Early eighteenth-century French medicine:
Setting the stage for revolution
EMIL F. FREY

I. Introduction: The State of the Art
Seventeenth-Century. Hiding their general ignorance behind a superfluous use of
Latin phraseology, medical practitioners in seventeenth-century France were
more sought after for their erudition than for any competence in curing their
patients. Indeed, the general outcome of the disease seems to have held less
importance in the eyes of society than did the manner in which the doctor acquitted
himself with his patient. Protocol became the sina qua non of the day.
The medical profession as a whole was awash on a crimson tide of phlebotomy as
bloodletting remained the prima facie treatment for all diseases. Labelling all
scientific discoveries heretical, medical men universally shunned any practice
which hinted at a modem approach. Led by Guy Patin, Dean of the Faculte de
medecine, medical practitioners became increasingly loyal to the status quo. Patin
was an inveterate advocate of venesection for every ailment known to mankind.
The extent of his prognostic skills can be found in his correspondence: 'Inflammation of the lung is always fatal to those who have red hair' 1 •
As long as the medical practice remained in the grip of Patin and his ilk, it was
bound to continue to be of little help to its patients. Health, however, was the
'summum bonum and men, women, and children sought it through prayers, stars,
kings, toads, and science' 2 •
On the other hand, medical research continued to forge ahead. Its adherents
formed a class unto themselves, however, and rarely crossed paths with the
pertinacious practitioners. Knowledge in the fields of anatomy, physiology and
chemistry was expanding and surgery slowly gained ground in both method and
status. In 1628 an Englishman, William Harvey, made the discovery that blood
circulates, but it would be many years before this breakthrough would become
accepted by the Faculte de medecine.
Eighteenth-Century. Appalling conditions in public sanitation and personal
hygiene resulted in widespread epidemics that continued well into the eighteenthcentury. Royal bodies proved to be no more immune to the ravages of disease than
did the bodies of commoners, as successive outbreaks of smallpox between 1712
and 1715 claimed the lives of three heirs to the French throne. Until 1723 the
government resided in the hands of a regent, Philippe, Duke of Orleans. Upon
assuming the throne at the age of2l, Louis XV, great-grandson of Louis XIV, found
a country basking in general prosperity, but with a growing influence of the
bourgeoisie.
C/ioMedica, Vol. 17no. l,pp. 1-13

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B.M. Israel, Amsterdam, The Netherlands
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Emil F. Frey

In spite of the nobility, the emerging bourgeoisie sought more freedom in the
conduct of their affairs, suppression of the privileges of birth and a share in the
formation of laws. Their increasing desires for parity brought on the cataclysmic
outburst in 1789. The French Revolution was to bring changes across the board in
French society and the medical profession was not immune to such sweeping
reforms. The class rivalry which culminated in the Revolution gave a great impetus
to intellectual life that resulted in a rage to learn throughout the country.
General scientific progress had a great impact upon medicine. Improvements in
the microscope and thermometer, the rise of chemistry and biology, and the
advancing knowledge of anatomy and physiology were all reflected in medical
research. Scientific thought flourished, doctors and medicine did not escape its
influence.
Many men of culture and achievement flourished, but so did quackery, and excessive bleeding and
blistering were not out of fashion ... There was still much pomposity and humbug, but medicine was
evolving from a craft to an art. A lot of eponymous pills and powders date from this time 3 •

There has always been a large degree of superstition associated with the
medicinal properties of drugs. In pursuit of good health, mankind has swallowed,
chewed, salved and rubbed with great dedication, an immense assortment of weird
and wonderfully vulgar substances, each replete with testimonials to its curative
powers. Many of these nostrums had their origins in medieval superstitions.
Mummy, unicorn's hom, and bezoars appealed to the imagination because of their unusual
character, but even the most commonplace substances might develop supposedly medicinal virtues
if they had unusual or gruesome associations. Usnea was a substance of this nature. It was moss;
not ordinary moss, but moss scraped from the skull of a criminal who had been hung in chains.
U snea was an official drug in the pharmacopoeia until the nineteenth-century; it was carried by all
apothecary shops, and the first edition of the Encyclopedia Britannica devoted a section to its
curative properties 4 •

Toward the middle of the eighteenth century, attempts were made to protect the
consumers of such pills, powders and potions. Registration of drug content was
required, prompted by the discovery that many cure-alls contained poison.
Thus, early-eighteenth-century medical practice continued to be a 'somewhat
barbarous affair, coming down to physic, emetic, broth, simples, poulticing, and
bleeding. Most maladies were attributed to inflammation of the blood, and there
were doctors who phlebotomized their patients to death' 5 •
Taken as a whole, eighteenth-century French doctors did not display a
preeminent amount of intelligence nor humanitarianism in the conduct of their
profession. With the state of the art in such a lamentable condition, it is little
wonder that medical practitioners were held up for ridicule by literary figures of the
day and almost universally condemned by the intellectuals. Voltaire is supposed to
have considered medicine to be both conjectural and murderous. He violently
denounced the popular remedies of his day and deplored the hospital conditions 6 •
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II. The Doctor in Literature and Drama
Doctors and medicine have been derided by literary figures from remote times
onward. The doctor has always been a familiar figure in literature. According to Sir
William Osler:
Many details relating to the character and to the life of physicians are gleaned only from secular
authors. So much of the daily life of a civilized community relates to problems of health and disease
that the great writers of every age of necessity throw an important sidelight, not only on the
opinions of the people on these questions, but often on the condition of special knowledge in
various branches ... The satire of Moliere, malicious though it may be, has preserved for us phases
of medical life in the seventeenth-century for which we scan in vain the strictly medical writings of
that period 7 •

Moliere. The seventeenth-century physician was criticized for 'his fees, his
pompous dress in gown, wig, and conical hat, his grandiloquent speech, and his
sometimes mortal mistakes' 8 • In the comedies of Moliere, the doctor becomes a
vehicle for social satire and is used to personify the foibles of a whole profession.
With great abandon Moliere laughs at the manners and customs of physicians of his
day, but above all it is the blind respect for ancient doctrines and their obstinate
refusal to accept modem medical discoveries that provide the most meat for the
playwright's knife.
The pedantic and ignorant figure of seventeenth-century satire entered the
eighteenth-century equally ill-equipped. The characterization, in pace with
emerging middle-class values, has taken on the overtones of a fashionable fop, but
as a physician he is just as impotent in the face of disease as were his seventeenthcentury ancestors.
He talks and reasons endlessly. The least occurrence, the most insignificant remark, incites in him a
flow of grandiloquent language, embellished with classical allusions or absurd maxims and
crammed with quibbling redundancies and heavy philosophic lucubrations. The pedantic drollery
of his speech is emphasized by ... the ponderous gravity with which he utters his sentences in
macaronic Latin 9 •

Frequently the words 'doctor' and 'assassin' were considered synonymous.
Indeed, in many characterizations, the physicians are strongly convinced that all
the ills of the body reside in the blood and in order to get to the bottom of a malady,
they eagerly drain their patients' blood to the last drop!
Le Sage. Inheritor of Moliere's satirical scalpel was Alain Rene Le Sage.
Educated at a Jesuit college in Brittany, Le Sage continued to study law in Paris.
Drawn to the literary salons of the city, he soon abandoned his legal career and
devoted himself instead to literature and the theater. In association with the
popular Theatre de la Foire, he wrote more than 100 comedies ridiculing the

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transgressions of Parisian society. But it is for his Histoire de Gil Bias de
San til lane that LeSage is best known today. Much praised by literary historians
as the first 'picaresque' novel, 'Gil Bias' contains many vivid caricatures of
eighteenth-century French physicians. Although several doctors appear throughout the novel, it is upon the character of Dr. Sangrado that Le Sage concentrates
his venom.
Set in Spain, 'Gil Bias' relates the adventures and education of a clever young
valet as he progresses from one master to another, always surpassing the skill of his
employer, be it amatory or medical. Although LeSage set his novel in Spain, it is
the French society that bears the brunt of his caustic pen. Dr. Sangrado (Spanish
for phlebotomist) indoctrinates Gil Bias with the finer aspects of medical practice,
his one remedy for all maladies being the forced drinking of water interspersed with
frequent bleedings. His apprentice becomes so adept that Sangrado limits his own
practice to the nobility and clergy, leaving the baser born among his patients to the
ministries of Gil Bias. During an epidemic both physician and valet compile an
identical record: 100 percent fatalities.
Character names were as important to Le Sage as they had been to Moliere.
Besides Sangrado, Gil Bias encounters Dr. Cuchillo (Spanish for knife). Dr.
Trousse-Galant (French for sure death) appears in Le Sage's comedy La
Tontine. Trousse-Galant was also an inveterate phlebotomist who thought it a
criminal offense to question the recommended remedies. As long as proper
protocol has been observed, a mere death concerns him little: 'A good doctor
always goes on in the old way and never resorts to methods that shock the
established principles' 10 .
Le Sage took advantage of every opportunity to ridicule the medical practitioners of his acquaintance. In La Foire des fees he writes the following
lines for Milloni: 'the doctors deserted their patients--and the, patients got well' 11 •
LeSage also anticipated the feminist movement oflater centuries. In The W or I d
Turned Upside Down he created a totally unknown creature of the eighteenth-century: a woman doctor! Women served as midwives but it was totally
unthinkable that one should venture into the all-masculine realm of the Faculte de
medecine!
Although Le Sage tended to populate his comedies with many vitriolic caricatures of doctors, it is the emaciated Dr. Sangrado that commands the most
attention. The good doctor's medical philosophy consists of two salient points:
bleeding and purging. This is abundantly evident in Sangrado's instructions to Gil
Bias, upon taking him as an apprentice:
Without more ado, I will initiate you in the healing art, of which I have for so many years been at the
head. Other physicians make the science to consist of various unintelligible branches; but I will
shorten the road for you, and dispense with the drudgery of studying natural philosophy, pharmacy,
botany, and anatomy. Remember, my friend, that bleeding and drinking warm water are the two

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grand principles; the true secret of curing all the distempers incident to humanity ... Here you have
the sum total of my philosophy; you are thoroughly bottomed in medicine, and may rise yourself to
the summit of fame on the shoulders of my long experience".

Armed with such profound expertise, Gil Bias proceeded to hang out his shingle!
Indeed, Gil Bias's first encounter with Sangrado sheds light on the medical
methods used by the physician. Learning of the patients' dietary practices which
consisted of nothing more frivolous than soup and gravy the doctor was aghast:
Soups and gravy! exclaimed the petrified doctor. Upon my word, it is no wonder you are ill... We
must have done with pampering our appetites: the more insipid, the more wholesome. The human
blood is not a gravy! Why, then, you must give it such a nourishment as will assimilate with the
particle of which it is composed 13 •

Treatment then began; the actual bleeding itself, however, being more
mechanical in nature, was vouchsafed to the hands of an assistant.
Sangrado then sent me for a surgeon of his own choosing, and took from him six good porringers of
blood, by way of a beginning ... He then said to the surgeon ... you will take as much more three
hours hence and tomorrow you will repeat the operation. It is a mere vulgar error, that the blood is
of any use in the system; the faster you draw it off, the better ... When the doctor had ordered these
frequent and copious bleedings, he added a drench of warm water at very short intervals, maintaining that water in sufficient quantities was the grand secret in the materia medica. He then took
his leave .... We set on the kettles in a hurry; and, as the physician had desired us above all things to
give him enough, we began by pouring down two to three pints at as many gulps. An hour after, we
beset him again: then returning to the attack time after time, we fairly poured a deluge into his poor
stomach. The surgeon, on the other hand, taking out the blood as we put in the water, we reduced
the old canon to death's door in less than two days 14 •

These methods appear fairly typical of the eighteenth-century physician. The
fact that they are not unduly exaggerated may be found by comparing the above
scene to actual instructions from a barber-surgeon's manual in use in Venice in the
late seventeenth-century.
Two veins in the hand are used for bleeding, one of which descending from the cephalic vein passes
to a point between the thumb and index finger. .. The other is commonly called the salvatelle ...
which ends between the little finger and the ring finger.
The first vein, coming down from the head, should be opened only where the cephalic vein joins
the trunk vein, or at the elbow; or in case of aversion such as I have observed in angina, before
letting blood from the hand as already mentioned and then under the tongue both for drawing off
matter from the head and for treating ailments of the mouth or face, or for the physician's other
purposes ... This incision can be made either in the right or left hand.
The second vein, as the salvatelle, is concerned in the left hand with affections of the spleen, and
in the right hand with affections of the liver. ..
But to bleed this vein well it is essential first for the attending barber to prepare hot water in which
the patient's hand is placed so that the heat swells it and the vein becomes more prominent. ..
After making the incision the hand is again dipped in hot water so that blood will flow more freely
instead of slowly ... When sufficient blood has been drawn off the wound is bound up (in a manner to
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Emil F. Frey
allow) that the coarse, impure blood which is putrefied and infected can escape while coarse and
impure blood retained at the opening will prevent escape of the fine healthy blood, which would
debilitate the patient, aggravate his illness and corrupt his humors, his health returning unless he
suffers a prolonged illness or dies ' 5 .

There were a few doctors who disagreed with the standing therapy of bloodletting. Le Sage was not unawar.e of their existence and recognized them in the
character of Dr. Cuchillo. Gil Blas, now practicing the healing arts himself,
encounters Dr. Cuchillo and the two cannot agree upon a program of therapy.
Thereupon the little pulse-counter set himself about reviewing the patient's situation; and after
having dilated to me on all the symptoms, asked me what I thought of the fittest method of
treatment. I am of the opinion, replied I, that he should be bled once a day, and drink as much warm
water as he can swallow. At these words, our diminutive doctor said to me, with a malicious
simper,--And so you think such a course will save the patient? Never doubt it, exclaimed I, ... it
must produce that effect. because it is a certain method of cure for all distempers ... I discover by
your language, said Cuchillo, the safe and sure method of practice Doctor Sangrado instills into his
pupils. Bleeding and drenching are the extent of his resources. No wonder so many worthy people
are cut off under his direction ... who, with all his arrogance and affectation is but a ninny! 16

The doctors of the time, wrapped up in their long cloaks of dogma, took themselves quite seriously. According to Ray and Max Kahn, 'They hotly resented any
infringement of their prerogatives. They chafed under criticism and were furious,
indeed, at those who ridiculed them. Better than most people, they knew that their
dignity hip a mass of ignorance, and that the impression they produced was due to
their flowing gowns and their pseudo-Latin jargon' 17 •
Before leaving 'Gil Blas', it is important to note that even the most perspicacious
valet is not immune from sickness, as Gil Blas himself became ill and sent for a
doctor.
The doctor came up to my bedside, felt my pulse, looked in my face, and, discovering undeniable
symptoms of approaching convalescence, assumed an air of triumph, as if it was all his handiwork,
and said there was nothing wanting but to keep the bowels open, and he flattered himself he might
boast of having performed an extraordinary cure. Speaking after this manner, he dictated a
prescription to the apothecary, looking in the glass all the time, adjusting the dress of his hair, and
twisting his visage into shapes which set me laughing in spite of my debility. At length he took his
leave with a slight inclination of the head, and went his way, more taken with the contemplation of
his own pretty person, than anxious about the success of his remedies 18 •

Beaumarchais. Continuing in much the same vein as LeSage, de Beaumarchais
created the 'valet extraordinaire', Figaro, in two comedies written in the latter half
of the eighteenth-century: The Barber of Seville and The Marriage of
Figaro. The operas based on these productions have surpassed their originals in
popularity. In both comedies a key character is Dr. Bartholo who has his roots in
the caustic characterizations of both Moliere and LeSage. Bartholomay be drawn
with a kinder pen but the addlepated doctor is still just as helpless in the face of
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disease as were his predecessors. Dr. Bartholo, however, is the last of his kind. As
the doctors themselves began to change, their literary portraits evolved with them
and showed a more humanitarian approach to characterization.
III. The Evolution of Medical Training

The doctors were only as good as their training allowed them to be. While
scientific discoveries were advancing, the medical schools of the time took little
note of such progress. Although a degree from a recognized institution was
generally required for the legal practice of medicine in the early eighteenth-century,
the training which went into obtaining the degree bore little resemblance to medical
training as we know it today. The faculties stubbornly resisted scientific discoveries, choosing instead to perpetuate the ideology of Galen and Hippocrates.
Surgeons continued to be thought of as mere menials by the Faculte de medecine
and not fit for their privileged company. Therefore, surgeons established their own
schools, the chief among them being Saint Come in Paris.
With such a universal acceptance of bleeding as the sole treatment for all
diseases, apprentices had to be trained in the unlikely art. Equipped with training
manuals such as the one discussed earlier, the students practiced their phlebotomatic skills on volunteers who made the rounds of the surgical schools, offering
to open their veins for a little financial remuneration.
The education of medical students slowly began to improve, but even so, the
faculties at the recognized institutions were limited to only a few professors. 'Each
teacher collected fees for his own course, and issued tickets of admission, sometimes on the backs of playing cards. Certain hospitals now began to teach clinical
medicine' 19 •
Prior to the seventeenth-century, there was no systematic clinical teaching. The
universities bestowed degrees on the basis of a spoken disputation. There was
virtually no contact with patients during the course of instruction. The University
of Leyden in Holland established clinical teaching in the 1630s. Hermann Boerhaave, appointed to the faculty at Leyden in 1701, became the first great clinical
teacher. His methods slowly found their way into the French universities.
N. Surgery Becomes Socially Acceptable
Seventeenth-Century. Surgery struggled throughout the seventeenth-century for
recognition as a reputable profession. Practitioners found themselves caught by the
hostility of the physicians and the envy of the barbers who, while under the control
of the Faculte de medecine, still performed some minor operations. Surgeons
frequently had trouble separating their art from that of the common barber, who,
'deft at wielding the razor, could serve for the ordinary task of opening a vein or
boil, and who could, on occasion, presume to essay major operations, such pre-

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Emil F. Frey

sumptions being limited only by the willingness of certain feudal lords to resort to
the gallows in rewarding unsuccessful operations' 20 •
In 1657 the barber-surgeons decided to amalgamate with the surgeons at Saint
Come. Such an action would remove them from the control of the Faculte de
medecine and at the same time strengthen the hands of the surgeons in their
quarrels with the doctors. Guy Patin was understandably not amused by this idea.
In fact, the very thought of a merger between the two groups of surgeons incurred
his wrath and he made his feelings abundantly clear:
We are now at war with our barber-surgeons who wish to unite with the surgeons of Saint Come ...
(those of Saint Come) are miserable rascals, nearly all tooth-pullers and very ignorant. .. and they
would make for us, doctors ... (ignorant of Latin), who would not know even how to read or write .. .
We would only have a company of barber-surgeons ... which would be dependent on our Faculte .. .
and pay us every year a certain sum for the rights which we have in their functions. But we do not
wish robes, bonnets, licenses, nor any similar abuses 21 •

In 1660 the merger was enacted over the protests of Patin. By 1667, however,
Patin had acquiesced and the one guild was placed under the authority of the
Faculte de medecine. The officers of the guild were instructed to appear before the
Faculte each year on the day after the feast of Saint Luke to take the customary
oath. This practice continued until the Assembly abolished all faculties on 18
August 1792.
The status of surgery was assured by a successful operation on Louis XIV in 1686
to remove a fistula. 'Many of the courtiers, although not suffering from any trouble
of a similar nature, insisted on submitting themselves to a like operation in order to
show their submissive devotion to their royal master' 22 • In recognition of his
service, the surgeon received 15,000 louis d'or, a country estate, and a patent of
nobility. From then on surgery became socially acceptable.
Eighteenth-Century. In 1724 Louis XV granted five professorships in surgical
instruction to the College of Saint Come. This was more than the Faculte was
willing to accept.
Decked out in their scholastic robes, the physicians, headed by the dean of the Faculty, preceded
by a beadle and an usher, marched to Saint Come in solemn array, in spite of the bitter cold weather,
the snow and sharp sleet, which made their red robes almost unrecognizable. Cheering one another
on with great cries and oaths and followed by a great crowd of people, they at length ranged
themselves in a long line against the wall, while the dean presented himself at the door of the college
accompanied by the only anatomist of the Faculty, who stood behind him holding a skeleton. Cries
and imprecations, knocks and threats to break down the door, were only greeted by the jeers of the
students from within ... the people suddenly turned and drove the doctors away without regard for
their furs and costly raiment 23 •

Dentistry joined the ranks of surgery as a separate art in 1728, and in 1743 the king
issued an ordinance that freed the surgeons from the guild of barbers and wigmakers. The ordinance also required a college degree as a prerequisite to surgical
practice. At last surgery had come of age in France and Paris became the surgical
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center of the world. While Voltaire was quick to criticize doctors, he had great
respect for surgery and referred to it as the most useful of all the arts.
V. Making an Anatomy

Two powerful prejudices were operating against the surgeons in their struggle to
win parity with the physicians. One was the opposition to any type of manual labor
or anything that smacked of it and the other was a feeling of revulsion against
anything associated with corpses. In order for the medical arts to advance, there
had to be a greater knowledge about the human anatomy. Even though courses of
anatomy soon began to be taught at the universities, subjects for dissection were
nearly impossible to obtain.
Only the bodies of executed criminals were allowed to be dissected and the Dean
of the Faculte de medecine was the sole legal owner of all such objects. Pitched
street battles frequently occurred following an execution to determine who would
obtain the body.
The Place de Greve would swarm with students come from surgeons, barbers, and physicians ...
Hardly was the breath out of the wretch's body when the scaffold was carried by storm. A hideous
game of football would be played through the streets, the goal being some surgeon's shop, which
when reached was instantly barricaded against the enemy 24 .

Sometimes the surgeons and physicians were on speaking terms. Then, following
an execution, the body of the criminal was brought to the Faculte and both surgeons
and physicians took part in a 'Ceremony of Making an Anatomy'. Since manual
work was beneath the dignity ofthe medical professors, the actual dissection was
performed by a barber-surgeon while the professor lectured to the audience. But it
soon became apparent that the barber-surgeons were better informed than their
masters ofthe Faculte.
Medical students continued to have difficulty obtaining subjects to study. Many
dissections took place near graveyards as the students were forced to rob graves for
corpses to dissect. A startling new business began to develop which caused the
sentiments of the public to be even more strongly opposed to dissection.
Grave-robbing finally developed into a profession and men known as "resurrectionists" made a
business of supplying medical schools. This practice eventually led to murder as a means of
obtaining bodies. To avoid the incentive of crime, laws were enacted in the nineteenth-century to
provide medical schools with unclaimed bodies 25 •

Nevertheless, anatomical studies did Improve which in tum aided the
advancement of medical sciences. In Italy, Giovanni Battista Morgagni, professor
of medicine at Padua, kept clinical records of all cases under his care. Numbering
around 700, their publication in 1761 founded the discipline of pathological

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anatomy. Hospitals were no longer reluctant to provide cadavers for his work and
he carried on his experiments without protest from church or state.
VI. Conclusions: Setting the Stage for Revolution

As the eighteenth-century progressed, the medical sciences advanced slowly.
Once the overwhelming influence of Guy Patin and the Faculte de mectecine began
to give ground, new medical discoveries found their way into acceptance. The
doctors as a whole became less pedantic and more cheerful. Efforts were made to
improve public sanitation and hospital care. Phlebotomy was beginning to give
ground as the major treatment. Medicine was still full of quackery and mysticism
but progress was being made in the areas of anatomical research and physiology.
Medical schools were becoming more thorough and unlicensed practice was fading
away. In short, the early part of the eighteenth-century saw an attempt to put things
in order in anticipation of a number of major medical discoveries that took place in
the second half of the century. But in order for these discoveries to be accepted,
public attitudes had to be changed.
Perhaps the best example of the new doctor who was emerging in the early part of
the eighteenth-century can be found in Theodore Tronchin. He was a student of
Boerhaave at Leyden and practiced for twt:nty years in Amsterdam. In 1749, while
practicing in Geneva, he introduced inoculation for smallpox to his patients which
met with great success. Although inoculation had been known and practiced for
many years in Eastern countries, the preventive measure was slow to gain
recognition and acceptance in England and on the Continent. Invited to Paris in
1756, Tronchin inoculated the children of the Duke of Orleans. Parisians were
amazed at such courage, but soon were flocking to him for inoculation against the
dread disease.
Tronchin's methods soon found rapid acceptance in other areas as well. He 'told
his patients to take less mediCine and more exercise in the open air, to eat simple
foods, to bathe more frequently, to wash in cold water, discard their wigs, nightcaps, and bed curtains, and retire and rise at an early hour. He startled the court of
Versailles by ordering the windows of the palace ... to be opened at least part of
every day, even in winter' 26 •
Tronchin was very much the fore-runner of modem medicine. Only a few years
earlier his ideas would have gained little acceptance and he would have been
branded a heretic. But as medicine continued to evolve, his methods became more
widely accepted. Tronchin returned to Geneva. Voltaire, during a sojourn in
Geneva, placed himself under Tronchin' s care, praising him highly.
Although perhaps the greatest medical achievement in early eighteenth-century
France was the acceptance of surgery as a reputable branch of medicine, the
practice itself was shedding much of its dogma. Comparing Tronchin with Patin, it
is possible to see how far medical science had come. No longer would a Gil Bias find
it possible to practice medicine without any formal training; nor would he be likely
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to find a Dr. Sangrado draining the last drop of blood from his patients. Although it
still was practiced, phlebotomy was declining in popularity. Finally, it can be said
that patients were beginning to recover with their doctor's help instead of in spite of
it.

NOTES
I. Patin to Andre Falconet, 26 October 1658, quoted in Francis R. Packard, Guy Patin and the Medical
Profession in Paris in the XVlith Century. New York, Paul B. Hoeber, 1924, p. 257.
2. Will and Ariel Durant, The Age of Louis XIV. New York, Simon and Schuster, 1963, p. 525.
3. H.S. Carter, Medicine and Literature. In: Glasgow Medica/Journal. 30, 1949,525.
4. Howard W. Haggard, Devils, Drugs, and Doctors. New York, Harper & Brothers, Publishers,
1929, p. 327.
5. Christine E. Petersen, The Doctor in French Drama 1700-1771. New York, Columbia University
Press, 1938, p. 113.
6. Ibid., p. 107.
7. William Osler, Physic and Physicians as Depicted in Plato. In: Boston Medical and Surgical
Journal. 128, 1893, 129.
8. Durant, The Age of Louis XIV, p. 528.
9. Petersen, The Doctor in French Drama, p. 5.
I0. Alain Rene LeSage, La Tontine, comedie en un acte (sc. 3). In: Recueil des pieces mises au theatre
franr;ais. Vol. I. Maestricht, n.p., 1774, p. 368.
II. Alain Rene LeSage, La Foire desjees (act I, sc. 9). In: Oeuvres choisies. Vol. 14. Paris, n.p., 1783,
p. 273.
12. Alain Rene Le Sage, The Adventures of Gil Bias of Santillane. Trans. Tobias Smollett, vol. I.
Philadelphia, J.P. Hom and Co., 1930,pp. 101-2.
13. Ibid., p. 93.
14. Ibid., pp. 94-95.
15. Cintio d'Amato, On the Correct Method of Making Incisions in Veins of the Hand, and on Their
Treatment. Trans. J .F. Smith, in: Source Book ofMedical History. Comp. Logan Clendening. New
York, Dover Publications, Inc., 1960, pp. 285-87. Quoted passage is from Chapter XIX of Amato's
Prattica nuova, et utilissima di tutto quello, ch' al diligente barbiero s' appartiene. Venetia, Battista
Brigna, 1669.
16. LeSage, TheAdventuresofGilBlas. Vol. l,pp. 106-7.
17. Ray G. and Max Kahn, Quixotic Medicine. In: Medical Life. 33, 1926, 174.
18. LeSage, The Adventures of Gil Bias. Vol. 2, pp. 272-73.
19. Will and Ariel Durant, The Age of Voltaire. New York, Simon and Schuster, 1965, p. 592.
20. Petersen, The Doctor in French Drama, p. 57.
21. Patin to Spon, 13 July 1657, quoted in Packard, Guy Patin, pp. 242-43.
22. Ibid., p. 277.
23. Emile Forgue, Chirurgiens et Medecins. In: Montpellier Medical. 33, 1911, 10-11.
24. James William Barlow, Doctors at War. London, David Nutt, 1914, pp. 20-21.
25. Haggard, Devils, Drugs, and Doctors, p. 149.
26. Durant, The Age ofVoltaire, p. 601.

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12

Emil F. Frey

Fig. 1. David de Planis Campy, Discours de laphlebotomie. Paris, 1621. Title page .
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Early eighteenth-century French medicine: Setting the stage for revolution

Fig. 2. Gideon Harvey, Ars curandi morbos expectatione. Amstelodami, 1695. Frontispiece.

13

Fig . 3, 4, 5 . Cintio d' Amato, Prattica nuova. Venetia,
1669. Pages 14,26, 28.

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J.-M. Charcot et Paul Richer

J.-M. Charcot et Paul Richer

Les difformes et les malades
dans l'art

Les demoniaques dans l'art

Reprint of the edition Paris, 1889.
4to. 87 text -illustrations (partly renewed)
(VIII, 162 pp) . Cloth binding.

Reprint of the edition Paris, 1887.
4to. 67 text-illustrations (partly renewed)
(116 pp) . Cloth binding.

ISBN 90.6078.059.0

ISBN 90.6078.060.4

Hfl90,-

Hfl80,-

Medicine and Art

Charcot was a talented artist; he
collaborated with. Richer, artist at
'La Salpetriere', the greatest clinic of his
time for diseases of nervous system, in the
production of interesting books on disease
and deformity as portrayed by artists,
books which have put the study of
medicine in relation to art upon a sound
footing .

(Garrison & Morton nr. 660516; Semelaigne,
Les Pioniers de la psychiatrie
Jranfaise II, pp. 716-725 ;
Garrison, Contributions pp. 82617)

Both books together

Hfl150,-

B. M. ISRAEL BY.
N .z. Voorburgwal 264
AMSTERDAM

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Evolution de l'histologie du systeme nerveux
au XIXe siecle;
1' impulsion donnee par Camillo Golgi
( 1844-1926)*
GEORGETTE LEGEE

SUMMARY
Fontana had been studying the structure of nerves by method of dissociation and with the use of a
microscope since the end of the XVIIIth century. The imperfect instruments, however, only
permitted no more than crude observations. As regards the microscopic structure of the nerve
centres, the methods which had been used by Schneider and Schwann to constitute the cell theory
from 1832 and onwards, were not sufficient to reveal the existence of specific cells in the middle of a
ganglion. The nerve cell became perceptible for the first time in 1847 (Remak, Helmholtz, Wagner),
as a result of an improvement in the dissociation ofthe nerve substance.
But the histology of the nervous system has substantially been the result of the work in the second
half, and moreover the last quarter of the 19th century. The method of dissociation was improved
by Deiters, while the application of thin section by Stilling made it possible to elucidate the
structure of the fibre as well as the structure of the nerve cell and of the neuroglia(Ranvier). But the
breakthrough was due to the method discovered by C. Golgi (1873). The use of his method
permitted the establishment of the individuality of the nerve cell (Ramon y Cajal), to which
Waldeyer gave the name of neurone. The letters of A. Kolliker to C. Golgi revive this period of great
progress in the histology of the nervous system, but also depict the essentially humane character of
C. Golgi.

L' anatomie microscopique des organes du systeme nerveux est dominee par des
preoccupations physiologiques. La connaissance des elements du tissu nerveux,
cellules et fibres, va permettre de concevoir l'arc reflexe avec ses voies centrifuges
et centripetes et ses organes centraux representes par les corps cellulaires. Les
relations fonctionnelles entre la moelle epiniere et Ies differents organes de
l'encephale, ainsi que les interactions entre les differents centres encephaliques
necessitaient une connaissance rigoureuse des relations anatomiques entre les
multiples fibrilles nerveuses et les corps cellulaires. II fallait demeler une structure
qui apparaissait inextricable dans un tissu ou les premieres methodes de coloration
restaient infructueuses.
Vers Ia fin du l8e siecle, les premieres observations microscopiques concement
essentiellement le systeme nerveux peripherique. Elles sont dues a Felix Fontana
(172{}...-1805) et sont liees au probleme physiologique du retour de l'irritabilite et de
la fonction d'un nerf quelque temps apres sa section. Mais il ne s'agit encore que de
nerfs, c'est-a-dire de paquets de fibres non individualisees.
ClioMedica, Vol. 17no. l,pp. 15-32

0

B.M. Israel, Amsterdam, The Netherlands
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16

Georgette Legee

Vers Ia meme epoque Vicq d'Azyr (1748-1794) comparait des coupes macroscopiques de centres nerveux aux observations recueillies par Ia dissection de ces
memes organes. Et, s'il avait recours au microscope, l'imperfection de cet
instrument ne permettait pas d'obtenir des renseignements precis concernant Ia
structure fine des centres nerveux 1 •
Les veritables methodes histologiques vont naitre en meme temps que l'apparition du microscope achromatique, et leurs perfectionnements successifs seront
lies aux progn!s de l'optique et de Ia chimie des matieres colorantes. Aussi l'Allemagne jouera-t-elle un grand role dans !'impulsion donnee aux premieres
recherches.
Au point de vue histologique pur nous distinguerons une premiere periode
pendant laquelle s'elabore Ia connaissance des elements du tissu nerveux: Ia fibre
nerveuse, Ia cellule nerveuse et ses prolongements, Ia cellule nevroglique ou
araignee. Les recherches aboutissent au schema morphologique de Ia cellule
nerveuse donne par O.F.K. Deiters (1834-1863). C'est alors que s'edifient des
theories ou !'imagination se mele aux observations.
II faudra attendre Ia seconde periode qui commencera par Ia decouverte de C.
Golgi (1843-1926) pour que l'histologie du systeme nerveux prenne vraiment son
essor grace a l'observation rendue possible des connexions intercellulaires. Des
lors l'histologie sera capable de rendre de grands services a Ia physiologie.
Premie're periode

Elle est caracterisee par le perfectionnement de Ia methode des dissociations:
dissociation mecanique par de fines aiguilles, et dissociation chimique par le
ramollissement du tissu interstitiel formant 'ciment' entre les cellules nerveuses,
sous !'action de substances chimiques. Le microscope achromatique peut alors
reveler des elements de Ia substance blanche et de Ia substance grise. C'est ainsi
qu 'en 1833 C. G. Ehrenberg ( 1795-1876) examine des nerfs dissocies et decouvre Ia
fibre a myeline. En 1847 R. Remak (1815-1865), A. Hannover (1814-1894), H. von
Helmholtz (1821-1894), R. Wagner (1805-1876) etc. utilisent Ia meme methode sur
les ganglions et Ia pulpe grise des centres; Ia cellule nerveuse, isolee pour Ia
premiere fois, les frappe par son aspect generalement multipolaire. Au moment de
cette decouverte tous les prolongements de Ia cellule semblent equivalents. Mais
bientot, R. Wagner, etudiant les corpuscules geants du lobe cerebral electrique de
Ia torpille observe qu 'un seul prolongement est tres long et possede Ia structure
propre aux fibres nerveuses. Remak fait Ia meme observation sur les cellules
multipolaires de Ia moelle epiniere et du cerveau du boeuf.
Mais, c'est en 1865 que O.F.K. Deiters, grace a sa methode de dissociation par
des solutions faibles de bichromate de potassium, peut generaliser, a toutes les
cellules 'ganglionnaires', eta tousles vertebres, Ia dualite anatomique et fonctionnelle des prolongements cellulaires. Toute cellule nerveuse multipolaire possede
done deux sortes de prolongements:
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Evolution de l' histologie du systeme nerveux au XIXe siecle

17

l. un prolongement fin, lisse, non ramifie, se continuant par un tube nerveux;
c'est 'le cylindre de !'axe' (Achsencylinderlortsatz);
2. des prolongements multiples, courts, epais, acontours raboteux, tres ramifies,
qu'il appelle protoplasmiques.
Deiters decouvre aussi Ia cellule nevroglique qui ne possede pas de 'cylindre de
I' axe'. Les histologistes qui suivront, me me quand ils traiteront Ia substance grise
de vertebres tres divers par des procedes plus delicats de dissociation ou par Ia
methode plus parlaite des coupes fines et transparentes due aRolando (1773-1831)
et Stilling (1810-1879) auront fort peu a ajouter au schema morphologique de Ia
cellule nerveuse, tel qu'il est dessine par Deiters. Tels seront les cas de: J. Henle
(1809-1885), A. von Kolliker (1817-1905), J. von Gerlach (1820-1896), Max
Schultze (1825-1874), Th. Meynert (1833-1892), L. Ranvier (1835-1922), G.A.
Schwalbe (1844-1916), etc ...
Les travaux de Deiters ouvrirent Ia voie a des hypotheses gratuites. Lui meme
admit comme une possibilite, que des fibres fines pouvaient naitre du contour des
prolongements protoplasmiques. Cette idee incita Gerlach a concevoir sa theorie
des reseaux, theorie erronee qui allait exercer une influence nefaste sur Ia direction
des recherches anatomiques. Elle etait ainsi con~;ue: les prolongements protoplasmiques se resolvent en un reseau de mailles sern!es comprenant les corps
cellulaires de Ia substance grise; les travees du reseau se n!unissent a nouveau pour
former des fibres de Ia substance blanche se continuant avec les tubes nerveux. Les
tubes nerveux ont done une double origine: l'une directe, Ia cellule nerveuse, et
!'autre indirecte, le reseau protoplasmique interstitiel.
Cette theorie recueillit de nombreux adeptes. Mais ni Max Schultze, ni Henle
n'avaient observe les pretendues anastomoses de Gerlach; ils ne se laisserent pas
aveugler.
Une autre theorie, aussi fausse et basee sur une illusion d'optique plus grossiere,
fut celle de E. Harless ( 1820-1862) qui pretendait a voir observe le cylindre-axe des
grandes cellules du lobe electrique de Ia torpille sortir du noyau. Et cette theorie eut
aussi ses adeptes, tant il est vrai que 'Moins les methodes de travail et d'analyse
soot peiiectionnees, plus sont puissantes et nombreuses les theories.'

Deuxieme periode
L'apparition de ces theories repondait a un besoin d'explication que meme les
methodes des coupes minces, qui se perlectionnaient, etaient incapables de
foumir. Excitabilite, conductibilite etaient des proprietes essentielles du systeme
nerveux que Ia physiologie experimentale mettait en evidence avec de plus en plus
de precision. II etait necessaire pour etablir le pont entre physiologie et histologie
de savoir exactement comment prenaient naissance les axones essentiellement
conducteurs, comment leurs arborisations terminales entraient en relation avec les
cellules nerveuses voisines, que! role jouaient les prolongements protoplasmiques
(role trophique ou conducteur d'influx). II fallait mettre en evidence les connexions
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18

Georgette Legee

microscopiques qui permettaient le passage des influx sensitifs et moteurs.
Ce fut Camillo Golgi qui, en 1873, decouvrit Ia methode qui allaitjeter une vive
lumiere sur ces differents problemes. Cette decouverte spectaculaire frappa tous
les esprits. S. Ramon y Cajal (1852-1934) se plait a Ia rapporter:
Un marceau de tissu nerveux trainait de puis quelques jours, durcissant dans du liquide de Muller
pur ou melange d'acide osmique. Distraction d'histologiste ou curiosite de savant, le voila immerge
dans un bain de nitrate d'argent. Les aiguilles rutilantes, aux reflets chatoyants d'or, attirent
aussitot l'attention. On le sectionne, on deshydrate ces coupes, on les eclaircit, on les regarde.
Spectacle inattendu! Sur un fondjaune d'une translucidite parfaite, apparaissent, clairsemes, des
filaments noirs, lisses et minces, ou epineux et epais, des corps noirs, triangulaires, etoiles,
fusiformes! On dirait des dessins ii /'encre de Chine sur un papier transparent du Japon. L'oeil,
habitue aux inextricables lacis des coupes au carmin eta l'hematoxyline ou I' esprits· efforce en des
prodiges de critique et d'interpretation toujours en suspens, est deconcerte. lei, tout est simple,
clair sans confusion. II n'y a plus a interpreter, il n'y a qu'a voir et constater cette cellule aux
multiples branches, rameuses, couvertes de givre, embrassant de leur ondulations un espace
etonnamment grand; cette fibre lisse et egale qui nee de Ia cellule, s'en eloigne a des distances
enormes, et, tout a coup, s'epanouit en une gerbe d'innombrables fibres bourgeonnantes; ce
corpuscule confine a Ia surface d'un ventricule, d'ou il envoie une tige se ramifier jusqu'a Ia surface
de l'organe; d'autres cellules etoilees, comme des comatules ou des phalangides. Emerveille, l'oeil
ne peut se detacher de cette contemplation. Le reve technique est realise! L'impregnation metallique a fait cette dissection fine, inesperee. C'est Ia methode de Golgi. Elle porte le nom du savant
professeur de l'Universite de Pavie, qui, le premier, en 1873, Ia publia 2 •

Cette reaction exclusive du nitrate d'argent sur le bichromate de potassium au
sein des cellules nerveuses rendait !'analyse anatomique facile et source dejoie, et
Golgi peut rapidement completer le schema morphologique de ces cellules. II ecrit:
I. Les expansions protoplasmiques se terminent par des extremites libres.
2. Toute cellule nerveuse possede un cylindre-axe qui, pendant son trajet, emet
des fibrilles collaterales ramifiees coup sur coup.
3. L'anatomie du cylindre-axe permet de distinguer deux types de cellules nerveuses: le premier type pourvu d 'un cylindre-axe qui, tout en emettant des fibrilles
collaterales conserve son individualite dans Ia substance blanche ou les racines
motrices de Ia moelle ou il se porte; et le second type muni d'un cylindre-axe qui
perd vite son individualite, se resolvant immediatement, dans Ia substance grise ou
il est ne, en une arborisation terminale. Les conformations devinrent aussitot
unanimes (Ramon y Cajal, W. His (1831-1904), Kollikeretc.)
En realite !'oeuvre de Golgi, comme celle de Deiters, presente deux parties:
l. La methode et les faits, creations fecondes accueillies avec enthousiasme;
2. !'interpretation, toute impregnee du milieu scientifique de l'epoque ou
!'influence de Gerlach etait encore puissante. Aussi Golgi admet-ill'existence d'un
reseau interstitiel dans Ia substance grise. II soutient que les prolongements protoplasmiques ont un role nutritif et qu'il existe deux sortes de cellules nerveuses
correspondant aux cellules sensitives et matrices.

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Evolution de l'histologie du systeme nerveux au X/Xe siecle

19

La correspondance de A. von Kolliker a C. Golgi, de mai 1887 a mai 1905, reflete le
climat de l'epoque et fait ressortir Ia valeur de !'oeuvre de C. Golgi. Le 3 mai 1887
Kolliker ecrit:
Tres honore collegue!
Permettez-moi de vous presenter mes meilleurs remerciements pour vos belles preparations du
systeme nerveux. Je n'ai encorejamais vu de si belles cellules nerveuses etje vous felicite d'avoir
trouve une methode qui permet de mettre en evidence leurs prolongements si clairement.

Et, le 22 mai, Kolliker fait part des premiers resultats qu'il vient d'obtenir avec Ia
methode de Golgi:
Je vous felicite d'avoir decouvert et introduit dans Ia science, cette belle methode, qui avec celle
de Weigert-' marque une nouvelle epoque dans l'anatomie microscopique du systeme nerveux
central.
J'ai de suite essaye votre methode sur un cerveau d'un cheval et le cervelet humain dont je
possedais des pieces durcies dans le liquide de Muller' et les deux ont donne de belles preparations.

Mais Kolliker adresse aussi quelques critiques:
Mais vous ne me prendrez pas en mal, si tout en acceptant vos decouvertes,je ne puis etre d'accord
avec vous dans toutes vos conclusions. Je suis de !'avis, que les prolongements protoplasmiques
sont tous de nature nerveuse ... En sus je n'ai pu acquerir Ia conviction de !'existence de votre
plexus nerveux ... Ne veuillez pas me prendre en mal, sije ne puis etre d'accord avec vous sous tous
les rapports. Vos me rites dans ce departement sont si grands qu'un peu d'opposition ne peut que les
faire ressortir plus encore.

S. Ramon y Cajal (1852-1934) fut le premier a utiliser largement Ia methode de

Golgi, ala perfectionner eta s'opposer energiquement a Ia conception d'un reseau
interstitiel. II appliqua la methode de Golgi au systeme nerveux d'embryons et
Kolliker loue cette initiative (lettre a Golgi du 12 mai 1890). Des 1888, Ramon y
Cajal pouvait donner les conclusions suivantes:
l. Qu'il s'agisse de ramifications finales de cylindres-axes, de collaterales de
cylindres-axes ou de prolongements protoplasmiques, dans tous les cas ce sont
toujours des branchilles lib res qui forment les terminaisons. La cellule nerve use
avec tout !'ensemble de ses divisions et subdivisions constitue done une individualite absolument independante, et pour employer /'expression de Waldeyer 5 nous
I' appellerons neurone.
2. Cette parfaite liberte de l'extremite terminale du cylindre-axe, nous Ia
constatons aussi et avec la demiere evidence, pendant la periode embryonnaire,
dans le cone de croissance.
3. Libres, les ramifications terminales ne s'unissent done point a d'autres
ramifications nerveuses. Non, elles s'appliquent purement et simplement, par
contact, sur le corps ou sur les expansions protoplasmiques d'autres elements
cellulaires.
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20

Georgette Legee

4. Les courants nerveux, au passage d'une cellule al'autre, se transmettentdonc
des fibres nerveuses de l'une au protoplasma cellulaire de l'autre. Et quoique cela
soit contraire a l'opinion dominante, nous declarons que, lui aussi, ce protoplasma
cellulaire, qu' il appartienne au corps ou aux prolongements dendritiques, jouit de la
faculte de transporter l' ondulation nerveuse; ce n' est done point un simple appareil
de nutrition 6 .
5. Les nerfs sensitifs et sensoriels ne naissent pas dans les centres. Leur origine,
ainsi que His la signala naguere, est dans les cellules ganglionnaires extracentrales. Partis de la, les cylindres-axes, assembles en nerfs, arrivent aux centres
et s'y bifurquent chacun en deux branches, l'une ascendante, l'autre descendante.
De ces branches se detachent de nombreuses collaterales allant envelopper le corps
des neurones moteurs et d'association.
6. Le cylindre-axe d'un grand nombre de cellules nerveuses centrales se bifurque de meme lorsqu'il parvient ala substance blanche, et, en certains cas, il peut
aller jusqu'a donner trois tubes et plus destines a des regions blanches differentes.
Grace ala methode de Golgi, originale ou modifiee en double impregnation par
Ramon y Cajal, de nombreux histologistes confirment les resultats precedents.
Bientot, il ne reste plus rien des reseaux de Gerlach. De plus, Retzius et Lenhossek
constatent la similitude morphologique des neurones de vertebres et d'invertebres 7 •
Ainsi les decouvertes vont se multiplier et reveler la structure intime du cerveau
du cervelet, du bulbe rachidien et de la protuberance annulaire, du bulbe olfactif, de
la moelle epiniere, des ganglions rachidiens et sympathiques etc.
Kolliker, A. van Gehuchten (1861-1914), sont parmi les investigateurs les plus
celebres. Mais Kolliker tient a valoriser les travaux de C. Golgi. Le 26 mai 1890, il
l'engage a publier ses travaux sur la moelle epiniere, qui ne sont pas connus. Illui
fait remarquer que ses travaux, publies dans de nombreuses petites revues, sont
impossibles a trouver a l'etranger.
Le lendemain, ayant re~u de Golgi ses Studi istologici sul midollo
spin ale de 1881 , il est surpris de la richesse de ces travaux et lui ecrit:
C'est done malheureusement votre faute, si moi et d"autres ont attribue a Ramon y Cajal
beaucoup de choses qui vous appartiennent.
Maintenant queje suis en possession de ce travailj'en traduirai les principaux passages pour mon
memoire sur Ia moelle epiniere, qui en somme ne sera pas beaucoup plus qu'une confirmation de
vos decouvertes ...
Sije suis bien oriente,je ne puis attribuer rien d'autre a Ramon y Cajal que Ia description detaillee
de Ia bifurcation des fibres sensitives. Quant a ses collaterales, vous les avez deja vues. Ai-je raison
en cela? Ou auriez-vous deja decrit ces bifurcations ailleurs? (27 mai 1890).

A nouveau le 2janvier 1891, Kolliker re($oit trois brochures de Golgi sur le Tractus
olfactif (1882), le bulbe olfactif ( 1875) et la retine du cheval ( 1872). Et, a nouveau il
lui demande de cesser de publier ses travaux dans des revues qui ne sont pas
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Evolution de l' histologie du systeme nerveux au XIXe siecle

21

repandues et connues. 'N ous ne pou vons pas no us abonner a to us vos joumaux et il
sera necessaire de vous concentrer a ou on deuxjoumaux.' 'Heureusement', dit-il,
'vous avez maintenant votre Anatomischer Anzeiger de Siena', c'est-a-dire II
Monitore Zoologico Italiano fonde en 1890.
Le 15 mars 1894, Kolliker entretient Golgi de la parution prochaine de la
traduction allemande de ses ouvrages. La faculte de Wiirzburg serait fiere d'etre
citee par Golgi dans sa preface 8 •
En 1896, Kolliker acheve le second volume de Ia 6e edition de son Histologic. A
plusieurs reprises il rend hommage a Golgi:
J'espere que vous trouverez que le nom de Golgi est toujours pour moi un nom venere etqueje lui
rend honneur autant que possible. ( 16 janvier 1896).
Vous trouverez votre nom a beau coup d'endroits et vous verrez queje vous regarde comme celui
qui a le premier ouvert Ia voie pour une comprehension vraie de Ia structure si compliquee du
Cerveau et je n 'ai besoin que de nommer le bulbe olfactif, Ia couche grise de cerveau et Ia Come
d' Ammon pour rappeler vos grandes decouvertes. (15 juillet 1896).

C. Golgi cootie a !'appreciation de Kolliker tous ses nouveaux travaux. Le 12
octobre 1798, Kolliker repond:
J'ai re<;u et lu avec un interet bien vifvotre nouveau travail sur Ia structure des cellules nerveuses
[II s'agit de sa decouverte de l'appareil rhiculaire interne]. Malheureusement le mot de l'enigme
m'echappe aussi et il faudra pour le moment se contenter d'observer avec attention et sans arriere
pensee.

Et, le 14 mai 1900, il prie Golgi de lui quelques preparations:
... j'ai encore une grande faveur a vous demander, savoir de m'envoyer des preparations del
reticolo interno des cel/ules des gang/ions spinaux, des cellules de Ia moelle et des cellules de
Purkinje et des ce/lules pyramidales du cerveau. Rieffini e Giacomini m'ont aussi promis de leurs
preparations, ainsi que Negri et Pens a e Marenghi et peut etre votre influence sur ces collegues les
obligerait de ne pas oublier tout a fait. .. Quant a votre apparato reticolare je suis de l'avis qu'il faut
le com parer aux canaux que vous avez trouves dans les glandes peptiques et le regarder comme un
systeme de canalicules interieurs en rapport avec les proces chimiques, qui ont lieu dans les cellules
nerveuses et peut-etre aussi avec les fonctions speciales des cellules. Quant aux canaux de
Holmgren et de Bethe il me parait, qu'ils different des votres, vu que vous n'avezjamais observe
des communications avec I' exterieur des cellules 9 •

L'estime de Kolliker pour Golgi etait sincere et profonde. Aussi, en 1894, la
Faculte de medecine de Wiirzburg decema le prix Rinecker a Golgi. Le 8 decembre
1893, Kolliker est heureux d'ecrire:
Mon cher ami! Je viens vous annoncer que notre Faculte de medecine a dec rete par unanimite!le
vous donner le Prix Rinecker, qui se donne tousles trois ans pour les travaux les plus remarquables
dans une des branches de Ia medecine ... Ce prix a ete fonde il y a 3 ans par le fils de notre collegue
Rinecker, en l'honneur de son pere, membre distingue de notre faculte, eta ete donne pour Ia

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premiere fois en 1891 aRobert Koch ... Cette annee no us avions dec rete que le prix serait donne aun
anatomiste et nous n"avons pas trouve de meilleur. que vous. mon cher ami, qui avez contribue
puissamment au progres de l'anatomie fine du systeme nerveux par vos decouvertes et par vos
travaux.

Et, des 1901, Retzius ayant refuse d'etre propose pour le prix Nobel, Kolliker
proposa de suite Golgi. Ebner, His, Recklinghausen firent de meme.
Io ho proposta uno solo e questo e il mio amico, il grande Camillo Golgi! Anche v. Ebner, His e
Recklinghausen hanno propos to Golgi e vede dunque che il amico Golgi a niente altro da fare che da
aspettare. (Wiirzburg 26.1.1901)

Mais, en 1901, 1e prix fut attribue a E. Behring (1854-1917) pour ladecouverte des
serums antidiphterique et antitetanique. II fallut attendre 1905 pour que le prix
Nobel soit partage entre C. Golgi et S. Ramon y Cajal. Et, le 11 decembre 1906, 1ors
de Ia reception des prix a Stockholm, Golgi intitulait sa conference: La doctrine du
neurone. Theorie etfaits. Son but est d'exposer uncertain nombre de faits s'opposant a une conception du neurone qu'il qualifie de doctrine. L'impulsion donnee
par sa decouverte de 'Ia coloration noire' a permis d'affirmer que le corps de Ia
cellule nerveuse avec to us ses prolongements constituait un organisme elementaire
independant. A cette unite 'entrevue', dit-il, Waldeyer a donne le nom de neurone.
L 'oeuvre de plusieurs savants a precise que le neurone constituait une triple unite
independante:
I. le neurone est une unite embryologique, c'est-a-dire derivant d'une cellule
embryonnaire unique;
2. le neurone est anatomiquement, meme a l'etat adulte, une unite cellulaire;
3. le neurone est une unite physiologique.
Les faits apportes par Golgi concement essentiellement les rapports entre les
neurones. II oppose a I' independance des neurones, a leurs relations par continuite
entre corps cellulaires et arborisations terminates, !'existence d'un reseau diffus
permettant des contacts multiples entre collaterales et fibrilles nerveuses 1es plus
tenues.
Au point de vue histogenese, Golgi rappelle !'affirmation de His concernant
l'independance des neuroblastes chez l'embryon humain. Mais dans l'embryon de
poulet, a !'aide de 'Ia coloration noire' on a pu observer des faits d'une finesse et
d'une complexite surprenante.
'On est done porte a croire, dit-il, que cette pretendue independance n'est, au
fond, que l'impossibilite de verifier des rapports plus intimes qui peuvent exister.'
Et il conclut: 'dans l'etat actuel des connaissances relatives a l'histogenese du
systeme nerveux, il n'est pas possible d'affirmer avec certitude que ce que nous
savons sur I' origine des cellules nerveuses ait une valeur fondamentale bien sure et
puisse servir a Ia pretendue independance embryologique de Ia cellule nerveuse'.
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terales, et ceux dont le prolongement nerveux se subdivise rapidement en un
nombre infini de fibrilles. Le premier type est represente par les neurones multipolaires des comes anterieures de Ia moelle epiniere, le second par les cellules de
Purkinje du cervelet. Au n!seau diffus prennent part toutes les fibrilles nerveuses
de ces deux types de neurones. Surles rapports entre ces fibrilles Golgi exprime
cette idee importante:
En presence d'une disposition reticulaire aussi fine que celle que j'ai decrite alors, disposition
dans laquelle les fibrilles depourvues d'enveloppe isolante de myeline courent cote a cote ou bien
tres pres les unes des autres et ont entre elles des rapports de contact frequents et etendus, j'ai
declare qu'il n'y avait pas lieu de croire que Ia continuite directe entre les fibrilles de differentes
provenances etait une condition sine qua non pour Ia transmission de !'excitation des unes aux
autres. J 'ai pense au contraire que ces rapports etaient plus que suffisants pour que I' excitation fut
transmise en tous sens ... Ce que je viens de rappeler sur le reseau ... prouve Ia continuite
anatomique et fonctionnelle entre les cellules nerveuses. Et voila Ia raison qui m'empeche
d'admettre !'idee de cette independance de chaque cellule nerveuse qui est le fondement essentiel
de Ia doctrine du neurone.

L' organisation de Ia fascia dentata, dit -il, se prete particulierement a illustrer les
rapports entre fibrilles eta demontrer I' action d' ensemble de cellules nerveuses par
opposition a Ia pretendue action individuelle. Dans les debats sur le neurone,
explique Golgi, les prolongements protoplasmiques ontjoue un role important. II
ecarte Ia conception du reseau nerveux de Gerlach constitue par les subdivisions
infinies de ces prolongements, et qui a pu preter a confusion avec son reseau
diffus 10 • D'apres les terminaisons renflees qu'il observe au niveau de certains
vaisseaux sanguins, il pense qu'il serait logique d'attribuer aces prolongements, a
cote de leur role nerveux conducteur, un role nutritif. Les travaux de Monti ont, en
effet, montre que !'occlusion embolique de petits vaisseaux cerebraux entraine Ia
degenerescence des prolongements protoplasmiques toumes vers le vaisseau
occlus (observation experimentale faite au moyen de Ia reaction noire). Cette
degenerescence gagne ensuite le corps cellulaire puis !'axone. Mais Golgi avoue
que le probleme de Ia structure des cellules nerveuses et de Ia signification de leurs
differents elements est encore bien loin d'etre resolu.
Au sujet de I' appareil reticulaire endocellulaire qu'il a decrit lui-meme sur les
ganglions intervertebraux de cheval et de chien, il declare aussi que Ia signification
de ces appareils represente encore un probleme irresolu. D'autre part, les etudes
d'Apathy sur Ia structure fibrillaire de cellules nerveuses d'invertebres ne peuvent
etre transferees aux vertebres, rien n'autorise de telles extrapolations. De plus,
Golgi rap porte aussi I' opinion de Jaderholm:
Amon avis, declare ce demier, les formations reticulaires des cellules doivent etre considerees
comme des produits artificiels determines par un phenomene d'agglutination. Ces formations
reticulaires peuvent etre aussi simulees par le plasma qui, coagule sous forme de reseau, se colore
en meme temps que les fib rilles, cela arrive le plus sou vent par Ia methode de Donaggio, beaucoup
moins frequemment par celle de Cajal et tout a fait rarement par celles de Be the et de Bielschowsky.

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Ramon y Cajal a, en effet, decrit largement les fibrilles du corps cellulaire et des
prolongements protoplasmiques mais, selon Golgi, aucune de ces questions n'est
resolue. Des resultats differents obtenus par des voies differentes convergeront
peut-etre vers un meme but.
Golgi examine enfin le probleme du neurone unite physiologique, lie a Ia theorie
de Ia polarisation dynamique ebauchee par van Gehuchten, et que Ramon y Cajal
a developpee et etendue.
En realite, pense Golgi, ni cette theorie, ni Ia loi de A. V. Waller (1816-1870)
n'exclut l'idee de !'existence du reseau nerveux diffus. Mais, dit-il, 'Ia doctrine de
l'independance fonctionnelle du neurone aurait pu trouver un appui indirect dans
les etudes sur les localisations cerebrates, pourvu que !'idee de localisation gardat
sa forme initiale, c'est-a-dire qu'on attribuat a des regions bien determinees et
delimitees du cerveau des fonctions sensitives et motrices bien distinctes et
precises.' Mais les idees sur les localisations ont evolue: on cons tate peu de
precision dans les limites des zones, on observe des possibilites de substitutions et
de compensations, ce qui s'accorde avec les relations multiples entre neurones
observees par Golgi dans le reseau diffus qui presente le maximum de complication
et d'extension de rapports entre fibrilles. Golgi avait d'ailleurs ecrit:
Tout en declarant inadmissible !'existence de districts cent raux exactement bomes, representent
le siege exclusif de Ia distribution centrale des fibres nerveuses, nous croyons pourtant pouvoir
admettre qu 'il existe des territoires affectes a Ia distribution preponderante et plus directe des
fibres.

II se rallie a !'idee que Ia fonction specifique n'est pas en rapport avec des
particularites d' organisation des centres, mais plutot avec Ia specificite des organes
peripheriques transmetteurs ou recepteurs. Enfin il conclut:
Aucun des arguments, sur lesquels Waldeyer a appuye Ia doctrine de l'individualite et de
l'independance du neurone, ne saurait soutenir l'examen .
. .. Les cellules nerveuses au lieu de deployer une action individuelle agissent avec ensemble .
.. . je ne puis abandonner !'idee d'une action unitaire du systeme nerveux.

Le 12 decembre 1906, Ramon y Cajal presentait egalement sa conference a
!'occasion de Ia remise du prix Nobel. Elle s'intitulait: Structures et connexions des neurone s. Elle apportait uncertain nombre de faits, obtenus avec
la methode de Golgi et confirmes par celle de P. Ehrlich (1854-1915)1', qui ont
revele Ia disposition terminate des fibres nerveuses ('ramilles' des axones et des
collaterales nerveuses) et les rapports entre neurones. Elle envisageait ensuite Ia
texture du protoplasme nerveux et Ia doctrine neurogenetique de His. Les faits
reconnus impliquent, selon Cajal, trois postulats physiologiques:
I. Les systemes de ramifications pericellulaires complexes font admettre que les
courants nerveux se transmettent d'un element a !'autre en vertu d'une sorte
d'induction ou influence a distance.
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2. Corps cellulaires, prolongements dendritiques et cylindres-axes soot des appareils de conduction; ils pn!sentent la meme structure fibrillaire.
3. Lamarche des impulsions se fait des dendrites a !'axone: c'est la polarisation
dynamique des neurones.
Ayant pose ces postulats Ramon y Cajal expose d'abord quelques exemples
frappants de connexions intemeuronales: connexions des racines sensitives de la
moelle epiniere; connexions des fibres visuelles et des cellules de la retine; connexions des cellules et des fibres dans une lamelle cerebelleuse. 11 examine le cas
des fibres centrifuges des organes centraux (sans d'ailleurs pouvoir leur attribuer
un role defini). II affirme que dans le domaine histologique les resultats ainsi
obtenus par les methodes de Golgi et d'Ehrlich peuvent etre consideres comme
definitifs. Par contre, lorsqu'il envisage la texture fibrillaire du protoplasma nerveux, etudie par sa methode du nitrate d'argent reduit ou par les autres procedes
neurofibrillaires (Simarro, Donaggio, Bielschowsky ... ), il reconnait que les
inductions physiologiques tirees des observations peuvent etre contestables: 'Nos
affirmations'' dit-il, 'ne sauraient aller au-dela des revelations des methodes
contemporaines.' II ajoute meme:
PeuH!tre la technique decouvrira-t-elle avec le temps quelque procede de coloration capable de
deceler des connexions nouvelles et plus intimes entre les neurones supposes en contact. On ne
peut rejeter a priori la possibilite que Ia foret inextricable du cerveau dont nous nous imaginons
a voir determine les dernieres branches et feuilles ne possede encore quelque enigmatique systeme
de filaments reliant !'ensemble neuronal comme les lianes rattachent les arbres des forets tropicales. C'est la une idee qui, pour se presenter a nous avec le prestige de !'unite et de la simplicite, a
toujours exerce et exerce encore une puissante suggestion meme sur les esprits les plus serins.

Ramon y Cajal rapporte ensuite de nombreuses preuves qui detruisent l' hypothese 'catenaire' de Dohrn, suivant laquelle les ax ones des nerfs se formeraient par
fusion d'une chaine de cellules ectodermiques:
1. dans la regeneration on observe le bourgeonnement de la fibre, la formation de
'boules' ou bourgeons d'accroissement, et jamais la participation de cellules
annexes comme les cellules de Schwann;
2. de meme, dans Ia neurogenese on observe le meme bourgeonnement a partir
des neuroblastes de His.
L 'hypothese catenaire est done impossible a soutenir: il y a autonomie regeneratrice des neurones adultes, il y a individualite neuronale des les premiers stades
embryonnaires. Cette hypothese, ainsi que celle de l'origine pluricellulaire de la
cellule nerveuse, avait aussi ete rejetee par C. Golgi.
Nous avons vu que la methode de Golgi avait ete rapidement adoptee par de
nombreux histologistes, non seulement par Kolliker et par Ramon y Cajal qui la
perfectionna, mais aussi par to us ceux qui participerent a I' evolution de la connaissance du neurone en anatomie comparee et histogenese aussi bien qu'en histologie

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26

pure. Et, lorsque C. Golgi re~oit le prix Nobel, il termine ainsi sa conference:
Je n'ose pas attribuer cette supreme distinction a rna valeur personnelle, ni directement a mon
oeuvre, pour si patiente qu'elle ait ete et constamment dirigee vers les recherches scientifiques,
mais je me permets de croire qu'elle a ete attribuee en reconnaissance, non immeritee, du travail
accompli par tous ceux qui puiserent dans mes etudes une impulsion feconde en bons resultats.

Son honnetete intellectuelle, ses scrupules, sa prudence, ont reserve pour
l'avenir une voie libre. Ramon y Cajallui-meme, dans sa conference, a fait preuve
de modestie, lui dont Kolliker disait: 'II se croit le premier histologiste et le seul a
qui est permis d'avoir une opinion sur Ia structure du systeme nerveux' (lettre du 24
fevrier 190 1), apropos des jugements emis par Ramon sur les travaux de Golgi et de
son ecole.
Comme le remarque Golgi, des resultats differents pourront, plus tard, se
rejoindre, et il aime aciter les 'nobles paroles' d'Alfred Nobel:
Chaque nouvelle decouverte laisse dans le cerveau des hommes des germes qui rendent possible
qu'un nombre de plus en plus grand d' esprits des nouvelles generations devienne capable d'embrasser de plus vastes conceptions scientifiques.

II ajoute:
Mon voeu est que ces nouvelles etudes anatomiques, sur lesquelles cette Academic [de Stockholm], dans un ordre d'idees si eleve, a voulu attirer !'attention du monde, puissent representer un
nouvel element de progres pour l'humanite.
C. GOLGI, ILLUSTRATIONS

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Discours pour le prix Nobel, 1906: La doctrine du neurone.
Fig . 2. Tai pu verifier que les fibrilles
nerveuses venant du prolongement nerveux des cellules de Ia couche moleculaire, ne font que passer pres du corps
des cellules de Purkinje pour se continuer dans le riche et fort caracteristique
reseau existant dans Ia couche de
grains.

Les deux types de cellules nerveuses distingues par C. Golgi.
Fig . 3. 'cellule de Ia region antero-laterale des comes anterieures de Ia moelle
epiniere; son prolongement nerveux
penetre dans une racine anterieure apres
a voir produit une serie de branches collaterales finement subdivisees. '

Fig. 4. Cellule de Purkinje du cervelet ; son pro- .
longement nerveux traverse Ia zone granuleuse,
produisant lui aussi une serie de fibrilles tres
fines, et va ensuite se joindre aux fibres nerveuses de Ia substance blanche des circonvolutions cerebrales.
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Georgette Legee
Fig. 5. 'cellule du deuxieme type de
Ia moelle epiniere (zone de passage
entre les comes anterieures et posterieures)' ou neurone intercalaire.

Fig. 6. Cellule de Ia couche des grains du cervelet. Un des
exemples les plus caracteristiques de Ia fa~on dont se comporte le prolongement nerveux des cellules du deuxieme
type.

Fig. 7. Continuite artatomique et fonctionnelle entre les cellules nerveuses illustree par Ia
structure microscopique de Ia fascia dentata. 'Les petites cellules nerveuses qui
constituent Ia couche elegante et caracteristique de Ia fascia dentata, envoient leurs
prolongements protoplasmiques vers Ia surface de cette circonvolution rudimentaire, et en
meme temps elles emettent par le pole oppose un unique et tres mince prolongement
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nerveux. Celui-ci, du moins pour ce qui regarde Ia plus grande partie des cellules, se
subdivise en filaments d'une extreme tenuite qui donne lieu a Ia formation d' une zone
reticulee. D'autre part, un faisceau bien individualise des fibres provenant de Ia fimbria et
de Ia couche medullaire qui revet Ia surface ventriculaire de Ia corne d'Ammon, se dirige
vers lafascia dentata.
Les fibres de ce faisceau ... se subdivisent d'une fa~on excessivement compliquee, s'entrelacent avec les branches des prolongements nerveux des cellules en formant avec elles Ia
zone reticulaire .
.. . On a ainsi I' impression que Ia couche reticulaire se trouve interposee comme un terrain
commun entre les prolongements nerveux des cellules d'un cote, et les fibres nerveuses de
I' autre.
Tout ce qu' on releve de ces rapports parle en faveur d'une action cumulative des cellules
de toute Ia fascia dentata , et contre une action individuelle de ces cellules.'

Fig. 8. 'II n'est pas difficile de voir quelques uns
de ces boutons terminaux s 'avancer parfois
meme au-dela des limites des circonvolutions
jusqu 'au vaisseaux meningiens.' Exemple, sur
le cervelet de jeunes oiseaux.
'En presence de ce fait, n'est-il pas logique de
penser que les prolongements protoplasmiques
representent aussi des organes de nutrition pour
le corps cellulaire?'

Fig. 9. Appareil reticulaire endocellulaire: cellule nerveuse des ganglions intervertebraux
chez le chien.
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30
S. RAMON Y CAJAL, ILLUSTRATIONS

Discours pour le prix Nobel, 1906: Structure et connexions des neurones
Fig. 10. Connexions des cellules et des fibres
dans une lame lie cerebelleuse
A cellule etoilee de Ia zone plexiforme
B neurone de Purkyne
b dendrites des neurones de Purkyne
C collaterale recurrente
D fibre grimpante

Fig. II. Neurofibrilles des neurones des vertebres: cellules de Ia moelle epiniere du lapin de
quelques jours.

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NOTES

* Communication presentee au Symposium de l'Academie internationale de l'Histoire de Ia Medecine, Strasbourg 1980

I. Cette methode, fructueuse au point de vue macroscopique, fut encore utilisee dans le courant du 19e
siecle par K.F. Burdach (1776-1847), A.L. Foville (1799-1840), F. Arnold (1803-1890), J. Henle
(1809-1885), K.B. Reichert (1811-1876) etc.
2. C. Golgi, Sui/a struttura della sostanza grigia del cervel/o. In: Gazetta medica lombarda, Milano,
t.IV, 1873.
3. Carl Weigert (1845-1904) fut professeur d'anatomie pathologique a Leyde puis a Francfort-surMain. II decouvrit une methode de coloration des fibres a myeline. II utilise I' action combinee du
bichromate de potassium qui durcit le tissu nerveux et de l'hematoxyline qui teint. II obtient ainsi
des laques de couleur vive qu'un lavage plus ou moins prolonge au prussiate de potassium borate
enleve a tout ce qui n'est pas myelinise. Cf. Ueber eine neue Untersuchungsmethode des Centralnervensystems. In: Centra/blatt fur die medicinischen Wissenschaften, 20, 1882, p. 753-757,
772-774.
4. Heinrich Miiller ( 1820-1864), ami de Kolliker, inventeur du liquide fixateur qui porte son nom, dont
Ia composition est donnee, in Anatomische Untersuchung eines Mikrophtalmus. In: Verhandl. d.
Physic. Medic. Ges. Wurzburg, 10, 1860, p. 138-146, Tab. I, Fig. 12-15.
5. Wilhelm von Waldeyer (1836-1921); c'est en 1891 qu'il donna le nom de neurone a !'ensemble de Ia
cellule nerveuse et de ses prolongements.
6. Cf. aussi lettre de Kolliker a Golgi du 22 decembre 1890: 'Que dites-vous du nouveau travail de
Ramon et de l'action conductrice, qu'il suppose aux prolongements protoplasmiques des grandes
cellules du lobe olfactif?'
7. Cf. lettre de Kolliker a Golgi du II mars 1891: 'Avez-vous re~u le nouveau travail de Retzius sur le
systeme nerveux des crustaces? Tres important.' Gustaf Magnus Retzius (1842-1919) fut professeur d'anatomie puis se consacra a Ia publication du periodique Bio/ogische Untersuchungen.
8. II s'agit de Ia traduction suivante: Untersuchungen uber den feineren Bau des centra/en und
peripheren Nervensystems. Jena, G. Fischer, 1894, 272 p., atlas de 30 pl.
9. Kollikerparle aussi de ses travaux. Dans sa lettre aGolgi, du 8 fevrier 1900, il ecrit: 'Io mi occupo in
questo invemo specialmente del systema nervose centrale deii'Omithorhynchus, deii'Echidna,
della Phalangista e del Dasypus e ho l'intenzione di dimostrare una seria di preparati a Pavia' [pour
le congres d'anatomie de Pavie de 1900].
'Un articolo sull" incrociamento dei fascicoli pyramidali di questi animali e stato publicato nello
volume du cinquantenaire de Ia Societe de Biologie de Paris.'
Cf. aussi lettres du 25 decembre 1900 et du 24 fevrier 190 I.
I0. Golgi note que plusieurs confusions ont ete faites au sujet de son reseau diffus:
I) on a donne le nom de Golgi-Netz a un reseau pericellulaire et peridendritique qui a ete decrit;
2) Bethe a appele reseau de Golgi une formation qui revet parfois l'apparence d'un reseau
(formation dec rite parGolgi), mais qui n'a rien de commun avec son veritable reseau nerveux diffus.
II. Paul Ehrlich (1854-1915), cree une nouvelle methode de coloration des neurones, en 1886. Lebleu
de methylene d'Ehrlich, est une couleur de composition chimique particuliere, n'ayant de propriete
elective que sur les neurones et leurs prolongements, mais seulement sur le tissu nerveux vivant ou
recemment mort. La methode d'Ehrlich fut done, a ses debuts, utilisee seulement pour les organes
nerveux peripheriques des vertebres et pour les organes nerveux centraux et peripheriques des
invertebres (Retzius). L'emploi d'un fixateur indelebile (le molybdate d'ammonium substitue au
picrate d'ammonium ou fixateur infidele de Dogie/) permit d'etendre l'emploi du bleu de methylene
d'Ehrlich a tousles systemes nerveux.

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Georgette Legee

BIBLIOGRAPHIE
Belloni, L., L' epistolario di Albert Koelliker a Camillo Golgi a/ Mus eo per Ia storia della Universita di
Pavia. Milano Istituto Lombardo di Scienze e Lettere, 1975, vol. XXVI, Memoria 4.
Burdach, E., Beitrag zur mikroskopischen Anatomie der Nerven. Konigsberg, 1837.
Dejerine, J .J., Anatomie des centres nerveux. Paris, Rueff, 1895-190 I, 2 vol. chap. I, Methodes utili sees
dans !'etude des centres nerveux.
Golgi, C., Opera omnia. Milano, V. Hoepli, 1903, 3 vol. in-4°.
Sullafina anatomica degli organi centrali del sistema nervoso. Milano, 1886.
Kruta, Vladislav, A note on the history of Purkyne cells. In: J.E. Purkyne (1787-1869), Centenary
Symposium. Bmo, UniversitaJ.E. Purkyne, 1971, p. 125-136.
Malpighi, M., Opera omnia. Ludg. Bat., P. Vander Aa, 1687,2 vol. in-4°.
Ramon y Cajal, Santiago, Les nouvelles idees sur Ia structure du systeme nerveux chez/' homme et chez
les vertebres, trad. de l'espagnol par le Dr L. Azoulay. Preface de M. Mathias Duval. Paris, C. Reinwald
et Cie, 1894.
La methode a/' argent reduit associee a Ia methode embryonnaire pour/' etude des noyaux moteurs et
sensitifs. In: Bibliographie anatomique. Revue des travaux en langue fran<;aise, anatomie, histologie,
embryologie, anthropologie, Berger-Levrault et Cie, fascicule 5, t.XIII.
Methode a /'argent reduit ou methode simple pour Ia coloration des neurofibrilles avec ses resultats
dans les difft?rents centres nerveux. Ibid., fascicule 1, tome XIX.
Die Retina der Wirbelthiere. Untersuchungen mit der Golgi-Cajai-Chrom silbermethode und der
Ehrlich' schen Methylblaufiirbung nach Arbeiten von S. Ramon y Cajal, Professor der Histologie an der
Medic. Fakultat zu Madrid. In Verbindung mit dem Verfasser zusammengestellt, iibersetzt und mit
Einleitung versehen von Dr. Richard Greeff, Privatdozent fiir Augenheilkunde an der Universitat zu
Berlin mit 7 Tafeln und 3 Abbildungen im Text. Wiesbaden, Verlag von J.F. Bergmann, 1804.
Histologie du systeme nerveux. Trad. fran<;aise par le Dr L. Azoulay. Paris, A. Maloine, 1909.
Ranvier, L., Le~ons sur /'histo/ogie du systeme nerveux. Paris, F. Savy, 1878,2 vols.
Remak, R., Observationes anatomicae et microscopicae de systematis nervosi structura. Berolini,
1838.

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An ancient Greek theory of hemispheric
specialization
GERT-JAN LOKHORST

It seems to be a matter of general consent nowadays that theories on asymmetrical functional differences between the cerebral hemispheres were first
proposed in the nineteenth century. Most people will probably think of Broca's
1861 discovery of a speech centre in the left frontal lobe as the first step in this field.
Some will go back somewhat further and think of Marcel Dax, who allegedly
discovered Broca's centre in 1836 1 • This is, however, the 'terminus post quem';
even in studies devoted to the history of hemispheric specialization, of which a
number have appeared in recent years 2 , it is invariably asserted that:
it was in fact only in the nineteenth century that questions as to the possible asymmetry of
function of the two cerebral hemispheres of Homo sapiens began to be raised 3 •

In this paper, it will be shown that this picture is incorrect. I want to draw
attention to a Mediaeval Latin text in which an ancient Greek theory on hemispheric specialization is quite unequivocally stated. The text has already been
published twice; however, except for one passing reference from 1917 4 , it seems to
have gone completely unnoticed.
The text in question may be found in the second part of a short medical treatise
which according to V. Rose 5 has only been preserved in the so-called Brussels
manuscript of Theodorus Priscianus, dating from the twelfth century6 • The
manuscript does not state the name of the author of the treatise. Count Hermann
von Neuenar, its first editor, mistook Theodorus Priscianus for the writer of the
treatise 7 • On the basis of its content and its language it must, however, be attributed
to Priscianus' teacher, the fourth-century contemporary of Augustine, Vindicianus8.
Vindicianus' source seems to have been one of the lost works of Soranus of
Ephesus, the second-century gynaecologist who also took a great interest in the
history of medicine. Unfortunately, it cannot be established with certainly whose
doctrine So ran us was expounding. As the opinions expressed are similar to those of
Diodes of Carystus, in so far as these are known, Wellmann 9 thought the entire
second part of the treatise could be traced back to this famous physician from the
fourth-century B.C., whom Soranus is known to have held in high esteem. Later
on, however, Jaeger 10 was more cautious and pointed out that we may only ascribe
those parts to Diodes for which we have independent evidence that he held them.
Unfortunately, we do not have such evidence for the theory of the hemispheres.
ClioMedica, Vol.l7no.l,pp.33-38

<D

B.M. Israel, Amsterdam, The Netherlands
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34

Gert-Jan Lokhorst

But as the theory is embedded in views which we do know to have been held by
Diocles, there is at least indirect evidence that he accepted it.
The relevant passage discusses the cause of 'phrenitis' (delirium and raving
accompanied by fever; frenzy, madness). On phrenitis opinions differed widely.
According to the view one held as to the location of the soul, its cause was sought
variously in the blood, the brain or the diaphragm (phren). We know that Diocles
thought phrenitis occurs when an inflammation of the diaphragm spreads to the
heart. He saw the left ventricle of the heart as the principal seat of the 'psychic
spirit' (psychikon pneuma) and, therefore, of the soul (psyche, phronesis, gnome).
Like the blood, carrying the 'innate heat', the psychic pneuma is transported from
the heart to the other parts of the body through the hollow arteries and veins, with
the result that sensory impressions from all over the body can reach the psyche in
the heart. After the heart, the brain is the most important organ in this process,
because it plays an intermediary role in vision, hearing, smell and taste. The
processes taking place in the brain are, in fact, of a sufficiently high level to be
called 'psychical' as well; thus, the psyche is not confined to the heart but is
extended between the heart and the brain, and it might even be said that the brain is
the seat of a 'second soul' (aile psyche). As is to be expected, a disruption of the
flow of pneuma to the brain will, following this view, have serious consequences;
and this is, indeed, precisely what gives rise to phrenitis 11 •
All this we know from Greek sources. As the Latin passage on phrenitis accords
well with this material, it may well represent Diocles' views; but in that case, the
surprising theory on the asymmetrical function of the brain which it contains may
also have been held by him. As we have no evidence that others proposed it, he is in
any case the only possible candidate known to us.
The manuscript text, which has been rendered very inaccurately in the previous
editions ofVindicianus' treatise 12 , reads as follows 13 (see illustration):
Freneticam passionem inquit fieri tumore in cordea suffecto et offocatob sanguine, seu calore
consuetudinario, ex quo cerebrum sensum et intellectum praebet. Aliud est enim quodc intellegitur, aliud quodc sentitur. Sic itaque duo cerebra sunt in capite constituta: unum quod intellectum dat, aliud quod sensum praebet. id est quod in dextra parte iacet, ab eo sentitur; a sinistro
vero intellegitur. ob hoc sub ea parte subiacente corde et semper vigilante, audiente et intellegented, quia et au res habet ad audiendum.

Emendations by Wellmann 14 : a. Wellmann writes erroneously in corpore, which he
subsequently emends to in corde. b. Read: effecto et suffocato. c. Read: quo. d.
Read: intelligente. Translation:
He (i.e., Diodes or Soranus) says that phrenitis arises from the formation of a swelling (inflammation) in the heart and the suffocation of the blood or the innate heat, from which the brain derives
sense perception and the understanding. The latter is namely that with which we understand, the
former that with which we sense. Accordingly, there are two brains 15 in the head, one which gives
understanding, and another which provides sense perception. That is to say, the one which is lying

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An ancient Greek theory of hemispheric specialization

35

on the right side is the one that perceives; with the left one, however, we understand. Because of
this, this is also being done by the heart, which is lying under this (i.e., the left) side (of the head),
and which is also continually vigilant, listening and understanding, because it also has ears to hear.

f

mlt'tUl"(:pd{ftonCuuruttfren t:umOf'e!·Ul

u.J~ fu/1it:'tt' ~~o/1bc.tcD (:JJ'5'lltle'/feuu.Jo
~crueaultrurw ·~quo ~rii· en(um ~·~
urrelktum pbec--ALuJ elt-entm 'Tu~J mrel
~'dl'uJ'1uod fettatu~

r

~rc~,Juocerebm thnrtlm;'Ptte"~~.

r:u_-;'1tintr114ttlicl.ttr.WtuJ'frarrumpk.
ult/b-qttuuL:ttm p~ fdCCC·dbeo fcnru:ur.

a(uu/lrv tl~obbocfu/,~~
(ub ucetttr-cordc~femJ! U~·~rubaz
n~ ..~·t~..·~Uta~~{,.J,a;~
uztdtmclii·Qf!od ~ficordM-Wberumtrt(l
The Latin passage on hemispheric specialization discussed in the text. Copyright Bibliotheque royale
Albert Jer, Bruxelles; manuscript 1.342-50, fol. 52v.

Of course, we cannot accept the theory given here in its entirety. The idea
mentioned in the last sentence- that we hear with the auricles of the heart 16 - was
already rejected in Antiquity. The reasoning which leads to the conclusion that the
left hemisphere is the thinking hemisphere does not sound very modem either.
Moreover, it is a serious shortcoming that no observational basis is given.
Yet, it need hardly be pointed out that the theory of hemispheric specialization
presented is in itself amazingly modem, even when taken quite literally. Not only is
it reminiscent of nineteenth-century theories like that of Hughlings Jackson, who
postulated that the left hemisphere is connected with the logical forms of consciousness dependent on speech, while the right is specialized for visual perception
and is responsible for more direct, visual forms of contact with the world 17 ; it is also
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Gert-Jan Lokhorst

very close to the theory held by many modem investigators that the left hemisphere
is specialized for intellectual, rational and verbal activities while the right is
superior in a great number of perceptual, visual and spatial tasks. One modem
author characterizes the difference even in terms identical to those of the Latin
text: 'intellectual' versus 'sensuous' 18 •
It is no longer possible to ascertain whether this remarkable view of hemispheric
specialization originated with Diodes (if it is, indeed, his). Before him, Alcmaeon
and Empedocles had already distinguished between 'sensus' (aisthesis) and 'intellectus' (dianoia, phronesis), but the latter considered them as identical, while there
is no evidence that the former located them in different hemispheres 19 • It may
already have been surmised in Diodes' time that the hemispheres are different in
that they only exert motor control over the opposite side of the body 20 • But this
notion of symmetricallateralization of function is fundamentally different from the
idea of functional asymmetry. Instead of paving the way for it, the former notion
may even have constituted an obstacle to recognition of the latter 21 •
How the theory fared after Diodes is clearer: it fell into complete oblivion. The
reason for this is probably the popularity of later accounts of brain function in
which emphasis was laid on processes taking place in the cerebral ventricles; the
fact that this is a unitary system overshadowed the anatomical duality ofthe brain.
Those who saw the heart as the seat of the soul naturally tended to be still less
interested in the hemispheres. Even when the substance of the brain became the
'organ of the soul', the soul was assigned to undivided structures in the midline, for
since we have but one soul, it was regarded as highly implausible that its organ
should be double, as was explained very convincingly for the time by Descartes 22 •
Not until Gall in the early nineteenth century established his two celebrated
principles of cerebral localization of function and the dependence of mental
phenomena on the cortex was attention drawn again to the doubleness of the brain,
for the first principle could be applied interhemispherically as well as intrahemispherically, whereas the second posed the paradox that we have one mind
while its organ, the cortex, is clearly double. It was only then that speculation
sprang up again 23 , and it was not long before the first discoveries were made. These
considerations do not only apply to Diodes' theory; by the same reasoning it is
probably unprofitable to look for any theories on hemispheric specialization
between, say, Galen and Gall 24 •
It cannot be denied, then, that Diodes' theory, though substantially correct,
stands quite isolated and was not in the least instrumental in bringing about the later
developments in this area. Nevertheless, I think it should be acknowledged that
when nineteenth-century investigators started to discuss hemispheric specialization, they were unwittingly reintroducing a concept by then already 2200 years
old.

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An ancient Greek theory ofhemispheric specialization

37

NOTES
The author wishes to thank Ms. Marijke Engelbrecht and Ms. Beth Morrel for assistance with
translations.
I. Dax, M., Lesions de Ia moitit' gauche de I' encephale coincident avec I' oubli des signes de lapensee.
In: Gaz. Hebdom. Med. Chir., 1865, 2nd series, 2, 259-262.
See also: Critchley, M., La controverse de Dax et Broca. In: Rev. Neural., 1964, 110, 553-557.
(English translation in: Critchley, M., The divine banquet of the brain. New York, Raven Press,
1979, pp. 72-82.)
2. E.g., Benton, A.L., The 'minor' hemisphere. In: J. Hist. Med. All. Scis. 1972, 27, 5-14. Benton,
A.L., Historical development of the concept ofhemispheric cerebral dominance. In: Spieker, S.F.,
Engelhardt, H.T., eds., Philosophical dimensions of the neuro-medical sciences. Dordrecht,
Reidel, 1976, pp. 35-57. Oppenheimer, J .M., Studies of brain asymmetry: historical perspective.
In: Ann. N.Y. Acad. Scis. 1977,299,4-17.
3. Oppenheimer, op. cit., p. 4.
4. Revesz, B., Geschichte des Seelenbegriffes und der Seelenlokalisation. Stuttgart, F. Enke, 1917, p.
20.
5. Rose, V., ed., Theodori Prisciani Euporiston Libri Ill. Leipzig, B.G. Teubner, 1894, preface, p. v,
p. 400.
6. Brussels, Bibliotheque Royale Albert Ier, M.S. 1342-50, fol. 48r-52v.
7. Neuenar, H. von, ed., Octavii Horatiani Rerum medicarum libri quatuor. Per Heremannum
comitem a Neuenar integro candori nuper restitutus autor. Argentoratus (= Strasbourg), Apud
Joannem Schottum, 1532.
8. Wellmann, M., Die Fragmente der sikelischen Aerzte Akron, Philistion und des Diokles von
Karystos. Berlin, Weidmannsche Buchhandlung, 1901, p. 2 ff. Jaeger, W., Diokles von Karystos.
Die griechische Medizin und die Schule des Aristoteles. Berlin, W. de Gruyter, 1938 (repr. as 2nd
ed., 1963 ), p. 188. On Vindicianus, see also: Deichgraeber, K., Vindicianus. In: Wissowa, G., et al.,
eds., Paulys Realencyclopaedie. 2nd series, vol. 17. Stuttgart, A. Druckenmueller, 1961, cols.
29-36.
9. Wellmann, op. cit., p. 8 ff. On Diodes, see also: Wellmann, M., Diokles von Karystos. In: Wissowa,
G., ed., Paulys Realencyclopaedie. Neue Bearbeitung, vol. 9. Stuttgart, J.B. Metzler, 1903, cols.
802-812. Kudlien, F., Probleme urn Diokles von Karystos. In: Sudhoffs Arch. Gesch. Med.
Naturw. 1963,47,456-464.
10. Jaeger, op. cit., p. 190-191.
II. See the fragments on Diodes, ed. by Wellmann, op. cit. (1901).
12. Neuenar, H. von, op. cit., p. 102 ff. Wellmann, op. cit. (1901), p. 208 ff. Both editions use the
Brussels codex.
13. Brussels codex (op. cit.), fol. 52v, column 2, line 12-23.
14. Wellmann, op. cit. (1901), p. 19-20,234.
15. This synecdochical use of 'brains' for 'hemispheres' (tatum pro parte), is, of course, still very
common today. (Hippocrates, On the sacred disease, ch. 3 (Littre VI 366), and Aristotle, Historia
animalium I, 16, 494b31, describe the brain as one organ, divided into two parts.)
16. Compare Vindicianus, Epitome alt'era 18. In Rose, op. cit., p. 474: 'duas aures habet (sc. cor), ubi
mens hominum animusque commoratur. unde quicquid nobis iudicii est, venit per ipsas cordis
au res, omnis et cogitatio extollit et omnis erigitur tumulos'. (The heart, where men's mind and soul
reside, has two ears. Hence all we have knowledge of comes through these ears of the heart, all
thinking arises, and all feeling is aroused.)
17. Jackson, J .H. On the nature of the duality ofthe brain. In: Med. Press and Circular. N.S., 1874, 17,
19-21, 41-44, 63-66. Repr. in Brain. 1915, 38, 80-103; and in Selected writings of John Hughlings
Jackson. London, Hodder and Stoughton, 1932, vol. 2, pp. 129-145.
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Gert-Jan Lokhorst

18. Blackburn, T.R. Sensuous-intellectual dichotomy in science. In: Science. 1971, 172, 1003-1007.
Cited in the context of hemispheric specialization by Ornstein, R.E., The psychology of consciousness. New York, Penguin, 1975, p. 83; and by Bogen, J.E., Some educational aspects of hemispheric specialization. In: Dromenon, 1979, I, no. 5-6, 16-21.
19. Theophrastus, De sensibus 4, 23, 25. Aristotle, De anima 427a21. In this context it should, however,
be noted that Diocles probably held another theory on functional left-right asymmetries of the body
that he did owe to Empedocles, viz. the theory that boys develop OJ) the right side of the uterus, girls
on the left. See Wellmann, op. cit. (1901), p. 35, 199. Cfr. Vindicianus, Gynaecia 21, in Rose, op.
cit., p. 456-7.
20. Although Aretaeus of Cappadocia (second century A.D.) was the first author who stated the
principle of contralateral innervation explicitly (De causis et notis diutunorum affectuum, bk. I, ch.
7), the correlation between unilateral injuries of the head and paralysis of the opposite half of the
body is already frequently noticed in the Corpus Hippocraticum.
21. Cfr. Benton, op. cit. (1976), p. 42.
22. Descartes, R., Traite des passions de /'arne. Amsterdam, L. Elzevier, 1649, part I, art. 32. Letters
to Meyssonnier (Jan. 29, 1640) and to Mersenne (April I, 1640, July 30, 1640, Dec. 24, 1640). In:
Alquie, F., ed., R. Descartes: Oeuvres philosophiques. Paris, Gamier, 1967, val. 2, pp. 156-158,
164-168,248-254,298-302.
23. E.g. Watson, H., What is the use of the double brain? In: Phrenol. J. and Miscellany. 1831, 9.
Holland, H., On the brain as a double organ. In: Ch. 12 of Medical notes and reflections. London,
Longman, Orme, Brown, Green, and Longmans, 1839,pp. 151-167. Wigan, A.L., The duality ofthe
mind proved by the structure, functions, and diseases of the brain. London, Longman, Brown,
Green, and Longmans, 1844. Wigan, A.L., A few more words on the duality of the mind. London,
T.C. Savill, 1847.
24. This is borne out by a work like Du Pui's medical dissertation of 1780, which appeared just before
Gall became active. Although it is wholly devoted to medical differences between organs on the left
and the right side of the body, and although the second part of it exclusively discusses the nervous
system, not a single reference is made to the possibility of hemispheric asymmetry. See Du Pui,
M.S., Dissertatio medica inauguralis de Homine dextro et sinistro. Leiden, Apud Fratres Murray,
1780 (esp. pp. 107-191.)

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News &Notes
I. lYe COLLOQUE INTERNATIONAL HIPPOCRATIQUE
Lausanne, Switzerland, 21-26 September 1981

The Ne Colloque International Hippocratique took place the 21-26 September
1981 at Lausanne, Switzerland under the sponsorship of La Faculte des lettres de
l'Universite de Lausanne, La Section des Sciences de l'Antiquite.
Attended by more than eighty scholars from thirteen countries, the colloquium
opened with an introductory address by Fram;ois Lasserre (Universite de Lausanne), president of the organization committee. A moving eulogy for Louis
Bourgey was then delivered by Jacques Jouanna (Universite de Strasbourg).
Forty-five papers were presented on a broad spectrum of topics relating to the
theme of the colloquium-La collection hippocratique: formes de pensee. Among
the topics discussed variously were the following: philosophy and medicine; magic
and medicine; literacy and medicine; literary and linguistic modes of expression;
the theory and practice of the medical art, touching upon such subjects as surgery,
pharmacology, dietetics and astronomy. A special evening session, followed by a
reception, was organised by La Faculte de medecine de l'Universite de Lausanne;
Charles Lichtenthaeler (Medizinhistorisches lnstitut der Universitat Hamburg;
Universite de Lausanne, La Faculte de medecine) spoke on the subject: 'En 1981
comme en 1948: relations experimentales de causalite et analogies hippocratiques'.
In conjunction with the colloquium there were two exhibitions organised by La
Section des Sciences de 1' Antiquite de la Faculte des lettres: 'Autourd'Hippocrate'
(at the Bibliotheque cantonale et universitaire), an exhibition of books relating to
ancient medicine; 'Medecine antique' (at the Musee historique de l'AncienEveche) with a published catalogue (Renes/Lausanne: Grafiheld SA, 1981), an
archaeological and historical exhibition, which brought together a considerable
number of archaeological artifacts, texts and documents relating to Greek, Roman
and Graeco-Roman medicine.
The deliberations of the colloquium were further complemented by a pleasant
excursion in Valais, including a visit to Sian and 1' Abbaye de Saint-Maurice and by
a reception given by le Conseil d'Etat du canton de Vaud et la Municipalite de
Lausanne at the Villa Mon-Repos.
The proceedings of the lYe Colloque International Hippocratique will be
published in 1982; the next Hippocratic colloquium will take place in 1984 at Berlin.
JOANNE H. PHILLIPS

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40

News & Notes

II. DYNAMIS. A NEW JOURNAL
The Department of the History of Medicine of the University of Granada (Spain) is
pleased to announce the publication of Dynamis. Acta Hispanica ad Medicinae
Scientiarumque Historiam Illustrandam, a journal devoted to the history of
science and medicine which joins the only two other specialist journals in this field
in the Spanish speaking world, Asclepio from the Instituto Amau de Vilanova
(C.S.I.C., Madrid) and Llull from the Sociedad Espanola de Historia de las
Ciencias, to meet the growing interest in the history of sciences in Spain. 'Dynamis'
welcomes original contributions from scholars of whatever discipline whose work
bears on the fields of the history of scientific ideas, the practical and social aspects
of medicine or science, the history of educational, scientific and medical
institutions as well as its relationship with economic, political, philosophical or
religious doctrines and attitudes. 'Dynamis' offers an open forum, with no limit
regarding chronology, cultural area or nature of the subject. Papers are accepted in
Spanish, English, French, German or Italian. 'Dynamis' is published once a year in
a single volume of about 350 pages. The first issue, dated 1981, has just appeared
with contributions from P. Lafn, M. Me Vaugh, J.M. L6pez-Piiiero, R. Gago, J.L.
Carrillo, S. Mauskopf, L. Garda Ballester and others. Subscription rates amount
to $14 per year (postage included).
Address: Secretariado de Publicaciones
de la Universidad de Granada
Hospital Real
Granada/Spain
III. LE GROUPE IN FORMATIQUE ET HISTOIRE
A !'initiative d'un certain nombre de chercheurs et d'universitaires en histoire
modeme et contemporaine, un groupe Informatique et histoire vient d'etre
constitue. II se propose:
1. d'organiser des rencontres sur des themes tels que !'utilisation de l'informatique en demographie historique, l'emploi des micro-ordinateurs,
2. de publier un bulletin de liaison qui recensera les activites de recherche et
servira a echanger des informations pratiques.
Si votre experience ou vos projets VOUS conduisent a vous interesser a l'emploi
de l'informatique en histoire modeme et contemporaine, ils vous appellent ales
rejoindre.
Adresser Ia correspondence c/o E. Meyer, C.E.I.A.S., 54 Bd. Raspail, 75270 Paris
Cedex 06, France.

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News & Notes

41

IV. DANK AN DIE ANTON-BETZ-STIFTUNG
Es hat sich im vergangenen Jahr gezeigt, daB auch eine internationale Zeitschrift
wie Clio Medica mit finanziellen Schwierigkeiten zu kampfen hat: Der Verlag B.M.
Israel, der seit mehr als zehn Jahren (ab Bd. 6/1971) die Clio ohne ZuschuB
herausbringt, hat erklart, daB er fiir Bd. 17/1982 und die folgenden Bande eine
finanzielle Stiitzung benotigt, da die Zahl der Abonnenten nicht ausreicht, urn die
Zeitschrift in gewohnter Qualitat weiter zu drucken. Auch istja der Preis seit 1971
unverandert gleichgeblieben.
Der Versuch, eine Stiitzung der Clio von denjenigen Institutionen zu erlangen,
die jeweils die nationalen medizinhistorischen Zeitschriften subventionieren,
scheiterte daran, daB Clio Medica ein internationales Periodicum ist. So sehr seit
Jahren von internationaler Zusammenarbeit gesprochen wurde: es gelang nicht,
eine Stelle zu finden, die in der Lage ware, Clio Medica zu fordern.
In dieser Situation hat sich der Vorstand der 'Anton-Betz-Stiftung der
Rheinischen Post e. V.', von Prof. Dr. H. Schadewaldt angesprochen, bereit
erkUirt, mit einem ZuschuB die aktuelle Schwierigkeit, die Ieicht zu einem
Untergang der Clio Medica gefiihrt hatte, zu beheben. Hierfur mochten die
Herausgeber an dieser Stelle offentlich ihren Dank aussprechen.

