Age of Renovation (continued).—Animal Magnetism: Mesmer, 1754-1815. Braid.—Brunonianism: John Brown, 1735-1788.—Realism: Pinel, 17451826. Bichat, 1771-1802. Avenbrugger, 1722-1809. Werlhof, 1699-1767. Frank, 1725-1801.—Surgery: Petit, 1674-1750. Desault, 1744-1795. Scarpa, 1772-1832. Gunbernat, 11790. Heister, 1683-1758. Von Siebold, 1736-1807. Richter, 1742-1812. Cheselden, 1688-1752. Monro (1st), 1697-1767. Pott, 1749-1787. John Hunter, 1728-1793. B. Bell, 1806; J. Bell, 1820; C. Bell, 1842. Smellie, 1680. Denman, 1753-1815.—Revival of Experimental Study: Haller, 1708-1777. Winslow, 16691760. Portal, 1742-1832. Vicq d'Azyr, 1748-1794. Morgagni, 1682-1772.—Inoculation against Small-pox: Lady Montagu, 1762. Edward Jenner, 1749-1823.

During the eighteenth century also arose the illusory doctrine of Animal Magnetism, which obtained among all classes a following that can be accounted for only by the attractiveness of the marvelous and unexplained. Frank Mesmer, born near Lake Constance, in 1754, was early a victim of romantic yearnings, and his graduating thesis, delivered in Vienna, dealt with the influence of the planets upon man and the use of the magnet. After traveling extensively he erected a private institution, where he treated blind girls, fidgety old maids, and simpletons, until his deceptive methods were unmasked by a commission appointed by the Empress Maria Theresa, and he was compelled to leave Vienna in twenty-four hours. This martyrdom recommended him in Paris, where the so-called Mesmerism speedily became fashionable. He finally undertook instructions in magnetizing, at the rate of 100 louis a head, and founded the "Order of Harmony." His so-called baquets were tubs with magnetic ducts, partially filled with soft water and all kinds of ingredients, and armed with iron conductors, with which his pupils, joining hands, placed themselves in contact. At these sÉances Mesmer appeared in lilac-colored clothes and professed to reinforce the action of the tubs by looks, gestures, playing upon the harmonica, and touching the subjects with wand or fingers. "If any one, particularly a lady, had a crisis at this time, she was borne to the 'crisis-chamber' by Mesmer himself, where he treated her alone, as only when alone, he claimed, could he attain success." He speedily became wealthy; managed to deceive even the Queen of France; and, when he threatened to deprive the country of his presence, 20,000 francs were offered him to instruct others in his art. This offer, however, the wily charlatan declined. In 1785 some fool penned an article extolling him as a worker of miracles; this stimulated the authorities to organize a committee of investigation, the adverse decision of which, along with some contributory evidence, made Paris too warm for him. After the revolution he returned, but his day had passed, and he figures no more in medical history. He has had many imitators, and the mesmeric craze, at times, has infested different portions of the civilized globe; even some who were eminent in science have fallen into the snares of so-called Mesmerism,—notably Olbers, the discoverer of a number of asteroids. Mystic medical doctrines, founded upon Mesmer's views, still continue in certain circles, though the majority have long since succumbed to the advances of scientific psychology. In this connection it is proper to speak of the revived interest in "animal magnetism" due to the researches of Dr. James Braid, of Manchester, England. This gentleman, in 1842, published a work which pretty thoroughly exposed the fallacies of the doctrine of Mesmer, and expounded many of the truths that were entangled therein. He was among the first, perhaps, to employ the phrase "animal magnetism," and was the author of the term "hypnotism," though in his day the popular title was Braidism.

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During the middle of the eighteenth century arose a doctrine that, in its novelty, ease of practical application, and apparent consistency (through the ingenious employment of certain vital phenomena), secured such a hold that its influence continued even into the present century. This was the "Brunonian doctrine," promulgated and upheld by the great foe and rival of Cullen,—Doctor John Brown. In youth very precocious, though of most humble birth, Doctor Brown had mastered the Latin language at the early age of seven years, and three years later essayed to learn a trade. At the age of twenty he left his native village of Dunse for Edinburgh, seeking employment as a tutor and intending to study theology. Poverty soon compelled him, however, to take a rural school, but he returned a few years later (in 1759) to the Scottish Athens and began the study of medicine, supporting himself meantime by rendering theses into Latin and by teaching, translating, and quizzing. Finally, he attracted the attention of Cullen, to whom he became useful through his knowledge of the classics; but, ultimately, a foolish quarrel made bitter enemies of the former friends. In 1770, in private lectures, Brown began to advance the theory to which he had been led by one of his own attacks of gout that disappeared under the use of stimulants, the disease having previously always been aggravated by the treatment prescribed and that was held to be orthodox,—viz., antiphlogistic. He had now become somewhat dissolute, and the students he gathered about him were of very much the same character; but they formed the nidus of a great following opposed to Cullen, and quarreled on all occasions with the adherents of the latter. Finally, Doctor Brown removed to London, where fortune seemed to smile upon him, as he gained rapidly in reputation and practice; indeed, he barely missed a call to Berlin and another to Padua as a teacher, the scale being turned against him by his dissolute habits. Though possessed of the highest mental gifts, Brown was unfortunate in lack of mental stamina. He taught that life is not a natural condition, but an artificial and necessary result of constant irritations; all living beings, therefore, tend toward death. Health is an intermediate grade of excitement; diseases, which are either sthenic or asthenic, represent either too high or too low a grade of excitement. It has been said that Brown's teachings slaughtered more human beings than the French RÉvolution and the wars of Napoleon combined. In England this system found no important followers, but in America Benjamin Rush, of Philadelphia (1745-1815), distinguished himself as an adherent. In Spain and France it found little place; but in Italy, and later in Germany, it secured a numerous and important following, which numbered, among others, Scarpa, Massini, and Girtanner.

