DISTINGUISHED SWISS PHYSICIANS WHO PLAYED A PROMINENT PART IN THE DEVELOPMENT OF THE SCIENCE AND ART OF MEDICINE IN GERMANY

Among the men who may properly be included in the present class of distinguished German physicians I have no hesitation in naming von Haller and Zimmermann, notwithstanding the fact that both of them were natives of Switzerland—that is, German Switzerland.

Albrecht von Haller, whose many contributions to the science of medicine have assured him a permanent and very high position in the temple of fame, was born October 16, 1708, of parents who belonged to two of the old patrician families of Berne, Switzerland. In childhood he suffered from rachitic symptoms and was constantly ailing; but, despite these drawbacks, he manifested at a very early age evidences of possessing to an unusual degree certain intellectual gifts and of having a genuine love for work. Thus, for example, he began—shortly after he had learned to write—recording in alphabetical order all the words that he had been taught and the meaning of which had been explained to him. At the age of ten he prepared for his own use a vocabulary composed of Chaldean, Hebrew and Greek words, and two years later he compiled, from the dictionaries of Moreri and Bayle, a collection of concise biographies of the men who had achieved celebrity in the more important branches of science, and he surprised his teachers by his ability to compose verses in Latin as well as in his native language, German. Before he reached his fifteenth year he had attained considerable distinction, both as an anatomist and as a poet, a combination of gifts extraordinarily rare. He received his early training in anatomy and general medicine at the University of TÜbingen, under the guidance of the two Duverneys, father and son, and of Elias Camerarius, all three of whom were professors of considerable celebrity in their respective departments. Jean Guichard Duverney (1691–1759), for example, was the first anatomist to furnish a complete and very thorough description of the solar plexus.

An incident which occurred during his student days at TÜbingen reveals so strikingly von Haller’s strength of purpose and his unwillingness to permit anything to divert him from the path which he had decided to follow, that I shall not hesitate to relate it briefly here. In company with a few of his fellow students he participated in one of those beer-drinking bouts which are of such frequent occurrence in German university towns, and was in due course of time made acquainted with the legitimate effects that follow such excessive indulgence—effects that are felt as “seediness” and a sense of physical misery (symptoms to which the Germans have given the striking but untranslatable name of Katzenjammer). This single experience sufficed to impress upon von Haller’s mind the folly of such indulgence and he never afterward permitted himself to take part in an excess of this nature.

Although von Haller, upon the death of his father, had been left with very slender financial means, he managed, under the guidance of Albinus, on leaving TÜbingen in 1725, to visit Leyden, in Holland, where he was able to prosecute his anatomical researches and at the same time to follow the instruction of Boerhaave, who was still at that period in full possession of his powers as a teacher. Extraordinary as it will appear to the physicians of to-day, von Haller, when only nineteen years old, passed successfully the required examinations at Leyden and was given the degree of Doctor of Medicine (1727).

From Holland von Haller went first to London, where he accepted the invitation of James Douglas, the anatomist, to assist him in his studies of the structure of the bones. Then from there he next visited Paris (1728), where he had for his teachers Le Dran, the distinguished French surgeon, and Winslow, the well-known anatomist. It was his original intention to make a prolonged stay in the French metropolis, but, unfortunately, his ambition to get ahead as fast as possible in the study of anatomy led him to disregard certain precautions which, in the early part of the eighteenth century, it was not at all safe for men interested in this branch of medical science to neglect. Recognizing the fact that, in order to advance his knowledge of anatomy, he must have a certain amount of human dissecting material at his command, and finding that he could procure this material in no other way than by the process commonly known as “body-snatching,” he decided, in association with one of the prosectors of the medical school, to adopt that method of procuring the material needed. The plan was successfully carried out, the disinterred body was transferred to von Haller’s apartment, and the two enthusiastic anatomists had already done a certain amount of dissecting when an unexpected obstacle was encountered. The layman who occupied the adjoining room overheard enough of the conversation that was being carried on between von Haller and his friend to suspect strongly the true nature of the work in which they were engaged. But, to make sure that his surmise was correct, he bored a peek-hole through the partition wall, and thus was able to remove from his mind all doubt about the nature of this work. The police were promptly notified, and von Haller was summoned to appear before the authorities to answer the charge of having disobeyed the law relating to dissections of the human body. Not being able to furnish a satisfactory reply to this charge, and wishing to escape from the severe penalties that would certainly have been inflicted upon him had he been apprehended, von Haller went at once into hiding in Paris and eventually succeeded in making his way over the border into Switzerland.