V. INTERNATIONAL ASSOCIATION FOR THE STUDY OF PEOPLE AND
THEIR PHYSICAL SURROUNDINGS (I.A.P.S.)
The Objectives of the Association are:
To facilitate communication among those concerned with the study of the relationship between people and their physical surroundings and by so doing to maintain
and improve the quality of re~earch being conducted in the cause of improving the
physical environment and human well-being.
Over the past few years a number of conferences have been held in various
countries bringing together people from all over the world who share an interest in
the significance of the physical surroundings for the people who experience those
surroundings. International conferences have been held in a number of places
(Kingston 1970, Surrey 1972, Lund 1973, Strasbourg 1976, Louvain-la-Neuve 1979
and Surrey 1979). Because of the current and developing significance of research
and practice in this area, it is clear that the time is right to form an international
organization which will bring together the great variety of work being done by those
actively involved in studies of people and their physical surroundings, such as
psychologists, sociologists, architects and planners.
Consequently, at the International Architectural Psychology Conference at
Louvain-la-Neuve in 1979 and the International Conference for Environmental

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News & Notes

42

Psychology at Surrey in 1979, it was agreed to form a new association. People from
a variety of countries and disciplines were elected to serve as members of a
provisional committee to establish the new organization. At a meeting in London
on 26th September 1980, a provisional board was formed, which then elected an
Executive Committee. The Executive Committee met in Kingston on 28th
November 1980, to formulate the Constitution (copies of the Constitution are
available from the Secretariat on request) and prepare the ground to call for
members. At a subsequent meeting in Louvain-la-Neuve on 27th March 1981, the
details were agreed. We now invite people to join the Association.

Members of the Executive Committee:
Docent Rikard Kuller (Chairman), Lund Institute of Technology, Sweden
Dr. David Canter (Secretary), University of Surrey, England
Ms. Sue-Ann Lee (Publications Officer), Kingston Polytechnic, England
Prof. Jules Simon, Universite Catholique de Louvain-la-Neuve, Belgium
Prof. Dimitris Fatouros, Aristotle University ofThessaloniki, Greece

Other members of the Board:
Dr. Hartmut Espe, Hochschule der Ki.inste Berlin, Germany
Mr. Ian Griffiths, University of Surrey, England
Prof. Masao Inui, Tokyo Institute of Technology, Japan
Mr. Michael Kemp, DHSS, London, England
Prof. Alan Lipman, Welsh School of Architecture, Cardiff, Wales
Dr. Sophia Martinou, Athens, Greece
Dr. Arie Peled, Technion-Israel Institute ofTechnology, Haifa, Israel
Prof. Niels Prak, Technische Hogeschool Delft, Netherlands
Prof. Amos Rapoport, University of Wisconsin-Milwaukee, USA
Prof. Jean Remy, Universite Catholique de Louvain, Belgium
Mr. Martin Symes, University College London, England
Ms. Franr;oise Szigeti, TEAG - The Environmental Analysis Group, Ottawa,
Canada.
The next international conference of the lAPS will be held in Barcelona from 15th
- 17th July 1982. People wishing to obtain further details should write directly to the
conference organizers at the addresses below. Details of the conference programme will be available during February 1982.

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43

Conference organizers:
Enric Pol and Montserrat Morales
Institut de Ciences de l'Educacio
Universitat de Barcelona
Placa de la Universitat
Barcelona 7
Spain.

Joseph Muntanola
Director, Escola
T.S. d' Arquitectura
Barcelona 28
Spain.

VI. THE ISRAEL COLLOQUIUM FOR THE HISTORY, PHILOSOPHY AND
SOCIOLOGY OF SCIENCE 1981-1982
The founding is announced of the Israel Colloquium for the History, Philosophy
and Sociology of Science. Co-sponsored by the Hebrew University of Jerusalem,
Tel Aviv University and the Van Leer Jerusalem Foundation, and in collaboration
withR.S. Cohen and M. Wartofsky of the Boston Colloquium for the Philosophy of
Science, it offers, annually, a series of public lectures alternately in Jerusalem and
Tel Aviv. The lectures are given by scholars from Israel and from abroad; each
lecture is followed by a commentary and is open to a public discussion. Selected
papers from the Colloquium will be published by the Humanities Press. For further
information, please write to Edna Ullmann-Margalit, The Israel Colloquium, P.O.
Box 4070, Jerusalem 91040, Israel.
The Center for the History and
Philosophy of Science, Medicine
and Technology, The Hebrew University

The Institute for the History
and Philosophy of Science,
Tel-Aviv University

The Van Leer Jerusalem, Foundation.

VII. THE INTERNATIONAL COMMISSION ON THE HISTORY OF
WOMEN IN SCIENCE, TECHNOLOGY AND MEDICINE
A new International Commission on the History of Women in Science, Technology and Medicine was established recently at the XVIth International Congress
of the History of Science in Bucharest, Roumania. The Commission is an official
subunit of the Division of the History of Science (DHS) of the International Union
of the History and Philosophy of Science (IUHPS), a member of the International
Council of Scientific Unions (ICSU) of UNESCO. The purposes of the new
Commission are:
I. to promote communication among scholars doing research on the subject;
2. to hold meetings between international congresses and form symposia at
subsequent congresses;
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3. to prepare bibliographies and promote the preservation of relevant records;
and
4. to encourage the comparative, international history of women in these fields.
At its first meeting, held in Bucharest after its formation, the new Commission
decided to start a newsletter, organize an international bibliography, prepare a
directory of researchers, and hold a workshop on the history of women scientists in
particular countries in August 1983. Those wishing to receive the newsletter (at
present, free) should send their addresses to Dr. Eva Vamos, National Museum of
Science and Technology, H-1117, Budapest, XI Kaposvar u. 13-15, Hungary. She
is also making plans for the 1983 workshop, which will be held at a conference
center outside Budapest in conjunction with a conference there on 'Science and
Technology in Central Europe, 1914-1938'. Persons interested in attending this
workshop, especially those who wish to present papers, should write Dr. Vamos at
the above address.
The Commission will hold a second (partial) meeting in Paris in August 1982,
during the XXVIIIth International Congress on the History of Medicine, August
29-September 3. Persons interested in attending this meeting and discussing plans
for future work on the history of women in medicine should write Dr. Danielle
Jacquart, 74 Rue des Cevennes, 75015 Paris, France.
Other interested persons are urged to contact the Commission's chairperson, Dr.
Margaret Rossiter, 2410 Oak St., Berkeley, CA 94708, USA. The next International
Congress of the History of Science will be held in Berkeley in August 1985.

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Correspondence
BREVE REPONSE AM. ANTHONY PREUS
Dans le Numero 2/3, t. 16de laClioMedica (decembre 1981, p. 154), M. Anthony
Preus me reproche de m'etre contredit. II n'en est rien. Je maintiens que 'toute
approche d'ensemble de la Collection hippocratique serait actuellement prematuree'. Nous en avons en effet pour un demi-siecle, pour un siecle d'analyse. Mais
cela ne do it pas no us empecher, tout au contraire, de degager Ia doctrine medicate,
la me thodologie scientifique et I' esprit de cette partie de Ia Collection hippocratique qui se confond avec les traites dits 'authentiques'. II s'agit Ia d'une tache
differente, plus modeste mais a notre portee des a present, dont je m'occupe
moi-meme depuis plus de trente ans dans un isolement scientifique presque
complet. Des 1959, dans Ia seconde de mes 'Deux Conferences', j' ai montre I' utilite
de cette direction de recherches, sans trop convaincre helas ni les historiensmedecins, niles philologues.
Ace propos,j'aimerais encore mettre I' accent sur une autre confusion. Plusieurs
auteurs anglo-saxons ont prouve ces demieres annees que les arguments tires de
Ctesias de Cnide, d'Herophile et de Galien pour prouver l"authenticite' des
Epidemiques III et I (III vient avant I, cf. mon etude hippocratique de 1960, dont
presque personne ne tient compte), du Pronostic et des traites de Ia meme famille
etaient moins surs qu 'on ne l'avait pense jusqu 'ici. Ces recherches sont utiles. Mais
il n 'enfaut pas tirer des conclusions erronees. Le fait que des arguments precedemment invoques pour defendre une these deviennent douteux ne signifie pas encore
ni necessairement que cette these elle-meme soit fausse! Bien plus: on a pu Ia
confirmer par de nouveaux arguments. Je rappelle mon etude sur 'Thucydide et
Hippocrate' (1965). En 1975, M. J.-E. Dugand montra au Colloque hippocratique
de Mons qu'Antiphon le Rhamnonte fit condamner le medecin Hippocrate, probablement pour 'lakonismos' (cf. p. 237-241 des Actes du Colloque), et cela vers 411
avant J. -C., done a I' epoque me me ou pour d 'aut res raisons de poids no us pensons
que notre Hippocrate se trouvait a Thasos et y redigeait ses Epidemiques III et I!
Tout recemment enfin, de nouvelles preuves ont surgi faisant d'Hippocrate luimeme I' auteur du Traite 'Des Airs ... '. C'est une intervention de M. Fernand
Robert au Colloque hippocratique de Lausanne (1981) qui m'y a fait penser, et M.
Robert en parlera dans une prochaine communication. (Pour d'autres arguments,
cf. rna contribution au Colloque hippocratique de Paris, p. 353.)
Quelques Anglo-Saxons paraissent croire que j'ai de l'animosite a l'egard de
Ludwig Edelstein. lis se trompent; sa destinee fut traversee. Seulement, j'estime
que la meilleure maniere d'honorer un savant n'est pas de repeter ses erreurs, mais
de les corriger. Un certain 'anti-hippocratisme' a fait un tort considerable a Ia
recherche hippocratique, pendant un demi-siecle! On s'en apercevra tot ou tard.
CHARLES LICHTENTHAELER
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LTULIUS HIRSCHBERG

THE

HISTORY
OF

OPHTHALMOLOGY
ELEVEN VOLUMES

translated by Frederick C. Blodi, M.D.
Professor and Head, Department of Ophthalmology
The University of Iowa

This monumental history will now be available in English. Volume I (which has already been
translated and is in print) will appear during 1982.
It is planned to publish the following volumes in rapid sequence, usually two to three volumes per
year.
The price of each volume will be $ 78.00 provided that they have been ordered before volume I
appears. This is a subscription price. If the entire series is ordered, the price per volume will not
change over the following years. Included in the price is packing, insurance and postal fees. Volume I can also be obtained as a single volume (only up to May 30, 1982) at a price of$ 98.00.
Each volume of the series will be billed individually.
If more details are requested, we would be happy to send you the full Table of Contents of volume I. This will be mailed to you by surface mail($ 5.00) or by air mail$ 8.00). (CASH PLSE.)

WAYENBORGH
VERLAG · EDITIONS · PUBLISHER
P.O.BOX 200 646
D- 5 300 BONN 2 <WEST GERMANY)

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Book Notices
Vaidya B. Dash-Vaidya L. Kashyap, Basic Principles of Ayurveda. New Delhi, Concept Publish. Co,
1981 (Distributed in the U.S. by Humanities Press). XXVII, 627 pp., cloth, U.S. $37.-.
This is the second volume in the Todaranda Ayurveda Saukhyam Series edited by two
Ayurvedic officials in New Delhi, Vaidya B. Dash, Deputy Adviser for the Ministry of Health and
Family Welfare, and Vaidya L. Kashyap, Senior Physician in the Directorate General of Health
Services. The book contains an Ayurvedic tract compiled in the sixteenth century by an official named
Todara Malia. The original Sanskrit text and its English translation are followed by a valuable glossary
of terms and several commentaries. While this work is primarily intended for prospective Ayurvedic
practitioners, historians will also be interested in examining the principles and practices of an archaic
medical system still very popular in India.
Arthur E. Imhof, Mensch und Gesundheit in der Geschichte. Vortriige eines internationalen Colloquiums in Berlin vom 20.-23. September 1978. Husum, Matthiesen Verlag, 1980. VIII, 415 pp., paper,
DM69,-.
Historians of medicine and science will be delighted to know that Edith Heischkel-Artelt, Ro/fWinau,
and Heinz Mueller-Dietz have assumed editorial responsibilities for the revival of the Abhand1u ngen zu r Ge schich te der Med iz in und de r Nat u rwi sse n schafte n, a specialized
journal published in the 1930's. Volume 39 (vol. 38 appeared in 1942) attempts to resume a tradition
initiated by Prof. Paul Diepgen, then director of the Institute for the History of Medicine at the
University of Berlin.
In this issue, readers will find seventeen papers originally delivered by a truly international panel of
scholars at a 1978 colloquium in West Berlin. The topic 'Man and Health in History' drew a number of
historians, demographers, physicians, ethnologists, sociologists and theologians who examined in their
works the ecology of disease, conceptualization of disability, and human response to illnes, including
individual curing and organized societal health care efforts. Arthur E. Imhof, organizer of the meeting
and editor of the papers deserves praise for his efforts to get this group of excellent presentations into
print.
Rustomjee N. Khory-N .N. Katrak, Materia Medica of India and Their Therapeutics. Reprint of the
edition 1903. New Delhi, Neeraj Pub!. House, 1981. (Distributed in the U.S. by Humanities Press). 809
pp., cloth, U.S. $56.25.
In 1903 two medical officials from Bombay collected all herbal preparations then in popular use and
produced an extensive catalogue for the benefit of native healers and domestic curing. Each plant was
listed by the official botanical name followed by its various vernacular designations, parts used,
constituents, preparation, and uses. The book also contains a classification of drugs according to their
physiological effects and an alphabetical list of ailments to be treated by the herbs. With its wealth of
information historians will find the reprint of great interest.
Heinrich Rodegra, Das Gesundheitswesen der Stadt Hamburg im /9. Jahrhundert unter Beriicksichtigung der Medizinalgesetzgebung (1586-/8/8-/900). Sudhoffs Archiv, Beiheft 21. Wiesbaden, Franz
Steiner, 1979,217 pp. + 14 plates, DM 44,-.
The old Hanseatic city of Hamburg long attended to the public regulation of the affairs of its diverse
host of medical practitioners. Rodegra, who has already published a study of the development of

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Hamburg's hospitals, now provides a detailed account of municipal medical administration, tracing
events from the Apothecaries Act of 1586 to and after the decisive Medical Ordinace of 1818. He seeks
especially to depict the aftermath of this Act, showing how the city, by means oflegal enactments and an
effective Gesundheitsrat, sought to assure itself a supply of qualified medical and pharmaceutical
practitioners, attended increasingly to public health problems, oversaw and encouraged instruction in
the medical arts and provided for the support and improvement of hospital facilities. Given the
comprehensiveness of his account and also the economic and demographic importance of nineteenthcentury Hamburg, Rodegra's volume offers an excellent portrayal of the concrete manifestation of
Johann Peter Frank's ideal of 'Medicinische Polizey' and an invaluable because highly detailed record
of the creation of state medicine on the Continental model.
Calvin W. Schwabe, Cattle, Priests, and Progress in Medicine. The Wesley W. Spink Lectures on
Comparative Medicine. Volume 4. Minneapolis, University of Minnesota Press, 1978, XIII, 277 pp., (no
price stated).
The author, an internationally known authority in veterinary medicine, presents the provocative
thesis that medical practice in ancient civilizations received its first critical amount of factual data from
the care of domesticated animals. The book contains a vast amount of information about historical
developments in the Near East which is juxtaposed to anthropological data from contemporary African
cattle cultures. The early fame and skill of ancient Egyptian healers throughout the ancient world is
traced to the priestly functions of protecting animals considered objects of worship or sacrificial victims
in religious ceremonies and divinations. Although credible, Professor Schwabe's arguments must await
further comparative studies of archaic medical systems. However, the historical linkage of veterinary
and human medicine merits attention and could be quite valuable in future research.
Veronica Strong-Boag, ed., 'A Woman with a Purpose': The Diaries of Elizabeth Smith 1872-1884.
Toronto, University of Toronto Press, 1980, XXXVIII, 298 pp., illus., paper, U.S. $10.00.
Elizabeth Smith entered medicine in the 1880s at a time when Canadian medical schools resisted the
entrance of women. Her diaries record her early life, her struggle to gain a place in the male medical
school at Queen's University and her battle with discrimination while a student. The diaries end in 1884
as she launches her career as one of the first woman doctors to be trained in Canada. The diaries provide
insight into the struggle that women waged in order to get a medical education and illuminate the
strength of that first generation of women doctors. Veronica Strong-Boag presents an extremely useful
introduction.
Elizabeth H. Thomson, Harvey Cushing. Surgeon, Author, Artist. Reprint, revised, of the 1950
edition. New York, Neale Watson Academic Pub!., 1981, XVIII, 347 pp., illus., cloth, U.S. $17.00,
paper $7 .50.
This highly readable biography supplements the official account published by John F. Fulton in 1946,
adding a considerable amount of information that only became available after Mrs. Cushing's death.
Historians of twentieth-century American medicine will especially appreciate the timely and revised
reprint of what reviewers called a 'sympathetic portrait' sketched with special sensitivity and good
humor.

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Book Reviews
Mary Brown Bullock, An American Transplant: The Rockefeller Foundation and Peking Union Medical College. Berkeley, University of California Press, 1981 XXVII, 280 pp., U.S. $17.50.
Peking Union Medical College (PUMC), the 'Johns Hopkins of China', was the fabulous product of
Rockefeller evangelical zeal wed to scientific medicine. In the wake of the Flexner reforms, the China
Medical Board of the Rockefeller Foundation began to pour tens of millions of dollars into a program to
establish in China a model medical school and hospital of world-class standards. It succeeded, and by
the late 1920s, PUMC was graduating a tiny elite that would very quickly- as Bullock's study showsconstitute China's leading medical and public health educators and administrators. In Bullock's very
capable hands, the dramatic story ofthis cross-cultural institutional transfer is thoroughly intriguing and
full of insights about the complex problems of assimilating and adapting elements of foreign scientific
culture.
Two other monographs on PUMC (one by John Bowers, another by Mary Ferguson) have appeared
earlier. But they are limited to internal administrative history, curriculum, and observations of the
Western researchers who worked at PUMC; that is, they pay virtually no attention to the larger Chinese
cultural context or to the careers of the Chinese graduates of PUMC. In contrast, Bullock's well written
and researched study is comprehensive topically and chronologically. It takes us from the founding and
early administrative problems of PUMC in the 1920s, through the period of the Nationalist Revolution,
into the difficult years of the Japanese occupation, and in a fascinating epilogue, right into the 1970s in
the People's Republic.
Always sensitive to the problems of cultural assimilation, Bullock deals with such issues as the
mandated use of English as the language of instruction at PUMC; the social origins of students and the
means used to assure that their 'premedical' training would be sufficient to meet the very high standards
of PUMC; and the early discrimination at PUMC against Chinese faculty in the areas of salary and
administrative power. Her most significant departure is her intelligent handling of the problem of
'appropriateness': Just how suitable to China's needs was the PUMC/Hopkins model? What curricula
and institutional arrangements would have been better suited to a massive rural society? (And here, one
cannot help but join Bullock in asking whether and to what extent the 'Hopkins model' was even suitable
for the needs of American society; or if it worked in America.) She deals with these essential questions
by exploring programs and careers linked with PUMC, but in effect contradictory to PUMC's main
orientation: her chapters on Dr. John Grant's public health programs and on experimental rural
para-medical programs are not only important for their critique of PUMC, but they are startling for their
revelation of early heralds of the Chinese Communist's approach to health care.
Bullock's command of intimate detail is impressive. She was perhaps the first to exploit the Rockefeller Archives when they were opened to the public in 1973. In addition, she has drawn on the private
papers of key figures such as William Welch, Simon Flexner and Roger Greene, and she has interviewed
no fewer than seventeen people who were intimately involved with PUMC. This permits her to present
all.(and especially the Chinese side) of the picture and to illustrate what has up to now been known
superficially if at all. (For example, there is her reconstruction of the successful PUMC drive to discover
the cause and treatment of Kala-azar.)
This outstanding study should be read by all who are interested in the history of American medicine
and the role of the 'Rockefeller medicine men' in it, but most importantly, it should be read for its great
insights into the process and problems of transferring American medicine to China, or any non-Western
culture.
LAURENCE A. SCHNEIDER
Clio Medica, Vol. 17no. 1, May 1982
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Carlo M. Cipolla, Fighting the Plague in Seventeenth Century Italy. Madison, WI, University of
Wisconsin Press, 1981, XI, 123 pp., cloth, US $13.50
Carlo M. Cipolla. Faith, Reason, and the Plague in Seventeenth Century Tuscany. Trans. by M. Kittel.
Ithaca, NY, Cornell University Press, 1979, XI, 113 pp., US $9.95.
In these two books, Carlo Cipolla returns to a subject upon which he has written extensively, the
public health magistracies of Renaissance and Early Modem Italy. On this occasion, he has focussed on
their efforts in the face of plague. Both works are based upon extensive archival research and the sort of
effortless acquaintance with an historical epoch which only comes from years of study. Yet for all their
promise, these are disappointing books.
Fighting the Plague in Seventeenth Century Italy is based upon the Curti Lectures
given at the University of Wisconsin in 1978. There are three essays, of which the second, 'Public Health
and International Relations' is the most successful. In it, Cipolla traces the relations of various public
health agencies, though primarily those of Florence and Genoa, in the face of a plague epidemic in 1652.
The forces of political expediency, economic pressure, jealousy and suspicion are seen at work. The
author's characterizations of persons o.nd events are sure and believable, his ease with the period
evident. The documentation is superb and this essay leaves little to criticize.
The third essay, 'The Balance-Sheet of a Plague Epidemic: The Case of Pistoia in 1630-31' is likewise
exhaustively documented. Rates of infection and death, seasonality of disease, the costs of public health
measures and many other equally fascinating data are presented. Yet where this wealth of material cries
out for interpretation, Cipolla offers aggravatingly little. When he does analyse, there is often an
apparent contempt for the ignorance of those combating the plague. Repeatedly he states which
measures were right, or helpful, and which wrong. Unfortunately, he is not himself always correct and
lacks the excuse of living in the seventeenth century. For example, he condemns the extermination of
dogs and cats, which were felt to spread plague. Yet it is recommended today that these animals be
dusted for fleas to prevent spread of plague.
The Pistoia epidemic had a very low mortality, about 1.5% of the population. Cipolla says this is an
'epidemiological puzzle', without offering any real hypothesis to account for it. There are a number of
hypotheses which might easily explain it, some readily testable. Again, this lack of explanation is
frustrating in the face of such a wealth of documentation.
These problems are most apparent in the first essay, 'Theory, Observation and Policy'. Here the
author discusses theories about plague and measures undertaken to control it. In the Introduction, he
contrasts the 'organizational genius' of the health organizations with their 'totally absurd notions
concerning the etiology of disease' (p. 5), and in this essay he carries this point through. He consistently
denigrates medical knowledge in the period referring to 'dogmatic ignorance' (p. 8), and 'nonsensical
provisions' (p. 14). He states that 'the real test of accuracy is observation' (p. 9), but goes on to dismiss
those contemporary observations with which he does not agree.
I would find this more excusable if the author himself were free of medical errors, but he is not. He
states (p. 92) that 'we have learned to distinguish between bubonic and pneumonic plague and some
distinguish between bubonic and septicemic plague, though the septicemic form is but the fulminant
expression of the bubonic type'. This one sentence is quite misleading. First of all, there is both primary
and secondary pneumonic plague. Only primary pneumonic plague is acquired by respiratory contact
and is exceedingly rare. Most pneumonic plague is a metastatic infection acquired from a flea and
beginning as bubonic or septicemic plague. Septicemic plague is more fulminant than bubonic but is not
always bubonic to start with. These distinctions are worth noting since they bear on questions of the
epidemiology of the disease. Cipolla condemns definitions of disease based on clusters of symptoms on
the ground that they are worthless (p. 94). Yet digitalis worked as well for congestive heart failure before
anyone knew what caused it. Steroids treat temporal arteritis effectively even though we do not know
the etiology of the disease. Tetracycline cures Whipple's Disease even in ignorance of its etiology.
Faith, Reason, and the Plague isbycontrastalighterbook,primarilyanarrativeofhuman
relations during a plague epidemic in Monte Lupo in 1630-31. The author sketches in the efforts of the
public health officials and the reactions of the populace. Once again the documentation is superb and the
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51

characters are deftly fleshed out. The story is told with considerable verve and charm. Once again we
see the interplay of many forces, economics, conflicts of Church and State, personal rivalries and
character flaws.
Some of the same problems beset this book as the other, however. Again we see the quick condemnation of the medical ignorance of the period. Once again in the face of so much documentation, the
interpretation of matters other than personal motivation is superficial or lacking. I cannot help being
disappointed that an historian of Professor Cipolla's quality should have left so much unsaid.
STEPHEN R. ELL
E.J. Evans and J. Richards, A Social History of Britain in Postcards 1870-/930. London & New York,
Longman, 1980, $23,-.
A.H. Murken, Hier liegt mein Mann und liisst schon griissen. Miinster, Coppenrath, 1978 (no price
stated).
At present there are well over 150 books on postcards in print. Although a good many are little more
than catalogs or price-guides, others are grist to the mill of social historians. Among historians who have
discovered the collectors' world of postcards, E.J. Evans and J. Richards from the University of
Lancaster, England, have produced an attractive and intriguing 'Social History of Britain'.
Following a general introduction to postcards, six chapters cover: 'urban life', 'work', 'food, shops
and marketing', 'travel and transport', 'leisure and recreation'. and 'beside the seaside'. Each chapter
has a brief outline of the theme or themes, suggestions for further reading and a series of picture
postcards captioned in great detail. The views on the cards, which generally include people, are used to
provide informatior supplementary to the text. Because of the visual appeal of the cards that approach is
effective and pedagogically useful through reinforcing ideas from a different angle.
Matters of health are implicit in many views, such as the 1925 scene of a rowof'council' houses, rents
for which were subsidized. Between 1919 and 1929 nearly haifa million such houses were built, helping
to relieve overcrowding. Explicit medical scenes in the book include one on the early use of ultraviolet
light for treating tuberculosis of the skin in the London Hospital, Whitechapel. All in all this book is
invaluable as much for provoking questions as for the information provided.
The second book under review is for the ·~ecialist'. Along with 125 postcard views of German
hospitals, mostly published between 1900 and 1914, A.H. Murken provides a brief but useful introductory text. The captions to each card are disappointingly short and varied in content. The pictures
naturally raise many questions about architectural style, numbers of beds, special features, etc., and
such data is rarely included, though admittedly it is often difficult to obtain.
The title of the book, taken from a message on the back of a card, remains tantalizing, for no other
messages are included that might provide, for instance, glimpses of anxious, often frightened patients
behind the portals of the often awesome, institutional looking buildings. The following example comes
from an American card posted in 1929. 'I came here a week ago to have my eye treated. Have passed
through a tedious week of exams. Have no idea what the outcome will be. They have to operate on the
trouble, i.e., behind the ball. I am so anxious to get home.'
If there are disappointments with Murken's book, it is largely because the title promised more than is
given. Fortunately, we are still left with a worthwhile contribution to the growing literature on the
history of hospitals. Further, together with the book by Evans and Richards, we have a forcible
reminder thas postcards are invaluable sources of information rarely used by medical historians.
J .K. CRELLIN

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Book Reviews

Adolf Faller, Wertschiitzung von Stensens 'Discours sur /'anatomie du cerveau'. Veriiffentlichungen
der Schweizerischen Gesellschaft fiir Geschichte der Medizin und der Naturwissenschaften Bd. 35.
Aarau, Frankfurt a.M., Salzburg, Verlag Sauerliinder, 1981, 96 pp., SFr./DM30,-.
Adolf Faller eriirtert in seinem Buch die Abhiingigkeit und Kritik Stensens an bzw. von Descartes in
Fragen der Funktion des menschlichen Kiirpers als Maschine, behandelt Stensens Vorgeschichte und
Pariser Aufenthalt, bei dem der 'Discours' im Hause und wissenschaftlichen Kreis Thevenots entstand,
geht auf die Druckgeschichte des 'Discours' ein und gibt einen kurzen Oberblick iiber die makroskopische Hirnanatomie sowie Hirnforschung vor und zur Zeit Stensens.
Er beschreibt gut den Inhalt des 'Discours', gibt die Kritik Stensens an den Priiparations- und
Forschungsmethoden seiner Zeitgenossen wieder und bespricht die Priiparationsmethoden Stensens
sowie dessen Fortschritte auf dem Gebiet der Hirnforschung. Weiter folgt eine kritische Wiirdigung der
Abbildungen im 'Discours'. Der Hauptteil des Buches gilt den Ausgaben des 'Discours' und vor allem
der Wirkungsgeschichte des Traktats vom 17. bis zum 20. Jh., er ist hauptsiichlich eine Sammlung von
wiirtlichen Zitaten in Original und Obersetzung, die in einer kurzen Zusammenfassung enden. Zu
wiinschen wiire manchmal eine etwas genauere Dokumentation. Eine Anmerkung am Rande sei
erlaubt: Fabrica in Vesal's De humani corporis fabrica libri VII ist keineswegs als
'Maschine' zu interpretieren, wie Faller es tut (S. II), sondern mit 'Bauwerk', 'Struktur' zu iibersetzen.
HELMUT WINKLER
Richard W. Fox, So Far Disordered in Mind: Insanity in California 1870-1930. Berkeley, University of
California Press, 1978, XVI, 204 pp., U.S. $10.-.
Norman Dain, Clifford W. Beers: Advocate for the Insane. Pittsburgh, University of Pittsburgh Press,
1980, XXIX, 392 pp., U.S. $19.95.
Leland V. Bell, Treating the Mentally Ill. From Colonial Times to the Present. New York, Praeger,
1980, XI, 245 pp., illus., U.S. $21.95.
During the last two decades the shape and character of American history has been sharply altered by
what has become known as the 'new' social history. To the detriment of historical scholarship,
traditional specialties such as intellectual history have been eclipsed. But the balance sheet has not been
one-sided; the new social history has refurbished older fields and created newer ones as well. The
history of the care and treatment of the mentally ill is illustrative of these larger developments. In
France, Michel Foucault's ideosyncratic but provocative analysis of the eighteenth century turned
scholarly attention to the problem of understanding the origins of institutional care of the insane and
other 'deviant' groups. In the United States interest in the subject was stimulated by such scholars as the
late George Rosen and more recently by David Rothman, Andrew Scull and others.
The distance between the traditional and contemporary approach is best revealed by comparing
Albert Deutsch's classic and still valuable The Mentally Ill in America (first published in
1937) with more recent works. Deutsch's work was within the Progressive tradition of American
historiography; he emphasized the progression from barbarism to humanitarianism to science. His
pioneering history, therefore, began in colonial America when the mentally ill were either ignored or
abused, proceeded through the founding of institutions in the nineteenth century and concluded with the
unfinished task of upgrading institutional care in the middle of the twentieth century. Disinclined to
ignore shortcomings in the care and treatment ofthe mentally ill, Deutsch nevertheless looked forward
to a new era in which humanitarianism and science combined to solve an age-old problem.
By way of contrast, Richard W. Fox's 'So Far Disordered in Mind' is concerned with very different
issues. His book is a study of the social and cultural meaning of insanity in California from 1870 to 1930
and rests upon a quantitative analysis of the more than 12,000 people residing in San Francisco who were
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declared insane and committed to mental hospitals between 1906 and 1929 by the city's Superior Court.
At the outset Fox concedes that this group had litile in common and came from a heterogeneous
background. What united them was 'a type of relationship to other people'; the insane were 'disturbing,
peculiar, incomprehensible'. But they became insane not when they crossed a clearly defined line
between health and sickness, but rather 'when other individuals decided they could no longer be
tolerated'. Indeed, Fox argues that by the early twentieth century a crucial distinction between 'mental
disease' and 'insanity' had come into being. Insane persons committed to mental hospitals not only had
to display evidence of a disordered mind and destructive tendencies, but rather that 'relatives,
acquaintances, or public officials considered them both bothersome and unproductive, a threat not just
to familial or public tranquility but also to canons characteristic of bourgeois society'. The mentally ill,
on the other hand, might be functioning members of society; their sickness was neither 'incapacitating
or chronic'. Hence the spirit of toleration and sympathy toward the mentally ill helped to 'legitimize the
prolonged detention of the insane'.
Although provocative and valuable, Fox's book is not persuasive. Indeed, his use of demographic
data illustrates some of the basic difficulties related to quantification. First, aggregate data mandates the
blurring of distinctions. Words such as 'violent' and 'destructive' have a variety of meanings. A criminal
who is violent and destructive behaves differently from a violent and destructive mentally ill person; yet
the description and words are identical. To quantify such words is to dismiss the context in which they
are used. Secondly, Fox is unable to link data and thesis; the gap between his demographic categories
and his hypothesis is extraordinarily broad. Nor does he demonstrate a change in the social characteristics of the insane between the nineteenth and twentieth centuries (or perceptions of the insane) that
would support his allegation that after 1900 a critical distinction was made between insanity and mental
disease. Finally, California was quite different from other states. Even if Fox's thesis is applicable to
California (and I was not persuaded that it is), it does not mean that it is valid elsewhere. Despite these
criticisms, Fox's book is an important contribution, and his use of quantitative data will be emulated by
others seeking answers t6 puzzling questions.
Norman Dain 's biography of Clifford W. Beers, on the other hand, is of a quite different genre. Based
on exhaustive research into both unpublished and published sources, Dain has attempted to portray the
life of an individual whose name is synonymous with the twentieth-century mental hygiene movement.
Born. in 1876, Beers had a relatively conventional childhood and graduated from the Sheffield Scientific
School at Yale in 1897. Institutionalized for the first time in 1900, he spent a good part of the succeeding
three years in a mental hospital. His experiences led him to write a classic autobiography (A Mind
That Found It se It), which he hoped would become the forerunner of a broad based movement to
improve the condition of the institutionalized mentally ill.
In a series of illuminating chapters, Dain traces the growing conflict between Beers and AdolfMeyer.
Rejecting Eunice Winters' earlier assertion that the struggle was one of amateur versus professional,
Dain demonstrates that the differences between the two were far more complex and subtle and involved
claims of professional autonomy as well as strikingly different personalities. Meyer eventually resigned
from the National Committee for Mental Hygiene (NCMH), the organization created by Beers. By that
time, however, the struggle had redirected the goals of the NCMH away from mental hospitals and
toward a more popular but amorphous concept of mental hygiene.
Dain 's biography is strongest for the period before 1920. After that date his concern with Beers as an
individual causes him to lose sight of the NCMH and the mental hygiene movement generally. Indeed,
the least rewarding part of the book deals with the 1920s and 1930s, when the NCMH had moved far
away from its original concern with the institutionalized mentally ill. Nevertheless, Dain's book
demonstrates how exhaustive research, even at the level of individual biography, can illuminate a larger
movement. If he has not succeeded in adequately studying the larger movement, he has produced a
rewarding and what in all likelihood will be the definitive study of Beers. The strength of the work lies in
the attention to details and obvious mastery of the narrative. Many contemporary scholars who tend to
blur the distinction between history and ideology would profit from a careful reading of Dain's fine
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encompassing framework. Dain's book may very well seem old-fashioned by modem scholarly
standards, but it possesses all of the traditional virtues all too often absent from many contemporary
works.
Leland Bell's 'Treating the Mentally Ill' is a useful general introduction to the subject, although it by
no means supersedes Deutsch's classic work. Despite a lengthy bibliography of primary sources, the
book is actually based on a reading of the secondary literature. Bell's treatment of the eighteenth and
nineteenth centuries is better than his treatment of the more recent period, largely because historians
have devoted more attention to the earlier period. For those who know little about the subject, Bell's
work will prove useful; specialists in the field, on the other hand, will find little that is new. Indeed, Bell
misses the import, especially in the recent period, of the role of economic and administrative structures.
The debate that led to the founding of the Joint Commission on Mental Illness in the 1950s, for example,
was in large measure a debate over sources of funding rather than a debate over the delivery of
psychiatric services. Such shortcomings notwithstanding, Bell's work will serve a useful purpose if it
reaches a general audience unfamiliar with the subject.
Taken as a group, these books illustrate the growing interest in the history of the care and treatment of
the mentally ill. If they do not yet suggest the outlines of a comprehensive interpretation, their very
appearance offers the hope of a better understanding of the problem. Whether this hope will be realized
in the future, however, remains an unanswered question.
GERALD N. GROB

Toby Gelfand, Professionalizing Modern Medicine: Paris Surgeons and Medical Science and
Institutions in the Eighteenth Century. Westport Connecticut, Greenwood Press, 1980, XVlll, 271 pp.
illus., cloth, U.S. $29.95.
This book, like Gaul, has three parts- each of them equally important to the author. In Part I, 'The
emergence of a surgical profession, 1660-1750', Gelfand demolishes the stereotype of the eighteenthcentury surgeon as an artisan still trained by the traditional apprenticeship method and therefore devoid
of Latin, learning and polish. By the middle of the century, he writes, 'virtually all Paris master surgeons
took arts degrees and publicly defended theses in Latin' (77). Surgery had become a profession that
rivalled medicine.
In Part II, 'The structure of surgical education, 1750-1794', Gelfand shows how, through astute
political manoeuvers by the king's first surgeons, Mareschal, La Peyronie and La Martiniere, the
surgeons obtained the right to teach, free from physicians' supervision. In 1731, they opened their own
academy and in 1750, became a 'college' that depended directly upon the king- like the prestigious
College de France that Francis I founded to foster humanistic learning in the Renaissance. The hero of
Gelfand's story is Pierre Joseph De sault, surgeon-in-chief at the H6tel-Dieu of Paris from 1785 till his
death ten years later. He serves as an exemplar of how a surgical education was instrumental in creating
the substance of Gelfand's Part III, 'Models for medicine in a revolutionary context'. Here Gelfand
claims that the bedside teaching and clinical training, so important in the revolutionary reform of
medical education in 1794, should be credited mainly to the influence of surgery. He argues that many
surgeons in the countryside had long engaged in the practice of medicine, were already 'doctors', before
the law bestowed the title. He also tells us that most physicians of the revolutionary period and the early
nineteenth century came from surgical backgrounds. They rose above their fathers' station, while many
doctors' sons, in tum, entered the other liberal professions, forsaking medicine.
The strengths of this book lie in its tight structure and in the abundant documentation, particularly
from professional records in the appropriate Parisian repositories, often derived from the polemical
literature in the dogged rivalry between physicians and surgeons. Gelfand is particularly adept at
summarizing arguments clearly, as for example those by Quesnay for the surgeons in the 1740s, or those
by Chambon de Montaux for the physicians.
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I find the book less clear where it deals with the hospitals. The difference between the hospital (for
therapy) and the hospice (for custodial care) is never made apparent- perhaps in deference to the fact
that, in the eighteenth century, the terms were often confused. Yet the distinction helps explain a fact
that Gelfand rightly finds disturbing: the virtual absence of physicians from the hospices. These housed
inmates defined as incurable. The diagnosis having been made, it was felt that doctors could be
dispensed with. The innovation of having, in the hospices, infirmaries and physicians for the indigent
patients (and not just for administrators and staff), was an 'enlightened' advance of the 1780s.
Since surgeons formed virtually the only professional staff in the hospices and far outnumbered the
physicians in the hospitals, Gelfand assumes that they shouldered the major burden of patient care. I
think that it would be fair to credit a large part of this work to the nursing orders, especially the
Augustinian nursing nuns and the Brothers of Charity. The Brothers in particular underwent stringent
apprenticeships and emerged as ~killed practitioners in hospital pharmacy, lithotomy, or psychiatric
nursing. Their Charity Hospital in Paris, their Convalescent Home, rue du Bac, and the Charite de
Charenton were all judged exemplary by the revolutionary critics. While doctors practiced there,
patient care remained in the Brothers' hands.
This book should be of particular interest to our French colleagues who work in the same field, Dean
Pierre Huard, the distinguished anatomist who has published widely on surgery and medicine during
this era, and Dr. M.J. Imbault-Huart whose pioneer work in the archives of the Paris medical faculty has
put us all in her debt and who published an excellent thesis in I975 entitled L' e co Ie pratique de
dis s.e c t ion de Paris de I 7 50 a I 8 2 2: o u I' influence d u concept de me dec in e
pratique et de medecine d'observation dans l'enseignement medico-chirurgical au I8eme siecle et au debut du I9eme siecle.
A final word about translation: Gelfand uses some felicitous phrases that clarify the complicated
world of academic surgery and medicine: 'chief resident' for gagnant-maitrise, 'designate' for en
survivance, 'permanent secretary' for secretaire perpetuel, 'intern' for compagnon, 'clinical surgery'
for clinique ext erne, and 'clinical medicine' for clinique interne. This is a solid book.
DORA B. WEINER
Frank Honigsbaum, The Division in British Medicine: A History of the Separation of General Practice
from Hospital Care, 1911-1968. New York, St. Martin's Press, I979, XVI, 445 pp., U.S. $27.50.
Arnoid J. Heidenheimer and Nils Elvander, eds., The Shaping of the Swedish Health System. New
York, St. Martin's Press, I980, 245 pp., U.S. $27.50.
Most studies of medical delivery systems in individual countries are not very theoretical and do not
provide very much knowledge about the similarities and differences among national medical systems.
Within modest limits, however, these two studies focus on the medical histories of individual countries
within a comparative framework, and for that reason, their value transcends the individual countries
with which they are primarily concerned.
The better of the two books is that by Frank Honigsbaum, 'The Division in British Medicine'. The
study is primarily concerned with the division between general practitioners and hospital based doctors
in Britain during the twentieth century. The book begins with the National Health Insurance (NHI) Act
of 1911, as it was with that act that the state intervened on a large scale in the British medical system.
The book is a gold mine of information and no previous study has contained so much information
about the relationship between the medical profession and the state during the years between 191 I and
I948. Even so, the study does suffer in its conceptualization. While the main concern of the author is
with the cleavages within the British medical profession, much of the study focuses on such topics as the
development of the Ministry of Health in I919, the Dawson Report in I920, the rejection of the type of
health centers proposed by the Dawson Report, and the emergence in 1948 of the National Health

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Service with a different type of health center. And yet for a study which has as its primary concern the
divisions within the medical profession, the author fails to offer a satisfactory explanation as to why he
focuses so much attention on the emergence of the Ministry of Health and the Dawson Report. In short,
the focus of the study is not so much on the divisions within the British medical profession as it is on
various topics in the history of the British medical delivery system, with frequent comparisons with the
American system. Because the study devotes very little attention to the period since 1948, the analysis
does not shed much light on the extent to which the National Health Service intensified cleavages within
the medical profession - though this is an important period for understanding the history of division
within the British medical profession. Nor does the study devote much systematic attention to the
consequences of division within the medical profession. And yet, the consequences of cleavage within
the British medical profession have been profound. Because the profession was seriously divided
between general practitioners and hospital based doctors, consumers in Britain historically have been
somewhat more powerful vis-a-vis the medical profession than in America. Thus, British consumers
have historically been in a better position to dictate the conditions under which medical services would
be provided for the society. In contrast, the American medical profession has not historically been
seriously divided between general practitioners and hospital based doctors; and because of the ethnic
and racial heterogeneity of American society, consumers have historically not been able to play an
important role in shaping the conditions under which medical services have been provided in America.
While Honigsbaum does make occasional references to the American system, his study is not
explicitly comparative, and perhaps for that reason, he is insensitive to the consequences which have
resulted from the sharp divisions within the British medical profession. Despite the conceptual weakness of the study, however, Honigsbaum has read almost everything on the subject of the British
medical profession in the twentieth century- including almost all of the medical journals. And no one
who is interested in the history of the British medical system can afford to ignore his study.
The other study, 'The Shaping of the Swedish Health System', is a collection of nine essays by a group
of American and European scholars. As the essays are quite eclectic in nature, there is no theoretical
framework holding them together. The best essays are those by Arnold Heidenheimer, 'Conflict and
Compromises Between Professional and Bureaucratic Health Interests, 1947-1972', by Odin Anderson
and James Bjorkman, 'Equity and Health Care: Sweden, Britain, and the United States' and by
Hirobumi Ito, 'Health Insurance and Medical Services in Sweden and Denmark, 1850-1950'.
Most ofthe essays have a strong historical dimension, as they assume that the contemporary structure
of the Swedish medical delivery system can be understood only by employing a long term perspective.
Several of the essays have a comparative perspective, especially those by Ole Berg on the
modernization of medical care in Norway and Sweden, by Ito and by Anderson and Bjorkman
mentioned above.
Two perspectives are implicit in several of the essays, but because they are not explicit, they fail to
develop several themes in the history of modem medical delivery systems, including that of Sweden.
Several of the essays focus on the importance of the variable centralization-decentralization in
explaining the performance of the Swedish system. Others focus on the power of interest groups in
shaping performance- especially the power of the medical profession and various consumer groups.
Unfortunately, the essays do not have an explicit theoretical framework which develops the relationship
between performance characteristics on the one hand and on the other centralization and the power of
groups.
Other recent work demonstrates that highly centralized systems are more egalitarian, less innovative,
less costly and have medical resources less equally distributed across regions. As the Swedish system is
somewhat decentralized, it is not surprising that it is highly innovative, has considerable variation from
county to county in the distribution of medical resources and is not very cost efficient.
These essays, like other recent literature in the area of comparative politics, do focus on the role of
interest groups in shaping system performance - but there is no systematic discussion of the types of
performances desired by lower and upper income groups, physicians, and government bureaucrats- or
how the power of these groups has affected the performance of the Swedish medical delivery system.
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However, there is an emerging body of social science literature which suggests that lower income
consumers use their power to equalize medical benefits via public spending and to promote general
services rather than specialized ones. They tend to be less concerned with innovation than higher
income consumers, who are more concerned with maintaining their control over discretionary funds
and with promoting specialized personal services which they are able to purchase in the private sector.
Upper income groups prefer goods provided by private markets, for the marketplace permits more
prosperous individuals to exert influence over the form, quality and utilization of consumption goods.
Professionals among the providers attempt to maximize programmatic and technological innovations,
since these call for more oftheir special skills, and tend to enhance their income and/or prestige. For the
same reason, providers tend to promote the development of specialized services, which in turn
stimulate innovations.
Whereas providers tend to oppose organizational and technological standardization because it means
they have less control over services, government administrators tend to favor standardized services as a
means of reducing costs and maintaining control over public programs. For the same reasons, they are
less likely to be highly supportive of technical innovations.
Because the discussion of the role of interest groups in shaping the performance of systems is
somewhat idiosyncratic in these essays, they make no theoretical advance in helping us to understand
the relationship between the distribution of power and performance in the delivery of human services.
But even though these two books are not very theoretically oriented, they do advance our knowledge
of the health delivery systems of Sweden and Great Britain. And scholars working on these two
countries will find both studies very useful.
J. ROGERS HOLLINGSWORTH

Helge Kjekshus, Ecology Control and Economic Development in East African History: A Case of
Tanganyika, 1850-1950. University of California Press, 1977,215 pp., $18.-.
Disease in African History: An Introductory Survey and Case Studies. Edited by Gerald W. Hartwig
and K. David Patterson. Duke University Center for Commonwealth and Comparative Studies Series,
no. 44. Duke University Press, 1978,258 pp., $13.75.

K. David Patterson, Infectious Diseases in Twentieth-Century Africa: A Bibliography of Their
Distribution and Consequences. Crossroads Press, 1979,251 pp., $25.-.
The study of disease as a factor in African history is a field just getting underway. The three titles,
above, are among the first studies to break this new ground. Kjekshus, a political scientist, wrote his
book to stimulate historians to broaden their scope of historically important processes and include the
concepts of ecological change. Hence, the book tends to be rather polemical. Both Hartwig and
Patterson, in turn, saw the importance of disease in African history in early 1974 and invited a number of
scholars to participate in a conference on the topic. The volume, which is being reviewed here, is the
proceedings of that conference. Patterson has continued his work on disease by providing an immensely
useful bibliography on disease in Africa in the twentieth century and has just published a new book
entitled, Health in Colonial Ghana with the same press.
Kjekshus wrote his book to move the study of African history away from what he thought (correctly)
was an undue emphasis on the study of political and religious history. Instead, he tried to show that a
crucial element in nineteenth century East African history was the Africans' struggle to control his
environment. This battle, Kjekshus feels, was successful until the end of the century, when German
colonial forces disrupted traditional African economies. The consequence of this disruption was an
ecological collapse, which resulted in significant depopulation due to disease.

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In order to support his hypothesis, Kjekshus showed that nineteenth century East African societies
had reached an ecological equilibrium both with the environment and disease. He believed that the
population in that century was either stable or slowly expanding, despite the manifold changes resulting
from the new long-distance caravan trade. The picture that Kjekshus paints is one of Africans in
complete control, with efficient agricultural production schemes, new iron technologies and control
over the tsetse infested bush through careful animal husbandry.
The book's bibliography is rather comprehensive, particularly, his coverage of German works.
Unfortunately, many of the same sources which Kjekshus employed to paint his picture of the
nineteenth century can be used to show a very different scene. In truth, the nineteenth century was a
period of rapid change for African societies, which had to cope with the intrusion of outside traders,
slave raiding, famines (scarcely mentioned by Kjekshus) and outbreaks of epidemic disease.
As stated above, the book is polemical. Kjekshus was trying to dispel many myths concerning
precolonial African societies. Unfortunately, he went too far and created a false image of nineteenth
century East Africa. Nevertheless, his work has stimulated a number of African historians to rethink
some of their basic preconceptions of precolonial East African societies.
'Disease in African History' grew out of a symposium organized by Hartwig and Patterson in 1975.
The papers presented in the volume include case studies from East, West and Central Africa. The book
begins with an introductory overview by the editors of both the role and effect of disease in African
history. An article by Hartwig follows concerning the effects of sickness in nineteenth century East
Africa. He also has an article on louse-borne relapsing fever in the Sudan. Charles Good has contributed
a piece on the spread of tick-borne relapsing fever in East Africa. Next, Patterson discusses river
blindness in northern Ghana. The book continues with Azevedo's work on the Sara of Chad and their
experience with epidemic disease. Delancey discusses his work on plantation workers and health in
Cameroon. The remaining research piece is by James W. Brown, who writes about the Asante of Ghana
and disease in the early colonial period. The volume concludes with an up-dated and condensed version
of Patterson's bibliographic essay on medicine and disease in Africa, which originally appeared in
History in Africa in 1974.
As in any work breaking new ground, the quality of the essays in uneven. Some contributions, such as
Patterson's and Good's, are excellent; others are not. A few of the authors had problems dealing with
the medical literature and data. Furthermore, many of the authors did not venture beyond contemporary
explanations of the epidemics they discuss. Patterson and Good were the exceptions and their
contributions clearly stand out. Delancey, Brown, and Azevedo all mainly describe various incidents of
disease in their respective geographic areas. When any analysis is offered, it is rather simplistic.
The volume as a whole contains one other theme which needs to be reconsidered. Hartwig, Patterson,
Azevedo, and Brown have all expressed the notion that at the beginning of the nineteenth century
African societies lived in relative isolation. They believe that this isolation left the societies vulnerable
to epidemic disease. Hence, when isolation broke down in the nineteenth and early twentieth centuries,
epidemic disease ravaged these societies, as it had populations of the New World and Oceania.
However, this analogy between Africa and the New World and Oceania is false. The devastation of the
latter two populations was clearly the result of virgin soil epidemics of smallpox, measles, yellow fever,
etc. These diseases, though, have a long history in Africa. The book's introductory overview puts forth
a number of sophisticated reasons for changing disease patterns in the twentieth century. I am sure that
there are similarly complex reasons for new disease patterns in earlier eras, rather than an initial
introduction of epidemic disease.
The topic of disease in African history is one of crucial importance for understanding the experiences
of the nineteenth and early twentieth centuries. Despite some drawbacks, this work makes some
headway into dealing with a vastly complex subject. The articles are sufficiently non-technical so they
can be read by both non-Africanists and novices in medical history. I do recommend that all historians of
both Africa and disease read the book (with care in places) to provide both a better understanding of the
past and of Africa's peculiar medical problems.

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Patterson's bibliography on infectious disease in twentieth century Africa provides historians with an
invaluable research tool. He has surveyed the major journals in African studies, tropical medicine,
public health and the appropriate medical specialities. The entries have been arranged under the
headings: reference works and bibliographies, general works and texts, and one of thirty-four entries of
various diseases. The compiler has then provided both an author and geographical index.
Obviously, no bibliography can be comprehensive, but Patterson has covered an impressive number
of journals in compiling over three thousand entries. There are a few tricks in using the bibliography,
such. as, yellow fever being listed under arbovirus infections and making sure to check the 'catch-all'
section. The work serves, however, as a valuable starting point for historians, not familiar with
medicine, to begin work in the history of disease in Africa. Patterson's work blends very nicely with
Steven Feierman's bibliography, Health and Society in Africa: A Working Bibliography, which covers various aspects of traditional African medicine and health care.
MARC H. DAWSON
F. Kriiupl Taylor, The Concepts of Illness, Disease and Morbus, Cambridge, Cambridge University
Press, 1979, IX, 131 pp., $14.95.
Over the last decade there has been a marked increase of interest in the history and philosophy of
medicine. A major focus of scholarly investigation has been the nature of concepts and classifications of
disease. These analyses have been pursued out of interests in the history of nosography and nosology, as
well as from interests in historiography. In this latter vein, one must note Ludwik Fleck's En tstehung und Entwicklung einer wissenschaftlichen Tatsache (1935),astudyofthe
concept of syphilis, which was rediscovered because of its influence on Thomas Kuhn's The S trueture of Scientific Revolutions (1962). This literature is paralleled by a growing, but already
substantial, interest on the part of philosophers and physicians in conceptual or philosophical concerns
with the concepts of health and disease. These interests, though for the most part pursued for scholarly
reasons, have a bearing upon the development of computer diagnostic programs and the improved
understanding of medical decision-making.
This slim volume by F. Kriiupl Taylor offers an interesting contribution to both the history and
philosophy of medicine. The volume attempts much. It offers a brief historical overview, and an analysis
of conceptual and logical problems in the classification and diagnosis of diseases. It offers as well a set of
suggestions regarding distinctions among the various senses of 'disease entity'. It does this, however, in
near innocence of references to the substantial literature available in the history and philosophy of
medicine in 1978, when one would presume this volume went to press. Had the volume attended to this
literature of the early '70's, one could with greater ease place it within current scholarly investigations.
Many of the concerns addressed by Kriiupl Taylor have, for example, been touched upon by Hendrik
Wulff in Rational Diagnosis and Treatment (1976), and by Edmond Murphy in The
Logic of Medicine (1976). Still, Kriiupl Taylor's volume has the special merit of suggesting the
relevance of the work of philosophers such as RudolfCarnap, Gottlob Frege, Willard Van Orman Quine
and Alfred North Whitehead to problems of classification in medicine.
Though the book is organized in nine short chapters, it has three principal foci. The first is historical,
reviewing notions of disease. The emphasis is upon ontological theories of disease (here Thomas
Sydenham is discussed) and reactive theories of disease (here RudolfVirchow is discussed). By reactive
theories Kriiupl Taylor means those that held disease entities to be properly understood as bodily
reactions to pathogenic factors. The second focus is upon problems of classification and diagnosis.
Finally, suggestions are made with regard to a preferred understanding of 'disease entity' and with
respect to specifying the intension of classes of patients.
Kriiupl Taylor presupposes, and in part explicitly uses, what could serve as a very useful classificatory grid in the analysis of the history of concepts of disease. He distinguishes among etiological
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physical disease entities. A careful application of these distinctions to the history of ontological theories
of disease, which he reviews, would have offered clarity in an area usually marked by confusion. In
denominating nosologists of disease as 'ontologists', few authors have explicitly and carefully shown
why particular authors in particular works have seen disease entities to be such. They have failed to
distinguish among medical phenomena being disease entities because they possessed unique causal
antecedents, because they constituted a clinical taxonomic cluster of findings, because they were
marked by an identifiable cluster of pathological data, or because they were seen to be independent
beings in some more metaphysical sense. Kriiupl Taylor employs these distinctions in the volume.
However, the volume would have benefited from a more schematic display of the distinctions and their
relevance to the various senses of 'disease entity' used by Rudolf Virchow, Thomas Sydenham,
Franr;ois Boissier de Sauvages de Ia Croix, as well as by modern physicians Kriiupl Taylor mentions.
Etiological disease entities are central to Kriiupl Taylor's concern. He reviews the difficulty of
identifying valid, reliable and efficient indicators of the etiological roots of clinical findings. Here, for
example, he contrasts the trustworthiness of exteroceptions, introceptions and interoceptions. He also
would prefer a state of affairs in which the taxa in nosologies could be specified in terms of unique
causes. This search, however, is likely to be ephemeral, for events are due to the final balance of many
causal factors. One chooses a causal factor for one's attention, because of its relevance to one's
particular interest, thus rendering other causal factors merely background conditions. Thus, since the
development of an infectious disease also presupposes a genetic susceptibility to the organism, to term it
an infectious disease is to decide that genetic variables are not important to the particular classificatory
goals at hand.
This is, of course, an important point in the history of medical causality, one not overlooked by Rudolf
Virchowinhisargumentin Hundert Jahre allgemeiner Pathologie (1895)thatthepresence
of diphtheria bacilli was not a sufficient condition for the development of diphtheria. Most disease states
are probably not only the outcome of complex webs of causality, but of alternate causal complexes, so
that many particular causal elements of those complexes are neither necessary nor sufficient conditions
for the disease in question. As a result, physicians are likely to be forced to abandon the hope for
monogenic disease entities and accept instead more complex classifications recognizing the complexity
of causal antecedents. Kriiupl Taylor's statement, 'If we were omniscient, then every individual morbus
in the iwsological domain would be monogenic' (p. 79), is an expression of a view of disease conditioned
by the hope for final unambiguous classifications based on unambiguous causal accounts allowing for
specific prevention, if not specific treatment.
The volume closes with a discussion of the concept 'morbus', which Kriiupl Taylor introduces to
denote both the illness and disease attributes of a particular empirical class of patients. Kriiupl Taylor
distinguishes between diseases which identify 'Virchowian disease entities' or particular configurations
of pathological abnormalities, and illnesses which consist of clinical phenomena. The concept morbus is
to encompass both. In these discussions, brief but interesting analyses are made of these concepts and
their relation to notions of normality and abnormality, as well as to molecular accounts of illnesses and
disease.
Though this volume is brief, it accomplishes much. It offers for the most part, to the beginner a lucid
and well-written introduction to some problems in the history and philosophy of medicine. Even for
those acquainted with the literature concerning concepts of health and disease, there will be enough to
merit a reading.
H. TRISTRAM ENGELHARDT, JR.
Frank C. Mevers, ed., The Papers ofJosiah Bartlett. Hanover, N.H., University of New England, 1979,
xxxvii, 477 pp., illus., $25.-.
Josiah Bartlett (1729-1795) of New Hampshire is perhaps best known as one of the physicians who
signed the Declaration of Independence. A practicing physician at the age of 21 and in his later years a
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founder and president of the New Hampshire Medical Society, he was also a man of weight and
influence in the affairs of his province and state- select man, justice of the peace, militia officer, member
of Congress, chief justice, and governor. He supported a large family by farming, and died owning farms
and rights to land. How, one wonders, had he time for medicine? The fact is that, after 1765, he seems to
have practiced little. Like Joseph Warren, John Brooks, William Eustis and other New England
physicians of his day, he seems to have taken more satisfaction from public service than from medical
practice and it is for his public services that he will be longest remembered.
This selection of Bartlett's correspondence reflects and records those public interests, providing a full
view of the career of a New Hampshireman who observed and participated in the movement for
independence and the establishment of the union.
For the social historian Bartlett's letters offer glimpses and reactions to persons and places strange to
a downright Yankee's eyes. 'The Living in so Grand a City [as Philadelphia) without the pleasure of a
free Country Air is not very agreeable to me,' he observed. York, Pennsylvania, where Congress met
during the winter of 1777-78 was more healthful; but prices were exorbitant. 'Beside the Disagreeable
manner in which these people [the Pennsylvania Germans) Cook their victuals, and the Sluttish manner
of washing our linnen in Cold Water only, which has already almost ruined mine, makes me willing to
quit this place.'
Medical historians will find some interesting bits of information. The first letter in the collection is a
bill for medicines and another early letter contains advice from a lawyer for one of Bartlett's patients, an
unmarried mother who wanted the father to pay for the baby's support. A number of letters between
Josiah Bartlett and his wife refer to smallpox. It prevailed in Philadelphia in 1775 when Josiah attended
the Continental Congress there and he prudently had himself inoculated; but such was the danger of
infection that he warned Mary 'to hold all my Letters over the Smoke a Little before you handle them
much.' The next year smallpox broke out in Boston and was carried into the country by refugees from
the city. At Portsmouth, Mary told her husband, the selectmen asked permission of the Committee of
Safety to open an inoculation hospital. Many of the personal letters contain inquiries about health and
reports of headaches, fevers, pains and other indispositions, whose frequency belie a popular impression that our ancestors were strong and healthy.
The editor has done a commendable job in selecting, transcribing, and annotating the 380 letters in this
volume. Those he did not include- 415 in number- are listed in an appendix, with date, a brief
descriptive note, and the location of the letter in the microfilm publication of 'The Papers of Josiah
Bartlett' (7 reels, 1976). There is also a bibliography. Dr. Mevers has resisted the temptation to write a
history of New Hampshire,; but in identifying footnotes and explanatory headnotes he has provided the
minimal information a reader requires. This is a book of reference that is sure to serve the needs
pricipally of general students of the Revolutionary and early National periods but also of historians of
medicine who, assessing medical practice in 18th century America, may wonder why so many intelligent
and reliable physicians achieved wider and more lasting reputation in other fields.
WHITFIELD J. BELL, JR.
Enid Rhodes Peschel, ed., Medicine and Literature. Introduction by Edmund D. Pellegrino. New York,
Neale Watson Academic Publications, Inc., 1980, 204 pp., $15.-.
•Medicine and Literature', edited by Enid Rhodes Peschel, is an excellent collection of new material
arranged in three parts, 'Doctor-Writers', 'Doctors Portrayed in Literature' and 'Disease as an Alteredor Heightened - State of Consciousness'. The twenty-three contributors bring to the topic their
knowledge in related fields of criticism. The result is a useful and stimulating interface between two
fields which at first glance may appear to have little in common- but only at first glance.
Significantly, this interface does not depend merely on the facts that some physicians are also writers
and that some literary works are about physicians or characters being treated for disease. The humane
introduction by Edmund D. Pellegrino says it best: 'To look compassionately is the summit of artistry
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for both medicine and literature; to take part in the struggle is the morality they share.' While it would be
hard for me to relate some writers and physicians to that statement (Ezra Pound or the Nazi doctors
compassionate?), it is, nevertheless, a fine statement of the humanistic ideal. Structurally, Pellegrino
sees the narrative qualities of the patient's history and literary stories as another link between the two,
but he correctly notes that 'the writer's tale transcends the clinician's history', since literary narrative is
an example of the concrete universal, a statement only partly true of the case history, which has a more
immediate and particular aim. As Pellegrino comments, 'Literature also teaches the physician something of the significance of symbol and language as the media linking human minds and personalities.'
The scientific method, in which physicians have been carefully and necessarily trained, insists on clear
distinctions between opinion and fact, intuition and scientific validation. Yet an ability to respond to
nuances of symbol and language, although given scant attention in most areas of medical education,
could help the physician to recognize the unstated and perhaps unconscious meanings which the patient
attaches to his illness and his body and to understand that the body is an organic system which not only
includes specific physical properties but, like the work of art, is charged with metaphorical values as
well.
Only a few of the twenty-three articles collected in 'Medicine and Literature' can be mentioned here;
all are well worth reading for physicians, literary scholars, or humanists interested in relating the two. In
an essay on Chekhov by Stephen Greco, we learn how Chekhov's metaphor,' "I look upon medicine as
my lawful wife and literature as my mistress",' expressed an ambivalence reflected in his 'curiously
uncomplimentary' treatment of physicians such as Dom in The S e ag u II, Astrov in UncI e
Vanya and Chebutykin in The Three Sisters. In a study of Rabelais, Raymond C. LaCharite
demonstrates that 'it is [Rabelais 'sj uncanny use of the human body as a pulsating, throbbing metaphor
for the whole of life that best illustrates his sensual and luxuriant imagination and his manipulation of
physiology and medicine for esthetic and teleological ends'. In a study of Tobias Smollett, Harold Gene
Moss shows that in Roderick Random, Smollett, who had been a medical apprentice and later was
commissioned as a surgeon's mate on a naval vessel, interweaves the theme of 'the revival of health
from a "diseased" state' with the romance of a young man's frustrated 'efforts to establish himself
within society.' In an essay on the contemporary surgeon-writer Richard Seltzer, Enid Rhodes Peschel
suggests that Seltzer (whom she admires as much as I do) was early drawn to Roman Catholic liturgy,
although he was raised a Jew and that this influence helped to shape the ritual and mystical elements of
his stories in Rituals of Surgery and Mortal Lessons: Notes on the Art of
Surgery. In a study of Gustave Flaubert, Eugene F. Gray relates the author's 'incisive style' and
'critical, analytical' approach to Madame Bovary to 'the clinical view of life' nurtured in
Haubert's upbringing in a medical family and expressed in his beliefthat in time' "art will be scientific,
just as science will become artistic" '. Andrew E. Slaby and Laurence R. Tancredi, in. their article
'Literary Insights and Theories of Person', show how literature can become 'an adjunct to the person of
the physician, to heighten sensitivity to the full creative potential of human beings and to the complexity
of psychological and physical forces that militate to destroy them'. In explaining the function of
literature 'in the expansion of what is known about human personality and the workings of the mind', the
authors relate the problems of sexual identity in D.H. Lawrence's The Fox and Women in
Love, E.M. Forster's Maurice, and Virginia Woolf's Orlando to Erik Erikson's theory of
'identity versus role diffusion' in adolescence. Among the other writers considered in 'Medicine and
Literature' are Louis-Ferdinand Celine, Samuel Garth, Arthur Schnitzler, William Carlos Williams,
Albert Camus, Martin du Gard, Marcel Proust, Henri Michaux, Thomas Mann, Andre Breton, and Walt
Whitman. It is a very useful collection.
JAMES C. COWAN

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Martin S. Staum, Cabanis, Enlightenment and Medical Philosophy in the French Revolution.
Princeton, N.J., Princeton University Press, 1980, XI, 430 pp., US $27.50.
While important work on P.J.G. Cabanis (1757-1808), the physician and physiologist, has been
published in Europe in this century (most recently Claude Lehec and Jean Cazeneuve' s critical edition
of his work, 1956), this is the first comprehensive study of his thought and politics and the only account
in English. Based on amazingly thorough research in archives and in medical and physiological treatises
written between 1750 and 1830, Staum situates Cabanis' thought in relation to his predecessors and
colleagues better than any study I have read.
Following in the direction of Colonna d' /stria's articles (1911-1917), Staum has written a sympathetic
rehabilitation of this neglected leader of the French Directory and Empire's school of 'ideology', or
psychological sensationalism and analytical methodology. Cabanis' famous or infamous Rapports
du physique et du moral de l'homme (1802)whichwentthrougheighteditionsbyl844has
usually been seen as a systematic medical conclusion to the Enlightenment materialism of Diderot,
D'Holbach and La Mettrie. While Staum recognizes and fully explores Cabanis' links to these authors,
the originality of his work lies in the thorough examination of Cabanis' debt to the Montpellier vitalistic
school of physiology which permeated the French medical world by 1800. The relationship of life to
matter, of body to soul or to some vital force, the dynamic properties of matter such as attraction,
chemical affinity, electricity and even sensibility and emergent intelligence were the dominant questions
of medical discourse. Rejecting the mechanistic dualism of Descartes, Cabanis developed a
physiological monism which Staum maintains was not materialistic. Cabanis' reputation for such
depends on a key passage which is not quoted here as it was in one ofStaum's earlier articles: 'The brain
in some way digests impressions and organically it effects the secretion of thought.' Staum argues that
while Cabanis was a transformist and saw no 'difference in kind between living and nonliving matter' (p.
179), his emphasis on instinct, his important contribution to knowledge of the irritability of muscles as a
vital activity, and of the role of the nervous system in sensation and his 'most significant contribution'
(p. 191)- the analysis of internal sensations and subconscious impressions (e.g. malaise)- all separate
him from eighteenth century materialism with its external sensationalism (Condillac's statue man) and
mechanism (La Mettrie's L' Homme Machine). In this light Staum agrees with C. d'Istria (whose
article is listed in the bibliography but should be cited inch. XI) that the posthumous, 'Lettre aM.F ....
sur les causes premieres' in which Cabanis postulated the existence of an intelligent cause of the
universe and the immortality of the soul was neither a conversion nor a lapse but a logical development
of his earlier vitalism.
Cabanis' tabulation of symptoms and the variable physical factors affecting moral well-being- age,
sex, temperament, diet, climate- is akin to Pinel's Nos o I o g i e ( 1798) and hence to what Foucault
terms the classic episteme of static classification. However, Caban is' vitalism counterbalances this trait
and furthermore Staum does not feel that Cabanis' medical reformism and his conservative republicanism- his disapproval of extensive poor relief which would interfere with a 'liberal' natural order, his
dislike of Jacobinism, his advocacy of press censorship during the Second Directory and his active
involvement in the coup d'etat of Napoleon- confirms Foucault's vision of medicine as an instrument of
social control in this period. Cabanis supported widespread primary education, wanted personalized
small clinics to replace the Hotel Dieu and Hopital General and above all was convinced in human
perfectibility through medical harmonizing of temperament.
Staum is complete on Cabanis' intellectual predecessors but less so on his medical heirs of the
nineteenth century about whom we need to know much more. A fuller picture of Cabanis' role as an
intermediary between eighteenth century materialism and vitalism and nineteenth century voluntarist
and activist psychology launched by Maine de Biran, who was inspired by Cabanis among others, needs
fuller exposition. As it stands, Staum's book is a very important contribution to the history of French
medicine in the early phase of its grandeur.
EMMET KENNEDY
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Morris J. Vogel, The Invention of the Modern Hospital: Boston 187{}-1930. Chicago, University of
Chicago Press, 1980, IX, 171 pp., U.S. $15.50.
Morris Vogel has taken for his theme the group of hospitals serving the City of Boston and except for
brief mention, has not concerned himself with any others. But his book must not be regarded simply as a
contribution to local history. The present writer is more intimately acquainted with the history of British
hospitals. While reading Vogel's book, he found himself repeatedly remarking on similarities between
the development of the Boston group and of its counterparts in Britain. The same is doubtless true of the
majority of hospital groups in North America. Thus Vogel's book is a microcosm, a detailed description
of a comparatively small hospital complex which is also the story of hospital development at large.
Hospitals are part of the social scene and hospitals changed their function in accordance with changes in
the social surroundings.
The author has concentrated upon the period between the American Civil War and the Second World
War, a period characterised by rapid progress in scientific medicine and by the waning influence of the
traditional aristocratic or 'Brahmin' caste. He examines the motives prompting foundation of a
voluntary hospital, taking as his example the Massachusetts General founded in 1811. Here he avoids
the pitfall which has entrapped so many modem social historians. He does not insist that founders acted
solely from self-interest but allows that stewardship, the self-imposed obligation of the wealthy to help
the less fortunate, was a primary motive. Hospitals of the 1870s, inefficient and feared by their inmates
though they may have been, existed only for the benefit of the poor. They had largely the same purpose
as their mediaeval predecessors, the care rather than the cure of the sick. Supported, managed and
served by a benevolent elite, the ·Brahmins· who resented interference from anyone outside their caste,
the hospitals became inbred as regards medical staffing and entirely parochial in their patient catchment
area.
An expanding population and dissatisfaction with the elitist closed shop of the voluntary hospitals led
to the foundation of municipal infirmaries which removed care of the sick from the almshouse in
America and the workhouse in Britain. Vogel takes as his example the Boston General 'the poor's own
hospital'. Patient criticism of the voluntary hospital tended to be regarded as ingratitude. Emergence of
the urban political machine gave the patient a voice in management through the ward boss or councillor
who represented a lower class constituency.
Industrialisation produced the 'lodger' who could not be classed as 'poor' but required inpatient
treatment when sick. The nursing home or private hospital developed to meet their need. The old
established hospitals followed suit, building their own private hospitals for fee-paying patients. The
middle and upper class were gradually drawn into the hospital ambit. Workmen's compensation and
third party payments spelled the end of patient care as an object of charity. Hospital appeals emphasised
the need for capital expenditure and research facilities. Hospital support was no longer an expression of
upper class stewardship but became a community responsibility. As medicine became more scientific
and more complex, so hospital and medical school were drawn into closer collaboration. The hospital,
originally founded for the care of the sick poor, was transformed into a training ground and an
instrument of research.
Morris Vogel tells the story well. He has researched his subject deeply. This is a short but trenchant
book which is an important contribution to social history.
FREDERICK F. CARTWRIGHT
Maxwell M. Wintrobe, Blood, Pure and Eloquent. A Story of Discovery, of People, and ofldeas. New
York, McGraw Hill Book Co., 1980, XXIII, 771 pp., illus. US $30.-.
The Blood, Pure and Eloquent, in the words of John Donne, leads us in this remarkable book to a feast
of reason. Nineteen physicians who have been leaders in the development of our current understanding

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of the functions and diseases of the blood have written chapters describing the various aspects of the
history of hematology. The book was conceived by Dr. Maxwell Wintrobe of the University of Utah,
whose own contributions to his special field, such as the hematocrit determination, are world renowned.
To this book he contributed an opening chapter reviewing our long fascination with the blood and a
short concluding one, 'The Lessons of History'. Except for Gerald D. Hart's chapter on 'Ancient
Diseases of the Blood', the eighteen remaining chapters concern themselves mainly with 20th century
developments, although the earlier historical understanding of blood transfusion, of inflammation and
so on are also to be found in this book.
There are chapters about the functions of the various blood cells and how we have come to understand
them, of blood groups, and chapters devoted to various anemias and leukemias. All authors have
provided extensive references to the pertinent primary literature, some of it of quite recent vintage.
Thus anyone attempting to write the history of 20th century medicine will have an easier task because so
much information is available in this book. That much here is really a review ofthe literature in chronicle
fashion and lacking both interpretation as well as a broader historical context is of small matter.
The rapidly increasing knowledge of cellular function and heredity in the last two or three decades is
an exciting, one can even say an exhilarating, story. In two anemias, Thalassemia or Mediterranean
anemia and in sickle cell anemia, we can see clearly how the developments of basic biology have become
crucial to the understanding of the pathogenesis.
With the discovery of an inherited hemoglobin abnormality by Linus Pauling and his co-workers
around 1950, the molecular basis of disease was established. Subsequent events in genetics, biochemistry, immunology, virology, and molecular biology are all well-known to today's students. For
those of us having to learn a new language in order to write recent history, the authors of this book
provide a very useful guide. In some of the chapters there is more than mere review of the literature,
useful as that is in itself. C. Lockard Conley, for instance, in his chapter on sickle cell anemia, surely one
of the very best in a good book, even tells us what specifically stimulated various investigators to try
their experiments. Thus a step toward historical understanding. The chapters on Thalassemia by D.J.
Weatherall, on bone marrow by Mehdi Tavassoli, on defenses of the body by Charles G. Craddock and
those on transfusion and on blood groups by Louis K. Diamond also provide an historical context. Dr.
Weatherall clearly guides us through the interesting fifty year story from the original description of
Thalassemia by Thomas Cooley to an era of discovery of its pathophysiology to the present realm of
molecular biology.
All in all, then, a book that should be of great interest to historians of medicine, to physicians, and to
biologists who would like to learn about some of the applied aspects of their science.
GERTH. BRIEGER

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New announcement of two medical
biographical dictionaries
Two medical biographical dictionaries of the early nineteenth century will now
appear in one reprint edition. This edition replaces the edition, announced earlier,
containing only the work of Jourdan. As both dictionaries supplement each other,
we found it justified to arrange these important works in one binding.
Both works contain lenghthy biographies supplemented by exhaustive and
accurate bibliographies of physicians of the past. Profit by this unique offer to
acquire both rare works at once!
A.J .L. Jourdan (ed.), Dictionaire des sciences mooicales. Biographie Medicale.
Reprint of the edition Paris, Pancoucke 1820-1825, 7 volumes, 4024 pp. of the original edition
slightly reduced on 1008 pp. of our reprint edition.

J .E. Dezeimeris, C.P. Ollivier & J. Raigne-Delorme (eds.), Dictionnaire historique
de Ia medecine ancienne et moderne.
Reprint of the edition Paris, Bechet Jeune 1828-1839,4 volumes in 5, 2902 pp. of the original
edition slightly reduced on 726 pp. of our reprint edition.

Both multi-volume works in one volume of 1734 pp., format 20 x28 em., cloth
binding.
Subscription price f 580,After publication f 650,Date of publication: April 1982.
See also: Hirsch, Vol. 1, p. XVIII & p. XXV.
(We kindly request you to renew your subscription in the event that you subscribed
to the Jourdan edition announced earlier.)

r B. M. Israel b.v. Publishing Dept.
~I

N.Z. Voorburgwa1264
1012 RS Amsterdam, The Netherlands

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Books Received*
ANTHROPOLOGY
Michael R. Zimmerman, Foundations of Medical Anthropology. Anatomy, Physiology, Biochemistry,
Pathology in Cultural Context. Philadelphia, W.B. Saunders Co., 1980, VII, 214 pp., illus., (no price
stated).
BASIC SCIENCES
William Coleman and Camille Limoges, eds., Studies in the History ofBiology vol. 5. Baltimore, Johns
Hopkins University Press, 1981,205 pp., cloth, U.S. $18.-.
Robert G. Frank, Jr., Harvey and the Oxford Physiologists: Scientific Ideas and Social Interaction.
Berkeley, University of California Press, 1981, XVIII, 368 pp., ill us., cloth, U.S. $27.50.
Shirley A. Roe, Matter, Life, and Generation. Eighteenth-century embryology and the Hailer-Wolff
debate. New York, Cambridge University Press, 1981, X, 214 pp., cloth, U.S. $32.50.
E. Schultheisz, ed., History ofPhysiology. Advances in Physiological Sciences, vol. 21, Proceedings of
the 28th International Congress of Physiological Sciences - Budapest 1980. Budapest, Akademiai
Kiado, 1981, XVI, 208 pp., ill us., (no price stated).
Vanio Vannini- Giuliano Pogliani, The Color Atlas of Human Anatomy. Trans!. & rev. by R.T. Jolly.
New York, Harmony Books, 1980. 107 pp., paper, U.S. $6.95.
BIBLIOGRAPHIES AND DOCUMENTATION
David Bearman and John T. Edsall, eds., Archival Sources for the History of Biochemistry and
Molecular Biology. A Ref~rence Guide and Report. Philadelphia, American Philosophical Society,
1980, XII, 338 pp., U.S. $29.50.
Peter K. Knoefel, Felice Fontana /730-/805. An Annotated Bibliography. Trento, TEMI, 1980, 113
pp., (no price stated).
National Library of Medicine, Bibliography of the History of Medicine, No. 15, 1975-1979. Washington, D.H.E.W., 1981, LXXII, 924 pp., (no price stated).
Veronica Strong-Boag, ed., A Woman With a Purpose. The Diaries of Elizabeth Smith 1872-1884.
Toronto, University of Toronto Press, 1980, XXXVIII, 298 pp., illus., U.S. $10.-.
Achim Thorn and Karl-Heinz Karbe, Henry Ernest Sigerist ( /89/-1957) Ausgewiihlte Texte. Sudhoffs
Klassikerder Medizin-Neue Folge I, Leipzig, J.A. Barth, 1981, 144 pp., DDR M. 23,-.
BIOGRAPHY
Alice Rossler, ed., Gotthi/f Heinrich Schubert. Gedenkschrift zum 200. Geburtstag des romantischen

*

CLIO MEDICA reserves freedom of decision regarding the assignment ofpublicationsfor review.

Clio Medica, Vol. 17 no./, May /982
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Books Received

Naturforschers. Erlanger Forschungen Reihe A Bd. 25. Universitatsbund Erlangen-Nurnberg e.V.,
1980, 148 pp., (no price stated).

CHEMISTRY
Juan L. Carrillo and Roman Gago, Memoria sabra una nueva y metodica clasificacion de los fluidos
elasticos permanentes y gaseosos de Juan Manuel de Arejula (1755-1830). Malaga, Universidad de
Malaga 1980,47 pp., Ptas 150.-.
DENTISTRY
Cesar A. Mena, Historia de Ia Odontologia en Cuba. Periodo Colonial (1492-1898). Miami, Ediciones
Universal, 1981, XXII, 394 pp., (no price stated).
Frank Hobi, Zahniirztliche Rontgenologie von den Anfiingen his zum Jahr 1914. Ihre Entwicklung in
der Schweiz unter Berucksichtigung der im Ausland geschaffenen Voraussetzungen im Rahmen der
Zahnheilkunde jener Zeit. Zurcher Medizingeschichtl. Abh. NR N r. 145. Zurich, Juris Druck u. Verlag,
1981, 126pp., sFr. 27.-.
EDUCATION
Ernst Bezel, Johann Jakob Steger 1798-1857- Beispiel eines Medizinstudiums im friihen 19. Jahrhundert nach den Briefen an seine Eltern. Zurcher Medizingeschichtl. Abh. NR Nr. 147. Zurich, Juris
Druck u. Verlag, 1981, 156 pp., sFr. 33.-.
EPIDEMIOLOGY AND DISEASE
Leonard J. Bruce-Chwatt and Julian de Zulueta, The Rise and Fall of Malaria in Europe. A historicoepidemiological study. Oxford, Oxford University Press, 1980, XVI, 240 pp., ill us., U.S. $36.-.
Juan Carrillo and Luis Garcia Ballester, Enfermedady Sociedad en Ia Malaga de los siglos XVJJiy XIX.
-I. La Fiebre Amarilla (1741-1821). Malaga, Universidad de Malaga 1980, 199 pp., tablas graficos y
mapas, Ptas. 400.-.
Carlo M. Cipolla, Fighting the Plague in Seventeenth-Century Italy. Madison, WI., University of
Wisconsin Press, 1981, XI, 123 pp., cloth, U.S. $13.50.
Alex C. Michalos, North American Social Report. A Comparative Study of the Quality of Life in
Canada and the USA from 1964 to 1974. Vol I Foundations, Population and Health. Dordrecht,
Holland, D. Reidel Pub!. Co., 1980, X, 278 pp., tables and graphs, (no price stated).
ETHNOLOGY
Antonio Scarpa, Etnomedicina. Verita scientifiche, strane credenze e singolari terapie, meritevoli di
verifica, delle medicine tradizionali dei popoli. Milano, F. Lucisano, 1980, 549 pp., ill., paper,
L. 28.000,-.
EXPERIMENTATION
James H. Jones, Bad Blood. The Tuskegee Syphilis Experiment. New York, Free Press, 1981, XIII, 272
pp., cloth, U.S. $14.95.
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69

Books Received

James Turner, Reckoning With the Beast. Animals, Pain, and Humanity in the Victorian Mind.
Baltimore, Johns Hopkins University Press, 1980, XII, 190 pp., cloth, U.S. $14.-.
GENERAL HISTORIES, ANTHOLOGIES, SURVEYS
J6zsef Antall, Pictorial History of European Medicine and Pharmaceutics. Budapest, Corvina Kiad6,
1981, 143 pp., 92 plates, (no price stated).
Asclepio. Archivo Iberoamericano de Historia de Ia Medicina y Antropologia Medica, Vol. XXXII,
1980. Madrid, Instituto 'Arnau de Vilanova' de Historia de Ia Medicina, Consejo Superior de Investigaciones Cientificas, 1980, 503 pp., 1.200,- ptas.

Kurt Ganzinger, Manfred Skopec and Helmut Wyklicky, eds., Festschrift fur Erna Lesky zum 70.
Geburtstag. Wien, Verlag Bruder Hollinek, 1981,212 pp., oS 240,-.
Roger Rulliere, Abrege d' Histoire de Ia Medecine. Paris, Masson 1981, 376 pp., (no price stated).
HEALTH PROFESSIONS
William Canniff, The Medical Profession in Upper Canada 1783-1850. Reprint of the edition 1894.
Toronto, Hannah Inst. for History of Medicine, 1980,688 pp., (no price stated).
MEDICINE
Johanna Bieker, Die Naturhistorische Schule 1825-1845. Ein Beitrag zur Geschichte der Klinischen
Medizin in Deutschland. Stuttgart, G. Fischer Verlag, 1981, IX, 175 pp., paper, (no price stated).
Philip Cash, Eric H. Christianson and J. Worth Estes, eds., Medicine in Colonial Massachusetts
1620-1820. Boston, Colonial Society of Massachusetts, 1980, XXIII, 425 pp., illus., (no price stated).
Vaidya B. Dash and Vaidya L. Kashyap, Basic Principles ofAyurveda. New Delhi, Concept Publishing
Co., 1981 (Distributed in the U.S. by Humanities Press), XXVII, 627 pp., cloth, U.S. $37,-.
Arthur Donovan and Joseph Prentiss, James Hutton's Medical Dissertation. Transact. Am. Philos.
Soc., vol. 70, part 6. Philadelphia, Americ. Philos. Soc., 1980, 57 pp., U.S. $8.-.
Notker Kessler, Die freie Hei/tiitigkeit im Gesundheitsgesetz des Kantons Appenzell Ausserrhoden.
Zurcher Medizingeschichtl. Abh. NR N r. 146. Zurich, Juris Druck u. Verlag, 1981, 51 pp., sFr. II,-.
JohnS. Haller, Jr., American Medicine in Transition, 1840-1910. Urbana, University of Illinois Press,
1981, XII, 458 pp., illus., cloth, U.S. $27.95.
Ian Maclean, The Renaissance Notion of Woman. A study in the fortunes of scholasticism and medical
science in European intellectual life. Cambridge, Cambridge University Press, 1980, VIII, 119 pp.,
cloth, U.S. $16.50.
S.E.D. Shortt, ed., Medicine in Canadian Society- Historical Perspectives. Montreal, McGill-Queen 's
University Press, 1981, XIII, 506 pp., paper, Can. $11.95.
Nancy G. Siraisi, Taddeo Alderotti and His Pupils. Two Generations of Italian Medical learning.
Princeton, N.J., Princeton University Press, 1981, XXIII, 461 pp., cloth, U.S. $32.-.

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Books Received

MILITARY MEDICINE
Rolf Valentin, Die Krankenbataillone. Sondenormationen der deutschen Wehrmacht in Zweiten Weltkrieg. Schriftenreihe Enahrungen des deutschen Sanitatsdienstes im Zweiten Weltkrieg Bd. 2. Diisseldon, Droste Verlag, 1981, 250 pp., DM 48,-.
NUTRITION
Karl Y. Guggenheim, with the assistance of Ira Wolinsky, Nutrition and Nutritional Diseases- The
Evolution of Concepts. Lexington, Mass., The Collamore Press, 1981, XII, 378 pp., (no price stated).
PATHOLOGY AND PALEOPATHOLOGY
Aidan and Eve Cockburn, Mummies, Disease, and Ancient Cultures. Cambridge, Cambridge
University Press, 1980, X, 340 pp., illus., U.S. $49.95.
Alvin E. Rodin, Oslerian Pathology. An Assessment and Annotated Atlas of Museum Specimens.
Lawrence, Kansas, Coronado Press, 1981, XVIII, 250 pp., ill us., U.S. $25.-.
PHARMACYANDPHARMACOLOGY
Richard Blum, Andrew Herxheimer, Catherine Stenz! and Jasper Woodcock, eds., Pharmaceuticals
and Health Policy. International Perspectives on Provision and Control of Medicines. New York,
Holmes & Meier Publishers, 1981, 272 pp., cloth, U.S. $37.50.
Rustomjee N. Khory and N .N. Katrak, Materia Medica ofIndia and Their Therapeutics. Reprint, New
Delhi, Nee raj Pub I. House, 1981, 809 pp., cloth, U.S. $56.25.
Milton Silverman, Philip R. Lee and Mia Lydecker. Pills and the Public Purse. The Routes to National
Drug Insurance. Berkeley, University of California Press, 1981, XVIII, 232 pp., cloth, U.S. $15.95.
Peter Temin, Taking Your Medicine. Drug Regulation in the United States. Cambridge, MA., Harvard
University Press, 1980, VII, 274 pp., cloth, U.S. $18.50.
POPULAR HEALTH
Beryl Rowland, ed. & trans!., Medieval Woman's Guide to Health. The First English Gynecological
Handbook. Kent, Ohio, Kent State University Press, 1981, XX, 192 pp., illus., cloth, U.S. $17.50.
PSYCHIATRY AND PSYCHOANALYSIS
Gemma Jappe and Carl Nedelmann, eds., Zur Psychoanalyse der Objektbeziehungen. Stuttgart,
Frommann-Holzboog, 1980, 262 pp., (no price stated).
Joseph P. Morrissey, Howard H. Goldman and Lorraine V. Klerman, eds., The Enduring Asylum.
Cycles of Institutional Reform at Worcester State Hospital. New York, Greene & Stratton, 1980, XI,
356 pp., ill us., cloth, U.S. $31.50.
SOCIETIES AND INSTITUTIONS
Mary Brown Bullock, An American Transplant: The Rockefeller Foundation and Peking Union
Medical College. Berkeley, University of California Press, 1981, XXVII, 280 pp., U.S. $17.50.
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Books Received

71

Norman Howard-Jones, The Pan American Health Organization: Origins and Evolution. Geneva,
W.H.O., 1981, 20pp., SWfr7,-.
John Ettling, The Germ of Laziness. Rockefeller Philanthropy and Public Health in the New South.
Cambridge, MA., Harvard University Press, 1981, X, 263 pp., cloth, U.S. $18.50.
SURGERY
Karel B. Absolon, The Surgeon's Surgeon: Theodor Bi/lroth 1829-1894. Vol. I. Lawrence, Kansas,
Coronado Press, 1979, XXIV, 282 pp., illus., U.S. $15.-.
Elizabeth H. Thomson, Harvey Cushing. Surgeon, Author, Artist. Reprint, revised, ofBenry Schuman
ed., 1950. New York, Neale Watson Academic Pub!., 1981, XVIII, 347 pp., illus., cloth, U.S. $17.-,
paper, $7.50.
ZOOLOGY
Jan Swammerdam. Themanummer van het Tijdschrift voorde Geschiedenis derGeneeskunde, Natuurwetenschappen, Wiskunde en Techniek, 1981,4, 2. pp. 61-118, Amsterdam, Rodopi, 1981, Hfl. 10,-.

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Four Books on the History
of Medicine
Carel M. van Hoom, Levinus Lemnius 1505-1568. Zestiende-eeuws
Zeeuws geneesheer. Thesis. 1978, 532 pp., 10 illustr., bibliography,
index of names. Price: f 95,-.
The Zierikzee physician Levinus Lemnius (Lieven Lemse) was a somewhat striking
figure in the sixteenth century, the age that was in many respects a period of transition.
Thus we find elements from the Middle Ages as well from the Renaissance in his way of
thinking. In his attitude towards mentally ill people he has been looked upon as a
forerunner of the Enlightenment. He was given the honorary title of 'the hygienist of his
time'.
'Very useful in this respect is the survey made of the pharmacopoeia by Lemnius,
probably in circulation at that time ... ' D. de Moulin in Tijdschrift voor de Geschiedenis
der geneeskunde, natuurwetenschappen, wiskunde en techniek.

Michael M.E. Grafv. Matuschka, Lambert van Velthuysens (1622-1685)
Menstruationstheorie in ihrer wissenschaftshistorischen Bedeutung.
1980,72 pp., I portrait, bibliography, index of names. Price: f 36,-.
Lambert van Velthuysen was the first to have correctly recognized a causality between
the ovarian function and menstruation. He succeeded in establishing a theory of menstruation, the validity of which has been recognized by modern medicine. A contribution
to the early history of the endocrinology of the ovaries.

Jean-Jacques Peumery, Les origines de Ia Transfusion Sanguine. First
book edition, 1975, of the articles which appeared in our periodical Clio
Medica in the course of 1974. 82 pp., 11 illustr., bibliography, index of
names. Price: f 36,-.
Faire passer du sang d'un sujet dans un autre est, de nosjours, un acte medicale des plus
courants. Pourtant, Ia transfusion sanguine a derriere elle toute une histoire, une histoire
pittoresque et captivante ...

Isaac van der Sluis, The Treponematosis of Tahiti. Its ongm and
evolution. A study of its sources. Thesis. 1969, 178 pp., catalogue of
sources. Price: f 41,50.
Veneral disease imported? In this thesis, the author has attempted to answer two
questions: firstly, was the treponematosis of Tahiti imported by European explorers ... ?
and secondly, was it yaws or syphilis?
' ... This monograph is strongly recommended to epidemiologists interested in yaws and
venera( diseases.' B.A. Southgate in The Journal of Tropical Medicine and Hygiene.

B .M. Israel b. v.
N.Z. Voorburgwal264
1012 RS Amsterdam, The Netherlands
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Contributors to this issue
BELL, WHITFIELD J., JR., executive officer of the American Philosophical Society since 1977,
was librarian of that institution from 1966 to 1980, succeeding the distinguished medical historian
Richard H. Shryock. A student of early American history, he is interested in the history of science and
medicine, and is the author of a biography of Dr. John Morgan, founder of the first American medical
school, and of other works.
BRIEGER, GERTH., M.D., Ph.D. is professor and Chairman, Department of the History of Health
Sciences, University of California, San Francisco. He is currently serving as president of the American
Association for the History of Medicine and his main research interests are in twentieth-century
medicine.
CARTWRIGHT, FREDERICK FOX, Chairman, Faculty of History and Philosophy of Medicine,
Society of Apothecaries of London and Past President, Section of the History of Medicine, Royal
Society of Medicine as well as late Chairman, Department of History of Medicine, King's College
Hospital. He is the author of Disease and History: A Social History of Medicine.
COWAN, JAMES C., Editor of The D.H. Lawrence Review, is the author of D.H. Lawrence's
American Journey ( 1970) and of D.H. Lawrence and the Resurrection ofthe Body, in: The Healing Arts,
ed. Joanne Trautmann (Southern Illinois University Press, 1981). His volume of bibliographical
abstracts, D.H. Lawrence: An Annotated Bibliography of Writings about Him is being published by
Northern Illinois University Press (in press).
CRELLIN, JOHN K., Associate Professor of Community and Family Medicine and Director of the
Medical History Program at Duke University, Durham, N.C. His principal interests, at present, are the
history of therapy and 20th century medicine.
DAWSON, MARC H., instructor of history at Union College, Schenectady New York. He is
currently finishing a doctoral dissertation entitled, Social and Epidemiological Change in Kenya,
/880-/920, at the University of Wisconsin.
ELL, STEPHEN R., M.D., Ph.D., resident in Diagnostic Radiology at the University of Chicago,
instructor in the Biological Sciences, Collegiate Division and member of the Morris Fishbein Center for
the History of Science and Medicine. He received a Ph.D. in Medieval History from the same
university. Research interests include the epidemiology of medieval disease. Recent publications
include Some Evidence for Interhuman Transmission of Medieval Plague, in: Reviews of Infectious
Disease, 1979 and Interhuman Transmission of Medieval Plague, in: Bulletin of the History of
Medicine, 1981. Currently he is researching the epidemiology of medieval leprosy based on recent
advances in the understanding of the microbiology of the disease.
ENGELHARDT, H. TRISTRAM, JR., is Senior Research Scholar at the Kennedy Institute of Ethics
and Rosemary Kennedy Professor of the Philosophy of Medicine at Georgetown University. He holds a
Ph.D. in philosophy and an M.D. degree. With Stuart Spieker, he is co-editor of the Philosophy and
Medicine series through Reidel Publishing Company, now in its tenth volume.
FREY, EMIL FERDINAND, Professor of Library Science (and Library Director), University of
Texas Medical Branch, Galveston, Texas, 77550, U.S.A. Professional and teaching experience from
1946, in England, Nigeria, Switzerland and the U.S.A. Research and consultation on the development,

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74

Contributors to this issue

management and computerization of university medical libraries. Recent publications relate primarily
to the history of medicine.
GROB, GERALD N., is Professor of History at Rutgers University, New Brunswick, N.J., U.S.A.
He is currently working on the second volume of his history of mental hospitals in the United States
covering 1875-1940. His previous books include Mental Institutions in America: Social Policy to I875,
The State and the Mentally Ill, and Edward Jarvis and the Medical World of Mid-Nineteenth Century
America.
KENNEDY, EMMET, an associate Professor of modem European history at George Washington
University is the author of A Philosopher in the Age ofRevolution, Destutt de Tracy and the Origins of
''Ideology'' (Philadelphia, 1978). He is currently working on a cultural history of the French Revolution.
LEGEE, GEORGETTE, agn!gee des sciences biologiques et geologiques, fait actuellement surtout
des recherches en histoire de Ia biologie et de Ia medecine, specialement en histoire de Ia neurophysiologie (fin 18e et 19e siecle). Publications: plusieurs articles dans Histoire et Nature, cahiers de
I' Association pour l'histoire des sciences de Ia nature, dont elle est secretaire generate, et dans d'autres
revues. En preparation: un ouvrage sur le physiologiste M.J.P. Flourens (1794-1867). Membre du
Comite national des travaux historiques et scientifiques. Egalement licenciee en philosophie des
sctences.
LICHTENTHAELER, CHARLES, Faculties of Med. at Hamburg/FRG and Lausanne/Switzerland.

LOKHORST, GERT-JAN, studied medicine and philosophy at Erasmus University, Rotterdam, The
Netherlands, where he is currently working in the Department of Philosophy. His book De dubbele
mens, dealing with historical, neurological and philosophical aspects of the split-brain syndr~me, will be
available by the end of 1982.
PHILLIPS, JOANNE H., M.A., Ph.D. (1977) in Classical Philology, Harvard University. Field of
research: The history' of ancient Greek and Roman Medicine. Since 1978 Assistant Professor of
Classics, Department of Classics, Tufts University, Medford, Mass./U .S.A.
ROGERS HOLLINGWORTH, J., Professor of History and Chairperson of the Program in
Comparative World History at the University of Wisconsin (Madison). His recent publications,
research, and teaching have concentrated on the study of comparative public policy. He is presently
completing a book length study of the medical delivery systems of Great Britain and the United States in
the twentieth century.
SCHNEIDER, LAURENCE A., Professor of Chinese History at State University of New York at
Buffalo and coordinator of the national research group Science in Modem East Asia. He has published
widely on modem Chinese cultural history and recently is the editor of the symposium Science in
Modern East Asia (SUNY Buffalo: Council on International Studies, 1980). Currently, he is writing a
comprehensive study of the development of the natural sciences in 20th century China.
WEINER, DORA B., Professor of history at Manhattanville College in Purchase, New York, a
vice-president of the International Society and a member of the International Academy of the History of
Medicine. Her books include Raspail: Scientist and Reformer. She is currently preparing a bilingual

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Contributors to this issue

75

edition of Philippe Pinel's essay on The Training of Doctors for the Sigerist Supplement Series to the
Bulletin of the History ofMedicine published by the Johns Hopkins University Press. She is also at work
on a book on The Citizen as Patient: Plans and Achievements in Health Care during the French
Revolution and under Napoleon.
WINKLER, HELMUT, M.A., geb. 1950. Studium der Geschichte, Mittellateinischen Philo Iogie und
verwandter Fiicher Universitiit Erlangen; M.A. in Mittellateinischer Philologie und Mittelalterlicher
Geschichte 1974 Universitiit Erlangen. Dissertation iiber Thema der mittelalterlichen Geschichte. Seit
1981 Wissenschaftlicher Mitarbeiter am Institut fiir Geschichte der Medizin der U niversitiit Wiirzburg.
Plant Spezialisierung auf dem Gebiet der Medizingeschichte des Mittelalters und der Friihen Neuzeit.
Besonderes Arbeitsgebiet: Pietro d' Abano, kritische Ausgaben und Untersuchungen.