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Another system which attained influential development, extending even into the present century, was the so-called Realism, originated by Pin el (1745-1836). Born in poverty, and designed for the Roman Catholic Church, Pinel did not turn his attention to medicine until his thirtieth year, but on completing his studies he rapidly rose to positions of importance. Led to the investigation of mental diseases by the fate of one of his particular friends, who had become insane, escaped into the forest, and was there devoured by wolves, Pinel speedily developed a great interest in this class of sufferers. The lot of the insane at this time was most pitiable: they were imprisoned, chained, and treated worse than wild beasts. In his efforts to improve their lot, Pinel acquired the title of conservative and aristocrat, either of which was almost equivalent to a death-sentence. Unterrified, however, he appeared before the Paris Council and urged the adoption of reformatory measures, replying to the challenges of skeptical and selfregardful opponents by liberating a number of insane patients who were in his charge. The courage thus exhibited receives appreciation in our time, if never before. Not the least of Pinel's services was the substitution of analytical for synthetical methods; he also sought to determine disease by a diagnosis carefully constructed from symptoms, but unfortunately he made pathology and anatomy subordinate factors. He was a pupil of Barthez, but he placed his preceptor's vitalism far in the background.

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Francois Bichat, born in 1771, earned high rank both as a clinician and an anatomist. His education was begun in Nantes, but he studied surgery and anatomy in Lyons and Montpellier, subsequently going to Paris, where he became a member of Desault's family. After the death of his patron he lectured on surgery, and from 1797 on anatomy. Possessed of a feverish scientific activity, he became a member of the SociÉtÉ d'Emulation. Death overtook him in 1802 as the sequel of consumption and an injury received through a fall. He was the most capable physician of France in his time, and, brief as w>as his span of life, he was author of nine important volumes, the chief of which were a Treatise on Membranes and works on general and pathological anatomy. From the latter a new tendency in study took origin. He it was who gave utterance to the aphorism: "Take away some fevers and nervous troubles, and all else falls to the kingdom of pathological anatomy." As an evidence of his energy, it is related that he in one winter examined seven hundred bodies. He taught how to discriminate between disease processes, and notably subdivided peripneumonia into pleurisy, pneumonia, and bronchitis, these having been previously confounded. He once remarked: "You may observe disease of the heart, lungs, abdominal viscera, etc., night and morning by the sick-bed for twenty years, yet the whole furnishes merely a jumble of phenomena which unite in nothing complete; but if you open a few bodies, you will see the obscurity speedily give way,—a result never accomplished by observation if we do not know the seat of the disease." To Bichat is also due our modern recognition of cellular, osseous, fibrous, and other tissues, as such, wherever they appear throughout the body. He differentiated, without the aid of the microscope, twenty-one different tissues as simple and similar elements of the body, enumerating them as one does the chemical elements; he described the stomach as composed of mucous, serous, and muscular layers; overthrew the speculative tendency of medicine, and placed facts in the front rank; and so conspicuous were his services that he has been termed the "Napoleon of Medicine." He supplemented the influence of Pinel upon the side of pathological anatomy; called sensibility and contractility vital properties, whose alterations constitute disease, claiming, however, that the vital properties of individual tissues differed among themselves. His life and works are revelations to young men and show what can be accomplished at a very early age by sufficiently active and harmoniously developed brains.

In reviewing the theories and lives of those mentioned as medical luminaries of the eighteenth century, one experiences a feeling of mingled respect and disappointment—respect for the devoted way in which they worked and sought for the truth, and disappointment at so much waste of intellectual power and labor. The lesson is also taught, and should be impressed, that in all so-called new systems old principles for the most part reappear, and that the labors of the past are rarely so deliberately consulted as to guard against repetition and revamping of theories that had long before been proved futile.