In 1729 he began the practice of medicine in his native city, after having taught anatomy for a short time in Basel; but he took only a subordinate interest in the treatment of disease, his preference being strongly for the scientific and literary parts of medicine. In 1734 or soon afterward he published a collection of his own odes and letters in German verses. These reveal very fully the nobility of his character, his good sense and the high standard of his philosophy. Dezeimeris says that von Haller offers the very first example of a man who has been able to develop to an equal degree his talents of poet and of anatomist.

In 1735 he was appointed Chief Custodian of the Public Library at Berne, and while he held this office he prepared a catalogue raisonnÉ of all the books contained in that collection. At the same time he wrote a classified, chronologically arranged list of the 5000 or more coins and medals which are preserved in the library.

In 1736 the Hanover Regency offered him the professorship of anatomy, botany and surgery in the University of Goettingen, and agreed at the same time to furnish all the money needed for carrying out the extensive plans which he had formed for improving the facilities for teaching these branches of medical science. Von Haller unhesitatingly accepted the invitation, and during the following seventeen years (1736–1753) devoted his time and his best efforts to the fulfilment of the duties which his triple chair involved. Not only did anatomy, botany and surgery greatly thrive during this long period of time, but the university through his intelligent efforts gained in many other directions. It was upon his advice, for example, that the beautiful anatomical theatre at Goettingen was built and equipped. The botanical garden was another of the creations at Goettingen which owed its existence to von Haller. If I were to furnish a list of the improvements which, one after the other, were carried out in the university at his suggestion I would certainly be obliged to mention among other things the following: an establishment in which pupils might receive proper training in anatomical and botanical drawing; the creation of a cabinet of anatomical specimens and of a college of surgery; and finally the founding of a school for midwives. In short, it was largely due to von Haller’s enlightened conception of what such an institution of learning requires and to his untiring efforts that the University of Goettingen became, toward the end of the eighteenth century and during the first half of the nineteenth, one of the leading universities of Europe. Indeed he might justly be called its founder.

Von Haller’s health suffered under this long strain, and he was therefore more than justified in asking the Regency of Hanover for permission to resign and take up his residence in Switzerland. His request was unhesitatingly granted; and, after resting for a few months from his recent labors, von Haller resumed those quiet literary undertakings which he loved so keenly and which enabled him to publish such famous works as the following:—

“Primae Lineae Physiologiae” (First Lines of Physiology), Goettingen, 1747 (also 1751)—the very first systematic treatise on physiology of which we have any knowledge. A German edition was not published until 1759–1776.

Commentaries on Boerhaave’s “Institutiones Medicinae,” 1739–1744.

“Elementa Physiologiae Corporis Humani,” 8 vols., Lausanne, 1757–1766; the most important of all his works.

“Bibliotheca Anatomica,” 2 vols., 1774–1777.

“Bibliotheca Chirurgica,” 2 vols., 1774–1775.

“Bibliotheca Medicinae Practicae,” 4 vols., 1776–1788.

“ExpÉriences sur les Parties Sensibles et Irritables,” 4 parts, Lausanne, 1759.

These titles represent only a small part of the numerous books and elaborate essays published by this tireless worker. In 1749 he was ennobled by the Emperor, thus gaining the right, so highly esteemed in Germany, of placing a “von” before his name.

In the middle of the eighteenth century there appears to have existed considerable confusion in the minds of scientific men regarding the distinction between the terms “sensibility” and “irritability,” and to von Haller is due the credit of having once and for all defined the correct meaning of these words. As early as in 1747, when he published the first edition of his treatise on physiology, von Haller taught that the contractile force of muscles is supplied by the nerves, and that in this way they acquire irritability, a force which they cannot exercise except through the influence of the nerves. Irritability, therefore, is not a characteristic that originates in muscular tissue but is conferred upon it by the nerves. Von Haller’s experiments reveal the fact that the heart possesses the maximum degree of irritability. Next in order come the intestines and the diaphragm, the ordinary red muscles possessing a lesser degree of irritability.

In order that the reader may form at least some idea of von Haller’s manner of treating physiological topics I give below a rough translation^[6] of the first three paragraphs which occur in Chapter XX of his Primae Lineae Physiologiae (edition of 1751):—

564.—The power which a person in perfect health possesses freely to exercise the different senses and to perform voluntary movements is called wakefulness or the state of being awake; the absence of the power to make voluntary movements and to utilize the different senses, combined with the quietude of all of them, bears the name of sleep.