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A.L.J. Bayle et A.J. Thillaye

D. LeClerc

Biographie medicale par ordre
chronologique

Histoire de Ia medecine.

D'apres Daniel LeClerc, Eloy, etc. mise
dans un nouvel ordre, revue et
completee.

Ou l'on voit l'origine& les progres de

Reprint of the edition Paris, 1855.
2 volumes (560; 950 pp). Cloth binding.
The biographies are chronologically
arranged with extensive bibliographical
information and are based on the
works of Daniel LeClerc, Histoire de La
medecine; Eloy, Dictionnaire historique de
La medecine ancienne et moderne;
J. E. Dezeimeris, Dictionnaire historique
de la medecine and A. J. L. Jourdan,
Dictionnaire des sciences medicales. Starting
in 1526 BC and ending in 1813 AD,
it gives the life and works of famous
medical doctors of all nations and
peoples.
Garrison, Sources 'of medical biography
p. 699: "... Bayle and Thillaye, although
alphabetized only in the index, is the
handiest of all, and was always on
Osler's desk; . .. "

Hfl215,-

cet art, de siecle en siecle; les sectes,
qui s'y sont formees; les noms des
medecins, leurs decouvertes,
leur opinions, & les circonstances les
plus remarquables de leur vie.

Reprint of the edition Den Haag, 1729.

2 volumes in I.
Front. and 8 plates, I folding table.

(XVIII, 820, XV Ill pp). Cloth binding.
"The first large history of medicine. It is
still consulted to-day, Leclerc is
sometimes called the 'Father of the
history of medicine'. The first edition of
this work appeared in 1696, but later
editions are more useful." Reprint of the
last and best edition.
(Hirsch If!, p. 770; Osler 6036; Bayle &
77zillaye II; p. 49-57; Garrison & Morton
nr. 6379)
ISBN 90.6078.019.1

Hfll60,-

B.M. ISRAEL

B.M. ISRAEL

N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands

N .Z. Voorburgwal264
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The Netherlands
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J. Bertrand

P. Harting

L' Academie des Sciences et les
Academiciens de 1666 a 1793

Das Mikroskop. Theorie,
Gebrauch, Geschichte und
gegenwartiger Zustand
desselben

Reprint of the edition Paris, 1869.

Zweite deutsche original Ausgabe vom
Verfasser revidirt und vervollstandigt.
Herausgegeben von F. M. Theile.
Reprint of the edition Braunschweig,
1866.

This reprint is enlarged with a newly added
index.
(VI, 434, X pp). Cloth binding.

Only history of the"Academie des
Sciences de France."
Table of contents:
L'academie. L'academie de 1666.
L'organisation de 1669. Les finances de
l'academie. Les expeditions scientifiques.
Les rapports. Les prix. Les academiciens.
Les secretaires perpetuels.
Les geometres, les mecaniciens et les
physiciens, les chimistes, les naturalistes.
L'academie de 1789 a 1796.
Listes des personages.
ISBN 90.6078.043.4

Hfl 72,-

With a new introduction by
drs. P van der Star.
1 coloured plate, 466 text-illustrations.
3 volumes in I. (XVI, 348 ; VI, 310;
IX, 452 pp). Cloth binding.
It is the best and most copiously
illustrated history of the microscope,
and is divided in three parts :
l. Theory and general description of
microscopes,
2. The microscopic research and its
development,
3. The history of microscopic
instruments from the earliest sources
(Seneca, Plinius) till 1850.
Each part is richly illustrated.

(Garrison &Morton 270; Clay &Court i.l.c.;
Hirsch, Lexicon,lll,p. 70; Poggendorff, /,
7027-2,11/,p. 597)
ISBN 90.6078.054.X

Hfl210,-

B.M. ISRAEL
N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands

B.M. ISRAEL
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The Netherlands
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C. L. F. D. Cuvier

J. B. J. Delambre (editor)

Rapport Historique sur les
Progres des Sciences
Naturelles

Rapport Historique sur les
Progres Mathematiques

Depuis 1789.
Reprint of the edition Paris, 1810.
(XVI, 394 pp). Cloth binding.

Depuis 1789.
Reprint of the edition Paris, 1810.
(VIII, 362 pp). Cloth binding.

By order of Napoleon, Cuvier reported
on the progress of physical and natural
sciences during the French Revolution,
as did Delambre on mathematics.
The part on chemistry sciences is
mostly the result of reports by other
great scientists as Guyton, Chaptal,
Vauquelin, De Jussieu, Tessier, Halle
and Lacepede, whereas the part on
natural history contains specially the
scientific work of.Cuvier himself, who
was the founder of palaeontology and a
great comparative anatomist.
(Poggendorff I,p. 507; Barton, A guide to the
history of science,p. 717; Wheeler Gift P. 702)
ISBN 90.6078.052.0

"Prepared by order of Napoleon reports
on progress of science from 1789 to 1810.
Including mechanics, astronomy,
geography, arts and industries."
The work describes the inventions, and
mentions the publications on various
fields of science by Laplace, Condorcet,
Delambre, La Perouse, Lavoisier,
La Lande, Baud in, d'Aiembert,
Bourgainville, Breguet, Biot, Borda,
Betancourt, Fleuret, Aubert, etc. etc.
(Poggendorff I, p. 539; Smith, History of
mathematics I,p. 492; Sarton, A guide to the
history of science, p. 717; Cantor I V, p. 207;
Wheeler Gift nr. 703)
ISBN 90.6078.009.4

Hfl40,-

Hfl56,-

Set Cuvier & Delambre

Set Cuvier & Delambre

Hfl85,-

Hfl85,-

B.M. ISRAEL
N .z. Voorburgwal264
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The Netherlands

B.M. ISRAEL
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The history and philosophy ofknowledge of

THE BRAIN
AND ITS

F

CTIONS
Edited by
F. N. L. POYNTER PHD., F.L.A.

This symposium brought together a number of the
most distinguished British and American neurologists. The papers and discussions form a valuable
survey of our knowledge of the brain from earliest
times up to the present day.
ISBN 90 6078 063 9
Dfl. 48,-

B. M. ISRAEL BY.
N.Z. Voorburgwal264
AMSTERDAM

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Clio Medica
Acta Academiae Internationalis Historiae .!Hedicinae

CLIO MEDICA provides the channel ofcommunication
for a world wide network ofpeople interested in establishing
a medical historiography of a high standard of scholarship.
It aims to contribute towards a better understanding
of the development of medicine.

SPECIAL OFFER.
All back issues from Vol. 6 up to Vol. 16 are available
for Dfl. 450,- only (postage & handling Dfl. 40,-).
We have a limited amount of sets in stock.
Profit by this unique offer ...

B. M. ISRAEL
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Zur Rolle einer Psychohygiene im Griechenland des 5. vorchristlichen Jahrhunderts bis
zur Zeitenwende
KLEMENS DIECKHOFER

SUMMARY
The role of a psychohygiene in Greece of the 5th century B.C. until the turn of the era.
The article gives a survey of the psychohygienic ideas and conceptions appearing during this period,
which were closely connected with a range ofphilosophical thoughts, by means ofcontemporary texts.
From the epoch of the Greek comedy as reflection of the everyday-life of the Polis, Aristophanes has
been quoted. The importance of the Epicurean philosophy and the spiritual guidance throughout the
post-Epicurean stoa with its representatives Zenon, Chrysipp, Panaitios, Poseidonios and finally
Epiktet, the latter being the most important representative of the fashionable philosophy during the
Roman imperial reign, has been emphasised and analysed.
The available sources show that eudaimonia, happiness, namelyfreedomfrom anxiety, menace and
feelings of hatred, and furthermore the surveying of worldly wisdom, the control of one's impulses
through Logos and education, harmony to compensate the contrasts, helpfulness towards·one's
fellow-men as well as the education of the individual to gain inner freedom, represent the most
important antique directives of the mind in the sense of a rudimental psychohygiene and psychoprophylaxis.

Einleitung
Oberall dort in der Geschichte, wo urspriingliches Gefiihl fur die Natur sich mit
philosophischen Gedanken zu mischen begann, in deren Folge ganze Systeme von
Theorien entstanden, die naturwissenschaftliche, ethische und nicht zuletzt medizinische Fragen und Ansichten in sich schlossen, konnen wir zu Recht vermuten,
daB wir es auch mit Ansatzen zu solchen Fragen zu tun haben, die wir heutzutage
unter der Rubrik 'Psychohygiene und Psychoprophylaxe', also einem seelischen
Gesundheitsschutz im weitesten Sinne, subsumieren.
Fiir die Kulturgeschichte der romischen Kaiserzeit konnten wir friiher bereits in
einer Obersicht die wichtigsten Rudimente fiir diese geistige Haltung zeigen 1 •
Wenden wir uns nun den Anfangen einer Wissenschaftsgeschichte im Rahmen der
griechischen Philosophie zu, urn dort den Fragen der Psychohygiene nachzugehen.
Der griechische Mythos, also die vorwissenschaftliche Epoche griechischen
Geistes, vermochte uns gewiB noch keine Ansatze zur Psychohygiene zu liefern,
wurde doch der Wahnsinn des Menschen, als Ausdruck einer gottlichen Macht
wirksam, nicht negativ erlebt, sondern in die Ordnung der Menschenwelt einbezogen.
Clio Medica, Vol. 17, Nos. 2/3, pp. 81-94

v B.M.lsraii/, Amsterdam, The Netherlands

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82

Klemens DieckhOfer

Das denkende Schauen und das schauende Denken (Schumacher2 ) als Vorgang
der Theorie (theoria), eine Methode, die die alten Philosophen praktizierten, ermoglichte es indes schon den Vorsokratikem, eine gewisse seelische Ordnung und
Storung seelischer Befindlichkeit zu beschreiben. So gilt die Luftbeschaffenheit in
der damaligen Philosophie als Kriterium des lntellekts. Die Lufttheorie des
Diogenes von Apollonia auf Kreta (ca. 460--390 v.Chr.), einem Anhanger der
jonischen Philosophenschule, der ein uns verloren gegangenes Werk Uber die
Natur (peri physeos, nach 405 v.Chr.) schrieb, greift u.a. auch Augustinus im
Gottesstaat 3 wieder auf.
So ist trockene, reine Luft dem Verstande giinstig, ihre diesbeziigliche Beschaffenheit halt schadliche Feuchtigkeit ab, die den Verstand nur beeintrachtigt. Hieraus wird gefolgert, daB Exzesse im Trinken und Essen dem Geist schadlich sind 4 •
Das Element der Luft und deren Storbarkeit diente somit nicht als irgendein
Symbol, sondem als Gegebenheit, das Wesen der Dinge zu schauen und auf
leib-seelische Schadigungen hinzuweisen 5 •

Die Epoche der griechischen Komodie
In der Zeit, da die Dichter Eupolis (urn 430 v.Chr.) und Aristophanes (urn 445
v .Chr.) mit ihren Lustspielen den Zeitgeist der Polis widerspiegeln, gibt es kein
Gebiet des offentlichen Lebens, das nicht beiBend karikiert wird. Laster und
geschlechtliche Verirrungen, die von angesehenen Personen bekannt wurden,
werden in der Komodie offen gebrandmarkt. So ist die Komodie im 5. vorchristlichen Jahrhundert ein wahrer Spiegel des Alltagslebens der gesamten Polis.
Nie war die Freiheit des Wortes mehr gegeben als zur Zeit der attischen Komodie;
das setzte gewiB ein groBes MaB an Toleranz voraus, saBen doch die Verspotteten
als Zuschauer im Theater. Die Komodiendichter legten also den Finger auf offene
Wunden, an denen das Zeitalter !itt. Wenn Aristophanes den Aischylos und
Dionysos in den Froschen 6 sagen laBt:
Aischylos: Doch niemand versteht sich auf Fackellauf mehr
Vor Mangel an miinnlicher Obung.
Dionysos: Ja, wahrlich so hab ich mich neulich erst
Bei den Panatheniien zu Tode gelacht:
Da keucht auf der Bahn so ein Faultier daher,
BlaB, feist und gebiickt, ganz weit hintendrein,
Der pustet' erschrecklich! Den finden am Tor
Die Keramier auf und durchbleuten ihm derb
den Buckel, die Lenden, den Bauch und den SteiB,
Und wie sie mit klatschender Hand ihn gewalkt,
Mit siiuselndem Wind
Aufbliist er die Fackel und fliichtet.

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Zur Rolle einer Psychohygiene im Griechenland

83

Die Generation im Aristophanischen Zeitalter ist also nicht mehr sportlich
trainiert, im Waffentanz der Panathenaien wird der Schild nicht mehr beherrscht.
Selbst beim Fackellaufversagt die schlapp gewordene Jugend. Kein Wunder, denn
die Ringschulen werden nicht mehr besucht, da man sich auf die faule Haut legt. So
spricht Aischylos an anderer Stelle:
Dann ferner hast du die Burger gelehrt, sich aufs Plaudern und
Faseln zu legen,
Das hat die Paliistra entviilkert und wund die Hintern mit Sitzen
gerieben ... 7 •

Anstatt verschroben zu schwatzen und auf dem Markt zu witzeln, sollte die Jugend
vielmehr lustwandeln im Hain des Akademos 8 , urn eine frische Gesichtsfarbe und
einen markigen Wuchs zu erhalten. Aristophanes nimmt aber kein Blatt vor den
Mund, wenn er in den W o Ike n den Anwalt der guten Sache dazu Stellung
nehmen laBt, wie es denn wirklich psychophysisch mit der Jugend derzeit bestellt
sei 9 :
Doch wenn du es treibst nach der Mode von heut',
Dann wird dein Gesicht bleichsiichtig und gelb,
Deine Schul tern gedriickt und schmiichtig die Brust,
Deine Zunge wird lang, weit offen dein Maul,
Und groB dein Gemiicht und klein dein GesiiB!
(Auf den An walt der schlechten Sache deutend):
Der redet dir ein,
DaB das Schone gerade das HiiBliche sei
Und das HiiBliche schiin;
U nd am Ende beschmutzt er dir Leib und See I'
Mit Antimachos' 10 siiuischer Wollust.

GewiB sind diese im Lustspiel dargebotenen Karikierungen als Ubertreibung zu
werten; der Wahrheitsgehalt im Kern der Pointen stehtjedoch nicht in Frage 11 •
Die Seelenleitung Epikurs

Etwa hundert Jahre nach des Geburt der Aristophanes wird Epikur (341-270
v.Chr.) in Samos geboren.
Mit der epikureischen Philo sophie tritt der Mensch in der griechischen Antike in
einen neuen Geistesabschnitt. War einerseits die alte Religion langst weitgehend in
den Hintergrund getreten, so bestand andererseits unter den Menschen der sehnsiichtige Lebenswunsch fort, die Hesychia, die heitere Seelenruhe, in einer festfundierten Weltanschauung zu erwerben und in sich zu tragen. Hier konnte nur die
Philosophie helfen. Im Garten (kepos) Epikurs 12 wurde jedem die fro he Botschaft
verkiindet, die Eudaimonie unabhangig von auBeren Umstanden zu finden. Der
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Klemens Dieckhofer

Staatsbiirger der Polis Athen sollte sich nunmehr auf seine menschliche Seite
besinnen und personlichen Zielen nachgehen. Das hatte der Athener Epikur, der
eine gliickliche Jugend in seiner Familie genoB, bald erkannt.
Heutzutage klar definierte Ziele der Psychohygiene, die eine relative Freiheit
von Angst, Bedrohung und HaBgefiihlen ermoglichen sollen, namlich die Hihigkeit
zur Entwicklung einer Selbstfindung, Selbsterkenntnis und Selbstbeshitigung,
wurden in der griechischen Klassik folglich schon weitgehend antizipiert.
Hatte der Lehrer Nausiphanes (ca. 360-300 v.Chr. in Teos) Epikur auf den
panhellenischen Wesenszug der Anteilnahme jedes Burgers am offentlichen Leben
einschworen wollen, so ging Epikur bald eigene Wege, urn sein individualistisches
Lebensziel zu erreichen. Unter Philosophie verstand Epikur etwas ganzlich
anderes als Plato (427-348 v.Chr.) und Aristoteles (384-322 v.Chr.). Nicht der
Drang nach Wahrheit und Erkenntnis, sondem die praktische Lebenskunst, aus
der erst die Erkenntnis flieBen konne und ihren Wert erhalte, wares, worum es
Epikur ging. Seine Methode war also als deduktiv zu bezeichnen. Von allgemeinen
Grundprinzipien schritt er fort zu Detail-Untersuchungen.
Anregungen fiir seine empirischen Erkenntnisse empfing Epikur von der empirischen Richtung der
damaligen Medizin, aber auch aus der Naturphilosophie Demokrits (ca. 460-370 v.Chr.) und der
Lebensform des Bukolikers Theokrit (l.H. 3. Jh. v.Chr.).
Die allgemeine Bildung war ihm fiir seine Schiiler gleichgiiltig 13 , jedenfalls nur dann wertvoll, wenn
sie den Menschen zur Eudiimonie, zur Gliickseligkeit, zu fiihren versprach.

Epikur will den von Angst vor dem Schmerz und dem Tode gequaiten Menschen
durch sein philosophisches System erlosen. Leben und Seele ergeben sich seiner
Uberzeugung nach durch die Verbindung bestimmter Atome, alles Konkrete auf
der Welt ist fiir ihn rein zufallig, es sind fiir ihn atomare Komplexe in fliichtigen,
schnell wieder zerfallenden Welten. Die Seele lost sich nach dem Tode ebenso wie
der Korper seiner Ansicht nach wieder aufund wird zum Nichts 14 • Gotterfurcht 15
und Hadesqualen werden von ihm so ad absurdum gefiihrt.
Hatte Plato sich im Gorgias eindeutig gegen das Lustprinzip ausgesprochen 16 , so nahmen Epikur wie Eudoxos 17 an, daB sich der Trieb des Menschen
grundlegend auf die Lust richte; Epikur verstand darunter das Lustgefiihl, das
beispielsweise nach Stillung des Hungers eintritt 18 . Jedes Lustgefiihl halt Epikur
grundsatzlich fiir gut, solange es nicht gr6Bere Unlust nach sich zieht. Epikur, der
selbst dauemd kranklich und oft ans Bett gefesselt war 19 , meinte nicht nur die
Satisfaktion in geistigen Freuden, die das Ideal der Euthymie, der heiteren Seelenbestimmung, im rechten MaB bescheren soll, nein, auch die wohlige Behaglichkeit
des sen, der frei von k6rperlichem Schmerz ist, wird in seiner neuen Philosophie fiir
den Menschen intendiert.
In einem seiner Lehrbriefe 20 erfahren wir, daB nicht die Liiste der Schlemmer
und des Augenblicks gemeint sind, sondem der Zustand, da der Mensch in psychophysischem Wohlbefinden lebt. Dabei versucht der Weise, die Stiirme des Lebens
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Fig. I. Epikur(341 - 270v.Chr.J

zu meiden und in der Zuriickgezogenheit sein Leben selbst zu bestimmen, wie er in
seinerEthik(fr. 137: Lathebi6sas- Lebe im Verborgenen)form uliert.
Wie wares nun mit dem Garten Epikurs und seiner Organisation bestellt? l/setraut Hadot 2 1 hat uns
jlingst noch ein eindrucksvolles Bitd vom Autbau dieser Phitosophenschute vermittett.
Menschen beiderlei Geschlechts, Famitien mit ihren Kindem sowie Sktaven stand die Schute ofTen.
War man beglitert, so stellte man sein Vermiigen der Lebensgemeinschaft zur Vetfugung, ein
Prinzip, das den Pythagoraern schon zugeschrieben wurde. Im librigen wuBte Epikur fUr die
auBeren Voraussetzungen in seiner Schute Sorge zu tragen, da er von reichen Freunden unterstutzt
wurde. Das soli nicht heiBen, daB der Lebensunterhalt eines Schuters in dieser Gemeinschaft etwa
unbescheiden gewesen ware; der Grundsatz auBerster Bedutfnistosigkeit in der epikureischen
Lehre wurde zum Prinzip erhoben.
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86

Klemens Dieckhofer

Eine erfolgreiche Seelenleitung bedeutete es ja immerhin schon, wenn auf engem
Raum so viele Altersstufen unterschiedlichster Provenienz miteinander in Harmonie lebten, unter der obersten Leitung ihres Meisters Epikur, der den Titel
'Fuhrer' (hegem6n)2 2 trug. Seneca 23 und Cicero 24 sind fiir uns die antiken Gewahrsmanner von dieser bunt gewurfelten epikureischen Gemeinschaft und ihrer
gleichwohl harmonischen Ubereinstimmung untereinander.
Im philosophisch-dogmatischen Lehrplan Epikurs 25 werden insbesondere die
von Diogenes Laertius mitgeteilten "kyriai doxai" aufgefiihrt, welche die fur die
Seelenleitung wichtigsten Sentenzen enthielten; die ersten vier wurden in die
Formel der Tetrapharmakos 26 zusammengenommen. Wahlweise konnte jeder
Schuler sich dann weiterbilden, urn in Higlicher Meditation (wie dies auch Seneca
gegenuber seinem fiktiven Schuler Lucilius tat) zusatzliches philosophisches Rustzeug fiir den Lebenskampf zu erwerben.
In Epikurs Werk 27 erfahren wir, daB our der Tor nach Delikatessen und feiner
Kleidung strebt, Ansehen, Amter und Ruhm erheischt, was alles indes den inneren
Seelenfrieden stort und der Ataraxie, der Freiheit von aller seelischen Unruhe, our
hinderlich ist.
Ein Schiiler Epikurs konnte, so heiBt es, in jeder Lebenslage glucklich sein,
selbst wenn er auf dem Altar des Stieres von Phalaris 28 gefoltert wurde. Epikur
predigte als Tugenden die Phronesis als die 'MeBkunst', die Lebensklugheit auf
dem ganzen Lebenswege, die Tapferkeit zur Abwehr des Schmerzes, die Selbstbeherrschung zur Uberwindung der Begierden und Triebe, die Gerechtigkeit
schlieBlich als Schutzwall vor inneren und auBeren Konflikten.
Aus seiner atomistischen Denkungsweise heraus sieht Epikur den Menschen
nicht als Gemeinschaftswesen, als zoon politik6n, sondem als Einzelwesen, 'Individuum', das isoliert in der Welt steht. Egozentrik und Lustgefiihl bestimmen
insofem auch das kindliche Verhalten nach Epikur; erst spiiter erfolgt dann die
Erkenntnis, daB der Mensch die Gemeinschaft fiir sein Dasein braucht, in dem der
Staat ihm beispielsweise seine iiuBere Sicherheit dafiir anbietet. Auf diesem Umwege wird auch der individualistische Epikuriier ein loyaler Staatsbiirger, ohne
sich allerdings in politischer Tatigkeit aufzureiben.
Die Seelenfiihrung in der nachepikuriiischen Stoa
1. Zenon
Konnte man den Hedonismus, den die Lehre Epikurs predigte, egozentrisch und
unsozial nennen, so war die Weltanschauung des Kypriers Zenon aus Kition (ca.
334-263 v .Chr.) auf die Gemeinschaft hin ausgerichtet, in welcher der Einzelne die
Gluckseligkeit erwerben konnte.
Etwa ein Jahrzehnt jiinger als Epikur, trat er im Jahre 30 I selbst mit einer eigenen Weltanschauung
hervor und eroffnete in der Poikile Stoa in Athen seine Lehrtiitigkeit. Sah sein Zeitgenosse Epikur
die Welt nur als Zufallsgebilde, so basierte die Philosophie Zenons auf staunender Ehrfurcht vor
der ZweckmiiBigkeit des Kosmos 29 •
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Fig. 2. Zenon (ca. 334-263 v.Chr.)

Die Tugend betrachtete Zenon als hinreichend fiir den Erwerb der Gliickseligkeit.
Die Tugend besitze jedoch nur der Weise, wie Zenon zu wissen glaubt. Als
Lebensziel bezeichnete Zenon ein Leben ganz in Obereinstimmung mit der Natur.
Die Masse der Menschen hielt der Philosoph aus Kition indes fiir ungliickselige
geisteskranke Toren.
2. Chrysipp
Einer der N achfolger Zenons, der Syrer Chrysipp von Soloi (ca. 281-208 v. Chr. ),
welcher der Stoa die straffe Form wiedergab 30 , ging in seinen Forderungen iiber
Zenon noch hinaus: Hatte jener die Beherrschung der Triebe gefordert, so steigerte
der Emeuerer der Schule dieses Postulat zu einem U nempfindlichwerden gegen die
von auBen kommenden Eindriicke.
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Klemens Dieckhofer
Jede stiirkere Gefiihlsregung muBte als Krankheitserscheinung unterdriickt werden. Es liiBt sich
Ieicht denken, daB bier also ggfs. fiir den Einzelnen die Voraussetzungen fiir eine neurotische
Fehlhaltung nach unserem heutigen Psychiatrieverstiindnis gegeben waren, von Psychohygiene
ganz zu schweigen. Die Schwarz-WeiBmalerei, die Leidenschaftlichkeit und der Doktrinismus der
Lehre war den Griechen ganz fremd, so daB scharfe Angriffe nicht ausblieben, urn sich einer solch
strengen Ethik mit radikaler Durchfiihrung des Heimarmenegedankens 31 zu widersetzen.

3. Panaitios
Aus Rhodos stammte Panaitios (ca. 180-110 v. Chr.), wo nicht nur hellenisches
Polisgefiihl eine Rolle spielte, sondem sportliche Behitigung die Kraft und
Harmonie des Korpers betonten. Panaitios fiihrte die Stoa wieder zu einer Philosophenschule, die auch aus dem Ausland ihren Zustrom fand. Der aufrechte Gang
des Menschen, so lehrt es der Logos der jetzigen Stoa, habe die Aufgabe, den Blick
in die Weite zu richten und sich iiber das Animalische zu erheben. Die Nahrungsaufnahme geschieht nach Panaitios kultiviert bei der Spezies Mensch; so dienen
auch Mund, Zalme und Zunge einer hoheren Aufgabe.
Das Antlitz der Erde vermag der Mensch zu venindem, er hat in der Natur eine
zweite Natur geschaffen 32 . Triebleben und Logos werden als zweifache Wesenskomponente der Seele begriffen. Der Logos soil zwar das Triebleben beherrschen,
doch nicht in totaler Apathie vollig unterdriicken.
Die Seele ist bei Panaitios zwar auch den Leiden, pathe, ausgesetzt. Leiden wird aber als Vorstufe
des Vergehens, des Todes, angesehen. Die Seele kann also Panaitios zufolge nicht unsterblich sein.
Hier wird die Diesseitigkeit des philosophischen Gedankengebiiudes des Stoikers Panaitios klar
erkennbar.

Sein hellenischer Gemeinschaftssinn befahigt Panaitios auch dazu, eine soziale
Einstellung des Einzelnen gegeniiber dem Staate zu wecken: Hilfsbereitschaft und
den Willen, dem Nachsten mit Rat und Tat beizustehen. Die Kraft dazu- auch
gegeniiber den Stiirmen des Lebens - verleiht ihm die Megalopsychie, die eine
Uberlegenheit iiber die irdischen Dinge ermoglicht. Die Gesamtseele lebt in der
Selbstbeherrschung, die Unterdriickung des Schwacheren muB durch den Dienst
in der Gemeinschaft aus dieser Tugendhaltung heraus verhindert werden. Die
syntone Personlichkeit lebt so stets aus einer inneren seelischen Mitte heraus,
angemessen (preponta) das Sosein des Alltags empfindend.
MaB und Harmonie als Ausgleich des Gegensatzlichen sollten die tiefen Sehnsiichte der hellenischen Psyche in der Philosophie des Panaitios bestimmen helfen.
Als Pflicht des freien Griechen galt ja stets die gymnastische Pflege des nackten
Korpers, und in der Diaita, der richtigen Lebensweise, fand jeder Einzelne eine
sinnvolle Erganzung. Eine so ausgepragte sittliche Personlichkeit brauchte auch
nicht die sinnliche Schonheit zu verachten, die das Chrysipp'sche Schuldogma in
lebensvemeinendem Optimismus entthront hatte.
Unter diesen neuen Auspizien konnte die von Panaitios gepragte stoische Lehre
ihren Siegeszug durch das gesamte Abendland antreten.
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Fig.3. Poseidonios(ca. 135-51 v.Chr.)

4. Poseidonios
Poseidonios (ca. 135-51 v.Chr.) aus Apamea am Orontes in Syrien als der
universalste Geist des Hellenismus muB im Zusammenhang mit Vorstellungen urn
die Psychohygiene deshalb kurz genannt werden, da er die Heranbildung wissenschaftlicher Personlichkeiten zu fordem trachtete, die ihre eigene Einstellung zum
Leben erarbeiten sollten. Von seinem Lehrer Panaitios hatte er gelemt, was die
Merkmale einer Personlichkeit sind, wie Worte, Kleidung und Gebarden des
Einzelnen zu beurteilen sind. Dies studierte er auf seinen Forschungsreisen von
Gades bis bin zu den Kelten, so daB sich sein Blick fiir die Individualitat eines
Volkes scharfen konnte.
Das Leben beschaftigte ihn als Urphanomen. Sein und Leben betrachtete er in
echt hellenischem Sinne als zusammengehorig. So versteht er auch die Gotterwelt:
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Klemens Dieckhofer

Man rniisse sie in der Fiille des Lebens als 'plastische Einzelgestalten' 33 auffassen.
Zur vollen Gliickseligkeit gehoren aber auch irn Diesseits nach der Uberzeugung
des Poseidonios Gesundheit und giinstige U rnsHinde irn aul3eren Leben. Der Logos
rnu13 indes den Ton angeben, irrationale Triebe haben sich der Vemunft unterzuordnen. Uberschreitet der Mensch ein solches Gebot, so ist dies als Pathos
verwerflich. In Grenzen ist das Streben nach Anerkennung und Lust in der Lehre
des Poseidonios durchaus erlaubt.
Die Erziehung brauche auch, so rneint er, die Triebentwicklung nicht zu unterdriicken. Aber der Logos rniisse die Oberhand be hal ten. Auch werde die Erziehung
dazu beitragen, den Mut zu fordem, urn zurn Ziele zu fiihren. Diat und Korperpflege sind als geeignete Mittel Poseidonios zufolge schon von Geburt an einzusetzen, urn dern Gesarntorganisrnus eine richtige Mischung zu verleihen.
lnsofem iibemahrn Poseidonios weitgehend das Gedankengut Platons.

5. Epiktet
Der Stoiker Epiktet gilt als bedeutendster Vertreter der Modephilosophie in der
rornischen Kaiserzeit des 1. Jahrhunderts n.Chr. Personlichkeit und Werk dieses
letzten bedeutenden Stoikers, der in der rornischen Kaiserzeit lebte, sollen die
vorliegende Untersuchung zur grundlegenden Vorstellung urn eine psychohygienisch ausgerichtete Seelenleitung in der Antike beschlie13en.
Epiktet aus Hierapolis in Phrygien lebte von ca. 50-120 n.Chr. Urspriinglich Sklave, arbeitete er
spiiter als Freigelassener des einfluBreichen Sekretiirs von Nero (37--68 n.Chr.) namens Epaphroditos, der urspriinglich auch ein Freigelassener war. Dieser lieB ihn die Schute des Musonius Rufus
(ca. 30-108 n.Chr.) besuchen; ein Stoiker, der damals diese Lehre iiuBerst erfolgreich vertrat und
u.a. Epiktet auch mit den sokratischen Schriften eingehend bekannt machte.
Epiktet hatte zwar eine Beinliihmung, war aber umso beweglicher und eifriger im Geist und in
seiner Lehranstalt Nikopolis in Westgriechenland leidenschaftlich engagiert. War Sokrates schon
der Oberzeugung, seinen Mitmenschen tatkriiftig helfen zu miissen, so war auch der Freigelassene
Epiktet von dem Feuereifer beseelt, Menschen in seelischer Not beizustehen.

Das geistige Erbe Epiktets, der selbst nichts Schriftliches der Nachwelt iiberlieferte und nur irn lebendigen Wort gegeniiber seinen Schiilem wirkte, ist uns in
einern En chi rid i o n34 genannten kleinen Werk durch den Romer Flavius
Arrianus 35 erhalten.
Naturphilosophie und Logik interessieren den Philosophen Epiktet nicht rnehr.
Bleibt einerseits die Welt mit dern Walten der Gotter (besonders Zeus) in seiner
Lehre fest verankert, so steht doch die Erziehung des Einzelnen zur inneren
Freiheit und zu vertrauensvollern Urngang mit schicksalhaften Gegebenheiten irn
Zentrurn seiner Lehrrneinung. Das individuelle Erlebnis mit seiner Personlichkeitsausstrahlung fiihrte Epiktet viele Schuler zu, die ein erzieherisches Ethos beherzigen sollten, ohne alles urnstandliche Biicherwissen, in schlichter, rechtschaffener und derniitig frornrner Haltung. Den Weg zur Freiheit, die das Tier instinktiv
anstrebe, rniisse sich der Mensch durch die Philosophie erwerben, so erklarte der
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Zur Rolle einer Psychohygiene im Griechenland

Freigelassene Epiktet seinen Horem.
Von Epiktet, der Halbheiten nicht liebte und anstelle der klassischen Einteilung
der Dinge in Guter, Ubel und Adiaphora lieber eine Zweiteilung ohne Mittelstufe 36 ,
also ein Entweder- Oder vorzog, erfahren wir schon zu Beginn des Enchiridion des
Arrian die programmatischen Satze seiner Philosophie:
Der wichtigste Unterschied der Dinge ist der, daB die einen in unserer Macht stehen, die anderen
nicht. In die erstere J<lasse gehi:iren Urteil, Trieb, Begierde, Ablehnung, mit einem Worte alles, was
unser Werk ist. In die letztere Klasse gehi:irt unser Leib, unsere Habe, unser Ruf, unser Amt, kurz
alles, was nicht unser Werk ist. Was in unserer Macht steht, ist seiner Natur nach frei, kann nicht
verwehrt noch verhindert werden. Was nicht in unserer Macht steht, ist ohnmachtig und
knechtisch, kann verwehrt werden und gehi:irt einem anderen zu. Bedenke also, daB du in Hindernisse, in Klagen, in Unruhe geraten und gegen Gott und Menschen Beschwerden flihren wirst,
wenn du das seiner Natur nach Knechtische fiir frei und das andem Angehi:irige fiir dein Eigentum
hiiltst. Wenn du dagegen nurdas, was wirklich de in ist, fiir dein ansiehst, was aber andern angehi:irt,
fiir das, was es ist, fiir etwas Fremdes, so wird dich niemandjemals zwingen, niemand dir wehren,
du wirst gegen niemand.Beschwerde fiihren, niemanden anklagen, wirst nichts widerwillig tun, es
wird dir niemand Schaden zufiigen, du wirst keinen Feind haben; denn es wird dir nichts begegnen,
was dir nachteilig sein ki:innte.

Fiir den Menschen gibt es nach Epiktets Uberzeugung nur einen einzigen Weg zum
Gliick: Er muB sich den Zugang zur inneren Freiheit suchen, die als das hochste
Gut und wahre Lebensziel gepriesen wird, losgelost von einem auBeren Machtstreben, das dem Menschen lediglich Fehlschlage, Sorgen und Kummer bereitet.
Die auBeren Dinge, so ruft er seinen Schiilem ZU, konnten nur durch die falschen
Werturteile nachteilig fUr den Menschen werden.
Subjektiv konne der Mensch seine Entscheidung sehr wohl fall.en. Wer den
Reichtum beispielsweise als nicht gut empfinde, konne ihn ebenso fur sich
ablehnen wie die Familie, wenn diese die Reinhaltung des Inneren, den Weg zur
Freiheit, fUr den stoischen Junger inhibiere.
Andererseits betont Epiktet grundsatzlich die Pflichten gegenuber den Mitmenschen, auch gegenuber dem kranken Familienmitglied, das man ertragen
miisse, ohne sich durch die Flucht zu entziehen.
Eine bei Arrian im Enchiridion genannte wahre Zauberformel des Epiktet
gegeniiber unliebsamen und schicksalhaften Machten lautete: 'Es geht mich nichts
an' 37 • So sollte der Mensch der Antike sich auch zweckmaBig von allen Affekten
distanziert halten, urn die Erhabenheit tiber das Irdische und die Eudamonie zu
ertragen. Dabei wird die Selbsterfahrung und fortwahrende Selbstbeobachtung als
vordringliche sittliche Aufgabe immer wieder betont.
Vor schlechtem Umgang wird ebenso gewamt wie vor einer unregelmaBigen
Selbstpriifung und Selbstbesinnung. Als Mittel hierzu konnten dem Weisen u.a.
Einschrankung von Speise und WeingenuB dienen.
Sittliche Vollkommenheit erblickt Epiktet in der Verwirklichung von Aid6s und
Pistis 38 beim Einzelnen.

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Bezeichnete schon die alte Stoa die Aid6s als vernunftgemiiBe seelische Bewegung, mithin als ein
sittliches Basisgefiihl, das den Menschen beispielsweise bei Verfehlungen erroten lasse, so meint
Pistis das besondere Verhalten zum Mitmenschen: Geselligkeit, Zuverliissigkeit in der Pflichterfiillung, die Vertrauen begriinden helfe.

Die Ehe galt Epiktet als heilig. Ehebruch wurde als verwerflich i.S. des BewuBtseins urn eine Gerneinschaftsptlicht angesehen. Vorehelicher Geschlechtsverkehr
sei zu rneiden. Ehe und Kinderzeugung wurden als selbstversHi.ndliche Biirgerptlicht in die soziale Ethik Epiktets einbezogen.
Der ehernalige Sklave Epiktet predigte auch die These von der Gleichheit aller
Menschen, wie iiberhaupt Philanthropie seine gesarnte Lehre bestirnrnte.
Haben wir irn Vorstehenden nun auch einige Beispiele Epiktets zur Seelenleitung und rudirnentaren Seelenhygiene dargestellt, so sei abschlieBend noch ein
Wort zur Korperhygiene urn die Zeitenwende vermerkt.
Der Leib gehorte fiir Epiktet zwar einerseits zu den Objekten, 'die uns nichts
angehen'. Dennoch verschrnahte Epiktet die Kyniker, die den Korper absichtlich
vemachlassigen. Drastische Worte belegen dies:
So stelle dir nun vor, dein Leib sei dir, wie ein Pferd, anvertraut worden. Wasche ihn, trockne ihn,
mach, daB niemand Eke! oder Abscheu davor hat! Wem ekelt aber vor einem garstigen, stinkenden,
iibelfarbigen Menschen nicht noch mehr als vor einem, der mit Kot beschmutzt ist? Der iible
Geruch des letzteren ist nur von auBen und liegt ihm nur auf der Haut; der des ersteren aber kommt
daher, daB er sich innerlich keine Pflege antut und gleichsam inwendig faul ist40 .

Insofem teilt der Stoiker Epiktet den Standpunkt seines Zeitgenossen, des Satirikers Juvenal (ca. 58-ca. 138 n.Chr.), der das gefliigelte Wort priigte:
Mens sana in corpore sano 41 .
Im Text erwiihnte Autoren
Diogenes von Apollonia
Demokrit
Aristophanes
Eupolis
Plato
Theokrit
Aristoteles

Historische Daten im Vergleichszeitraum
460-390
460-370
445-387
430
427-348
I. H. 4. Jh.
384--322

460-377
(462-429)

Hippokrates
Perikles

495-429

Alexander d.Gr.

356--323 (336--323)

Epikur

341-270

Archimedes

Zenon
Chrysipp
Panaitios
Poseidonios
Epiktet

334-263
281-208
180-110
135- 51
50-120

162-133
Tiberius Gracchus
106-- 43
M.T. Cicero
100- 44 ( 50- 44)
C. Caesar
C. Octavianus Augustus 63v.-14 n.Chr. (44v.-14 n.Ch
Hadrian
76--138 (117-138)

285-212

Fig. 4. Zeittafel als synoptisch- historische Orientierungshilfe.
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93

ANMERKUNGEN
I. Dieckhofer, K., Psychohygienische Konzepte in der romischen Kaiserzeit. In: Ther. d. Gegenw.
1981,120,80-95.
2. Schumacher, J., Antike Medizin. !. Bd. Berlin, De Gruyter, 1940, S. 4.
3. Augustinus, A., Vom Gottesstaat. Miinchen, DeutscherTaschenbuch-Verlag, 1977,8, Buch, Kap.
2, s. 374.
4. Leibbrand, W.A. Wettley, Der Wahnsinn. Freiburg/Miinchen, Alber, 1961, S. 16.
5. Schumacher, a.a. 0., S. 5.
6. Aristophanes, Antike Komodien. Die Frosche. Miinchen, Winkler, o.J., 1087 f.
7. Ebd., 1069 ff.
8. Altattischer Heros, dem im NW vor den Mauem Athens ein Heiligtum errichtet worden war; in
seiner Niihe befand sich die von Platon zwischen 387 und 361 v.Chr. gegriindete (und bis zu ihrer
Aufhebung du_rch Justinian im Jahre 529 n.Chr. existente) Philosophenschule der Akademiker.
9. Aristophanes, Antike Komodien. Die Wolken. Miinchen, Winkler, o.J., 1015 ff.
10. Antimachos von Teos, wahrscheinlich Epiker aus dem 8. Jh. v .Chr.
II. Kranz, W., Die Kultur der Griechen. Leipzig, Dieterich' sche Verlagsbuchhandlung, 1943, S. 457.
12. Das Gartengrundstiick hatte Epikur eigens zu diesem Zweck erworben.
13. Epikur, Von der Uberwindung der Furcht. Katechismus, Lehrbriefe, Spruchsammlung, Fragmente. Zurich, Artemis, 1949, fr. 28, S. 63; auch fr. 75, S. 103.
14. Ebd., Brief an Menoikeus. S. 45.
15. Gotter leugnet Epikur trotz seiner materialistischen Grundeinstellung nicht. Cf. Epikur, a.a.O.,
BriefanMenoikeus, S. 44f. u. fr. 3, S. 58 sowie 28, S. 63.lhre im TraumdemHellenenerschienenen
Abbilder sind fiir den Menschen Vorbild, die Gotter wohnen in Zwischen wei ten und greifen nicht in
das menschliche Dasein ein. Cf. auch Pohlenz, M., Gestalten aus He/las. Miinchen, Bruckmann,
1950, s. 569.
16. So in der Unterredung zwischen Sokrates und Kallikles, cap. LX. Cf. Plato, Gorgias, ed. C. Fr.
Hermann. Lipsiae, in aedibus Teubneri, 1926, pg. 285.
17. Eudoxos von Knidos (ca. 400- ca. 347 v .Chr.). Mit seiner Lehre, daB die Lust das hochste Gut sei,
hat sich Plato im Philebos offenbar auseinandergesetzt. Aristoteles erortert diese Frage im 10. Buch
der Nikomachischen Ethik.
18. Epikur, a.a.O., fr. 29 (und 27).
19. Pohlenz, a.a.O., S. 564.
20. Epikur, a.a.O., Brief an Menoikeus, S. 48.
21. Hadot, I., Seneca und die griechisch-romische Tradition der Seelenleitung. Berlin, De Gruyter,
1%9, s. 48 ff.
22. lhm waren 'Unterfiihrer' in niedriger Rangstufe nachgeordnet.
23. Cf. Sen. ep. 52, 3.
24. Cf. Cic. de finibus I, 65. In den Zeiten Ciceros ist iibrigens die Zahl der Epikureer schon beachtlich.
Hierzu: Schmidt, H., Epikurs Philosophie der Lebensfreude. Leipzig, Kroner, 1911, S. 20.
25. De Witt, N. W., Epicurus and His Philosophy. University of Minnesota Press, 1954, S. llO ff.
26. Aphobon ho theos, anafsotheton ho thanatos kai t'agath6n eiikteton, to de deinon euekkartereton.
( = Gott ist nicht furchteinfloBend, der Tod nicht empfindbar, das Gute ist ein edler Besitz. So ist
man gestiirkt gegeniiber dem Schrecklichen.)
27. Epikur, a.a.O., bspw. fr. S. 58 ff.
28. Cf. Epikur, a.a.O., fr. 155. Phalaris (570-554 v.Chr.), Tyrann von Agrigent, gelangte als reicher
Mann zu den hochsten Amtern. Erpressung und Mordlust wurden ihm nachgesagt. Perillos, ein
Erzarbeiter aus Agrigent, soli dem Tyrannen einen ehernen Stier gefertigt haben, in den ein Mensch
geworfen und durch untergelegtes Feuer verbrannt werden konnte. Das erste Opfer wurde indes
Perillos selbst (Cf. hierzu Ov. a.a. I, 653).

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Klemens Dieckhofer

29. Pohlenz, a.a.O., S. 583.
30. Pohlenz, M., Die Stoa. Geschichte einer geistigen Bewegung. 4. Aufl., Giittingen, Vandenhoeck &
Ruprecht, 1970, S. 143. Im Zusammenhang mit Chrysipp als dem Emeuerer der Stoa sei am Rande
erwiihnt, daB sich Albert Schweitzer in den Fragen einer Psychohygiene geme auf die Stoiker
berief. So bei: Lindemann, H., Was ist Psychohygiene? In: Jugendrotkreuz und Erzieher. 9, 1975, I.
31. Die Pronoia, als vernunftgemiiB gestaltende und erhaltende Kraft, ist mit dem Logos und mit der
Physis identisch. In gewissem Sinne ist sie die Gottheit, andererseits die Heimarmene. Diese
bedeutete den liickenlosen Kausalzusammenhang, wonach sich auf dieser Welt alles vollzieht
(Heimarmene =series causarum). Cf. Pohlenz, Die Stoa ... , a.a.O., S. 101 ff.
32. Cf. Cic. de nat. deor. II, 152.
33. Pohlenz, Die Stoa ... , a.a.O., S. 215.
34. Epiktets Handbuch, in: Epiktet. Was von ihm erhalten ist. Nach den Aufzeichnungen Arrians.
Heidelberg, Winters, o.J. Im folgenden wird !aufend auf dieses Enchiridion Bezug genommen, ohne
daB stets weitere Quellenhinweise erfolgen.
35. Geschichtsschreiber aus Nikomedeia, I. Jh. n.Chr.; aus vornehmem Hause. Statthalter in Kappadokien unter Hadrian (76- 138).
36. Pohlenz, Die Stoa ... , a.a.O., S. 330.
37. Epiktets Handbuch, a.a.O., I, 5.
38. Aidos, Scheu, Anstand, Riicksicht. Urspriinglich giittliche Gestalt (Cf. Hes. erg. 197-201).
Pistis = Glaube, Vertrauen, religiiiser Glaube; in der platonischen Erkenntnistheorie (Liniengleichnis, Plat. rep. 6, 509 D- 511 E) die unterste Erkenntnisstufe, die sich auf die Abbildungen von
Gegenstiinden bezieht.
39. Die Ziihne pflegte man mit Pulver. Bei Plin. nat. 28, 178 bspw. werden Rezepte genannt. Schminken
(von Epiktet verworfen) war iiblich. Neben dem regelmiiBigen Bad wurden Waschungen mit einer
Mischung von Kalk und Holzasche oder Tonerde vorgenommen. Die geiilten Kiirper wurden durch
Striegeln gereinigt.
40. Epiktet. a.a.O., II. Reinlichkeit 17-18.
41. Juvenal, Satiren. Miinchen, Goldmann, 1958, X, 356.

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'Sympathy' in the neurophysiology of
Thomas Willis
RICHARD Y. MEIER

Sympathy as a medical concept
Sympathy is a Greek word long familiar to us in the realm of human interaction.
Most commonly we think of sympathy as an involuntary emotional response to the
condition of another human being, especially if that condition has taken a sudden
turn for the worse. But there can also be
'fellow-feeling' with another's
happiness, which may be shared between two individuals or among a larger group.
In addition to such feelings, there is also sympathetic behavior-forexample, in the
notorious yawning reaction. On another level, one may sympathize in the sense of
being favorably disposed toward another person's character, opinions, or actions.
People who have sympathy for each other can work together harmoniously,
whereas the opposite feeling of antipathy can lead to unpleasant relationships or
even social chaos.
In the early eighteenth century, the human capacity for sympathy became a
favorite subject of moral philosophers. But there was a much older, medical
tradition which applied the concept of sympathy not to relationships between
individual persons, but rather to internal parts of the human body. Such parts do
not exist and function in complete independence, but rather affect each other in a
multitude of ways. Parts were said to sympathize with each other when a change in
the condition of one part brought about some change in the condition of another.
Sympathy (also known by its Latin equivalent 'consensus') was regarded both as a
localized affair between two or three parts, and as a condition involving the entire
body which, when healthy, exhibited a general sympathetic harmony. The earliest
known expression of this physiological sympathy appears in the Hippocratic
treatise Nutriment and has been translated as follows:

a

Conflux one, conspiration one, all things in sympathy; all the parts as forming a whole, and
severally the parts in each part, with reference to the work 1 •

Both striking and obscure, this passage was cited by Galen and many other
physicians well into the eighteenth century. Various interpretations were given
which cannot be covered here. But it should be pointed out that sympathy did not
always refer to a healthy relationship among the parts, but quite often to a
pathological situation. That is, the sympathetic affect of one part on another may be
adverse to the functioning of another, or to both. And again, this may involve only
certain parts or have a traumatic effect on the entire body.
ClioMedica, Voi.I7,Nos.2/3,pp.95-lll

©

B.M. Israiil, Amsterdam, The Netherlands
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Richard Y. Meier

A sympathetic influence does, of course, involve a causal relationship, in which
the response of one part is the effect of something happening elsewhere. However,
a peculiar feature of the sympathetic relationship is that the condition of one part is
not in itself directed toward achieving a particular response from another- no more
than one person's yawn is aimed at provoking a yawn from someone else. In
interpersonal relationships as well as in physiology, the term sympathy was
generally used to indicate an involuntary effect. Thus the purposive movement of
an arm or leg in response to commands from the brain was not usually regarded as a
case of sympathy.
Something which did count as sympathy was the vomiting action of stomach and
diaphragm in response to the presence of a stone in the kidney- to give one example
cited through the centuries. The parts typically said to be involved in sympathy
were the heart, stomach, kidneys, intestines and other internal viscera whose
functions are not subject to voluntary control. These organs may, of course, be
affected by conscious experiences, and so were often said to act in sympathy with
certain 'passions' occurring in the brain.
Few of those who employed the concept of sympathy made any attempt to
analyze its meaning, even to the extent I have attempted here. But while the
'sympathy of the parts' was taken as an obvious fact, the actual basis of sympathetic interaction was regarded by many as a challenge. Just as it is difficult to see
how persons manage to affect each other sympathetically, so it is not immediately
obvious how different parts of the body- especially those remote from each othercan be mutually influenced in various ways. In short, sympathetic phenomena
require some kind of explanation.
The problem of sympathy may be said to involve a mystery of transmission; that
is, a physician who wished to explain a case of sympathy had to discover the means
by which the condition of one part was being communicated to the other. Fortunately, the body does not contain a mere collection of parts, but a system of parts
connected to each other by various structures. These connecting structures offer
the possibility of being seen as transmission routes through which sympathetic
influences might be communicated. Sympathetic relationships between parts can
then be explained by the identification of certain sympathetic connections.
The Hippocratic dictum quoted above was not immediately followed up with
investigations of the structural basis of sympathy. By the time of Galen, however,
advances in anatomical knowledge had made it clear that two basic structures were
available as pathways of sympathetic transmission: the vascular system and the
nervous system. Galen's treatise De usu partium singles out blood vessel
connections as explanation for a case of sympathy already noted in certain Hippocratic works, namely the sympathy between breasts and uterus during menstruation and pregnancy, and also under various pathological conditions. 2
The use of neural connections to explain sympathy has its major precedent in
another Galenic treatise, De I o cis affect is. Here Galen classified all
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pathological conditions as being either 'idiopathic', i.e., originating in the same part
where the disease or injury is being felt, or 'sympathetic' where a condition arising
in one part has an effect which is felt in another3 • Many sympathetic disorders are
then discussed without any reference to definite connecting structures. But in the
case of local muscle spasms which lead to more general convulsions in other parts
of the body, Galen pointed out that spasms typically spread only to certain parts
which are connected by common nerve branches4 • In the midst of this discussion he
also stresses the interconnectedness of the nervous system by comparing it with a
tree, whose trunk is the brain and spinal cord, and whose branches are the
peripheral nerves. While thus hinting at a more extensive role for the nervous
system in mediating sympathy, Galen's own exploitation of the possibilities
remained limited.
Galen's views on neural sympathy were echoed in the works of Renaissance
physicians, some of whom we shall mention later. But the first to attempt a
comprehensive investigation of the nervous system as a way of understanding
sympathy was the seventeenth century English physician Thomas Willis (16211675). Willis wrote the first book devoted completely to the nervous system, and
was also the first to trace out many of the neural connections between the viscera of
the abdomen and thorax. The result was the first detailed description of what is still
called the 'sympathetic nervous system'.
The ancestry of the term 'sympathetic' has not gone unnoticed by historians of
neurophysiology 5 , but most have concentrated on finding early precedents for the
modem concept of reflex action; sympathy has often been represented as a
primitive or metaphysical idea which impeded progress 6 • Occasional passages
describing phenomena we would now interpret as reflexes can certainly be found in
Descartes, Willis and a number of eighteenth century figures. But there is much
more to be gained by understanding Willis on his own terms, rather than focusing
on anticipations of a modem idea that was scarcely central to his thought. In the
following exposition of Willis, I hope to demonstrate that his interest in explaining
sympathetic phenomena furnished a strong and fruitful stimulus for his explorations of the peripheral nervous system.
Willis- Education, Career, and Influences
The life of Willis has not been given an exhaustive study, but the main events of his
career are known 7 • After receiving a B.A. and M.A. from the liberal arts curriculum
at Oxford, Willis decided to study medicine and obtained a Bachelor of Medicine
degree with license to practice in 1646. Further study was made difficult by the
English Civil War; he did not receive the doctorate until 1660, the year which
marked the end of Republican rule and the restoration of the English monarchy. In
1660 Willis also became Sedleian Professor of Natural History at Oxford, at least
partly as a reward for his loyalty to the King and to the Anglican Church. After
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holding lectures at Oxford for several years, Willis moved to London in 1667 and
established a lucrative private practice there.
Willis's first publication was his De fermentatione of 1659, parts ofwhich
are discussed below. But his fame rests chiefly on his classic Cere bri ana tome
(1664), which was by far the most extensive treatment ofthe nervous system up to
that time. The first half of the book presented a more accurate dissection of the
brain than any carried out before; one particular structure, an arrangement of
arteries at the base of the brain, has survived in the nomenclature as the 'Circle of
Willis'. But here we are chiefly interested in the second half of the book, whose
contents are indicated by the subtitle, 'cui accessit nervorum descriptio et usus'. In
this section we find a description of the cranial nerves, which had been classified
into seven pairs since the time of Galen. Willis increased the number to ten, and his
scheme was accepted through the eighteenth century. Detailed descriptions were
provided for the vagus nerve (his eighth pair, our tenth) and the other great visceral
nerve which he called the intercostal, and we call the sympathetic. In speculating
on the functions of these and other nerves, he frequently employed the concept of
sympathy.
A search for possible influences on Willis reveals a more complex history than
our earlier account of sympathy might suggest. Undoubtedly the works of Hippocrates and Galen were among his primary sources. The curriculum at Oxford
was still fairly conservative, and he would have been required to get a thorough
grounding in classical medicine 8 • Some passages in 'Cerebri anatome' indicate an
aquaintance with Galen's 'De locis affectis'. However, Willis's correlation of
nervous and sympathetic phenomena is far more extensive than could have been
suggested by Galen alone.
Sympathy was, in fact, a popular theme among physicians of the sixteenth arid
seventeenth centuries, though in a form that was often alien to the Galenic
tradition. As Temkin once remarked, Galen's use of the term did not imply anything
mysterious, i.e., metaphysical or supematural9 • But in the Renaissance there was
much discussion of sympathy not as a physiological but rather as a cosmic
phenomenon in which supernatural forces were involved. The roots of this cosmic
sympathy have been traced back to the views of certain Stoics 10 , who regarded the
entire universe as a kind of organism whose parts interact sympathetically by
means of a quasi-material pneuma 11 • In the later philosophical movement known as
Neoplatonism, the agent of cosmic sympathy became a completely immaterial
world soul 12 •
Neoplatonic views of this kind may be found in many major figures of Renaissance philosophy and medicine, such as Marsilio Ficino, Agrippa von Nettesheim,
and Paracelsus. Seventeenth century medicine was especially influenced by the
Paracelsian philosophy, as adopted and modified in various ways by Daniel Senner!, Robert Fludd, and Johann Baptista van Helmont 13 • The direct influence of
these figures had largely faded by the time of Willis, but there are many passages in
his writings which show a definite familiarity with van Helmont.
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Each Renaissance physician had his own peculiar view of cosmic sympathy, but
the general outlook may be summarized briefly 14 • Here on earth, i.e. within the
material sphere or 'microcosm', all things are affected by forces which either draw
them together in sympathy, or drive them apart in antipathy. The causes of
sympathy and antipathy may have a material component, but are heavily influenced by celestial forces ofthe 'macrocosm', or the entire universe as pervaded
by the world soul. Events in our sublunary microcosm are drawn into sympathy
with the macrocosm by the world soul, which exercises influence by way of
emanations from the stars. As the most perfect creature of the microcosm, man is
particularly subject to these astral influences, hence the widespread belief in
sympathetic correspondences between specific organs of the body and constellations of the Zodiac 15 .
Preoccupation with the celestial aspects of sympathy among the Paracelsian
physicians tended to distract from any consideration of sympathetic connections
within the body itself16 • A somewhat greater concern with the material world is
seen in the large volume of literature on sympathetic cures 17 • Cures of this sort
involved the use of various materials believed to be capable of having a favorable
effect upon a patient even at great distances; the most famous recipe being the
unguentum armarium or weapon-salve, which was supposed to improve the
condition of wounds by application to the weapon instead of the wound itself.
Writers from Paracelsus to the English Paracelsian Robert Fludd generally
explained this curative action-at-a-distance by means of cosmic forces 18 • But van
Helmont eventually denied any role to celestial powers 19 , and a contemporary of
Willis named Kenelm Digby developed an elaborate hypothesis which accounted
for these cures by a material effluvium of atomic particles 20 .
Although the literature on sympathetic cures shows a tendency to bring the
philosophy of cosmic sympathy down to earth, there is little evidence for a direct
link between the cosmic tradition and the sympathy of the body's parts by means of
nerves. But because of this tradition, the general notion of sympathy enjoyed far
more prestige in seventeenth century medical thought than among the ancient
Greek physicians. Willis and his contemporaries were quite aware of the
Renaissance literature, even as they were searching for alternatives to the
invocation of cosmic or occult forces.
Meanwhile, the tradition of nerve-mediated sympathy based on Galen had never
completely died out. Passages in the writings of such famous names as Ferne/,
Cardano, Sennert, Du Laurens and Harvey are taken directly from 'De locis
affectis', or other Galenic passages relating to sympathy. Jean Femel's De
morbi s eo rum que c au sis (Book 1, Chapter 4) reasserts the distinction
between idiopathic and sympathetic disorders, and classifies the means by which a
disease or injury can affect a distant part by sympathy 21 . While Feme! provided
little more than a summary of Galen's position, others allowed a more extensive
role for the nerves than indicated by the original Greek model. Thus a treatise

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attributed to Girolamo Cardano says that cranial nerves may be involved in
epilepsy 22 , whereas Galen had spoken vaguely of a 'pneumatic substance' rising to
the brain23 • The anatomist Du Laurens argued very specifically for the ability of
auditory nerve branches to mediate 'the marvelous sympathy of the ears with the
palate, tongue, and larynx' 24 • Several of the Renaissance figures who preserved
and extended this Galenic tradition also had a lively interest in cosmic sympathy,
particularly Feme! and Cardano. But this interest always appears in works or
passages entirely separate from those reflecting the Galenic influence, and it seems
that no attempt was made to establish a connection between the two different
realms of sympathy.
The influence of Galenic ideas on sympathy continued well into the seventeenth
century, as can be seen in the lectures of William Harvey. His interest in the
neuroanatomical details of sympathy was at least as great as that of Du Laurens.
For instance, certain branches of the vagus which innervate the stomach are seen
as the basis for sympathy between that organ and the brain:
Because of these nerves there is great sympathy between the stomach and the brain and vice-versa,
wherefore if the brain be injured vomitings and migraine ensue, while if the stomach be affected the
brain suffers and debility and melancholy follow 25 •

Similarly, Harvey considered other branches of the vagus responsible for
sympathy between the stomach and kidneys 26 • Several decades later, Willis would
be trying to explain these visceral sympathies by a much more thorough description
ofthe vagus than any given before.
How much Willis may have learned from Harvey's lectures is uncertain, but
virtually all English scientists doing anatomical work in the late seventeenth
century were influenced by Harvey, either by reading his works or by direct social
acquaintance with the man himself2 7 • Willis enjoyed extensive contacts with these
scientists through participation in the famous 'Oxford Circle' of the 1650's, a group
which included such notables as John Wilkins, John Wallis, Seth Ward, Robert
Boyle, Robert Hooke, William Petty, and Christopher Wren. Anatomy, of course,
was only one ofthe major interests they shared; they were at least as interested in
chemistry, and in exploring the implications of the 'mechanical' or 'corpuscular'
philosophy that was popular at the time. While most members of the Oxford group
did not hold academic positions, it has been shown that interest in the new chemical
and mechanical philosophy had already begun to penetrate the traditional curriculum at Oxford and Cambridge 28 •
Willis also took an interest in chemistry and, as we have already mentioned,
devoted his first publication to the subject of chemical fermentation. When he later
became immersed in the study of the nervous system, he still made use of chemical
ideas in order to describe nerve function. In fact, his own peculiar version of the
chemical philosophy may have led him to give the nervous system - and also
nervous sympathy- an importance they had never been given before.
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From Fermentation to Neurology
Willis's 'De fermentatione' is of great interest in its own right as an early chemical
physiology, but we are concerned with it as a prelude to 'Cerebri anatome'. The
notion of chemical 'ferments' as the basic processes of life had been a central
feature of Van Helmont' s thought and Willis undoubtedly drew inspiration from the
famous Paracelsian while avoiding his obscure metaphysical language. Seeking to
base fermentation on physical and chemical principles acceptable to his contemporaries, Willis also retained parts of the traditional Galenic physiology.
At the beginning of his treatise, Willis considers three well-known approaches to
physical reality. He dismisses the classical four elements as crude and lacking in
explanatory power29 • He is more favorably inclined toward atomism, because it
can provide a mechanistic explanation of things, 'without recourse to occult
qualities, sympathy, or other refuges of ignorance' 30 • Thus Willis rejects the occult
tradition of sympathy from the start. But even atoms are too far removed from the
actual qualities of things as they appear to our senses, a problem which leads Willis
to embrace the third alternative of' chemical principles'. Taken from the alchemical
tradition, these are enumerated as spirits, sulfur, salt, water and earth31 • As a
concession to atomism, they are said to exist in particulate form and as such enter
into the composition of bodies.
Of these chemical principles, salt, sulfur and spirits are the three which are
essential to the process of fermentation. Salt is a principle of stability and the least
active, sulfur is fiery and considerably more active, but spirits are so active that
they constitute the primary agents of all life and motion 32 • The different ferments
which these principles make possible are apparently designed to replace the
Galenic faculties as the basis for such activities as sensation, motion, digestion,
nutrition and excretion.
However, an important link with the Galenic physiology is retained in the exalted
position allotted to 'spirits'. While Galen and his followers would not have
considered spirits a chemical principle, they could have easily agreed with Willis
that in the animal body, 'the major use of spirits is for sense and motion ' 33 • In 'De
fermentatione', Willis does not adopt the traditional triad of spirits as natural, vital
and animal; he seems to think there is a multiplicity of spirits with each becoming
involved in a different ferment. But the one kind of spirits which he specifically
names and discusses in some detail is none other than the animal spirits in the brain
and nerves 34 •
As in Galenic thought, animal spirits are elaborated in the brain out of material
present in the blood, except that Willis sees this as a distillation process which
separates out only the most subtle spirits, others being excluded from the fine
channels of the brain and nerves 35 • This distillation is a kind of ferment, yet the
product itself will presumably have an important role in bringing about whatever
ferments are necessary for sense and motion. Specifics on how animal spirits are
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involved in chemical processes are lacking in this treatise; later, certain details do
appear in 'Cerebrianatome' and Pathologiae cerebri.
But it is more important to see how Willis transformed both Galenic physiology
and the chemical philosophy of his day: having defined 'spirits' and the most active
principle in nature, the most subtle and active of all spirits are identified as the
animal spirits of the nerves which, by implication, become the most important
agents for promoting vital ferments. This combination of traditions accorded the
nervous system a much higher status than ever found in Van Helmont, and a more
exalted role than ever envisioned by Galen. The stage was set for a physiology that
was first and foremost a neurology and thence for a completely neurological
explanation of sympathy.

Nerves, Spirits, and Sympathy
Willis may have coined the term neurologia 36 • It is found in Chapter 19 of 'Cerebri
anatome', along with a passage extolling the importance of studying the nervous
system, both for general knowledge and medical practice:
The anatomy of the nerves furnishes more pleasant and useful speculations, than the contemplation
of any other parts in the living body: for from it are produced true and genuine reasons for the very
many actions and passions normally occurring in our body, which otherwise seem very difficult and
inexplicable; and no less from this fountain can the hidden causes of diseases and symptoms,
commonly classified with the illusions of fortune tellers, be rooted up and clearly laid out 37 •

The nervous system, in other words, is the key to previously obscure mysteries
which, like sympathy, have been given occult explanations. Since a great deal can
be learned about the nerves by anatomical dissection, they can furnish even plainer
evidence than the 'chemical principles' of 'De fermentatione'. But the internal
structure and contents of nerve fibers were not so directly accessible to the knife,
and continued to furnish Willis with a field for speculation in which chemical ideas
were useful.
Willis offers a definition of the term 'nervous system' which is basically
traditional, but with some special emphasis on its ability to act either locally or as a
whole:
Let us comprehend under this name all parts endowed with animal spirits, upon which motion and
sense necessarily and immediately depend- whether for accomplishing only one of these, or both
together everywhere in the body 38 .

Much as in Galen, the nervous system is compared to a tree, of which the brain and
cerebellum are the roots, the medullary substance of the nerves is the pith, and the
multitudinous nerve fibers are the branches, twigs and leaves. At the same time,
however, Willis also says that the nerves are like a solar system, in which beams of
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light radiate from a center or rather from the brain and cerebellum as dual
luminaries 39 • Willis preferred rays of light as a better analogy for the action of
animal spirits than either the flowing of rivers or the passage of air through organ
pipes 40 . Instead of the traditional hollow nerve channels, he proposed a spongy,
porous structure full of contiguous alveoli through which the animal spirits pass. 41 •
In another break with tradition, Willis postulated the existence both of animal
spirits and of a denser fluid called 'nervous juice'; the latter diffuses slowly
throughout the nerve fibers and acts as a stabilizing factor for the much more
etherial spirits which pass through with lightning speed 42 •
Willis's most original move, however, was to divide the animal spirits themselves into two different kinds. His speculations on brain function in the first part of
'Cerebri anatome' had led him to believe that the cerebrum was primarily
responsible for sensory perception and the movement of voluntary muscles, while
the cerebellum was the origin of nerves supplying the heart, lungs, stomach,
intestines and other involuntary viscera43 • This meant that the cerebrum and
cerebellum must each be producing spirits suitable for these different tasks. The
distinction between voluntary and involuntary movements goes back to Aristotle,
but no one before Willis had traced this to a basic difference within the nervous
system. Since the voluntary, 'cerebral' nerves receive very little mention in this
book, Willis seems to have made this twofold division in the interest of establishing
the involuntary nervous system as a special object of study. The involuntary nerves
and spirits regulate internal visceral functions which had interested Willis as a
chemist and which had long been recognized to affect each other sympathetically.
The harmonious function of the involuntary viscera requires them to be regulated
by animal spirits which act in a smooth, even fashion, rather than the irregular,
discontinuous flow of spirits commanded by the will 44 • Willis speaks of a certain
internal 'sense' with which involuntary spirits are endowed; he then proceeds to
equate this special sense with sympathy: 'sensio, sive sympathia' 45 • This is
contrasted with a 'sensio molesta' which results from disturbances in the animal
spirits. Willis probably took the equation of sense and sympathy from a very similar
passage in Van Helmont' s treatise on sympathetic cures46 • But he does not develop
the implication that this internal sense could be the ultimate basis for the sympathetic harmony which the involuntary nervous system brings about. For the rest
of 'Cerebri anatome', sympathy is not something which results from a quality
intrinsic to animal spirits, but rather from the fact that nerves and spirits are
channels of communication among the parts which sympathize.
The first example of sympathetic communication discussed by Willis concerns
the two major divisions of the nervous system itself, i.e. the voluntary and involuntary, whose spirits derive separately from the cerebrum and cerebellum.
There must be some communication between these systems since, after all, events
in the conscious mind and movements of involuntary viscera are known to affect
each other. In Willis's terminology, the task is to find a basis for the 'commerce'
between 'passions' which arise in the 'sensitive soul' and movements occurring in
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the 'praecordia' (organs near the heart) and the 'viscera' (in the lower thorax and
abdomen).
When confronted with an instance of sympathy, Willis's typical strategy is to
locate a neural structure which by virtue of its position furnishes a likely passageway between the parts which it connects. But whenever anatomical observation
fails, he proposes a hypothetical passage. For the case at hand, he singles out four
'prominences' conveniently located on the brain stem between the cerebrum and
cerebellum. In Willis's day, these were called the 'nates' (buttocks) and 'testes',
two of each; in modem terms they are the corpora quadrigemina. Willis 'conjectures' (as he frankly admits) that these four bodies contain passages which allow
the two kinds of spirits to meet and mingle- though only in limited amounts- so that
one cannot overwhelm the other-4 7 • However innacurate in the modem view,
Willis's conjecture formulated the basic problem of finding a locus of communication between conscious and autonomic functions, a locus now primarily
identified with the hypothalamus 48 .
After this first hypothesis, all other passageways for mediating sympathy are said
to be located in peripheral nerve fibers, Willis immediately singles out the smallest
of the cranial nerves, which happen to be located just below the corpora quadrigemina, near the supposed intersection of voluntary and involuntary spirits. Now
called the trochlear pair, Willis called them the 'pathetic' nerves (nervi oculorum
pathetici). Even though they innervate only one (voluntary) eye muscle, they make
it possible for eye expression to reflect conditions in the praecordia and viscera, or
passions in the brain, so that 'in each kind of action, the movement of the eye is
affected by a certain manifest sympathy' 49 .
We must now proceed to the heart of Willis's sympathetic neurology, which is
found in his treatment of the remaining cranial nerves.
Sympathy and the Cranial Nerves
Willis enumerated ten cranial nerves, of which the upper three (olfactory, optic,
oculomotor) were sensory or voluntary because of their cerebral origin. The fourth
was the 'pathetic' nerve which carried both voluntary and involuntary spirits. All
nerves arising below the trochlear he considered cerebellar and thus involuntary.
He was aware that these lower nerves originate from the pons and medulla oblongata, but he classified these structures as extensions or appendices of the cerebellum, from which their animal spirits are derived 50 . Meanwhile, a duct inside the
brain stem carries cerebral spirits down to the spinal nerves, in which Willis had no
interest.
Although he regarded the upper three nerves as strictly cerebral, he gave two of
them sympathetic functions. Thus the olfactory nerve not only provides the sense
of smell but also, by connecting with the fifth (trigeminal) nerve which sends some
branches to the palate, insures a 'strict affinity' between smell and taste. Without
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actually identifying such a connection, Willis thought that it must exist, 'because
the organ of smell ought to have consensus with certain other parts' 51 • The third or
oculomotor nerve can supplement the action of the fourth in emotional eye expression by means of intracranial connections with the fourth, fifth and sixth nerves, all
of which are involuntary.
For us the fifth nerve is the great sensory nerve ofthe head and face, but Willis
saw it as the primary sympathetic network connecting different areas of the face
and, by its branches to the lower nerves, connecting the face as a whole with the
praecordia and viscera. As the source of sympathetic action within the face he
pointed to the root of the nerve (in the pons), where all its branches are drawn
together in a bundle:
The reason for so many nerves, with so many various divisions and being destined for places remote
from each other, yet originating together and collected as if into the same bundle, is so that in all
parts for which these nerves provide, a certain sympathy and consensus of actions may be
preserved 5 2
0

Further down, Willis believed the fifth nerve to be involved in the sympathetic
arousal of sexual passion, due to a (remarkably direct) connection with the great
sympathetic nerve itself. That is, erotic stimulation usually begins with the lips,
which are copiously innervated by the fifth and then travels straight down to the
genitals. Willis's description of the events here has a certain 'Restoration' flavor,
which is perhaps best conveyed by quoting from the 1681 Pordage translation:
Hence the re~son is plain, why these parts are so very sensible, and besides, why the mutual kisses
of Lovers, impressed on the Lips, so easily irritate love and lust by affecting both the Praecordia
and the Genitals; to wit, because the lower branching of the same fifth pair actuates these parts
constituted in the middle and lower belly, and draws them into like affection with the Lips 5 3
0

Of the upper cranial nerves, the fifth is obviously the most important for the
mediation of sympathy. But a far more extensive influence is exercised by the
eighth or vagus nerve, which arises from the medulla oblongata, sends its two main
trunks down to the thorax and upper abdomen, and gives off branches to all the
major organs in these areas. Today the vagus is seen as the main component of the
'parasympathetic' division of the autonomic nervous system. For Willis, it was the
most important 'sympathetic' nerve aside from the sympathetic nerve itself.
Willis traced out the anatomy of the vagus nerve in much greater detail than his
predecessors. Of previous descriptions he cites only that by Fallopio, who
described the origin of the nerve and a certain 'olive body' located slightly further
down, a body which he also called a 'plexus' 54 • Willis went on to describe many
other nerve plexuses which are found among the visceral nerves, unfortunately
without making a clear distinction between a plexus and a ganglion, though he
sometimes mentions a 'ganglioform plexus'. As places where nerve fibers become
more intimately associated, plexuses were considered by Willis (and many after
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him) as useful devices for mediating sympathy among involuntary organs.
Below the olive-shaped 'plexus' near the root of the vagus, Willis accurately
located the upper and lower (or superficial and deep) cardiac plexuses and also an
esophageal plexus. He notes further that the lower visceral branches of the vagus
make connections with the splenic, hepatic and mesenteric plexuses of the sympathetic nerve; however, he does not try to trace out these connections in every
detail. Although Willis provided the most exhaustive account of the vagus up to his
time, his anatomical description is much shorter than the following chapter (24) on
vagal function which, as he makes clear, is to insure the sympathetic coordination
of the heart, lungs, esophagus and stomach.
For example, Willis notes that fibers from the recurrent nerve (a branch of the
vagus) innervate both the heart and larynx. This neural connection insures a
sympathy (also called a 'sympraxis') between heart movement and emotional
expression by means of the voice:
And hence the cause is clear, why each recurrent nerve sends out cardiac branches from its node of
reflection; namely so that in affections whose signs the trachea, with the help of those nerves, emits
as sounds and cries, the heart itself may be affected in its own way ... Indeed also in laughter,
rejoicing and song, the heart, being led by the passage of those nerves into a consensus and
sympraxis with the trachea, at once drives out the blood with a faster pulse 55 •

Laughter and singing are thus 'good for the heart' because they move the blood
along faster and prevent it from stagnating. But vagal connections may also allow
for pathological types of sympathy, as when a cough induces vomiting, or the cough
itself is induced by a disturbance in the stomach, though all is well in the lungs 5 6 •
Since Willis saw no branches of the vagus below the stomach, he did not consider
it to be involved with sympathies of the lower viscera. For him, communication
between the lower abdomen and all the higher organs (including the brain) is made
possible only by the sympathetic nerve itself. It might be noted that the actual use of
the name 'sympathetic' for this nerve was not suggested until the eighteenth
century and was slow in being adopted. Following the usage of his time, Willis
called it the 'intercostal' nerve because of the position of its main trunk 'between
the ribs' while running approximately parallel to the spinal cord.
Willis did not number the intercostal among the cranial nerves, but nevertheless
thought it to have a cranial origin, arising from branches of the fifth and sixth
nerves. Below this supposed origin, he identifies a ganglioform plexus (probably
the superior cervical ganglion) and a lower one (probably the stellate) which sends
fibers to the recurrent nerve, cardiac plexus, trachea and esophagus. Further
down, he notes seven mesenteric plexuses in the lower thorax and abdomen. As
with the vagus, the anatomical detail was unprecedented, yet there is no attempt to
trace every possible nerve branch. Having dispensed with the anatomy of the
intercostal, Willis devotes two chapters to its many sympathetic functions.
The primary function of the upper part of the intercostal is to serve as an
'internuncios' between the praecordia and the brain, so that:
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between the conceptions of the brain and the affections of the praecordia, and also the actions and
passions of almost all parts of the entire body which pertain to involuntary function, consensus and
commerce occur as rapidly as possible 57 •

One may ask why this internuncial role was assigned to the intercostal nerve rather
than the vagus, which, being a large cranial nerve supplying the praecordia, would
seem fit to carry messages from the brain more directly. From his work in comparative anatomy, Willis knew that the vagus does provide communications among
heart, brain and other organs in the lower animals, where the intercostal is not well
developed. But since man has not only passions but 'cerebri conceptus'- ideas and
judgements - sympathy between heart and brain requires a heavy contribution
from the intercostai5 8 .
Willis shows an admirable awareness that sympathy between heart and brain is
not a unilateral influence but a constant reciprocal interaction. Thoughts and
passions in the brain will send down messages via the intercostal which affect the
heart. But when the action of the heart is altered, either by brain activities or from
other sources, it will send back its own influences, not only by way of the cardiac
nerves but also by affecting blood flow to the brain, which can bring about any
number of ideas and fantasies. But then again, if an overexcited heart causes
excessive mental agitation, the brain will begin to act as a restraint upon the organ
which is disturbing it5 9 •
Below the stomach area- where, according to Willis, the vagus does not reachall sympathy depends on the intercostal nerve alone. As with the interaction
between brain and heart, sympathy among the lower organs often involves a
regulation to maintain balance. For instance, there is a need for the liver to produce
the right amount of bile for the intestines, just as the intestines must deliver the right
proportion of chyle to the liver. Willis says that both of these actions are
coordinated with each other due to connections between the hepatic plexus and the
'greatest plexus of the mesentery'. Regulation of the bile must be especially precise
and Willis makes the nerves responsible for the timely release of material from the
bile duct.
Wherefore it is necessary for there to be a very strict affinity between these viscera, and the more so
because the bile should not be continually poured from the gall bladder into the intestines, but by
occasions and intervals for the sake of certain uses. For the nerves, being very well aware of the
needs of each part, remind them both of their mutual obligation, and stir them to action according to
the existing circumstances 60 •

One final example vividly illustrates Willis's purpose of replacing the sympathy of
occult forces by a sympathy of neural connections. The 'greatest plexus of the
mesentery' mentioned above held a special fascination for him. Without explicitly
calling it the 'solar plexus', he does compare it with a sun which is also the center of
an entire solar system, of which the lesser plexuses in the abdomen are the planets.

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The greatest plexus of the mesentery, placed like the sun in the middle of all the others, disperses
nerve fibers as it were like rays all around in every direction, and not only projects these into each
individual plexus, as if so many planets, with a peculiar aspect or irradiation, but also into many
parts of the intestines, blood vessels, and other parts placed all around 61 •

Terms like 'aspect' and 'irradiation' recall the language of Robert Fludd and other
Paracelsian physicians who might have been willing to see the solar plexus as a true
microcosm of the universe. But for Willis, the solar analogy is only a convenient
way of describing a complex anatomical structure. And in the same paragraph
which compares this mesenteric plexus to the sun, Willis describes one of its
primary functions: its descending fibers are those upon which 'every action of the
intestines, and especially the peristaltic movement of vermiculation depends ' 62 • In
other words, these sympathetic nerves emanating from the center of the great solar
system are charged with the task of regulating excretion. In the neurophysiology of
Willis, the long tradition of cosmic sympathy is finally brought down to earth.
Conclusion

Willis's text gives many more examples of sympathetic communication mediated
by involuntary nerves. Here we have only cited a few instances in order to show
that the concept of sympathy was virtually indispensable to his understanding of
these nerves. There is no need to claim that the explanation of sympathy was his
sole reason for undertaking a description of the neural network; to an extent, Willis
was simply seizing upon a territory which had largely remained unexplored by the
great anatomists of the Renaissance. But most probably he would not have taken
such an interest in the anatomy of cranial and visceral nerves if he had not also seen
them as a way of throwing light on physiological phenomena which his predecessors had left in a mysterious state.
Willis's attempt to give sympathy a neurological basis also served to throw light
on the nature of the nervous system itself. That is, he not only pointed out
anatomical connections as a way of reducing the mystery of sympathetic actions,
but also used the existence of sympathetic phenomena to make sense out of a
visceral network which itself had been something of a mystery. The result of this
approach was both a structural description of unprecedented detail and the first
attempt to provide a functional definition, not only for a few scattered nerves, but
for an entire interconnected system.
Of course, Willis also left a good many problems unsolved. While showing
repeatedly that sympathetic communication between major organs depends on
nerves, he made only occasional attempts to say how there can be communication
among the nerve fibers themselves. And having described the sympathetic
functions of so many nerves, he did not consider the need for some kind of central
coordinating agency. These and other problems received more attention in the
eighteenth century, especially from certain physicians in Scotland63 • But even
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those who criticised Willis continued to build on his achievements and looked to
'sympathy' as a major function of the nerves.

NOTES
I. Nutriment 23, trans. W.H.S. Jones, Hippocrates, Loeb Classical Library, vol. I, p. 350.
2. Galen, De usu partium 14, 8. See: On the Usefulness of the Parts of the Body. Trans. M.T. May,
Ithaca, Cornell Univ. Press, 1968, vol. 2, p. 638.
3. Galen, De locis affectis I, 3. In: Opera Omnia. Ed. Kiihn, Leipzig, 1821-33, vol. 8, p. 30.
4. De locis affectis 4, 3. In Kiihn, vol. 8, p. 230.
5. See esp. J .N. Langley, Sketch ofthe Progress ofDiscovery in the Eighteenth Century as regards the
Autonomic Nervous System, in: The Journal ofPhysiology, 50, 15 May 1916, p. 225-258; and Donal
Sheehan, Discovery of the Autonomic Nervous System, in: Archives of Neurology and Psychiatry,
Chicago, 35, May 1936, p. 1081-1115.
6. Franklin Fearing, Reflex Action. Baltimore, Williams & Wilkins, 1930, pp. 9-13; Hebbel E. Hoff
and Peter Kellaway, The Early History of the Reflex, in: Journal of the History of Medicine and
Allied Sciences, 7, 1952, p. 211-249; Georges Canguilhem, La formation du concept du reflexe aux
XVlie et XV/Ile siecles. Paris, Presses Universitaires de France, 1955.
7. The lengthiest account is by Hansruedi Isler, Thomas Willis 1621-1675: Doctor and Scientist. New
York, London, Hafner, 1%8. The most recent source is theDictionaryofScientific Biography, vol.
14, Thomas Willis by Robert G. Frank, Jr.
8. Phyllis Allen, Medical Education in Seventeenth Century England. In: Journal of the History of
MedicineandAlliedSciences.l, 1946,p.ll9-121.
9. Owsei Temkin, The Falling Sickness. Baltimore, Johns Hopkins, 1945, p. 62.
10. Karl Reinhardt, Kosmos und Sympathie. Miinchen, C.H. Beck'sche Verlagsbuchhandlung, 1926,
esp. p. 51-54; S. Sambursky, The Physics of the Stoics. London, Routledge & Kegan Paul, 1959, p.
41-44.
II. Max Pohlenz, Die Stoa: Geschichte einer geistigen Bewegung. 4. Auflage. Gottingen, Vandenhoeck & Ruprecht, 1970, p. 101-102.
12. See the discussion of Plotinus in Walter Pagel, Paracelsus: An Introduction to Philosophical
Medicine in the Era of the Renaissance. Basel & New York, S. Karger, 1958, p. 224.
13. Further discussion of this era may be found in my Sympathy as a Concept in Early Neurophysiology. Ph.D. dissertation, University of Chicago, 1979, Chapter I.
14. A fuller exposition is in Pagel, Paracelsus, p. 65-72; a more recent treatment of Renaissance
sympathy is by Michel Foucault, The OrderofThings. New York, Vintage Books, 1971, p. 17-30.
15. Pagel, Paracelsus, p. 67. 117-121,254.
16. Cf. Dietlinde Goltz, Naturmystik und Naturwissenschaft in der Medizin urn 1600. In: Sudhoffs
Archiv. 60, 1976, p. 51-58.
17. Much of this literature was collected by Silvestrus Rattr~y into a volume entitled Theatrum
sympatheticum auctum. Nuremberg, apud J.A. Endterum & '}volfgangijuniores haeredes, 1662.
18. See Allen Debus, Robert Fludd and the Use of Gilbert's 'De Magnete' in the Weapon-Salve
Controversy. In: Journal of the History of Medicine and Allied Sciences. 19, 1964, p. 389-417.
19. Compare Van Helmont's treatise De magnetica vulnerum curatione and De sympathicis mediis,
both printed in his Ortus medicinae. Amsterdam, Ludovicus Elsevir, 1648.
20. Sir Kenelm Digby, Of Bodies and Man's Soul, with Two Discourses of the Power of Sympathy and
the Vegetation ofPlants. London, John Williams, 1669. Digby's hypotheses are discussed in detail
by Lester S. King, The Road to Medical Enlightenment. London, Macdonald; New York,
American Elsevier, 1970, p. 140--145.
21. In Jean Fe mel, Opera medicinalia. Venice, apud Franciscum de Portonaris, 1566, p. 222.

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22. Girolamo Cardano, De epilepsia, in Opera Omnia. The 1662 Lugduni edition with an introduction
by August Buck. New York, Johnson Reprint Corp., 1967, vol. 10, p. 388.
23. Galen, De locis affectis, l, 6.
24. Andre Du Laurens, Historia anatomica humani corporis. Frankfurt, apud M. Beckerum, 1600, Lib.
VI, Quaest. II, p. 892-93.
25. The Anatomical Lectures of William Harvey. Trans. and ed. by Gweneth Whitteridge. Edinburgh
and London, E. & S. Livingstone, 1964, p. 81.
26. Ibid., p. 169. As Whitteridge points out, many of Harvey's ideas in these lectures were taken from
the Basel anatomist Kaspar Bauhin.
27. Robert G. Frank, Jr., The Image of Harvey in Commonwealth and Restoration England. In:
William Harvey and His Age. Ed. J.J. Bylebyl, p. 117-129. See also Frank's outstanding study of
the Oxford Circle, Harvey and the Oxford Physiologists. Los Angeles, University of California
Press, 1980.
28. Robert G. Frank, Jr., Science, Medicine, and the Universities of Early Modern England. In:
History of Science. II, 1973, p. 194-216, 239-269; see also Charles Webster, The Great Instauration. London, Duckworth, 1975, p. 136-143.
29. Thomas Willis, De fermentatione, in: Opera omnia. Amsterdam, apud Henricum Wetstenium,
1682, p. 2.
30. Ibid.
31. Ibid.
32. Ibid., p. 3.
33. Ibid.
34. Ibid., p. 13. The pervasive role of spirits as animal spirits is also apparent in the lectures delivered by
Willis in the years following publication of De fermentatione. See: Thomas Willis's Oxford
Lectures, ed. by Kenneth Dewhurst. Oxford, Sanford Publications, 1950.
35. Ibid.
36. William Feindel, Thomas Willis (1621-1675) The Founder of Neurology. In: Canadian Medical
Association Journal. 87, II. August 1962, p. 295.
37. Willis, Cerebri anatome. London, J. Martyn & J. Allestry, 1664, p. 235-236. See also the 1681
translation by Samuel Pordage, published in a modern facsimile as Anatomy of the Brain and
Nerves. Tercentenary Edition. Montreal, McGill University Press, 1965, vol. 2, p. 125. Pordage's
English version is very helpful, but the translations in this paper are my own.
38. Cerebri anatome, p. 236.
39. Ibid.
40. Ibid., p. 238-239.
41. Ibid., p. 242.
42. Ibid., p. 242-243.
43. Ibid., p. 187-188.
44. Ibid., p. 188, 198.
45. Ibid., p. 198.
46. Van Helmont, De magnetica vulnerum curatione. Paragraph 32. In: Ortus medicinae. Amsterdam,
Ludovicus Elsevir, 1648; reprinted., Brussels, Culture et Civilisation, 1966.
47. Cerebri anatome, p. 176-178.
48. Raymond Hierons and Alfred Meyer, Some Priority Questions arising from Thomas Willis's Work
on the Brain. In: Proceedings of the Royal Society of Medicine. 55, 1962, p. 291-292.
49. Cerebri anatome, p. 182.
50. Ibid., p. 194-195.
51. Ibid., p. 280.
52. Ibid., p. 288.
53. Anatomy of the Brain and Nerves. 1965 facsimile, p. 143.

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54. Gabriele Fallopio, Observationes anatomicae (1561), in: Opera quae adhuc extant omnia. Frankfurt, apud Haeredes A. Wecheli, 1584, p. 456.
55. Cerebri anatome, p. 330.
56. Ibid., p. 337.
57. Ibid., p. 349-350.
58. Ibid., p. 355-356.
59. Ibid.
60. Ibid., p. 379.
61. Ibid., p. 380.
62. Ibid.
63. See Christopher Lawrence, The Nervous System and Society in the Scottish Enlightenment. In:
Natural Order: Historical Studies of Scientific Culture. Ed. Barry Barnes and Stephen Shapin.
Beverly Hills & London, Sage Publications, 1979; also my dissertation, Chapter 4.

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Catalogue 95

Books on Philosophy, Theology,
Occultism, Psychology, etc.

B.M. ISRAEL B.V.
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Jan Swammerdam (1637-1680) and his
Biblia Naturae
GERRIT A. LINDEBOOM

Introduction
A century ago, on February 17th ofthe year 1880, the bicentenary of the day of Jan
Swammerdam' s death, the Society 1 for the Advancement of Physiology, Medicine
and Surgery gathered in the Old Walloon Church 2 , in order to commemorate the
great naturalist.
In that place of worship Swammerdam was buried on the 21st February of 16803 .
Delegates of numerous learned societies as well as the Lord Mayor and an
alderman, honoured the ceremonious assembly with their presence.
In a formal oration Professor Stokvis, a pharmacologist, sketched the life and
merits of his famous compatriot4 . Then a garland was placed on the opened grave,
and an oval marble tablet, walled up in a column, was unveiled.
As not one single portrait of Swammerdam has been preserved, only the words
'Indefessus Scrutator Naturae', as well as the dates of his birth and death were
added to his name. The audience then made its way to the near-by stately house in
the canal, Oude Schans (No. 18), situated near the old 'Montelbaan' tower, where
Swammerdam was born and had lived. A stone tablet, bricked up high in the front
ofthe house, was unveiled. Here his name, followed by the words 'His research is
an example for ever', is to be read in Dutch 5 • That example was followed by a
symposium, sacred to his memory, on 14th February 1980- exactly a century
later6 •
Youth and Studies
Let us have a look at the troublesome life of Jan Swammerdam who, later on, called
himself Johannes. The boy grew up in his birthplace, situated near the harbour of
the IJ. His father, a chemist, did not only have a pharmacy in his house, but also
cultivated there a collection, a cabinet of China-ware and all kinds of natural
curiosities (exotic plants, stones, furs and bones of animals), which he acquired
from the sailors returning from the East and West Indies to the prospering capital.
His cabinet attracted many visitors from his own country and from abroad, even
royalties 7 • He transmitted this passion for collecting to his son, but Jan's mind was
irresistably captivated by the world of the small and the very small animals,
especially by the insects. In fact, he had an inborn disposition for the study of
nature.
ClioMedica, Vol.I7,Nos.2/3,pp.l13-131

10 B.M.

israel, Amsterdam, The Netherlands
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Yet, Swammerdam pere, a sturdy Calvinist, had destined his son for the ministry
and Jan was not allowed to start the study of medicine atLeiden University until he
wa~ 24 years old. We do not exactly know what he did before. Undoubtedly he was
most of the time engaged in building up a collection of insects, but probably he did
not omit to attend the yearly public anatomies of the Surgeons' Guild, delivered by
Johannes Deyman (1620--66) 8 , and perhaps he attended some private anatomical
lectures of G.L. Blasius (c. 1625-92), professor of medicine at the Amsterdam
Athenaeum9 .
In spite of that, it remains an astonishing fact that during his two years' stay at
Leiden (1661--63) 10 the student Swammerdam independently performed, in his
lodgings, original experiments as probably never had been undertaken before.
Swammerdam demonstrated some of these experiments before his friends, and
also to one of his teachers; Franr;ois de le Boe Sylvius (1614-72) 11 • He described
many of these experiments in his Tractatus de respiratione, which
appeared in 1667, one month after his graduation 12 • A few of them are pictured in
the rather peculiar frontispiece of the small book 13 •

Fig. J. Frontispiece of Swammerdam 's Tractatus de R espiratione.
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Swammerdam seems to have studied the respiratory volume in a dog tied up
under water, after having inserted, air-tight, a copper tube in the trachea of the
animal, through which he also could inflate the lungs by means of a pair of bellows.
He tried to evaluate the part played by the intercostal muscles and the diaphragm. Being under the influence of the Cartesian philosophy, it was his
endeavour to prove that pressure is the main factor not only at expiration, but also
at inspiration. During expiration air is pressed out by the contraction of the muscles
of the chestwall and the diaphragm. At inspiration by the expanding of the chest,
which is due to muscle action, the pressure of the surrounding air rises and thereby
forces the air into the lungs.
This theory, now usually called the Cartesian circle, of course belongs to the
early history of the theory of respiration 14, but nevertheless, the book is today
considered to be one of the classics of physiology.

In France
During the period between his final examination at Leiden in October 1663, and his
graduation four years later, Swammerdam made a study-tour of France (1664--65),
where he passed perhaps the happiest time of his life. At Saumur 15 he did not only
study the life of the mayflies, swarming in myriads at the edges ofthe low-levelled
River Loire, separately and independently from Frederik Ruysch, he also
discovered the valves in the lymphatic vessels 16 . He demonstrated these valves at
the dried vessels, by inflating them through minute tubes, before a company of
physicians there on the 19th of June 1664 16 .
At Paris his fellow-student and friend from Leiden, the Dane Nic. Steno,
introduced him to the learned company, which gathered regularly in the spacious
residence of the maecenas Melchizedec Thevenot (1620-92) 17 •
It was this very circle which, soon afterwards, became the' Academie Royale des
Sciences' 18 • Swammerdam may have attended the famous lecture on the anatomy
ofthe brain, delivered by Steno before that company in 1665 19 •
Thevenot was to become the lifetime paternal friend of the reticent young
Dutchman, who, only after being urgently requested, was persuaded to show once
or twice his unbelievable skill in anatomizing an insect. Thevenot procured him the
opportunity to continue his entomological studies at his country-seat in Issy (near
Paris), where his footmen had to catch all sorts of insects in order to satisfy
Swammerdam's inquiring mind 20 •
After his return to the paternal home he joined a small company of Amsterdam
physicians who were much interested in human and comparative anatomy 21 . He
prepared the spinal marrow with the roots of its nerves, and made fine drawings of
his findings, which, however, were published by professor Blasius without duly
giving Swammerdam the credit of his work 22 •

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During the next years he spent part of his time studying the human normal and
morbid anatomy 23 • Together with his former teacher, Johannes van Horne 24 , he
studied the female organs by injecting beeswax into the uterine vessels, and both
scientists were among the first to conceive the idea that the ovaries are not
rudimentary organs - testes muliebres - according to the then prevailing general
view, but nothing else than the site of the human eggs nowadays known as the
Graafian follicles. Some years later, in 1672, Swammerdam would put his quarrel
with Reinier de Graaf on the priority of the discovery before the Royal Society at
London 25 •

Fig. 2. Preparation of the womb of a human subject, made and drawn on 21 January 1667. The blood
vessels are filled with wax. Loose sheet of the plate dedicated toNic. Tulp (1671). The plate was inserted
in the Miraculum Naturae (1673).

After the death of Van Home (1670) Swammerdam obtained permission to
perform postmortems at Peter's Hospital in Amsterdam 26 • These postmortems as
well as other investigations led to a new theory on the genesis of inguinal herniae.
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117

Most of his time, however, he was roaming about, day after day, in the watery
environs of the town, catching insects, even at evening time, at the numerous
ditches and pools or along the banks of the rivers Rhine and IJssel, or the Vecht
near the castle Nijenrode during a stay there 27 . It was inevitable that during these
trips he caught a serious infection of malaria28 , which caused attacks of fever, and
weakened his health. In spite of that he pursued his investigations as much as
possible. At home he anatomized the small creatures (which he preferably called
the bloodless small animals) with an unequalled ability, on a copper table,
especially constructed for him by a renowned instrument-maker named
Musschenbroek. He worked in the morninghours at bright sunlight, often from six
to twelve, using very small instruments, such as knives, pincets, needles, and in
particular tiny scissors. The results of these investigations were published in a book
on the general history of insects, which appeared in Dutch in 1669, but with the
main title in Latin: Historia generalis insectorum, to which was added
'or: General history of the bloodless small animals'.

