical schools in Europe in the
first few years of the century, should read the account of the travels
of Joseph Frank of Vienna.(10) The description of Corvisart is of a
pioneer in clinical teaching whose method remains in vogue today
in France--the ward visit, followed by a systematic lecture in the
amphitheatre. There were still lectures on Hippocrates three times a
week, and bleeding was the principal plan of treatment: one morning
Frank saw thirty patients, out of one hundred and twelve, bled!
Corvisart was the strong clinician of his generation, and his accurate
studies on the heart were among the first that had concentrated
attention upon a special organ. To him, too, is due the reintroduction
of the art of percussion in internal disease discovered by Auenbrugger
in 1761.
(10) Joseph Frank: Reise nach Paris (etc.), Wien, 1804-05.
The man who gave the greatest impetus to the study of scientific
medicine at this time was Bichat, who pointed out that the pathological
changes in disease were not so much in organs as in tissues. His
studies laid the foundation of modern histology. He separated the
chief constituent elements of the body into various tissues possessing
definite physical and vital qualities. "Sensibility and contractability
are the fundamental qualities of living matter and of the life of our
tissues. Thus Bichat substituted for vital forces 'vital properties,'
that is to say, a series of vital forces inherent in the different
tissues."(11) His "Anatomic Generale," published in 1802, gave an
extraordinary stimulus to the study of the finer processes of disease,
and his famous "Recherches sur la Vie et sur la Mort" (1800) dealt
a death-blow to old iatromechanical and iatrochemical views. His
celebrated definition may be quoted: "La vie est l'ensemble des
proprietes vitales qui resistent aux proprietes physiques, ou bien la
vie est l'ensemble des fonctions qui resistent a la mort." (Life is the
sum of the vital properties that withstand the physical properties,
or, life is the sum of the functions that withstand death.) Bichat is
another pathetic figure in medical history. His meteoric career ended
in his thirty-first year: he died a victim of a post-mortem wound
infection. At his death, Corvisart wrote Napoleon: "Bichat has just died
at the age of thirty. That battlefield on which he fell is one which
demands courage and claims many victims. He has advanced the science of
medicine. No one at his age has done so much so well."
Public-domain text, read in full here on John Shaqi.
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