565.—In sleep the mind either stops thinking entirely of the things which have been stored up by the individual in his memory or which are well-known facts, or else it busies itself exclusively with certain ideas or with impressions that produce upon the mind, at the time, pictures almost as vivid as the actual things or occurrences which they represent would produce. The term “insomnia” is employed when it is desired to designate the latter condition of the mind, and the mental pictures thus presented produce the effect that—although voluntary motions are at the time all in abeyance, and although the mind is absolutely quiet in all other respects—there remain certain directions in which it continues to operate actively, thus producing an elevation of the spirits (i.e., a certain degree of excitement) and more or less wakefulness. Sometimes a certain number of voluntary movements are associated with these mental impressions, and this may occur in such a degree that the organs of speech and many of the joints—indeed at times all of them—are compelled to act in harmony with the mental impressions. When this degree of insomnia is reached the person so affected is called a “somnambulist.”

566.—But in sleep the distribution of the humors of the body goes on without let or hindrance; and, similarly, the circulation of the blood, the peristaltic action of the stomach, intestines and sphincters, and the respiratory movements continue their activity. This complex state of affairs—viz., the coexistence of quietude of certain parts of the body with continued motion in other parts—has made it difficult to ascertain the mechanical cause of sleep.^[7]

In his investigations into these subjects, von Haller placed his reliance mainly on vivisections and on experiments made upon animals. “A single experiment of this nature,” he said, “is often sufficient to disprove the deceptive conclusions or views that have prevailed through a period of years.” It is to John Hunter of England, however, says Puschmann, that the greatest credit is due for the introduction of the experimental method as a means of ascertaining the truth in questions of pathology; and von Haller was unquestionably one of the first German physicians to adopt the method.

Von Haller died at Berne on December 12, 1777.

Johann Georg Zimmermann was born in 1728 at Brugg in the Canton de Berne, Switzerland. Left an orphan at the age of eighteen, and obliged without aid from outside to choose the career which he would follow, he decided to study medicine; and with this object in view he went to Goettingen, Germany, where he was received into the family of Albrecht von Haller, who was at that time a professor in the university. Five years later (1751), when he took his doctor’s degree, he chose for the subject of his thesis, at von Haller’s suggestion, the doctrine of irritability. Upon his return to Berne in 1752, he began the practice of medicine and shortly afterward accepted the position of official physician for his native town of Brugg. It was during this period of his life that he wrote those treatises which made his name famous throughout Germany, viz., “On Solitude,” Zuerich, 1756; “On Experience in the Practice of Medicine,” Zuerich, 1763 and 1767; “On National Pride,” Zuerich, 1768 (5th edition); and “On the Epidemic of Dysentery which prevailed during the year 1765,” Zuerich, 1767 (later edition in 1789).

In 1768, through the influence of Dr. Tissot, of Lausanne, he was given the appointment of Physician to the King of England at the Court of Hanover. During the last years of his life he took a great interest in political events, recognizing with remarkable foresight the approach of an immense revolution. So strong was his belief that current events pointed to the approach of such a catastrophe, and so depressing were the effects of this belief upon his naturally hypochondriac type of mind, that the last years of his life were thereby rendered most painful. He died on October 7, 1795, not long after the full effects of the Reign of Terror had developed in France.

Tissot, who had known Zimmermann well for more than forty years, has written a most interesting notice of his life and has placed a just estimate upon the value of his writings. (Dezeimeris.) Sprengel, the author of a well-known and highly esteemed history of medicine, speaks in the following terms of Zimmermann’s treatise “On Experience in the Practice of Medicine”:—

The manly and brilliant style in which it is written, its fascinating eloquence, and the special talent which the author displays in rendering marvelously clear—without at the same time robbing them of any of their accuracy—the most obscure topics, make this book of Zimmermann’s a veritable chef-d’oeuvre.... The importance of genuine experience, its difference from false or blind routine, the advantages which real erudition confers and the necessity of combining it with experience, the nature of the obstacles which an observing spirit must overcome, the absolute need of good observations and the useful qualities which they should possess, the effects of genius, and the manner in which conclusions are to be drawn by analogy and by induction—these are the questions with which the author of this classical treatise deals.