Conflict with his father. Mysticism.
Yet, Swammerdam pere considered all this important scientific work as mere
trifles. He began to urge his son, now in his thirties already, to earn his own living as
a doctor. He reproached him and quarrelled with him day after day. Swammerdam
gradually became depressive, seeing no escape whatsoever from his untenable
life-situation. He felt neither inclined nor capable for medical practice, and no
position as a naturalist was available to him in Holland at the time. True- during a
stay in Holla~d the young prince of Tuscany paid a visit to the Swammerdam
cabinets, and on that occasion showed himself prepared to buy the rich collection
of insects at a price of 12000 guilders, provided that Swammerdam himself would
take it to Florence and would enter his service. But Swammerdam declined
politely. As a republican and a convinced protestant he liked his freedom of opinion
and speech, and he feared that he would not be at ease at a Catholic court29 •
He was, in fact, of a profound religious nature. He had always believed that his
studies of the secrets of nature served to honour the Creator as he had expressed at
the end of the 'Historia generalis insectorum'. He once wrote to Thevenot, his
faithful correspondent: 'Illustrious Sir, I present to you the omnipotent finger of
GOD in the anatomy of a louse' 30 • However, he now began to doubt, whether his
studies of nature did not wrongly detract him from the worship of God; he turned
his mind entirely to religion, and finally fell more and more into mystical
meditations and into a period of mysticism. In his serious distress and state of mind
he sought rescue by letter with a religious fanatic, Antoinette Bourignon (1616-80)31. This French woman, originally Roman Catholic, being of an imperious and
grasping character, endeavoured to unify Catholics and Protestants into one
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Gerrit A. Lindeboom

community of true believers. During a stay of some years at Amsterdam she had not
only published some books, eagerly read by Swammerdam, but she had also made
some devoted disciples. With a few ofthem she had fled to the Duchy Schleswig,
where she had founded a religious community, living in the small shallow-island of
Nordstrand.
In her reply to Swammerdam's letter the authoritative 'Light of the World'- as
she was considered by her followers- declared all his scientific investigations to be
no more than 'amusements de Satan' 32 • He had to give up that work, to abandon
everything, and to join her community. In his desperate state Swammerdam
decided to obey, but humbly requested to be allowed still to publish his almost
completed work on the may-fly. The request was granted graciously. Swammerdam did not, however, publish the book without the imprimatur of Antoinette
Bourignon in the form of her letter giving the consent, at the very beginning of the
book. He gave the original description of the may-fly in a religious setting as already
appearsfromthetitle: Ephemeri vita orapictureofhumanlife 33 • Themay-fly
(Palingenia longicauda), originating from a small worm living in the river-mud and
flying only during one day in the month of June, was now to himfirstofall a symbol
ofthe fugitivity of human life. In fact, the book was one long sermon, consisting of
meditations, admonitions, prayers and even religious poems entirely draping the
history of the may-fly and the strictly scientific descriptions of the life and structure
ofthe insect 34 •
He stayed in the community for nine months, during which he had to copy and
translate writings of Miss Bourignon 35 • Presumably, he was rather disillusioned
when he returned in June 1676, but meanwhile he had regained his former balance
to a certain extent.
In any case, he no longer considered his scientific achievements to be worthless,
but was convinced again that they could serve to honour the power and wisdom of
the Almighty, and to a better understanding of Nature by later generations. His
weakened health did not permit him to work in the open field anymore, but
fortunately his friends had dissuaded him from destroying his papers at his
departure. So he decided to do his utmost in describing the course and the results of
his investigations. Moreover, he applied himself intensely to anatomical
and microscopical work at home 36 .
After that he intended to sell his collection of insects, hoping to be able to live of
the proceeds for many years, maybe in France with Thevenot.

Completing his manuscripts
The completion of his 'great work'- as he called it- was retarded by domestic
troubles. After his father's death (buried 26th of April 1678) the family wished to
have catalogued his collections in order to have them sold by auction, and
Swammerdam had to spend several months on this tedious task 37 •

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Finally, after two years, his manuscripts, written in Dutch, were ready for the
press, but the Latin translation he considered necessary had to be made yet. For
this purpose he entrusted them to a translator (Herman Wingendorp), who resided
at Leiden. Unfortunately he did not live to see the translation completed and the
work printed. Fevers exhausted his weakened body; he stubbornly neglected the
ad vices of the five friendly physicians 38 , who visited him at his sick-bed; they did
not administer him the only medicine, which could have saved his life- the bark
from Peru, brought along from South America to Europe since long. Too late he
himself wrote to Thevenot asking him to send the remedy from Paris. Feeling the
end of his life approaching, Swammerdam made his will on the 25th of January
168039 • He died three weeks afterwards.
The vicissitudes of the manuscripts
By his will Swammerdam left all his manuscripts to his faithful French friend
Thevenot in order to have them published. However, the Leiden translator refused
to yield the costly papers. After a long law-suit, in which the Leiden professor
Burcher de Voider (1643-1709) acted on behalf of the heirs, the manuscripts could
finally be sent to Thevenot in May 1682. Yet the ageing Thevenot, a great traveller,
who had published several itineraries, a few of which had been translated from the
Dutch into other languages, did not fulfill the wish of the dying Swammerdam.
Thevenot died ten years later (1692) without having published any of them. After
his death the manuscripts were sold40 , and from that moment on they sank into
oblivion for some thirty years.
In the early twenties of the following century Boerhaave learned that they were
in the possessionofGuichardJoseph du Verney (1648-1730), who had bought them
for 50 ecus 41 • There was a rumour that the aged anatomist assiduously made
entomological studies intending to edit them. Not liking this idea, Boerhaave wrote
to Du Verney and received, at his request, prints of some plates, which had,
apparently, already been engraved. On inspection of the splendid figures Boerhaave decided at once to try to regain the manuscripts for the author's native
country. After long negotiations by the intermediary of a Paris minister (Marc
Guillot) and the young Dutch anatomist Willem Roel/42 , who stayed in Paris at the
time, he finally succeeded in purchasing the manuscripts with plates at the price of
1500 French guilders cash payment on the 20th of March 1727. This certainly was a
noble gesture of national importance made by the usually very economic Leiden
professor.
Once in his possession, the extremely busy Boerhaave, who, at the time,
occupied three chairs in the Leiden Medical Faculty, decided to undertake the
editing himself. For the Latin translation he secured the help of the young doctor
Hieronymus David Gaubius, who was to become his colleague as professor of
medicine and chemistry in 173443 •
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Gerrit A. Lindeboom

I20

The enterprise took several years. Boerhaave added a long biography of Swammerdam, which he dated II th September I735 44 • Apparently the work was ready
for the press at that time. Subscriptions for 338 copies were easily found. The work
was printed in two big folio volumes, the first of which appeared in January I737. It
must have been a great satisfaction to Boerhaave when he received the first copy of
the second volume (with the plates) in the early days of September I738, even
though he was lying on his sick-bed, feeling his death already approaching 45 •

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size 30x 17 em.
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Jan Swammerdam (1637-1680) and his Biblia Naturae

121

Title, plates and contents of the 'Biblia Naturae'
Boerhaave borrowed the suitably chosen title: 'Biblia Naturae' (Bible of Nature)
from one of Swammerdam's letters to Thevenot 46 , in which he deplored that his
friend Steno had closed the 'Bible of Nature' definitely (after having experienced a
religious crisis similar to that one Swammerdam had, and during which he changed
his- Lutheran- religion, and became a Roman Catholic priest and vicar apostolic
in Northern Germany). Evidently to Swammerdam the title had a religious connotation, revealing the spirit in which he performed his painstaking investigations.
Hence the title of the English version: 'Book of Nature' (1758) is certainly a
mistranslation 47 •
The work is not the least 'famous for the detail and accuracy of its plates ' 48 • All of
the 53 plates, most of which are showing several figures, originally have been
drawn by Swammerdam himself, in Indian ink, with the exception perhaps of the
last one 49 • They are engraved, at least partly, by a Dutch artist (V.d.Spijk), who
signed fourteen of them.
As the full title indicates, the 'Biblia Naturae' primarily deals with the history of
insects, but also includes innumerable observations of rarities in nature.
Boerhaave inserted into the work the contents of the 'Historia generalis insectorum' as well as the scientific parts of the 'Ephemeri vita'. In fact, it contains much
more than that.
Experts consider Swammerdam's treatise on the bees as his most 'detailed and
accurate anatomical work' 50 • An example of Swammerdam's striving for a Cartesian mathematical exactitude is revealed by the fact that he once (in June 1673 or
1674) opened a beehive and counted in it 'including larvae and nymphs a total of
18.966 "little animals" whereas 2.438left it on swarming' 5 1 •
Swammerdam studied the structure of the larvae of the bees after having put
them into brandy and then into different colouring liquids in order to be able to
distinguish the various parts. Time is lacking to describe the various new techniques he employed such as, apart from inflating with air, injecting coloured
preserving material, solving fatty parts by turpentine, and dissecting under water.
For inspecting he often used very small microscopes 5 2 of the size of a pea, which
the Amsterdam burgomaster Budde had taught him to make from melted glass. The
English zoologist, the late professor of zoology Cole, who, in his country, is the one
to have paid the greatest attention to Swammerdam, stated:
The plan of the treatise, based on selected types, is monographic, comparative and experimental,
and it is indubitably the foundation of our modem knowledge of the structure, metamorphosis and
classification of insects.

Yet, the 'Biblia Naturae' contains more, such as observations on the crustacea and
the mollusca, especially on some snails and the cuttle-fish53 .

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Gerrit A. Lindeboom

Fig. 4. Female organs, sting and poison gland of the honey-bee. Plate XIX of the Biblia Naturae .
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Jan Swammerdam (1637-1680) and his Biblia Naturae

123

The treatise on the frog is most important for physiology. In fact, it has been
Swammerdam who introduced the frog into the study of muscle contraction, and it
is owing to him that the frog is now used everywhere in the physiological laboratories for teaching.
Swammerdam was the first to make muscle-nerve preparations to study the
contraction of the muscles 54 •
Furthermore he succeeded in refuting the old Galenic theory that muscle contraction is accompanied by an increase in bulk, caused by the influx of animal
spirits. For this purpose he constructed ingeniously made glass plethysmographs.
The muscle was hermetically enclosed in the simple instrument, which showed
changes in volume by a very small drop of water in a thin glass tube. By mechanical
stimulation of the cut nerve outside the instrument he could evoke contractions as
often as he liked.
With the help of such a volume-meter he also studied the still pulsating heart of a
frog, from which he had scrapped off the pericard with his nails.
In another experiment - so difficult and subtle that he sometimes became
crest-fallen- he put a muscle into a syringe with only a short piece of nerve still
connected to it. This piece of nerve was put in the eye of a silver-wire, which was
conducted through the eye of a small, erect copper bar, and subsequently outside
through the piston of the syringe. By pulling the silver-wire Swammerdam could
evoke a contraction of the muscle, caused as he believed by mechanical stimulation. It seems to be very probable, however, that an electrical stimulation
originated from the contact of the silver-wire with the copper eye of the bar essentially the same phenomenon described by Galvani a century afterwards 5 5 •
Indeed, there is almost no end to the discoveries described in the 'Biblia Naturae'
(Cole 56 ).
Yet, the rich contents of the invaluable book were almost forgotten by the
scientific world for about a century. It was the young scientist Karl Ernst von Baer
(1792-1876), afterwards professor at St. Petersburg, who drew the attention to the
scientific merits of Swammerdam in an address delivered on the occasion of the
opening of a new anatomical theatre at Konigsberg in 181757 • Nowadays, Swammerdam is recognized as one of the greatest naturalists of the seventeenth century,
not only ofThe Netherlands, bus also of the whole of Europe.
Hundred years ago our country honoured its famous son by unveiling memorial
tablets. This time the Amsterdam Society took the initiative for the production of a
complete facsimile edition of the 'Biblia Naturae', which, moreover, is the first
complete re-edition of the original work as provided by Boerhaave. This certainly is
nothing less than a homage worthy of the genius of the great naturalist - and there
can be little doubt that it is even more in the spirit of its unhappy author, Johannes
Swammerdam.

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Gerrit A . Lindeboom

124

c

d

b

Fig. 5. Swammerdam 's experiments with the muscle-nerve preparation.

NOTES
I. The Amsterdam 'Genootschap ter bevordering van natuur-, genees- en heelkunde' (Society for the

Advancement of Physiology, Medicine and Surgery) was founded in 1790. Its main founder was the
well-known anatomist, Andreas Bonn (1738-1818). Bonn was appointed professor of anatomy and
surgery at the Amsterdam Athenaeum lllustre in 1771 . See for the history of the 'Genootschap' C.C.
Delprat, in: Ned.T.Geneesk. 60, 1917, p. 72.
2. The Walloon Church is situated in a little square in the canal named Oudezijds Achterburgwal(No.
157), near the Oude Hoogstraat. It is the former chapel and the only remnant of the mediaeval
monastery of the St. Paul Brothers. The chapel was probably built in 1409, and since rebuilt,
renovated and enlarged several times. It was given to the parish of the Walloon refugees as church
by the City Fathers in 1586, and is still in use as such nowadays .
3. Jan Swammerdam, born on 12 February 1637, was not baptized in the Walloon Church, as
sometimes has been stated, but in the 'Oude Kerk ' (Old Church) on 15 February of that year. His
parents were Jan Jacobsz. Swammerdam (1606-78) and Baertgen (Barentje) Jans Corver. His
father, an apothecary, bought a family-grave in the Walloon Church on the occasion of the death of
his father, Jacob Dirksz., a timber-merchant, in 1645. The latter had moved from his birthplace
Swammerdam to Amsterdam (hence the surname).
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4.

5.

6.

7.

125

The mother of Jan Swammerdam, the naturalist, was buried in this grave on 13 December 1661,
and his father on 26 April 1678. See for his genealogy: H. Engel, Records on Jan Swammerdam in
the Amsterdam Archives. In: Centaurus. I, 1950, 143-155.
The genealogy of Swammerdam's mother, Baertgen Jans Corver, is dealt with at length in a
postcript by I.H. van Eeghen, added to G.A. Lindeboom, Jan Swammerdam (1637-1680) als
Amsterdammer. In: Jaarboek Genootschap Amstelodamum. 1981, p. 51.
The commemorative address ('Redevoering') of Prof. B.J. Stokvis (1834-1902), provided with
many useful annotations, is to be found in Herdenking van Jan Swammerdam's 200-jarigen
Sterfdag, op 17 Februari 1880, published by the 'Genootschap' mentioned above (Univ. Libr.
Arnst., 658E20).
The Society first held an extraordinary meeting in the Senate Room of Amsterdam University one
hour before the memorial assembly gathered on 17 February 1880, only to institute the Swammerdammedal. In the meeting in the Church Prof. Stokvis also read a short address of the Utrecht
professor P. Harting (1812-85), who was prevented from pronouncing it because of an illness.
On 15 February 1980 the Swammerdam medal was awarded to Professor J .Z. Young. Formerly,
the medal was awarded to Ph.F. von Siebold (1880), E. Haeckel (1890), K. von Gegenbauer (1900),
H. de Vries (1910), Max Weber (1920), H. Spemann (1930), G. Grijns (1940), M.W. Woerdeman
(1950), N.H. Swellengrebel (1956), V.B. Wigglesworth (1966), and N. Tinbergen (1973).
The inscription on the tablet, unveiled on 17 February 1880, runs as follows: 'Jan Swammerdam.
1637-1680. Zijn onderzoek der natuur blijft een voorbeeld voor aile tijden'. The house, built in 1610,
was bought by Swammerdam's father about 1628, and remained in the possession of the family until
1715. Swammerdam's birthplace had originally a gable, ornamented with a six-rayed star from
which it drew its name: 'De (vergulde) Star'. Further the front was adorned with carved stone scroll
work. All these ornaments were removed in the nineteenth century. F .J. Cole gave an illustration of
an old photograph, on which the gable is still to be seen in a short note: 'The Birthplace of Jan
Swammerdam' (Isis. XXVJI, 1937, 452), and moreover a picture of the modern appearance in
another short note: Swammerdam's Home, in: Annals of Science. II, 1937,236.
The present article is the annotated version of the address delivered at the opening session of the Jan
Swammerdam Tri-Centenary Memorial Symposium on 'Brain and Behaviour', organized in honour
of Prof. J.Z. Young, F.R.S. by the 'Genootschap ter bevordering van natuur-, genees- en heelkunde', and held in the seat of the 'Koninklijke Nederlandse Akademie van Wetenschappen' (Royal
Dutch Academy of Sciences), the so-called 'Trippenhuis' (Kloveniersburgwal29, Amsterdam), on
14 and 15 February 1980.
The main modern sources for the life of Swammerdam are: A. Schierbeek, Jan Swammerdam
1637-1680. His Life and works. Amsterdam, Swets & Zeitlinger, 1%7; Joh. Nordstrom, Swammerdamiana. Excerpts from the Travel Journal ofOlaus Borrichius and Two Letters from Swammerdam to Thevenot. Together with an Appendix: The History of Swammerdam's Demonstration of
the Valves in the Lymphatic Vessels. In: Lychnos. XV, 1954-55, p. 1-65; G.A. Lindeboom, The
Letters of Jan Swammerdam to Melchisedec Thevenot. Amsterdam, Swets & Zeitlinger, 1975;
further quoted as Linde boom (1975), or as Letters.
The main work of Swammerdam was published posthumously, in folio, by Boerhaave: Jan
Swammerdam, Bybel der Natuure I Biblia Naturae. With a Latin translation by H.D. Gaubius,
edited by Herman Boerhaave, 2 vols. Leiden, 1737-1738. Facsimile, Utrecht, De Banier, 1980.
Prefixed is Boerhaave 's Vita Auctoris. The Biblia Naturae appeared in an English translation by T.
Felloyd, with the somewhat changed title: The Book of Nature, London 1758, f'.
That Swammerdam pere had important rarities in his cabinet is shown by the fact that Willem Piso
(1611-78) borrowed the skull of a babirossa (hog-deer, an animal then only to be found in the island
of Buru) for his work De Indiae Utriusque re naturali et medica. Amstelodami 1658, f'. The names
of several visitors of the cabinet of Swammerdam pere, who described their visits in diaries, are
mentioned by H. Engel, in his Alphabetical List of Dutch Zoological Cabinets and Menageries,
published in Bijdragen Dierkunde, 27, 1939, pp. 247-346. The list was taken over by A. Schierbeek
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8.

9.

10.

II.

12.

13.

14.

15.

Gerrit A. Linde boom
(op.cit.) as Appendix V (p. 195-96). Here may be mentioned only the names of Olaus Borrichius
(1662), the Prince of Tuscany (1668), Paul Boccone (1674), and Holger Jacobaeus I 1674).
Dr. Joannes Deyman ( 1620--66) succeeded Dr. Nicolaas Tulp (who had filled the office for 25 years)
as praelector anatomiae in 1653. Therefore it is very improbable that Swammerdam has attended
any public anatomy performed by Nic. Tulp.
Gerard Leonard Blasius (Blaes, c. 1625-92), the eldest son of the architect of the King of Denmark,
studied medicine at Copenhagen and Leiden, and settled in practice in Amsterdam. He was
appointed professor at the Amsterdam Athenaeum on 4 September 1660. According to B.W.Th.
Nuyens (Het ontleedkundig onderwijs te Amsterdam in dejaren 1550 tot 1798. Amsterdam, 1928, p.
30, first published in the 'Jaarverslag van het Koninklijk Oudheidkundig Genootschap', 1928,
45-96) Blasius taught anatomy to some young men in 1659. Swammerdam may have been one of
them.
Swammerdam matriculated in Medicine at Leiden on II October 1661, and passed the final
examination just two years later, on II October 1663. He then was a medical candidate; usually the
graduation followed in the next days. It is not quite clear why Swammerdam did not take his degree
in 1663. He then already had performed enough experiments to write a thesis of more than usual
importance. Probably he did not like to describe his experiments until he would be able to present
them as a doctor medicinae to the learned world. He obviously had an ambitious nature. See also
next note.
In order to demonstrate the passage of the air into the blood he pressed air into the lungs of a dog
with a pair of bellows with such a pressure that he found foam in the ventricles of the heart when he
opened them afterwards. He performed this experiment on 15 January 1663, in the presence of
Sylvius (see F. Sylvius. Disputationum medicarum pars primus S. decas (first published
Amstelod., 1663) Jena, 3 1674, Additamentum 79, p. 121; full quotation by Schierbeek (1967),
op.cit., p. 193). Swammerdam demonstrated similar experiments to 0. Borrichius (see Nordstrom,
op.cit.).
Swammerdam took the degree of M.D. on 22 February 1667 after defending a set of23 propositions
(positiones inaugurates), mostly referring to respiration. His book, the Tractatus de Respiratione,
appeared a month later. Apparently he considered the results of his research too important to serve
only as a, often soon forgotten, thesis (dissertatio inauguralis). However, the propositions were
added at the end of his book. After the last proposition he wrote the device: Respirando consumor &
sic erit.
The full title of the small book runs as follows: Tractatus physico-anatomico-medicus de
respiratione usuque pulmonum. In quo primam respirationis inchoationem, aeris per circulum
propulsio statuminatur, attractio exploditur; experimenta ad explicandum sanguinis in Corde tam
auctum quam diminutum Motum in medium producuntur. Lugd. Bat., 1667. The work was
dedicated to Mr. M. Thevenot, formerly ambassador of the King of France, whose hospitality
Swammerdam had enjoyed during his stay in France (see below). After the dedication two Latin
poems are inserted. The first is anonymous: ·Amicus amico cecinit', but, as we know, made by his
colleague Matth. Sladus. The second is signed by Joh. Nic. Pechlin (1644--1706), the son of a Leiden
Lutheran clergyman; Pechlin was appointed professor of medicine at Kiel afterwards ( 1673).
Swammerdam's theory met severe criticism during his life-time already. In 1674 Joh. Bapt. a
Lamzweerde even wrote a book against it, under the contemptuous title: Respirationis Swammerdammianae expiratio. Amstelod., 1674,8°.
A small Protestant University had been erected at Saumur in 1585. Swammerdam lived there with
one of the few professors, Tanaguy Faber (1615-1672), a well-known classical philologist. He also
became acquainted there with the professor of theology, Isaac d'Huisseau (or Duisseau, Duissenius), who was an amateur naturalist, and lived in a house with a garden sloping down to the River
Loire. He drew Swammerdam's attention to the fact that the gnat develops from an egg, and
therefore was born in water (cf. Biblia Naturae, p. 349).

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16. Swammerdam described this fact in a letter, dated 28 June 1664, to his former fellow-student Nic.
Steno ( 1638-86), whom he thought to be in Copenhagen at the time. Therefore, Swammerdam sent

17.

18.
19.

20.

21.

22.

23.

the letter to his own father in Amsterdam, with the request to foreward it to Copenhagen. The latter
showed the letter to some learned men, maybe also to Fred. Ruysch. Hence, young Swammerdam
later became uneasy about his priority, as Ruysch described the valves in the vessels in his small
book Dilucidatio Valvarum in vas is lymphaticis, et lacteis (Hagae Com., 1665; facsimile edition,
with an introduction by A.M. Luyendijk-Eishout. Nieuwkoop, B. de Graaf, 1964). See Lindeboom
(1975), op. cit., p. 39--41, and Nordstrom, op. cit., p. 41-50. See for the relations between
Swammerdam and Steno: B.P.M. Schulte, Swammerdam and Steno. In: Steno and Brain Research
in the seventeenth century. Analecta Medicohistorica 3. Oxford & New York, Pergamon Press,
1968, p. 35-41.
A short autobiography ofThevenot is to be found in the sale's catalogue of his library: Bibliotheca
Thevenotiana sive Catalogus impressorum et manuscriptorum librorum Bibliothecae viri clarissimi
D. Melchisedeci Thevenot. Lutetiae Parisiorum, 1694.
This was due to the int1uence of the well-known statesman, Minister Colbert.
This lecture was not published until four years later: Discours de Monsieur Stenon, sur /'Anatomie
d,u cerveau A Messieurs de /'Assemblee qui sefait chez Monsieur Thevenot. Paris, 1669. Facsimile
edition, with an introduction, privately printed by Nyt Nordisk Verlag, Copenhagen, 1950.
In the dedication of Swammerdam's De Respiratione to Thevenot, already mentioned above, we
read: 'Nihil dicam de laudabili Tua curiositate, cui ut satisfaceres, e proximo t1umine Sequana, per
pedissequos Tuos omnis generis Insecta, eadem cognoscendi & examinandi gratia colligere, atque
ad me perferre jussisti'.
The notes of this small Company were published anonymously in two small volumes: Observationes anatomicae selectiones Collegii privati Amstelodamensis. Caspar Commelin, Amstelod.,
1667; pars altera 1667. Undoubtedly most notes were written down by Swammerdam, who in his
Miraculum Naturae (1672, p. 40) speaks of our observations (ex observationibus nostris a
Commelin editis). Both volumes have recently been reprinted, as facsimile, Observationes Anatomicae Collegii privati Amstelodamensis. Pars prior ( 1667) et altera (1673), with an introduction by
G.A. Lindeboom, Nieuwkoop, B. de Graaf, 1975 (series: Dutch Classics in History of Science
XIX). See also: G.A. Linde boom, Het Collegium privatum Amstelodamense. In: Ned.T.Geneesk.
119, 1975, 1248-54, ill.
Apparently Blasius felt entitled to arrogate to himself discoveries or works of young medical men,
who had not yet taken their degrees. He had tried to do so with the discovery of the duct of the
parotideal gland, which was made in his residence by his young countryman Steno living with him.
See: Th. Bartholinus, Epistolarum medicinalium centuria Ill. Hagae Comitum, 1740, p. 86. The
quarrel on the priority ended with the victory ofSteno, whose name became permanently connected
with the ductus parotideus. In a similar way Blasius now published a book, entitled
Anatome medullae Spinalis ( 1666), based on the work and with the figures of Swammerdam. See
Lindeboom (1975), Letters, I.e., p. 48.
As early as 1663, still being a student at Leiden, Swammerdam showed himself an accomplished
anatomist. He then made a preparation of the thoracic duct of a dog, which was seen by Borrichius
as the latter wrote to Thomas Bartholinus on 12 May 1663: 'Servat Swammerdammius inter rariora
sua ductum thoracicum spiritu didistentum [!], molossoque exemptum, cui paulo infra claviculas
duo crura enata sunt calamum scriptorium amplitudine aequantia, sed coeunt tamen in unum
canalem ante ingressum in venam subclaviam' (Th. Bartholinus, Epistolarum medicinalium
centuria IV, Hagae Com., 1740, p. 393). Swammerdam preserved the preparation in his collection,
where it was still present about the time of his death (1680). See: G.A. Linde boom, Het cabinet van
Jan Swammerdam. Amsterdam, Rodopi, 1980. The ductus thoracicus, discovered by Pecquet in a
dog in 1647, was described in man by Swammerdam's teacher, Johannes van Horne (Novus ductus
chyliferus, nunc primum delineatus, descriptus et eruditorum examini expositus. Ludg. Bat., 1652).

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Gerrit A. Linde boom

24. Johannes van Horne (1621-70) was the son of a wealthy Amsterdam merchant. After his medical
studies he travelled abroad for many years. He was appointed professor extraordinary of anatomy
at Leiden in 1651, and became full professor in the next year. The investigations of Van Horne and
Swammerdam were performed at Van Home's house at Leiden. Van Horne furnished the material
and paid the costs, while Swammerdam did the most of the anatomical research.
25. On 21 January 1667 Swammerdam made a preparation of the inner female organs by injecting the
vessels. At the time he made a draught of it, which he worked out to a fine drawing in 1671, and then
published it as a loose sheet, dedicated to d0ctor Tulp. He inserted the plate in his book Miraculum
Naturae sive uteri muliebris Fabrica, Lugd. Bat., 1672, which he sent, together with the
preparation, to the Royal Society in London to obtain its verdict in the quarrel with DeGraaf. Some
years before Van Horne already had published a brochure on the subject (Suarum circa partes
genitales prodromus in utroque sexu observationum, Lugd. Bat., 1668, 12°, usually called the
Prodromus). However, in his Miraculum Naturae Swammerdam claimed to have done the real
work.
26. Van Horne unexpectedly died on 5 January 1670. Swammerdam obtained permission to perform
post-mortem and anatomical investigations on deceased persons in the Peters Hospital as soon as
on 23 January next. He owed this to one of the four burgomasters, Coenraad van Beuningen
(1622-93), with whom he had become acquainted in Thevenot's circle during his stay at Paris
(1664-65). At the time Van Beuningen was ambassador of the States General ofThe Netherlands at
the French Court.
27. Swammerdam was friendly with Mr. Ort, Seigneur of Nijenrode, who invited him repeatedly for a
stay with him at his castle named N ijenrode, situated on the river Vecht near Breukelen. The castle
was burnt down during the French invasion in 1672, but partly rebuilt, so that Swammerdam could
stay there in 1678 for several weeks (see: Lindeboom (1975), op.cit., 112, 116, 118).
28. Swammerdam suffered from malaria in 1670 already, when he was not able to leave his home for ten
weeks. In that year he stayed at the village of Sloten, situated near Amsterdam, for some time in
order to restore his health. He never did entirely recover from the malaria fevers, which became the
cause of his death ten years afterwards.
29. The young prince of Tuscany, who succeeded his father as Grand Duke Cosimo III in 1670, visited
the Swammerdams in 1668. See: G.J. Hoogerwerf, De twee reizen van Cosima de Medici, prins van
Toscane, door de Nederlanden (1667-1669). Journalen en documenten. Amsterdam, 1919. On that
occasion he was accompanied by the Italian scientist Lorenzo Magalotti (1637-1712), and his
French friend Melchizedec Thevenot, who probably stayed in The Netherlands for several months.
Regrettably we have no diary of Thevenot's sojourn in the Republic. Magalotti officiated as
secretary to the Accademia del Cimento, later as ambassador at Mantua and Vienna; finally he was
Privy Councillor. Magalotti edited the Saggi di Naturali Esperienze fatte nell' Accademia del
Cimento, Firenze, 1667, a work which was in the possession ofBoerhaave (see Boerhaave's sales
catalogue Bibliotheca Boerhaaviana (Lugd. Bat., 1739, p. 28).
30. See Linde boom (1975), I.e., p. 100 (and Plate VI, next to page 103); also Biblia Naturae, p. 67. This
letter to Thevenot was written after Swammerdam's period of mysticism, presumably in Aprill678.
31. Swammerdam did not dare to approach Antoinette Bourignon directly. So he sought the intermediary of his friend Jan Tielens, formerly a rich Amsterdam merchant, whom she had accepted,
together with three others, as her spiritual child by a 'Pact d'Alliance', drawn up by a Haarlem
notary in the spring of 1671. Tielens was in her company when she sailed from Enkhuizen to
Schleswig in June 1671. So Swammerdam wrote a letter to Tielens, dated 18 Aprill673, published
by Henri Boucquet, Le mysticisme d'un anatomiste du XVlie siecle, in: Aesculape, 1912, 171-76.
From this letter it appears that he considered the highly venerated Antoinette Bourignon as the
woman described by St. John in the Apocalyps (chapter XII). Swammerdam soon received the
permission he had asked for, and wrote his first letter to Bourignon on 29 Aprill673.
32. Swammerdam had to wait untill8 August next before Bourignon wrote him a long reply. See: G.A.
Lindeboom, Antoinette Bourignon's letter to Jan Swammerdam, in: Janus, LXI, 1974, p. 183-99
(original French with an English translation).
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33. The full title of the book runs as follows: Ephemeri Vita of ajbeeldingh van 's Menschen Leven I
vertoont in de I wonderbaarelyke en nooyt gehoorde Historie van het vliegent ende een-dag-levent
Haft ofOeveraas. Amsterdam, Abr. Wolfgang, 1675. The religious contents of the Ephemeri vita
are important for the history of religion and literature in The Netherlands. The poems (several of
them being paraphrases of parts of the Bible) were collected and presented by G.A. Lindeboom,
Ontmoeting met Jan Swammerdam. Series: Ontmoetingen met mystici, No. 3. Kampen, Kok,
1980.
34. According to F.J. Cole (A History of comparative Anatomy. London, 1944, p. 270) Swammerdam
had followers in establishing relations between biology and religion. This has been called InsectoTheology. In this context Cole refers to the prominent English entomologists William Kirby
(1759-1850) and William Spence (1783-1860), who co-operated in the famous Introduction to
Entomology ( 1815-26).
35. For those writings of Antoinette Bourignon, which may have beeri translated by Swammerdam,
see: Marthe van der Does, Antoinette Bourignon, Sa vie ( 1616--1682), Son oeuvre. Thesis. Groningen, 1974. There is some doubt, whether the Dutch translation De wonderbaarlijke verhandeling
van de Vaste ofWaare Deugt (1677) was made by Swammerdam, or by Just. Schrader; cf. Stokvis,
I.e., note 17, and R. Sinia, Johannes Swammerdam in de Lijst van zijn tijd. Thesis. Leiden, 1878, p.
77.
36. It is a common error to think that Swammerdam did no more research after his return to Amsterdam
(F.J. Cole, Nature. 1937, p. 218-20). From his letters of the next years it appears abundantly how
deeply engaged he was in microscopical and other studies of the bees, snails, lice, etc. We know that
he kept snails in a bowl at home (Biblia Naturae, p. 179). The work on the bees was not completed
before II November 1677 (Lindeboom (1975), I.e., p. 76).
37. The auction of the cabinet of Swammerdam pere was planned in August 1679, but it was postponed
to May 1680. Most probably his son's cabinet was also sold by public auction at that date.
38. Swammerdam's friends were Mattheus Sladus, Petrus Hotton, Justus Schrader, Frederik Ruysch,
and Petrus Guenellon Sen. Thevenot recommended the use of quinine (Peruvian bark) from Paris,
and Swammerdam asked him to send the remedy, but apparently it did not arrive in time. There may
have been two reasons why the Peruvian bark was not prescribed by the Amsterdam physicians. In
spite of the fact that Roland Sturmius (Storms) had recommended it in intermittent fevers in his
book, entitled Febrifugi peruviani vindicarum, pars prior et altera, Antverpiae, 1659, 12o, the use of
the Peruvian bark was still controversial in the sixties and the seventies of the 17th century. V.F.
Plemp (Louvain) and J.J. Chiffiet (France) opposed it. Moreover, the Peruvian bark (cortex
Peruvianus) was scarce and difficult to obtain, so that the price was very high (for one pound ofthe
bark were charged £8 in England in 1680).
39. Swammerdam left papers of value to Marguerita Volckers, who paid the legacy-duties ('twintigste
penning') on 10 April 1680. Boerhaave (VitaAuctoris) described her as the wife of Doctor Daniel de
Hoest, but at the time of Swammerdam's death she was still an unmarried young woman. In fact,
she was a niece of Swammerdam, and one of the executors of his will.
40. Curiously enough, I did not find Swammerdam's manuscripts mentioned in the sale's catalogue of
Thevenot's library (Bibliotheca Thevanotiana, Lutetiis Parisiorum, 1694). Thevenot has published
only two treatises of Swammerdam, in French, in hisRecueil des Voyages in 1681, i.e., Les histoires
naturelles de l'Ephemere et du cancellus ou Bernard /'Hermite. Moreover, he added a summary of
the Catalogue of Swammerdam's cabinet (facsimile by G.A. Lindeboom, Het cabinet van Jan
Swammerdam. Amsterdam, Rodopi, 1980). At the time Thevenot was not yet in the possession of
the manuscripts left by Swammerdam, as he did not obtain them, after the law-suit, untill682.
41. Boerhaave made his first inquiries about the where-abouts of the manuscripts by his learned English
friend William Sherard ( 1659-1728), a lawyer and botanist, during a stay of the latter at Paris in 1722.
In November 1723 he apparently had some plates which he could study, and four years later, on I
August 1727, he wrote Sherard that he had bought all the manuscripts and (copper-)plates ('toutes

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42.

43.

44.

45.
46.
47.
48.
49.

50.

51.
52.

Gerrit A. Lindeboom

les oeuvres manuscrits, & toutes les planches'). See: G.A. Lindeboom, Boerhaave's Correspondence I Leiden, 1962, p. 119 and 154.
Willem Roell (1700-75) took his medical degree at Leiden in 1725. In 1728 he became an assistant to
the very aged Fred. Ruysch, and in 1731 his successor as praelector anatomiae et chirurgiae at the
Surgeon's Guild. In 1755 he became professor at the Amsterdam Athenaeum, but he resigned in
1762.
After Boerhaave had resigned his professorships of botany and chemistry (1729), young Gaubius
( 1705-80), born at Heidelberg, was appointed lector on chemistry on 9 January 1731. See further on
Gaubius: S.W. Hamers - van Duynen, Hieronymus David Gaubius 1705-1780. Thesis Free
University Amsterdam. Assen, Van Gorcum, 1978.
Boerhaave dated his biography ofSwammerdam (VitaAuctoris) II September 1735. Obviously the
work was then ready for press. He dated the dedication to the four burgomasters of Amsterdam 15
December 1736. The first volume appeared in January 1737, the second one in September 1738.
Besides the ordinary edition, a de luxe edition on large paper was put available. At the time it was
customary that in the bookshops books were delivered sewed or in loose sheets. This accounts for
the fact that there exist copies bound in three volumes, and that in most copies all plates are bound
up in the second volume, whereas in other ones the first sixteen plates (I-XVI) are inserted in
volume one.
See: G.A. Lindeboom, Boerhaave's Correspondence II. Leiden, 1964, pp. 380-84.
For Swammerdam, nature with all its secrets and wonders was like a book revealing the greatness of
the Creator. In his correspondence he has used the term 'Bible of Nature' (Letters, p. 84).
This is also stated by Cole (1944), I.e., p. 272.
F.J. Cole (1944), I.e., p. 285.
This plate, the last one, represents the ferns and its sporangia. Just like some thirteen other ones, it
is signed: J. v.d. Spijkfecit, which probably only means that Vander Spijk (about whose identity I
was not able to ascertain anything) engraved it. In any case, in his Vita auctoris Boerhaave says that
Swammerdam not only showed the semenfilicis to the Leiden professor of botany Arnold Sijen
(1640-78) in 1673, but also made a drawing of it. He demonstrated the semenfilicis to Constantijn
Huygens as well (Letters, p. 142, n. 3).
Cole (1944), p. 288. Swammerdam first finished his work on the bees on 30 September 1673 (or 1674,
cf. Schierbe::k (1967), p. 62), intending to publish a separate book on it. However, the depressive
and mystical state of his mind prevented the execution of this plan. Some references to such a work
(Historia apium) in the older literature are misleading. After his return from Schleswig (1676)
Swammerdam resumed the study of the bees, in particular of their anatomical structure, using his
small, greatly magnifying microscopes. In 1677 he was entirely engaged in this work, and- for
example - he counted 5000 eggs in the ovaries of a bee. On II November (1677) he informed
Thevenot that it finally was completed, although he admitted that many things asked for further
examination. When Boerhaave got Swammerdam's manuscripts in hand, he has for a moment
considered to publish the Historia apium separately, but gave up this plan, so he says, for fear of
unauthorized reprints.
Biblia Naturae, p. 540; Schierbeek (1967), p. 158. There are many other examples of his endless
patience in the Biblia Naturae.
Swammerdam was one of the most skilled and assiduous microscopists of his century.lt is an error
to think that he only used microscopes made by the Leiden instrument-maker Samuel van Musschenbroek (1639-82), which, in fact, he did in his early career. They had no more magnifying power
than a modern magnifying-glass. Later, in particular in his last years, he used very small glass
microscopes, which he himself made by melting the end of a thin thread of pure glass in a flame, after
the method indicated by Johannes Hudde (1628-1704), later a burgomaster of Amsterdam. These
so-called blown glasses have a magnifying power which is the greater the little sphere is smaller, and
goes up to a 1000 times and higher (cf. P. Harting, Das Mikroskop. 1866. Facsimile of3 volumes in
one binding, Amsterdam, B.M. Israel, 1970, III, p. 44). These very small glasses were rather easy to
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131

make, but rather difficult to handle. The smallest used by Swammerdam had a diameter of one or a
half millimeter. They had to be set in thin copper blades, and then were often mounted in some
apparatus. Swammerdam's unusual manual dexterity helped him to make a fruitful use of them.
See: G.A. Lindeboom, Jan Swammerdam als microscopist. In: Tsch. Gesch. Gnk. Natuurk. Wisk.
Techn. 4, 1981, No.2, p. 87-110.
53. On the cuttlefish (Sepia maris) see Bib/. Nat., 876-902. Swammerdam also gives some botanical
observations, such as on a black poplar (p. 770), on the pink and the little insects in this flower (p.
861), and on the ferns (p. 907-10; see also Letters, p. 154 and 159).
54. Bib/. Nat. II, 835.
55. See: G.A. Lindeboom, Dog and Frog. Physiological experiments at Leiden during the seventeenth
century. In: Th. H. Lunsingh Scheurleer et a/, Leiden University in the seventeenth century,
Leiden, 1975, p. 279-93; idem, De verdiensten van Jan Swammerdam voor de medische wetenschap. In: Ned.T.Geneesk. 124, 1980, p. 2135-41. Once Swammerdam was very near to the
discovery of electric stimulation of the nerve, cf. D. Papp, Une experience 'Galvanique' de
Swammerdam. In: Proceedings lOth International Congress on the History of Sciences. Ithaca,
1962, vol. 2, p. 921-23, Paris, 1964.
56. Cole (1944), I.e., p. 285.
57. Baer, K.E. von, Johannes Swammerdam' s Leben und Verdienste urn die Wissenschaften. In: K.E.
von Baer, Reden gehalten in wissenschaftlichen Versammlungen. Petersburg, 1864, p. I. In 1864
Von Baer wrote an introduction to the address delivered in 1817.

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Catalogue 96

Books on Pharmacy,
Homoeopathy, Toxicology,
Chemistry, Alchemy,
Botany, Balneology, etc.

B.M. ISRAEL B.V.
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Aspect des cellules sanguines au XIXe siecle*
JACQUES LOUIS BINET

SUMMARY

Although the erythrocytes are known since the 17th century, their quantification and their way of
production could only be described in the 19th century. As the result of the first cytological and
histological colorations at that time, the different types of leucocytes were discovered and the first
clinico-cytological descriptions of leucaemia and of ganglionic disturbances could be made. The
platelets were also identified, the knowledge of their functions and of their pathological aspects,
however, was still very fragmentary.

Indifferente jusqu 'ici a son his to ire l'hematologie se cherche maintenant un passe.
L'annee 1980 en apporte trois temoignes: Ia publication par M. W. Wintrobe 1 de
B Io o d , pure and e Io que n t qui regroupe une serie de recherches historiques
par des specialistes actuels des differents chapitres des maladies du sang; I' annonce
de A History of Blood cells 2 oil M. Bessis et G. Delpech analyseront
l'histoire des decouvertes, des erreurs et des theories sur les cellules sanguines
depuis trois cents ans; !'organisation au demier congres international d'hematologie a Montreal d'un symposium sur l'histoire de l'hematologie auquel participaient G. Hart, A.J. Erslev, A.H.T. Robb-Smith, M. Bessis et M.W. Wintrobe 3 •
Enfermee dans une opposition presque systematique contre la theorie cellulaire,
une suspicion tout aussi systematique contre ce qui se fait en Allemagne, l'ecole
fran<;aise malgre sa pleiade de grands cliniciens apparait au deuxieme plan de cette
hematologie du XIXe siecle. Nous tenterons d'analyser le role de cette opposition
dans les trois chapitres sur les globules rouges, les globules blancs et les plaquettes
avec pour chaque chapitre l'etude des cellules, de leur physiologie et de leur
pathologiejusqu'en 1900.
Globules rouges
En 1800 !'existence, et Ia morphologie des globules rouges soot connues depuis
cent trente ans. Ils soot apparus sous Ia plume de Leeuwenhoek des 1674, la
description de Bartholin en 1678, l 'illustration de Swammerdam en 1737, et celle de
Gerard de Lairesse, dans le traite deBidloo en 1685. Ils soot mesures par Senac en
1749. La decouverte en 1830 du microscope a objectif achromatique, Ia mise au
point par Ehrlich des techniques de colorations des 1877, celles de Pappenheim en
1896 ont permis de progresser dans I' etude des organes hematopoietiques; mais
plus qu 'un deroulement chronologique, qui no us conduirait avec une fausse
logique aux conceptions actuelles, il nous semble important d'insister sur les
problemes poses par les notions de quantification de globules rouges, celles de Ia
Clio Medica, Vol. 17, Nos. 2/3, pp. 133-144

©

B.M. Israel, Amsterdam, The Netherlands
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Jacques Louis Binet

fonction de la moelle et de la rate, la construction des grands cadres nosologiques
au XIXe siecle.
1. Nous avons deja etudie ailleurs 4 la difficulte pour les hematologistes fran($ais de
quantifier le nombre de globules rouges. Bien sur des 1840 G. Andral et G. Gavarret
publiaient 5 leur technique de quantification des globules rouges, technique ponderale, ne faisant pas appel au microscope; a partir d' un prelevement de 360 grammes
de sang le pourcentage des globules rouges est determine et il permet aG. Andral
dans son Traite d'hematologie pathologique de definir Ia notion de
polyglobulie et d'anemie:
res tent done les globules, etc· est effectivement Ia grande elevation de leur chiffre qui fonde dans le
sang le caractere de Ia plethore: dans les 31 signees dont j'ai parle j'ai trouve pour moyenne des
globules le chiffre 141; pour minimum 131, et pour maximum 154 ( ... ). Les individus dont le sang
contient une surabondance de globules sont sujets a quelques accidents speciaux ( ... ). Cette
diminution de I' element globulaire du sang est le caractere fondamental de l'anemie. J'ai trouve,
comme moyenne du chiffre des globules, dans 16 cas d'anemie commen'<ante le chiffre 109, et dans
24 cas d'anemie confirmee le chiffre 65 ( ... ). Ainsi done nous voyons un des principes du sang
exercer tantot par son augmentation, tant6t par sa diminution spontanee une influence telle qu'il
devient le point de depart et le seul element materiel d'une maladie.

Le microscope n'a pas sa place dans les quantifications d' Andral et pourtant le
microscope peut, par exemple signaler des differences dans le volume ou dans Ia
forme des globules:
( ... )II m'a paru, dans deux cas de chlorose, que les globules etaient devenus beaucoup plus petits
qu'on ne les voit ordinairement, et en meme temps un certain nombre n'avait plus leur forme
accoutumee; ils etaient comme brises et dissemines, comme des especes de fragments dans le
champ du microscope 6 •

Dans son Cours de microscopie complementaire des etudes medicales7 et !'atlas qui l'accompagne un an plus tard en 1845 selon les daguerreotypes8, A. Donne represente Ia maniere de mesurer les globules rouges au
microscope et les problemes poses par cette mesure.
A !'oppose de ces travaux, les maitres de !'ecole fran($aise restent tres opposes a
!'approche quantitative des phenomenes biologiques. De Bichat aClaude Bernard
bien qu'il s'agisse de problemes differents, c'est toujours Ia meme systematique
opposition.
Dans les recherches physiologiques sur Ia vie et Ia mort de 1829, Bichat ecrit:
Appliquees aux actes de Ia vie, les mathematiques ne peuventjamais offrir de formules generales.
On calcule le retour d'une comete, les resistances d'un fluide parcourant un canal inerte, Ia vitesse
d'un projectile; mais calculer, avec Borelli, Ia force d'un muscle, avec Keil, Ia vitesse du sang, avec
Jurine et Lavoisier Ia quantite d'air entrant dans le poumon, c'est biitir sur un sable mouvant un
edifice solide par lui-meme, mais qui tombe bien tot faute de base assuree.

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Dans le Cahier rouge 9 Claude Bernard ne s'exprime pas autrement:
en physique, il peut etre utile d'avoir des experiences tres exactes parce que dans les calculs que
l'on fera, ces erreurs, s'il y en avait, se multiplieraient. On pourra egalement prendre des
moyennes, on reamenera tout aune meme quantite (... ).
Mais en physiologie, ce serait absurde d'agir ainsi. Les moyennes, les "ramenages" au kilo, tout
cela est sans utilite et meme nuisible, parce que cela parait exact et que c'est faux.

II reprend dans le Cahier de notes 10 :
Ce fut sans doute une grande chose quand Descartes inventa le calcul integral en changeant les
notions de forme en notions de quantite, et encore ne peut-on integrer plus loin. C'est une erreur de
croire qu'en biologie cela soit possible. L'ecole allemande est dans le faux sous ce rapport; elle
mesure tout, transforme tout en qualite ce qui ne signifie rien. La notion de quantite qui est d'autant
plus importante a considerer dans les mathematiques, l'est d'autant en moins en biologie. C'est Ia
notion de qualite, d'essence qu'il faut saisir. Or, elle est essentiellement variable. Absurdite des
calculs qui prennent une secretion en 24 heures, Ludwig, Du Bois Reymond sont dans le faux parce
qu'ils croient a certaines precisions qu'ils ne peuvent atteindre. lis courent apres Ia quantite
(introduire cet element dans le discours preliminaire).

C'est pourtant un eleve de Claude Bernard, L.C. Malassez, qui consacra sa these
en 1873 a Ia numeration des globules rouges. II sera suivi par Hayem et Nachet en
1875, mais avait ete precede par Vierordt en 1852 et Welcker en 1854.
2. Ces recherches quantitatives font apparaitre une nouvelle instrumentation et
une nouvelle approche de l'etude des anemies. II suffit de relire les differents textes
d'Hayem a Ia fin du 19e siecle (Du sang 1880, Lec;ons sur les modifications du sang 1882, Lec;ons sur les maladies du sang 1900) pour
suivre l'installation des premiers laboratoires d'hematologie. Plusieurs formes de
pipette (du tube capillaire de Malassez a celle d'Hayem), plusieurs liquides de
dilution (celui de Malassez, le serum iode de Max Schultze, les deux liquides
d'Hayem), plusieurs cellules permettant de compter les globules rouges avec Ia
grille de compte soit dans l'oculaire, soit derriere la cellule comme l'a imagine
Gowers, ou sur l'objectif comme l'a realise Nachet pour Hayem. De nombreux
appareils sont mis au point de 1870 a 1900 pour doser l'hemoglobine: hematinometre de Hoppe-Seyler, appareil de Welcker, colorimetre de Duboscq et Laurent
deja utilise dans l'industrie sucriere, spectroscope de Preyer, procede de Quinquaud, utilisant }'absorption de l'oxigene, globulimetre de Monteggaza, photometre de Vierordt, colorimetre de Malassez, haemo-chromometre de Quincke,
chromo-citometre de Bizzozero, chromometre d'Hayem-Nachet.
Sur le meme prelevement sont comptes les globules rouges et quantifiee l'hemoglobine, le resultat de cette derniere mesure ou 'richesse globulaire' etant exprime
en chiffre de globules rouges au contenu d'hemoglobine. Le rapport numeration de
globules rouges-richesse globulaire ou 'valeur globulaire' permet d'apprecier Ia

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quantite d'hemoglobine contenue dans chaque globule. Sans a voir encore Ia valeur
semiologique qu'il a pris dans le classement des anemies il constitue deja une
premiere aide a Ia classification des anemies un peu faussee par !'imprecision des
methodes de dosage de l'hemoglobine.
3. L'origine medullaire des globules rouges fut decouverte les memes annees 1868
et 1869 11 par un professeur de l'universite de Konigsberg, E. Neumann qui Ia
presenta a I' academie des Sciences so usIa responsabilite de Claude Bernard 12 et un
jeune medecin de Pavie, G. Bizzozero qui avait attendu Ia premiere publication de
Neumann pour faire part de son experience; M. Tavassoli a bien montre tout ce qui
opposait et s 'opposera longtemps a Ia demonstration d' un tel phenomene: Ia nature
nucleaire du globule rouge imaginee par Wharton Jones en 1846 et Erb en 1865 est
encore defendue par Pouchet en 1878; l'origine hepatique de l'erythropoiese
soutenue par Weber en 1846, devient en 1874 vasculaire pour Ranvier qui luttera
toute sa vie contre Ia theorie cellulaire pour convaincre Rollet en 1870, Rindfleisch
en 1880 et Malassez en 1882. Le mecanisme de Ia disparition du noyau reste l'objet
de controverses: si pour Neumann lui-meme il etait lie un phenomene de resorption, Rindfleisch, Bizzozero et Malassez evoquent deja un mecanisme d'expulsion
nucleaire. Malassez par des mesures prouve qu'il ne peut etre question de resorption, mais en tire un nouvel argument pour reprendre Ia theorie de Ranvier, refuser
Ia theorie cellulaire et y voir une nouvelle illustration du phenomene de bourgeonnement cellulaire a l'origine des lignees erythropoietiques. Cette diversite d'interpretation vient d'abord d'un obstacle methodologique et conceptuel: les techniques de fixation, de coloration, les modeles etudies (hommes, animaux) varient
d'un auteur a !'autre: s'y ajoutent surtout des probh!mes conceptuels et Hayem,
refusant longtemps d'accepter Ia theorie cellulaire consacrera de nombreuses
pages a refuter Bizzozero. Surtout en pathologie il n'existe aucune methode pour
etudier Ia modle et celle-ci ne sera correctement exploree que 25 ans plus tard.
4. Le role de Ia rate reste discute. A l'erythropoiese physiologique imaginee par
Billroth, Ecker en 1847 et Kolliker en 1854 ajoutent une fonction d'erythrophagocytose physiologique. Si, comme aujourd'hui, Virchow admet seulement les
proprietes d'erythrophagocytose en pathologie, cette fonction de Ia rate s'integre
dans un schema de maturation cellulaire qui n'est plus le notre.
C'est en pathologie que les notions les plus nouvelles apparaissent et Crosby a
bien montre que des Ia fin du XIXe siecle, grace au progres de Ia chirurgie, Ia
splenectomie pouvait etre suivie de survie: en 1888 Wells intitule un travail
Remarks on splenectomy with a report of a successful case et
dans les 274 cas rassembles par Vanverts en 1898, 70 succes soot retrouves. Des Ia
fin du siecle le role de Ia rate dans certaines anemies commence aetre etudie, avec
Banti (Dell' anemia splenica en 1882) et Hayem en 1889 (Du sang et de
ses alterations anatomiques). Os/erpublieraen 1902 Anemia splenica
et Micheli en 1911 precisa les premieres indications hematologiques de cette
intervention.

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5. Plusieurs grands cadres physio-pathologiques sont individualises. A cote de Ia
notion de chlorose qui ne recouvre pas seulement celle de carence martiale apparait
celle d'hemolyse autour du symptome 'd'hemoglobinurie', de Ia description des
premiers cas de spherocytose congenitale et d'anemies hemolytiques acquises.
La distinction hematurie, hemoglobinurie est due a Secchi (1872); Ia description
de I'hemoglobinemie a Kuessner ( 1879), mais les cadres cliniques (aujourd 'hui tout
a fait exceptionnels) dans lesquels ces symptomes s'observaient avaient deja ete
decrits depuis longtemps. Reprenant l'histoire de l'hemiglobinurie paroxystique au
froid I. V. Dacie 13 a montre sous quels masques elle avait dec rite 'bloody urine' par
Elliotson; Ein Fall von intermittirender Winterhaematuria dans le
Lancet en 1860; Notes of four cases of intermittent haematuria
par Dickinson en 1865 et Urine from a case of intermittent haematuria: bloody urine, free from red cells in sediment par Wiltshire
en 1867. Apres Ia decouverte de l'hemoglobinurie des descriptions continuent
(Rosenbach 1880, Enrlichen 1881, Chvosteck 1894) jusqu'a ce que Donath et
Landsteiner 14 decrirent le phenomene d'autolyse (1904) et Eason lui confirme sa
signification. Pour les hemoglobinuries d'effort decrite en Allemagne chez les
soldats en 1881 (Fleischer) et en Angleterre chez les athletes en 1894 (Dickinson) il
faudra attendre 1964 pour que Davidson comprenne Ia cause de l'hemolyse.
L'hemoglobinurie nocturne paroxystique, dont l'anomalie globulaire est demontree par Hismans et van den Begh (1911) est deja correctement decrite par Gull
(1866) et Strubing (1882).
La sperocytose congenitale porte aussi le nom de Ia maladie de Minkowski qui Ia
decrit en 1900 et Chauffard en 1907, mais Ia encore se profilent de nombreux
pn!curseurs.

P. Chevallier cite Nona:
Commune aux deux sexes, de tous Jes ages et meme, contrairement a !'opinion gem!ralement
accreditee, elle est plus commune dans J'enfance qu'aux autres periodes de Ia vie. Entin, elle est
essentiellement hereditaire; il n'est pas rare qu'elle atteigne une mere et son enfant, et d'autres
parents proches; les enfants d'une meme famille soot parfois tous chlorotiques. Chez les filles et Jes
femmes, Ia chlorose n'est jamais Ia consequence d'un trouble de regles; elle precede d'ailleurs
constamment le derangement de Ia menstruation. Tres souvent, les enfants chlorotiques se
developpent mal. Le fer n'est pas Je remede specifique de Ia chlorose ni meme une medication
veritablement curative. C' est cependant un palliatif qui peut ameliorer.

P. Chevallier conclus:
Degagee des digressions alors a Ia mode, peut-on rever meilleure description? Huit ans durant
)'auteur a recherche des chlorotiques et en a trouve 68,27 du sexe masculin et 41 du sexe feminin:
moin d'un an, 3 (un bebe de cinq mois n'est pas compris dans Ia statistique); d'un an a deux ans, 17,
de deux a trois ans, 6, de trois a quatre aRS, 5, de 4 a 5 ans, 4, de 5 a 6 ans, 6, de 6 a 7 ans, 4, de 7 a 8
ans, 7,de8a lOans, 5,de lOa 15 ans, II.

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Nona precise enfin que Ia chlorose des enfants a ete vaguement entre vue par
Sauvages, revoquee en doute par les auteurs du Compendium, pas see so us silence
par Ia majorite des auteurs qui ont ecrit sur les maladies des enfants et decrite par
Roger dans un memoire sur I' auscultation de Ia tete (1859). Car l'auteur n'echappe
pas a son milieu et attribue de !'importance au bruit de souffle dans les gros
vaisseaux du cou 15 .
J. Dacie a retrouve une communication de deux medecins de Liege, Van/air et
Masius, qui soumettent en juin 1877 un memoire de presque cent pages sur Ia
microcythemie a l'Academie Royale de medecine beige: deux soeurs anemiques,
icteriques avec splenomegalie, des 'globules atrophiques' dont Vanlair a des sine Ia
petite taille et Ia forme discoldale dans une lithographie en couleur. C'est dans Ia
rate qu'ils seraient 'soustraits' a Ia circulation sanguine, qu'ils deviendraient
spheriques et moins 'vivants' sans pouvoir etre detruits par le foie qui reste
atrophique chez ces patients.
Dans les Transactions of the clinical society of London Wilson
(1890) et Wilson et Stanley (1893) sous le titre de splenomegalie congenitale
decrivent six membres d'une meme famille avec subictere, anemie, splenomegalie
et a l'autopsie de l'un entre eux une rate engorgee de globules rouges. La mort
serait due a une hemolyse active d'origine splenique. Ne figure aucune description
des globules rouges, mais 33 ans plus tard Campbell confirme ce diagnostic chez le
seul survivant.
La publication de Minkowski au congres de medecine interne de Wiesbaden
(avril 1900) n'apporte, pour Dacie, pas grand chose de plus que celle de Wilson:
dans huit membres d'une meme famille alsacienne ictere chronique depuis
l'enfance, splenomegalie, urobilinurie, lithiase vesiculaire, eta l'autopsie l'accent
est mis sur I' importance des depots de fer, peut-etre Ia consequence d'une maladie
splenique. Pas de description des globules rouges, mais un resume de ce travail sera
publie dans Ia Semaine medicale, et lu par Chauffard qui le cite dans sa
publication de 1907. Avec Chauffard un nouveau signe apparait dans Ia 'pathogenie
de l'ictere congenital': Ia plus grande sensibilite de ces petits globules rouges aux
solutions hypotoniques selon Ia technique dec rite en 1903 dans Ia these de Ribierre
qui permet clairement de distinguer ces globules rouges de ceux des autres types
d'ictere ou ils sont plus grands et plus resistants aux solutions hypotoniques.
La notion d'ictere hemolytique acquis par opposition a celles des icteres congenitaux apparait aParis au debut du XXe siecle eta d 'abord ete qualifiee d 'Hayem et
Widal. Il suffit de relire les etudes d'Hayem sur L 'ictere infectieux et
chronique splenomegalique de 1898, 1899et 1900pourpercevoirque sielles
permettaient de separer les icteres d'origine hepatique de ceux d'origine hemolytique le terme 'infectieux' n'a pas grande signification et qu'en 1927 dans le
premier numero du Sang les hematologistes fran<;ais font de ces quatre cas
cliniques les premieres observations de spherocytose congenitale. Avee Ia
publication de Widal, Abrami etBrule en 1908, celle de Legendre et Brule en 1909,
la separation ictere congenital-ictere acquis est claire, mais elle repose sur un signe
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en inconstant et rare sur lequel avait insiste Widal par analogie avec son test
diagnostic dans la fievre thypoide: !'autoagglutination des globules rouges.
'L'autoagglutination des hematies restait constamment intense et rapide prenant
une veritable valeur diagnostique.' Les hemolysines decrites par Chauffard,
Vincent et Troisier seront longtemps purement hypothetiques. Il faudra attendre
1939 pour que Dameshek et Schwartz les imaginent a nouveau; il faudra Coombs en
1946 pour les mettre en evidence au laboratoire.
Le cadre d'anemie pemicieuse progressive s'individualise lentement ala fin du
siecle par la notion de macrocytes rapportee par Hayem, celle de megaloblaste
decouverte par Ehrlich et son evolution fatale. Son histoire se traine longtemps
d'abord dans les problemes d'attribution, de definition cytologique et le role des
signes associes.
A propos du nom a donner a la maladie, P. Chevallier ecrit 15 :
La description de Biermer date de 1868 et 1871. Assurement ellen' etait pas d 'une extreme precision
ni d'une extreme nettete. La clinique englobait divers affections, puisque 1e savant de Zurich
considerait Ia tendance hemorragique comme un des sympt6mes principaux. Bien entendu Biermer
eut des precurseurs comme James Combe et Georges Kelile en 1822 et surtout comme le deja
celebre Thomas Addison en 1849. Les Ang1ais reclament pour lui Ia paternite de Ia maladie.
Cependant sa lecture a Ia South London Medical Society (sur une maladie anemique des capsules)
n'est pas tres convaincante. Mais c'est son eleve Wilks qui en 1874lui a fait hommage de Ia variete
anemique qui lui-meme en realite erigeait.

W.B. Castle a recemment montre que les observations suisses et anglaises ne
repondaient pas au meme mecanisme 16 .
L'aspect cytologique fut long a reconnaitre. Sides 1874, Sorensen insiste sur
!'importance de l'anemie, elle est definie par la microcytose sur des dessins de
frottis sanguins publies par Eichhorst et lena en 1876, et par l'inegalite de tailles et
de formes de globules rouges ou poi:kilocytose dans le travail de Quincke en 1877.
C'est a Hayem et Alaache que l'on doit la notion de macrocyte et celle d'index
colorimetrique pour affirmer la maladie par Ia numeration et le dosage de l'hemoglobine. En 1880 fut donnee une autre base cytologique a Ia maladie, celle de
megaloblaste apparaissant dans le sang et avec elle toutle probleme sur l' origine de
cette anomalie: forme embryonnaire pour Pepper et Cohnheim; reponse a une
stimulation peripherique pour Neumann.
La presence des autres signes associes: la glossite, les signes neurologiques, est
signalee, mais en 1906leur relation avec la maladie reste inconnue, tant autant, bien
sur, que le menanisme metabolique de la maladie qui reste Ia grande decouverte
hematologique de Ia premiere moitie du XXe siecle.
Anemie pemicieuse macrocytaire, anemies hemolytiques, anemies microcitaires; les grands cadres diagnostics du XXe siecle sont deja dessines, et Ia chlorose
disparait: plus le mot que Ia realite car c'estjustement Ia periode oil grace a Hayem
ses caracteres hematologiques sont mieux definis, mais Hayem groupe toujours
sous le meme terme les anemies hypochromes, mais aussi certaines hemolyses
hereditaires et des anemies avec splenomegalie. Paul Chevallier ecrit:
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fin du XIXieme siecle et debut du XXieme siecle: Ia chlorose a disparu (... ) c'est Knud Faber qui de
1900 a 1909 eut le merite d'ecarter Ia chlorose de Ia grande rate et de ne plus parler que d'anemie
hypochrome essentielle.

A !'oppose, en 1892, Vaquez isola du cadre des cyanoses !'erythrose liee a Ia
polycythemie essentielle avec splenomegalie, mais en 1900 Hayem n'admet pas
toujours ce nouveau cadre:
quant a !'hypothese de M. Vaquez relativement a Ia participation de l'hyperglobulie dans Ia
production de Ia cyanose, elle me parait inacceptable; c' est ce me semble, l' effet pris pour Ia cause.

Globules blancs
I. La premiere image de globule blanc date de 1772. Hewson represente acote d'un
thymus sur le thorax d'un enfant nouveau-ne, les dimensions et !'image des
vesicules du sang humain telles qu'elles apparaissent au microscope ( ... ) oil Ia partie centrale
solide, precedemment dec rite, se distingue clairement au centre de chaque vesicule ( ... ), les
dimensions et !'image des particules des ganglions lymphatiques humains au meme grossissement
que dans !'experience precedente, et un ganglion lymphatique humain avec ses cellules.

Le XIXe siecle verra cette iconographie se developper avec Wagner qui des sine en
1839 'lymphae granuleum sanguini immixtum', Wharton Jones qui reproduit en
1846 les granulations des polynucleaires et leurs mouvements, et les publications
de Max Schultze en 1865. En 1880 Paul Ehrlich utilise des colorants atrois types de
radicaux acides (fuchsine, sofranine), basiques (eosine, benzaline, nigrosine) et
neutres (rosalinine, acide picrique) et classe selon !'aspect des cellules fixees et
leurs reactions avec ces colorants les globules blancs en quatre groupes: lymphocytes, larges mononucleaires, larges mononucleaires a noyau edente, polynucleaires agrains neutrophiles, acidophiles ou basophiles.
2. La fonction des lymphocytes et des mononucleaires n'apparaitra clairement
qu 'il y a quelques annees. Celie des polynucleaires est reconnu des 1884, mais pour
que Ia decouverte de Metchnikov soit applicable aux polynucleaires, pour que Ia
phagocytose des corps etrangers puisse expliquer Ia signification du pus, il fallait
admettre deux autres notions nouvelles, elles aussi decouvertes au XIXe siecle:
l'identite des cellules du pus et des cellules sanguines; Ia diapedese leucocytaire.
C'est Ia progression de ces trois concepts (identite des cellules sanguines et des
cellules du pus, diapedese, phagocytose des corps etrangers), c'est l'histoire de
Ia recherche de cette signification du pus qu'a longuement analyse C.G. Graddock17. Bien que Virchow ait admis en 1847 l'origine mesenchymateuse des
cellules du pus, de nombreux chercheurs tentent de demontrer le passage des
cellules du sang vers les tissus: imagine par Mascagni au XVIIIe siecle, il est decrit
par Dutrochet qui dans son livre de 1824 qualifie Ia cellule de !'inflammation de
cellule 'vagabonde' (il se retractera plus tard) et observe in vivo par William
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Addison dans Ia patte de Ia grenouille, par Waller dans Ia langue et par un eleve de
Virchow (Cohnheim) qui l'etudie dans Ia comee et le mesentere de Ia grenouille.
3. L'histoire des leucemies 18 peut etre rattachee a celle du pus puisque c'est sous le
double significatif de presence de pus dans le sang et de splenomegalie que J.H.
Bennett decrit les deux premiers cas en octobre 1845 19 • Six semaines plus tard R.
Virchow utilise des termes tres voisins (weiBes Blut)2° comme D. Craigie 21 dans Ia
revue que celle ou publiait Bennett (Presence of purulent matter in the
blood). A. Donne chez qui avait ete travaille Bennett avait publie dans son cours
de microscopie !'observation d'un malade de l'Hopital de Ia Charite dont le sang
pn!sentait une telle quantite de globules blancs, qu'en raison meme de Ia nature de son affection
j'etais porte a croire que le sang etait reellement mete de pus.

Dans cette courte observation qui ne depasse pas trente deux !ignes A. Donne va un
peu plus loin:
mais en definitive il ne fut pas possible de cons tater une difference entre ces globules et les globules
blancs; et en effet, on ne trouva a l'autopsie aucune trace de pus dans les vaisseaux, ni dans
l'interieur des caillots 6 •

On en revient au probleme de Ia maturation des globules blancs qui pour tous ces
auteurs admettent depuis Hewson que les globules blancs se transforment en
hematies.
Je suis porte a croire, [conclut A. Donne) que l'exces de globules blancs tient plut6t au defaut de
transformation de ces globules en globules rouges( ... ); ce ne serait, encore une fois, que le resultat
d'un arret de developpement dans ces particules transitoires.

II faudra attendre 1856 pour que Virchow rattache cette hyperleucocytose a des
lesions de Ia rate dans certains cas ou des ganglions dans d'autres. II faudra les
colorations d'Ehrlich et les travaux de Naegeli pour une veritable classification
cytologique. II faudra admettre Ia theorie cellulaire et le role hematopoietique de Ia
moelle pour rattacher ces anomalies sanguines aux vrais organes producteurs.
4. En 1832 Thomas Hodgkin decrit huit patients avec adenopathies et splenomegalie, sans doute provoquees par la tuberculose, mais d'evolution differente de
celle de cette maladie. En 1856 S. Wilks du meme hOpital que Hodgkin (le Guy's
Hospital) decrit six cas d'adenopathies avec splenomegalie eta Ia fin de son article
signale qu 'il vient de connaitre le contenu du travail de Hodgkin. En fait trois de ces
patients ont deja ete decrits par Hodgkin, et neuf ans plus tard dans une nouvelle
description il donne a Hodgkin le nom de cette maladie qu'il distingue de Ia
tuberculose du cancer, et de l'amylose 18 .
Le terme de lymphosarcome apparait chez Virchow en 1863 et sera repris par
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Kundrat en 1893, et malgre celui de pseudoleucemie de Cohnheim apparu en 1856
les grands cadres nosologiques des maladies lymphoproliferatives malignes sont
deja dessines a Ia fin du XIXe siecle pour ne plus progresser que depuis plusieurs
annees avec les nouveaux traitements curatifs de Ia maladie de Hodgkin et les
progres sur l' ontologie et Ia diversite fonctionelle des populations lymphocytaires.
Plaquettes

Derniere cellule sanguine a etre reconnu, Ia plaquette a des fonctions encore tres
discutees au XIXe siecle. Comme cette physiologie et cette pathologie plaquettaires sont de connaissance tres recente les questions posees en 1900 restent
aujourd'hui d'actualite.
1. Bien que J. Caen ait retrouve une description tres ancienne des plaquettes 22 , leur
individualisation appartient au XIXe siecle23 ' 24 ' 25 ' 26
A. Donne ecrit dans son cours de microscopie:
La troisieme espece ne merite pas le nom de globule; ce ne sont que de petites granulations,
appartenant au chyle qui sont incessament deversees dans le fluide sanguin (.,)petites particules
blanches, petits grains isoles ou agglomeres et n'ayant pas plus de l/300e de millimetre.

Leur relation avec les chylomicrons n'est pas clairement etablie. Georges Gulliver
et W. Addison les observe aussi en 1842 dans un caillot sanguin. 'Je pense, ecrit W.
Addison, que ces petites particules n'ontjamais ete encore vues.' En 1874 W. Osler
les fait aussi representer iso1ees les unes des autres a l'interieur d'un vaisseau, et
agglomerees dans une goutte de sang coagule; ne connaissant rien de leurs facteurs,
illes distingue des bacteries. Comme W. Osler, J. Bizzozero les etudie in vivo les
vaisseaux de mesentere et leur consacre une monographie en 1882: il separe les
phenomenes de l'hemostase primaire de ceux de Ia coagulation et decrit Ia formation du caillot plaquettaire. En 1885 Eberth et Schimmelbusch analysent plus
longuement ce phenomene du 'clou plaquettaire' apres lesion vasculaire. En 1866
Wright etudiant Ia moelle demontre malgre les theories d'Hayem l'origine megacaryocytaire des plaquettes. II faudra cinquante ans plus tard l'utilisation du
microcinema pour que M. Bessis et J.P. Thiery puissent suivre le deroulement du
phenomene.
2. Les fonctions de ces plaquettes restent encore tres discutees. La retraction
physiologique du caillot a ete observee bien avant Ia description des plaquettes.
Hayem dans ses etudes repetees sur ce qu 'il appelait 'l 'hematoblaste' avait montre
contrairement a Denys Ie role des plaquettes dans les purpuras et leur participation
a Ia constitution du caillot au sein de Ia fibrine. Eberth et Schimmelbusch l'avaient
aussi imagine, mais c' est 1966 que Lesourd et Pagniez etablierorit definitivement Ia

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relation plaquette et retraction du caillot.
Le temps de saignement fut decrit par Stoker en 1823, mais il faudra Ia publication de Duke en 1910 pour son introduction en pratique medicale.
3. Dans l'histoire du purpura T.H. Spaet 23 montre comment Hayem en 1891
decouvre le substratum cytologique (diminution du chiffre des plaquettes) du
tableau decrit en 1777 par Werlhof. La lecture des textes fait apparaitre une realite
plus complexe et plus riche.
C'est en fait un histologiste beige, Denys, qui en 1887 observe 'une absence
presque absolue' de plaquettes dans un purpura, et c'est apres avoir lu cette
publication qu'Hayem fait compter les plaquettes et note leur diminution dans un
premier cas observe en mai 1880, un second qui fera !'objet de sa communication en
juillet 1891 et plusieurs autres qui feront !'objet de quatre chapitres reunis en 1900
dans 'Les le<;ons sur les maladies du sang'. C'est Ia qu'il montre comment Ia
diminution des plaquettes s' accompagne d 'une anomalie de Ia retraction du caillot.
La discussion de ces observations fait apparaitre des donnees encore plus
interessantes. Elle situe cette nouvelle forme de purpura dans les differents cadres
nosologiques de l'epoque: elle le replace par rapport a l'hemophilie, au scorbut 'qui
a regne so us formed 'une petite epidemie pendant le siege de Paris et se voit encore
chez les prisonniers', au purpura rhumatismal a celui des maladies reconnues
microbiennes et des maladies cachectisantes ('leucemie, adenie empaludique
chronique, degenerescence amyloide'). Elle met !'accent sur les divers aspects
evolutifs ('Ia forme rap ide et intense peut se terminer fatalement en quelques jours
( ... ).La forme chronique, bien qu'elle n'ait guere !'attention des auteurs, n'est pas
tres rare'). Dans !'analyse du mecanisme elle fait apparaitre d'apres une etude
experimentale faite sur le chien des reactions au serum heterologue le mecanisme
de Ia coagulation intra-vasculaire dec rite so us le nom de 'precipitation granule use'.
Conclusion
De cette histoire des cellules sanguines au XIXe siecle trois premieres conclusions
peuvent deja se degager. L'attribution d'une decouverte reste souvent difficile a
fixer car !'observation nouvelle d'un phenomene est toujours integree dans le
contexte des connaissances du temps, qui n'est plus le notre et c'est en fonction de
nos connaissances actuelles, c'est retrospectivement que nous reecrivons cette
histoire. Le role des nouvelles techniques (les appareils de quantification, !'amelioration des procedes microscopiques, Ia mise au point des nouveaux procedes de
fixation et de coloration) est essentiel, mais reste limite, ordonne et meme subordonne aux theories de l'epoque eta sa maniere de poser les problemes. II en est des
theories pour l'histoire de l'hematologie comme de !'image pour le cytologiste:
'Elle est, ecrit M. Bessis, ambigue; elle n'est pas Ia realite, mais elle est
irrempla<;able. ' 27
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144
REFERENCES

*

Communication presentee au symposium de l'Academie internationale d'Histoire de Ia Medecine,
Strasbourg 1980.

Nous tenons a remercier M. Bessis, G. Delpech et G. Flandrin qui ont bien voulu nous foumir de
nombreux documents.
l. M. W. Wintrobe, Blood, pure and eloquent. A story of discovery, ofpeople and of ideas. McGrawHill, 1980.
2. M. Bess is et G. Delpech, A history of blood cells. Springer Verlag (a paraitre en 1982).
3. History ofHematology. 18e Congress of the International Society of Hematology. Montreal, 1980.
4. J.L. Binet, Historical notes on quantitative blood cells measurements. In: Blood Cells. 1980, 6, 507.
5. G. Andral et G. Gavarret, Recherches sur les modifications de proportion de quelques principes du
sang. In: C.R. Acad.Sci. Paris, 1840, I, 24.
6. G. Andral, Essai d'hematologie pathologique. Paris, Fortin et Masson, 1843.
7. A. Donne, Cours de microscopie complementaire des etudes mtidicales. Paris, Bailliere, 1844.
8. A. Donne et L. Foucault, Cours de microscopie complementaires des etudes medica/es. Atlas
execute au daguerreotype.
9. Claude Bernard, La cahierrouge. Paris, Gallimard, 1942.
10. Claude Bernard, Cahier de notes 1850-1860. Paris, Gallimard, 1965.
II. M. Tavassoli, Bone marrow: the seedbed of blood. In: Blood, pure and eloquent. Deja cite.
12. E. Neumann, Du role de Ia moelle osseuse dans /a formation du sang. In: C.R. Acad. Sci. Paris,
1869, 1112.
13. J. V. Dacie, The life span of red blood cell and circumstances ofits premature death. In: Blood, pure
and eloquent. Deja cite.
14. Des nouveaux resultats de recherches sur les travaux de Donath et Landsteiner: voir I' article de D.
Goltz, Das Donath-Landsteiner-Hiimolysin. Die Entstehung eines Mythos in der Medizin des 20.
Jahrhunderts. In: Clio Medica. Amsterdam, 16, 1982,4, pp. 193-217.
15. P. Chevallier, Anemies et polycythemies chroniques. Macrographies medicales et scientifiques.
Paris, 1960.
16. W.B. Castle, The conquest ofpernicious anemia. In: Blood, pure and eloquent. Deja cite.
17. C.G. Craddock, Defenses of the body: the initiators of the defense, the ready reservers and the
scavengers. In: Blood, pure and eloquent. Deja cite.
18. F.W. Gunz, The dread leukemias and the lymphomas: their nature and their prospects. In: Blood,
pure and eloquent. Deja cite.
19. J.H. Bennett, Two cases ofdisease and elargement ofthe spleen in which death took place from the
presence ofpurulent matter in the blood. In: Edinburgh Med. Surg. J. 1845, 64,413.
20. R. Virchow, Weisses Blut. In: Froriep's Notizen. 1845,36, 151.
21. D. Craigie, Case of disease of the spleen, in which death took place in consequence of the presence
ofpurulent matter in the blood. In: Edinburgh Med. Surg. J. 1845,64,400.
22. J. Caen, Communication personnelle.
23. T .H. Spaet, Platelets: the blood dust. In: Blood, pure and eloquent. Deja cite.
24. L.M. Tocantins, Historical notes on blood platelets. In: W. Dameshek, F.H.L. Taylor, R. Minot,
Symposium ofHematology. New York, Grune and Stratton, 1949.
25. A.H.T. Robb-Smith, Why the platelets were discovered. In: BR. J. Haematol. I%7, 13,618.
26. C. Dreyfus, Some milestones in the history of hematology. New York, Grune and Stratton, 1957.
27. M. Bessis, Blood smears reinterpreted. Springer International, 1977.

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Great doctors and scientists as free masons*
ERWIN H. ACKERKNECHT

During the summer of 1898, the nineteen year old Russian student Lew D. Bronstein was retained in the prison of Odessa, where he, on his visits to the library,
encountered works dealing with freemasonry. He was fascinated by the extension
and contradictions of this, now, two and a half centuries old movement and he
wrote a Marxist book on it. The manuscript was lost and Bronstein turned to other
subjects. Under the name of LeoTrotski, he became together with W.I. Lenin, the
author of one of the most fatal events in history: the Russian October Revolution of
1917.
The fascination of the young man is not difficult to understand. The order has had
six English and seven German kings in its ranks, including Frederic the Great.
Many of the leaders of the American Revolution (Washington, Franklin, Jefferson)
were also Masons, and so were at least fifteen presidents in the U.S.A.
Freemason vocabulary was used in the Declaration of Independence, and
military lodges existed during wars of revolutions and of states on both sides. Most
of Napoleon's marshalls were freemasons, as well as their adversaries Wellington,
Nelson, Gneisenau, BlUcher and Kutusow. The generals McArthur, Marshall and
Bradley continued the conspicuous tradition of military masonry.
During the French Revolution, freemasons acted as moderates (Condorcet,
Lafayette), or as terrorists (Cauthon, Marat), but also as reactionaries (J. de
Maistre, the brother of the king, and later Guizot and Decazes). In more recent
times we know mason-statesmen like Gambetta, Stresemann, Cecil Rhodes,
Churchill, Eugen Debs, Rob. La Follette and W.J. Bryan. Also leaders of national
uprisings were often masons: Bolivar, Rizal, Kosziusko, Kossuth, Garibaldi and
Chiang Kai-shek. Among prominent business leaders we only mention here Astor,
Krupp and H. Ford. Famous mason writers were: Boswell, A. Pope, J. Swift, Rob.
Burns, Sir Walter Scott, 0. Wilde, R. Kipling, Mark Twain and the whole classic
school of German literature from Lessing to Goethe and Ruckert. As freemason
musicians, we mention: Haydn, Mozart, Liszt and Sibelius. Last but not least:
many great scientists and doctors, to be dealt with later in this article, were masons.
And there still exist ten thousands of lodges in non-totalitarian countries 1 •
Such a movement seems to be an important historical phenomenon and it is
amazing that professional historians have rarely tackled it. The majority of the
more than 60,000 books on the subject are either accusations or apologies. Perhaps
the historians who abstained from dealing with secretive masonry were wise, and I,
as a 'profane', was unwise in yielding to the temptation to examine the facts at least
in my speciality: the history of medicine and science. I hope to find lenient judges
for this fragmentary experiment, and a few continuators.
Clio Medica, Vol. 17, Nos. 2/3, pp. 145-156

<D

B.M. Israel, Amsterdam, The Netherlands
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Erwin H. Ackerknecht

Freemasonry in the modem sense dates from John the Baptist's Day of 1717, when
four London lodges united under a Grand Master to form the Grand Lodge of
England. These lodges of 'speculative' masons originated from medieval guildlike
structures of actual ('operative') masons. During the 17th century these lodges (like
many other guilds in other places) 'accepted' more and more outsiders, nonmasons. Clergymen had frequently been members before, as in the time of the
cathedrals architects were often clergymen. Lawyers, doctors, officers, noblemen,
businessmen etc. were added as 'accepted', or 'speculative' masons till the
majority of the lodges' members were speculative masons. The best known of such
17th century additions in England are the alchemist Elias Ashmole and the manyside genius Sir Christopher Wren 2 •
We do not need to discuss attempts to connect our forefather Adam, Hiram, the
Gnostics, the quatuor coronati (martyrised in 298, because they refused to make a
statue of Asclepius), the Knights Templar or the old Rosicrucians with the history
of the masonic lodges, because these legends might be of high symbolic value, but
lack historical foundation.
The first Grand Masters of the London Grand Lodge were Anthony Sayer,
George Payne and the physicist John Theophilus Desaguliers. With the Duke of
Montagu (MD and FRS, died in 1749), an uninterrupted line of royal or noble
Grandmasters started in 1721. In 1723 James Anderson, a Scotch clergyman and
genealogist, published the famous 'Constitutions' for the Grand Lodge, which
contained a number of 'Old Charges', masonic guild oaths (their form reminds us of
the Hippocratic Oath). In 1724 the important committee of charity was started.
In 1725, sixty-eight lodges had already joined the Grand Lodge. In 1729, the
movement spread out abroad (first French Lodge 1729, first German Lodge 1737).
In spite of the first papal edict against freemasonry in 1738 (the bull is maintained up
to this day), the number oflodges increased rapidly everywhere 3 •
Although freemasonry is neither a political party nor a religion, it had in common
with them its continuous scissions. In England the movement split into the socalled 'ancients' and 'modems' in 1751, to be reunited in 1815. Another source of
division was the question of the High Grades (so-called Scottish rite, supposedly
originating from the Templars), connected with the name of David Ramsey, a
Jacobite refugee in France, who also promoted the idea of the Encyclopedie.
During the eighteenth century, a number of other movements entered the lodges
in order to use them for their own purposes, e.g. the Rosicrucians (alchemists), the
Martinists (and other spiritists), the Illuminati (political reformers) 4 • Even
notorious crooks like Cagliostro founded lodges. In 1797, a French Jesuit emigre,
abbe Barruel, needed five volumes to 'prove' on the basis of a number of hallucinations that the French and all other revolutions were a conspiracy of Freemasons (and jews). In spite of their absurdity, these lies (also used by the Nazis)
never sank into oblivion.

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Today we know two sorts oflodges: those of St. John, giving four grades, colour:
blue, and those of St. Andrew, giving the thirty-three High Grades. Internationally,
the lodges of Anglosaxon origin prevail. The German lodges belong to these; they
were, however, divided into humanitarian and 'christian' (that is antisemitic,
nationalistic) lodges till1933 5 •
The important French 'Grand Orient' and other Latin Grand Lodges are no
longer 'recognized' by the English Grand Lodge since 1877, as they eliminated the
obligatory belief in a personal god (GAOTU, Grand Architect Of The Universe)
from their statutes. The GAOTU itself had been a Deist notion. Since 1809 France
has two Grand Lodges. Latin Masonry, which has been fought bitterly by the
catholic church, is certainly more political than Anglosaxon masonry, which is
primarily a conviviality masonry 6 •
While the Old Charges of operative Masons usually begin with a reference to
Jesus, the first charge of Andersons's Constitutions states that the mason is neither
a 'stupid atheist nor an irreligious libertin', but 'tis now thought more expedient
only to oblige them to that religion to which all men agree, leaving their particular
opinions to themselves'. The second charge states that the mason is a peaceful
subject, wherever he lives and works 7 • The first charge means tolerance, and this
was undoubtedly of great attraction in England which had just gone through
hundred years of religious intolerance. Only with tolerance, the other attraction,
'brotherhood', could be realized in a caste society. Brotherhood meant sociability
as well as charity. The goal of the masons was (and is) 'humanity', the great
peaceful brotherhood of free and equal men, 'the temple', which they tried to build
through selfinsight, selfcontrol and selfimprovement. They learn these virtues
through symbols in ritual ceremonies in secret societies. For us this sounds strange,
but in the 17th and 18th centuries secret societies were quite normal.
The Royal Society started as 'invisible college'. The members of the German
Imperial Academy had secret names like the Illuminati. Frederic II called secret
societies 'the taste and fashion' of his century. Symbolism was current everywhere.
Masonic symbolism has mostly christian or alchemist or operative mason roots.
The ritual of building the temple brings about 'enlightenment' (the light is the
masons' symbol), rebirth, perfection, insight through love. It is nothing but natural
that music and burial ceremonies play a great role in masonry. Originally, faith,
love and hope were also mason watch words. But they were replaced by charity and
humanity, or wisdom, strength and beauty, more corresponding to masonic ideals.
In 1849, French masonry even adopted the watch words of the Republic: liberty,
brotherhood, equality 8 • In view of the vagueness of masonic theories and their
variations in different times and places, it is not surprising that freemasonry has
been characterized in different ways; as 'an attempt of Christianity to adapt itself,
as 'a laicised protestantism', or 'a prefiguration of Rotary' 9 •

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Erwin H. Ackerknecht

I will submit a list of 160 outstanding doctors and scientists in four countries 10 • I
would like to emphasize that in view of the secretiveness of freemasonry, this is
only the top of an iceberg. I have omitted doctors and scientists who were only
outstanding masons, but not outstanding in their profession, and those where
suspicion of their membership is very strong (like Gal{) and where no actual proof
can be produced. More details of the 160persons can mostly be found in: Ligou, D.,
ed., Dictionnaire Universe! de Ia France-Ma'.;onnerie.Paris 1974;or
Lennhoff, E. and Posner, C., Internationales Freimaurer-Lexicon.
Munchen, 1932.
A look at these lists seems to confirm that historians of medicine and science
cannot disregard a movement which had people like John Brown, Edward Jenner
and Sir Humphrey Davy; Joh. Peter Frank, Rei/, Hufeland and Klaproth; Caban is,
Dupuytren, Mesmer and Ch. Riche!; Benj. Franklin, W.C. Long and Leonard
Wood in its ranks. On the other hand, the fragmentary and contradictory character
of our sources requires the utmost caution when it comes to drawing conclusions. It
is for instance impossible to say today whether the percentage of doctors or
scientists as members of the lodges was higher than their percentage of the
population in general. The 18th century French lists published by A. Le Bihan do
not suggest a higher percentage 11 . The fact that out of the 21 Swiss Grandmasters
(1844-1944), 6 were doctors 12 , or out of the 30 Presidents of the French Grand
Orient between 1871 and 1973, again 6 were doctors is in favor of the contrary 13 •
Doctors are still the third strongest professional group in German freemasonry 14 .
We can only hope that more research will be spent in this field, so that more
certainty about the facts can be obtained. It also should be mentioned that among
all professions doctors often form special lodges only recruiting members out of
their own profession. Theophile de Bordeu e.g. was a member of several of such
lodges.
In the four countries, the outstanding men formed 'clusters', like in so many
other fields of history. In French medicine, for instance, we know the 'enlightenment' cluster from Bordeu to Cabanis. The relations between enlightenment and
freemasonry are very complex and the historians of the enlightenment do not help
us much in this respect. Hazard just mentions freemasonry as 'one of the ferments
of the age of enlightenment'. Peter Gay does not mention freemasonry at all. For
Valjavec freemasonry is one of the 'tributaries' of enlightenment; it is an expression of the mystic inclinations of the century. Bernard Fay, the later antimasonic henchman of the Nazis in France, presented the same old stupid equation
in a very elegant way: the lodge of nine sisters = freemasonry = enlightenment =
revolution. Recently, this has been excellently reexamined by Roger Priouret and
J. Rogalla von Bieberstein. The problem lies in the fact that freemasonry and
enlightenment have much in common in ideas and adherents, but freemasonry is
only one element of enlightenment and enlightenment only one element of freemasonry16.

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A second cluster in French medical history is the 'Paris Clinical School' group,
embracing a.o. Larrey, Dupuytren, Esquirol and Civiale 17 • The 'physiology' group
(Flourens, Paul Bert, Ch. Richet) is much smaller, but still shows a L. Lapique in
our century 17a. Amongst the scientists the 'enlightenment' or '9-soeurs' group,
beginning with Lalande and ending with Lacepede, is most brilliant, but the 19th
century offers much less 18 •
In the German language sphere, the earlies eminent group is the Viennese of the
period of enlightenment under Josef II: Joh. Peter Frank, von Born, Leber, Barth
etc. 19 • German enlightenment is represented by the Forsters, Soemmerring,
Wedekind, Klaproth etc. The group Rei!, Hufeland, Purkinje, Froriep, Oken is very
close to Jena-Weimar and German classic literature. Data on the U.S.A. is
surprisingly scanty. Is this however, the effect of actual dearth or only scanty
reporting?
The U.S.A. had the early Republican group with famous people like Franklin,
los. Warren, Lyman Spalding etc. Yet in the following century they still count
well-known names as W.C. Long, A.A. Michelson, Leonard Wood and Charles H.
Mayo.
In England, participation of Royal Society members, especially in the 18th
century, is conspicuous. Desaguliers, the Huguenot refugee and friend of Newton,
and Sir Christopher Wren stand at the cradle of English freemasonry. Gould 20
counts more than twenty members of the Royal Society as freemasons around
1730. Of course, at that time the majority of the Royal Society were still amateurs.
In medicine, men as Pott, Brown and Jenner are freemasons in the 18th century.
Again the 19th century has less to offer. Still we find in our list names like Sir
Humphrey Davy, Benjamin Ward Richardson and Alex. Fleming.
Let us see what the motives were of these men to enter the lodges. Were there
any specific motives for doctors and scientists to do so? This question is very
difficult to answer in view of the fact that the majority of the biographies and the few
autobiographies of these men never touch the point. We know for instance that
Klaproth, Chaptal and A. Fleming were very active masons in high masonic offices
most of their lives. But that is about all we know.
The famous anatomist K.F. Burdach (1776-1874) 21 lists as the reasons that
attracted him to the lodges the ideal of a federation of humanity, fraternal unity,
serene enjoyment of life, spiritual and moral growth. This fraternal federation was
of course only possible on the basis of religious tolerance and a coexistence of
ideologies in the lodges. This idea was undoubtedly widely attractive, especially to
doctors and scientists, often living in feud with dogmatism and orthodoxy. It was
also particularly dear to persecuted religious minorities like freethinkers, jews,
protestants in catholic countries, and dissenters in countries with protestant state
churches 22 • G. Forster or Hufeland do not hide their anti-catholic tendencies 23 .
Reil does not believe in the immortality of the souF 4 •
The idea of brotherhood implies furthermore internationalism and the absence of
classbarriers, both also particularly congenial to scientists. Hufeland turned down
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Erwin H. Ackerknecht

ennoblement. Larrey thus rapidly found friends in Berlin. Reil had access to strata
of society (Goethe etc.), otherwise not open to him; through masonry Burdach
knew Councilor Schmalz and Deshayes, and Hufeland could meet Mirabeau 25 • In
becoming a mason, they had become members of an elite. Freemasonry served
what seems to be a basic need of most human beings: sociability. In my opinion this
is mainly the reason of the presence of numerous military men (including army
doctors) in masonry and military lodges. In their isolated and migratory existence
lodges were very helpful to officers.
On special celebration days (St. Johns Day), special songs would serve the goal
of sociability. The need for others does not come to an end with death. According to
his son, Charles H. Mayo answered the question why he joined the masons: To be
sure that there will be somebody at my funetaF 6 • Funerals and speeches at the
grave play an important role in masonic lore. There are even masonic cemeteries in
some countries (U.S.A., Italy).
A powerful element of attraction is the financial support, especially in societies
without state welfare institutions. J .G. Forster was freed from the debtor's prison
in London through money collected by masons; Burdach's widowed mother and
her children were helped by a lodge in Germany 27 • Freemasons were proud and
very active in practicing philanthropy, founding hospitals, schools, homes for
orphans or handicapped people, supporting research etc. It is unavoidable that the
brothers also furthered each others careers. Ramsay already denounced the
dangers of careerism in masonry. The success of outsiders as John Brown, A.
Mesmer and S. Hahnemann is almost unthinkable without freemason support.
Masons were in this respect no better and no worse than the catholic church or
other religious communities, political parties or clubs.
One shoudn't forget either that motivation is always complex. With a character
like Dupuytren one would assume pure careerism. Yet Balzac's Messe de
I' AI thee reveals other aspects of his personality which might have attracted him
to freemasonry.
In the beginning the question of scientific curiosity of acquiring secret knowledge
loomed largely in the lodges. Dr. W. Stukeley (1687-1768) writes in his autobiography: 'His curiosity led him to be initiated into the mysteries of masonry,
suspecting it to be the remains of the mysteries of the ancients.' Stukeley had, like
many of his contemporaries, strong antiquarian interests 28 •
With similar hopes Georg Forster and S. Soemmering worked for four years in a
Rosicrucian lodge in Cassel. By 1784 they retired, bitterly disappointed (which did
not prevent Forster joining a lodge again in Vienna for purely utilitarian reasons in
1784 29 ). Berthollet had a similar experience with a Mesmerian lodge.
While hopes to acquire scientific knowledge faded (though the last book of Sir
Humphrey Davy, his Consolations in Travel of 1829, still reflects it) the
acquisition of 'virtue', selfcontrol, insight into one's self, wisdom and strength was
intensely felt. We have already quoted Burdach in this respect. Bordeu said: 'C'est

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151

surtout le coeur que nous voulons former' 30 • In his autobiography Hufeland feels
grateful towards a movement which helped him to know himself better31 •
In this respect, ritual might also serve a sceptical scientist or doctor. Rituals and
symbols have been with us ever since the stone age, on account of the emotional
satisfaction they offer. Even the communists did not dare to give them up. The
'metaphysical need', the attraction of mysteriousness, the miraculous, combined
with a longing for beauty are undeniable even in the most intellectual individual.
Freemasonry was able to fulfill these needs accordingly as the older religions and
their churches were increasingly discredited and unable to do so.
Quite apart from personal reasons, affiliation with masonry was often 'hereditary', like the doctor's profession itself.
Summarily we can say that some of the motives for joining masonry might have
been more attractive to doctors and scientists than to the average educated layman
of his time, especially between 1730 and 1850. We mentioned: religious tolerance,
overcoming of national and caste barriers, scientific curiosity, philanthropy (an
importqnt motive for doctors). But it is too early to come to more definite
conclusions. This is after all a first attempt at a very complex problem. And
scientific caution seems preferable to precipitation. We have collected what we
believe to be a respectable and provocative amount of data, but we probably know
only a small minority of the freemasons we should know. For the time being we
must continue identifying individuals as well as probing deeper into clusters like
those in Goettingen or Vienna. Knowledge of these elements will give us more
insight in their position and their structure. But the documentation is still too scanty
to come to definite conclusions. Further research seems worthwhile.

NOTES

*

Logan Clendening Lecture, Kansas City, September 5, /98/.
I am very grateful that the honour to be the Logan Clendening lecturer was bestowed upon me.It
was not my privilege to meet Dr. Clendening personally, but in the Baltimore Institute, where I
worked during the last years of his life, he was often mentioned with respect and his then recent
source book (1942) was carefully studied. Dr. Clendening was one of the last outstanding medical
men, who was also a eminent medical historian, and thus doubly attractive to those who are not
only interested in the now fashionable social history of medicine, but in the medical history of
medicine as well. The phenomenon of double eminence was not so rare in the nineteenth century
when you think ofpeople like Virchow, Wunderlich, Andral, Hack-Tuke, Pierre Janet etc. It was a
strange accident when I was in Paris a few weeks ago (1981 ), as one of the official speakers at the
200th anniversary of Laennec, one of the greatest diagnosticians of all times, and that I am now
honouring a medical historian who, as a clinician, was eminent in diagnostics. But 1 wil not speak of
the history of diagnostics today, as I have been separated from practical diagnostics for 48 years
and overwhlemed by the changes which have occired during this time. My subject today is one
apparent,y never tackled before: 'Great doctors and scientists as Freemasons'.
I. Lennhoff, E. and Posner, C., Internationales Freimaurer-Lexicon. Miinchen, 1932, pp. 40-44.
Pick, E. and Knight, G.N., The Pocket History ofFreemasonry. London, 1977, pp. 324-29.
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Erwin H. Ackerknecht

2. Gould, R.F., History of Freemasonry. London, 1951. Mackay, A.G. et. al., Encyclopedia of
Freemasonry. Chicago, 1950. Wolfstieg, A., Bibliographie der freimaurerischen Literatur. Leipzig, 1926. Lennhoff, E., Die Freimaurer. Wien, 1929.
3. Knoop, D. and Jones, G.P. The Genesis of Free Masonry. London, 1947.
4. Lennhoff, E., I.e., p. 125ff. Chevallier, P., Histoire de Ia Franc-Ma<;onnerie Fran<;aise. Paris, 1975,
vol. I, pp. 211-256, gives a good survey of mystic trends in freemasonry.
Frick, K.R.H., Die Erleuchteten. 3 vols. Graz, 1973, 1975, 1978.
5. Lennhoff, E., I.e., p. 111-170. Steffens, Manfred, Freimaurer in Deutschland. Flensburg, 1964.
6. Naudon, P., La Franck-Ma<;onnerie. Paris 1968.
Chevallier, P., I.e.
7. Anderson, S., see Pick and Knight. p. 76-77.
8. Chevallier, P., I.e., vol. II, p. 336.
9. Chevallier, P., I.e., vol. III, p. 415.
Bieberstein, J.R. v ., Die These von der Verschworung 1776-1945. Bern, 1978. p. 22.
Priouret,La Franc-Maqonnerie sous les lys. Paris, 1953, p. 172.
10. See Appendix.
II. Le Bihan, A., Francs-Maqons parisiens du Grand-Orient de France. Paris, 1966.
12. Die Freimaurerei in der Schweiz. Ed. H. Bessler. Bern, 1944, p. 195ff.
13. Naudon, P., I.e., p. 57.
14. Steffens, M., I.e., 572.
15. Bordeu, Theoph. de., Correspondance. 3 vols. Montpellier, 1979, vol. I, p. 26, 146,274.
16. Hazard, P., La pensee Europeenne au /Be siecle. Paris, 1946.
Valjavec, Geschichte der Europiiischen Aufkliirung. Wien, 1961.
Fay, Bernard, La Franc-Ma<;onnerie et Ia Revolution en /Be. Paris, 1935.
Priouret, I.e. Bieberstein, I.e.
17. Ackerknecht, E.H., Medicine at the Paris Hospital/794-JB4B. Baltimore, 1967.
17a. For Free Mason doctors as prominent politicians in the Third Republic see: Leonard, Jacques, La
medecine entre les pouvoirs et les savoirs. Paris, 1981, p. 273-274.
18. Amiable, L., Une Loge maqonnique d"avant 17B9: Les Neufs Soeurs. Paris, 1897. (The '9 sisters'
were founded in 1776).
19. Lennhoff, E., I.e., p. 171 ff.
20. Gould, R.F., I.e., vol. II, p. 400.
21. Burdach, K.F., Riickblick aufmein Leben. Leipzig, 1848, p. 568.
22. Ackerknecht, E. H., German Jews. English Dissenters. French Protestants. 19th century pioneers
of Medicine and Science. In: Rosenberg, Chari., Healing and History. NY, 1979, pp. 86-96.
23. Hufeland, Chr. W., Selbstbiographie. Stuttgart, 1937, p. 116.
Burdach, I.e., p. 568. Forster, G., Briefwechsel mit Sommerring. Braunschweig, 1877, p. 45, 51,
305,517.
24. Eulner, H.H. et al., Joh. Chr. Rei/. Leipzig, 1960, p. 28.
25. Triaire, P., D. Larrey. Tours, 1902, p. 512. Eulner, I.e., p. 8. Burdach, I.e., p. 170, 190. Hufeland,
I.e., p. 66.
26. Mayo, Ch. W., Charles H. Mayo. New York, 1968, p. 146.
27. Burdach, I.e., p. II. Hoare, M.E., Joh. Reinhold Forster. Melbourne, 1976, p. 196.
28. Pick and Knight, I.e., p. 74.
29. Forster, I.e., p. 33, 66, 110, 117.
30. Priouret, I.e., p. 164.
31. Bordeu, I.e., vol. III, p. 271.
32. Hufeland, I.e., p. 120.

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APPENDIX

French Doctors:
Michel Prokope 1689-1739
Theophile de Bordeu 1722-1776
Fr. Anton Mesmer 1735-1815
Bern. Peyrile 1735-1804
J os. J. Guillotin 1738--1814
Pierre Sue 1739-1816
Ch. F. Andry 1741-1829
Jos. Raulin 1742-1794
Jean Paul Marat 1744-1794
P.F. Percy 1754-1825
PierreJ.G. Cabanis 1757-1808
Rene Pierre Flamant 1762-1833
J.D. Larrey 1766--1842
P.G. Vassall769-1835
J.A. Durocher 1770--1848
J. Et. D. Esquiro11772-1840
Guillaume Dupuytren 1778-1835
Charles M. Gaultier de Claubry 1785-1855
Jean Civiale 1792-1867
M.J.P. Flourens 1794-1867
Ul. Tn!lat 1795-1879
Phil. Jos. Benj. Buchez 1796-1865
Emile Littre 1801-1881
Ange Guepin 1805-1873
Alph. Baudin 1811-1851
Paul Bert 1830--1886
Lous Guillaume 1833-1924
Emil Combes 1835-1929
J.M.A. de Lanessan 1843-1919
Paul Reclus 1847-1914
Charles Richet 1850--1935
Ch. Debierre 1853-1932
V. Augagneur 1855-1931
Eug. Doyen 1859-1916
Cam. Savoire 1869-1951
Louis Lapique 1886-1952

Medical polemist
Eminent physician in Montpellier and Paris
Inventor of 'animal magnetism'
Eminent surgeon. Cancer specialist
Physician and philanthropist (Loge des 9 soeurs)
Prof. of surgery
Docteur regent, examined Mesmerism and
vaccination
Mil. surgeon
Revolutionary
Military surgeon
Famous medical leader (9 soeurs).
Surgeon and Obstetrician. Strasbourg
The great surgeon
Early digitalispromotor
Eminent military surgeon
The great psychiatrist (Loge St. Victor des Amis
de Ia Victoire)
The great surgeon
Eminent physician
The great urologist
The great physiologist
Psychiatrist and hygienist
Hygienist and statesman
Physician and great scholar
Physician and philanthropist
Physician and martyr of 1851
Great physiologist and statesman
Physician. Founder of Swiss Off. of Statistics
Famous statesman
Professor in Paris and statesman
Surgeon
Prix Nobel, physiologist
Prof. Lille, senator
Prof. Lyon, statesman
Eminent surgeon
Famous fighter against Tb.
Eminent physiologist. In 'Resistance'

French Scientists:
Cassini II (Jacques) 1677-1765
Louis de Jaucourt 1704-1779
J.F. GautierDagoty 1710--1785
A.G. Pingre 1711-1796
J.L. Dalembert 1717-1783
J.J. Lalande 1732-1807

Astronomer
Important collaborator of the Encyclopedie
Naturalist
Astronomer
Mathematician, encyclopedist
Astronomer, College de France (9 soeurs)
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154
J.S. Bailly 1736-1793
J .M. de Montgolfier 1740-1810
A.A. Cadet de Vaux 1743-1828
M.J. Caritat de Condorcet 1743-1794
G. Monge 1746-1818
Cl. Berthollet 1748-1822
P.S.M. Laplace 1749-1827
D. Dolomieu 1750-1801
F. Pilatre de Rozier 1754-1785
A.F. Fourcroy 1755-1809
J.H. Hassenfratz 1755-1827
J .A. Chaptal1756-1832
B.G.E. Lacepede 1756-1825
C.F. Volney 1757-1820
Ch. L. CadetdeGassicourt 1769-1821
Charles Dupin 1784-1873
F. Arago 1786-1853
J.N. Ganna11791-1852
Fr. Raspaill794-1878
SadiCarnot 1796-1832
J.M. Silbermann 1806-1865
Elise Reclus 1830-1905
A.G. Eiffell832-1923
Ch. Lauth 1836-1913
A.A. Hovelaque 1843-1896
F. Dubref 1850-1916
Paul Rivet 1876-1958
G. Dalloni 1880-1956

Erwin H. Ackerknecht
Astronomer (9 soeurs)
Inventor (9 soeurs)
Chemist, apothecary, agronomist
Mathematician
Famous mathematician
Famous chemist
Physicist
Geologist
Physicist and aviator
Eminent chemist (9 soeurs)
Physicist and mining engineer
Eminent chemist and statesman
Naturalist (9 soeurs)
Explorer
Apothecary, hygienist (Illegitimate son of Louis XV)
Mathematician, economist
Famous astronomer
Chemist, hygienist
Chemist, microscopist
Physicist, thermodynamics!
Physicist, geographer
Famous geographer
Engineer
Eminent chemist
Anthropologist
Psychiatrist, statesman
Anthropologist
Geologist

Doctors from the German language sphere:
G. van Swieten 1700-1772(?)
Albrecht v. Haller 1708-1777
Ferd. Leber 1727-1808
Diethelm Lavater 1740-1826
J.F. Goldhagen 1745-1788
Jos. Barth 1745-1818
Joh. Peter Frank 1745-1821
Gg. Prochaska 1749-1820
S.Th. Soemmerring 1755-1830
J. Hahnemann 1755-1843
J.C. Reil1759-1813
G.Chr. Wedekind 1761-1831
Chr. W. Hufeland 1762-1836
K.F. Burdach 1776-1847
Ludw. Friedr. v. Froriep 1779-1847
G.H. Bergmann 1781-1861
G.E. Purkinje 1787-1869
C.F. von Graefe 1787-1840
G. Kloss 1787-1845

Famous Vienna clinician
The great physiologist
Court surgeon of Maria Theresia
Brother of Joh. Kaspar Lavater
Clinician, botanist
Prof. of anatomy, ophthalmologist of Josef II
Father of Public Health
Prague Anatomist, physiologist, ophthalmologist
Famous anatomist
Inventor of Homeopathy
Famous clinician
Eminent promotor of vaccination
Famous clinician
Anatomist
Prof. of obstetrics, publisher
Pioneer psychiatrist
Famous physiologist
Eminent military surgeon
Pioneer syphilologist. Historian of Freemasonry

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Great doctors and scientists asfreemasons
D.W.H. Busch 1788-1858
C.G. Jung sen. 1793-1869
C. Otto 1795-1879
F.L. Meissner 1796--1860
AI. Knoblauch 1820--1899
Heinr. Moller 1841-?
F.K. Birch-Hirschfeld 1842-1899
A. Kreidl1864-1928
Paul Seiter 1866--?
Jul. Tandler 1869--1936

Military surgeon and obstetrician
Eminent Basle prof.
Early pharmacologist, phrenologist
Eminent obstetrician
Pioneer syphilologist
Eminent veterinarian
Renowned pathologist
Famous physiologist
Pediatrician
Eminent anatomist and hygienist

Scientists from the German language sphere:
J.R. Forster 1729--1798
J.Chr. Schubart v. Kleefeld 1734-1787
Joh. Beckmann 1739--1811
J. von Born 1742-1791
M.H. Klaproth 1743-1817
Geo. Forster 1754-1794
F.G. Gerstner 1756--1832
K.L.M. Giesecke (al. J.G. Metzler) 1761-1833
H.F. Link 1767-1850
H.Chr. Oerstedt 1777-1851
L. Oken 1779--1851
Ad. de Chamisso 1781-1838
F. Poselga 1786--1838
0. Erdmann 1804-18%
Hermann Settegast 1819--1908
Gust. Karsten 1820--1900
J.V. Carus 1823-1903
A.E. Brehm 1829--1884
W. Ostwald 1853-1932
Ad. Marcuse 1860--1930
Paul Kammerer 1880--1926

Naturalist
Agronomist
Gottingen prof., created notion of technology
Mineralogist
Apothecary. chemist. Discovered Uranium and
four other metals.
Naturalist
Engineer Prague
Geologist Vienna, Greenland, Dublin
Botanist, apothecary
Physicist (electromagnetism)
Naturalist
Naturalist, Poet
Mathematician. Director Military School, Berlin
Chemistry Prof.
Agronomy Prof.
Physics Prof.
Zoologist, translated Darwin
Zoologist
Chemist, Nobel Price
Physics Prof.
Zoologist

English doctors:
J. Arbuthnot 1667-1735
W. Stukeley 1687-1768
ca. 1680 John Beal
ca. 1680 Fr. Drake
Richard Manningham 1690--1759
John de Montagu ca. 1695-1749
John Wesley 1703-1791
F. Dassigny 1707-1744
Perc. Pott 1713-1788
B. Ruspini 1728-1813
John Brown 1736--1788
W. Withering 1741-1799
Edw. Jenner 1749--1823

Physician to Queen Anne, writer
Physician, archeologist
also archeologist
Outstanding obstetrician
MD, FRS
The famous sectarian was also a healer
Dublin
Famous surgeon
Court dentist
The inventor of Brunonianism
Digitalis research
Vaccination
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156
R.T. Crucefix 1797-1850
Sir James Burnes 1801-1863
Benj. Ward Richardson 1828-1896
Sir William R. Smith 1850--1932
Sir D'Arcy Power 1856--1931
A. Conan Doyle 1859--1930
J.H. Evans 1870--?
AI. Fleming 1881-1955

Erwin H. Ackerknecht
Philanthropist
created Medical Organisation in India
Anesthesia. Temperance Movement (Quatuor
Coronati)
Public health
Court surgeon, medical historian
Inventor of Sherlock Holmes & Dr. Watson
Cancer research
Penicillin, Nobel Price

English scientists:
Elias Ashmole 1617-1692
Sir Christopher Wren 1632-1723
J.Th. Desaguliers 1683-1744
M. Folkes 1690--1754
Sir Jos. Banks 1743-1820
J.L. MacAdam 1756--1836
Sir Humphrey Davy 1778-1829
E.W. White 1851-?
H.C. Plummer 1875-1946

Archeologist, alchemist
Astronomer, architect, blood transfusion
Physicist, friend of Newton
Mathematician, archeologist
Botanist, pres. Royal Society 1778-1820
Engineer
The great chemist
Psychologist
Astronomer Dublin, USA

USA doctors:
Thomas Cadwalader 1708-1799
M. Thornton 1714-1803
J. Crack 1730--1814
LymanHalll731-1790
Joseph Warren 1741-1775
John Jeffries 1745-1819
F. Dalcho 1770--1836
Lyman Spalding 1775-1821
W.C. Long 1815-1878
Leonard Wood 1860--1927
Charles H. Mayo 1865-1929

Philadelphia. Inoculation, dry gripes
Signer dec!. of independance
Military surgeon
Signer dec!. of independance
Inoculation. GM Boston Lodges, killed at Bunker
Hill
Aeronaut
Military surgeon, Charleston
U.S. Pharmacopoeia
Ether anesthesia
Military surgeon, general
The great surgeon

USA scientists:
Benjamin Franklin 1700--1790
El. Kent Kane 1820--1857
A.W. Greeley 1844-1933
Luther Burbank 1849--1926
A.A. Michelson 1852-1931

statesman and philosopher
Explorer
Explorer, engineer
Plant breeder
Physicist, Nobel Price 1907

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News &Notes
I. MEDICAL HISTORY IN SWITZERLAND

Switzerland is well known as a small country (in the order of magnitude of the State
of Maryland). As far as universities go (seven) and even medical history, that
stepchild of medical education, it is not doing too badly.

Basel: Basel has a regular teaching program, which is taken care of by PD Dr. U.
Troehler, honorary instructor Dr. R. Bernoulli and Dr. Marie Louise Portmann.
The center of teaching and research is the Medizin-historische Bibliothek, Klingelbergstr. 23, 4000 Basel. It was built by Prof. Dr. H. Buess, who retired in 1981 after
forty years of tireless efforts on behalf of medical history in Basel. Prof. Buess
initiated also in 1953 a series: Basler Veroffentlichungen zur Geschichte der Medizin und der Biologie (Benno Schwabe Verlag,
Basel), which is still appearing. In Basel exists also the 'Schweizerische Sammlung
fiir Apothekenwesen'.
Bern: In Bern Prof. Dr. Esther Fischer-Homberger handles the teaching and is the
Director of the Medical History Institute, Biihlstr. 26, 3012 Bern. The Institute
owns a specialised library as well as an object collection (especially spectacles)
both brought together by the late Prof. Erich Hintzsche (1900-1975). The Hans
Huber Verlag, Bern, publishes a series: Berner Beitrc'ige zur Geschichte
der Medizin und Naturwissenschaften. The same publisher also brings
outaseries: Hubers Klassiker der Medizin und Naturwissenschaften (ed. by Prof. Erwin H. Ackerknecht and Prof. Heinrich Buess).
Fribourg: Medical history teaching is provided by the anatomy professor Dr. Ad.
Faller, known for his publications in the history of anatomy.
Geneva: Medical history teaching is taken care of by Dr. phil, Dr. med. Jean
Starobinski, Prof. of History of Medicine and Prof. of Literature, 12, rue de
Candolle, 1205 Geneve. Geneva has also a Musee d'Histoire des Sciences, Villa
Bartholomee, 1208 Geneve. Dir.: Dr. M argarida Archinard. The Musee offers also
temporary expositions.
Lausanne: Prof. Dr. Charles Lichtenthaeler, Prof. of the History of Medicine in
Hamburg, but a native of Lausanne, gives once per year a short survey course.

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Zurich: Teaching is provided by Prof. Dr. H.M. Koelbing, the director of the
Institute; Prof. Dr. H.H. Walser, PD Dr. H. Balmer and Dr. A. Gelpke. The
Institute, Ramistr. 71, 8006 Zurich is furnished with a large specialised library and a
Museum (Curator: PD Dr. U. Boschung). The Institute publishes a series:
Zurcher Medizingeschichtliche Abhandlungen (Juris Verlag, Zurich).
In 1921 the 'Schweizerische Gesellschaft fiir Geschichte der Medizin und Naturwissenschaften' was founded in Bern. It has 284 members. Its annual meetings are
well attended. (Secretary Dr. A. Gubser, Institute of History of Medicine, Ramistr.
71, 8006 Zurich). Since 1922 it publishes irregularly a monograph series: Veroffentlichungen der Schweizerischen Gesellschaft fur Geschichte der Medizin und der Naturwissenschaften. Itsjoumal Gesnerus
is biannual (Red. Prof. Dr. C. Haffter, Medizinhistorische Bibliothek, Klingelbergstr. 23, 3730 Basel). The late Prof. Hans Fischer has edited it faithfully for over
thirty years since its appearance in 1943. The society cultivates the history of
medicine as well as the history of science. Both branches live peacefully together.
But the medicos are a majority. The history of science has so far no chair or institute
in Switzerland. There are also no theses written in the history of science, while
medical students still relatively often choose a historical subject. The results are
frequently published in the above mentioned series. This is one of the reasons why
the centers of medicohistorical activity are found in the university towns. Swiss
medical history als enjoys the financial support of the 'Dr. Markus GuggenheimSchnurr-Stiftung fur Geschichte der Medizin und der Naturwissenschaften'.
ERWIN H. ACKERKNECHT

II. RESEARCH IN PROGRESS: HISTORY OF BIOMEDICAL SCIENCES
The American Association for the History of Medicine is planning, in early 1983, to
issue a new listing of current research being conducted on topics in the history of
medicine and related sciences, including dissertations. Individuals and department
heads desiring to have their projects and those of their students listed are urged to
send the following information: 1) Name; 2) Institution or mailing address; 3) Title
of substantial research topics; 4) Estimated completion date. Send communications before December 1, 1982 to: Charles G. Roland, M.D., 3N10-HSC
McMaster University, Hamilton, Ontario L8N 3Z5, Canada.

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Books Received*
BASIC MEDICAL SCIENCES
Max Neuberger, The Historical Development of Experimental Brain and Spinal Cord Physiology
Before Flourens. Translated and edited, with additional material by Edwin Clarke. Baltimore, Johns
Hopkins University Press, 1981, XXV, 391 pp., hardcover, U.S. $20.-.
Edward B. Roberts eta!., eds., Biomedical Innovation. Cambridge, M.I.T. Press, 1981, XVII, 395 pp.,
cloth, U.S. $27.50.
Karl E. Rothschuh, History of Physiology. Translated and edited, with a new English bibliography by
Guenter B. Risse. Huntington, Robert E. Krieger, 1980, XXI, 379 pp., illus., paperback, U.S. $12.50.
BIBLIOGRAPHIES AND DOCUMENTATION
Estelle Brodman, Special Collections, Library, Washington University School of Medicine. St. Louis,
Washington University, 1981,66 pp., (free pamphlet).
National Library of Medicine, Bibliography of the History of Medicine, No. /6, /980. Washington,
Government Printing Office, 1980, U.S. $8.50 ($10.65 foreign).
BIOGRAPHIES
George W. Corner, The Seven Ages ofa Medical Scientist, An Autobiography. Philadelphia, University
of Pennsylvania Press, 1981, XII, 411 pp., cloth, U.S. $25.-.
Paul Saunders, Edward Jenner: The Cheltenham Years 1795-1823, Being a Chronicle of the Vaccination
Campaign. Hanover, NH, University Press of New England, 1982, XVIII, 469 pp., illus., U.S. $27.50.
DENTISTRY
Fran~oise Loux, L'Ogre et Ia Dent. Pratiques et Savoirs popu1aires, relatifs aux dents. Paris, BergerLevrault, 1981, 190 pp., ill us., (no price stated).

DOCUMENTATION
Hildegard von Bingen, Physika (1150--1157). Transl. into German from the 1882 Paris edition of J.P.
Migne by H. Reier. Kiel, by translator, 1981, (no price stated).
Hippocrates, The Hippocratic Treatises "On Generation", "On the Nature of the Child", "Diseases
IV". A Commentary by lain M. Lonie. Berlin, Walter de Gruyter, 1981, XXXIX, 406 pp., cloth, DM
220.-.
EDUCATION
Owen H. Wangensteen, ed., Elias Potter Lyon: Minnesota's leader in Medical Education. St. Louis,
Warren H. Green, 1981, XIII, 292 pp., cloth, U.S. $14.50.

* CLIO MEDICA

reserves freedom of decision regarding the assignment of publications for review.

Clio Medica, Vol. 17, Nos. 2/3, December /982

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Books Received

EPIDEMIOLOGY AND DISEASE
W.H.O., The Global Eradication of Smallpox. Final Report of the Global Commission for the Certification of Smallpox Eradication. Geneva, World Health Organization, 1980, 122 pp., Sw .fr. II.-.
GENERAL HISTORIES, ANTHOLOGIES AND SURVEYS
Jozsef Antall, Pictorial History of European Medicine and Pharmaceutics. Translated by I. Kemenes.
Budapest, Corvina Kiado, 1981, no pagination, (no price stated).
W.F. Bynum and V. Nutton, eds., Theories of Fever from Antiquity to the Enlightenment. Medical
History, Supplement No. I. London, Wellcome Institute for the History of Medicine, 1981, IX, 154 pp.,
£6.-.
David Hamilton, The Healers, a History of Medicine in Scotland. Edinburgh, Canongate Pub!. Ltd.,
and Gretna, Louisiana, Pelican Publishing Co., 1981, XIII, 318 pp., £12.95.
Michael B. Shimkin, Some Classics ofExperimental Oncology, 50 Selections, 1775-1965. Washington,
U.S. Dept. Health and Human Services, 1980, IX, 739 pp., (no price stated).
Lloyd G. Stevenson, ed., A Celebration of Medical History, The Fiftieth Anniversary of the Johns
Hopkins Institute of the History of Medicine and the Welch Medical Library. Baltimore, MD, Johns
Hopkins University Press, 1982, VI, 228 pp., hardcover, U.S. $17.-.
HEALTH PROFESSIONS
Nancy Mandelker Frieden, Russian Physicians in an Era of Reform and Revolution 1856-1905.
Princeton, Princeton University Press, 1981, XVII, 378 pp., cloth, U :S. $32.50.
Francisco Guerra, El Medico Politico. Su influencia en Ia historia de Hispano America y Filipinas.
Madrid, Afrodisio Aguado, 1975,350 pp., (no price stated).
Edward J. Kealey, Medieval Medicus. A Social history of Anglo-Norman medicine. Baltimore, Johns
Hopkins University Press, 1981, X, 211 pp., cloth, U.S. $16.50.
HISTORY OF SCIENCE
W.F. Bynum, E.J. Browne and Ray Porter, eds., Dictionary of the History of Science. Princeton,
Princeton University Press, 1981, 495 pp. and bibliography, U.S. $40.-.
Joseph Needham, Science in Traditional China. A Comparative Perspective. Cambridge, Harvard
University Press, and Hong Kong, The Chinese University Press, 1981, X, 134 pp., ill us., cloth, U.S.
$12.50.
Dov Ospovat, The Development of Darwin's Theory. Natural History, Natural Theology, and Natural
Selection, 1838-1859. Cambridge, Cambridge University Press, 1981, XII, 301 pp., cloth, U.S. $39.50.
G.S. Rousseau and Roy Porter, eds., The Ferment of Knowledge. Studies in the historiography of
eighteenth-century science. New York, Cambridge University Press, 1980, XIII, 500 pp., cloth, U.S.
$39.50.

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161

HOSPITALS
David A. Howard, The Royal Indian Hospital ofMexico City. Special Studies No. 20. Tempe, Arizona,
Center for Latin American Studies, Arizona State University, 1980, 99 pp., (no price stated).
MEDICAL SPECIALTIES
Lynne A. Leopold, Radiology at the University ofPennsylvania 1890-1975. Philadelphia, University of
Pennsylvania Press, 1981, XVI, 163 pp., illus., cloth, U.S. $35.-.
Gesa Wunderlich, Krankheits- und Therapiekonzepte am Anfang der deutschen Psychiatrie (Haindorf,
Heinroth, Ideler). Husum, Matthiesen Verlag, 1981, 132 pp., paper, DM 32.-.
MEDICINE
Audrey B. Davis, Medicine and its Technology: an Introduction to the History of Medical Instrumentation. Westport, Greenwood Press, 1981, XIV, 285 pp., illus., U.S. $37.50.
Kenneth Dewhurst, ed., Willis's Oxford Casebook (1650-52). Oxford, Sandford Publications, 1981, IX,
15'9 pp., illus., £12.-.
Dietrich von Engelhardt- Heinrich Schipperges, Die inneren Verbindungen zwischen Philosophie und
Medizin im 20. Jahrhundert. Darmstadt, Wissenschaftliche Buchgesellschaft, 1980, VI, 190 pp., DM
49.-.
Lester S. King, Medical Thinking: A Historical Perspective, Princeton, NJ, Princeton University Press,
1982, V, 336 pp., cloth, U.S. $19.50.
A. McGehee Harvey, Research and Discovery in Medicine, Contributions from Johns Hopkins.
Baltimore, Johns Hopkins University Press, 1981. XIII, 322 pp., hardcover, U.S. $25.-.
A. McGehee Harvey, Science at the Bedside. Clinical Research in American Medicine 1905-1945.
Baltimore, Johns Hopkins University Press, 1981. XIX, 554 pp., hardcover, U.S. $17.50.
Michael M.E. Graf v. Matuschka, Lambert van Velthuysens (1622-1685) Menstruationstheorie in ihrer
wissenschaftlichen Bedeutung. Amsterdam, B.M. Israel, 1980, VII, 72 pp., Hfl. 36.-.
Edmond A. Murphy, Skepsis, Dogma, and Belief. Uses and Abuses in Medicine. Baltimore, Johns
Hopkins University Press, 1981. X, 176 pp., U .S.$14.95.
Ronald L. Numbers and Judith Walzer Leavitt, eds., Wisconsin Medicine. Historical Perspectives.
Madison, University of Wisconsin Press, 1981, IX, 212 pp., illus., cloth, U.S. $18.50.
J.V. Pickstone, ed., Health, Disease and Medicine in Lancashire 1750-1950. Dept. of History of
Science and Technology, Occasional Publications No. 2. Manchester, UMIST, 1980, 103 pp., £2.-.
Herbert Reier, Gesundheit, Krankheiten und Aerzte bei den Goren. Kiel, by author, 1981, [no price
stated].

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Charles Webster, ed., Biology, Medicine and Society 1840-1940. Cambridge, Cambridge University
Press, 1981, IX, 344 pp., cloth, U.S. $37.50.
PHARMACYANDPHARMACOLOGY
Sami K. Hamameh and Ernst W. Stieb, Pharmacy Museums and Historical Collections on Public View
in the United States and Canada. Madison, American Institute of the History of Pharmacy, 1981, 144
pp., paper, U.S. $6.50.
Gerald E. Markle and James C. Petersen, eds., Politics, Science and Cancer: The Laetrile Phenomenon. AAAS Selected Symposiums 46. Boulder, Westview Press, 1980, XV, 190 pp., (no price
stated).

H. Wayne Morgan, Drugs in America: A Social History, 1800-1980. Syracuse, Syracuse University
Press, 1981, XI, 233 pp., illus., cloth, U.S. $20.-.
PHILOSOPHY AND MEDICINE
Pierre-Jean-Georges Cabanis, On the Relations Between the Physical and Moral Natures of Man.
Translated by Margaret Duggan Saidi. Edited by George Mora with introductions by S. Moravia and G.
Mora. Baltimore, Johns Hopkins University Press, 1981, 2 vols. XCI, 796 pp., hardcover, U.S. $28.50.
Ludwig Hasler, ed., Schelling. Seine Bedeutung fiir eine Philosophie der Natur und der Geschichte.
Stuttgart-Bad Cannstatt, Frommann-Holzboog, 1981,315 pp., cloth, DM 48.-.
POPULAR HEALTH
Anita C. and Michael Fellman, Making Sense of Self. Medical Advice Literature in Late NineteenthCentury America. Philadelphia, University of Pennsylvania Press, 1981, VIII, 198 pp., cloth, U.S.
$16.50.
PSYCHIATRY AND PSYCHOANALYSIS
Clifford W. Beers, A Mind that Found Itself. An autobiography (1907). Contemporary Community
Health Series. Pittsburgh, University of Pittsburg Press, 1981, XVII, 205 pp., cloth, U.S. $12.95; paper,
$5.95.
Michael MacDonald, Mystical Bedlam. Madness, anxiety, and healing in seventeenth-century England.
Cambridge, Cambridge University Press, 1981, XVI, 323 pp., U.S. $39.95.
Francis Schiller, A Mobius Strip. Fin-de-Siecle Neuropsychiatry and Paul Mobius. Berkeley, University of California Press, 1982, 134 pp., U .S.$20.-.
Andrew Scull, ed., Madhouses, Mad-Doctors, and Madness. The Social History of Psychiatry in the
Victorian Era, Philadelphia, University of Pennsylvania Press, 1981, XIII, 384 pp., (no price stated).
Richard Wollheim, Sigmund Freud. New York, Cambridge University Press, 1981, XIX, 292 pp.,
paper, U.S. $7.95.

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163

PUBLIC HEALTH
Teizo Ogawa, ed., Public Health. Proceedings of the 5th International Symposium on the Comparative
History of Medicine-East and West. Tokyo, Saikon Publishing Co., 1981, VI, 189 pp., (no price stated).
SURGERY
Francisco Guerra, Las Heridas de Guerra. Contribuci6n de los Cirujanos Espaiioles en Ia Evolucion de
su Tratamiento. Santander, Universidad de Santander, 1981, XVI, 237 pp., (no price stated).
Henk J. Klasen, History of Free Skin Grafting, Knowledge or Empiricism? Berlin, Springer Verlag,
1981, XII, 190 pp., illus., DM 78.-.

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Four Books on the History
of Medicine
Carel M. van Hoom, Levinus Lemnius 1505--1568. Zestiende-eeuws
Zeeuws geneesheer. Thesis. 1978, 532 pp., 10 illustr., bibliography,
index of names. Price: f 95,-.
The Zierikzee physician Levinus Lemnius (Lieven Lemse) was a somewhat striking
figure in the sixteenth century, the age that was in many respects a period of transition.
Thus we find elements from the Middle Ages as well from the Renaissance in his way of
thinking. In his attitude towards mentally ill people he has been looked upon as a
forerunner of the Enlightenment. He was given the honorary title of 'the hygienist of his
time'.
'Very useful in this respect is the survey made of the pharmacopoeia by Lemnius,
probably in circulation at that time ... ' D. de Moulin in Tijdschrift voor de Geschiedenis
der geneeskunde, natuurwetenschappen, wiskunde en techniek.

Michael M.E. Graf v. Matuschka, Lambert van Velthuysens (1622-1685)
Menstruationstheorie in ihrer wissenschaftshistorischen Bedeutung.
1980,72 pp., 1 portrait, bibliography, index of names. Price: f 36,-.
Lambert van Velthuysen was the first to have correctly recognized a causality between
the ovarian function and menstruation. He succeeded in establishing a theory of menstruation, the validity of which has been recognized by modern medicine. A contribution
to the early history of the endocrinology ofthe ovaries.

Jean-Jacques Peumery, Les origines de Ia Transfusion Sanguine. First
book edition, 1975, of the articles which appeared in our periodical Clio
Medica in the course of 1974. 82 pp., 11 illustr., bibliography, index of
names. Price: f 36,-.
Faire passer du sang d'un sujet dans un autre est, de nos jours, un acte medicale des plus
courants. Pourtant, Ia transfusion sanguine a derriere elle toute une histoire, une histoire
pittoresque et captivante ...

Isaac van der Sluis, The Treponematosis of Tahiti. Its origin and
evolution. A study of its sources. Thesis. 1969, 178 pp., catalogue of
sources. Price: f 41,50.
Venera! disease imported? In this thesis, the author has attempted to answer two
questions: firstly, was the treponematosis of Tahiti imported by European explorers ... ?
and secondly, was it yaws or syphilis?
•... This monograph is strongly recommended to epidemiologists interested in yaws and
venera! diseases.' B.A. Southgate in The Journal of Tropical Medicine and Hygiene.

B .M. Israel b. v.
N.Z. Voorburgwal264
1012 RS Amsterdam, The Netherlands

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Book Notices
JohnS. Haller, Jr., American Medicine in Transition, 1840-1910. Urbana, University of Illinois Press,
1981 XII, 458 pp. Illus., cloth, US $27.95.
The author has attempted to sketch the transformation of American medicine from mid-nineteenth
century to 1910 through a highly selective series of unconnected essays. Important subjects such as
surgery, the germ theory, hospital and laboratory medicine are virtually ignored. Studded with frequent
quotations, the work lacks cohesion and fails to provide a useful focus for further analysis and research.
However students of American medicine will find in the book's numerous notes a rich bibliography of
primary sources.
Sami K. Hamarneh and Ernst W. Stieb, Pharmacy Museums and Historical Collections on Public View
in the United States and Canada. Madison, WI, American Institute of the History of Pharmacy, 1981,
144 pp., paper, US $6.50.
The authors, both professional historians of pharmacy, provide readers with the most comprehensive
guide to 152 pharmacy museums and historical collections located in North America. Each entry
provides an address and brief history of the exhibit, occasionally illustrated with photographs of
exhibits. Historical markers placed by the American Institute of the History of Pharmacy are listed. The
book concludes with a useful bibliographic guide.
Saul Jarcho, trans!. and comment., The Concept of Heart Failure from Avicenna to Albertini. Cambridge, MA, Harvard University Press, 1980, XIII, 407 pp., US $45.-.
In this very scholarly contribution, Jarcho has assembled the story of how the modern concepts of
congestive heart failure have arisen. In early times, the individual symptoms and signs of heart failure
were described as separate entitles and as a result, Jarcho had to unearth his evidence from quite diverse
sources. Beginning with Avicenna's Canon of Medicine (II th Century), he weaves his
narrative through six centuries to the Conspectus of Johannes Junckerus (1734). The breadth of
Jarcho 's scholarship is emphasized by the fact that, with the exception of the chapter on Giovanni Maria
Lancisi, all of the translations were made by him.
In his selection of the writings to be excerpted, he chose large excerpts over small as being more
instructive. In his view, the larger excerpt enables the reader to understand better the medical, social
and literary background. This makes the volume excellent for the scholar interested in this problem but
puts this book beyond the scope of the average reader of medical history. It is a valuable contribution
and will appeal to the cardiologist interested in the historical evolution of his field.
A. McGEHEE HARVEY
M.J. van Lieburg, ed., Volume Commemorating the 75th Anniversary ofG.A. Linde boom. Amsterdam,
Medisch Encyclopaed. Inst. VU 1980, VIII, 219 pp., Dfl. 30.-.
This Festschrift brought together a distinguished group of friends and colleagues of Professor
Lindeboom paying tribute to a scholar who has generously contributed to Dutch medical history, the
International Academy and Clio Medica. Appropriately, D. de Moulin begins the volume with an

Clio Medica, Vol. 17, nos. 2/3, December 1982
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analysis of Lindeboom's accomplishments while A. Ham and M. Kermer present his latest list of
publications between 1975-79. Informative articles written by Karl E. Rothschuh, Joshua 0. Leibowitz,
Loris Premuda, Pieter Smit, Antonie Luyendijk-Elshout, Richard Toellner, Marielene Putscher and
others follow.
Gerald E. Markle, James C. Petersen, eds., Politics, Science, and Cancer: The Laetrile Phenomenon.
AAAS Selected Symposiums 46. Boulder, CO, Westview Press, 1980, IV, 190 pp., (no price stated).
For those who have simply followed the debates surrounding the use of Laetrile in cancer therapy
through newspaper headlines, this book will be warmly welcome. The editors, both sociologists of
science, have assembled the papers delivered at a symposium on this topic organized during a recent
meeting of the American Association for the Advancement of Science. Professor J. Harvey Young, a
historian well known for his publications on American health quackery, provides a comprehensive
historical review of Laetrile while other participants focused on the political, legal, and ethical issues
surrounding the use of this substance. A final commentator accurately portrays the controversy over
Laetrile as an 'example of widespread ideological resistance to the rationality and reductionism
epitomized by science and broad political resistance to the pervasive influence of professional expertise
in many areas of personal life'.
Alex C. Michalos, North American Social Report. A Comparative Study of the Quality of Life in
Canada and the USA from 1964 to 1974. Volume I. Foundations, Population and Health. Dordrecht,
Holland, D. Reidel Publishing Co., 1980, X, 278 pp., tables and graphs, (no price stated).
Employing official national statistics from both the U.S. and Canada, the author compiled a vast
amount of health-related information for integration into certain indicators designed to measure the
quality and value of human life. His conclusion is that between 1964-1974 quality of life in Canada was
higher than in the U.S. and Canadians also paid less and received more from their health care system
than Americans. Historians may consider employing some of the methodology in their own
reconstructions.
M. Michler, J. Benedum, Einfiihrung in die Medizinische Fachsprache, 2nd corrected ed., Berlin,
Springer Verlag, 1981, XIV, 358 pp., illus., DM78,-.
The original authors, together with a set of new clinical collaborators, have succeeded in expanding
the original 1972 edition of this work intended for use by German medical students who are no longer
exposed to the traditional introductory course in Latin. Written by medical historians, this introduction
indeed allows for the presentation of basic historical facts linked to medical terminology.
Mark M. Ravitch, A Century of Surgery 1880-1980. The History of the American Surgical Association.
2 vols., Philadelphia, J:B. Lippincot, 1981, XLIII and VII, 1613 pp. and two indexes, illus., cloth,
us $195.-.
Dr. Ravitch, a prominent figure in contemporary American surgery, has provided readers with a
chronologically arranged collection of papers presented at the annual meetings of the American Surgical
Association and published in its Transactions since 1880. The numerous excerpts are followed by
quotations from the ensuing discussions and commentaries, thereby allowing a panoramic view of the
developments. For the more recent literature the author was forced to limit his anthology to those
papers which introduced new subjects and techniques. An alphabetically arranged list of fellows and
officers of the American Surgical Association is followed by two separate indexes dealing with scientific
and organizational matters respectively. Historians and physicians interested in the development of
American surgery during the last century will find this lavishly produced compilation highly
informative.
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Book Reviews
William Canniff, The Medical Profession in Upper Canada 1783-1850. Reprint of the edition 1894.
Toronto, Hannah Inst. for History of Medicine, 1980,688 pp .. Can. $24.95.
Shortt, S.E.D., ed., Medicine in Canadian Society Historical Perspectives. Montreal, McGill-Queen 's
University Press, 1981, XIII, 506 pp., paper, Can. $11.95.
'The Medical Profession in Upper Canada', by physician and amateur historian William Canniff, was
the first major work of Canadian medical history. The first two of its three parts narrate the efforts of
medical practitioners in Upper Canada (roughly present-day Ontario) to 'promote the respectability,
learning, and usefulness of the medical profession, and to raise it to that dignified position which it holds
in other countries' (p. 116). Those efforts took the form of appeals forlicensing legislation, imposition of
standards to insure that licensed practitioners were adequately trained and a lengthy campaign for the
establishment of a medical school at King's College (a predecessor of the University of Toronto). The
narrative also includes laudatory accounts of other institutions - hospitals and professional
organizations- which served to enhance the power and prestige of physicians. The third part (460 pages
long) comprises 271 biographies of physicians who practiced in Upper Canada in the period covered.
The narrative of the first two parts proceeds mainly by extensive quotation from a variety of primary
sources; the minutes of the Upper Canada Medical Board and the short-lived College of Physicians an.d
Surgeons of Upper Canada are reproduced in something approaching their entirery. Because the
authority of science - fundamental to the authority now accorded the medical profession- had not by
1850 achieved wide acceptance, the activities of such early professional organizations cannot be given
much weight in accounting for the subsequent development of the profession. Also, although the
professional activities Canniff reported took place in years of settlement and rebellion in Upper Canada,
his reports are those of an antiquarian and generally ignore the effect of political tensions and social
assumptions. For these two reasons, Canniff s work makes little direct contribution to an understanding
of the growth of medical authority. On the other hand, it may be of considerable use as an anthology of
primary sources; the tone of Board and College minutes and the underlying assumptions perceptible in
them afford a good view of professional and colonial attitudes. More important, the biographies and
detailed accounts of licensing examinations could well contribute to studies of the origins, training, and
geographic and social mobility of nineteenth-century doctors.
'Medicine in Canadian Society' comprises a set of eighteen historical essays on medical topics (all but
four from the 1970s and all but one previously published) accompanied by a bibliography and a
historiographic essay by the editor, physician and historian S.E.D. Shortt. The essays are here
enumerated in two groups, those whose subject is the medical profession per se and those whose
primary focus is the material or social context in which Canadian medical history has unfolded, but most
in either group give a reasonable sense of the interaction of medical affairs with the rest of life, and any
social historian should find the collection as a whole useful.
Official regulation of the medical profession in the Northwest Territories from 1880 to 1905, in Upper
and Lower Canada (roughly present-day Ontario and Quebec) from 1800 to 1870, and in Lower Canada
in the 1830s is the subject matter of essays by H. Neat by, J.F. Kett and B.R. Tunis (respectively); Kett
compares the development of licensing and standards in Canada and the United States; Tunis focuses on
the competition between medical school and licensing board for control of standards. There are studies
of the response of the medical profession to various cultural and political developments: V. Strong-Boag
on women doctors and feminism, T.E. Brown on response to psychoanalysis from 1908 to 1913, R.S.
Bothwell andJ.R. English on response to health insurance from 1910 to 1945. The interaction of science

Clio Medica, Vol. 17, nos. 2/3, December 1982

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and medicine is studied in G. Bilson's essay on cholera in the nineteenth century and in C.G. Roland's
on the early years of antiseptic surgery. M. W. Andrews presents a general account of medical
attendance in Vancouver from 1886 to 1920.
Seven essays deal with health and public health work: R. Fortuine on the health of the Eskimos at the
time of outside contact, A.J. Ray on the diffusion of diseases in the prairies (the Hudson's Bay
Company's vast Northern Department) from 1830 to 1850, R. MacKay on poor relief and medicine in
eighteenth-century Nova Scotia, D. Francis on nineteenth-century lunatic asylums in the maritime
provinces, N. Sutherland on attention paid to the health of school children in English Canada from 1880
to 1914, T. Copp on Montreal from 1870 to 1930 and J.P.D. McGinnis on the impact of the 1918--1919
influenza epidemic. Sexual attitudes are the subject of essays by M. Bliss on pre-Freudian sex education
and by A. McLaren on birth control and abortion from 1870 to 1920.
In his historiographic essay, Shortt evaluates medical history in Canada as having 'barely left the
list-compiling dark ages' (p. 3), and the power and quality of analysis in this collection is not all of the
highest order. Nevertheless, all these essays are legitimate works of scholarship, and this first singlevolume sample of a comparatively open field of historical research in Canada should stimulate further
growth and synthesis. It should be particularly valuable as a reminder that questions of North American
history- even those relating to the most recent periods- cannot be resolved with reference to the United
States alone; although the United States and Canada share many attitudes and customs, they still differ
significantly- particularly in that central and government control has played a greater part in the making
of Canadian society.
MARGARET W. ANDREWS
Michael Durey, The Return of the Plague. British Society and the Cholera 1831-2. Dublin, Gill and
Macmillan, 1979, New York, Humanities Press, 1979,269 pp., US $37.50.
Environmental, social and psychological aspects of the cholera outbreak in Britain in 1831-2 are
Michael Durey's primary focus in this study. The author devotes two chapters of his work to the
physical environment in which cholera survived and thrived. He assesses the relative quality of sewer
facilities, water supply and water cleanliness in the London districts and relates the differences in
cholera's effects to these variables.
Durey also examines the character of government policy, making a strong case for the importance of
traditions of local autonomy as a pre-existing feature of the political landscape with which officials had
to deal when faced by epidemic disease. The hesitancy of the central government, combined with fiscal
conservatism and self-interested public health policies at the local level, led to frequent bungling and
ineffectiveness in dealing with the disease when it hit a community. Officials, whether central or local,
could look for little help from the medical profession in this period. On the basic question of the cause of
the spread of cholera, the doctors were divided between contagion and miasma- and their uncertainty
left room for economic and political motives to bear heavily on public health policy.
The medical profession provides a central focus for Durey's work. He rejects any suggestion that
medical men treated cholera victims with malice, but he also finds that medical measures had little
positive effect on the course of the disease or the epidemic. More important for Durey's purposes is the
image of the medical profession in this period. He finds that the popular disturbances that erupted in
response to cholera can be linked directly to the fear of the poor that their bodies and those of their
relatives would be denied Christian burial- carted, instead, to the dissecting room of the local anatomy
school. News of grave-robbing and the needs of medical education gave substance to their fears.
Durey's case for the significance of the hostility of the poor toward the medical profession might have
been strengthened by a more careful examination of the social structure of the profession and by more
use of the case study approach that he uses so effectively elsewhere in the book.

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The most interesting and novel feature ofthis book is its methodology. Drey wants to study more than
the biological features of epidemic disease. In his pursuit of 'mentalities', he draws on the work of
sociologists who have explored popular responses to disaster, and he uses their social and psychological
findings as tools of analysis in his examination of cholera in Britain. Similarly, he draws on the work of
anthropologists in explaining the importance of working-class burial rituals and the stresses that
government demands for rapid burial place<;! on the poor.
'The Return of the Plague' is a provocative and suggestive book. It is strongest in its use of
comparative materials and in its fresh inquiries into the tensions between the strength of popular custom
and habit and the wavering, uncertain, but unavoidable demands of government and medical science. In
comparing British cholera disturbances with those on the continent, Durey finds little evidence for class
conflict in Britain and he concludes that the fundamental stability of British society was reflected in the
resilience with which it weathered the social and psychological effects of cholera in 1831-2.
M. JEANNE PETERSON
Henning Eichberg, Leistung, Spannung, Geschwindigkeit. Sport und Tanz im gesell:;chaftlichen Wandel des 18./19. Jahrhunderts. Stuttgarter Beitriige zur Geschichte und Politik Bd. 12, Stuttgart, KlettCotta, 1978,353 pp., DM 86,-.
Mit Eichbergs Habilitationsschrift 'Leistung, Spannung, Geschwindigkeit' halt man ein Buch in der
Hand, das sowohl als Beweisgang wie als Nachschlagewerk und zur Unterhaltung zu empfehlen ist.
Erfrischend hebt sich seine Strukturanalyse des Bewegungsverhaltens von der sonst meist eklektizistisch dargebotenen Geschichtsschreibung ab. So steht er zu seiner Vorentscheidung, Sport und Tanz in
Analogie zur Gesellschaft zu setzen, und verfolgt diese Sichtweise konsequent, zuniichst in der
Auswahl und Beschreibung von Phiinomenen, dann in ihrer strukturgeschichtlichen Aufarbeitung.
Die Konsequenz der Fragerichtung liiBt die Arbeit notwendig zu einer soziologisch orientierten
U ntersuchung werden. Beschreibung und Analyse der Bewegungsformen als Ausdruck ihrer Zeit geben
neue Einsichten in historische Entwicklungen, die weit iiber eine als zeitlos vorhandene Soziologie
hinausgehen. Lebendige Beschreibungen etwa eines Ballhauses des 17. Jahrhunderts oder eines
hofischen Menuetts sind nicht nur zur 'Illustration' des Textes dienlich, sondern werden methodisch
richtig als Teil der Analyse eingesetzt, darin den Methoden der Kunstgeschichte verwandt und zugleich
der Medizingeschichte von Nutzen.
Eichberg reiht sich mit seiner Arbeit in die Gruppe der historischen Verhaltensforscher ein, die die
alltiiglichen Tiitigkeiten zum Angelpunkt ihrer lnterpretationen machen. Wer das Buch durcharbeiten
will, muB sich durchgiingig auf die Komplexitiit einer geschichtlichen Betrachtung einlassen.
M. PUTSCHER/CHRISTA BALS
John Ettling, The Germ of Laziness. Rockefeller Philanthropy and Public Health in the New South.
Cambridge, MA, Harvard University Press, 1981, X, 263 pp., cloth, US $18.50
The hookworm became a hidden feature of life in the American South early in the region's history.
Introduced by the Africans that were transported to Virginia in the opening days of colonization, the
parasite quickly infected the inviting southern soil. Succeeding generations of unsuspecting hosts
spread it throughout the region. By the beginning of the twentieth century the hookworm infected an
estimated forty percent of the southern population. Despite its costly human and economic toll, the
parasite went unnoticed until Charles Wardell Stiles, a zoologist with the United States Department of
Agriculture, discovered its presence in the 1890s. But an additional two decades were to pass before
steps were taken to bring it under control. Not until the founding of the Rockefeller Sanitary Commission for the Eradication of Hookworm, in 1909, was a systematic attempt made to rid the South of the

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hookworm. John Ettling's 'Germ of Laziness' recounts and analyzes the creation and operations of this
joint venture in philanthropy and public health.
Neither the first nor the largest of the Rockefeller philanthropies, the Sanitary Commission was
created for five years with an endowment of$1 ,000,000. It began operations in 1910 against a backdrop
of a poor southern record in public health and regional suspicion. Undaunted, the commission, through
such agencies as the medical profession, public health officials, boards of trade, schools and the press,
sought to convince the people of the eleven southern states that participated in the anti-hookworm
campaign that the parasite was endemic; that it posed an increasingly serious threat to their health and
economic well-being; and that it could be easily cured by a dose of thymol and Epsom salts and could be
prevented through the construction of sanitary privies and the wearing of shoes out-of-doors. The
mobile dispensary, an innovation of the Sanitary Commission's ·field workers, proved to be its most
effective educational and therapeutic weapon. By the end of its allotted life span the commission had
overcome the South's initial suspicion, had made considerable headway toward educating the region's
people to the presence and dangers of the hookworm and had begun to bring the parasite under control.
To the great dismay of its workers and supporters, the life of the Sanitary Commission was not
extended. It was terminated as planned in 1914 and its unspent funds and possessions were transferred
to the newly created Rockefeller Foundation which sought to combat health problems on an international scale. Judged solely in terms of the eradication of hookworm in the South (never the goal of the
commission, Ettling points out, but a publicity ploy), the Sanitary Commission cannot be judged by an
unqualified success. Its true success, Ettling holds, lies in its demonstrable impact on the upgrading of
state and local public health agencies in the South and in its role as precursor and model for the more
ambitious, better funded Rockefeller Foundation.
Ettling places the Sanitary Commission in the context of American reform during the Progressive
years of the early twentieth century. In fact, this organization provides important insights into the
reformist activity of the era: on the one hand, it represents the convergence of scientific medicine and
public health, two previously separate tributaries of American philanthropy; and on the other, its
activities are illustrative of the problems faced and solutions attempted by the larger, more diverse
progressive attempts at reform. Ettling devotes much attention to the principal personalities involved in
the founding and operation of the Sanitary Commission in the belief that they imparted to the organization one of its most important meanings. These figures were Charles Wardell Stiles, the discoverer
of hookworm in the South; Frederick T. Gates, the head of the Rockefeller philanthropies; Rockefeller,
the plutocrat-philanthropist; Walter Hines Page, the journalist who played a crucial role in the founding
of the Sanitary Commission by putting Stiles in contact with Gates; and Wickliffe Rose, the philosophy
professor who headed the commission. Quite different at first glance, these men, Ettling reveals, had
much in common. All of them had rural or small-town backgrounds and evangelical religion had been a
major determinant in shaping their early lives. As twentieth-century men of affairs, they believed that
they had put these formative forces - and religious superstition in particular- behind them. But their
evangelical heritage, Ettling is convinced, unconsciously shaped their emotional response to the world
of the early twentieth century. As a result, the work of these men in the formation and operations of the
Sanitary Commission constitutes a bridge between the older individualistic, evangelical world of the
nineteenth century and the modern bureaucratic one.
Ettling is deserving of high praise, for he has written an important book. He deals with a highly
complex topic in an expert manner. He combines social, intellectual, and institutional history with grace
and charm. The book is exhaustively researched and written with great felicity in style. The result is a
work of immense and enduring value to intellectual, social, and medical historians.
JAMES 0. BREEDEN

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Felice Fontana, Carteggio con Leopolda Marc'Antonio Caldani ( 1758-1794). Renato G. Mazzolini and
Giuseppe Ongaro, eds. Trento, Societa di Studi Trentini di Scienze Storiche, 1980, 396 pp., Lire
16.000.-.
Although Felice Fontana's place in the history of eighteenth-century physiology has long been
appreciated, he has lacked an adequate biography, in part because of the dispersion of his correspondence and other manuscript materials. The volume under review is the first in a series of Fontana's
correspondence projected by the Societa di Studi Trentini, which has also just begun a Fontana
monograph series whose first volume is an annotated bibliography by Peter K. Knoefel.
The leitmotiv of Fontana's correspondence with Caldani is von Haller's concept of irritability, a
doctrine which, according to Fontana's quip, had irritated the whole of Italy (to judge by the polemics on
the subject by Italian researchers). Caldani had introduced electricity into experimental physiology as a
new method of stimulation and had discovered that electrical stimuli caused muscles to contract and
stimulated the pulse. Fontana's own interest in the subject was developed in a series of experiments
conducted jointly with Caldani in 1755, and his continuing interest in the problem is amply reflected in
their subsequent correspondence. Fontana observed that electrical stimulation did not prove, as
Caldani proposed, that muscles normally contracted because of electrical charges.
A number of Fontana's other interests documented here were likewise related to irritability. In his
studies on snake venom, Fontana attempted to refute Richard Mead's concept of its action on nerve
fluid, preferring the hypothesis that venom acted through the blood (see Clio 15, No. 1-2). Of similar
orientation were his experiments on the movements of the iris: he disagreed with Caldani's hypothesis
that contractions were produced by an 'afflux of humors' caused by light irritating the retina. Fontana
thought movements of the iris to be voluntary, since he observed that animals could contract or dilate
the iris with or without the presence of light.
Fontana's scientific interests and skills extended well beyond the bounds of physiology. He repeated
Lavoisier's experiments on the decomposition of water in air, leading him to deny that hydrogen was
one of the principal components of water. The Duke of Tuscany appointed him director of his Cabinet of
Physics and Natural History. The twenty letters referring to the subject include interesting references to
scientific instruments and to Venetian glassmakers. Finally, he built a marvelous detachable anatomical
statue of wood, containing 2000 pieces, whose difficulty of construction he confided to Caldani.
The lengthy introduction preceding the edition of 129letters exchanged by Fontana and Caldani is an
excellent guide to Fontana's scientific work, and the edition itself is superb, with extensiv.e bibliographical and substantive footnotes.
THOMAS F. GLICK
Wayland D. Hand, Magical Medicine. The Folkloric Component of Medicine in the Folk Belief;
Customs, and Rituals of the Peoples ofEurope and America. Berkeley, University of California Press,
1980, XXVII, 345 pp., US $22.50.
L'ouvrage de W.D. Hand constitue un veritable petit traite d'anthropologie medicale, a Ia fois
passionnant et indispensable, tant pour les ethnologues que pour les historiens de Ia medecine. Sont ici
rassembles 23 courts articles, ecrits par !'auteur dans differentes revues et ouvrages collectifs, entre
1965 et 1980. L'ouvrage n'estjamais repetitif, comme il arrive trop souvent dans ce genre de reedition.
Au contraire, des themes- comme le rituel therapeutique de 'passer sous' (un arbre, de Ia terre ... )- sont
abordes sous p1usieurs angles, et !'analyse de leurfonctionnement y gagne en profondeur. Un index, des
notes importantes, une bibliographie generale, ajoutent encore de Ia coherence a !'ensemble.
II s'agit a Ia fois d'une recherche d'anthropologie des societes complexes et d'une recherche comparative. L'auteur part en effet de tout un corpus de recettes medicales qu'il a accumulees lors de son
travail pour le 'dictionnaire des croyances populaires et des superstitions americaines'. II compare ces

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recettes medicates americaines a d'autres recettes europeennes, en affirmant d'emblee son parti pris de
parler de Ia 'medecine populaire europt'enne et americaine, et non de Ia medecine magi que de ce que I' on
appelle generalement les cultures primitives'. II y a done un lien evident avec l'histoire de Ia medecine,
auquel !'auteur fait appel explicitement en soulignant le probleme des interrelations entre medecine
populaire et medecine savante, et notamment, comment certains elements du savoir populaire sont
passes dans Ia pratique medicate, notamment dans le domaine de l'herboristerie. Fa"on originate et
fructueuse de poser un probleme qui n'est que trop souvent aborde de fa"on unilineaire, dans le sens
inverse du passage de Ia medecine savante a Ia medecine populaire.
La fa"on de proceder de W.D. Hand est Ia meme d'un article a I' autre, ce qui donne a l'ouvrage une
rigueur certaine et en fait veritablement un instrument de travail. A travers tel ou tel rituel precis de
medecine magique, I' auteur se livre a un inventaire munitieux des differentes formes que prend ce rituel
dans differentes cultures europeennes et americaines. II suggere souvent, a partir de Ia, des !ignes
d'interpretation ou des pistes d'interrogation pour des recherches ulterieures. De nombreuses recettes
sont citees de fa"on detaillee, ce qui rend Ia lecture de l'ouvrage tout a Ia fois passionnante et
interpellante pour le chercheur. U n inventaire des maladies traitees par tel ou tel rituel est sou vent
esquisse.
L 'auteur analyse ainsi une serie de rituels, tous fondamentaux dans le folklore medical, tant americain
qu'europeen. II met d'abord en lumiere !'importance symbolique de differents details dans Ia fa"on de se
soigner (lieu, direction, epoque, etat du guerisseur et du patient) et egalement les interdits de Ia vie
quotidienne qui peuvent etre cause de maladies. Un article developpe ainsi de fa"on tres ingenieuse Ia
relation entre !'apparition d'orgelets et le fait d'avoir urine sur Ia voie publique. D'autres articles traitent
des differentes fa"ons de transmettre Ia maladie pour s'en debarasser. Un article general est complete
par des articles specifiques sur Ia fixation de Ia maladie a un arbre, Ia mensuration, de Ia maladie, son
encerclement, le fait de jeter pardessus son epaule un objet intermediaire. L 'auteur aborde ensuite, avec
Ia meme coherence, les differents moyens d'acquisition d'un 'don de guerison' lie a des caracteristiques
individuelles etranges, les differents types de maladies qui sont considerees comme des chatiments
divins (avec un appel explicite a l'histoire de Ia medecine pour analyser !'influence de Ia religion
officielle) les differents types de contact therapeutique avec un mort. La fa"on particuliere de se
debarasser de Ia maladie en 'passant a travers' (un arbre, un trou de terre ... ) retient longtemps !'auteur
dans un article illustre important. C'est en effet une dimension a Ia fois ancienne et encore tres vivante
sous des manifestations differentes, de Ia medecine populaire. L'auteur insiste ace sujet sur Ia necessite
de recourir a l'enquete orale, d'obtenir des explications 'indigenes' sur les differentes phases du rituel.
Viennent ensuite des annotations tres riches sur !'inhalation comme procede therapeutique dans les
maladies respiratoires (il s'agit Ia des differents types d'air que I' on doit respirer) et sur les sacrifices
animaux, en particulier !'utilisation therapeutique de Ia taupe. Dans ce cas egalement, la reference a
l'histoire de Ia medecine est importante et explicite. Le livre comporte egalement quelques articles
traitant plus particulierement de la sorcellerie et du mauvais oeil dans leur relation avec la maladie, qui
amenent !'auteur a aborder les problemes des relations avec Ia medecine et Ia sorcellerie africaines.
C'est egalement sous cet angle qu'il analyse les problemes de I' intrusion animate dans le corps humain.
Un article de synthese sur Ia medecine magique de I' ouest des Etats Unis donne des exemples precis des
differents principes (sympathie et contagion) a I' oeuvre dans Ia medecine homeopathique populaire.
Dans certains articles, Ia cause ou le traitement de certaines maladies (orgelet, rhume, troubles
respiratoires ... ) sont abordes de fa"on specifique.
Cet ouvrage est sans doute d'autant plus interessant pour l'historien de Ia medecine qu'il aborde
maladies et remedes so us I' angle symbolique des rituels plutot que so usIa dimension positiviste eta mon
avis reductrice qui serait celle des symptomes de maladie et des produits therapeutiques. II met ainsi en
lumiere une veritable mise en scene de Ia maladie, dans laquelle les gestes de Ia vie quotidienne, les
moindres objets, s 'eclairent d 'une dimension nouvelle. Ainsi, il insiste sur les 'objets intermediaires' qui
representent Ia maladie et le corps malade. On peut toutefois regretter que trop sou vent I' auteur se soit
contente de juxtaposer des faits et so it reste trop timide ou hesitant dans leur interpretation symbolique.
Quoi qu'il en soit, ce livre foisonnant constitue une bonne base de depart pour de nombreuses
recherches dans des directions multiples: du cote de Ia collecte des donnees, du cote des relations entre
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medecine populaire et medecine savante, et notamment des relations entre recours a Ia medecine
officielle et recours a Ia tradition dans une societe complexe, du cote de Ia comparaison internationale.
Pour cette comparaison, dont le livre donne un apen;u de Ia richesse, il faudrait prealablement etablir
avec rigueur les elements de codage d'un corpus national des recettes de medecine populaire, tache pour
laquelle I' auteur donne des elements precieux toutle long de son ouvrage. Ce n'est en effet qu'a partir
d'un codage precis, qui prendrait en compte les rituels, que pourront s'etablir des comparaisons
rigoureuses, d'une part entre pays, d'autre part avec Ia medecine savante des differentes epoques. Le
travail de W.D. Hand en constitue Ia premiere etape, indispensable et fructueuse.
FRAN<;:OISE LOUX
James H. Jones, Bad Blood. The Tuskegee Syphilis Experiment. New York, Free Press, 1981, XIII, 272
pp., cloth, U.S. $14.95.
The dust jacket for 'Bad Blood' describes the book as the 'scandalous story of the Tuskegee
experiment- when government doctors played God and science went mad'. The reader expecting the
contents to match that lurid summary will be pleasantly surprised, because Professor Jones has given us
a generally balanced analysis with a full understanding of the human failings that contributed to this
unfortunate chapter in the history of human experimentation. Only in the Epilogue does a judgmental
stance reveal itself, and there some would argue, such a posture is justified.
In 1972 a journalist revealed that for 40 years the United States Public Health Service had been
conducting what was called the Tuskegee Study which was designed to demonstrate the effects of
untreated syphilis on black men in Macon County, Alabama (399 syphilitics and 201 controls). By 1972
only some 76 of the untreated group still survived. How many of the others died of syphilis is a matter of
some dispute, the estimates ranging from 28 to 100.
Af~r the story broke, the media, many governmental officials and others were highly critical ofthose
responsible for the experiment, accusing them of racism at best and genocide at worst. The Jones
account demonstrates that such predictable outbursts, as usual, only cloud the matter and deprive those
involved of any chance of learning anything useful from history.
To examine the related questions (I) was the experiment ethical and (2) was it racist, the story should
be examined in two phases separated by the years 1945-50 in which penicillin became generally
available. Whether the patients were deprived of useful therapy in the earlier years is highly unlikely.
One need not debate the efficacy of the pre-penicillin treatment of syphilis- the fact is made abundantly
clear that the men chosen for the study were not going to be treated in any event, because, among other
reasons, there was no money to provide such treatment. At its inception was the study unethical? By
1930-40 standards almost certainly not, because normative ethics governing human experimentation
did not exist at the time. On this point the reader should remember that there was no general discussion
within medicine of the ethics of human experimentation until after Beecher's article in 1966.
Was the study racist in its inception? Who can doubt that? In 1932 racism was an unexamined part of
life both in the North and South. It was so much a part of human existence that it probably never entered
the conscious thinking of any of the principals in the Tuskegee Study. As Jones shows, black
cooperation was easily attainable at all levels of the project, including physicians, nurses and heads of
academic institutions.
After penicillin became available, the study continued, apparently without any serious consideration
of treating the participants with an agent now demonstrated as highly effective against syphilis. In
dissecting this part of the story, Jones is at his best. Simple bureaucratic inertia played a major role. The
study was by now something of a sacred cow and the succession of men responsible for continuing it had
grown up with it, at times as active participants. By 1970 ethical thinking in medicine had matured
greatly. The Tuskegee Study was never examined in light of these changes. By the developing new
standards it was clearly unethical, a fact which was slowly beginning to bother those responsible. Still, it
took a journalistic expose to bring the experiment to an end.
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The ultimate irony is that the study was flawed from the outset. Its ostensible purpose was to study the
effects of untreated syphilis, but to get the men to volunteer, all were given treatment, albeit probably
inadequate. In addition, over the years, some probably received penicillin for other indications.
How seriously the men were damaged by being denied penicillin can never be known. They were not
accepted into the study unless their syphilis was in its later stages. Another 20 years elapsed before
penicillin became widely available. By then the main structural damage had already occurred, and it is
doubtful that the usual course of penicillin would have had much effect. Still, there is no gainsaying the
effects of untreated syphilis. One of the Study's own articles concluded that 'the life expectancy of a
Negro man between the ages of25 and 50 who is infected and receives no treatment is, on the average,
reduced by about 20%'.
Thanks to a lucid pen and well-ordered format the book is an easy read. The errors are few and minor.
The Wassermann test is dated at 1907 instead of 1906, spinal taps involve putting the needle directly into
the 'spinal cord' rather than spinal canal and the isolation of the agent of smallpox is placed in the 19th
instead of 20th century.
All in all Professor Jones has produced a fine book. I know of no better example of using history to
vitiate the simplistic morality so often found in the black and white of headlines.
ROBERT P. HUDSON
Ian Maclean, The Renaissance Notion of Woman, A Study in the fortunes of scholasticism and medical
science in European intellectual life. Cambridge, Cambridge University Press, 1980, VIII, 119 pp.,
cloth, U.S. $16.50.
It has been a long time since Jules Michelet invented the Renaissance and defined it in part as the age
when light began to shine on the discordant chaos of our old customs. Accepted by noted historians such
as John Addington Symonds and Jacob Burckhardt in the nineteenth century, Michelet's conceit has
undergone radical revisions in the twentieth.
Recent scholarly investigations of European social history between 1300 and 1650 have demonstrated
that the age· s great creativity, instinct for beauty and talent for innovation also had a darker side. Rather
than being the era which liberated mankind from the tyranny of medieval dogma and superstition, it has
been shown to have been a period when traditional ideas were reexamined, reevaluated, and reinforced,
often to the detriment of identifiable and relatively defenseless groups whose members in earlier times
may have been shunned, but were not severely persecuted.
Renaissance society vented its active hostility on those it considered inferior. Numerous instances of
savage assaults on heretics, jews and witches illustrate this dismal characteristic of the age. Moreover,
as Professor Maclean establishes, in his study ofRenaissance attitudes, half the population was included
in a subordinate category. His principal theme is that despite a few alterations in certain details, the
traditional notion that women were by nature inferior was accepted and promulgated by Renaissance
theologians, physicians and jurists.
Professor Maclean traces the origins of the idea to the Pythagorean schema of dualities as transmitted
primarily in the writings of Aristotle. The doctrine, he argues, was strengthened through the influence of
the Pauline, as well as the exegetic writings of the Church Fathers and of the medieval scholastics. Since
their interpretations were quarried by both Catholic and reformed theologians, woman's natural and
mystical inferiority was maintained virtually unopposed in Renaissance and Reformation theological
treatises. Woman, believed capable of sharing equally with her husband in the delights of the next life,
was assigned a limited and subordinate role to him in this one.
If no strong advocate of woman's equality is to be found among the works of Renaissance theologians,
at least the suggestion of such gallantry is discernible in the writings of their contemporaneous
physicians. Galen's two-seed theory was the theoretical basis for this position which contrasted sharply
with the Aristotelian theory of generation.

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According to Aristotle, as understood by the medieval and Renaissance investigators, the female
supplied only matter in the process of generation, and he?ce was characterized by passive and material
traits, cold and moist humors. Since the male provided the active principle, he was clearly the more
important and superior partner.
These views, as expounded during the Renaissance by neo-Aristotelians, were challenged by
Galenists who maintained that both partners furnished semen, but admitted that the female seed was
colder and less perfect than the male. Though Renaissance medical authors proclaimed woman perfect
in her own sex and composed numerous treatises on gynecology and gynecological problems, in the
main, they considered woman physiologically inferior to man, a judgment in which jurists and legal
scholars concurred.
This study, based entirely on the examination of scholarly writings, is a fine introduction to the
subject of attitudes toward women in an important epoch. Historians of medicine will be disappointed to
find that the author has included no medical selections among the texts printed in the appendix, but
should be pleased with the extensive annotations to the chapter on medicine, anatomy and physiology.
A contribution to our knowledge about woman's place in society, this work is also important reading for
all those who seek to understand an era that has been termed the most psychically disturbed in European
history.
YNEZ V. O'NEILL
A. McGehee Harvey, Research and Discovery in Medicine Contributions from Johns Hopkins.
Baltimore, Johns Hopkins Press, 1981, XIII, 322 pp., illus., $25.-.
A McGehee Harvey has been affiliated with the Johns Hopkins Medical Institutions for half a century.
In addition to being an accomplished researcher, a world renowned diagnostician, medical educator and
author, he is rapidly developing a reputation as one of our most dedicated and productive medical
historians. His historical efforts have centered around subjects with which he is intimately familiar:
Johns Hopkins, the origins and development of clinical research in America, and the professionalization
of medical education in the twentieth century.
The present work is comprised of twenty-one biographical and historical sketches centering around
men and events at the Johns Hopkins Medical Institutions from the late nineteenth to the mid twentieth
century. It extends, therefore, theauthor'searliervolume Adventures in Medical Research
- A Century of Discovery at Johns Hopkins. Baltimore, Johns Hopkins Press, 1976.
Although the focus of the essays is biographical, Harvey has enlivened them with liberal use of printed
primary materials and a pleasing style. In producing these essays Harvey has relied upon his familiarity
with biomedical science and research, his intimate knowledge of the Johns Hopkins and its faculty, and
the abundant manuscript materials available in the Institution's Archives, of which he is Associate
Archivist. The accomplishments of his subjects are placed in the context of medical education, science
and practice of their time.
Individuals treated in separate chapters include several familiar figures, among them, William Osler,
William Halsted, Harvey Cushing, William Councilman and Henry M. Hurd. Lesser known figures
include Arthur D. Hirschfelder, a pioneering cardiologist and cardiac physiologist, Charles E. Simon, an
early virologist, and G. Canby Robinson, a medical educator who emphasized the social aspects of
patients and their illnesses long before this was fashionable. The contributions of these and other
secondary figures are rescued from oblivion and cause one to reflect on how short-lived one's impact is
even within his own institution or narrow field of scientific or intellectual endeavor. The focus of some
chapters are special topics, chiefly infectious diseases, rather than single individuals. For tuberculosis,
yellow fever, syphilis and dysentery the accomplishments of Hopkins' clinicians and researchers are
reviewed. Two important chapters dealing with the impact of William Halsted on surgical training and
sub-specialization within surgery are included. The volume amply demonstrates the accomplishments
made possible by the successful integration of science with medical practice which has characterized the
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Johns Hopkins Medical Institutions since their founding.
The typography of the volume is pleasing and a number of relevant illustrations complement the
essays. The format is larger than the 1976 companion volume since the Johns Hopkins Press elected to
reprint the essays from the quarto Johns Hopkins Medic a I J o urn a I without resetting the
type. Extensive bibliographies of published primary material accompany each essay. Unfortunately, no
index is included which limits access to the wealth of material contained in the work.
W. BRUCEFYE
A. McGehee Harvey, Science at the Bedside. Clinical Research in American Medicine 1905-1945.
Baltimore, Johns Hopkins University Press, 1981, XIX, 554 pp., hardcover, US $17.50.
This book shows how physicians devoted to clinical medicine uncover and incorporate the data of
laboratory science into medicine in order to enrich, not impair the clinical approach. At least during the
period surveyed, physicians responsible for patient care carried out studies humanely and honorably,
for the benefit of the patients involved and others who might come later. There was no need for
human-studies committees, patient's-rights organizations, etc.
Today's problems in these respects grew out of developments in Germany over 150 years ago.
Whereas the medicine of Great Britain, Ireland and France was shaped by the Enlightenments that these
countries had earlier experienced, events in German medicine took a different direction, for that
country had had no Enlightenment. (The German Aujkliirung is not comparable, since it was only an
attempt- a futile attempt - to make the philosophies of Hegel and his followers intelligible.) By the
mid-nineteenth century in Germany, Scientific Materialism, expounded by the physicians Vogt,
Mulder, and Moleschott, took a leading position in German philosophy, with its claim that the thenaccepted physics and chemistry- which we now recognize as fragmentary, erroneous, and irrelevantexplained all of life. At about the same time three Berlin medical reductionists, Helmholtz, Brucke, and
duBois-Reymond were teaching that all physiology was nothing but physics. A little later Virchow and
then Cohnheim declared that medicine was to be found only in the laboratory of pathologic physiology,
with the clinic and the post-mortem room mere 'outposts'. This notion was formalized with the creation
of the Kongress fur innere Medizin in the 1880's. (The word innere is usually translated in America as
internal, whereas another of its meanings- core, or essence- is the one that is applicable here.) Journals
and textbooks of innere Medizin followed and were prominent until after World War I.
After our Civil War, the flow to France of American physicians who wanted Continental training
diminished and most such Americans went to German-speaking countries. Those with clinical interests
went mainly to Vienna, whereas those with academic ambitions went mostly to Germany. A number of
the latter physicians brought back the Virchow-Cohnheim notion to this country, and tried to root it
here. However, the distinguished clinicians of Hopkins and elsewhere refused to adopt the notion, and
remained clinically committed.
Harvey's book has faults. One is that the approach is hardly more than a listing of events, and in many
cases no more than a table of organization of various clinics. The main fault is that Harvey does not tell
why and how the men avoided the Curse of Herophilus. The Curse of Herophilus, for those who do not
know about is, refers to a leader of pre-Christian Alexandrian medicine. Tertullian described him as
mistreating patients 'for the love of knowledge'. Both Celsus and Tertullian accused Herophilus of
human vivisection whose aim was the advancement of knowledge. If one doubts that any physician
would do this, proof exists in a fresco in a catacomb in Rome which clearly shows such a scene: the
professor is expounding, the prosector is cutting, and the students are doing nothing. The patient
appears to be displeased.
Today, when in many teaching hospitals patients seem to be treated asmere audio-visual aids to
research, the distinction between patient-oriented physicians on the one hand, and disease-oriented or
theory-oriented physicians on the other, is abundantly clear. Harvey does not emphasize sufficiently
the role of the first of these groups in greatly advancing medicine.
MARK D. AL TSCHULE

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Isabel R. Plesset, Noguchi and his Patrons. Rutherford-Madison-Teaneck, Fairleigh Dickinson
University Press. London/Toronto, Associated University Presses, 1980,314 pp., illus., $25.-.
Depuis l'ouvrage deja ancien de G. Eckstein (1931) on ne possedait aucune biographie du microbiologiste nippo-americain Hideyo Noguchi (1876-1928) et le present livre vient combler cette lacune.
En plus de 300 pages !'auteur qui n'est pas de formation medicale, mais dont le pere, medecin, collabora
avec Noguchi retrace les etapes de Ia courte mais etonnante vie de son heros. Issu d'une pauvre famille
paysanne japonaise, Noguchi, par sa volonte et sa perseverance arriva a s'imposer comme l'un des
grands microbiologistes de son epoque. Parmi ses decouvertes les plus marquantes, il faut citer ses
recherches de 1926-27 sur Ia maladie de Carrion (fievre d'Oroya ou verruga peruana) dont il isola le
microbe (Bartonella bacilliformis) en montrant qu'il s'agissait de deux formes d'une meme affection.
Noguchi fut moins heureux en ce qui conceme les maladies d'origine virale: ses essais de culture in vitro
du virus rabique (1913) et poliomyelitique furent en fait des echecs. II en fut de meme avec le trachome
qu 'il croyait du a une bacterie (Bacterium granularis) et surtout avec Ia fievre jaune dont il devait mourir
a Accra (Gold Coast) age seulement de 52 ans. Noguchi pensait en effet que cette maladie etait due a un
Spirochete (Leptospira icteroides) alors qu'il s'agit en fait d'un virus, ce qui sera demontre par Stokes,
Bauer et Hudson en 1928, l'annee-meme de Ia mort de Noguchi.
Tout ceci demontre I' exageration des propos de Theobald Smith qui voyait en lui Ia plus grande figure
de Ia microbiologie depuis Pasteur et Koch. L' ouvrage de Madame Plesset, excellent au point de vue
biographique par Ia vaste documentation en grande partie inedite qu 'elle a utili see est moins precis en ce
qui conceme !'appreciation exacte de ses travaux scientifiques. La bibliographie omet plusieurs articles
importants en anglais: S. Flexner, Hideyo Noguchi, A biographical sketch, Science, 69, 1929, 653~60;
C. E. Dolman, H. Noguchi (1876-1928) his final effort, Clio Med. 12, 1977,131-145 etdeux en franr;ais de
Le Goff (1914) et de P. Atanasiu et J. Theodorides (Hist. Sci. Med. 10, 1976). Malgre ces critiques
mineures tous les historiens de Ia microbiologie et de Ia pathologie infectieuse seront tres interesses par
cet ouvrage tres documente et meticuleux.
J. THEODORIDES
Alvin E. Rodin, Oslerian Pathology: An Assessment and Annotated Atlas of Museum Specimens.
Lawrence, Kansas, Coronado Press, 1981, xviii, 250 pp., illus., cloth, U.S. $25.-.
Osler serves well as the epitome of the later 19th century clinician-pathologist. He believed in the
value of a strong training in pathology for all practitioners, and he grounded his voluminous and
influential bibliography in knowledge obtained in the autopsy room. Rodin recapitulates this aspect of
Osler's career, and attempts to illustrate the dimensions of his pathologic knowledge by analyzing the
extant tissue specimens prepared by Osler.
One mystery that Rodin does not eludicate, presumably because the answer is unknown, is, what has
happened to the substantial corpus of museum specimens that came from Osler's hand? Purportedly,
there were several hundred by the time he left McGill in 1884. Now there are 55. There was a fire in 1907,
and that explains some of the wastage. But if these hundreds of specimens were identified with their
hero's name, how could McGill have permitted them to disappear? Whatever the reason, Rodin is left
with this relatively small group of 55 preparations as his primary source.
For pathologists (and ardent Oslerians), Rodin presents a great deal of information on these specimens, including photographs of them all, as well as the text of the labels. Also reproduced are the
complete autopsy protocols that match 10 of the specimens. It seems unlikely that any more complete
documentation would ever be required.
Rodin shows clearly how productively Osler used such material. A specimen might be reported
briefly as part of a pathologic presentation, in more detail as part of a case report, as one of a series of
related cases in a more substantive article, and then be referred to in The Principles and
Practice of Medic in e. But this is just another proof of his reliance on findings from the morgue.
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Rodin also faces the more general question of Osler's influence, as a pathologist, on pathology and on
medicine generally. Here, there may be those who will claim that Rodin's enthusiasm is insufficiently
critical. He states, for example, that it was through Osler's activities in pathology that 'the European
tradition of morphology, as a basis for understanding disease, was transferred to the North American
continent' (p. 87). Maulitz, however, in his survey of pathology in America, traces this transfer to men at
least a generation previous to Osler 1 • Similar criticisms might be made ofthe assessment of Osler's role
in encouraging the use of the microscope. Nevertheless, even if some of his interpretations are
questionable, Rodin has done a service by providing what will surely remain as the definitive
presentation of the extant tissue specimens from Osler's extensive work in the autopsy room.
I. R.C. Maulitz, Pathology. In: R.L. Numbers, ed., The Education ofAmerican Physicians: Historical
Essays. Berkeley, Los Angeles and London, University of California Press, 1980. See particularly
pp. 131-135.
CHARLES G. ROLAND
Shirley A. Roe, Matter, Life, and Generation. Eighteenth-century embryology and the Haller- Wolff
debate. New York, Cambridge University Press, 1981. X, 214 pp., cloth, US $32.50.
It is a pleasure to encounter an historian who has a real point to make, a thesis to defend, about the
way - or one of the ways - in which biomedical thought has evolved. Historian Roe presents such a
thesis of her defense which is complex but generally clear and convincing. Her argument resembles an
elaborate machine composed of many smaller machines each of which operates smoothly to assure the
operation of the whole. Roe tells her story in just 156 pages (plus 86 notes and a bibliography of345 titles
all actually cited in the text). An appendix offers English translations of important documents used and
the whole book is copiously indexed.
The 'time-slice' Roe elects to explore is, approximately, the third quarter of the eighteenth century
when the preformation-vs-epigenesis controversy was especially acute. She focuses on two major
figures, preformationist Albrecht von Haller and epigenesist C.F. Wolff, who opposed each other in
publications and in an exchange ofletters. Roe's thesis about them is that 'the embryological positions
of these two physicians were largely dictated by their philosophical positions'. Although she develops
this thesis with special reference to Haller and Wolff, she occasionally intimates and presently explicitly
states that her thesis is of quite general application, in other words that philosophical considerations
have often determined positions taken by scientists on unsettled scientific issues. In such cases,
philosophical and/or other extrascientific influences prevail at least until, and sometimes even after, the
issue in question is scientifically settled.
Roe develops her thesis in an admirably orderly manner. An introductory chapter treats the history of
preformation and epigenesis from ca 1650 to 1750. A second chapter details Haller's changing embryological ideas; a third, his embryological conflict with Wolff; a fourth, the philosophical controversy
between them; a fifth, Wolff's further intellectual development after his interaction with Haller had
ended. A final sixth chapter summarizes and elaborates Roe's argument to make her defense as far as
possible, conclusive.
'Philosophy', as Roe uses the term, includes both (a) the religious predilections of Haller and Wolff
and (b) their differing interpretive procedures. For Haller, as here depicted, religion was an a priori
commitment; a paradigm which scientific hypotheses must fit, or else be rejected. Wolff by contrast
went ahead scientifically without advance religious precautions. Afterwards, he said that it had seemed
safe to proceed in this manner because, whatever he discovered, God remained the instigator of it all. As
to interpretive canons, we learn that both theorists were committed empiricists (were aggressive,
ingenious observers) but that their microscopical observations were sufficiently ambivalent to allow
each to seem to find support for his own preconceptions. We hear likewise that both were affected by the
mechanicism that prevailed at the period but that their ways of adapting mechanics to living organisms
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differed and that Haller was a more self-conscious and insistent mechanist than Wolff. Finally, Wolff
differed from Haller in being decidedly rationalistic. He wanted each set of related natural events to
have a common rationale, an adequate or sufficient reason for occurring. Wolff believed it possible to
deduce sufficient reasons from general principles in the manner of Descartes, though with less
disastrous results since Wolff tested his deductions empirically in a more careful manner than Descartes
had done.
Wolff thought he had found sufficient reason for epigenesis in his supposition that an unexplained
'essential force' (similar but not identical to physical forces) caused inchoate structures in the newly
formed individual to give rise by a process of secretion to other structures which, after undergoing
solidification, gave rise by secretion to still other structures and so on. These were events that Wolff
thought he had actually observed. But Haller denied that a uniformly acting force could transform
initially uniform matter into meaningfully nonuniform matter as epigenesis required. (Haller, an
enthusiastic Newtonian, here applied to the embryo a point that Newton had applied- in the Bentley
letters, I believe- to the origin of the cosmos.) Haller thought that epigenesis would have needed an
organizing agent, a more or less adventitious 'Building Master' or guide. Along with other preformationists he wished to avoid both (a) the atheistic implications of unguided epigenesis and (b) the
antimechanistic implications of evoking a guide. So he joined company with those who believed that
God had seeded the earth with already-organized mechanical germs of all future living beings. Roe's
treatment of these matters admirably illustrates the strong alliance that existed at that period between
mechanicism on the one hand and Christian theology on the other. It shows that the disengagement of
science from its Medieval misalliances with philosophy and religion was not yet complete.
Roe thinks it unimaginable that either of her two adversaries would have found it possible to surrender
his scientific beliefs even had the other's beliefs been shown to be true. This striking conjecture (which
Wolff would have denied) shows the depth of Roe's conviction that the Haller-Wolff controversy was
fundamentally philosophical and only secondarily scientific. She compares the conflict to a collision of
two philosophical icebergs only the points of which were scientific. She thus offers Hailer-Wolff as an
exception to the conventional interpretation according to which philosophical and religious encroachments have been occasioned by failures of science to solve its own scientific problems. Such failures
have occurred when science tackled problems that were not yet ripe for solution. For example, no
branch of eighteenth-century biology proved more resistant to reductive analysis than embryology
proved. Epigenesis became the favored position. But the effort to explain epigenesis was plagued by
philosophical (vitalistic, teleological and idealistic) incursions not only then but thereafter. This
situation lasted until, and even after, embryology began to yield its secrets to experimentation in the late
nineteenth century.
For a book to raise more questions than it answers (sometimes a pejorative judgment) becomes, with
Roe, a capital virtue. She makes a major contribution to the historiography of science by asking, in
effect, how science and philosophy have interacted in the scientific mind and more particularly, how
that interaction has differed for different scientific problems and under the circumstances prevailing at
different places and times. Roe answers this question with respect to a particular issue that became
acute during the culminating decades of the Enlightenment in Europe. It remains for her and other
historians to answer it with respect to issues that became acute under other circumstances and in other
contexts and to do so without losing sight of intrascientific determinants as well. Such studies will
disclose that philosophical considerations are by no means always pre-emptive (witness the triumphs of
a William Harvey whose orientation nevertheless was antireductive, teleological, and more than
vaguely animistic).
Readers of Roe may find themselves, as did this reviewer, often pausing to ponder the ceiling, because
her ideas are provocative beyond the limits she wisely sets for herself. When I laid the book down after
the indispensable several readings I found myself wishing that Haller and Wolff might return to witness
the denouement of the issue they argued. Both parties have, in a sense, proved correct. In the
development of higher animals as now understood epigenesis prevails, as Wolff had wanted it to. But

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epigenesis has turned out, as Haller had insisted, to need a Building Master, a guide. And it is the guide
(each animal's inherited constellation of genes) that exists already preformed when individual life
begins. Roe notes that Wolff had had a premonition with respect to material guides. The modem view
differs in that evolution-theory has entered the picture to show how the material guide could have come
into being.
THOMAS S. HALL
Hakim Mohammed Said, Medicine in China. Karachi, Pakistan, Hamdard Academy, 1981, 826 p. avec
index et illustrations, US $40.-.
La 'medecine en Chine' est mal connue, faute d'enquetes sur le terrain. On assiste, en France, a Ia
proliferation de publications qui relevent de l'exotisme ou de l'imaginaire. Le Professeur Hakim
Mohammed Said n'a pas voulu tomber dans ce piege. II sait que Ia 'medecine des Chinois' est double
(occidentalisante et traditionaliste). Elle exprime une volonte qui explique le succes de Ia 'medecine
combinee' (association des pratiques traditionnelles: acupuncture et moxibustion; massages et techniques respiratoires; physiotherapie et phytotherapie) aux methodes de Ia medecine dite scientific
(chimiotherapie, radiotherapie et chirurgie).
II suffit de se rendre a Xuan-wu (Beijing) pour comprendre Ia portee de cette 'medecine chinoise'axee sur Ia prevention- qui se veut pluridisciplinaire. L'art de guerir doit etre resitue dans le contexte de
Ia societe chinoise (1980). La Chine compte actuellement 582 hopitaux, 24 ecoles de medecine et 43
instituts de recherches pour une population de 970.920.000 habitants, regroupes sur un territoire
d'environ 9.600.000 kilometres carres.
II n' est pas aise de conter l'histoire de Ia medecine en Chine. Le Professeur Hakim Mohammed Said et
ses collaborateurs (Mrs. L.A. D'Silva, Miss Sadia Said, Dr. Zafaryab Husain, Dr. M. Ilyas, et Mr.
Hakim Ghulam Rabbani) ont tente l'incroyable pari de reunir en un ouvrage theorique les pratiques
millenaires de Ia medecine chinoise. Cette etude, volontairement axee sur Ia medecine traditionnelle (Ia
medecine du peuple chinois) ne neglige pas les acquis de Ia medecine occidentale (anesthesies, anastomoses, greffes etc.). Elle s'etend de Ia periode de~ Empereurs legendaires a Ia Republique populaire de
Chine. Mais le lecteur ne trouvera pas- ici- une 'Histoire de Ia medecine chinoise', dans le sens strict du
mot, c'est-a-dire une etude du passe s'appuyant sur !'analyse des textes chinois. Toutes les references
de 'Medicine in China' sont en langue anglaise (voir: Bibliographie, p. 803-804).
Mr. Said presente Ia medecine chinoise en une serie d'articles recoupes par des commentaires
historiques ou des donnees du Chinese Medic a I Jour n a I. II choisit d 'emblee son interlocuteur en
Ia personne de Lu Zhi-jun, tenant de Ia medecine traditionnelle chinoise, qui vient de presenter Ia
premiere revue chinoise d'acupuncture et de moxibustion avec resumes en langue anglaise (Zhongguo zhen-jiu xue,Beijing,1981.nol,50p.).
On peut distinguer dans I' important travail de Mr Said trois grandes parties:
I. Organisation de Ia sante et structure de Ia medecine chinoise (Organigramme de I' Academie de
medecine traditionnelle de Beijing et Instituts regionaux de Nanjing et Shanghai; Chinese Medical
Association a Beijing et prise en charge dans les communes populaires, p. 31-99. Cette enquete est
completee par une analyse du developpement medical, du controle des maladies parasitaires et du role
des medecins aux pieds-nus, p. 682-801).
II. Commentaire de l'histoire de Ia mectecine chinoise (Principe du Yin et du Yang, theorie des 5
elements et evolution de Ia medecine chinoise a travers les ages, p. 106--149. Histoire de Ia Materia
medica, livres, documents et phytotherapie, p. 286--307).
Ill. Applications de Ia medecine. a. Disciplines traditionnelles: traitement des brules, p. 154-168;
nephropathies, p. 193-199; maladies nerveuses et mentales, p. 200--204; thrombo-angeite obliterante p.
205-213; traitement de Ia surdite par Radix puerariae, p. 214-222; ophtalmologie traditionnelle (cataracte et trachome), p. 348--375. b. Disciplines occidentales: Recherches sur le cancer, p. 223-229;

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n!ticulose, p. 543-549; experimentation sur )'animal, p. 308--347; anesthesiologie, p. 376-386; chirurgie
(chirurgie viscerale, chirurgie reparatrice, neuro-chirurgie, chirurgie a coeur ouvert, p. 480--542). Une
place considerable est accordee aux massages, a Ia physiotherapie eta !'acupuncture, p. 551-681.
L'histoire de Ia medecine chinoise ne doit pas etre dominee par des recherches de philologie pure ou
par des histoires livresques, mais par !'etude des faits sociaux. Elle doit deboucher sur Ia realite des
pratiques chinoises.
M.WONG
Antonio Scarpa, Etnomedicina. Verita scientifiche, strane coedenze e singolari terapie, meritevoli di
verifica, delle medicine tradizionali dei popoli. Milano, Franco Lucisano, 1980, 549 pp., illus., paper,
Lire 28.000,-.
In der Einleitung bespricht der Verfasser zuniichst Entstehung und Entwicklung der Ethnomedizin in
der Welt und insbesondere in ltalien. Aus den 14 Abschnitten der ersten Buchhiilfte hebt sich die
Abhandlung iiber den EinfluB der Gestirne auf die einzelnen Korperteile sowie die Auswirkung von
Wind, Regen, Donner, Blitz und Regenbogen auf die Psyche der Naturvolker heraus. In einem anderen
Abschnitt wird die Rolle des Wohn- und Lebensbereichs in der traditionellen Erfahrungstherapie der
Volksstiimme der verschiedenen Erdteile besprochen. Erniihrung und Wasserversorgung werden gesondert behandelt, ebenso die Prophylaxe der iibertragbaren Krankheiten. Der Bestattung von Leichen
in den verschiedenen Arten (Feuer, Wasser, Erde, Mumifizierung usw.) ist ein weiteres Kapitel
gewidmet. In iiber 150 Seiten wird anschlieBend die Therapie durch Traum und Trance, animalische und
pflanzliche Substanzen, durch magische Medizin oder Kannibalismus erortert.
Im zweiten Teil des Buches werden die rituellen Operationen und die Geburtshilfe, einschlieBlich des
Kindbetts des Ehemannes, die Kinderpflege und Geriatric, transkulturelle Psychiatric und 'Rechtsmedizin' dargestellt.
Das Buch zeichnet sich durch eine gute Bibliographie hinter jedem Kapitel und durch ein umfassendes Stichwortverzeichnis aus. Ferner sind aile im Text genannten und nach ihren Wirkungen
besprochenen Tiere, Pflanzen, Mineralien, Steine und Erden alphabetisch erfaBt. Die zahlreichen
schwarz-weiBen und bunten Hilder sind iiuBerst instruktiv. Das Buch (528 Seiten Text) verdient viet
Aufmerksamkeit und ist nicht nur fiir U niversitiitsbibliotheken und Volkerkundemuseen zu empfehlen,
sondern ist auch ein wertvoller Besitz in der Biicherei eines jeden Ethnomediziners. Da es eine
Fundgrube von Spezialwissen ist, wiire eine Obersetzung in eine andere europiiische Sprache sehr zu
begriiBen.
E. PUSCHEL
Gotthilf Heinrich Schubert, Gedenkschrift zum 200. Geburtstag des romantischen Naturforschers.
Hrsg. v. A. Rossler. Erlanger Forschungen, Reihe A, Bd. 25. Erlangen, 1980, 148 pp., (no price stated).

Die von A. Rossler herausgegebene und mit einer informativen Einleitung versehene Sammlung von
Aufsiitzen gilt dem Gediichtnis eines Mannes, der heute weniger als Naturforscherdenn als Wegbereiter
der psychoanalytischen Erforschung des Traumes und des UnbewuBten bekannt ist. Mit der Stellung
Schuberts innerhalb der romantischen Naturforschung befaBt sich eingangs D. v. Engelhardt, der aus
seiner umfassenden Kenntnis der romantischen Naturphilosophie die 'diszipliniire Weite des Naturphilosophen' sowie die teils enthusiastische, teils distanziert-ironische Rezeption Schuberts durch
seine Zeitgenossen in groBen Linien nachzeichnet, jedoch eine niihere Durchleuchtung Schuberts als
Naturforscher streng vermeidet. So bleibt unklar, welche konkreten Erkenntnisse und selbstiindigen
Beitriige auf dem Gebiet der Naturforschung Schubert - abgesehen davon, daB er heute 'zu gegen-

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wiirtigen Oberlegungen iiber Ziele und Grenzen der Naturwissenschaft' anregen kann - wirklich
geleistet hat. Dem miihsamen Geschiift, an einem einzelnen, allerdings nicht unwichtigen Problem,
niimlich der Artenfrage, Einblick in die besondere Methode der spekulativ-metaphysischen Naturerkliirung zu gewinnen, unterzieht sich mit Erfolg H. Querner. Seine sorgfiiltige Analyse erlaubt den
iiberraschenden Nachweis, daB Schubert nicht nur an eine idealgenetische Verwandtschaft der Organismen, sondem sogar zeitweilig an einen kontinuierlichen realgenetisch fundierten Artenwandel
geglaubt, diesen Gedanken aber nicht konsequent verfolgt hat. Schuberts konkrete Verdienste im
Bereich des Bildungswesens, als Lehrer und Rektor des neu gegriindeten Realgymnasiums in Niimberg
beleuchtet A. Geus auf dem Hintergrund der Entwicklung des Realschulwesens in Bayern. Anhand der
Zeugnisse ebenso wie der Kurzlebigkeit dieser Anstalt (1809-1816) gewinnt man allerdings den Eindruck, daB Schuberts Leistungen sich mehr im Entwurf und in der Idee denn in dem unmittelbar
praktisch-naturwissenschaftlichen U nterricht erschopften.
Der iiberwiegende Anteil der Beitriige gilt den von religiosen Vorstellungen gepriigten naturphilosophischen Anschauungen Schuberts, die vor allem in einem seiner Hauptwerke, der S y m b o I i k des
Traumes, deutlich zum Ausdruck kommen. Diese Schrift untersucht X. Tilliette im Vergleich zur
Weltanschauung Schellings, die sich Schubert in reichem MaBe zu eigen gemacht hat. Aus der kritischdistanzierten Betrachtung geht hervor, wie bei Schubert die anfiingliche Naturbegeisterung schon bald
in eine Naturandacht umschliigt. Diese Entwicklung liiBt verstehen, daB Schubert, anders als spiiter
Freud, der den Traum als erstes Glied in der Reihe abnormer psychischer Gebilde auffaBte, die
Traumsprache auf eine Ebene mit geheimer Offenbarung, Prophetie und Vision stellte, so daB die
Symbolik des Traumes fiir Schubert mehr zur Entriitselung der Natur als zur Entschliisselung des
Menschen diente. Wenngleich sich gelegentlich auch Parallelen zu Gedanken Freuds und zu lung
ziehen lassen, so verschweigt X. Tilliette doch nicht die Schwiichen dieser, von romantischer Stimmung
und Gefiihl getragenen Traumwanderung, die bemerkenswerterweise selbst Schelling abgestoBen hat.
DaB Schubert ohne Zweifel die · Seelenkunde' als zentrales Problem seiner wissenschaftlichen Tiitigkeit
zeitlebens beschiiftigt hat, geht deutlich aus der Korrespondenz mit dem Verleger Cotta hervor, der die
vier Auflagen der 'Geschichte der Seele' betreute. Der Briefwechsel, der von D. Kuhn mit ausfiihrlichen
Erliiuterungen in dem vorliegenden Band erstmals publiziert wird, zeigt die Miihe und Sorgfalt, die
Schubert sowohl auf die Erganzungen und Anderungen als auch auf die Lesbarkeit des Textes verwendete, und liiBt erahnen, wie sehr Schubert dieses Werk, das nach seinen eigenen Aussagen das
'Beste und lnteressanteste, was ich wiihrend meines Pilgerlaufes auf Erden an Erfahrungen und
Erkenntnissen mir erworben habe', enthielt, als eine Herzens- und Glaubensangelegenheit betrachtete.
Der sich anschlieBende, von H. Weigelt edierte sporadische Briefwechsel Schuberts mit Amalie
Sieveking ist weniger aufschluBreich fiir die Personlichkeit Schuberts, indes urn so wichtiger fiir die
historische Entwicklung der Diakoniebewegung. Der vorziiglich dokumentierte und mit umfassenden
bibliographischen Angaben versehene Band schlieBt mit einigen, von W. Hahn zusammengetragenen
Zeugnissen iiber Schuberts enge Verbindung zum Kreis der Erweckungsbewegung, die die friihe
Hinwendung Schuberts zu mystisch-theosophischen Stromungen und die eindeutige Dominanz des
Naturphilosophen iiber den Naturforscher belegen.
IRMGARD MULLER
John A. Shepherd, Lawson Tait: The Rebellious Surgeon ( 1845-1899). Lawrence, Kansas, Coronado
Press, 1980, xv, 249 pp., contains bibliography ofTait's publications (328 items), and II illustrations (no
price stated).
A.J. Youngson, The Scientific Revolution in Victorian Medicine. New York, Holmes and Meier
Publishers, Inc., 1979,237 pp., $22.50.
At a minimum, a biographer must paint a sympathetic view of his subject that enables the reader to

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assess the role which the subject played. What is curious about John Shepherd's biography of Lawson
Tait (1845-1899), provincial British gynecological surgeon, is that Shepherd spends so much of his
volume painting an unsympathetic picture ofTait's short, cantankerous career. Only in the concluding
chapter does a balanced assessment appear and by then the author's conclusion does not quite fit the
rest of the book.
Educated at Edinburgh University and at the Extramural School of Medicine, Tait fell under the
lasting influence of James Syme and James Simpson. In 1867, he became house surgeon at Clayton
Hospital and the Wakefield Dispensary, and three years later he set up his practice at the 'makeshift'
Birmingham and Midlands Hospital for Women. In 1878, after attaining a degree of fame, Tait opened a
private hospital for women.
Tait' s hospital affiliation led him to contribute in the field of gynecological surgery. Tait was a radical
surgeon in a period when the profession was generally conservative. He pioneered in ovarian surgery,
operative management of ectopic pregnancy and excising of uterine fibroids. Tait advocated the bold
step of exploratory laparotomy when the diagnosis was uncertain. His radical bent drew criticism from
conservative colleagues, but Shepherd maintains that it was Tait's abrasive personality, self aggrandisement, and quickness to expose the faults of others that led to his unpopularity.
Central to Shepherd's book are two chapters, one dealing with Tait' s lifelong opposition to Listerism,
the other dealing with Tait's personal relationship to Charles Darwin. In neither chapter does Tait
emerge in a favorable light. Shepherd maintains that there were respectable reasons to oppose Lister;
for example, other surgeons achieved similar operative successes with the much simpler technique of
cleanliness and that in 1867 Lister had not shown definitely that germs caused suppuration. But
Shepherd does not show that Tait maintained these arguments, but rather that he was poorly read and
illogical and that he based his opposition on 'shaky analogies' to Darwin. Shepherd's most plausible
explanation ofTait's opposition to Lister was that his teachers, Syme and Simpson, also opposed Lister
and that Tait simply was never able to grow beyond his schooling. Shepherd presents lengthy correspondence (1871-1882) between Tait and Charles Darwin largely, I think, to place Tait on the right
side of at least one major scientific issue, evolution. What emerges from the correspondence, however,
is that Tait seems to have pestered Darwin with his own unoriginal work and that Tait may not have
always fully understood Darwin. Darwin comes across as patient, kind, and sparing of deserved
criticism.
Tait dropped rapidly from professional sight in the 1890's. He became involved in a messy litigation
after accusing a general practitioner of mishandling a case. Tait himself was accused of seducing a nurse.
In addition, he fell ill to kidney stones and seems to have developed progressive renal failure. Together
these events led him to retire from public life.
Tait is a complicated figure who would tax the abilities of any biographer. He was not quite a hero yet
something short of villain. I think the book could have been stronger had Shepherd sorted out the
ambiguities and made his own interpretation clear from the start.
Although the title ofYoungson's volume suggests a synoptic view of Victorian Medicine, its subject is
much more limited in scope. Instead the author, Director of the Research School of Social Sciences at
the Australian Natural University, asks why some medical ideas are so vigorously resisted; in
particular, why did British physicians resist anesthesia (especially with chloroform) and Listerism.
Youngson tries to assess what role pain has played in the history of surgery. As evidence of pain's
importance, he points to the reluctance of patients to submit to operations, the unwillingness of some
surgeons to inflict pain, the lightning speed of many operators and the relatively few operations actually
performed. Youngson does not consider some of the wider issues concerning pain: just what role pain
played in society; many medical procedures besides surgery were painful, for example, purging and
venesection; and even after the introduction of anesthesia, pain remained (just ask anyone who has
undergone surgery).
Resistance to chloroform in surgery was shortlived with most critics focusing on the real dangers of
over- and under-anesthesia. In midwifery, the discussion was longer, 'less scientific' and more
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emotional. Critics rightly pointed out that labor took far longer than shmt-lived operations and that there
were no firm data on how chloroform effected uterine contractions. For the most part, obstetricians
accepted anesthesia fairly quickly because their patients demanded it. A few obstetricians held back
because they thought childbirth without pain was unnatural.
Youngson finds the resistance to Listerism much more complex. Lister was grave, unapproachable,
and occasionally insulting. His method constantly shifted and surgeons frequently confused the virtues
of carbolic acid with antisepsis. One reason for poor initial acceptance was that Lister did not convince
surgical leaders. Some doubted the germ theory; others confused that debate with concern over the
deplorable state of the hospital; still others opposed anything too closely associated with Scottish
medicine.
In a final chapter, Youngson raises some additional reasons for resisting chloroform and Listerism.
Perhaps reluctance to use chloroform in midwifery resulted from a 'medley of deepseated Victorian
male prejudices'. Youngson suggests that a major reason why older surgeons opposed Listerism was
that antisepsis changed the style of operating to 'careful, not spectacular, surgery' and that it forced
surgeons to account for post-operative infections. These are intriguing ideas, but they are not explored
or documented in any way. Youngson proposes a general model for the resistance to medical ideas
which explores the complex relationship between the innovator, the idea and the audience (both medical
and non-medical). This model is again interesting, but it is not well integrated into the rest of the book.
Youngson illustrates his points with many good primary sources. For example, there are nice
descriptions of operating rooms and medical student examinations. Unfortunately, his chapter notes
omit much of the secondary material on anesthesia, antisepsis and germ theory. Even more surprising,
he refers to none of the considerable research on the resistance to accepting these ideas.
PETER C. ENGLISH
Peter Temin, Taking Your Medicine. Drug Regulation in the United States. Cambridge, MA, Harvard
University Press, 1980, VII, 274 pp., cloth, U.S. $18.50.
Richard Blum, Andrew Herxheimer, Catherine Stenz!, Jasper Woodcock, eds., Pharmaceuticals and
Health Policy. International Perspectives on Provision and Control of Medicines. New York, Holmes &
Meier Publishers, 1981, 272 pp., cloth, U.S. $37.50.
Both of these books deal with the question of the provision and regulation of drugs. Temin 's book,
however, is the work of a single author and deals specifically with the subject of drug regulation in the
United States. The volume edited by Blum et al., on the other hand, is a collection of essays by a number
of authors and deals with the use, distribution and control of medicines internationally.
Neither of these books is primarily a history of the subject under consideration. Of the two, the Temin
volume will be of much greater interest to historians, although the book is not, as the title might suggest,
a general history of drug regulation in the United States. It is rather an evaluation and critique of the
development and present status of federal drug controls, with heavy emphasis on the requirements for
pre-market testing of new drugs and the division of drugs into prescription and over-the-counter
categories.
Temin's book will be of value to anyone interested in drug regulation and its history in the United
States. As an economic historian, he draws heavily upon economic and social science theory and
models in analyzing his subject. Historians will benefit from Temin's insightful interpretations of the
processes of drug marketing, the behavior of consumers and physicians with respect to drug selection,
the consequences of government regulatory policies, etc. His historical overview will be useful and
stimulating to the informed reader, but not the best introduction to the subject for those with little
background in the history of drug regulation.
Temin too freely makes unsupported and questionable historical generalizations and statements.

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What evidence is there, for example, that licensing laws for the health professions came about largely as
an effort to oppose the threatening monopoly power of large corporations? It fits in with the author's
theory to say that the Food and Drug Administration (and its predecessor agency) consciously changed
its strategy from one of encouraging instrumental behavior amongst consumers to one of supplanting the
market with hierarchical arrangements, but Temin hardly offers compelling evidence for this point of
view. To state that the drug industry in the 1930's 'did not advertise to doctors' and 'did not engage in
large-scale research' is simply inaccurate. There were no animal studies that demonstrated, as the
author claims, the usefulness of 'primitive penicillin' in the nineteenth century.
In spite of these deficiencies, Temin's book is well worth reading by anyone interested in drug
regulation. He offers some interesting suggestion for reform, although this reviewer was disappointed
that his recommendations were not more concrete and extensive, especially in the light of his
penetrating discussion of the issues involved. Temin is basically in favor of allowing people to make
more choices for themselves in the drug field, although trying to make sure that their choice is an
informed one. He would, e.g., allow people to choose Laetrile as a cancer treatment.
The volume by Blum et al. contains essentially no history. It too will be of value, however, to those
interested in drug control, especially since it attempts to deal with the subject (as most works in the
literature do not) on an international scale. The essays are uneven in length and quality, but all offer food
for thought. Topics covered include, in part, the introduction and promotion of drugs, factors affecting
individual use of medicines, economic considerations in the provision of medicines and the role of
international organizations in drug policy.
JOHN PARASCANDOLA
James Turner. Reckoning with the Beast. Animals, Pain, and Humanity in the Victorian Mind. Baltimore, Johns Hopkins University Press, 1980. XII, 190 pp., illus., cloth, US $14.-.
James Turner traces the emergence of the kindness-to-animals movement from its obscure eighteenth-century roots to its proto-ecological transformation near the end of the Victorian era. To explain
the rise of compassion for animal suffering, he invokes the great nineteenth-century processes of
industrialization and urbanization. Turner argues that the move toward the factory and the city, together
with scientific developments such as Darwinism and the efforts of the physical anthropologists that
reinforced man's kinship with the animals, created deep psychological stress and trauma, which in turn
produced a new and distinctively modem revulsion toward pain and suffering. For Turner, the animal
protection movement, encompassing vegetarianism, antivivisection, and the establishment of societies
for the prevention of cruelty to animals, provided a 'kind of therapy' to relieve the tensions incurred by
an agrarian society groping toward modernization. Although kindness to animals did not represent the
only available option for the groundswell of humanitarian sentiment, according to Turner, it was
perhaps the safest outlet, because it posed no threat to the existing social and economic order.
Of most interest to medical historians are Turner's chapters on the Anglo-American antivivisectionists and their polemical battles with medical scientists and physicians. For the British
anti vivisectionists, Turner relies almost exclusively on Richard French's indispensable volume Antivivisection and Medical Science in Victorian Society andoffersfewnewinsights.
He does make an original contribution to the historiography of the American movement, exploiting
hitherto unused and unpublished materials. Chronicling the legislative battles of the antivivisectionists
and their foes, he explores the Victorian ambivalence toward science and the antivivisectionist fear of
the moral and religious decay it seemed to forbode. Curiously, he omits discussion of the threat medical
scientists brandished in support of unrestricted animal experimentation: if animals were unavailable,
man would be the experimental subject. Turner gives scant attention as well to the efforts of the A.M.A.
in combatting the antivivisectionists and at times treats physicians as an homogeneous group, which
does injustice to the complex allegiances and prejudices of American practitioners.
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Turner characterizes the activities of the British and American animal protectionists as essentially
similar. Although the movements shared many points of reference - indeed, in many instances the
American experience was largely derivative from the British - there were distinct differences that
Turner leaves unaddressed. Why, for example, did the American campaigns to limit experimental
medicine flourish in the 1890s and 1900s when, according to Turner, this was precisely the time when the
antivivisectionist position became untenable because of the discovery of diphtheria anti-toxin?
Turner's volume is a much-needed study of the animal protectionists and the controversies they
provoked. However, his explanation of the psychological traumas of modernization and the therapeutic
embrace of kindness to animals remains elusive. In his search for the hidden meanings and unconscious
desires of the animal protectionists, Turner seems not to consider the possibility that some humanitarians were genuinely concerned about animal suffering and eager to alleviate abuses. Although many
of the antivivisectionists passionately stretched the bounds of credibility in their quest to abolish
vivisection, some reformers soberly sought to restrict the activities of medical scientists in order to
forestall unnecessary cruelty. For such men and women, vivisection cut both ways: it was a necessary
scientific tool the cost of which in animal suffering could be minimized by stringent legislation-and
prudent policing.
SUSAN EYRICH LEDERER
Paul U. Unschuld, Medizin in China, Eine Ideengeschichte. Miinchen, C.H. Beck, 1980, 335 pp., paper,
DM38.-.
Undoubtedly, there is an increasing interest for traditional Chinese medicine in the West and
discussions about the question whether for instance, acupuncture should be considered a science or a
pseudo-science are still continuing. In China however, traditional medicine is still practised in every
hospital and propagated by the government and this fact alone shows another way of approaching the
human effort to protect or to restore this balanced situation known as health. What is missing in all these
discussions is the realisation that medicine cannot be understood apart from the anthropological model
it is based upon; a model which is related to a philosophical approach oflife.
In his new work P.U. Unschuld, already known as the author of Pen-tsao, 2000 Jahre
t radi tionelle Pharmaze uti sc he Lite ratu r Chinas (1973), makes a study of the medicinal
concepts throughout the various periods of Chinese history starting from this ideological background. In
this way he throws light on the sense and the meaning of some medical and pseudo-medical practices,
which developed during the long history of China and which were typical of the various periods. For this
reason, the book is not only a contribution to the history of medicine, but also to philosophical ideas and
social or economical situations, i.e. to the history of Chinese culture as a whole. It is true indeed that
many studies on the technical aspects of Chinese medicine are already at our disposal, but are still highly
in need of an anthropological study of traditional medical science.
It is a very long evolution from the medical practices ofthe oracle bones, the demonical medicine, the
religious medicinal practices and the medical sciences of recipes, to Buddhist healing, the correlational
medicine and finally modern western medical science, while all of them have been influencing the
Chinese medical arts. Naturally, next to the new forms and concepts, the older ones remain in practice,
even up to the present day.
In the first chapter, Unschuld gives a description of medicine in the Shang-period, relying on the
oracle-bone inscriptions. Disease was regarded as being caused by critical situations, e.g. in the
harmonica! relation with the ancestors, but also by natural circumstances. Both these approaches of the
phenomenon 'disease' will dominate medicine for centuries. On the one side, demonology develops
during the Chou, whereas the concept of structural similarities ("systematische Entsprechungen",
systematic correspondences) is a typical feature of the doctrine of the Yin-yang and the Five Phases
(wrongly called the Five Elements). At the same time the knowledge of medicinal herbs was in the first
place a result of Taoist studies.
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With Buddhism, Indian ideas reached China, but as we can note in other fields of science, there was
no strong influence and few Indian concepts were incorporated into traditional Chinese medicine. Unschuld characterizes the Sung-period as 'Progress with a look backwards' (Fortschritt mit dem Blick
zuriick) and indeed, under the influence of Sung rationalization, the old medical science was systematized. This process was prolonged during the Ming-period. In the Ch'ing-period western medicine
was introduced in China.
Unschuld describes his method as follows: Needham only looks for the valuable Chinese contributions to world-medicine and elucidates what still lasts in the light of modern science. Porkert's
approach consists of describing the 'alternative' aspects of Chinese medicine and according to Unschuld, this approach is too selective to provide a general image. In contrast with these methods he tries
to understand Chinese medicine itself, attempting to approach the subject historically as well as
systematically. This is indeed the only way of elucidating Chinese medical science as a part of Chinese
culture, and at the same time the great value ofUnschuld's work.
U nschuld points out three fundamental paradigms of medical thinking in general: the correspondence
of phenomena as the basis of magical medicine; the belief in invisible persons on which the medical art,
explaining diseases caused by ancestors, demons or deities, relies; the linear-causal laws underlying
modem medical science, a· part of applied natural science. On the other hand, it is true that social
circumstances are influencing medicine: these are political, economical and structural in nature. When
new concepts arise, the older ones keep living on in peripheral social groups.
Unschuld's book is very clarifying, because there are indeed several good technical descriptions of
medical practices, but in very few studies the link with philosophical and ideological backgrounds has
been made.
In conclusion, U nschuld' s approach can lead to a correct understanding ofthe sociological dimension
of a science, not as an isolated abstraction, but integrated in a living society. This book undoubtedly is a
milestone, also for the history of science in general which should always be studied in relation to the
culture from which it originates, and not as a single marginal development of a separate human activity.
Science is an important aspect of all cultures; in this sense, Unschuld's book is also very valuable for the
pure methodological approach of the phenomenon 'science' in general and an excellent example for
future studies.
ULRICH LIB BRECHT

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J.-M. Charcot et Paul Richer

J.-M. Charcot et Paul Richer

Les difformes et les malades
dans l'art

Les demoniaques dans l'art

Reprint of the edition Paris, 1889.
4to. 87 text-illustrations (partly renewed)
(VIII, 162 pp). Cloth binding.

Reprint of the edition Paris, 1887.
4to. 67 text-illustrations (partly renewed)
(116 pp). Cloth binding.

ISBN 90.6078.059.0

ISBN 90.6078.060.4

Hfl90,-

Hfl80,-

Medicine and Art

Charcot was a talented artist; he
collaborated with. Richer, artist at
'La Salpetriere', the greatest clinic of his
time for diseases of nervous system, in the
production of interesting books on disease
and deformity as portrayed by artists,
books which have put the study of
medicine in relation to art upon a sound
footing.
(Garrison & Morton nr. 660516; Semelaigne,

Les Pioniers de la psychiatrie
frant;aise !l, pp.716-725;
Garrison, Contributions pp. 82617)

Both books together

HfllSO,-

B. M. ISRAEL BY.
N.Z. Voorburgwal264

AMSTERDAM

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Contributors to this issue
ACKERKNECHT, ERWIN H., is emeritus professor of medical history in Zurich, Switzerland, and
the author of 12 books, among them Malaria in the Upper Mississippi Valley (1700-1900), History and
Geography of the Most Important Diseases, and Short History of Psychiatry. At present he is working
on the history of the "diseases of wealth".
ALTSCHULE, MARK, D., is currently Honorary Curator of Prints and Photographic Materials,
F.A. Countway Library of Medicine; trustee and former president of the Boston Medical Library;
president of Totts Gap Institute, Bangor, Pennsylvania; and biomedical consultant, Office of Naval
Research, Boston. He was in the Harvard Medical School class of 1932. His last book was The
Hypovolemic Anemia of Trauma (with C.R. Valeri). His next is a history of clinical medicine.
ANDREWS, MARGARET W., is an Assistant Professor in the History Department of Washington
State University. She received the Ph.D. from the University of British Columbia in 1979; her
dissertation, supervised by John M. Norris, was on medical services in Vancouver, B.C., 1886-1920.
Her work has appeared in BC Studies and the Journal of Canadian Studies. She is currently working on
the early history of public health services in B.C. and the northwestern U.S. and on the background and
professional reaction to health insurance.
BINET, JACQUES-LOUIS, ne a Paris 1932; maitre de conferences agrege d'hematologie, medecin
des Hopitaux 1964; Professeur a Ia Faculte de medecine 1973; Chef du Departement d'Hematologie du
Centre Hospitalier U niversitaire de Ia Faculte de Medecine Pitie-Salpetriere 1974; Redacteur en chef de
Ia Nouvelle Revue Franr;aise d' Hematologie 1981.
BREEDEN, JAMES 0., Ph.D., is Associate Professor of History, Southern Methodist University,
Dallas. His research specialty is the history of science and medicine in the American South. He is
currently preparing a social history of southern science.
DIECKHOFER, KLEMENS, Prof. Dr. med., assoc. prof.; b.: Bonn, 1938. EDUC.: studied med.,
psychology, and Latin philology at Univs. of Bonn and Munster/Westphalia. Qual.: 1968, doctorate;
1974, habil. in neurology and psychiatry (Prof. Weitbrecht); 1975, habil. in hist. ofmed. (Prof. Mani) and
permanent collaborator in the Institute ofHist. ofMed. Bonn. Univ. Car.: asst., RWTH Aachen, dept.
of neurology and Clinic for Nervous Diseases, Bonn Univ.; 1972, med. specialist; since 1974 sen.
psychiatrist, Clinic for Nervous Diseases, Bonn Univ.; 1979, assoc. prof., Bonn. PUBL.: some 50
pubis. in trade journals on psychopathological and medico-hist. problems, 4 book contbns. and monograph: El desarollo de Ia psiquiatria en Espaiia. Madrid, 1980. MEM.: Dtsch. Ges.f.Geschichte der
Medizin (hist. ofmed.); Allg. Arztl.Ges.f.Psychotherapie (psychotherapy).
ENGLISH, PETER C., AB Chemistry, Duke 1969; Ph.D. History, Duke 1975; M.D. Duke 1975, is
assistant professor of History and of Pediatrics. His special area of teaching focuses on the role of
epidemic diseases and public health in the history of racial groups that have come to comprise the
Western Hemisphere. Past research has centered on the history of surgery, and he has recently
published Shock, Physiological Surgery, and George Washington Crile: Medica/Innovation in the
Progressive Era, Greenwood Press 1980. He has shifted research interests to study the history of
children, concentrating on the foundling homes and orphanages as precursors both to children's
hospitals and to foster care.

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Contributors to this issue

FYE, W. BRUCE, Chairman, Department of Cardiology, Marshfield Clinic, Marshfield, Wisconsin,
and Adjunct Assistant Professor of the History of Medicine, University of Wisconsin Center for Health
Sciences, Madison, Wisconsin. He is working on a major study of the professionalization of physiology
in America and serves as the President of the Marshfield Medical History Club.
GLICK, THOMAS F., is professor of history at Boston University. He is the editor of The
Comparative Reception of Darwinism (1974) and Science and Revolution (forthcoming) and is
interested in the impact of modem scientific ideas in Spain and Spanish America.
HALL, THOMAS S., is an historian of physiology whose chief publications have been a history of the
scientific effort to distinguish living from nonliving things, ca 700BC- 1990AD, an annoted first English
edition of /'Homme, the major medical treatise of Rene Descartes; and several journal articles on these
and related topics. He is currently University Professor Emeritus of Biology and the History of Science,
Washington University, Saint Louis, Missouri 63130 and engaged on a planned book-lenght assessment
of the importance of Descartes to the history of medical thought.
HUDSON, ROBERT, M.D., is Professor and Chairman, Department of the History and Philosophy
of Medicine, University of Kansas Medical Center, Kansas City, Kansas. He has just completed work
on a conceptual history of disease.
LEDERER, SUSAN EYRICH, is a doctoral candidate at the University of Wisconsin, Department
of the History of Science, where she is currently working on a dissertation on the American antivivisectionists and the controversy over human experimentation.
LIBBRECHT, ULRICH, Ph.D., Professor in Classical Sinology at the university of Leuven,
Belgium. Licenciate of the unjversity of Ghent, Ph.D. of the university of Leiden, Netherlands.
Specialisation: history of Chinese science, Chinese logical thinking. Author of Chinese Mathematics in
the 13th century, M.I.T. Press, 1973, and of several books and articles on the history of mathematics and
philosophy.
LINDEBOOM, GERRIT A., Prof. Dr., (b. 1905), emeritus-professor of Internal Medicine and
Medical Encyclopedia at the Free University in Amsterdam (195~75), published, apart from many
medical articles and several books, and also medico-historical articles, several biographies (of K.F.
Wenckebach (1965), Reinierde Graaf(l973), Florentius Schuyl (1974), and A. van den Spiegel (1978), all
in Dutch; in English of Herman Boerhaave (1%8, London)). Furthermore, he published, inter alia, 3
volumes Boerhaave' s Correspondence (1%2, 1964, 1979, Leiden), Bibliographia Boerhaaviana (1959)
and Iconographia Boerhaavii (1%3), and The Letters of Jan Swammerdam to Melchisedec Thevenot
(1975, Amsterdam).
LOUX, FRAN<;OISE, Chargee de recherches au Centre national de Ia recherche scientifique, Centre
d'ethnologie fran'<aise, Musee des Arts et Traditions populaires, Paris. Recherches sur Ia medecine
populaire fran'<aise, les soins au corps et leurs significations, Ia petite enfance. Livres: Lejeune enfant et
son corps dans Ia medecine traditionnelle, Flammarion, 1978; Sagesses du corps: proverbes populaires
relatifs Ia sante et Ia maladie, Maisonneuve et Larose, 1978; Le corps dans Ia societe traditionnelle,
Berger Levrault, 1980; L'ogre et Ia dent, Berger Levrault, 1981.

a

MCGEHEE HARVEY, A., M.D., is the Distinguished Service Professor of Medicine, Johns Hopkins
University of Medicine, Baltimore, Maryland, U.S.A. He is the author of Science at the Bedside:
Clinical Research in American Medicine 1905-1945 just published by the Johns Hopkins University
Press.

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Contributors to this issue

191

MEIER, RICHARD Y., received his Ph.D. from the university of Chicago, 1979. He worked for the
Department of Special Collections, Library of the Health Sciences, University of Illinois at the Medical
Center, Chicago till 1981. Now postdoctoral fellow at the Institute of the history of medicine at Johns
Hopkins University.
MULLER, IRMGARD, born 1938 in Dusseldorf, studied pharmacy in Freiburg/i.Br. and graduated
in 1962. In 1%3 she was a certified chemist. She then studied history, history of medicine and history of
pharmacy in Freiburg, Bonn and Dusseldorf. In 1969 she took her doctor's degree in natural sciences at
the Dusseldorf University with a thesis on the supply of medicaments aboard the sailing vessels. From
1969-76 scientific assistent at the Institute for the History of Medicine at Dusseldorf University. From
1970 on several annual stays at the Zoological Station for the research of oceanic biology in Naples
(supported by the Deutsche Forschungsgemeinschaft). In 1976 habilitation in history of pharmacy and
natural sciences in Dusseldorf. Since 1977 professor for the history of medicine at Marburg University.
Publications in the fields of the history of drugs and medicaments, history of naval medicine and naval
pharmacy, history on oceanic biology and the history of medicine.
0 'NEILL, YNEZ VIOLE, is an Associate Professor of Medical History, UCLA School of Medicine,
Los Angeles, California. Her book, Speech and Speech Disorders in Western Thought before 1600, was
published in 1980, and she is presently preparing a study of the early history of anatomy and physiology
for publication. Several of her articles have appeared in Clio Medica as well as in other scholarly
journals.

PARASCANDOLA, JOHN, is professor of the History of Pharmacy and History of Science,
University of Wisconsin-Madison, and editor of the recent work History ofAntibiotics. A Symposium
(1980). He is currently working on a study of John Abel and the development of pharmacology.
PETERSON, M. JEANNE, is an Associate Professor of History at Indiana University, Bloomington,
and an Associate Member of the Department of the History and Philosophy of Science there. Social
history is her major research interest, reflected in her book, The Medical Profession in Mid-Victorian
London. She is currently working on a study of the Paget family, well-known in Victorian England for
the medical men it produced.
PUSCHEL, ERICH, Prof. Dr. med. habil., former director of Landes-Kinderklinik Bochum, now
prof. of history of medicine at Bochum University. Grad. 1931. Publ.: more than one hundred papers on
pediatrics and history of medicine.
ROLAND, CHARLES G., is Jason A. Hannah Professor of the History of Medicine at McMaster
University, Hamilton, Ontario, and Secretary-Treasurer of the American Osler Society. His historical
research centers on Canada, particularly in the 19th century; he has in preparation a bibliography of
secondary sources in the history of medicine in Canada.
THEODORIDES, JEAN, Prof. Dr., 16, Square Port Royal, 75013 Paris, France.
WONG, MING, Membre effectif de I' Academie internationale d'histoire de Ia medecine, Maitre de
recherche (Medaille de bronze du C.N.R.S.), Ingenieur l.T.A., dirige actuellement le 'Groupe de
recherches sur l'histoire de Ia medecine chinoise' de l'l.R.U. (lnstitut de recherche universitaire,
Universite de Paris XII).

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JULIUS HIRSCHBERG
THE

HISTORY
OF

OPHTHALMOLOGY
ELEVEN VOLUMES
translated by Frederick C. Blodi, M.D.
Professor and Head, Department of Ophthalmology
The University of Iowa

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The beginning of quantification in physiology
EMIL SCHULTHEISZ
In the history of medicine it is uncertain what time can exactly be mentioned as
'the beginning' of the physiological era. Personally, I am convinced that clinical
and non-clinical medicine did not develop separately, but that their history nearly
followed the same path. So its beginning must have been in the time which I would
like to call the 'classical-background-period' of modem, partly experimental medicine, both in the clinical and the non-clinical disciplines.
It is generally known that non-clinical medicine is not equivalent to experimental
medicine. It might be said that experimental medicine started to develop in the
renaissance, but its predecessor is Herophilos. Markellinos writes:
Herophilos placed such a great faith in the frequency of the pulse as a reliable symptom that he
constructed a clepsydra with a capacity corresponding to the normal pulse beat at each age. In
visiting patients he set up the clepsydra and felt the pulse of the feverish, then the more the pulse
beats exceeded the normal number by time the clepsydra was filled, all the more was the pulse
accelerated, according to his explanations, that is to say the more or less was the fever.'

Nicolaus ofCusa (1401-1464) was an abundantly productive writer: in addition to
his theological writings he touched upon various topics such as law and government, metaphysics, astronomy, philosophy and science. The works of Nicolaus
Cusanus were widely known to scholars of that time. Therefore it is not surprising
that the subject of later experiments and the way of thinking of van Helmont are
very similar to those found in Cusanus' Idiota de Static is Expe rimentis.
The 'Idiota' comprises four books: De Sapientia (two books), De Mente
and De Staticis Experimentis. This work was finished in September of
1450. The four books of the 'Idiota' have been written in the dialogue form in which
Cusanus' opinions are expressed by the Idiot or citizen (i.e. the layman, in modem
terms) in response to the questions posed by the Orator.
The style of communication between the 'Orator' and the 'Idiot', and the concept
of the knowledge that can be gained by understanding the differences existing
between Orator and Idiot are both clearly revealed in the passage quoted from a
later English translation of 1650 (printed for W. Leake, London).
Author: In the Roman forum or market place, a certain poor Idiot or private man, met a very rich
Orator, whom courteously smiling he thus spoke unto:
Orator: How canst thou being an Idiot, be brought to the knowledge of thy ignorance?
Idiot: Not by thy bookes, but Gods books.
Orator: Which are they?
Idiot: Those which he wrote with his own finger. 2

Clio Medica, Vol. 17, No. 4, pp. 193-197 ©B.M. Israel, Amsterdam, The Netherlands
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194

Emil Schultheisz

The Idiot claims that such a work would be most welcome, whereupon the Orator
attests that no man could do better than the Idiot. Lack of 'leisure' keeps the Idiot
from performing the work.
The Orator states:
Tell me the profit of it, and the meanes how to doe it, and I will see that I my selfe, or some other,
at my entreaty can doe at it.
Idiot: By the differences of weights, I think wee may more truly come to the secret of things, and
that many things may be known by a more probable conjecture. J

Then the text continues with about 15 pages concerned with devices whereby the
virtues of stones may be weighed. Then the Orator continues:
Orator: These be fine things, but might not the same be done in Herbs, and all kinds of woods,
flesh, living creatures, and humors?
Idiot: In all I think. For weighing a piece of wood, and then burning it thoroughly, and then
weighing the ashes, it is knowne how much water there was in the wood, for there is nothing that
hath a heavier weight but water and earth. It is knowne moreover by the divers weight of wood in
aire, water and oyle, how much water that is in wood, is heavier or lighter than clean spring water,
so how much aire there is in it. So by the diversity of the weight of the ashes, how much fire there is
in them: and of the Elements may bee forgotten by a nearer conjecture though precision be
inattaingible. And as I have said of Wood, so may be done with Herbs, flesh, and other things. 4

The ideas which made John Dee (1570), the well-known physician, praise Nicolaus ofCusa's quantative use of the balance 5 derive from the principles recorded in
'De Staticis Experimentis', while they also prompted Santorio Santorio to write his
De Statica Medicina6 in 1614. In the same tradition Stephen Hales wrote his
Vegetable Staticks (1727), to form a part of his two volume Statical Essays (1738) later and which is regarded as the first English treatise on plant
physiology 7 •
Cusa essentially begins with the sceptical idea of the impossibility of attainment
of perfect or complete knowledge of this earth, and furthermore the need to
approach the truth by short, incomplete steps which are true as far as they go.
These are his 'conjectures' which nonetheless comprehend read knowledge, increasingly subject to continuing experience and participating effectively in truth as
it is, for, with Plato, he believed that 'the knowledge which we have will answer to
the truth which we have'. 8 A natural development of this view was his doctrine of
'Learned Ignorance', that the more we learn, the more we come to a realization of
our own real ignorance in the face of the Infinity.
Cusa's rebellion against the scholastics included a reaction against reason and
logic in learning about God, the Universe, or the world around us. In the metaphysics he makes a distinction between reason and intellect:
Reason must think in opposites. A is either B or not B. A figure is either a circle or not-a-circle. A
square is not-a-circle. To Reason, a circle and a square are separate, yet as the number of sides
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The beginning of quantification in physiology

195

increases toward infinity, the difference between a polygon and circle disappears, and the law of
opposites no longer holds, but a new law appears, the Coincidence of Opposites. This is an act of
intellect. God is of course both Being and Non-Being, and the reconciliation of opposites in Him
gives the real validity to the whole argument. 9

In the physical world, reason and logic are in no greater measure the fundamental
approach to wisdom than observation or measurement, which are so important that
they become practically the etalon of the human mind. This is expressed at the very
first pages, which echo the words of a sermon of Johannes Tauter, one of the
great German mystics (nevertheless, scientist!) who had written that:
The great masters of Paris read big books and turn the pages; this is good, but others read the living
book where everything lives eternally and turn to the heavens and the earth .... 10

This is the beginning of physiological thinking in medicine.
Cusa's association of mind and measurement comes back in the form of a Latin
pun later on:
I think there is not, nor ever was, any perfect man that did not frame some conception of the
mind, such as it was I for my part, have a conception, that the mind is the bond and measure of all
things, and I conjecture it is called Mens a mensurando, the mind from measuring.''

As mentioned before, Cusa's observations in relation to natural philosophy are
to be found in the 'Fourth Booke Concerning Statick Experiments', or 'Experiments of the Ballance'. This book also involves a discussion on the value of
measurement in a complex of varying circumstances. The weight of water is first
considered, recalling Vitruvius who, writing of architectura, bids us chuse such a
place to dwell in, as hath light and airy waters, and avoid them places, whose waters
are heavy and earthy. 12
It goes on to the specific gravity of blood and urine, in sickness and health, at
various ages, and in different countries, then to 'Herbes, Stocks, Leaves, Fruits,
Seeds, and Ju yces' 13 applied in medicine, to be followed by directions for counting
the pulse, letting water run out of a clepsydra 'whilest the pulse of a sound young
man would stick an hundred' and weighing the water as a measure of time. By such
a technique one might, come to the diversity of the pulse in a young man, and an old
man, in a sicke man, and a sound man; and so by consequent, to the truer
knowledge of the disease. 14
In a similar manner the rate of breathing might be measured at various ages and
during diverse infirmities. Other studies might be made on men from different parts
of the world. Then the subject shifts to specific gravities of various substances,

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Emil Schultheisz

196

woods, oils, liquors, metals, and precious stones, and to the measurement of the
power of atttraction of the magnet.
Later the Orator asks:
There is a Saying that no pure Element is to be given, how is this prov'd by the Ballance?

The Idiot replies:
If a man should put an hundred weight of earth into a great earthen pot, and then should take
some Herbs, and Seeds, and weigh them, and then plant or sow them in that pot, and then should
let them grow there so long, untill hee had succesively by little and little, gotten an hundred weight
of them, hee would finde the earth but very little diminished, when he came to weigh it againe: by
which he might gather, that all the aforesaid herbs, had their weight from the water. Therefore the
waters being engrossed (or impregnated) in the earth, attracted a terrestreity, and by the operation
of the Sunne, upon the Herb were condensed (or were condensed into an Herb). If those Herbs bee
then burn't to ashes, mayest not thou guesse by the diversity of the weights of all; How much earth
thou foundest more then the hundred weight, and then conclude that the water brought all that?
For the Elements are convertible one into another by parts, as wee finde by a glass put into the
snow, where wee shall see the aire condensed into water, and flowing in the glass. So wee finde by
experience, that some water is turned into stones, as some is into Ice; and that there is in some
fountaines a hardening and petrifying vertue, which turnes the things that are put into them, into
stone. For so say they, there is a certaine water found in Hungary, which through the power of the
vitriall which is in it, turneth Iron into Copper; for by such powers and vertues, it is manifest that
the waters are not purely elementary, but elementated. 15

Finally the Idiot says:
Experimental knowledge requiereth Ionge writings, for the more they are, so much the more
easily may wee come from the experiments, to the Art which is draw!l from them. 16

After the 13th century there was a pause in the intellectual development of
western Europe as written by Garrison 17 • Nevertheless, Dampier 18 reported that
there was a continual process of change in the intellectual concepts and throughout
this period of transition we can trace the various systems of thought, which in full
vigour, formed the great flood of Renaissance.
The Renaissance was very far from being exclusively literary. Renaissance
medicine has its roots in logical analysis, as well as in certain empiric studies. As
soon as they had thrown away the shackles of scholastic authorithy, the men of
Renaissance used the lessons which scholastic method had taught them. They
began observing in the conviction that nature was consistent and intelligible, and
when they had framed hypotheses by induction to explain their observations, they
deduced by logical reasoning consequences which could be tested by experiment.
Scholasticism had trained them to destroy itself.
The aim of this paper is to outline some of the literary data, which came into
shape under the influence of the late medieval and the renaissance conceptions, in

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The beginning ofquantification in physiology

197

relation to the scientific development of a quantified medical theory, and to illustrate these in the development of Baroque medicine later.
It seems that Nicolaus ofCusa was the first to apply the fundamental principles of
measuring, in which he preceded the e.xperimental practice of van Helmont with
150 years.

NOTES
I. Schone, H., Markellinos' Pulslehre. Festschr. z. 49. Versamml. deutscher Philologen. Basel, 1907,
p. 452.- See also Magazis. G. eta!., Perspectives on Physiological monitoring: Markellinos "On
the pulse". In: Cardiovasc. Res. 1978, 16,83-109.
2. Cusanus, Op. cit., p. 171.
3. Ibid., p. 171-172.
4. Ibid., p. 187-188.
5. Nicolai de Cusa Opera Omnia iussu et Auctoritate Academiae litterarum Heidelbergensis ad
codicum fidem edita. Ludovicus Baur, ed. Lipsiae, 1937. (ldiota is in volume V.) See also:
Schultheisz, E. and Tardy, L., The contacts of the two Dees and Sir Philip Sidney with Hungarii:m
Physicians. In: Communicationes Hist. Artis Med. Supplementum. Budapest, 6, 1972, p. 97-111;
Deacon, R., John Dee- Scientist, Astrologer and Secret Agent to Elizabeth I. London, 1968.
6. Santorio, Santorio, De Statica Medicina Aphorismorum Sectiones Septem cum Commentario
Martini Lister. Lugduni Bataviorum, 1703.
7. Hales, Stephen, Vegetable Staticks or, An account of some statical experiments ... London, 1727,
p. 376.
8. The dialogues of Plato. Ed. B. Jowett. Oxford, Vol. IV, p. 645 (Plato, Parmenides).
9. Hoffman, E., Nikolaus von Cusa. Zwei Vortriige. Heidelberg, 1947, p. 80.
10. Die Predigten Tauleris. Ed. Vetter. Berlin, 1910, p. 421.
II. Cusa, op. cit., p. 59.
12. Ibid., p. 172.
13. Ibid., p. 174.
14. Ibid.,15. Ibid., pp. 188-190.
16. Ibid., p. 191.
17. Garrison, F.H., History of Medicine. New York, 1924, p. 197.
18. Dampier, W.C.,AHistoryofScience. Cambridge, 1966, p. 97.

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New announcement of two medical
biographical dictionaries
Two medical biographical dictionaries of the early nineteenth century will now
appear in one reprint edition. This edition replaces the edition, announced earlier,
containing only the work of Jourdan. As both dictionaries supplement each other,
we found it justified to arrange these important works in one binding.
Both works contain lenghthy biographies supplemented by exhaustive and
accurate bibliographies of physicians of the past. Profit by this unique offer to
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A.J .L. Jourdan (ed.), Dictionaire des sciences medicales. Biographie Medicale.
Reprint of the edition Paris, Pancoucke 1820-1825, 7 volumes, 4024 pp. ofthe original edition
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J.E. Dezeimeris, C.P. Ollivier & J. Raigne-Delorme (eds.), Dictionnaire historique
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Reprint ofthe edition Paris, BechetJeune 1828--1839, 4 volumes in 5, 2902 pp. of the original
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Both multi-volume works in one volume of 1734 pp., format 20 x28 em., cloth
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Subscription price f 580,After publication f 650,Date of publication: April 1982.
See also: Hirsch, Vol. 1, p. XVIII & p. XXV.

(We kindly request you to renew your subscription in the event that you subscribed
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B. M. Israel b.v. Publishing Dept.
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'Ratio' und 'Experimentum':
Johannes Bohn ( 1640 -1718) und die italienische
Experimentalphysiologie*
FRANCESCO TREVISANI
SUMMARY
The Bohn-Malpighi-Bellini debate over the existence of 'liquor nerveus' and the functions of the
spleen, though far from reaching a positive solution, emphasizes an exchange between the
concepts of ratio and 'experimentum', and that in spite of their use of experimental techniques.

Die erste Ausgabe des Circulus Anatomico-Physiologicus von Johannes Bohn erschien in Leipzig 1686. Das Werk- es gibt davon noch zwei Ausgaben 1 ,
die auch in Italien Iiihmlich bekannt geworden sind - ist Marcello Malpighi gewidmet: 'Censurae tuae praesens expono opusculum', schreibt Bohn. Dieser 'Circulus' braucht ein Zentrum, und keiner ist, besser als Du, in der Lage zu beurteilen,
ob es iiberhaupt eins gibt. Under fiihrt fort: das Wenige, was ich weiB und was ich
geschrieben babe, verdanke ich Dir 'ac colloquio quod per litteras amicissimas per
aliquot annos mecum coluisti'.
Hochstwahrscheinlich lemten sich die beiden nie personlich kennen. Nach
Absolvierung seiner Studien an der medizinischen FakulHit Leipzig, am 5.8.1663,
untemahm Bohn eine 3~ Jahre lange Studienreise, die ihn nach Danemark, Holland, England, Frankreich und der Schweiz fiihrte. Am 5. Aprill666 ist erwieder in
Leipzig, wo er nach seiner Dissertation De Pleuritia vera zum Doktor
emannt wird. In Leipzig wird er dann sein ganzes Leben lang bleiben 2 • Malpighi,
dessen groBer Ruhm erst kommen wird, ist zujener Zeit, und zwar zwischen 1662
und 1666, in Messina. So unterhielten die beiden nur schriftliche Beziehungen. Die
Briefe, die Anfang dieses Jahrhunderts von Mazzatinti fast aile inventarisiert und
spater von Adelmann 3 veroffentlicht wurden, befinden sich fast aile in Bologna. Es
handelt sich urn 16 Briefe aus der Zeit von Mai 1684 bis zum 15. Januar 1692. Von
den Briefen Bohns an Lorenzo Bellini und denen Bellinis an Bohn ist bis jetzt Ieider
keiner ausfindig gemacht worden. Von dem Werk De Urinis von Bellini erschien 1685 eine deutsche Ausgabe, der zwei weitere Ausgaben folgten 4 . Die
Einleitung samtlicher Ausgaben stammt von Bohn. Bohn stand im Briefverkehr
nicht nur mit Malpighi und Bellini, sondem auch mit den Schiilem von Malpighi:
Valsalva und Morgagni. Die Briefe befinden sich in Bologna und Forli 5 • Der
Briefwechsel von Bohn soH sehr umfangreich gewesen sein. Sein Biograph fertigte
eine Liste von Korrespondenten an, von denen ich nur Caspar und Thomas
Bartholin, Wedel, Hoorn, G. Patin und Schelhammer erwiihnen mochte. Ich babe
Clio Medica, Vol. 17, No. 4, pp. 199-206 ©B.M. Israel, Amsterdam, The Netherlands
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200

Francesco Trevisani

einige von diesen Briefen und einige Kopien von seinen Vorlesungen ausfindig
gemacht. Leider wird.diese Nachforschung, auch wenn sie beendet sein wird,
unvollkommen bleiben miissen, denn wenige Jahre vor seinem Tode (1718) verbrannte Bohn alle seine Schriften. Er wollte nichts Handgeschriebenes hinterlassen6. Hier mochte ich nur kurz darauf hinweisen und zu erklaren versuchen, was
derjenige, der als einer der Begriinder der experimentellen Methode 7 in der deutschen Physiologie in die Geschichte eingegangen ist, Malpighi und Bellini schuldig
war.
I. AM 28. AUGUST 1685 schreibt Bohn an Malpighi 8 , er habe das Vorhandensein der Nervenfliissigkeit, von der der Wissenschaftler aus Bologna in Cere bri
Corti c e gesprochen hatte, experimentell nicht bestatigen konnen. Zu Anfang des
Sommers desselben Jahres hatte Bellini von dem Leipziger Physiologen bereits
einen Brief in diesem Sinne erhalten. Daraufhin schlug er Malpighi vor, eine
gemeinsame Antwort 9 zu vereinbaren, und legte spater Oberlegungen zu einem
Versuch bei, den er dem Urteil seines Lehrers unterbreitete, urn das Vorhandensein der Fliissigkeit zu beweisen 10 •
Dieser Vorschlag von Bellini kam in Bologna zu spat an. Malpighi hatte inzwischen- am 2. Oktober 1685- Bohn schon geantwortet 11 • Und nun das 'Experimentum' von Bellini: Man nehme das Brustbein eines lebendigen Tieres, man
befreie es aus den Rippen, mit dem Daumen und dem Zeigefinger der linken Hand
driicke man einen der Nerven zusammen, die mit dem Zwerchfell verbunden sind.
Mit dem Zeigefinger und dem Daumen der rechten Hand driicke man denselben
Nerv etwas darunter zusammen. Bellini behauptete, die Fliissigkeit dort in der
Mitte gefunden zu haben, und setzte hinzu, wenn man die rechte Hand gegen das
Zwerchfell gleiten lasse, ziehe sich dieses zusammen.
Die Antwort von Malpighi an Bohn lautete:
Ja, es stimmt, wenn man einen Nerv bindet, kann man keine Anschwellung beobachten. Wegen
seines geringen Durchmessers kann darin keine groBe Menge Fliissigkeit flieBen. AuBerdem kann
die Kraft, die die Nervenfliissigkeit bewegt, nicht so groB sein wie die des Blutes. Auch die
NervengefiiBe, deren Struktur bis heute unerkannt blieb, konnen nicht Ieicht dehnbar sein. Man
kann aber nicht leugnen, daB in ihnen eine gewisse "tensio" vorhanden ist; diese tensio ist
bewiesen durch die Tatsache, daB sich die Nerven netzartig ausbreiten, so daB, wenn auf einer
Seite ein Hindemis oder eine Verletzung vorhanden ist, sich die Fliissigkeit auf die andere Seite
ausbreitet. Daher ist sie nicht Ieicht wahmehmbar. 12

Die Antwort ist geschickt, aber sie stiitzt sich aufkein 'Experimentum'. So muB
auch Bohn gedacht haben und daher sein EntschluB, das Problem fallen zu lassen.
Bellini dagegen brachte ein 'Experimentum'. Am 7. August 1686; nach einem Jahr
also, teilt Bellini Malpighi in einem Brief mit, er habe ein Schreiben von Bohn
erhalten, in dem dieser behauptet, das 'Experimentum' dreimal Wiederholt zu
haben, ohne jedoch eine Spur von Bewegung im Zwerchfell oder eine Fliissigkeit
bemerken zu konnen, wie ihm der ltaliener versichert hatte. Am Ende seines
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Briefes sagt Bohn jedoch, er habe den Brief von Bellini nicht richtig verstanden.
Bellini aber wuBte nicht, ob damit seine Handschrift oder seine Begriffe gemeint
waren 13 • Inzwischen war der 'Circulus' schon veroffentlicht worden. Malpighi
erhielt zwei Kopien davon, eine fiir sich und eine fiir Bellini, und am 14. Oktober
1686 schrieb er Bellini, er freue sich, sagen zu konnen, daB er das Buch von dem
Leipziger Wissenschaftler gut gefunden habe 14 • Am 5. Januar 1687 wiinschte sich
Malpighi von Bohn, die Themendes 'Circulus' in den Dissertationes weiterzu
vertiefen.
Diese Diskussion iiber das Vorhandensein der N ervenfliissigkeit hat unverwechselbare Spuren in dem 'Circulus' und in den 'Dissertationes' hinterlassen.
A. Circulus Anatomico-Physiologicus:
l - 'nihil humiditatis adhuc in nervis demonstratum fuerit' 15 •
2 - In dem Pro gym n as m a X I X , wieder iiber die N ervenfliissigkeit, schreibt
Bohn, er habe vertraulich 'Celeberrimos viros' befragt, die behaupteten, die mangelnde Dehnbarkeit der Nerven sei ihrer Struktur zuzuschreiben. Sie sind so
beschaffen, daB sie, wenn in ihrem Netz etwas zerreiBt, 'liquorem spirituosum
intercipere, autumant' 16 •
3 - Er blieb bei der Meinung, daB samtliche Experimenta, urn das Vorhandensein
der Fliissigkeit zu beweisen, so beschaffen sind, daB 'probabilitatem illam non
omnimode tollit, certe nihilominus concutit' (I.e.).
4 - Samtliche Experimenta, die das Vorhandensein der Fliissigkeit beweisen sollen, sind mehrdeutig, sie bieten also nicht nur eine einzige Deutung, und zum
SchluB sagt Bohn: 'Constabitque exinde, me nervorum fluidum non equidem haud
tamen credere' 17 : lch vemeine sie nicht, aber ich glaube nicht daran. Solien wir hier
auch einen Hinweis auf das 'Experimentum' von Bellini sehen?
B. Dissertationes:
l -Am 10.11.1687 18 bedankt sich Malpighi bei Bohn fiirdie Zusendung der Dissertation De sero seu lympha 19 • Es handelt sich urn eine alte, im Jahre 1668
vorgetragene und in den Exercitationes Physiologicae XXVI enthaltene
Dissertation. Das Werk ist sehr selten: ich konnte nur zwei Exemp1are ausfindig
machen (in London und in Marburg) 20 • Das Werk wurde ohne Wissen Bohns
veroffentlicht, auf Initiative eines Buchdruckers, der, nach der Meinung des
Autors, 'inepte & frivole' 21 gehandelt hatte. Bohn selbst besaB kein einziges
Exemplar seines Werkes 22 • Was behauptete Bohn in jener Dissertation? AuBer
dem Blut gibt es eine einzige Fliissigkeit ('serum seu lympha'), die als Nahrung der
Fasem, des Samens und aller fliissigen Teile des Korpers dient 23 •

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2- Exercitatio Physiologica de Cordis motu. Praeside J ohanne

Bohnio . . . Patrono ac Praeceptore 24 . Leipzig 1690, th. XXIV. Das
'Experimentum' von Bellini ist, genau so wie es war, wieder dargelegt. Ein 'fluidum nerveum' stockt zwischen den beiden Verengungen des nervus phrenicus.
Bellini aber wird nicht genannt. AuBerdem hatte Bohn kurz vorher dasselbe Experimentumineiner Schedula quadam invitatoria ad Anatomen publicam25 dargelegt. Von diesem Dokument konnte ich aber keine Spur finden.
lnnerhalb der Dissertation diente das Experiment dazu zu zeigen, daB sowohl die
Zusammenziehung des Herzens als auch die des Zwerchfells von der Nervenfliissigkeit abhangig sind, obwohl dies nicht die einzige U rsache dafiir ist 26 .

3- Casus aegri Somnambulationis. Praeside Johanne Bohnio.
Leipzig 1717 27 • Der Somnambulismus wird von der Ausdehnung der 'spiritus
animales' gegen die Peripherie verursacht 28 . Samtliche Krankheiten des Nervensystems riihren vom schlechten physischen Zustand der 'spiritus' her.
Die Lage blieb also unsicher. Hatte Bohn zunachst seine Meinung geandert und
war dann wieder auf seine urspriingliche Idee zuriickgekommen? Auf jeden Fall
bleibt eine Frage offen: Wozu verwertete er das Experimentum von Bellini? lst es
moglich, daB das Experimentum beim vierten Versuch gelang? Diese Fragen
miissen unbeantwortet bleiben, solange die 'Schedula' nicht ausfindig gemacht
wird, die der Au tor der Dissertation, Jacob Forrest aus Schottland, erwahnt. Aber
es sieht noch komplizierter aus: Der Verfasser der Biographie schreibt, man solle
beriicksichtigen, 'daB Er nicht aile Dissertationes selbst elaboriert, wie zum Theil
der Stylus, hier aber in diesem Verzeichnis der Buchstaben A als das Kennzeichen,
da man gewiB ist, daB der Respondens Autor gewesen, ausweiset' 29 . Nun, sowohl
'De Cordis motu' als auch Casus aegri Somnambulationis sind mit einem Aversehen. Die Autoren sind Jacobus Forrest und Johannes David Wipacher.
1704 veroffentlichte Bohn in Leipzig sein De Officio Medici Duplici,
Clinici nimirum ac Forensis. IndiesemFallistallesklar:AufSeite348legt
er das 'Experimentum' dar und behauptet, es stamme von Bellini. In der Tat hatte
Bellini in einem Brief an Malpighi geschrieben, er wiirde dem Leipziger Wissenschaftler das Experimentum nochmals darlegen 30 . Am 10. November 1687 fragte
Malpighi bei Bohn an, ob er den Brief von Bellini erhalten habe 31 .
Was behauptete Bohn in diesem Werk von 1704? Nur, daB das 'Experimentum'
von Bellini giiltig sei. Es bleibt aber unklar, ob die darausfolgende Wirkung dem
'spiritus' oder der Fliissigkeit zuzuschreiben ist. Das Experimentum ist demnach
schon klar; was nicht so klar ist, ist seine Deutung. Das Problem sei aber an und fiir
sich schwierig, gibt er zu, denn 'Existentia spirituum a posteriore Tantum innotescit' 32 . Diese spiritus sind nicht luftartig, 'quam hypo the sin me olim quoque coluisse
recordor' 33 , damals habe ich das behauptet, - diese Behauptung bezieht sich
zweifellos auf das Progymnasma XIX des 'Circulus', in dem Bohn schreibt, daB die
spiritus 'aeris mediae naturae' 34 zusammengesetzt sind, das heiBt, a us luftartiger
Materie, 'corpusculis sphaericis congesta',- aber sie sind auch nicht fliissiger Art.
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Das Wasser macht naB, die Luft kann eine Maschine in Bewegung setzen, wie
aber die Nervenfliissigkeit den menschlichen Korper bewegen kann, das bleibt
raselhaft 35 • Ein Beweis dafiir ist die Tatsache, daB die Medizin gegeniiber den
Krankheiten des Nervensystems vollig machtlos ist36 •
Jahrelang betrieb Bohn seitdem keine Anatomielehre mehr. Im Jahre l69J3 7
begann er, Therapie zu lehren, also werden die weiteren in seinen Schriften
erhaltenen Hinweise auf das Problem der spiritus durchaus sporadisch und vereinzelt sein. Was sich aber aus diesem verwickelten Thema schlieBen laBt, ist die
Tatsache, daB die Beziehungen zwischen ·'Ratio'' und · · Experimentum'' durchaus
nicht so klar und durchsichtig sind, wie man hatte annehmen konnen. Wenn auch
die "Ratio" ohne "Experimentum" keine Beweiskraft hat, braucht das Experiment seinerseits eine andere Ratio. Bohn war sich dessen ganz bewuBt.
II. AUCH UBER DAS Problem der Funktion der Milz batten Bohn und Malpighi
debattiert. Im VI. Kapitel von De Liene hatte Malpighi 'cogitata quaedam ...
dubitative enunciata' geauBert, und auBerdem hatte er behauptet, daB die Funktion
der Leber von der Milz abhangig sei 38 . Nach Bohn bringt diese Theorie zwei
Schwierigkeiten mit sich: l. Wenn die Milz entfemt wird, wird weiterhin Galle
produziert. 2. Die Galle bildet sich teils in der Gallenblase, teils in den Gallenrohren39. Hier sei darauf hingewiesen, daB Bohn 1682 und 1683 in den Acta
Eruditorum40 einige Bemerkungen iiber den Nutzen und die Produktion der
Galle veroffentlicht hatte. Am 2. Oktober 1685 antwortete Malpighi in einem Brief,
daB seine Theorie nur eine 'coniectura' war, setzte aber hinzu:
Solange es nicht bewiesen wird, daH die Galle in der gleichen Menge und mit der gleichen
Miihelosigkeit in einem Tier mit entfemter Milz produziert werde wie in einem, das die Milz noch
hat, werde ich bei meiner Meinung bleiben 41 •

In der Tat ergieBt sich die Vena lienalis nicht in die Hohlvene, sondem, indem sie
sich mit der Vena mesenterica superior verbindet, in die Pfortader. Also ...
Der Inhalt des Briefes ist wortgenau in dem 'Progymnasma' XVIII 'de Lienis Usu'
des 'Circulus' wiedergegeben. Was sagt Bohn dazu? DaB die Theorie von Malpighi
der Wahrheit am nachsten steht42 . Die beiden Einwande, die er gegeniiber Malpighi
im vergangenen Jahr erhoben hatte, werden wieder gemacht, aber dieses Mal miBt
er ihnen keine groBe Bedeutung bei, denn: l. hatte er inzwischen vermuten konnen,
daB der FluB des Blutes in Versuchsobjekten, bei denen die Milz entfemt worden
war, in der Leberarterie groBer wurde 43 , 2. die wahmehmbaren Eigenschaften der
Galle in einem Versuchstier, bei dem die Milz entfemt worden war, anders sind als
die wahmehmbaren Eigenschaften in einem Versuchstier mit Milz. Also ... 44
Was fiireine Lehre ist daraus zu ziehen? DaB das 'Experimentum' an und fiir sich
nicht die Kraft hat, eine gute Theorie hervorzubringen, daB aber eine gute Theorie
die Fahigkeit besitzt, Experimenta anzuregen.

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DER BRIEFWECHSEL BOHNS mit Valsalva dagegen hat bloB dokumentarischen Wert. Es handelt sich urn zwei Niederschriften von Valsalva, die erste vom
2. Juli, wahrscheinlich im Jahre 1705, die zweite vom 2. Marz 1706, und urn zwei
eigenhandige Briefe von Bohn45 , der zuerst die kurz bevorstehende Veroffentlichung der Zusammenfassung des De Aure Tractatus 46 in den 'Acta Eruditorum' mitteilte und ihm dann das Exemplar unmittelbar zusandte. Valsalva seinerseits antwortet mit der Zusendung der 'Epistola qua plus centum errores ... ' 1705 in Rom durch einen gewissen Horatius de Florianis ver6ffentlicht 47 • In dieser
EpistolawurdennichtnurdieFehlerinden Oculorum et mentis vigiliae 48
von Sbaraglia ans Licht gebracht, sondem auch allerlei Klatsch iiber die Hintergriinde der Polemik zwischen Sbaraglia und Malpighi erzahlt. Das Biichlein fangt
an- sagt Valsalva-, wo das Opus posthumum von Malpighi endete49 .
In der 'Affare Sbaraglia' spielte Bohn keine nebensachliche Rolle. In den 1691 in
Leipzig erschienenen Praelectiones therapeuticas hatte er in der Tat fiir
Malpighi gegen Sbaraglia Partei genommen 50 • Am 4. Mai 1706 verpflichtete sich
Bohn, die Epistola in den 'Acta Eruditorum' zu ver6ffentlichen, aber weder davon
noch von einer Dis put at i o de sensu u m51 , die der Leipziger Wissenschaftler
noch in demselben Jahr gehalten und dem Brief beigelegt hatte, ist eine Spur zu
find en.

ANMERKUNGEN

* Vortrag

gehalten zum: 'Symposium Neue Ergebnisse der Medizingeschichte' (21./22. November
1980, Freie Universitiit Berlin).

lch bedanke mich bei der Humboldt-Stiftung Bonn, mit deren Unterstiitzung diese Arbeit mog/ich
wurde.
I. Leipzig 1696 und 1710.
2.. Chr.E. Sicul, Neo-Annalium Lipsiensium ... , Continuatio IV .... ,Andere Bey/age zu dem Leipziger
Jahr-Buche, aufs Jahr 1718. Leipzig, 1718, 234-61. Vgl. auch: J.C. Rosenmiiller, De viris quibusdam qui in Academia Lipsiensi Anatomes peritia inc/aruerunt. Leipzig, 1816 (3.-12. Januar 1816),
7-9. Kurze modeme biographische Skizzen sind die von C. Rabl, Geschichte der Anatomie an der
Universitiit Leipzig. Leipzig, 1909, 40-1, und K.E. Rothschuh, in: Ch.C. Gillespie, Dictionary of
Scientific Biography, Vol. II, 237-8.
3. H.B. Adelmann, The Correspondence of Marcello Malpighi, Cornell University Press, 1975.
4. De Urinis et pulsibus. De missione Sanguinis. De febribus. De Morbis capitis et pectoris ... (Cum
praefatione Johannis Bohnii). Frankfurt/Main, 1685, 1698; Frankfurt und Leipzig, 1718.
5. Biblioteca Universitaria di Bologna (vgl. Mazzatinti, lnventaria dei manoscritti delle biblioteche
d'ltalia, Vol. XXVII, 99) und Biblioteca Comunale di Forli (Fonda Morgagni, Vols. 15 und 23), die
auch drei erste Niederschriften vom Jahre 1707 (2) und vom Jahre 1709 (I) und einen autobiographischen Brief von Bohn vom 27. September 1708 besitzt.
6. Sicul, 246.
7. Als Allererster M. Neuburger, Deutsche Experimentalphysiologen des siebzehnten Jahrhunderts.
In: Deutsche Medizinische Wochenschrift. 23, 1897, 483...{).
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8. Adelmann, Brief 53!, 1073.
9. Brief536, 1081, von Malpighi an Bellini, 8. Oktober 1685.
10. Die Kopie eines Teils der am 20. Oktober datierten Antwort von Bellini an Bohn ist in den
Notebooks von Malpighi (vgl. Adelmann, M. Malpighi and the Evolution of Embryology. Ithaca,
New York 1966, Vol. I, 483, Anm. 4) aufbewahrt.
II. Brief 535, 1079--80.
12. lb., 1080: 'Et licet non observetur turgentia, tensio tamen negari non potest. Ulterius notum est
nervos lateraliter ramulos per modum retis hinc inde frequenter propagare, unde facto impedimento
liquor ad latera derivari potest, et in adiacentes partes exonerari vigente praecipue irritationis
causa.·
13. Brief 599, 1204: 'Egli dice bene di non aver ben inteso Ia mia lettera, (il che non so se voglia dire del
carattere, 0 del sensor.
14. Brief607, 1224.
15. 173.
16. 273.
17. 274.
18. Brief647, 1301.
19. Leipzig 1668 (UB Leipzig: 4. Anat. u. Phys. 1300).
20. British Museum: 1179. g. II (29-55); UB Marburg: XI c B. 202. Das Exemplar der Library of the
Surgeon-General's Office (1881, Ser. I, Vol. II) enthiilt nur die ersten 13 von den 26 veroffentlichten
Dissertationen.
21. Circulus: ad Lectorem.
22. I.e.: '( ... ) harum exemplaria vel a me, vel a Bibliopolapetebant, quibus nihilominus neuter nostrum
gratificari poterat'.
23. Thes. XXIV.
24. UB Leipzig: 4. Anat. u. Phys. 1372.
25. lb.
26. · Alterum experimentum hoc est: in cane moribundo, remoto sterno & diaphragmatis parte antica a
costis avulsa, nervorum phrenicorum alteruter si digitis e regione cordis probe & eo usque comprimatur, donee ab omni motu ferietur idem septum, hinc manus alterius digitis, sub prioribus, semper
fixis, idem nervus levi compressione aliquoties versus inferiora stringatur: diaphragma denuo se
contrahere incipit, & motus, vitalibus aemulos, reassumit, qui tamen tandem deficiunt. Donee
etiam prioribus seu superioribus digitis sublatis & nervo sine omni compressione sibi ad aliquot
momenta relicto, postmodum per eandem digitorum stricturam ad pristinum phaenomenon se
recipiat Septum: hoc simul innuens, stagnare intra canales suos aliquamdiu fluidum nerveum per
digitorum stricturam nihilominus de loco in locum derivandum ac diaphragmati impellendum.'
27. UB Leipzig: 4. Spec. Pathol. 3210, aber auch im British Museum, in der UB Marburg und im
Wellcome Institute.
28. 31.
29. Sicul, 247.
30. Brief 599, 1204 an Malpighi, 7. August 1686: '( ... ) e pen) ho giudicato di dovergli respondere con
quella maggior chiarezza, che per me si possa, e poi fara egli. Se non fosse troppo ardire, io
pregherei V. S. eccellentissima a fame Ia riprova (rna forse ella ha fatta prima di me tale osservazione) e significare poi al sig. Bohn il successo. II vero e, per quanto ho veduto cento volte, che
separato il diafragma dalle costole, e fatte le note particolarita, si muove il diafragma, come scrissi
I' altra volta. Mando qui annes sa Ia risposta ad esso sig. Bohn aperta, accio ella Ia veda, e Ia giudichi;
e Ia mandi, se puo passare; Ia stracci, e l'abbrucci, se pensa, che sia poco confacevole aquel, che par
meglio'.
31. Brief 647, 130 I: 'Clarissimi Bellini nostri responsorias litteras iam ad tuas pervenisse manus
existimo'.

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32. De Officio, 348.
33. 'Neque eorum, qui aereae, aethereae similisve naturae spiritus hos autumant, quam hypothesin me
olim quoque coluisse recordor, nee qui igneos, lucidos, urinosos, sulphureos, &c. eos asserunt,
dogmata omni ambiguitate carent' (/.c., 349-50).
34. Circulus, 270.
35. De Officio, 351-2.
36. 'Hinc non adeo paradoxum erit meum assertum, Arti nostrae deficere remedia, quae spirituum
animalium inopiae suppetias adaequatas & immediatas ferant, seu in eorum substantiam convertantur, horumque motus perversos emendent, ac ad impetum aequabiles simulque vegetiores
reducant' (1. c., 356).
37. Sicul, 239.
38. De viscerum structura exercitatio anatomica. Bologna 1666, 144-50.
39. Brief 531, 1073: 'Sed duo sunt, quae ipsi adhuc difficultatem pariunt, I. quod exstirpato Liene bilis
gene ratio integra maneat, 2. quod aliquid bilis intra folliculum et reliqua vasa biliaria conficiatur, ad
quae tamen sanguis lienaris baud pertingit.' (An Malpighi, 28. August 1685).
40. Observationes quaedamAnatomicae. Structuram Vasorum Bilialorum & Motum spectantes (Leipzig 1682, 20-3); Observatio Circa Bilis Motum ab epate ad vesicam biliariam & intestinum (Leipzig
1683, 126-7).
41. Brief 535, 1080: 'nam non constat, an absente liene, bilis in eadem quantitate, facilitate, et eodem
animal is commodo separetur, quod indicare videtur experimentum'.
42. Circulus, 256.
43. '( ... ) neutiquam tamen frustraneum plane lienis in hoc negotio concurs urn esse, inde sequitur,
quatenus arteriosus forsan sanguis copiosius ejusmodi subjectorum epati illatus, similisve circumstantia defectum hunc corrigere potest'. (ib.)
44. 'verosimiliter proinde cum Malpighi concludo, bili in epate secemendae lienis functionem ministrari' (ib.)
45. Biblioteca Universitaria di Bologna: ms. 4031 (caps. CXXl). Es handelt sich urn zwei autobiographische Briefe von Bohn aus Leipzig (27. August 1705; 4. Mai 1706) und umzwei erste Niederschriften von Briefen des Valsalva aus Bologna (2. Miirz 1706; 2. Juli 1705 (?)).
46. Acta Eruditorum. 1705,462-74: De Aure Humana Tractatus. Bologna, 1705.
47. Die Epistola qua plus centum, & quinquaginta errores ostenduntur in recenti libro Oculorum, &
mentis Vigi/iae ... wurde zusammen mit einer Altera Epistola in illud idem argumentum von Luca
Terranova veriiffentlicht. In beiden Fallen handelt es sich im Pseudonyme: "Side Libri Auctoribus
quc<ras; magna hac de re in ltalia nostra esse dubitatio, asserentibus alijs, esse Opus Siculorum
lngeniorum, alijs Romanorum, alijs Bononiensiii", liest man in der ersten N iederschrift von
Valsalva vom 2. Miirz 1706. Der Sendung des Werkes folgte das Versprechen Bohns, das Erscheinen der Epistolae in den Acta Eruditorum verkiinden zu lassen.
48. Bologna 1704.
49. ' ... nonnulla continet circa statum, in quo Opus Posthumum a Cl. Malpighio relictum fuit' (2 marzo
1706).
50. Vgl. Adelmann (1966), 625,627,656.
51. · ... cui disputationem adjeci, nuper a me more Academicis nostris solemni pub lice de sensum'
(4 maggio 1706).

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Pierre Fauchard (1677?-1761). Expert pour
les dents, et maitre chirurgien de Saint -Come
de Paris
JEAN L. ANGOT
SUMMARY
Pierre Fauchard has raised enigmas namely as regards his professional life which we try to elucidate by
the analysis of his book.
He began his dental training with a naval surgeon who did not sail anymore and he started practicing at
the age of 19 with some dangerous interventions in the mouth of a friend. He benefited from the
imbroglio of his time when the dental practice was not much supervised. In 1699 there was a compulsory
examination to receive the title of 'Dental expert' which Fauchard obtained around 1708 in Paris.
A short time afterwards it appeared that he undertook studies to become a Master-Surgeon, which
title he obtained around 1714-1717, if one follows the 'Observations' in his book. As a matter of fact he
operated already before 1715 with the great master-surgeons of his time, which would have been
paradoxical if he had been only an Expert whose surgical operations described were not allowed by the
strict regulations of the College Saint-Come. His position as master-surgeon is revealed in the 1758
register of this company.
The title-page of his book indicates it too by its presentation, as one reads 'by Pierre Fauchard
surgeon' and at the next line: 'dentist in Paris'.
The present paper intends to show that P. Fauchard was a practitioner with serious and long medical
and surgical studies behind him.

Pierre Fauchard, qualifie de Chirurgien Dentiste au debut du XVIIIe siecle, et dont
Ia reputation va grandissant, a incite des chercheurs aconnaitre les phases ignorees
de sa vie professionnelle. A notre tour, nous essayons d'ordonner et de classer des
faits precis, en nous appuyant sur des textes incontestables, et depuis toujours a Ia
portee de tous. Pour nous renseigner, nous disposons de son Ouvrage et de
documents officiels.
Son livre: Le Chirurgien Dentiste ou Traite des Dents, en deux
tomes, paru en 1728 (juillet au plus tard), suivi d'une edition revue, corrigee et
augmentee en 1746, fut reedite apres son deces en 1786. C'est !'unique temoignage
de Pierre Fauchard sur Ia seule periode qu 'il fait connaitre de son activite entre 1696
et 1728.
De ce livre il faut lire avec attention les Prefaces, et dans le Tome I, les
soixante-et-une Observations sur des interventions, datees pour la plupart (plus 10
qui lui ont ete 'communiquees'). Au debut du volume, il presente des descriptions
anatomiques, pathologiques et therapeutiques assez melangees, telles qu'il les
con~oit ason epoque. Dans le Tome II, il donne des appreciations et des directives
operatoires; mais notre intention n'est pas d'etudier son oeuvre.
Clio Medica, Vol.

17, No. 4, pp. 207-221 ©B.M. Israel, Amsterdam, The Netherlands
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Jean L. Angot

Parses Observations, nous connaissons un succinct emploi de son temps durant
32 annees sur les 83 de sa vie. De sa naissance, de son enfance, de son education,
jusqu'a 18 ou 19 ans, il ne dit rien. Premiere indication: il se trouve a Angers en
1696.
I. Son identite

Parce qu'il a opere etantjeune dans les regions de Ia Basse-Loire et de I' Est de Ia
Bretagne, on a ecrit qu'il en est originaire, mais ne I' a-t-on pas fait naitre a Paris?
Voyons les documents connus, ceux que detiennent des descendants. lis nous
apprennent que Fauchard a epouse Elisabeth Guillemette Chemin, le 17 avril1729,
en l'Eglise Saint Sulpice a Paris. Le contrat de mariage stipule qu'il est 'veuf sans
enfant', sans plus ... C'est done son second mariage, dont nait un fils Jean-Baptiste,
le 19 mars 1737, baptise le lendemain en cette meme eglise, recevant le prenom du
Cure Mgr Languet de Gercy (qui avait amene Ia duchesse de Berry au repentir).
Fauchard est a nouveau veufle 10 novembre 1739. II se marie une troisieme fois,
a 70 ans, avec Catherine Louise Rousselot, dotee par son oncle Maillet, d'apres le
contrat du 5 juin 1747. A !'occasion de ces trois evenements importants, aucun
contrat de Notaire n'indique le lieu et Ia date de naissance de Fauchard.
Rappelons que les Registres de Paroisses soot al'epoque les seuls actes officiels;
ils mentionnent, pour les baptemes, Ia date, les noms des parents et parrains, pour
les mariages, la date, les noms et prenoms des epoux, pour les deces, Ia date et les
noms, ainsi que l'age du defunt, tel qu'il est annonce au Cure, sans en foumir Ia
preuve.
Nom; connais~ons d'autres documents car Fauchard procede a des transactions.
11 loue a Paris une habitation rue des Fosses St Germain (actuellement rue de
I' Ancienne Comedie), jouxtant le 16, dans Ia moitie etroite de Ia maison du 14, dit
"Hotel de I' Alliance", certainement avant 1729, puisqu 'il est paroissien de Saint
Sulpice lors de son second mariage, et il y demeurejusqu'en fin 1746. II demenage
le 1er janvier 1747 pour Ia rue des Cordeliers. II a achete le Chateau de Grand'
Mesnil, a Bures sur Yvette, en aout 1734 (non sans connaitre par Ia suite des
difficultes financieres), dont les archives essentielles ont disparu.
Par un acte etabli enjuin 1747, il est decide de Ia tutelle de Jean-Baptiste, puis de
son emancipation le 13 janvier 1755. A !'instigation de sa femme Louise Rousselot,
il est dresse un inventaire des meubles, prelude de Ia separation de biens enregistree en fevrier 1751.
En avril-mai 1760, Fauchard pressent-il sa fin, car il s'accorde avec sa femme
pour faire donation commune a Jean-Baptiste. Bien d'autres papiers notaries ou
d'huissiers, complexes mais dates m'a dit Dagen, montrent que P. Fauchard eut
des soucis et peut-etre des revers de fortune, mais ils n'ont pas permis de decouvrir
ses origines.

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Par chance, le Registre de la Paroisse Saint Come-Saint Damien, rue des Cordeliers, a echappe aux destructions de la Revolution. Il y est transcrit: 'Le 23 mars
1761, a ete inhume nef du Saint Sacrement, le corps du Sieur Pierre Fauchard,
ancien maitre chirurgien dentiste, epoux de Louise Rousselot, decede avant hier
age de 83 ans, rue des Cordeliers, sa paroisse'; c' est-a-dire le samedi 21 mars 1761.
Nous en sommes informes aussi par son faire-part d'inhumation (une affichette de
30 em sur 19 em), conserve a la Bibliotheque Nationale: ainsi annonc;ait-on les
evenements (fig. 1). Le depot de son corps dans la Chapelle du Saint Sacrement est
un temoignage de la consideration de son Clerge et de la Confrerie des Chirurgiens.
Ses mariages religieux, le choix du prenom de Jean-Baptiste, cette inhumation,
indiquent que Pierre Fauchard etait un fervent catholique.
Ce faire-part de deces permet de situer sa naissance entre le 22 mars 1677 et le 21
mars 1678; il y a done trois probabilites sur quatre, qu'il soit ne en 1677.
La petite Eglise Saint Come-Saint Damien, bien delabree, fut demolie en 1836;
les ossements releves avec ceux du cimetiere et du charnier, furent portes aux
Catacombes, sans aucun enregistrement ni precision de l'endroit, 76 ans apres le
deces de Fauchard. Qu'en surent ses descendants?

II. Son activite
Dans les 'Prefaces' il nous confie ses pensees et nous informe de ses debuts en
apprentissage, sans nous en indiquer le lieu ni l'epoque:
Je fus l'eleve de Monsieur Alexandre Poteleret, Chirurgien Major des Vaisseaux du Roy, tres
experimente dans les maladies de Ia bouche.

Au XVlle siecle, et au XVIIIe siecle, 'Major' etait une fonction de responsabilite
superieure sus ses collegues, aussi bien dans les services hospitaliers que dans le
Corps de Sante, ou ce titre n'impliquait pas de grade, car i1 n'en existait pas. Les
'Vaisseaux de guerre' composaient 'La Marine Royale' alors que les Vaisseaux dits
'du Roy' n'etaient que les batiments de la Marine de Commerce. Ce qui explique
que Mr Poteleret ne soit immatricule nulle part dans les livres de navigants de Ia
Marine, ni dans les hopitaux des differents ports, particulierement Nantes et
Rochefort, ni dans les diverses Archives de Ia Marine comme Medecin ou Chirurgien. Parmi les garc;ons, les aides-chirurgiens et compagnons, P. Fauchard est
egalement inconnu, d'apres nos investigations.
Doit-on suspecter I' existence de Poteleret 'Chirurgien tres experimente', qui
surement de par sa longue pratique, devait etre age, et avait obtenu l'autorisation
d'usage d'exercer la chirurgi~ ala campagne (a !'exclusion des grandes villes), et de
detenir une boutique avec le droit de barberie, probablement dans un arriere pays
co tier.
Notons qu'au chapitre XXI: 'Des mauvais effets' du Scorbut, Fauchard ecrit:
'mon dessein n'est seulement que de (les) traiter. .. On doit sou vent se rincer Ia
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bouche ... '- 'Ce que je dis est verifie par I' experience de ceux qui sont employes a
traiter ces sortes de maladies; par exemple, sur les Vaisseaux, dans les Ports ~e
Mer, et dans les grands Hopitaux, de meme que dans certaines Villes marecageuses ... Quoiqu' elle ne so it ni si maligne, ni si commune aParis ... '
Contrairement a son habitude, il ne se fie pas a ses 'expe-riences', il se refere a
celles des autres. Ceci prouve que Fauchard n'a ete en contact avec cette maladie,
ni en naviguant, ni dans les Hopitaux maritimes, mais qu'il en a ete instruit par
Poteleret, et ses amis, gens de mer. Apparemment Fauchard a du en traiter aParis?
Les Communautes de Chirurgiens recommandaient de s' initier aIa pratique 'des
l'adolescence'. Lejeune Fauchard a ainsi appris chez ce Maitre installe 'les
premiere teintures des connaissances que j'ai acquises dans Ia Chirurgie que
j'exerce'. II ne parle plus ensuite de ce Maitre, meme a !'occasion de sa premiere
intervention a Angers en 1696 grace aIa complaisance de Ia famille de Crespy de La
Mabiliere, sur le fils age de 22 ans, a 'Ia bouche tres difforme' des suites de Ia
persistance des dents de lait. Les incisives etaient lingualees et 'croisees les unes
sur les autres derriereles canines'. Apres a voir 'ote les trois canines d'une longueur
si considerable, tant de Ia machoire inferieure, que de Ia superieure ...j'ebranlai
avec le pelican les incisives derangees pour les rameneret les arranger ainsi les unes
apres les autres ... '. Notre operateur de 19 ans suit les directives redigees par
Dupont en 1647, qui fait mieux encore:
Les dents qui vont de travers.,. je les releve et les replante au niveau eta I' ega! des autres ... !

Dans cette seconde moitie du XVIIe siecle, l'exercice de Ia Chirurgie est desordonne malgre l"Union' enregistree en octobre 1656, des Chirurgiens Gradues et
des Barbiers, au grand mecontentement des Medecins. Cette situation favorise les
pratiques incontrolees des inciseurs, rhabilleurs, oculistes, lithotomistes, arracheurs de dents, etc ... dont l'Universite s'inquiete. Le Pouvoir emet de nouveaux
Statuts d'exercice pour 'La Communaute de Messieurs les Chirurgiens Jurez de
Paris', par Lettres Patentes, en septembre 1699, applicables par I' arret du Parlement du 3 fevrier 170 I.
Ces reglements sont aussi intitules: 'Statuts de Ia Communaute des Maitres en
I' Art et Science de Chirurgie de Paris', car Ia Chirurgie est classee depuis le Xllle.
siecle dans la Communaute des Arts et Metiers, comme etant un art manuel
(artisanal). Certains chirurgiens les refusent et s 'elevent de plus contre le maintien
de l"Union'.
Cependant, ces Statuts imposent un savoir accru pour les Chirurgiens et les
protegent par la creation, sous le controle de leur Communaute, de categories
d'operateurs denommes Experts pour la fonction dans laquelle ils sont re<;us.
'L'aspiran' doit avoir 'servi plusieurs Maitres ou Experts pendant trois annees, ou
deux annees consecutives chez l'un des Maitres Chirurgiens ou Experts'. Apres
avoir obtenu des 'consentements' aux echelons de Ia hierarchie des Medecins et
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des Maitres Chirurgiens, Taspiran est soumis a un Examen, compose d'un seul
acte, interroge tant sur Ia theorie que sur Ia pratique' (theorie apprise dans une sorte
de catechisme: Le Maistre en Chirurgie, redigt! par MMrs Verduc, pere et
fils).
Dans ses Observations, a Paris, en 1708, Fauchard nous apprend qu'il 'tire Ia
premiere grosse dent molaire de Ia macho ire inferieure cariee' a Mademoiselle
Deshayes, et que Tannee suivante, elle revient chez moi pour se faire nettoier Ia
bouche' (fig. 2).
En 1712, il soigne Mademoiselle Maziere 'demeurant a Paris, rue du Renard'.
Cette rue est situee dans le quartier de Saint Jacques de Ia Boucherie, centre des
affaires, ou Fauchard est installe, dit Andre-Bonnet, dans son livre Histoire
Generale de Ia Chirurgie Dentaire dontjefuslecollaborateur,etquim'a
assure en a voir eu Ia preuve.
De ce quartier, Fauchard re<;oit en 1720 le fils d'un 'quincailler' de Ia rue des
Mauvais Gar<_;ons; en 1721, l'epouse de Monsieur Begon, banquier rue de Clery; un
ancien chirurgien, un homonyme, a present marchand de toile rue des Dechargeurs; en 1723, Mademoiselle Le Moyne pres de Saint Magloire; en 1724, il se
'transporte' chez Monsieur Auger, epicier en gros, pour voir sa fille, rue de Ia
Verrerie. Fauchard demeure vraiment a Paris, et semble bien etabli sur Ia rive
droite, avant que d'aller rue des Posses StGermain.
Mais pour exercer en 1708, Fauchard doit etre admis tout au moins Expert pour
les Dents. Comme il ne peut detenir qu'un certificat de Poteleret, il est oblige
d'effectuer auparavant le stage des deux annees dans Ia boutique d'un Maitre
Chirurgien et ainsi, habiter dans Paris avant 1706, meme 1705.
Nous ignorons quand il a passe son Examen avec succes, car les Registres de Ia
Communaute des Chirurgiens de Paris des annees 1656 a 1743, date de Ia Declaration supprimant les privileges de !"Union', ont ete detruits volontairement pour
effacer ce que les Maitres Chirurgiens ont considere comme un 'outrage'. Mais un
Registre du College de Saint-Come de 1758 revele le nom de Fauchard dans une
liste d'Experts; de meme dans des almanachs 'Etat ou Tableau de Ia Ville de Paris'
de 1759 a 1761 (fig. 3). Ce titre d'Expert que d'ailleurs il dissimule, nous ne le
connaitrions s'il n'etait mentionne dans ces documents.
Les gains de Fauchard recemment installe a Paris, sont peut-etre insuffisants, car
il deploie en meme temps une grande activite lors de deplacements dans des villes
de !'Ouest ou, comme dans tout le Royaume, I' Edit restrictif de 1699 n'est pas
applique, qui permet toutes les pratiques (il ne le sera qu'en 1730). Son titre
d'Expert a Paris lui confere du prestige. Pourquoi choisit-il cette Region?
Deja en 1705, un R.P. Recollet du Lude vint le consulter. Nous avons relate son
intervention de jeunesse a Angers en 1696, ou il pratique a nouveau en 1715 (deux
sejours), et en 1717; a Nantes en 1711 et 1712 (deux sejours); a Rennes en 1713; a
Tours en 1716. II ecrit: 'En 1715, me trouvant a Angers' (page 342), et en cette
meme annee,: 'ou je me trouvais pour lors' (page 374), et encore: 'me trouvant a
Angers en 1717' (page 354).
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Ce sont bien des marques de passages; il n'apparait pas qu'il eut des logements
fixes; ou alors y retrouvait-il de Ia famille comme on le suppose. Sa premiere
epouse etait-elle de ces Regions? (Son second mariage n'interviendra qu'en 1729.)
Le grand nombre de localites rend le depouillement d'archives tres superficiel,
meme dans les villes. Elles ne nous ont pas permis non plus de decouvrir les
enregistrements d' exercices pourtant obligatoires dans ces differentes villes dont il
ne parle plus apres 1717. (Ses besoins en ressources financieres sont apparemment
satisfaits.) II y a une raison primordiale que nous verrons plus loin.
II se confine dans Paris; sa clientele s'est developpee et il a acquis un certain
renom. C'est que, des Regents et Chirurgiens Jurez apprecient sa valeur professionnelle et operent de concert avec lui ou lui confient leurs malades.
En 1719, Messieurs Chauvet et Antoine de Jussieu aux interventions inefficaces,
sont obliges de lui 'demander du secours'. En 1723, Monsieur Anel et d'autres
'Messieurs' se rencontrent chez lui. En cette annee, Monsieur Finot l'appelle pour
un malade atteint d'une tumeur. En 1724, Monsieur Helvetius lui 'envoie un
malade'; il soigne Monsieur Tartanson Chirurgien Jurez (marque de confiance);
Monsieur Verdier conseille a un malade de 'venir le trouver'. En 1724 et 1728, il est
en rapport avec Monsieur Petit. En 1725, une consultation de plusieurs Chirurgiens
sur un cas difficile a lieu dans les locaux de Saint-Come; ils le lui adressent, et
F au chard en obtient Ia guerison.
Le Professeur Winslow lui 'envoie plusieurs fois des personnes attaquees de ces
sortes de tumeurs', les paroulis (T. I p. 214), ainsi que le fait Dufaur. Toutes ces
interventions sont effectuees a son domicile, dont nous ignorons larue.
Apres Ia parution de son livre, les collaborations continuent. II est demande en
1732 a Ia Bastille pour soigner le curieux benedictin Dom Louvard, emprisonne le
31 decembre 1728 durant 5 annees, comme defenseur des Jansenistes, et s'opposant a Ia Bulle Unigenitus de 1713.
Pierre Fauchard, dans sa premiere Preface, juge severement les Chirurgiens sur
leur meconnaissance des maladies de Ia bouche, et dans ses Observations, sur leurs
erreurs operatoires: pages 353-354-360-378-384-390-402 (M. de Jussieu)- 405434 - et meme page 160 a l'egard du celebre Dionis qui utilise une pratique 'fort
dangereuse' dans certaine carie- (celui-ci ne pouvait s'en offusquer, etant decede
en 1718).
Cependant, de 1725 a 1728, il presente son manuscrit a d'anciens Prevosts du
College de Saint-Come, a Messieurs les Chirurgiens Jurez, et a six Docteurs
Regents de Ia Faculte de medecine, detenteurs du pouvoir de Controle sur Ia
Chirurgie, qui lui redigent des Approbations louangeuses et admiratives; ils apprecient lesjugements de ce novateur.
Dans le Tome I, des pages l76a235, les chapitres sontdes developpements ou P.
Fauchard traite des maladies graves des gencives et des maxillaires. Ce sont des
preceptes de Chirurgie d'un operateur experimente et instruit. Pour qui sait par Ia
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tions au lecteur soot des avis de 'prudence' et 'd'avoir recours aux conseils des
Medecins et Chirurgiens'. Dans ses 'reflexions' (qui sui vent chaque Observation),
ainsi que dans tous ses exposes de pathologie, il emploie un langage medical, acquis
par des annees de formation.
Rappelons que les attributions d'un Expert soot strictement limitees a ce qui
conceme les dents: detartrage, curetage des caries, 'plombages' et remplacement
des dents absentes. L'extraction est Ia seule intervention de caractere chirurgical
permise, a I' exclusion de toute autre, sans le recours a un chirurgien.
P. Fauchard, par ses operations de Chirurgie, souvent en entente avec des
Maitres Chirurgiens que nous venons d'enumerer, se situe bien au-dessus des
capacites d'un Expert et en enfreint les droits.
N'est-il pas surprenant et deconsiderant pour de grands 'Patrons', qu'ils operent
avec un Expert, et qu 'ils en acceptent les critiques sou vent vives a leur endroit dans
ce Manuscrit qu 'ils patronnent so us le titre de 'Chirurgien' Dentiste? Repreoons les
statuts de septembre 1699: ils indiquent a !'article 107:
'Ceux qui seront re<;us Experts ne pourront prendre Ia qualite de Chirurgien et seront obliges de se
conformer aux articles 103 et 104 (c 'est-a-dire payer les droits de visite et de ''confrairie '') tant pour
les incisions, operations, et remedes, que pour leurs etalages'.

En se qualifiant Chirurgien, Fauchard commet-il une autre infraction qui place
dans une situation embarrassante ses Approbateurs anciens Prevosts (investis
depuis 1301 de fonctions coercitives)?
Dans ses Prefaces, Fauchard s'insurge contre 'le Ieger examen' subi par ceux
apres lequel ils prennent le titre d'Expert pour les Dents 'quoique plusieurs d'entre
eux ne soient munis que d 'un sa voir au dessous du mediocre'. Mediocrite qui lui
portait ombrage en tant qu'Expert~
D'autre part, il ecrit: 'les progres queje fis avec cet habile homme (Poteleret) me
donnerent !'emulation'. Aussi, cette denonciation et son ambition le conduisentelles logiquement et tot a postuler ala Maitrise en Chirurgie. Mais quelles sont ses
possibilites?
Examinons les conditions imposees par les Statuts de Ia Communaute des
Maitres Chirurgiens Jurez de Paris. Selon l' Article 32: il faut etre 're<;u ou agrege en
Ia Communaute par le grand Chef-d'oeuvre', et etre de la religion catholique.
A !'Article 36: 'Aucun Aspiran ne sera admis a faire le grand Chef-d'oeuvre s'il
n'est fils de Maitre ou apprenti de Maitre ou s'il n'a servi un Maitre durant 6 annees,
ou plusieurs pendant 7 annees'.
A !'Article 53: 'le grand Chef-d'oeuvre sera compose d'une lmmatricule, d'une
Tentative, du premier Examen, des quatre semaines chacune d'Osteologie, d' Anatomie, des Saignees et des Medicaments; du demier Examen, et de Ia prestation de
Serment, sans que l'ordre en puisse etre change' .ll s'ajoute le processus complexe
de presentations, de soumissions, de droits a payer et d'interrogations.

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Dans ces Statuts, outre cet examen au nom artisanal, a !'article 81, il en existe un
autre dit Ia 'Iegere experience'. Aucun Chirurgien ne pourra etre dans ladite
Communaute (s'il n'est compris dans les articles ... dont le 30), avoir dans les
Hopitaux servi 'les pauvres en qualite de premier Compagnon durant six ans, et
qu'il ait servi les Maitres de'ladite Communaute pendant quatre annees, et fait
apprentissage chez l'un d'eux'- 'S'il est reconnu capable', il pourra passer cette
Iegere experience 'composee de deux examens faits en deuxjours differents dont le
premier sur Ia theorie et le second sur les operations'.
Le Noviciat, pour le grand Chef-d'oeuvre, d'apres Sauveur Morand, impose par
contrat de servir dans Ia boutique d'un Maitre et de suivre des cours et des visites
dans les Hopitaux. C'est le parti le plus dur, mais Ia depense est reduite.
Le second Noviciat suppose des ressources necessaires, a faire service dans les
Hopitaux, a suivre des praticiens accredites et des cours divers. C'est Ia fa<;on 'Ia
plus scientifique de se former a Ia pratique' et l'examen est plus facile.
Fauchard, qui doit tenir sa boutique d'Expert et peut-etre aussi de barbier pour
s 'assurer une independance pecuniaire, ne peut pre parer que I' examen de Ia 'Iegere
experience'. Saint Jacques de Ia Boucherie n'est pas eloigne de l'Hotel-Dieu,
renomme des 1680 pour ses conferences de Chirurgie faites par des 'CompagnonsChirurgiens Ordinaires'.
Depuis 1706, on y organise des 'travaux pratiques d'Anatomie'; les eleves
chirurgiens se repartissent en Chirurgiens gagnant Maitrise, en premiers Compagnons internes et Chirurgiens extemes (tres nombreux). Ce demier groupe
convient certainement a Fauchard. II peut suivre les cours prives ou publics, dont
ceux donnes au proche et vetuste amphitheatre d' Anatomie de Ia Faculte, rue de Ia
Bucherie, eta Saint-Come (actuellement rue de !'Ecole de Medecine).
II se trouve alors mis en relation avec les demonstrateurs: J .L. Petit, Malaval,
Lapeyronie, Verdier, Mareschal, et Winslow 'Professeur de Chirurgie en langue
fran<;aise dans les ecoles de Ia Faculte de Medecine', qui le tient au courant des
travaux de I' Academie des Sciences sur une conception de '!'arrangement des
couches qui forment et perfectionnent les dents'. II connait Jean Devaux, lequel
'permet !'usage de sa bibliotheque considerable aux eleves' qu'il juge favorablement. Celui-ci devient son correcteur et participe a Ia redaction du 'Traite des
Dents'.
Cela represente six a neuf annees d'organisation et de temps consacrees a son
'noviciat' apres 1706--1707 (epoque ou il etait devenu Expert).
Fauchard reussit l'examen de Maitre Chirurgien de Saint-Come.
Ce qui porte sa reception de Maitre Chirurgien de 1712 a 1716, soit entre 35 et 39
ans.
A partir de 1717, ses Demonstrateurs et ses Professeurs sont done susceptibles
de lui demander sa collaboration en Chirurgie, ce qu'il rapporte dans une Observation des 1719, ainsi que nous l'avons marque precedemment. A cette date, une

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legende fait arriver Fauchard a Paris (ce qu'il n'ecrit nulle part), aureole d'une
'reputation', alors que le titre 'd'Expert pour les Dents', n'est pas attribue dans les
Provinces avant fevrier 1730. Meme s'il avait ete Barbier-Chirurgien, aucune
equivalence n'etait plus possible dans la Capitate ou il n'aurait pas eu le droit de
pratiquer (ce qu'il faisait depuis 1706-1708). Sa seule reference n'etant que le
certificat d'apprentissage de Poteleret, il aurait du, repetons-le, pour devenir
Expert, servir de deux a trois ans chez un Maitre. C'est en 1722 qu'il aurait acquis
ce titre, a l'age de 45 ans. Peu honorable pour qui vilipende cet examen! Curieuse
'reputation' imaginee pour justifier les relations subites avec les grands Maitres
Chirurgiens de Paris et leurs Approbations!
Dioni!i ne previent-il pas les provinciaux des difficultes qu'ils rencontrent en
venant a Paris, tel Garengeot qui attire en 1711, ne peut exercer bien qu'il soit
Maitre es Arts et Chirurgien en Bretagne. II attend pour passer l'examen de la
'Iegere experience' jusqu'en 1725, 'apres avoir vecu miserablement pendant 14
ans'.
En Histoire, il est bon de verifier le plus possible les assertions transmises.
Nous avons consulte le Registre de Saint-Come de 1758 aux Archives Nationales
(qui avait ete conserve dans les papiers d'un Commissaire de Police du quartier
Saint Andre des Arts, sans doute pour une enquete). II est intitule Compte des
Recette et Depense faites pour le College Royal de St Come a Pari - depuis le
Premier Octobre 1757,jusqu' au Premier Novembre 1758- M. Pierre Rivals Maitre
en chirurgie, ancien Prevot, Receveur et Comptable. Nous avons obtenu des
precisions et retrouve au 'lOeme Chapitre a cause du droit de visite et de confrairie
de Messieurs les Experts', comportant 57 noms, sans specifications, celui de
'fauchart' (avec un t minuscule) qui paye 5livres pour 1758 (fig. 4).
·
En examinant le '8eme Chapitre a cause du droit de visite de Messieurs les
Maitres', parmi les 269 inscrits, nous avons eu Ia tres agreable surprise de lire le
nom de 'fauchar', en calligraphie identique a celle du chapitre des Experts, (le t
quasi invisible) et il est inscrit aux 'Debets' pour 45 livres (fig. 5). Fauchard paye
alors une redevance pour chacun de ses deux titres, conformement aux Arrets du
Parlement qui les fixe d'apres les deliberations generales du 'Corps et Compagnie
des Maitres en I' Art et Science de Chirurgie de Paris', des 25 fevrier et 26 mai 1755.
Cette decouverte fait que nous saisissons encore mieux les raisons de la consideration que lui portent ses collegues Chirurgiens. A la parution de son livre en
1728, Pierre Fauchard est bien Maitre Chirurgien du College de St Come, et depuis
au mains une douzaine d'annees.

III. La Page de titre (fig. 6)
Considerons dans son livre Ia disposition de Ia page de titre. 'LE CHIRURGIEN' tient seul toute une ligne, imprime en caracteres plus importants que
'DENTISTE', place au dessous. De meme plus bas, nous lisons: Par Pierre Fauchard, Chirurgien. Dentiste a Paris (situe aussi sur Ia ligne au dessous).
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Jean L. Angot

lei il prend bien le titre de Chirurgien, et annonce ensuite sa particularite de
Dentiste qui exerce a Paris. Fauchard veut-il tout d'abord marquer Ia preeminence
du Chirurgien sur Ia pratique du metier de dentiste? Sa Preface no us apprend qu 'il
souhaite aussi pour le 'dentiste' une capacite superieure a celle d'Expert pour les
Dents, qu 'il stigmatise, rappelons-le. Seul titre cependant qui lui a permis de vivre
de cet exercice durant pres de dix annees et de poursuivre sa formation pour
devenir Maitre en Chirurgie. II detient bien ces deux titres, tous deux agrees par Ia
Communaute de Saint-Come, mais il ne fait etat que du second!!
Ainsi dans Ia presentation de son livre il se situe medicalement Chirurgien. En
!'occurrence le mot 'Dentiste' est une entite; le Chirurgien qui exerce l'Art Dentaire peut I'indiquer aIa suite de son Titre. Si les deux mots se sui vent, il n'y a aucun
trait d'union, ce qui, sans meprise, exclut toute specificite d'une profession. (Le
faire-part de deces le confirme.) Cette absence de tiret dans Chirurgien Dentiste se
retrouve dans chaque 'Approbation' qui au surplus ne considere que Ia Chirurgie,
et ce que lui apporte Fauchard.
Voici quelques Approbations de surcroit tres elogieuses:
-De Monsieur Winslow, Docteur Regent, Censeur Royal: 'Ayant il y a plusieurs
annees, remarque dans son Auteur un grand fond de connaissances, d'habilete et
d'observations par rapport a cette partie de Ia Chirurgie,je l'ai moi-meme encourage a en faire part au Public.'- De Messieurs les Chirurgiens Jurez de Paris: 'Cet
ouvrage etoit tres essentiel a Ia Chirurgie.' - De Monsieur de Vaux, Chirurgien
Jurez et Ancien Prevost de sa Compagnie: 'Traite ... tres instructifpour ceux qui se
proposent de faire leur capital de cette chirurgie particuliere.' - De Monsieur
Tartanson, Chirurgien Jurez de Paris et Ancien Prevost de sa Compagnie: 'II
manquait a Ia Chirurgie une partie qui cependant ne lui etait pas moins necessaire
que toutes les autres ... Par cet Ouvrage cet Auteur rend notre Art complet.'
IV. Denomination: Dentiste, Chirurgien Dentiste
Depuis le XVe siecle, au moins, le peuple appelait 'dentiste' - designation
importee par les itinerants italiens - to us les genres d 'operateurs qui 'arrachaient les
dents'. Les Chirurgiens et les Barbiers, qui 's'occupaient' des dents, s'adjoignirent
ce nom, qui fut tolere par leurs Communautes de Saint-Come ainsi qu 'a leurs aut res
'specialistes'. Fauchard denomme 'Chirurgien Dentiste' ses predecesseurs: 'feu
Carmeline', 'feu Dubois, dentiste de Louis XIV', qui etaient des beneficiaires de
l"Union', avant 1699.
Dans les 'Etat ou Tableau de Ia Ville de Paris' de 1759 a 1761, que nous avons
cites, sous le vocable 'Dentiste' soot inscrits aIa fois les 'Maistres en Chirurgie' et
les 'Experts' ! Preuve a cette epoque de la distinction entre les Chirurgiens s' adonnant aI' art dentaire et les Experts; Fauchard meconnait ceux-ci dans ses directives
de technique operatoire du Tome II, et ne s'adresse qu'au 'Dentiste' qui est bien la
designation d'une categorie. Encore actuellement, quel que soit le Praticien et ses
titres, il est toujours appele 'le dentiste'.
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Pierre Fauchard (1677?-1761)

217

Fauchard n 'a aucune pate mite dans la creation du titre de 'Chirurgien-Dentiste',
qui deviendra officiel par des dispositions legislatives en 1892.
V. Ce qui reste a connaftre de Fauchard et des endroits oit it a vecu
II nous faut rechercher ce que fut sa jeunesse, particulierement la duree et
l'endroit de son apprentissage chez Poteleret, personnage qui pose une enigme. S'il
est apparent que Fauchard soit ne en province, il est prouve qu'il habita aParis par
obligation, au plus tard en 1706 afin d'effectuer son stage de deux annees pour
devenir Expert. Puis installe en boutique, quels furent les mobiles de ses rares
deplacements dans les villes de l'Ouest dont quelques confreres locaux et nousmeme, n'avons trouve aucune trace? Il n'y retoume plus apres 1717, lorsqu'il est
devenu Maitre en Chirurgie.
Les 'Observations' sont des exposes plutot chirurgicaux erratiques au regard des
longues annees de pratique dont il ne parle pas. Il dit seulement que 'les occupations continuelles, que me donne rna profession' l'ont empeche de 'mettre au
jour' son livre, avant celui d'un Auteur paru en 2e edition en 1727: Des Instruments de Chirurgie. Il en parait vexe et critique le chapitre de 82 pages et
4 planches d'illustrations d'instruments dentaires, a notre sens de meilleure
conception que les siens Fauchard dans son Tome II fait etalage de le($ons, particulierement au 'Dentiste',
mais il epargne Carmeline, qui n'a rien redige, et dont il a tire profit.
Notons que Fauchard ne beneficie d'aucune charge officielle.
Par Dagen, nous apprenons des evenements dans sa vie privee qui ont du peser
sur son activite professionnelle.
N ous ignorons cinq points importants: l' endroit de sa naissance, les lieux et dates
de son premier mariage, de sa premiere habitation a Paris, et les dates de ses
examens d'Expert et de Maitre en Chirurgie.
Quant aux endroits ou il est passe, il subsiste l' Amphitheatre des Chirurgiens de
Saint-Come, construit en 1691, modifie depuis, comme le fut aussi le Chateau de
Grand-Mesnil. Il existe Ia vaste Eglise Saint-Sulpice commencee en 1646, qui ne
comprenait que le choeur et le transept lors de son second mariage en 1729, et dont
Ia neffut terminee un an avant le bapteme de Jean-Baptiste.
L'essentiel pour I'Histoire de Ia Medecine et de la Chirurgie Dentaire etait
d'etudier le dossier de ce praticien de renommee mondiale, de situer son particularisme professionnel de Maitre Chirurgien que nous pensons avoir reussi a
determiner par analyses et deductions.
C'est vers Ia fin de notre etude que nous avons decouvert pour notre contentement cette confirmation dans le fameux Registre de Saint-Come.

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Jean L. Angot

218
BIBLIOGRAPHIE

Pierre Fauchard et son livre ontfait /'objet de nombreux ecrits (notamment ceux de G. Dagen) que nous
ne pouvons pas tous citer ici. No us nous bornerons aindiquer ies principaux dans/' ordre chronoiogique
de leur publication. Georges Dagen, un non praticien employe dans une maison de fournitures
dentaires consacrait ses samedis etjours de conge a des recherches dans ies bibiiotheques et vendait
ses articles ades revues ou bien ades co-auteurs ce qui explique son humilite.
N. Eloy, Dictionnaire historique de Ia Medecine. 4 vols. Paris, 1778.
L. Lemerle, Notice sur I'Histoire de /'Art dentaire. Paris, Bureaux de I'Odontologie, 1900, 221 p.
C.M. Manus, Pierre Fauchard. Dans: Dental Cosmos. 1907, 1233-1245.
G. Viau, La vie de Pierre Fauchard. Conference aIa Sorbonne, Paris, 16 decembre 1922.
B. W. Weinberger, The work ofP. Fauchard. Dans: Journal ofDental Research, 1924-26.
G. Dagen, La vie de Fauchard. Dans: Cadmus. Paris, Nov. 1934, 17-22.
L. Andre-Bonnet et J . Angot, Histoire generate de Ia Chirurgie dentaire. Lyon, Edit. du Fleuve, 1955,
255 p.
G. Dagen, Points obscurs de Ia vie de Fauchard. Dans: Revue Odonto-Stomatoi. Paris, fev. 1961,
170-178.
Montcorbier (=G. Dagen), P. Fauchard. Dans: La Semaine dentaire . 1961, 30 p.
A. Besombes et G . Dagen, Pierre Fauchard et ses contemporains. Paris, Publications medicales et
dentaires, 1961, 150p.
C. Gysel, La carriere du dentiste Fauchard. Dans: Rev. Be/g. Mid. Dent. 33, 1978,433-438.

OUS Gt~spri(Z d'affifter auCo,Jvoy, ServicJ
& Emerreme!Jt de ~o1Jjie11r

Pierre
. . ,_.,_,.,-"-·• FAUCHARD,ancietJ Ma1tre Cbirrtrgie11·
Drmtifle, Seigne11r drt Grand-MGnil, decedJ
............"'~""". eTt fa mai[o11 rui:' des Cordeliers; Qui ft
ra Lu11dy 2 Je. Mars 17 0 I. dix hettres
l'Eglife de Saint Cofme, fa Paroif!e , or't if fora

a

du moti11,

e1t

i11huml.
De ta part de 1\hdam~.: fa

:au P:ulem~nt, fon Fils.

RequicCca' in pace.

vcuvc, & de M Fauchard de G rand-Ml:nil, Avocat

Fig. 1. Faire-part du ded:s de Pierre Fauchard (Bib/. Nat.). (Photo F. Guiselin.)

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Pierre Fauchard (1677?-1761)

219

'-'1ttt1#;p-·rml1 •

.:1

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~4/dtril; ~ 17--ll't:k,d,~-f'l.. ~ ~r/rc..Pt-,lr'ti'l f/--tf/ivm,.5,if t- tt-ottlJ"f II-~~ ~<-/ M""'/. ~Nn,J,_h,f.k"'h •
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MESSIEU11.S,

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Barraud, rutS. 1-!onorl.
Courtois , { rut tlu Fo.ffe1 .!.
Bourdel, rut tk LArhu-fu .
Duchemin, GtrmJin.
lirocart , priJ l.t Bilrriert tlu Dumas, pris l~t rut tits Fon•
Sff;;tns S. Honor/,

dturs.

Caperon, l'l~t&e du Y. l.ouvu, Duvcrdier, r. S. And. Ju Artr
Fauchard, rut Ju Cordd.un.
Laudumiay; Qu.ti l't!lttiu; •
flamand, rut DJuphint.
Laveran, Cloitrt S. G.l'Auxu;
Fontaine, rut tla Fo./fi s S. Cu. Le Monier, rut Frommtau.
foucou, rut Su Muguuiu.
LeRoy, rut dt Grtntllt S. Hon.
Gaillard, rut du Fo.lfiJ S. Cu. ~ Leroux, Cimrtirrt S. hiln.
Halle de Ia Touche, Qu•i at Perria,
} rut du Four s.
l' Eeou.
Quetilrant,
Gum•in,
Hebert, rut Ju Fojfls S. Gtrm. Senequier, rue tit La H.zrpt•
.'Jourdain, Pont S. Mielrtl.
Tubeuf, Pottt .A/Jrit.
MJI S Calais , rut at Grtntllt S. Honor!.
"• l Hervieux , "" Gtoffroy- L~tfniu.

Fig. 3. Tableau des dentistes parisiens en 1759 (d'apres /'Almanach royal) . (Photo F. Guiselin.)
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. . ,.,1 ,
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Fig. 4. Registre des comptes du College Saint-Come de Paris (Arch. Nat. yll860) montrant que
Fauchard figurait parmi les experts . (Photo F. Guiselin.)
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"A (. \?n.~!lvc...,

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Fig. 5. Meme Registre prouvant que Fauchard figurait parmi les Maitres Chirurgiens. (Photo F.
Guiselin.)
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221

Pierre Fauchard (1677?-1761)

LE CHIRUR GIEN
DENTIS T£,
O'V

TRAIT£' DES DENTS.
0 U L'ON ENSEIGNE LES MOYENS
de lcs cntretcnir propres & Dtincs , de les
embell.ir , d'en rc1iarcr b. perte & de rcmedier leurs maladies, cclles d ·s Gencives & aux accidens qui pc:uvent furvet i1·
aux aurres parries voiiines des D nts.

a

a

Avec des Obfcrvations & des RcRexions !i.u·
plufieurs cas iingulicrs.
Ouvr~tg~

mrir:hi d~ eptarantc PlandJ(S.
en t.ai!Lt: douce.

Pu P 1 ERR F. FA ucu.ARD, Chirurgtcu
Dentill:e

a Paris.

TOM£ PREMIER.

A PARIS.
Chez ] E AN MARt E T T E, rue Saint Ja::ouc s
aux C olonncs d'Hcr.:!llc.
M. D C C X X VII J.

At'<C Approbatio111 f! Privi!egtJ d# Ro)'•

Fig . 6. Page de titre de l'ouvrage de Fauchard. (Photo F. Guiselin.)

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JULIUS HIRSCHBERG
THE

HISTORY
OF

OPHTHALMOLOGY
ELEVEN VOLUMES

translated by Frederick C. Blodi, M.D.
Professor and Head, Department of Ophthalmology
The University of Iowa

1bis monumental history will now be available in English. Volume I (which has already been

translated and is in print) will appear during 1982.
It is planned to publish the following volumes in rapid sequence, usually two to three volumes per
year.
The price of each volume will be $ 78.00 provided that they have been ordered before volume I
appears. 1bis is a subscription price. If the entire series is ordered, the price per volume will not
change over the following years. Included in the price is packing, insurance and postal fees. Volume I can also be obtained as a single volume (only up to May 30, 1982) at a price of$ 98.00.
Each volume of the series will be billed individually.

If more details are requested, we would be happy to send you the full Table of Contents of volume I. This will be mailed to you by surface mail($ 5.00) or by air mail$ 8.00). (CASH PLSE.)

WAYENBORGH
VERLAG · EDITIONS · PUBLISHER
P.O.BOX 200 646
D-5300 BONN 2 (WEST GERMANY>

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A Mid-nineteenth Century British Pediatrician's
Interpretations of the Mental Peculiarities
and Disorders of Childhood
ELIZABETH LOMAX
Inapaperentitled The pre-history of child psychiatry, publishedin
1964, Alexander Walk reviewed the 19th century medical literature on mental
disorders of childhood 1 • One of his purposes was to indicate pediatric contributions, neglected in previous surveys of the antecedents of modem child psychiatry,
including the contributions of Charles West (l8lfr.l898), mid-century founder of
Great Ormond Street Hospital, London. In this paper, West's perceptions of
normal and abnormal mental function in childhood will be examined in greater
detail, drawing in part from his published writings and otherwise from his case
records currently in the library of the Institute of Child Health, Guilford Street,
London.
Apart from obituary notices, an entry in the D.N.B. and two recent articles by
Dr. Felix Besser, little has been published on this eminent Victorian obstetrician
and pediatrician2 • Because of his Baptist parentage, West could not study medicine
at Oxford. Therefore, after training at St. Bartholomew's Hospital, he went to
Bonn University, then to Paris, finally obtaining a doctorate in 1837 at Berlin. In
1845, he was appointed lecturer in midwifery at the Middlesex Hospital, where in
1847 he gave a course oflectures on children's diseases, published as a text in 1848.
This work, expanded in 1854, went into seven editions and numerous translations.
In 1852, largely owing to West's enterprise, the Hospital for Sick Children was
opened in London, half a century after the establishment of the Enfants Malades in
Paris but the first institution of its kind in England. West was senior physician for 23
years, then consulting physician, but in 1877 he resigned all connections with the
hospital for reasons that remain unclear but were related to his conversion to
Roman Catholicism and to his unpopularity with the rest of the staff. Dr. Besser,
consultant dermatologist and archivist at Great Ormond Street, is planning a
biography which would elucidate the checkered career of this dominant figure in
Victorian medicine who was fated to spend the last 20 years of his life in relative
obscurity practicing as a roving private pediatrician between Nice, London and
Paris, where he died in 1898.
In the index to his notebooks, West indicated that he had kept records of all
pediatric cases under his care between 1838 and 1880. The files of children seen as
hospital out- or in-patients were collected in volumes entitled according to the
relevant years. The records of children first seen in private practice were filed
Clio Medica, Vol. 17, No. 4, pp. 223-233 ©B.M. Israel, Amsterdam, The Netherlands
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224

Elizabeth Lomax

separatelyas Medical Cases. Anadditionalvolume,entitled Disorders of
the Brain, contained case histories involving a variety of disorders including
acute tubercular hydrocephalus (tuberculous meningitis), tubercle and cancer of
the brain, convulsions, chorea, hypochondriasis, backwardness, idiocy and moral
insanity. Although this classification suggests that West considered extreme mental or behavioral peculiarities to be due to temporary, intermittent or permanent
cerebral dysfunction, his comments with regard to management and prognosis
indicate an almost exclusive concern with environmental factors at the treatment
level. His rationale may be summarized as follows: unless the child received special
care and education during his illness, however protracted, permanent intellectual
and moral damage would ensue whatever the biological outcome. Little could be
done to affect the presumed cerebral lesions, but judicious management was an
essential interim requirement in the hopes of full or partial recovery.
West discussed childhood mental disabilities in lectures delivered at Great
Ormond Street, in a chapter of his textbook on diseases of children and in the third
of a series of Lumleian lectures on 'Disorders of the nervous system in childhood'
delivered in 187 P. Before describing specific case histories, he usually characterized the differences between the immature and the adult mind. In the first place, a
child lived in the present without much thought of the past or the future. In sickness
he remained patient and placid, 'the prospect of death, even when its approach is
realized, and that is not so rare,' West cautioned', 'as some may imagine, brings in
general but small alarm. ' 4 Secondly, while the child lacked the reasoning powers of
an adult, he compensated for this deficiency by 'an exaggerated activity of his
perceptive faculties, a vividness of his imagination. ' 5 This trait was manifested in
the dreams of childhood, sometimes so terrifying that the youngster awoke screaming, sobbing and inconsolable. Even when fully conscious, he could conjure up
frightening visions or imagine some slight noise to represent a monstrous presence.
'The child who dreads to be alone, and asserts that he hears sounds or perceives
objects,' must not be branded a liar, West explained, for he 'often tells a literal
truth. ' 6 While such lively impressions were common enough in the healthy child,
they were likely to be greatly magnified by disorders of brain function.
Thirdly, moral qualities ('emotions' in modem parlance) were relatively more
highly developed than intellectual ones. A child was liable to intense love or hatred,
or to an unconquerable dread of some person or object that had left unpleasant
impressions, without enough reason to govern the frank manifestation of its emotions. When the youngster was thus led to wayward or capricious behavior, it was
for the adult to discover the underlying motive and act accordingly. West was later
to describe instances of malingering which he ascribed to a childish craving for
sympathy associated with· a parent lacking the wisdom to cope with the deception.
Finally, children were individuals and not, as so often thought, identical in their
propensities and qualities. For some, grief could be overwhelming, as West illustrated with reference to a small boy who apparently pined away of a broken heart after
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A Mid-nineteenth Century British Pediatrician's Interpretations

225

his father's death and also to French statistics between 1835 and 1844 demonstrating a known national average of 19 suicides yearly among children between
five and 15 years of age. Quoting from an investigation by a French physician,
Maxime Durand-Fardel, West pointed out that children usually killed themselves
in consequence of punishment, or of reproofs, or of ill-usage. These facts deserve
special attention;' he added, 'they prove how much more the susceptibility and
sensitiveness of children need to be taken into consideration than is commonly
done.' 7
West divided mental disturbances into two groups: those mainly affecting the
intellectual powers and those mainly involving the moral faculties, while indicating
that the two frequently coexisted. The severest forms of mental retardation or
idiocy, usually associated with physical defects, he thought to be almost exclusively of congenital origin. Lesser types of retardation were rarely so, but tended to
appear after the onset of epileptic fits, after severe illness and sometimes for no
obvious reason. A third group consisted of children suffering from general backwardness rather than any specific arrest in mental development. Borrowing from
Edouard Seguin, who called them 'enfants arrieres', West described such youngsters as retarded overall for their age, but as exhibiting a physical development,
manners, habits and intellect which would be considered quite normal in a younger
child. As Seguin had explained:
The idiot, even in the slightest degree of the affection, presents an arrest of development both of
body and mind; the backward child does not remain stationary, but his development goes on more
slowly than that of other children at his age; he is behind them in the whole course of their
progress, and his delay increasing every day, places at length an enormous distance between him
and them- a distance which, in fact, is unsurmountable. 8

Although they would be slow in learning and continue to lose ground to their
better developed peers, West insisted these children should not be regarded as
idiots or as too dumb to be worth teaching.
Sometimes, West cautioned his audience, dullness and inability to speak were
attributed to mental deficiency when the true cause was deafness or even an
impediment to articulation. Again a correct diagnosis was essential, for such
children should not be sent to an idiot asylum but to an institution for the deaf and
dumb. Serious illness during infancy could also inhibit the development of speech
and walking, even when unaccompanied by signs of brain damage. Similarly,
illness in later life could lead to regression, the child losing its former physical and
intellectual abilities, usually only temporarily but sometimes permanently. In such
cases West counseled patience and persistence in training in the hopes of recovery.
The prognosis was more dismal with perversion of the moral qualities, whether
or not associated with mental retardation. In West's opinion, 'want of affection,
mischief, spite, causeless rage, indicate a state from which recovery is far more
hopeless than from mere intellectual dullness. ' 9 Among the moral disorders, he
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226

Elizabeth Lomax

included hysteria, malingering, attacks of rage and violence- in effect, evidence of
what now would be called character or personality disorder. Passionate or uncontrolled behavior sometimes followed the onset of epilepsy, chorea or feeblemindedness. This West could understand, but he was 'puzzled' by instances of childhood
hypochondriasis, the disposition to complain of some imaginary pain or incapacity
or to exaggerate some real ailment. His comments on a young patient who could
neither eat, stand nor walk without evidence of any organic lesion, were indicative
of the pre-Freudian tendency to see all behavior as consciously motivated. When
the mother carried this little girl into his office, West first ascertained that the
paralysis was reversible, in his own words:
''Put her down,'' I said to her mother, ··and let me see her stand.'' ''Oh, sir! She has not put a foot
to the ground for seven months." The order was repeated, the child obeyed the unwonted tone of
command, and stood. "Now walk!" -again a remonstrance, but she walked. 10

The child was admitted to hospital where she reiterated her inability to eat or
walk. For a while she was fed like a baby and was induced to walk by first being
persuaded to stand. Support was then removed so that she was forced to shuffle to
the nearest prop rather than fall to the ground. The mother's visits were restricted
since they were usually followed by remission. After two months, the little girl was
much improved. Instead of being discharged home, she was sent to the countryside
where, according to West, 'having vainly attempted to deceive the intelligent
person who has charge of her, (she now) holds herself upright, and seems to have
given up all pretence of illness.'
West did not distinguish between hysteria and malingering as Charcot was to do a
little later in the century. Yet, while privately considering his patient a young fraud,
West 'treated her conscientiously and with success in contrast to some later nineteenth century pediatric psychiatrists who, according to James Hendrie Lloyd,
equating hysteria with degeneracy as well as moral perversity, found such patients
'repellent' 11 • This kind of contempt was foreign to West, as was the associated
concept of degeneracy which began to intrigue psychiatrists following the publicationofBenedictAugustinMorel's Traite des Degenerescences in 1857.
But many of West's 'moral' cases did not have a satisfactory outcome, particularly when the child was violent, passionate and uncontrollable. Regular school
was not the place for such children who, West pointed out, would soon get
themselves expelled while suffering the taunts and mockery of both teachers and
pupils in the meantime. Nor was a solitary undisciplined existence at home any
solution, for lack of playmates plus lack of education would compound the original
problem with serious risk of the child becoming totally withdrawn, morose and
unmanageable. If the family was well off, a private tutor or governess might be
engaged. Otherwise the youngster could be admitted to Great Ormond Street for
observation. But even this institution was not prepared to tolerate all indecorous
behavior. Thus, a boy of nine, admitted for the investigation of epileptic fits, was
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discharged unrelieved after two months. West explained that the child was dismissed because 'he had become liable to occasional seizures of maniacal excitement, in which he attacked the othe~ patients; besides which if any circumstances
displeased him, he not infrequently stripped himself and walked about the ward
naked, and this although usually a perfectly well-conducted child.' 12 One is left
wondering whether it was the violence or the nudity that most shocked the hospital
staff.
But if a specialized institution refused to put up with such occasional outbursts,
what were this boy's chances of acceptance in the outside world? West's repeated
assertions that moral disturbance bore a worse prognosis than intellectual deficiency reflected his perceptions of Victorian social values 13 • Whereas a dull but amiable
child, with some practical training, would not in later life be particularly disadvantaged since the common run of jobs was intellectually undemanding, the same
would not be true for a person of violent and unrestrained passions. At a time when
British society in general (that is, the family whether middle or lower class, the
church whether established or dissenting, and the school) put a premium on
selfcontrol, moral restraint and stoicism, an undisciplined or hypochondriacal
youth, further burdened by lack ofliteracy, would stand little chance of finding and
keeping employment let alone friends. West's statement that moral perversion
frequently led to moral insanity supports the modem view that the diagnosis of
insanity is, at least partially, a reflection of cultural perceptions.
Much of West's teaching was conventional. Like many other Victorians, as John
Duffy has indicated, West believed mental precocity and overwork in early childhood to be conducive to later mental disorder or to constitutional disease, particularly to tuberculosis and epilepsy 14 • Without seeking to explain these associations
but with examples of their occurrence, he warned against encouraging the very
young to overtax their minds. But on the subject of masturbation he was restrained,
not including this among the causes of mental disorder and idiocy as did many of his
contemporaries 15 • He merely referred to excessive masturbation as a sign of
serious moral disintegration, an effect rather than a cause.
West did not claim specialized knowledge, particularly with reference to the
training of mentally retarded children. Instead, he referred his readers to Seguin's
extensive pedagogic writings and to Samuel Gridley Howe's 1848 report to the
Massachusetts legislature concerning idiocy. At mid-century, the former provided
the most detailed theoretical, philosophical and practical analysis of education for
the mentally retarded; the latter represented the only attempt then available to
arrange information statistically. Yet West was skeptical of many of Howe's
numerical conclusions. For example, the Massachusetts report indicated that in
420 out of 574 cases the condition of idiocy was congenital. West thought this 'a
very considerable over-estimate', suspect because the American investigators had
relied on retrospective evidence, classifying as congenital all cases of retardation
said to date from infancy or early childhood 16 • Their findings should not therefore
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be taken too literally, particularly, in West's opinion, since a sense of hopelessness
was so commonly associated with a diagnosis of congenital affliction.
West's approach to each patient was essentially individualized in that he was
prepared to wait and observe the effects of further development and education
before reaching any firm conclusions as to a child's long-term prospects. His case
notes reveal some of the standards upon which he based a diagnosis. Usually the
records began with an account of any family history of serious illness or mental
disorder, followed by a description of the child's current troubles and previous
history including mode of delivery, condition at birth, feeding and physical activity
during infancy, and age at which teething, walking, speaking, and other milestones
were encountered. Further assessment varied with the age of the patient. With a
baby, for example, West noted the state of nourishment, muscular tone, and the
ability to follow a moving object with the eyes, or to grasp, or sit, or stand if
applicable. Any unusual movements such as head rolling or nystagmus were
charted, as were measurements of length of body and head circumference, the
number and state of the teeth, the size of the anterior fontanelle, and anatomical
peculiarities such as a highly arched palate, small jaws or an enlarged thyroid gland.
After an examination, West frequently jotted down a prognostic comment
without necessarily unduly alarming the parents at this stage. Thus, of a boy first
seen in December 1852 at the age of six months, West made the following comment
10 months later: 'My impression is that the case will tum out to be one of idiocy but
have directed the mother to come and see me in 3 months.' The final entry, nearly a
year later, read as follows:
I still occasionally see the boy- he has at different times suffered from fits during teething. I do not
think his intelligence increases or only v. slightly. At 2 yrs 4 mths he is still unable to hold up is
head, to speak or to stand. He has cut 20 teeth but they are encrusted with tartar, & as with many
idiotic children a profuse dribbling of saliva goes on almost constantly. 17

With this severely retarded child, there was little reference to education apart from
simple measures such as propping his head up with a cushion. But usually the
records indicate some more constructive suggestion which may be subsumed in the
following comment on an older mentally retarded girl subject to epileptic fits: 'I told
the friends ... that her intellect was to be developed by laying hold of any point in
which it seemed most developed as her love of order.' 18 This child had an impairment of speech which West found of fairly common occurrence among epileptics
and thought best treated by teaching the child simple chants and songs.
Whether or not a child was separated from its parents seems to have depended on
West's opinion of the mother's personality and intelligence as well as family
circumstances and the severity of the disorder. If thought necessary to remove the
child from home, recourse to an institution was by no means the only solution.
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tion in an idiot asylum, West might recommend a stay with friends of the family, or
in the country with a tutor or governess, or daily attendance at one of the newly
instituted kindergarten schools. Whatever the lack of facilities or money, he took
trouble in finding a solution. In one instance he arranged for a child to live with
family friends while under the constant supervision of a teacher from a nearby idiot
asylum 19 • But apparently West never suggested reformatory school, 51 of which
were established in England and Wales between 1854 and 1875 to replace prison as
detention centers for juvenile offenders 20 • These institutions were not under medical superintendence as were the idiot asylums and one may conjecture that West
wanted his young patients to remain under a medical system of care and thus
directly, or indirectly, under his supervision.
With regard to mental retardation, West seems closely to have followed Seguin's
physiological theory and practice. On the other hand, West's perception of childhood psychiatric disorders was similar to that of the British mental specialist, John
Conolly, whom he sometimes consulted over such cases 21 • Conolly, best known for
his abolition of physical restraint at the Hanwell adult asylum, was instrumental in
the establishment of a private asylum for mentally retarded children at Highgate in
1848 and of the first public institution of this kind in England in 1858 at Earlswood in
Surrey. His ideas on 'juvenile insanity' were published in 1862 22 • Conolly, like
West to whom he was senior by 25 years, stressed delinquent behavior, its differing
manifestations according to the sex and age of the child and the need for judicious
management. As Walk has indicated, the lectures 'are of interest in that they
disregard altogether the major disorders as seen in adults and deal almost entirely
with the emotional and behavioral deviations for which, Conolly says, parents now
consult the physician. ' 23
Conolly did not so much ignore the childhood psychoses as avoid differentiating
them from behavioral disorders. For, as a phrenologist, he could accept the
probability that much mental disorder was inherited, 'or at least born with the
individual', while also believing in the efficacy of early treatment and education in
all cases where the faculties of the mind were not wanting, as in severe idiocy, but
merely deranged or out of balance 24 • Phrenology, as taught by Spurzheim and the
Combe brothers, was an optimistic creed because it allowed for the modification of
innate faculties by later experience, i.e. through education 25 • For Conolly, the
causes of juvenile mania or insanity were similar to those of delinquency and all
were treatable through appropriate physical education and moral training. But by
the 1860s, when he was lecturing on juvenile mental disorder, phrenology was in
sharp decline, only enduring among some elderly practitioners like himself. The
younger men, including Conolly's son-in-law Henry Maudsley, believed as firmly
as ever in the inheritance of insanity, but now with the gloomy implication of
irreversibility, because they were thinking often in terms of the transmission of
actual brain lesions.

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Elizabeth Lomax

The former concept of the inheritance of a mutable 'predisposition' was giving
way to that of transmission of a far more rigid 'disposition'. This shift in opinion
was again given theoretical support by B.A. Morel in his 1860 Treatise on
Mental Diseases. Previous French psychiatrists, including Pinel and Esquirol,
had been satisfied to categorize mental disorders according to the symptoms
exhibited, but Morel now attempted a nosography based on etiology. His first and
largest group was that of 'hereditary insanities' determined by the inheritance of
degenerative factors and recognizable through their associated physical stigmata.
Next came the 'alienations due to intoxications', themselves of acquired origin but
liable to induce the stigmata of degeneration in the offspring. A third group, the
neuroses including epilepsy, hypochondriasis and hysteria, were capable of being
transformed into their own typical forms of insanity. 'Sympathetic folies', according to Morel, reflected pathology of the internal organs, while his last two
groups, 'idiopathic isanities' and 'dementia', were indicative of brain lesions: In
short, all forms of madness were due to congenital or acquired lesions of the
nervous system, brain or internal organs and the aim of psychiatry should be to
isolate the pathology peculiar to each form 26 •
Simultaneously the tendency was growing to perceive unusual childhood behavior as of innate origin. Brierre de Bois mont, for example, in a memoir published in
1858 indicated his own studies as demonstrating children to have inherited the
mental illness of their parents in 18 instances out of30 27 • Of one child, he wrote that
the 'wickedness seems innate'. As a medical student, James Crighton Browne told
members of the Edinburgh Royal Medical Society in 1859 'that mighty influences
are brought to bear upon the embryo at conception, and that a bias is then imparted
to the being'. 28 Morbid impulses and tendencies could also, he thought, be imparted to the fetus during gestation. These assumptions were not novel but the
young Crighton Browne diverged from tradition when he further asserted that
insanity could occur in utero and in infancy. Previously this had been deemed
impossible since the infant lacked any faculty of reason wherein the derangement
associated with madness could take place. But according to Crighton Browne,
mania, delusions and hallucinations could exist in early life, as evidenced by a child
trying to grasp at imaginary objects or shrieking as if terror stricken for no apparent
reason. Such behaviors might be of congenital origin, or due to poisoning or
disease; the point being made by the Edinburgh medical student was that mental
derangement could occur in infancy and the topic should no longer be neglected.
Maudsley laid much more emphasis on hereditary degeneration when he wrote
on the insanity of early life in 1867. Convulsions were the earliest indication of
madness, the signs of which would vary according to the age of appearance, but the
underlying cause was nearly always an imperfect nervous constitution due to a
degraded inheritance. 'The question of hereditary taint,' in Maudsley's opinion, 'is
in reality the important question in an examination of the insanity of early life. ' 29
Providing a synthesis of Morelian and Darwinian theory, he visualized degeneration as a process of dissolution, a change from higher organization to one of lesser
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complexity. The afflicted child was sub-human and therefore an object of contempt, 'a fundamental discord in nature', which would sooner or later assimilate it.
In the meantime, Maudsley added ominously, 'as a diseased element in the social
organism, it (the child) must be isolated or removed for the good of the organism'. 30
This type of thinking was totally foreign to West whose love for children and their
trust in him was legendary 3 1 • A deeply religious man, in the 1871 Lumleian lectures
West publicly disclaimed allegiance to the 'dreary creed' implicit, he thought, in
Darwin's just published Descent of Man. West's answer, as Besser had
indicated, went as follows:
The mystery of the suffering, indeed, is still in large measure incomprehensible, but an end is seen
to it all; not in the extinction of the weak for the sake of the strong, themselves to yield in tum to the
stronger; the race being all, the individual nothing, but the pertection of each individual ofthe race;
-a perfection to be attained not here, but higher. 32

Too rational to deny the probability of man's lowly physical descent, West retained
faith in the soul's immortality, so he could accept the sufferings of disturbed
children without resort to the emerging theories of degeneration and decadence. A
meticulous worker, he recorded any family history of mental disorder, but in his
published writings he made no mention of congenital causation except with reference to severe mental retardation, and then as being far less common than
intimated by Howe's statistics. He interpreted delinquency, hypochondriasis or
suicide in children as the result of an excessive, unchecked evolution of normal
tendencies, not as manifestations of aberrant innate traits. Delusions, in West's
opinion, were an exaggeration of the normally acute imaginary perceptions of
childhood; hypochondriasis was incited by the normal youthful desire for sympathy ~arried to excess; while suicide could be the result of disregarding a youngster's hypersensitivity.
As his mode of classification reveals, West perceived the brain as the organ of the
mind, but implicit in his methods of care was the accompanying belief that brain
function could be altered by judicious education. Thus, although not a phrenologist, West was in sympathy with Conolly and with the early nineteenth century 'cult
of curability'. Perhaps because of his faith, he avoided novel scientific theories and
could suspend judgment where it clashed with intuition. Instead of being influenced
by the current preconceptions, he acted as if further development in the most
appropriate environment available was the main criterion of a brain disordered
child's potential. In this and in his methods of examination, West seems strikingly
modem, while his profound faith reminds us of his early nineteenth century
dissenting heritage.

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Elizabeth Lomax

NOTES
The author thanks the Institute of Child Health for permission to use material in the Charles West
Library, and is grateful to Dr. Felix Besser and the librarians for assistance.
A shorter version of this paper was presented to the XXVI/ International Congress of the History of
Medicine, Barcelona, Spain in September, 1980.

I. Alexander Walk, The pre-history of child psychiatry, in: British Journal of Psychiatry. 1964, II 0,
754-767.
2. For information about Charles West, see Obituary notice, in: Lancet. 1898, i, 968-970; also British
Medical Journal. 1898, i, 921-923; Felix Besser, Dr. Charles West, in: Great Ormond Street
Gazette. 1973, 4-6, and Notes on Charles West and his grave in Chislehurst (Kent), in: History of
Medicine. 1975 (Autumn/Winter), 47-50; and Thomas Twistington Higgins, Great Ormond Street.
London, Odhams Press, 1952.
3. Charles West, On the mental peculiarities and mental disorders of childhood, in: Medical Times &
Gazette, 1860, i, 133-137; On cerebral symptoms independent of cerebral disease, in: Medical
Times & Gazette. 1861, i, 353-356; Lectures on the Diseases of infancy and Childhood. Philadelphia, Henry Lea, 1866 (4th American from the 5th English ed.), pp. 210-228; and On Some
Disorders of the Nervous System in Childhood. Philadelphia, Henry Lea, 1871.
4. Medical Times & Gazette. 1860, i, 133-137.
5. Ibid.
6. Ibid.
7. Ibid. Max. Durand-Fardel, Etude sur le suicide chez les enfants, in: Annales medico-psychologiques. 1855, ser. 3, 61-79. Durand-Fardel's analysis of the causesofjuvenile suicide was based on his
own investigation of26 children who had terminated their lives.
8. West, Lectures on the Diseases of Infancy and Childhood, 1866, pp. 223-224. Translation of E.
Seguin, Traitement moral, hygiene et education des idiots et des aut res enfants arrieres. Paris,
Bailliere, 1846, p. 72.
9. Medical Times & Gazette. 1860, i, 133-137.
10. Ibid.
II. J .H. Lloyd, Hysteria, in: An American Text-Book of the Diseases of Children. Ed. Louis Starr.
Philadelphia, W.B. Saunders, 1897, II, 727-740.
12. Medical Times & Gazette. 1860, i, 133-137.
13. For an assessment of Victorian moral values see, for example, Fran<;ois Bedarida, A Social History
ofEngland 1851-1975. Trans. by A.S. Forster. London, Methuen, 1979, pp. 90-92.
14. John Duffy, Mental strain and 'overpressure' in the schools: A nineteenth century viewpoint, in:
Journal of the History ofMedicine. 1968, 23, 63-79.
15. For example: Samuel Gridley Howe, Report of Commission to inquire into the condition ofidiots of
the Commonwealth of Massachusetts. Boston, Senate Document No. 51, 1848, p. 29: 'There is
another vice, a monster so hideous in mien, so disgusting in feature, altogether so beastly and
loathsome, that, in very shame and cowardice, it hides its head by day, and, vampire-like, sucks the
very life-blood from its victims by night; and it may perhaps commit more direct ravages upon the
strength and reason of those victims than even intemperance; and that vice is self-abuse.'
16. West, Lectures on the Diseases oflnfancy and Childhood. 1866, p. 225.
17. West, G.O.S. file, 1852-1855, case no. XVII.
18. West, 'Disorders of the Brain', case no. XVII.
19. West, 'Disorders of the Brain', case no. XVIII.
20. The Youthful Offenders Act, authorizing the establishment of reformatory schools, became law in
1854; see Ivy Pinchbeck and Margaret Hewitt, Children in English Society, Vol. /1. London,
Routledge and Kegan Paul, 1973, pp. 477-478; also, John A. Stack, The provision of reformatory

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21.

22.
23.
24.
25.

26.

27.
28.
29.
30.
31.
32.

233

schools, the landed class, and the myth of the superiority of rural life in mid-Victorian England, in:
History of Education. 1979, 8, 33-43.
For example, of case no. XVIII (note 19 above), a girl of six years subject to epilepsy and to fits of
violence and fury, West wrote: 'I met Dr. Conolly about her. His views seemed to coincide with
mine. He told me afterwards that his apprehensions about such cases were very considerable, that
he had seen them develop into insanity.'
John Conolly, Recollections on the varieties of insanity. Part JJ- Cases and consultations, in:
Medical Times & Gazette. 1862, i, 27-29, 130--132, 234-236, and 372-374.
A. Walk (note I above), 759.
J. Conolly, Medical Times & Gazette. 1862, i, 28.
For a discussion of phrenology's influence on early nineteenth century psychiatrists including
Conolly, see R.J. Cooter, Phrenology and British alienists, c. 1825-1845. Part ll: Doctrine and
practice, in: Medical History. 1976,20, 135-151.
B.A. Morel, Traiu! des Maladies Mentales. Paris, Masson, 1860, pp. 258--272. For an analysis of
Morel's influence on psychiatry in the second half of the nineteenth century, see Ruth Friedlander,
Benedict-Augustin Morel and the Development of the Theory of Degenerescence. Unpublished
Ph.D. dissertation, University of California, San Francisco, 1973; and Georges Genii-Perrin,
Histoire des origines et de /'evolution de /'idee de degenerescence en medecine menta/e. Paris,
1913.
A.-J.-F. Brierre de Boismont, Recherches sur /'alienation mentale des enfants, in: Annates d'Hygiene publique. 1858, 10, 363-398.
J. Crighton Browne, Psychical diseases of early life, in: Journal of Mental Science. 1860, 6,
284-320.
Henry Maudsley, The Physiology and Pathology of the Mind. New York, D. Appleton, 1867, p.
280.
Ibid., p. 290.
West's affection for children was dwelt upon by his obituary writers who, in 1898, seemed to find it
difficult to say much else in praise of the then almost forgotten founder of Great Ormond Street.
West, On Some Disorders of the Nervous System in Childhood. Philadelphia, Henry C. Lea, 1971,
pp. 127-128; quoted by F. Besser, Dr. Charles West, in: Great Ormond Street Gazette, 1973,6.

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J.-M. Charcot et Paul Richer

J.-M. Charcot et Paul Richer

Les difformes et les malades
dansl'art

Les demoniaques dans l'art

Reprint of the edition Paris, 1889.
4to. 87 text-illustrations (partly renewed)
(VIII, 162 pp) . Cloth binding.

Reprint of the edition Paris, 1887.
4to. 67 text-illustrations (partly renewed :
(116 pp) . Cloth binding.

ISBN 90.6078.059.0

ISBN 90.6078.060.4

Hfl65,-

Hfl75,-

Medicine and Art
Charcot was a talented artist; he
collaborated with. Richer, artist at
'La Salpetriere', the greatest clinic of his
time for diseases of nervous system, in the
production of interesting books on disease
and deformity as portrayed by artists,
books which have put the study of
medicine in relation to art upon a sound
footing.

(Garrison & Morton nr. 660516; Semelaigne,
Les Pioniers de la psychiatrie
franfaise II, pp. 716-725;
Garrison, Contributions pp. 82617)

Both books together HflllS,-

B. M. ISRAEL BY.
N.Z. Voorburgwal264
AMSTERDAM

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News &Notes
I. THE SECOND INTERNATIONAL ISLAMIC MEDICINE CONFERENCE

The 2nd International Conference on Islamic medicine was held, from March
29th to April 2nd, 1982, in Kuwait, at the invitation of the State of Kuwait under the
auspices of H.H. the Amir of Kuwait and the guidance of Dr. Abdul Rahman el
A wadi, the distinguished Minister of Public Health.
The organization of this conference was similar to the first conference (see report
in Clio Medica, Vol. 16, no. 1, pp. 48-49). Out of a considerably great number of
announced contributions 106 were selected; 70 of this selection were delivered and
could be discussed on the conference. The participants came from the following
moslem countries: AI Bahrain, Algeria, Egypt, Indonesia, Iraq, Jordan, Kuwait,
Malaysia, Mauritius, Morocco, Pakistan, Saudi-Arabia, Syria, Turkey, and from
two countries with moslem minorities: India and South Africa. The participants
from non-moslem countries came from: Canada, France, the F.R.G., Poland,
Romania, Spain, the--United Kingdom and the U.S.A. The solemn opening session
as well as all the conferences were held in the Kuwait Sheraton Hotel.
The permanent interest of Western science in Islamic medicine - actually
existing since the middle ages- is expressed in the relatively great number of nearly
40 participants from non-moslem countries, ten of them delivered speeches. In the
last two centuries oriental texts have been intensely studied by non-islamic
scientists.
The significance of this conference was expressed by Eric C. Forbes, second
Vice-President, International Union of the History and Philosophy of Science,
Division of History of Science (IUHPS/DHS):
'Although the Arabic-speaking countries of the Near and Middle East are wellrepresented in the International Council of Scientific Unions (ICSU), only Egypt,
Syria, and Pakistan are members of the IUHPS/DHS. It is the wish ofthe General
Assembly of that organisation, that Islamic historians of science and medicine will
in future participate across the spectrum of its activities, which include the collation, critical examination, interpretation and presentation of documentary and
material resources.
There is, and always will be, a need for international cooperation in identifying
and collating bibliographic reference sources covering all realms of literature. For
the Islamic world, a valuable start was made around the tum of the century by Carl
Brockelmann, and more recently through the labours of Fuat Sezgin, but much still
remains to be done. The IUHPS/DHS commissions for Bibliography and Documentation attempt to encourage and co-ordinate international work in this field;

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News &Notes

and a symposium on Documentation in the History of Science, Medicine and
Technology is currently being planned for 13th-16th September 1983 in Edinburgh
to which delegates from the Arabic-speaking world will be particularly welcome.
The selection of manuscripts and printed Arabic texts for critical study and
analysis is something which should be decided by an international consensus of
scholarly opinion, rather than be left to chance circumstances. The historian of
medicine's particular viewpoint must take account of the fact that the subjectmatter of medical history is a product of the social activity between physicians and
their patients; and since health conditions are as much a feature of human society as
its politics, economics, or religion, disease must be regarded as a cultural manifestation. It is not enough, therefore, for the medical historian to concern himself
merely with the development of the theoretical knowledge and practical skills
required by the physician in his treatment of a specific ailment. Social, psychological and spiritual factors are also important. The main danger inherent in attempts to interpret the facts and ideas of history is that we may fail to recognize the
influence of prejudices inherited from our per~onal, social and religious environment, or indeed from the norms of the epoch in which we now happen to be living.
More must be done to instil in Western politicians a better appreciation of what
forms of technical aid and what policies of medical care are of the greatest practical
utility to development in Third World countries. The two autonomous Scientific
Sections of the IUHPS/DHS which assume responsability for the promotion of
these concerns are the International Council of Science Policy Studies (ICSPS) and
the International Committee for the History of Technology (ICOHTEC); while the
international commission for the Teaching of History of Science is the organ most
concerned with the pedagogic aspect.
Many historians wrongly suppose that their task is complete when they have
succeeded in amassing, distilling and interpreting their data, and they do little to
prevent deliberately distorted accounts of their results to be reported in television,
radio and the press. Greater efforts of popularising their own works, the use of
audio-visual aids and the participation of authoritative translations of books and
articles about the various aspects of Islamic culture into the major European
languages, all help to combat the errors and misunderstandings that are often
incurred by professional communicators. The application of microcomputers to
develop educational programmes that will provide factually accurate information
about events in Islamic history or Islamic contributions to science and medicine is
another means to this end. There is now a need to bring these areas of knowledge
into the organisational framework of the IUHPS/DHS and into the intellectual
realm of its concerns, and I hope that this conference will provide a forum for an
active dialogue on such important matters.'
A report on the course of the conference is given in the following text by Paul
Ghalioungui (Cairo), Professor, M.D.:
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237

No words of praise could measure up to the abundance and organisation of the
meetings. The subjects treated in the 110 odd papers included:
The importance of spiritual and religious aspects in therapy.
The contribution of Muslim scholars in anatomy and surgery.
A seminar on Abu/ qasim al-Zahrawi.
The therapeutic methods mentioned in the Holy Koran and Hadith, used by
Moslem physicians.
A seminar on the advantage ofherbal treatment.
The relationship of the curricula of faculties of medicine to Islamic teachings.
The present situation and future prospects oflslamic medicine.
The influence of the Islamic heritage on other civilisations.
An important point that emerged was the different meaning given to the term
Islamic medicine: medicine as expounded in the Koran and the Prophet's tradition
(the Sunna), or the medicine of the Golden age of Islam, or the present state of
health and medicine in Islamic countries.
The first view that may be compared to the fundamentalist concept that everything is found in the Bible is, however, tempered by the modem Muslim
theologians' concept that the Holy Koran should be subjected to a constantly
renewed interpretation in the light of accruing scientific knowledge, the Holy Book
being considered as a repository of eternal knowledge, only gradually to be
revealed to man.
Nevertheless, too literal interpretations led to some unwarranted assumptions,
e.g. that honey is an absolute panacaea to all illness, based on a specious interpretation of verse (The Bee, 68, 69): 'And the Lord taught the bee to build its cells ...
then to eat all the produce (of the earth) ... There issue from within their bodies a
drink of varying colours wherein is healing for men.' Honey was accordingly
reported by some speakers to cure, in local applications to the eyes, in intravesical
instillations, and in oral administration, such varied conditions as cancer,
postherpetic leucomas, ulcerative conjunctivitis, keratitis, bilharzial cystitis and
chronic non-specific diarrhea, whatever the last term may mean. Unfortunately,
the reports were weakened by lack of accurate diagnostic criteria and of proper
scientific control. In particular, the treatment of chronic non-specific diarrhea had
to last several weeks and to be repeated at intervals. The local daily newspaper
Al-Siassa commented that such reports play into the hands of denigrators of the
Arabs.
A valiant attempt at supporting the ancient against the new was the exhibition in
force of supporters of herbal and Yunani medicine, only one speaker pointing out
that Yunani literally means Greek, not Islamic and that it clearly indicates its origin.
Before the advances of modem chemistry and pharmaceutical science, plants and
other 'simples' were the only therapeutic media available. It may be reasonably
assumed that, had modem sera, antibiotics, and alkaloids been known to Galen,

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Rhazes and Avicenna, they would not have hesitated to utilise them. The supporters of herbal medicine tend to forget that no physician denies the virtues of
plants from which all our pharmacopoeia was, until recently, drawn. But we prefer
the digitalis leaf with its variable content of active principle to the standardized and
trustworthy crystallised preparation. What plants can cure diphtheria, tetanus or
prevent measles and poliomyelitis? Such considerations leave one wondering at the
real purpose of such propaganda.
A saner and more fruitful view of Islamic medicine defines it in the light of divine
directions and urges a deeper understanding of the moral values of Islam, of the
ethical standards it demands, and of the Koranic concept of total health, that
encompasses mind and body. This was mainly the subject discussed in the sections
on the relationship of medical curricula of faculties of medicine to Islamic teachings
and the importance of spiritual and religious aspects in therapy.
In these multifacetted studies, two seminars stood out like gems. In the seminar
on Ibn al-N afis, a comparison of the dates of appearance ofthe Italian works that
dealt with the movement of the blood immediately preceding Harvey's De motu
cordis, the date of publication of Alpago's translation of part of the Arab author's
work was, in the mind of several speakers, sufficient evidence to the possibility of
the Italian's and consequently of Harvey's knowledge of Ibn al-Nafis's work.
A sp~aker, having completed a critical edition of the whole of Ibn al-Nafis's
commentary, pointed to many divergences from Galen's and Avicenna's anatomical descriptions, supporting the view that Ibn al-Nafis performed dissections.
Finally, a hitherto unknown manuscript of the Commentary, probably written
by Ibn al-Nafis himself long before his death revealed that the part of the Commentary concerning the lesser circulation was kept hidden by the author for several
decades. Another speaker described him, on the basis of his 'Fadil ibn Natiq', as a
philosopher who tried to reconcile religion and reason, basing himself on a teleological argument that is purported to prove the inevitability of the religious dogma,
and of the minutest details of the Prophet's life.
A second seminar on Al-Zahrawi stressed, apart from his survival works, his less
well-known contribution to pharmacy.
As a whole, the Conference was a great success; it provided a meeting ground of
scholars of the highest standing each his own speciality, and each with his own view
ofthe meaning oflslamic medicine.
As special importance was given to the pharmacotherapeutic presentations, an
analytical comment on this subject given by Professor Dr. Gunther Stille, pharmacologist, West-Berlin, is to conclude this survey:
'As it is impossible to comment upon all the details of the pharmacotherapeutic
presentations of today, I will pick out some important points in respect to clinical
evaluation of herbal drugs of the Islamic heritage.
Under 'applied research' the organizer of this meeting invited contributions to
modem methodology and results of well planned trials with a sound statistical
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analysis. There is no doubt that modem methodology of drug evaluation is very
useful in clinical pharmacology to record the pharmacodynamic effects of drugs in
men. But we have to differentiate between the pharmacodynamic effectiveness or
efficacy of drugs in men. To record the pharmacodynamic effect is one and to seize
the therapeutic usefulness in an other thing. It is the second question which is
crucial for the clinician.
Now there are some doubts as to whether the methods of modem Western
natural science are suited to the verification of therapeutic efficacy and usefulness
of all types of remedies from the heritage of classical Arabian medicine. The
differences between modem drug therapy and the herbal therapy of the classical
doctors are founded upon the differences in the basic understanding of disease. For
modem natural science, the cause of disease is a molecular or cellular defect. In
classical medicine a disharmony of humours and functions is the reason for the
diseased state of a patient. This conception reminds us of the modem conception of
cybernetics.
Let us have a look now at some contradictions:
1. The controlled trial is based on randomization.
A representative sample of patients is divided arbitrarily into treated and untreated groups. This is based on the premise that all patients with a specific disease
react in a comparable way within the limits of statistical deviations. According to
Ibn Sina and other ancient sages, however, the patient is an individual, characterised by his personal temperament. Ibn Sina said: 'One must realize that every
individual person has a temperament entirely peculiar to himself, and it is impossible for any other person to have an identical temperament, or even to
approximate thereto.' Thus the premise for randomization is not fulfilled. The
problems of randomization are discussed by Western clinicians and clinical
pharmacologists, too. The question is, how to build up a control group without
randomization. One possibility is to work with 'matched pairs'.
2. The controlled trial uses only one or a very limited number of symptoms as
criteria for evaluation. We speak of a 'reductionistic approach' in which we strip
the image of the diseased man of all personal attributes. This is in contrast to
classical Arabian medicine which describes the patient by a great number of general
attributes and which tries to complete the picture of the patient not only by
numerous somatic data, but also by his environment such as climate, season,
cosmic influences etc. We know this problem in the Western medicine very well
and there is a certain uneasiness about this situation.
3. There is one very important and essential difference between Western natural
science and classical medicine. Since Galilei scientists produce artificial conditions
for their scientific observations. This is the basis of the experiment and therefore of
the controlled clinical trial. Medical doctors become scientists, when they include
and exclude patients by arbitrary criteria and so manipulate the conditions of
observation. Ancient doctors, in contrast observed the patients in their natural
environments and natural conditions.
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4. A very important condition, especially for the double-blind study, is that the
doctor is excluded as far as possible. This means that not the therapeutic ability of
the doctor with the drug is tested, but rather the intrinsic curing activity of the drug.
This is a very important point. There must be some doubt that the herb or the
chemical have any curing efficacy at all. In my opinion there is a pharmacodynamic
effect of a drug in a definite treatment. What turns out to be efficient or inefficient,
though, is the therapy of a certain doctor who uses the drug as an instrument. In
good modem practice as well as in classical medicine the doctor is playing a
decisive part in the therapeutic process. Herbs, purgation and bloodletting are
instruments in his hand. It is difficult to imagine a blind doctor in the sense of
double-blind study in classical medicine. So I repeat: The controlled study with
randomization is well-suited to the study of pharmacological effects, to an
instrumental function of a drug. But we have to develop alternative approaches to
the therapeutic evaluation of drugs. The famous doctors of the past thought that
there is no disease, but only diseased people. This is true for us in the same degree.'
Here we find a synthesis of classical experience and modem thoughts about the
limits of medical technology, which might point to the future of a world-wide
conception of really effective therapies. This view into the future was one of the
underlying efforts of the 2nd Conference on Islamic Medicine.
P. GHALIOUNGUI, E. C. FORBES, G. STILLE, M. PUTSCHER

II. MEDICAL EVOLUTION AND METHODOLOGY
On the Activities of a University Department in Ankara
It seems safe to say that the scope and limits of any scientific activity would be
affected, to a significant extent, by the 'title' it has been given. And any change in
this title would result, normally, in a change of attitude towards the activity itself.
In the case of a domain such as medicine and its history, both being of academic
as well as popular interest, new terms of basic significance should be defined rather
precisely as future studies will be based on a new orientation directed by the
proposed terms. This is the reason why we have been trying, in our academic Unit
of Medical History and Deontology, to delimit carefully the meanings of the terms
'medicine', 'medical methodology' and 'medical evolution'.
This has been a rather recent development in the Unit however, because the main
orientation used to be of an essentially 'classical' nature, with a 'deified' approach
to medicine and its historical development, to the medical profession and its
activities. The Institute of the History of Medicine was founded in 1946, a year after
the opening of the Ankara Medical Faculty (affiliated to the Ankara University),

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with the same professor being active until his retirement ten years ago. Named as a
'chair' and later as a 'department' of Medical History and Deontology, our Unit has
lived through several vicissitudes at different times of its history -losing its identity
by being attached to another department and thus being d~pendent upon another
medical discipline, then becoming an independent unit again. With the appointment
of a new director, about a year and a half ago, the Unit has assumed a totally
different function, particularly at the postgraduate academic level.
The new director, Prof. Fuat A. Goksel, is a psychiatrist and has been teaching,
for more than twenty years, medical psychology and sociology, social psychology
and psychosocial studies in literature, as well as clinical psychiatry. Thus, his
academic activities have not been limited at all by his lectures for medical students,
mostly given at the Ankara Medical Faculty. His interest in the Philosophy of
science has been a great impetus to the postgraduate seminars and other activities
which his present unit carried out with the participation of academicians of quite
different origin, from linguists and social scientists to physicists, mathematicians
and philosophers. A main interest of Prof. Goksel is the domain of values, hence his
concern with deontology in medicine.
One of the two other academicians at the Unit, Dr. M. Cemil Ugurlu, is in origin a
specialist of physical therapy. Before assuming his present position about three and
a half years ago, he devoted several years to the study of a basic discipline,
Histology and Embryology, where his main interest was the physical and chemical
aspects of the methods used. More recently he has been working on the mathematical aspects of medicine and science, and the role of mathematics in human life.
The youngest member of the group of three academicians, Dr. Yaman Ors,
originally a pathologist, is now a lecturer at the Unit where he has been working for
more than thirteen years. His interest in biology as well as his background gave him
the opportunity of seeing medical activity as a general biological reality, and to
consider medicine and medical history as a 'corpus' and continuum. He has been
developing a concept in his discipline which he calls Medical Evolution, orientated
towards the study of earlier and present phenomena related to medicine, rather
than the classical subject matter of medical history. He has also been writing on
topics such as disease and evolution, cancer and the environment, general ecology
and history, as well as on medicosocial issues.
The undergraduate program of the Unit is undertaken by all three members of the
group and consists of the following and similar topics: discussion of the medical and
scientific knowledge, method in natural sciences, methodology of medicine and
medical history, stages and characteristics of medical development, impact of the
past upon medical concepts, medicine in earlier societies, the evolution of morphology, the evolution of psychiatry, the doctor-patient relationship, institutions in
medical evolution, legal and ethical aspects of medicine, medical deontology, and
so on. (Prof. Fuat Goksel is also lecturing at another medical faculty in Ankara,
following a program of his own but essentially with the same evolutionary
aooroach.)
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One of the points stressed in the Unit's approach to medical development is the
concern of objectivity, so far as is possible, in normative and deontological, as well
as factual and theoretical issues. An objective explanation and evaluation of the
material rather than a 'medical' or other indoctrination, conscious or not, has been
the departing point of our teaching activity. Consideration of failures as well as
successes in medical evolution, presentation of the content within the framework
of a cause-effect relationship and as stages of development, the use expected to be
gained at the end of the course, such are the principles adhered to in our program
directed to last-grade medical students.
Thanks to the efforts of Prof. Goksel and some of his colleagues in certain other
departments of the Faculty, we are hoping to be able to incorporate courses of
methodology at different levels of the curriculum and, also, for the assistants in
different specialities of medicine.
As for our multidisciplinary postgraduate activities, we have not been able, so
far, to find an opportunity for the publication of communications made by our Unit.
This is partly due to the inability of receiving written texts from the speakers and
partly to the insufficient secretarial services. All the same, the idea that contributors would later be able to submit their communications to scientific (and/or
popular) journals gives us satisfaction, just as the free discussion of topics on the
philosophy and methodology of science and medicine, together with related fields
such as dentistry, and their development, as well as on other academic issues such
as the derivation of scientific terms, systems theory, science and the society, and
the like.
More recently, we have undertaken, in collaboration with the departments of
Philosophy and Biology ofMETU (Middle East Technical University) and the Unit
of Molecular Biology at Hacettepe University, a joint program of 'Life Sciences
from the Viewpoint of the Philosophy of Science', which has begun as a series of
meetings on relevant topics including those of psychology - 'communication in
living systems', 'Claude Bernard and method in life sciences', 'the philosophy of
natural sciences', 'population genetics and molecular biology'.
As a great majority of these activities take place in our Unit, we are pleased to
have an opportunity to show our books and archeological and other material to
colleagues from different disciplines. We do hope that our collection of books of
different periods on almost every branch of medicine and in various languages with
some manuscripts among them, and an additional amount of non-medical works on
other fields, biology, history, art and so on, will be of greater use in the future to all
sorts of interested people- students, university teachers, researchers and others,
including, perhaps, those from other countries.
YAMANORS

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III. FIRST MEXICAN CONGRESS OF THKHISTORY OF MEDICINE
This event commemorated the 25th Anniversary of the Mexican Society of
History and Philosophy of Medicine and took place in Mexico City from February
24 to 26, 1982, under the able leadership of the current president of the Society, Dr.
Juan Somolinos Palencia, in the auditorium of the National Academy of Medicine
and the restored XVIIth century Palace that was the School of Medicine. Special
guests were Horacia Figueroa Marroquin from the Universidad de San Carlos,
Guatemala; Robin Price from the Wellcome Institute for the History of Medicine,
London and Guenter B. Risse from the University of Wisconsin, Medical School,
Madison U.S.A.
The event opened with welcoming speeches by the Mexican Secretary of Health
and Welfare, Dr. Mario Calles Lopez Negrete and the Honorary President of the
Congress as well as present incumbent of the medical history chair at the National
University, Dr. Francisco Fernandez del Castillo. The major conferences were
delivered by Miguel Leon Portilla, a renowned historian also from the National
University and the special participants already mentioned, who spoke respectively
about hospitals for the mesoamerican Indians, the history of physiology in Guatemala, the smallpox epidemic in Mexico and ecology of disease in history. Other
important presentations included subjects such as the soul in Nahuatl medicine,
survival of XVIII century Mexican Jesuits and the patient in medical history,
respectively by Alfredo Lopez Austin and Vicente Guarner.
After the closing remarks by Juan Somolinos Palencia, both participants and the
public were invited to visit the newly established Mexican Museum of Medical
History. Now it occupies the ancient building which in the XV lith century was the
sinister Palace of the Inquisition and later became the Medical School. After the
reconstruction, it houses the Museum and the Historical Library and Archives
now.
The First National Congress was indubitably a success, uniting historians,
physicians and above all medical students in discussions and fruitful exchanges.
Medical history is indeed alive and well in Mexico, rapidly reaching a level of
research and teaching already enjoyed in other countries with longer traditions and
greater financial support for higher education. More contacts with Mexican
counterparts are desirable and future planners of meetings in this country ought to
ponder the possibility of jointly sponsored activities.

IV. VOTE OF THANKS

To the Wellcome Trust, London and to the Pieter van Foreest Stichting,
Amsterdam

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In 1981 it already became quite clear that even an international periodical like
Clio Medica has to struggle with financial difficulties for its survival: Mr. Israel,
who had published Clio Medica for more than 10 years (starting with volume No.
6/1971) without any financial support, had, at that time, declared that he would
require a subsidy for volume 17I 1981 as well as for the following volumes, because
the number of subscribers was not sufficient.
The attempt to obtain financial aid for Clio Medica from those institutions
subsidizing the national medico-historical reviews was defeated by the fact that
Clio Medica is an international periodical. In spite of everything that has been said
about international co-operation for quite a few years now, it was absolutely
impossible to find an institution capable of supporting Clio Medica.
The first subsidy granted by the 'Anton-Betz-Stiftung der Rheinischen Post e. V.,
Dusseldorf (see Clio Medica, News & Notes 17-1) has now been continued by a
notable allowance given by the Wellcome Trust, London, who also supplemented
the grant given by the 'Robert-Bosch-Stiftung, Stuttgart'.
Lastly, the 'Pieter van F oreest Stichting, Amsterdam', has granted the amount
which was still missing in order to reach the end of 1983, thus guaranteeing the
appearance of Clio in full size up to and including volume 18.
Once again, the problems which could have easily led to the ruin of Clio Medica
have been banned for a while. For this reason the editors want to express their
gratitude in this place.

V. COMMEMORATION DU 150e
D' ANTOINE PORTAL (octobre 1982)

ANNIVERSAIRE

DE

LA

MORT

Les ler, 2 et 3 octobre 1982 a eu lieu dans le departement du Tam Ia celebration
du 150e anniversaire de Ia mort d'Antoine Portal (1742-1832) fondateur de l'Academie de Medecine.
Le Ier octobre les participants acette manifestation furent re<;us aI'Hotel de ville
de Castres (Musee Goya) apres qu'une plaque ait ete apposee sur Ia maison natale
de Philippe Pinel (1745-1826) a Jonquieres et que les professeurs P. Huard etA.
Sicard aient rappele son oeuvre d'alieniste.
La joumee du 2 octobre se passa a Albi avec des receptions au Palais de Ia
Berbie, chez le Dr. P. Amalric et Ia visite du Musee Toulouse-Lautrec et de Ia
cathedrale Sainte Cecile.
Le 3 octobre eut lieu a Gaillac, ville natale de Portal, !'inauguration d'un buste a
son effigie. Auparavant divers orateurs exposerent divers aspects de sa vie et de
son oeuvre:
Portal a Albi (P. Amalric); Portal et Gaillac (Mr. Yrissou); Portal et Montpellier
(J. Mirouze); Portal et Toulouse (G. Lazorthes); Portal et les academies etrangeres
(J. Fran~ois); eloge de Portal (A. Sicard).
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II convient de feliciter le Dr. P. Amalric qui avait pris l'initiative de cette
manifestation a laquelle participerent une quarantaine de membres fran<;ais et
etrangers de I' Academie N ationale de Medecine parmi lesquels figuraient son
President, le Prof. A. Sicard et son Secretaire perpetuel, le Prof. A. Lemaire.
JEAN THEODORIDES

VI. GENERAL MEETING OF THE INTERNATIONAL ACADEMY OF THE
HISTORYOFMEDICINE-PARIS, 1982
Report of the Secretary-General
At the opening of the General Assembly, Dr. J. Thedorides expresses his thanks to
Prof. Auquier, President of the University Rene Descartes and Prof. Huard, who
could obtain the 'Salle du Conseil' of the old Faculty of Medicine for our meeting.
Several members sent their apologies for not being able to attend the General
Assembly: M.M. De Moulin (The Netherlands), Dulieu and Grmek (France),
Koelbing (Switzerland), Larsen (Norway), Lopez Pinero (Spain), Risse (U.S.A.),
Schipperges (Germany), Schultheiss (Hungary).
Since our Strasbourg meeting (8-10 September 1980) the Academy has lost two
of its members: Prof. Eulner (Germany) and Prof. Wangensteen (U.S.A.), which
we had to replace, as well as Prof. Kruta (Czechoslovakia) who passed away in
1979. In the spring of 1982 three new members were elected: Prof. J. Cassedy
(U.S.A.), Prof. G. Rudolph (Germany) and Prof. H. Walser (Switzerland), the last
two were present at the Assembly.
We also learnt of the demise of Prof. Szpileczynski (Poland) and Prof. Siiheyl
Unver (Turkey). Thus there is still one vacancy as Prof. Siiheyl Dnver was a
honorary member.
As it had been announced at the Strasbourg meeting two years ago, the Secretary-General wants to resign from his functions starting from January 1, 1983. He
hopes to have maintained the Academy at its best level since 1976, and expresses
his thanks to the President Prof. J. Leibowitz (Israel) for his confidence. Madame
Imbault-Huart (France) has been elected as new Secretary-General. He also wants
to thank Prof. M. Putscher for all the time and care she has given to the publication
of our journal Clio Medica.
Article 4 of the statutes of the Academy says that the latter can elect three
honorary presidents among its members. At the London meeting (1970), Prof.
Bariety (France), Prof. Florkin (Belgium) and Lord Cohen of Birkenhead (U.K.)
had been elected for this function. As these three eminent members died since then,
it is proposed to the Assembly to elect Prof. Ackerknecht (Switzerland), Prof.
Belloni (Italy) and Prof. Huard (France) to replace them. This proposal has been
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accepted by the Assembly which uses the occasion to congratulate the two honorary presidents present at the Assembly.
Dr. Bowers (U.S.A.) resigned from his function of treasurer. Dr. Vetter (France)
accepts to replace him for the time being.
JEAN THEDORIDES

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Essay Review
David E. Stannard, Shrinking History: On Freud and the Failure of Psychohistory. Oxford, Oxford
University Press, 1980, 187 +XX pp., US$ 12.95.
Clio has been blessed and burdened by Psyche long enough to demand a serious historical and critical
treatment of the relationship. Approaching Professor Stannard's monograph with the hope that this
would be it, I was soon, however, disappointed.
This is a book about which it is difficult to be succinct. This is so, not because of the power and
subtlety of its author's argument, but because Stannard, at one time or another, exemplifies almost
every conceivable misconception and oversimplification with which one could approach psychoanalysis and its application to the living or the dead- as well as not a few about epistemology in general
and the historical enterprise in particular.
To begin with, Stannard has not done what it seems that any historian should do: a reasonably
complete history of his subject (which is at least as old as Mobius' prepsychoanalytic psychobiographies
of the late nineteenth century). Rather, he cites a handful of (by and large the most atrocious) examples
of the application of psychoanalysis to history and then arrives at the convenient conclusion that since
Freud's Leonardo (one of the first, and worst, examples ofpsychohistory) 'provides the uninitiated
reader with a sample of the type of work done by the psychohistorian' (p. 21 ), there is no need for him to
do a history of his subject!
Second, it soon becomes apparent that this is not a book about psychohistory at all. Instead, it is an
attempt to discredit psychoanalysis itself and, by so doing, any history that makes use of it. 'It is a
premise [undoubtedly the correct word] of this book that the best possible psychohistory would still be
bad history because of the limitations imposed by the weaknesses of the underlying theoretical
structure' (Stannard's italics, p. 21).
Unfortunately Stannard breaks another historical commandment here- that one should get inside the
author or body of work he is reappraising, rather than relying on secondary sources or others' criticisms
of him or it. Just as Stannard did not familiarize himself or his reader with the history ofpsychohistory,
he exhibits no appreciation of psychoanalytic theory (or even Freud's corpus) as a whole, nor of the
relationship among (and relative importance of) its component ideas. Moreover, the author does not
realise that within psychoanalysis itself there are many divergent schools of thought, and has no grasp of
the clinical method of dynamic psychiatry.
Although implicitly admitting the latter, Stannard (p. xv) excuses himself by comparing Freud's
suggestion that those unfamiliar with psychoanalytic methodology are in no position to criticize it to the
assertion that only a Jesuit can understand or criticize the teachings of Ignatius Loyola. Yet it seems to
me that there should be some middle ground between completing psychoanalytic training and total
ignorance of the way the analysts proceed. Perhaps the author could have read some of the better
textbooks on technique, spoken with a few analysts about their work, and even arranged to sit in on a
few clinical conferences or a continuing case presentation getting a first hand glimpse of how the theory
interacts with its data. What would one say about an analyst who wrote a diatribe against historical
methodology without first acquainting himself with the procedures of the academic historian?
Third, Stannard does not approach his subject with the sober and dispassionate attitude enjoined
upon the historian. This is no better exemplified than by his very language. Words and phrases like
'selfpossessed', 'tawdry and crackpot' (p. xi), 'mystic' 'intellectual charlatan' (p. xvi), 'pipedreams' (p.
xvii), and 'smokescreen of functionless private jargon and dogmatic Alice-in-Wonderland logic' (p.
xviii) abound. And we are not even out of the Preface! In the body of the book we encounter 'silliness'
(p. 29), 'retrospective soothsaying' (p. 70), 'harebrained ... pretentious ... dead wrong' (p. 82), 'quirky,
dogmatic, often oracular, and wholly unverified- indeed illusory' (p. 154), and so forth. One loses count
after a while. Nor does the author omit pseudopsychiatric moralizing, diagnosing psychohistory as
'narcissistic' (p. 151) and psychoanalysis as 'illusion'.
Clio Medica, Vol. 17, No.4, March 1983
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Where Stannard does not substitute namecalling for close reasoning and criticism, he resorts to
ridiculing analogies between psychoanalysis and astrology or spiritism (p. 10): '[The hypotheses of
psychoanalysis are] not unlike those of astrology: complex, vague, logically circular, intermittently
accurate (the result of chance and/or suggestion), and of scholarly interest primarily to the historian of
strange ideas' (both italics mine). Indeed, so many of his statements are like this that one almost
wonders if the writer himself really wants to be taken seriously.
Stannard mounts his attack in four waves, each occupying a chapter of the book: problems offact, of
logic, of theory, and of culture. The 'problems of fact' (p. 22) are examined largely through a critique of
the effectiveness of psychoanalytic therapy. The author sets the tone for this chapter with another of his
many guilt-by-association ploys, comparing the psychoanalytic theory of 'demons residing in the
unconscious' to the medicine man's soul capture hypothesis of mental disorder.
His argument, in a nutshell, is that if psychoanalytic theory is correct, then psychoanalytic therapy
must be proved superior to therapies based on other theories. Sidestepping for a moment the question of
the cogency of this premise, let us look at his argument. Taken at face value it would appear to be the
strongest in his book since statistical, quantitative studies (which are the only ones he will admit as
evidence) do not, for the most part, bear out that psychoanalysis is superior to other forms of
psychotherapy or even, for that matter, that psychotherapy is better than no treatment at all.
Stannard's argument is, however, open to criticism on at least two grounds. First of all, it ignores the
thorny issue of methodology in psychotherapy-outcome studies. Among the difficulties are: (I) agreeing
on what constitutes acceptable criteria for improvement- e.g. feeling better, going back to work, being
symptom-free for a year, radically restructuring one's self-world view and the behavior patterns that
issue therefrom, etc.; (2) controlling all the patient, therapist, and environmental variables; (3) establishing control groups not receiving treatment sufficiently similar to those who do; (4) determining
exactly what is meant by the so-called 'spontaneous cures' and the factors that produce them, and (5) the
fact that large-scale outcome research is attempting to quantify the unquantifiable- the subjective state
and system of meanings of the idiosyncratic human individual. Not surprisingly, the author rejects out of
hand the idea that success or failure must be determined, in large measure, on a case by case basis and by
how the particular client and therapist feel on the matter.
Stannard's primary error here is a failure to distinguish between psychoanalysis as explanatory
system and psychoanalysis as therapy. Presumably it is the former and not the latter in which he is
interested. Psychoanalytic theory is a way of thinking about patients, not of intervening with them. The
actual interventions depend upon whether one is doing psychoanalysis, insight oriented psychotherapy,
or supportive treatment with the particular patient and upon one's personal style as a therapist.
Stannard himself is dimly aware of the illogic of his procedure though he does not let it brake him in the
least (p. 57): 'disconfirmation of therapeutic effic&cy [which, in any event, has not occurred] ... does not
necessarily imply disconfirmation of the total system of explanation in question, any more than
confirmation of therapeutic efficacy would necessarily confirm the validity of that system' (Stannard's
italics).
One cannot discuss St&nnard's interrelated chapters on 'The problem of logic' and 'The problem of
theory' without examining his own problems of logic. A major one is his continual reification of
metaphors and models- the very thing, stmngely enough, he berates Freud for doing. For example, on
p&ge 141, he snidely comp&res the 'idea among some European-Americans that certain kinds of insanity
are the result of a trinity of mysticalforces in the mind that are called id, ego, and superego' (my italics),
to the Navaho notion that madness is caused by moths in the head. After begrudgingly acknowledging
that 'something-like' projection may operate, the author then goes on to add that 'empirical efforts to
confirm the existence of this postulated mechanism have failed to do so' (my italics). Similar statements
are made regarding repression and transference. He holds forth repeatedly (and negatively, of course)
on the 'existence and nature of the Freudian unconscious' (my italics, p. 58), the 'structure of the
unconscious' (my italics, p. 87), and the 'belief that [uncomfortable memories and desires] are lurking in
a place known as the unconscious' (my italics, p. 107).

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'Projection', 'repression', the 'id', 'ego' and 'superego', and the 'unconscious' are not mechanisms,
forces, or places in the literal sense. They will never be dissected out of the temporal or prefrontal cortex
nor precipitated out in a centrifuge. They are theoretical constructs or heuristic devices designed to help
us understand that most complicated of all realities- interpersonal relations. Like all models, they will
stand or fall on their internal consistency, explanatory usefulness and instrumental potency. Do they
help the clinician make sense of what he encounters? Can he test out his hypotheses with information
and reactions that the patient subseq~ently supplies? Can he influence reality with interventions based
upon these formulations? Finally, can the clinician make rough predictions from the patient's account of
his current problems and the patient's interactions with him to what he will uncover in the past history?
The answer to all these questions is a resounding 'yes'.
Let us next examine Stannard's contention that psychoanalysis falls prey to the 'post hoc, ergo
propter hoc fallacy'. Indeed, post hoc ergo propter hoc reasoning can be used in a logically objectionable way- by historians as well as psychoanalysts. Does that mean, however, that they should be
prohibited from using it altogether? Since analysts, as much as historians, cannot resort to controlled
experimentation on their subjects, then what are they to do if they cannot make causal inferences after
the fact? Good practitioners in both disciplines do not make such inferences from one isolated
occurrence of event 'B' after event 'A', but only after learning of many such sequences. Nor do they
take a simplistic, linear, unicasual view of things, recognizing rather that many factors usually come
together to produce a given event or behavior and that indeed the cause(s) and the effect(s) are often in a
state of inextricable mutual interaction. For example, merely because one patient's accident proneness
followed her boy friend's death did not necessarily mean that it was feelings about this event that caused
her symptoms or that her central issues had to do with separation and loss. It was only after taking her
history and encountering the sequence between abandonment and accidents several times that I
considered this to be a reasonable hypothesis.
Stannard then attacks thinkers such as Paul Ricoeur who seek to 'immunize' psychoanalysis against
experimental criticism by maintaining that the analyst is not concerned so much with actual events as
with the meaning .of these events. He calls such a viewpoint 'mystical' and maintains that it 'makes
utterly irrelevant actual life experience and the individual's interaction with others' (p. 150). 'Solipsism
thus becomes the final defense of a psychological theory that consistently has failed to weather the
rigors of experimental verification' (p. 115).
Had the author spent any time in clinical case conferences he would have learned that the clinician is
not unconcerned with external events ('actual reality'). It is simply that the analyst does not stop there,
but wants to know, above all, what they mean to individual patients, how they are perceived and
interpreted by them (e.g. 'psychical reality'). Furthermore, the psychoanalyst recognizes, as Stannard
does not, that there is no hard and fast line between the external event and the internal meaning. The two
are constantly interacting with one another. A person's habitual modes of perceiving and interpreting
self and world are a function of the history of his contact with actual reality (of his interpersonal
relations, in other words) at the same time that they feed back upon and actually influence that external
reality.
Stannard's reification of terms, his post hoc ergo propter hoc argument and his misunderstanding of
the analyst's concern with psychical reality are predicated upon naive misconceptions about epistemology in psychology and in history. Like von Ranke and the early Freud, he acts as if the simonpure
truth is sitting out there waiting to be discovered. In fine, he fails to appreciate that both psychoanalysis
and history are fundamentally interpretive and reconstructive enterprises. Rather than actually
discerning 'causes' or 'determinants', the analyst and the historian are involved in arriving at causal
inferences or explanations. Only in science, where one can engage in controlled and repetitive experimentation, can one speak of actually divining causes or determinants.
Furthermore, the historian deals with the real event no more or even less than the analyst. The noted
historian and philosopher of history Becker (1969, p. 181) has put it aptly:

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the historical fact is in someone's mind or it is nowhere ... The actual occurrence and the historical fact,
however closely connected, are two different things. The actual occurrence, the event, has passed, is
gone forever, never to be repeated ... (my italics).
Even the records with which the historian works are, Becker continues, not the event itself but only a
pattern of ink on paper left by someone with an image or idea of the event. It is, in other words, the
'historical fact' rather than the 'actual occurrence', that is the historian's concern. All dynamic
psychiatrists grasp this important distinction in their differentiation between the patient's 'actual
biography' (the irrecoverable external events) and his 'analytic' one (the events as perceived, interpreted, remembered and recounted by the person being analyzed) 1 •
Another of Stannard's misconceptions concerns the analytic theory of childhood determinism. He
acts as if this is the assertion that complex adult personality configurations and psychopathology can be
derived entirely from infantile events like weaning and toilet training. If he had read past Freud he would
have known that most analysts and analytically oriented therapists are not engaged in casting about for
traumatic 'whoppers· from the oral, anal, or phallic periods. Rather they are attempting to discern the
total pattern of the individual's interactions with parents and other important persons from infancy
through adolescence. It is this longitudinal pattern which is seen as determinative of the person's adult
view of self and world, and the behaviorthat issues therefrom. So-called psychohistorians, who collapse
complex social-political phenomena like the American Revolution into putative weaning habits, are
committing what a psychoanalyst himself (Erikson) has termed the 'originological fallacy'. This is
neither good history nor good psychoanalysis.
In his chapter on culture, the least problematic of the book, Stannard rightly warns against
generalizing from our own psychologies and views of self and world to those of people in other times and
places. He quotes a number of cross-cultural studies in support of this. Then he accuses psychoanalysis,
which he terms 'culture-bound', of 'myopically' imposing a presentistic system of explanation onto the
past. To begin with, arising in a particular historical era and cultural context psychoanalysis is no
different from any other science or discipline. That does not necessarily make its explanations any more
or less 'culture-bound· than those of any other discipline.
Even if some of dynamic psychiatry's substantive propositions about human psychology are culturebound, that does not mean that the model and method is so as well. In other words, it is likely that the
modal conflicts and developmental issues do differ somewhat across cultures and eras. Psychoanalysts
themselves have noted the changing incidences of psychopathological manifestations over time- the
symptom neuroses having declined, the character neuroses risen. The rise in narcissistic personality
configurations is by now a truism. Nevertheless, I maintain that, however much the content of the
psyche may vary, the psychoanalytic model will remain valid. The core of this model is as follows:
The mind is conceived of as a system of mental forces in motion. Observable or self-reportable
behaviors (including acts, feelings, and fantasies) are conceptualized as vectors between two or more
underlying (often unconscious) conflicting or complementary forces of varying magnitude and with a
history in the life of each individual. These forces (and I speak metaphorically) may be biological, social,
or, more commonly, an inextricable combination between the two. Dynamic psychiatry concerns itself
preeminently with the human organism's attempts to effect some sort of equilibrium among the internal
forces and between these forces and those of the environment. (Wallace, l982a)
This model does not specify what the conflicting or complementary forces must be. It allows for
different cultures interacting with the basic human biological endowment to produce utterly new forces
to reckon with. It allows for the impact of divergent social structures on biopsychosocial configurations
such as the Oedipus complex.
Truly Stannard will not give his foe an inch! Where he does concede that the 'harebrained analyst',
befogged in his 'smokescreen of... Alice-in-Wonderland logic', may have stumbled onto something he
calls it 'common sense' (in the case of projection), 'pre-Freudian common sense' (in the case of

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repression) or 'trivial' (in the case of the oral and anal personality configurations). As for the idea of the
unconscious he begrudgingly admits that 'it does easily appear to satisfy, in a popular [again] common
sense way, questions raised by phenomena ranging from dreams to forgetfulness to slips of the tongue',
and hence that 'the existence and nature ofthe Freudian unconscious must remain an open question, at
least in the everyday world of the nonlogician' (from which Stannard presumably excludes himself).
Does psychoanalysis have anything to offer the historian? I do not propose to give a clear and decisive
answer but rather to open up discussion with a point or two. First of all, it is obvious that I do not share
Stannard's faith in the intellectual and clinical bankruptcy of psychoanalysis itself. Quite the reverse in
fact. Indeed, I contend that any historian who cares to feel himself into psychoanalytic theory and
practice, as Stannard did not, will find himself in familiar territory - the historical method. The
psychoanalytic therapeutic investigation is founded upon a careful chronicling of each patient's life
course. Clinical psychoanalysis is a method for the study of the history of the individual and psychoanalytic theory (i.e. the 'metapsychology') is the philosophy of that history (Wallace, 1982a) 2 •
Second, psychoanalysis has been applied to history by many - probably most - in what Stannard
rightly calls a 'cavalier' and 'irresponsible' way. The more glaring errors include: analyzing whole
epochs and cultures as if they were so many mass minds; paying short shrift to nonpsychological factors;
acting as if the psyches of individuals in other ages and cultures are identical to our own; speculating in
the presence of little reliable psychological data; and excessive reliance on the instinctivist, id-psychological theories of early psychoanalysis. Nevertheless, merely because psychoanalysis is often misapplied in historical work does not necessarily mean that it is thereby inapplicable - any more than
historians' misuses of economics, geography, meteorology and epidemiology mean that these
disciplines are unutilizable in historical work.
It seems to me that, since the historian is primarily concerned with human behavior and since he often
finds himself making motivational inferences anyway, a psychology which is fundamentally historical
and motivational may have some potential usefulness for him. However, this utility is a much more
limited one than most 'psychohistorians' have imagined. This is because the psychoanalytic method is a
clinical method. It is applicable to one situation alone- the ongoing interaction between analyst and the
person being analyzed. Any transference of psychoanalysis to other situations- art, literature, culture
and history or biography - is a transference of insights originally arrived at by the clinical analytic
method, but it is not a transference of the method itself.
For example, using the clinical method of psychoanalysis Freud discovered that many mother-in-law
phobias are based on underlying oedipal conflicts. In Totem and Taboo he used this insight to
explain the institutionalized mother-in-law avoidances of whole primitive societies- whose members he
had never seen, much less analyzed (Wallace, 1982b). Failing to recognize that he had transferred the
insight but not the method, F!eud treated such hypotheses as if they had the same validity as the
empirically based propositions of clinical psychoanalysis. He did the same with Leonardo who, of
course, could not respond to Freud's interpretations, free associate to the vulture fantasy, or supply him
with slips, dreams, recollections and the other essentials of any analytic treatment! 3
In conclusion, I feel that the historian can make limited, psychoanalytically informed inferences
about figures for whom he possesses an abundance of information (diaries, letters, dreams, childhood
data, remembrances of contemporaries, etc.). Such hypotheses, however, must be put forward with
considerable caution and humility and must be considered in relationship to all the other, nonpsychological, factors in the person's life. Even more reticence is prescribed when one is looking at
groups or even historical periods 4 .
However useful psychoanalysis may be to the historian, I maintain that there is no place for a separate
discipline of 'psychohistory'. Indeed, I do not even like the word. History is history and it will make use
of whatever is at its disposal- psychoanalysis included. The historian should subordinate his method to
psychoanalysis no more than to any other discipline or limit his search to psychological factors no more
than to any other factors.

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In summary, Stannard has given us, not a balanced historical and critical study, but a polemic that
leans, when it suits him, on bits of history. It is, in other words, a tendentious piece, an attempt to close
off, rather than open up, discussion on the issues at hand. If it succeeds in doing the latter it will, despite
Professor Stannard, have served at least one useful purpose. The danger is that some historians,
ignorant of the methodology of psychoanalysis but knowledgeable of the shenanigans of many 'psychohistorians', will take Stannard's book as good reason to be done with the matter once and for all.
Fortunately, this book is written in such a snide and flippant style that this in itself will dissuade many
readers from taking it seriously 5 . Clio suffers when she becomes subservient to Mars quite as much as
when she is enslaved by Psyche.
NOTES
I. But here one would have to add that the analyst, in contrast to the historian, deals not only with
'historical facts' (i.e. the meaning of the past in the present) but with 'actual events'- the transference
(i.e. the patient's reenactment of historically determined behavior in the presence of the analyst). It is
the latter that gives the dynamic psychiatrist a route into the past (or, rather, into the reconstruction
of the past) that the historian does not have. This, coupled with the opportunity to question the matrix
of the historical facts (i.e. the patient), to test his historical theories against the subsequent responses
of this matrix, giv.es the psychoanalyst advantages in his work that the historian does not have in his.
2. The historical method of psychoanalysis may even have some provocative and constructive implications for the historical method of the academic historians - in particular in relationship to the
subjectivity-objectivity problem and the impact of each historian's particular personality and
psychodynamics on his attitudes toward, and perceptions and interpretations of, his material (be it
person or period).
3. It is interesting that Freud himself implicitly grasped this problem in the application of psychoanalysis to history though unfortunately he did not let it influence his psychohistorical speculation.
To Lytton Strachey, the British biographer, he wrote in December, 1928:
You recognize what historians are otherwise very apt to ignore, that it is impossible to understand the
past with any certainty, because we cannot guess at men's motives and their mental processes, and
so cannot interpret their actions ... So the people of times past are to us like dreams for which we are
given no associations, and only laymen can expect us to interpret dreams like that. (In: E. Freud, L.
Freud, I. Grubrich-Simitis, 1978, p. 244.)
4. I submit that the brand of psychoanalysis which would prove most useful to the historian is not
classical Freudian id psychology but rather the revisionist interpersonal, ego psychological and
object relations approaches.
5. Stannard's book begs comparison with Jacques Barzun's (1974): Clio and the Doctors:
Psycho-History, Quanto-History, and History. Barzun's work, in contrast to Stannard's, is a sober and balanced reappraisal of the use of psychoanalysis in history.
REFERENCES
Barzun, J., Clio and the Doctors. Chicago, Univ. of Chicago Press, 1974.
Becker, C.L., What Are Historical Facts? In: Ideas of History. Volume Two, ed. R. Nash. New York,
E.P. Dutton, 1969, pp. 177-193.
Freud, E., Freud, L., Grubrich-Simitis, 1., Sigmund Freud: His Life in Pictures and Words. Tr. C.
Trollope. New York, Harcourt, Brace, Jovanovich, 1978.
Wallace, E., Dynamic Psychiatry in Theory and Practice. Philadelphia, Lea and Febiger, 1982a.
Wallace, E., Freud and Anthropology: A History and Reappraisal. New York, International
Universities Press, 1982b.
EDWIN R. WALLACE IV

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Annali de/l'Jstituto e Museo di Storia della Scienza di Firenze, 6 (fasc. 2) 1981, 178 S. (no price stated)
Dem Andenken der Direktorin des Instituts und des Museums filr Wissenschaftsgeschichte in
Florenz, Maria Luisa Righini-Bonelli (1917-1981) ist Heft 2 des 6. Bandes 1981 der Anna1i dell'Istituto
gewidmet, wie uberhaupt Gedenkschriften und Festschriften sich in neuerer Zeit zunehmend in den
Schutz einer Zeitschrift begeben, in der sie dann auch Ieichter aufzufinden sind.
Von den sechs Aufsiitzen gelten vier der Astronomiegeschichte. Hier ist nur auf die Studie von
Stefano Caroti (p. 17-44) hinzuweisen, in der zu Alberto Magno e Ia Scienza, Bilancio
del 7. Centenario 1980 della sua morte eineObersichtuberneueStudiengebotenwird.
Unter den zahlreichen Arbeiten Alberts des GroBen, auch solchen zur Alchemie, zur Chemie,
Botanik, Psychologie usw., finden sich nicht eben viele, aber wichtige zur Medizin, auch speziell zur
Anatomie, Physiologie, Gyniikologie, Embryologie u.a. Es ist nicht nurfur die Wissenschaftsgeschichte lehrreich, zu sehen, wie bei Albertus Magnus und sonst im hohen Mittelalter die Medizin mit anderen
Wissenschaften und dem, was filr Wissenschaft gehalten wurde, im Zusammenhang gesehen wird. In
wieder anderer Weise ist gerade in neuerer und neuester Zeit erforscht worden, wie die Vertlechtung der
Medizin nicht nur mit den Naturwissenschaften, sondem auch mit den Geisteswissenschaften dazu
beitriigt, viele schwierige Fragen zu erhellen.
M.P.
Jozsef Antall, Pictorial History of European Medicine and Pharmaceutics, translated by I. Kemenes.
Budapest, Corvina Kiado, 1981, no pagination (no price stated).
The present work is an extension of the earlier Pictures from the History of Medicine
(1973) and draws heavily on objects from other European museums of medical history. Ninety two
plates .in full color with their explanatory notes form the bulk of this book. Both author and publisher
should be congratulated for their efforts.
Harald Breyer, Max von Pettenkofer. Arzt im Vorfeld der Krankheit. Leipzig, S. Hirzel Verlag, 1980,
234 S., ill., DDR M 14,-.
Certain figures often define major problem areas in medicine and the sciences, but the reach of Max
von Pettenkofer defies such easy rubrics. Celebrated especially for his ground-water theory of cholera
etiology, a theory whose various elements of truth too easily were taken to be the whole truth, his
greatest accomplishment was surely his career itself, that is, a life of extraordinary insight and activity
devoted to virtually all aspects of public health. Chemist, physiologist, epidemiologist, political manipulator, professor and administrator, von Pettenkofer has attracted numerous biographers. Breyer's
portrait is a comprehensive one, offering a cogent and lively introduction to the work of this multifaceted
humanitarian. Breyer also provides an excellent brief picture of public health inquiry and practice in
Germany in the second half of the 19th century, concerns that advanced rapidly with urbanization and
with the proposal of new medical and biological doctrines; von Pettenkofer's responses to these
changes, and not least his rivalry with Robert Koch, are carefully recorded.
W.F. Bynum, V. Nutton, eds., Theories of Fever from Antiquity to the Enlightenment. London,
Wellcome Institute for the History of Medicine, 1981. Medical History, Suppl. No. I IX, 154 pp. (no
price stated).

Clio Medica, Vol. /7, no. 4, March /983.

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The editors remark the abiding medical interest in fevers- probably no otherdisease(s) or symptom(s)
of disease was so frequently encountered by the physician- and also the shifting relationships between
theory and practice that the 'fevers' seemed also to promote. They emphasize, too, the perennial
obscurity of the subject, especially in regard to matters of diagnosis. The essays in this short volume,
whose coverage ranges from Hippocrates to Cullen, with intermediate attention to the views of
Continental and English physicians of the sixteenth to eighteenth centuries, are presented in admittedly
tentative manner. The authors portray the long hold over fever theory of Galenic doctrine and indicate,
too, the many but often slight variations on that doctrine; they also emphasize varied character yet
notable lack of major innovation in therapeutic procedures. But as a group the authors refreshingly
focus particular attention upon the priority in the medical mind of action and upon the broader social,
professional and intellectual context within which individual practice necessarily occurs. Theory by no
means is rendered historically irrelevant to practice, but other important historical problems are posed,
above all, that stated by Bynum (p. 147): 'over the long haul, therapy is more constant than theory ... In
the short run, however, there are pronounced swings in therapeutic fashion. Why?' This volume is a
commentary on that question, a volume that presents both familiar and much unfamiliar material and is
singularly rich in suggestions.
Karl Y. Guggenheim with the assistance.of Ira Wolinsky, Nutrition and Nutritional Diseases. The
Evolution of Concepts. Lexington, Mass., The Collamore Press, 1981, XII, 378 pp. (no price stated).
This is a history of the basic concepts underlying the nutritional sciences. The author has brought
together in chronological fashion from Greco-Roman antiquity to the present a vast amount of information explaining the evolution of his field. Descriptions of crucial clinical observations together with brief
biographical sketches of the most important contributors to nutritional knowledge constitute the bulk of
this work. A final section examines the history of primary nutritional diseases such as scurvy, beriberi,
pellagra and others.
David Hamilton, The Healers, a History ofMedicine in Scotland. Edinburgh, Canongate Pub!. Ltd. and
Gretna, Louisiana, Pelican Publishing Co, 1981, XIII, 318 pp., £12.95.
The author has successfully accomplished his task of providing a readable and interesting history of
health conditions and medical activities in Scotland. Chronologically arranged from the early Middle
Ages to t~e present, the book covers in more detail 18th and 19th century developments, including the
rise of Edinburgh Medical School. This work was especially written for the general reader and presents a
broad spectrum of healing activities from popular domestic practices to professional medical care,
blending scientific and social developments in exemplary fashion.
H. Hecaen, G. Lanteri-Laura, Evolution des connaissances et des doctrines sur les localisations
cerebrates. Bibliotheque neuropsychiatrique de langue fran~aise. Brugge, Desclee de Brouwer, 1977,
265 pp. (no price stated).
The authors emphasize that they will treat the 'doctrines' of cerebral localization; they do not
describe in detail experimental procedures but instead present and assay the conclusions drawn from
such empirical work. Following a short introduction that brings matters down to 1800, Hecaen and
Lanteri-Laura explore th~ work of Gall, Flourens and numerous others and the stimulus imparted to the
localization hypothesis by the phrenologists. This introduces the central dialectic of the book, namely,
the steady development of an experimental, anatomical and clinical defense of the idea oflocalization as
well as specification of particular localized cerebral activities, a development repeatedly opposed by a
varied group of physiologists and physicians. The authors trace this conflict well into the twentieth

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century. The book is comprehensive but sharply focused, particular doctrines and supporting (or
counter) evidence are clearly presented and, an event worthy of note in a French publication, both
subject and name indices are provided.
David A. Howard, The Royal Indian Hospital of Mexico City. Special Studies No. 20. Tempe, Arizona,
Center for Latin American Studies, Arizona State University, 1980, 99 pp. (no price stated).
The conclusion of this work is that eighteenth-century Spanish authorities sincerely attempted to
mitigate the health-related sufferings of the indigenous population, a finding that contradicts the
so-called Black Legend of cruelty and indifference attributed to members of the colonial power. The
author has carefully researched the archives of the Royal Indian Hospital of Mexico City for the period
in question and tells us about the rulers' commitment to Indian welfare. Given the paucity of secondary
sources concerning medico-historical subjects about colonial New Spain, this monograph constitutes a
most valuable addition to the literature.
Arthur E. Imhof, Die gewonnenen Jahre. Von der Zunahme unserer Lebensspanne seit dreihundert
Jahren oder von der Notwendigkeit einer neuen Einstellung zu Leben und Sterben. Ein historischer
Essay. Miinchen, C.H. Beck, 1981,279 S., DM 38,-.
In ei!lem vorziiglichen, verschiedenster Zwischentone fiihigen Deutsch erliiutert der Verfasser, was
sich im Laufe der letzten drei Jahrhunderte grundlegend geiindert hat und welche Auswirkungen der
ProzeB hat, der durchaus nicht etwa abgeschlossen, nicht einmal zu einem vorliiufigen Stillstand
gekommen ist.
Ein viet diskutiertes, freilich allzu oft auf wenige Schlagworte reduziertes Thema zeigt in der Hand
des Historikers einen ungemein groBen Facettenreichtum. In iiberraschender Weise werden archivalisch erarbeitete Daten kulturgeschichtlich so zum Sprechen gebracht, daB sich eine Fiille von Antworten zu Fragen der Sozialgeschichte und der Medizingeschichte ergibt. Freilich, wer nach dem Titel der
Studie eine neue ars moriendi erwartet, wird gewahr, daB ihm gerade dies, eine neue Einstellung zum
eigenen Leben und Sterben, nicht abgenommen werden kann. Die bemerkenswerte Auswahl aus dem
neueren Schrifttum enthiilt iiber 500 Titel.
M.P.
B.H. Kean, Kenneth E. Mott, Adair J. Russell, eds., Tropical Medicine and Parasitology: Classical
Investigations. 2 vols. Ithaca and London, Cornell University Press, 1978, XXII, 677 pp., illus., cloth,
us $58.50.
These formidable volumes constitute an anthology of extraordinary interest and rare merit. The
editors have collected and here publish in the original English or in English translation the writings of
some 200 authors writing in a veritable Babel of languages who have explored the parasitology of the
tropics. The organisms of interest are the protozoa and the helminths (bacteria, rickettsiae and viruses
are not included), and their life histories, their relation to human disease and, especially, how their study
has exemplified the gradual and often uncertain development of the experimental methods of scientific
medicine are here portrayed in a most graphic manner. The materials, which range from the seventeenth
to the twentieth centuries, are arranged by disease and associated parasites. Very brief biographical and
thematic introductions accompany each entry. There are numerous excellent illustrations, some in
color. Individual entries vary greatly in length and character, ranging from the simplest description of a
given organism to the most painstaking and ingenious procedures for tracing life cycles to the critical
moment of linking a particular pathogenic organism to a specific disease entity. The several entries
together thus constitute a remarkable collective treatise on tropical clinical medicine, medical ecology
and laboratory medicine, the whole constituting an important contribution to medical history as well as a
fundamental reference work in tropical medicine.
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Teizo Ogawa, ed., Public Health. Proceedings ofthe 5th International Symposium on the Comparative
History of Medicine- East and West. Tokyo, Saikon Publishing Company, 1981, VI, 189 pp. (no price
stated).
Sponsored by the Taniguchi Foundation, this volume presents ten essays dealing with public health
doctrine and practice in six countries. 'Public health' is very broadly understood, and thus hospital
services, specific diseases, administrative personal and provisions, medical 'police', environmental
parameters of sickness and health and numerous other topics are examined. Coverage ranges from
ancient India to modem Japan, with stops in between dealing with early and late public health
experience in Europe. Of particular interest is John Scarborough's comprehensive review and analysis
of that most vexed question, the various supposed public and private provisions for sanitation and
hygiene in ancient Rome. Many of the essays offer rich bibliographies and all are essential reading for
historians of public health and social medicine. (See also Clio Medica 15. 1980, 100.)
Dov Ospovat, The Development of Darwin's Theory. Natural History, Natural Theology and Natural
Selection, 1838-1859. Cambridge, Cambridge University Press, 1981, XII, 301 pp., cloth, US$ 39.50.
This is an important book, one that will modify many familiar views regarding Darwin's mature
formulation of his theory. The late Dov Ospovat places particular emphasis upon the invention by
Darwin during the 1850s of the notion of divergence and its relation to the central dynamic of natural
selection. Darwin's new view brought an end to the idea of perfect adaptation and afforded conceptual
as well as biological emancipation of the species. Species no longer were passively bent by selection
acting in response to environmental change; variation and selection, intrinsically biological processes,
became the major actors in the evolutionary process. This conclusion led Darwin to revalue the notion
of progress and to place supreme faith in a naturalistic account of biological adaptation, divergence and
species change. Ospovat stresses also the social development of these ideas, noting the constant
intellectual interaction between Darwin and contemporary naturalists and exploring Darwin's own
self-liberaiion from the dicta of natural theology.
William R. Rogers- David Barnard, eds., Nourishing the Humanistic in Medicine, Interactions with the
Social Sciences. Pittsburgh, University of Pittsburgh Press, 1979, XVI, 338 pp., hardcover, US$ 10.95.
Sponsored by the Philadelphia-based Society for Health and Human Values, this work includes a
series of essays presented during a program billed as dialogue between medicine and the social sciences.
As Dr. Edmund Pellegrino, the prime mover behind the project, writes in the foreword, there is
currently a great need to strengthen the intellectual links between these disciplines. Most papers are
original contributions covering such diverse subjects as healing, genetic engineering, medical ethics,
health care delivery and medical education. Two articles on nineteenth- and twentieth-century American medicine written by Barbara Sic herman are of interest to medical historians.
Beryl Rowland, ed. & transl., Medieval Woman's Guide to Health: The First English Gynecological
Handbook. Middle English Text, with Introduction and Modem English Translation. Kent, Ohio, Kent
State University Press, 1981, XX, 192 pp., illus., cloth, US$ 17.50.
This early fifteenth century treatise on obstetrics and gynecology antedates by almost a century The
Byrth of Mankynde, frequently regarded as the first English obstetrics text. Translated in
side-by-side pages from the original Middle English by Professor Beryl Rowland, who also provides an
introductory essay, it makes available for the first time this important book by an unnamed 'English
Trotula', the original of which resides in the British Library.

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The book will have a wide audience beyond Middle English scholars. Social historians will be
interested in the medieval perceptions of women as delicate creatures with special medical problems.
The text will open up new territory in women's studies literature as it addresses the efforts of women to
free themselves from dependence on male doctors. The author attempts to demystify women's diseases
and childbirth by providing a handbook of self help. Historians of science and medicine will find the
intermingling of ancient humoral theory with the medieval dissemination of empirical knowledge
fascinating. The sections of the text providing advice on labor and delivery are particularly revealing of
women's practices and medieval abilities to monitor complicated births. All readers will find Rowland's
interdisciplinary introduction helpful and will appreciate her painstakingly careful translation. The
publication of this text is a welcome addition to current knowledge.
JUDITH WALZER LEAVITT
Richard Toellner, ed., Aufkliirung und Humanismus. Wolfenbiitteler Studien zur Aufkliirung. Bd. VI.
Heidelberg, Verlag Lambert Schneider, 1980,271 pp., paperback, DM 58.-.
The editor has assembled fourteen papers presented during the 1977 symposium at the Lessing
Academy in Wolfenbiittel, West Germany. Authors were asked to prepare their papers around three
questions: how did the Enlightenment figures view their Renaissance predecessors, what role did
classical antiquity play in both historical periods, and finally how do historians comparatively assess
them. A paper by Charles Lichtenthaeler attempts to answer these questions with regard to medical
developments. He views Enlightenment physicians as the first 'modem' and 'progressive' individuals
who selectively rejected the humoral Hippocratic-Galenic theoretical structure while embracing
empirical and sensualist aspects of the ancient master from Cos, especially his clinical cases.
Paul C.L Triib, Heilige und Krankheit. (Geschichte und Gesellschaft, Bochumer Historische Studien
19, hg. Ferdinand Seibt u. Albrecht Timm.) Stuttgart, Klett-Cotta, 1978,307 pp., DM 74.-.
In Clio 14.1979 (I) 58-59 war davon die Rede, daB die Literatur zur Heiligenmedizin die Notwendigkeit der Zusammenarbeit mehrerer Wissenschaftsgebiete spiegele. Die hier vorliegende Arbeit beweist
dies in erstaunlicher Weise auch darin, daB sie in ihrer Literaturiibersicht von etwa 320 Nm. zumeist
ganz andere Titel nennt, als unter der eben zitierten Bibliographie mit fast ebensovielen Nm. zusammengestellt sind.
Weitgreifende, nach Krankheiten und Schutzpatronen geordnete Ubersichten geben auch iiber die
Mittel der Heiligen und iiber Krankheitsheilungs-Wunder (insbesondere in Lourdes) vielfiiltige Aufschliisse. Aus der Sicht der Gegenwartsmedizin wird in diesem Zusammenhang die Heilwirkung des
Seelischen auf die Macht des Religiosen zuriickgefiihrt. Die vorsichtig-niichteme, auch durch einen
Hang zum Statistischen bemerkenswerte Arbeit (eine gekiirzte Bochumer Dissertation von 1976) ist fiir
weitere Studien auf dem riesigen Gebiet der religiosen Medizin von erheblichem Nutzen.
Charles Webster, ed., Biology, Medicine and Society 1840-1940. Cambridge, Cambridge University
Press, 1981, IX, 344 pp., cloth, US$ 37.50.
Papers presented at a conference titled 'The Roots of Sociobiology' held in 1978 under the sponsorship of the Past and Present Society of Britain, form the bulk of this anthology. Topics such as
women's health, working-class mothers and infant mortality, the history of genetics, the origins of
eugenics and others are presented after a brief introduction by the editor. Interrelationships between the
biomedical sciences and social policy have increasingly come under historical scrutiny. The present
essays significantly contribute to that development.

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Michael R. Zimmermann, Foundations of Medical Anthropology. Anatomy, Physiology, Biochemistry,
Pathology in Cultural Context. Philadelphia, W.B. Saunders Co., 1980, VII, 214 pp., illus. (no price
stated).
Especially written for social scientists working on medical topics, Dr. Zimmermann's book provides a
welcome summary of principles in anatomy, physiology, biochemistry and general pathology. This is
followed by a more detailed examination of human functional systems such as the cardiovascular,
respiratory, digestive, nervous and others. All technical terms are briefly explained in a useful glossary.
Written in a simple, straightforward manner, this basic work could also be helpful to students of medical
history lacking such scientific background.

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Book Reviews
Ann Beck, Medicine, Tradition and Development in Kenya and Tanzania 1920-1970. Waltham, Mass.,
Crossroads Press, 1981, 115 pp. (no price stated).
Man muB fiir eine solche Studie zur Entwicklung in einem halben Jahrhundert sehr dankbar sein. Die
Autorin, die die Ergebnisse von zwolf Reisen vorsichtig zusammenfaBt, bringt aus dem medizinhistorischen Zusammenhang die Fahigkeit zu einem perspektivischen Sehen mit und kann diese Epoche
als eine Zeit begreifen, in der sich vieles we it schneller verandert, als in Jahrhunderten vorher.
Die besonderen Bedingungen fiir Tansania und fiir Kenia werden behutsam verdeutlicht. Das Nebeneinander von europaischer und traditioneller Medizin ist freilich ein weltweites, auch in Asien, Siidamerika und iiberall sonst sich darstellendes Problem dieser Zeit. Insofem mag man, auch wenn davon
hier nicht die Rede ist, die Untersuchung als eine Erforschung verschiedener Verhaltensweisen in
einem Umbruchzeitalter ansehen, das seine besondere Bedeutung in der Medizin womoglich starker
markiert als in vie len anderen Lebensbereichen.
Jedenfalls wird wohl zu wenig bedacht, daB die auffallige Beschleunigung der Prozesse in vielen
nicht-europaischen Landem nicht die Frucht einer neuen Selbstandigkeit ist, sondem ein allgemeines
Kennzeichen der Epoche.
Die Verfasserin hiilt es fiir unnotig, der Schwarz-WeiB-Malerei von kolonialer Unterdriickung und
von neuer, nun produktiver Tatigkeit in der eigenstaatlichen Freiheit zu widersprechen. Es wird
gezeigt, daB nicht wenige, ja daB fast aile Ziige einer neuen Entwicklung auf Vorhaben und Programme
der Kolonialzeit zuriickgehen. Entwicklungsplanungen kommen, nicht nur in Afrika, erst gegen Ende
der zwanziger Jahre zu groBerer Bedeutung. Das planerische Tempo beschleunigt sich dann erst nach
1945, zunachst auch nur auf einigen Gebieten.
Die Darstellung geht in erstaunlicher Weise immer wieder von der Reali tat Afrika aus. Insofem ist es
vielleicht zu verstehen, daB die alteren Anstrengungen unerwahnt bleiben und die seit den zwanziger
Jahren nur zum Teil niiher dargestellt werden. Die Zeit vor dem Zweiten Weltkrieg mit ihrem Denken
und ihren Moglichkeiten bei einem allgemeinen Interesse an Gesundheitsfiirsorge und Forschung hatte
eine etwas breitere Erorterung verdient. Wenn Afrika seinerzeit noch das passive Objekt europaischer
Entscheidungen war, so sind die heutigen Entscheidungen in Afrika doch groBtenteils Ergebnisse einer
Ausbildung in Europa.
Die Bedingungen der Medizin hingen friiher von der wirtschaftlichen Lage in Europa, besonders in
England ab, sie hangen heute nicht nur von den wirtschaftlichen Verhaltnissen Afrikas, sondem zum
guten Teil von intemationaler Unterstiitzung ab. Die zumeist vollig bauerliche Struktur der Wirtschaft
in den afrikanischen Landem bringt nicht nur erhebliche finanzielle Schwierigkeiten mit sich, sie fiihrt
auch zu einer Oberanstrengung der Stadte (mit Ausbildung ausgedehnter Slums) und zu einer Landflucht, die gerade die Gegenden betrifft, in denen Arbeitskrafte besonders benotigt wiirden. Fiir die
Beurteilung der Mittelaufwendung fiir die Medizin ist es sehr hinderlich, von der wechselnden, d.h.
abnehmenden Kaufkraft der aufgewendeten Summen keine Vorstellung zu haben.
Friih erkannte man die Notwendigkeit medizinischer Forschung, fiir die sich freilich eine Vielzahl
von Fragen auftat, da Untersuchungen in den verschiedenen Landstrichen notig waren. Ein Forschungszentrum kommt aber erst 1949 zustande. In einer Zeit, in der nun in den jetzt als national
aufgefaBten Gebietsbegrenzungen kein Geld und keine Zeit zur Verfiigung steht, versucht man miihsam, den ererbten Forderungen nachzukommen. Dabei erwies sich rasch, daB wirtschaftliche Produktivitiit und Gesundheit eng miteinander verkettet sind. Seit alters hatten die Gebiete sehr ungiinstige
Lebensbedingungen, und.die Unwissenheit in Gesundheitsfragen war sehr groB.
Die Obergangszeit vom kolonialen Dasein zu staatlicher Selbstandigkeit 1955-1961 war schwierig. Es
gab aber keine groBen Freiheitskampfe oder sonstige Auseinandersetzungen, so daB die bis dahin
ausgearbeiteten Entwicklungsplane weiterverfolgt werden konnten. Der erste Fiinfjahresplan ist in

Clio Medica, Vol. 17, no. 4, March 1983

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Tansania noch ohne Beriicksichtigung kiinftiger politischer Veranderungen aufgestellt worden.
Die Bauem leisteten in Tansania zunachst Widerstand gegen die Neuerungen; der Sozialismus
bewirkt zwar einige Veranderungen, kann aber noch nicht durchgreifen, da groBere Umwalzungen bei
den recht unbeweglichen Bauem gefiihrlich waren. Auch in dieser Hinsicht erscheint ein Vergleich
zwischen europaischen und afrikanischen Entwicklungen landlicher Verhaltnisse als falsch und
nutzlos. Die Biirokratie gerat in Gefahr, zu groB zu werden, und kann SozialisierungsmaBnahmen noch
nicht durchsetzen; sie wird mit starkem MiBtrauen beobachtet. 1964 und 1969 macht man neue Plane,
die aber auch noch ziemlich unrealistisch sind - Tansania hat noch keine politische, soziale und
okonomische Struktur aufzuweisen, die ihre Durchfiihrung moglich macht.
Es werden in dieser Studie die Bedingungen der Entwicklung der Medizin in Afrika an zwei Beispielen gezeigt. Von den vordergriindigen, nur vermeintlich wesentlichen politischen Vorstellungen her
kann man sich die Lage nicht oder viel zu wenig genau klarmachen. Es gibt mehrere Hauptschwierigkeiten fiir den Aufbau der medizinischen Versorgung in Tansania und Kenia. Trotz guter klimatischer
Bedingungen ist Tansania eines der arms ten Lander Afrikas.
Es fehlt an ausgebildeten Arzten, es herrscht ein besonderer Mangel an arztlichem Hilfspersonal. Es
war und ist schwierig, hierfiir geeignete Afrikaner zu finden, gar fiir entlegene Landstriche, in denen sie
besonders notwendig sind. Die Ausbildung von Hilfspersonal und die Aufklarung der Bevolkerung
findet ein groBes Hindemis in dem allgemeinen Mangel an Schulkenntnissen.
Der Aufbau und Ausbau eines Netzes von medizinischen Zentren fiir die fast nur bauerliche
Bevolkerung erscheint notwendig, es sind aber nur sehr begrenzte Mittel vorhanden, wahrend die
Bevolkerung unter den neuen Verhaltnissen- ohne Epidemien- geradezu beangstigend wachst. Die
Hauptrolle, die die vorbeugende Medizin zu spielen hatte, wird freilich durch die Forderungen des
Tages immer wieder zuriickgedrangt. Die kulturelle Verschiedenheit von europaischer Ausbildung und
afrikanischer Tradition wurde in den Planungen nicht geniigend beriicksichtigt. Deshalb bleibt es
zunachst bei schonen Programmen, bis 1971 eine realistische Halbierung der Ziele bei nur der Halfte der
Mittel, die nun wirklich zur Verfiigung stehen, einiges erreicht. Die Medizinkosten erweisen sich
freilich als riesig.
Viele Medikamente sind nicht zu beschaffen. Der Privatarzt, den man ausschalten wollte, muB noch
geduldet werden. Die Unteremahrung in Tansania bietet schwierige Voniussetzungen.
In Kenia ist die Lage etwas giinstiger. Vieles entspricht aber den Verhiiltnissen in Tansania. Ein
groBes, allgemeines Erziehungsprogramm soli die Grundlage fiir die Gesundheitsfiirsorge schaffen.
Schon 1946 gibt es einen umfassenden Plan fiir den Aufbau der Gesundheitszentren und fiir die
Ausbildung medizinischen Personals. Trotz des groBen Bevolkerungswachstums kann einiges verwirklicht werden. Mit der Unabhangigkeit 1963 entstehen zunachst groBe, nicht nur finanzielle Schwierigkeiten. Man verfiigt iiber zuwenig fachkundiges Personal, auch auf dem medizinischen Sektor. Der
Regionalismus, der sich ab 1964 zunachst durchsetzt, ist fiir die Versorgung der armen, besonders
bediirftigen Zonen sehr hinderlich, und die steigende Arbeitslosigkeit schafft weitere Probleme.
Nach der Darstellung der schwierigen Bedingungen, unter denen die heutige, westliche Medizin zu
arbeiten gezwungen ist, wird die Frage ausfiihrlich und aufschluBreich behandelt, wie denn vor der
Kolonialzeit und seither die Volksmedizin fiir die Bevolkerung sorgt.
Die Missionare, die Europaer iiberhaupt, waren, wie auch die Vertreter des Islam, Gegner der
Volksmedizin. Es dauert auch nach den ersten Untersuchungen iiber den bemerkenswert zweckmaBigen Pflanzengebrauch in der Volksmedizin, die schon 1908/1912 angestellt wurden, noch lange,
ehe die Bedeutung der Volksmedizin erkannt wird. Zwar setzt sich seit 1918 ein besseres Verstandnis
durch, aber erst 1936/1938 wird ihre materia medica genauer untersucht. Es handelt sich urn 27
verschiedene Pflanzen, die nun besser studiert werden, auch urn sie zu nutzen. Zwischen 1930 und 1950
kommt es zu gegenseitiger Duldung zwischen den beiden medizinischen Systemen.
Seit etwa 1960 ergibt sich eine neue Situation. In Tansania wird bezeichnenderweise die Frage
drangend, ob unter den politischen und sozialen Veranderungen die Volksmedizin iiberhaupt noch
tragbar sei, zumal ihre anatomischen Kenntnisse sehr begrenzt, ihr Wissen urn Ansteckungsgefahren
nicht ausreichend und ihre Praktiken verdachtig erscheinen. Aber der Glaube an die traditionelle
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Medizin iiberdauert das Selbstiindigwerden der Staaten. Zum Teil bleibt man, besonders in den
abgelegenen Gebieten, bei der herkiimmlichen Medizin, zum Teil versucht man, sie mit der europaischen zu kombinieren. Die traditionelle Medizin nimmt auch Gedanken der Hygiene, der Vorbeugung bei Ansteckungsgefahr u.a. in sich auf.
Andererseits stellt sich heraus, daB sie auch da manches Mal Heilungen zustande bringt, wo die
westliche Medizin nicht geholfen hat. Deshalb kann sie sich auch in der Stadt halten, da eine gewisse
Skepsis gegen die Technik der westlichen Medizin erhalten bleibt und die vorindustrielle Denkweise
durch die neuen stiidtischen Verhiiltnisse noch kaum veriindert ist. Die europiiische medizinische
Versorgung ist ohnehin iiberall zu knapp.
In neuerer und neuester Zeit kann der Wirkungszusammenhang von Magie und Pflanzenextrakt auch
von den Arzten besser begriffen werden: irgendwie ist der alte Aberglaube zugleich eine neue, wirksame, quasi psychosomatische Medizin. Da zudem die medizinischen Pflanzen nicht importiert werden
miissen, wiihrend ausliindische Medizin kaum verfiigbar und sehr teuer ist, kann die traditionelle
Medizin noch immer groBe Lucken der medizinischen Versorgung fiillen.
Man kann in Afrika vielleicht eine in Europa drohende Obertechnisierung vermeiden und zu einem
giinstigen Arzt-Patient-Verhiiltnis kommen. Die traditionelle Medizin, die in Kenia seit einem Jahrzehnt
durchaus wieder mehr Gewicht bekommen hat, wird nun auch in neuer Erkenntnis ihres spezifischen
Wertes als ein wichtiger Teil des nationalen BewuBtseins begriffen.
Als wichtigste Aufgabe der kiinftigen Jahre bleibt freilich doch ein groBes Netz medizinischer
Dienstleistungsstellen und die Ausbildung hierfiir geeigneter Hilfskriifte. Noch herrschen Unwissenheit
und Armut; der Mangel an brauchbaren Wohnungen, an sauberem Wasser, an einfachen sanitiiren
Einrichtungen ist iiber aile Vorstellung riesig.
Zweierlei fehlt den Untersuchungen zur Medizin in nichteuropaischen Gebieten: Man miichte
wiinschen, daB bald eine niihere Bestimmung der Eingeborenenmedizin miiglich wird - wie, in entsprechender Weise, auch die altiigyptischen sowie die antiken, insbesondere die riimischen AnstiiBe
z.B. der afrikanischen Kunst sichtbar werden. Und man miichte hoffen, daB aus den Archiven der
Krankenhiiuser, erst recht aus den Bestiinden der Staatsarchive zur Kolonialzeit, noch viele neue
Erkenntnisse gewonnen werden kiinnen.
M.PUTSCHER
Audrey B. Davis, Medicine and Its Technology: An Introduction to the History of Medical Instrumentation. Westport, Connecticut, Greenwood Press, 1981, XIV, 285 pp., illus., US$ 37.50.
Davis's history of medicine and its technology is both more and less than what it purports to be.
Conscious of the dearth of competent monographs in this area, Davis cites a variety of sources to consult
in a study of the technology of medicine. Her long tenure as curator of medical sciences at the
Smithsonian Institution has made her admirably suited for this task. Her knowledge of both historical
and artifact medical collections is vast and she has used it to good advantage. The book is handsomely
illustrated with photographs obtained from numerous archival collections supplemented with photographs taken by the author.
In a chapter on literature sources of medical instruments, Davis describes the secondary and primary
literature, including illustrated medical and surgical textbooks and museum catalogs of medical
instrument collections. She calls attention to the wealth of material available in the trade catalogs
published by manufacturers of medical instruments and notes the need for an annotated bibliography of
this valuable source. Davis concludes the book's historiographical section with a chapter on the
development of the major American and British medical instrument collections.
The second part ofthe book deals with medical instrumentation. The discussion is limited to advances
in medical technology in nineteenth-century Europe and America, and to just three subjects at that:
medical thermometry, the stethoscope, and concepts of the pulse and instruments for the measurement

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of blood pressure. This section inevitably will invite comparison to Stanley Joel Reiser's Medicine
and the Reign of Technology (1978). By limiting her account to three widely-adopted
technologies, Davis is able to describe in great detail many facets of their development only briefly
touched upon by Reiser, such as early history, instrument construction, different models, and
refinements that were made over time. Besides discussing many more of the advances in medical
technology, including notably instrumerlts for visualizing the internal organs of the body, Reiser is
concerned with how new instrumentation accommodated or challenged prevailing theories of health and
disease, altered the physician-patient relationship, and forced changes in the organization and delivery
of health care.
Reiser emphasizes the shortcomings of technology in medical decision making. He fears that
physicians are losing contact with their patients as they become increasingly dependent upon laboratory
tests, mainly of a chemical or bacteriological nature, the performance of which they are not competent
to judge. Davis is more sanguine about the risks and focuses instead on the extensive improvements in
medical care that technology effected. The development of instruments that extend the ears, eyes,
hands, and brain of the physician has made it easier to diagnose disease at an early stage, to establish
disease entities on the basis of signs and symptoms not detectable by the unaided senses and to suggest
new and more rational forms of therapy.
In two subsequent chapters, one on diagnosis and instruments, and the other on medical standards
and instruments, Davis describes the medical community's quest for exact measurements in the study of
physiology and pathology. These chapters reveal the extent to which Victorian medicine became
dependent on precision instruments for diagnosing diseases and for determining standards of normal
and abnormal physiological processes.
In the book's final section on the social implication of standards, Davis relates how medicine was
made to serve the needs of an urban-industrial society and the dilemmas sometimes posed for physicians
who were called upon to use their skills not solely or even primarily for the benefit of the persons they
were examining, but for the profit of their employers as in the case of physicians hired by railroad
companies to do eye tests and medical examiners employed by life insurance companies. Physicians
generally acquitted themselves well in these undertakings. However, a much darker view of the
physician's consultantship with industrial America can also be cited as in the often less than professional
behavior of company physicians hired to take care of miners in the coal fields of Appalachia and in the
dismal history of the involvement of psychiatry in state mental asylums and in civil and criminal court
proceedings.
Davis has written an enlightening introductory account of medicine and its technology while
preparing the way for other scholars to enter this important but neglected area of medical history.
STUART GALISHOFF
Anita C. and Michael Fellman, Making Sense of Self. Medical Advice Literature in Late NineteenthCentury America, Philadelphia, University of Pennsylvania Press, 1981, Vlll, 198 pp., cloth, US $
16.50.
One of the most bland genres of medical (or any) literature would appear to be that of the home health
guide or hygienic advice manual. The sex chapter(s) sometimes excepted, the subject matter of such
books is numbingly workaday and the moral of the story - that moderation is the straight and narrow
path to health- never changes. In recent years, though, historians have given increasing attention to the
theme that the motivation for preaching the moderation gospel does change with time and society, that
those seemingly mundane teachings about diet and dress are reflections of the larger cultural values,
hopes and insecurities of the teachers and the people they seek to instruct. Scratch its surface dullness
and medical advice literature will be found to be a sparkling record of social history, of popular
ideologies directed toward 'making sense of self and of one's times.
The dominant thesis of the Fellmans' book is that the times were especially troubled during the last

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third of the 1800s and popular health philosophy was consequently restrained, even pessimistic. The
self-assured ante-bellum period, during which health reformers had urged moderation as the required
method for achieving individual (and social) perfection, had given way to a nervous, uncertain age which
was content to use moderation as a coping mechanism. Maintenance, rather than enlargement, of
human powers was the most to be reasonably attempted in a civilization undergoing disturbing alteration from urbanization, industrialization, declining native birthrate and rising alien immigration. The
ways in which such cultural anxieties were translated into specific hygienic precepts are explored in
chapters dealing with the healthy self, the unhealthy self, the nature of the brain and will and their
relation to health, and, of course, sexual behavior.
The information and arguments of these chapters are conveyed clearly and documented adequately,
although the microcosm motif is occasionally worked beyond moderation- was the body human really
so intimately connected to the body politic that fear of social disorder prompted preoccupation with
bowel regularity? Generally, though, points are well-taken, yet even then they usually fail to excite or
surprise. Much of this ground has been tilled before and by limiting themselves to 140 pages of text, the
authors are unable to dig much deeper. The book generates the same mixed feelings usually produced by
the health advice manuals themselves: the reader is grateful for the useful information presented, but
suspicious that he had actually known most of it before.
There is also a feeling that the picture has been painted darker than need be, that the hygienic ideology
of the late nineteenth century was not quite so despairing of human perfectibility. The authors acknowledge that attitudes toward this question ranged fully from pessimism to optimism, yet except for a nice
characterization of the physical culture movement, they pay little attention to the bright end of the
spectrum. Ideas about heredity and evolution, for example, are portrayed as potent inhibitors of hopes
for general human improvement. But Martin Luther Holbrook, a medical advisor consulted by the
authors, found in both Lamarckian and Weismannian theories a rationale for exploiting evolution so as
to promote human progress on a grand scale.
It is still true, however, that there was an overall waning of hygienic ambition after the Civil War and
'Making Sense of Self contributes to our understanding of how that turning away from Jacksonian
utopianism came about.
JAMES WHORTON
Lester S. King, Medical Thinking: a Historical Preface. Princeton, New Jersey, Princeton University
Press, 1982,£13,80.
Only an author with Lester King's medical background could so successfully have discussed such
varied themes in historical perspective. When he began the study of medicine in 1928 insulin and liver
extract had just been introduced. Traditional remedies were beginning to be challenged in clinical trials.
Injections of gold salts, for example, had been approved uncritically in the treatment of pulmonary
tuberculosis until 1924 when twelve consumptive patients given this treatment were found to have fared
worse than a similar number injected with distilled water.
King outlines the history of tuberculosis beginning with Richard Morton's theory of a nutritional
defect causing wasting and a hectic fever. Gradually other pieces were fitted into the aetiologicaljigsaw.
Cullen diagnosed consumption on the basis of purulent sputum which sank in water; and the first
clinico-pathological correlation between the presence oftubercles and the natural history of the disease
was made by Laennec. The characteristic type of necrosis, caseation was first described by Virchow
while Villemin showed that the disease could be transmitted by a specific agent. Finally Robert Koch's
discovery of the tubercle bacillus raised false hopes in the stricken Anton Chekhov that a beneficial
vaccine might soon be available.
When discussing the classification of diseases, Lester King begins with Sydenham 's recommendation
of adopting a botanical system introduced by Boissier de Sauvages. The latter delineated ten main

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classes of disease, subdivided them into 295 genera and about 2,400 species. When applied to
psychiatric disorders this unwieldy classification yielded four orders, twenty three genera including
fourteen species of melancholia.
In general medical treatment has been conservative, but King rightly points out that the efficacy of
blood-letting in hypertension, pneumonia and right-heart failure accounted for its long therapeutic
survival. In an age of gluttony and polypharmacy, Georges Cheyne's recommendation of a plain diet
combined with exercise and abstinence proved more beneficial to his patients than medication.
When discussing the long survival of classical authority in medicine, King disagrees with Sarton's
view that Vesalius's anatomical discoveries represent a rebellion against the Galenic tradition. Supporting evidence for the survival of Galenism even later during an era of many new discoveries may be
judged from the attitude of the Helmontian chemists towards one of the leading experimentalists. They
disparagingly dismissed Thomas Willis as a 'Galeno-Chymist' which was, in fact, an accurate description of him. The rete mirabilis, for example, were for several centuries depicted in textbook illustrations
of the human brain despite the inability of anatomists to demonstrate them. For twenty years medical
students at Adelaide University dissected the frog from Huxley's textbook depicting the British species.
But they were, in fact, dissecting rana australienses but instead of discarding their textbooks students
concluded that the many anatomical 'variations' they found indicated that the frog was 'wrong'.
At a first glance answers to some of the problems that Lester King poses seem obvious. He devotes
chapters to the diagnosis and cause of disease; differences between health and disease; the definitions of
syndromes together with clinical and disease entities. King shows convincingly that in physical illnesses
many issues are much more complicated than the titles of his chapters indicate. These problems multiply
when applied to the aetiology, causation and diagnosis of psychiatric disorders. This could be
illustrated, in the nineteenth century, by Pierre Janet's cynical diagnostic variations. A poor patient was
diagnosed as 'psychotic' but if he was able to afford to move into a nursing home it was changed to
'neurasthenia' whereas those patients cared for in their own homes were regarded merely as 'eccentrics'. Today the relative significance of organic, psychological and sociological factors in the causation
of psychiatric disorders is hotly disputed.
Despite technological progress some seventeenth century recommendations for progress in medicine
are still relevant such as Bacon's insistence on observation, precision, experimentation, reasoning and
generalization.
Finally Dr. King discusses F/exner' s recommendations for progress in medicine through advances in
the basic sciences allied to improvements in methodology. Lester King argues convincingly that
throughout history good doctors have displayed similar characteristics.
Logical, lucid and learned, Lester King's wide erudition constantly provokes new thoughts and
provides fresh insights into old problems.
KENNETH DEWHURST
Felix Klein-Franke, Vorlesungen iiber die Medizin im Islam. Sudhoffs Archiv, Beiheft 23. Steiner,
Wiesbaden, 1982, 161 S., DM 52,-.
Fiir die Geschichte der islamischen Medizin, mehr noch fiir das Wesen und den Bestand der
islamischen Medizin wird hier die allgemeine Geschichte und das Schrifttum der Arzte befragt. Dabei
stellt sich eine Eigenart der Bedingungen des islamischen Denkens heraus, die bis heute zu verfolgen ist:
eine Liebe zu statischem Verharren auf einer Erkenntnisstufe, die einmal in theologischem Sinne fiir
richtig gehalten worden ist und also trotz mancher Veranderungen im einzelnen festzuhalten bleibt; im
Islam hat sich bis in die Gegenwart wissenschaftliches, philosophisches und weltanschauliches Denken
der Theologie zu beugen.
Von dieser Grundregel aus wird nicht nur die Oberlieferung der griechischen Medizin im Islam,
sondem auch die Entwicklung der islamischen Medizin selbst verfolgt. Da dem Medizinhistoriker die

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Kenntnis der orientalischen Sprachen zumeist nicht zu Gebote steht, wird man eine solche griindlichvorsichtige Untersuchung fiir besonders nutzbringend hal ten.
Die Friihzeit der islamischen Medizin wird in aufschluBreicher Weise aus der Dichtung sichtbar
gemacht. Es werden dann die Zentren der islamischen Medizin von Alexandria bis Bagdad behandelt,
unter EinschluB der persisch-sassanidischen Einfliisse und der zu U nrecht sonst oft vernachlassigten
Verbindungen zur byzantinischen Medizin. Eine Zentrale der Studien zur antiken Medizin, die ihre
Bliitezeit im 9. und 10. Jahrhundert haben, bildete sich in der Bibliothek von Bagdad heraus. Der
Aufschwung der islamischen Medizin im 9. Jahrhundert, dem eine kritisch-skeptische Haltung eignet,
wird hervorgehoben, ebenso die Forde rung der Arzte als Hofarzte.
In einem Kapitel iiber den Zusammenhang zwischen Medizin und Astrologie im Islam wird gezeigt,
daB fiir die Astrologie - und das heiBt auch fiir die Bestimmung des Zeitpunkts therapeutischer
MaBnahmen - besonders auch griechische Quellen genutzt worden sind. Ein Gleiches gilt fiir die
Verbindungen zwischen Medizin und Alchemie, fiir die ein erheblicherer persischer oder indischer
EinfluB einleuchtend verneint werden kann.
Das Corpus Hippocraticum genieBt hohe Autoritat, auch wenn diese Schriften zum Teil nur aus
Zitaten Galens bekannt sind. Die arabischen und syrischen Galen-Obersetzungen wurden besonders
wichtig, auch fiir die Ausbildung einer Terminologie. Die Ausstrahlung der islamischen Medizin bis ins
13. Jahrhundert beruht zu einem erheblichen Teil auf der erneuten Kenntnisnahme Galens, dl!r
besonders auch iiber islamische Quellen zu erreichen war.
Fiir das Gebiet der theoretisch-philosophischen Medizin ist Aristoteles fiir den Islam von gleicher
Bedeutung wie Galen. Im Spiegel der islamischen Medizin bestatigt sich die gelegentlich bezweifelte
Wirkung von Aristoteles auf die griechische Medizin.
Die vorherrschende Richtung in der islamischen Medizin, die dogmatische, steht unter dem EinfluB
Gal ens, mit dem Medizin als Philosophie aufgefaBt wird. Diese Anschauung erreicht im II. Jahrhundert
ihren Hiihepunkt, das heiBt, zu einer Zeit, zu der die islamische medizinische Forschung bereits zum
Stillstand kommt und der Niedergang einsetzt: Eine autoritatsglaubige Fortfiihrung der Tradition als
Grundlage des bestimmenden religiiisen Denkens fiihrt zunehmend zu einer Ablehnung von Wissenschaft aus religiiisen Vorbehalten auch gegeniiber kausalen Zusammenhangen und also auch gegeniiber
dem Experiment.
Dies fiihrt folgerichtig zu einer Gegenbewegung empirischer Medizin, die auch griechische Vorbilder
hat. Freilich halt der Hang zum Festhalten an der Oberlieferung die Anatomie auf dem Stand der
galenischen Kenntnisse, und der Mangel an Werken zur praktischen Medizin ist auffallig. Auf einigen
Gebieten, so insbesondere der Augenheilkunde, sind allerdings doch bedeutende Erfolge zu verzeichnen.
Der Wert der Studie liegt in der Verdeutlichung des Verhaltnisses von griechischer und arabischer
Medizin und darin, herauszuarbeiteri, daB die islamische Medizin von der griechischen durchaus
verschieden ist: Die theologische Bestimmtheit aller Wissenschaft und Philosophie, auch der Medizin,
wirkt bis in die Gegenwart nach.
Ein gutes Literaturverzeichnis ist erwahnenswert.
M.PUTSCHER
Erna Lesky, Franz Joseph Gall (1758-1828), Naturforscher und Anthropologe, Ausgewiihlte Texte,
eingeleitet, iibersetzt u. kommentiert von E. Lesky. Hubers Klassiker der Medizin und der Naturwissenschaften 15. Bern, Huber, 1979,217 pp., gebd. DM 43,-, brosch. DM 32,-.
Mit ausgewiihlten Texten gibt die Wiener Forscherin eine neue Obersicht zum Wirken Galls und zu
seinen Ergebnissen. Sie beschiiftigt sich hauptsachlich mit dem, was iiber seine Zeit und die Folgezeit,
die ihn als 'Phrenologen' schatzte, hinaus Beachtung verdient~ Von der Gegenwart her gesehen sind es
seine Beitriige zur Psychologie und Psychiatrie, zur Anthropologie, insbesondere zur vergleichenden
Verhaltensforschung, die ihn als einen bedeutenden Gelehrten ausweisen, der noch und wieder Beachtung verdient.
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Auswahl und Kommentierung der Texte arbeiten ein Bild heraus, das nicht nur fiir die Medizingeschichte an der Wende vom 18. zum 19. Jahrhundert von hohem Wert ist, sondern auch fiir eine
Anzahl von Wissenschaftsfragen, die in der Gegenwart neu diskutiert werden. Es ist also eine Perlensuche, die einen groBen Haufen Muscheln beiseite liiBt, man kann sie bewundern, da gezeigt wird, daB
geistige Leis tung wichtig und anregend bleibt, auch wenn sie zu groBen Teilen iiberlebt, iiberholt ist.
Von Galls bemerkenswerten Forschungen zum Gehirn mit dem Ziel, ein Verstiindnis des Menschen
in seiner leiblich-seelischen Ganzheit zu erreichen, werden eindrucksvolle Proben gegeben: das Gehirn
ist das Organ aller Neigungen, aller Gefiihle und aller Fiihigkeiten. Galls auBerordentliche Beobachtungsgabe fiihrt ihn auf die Bedeutung der organisch-biologischen Bedingungen bei Mensch und Tier
und zur Abkehr von allzu abstrakten Verallgemeinerungen. Er stellt auch Betrachtungen iiber Triiume
an, die z.T. neuerer Traumforschung vorarbeiten; vor allem widmet er sich der vergleichenden Verhaltensforschung mit groBem Erfolg.
Viele Beobachtungen und erste Experimente auf diesem Gebiet lassen ihn u.a. das Revierverhalten
von Tieren fast genau ein Jahrhundert vor anderen Forschern beschreiben. Ober die Verschiedenheit
und Gleichheit der Menschen gelingen ihm wichtige Formulierungen. Seine psychiatrischen Erfahrungen fiihren ihn zu Forderungen fiir die Behandlung der Kranken, mit denen er seiner Zeit, abgesehen
von wenigen Forschern sonst, ein erhebliches Stiick voraus ist.
Von dem, was seine Beriihmtheit in seiner Zeit und noch im 19. Jahrhundert ausmachte, von der
'Phrenologie' ist wenig oder nichts iibriggeblieben: · ... dass man in der That mehrere Fiihigkeiten und
Neigungen aus Erhabenheiten und Vertiefungen am Kopf oder Schedel erkennen kann ... '- (so schon
1798). Man ist angesichts der Bildnisse in der Kunst und infolge alltiiglicher Beobachtungen versucht,
dieser durchaus iiberholten Ansicht doch einige allgemeine Bedeutung zuzubilligen -; und man ist
neugierig auf eine neue Bearbeitung der groBen Schiidei-Sammlung Galls (in der sich sein eigener
befindet), die der Besitzer, das Musee de !'Homme in Paris, leisten miiBte.
M.PUTSCHER
Ronald L. Numbers, Judith Walzer Leavitt, eds., Wisconsin Medicine, Historical Perspectives,
Madison, Wisconsin, University of Wisconsin Press, 1981, IX, 212 pp., illus., cloth, US$ 18.50.
Having reviewed a good many books consisting of a series of essays, I approached 'Wisconsin
Medicine' with some qualms. Too frequently, assembled essays tend to be diffuse and overlapping,
especially when the authors represent different fields of history. Happily Numbers and Leavitt have
avoided the usual perils and have given us an excellent short account of the main developments in
Wisconsin medicine and public health. Following a brief introduction by the editors, eight essays or
chapters deal with various aspects of Wisconsin history: frontier medicine, medical practice, sectarian
or irregular practice, medical societies, hospitals, rural health, urban health and medical education.
Wisconsin's history, compared to the Eastern states, is relatively short, yet its medicine and public
health present in miniscule form the history of medicine and public health in the United States.
Beginning in the latter part of the 17th century malaria accompanied the settlement of the United States
all the way from New England to California. Despite its Northern location and much later settlement,
Wisconsin was no exception. As was true of all Northern states, as population increased and land was
cleared, malaria gradually receded, giving way to the more traditional diseases, diphtheria, scarlet
fever, typhoid, smallpox, the omnipresent tuberculosis and so forth. Guenter Risse's excellent chapter
on medical practice in Wisconsin from 1848 to 1930 could apply equally to much of America. Elizabeth
Keeney's essay on medical sects shows the strength of the irregular physicians and why it was that in
Wisconsin, as elsewhere, orthodox physicians only succeeded in securing licensure laws by cooperating
with the major sectarians.
The same factors which limited the development of medical societies in the United States during the
19th century held true for Wisconsin. Rural isolation, poor transportation facilities, and poorly educated

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physicians were scarcely conducive to strong professional organizations. Not until relatively late in the
19th century did social and economic changes make it possible for state and local medical societies to
exercise any significant influence. One might say the 20th century, since, as Ronald Numbers shows,
the state society did not become effective until after the reorganization of the AMA in 190 I.
The growth of American hospitals followed the late 19th-century developments in surgery and
medicine, a period when Wisconsin itself was coming of age. Although urban centers came late .to
Wisconsin, the state made rapid progress in providing institutions for the mentally ill and tuberculosis
patients, and, considering its large rural population, the number of general hospitals grew rapidly in the
20th century.
Two first-rate essays, one by Dale Treleven and the other by Judith Leavitt, survey rural and urban
health conditions. The deplorable sanitary conditions in 19th-century cities are well known, but
Treleven demonstrates that rural areas were far from the healthy clean paradises so often eulogized by
urban dwellers. Wisconsin had a relatively high percentage of European immigrants, many of whom
strongly opposed health measures. Despite this, the State was one of the first to establish a Board of
Health, and, although not a pioneer in the field, Wisconsin rapidly took advantage of new developments.
Before 1900 almost every village, town and city in the State had established a board of health, a record
not equalled by many states until the 1930's.
The essays are uniformly good and the editors have presented an excellent picture of their State's
medical history. The topical approach allows for more detail than might normally be true of a straight
narrative, and, at the same time, the editors have managed to avoid repetition and overlap. The book is a
welcome addition to the field.
JOHN DUFFY
Claude Quetel, Pierre Morel, Les Fous et leurs Medecines de Ia Renaissance au XXe Siecle. Paris,
Hachette, 1979,302 pp., illus., paper (no price stated).
Das Buch stellt die Behandlung von Geisteskranken vom Ende des 15. bis zum Anfang des 20.
Jahrhunderts dar und zeigt, daJ3 sie eben nicht erst amEnde des 18. Jahrhunderts einsetzt, sondem daB
man sich auch in den Jahrhunderten davor bemuht hat.
In dem Kapitel zur Therapie des Barock ist die eher als Burleske aufzufassende Operation des
'Steines des Wahnsinns' aus dem Kopf, der auch Bosch ein Bild gewidmet hat, ausflihrlich behandelt.
Des to mehr bedauert man, daB die ebenfalls sehr ergiebigen Themen des Narren und des Narrenschiffes
nur kurz gestreift werden. Neben dem bemerkenswerten ikonographischen Verzeichnis zur Steinoperation ist die reiche Bebilderung mit Abbildungen nach Slattern des 15.- 19. Jahrhunderts hervorzuheben, die den unerschiipflich reichen Bestanden der Bibliotheque Nationale, Paris, entnommen
sind, wobei aufnahere Angaben, die freilich oft sehr schwer zu ermitteln waren, ebenso verzichtet wird,
wie in der Literatur urn 1900, die z.T. aus den gleichen Quellen schopft und hier gut mit herangezogen
ist.
Als besondere Heilige wurden Ste. Dymphne und St. Menoux genannt. Mit Wallfahrten und Prozessionen (Tanzprozessionen) bis zu den Bluttransfusionen (vgl. Clio I. 1966, 33; 9. 1974, 131, 325; II.
1976, 125) und bis zu Fr. A. Mesmer (vgl. Clio 5. 1970, 360; 7. 1972, 303) wird das Verschiedenste
versucht, urn den psychischen Erkrankungen beizukommen. Die beachtliche Verwertung der alteren
Literatur, besonders des 18. Jahrhunderts, ergibt eine nutzbringende Obersicht zu den Arzneimitteln,
dem AderlaJ3, den Wasserkuren und Badern bis zu der Musiktherapie des 19. Jahrhunderts.
Ein groBes Kapitel gilt der Verwahrung der Kranken vom Narrenturm bis zum Asyl und dem
'traitement moral' neuerer Zeit mit den Krankensalen, Arbeitssalen, den Acker- und Gartenarbeiten urn
1900. Im wesentlichen werden d\e Verhaltnisse in Frankreich geschildert, was ja auch insofern eine
Berechtigung hat, als die franzosische Psychiatrie vom 18. bis ins 19. Jahrhundert flihrend gewesen ist.
Die Literatur findet sich, in einer oft etwas unbekummerten Zitierweise in den Anmerkungen, auf ein
besonderes Verzeichnis ist verzichtet worden.
M. PUTSCHER

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Francis Schiller, A Mobius Strip, Fin-de-Siecle Neuropsychiatry and Paul Mobius. Berkeley,
University of California Press, 1981, 134 pp., US$ 20.-.
The search for better understanding of mind-brain and mind-body relationships which concerned
physicians a century ago continues with much vigor today. Heightened interest in neuropsychology and
the increasing number of those attracted to this area in recent decades are testimony to this
phenomenon.
Francis Schiller, the able medical historian and author of the well received biography of Paul Broca
(see Clio 16, 1981, 175), returns to the 19th century to consider the career and writings of the German
psychiatrist Paul Mobius ( 1853-1907) who Freud regarded as a father of modem psychotherapy. Schiller
uses the works of Mobius as the points of reference for a critical review of the origins and evolution of
neurology and psychiatry.
Mobius in contrast to his illustrious contemporaries such as Broca, Charcot, Kraepelin and Alzheimer
never secured a professorship. Not bound by some of the restrictions often fostered by the dependent
relationships which may exist in an academic setting, Mobius proceeded to write freely on many aspects
of neurology and psychiatry. He saw no fundamental difference between organic and functional disease.
In his psychological writings Mobius considered the personality traits and psychopathology of
Rousseau, Goethe, Schopenhauer and Nietzsche. His work The Physiological Feeblemindedness of the Fe m a I e attracted considerable interest. Mobius viewed feeblemindedness
as a variation from a standard since the smaller brains of women deviated from the larger sized male
brain; the former were judged to be substandard in their physiologic capacity. Such an opinion was
shared by Broca and other anatomists of the period.
Schiller presents his material in succinct, scholarly fashion. Chapters devoted to psychotherapy,
hysteria and hypnosis are refreshingly written. Of particular note is the section which deals with
neuropathology and psychiatry. The fundamental contributions of the German anatomists-psychiatrists
to neuroanatomy and the later exclusion of these workers from what was judged to be neurology is an
excellent account of the divergence of neurologists and psychiatrists from their common heritage.
Although some aspects of the life of Mobius are presented, this reader would have appreciated more
detail about his career and his relationships with his contemporaries.
This is a short, exceedingly well written, excellent work. Readers interested in history, mind-brain
relationships and behavior will find this informative book pleasurable and a source of many valuable
references.
RICHARD SATRAN
W.H.O., The Global Eradication of Smallpox. Final Report of The Global Commission for the Certification of Smallpox Eradication. Geneva, World Health Organization, 1980, 122 pp., Sfr. II,-.
This 65 page document plus 57 pages of annexes documents what is hopefully the last chapter in the
long history of interaction between man, the variola virus and the vaccinia virus.
Although this document is fourth in the WHO Series: History of International Public Health, it is more
of an action document for policy decisions than a conventional history. However, it should provide an
unmatched, condensed source of historical information on the smallpox eradication, particularly for the
period from 1%7 until 1980. In addition, the numerous references to other WHO documents make it an
invaluable guide for historians studying the major human accomplishment: the first planned eradication
of a human disease.
The document was written by The Secretariat and Consultants and modified and agreed upon by The
Global Commission itself. It was presented to The Executive Board for their review in January 1980 and
to The World Health Assembly in May, 1980. It provided delegates all necessary information on the
smallpox eradication program, the conclusions and recommendations of the Commission in sufficient

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detail for the Assembly to take definitive action- which it did. The original report was augmented by a
forward by Dr. Mahler, The Director-General of WHO, and the resolutions of the 33rd World Health
Assembly. As Mahler says, 'Because of the uniqueness of the achievement. .. public health officials,
historians and future generations should have access to the evidence ... that smallpox eradication has
been achieved throughout the 'rorld.'
The document is divided into 14 sections with 19 annexes. It starts with a succinct summary and, as is
the case with most WHO policy documents, conclusions and recommendations are presented before the
detailed back-up material. The recommendations deal with WHO policy for the post-eradication era.
There are very brief sections: a condensed history of smallpox up to the time of eradication, clinical
features and diagnosis of smallpox, the epidemiology of smallpox and a very condensed summary of the
international involvement in smallpox control from 1924 to 1966.
As the document moves to the focus of interest, the eradication program, eleven pages are dedicated
to the establishment of the intensified smallpox eradication program and the strategy for intensified
eradication. These strategies deal with the problems of providing a potent and stable vaccine and the
development in West Africa for the 'surveillance and containment strategy' for vaccination. Thirteen
pages of the document are dedicated to the development of the eradication program in fourteen specific
countries, as well as very general summaries in efforts in other areas. Imported outbreaks and laboratory-associated outbreaks are briefly discussed. Nine pages are dedicated to the very interesting
process of certification of countries as being free from smallpox.
Two sections of this document deal with the potential hazards of return of smallpox to the world.
Monkey-pox and its relation to smallpox is discussed as well as the potential for releases of variola virus
from laboratories and the potential of 'whitepox' being a wild variant of smallpox. The final section
covers the human, material, logistic and monetary resources dedicated to the eradication program.
Of particular interest to historians are the resolutions of the Executive Board and World Health
Assembly relating to smallpox, and selected bibliography of WHO documents on smallpox eradication.
In summaJ;Y, this document provides useful background information for the historian or health
professionals not familiar with the clinical pattern, epidemiology and early history of smallpox. It also
provides very useful, detailed information not available elsewhere in any one source on the exciting
success of the first eradication of a human disease.
If there is any criticism of this document, it is the cautious, de-personalized 'W.H.O.' style which
removes much of the excitement. It fails to emphasize the important contributions of individuals such
as: Dr. D.A. Henderson in the monumental task of administering the complex and politically difficult
program of worldwide smallpox eradication and Dr. William Foege in the breakthrough of development
of the 'surveillance and containment' strategy. However, the purpose of the document was not to
convey the excitement and drama of smallpox eradication, but rather to give the bare facts, in as
condensed a manner as possible. In this goal, the nameless authors of the document have succeeded
admirably.
I would recommend the book to anyone interested in the first stage of the relationship between man
and the smallpox virus and to those interested in the difficult process of bringing about international
cooperation for the benefit of mankind.
TIMOTHY D. BAKER
Nancy G. Siraisi, Taddeo Alderotti and His Pupils. Two Generations of Italian Medical Learning.
Princeton, N.J., Princeton University Press, 1981, XXIII, 461 pp., cloth, US $32.-.
Nancy Siraisi's impressive new book describes with a wealth of detail the careers, thought and
nurturing contexts of a group of learned medieval academic medical and philosophical authors. At the
center of this circle was Taddeo Alderotti. Taddeo, a Florentine by birth (ca. 1206--1215), helped
establish Bologna as a distinguished center of organized, academic medicine before his death in 1295.

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Through his teachings and writings Taddeo contributed to the definition of professionalized medicine as
an academic discipline and shaped the content and methods of university instruction in medicine. His
efforts were extended by the circle of his pupils at Bologna. Focusing on.Taddeo and his pupils, Siraisi
has produced no less than an anatomy of academic medicine at Bologna in its social, professional,
institutional and intellectual dimensions. Through it she provides an exemplary orientation to the whole
of late medieval northern Italian medicine.
Siraisi depicts a group of individuals deeply rooted in civic and communal life, straining to acquire
legitimacy for their art through the status conferred by academic privileges and the discipline of
scholastic methodology. Still, their links to indigenous traditions of practical medicine remain patent.
Taddeo and three of his students, Dino del Garbo, Bartolomeo da Varignana and Mondino de'Liuzzi,
followed family traditions by choosing the art of healing, though now as a learned profession rather than
the surgeon's craft or pharmacist's trade. Of Taddeo's remaining students, Gentile da Cingoli was a
philosopher who never took a medical degree, Guglielmo da Brescia was in minor orders and Turisanus
entered a religious order late in life. Taddeo and other contemporary physicians sought to emulate
Bolognese jurists by organizing medicine into a learned profession within the institutional framework of
the medieval university. Siraisi notes the significant prestige, economic advantages, and social and
political influence this new institutional arrangement entailed relative to other practitioners.
Whatever personal, social and civic incentives motivated the academic organization of medicine
within the medieval university at Bologna, the perception of medicine as a learned discipline had, of
course, antique roots which were irrigated by the deep currents of natural philosophy in medieval
intellectual life. Thus, even before the academic organization of medicine at Bologna, Taddeo evidently
studied medicine in conjunction with the liberal arts and philosophy. When the movement toward
institutionalization came, it drew upon a pre-existing ideal to fashion a specific definition of 'learned
medicine' as a vehicle for transforming medical practice into an esteemed profession. Fully two-thirds
of Siraisi's book describe the institutional and intellectual contours of learned medicine as it was
shaped by Taddeo and his students. In northern Italy, at least, medicine was directly aligned with
philosophy and the liberal arts through the formation of joint university faculties. Hence medical
education and writing was marked by the commingling of Aristotelian natural philosophy and biological
thought with Hippocratic and Galenic medicine and its Arabic interpretations. In the main, Bologna
followed earlier medieval precedent by centrally highlighting the texts of the so-called Art ice II a as
introduction to and core of medical education. Taddeo and his pupils commented extensively on these
key texts, but importantly supplemented them with a fuller range of the works of Galen and
encyclopedic medical works of Arabic provenance, notably the Canon of Avicenna. Added to this
confluence of theoretical medicine and philosophy was a distinctly practical orientation which valued
clinical experience and the practices of surgery and dissection. Taddeo and nearly all his physicianpupils were intimately involved with and wrote about such practical aspects of medicine, though best
known in this respect is Mondino.
Let me offer a few comments about Siraisi's portrayal of the achievements of Taddeo and his circle.
While noting that, for Taddeo, 'medicine was subalternated to natural philosophy', (p. 122) Straisi
stresses the tendency of these physicians to regard medicine as an autonomous science directed toward
practical ends. Accordingly, I found an implicit ambivalence in this book concerning the role and
importance of philosophy t{) medicine in Taddeo's circle. As I have noted, philosophy and medicine
were institutionally wedded at Bologna. Moreover, as Siraisi illustrates in chapter six, Aristotle's
natural philosophy and biology formed a crucial theoretical basis for central medical ideas such as that of
complexion theory. Yet, despite these conjunctions, Siraisi concludes that, for the most part, Taddeo
and his pupils displayed few genuine philosophical concerns and strictly subordinated their
philosophical discussions to medical issues of immediate importance (see pp. 167-8). In a quantitative
sense, Siraisi's point is well-taken, since explicit philosophical discussion forms but a small portion of
the medical works penned by these authors. Nevertheless, one still senses the presence of sensitive
interpretive issues. While portraying Taddeo's circle as intimately part of an evolving 'secular' social,
institutional and intellectual life of northern Italian communes, Siraisi nonetheless wishes to avoid
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271

extreme views linking such 'secular' tendencies in medieval medicine with heterodox philosophical and
theological positions. If anything, according to Siraisi, Taddeo and his pupils displayed cautious and
conservative views. Philosophically, they displayed no credible signs of heterodox 'Averroism' sometimes imputed to them by historians. In attempting to underline their disregard for innovative and
heterodox philosophical discussions, Siraisi minimizes the extent to which philosophical and even
theological issues were pertinent to the medical concerns of Taddeo's circle: 'For the most part, [they]
simply went about the intellectual business of the learned physician, which was primarily to be zealous
in gathering and sifting through naturalistic explanations ... of psychological and physiological
phenomena' (p. 177 - emphasis added). Such zealous activity, I suggest, certainly required some
working convictions about what constitutes a 'naturalistic explanation'. Given the importance attached
to astrology as an adjunct to medicine and to related notions like 'specific form', such convictions must
certainly have been less than clearcut and ironclad. Assessing the theoretical possibility of 'naturalistic'
versus 'celestial' or 'divine' explanations, and 'manifest' versus 'occult' causes, in medicine must have
occasioned more than cursory interest in philosophical discussions when and where they did occur.
Indeed, discussion of such topics as the relationship of the soul to generation and to the heart, the role of
bio-medical spiritus, and the nature of life, which Siraisi notes in her authors, undoubtedly played a
formative role in establishing the philosophical assumptions that made physiological and psychological
explanations possible.
Siraisi emphasizes throughout the complete dedication of Taddeo and his circle to both theoretical
and practical aspects of medicine. The investigation of these complementary activities is a major
contribution of this book. In a chapter on the 'Topics of Discussion', Siraisi illustrates how scholastic
methodology was applied to the study and teaching of practical medicine, while at the same time cataloguing
for us the major concerns of her physicians in both aspects of medicine. This chapter is supplemented by
an enormously useful appendix containing a 'Register of Questiones' occupying over one hundred
pages. A final chapter on 'The Practice of Medicine' makes splendid use of medical cons ilia surviving
from Taddeo's circle, and contains an illuminating discussion of the strengths and limitations of this
genre for scholarly research. Siraisi treats far many more topics in medieval medicine and science than I
have been able to mention with clarity and erudition in this book. Anyone interested in medieval
medicine must read it. With this beautifully designed and printed book, Siraisi has produced a work of
first-rate scholarship. It deserves both praise and serious attention.
JAMESJ. BONO

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Four Books on the History
of Medicine
Carel M. van Hoom, Levinus Lemnius 1505--1568. Zestiende-eeuws
Zeeuws geneesheer. Thesis. 1978, 532 pp., 10 illustr., bibliography,
index of names. Price: f 95,-.
The Zierikzee physician Levinus Lemnius (Lieven Lemse) was a somewhat striking
figure in the sixteenth century, the age that was in many respects a period of transition.
Thus we find elements from the Middle Ages as well from the Renaissance in his way of
thinking. In his attitude towards mentally ill people he has been looked upon as a
forerunner of the Enlightenment. He was given the honorary title of 'the hygienist of his
time'.
'Very useful in this respect is the survey made of the pharmacopoeia by Lemnius,
probably in circulation at that time ... ' D. de Moulin in Tijdschrift voor de Geschiedenis
der geneeskunde, natuurwetenschappen, wiskunde en techniek.

Michael M.E. Grafv. Matuschka, Lambert van Velthuysens (1622-1685)
Menstruationstheorie in ihrer wissenschaftshistorischen Bedeutung.
1980, 72 pp., 1 portrait, bibliography, index of names. Price: f 36,-.
Lambert van Velthuysen was the first to have correctly recognized a causality between
the ovarian function and menstruation. He succeeded in establishing a theory of menstruation, the validity of which has been recognized by modem medicine. A contribution
to the early history of the endocrinology of the ovaries.

Jean-Jacques Peumery, Les origines de Ia Transfusion Sanguine. First
book edition, 1975, of the articles which appeared in our periodical Clio
Medica in the course of 1974. 82 pp., 11 illustr., bibliography, index of
names. Price: f 36,-.
Faire passer du sang d'un sujet dans un autre est, de nosjours, un acte medicale des plus
courants. Pourtant, Ia transfusion sanguine a derriere elle toute une histoire, une histoire
pittoresque et captivante ...

Isaac van der Sluis, The Treponematosis of Tahiti. Its ongm and
evolution. A study of its sources. Thesis. 1969, 178 pp., catalogue of
sources. Price: f 41,50.
Venera! disease imported? In this thesis, the author has attempted to answer two
questions: firstly, was the treponematosis of Tahiti imported by European explorers ... ?
and secondly, was it yaws or syphilis?
' ... This monograph is strongly recommended to epidemiologists interested in yaws and
venera! diseases.' B.A. Southgate in The Journal of Tropical Medicine and Hygiene.

B. M. Israel b. v.
N.Z. Voorburgwal264
1012 RS Amsterdam, The Netherlands
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Books Received*
Juri A. Aleksandrowski, Mit den Augen des Psychiaters. Leipzig, S. Hirzel Verlag, 1982,229 pp., ill us.,
Leinen, Mark 25,-.
Annali dell' Istituto e Museo di Storia della Scienza di Firenze. Rivista intemationale di Storia della
Scienza. Anno VI, Fasc. 2, Firenze 1981, 178 pp. (no price stated).

J6zsef Antall, ed., Orvostorteneti Kozlemenyek- Communicationes de historia artis medicinae 89--91.
Budapest, 1980, 345 pp. (no price stated).
J6zsef Antall, ed., Nepi gy6gyiuis magyarorsztigon- Communicationes de historia artis medicinaeEthnomedicine in Hungary. Suppl. 11-12. Budapest, 1979, 327 pp., ill us., (no price stated).
Gauranga Nath Banerjee, Hellenism in Ancient India. New Delhi, Munshiram Manoharlal, 1981.
Distributed in USA by Humanities Press (Atlantic Highlands, New Jersey) 276 pp., $20.-.
William B. Bean, MD, Walter Reed. ·A Biography. Charlottesville, Virginia, University Press of
Virginia, 1982, 190 pp., illus. $12.95.
Ann Beck, Tradition, Medicine, and Development in Kenya and Tanzania 1920--1970. Waltham, Mass.,
Crossroads Press, 1981, 115 pp. (no price stated).
Alexander Berghaus, Die Entwicklung der Methoden zur physiologischen Wertbestimmung von Digitalispriiparaten. (Abh. z. Geschichte der Med. und der Nat.Wiss. H. 42). Husum, Matthiessen Verlag,
1982, 135 pp., illus., brosch. DM 36,-.
Julius Bizzozero, On a new blood particle and its role in thrombosis and blood coagulation- Uber einen
neuen Formbestandteil des Blutes und dessen Rolle bei der Thrombose und der Blutgerinnung.
Reproduced from Virchow's Arch. path. Anat. Physiol. klin. Med. 90: 261-332 ( 1882). Trans!. by Eugen
A. Beck, M.D., Bern-Stuttgart-Wien, Verlag H. Huber, 1982, 156 pp., SFr. 26,-/DM 29,-.
Harald Breyer, Max von Pettenkofer. Arzt im Vorfeld der Krankheit. (Humanisten der Tat). Leipzig,
Hirzel Verlag, 1980,234 pp., ill., Mark 14,-.
Johannes Bringmann, Problemkreis Schufibruch bei der deutschen Wehrmacht im 2. Weltkrieg.
Schriftenreihe Erfahrungen des dt. Sanitiitsdienstes im 2. Weltkrieg Bd. 3. Dusseldorf, Droste Vlg,
1981, 166 pp., illus., DM 38,-.
Juan de Cardenas, Problemas y secretos maravillosos de las Indias. Nuestros disicos 3. Coleccion La
His to ria de Ia Medicina en Mexico. Mexico, Acad. Nacional de Medicina, 1980, 5. Aufl. (I. Aufl. 1591),
320 pp., (no price stated).
David T. Courtwright, Dark Paradise: Opiate Addiction in America before 1940. Cambridge, Massachusetts, Harvard University Press, 1982,270 pp., $20,-.
Susanne Dahm, Friihe Krankenbildnisse: Alibert- Esquirol- Baumgartner. Ki.ilner med.hist.Beitr. Bd.
21, Ki.iln, Forschungsstelle des lnst.f.Gesch.d.Med., 1981,441 pp., illus., br. DM 66,80.

*

CLIO MEDICA reserves freedom of decision regarding the assignment of publication for review

Clio Medica, Vol. 17, no. 4, March 1983

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Books Received

Rosemarie Dilg-Frank, ed., Kreatur und Kosmos. 1nternationale Beitriige zur Paracelsusforschung.
Kurt Goldammer zum 65. Geburtstag. Stuttgart-New York, G. Fischer Verlag, 1981,206 pp., paper DM
58,-.
Dieter Doering, Die Logotherapie Viktor Emil Frankls. Kolner med.hist.Beitr. Bd. 19. Kolner, Forschungsstelle des Inst.f.Gesch.d.Med., 1981, 272 pp., DM 27 ,80.
Fran<;ois Duchesneau, La Physiologie des Lumieres. Empirismes, Modeles et Theories. Den Haag, M.
NijhoffPubl., 1982, XXI+ 611 pp., cloth, Dfl. 185,-/US$ 97,-.
Ludike Duhme, Die Tabulae Anatomicae des Pietro Berrettini da Cortona. Kolner medizinhistorische
Beitrage Bd. 18. Koln, Forschungsstelle des 1nstituts fur Geschichte der Medizin, 1981, 185 pp., illus.,
DM40,80.
Paule Dumaitre, La curieuse destinee des planches anatomiques de Gerard de Lairesse - peintre en
Hollande - Lairesse, Bidloo, Cowper. Amsterdam, Rodopi, 1982. Distributed by Humanities Press
(Atlantic Highlands N.J.) 107 pp., ill., US$ 12,50.
Bruce Stansfield Eastwood, The Elements of Vision: The Micro-Cosmology of Galenic Visual Theory
According to Hurwyn Ibn Jshiiq. Philadelphia, American Philosophical Society, 1982 (Transactions of
the APS, Vol. 72, part 5), 59 pp., paperback$ 8,-.
Arthur Engel, Hiilsan fore fodelsen, Prenatal forskning i Sverige. Nordisk med.hist. Arsbok 1981,
Suppl. VIII. Stockholm, Museum of Medical History, 1981, 128 pp., ill., (no price stated).
Juan de Esteyneffer, Florilegio medicinal de todas las enfermedades. Torno I y II. Nuestros clasicos 2.
Coleccion La Historia de Ia Medicina en Mexico. Mexico, Acad. Nacional de Medicina, 1978, 6.Aufl.
( 1.Aufl. 1712), XXIV+ XII +937 pp. (no price stated).
S.P. Fullinwinder, Technicians of the finite: The rise and decline_ of the schizophrenic in American
thought, 1840-1960. Contributions in Medical History Nr. 9. Westport, Conn., and London, Greenwood Press, 1982, ix+253 pp., US$ 27,50.
Otto Glandien, Franz Xaver Messerschmidt (1736-1783)- Ausdrucksstudien und Charakterkopfe.
Kolner med.hist.Beitr. Bd. 20. Koln, Forschungsstelle des 1nst.f.Gesch.d.Med., 1981, 205 pp., illus.,
DM37,80.
Reinhard Gursch, Die lllustrationen Ernst Haeckels zur Abstammungs- und Entwicklungsgeschichte.
Diskussion im wissenschaftl. und nichtwissenschaftl. Schrifttum. Marburger Schriften zur Med.Gesch.
I. Bern, Ffm., Peter Lang, 1981, 181 pp., illus., SFr. 46,-.
Helmut Heintel und Brigitte Heintel, Historische Stiitten der Neurologie in Baden-Wiirttemberg.
Stuttgart, G. Fischer Verlag, 1982,72 pp., illus., kart. DM 28,-.
Dominique Hochli, 60 Jahre schizophren. Die Lebensgestalt R.G. als Spiegel einer Krankheit, der
Psychiater, der Psychiatrie. Zurcher Med.gesch.Abh. Nr. 150. Zurich, Juris Druck+ Verlag, 1982,49
pp., SFr. II,-.
Karl Hufbauer, The Formation ofthe German Chemical Community ( 1720-1795 ). Berkeley, University
of California Press, 1982, 288 pp., $ 40,-.

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Arthur E. Imhof, Die gewonnenen Jahre. Von der Zunahme unserer Lebensspanne seit 300 Jahren oder
von der Notwendigkeit einer neuen Einstellung zu Leben und Sterben, Ein historischer Essay. Miinchen, C.H.Beck, 1981,279 pp., kart. DM 38,-.
Rudiger Jopp, Einzelheiten zur Geschichte der Augenheilkunde von der Antike his urn 1800 am Beispiel
von Koln. Kolner med. hist. Beitr. Bd. 16. Koln, Forschungsstelle des Instituts fiir Geschichte der
Medizin, 1980,225 pp., illus., DM 28,80.
Richard Katz, Boiling Energy: Community Healing Among the Kalahari Kung. Cambridge, Massachusetts, Harvard University Press, 1982, xix, 329 pp., $25,-.
Josip Kis, Der Knochenpathologe Emil Looser (1877-1936). Zurcher Medizingeschichtl. Abhdlgn.
N .R. Nr. 149. Ziirich, Juris Druck+ Verlag, 1982, 68 pp., SFr. 16,-.
Felix Klein-Franke, Vorlesungen iiber die Medizin im Islam. Sudhoffs Archiv, Beih. 23. Steiner,
Wiesbaden, 1982, 161 pp., kart. DM 52,-.
Manfred Klimpel, F. von He bra, Atlas der Hautkrankheiten (1856-1876). Kolner med. hist. Beitr. Bd.
17. Koln, Forschungsstelle des Instituts fiir Geschichte der Medizin, 1980, 322 pp., illus., DM 40,80.
Wolfram Kock, ed., Nordisk Medicinhistorisk Arsbok 1981. Yearbook of the Museum of Medical
History Stockholm, 1981, 204 pp., kr. 60,-.
Wolfram Kock, ed., Nordisk Medicinhistorisk Arsbok 1980. Supplementum VII see: Ponten, Johan.
Supplementum VIII (1981) see: Engel, Arthur.
Thomas J. Kuehn and Alan L. Porter, Science, Technology, and National Policy. Ithaca, New York,
Cornell University Press, 1981, 531 pp., paperback $9,95, $39,95 hard cover.
Adolf Kussmaul, Memoirs of an old Physician. New Delhi, India: Amerind Publ. Co. Pvt. Ltd., 1981.
Distr. by the National Technical Information Service, Springfield, Virginia. 352 pp., $15,- domestic,
$30,- foreign, $4,- microfiche.
H.G. Lasch und B. Schlegel, eds., Hundert Jahre Deutsche Gesellschaft fur innere Medizin. Die
KongreB-Eroffnungsreden der Vorsitzenden 1882-1982. Miinchen, J.F. Bergmann Verlag, 1982, 987
pp. (no price stated).
Dominik Leupold-Kirschneck, Das Handauflegen. Eine iirztliche Urgebiirde in Geschichte und
Gegenwart. Basler Veroff. zur Gesch.d.Medizin u.d.Biologie Fasc. XXXIII. Basel/Stuttgart, Schwabe
& Co., 1981,81 pp., illus. (no price stated).
M.J. van Lieburg and R.Toellner, eds., Deutsch-niederliindische Beziehungen in der Medizin des 17.
Jahrhunderts. Vortrage des Deutsch-Niederlandischen Medizinhistoriker-Treffens 1981. Amsterdam,
Rodopi, 1982, 108 pp., ill., US $12,50.
Alonso Lopez de Hinojosos, Suma y recopilacion de Cirugia -con un arte para sangrar muy util y
provechosa. Nuestros clasicos I. Coleccion La Historia de Ia Medicina en Mexico. Mexico, Academia
Nacional de Medicina, 1977, 3.Aufl. ( l.Aufl. 1578), XXIV+ 227 pp. (no price stated).
Thomas Power Lowry, MD, The Classic Clitoris: Historic Contributions to Scientific Sexuality.
Chicago, Nelson-Hall, 1978, 120 pp. (no price stated).
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Books Received

G. Maloney et R. Savoie, Cinq cent ans de bibliographie hippocratique 1473-1982. St-Jean-Chrysostome (Quebec), Les Editions du Sphinx, 1982, iv, 290 pp., Canadian $30,-.
Michael E. Graf v. Matuschka, Gyniikologische Sterilisationen zur Zeit des Hexenwahns. Eine Studie
zur Geschichte der Human- und Veteriniirmedizin sowie des zeitgen6ssischen Rechtsdenkens. Graz,
Akadem. Druck- u. Verlagsanstalt 1981,69 pp., ill., (no price stated).
Richard Y. Meier (comp.), The Joseph H. Kiefer Catalog ofHistory of Urology and Medicine. Chicago,
Library of the Health Sciences, Univ. of Illinois at the Medical Center, 1981,207 pp., illus., paper$ 10,-,
cloth$ 25,-.
Evan M. Melhado, Jacob Berzelius, The Emergence of His Chemical System. Stockholm, Almquist &
Wiksell International and Madison, The University of Wisconsin Press, 1981,357 pp., Swkr. 225,-.
M. Michler & J. Benedum, Einfuhrung in die medizinische Fachsprache. 2., korrigierte Aufl., BerlinHeidelberg-New York, Springer, 1981, XIV + 358 pp., ill us., DM 78,-.
Nikolai Nikolajewitsch Mikloucho-Maclay, Briefivechsel mit Anton Dohrn. Hrsg. von Irmgard Miiller.
Beitriige zur Ethnomedizin, Ethnobotanik und Ethnozoologie IV. Norderstedt, Verlag fiir Ethnologie,
1980, 127 pp. (rio price stated).
Jose Maria Mocino, Disertaci6n de /afiebre epidemica, que padeci6 Cadiz, Sevilla y Ia mayor parte de
Andalucia desde el ano 1800 y principalmente de Ia que sufri6 Exica el ano 1804. Mexico, Soc.Mex. de
Hist. y Filos. de Ia Med., 1982,234 pp., (no price stated).
Regina Markell Morantz, Cynthia Pomerleau, Carol Hansen Fenichel, eds., In her own words: Oral
histories of women physicians. Contributions in Medical History no. 8. Westport, Conn., Greenwood
Press, 1982, xiv + 284 pp., illus., $29,95.
Peter Morys, Medizin und Pharmazie in der Kosmologie Leonhard Thurneissers zum Thurn (15311596). Abh. z. Gesch. der Med.u.Nat.Wiss. H. 43. Husum, Matthiessen Verlag, 1982, 179 pp., brosch.
DM46,-.
Daniel de Moulin, Huize Heyendael. Stamslot van de Medische Faculteit der Katholieke Universiteit
Nijmegen. Nijmegen, Katholieke Universiteit, 1982, 106 pp., ill us. (no price stated).
Irmgard Miiller, Die pjlanzlichen Heilmittel bei Hildegard von Bingen. Salzburg, Otto Miiller Verlag,
1982,215 pp., illus., DM 43,-.
Vivian Nutton, ed., Galen: Problems and Prospects. A Collection of Papers submitted at the 1979
Cambridge Conference. London, The Wellcome Institute for the History of Medicine, 1981, 281 pp. (no
price stated).
Teizo Ogawa, ed., History of Psychiatry: Menta/Illness and Its Treatments. Proceedings of the 4th
International Symposium on the Comparative History of Medicine-East and West October 21-27, 1979
Susono-shi, Shizuoka, Japan. Tokyo and Osaka, Saikon Publishing Co., Ltd. and the Taniguchi
Foundation, 1982, x, 216 pp. 10 papers in English (no price stated).
Dieter Oldenburg, Romantische Naturphilosophie und Arzneimittellehre 1800-1840. Aus dem Pharmaziegeschichtl. Seminar der TU Braunschweig Bd. 20. Braunschweig, Dt. Apothekervlg. Stuttgart,
1979, 267 pp. (no price stated).
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Donald J. Ortner and Walter G.J. Putschar, Identification of Pathological Conditions in Human
Skeletal Remains. Washington, Smithsonian Institution Press, 1981, 479 pp., ill.,$ 12,-.
I.Th. Papabasileos und Basil P. Rozos, Encheiridion Istorias tes Iatrikes, Vol. I, Athen, Panepistemiou,
1979,324 pp., illus. (no price stated).
K. David Patterson, Health in Colonial Ghana: Disease, Medicine, and Socio-Economic Change
1900-1955. Waltham, Massachusetts, Crossroads Press, 1981, xiii, 187 pp., tables and maps (Crossroads Press has since moved to Los Angeles, California) (no price stated).
Kathleen M. Pearle, Preventive Medicine: The Refugee Physician and the New York Medical Community 1933-1945. Working Papers on Blocked Alternatives in the Health Policy System II. Bremen,
Research Center on Social Conditions, Social Movements and Social Policy at the University of
Bremen, 1981,234pp., US$3,-orDM6,-.
Eike Pies, Willem Piso (1611-1678)- Begriinderder kolonialen Medizin und Leibarztdes GrafenJohann
Moritz von Nassau-Siegen in Brasilien. Eine Biographie. Dusseldorf, interma-orb Verlagsgruppe, 1981,
227 pp., illus. DM 48,-.
Zofia Podg6rska-Klawe, Od Hospicjum do Wsp6lczesnego Szpitala. Rozw6j Historyczny Problematyki
Szpitalnej w Polsce do Konca XIX Wieku. Wroclaw: Zaklad Narodowy im. Ossolinskich-Wydawnictwo
Polskiej Akademii Nauk, 1981,261 pp., plates (no price given).
Johan Ponten, Gudar, priister och liikekonst. Nordisk med. hist. Arsbok 1980, Suppl. VII. Stockholm,
Museum of Medical History 1980,79 pp., illus. (no price stated).
Hans Poser, ed., Formen teleologischen Denkens. Philosophische und wissenschaftshistorische Analysen. Kolloquium an der TU Berlin, WS 1980/1981. TUB-Dokumentation Kongresse u. Tagungen H.
II, Berlin 1981, XII+ 254 pp., DM 15,-.
Royal College of Physicians of London, ed., Sir Thomas Browne (1605-1682) and the Baroque. With a
postscript on his son Edward as Treasurer (1694-1703/04) and President (1704/08) of the College of
Physicians. Catalogue of an exhibition with an Introduction by Dennis Cole. London, 1982, 35 pp., (no
price stated).
Andrew W. Russell, ed., The Town and State Physician in Europe from the Middle Ages to the
Enlightenment. Wolfenbiitteler Forschungen Bd. 17. Herzog August Bibliothek Wolfenbiittel, 1981,
156 pp. (no price stated).
Hakim Mohammed Said, ed., Al-Biruni. Commemorative Volume: Proceedings of the International
Congress held in Pakistan Nov. 26- Dec. 12, 1973. Karachi, Hamdard Academy, 1979, illus., 844 pp. +
16 pp., ill us., Rs. 200,-, $ 30,-.
Heinrich Schipperges, Kosmos Anthropos. Entwiirfe zu einer Philosophie des Leibes. Stuttgart,
Klett-Cotta, 1981,484 pp. (no price stated).
Paul-Otto Schmidt, Asylierung oder familiale Versorgung- Die Vortrage auf der Sektion Psychiatrie
der Gesellschaft Deutscher Naturforscher und Arzte bis 1885. Abh. z.Gesch.d.Med.u.Nat. Wiss. H.44.
Husum, Matthiesen Verlag, 1982,219 pp., br. DM 56,-.

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Books Received

Martin Schwarzbach, Auf den Spuren unserer Naturforscher. Denkmiiler und Gedenktage. Ein Reisefiihrer. Stuttgart, S. Hirzel Vlg., 1981, 2% pp., illus., DM 28,-.
''Sehr geehrter Herr!'' Autorenbriefe aus dem Springer-Archiv. Katalog einer Ausstellung, gezeigt aus
AnlaB der Einweihung des Neubaus in Heidelberg am 7. Mai 1982. Heidelberg/New York, J. Springer
Verlag, 1982,48 pp., illus. (no price stated).

Helmut A. Seidl, Medizinische Sprichworter im Englischen und Deutschen. Forum Anglicum Bd. II.
Frankfurt/Main-Bern, Verlag P. Lang, 1982,406 pp., SFr. 77,-.
John C. Sheehan, The Enchanted Ring: The Untold Story of Penicillin. Cambridge, Massachusetts,
MIT Press, 1982, xvi, 224 pp., diagrams,$ 15,-.
Guido Sigron, Die Geschichte der Zahnmedizin in Graubunden. Zurcher Medizingesch. Abh. N.R. Nr.
148. Ziirich, Juris Vlg. 1981, !50 pp., Sfr. 30,-.
German Somolinos d'Ardois, Capitulos de historia medica mexicana IV. Relacion y estudio de los
impresos medicos mexicanos redactados y editados desde 1521 a 1618. Mexico, Sociedad mexicana de
historia y filosofia de Ia medicina, 1980, ill us., 192 pp. (no price stated).
German Somolinos d' Ardois, Capitulos de his to ria medica mexicana V. El primer exp/orador cientifico
de Ia naturalezay Ia medicina de Mexico. Mexico, Soc. mex. de hist. y filos. de lamed., 1981,57 pp. (no
price stated).
Paul Steinbriick und Achim Thorn, Robert Koch (1843-1910), Ausgewiihlte Texte. Sudhoffs Klassiker
der Medizin NF 2. Leipzig, Joh.Ambr.Barth, 215 pp., illus., brosch., Mark 28,-.
Karl Sudhoff, Kurzes Handbuch der Geschichte der Medizin. Unveranderte Neuauflage der 3.u. 4.
Aufl. von J.L. Pagels 'Einfiihrung in die Geschichte der Medizin' (1898), Berlin 1922. Basel, Karger,
1981, VIII + 534 pp., cloth SFr./DM 135 ,-, ca. US $ 81 ,-.
Leon Szyfman, Jean-Baptiste Lamarck et son epoque. Paris, Masson, 1982,448 pp., FF 150,-.
Hans-Joachim Schwanitz, Die Theorie der praktischen Medizin zu Beginn des 19. Jahrhunderts.
Pahl-Rugenstein Hochschulschriften 29. Koln, Pahl-Rugenstein Verlag, 1979, 134 pp., DM 18,-.
Claude Alexandre Thomasset, Commentaire de dialogue de Placides et Timeo. Une vision du monde a
Ia fin du XIIle siecle. Publications Romanes et Fran~aises CLXI. Geneve, Droz, 1982, 339 pp. (no price
stated).
John L. Thornton, Jan van Rymsdyk. Medical Artist of the Eighteenth Century. Cambridge-New York,
The Oleander Press, 1982, Ill pp., ill us.,£ 9,95.
Nelly Tsouyopoulos, Andreas Roschlaub und die Romantische Medizin. Die philosophischen Grundlagen der modernen Medizin. Medizin in Geschichte und Kultur Bd. 14. Stuttgart-New York, G.Fischer
Verlag, 1982, VIII+ 257 pp., DM 58,-.
J.A. Veiga-Pires and Ronald G. Grainger, eds., Pioneers in Angiography. The Portuguese School of
Angiography. Including translations of the original scientific communications. Lancaster-Boston-The
Hague, MTP Press Ltd., 1982, 131 pp., illus., £ 9,95.

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279

J. Voegen van Engelen, ed., De surinaamsche Artz 1786-1788. Facsimile met een inleiding van G.A.
Lindeboom. Publications of the Foundation for scientific research in Surinam and the Netherlands
Antilles No. 109. Utrecht, 1981, XXVI+ 101 pp., Hfl. 15,-.
James C. Whorton, Crusaders for Fitness. The History of American Health Reformers. Princeton,
Princeton Univ.Press, 1982, 359 pp., US$ 25,50.
Sir Gordon Wolstenholme, ed., Munk'sRoll vol. 6: 1966-1975. Oxford, IRL Press Ltd., 1982, xi+ 505
pp., illus., hardcover,£ 25,-, US$ 50,-.
Friedrich von Zglinicki, Die Wiege. Volkskundlich-kulturgeschichtlich-kunstwissenschaftlich-medizinhistorisch. Eine Wiegentypologie mit iiber 500 Abbildungen. Regensburg, F. Pustet Verlag, 1979,
419 pp., illus., DM 74,-.

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Catalogue 95

:;.=-- -

Books on Philosophy, Theology,
Occultism, Psychology, etc.

B.M. ISRAEL B.V.
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Contributors to this issue
AN GOT, JEAN L., Dr., Faculte de Chirurgie dentaire (Universite Paris V) est chirurgien--<lentiste de
Ia Faculte de Medecine de Paris et P.G. Dental School , Northwestern University (Chicago, USA) . II
prepare actuellement un ouvrage sur l' histoire de Ia chirurgie dentaire .
BAKER, TIMOTHY D., M.D., M.P.H., Professor of International Health, Professor of Public
Health Administration, Johns Hopkins University. Dr. Baker has worked as an epidemiologist (past
secretary and chairman Epidemiology Section, APHA) and health administrator (Asst. Dean, Johns
Hopkins School of Public Health ; Assistant and Acting Chief, AID, India; Vice President , University
Associates). Dr. Baker has published books, book chapters and articles in the fields of epidemiology,
health manpower, health planning and history of public health .
BONO, JAMES J ., received his Ph .D. from Harvard University . His dissertation is entitled, The
Languages of Life: Jean Ferne/ ( /497-1558) and 'Spiritus' in Pre-Harveian Bio-Medical Thought . With
Charles B. Schmitt he has published on Fe mel, Dalechamps and physician-apothecary disputes at Lyon
in the Bulletin of the History of Medicine . He is continuing work on Spiritus and medieval-Renaissance
medicine, and undertaking new research on active biological matter in early-modem Europe. He has
taught at Harvard and Wayne State Universities, and at the University of Michigan.
DEWHURST, KENNETH , M.D. , D.Phil., F.R .C.Psych ., has recently retired as Professor of
Psychiatry , University of the West Indies . His latest book is an edition of " Willis 's Oxford Casebook
( 1650-2)" .
DUFFY, JOHN , Ph.D. , is currently the Priscilla Alden Burke Professor of History at the University
of Maryland . His two most recent publications are The Healers : a History ofAmerican Medicine, and
Ventures in World Health : The Memoirs of Fred Lowe Soper which he edited . His major project is a
history of American public health but he is also working on a history of the Tulane University Medical
Center.
FORBES, ERIC G., was born 1933 in Scotland . University of St. Andrews tilll954. In 1955 he began
a five-year programme of solar physics research (St. Andrews, Arcetri, Gottingen), for which he duly
obtained a doctorate in 1961. After receiving his M.Sc . for History and Philosophy of Science at
University College , London , he was appointed Lecturer in History of Science at Edinburgh University,
where he is now Professor and Director of a Unit for the History of Medicine and Science . Numerous
contributions to 17th- and 18th century astronomy. His current research is centred upon the early
history of the Gottingen Academy of Sciences.
GALISHOFF, STUART, is associate professor of history at Georgia State University . He is the
author of Safeguarding the Public Health , Newark, 1895-1918 (Greenwood Press, 1975) and has written
at length on urban sanitation and the control of communicable diseases. He is currently co-editor of the
forthcoming Dictionary ofAmerican Medical Biography.
GHALIOUNGUI, PAUL, M.D., B.Ch., M.B., born 1908. Beside his lifelong activity in the practice
and teaching of clinical medicine, in the directing of research , and in the field of folk and historical
medicine, Paul Ghalioungui has acquired experience in studying the impact of environment on health .
He has surveyed nutrition, goiter,' and parasitic diseases for various agencies in the greater part of the
Nile basin from Upper Sudan to the Mediterranean as well as in the Libyan oases and, on a WHO

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282

Contributors to this issue

specialist goiter assignment, the north of Iraq. He published several books in Arabic, English and
Spanish: The Medicine of the Ancient Egyptians ( 1958), Ibn an-Nafis ( 1966) Abdel-Latif al-Baghdady
(1972) -all these in Arabic; Magic and Medical Science in Ancient Egypt (lrst ed. 1%3, London, 2nd ed.
1973 Amsterdam); Food- the Gift of Osiris (1977)- in English; Egyptian Medicine (1972)- in Spanish.
LEAVITT, JUDITH WALZER, Ph.D., Associate Professor in the Departments of the History of
Medicine, History of Science, and Women's Studies at the University of Wisconsin-Madison, is the
author of The Healthiest City: Milwaukee and the Politics of Health Reform, to be published by the
Princeton University Press. She is co-editor of three books, including Sickness and Health in America:
Readings in the History of Medicine and Public Health (1978) and Wisconsin Medicine: Historical
Perspectives (1981). Her research interests are the history of public health and women's health in
nineteenth century America.
LOMAX, ELISABETH, Lecturer in the History of Medicine at the University of California, Los
Angeles. Her research is mainly in the 19th century history of pediatrics and child development. Author,
in collaboration with Jerome Kagan and Barbara Rosenkrantz, of Science and Patterns of Child Care,
San Francisco, W.H. Freeman, 1978. Work in progress: 19th century conceptions of the interaction of
heredity and environment in childhood disease and development.
ORS, YAMAN, graduated from Ankara University Medical Faculty in 1960. Has degrees in
pathology and medical history. Lecturer in Medical History and Deontology at the same faculty.
Besides his efforts of developing a concept in the field of medical history (·'medical evolution''), he has
been writing on medico-biological topics (disease and evolution, cancer and the environment and
others) as well as on general ecology and history, and socio-political and medico-social issues. More
recent interests are in the field of methodology and philosophy of medicine, on which Dr. brs plans to
write more systematically.
SATRAN, RICHARD, M.D. is Vice-Chairman and Professor of Neurology at the University of
Rochester School of Medicine and Dentistry. He has written several articles dealing with French
neurology during the 19th century. His most recent paper, Les Debuts de Ia Societe fran~·aise de
neurologie, appeared in the Histoire des Sciences Medicales in 1981.
SCHULTHEISZ, EMIL, M.D., Ph.D.; Hon. M.D. Cracow; Prof. for History of Medicine, University Budapest; born 1923, Budapest; educ. University of Liberal Arts, Kolozsvar, and Medical Universities of Debrecen and Budapest. Qualification as specialist for internal diseases, 1954; Chief of Internal
Department, Central State Hospital 1960, Vice-Director, later Director 1970-72; Deputy Minister of
Health, later First Deputy Minister and Secretary of State for Health, 1972; Minister of Health 1974;
Director General Semmelweis Museum of Medical History until 1973, since then President of the
Scientific Council of the Museum; President of the Hungarian Society of History of Medicine (1970);
member of numerous medical societies in Hungary and abroad. - Publications: two books and more
than 140 medico-historical papers, 40 papers in the field of internal medicine, editor of six monographs.
STILLE, GUNTHER, Prof. Dr. med., Pharmakologe (Habil. 1969), 1959-1973 Forschungstiitigkeit
in verschiedenen lndustrielaboratorien des In- und Auslandes. 1975-1982 Leiter der Abteilung fiir
experimentelle und klinische Pharmakologie im Bundesgesundheitsamt und (seit 1979) Professor fiir
Pharmakologie an der FU Berlin. Seit 1982 im Ruhestand. Beschiiftigung mit Fragen der Ethnopharmakologie und des Gebrauchs von Drogen in verschiedenen Zeiten und Kulturen. Uber 100
Publikationen in Fachzeitschriften des In- und Auslandes zur Pharmakologie von Neuro- und Psychopharmaka, Hg. von zwei Biinden des Handbook of Experimental Pharmacology, Psychotropic Agents,
1980/81.

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283

Contributors to this issue
THEODORIDES, JEAN, Prof. Dr., 16, Square Port Royal, 75013 Paris, France.

TREVISANI, FRANCESCO, 1982 beauftragter Professor im Philosophischen Institut an der Universitat Messina und Assistent in Rom (Fakultat Magistero), ehemaliger Stipendiat der franziisischen
Regierung, des Deutschen Akademischen Austauschdienstes (DAAD) und der Humboldt-Stiftung.
Verfasser zahlreicher Publikationen iiber den wissenschaftlichen Werdegang von Descartes, iiber J.
Jungius und J.G. Berger. Er beschaftigt sich mit der Philosophie und Physiologie des 17. Jahrhunderts.
Ein Buch iiber "Cartesianismus und deutsche Medizin" ist im D'ruck.
WALLACE, EDWIN R., IV, M.D., is Director of Psychotherapy Education and Associate Professor
of Psychiatry at the Medical College of Georgia in Augusta. Holding degrees in history from the
University of South Carolina and the Johns Hopkins University, he has written numerous articles on the
history of psychoanalysis. He is the author of Freud and Anthropology: A History and Reappraisal
(New York, International Universities Press, 1982), Dynamic Psychiatry in Theory and Practice
(Philadelphia, Lea and Febiger, 1982), and is the co-editor of Essays in the History of Psychiatry
(Columbia, S.C., R.L. Bryan, 1980). His current research interests are epistemology in history and
psychoanalysis and the interface between religion and psychiatry.
WHORTON, JAMES C., is associate professor in the Department of Biomedical History, University
of Washington. He is the author of Crusaders for Fitness. A History of American Health Reformers
(Princeton University Press, 1982), and is currently investigating the history of sports medicine.

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Catalogue 96

Books on Pharmacy,
Homoeopathy, Toxicology,
Chemistry, Alchemy,
Botany, Balneology, etc.

B.M. ISRAEL B.V.
- 978-90-04-41867-7
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A.L.J. Bayle et A.J. Thillaye

D. LeClerc

Biographie medicale par ordre
chronologique

Histoire de Ia medecine.

D'apres Daniel LeClerc, Eloy, etc. mise
dans un nouvel ordre, revue et

Ou l'on voit l'origine & les progres de

complt~tee.

Reprint of the edition Paris, 1855.
2 volumes (560; 950 pp). Cloth binding.
The biographies are chronologically
arranged with extensive bibliographical
information and are based on the
works of Daniel LeClerc, Histoire de La
medecine; Eloy, Dictionnaire historique de
La medecine ancienne et moderne;
J. E. Dezeimeris, Dictionnaire historique
de La medecine and A. J. L. Jourdan,
Dictionnaire des sciences medicales. Starting
in 1526 BC and ending in 1813 AD,
it gives the life and works of famous
medical doctors of all nations and
peoples.
Garrison, Sources of medical biography
p. 699: " ... Bayle and Thillaye, although
alphabetized only in the index, is the
handiest of all, and was always on
Osler's desk; .. ."

HO 175,-

cet art, de siecle en siecle; les sectes,
qui s'y sont formees; les noms des
medecins, leurs decouvertes,
leur opinions, & les circonstances les
plus remarquables de leur vie.

Reprint of the edition Den Haag, 1729.
2 volumes in I.
Front. and 8 plates, I folding table.
(XVIII , 820, XVIII pp). Cloth binding.
"The first large history of medicine. It is
still consulted to-day, Leclerc is
sometimes called the 'Father of the
history of medicine'. The first edition of
this work appeared in 1696, but later
editions are more useful." Reprint of the
last and best edition.
(Hirsch Ill, p. 770; Osler 6036; Bayle &
Thillaye ll; p. 49-57; Garrison & Morton
nr. 6379)
ISBN 90.6078.019.1

HO 125,-

B.M. ISRAEL

B.M. ISRAEL

N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands

N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands
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J. Bertrand

P. Harting

L' Academie des Sciences et les
Academiciens de 1666 a 1793

Das Mikroskop. Theorie,
Gebrauch, Geschichte und
gegenwartiger Zustand
desselben

Reprint of the edition Paris, 1869.
This reprint is enlarged with a newly added
index.
(VI,434,X pp). Cloth binding.

Zweite deutsche original Ausgabe vom
Verfasser revidirt und vervollstandigt.
Herausgegeben von F. M. Theile.
Reprint of the edition Braunschweig,
1866.

Only history of the"Academie des
Sciences de France."
Table of contents :
L'academie. L'academie de 1666.
L'organisation de 1669. Les finances de
l'academie. Les expeditions scientifiques.
Les rapports. Les prix. Les academiciens.
Les secretaires perpetuels.
Les geometres, les mecaniciens et les
physiciens, les chimistes, les naturalistes.
L'academie de 1789 a 1796.
Listes des personages.
ISBN 90.6078.043.4

Hfl45,-

With a new introduction by
drs. P van der Star.
1 coloured plate, 466 text-illustrations.
3 volumes in I. (XVI, 348; VI, 310;
IX, 452 pp). Cloth binding.
It is the best and most copiously
illustrated history of the microscope,
and is divided in three parts :
I. Theory and general description of
microscopes,
2. The microscopic research and its
development,
3. The history of microscopic
instruments from the earliest sources
(Seneca, Plinius) till 1850.
Each part is richly illustrated.
(Garrison &Morton 270; Clay &Court i.l.c.;
Hirsch, Lexicon,Ill,p. 70; Poggendorfl, I,
7027-2, Ill,p. 597)
ISBN 90.6078.054.X

Hfl210,-

B.M. ISRAEL
N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands

B.M. ISRAEL
N .Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands
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C. L. ED. Cuvier

J. B. J. Delambre (editor)

Rapport Historique sur les
Progres des Sciences
Naturelles

Rapport Historique sur les
Progres Mathematiques

Depuis 1789.
Reprint of the edition Paris, 1810.
(XVI, 394 pp). Cloth binding.

Depuis 1789.
Reprint of the edition Paris, 1810.
(VIII, 362 pp). Cloth binding.

By order of Napoleon, Cuvier reported
on the progress of physical and natural
sciences during the French Revolution,
as did Delambre on mathematics.
The part on chemistry sciences is
mostly the result of reports by other
great scientists as Guyton, Chaptal,
Vauquelin, De Jussieu, Tessier, Halle
and Lacepede, whereas the part on
natural history contains specially the
scientific work of.Cuvier himself, who
was the founder of palaeontology and a
great comparative anatomist.

"Prepared by order of Napoleon reports
on progress of science from 1789 to 1810.
Including mechanics, astronomy,
geography, arts and industries."
The work describes the inventions, and
mentions the publications on various
fields of science by Laplace, Condorcet,
Delambre, La Perouse, Lavoisier,
La Lande, Baudin, d'Aiembert,
Bourgainville, Breguet, Biot, Borda,
Betancourt, Fleuret, Aubert, etc. etc.

(Poggendorff I,p. 507; Barton, A guide to the
history of science,p. 777; Wheeler Gift P. 702)
ISBN 90.6078.052.0

(Poggendorff!, p. 539; Smith, History of
mathematics I,p. 492; Sarton, A guide to tlte
history of science,p. 177; Cantor IV,p. 207;
Wheeler Gift nr. 703)
ISBN 90.6078.009.4

Ht135,-

Hfl40,-

Set Cuvier & Delambre

Set Cuvier & Delambre

Ht160,-

B.M. ISRAEL
N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands

Ht160,-

B.M. ISRAEL
N.Z. Voorburgwal264
1012 RS Amsterdam
The Netherlands
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The history and philosophy ofknuwledge of

THE BRAIN
AND ITS

F

CTIONS
Edited by
F. N. L. POYNTER PHD., F.L.A.

This symposium brought together a number of the
most distinguished British and American neurologists. The papers and discussions form a valuable
survey of our knowledge of the brain from earliest
times up to the present day.
ISBN 90 6078 063 9
Dfl. 48,-

B. M. ISRAEL BY.
N .Z. Voorburgwal264
AMSTERDAM

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