Let me now mention a few other of the physicians of the last century who have left more or less of an impress upon their successors and upon our science. One man, in particular, historians are wont to remember with the honor that was denied him by his colleagues and contemporaries. I refer to Leopold Avenbrugger, who was born in Graz in 1722, and who, after pursuing his philosophical and professional studies in his native city, obtained, at the age of twenty-nine, charge of a Spanish military hospital; while thus employed lie invented the art of percussion as applied to diagnosis. This he gave the test of experience during seven long years before making it known to the profession, and even then it was not appreciated, but remained practically unnoticed until after his death, which occurred in 1809. He did receive a patent of nobility from the Emperor Joseph II, but this hardly compensated him for the contumely heaped upon him by his colleagues. Paulus Ægineta employed sounds and specula; Santoro used the balance, counted the pulse, and resorted to the use of the thermometer; Boerhaave employed the thermometer and the simple lens; Floyer, and after him Haller, utilized the watch in marking seconds; a Salernian practitioner utilized auscultation and percussion in tympanites and ascites; but the diagnosis of diseases of the great viscera by percussion was never known before Avenbrugger. His booklet of twenty-two pages, unsalable in his time, is to-day held worth far more than its weight in gold. His famous colleague, de HaËn, wrote fifteen volumes without a word on percussion; Van Swieten did it no greater justice; in his great treatise the History of Medicine, Sprengel barely alludes to it; yet the contents of Avenbrugger's booklet were of more practical value than all that these other men ever wrote, or all the results of the vast and bloody campaigns during which it slept. In 1808 this volume was rescued from oblivion by Corvisart, who translated it into French and proclaimed its undying value.

During the earlier part of this century lived Werlhof, of HelmstÂdt (1699-1767), a far-famed observer, author, and practitioner, who declined a professorship, and especially distinguished himself as a writer of German poetry. Though possessed of an exceptional knowledge of modern tongues, he wrote only in Latin,—the scientific language of the day. In 1734 he was appointed physician to King George II, in which position he attained world-wide fame, while indefatigable in his efforts to elevate science. He first described the disease known by his name,—morbus maculosus Werlhofii,—and struggled hard to establish in Germany the use of cinchona.

From 1740 to 1802 flourished Wichman, of Hanover, highly esteemed as a writer and practitioner. He is especially known for his pleas in favor of more scientific diagnosÉs, and his demonstration of how to make them. The rÔle of the itch-mite in the transmission of scabies he demonstrated upon himself; to be sure, Bonomo, a hundred years before, had called attention thereto, but with little avail.

Another eminent Hanoverian was the fickle, stubborn, and misanthropic Zimmerman, born in 1728, in Berne, upon whom misfortune and disease played many shabby tricks. He was, however, a man of ingenious endowments, and merits especial regard, because he sought to free medical science from the charge of being a secret art.

Another of the prodigies of medical history was J. P. Frank, born (1725) in the Bavarian Palatinate, of pauper parents, and, while an infant, abandoned by a cruel father. His early life was passed in a religious school; at twenty-five he became a court and garrison physician, and later a professor in Gottingen; finally he went to Vienna, where he died in 1801. He was greatly beloved by his pupils, and Walther, the famous surgeon, said of him: "No one ever made so elevating and permanent an impression on me." He published an extensive work on forensic medicine and sanitation,—wherein he took up the hygiene of the individual, of the family, and of the school,—which constituted an effort far ahead of anything of the kind previously known. He is also memorable for efforts toward increasing the population, for the Thirty Years' War had depopulated extensive districts—to such a degree, indeed that in 1750 bigamy was legalized in Nuremberg and many other towns. Frank was distinguished for a keen and even caustic humor, whose subject was not infrequently himself.

From 1707 to 1782 there lived in England one Sir John Pringle, chief of the Army Medical Department, known to this day as an author upon military hygiene. John Huxliam (1794-1868) advanced our knowledge of putrid dissolution of the blood. John Howard (1766-1790) rendered eminent service in prison reform. Heberden (1710-1801) was the first to describe varicella, and also angina pectoris—which was long known as Heberden's asthma. John Fothergil (1712-1780), a Quaker, acquired fame by his observations on chronic angina, neuralgia, and hydrocephalus; was likewise a benefactor of the poor, regarding them as "bridges to the pockets of the rich"; indeed, a large part of what he gained from the latter class he bestowed in charity, and at his death left £200,000 for the same purpose. Radcliffe (1750-1814) was an eminent, witty, successful practitioner of London, who was wont to declare that, as a young practitioner, he possessed twenty remedies for every disease, but at the close of his career had found twenty diseases for which he had not one remedy. Richard Mead (1673-1754) was a prolific writer, and the author of the first quarantine regulations adopted in England. Contemporary with Mead was Lettsom,—the busiest, most philanthropic, and most successful physician of his day,—whose practice, although a large part of it was gratuitous, brought him sixty thousand dollars a year, and who gave away immense sums for charitable purposes; also, Thomas Dover, who invented the sedative known by his name and who died in 1741. Akenside, physician and poet (1721-1770), wrote on dysentery. Baillie, of Edinburgh, was the first to accurately describe the morbid anatomy of gastric ulcer.

Among the French surgeons must be mentioned la Peyronie, of Montpellier, born in 1668, who ultimately became director of the Academy of Surgery and surgeon to the king. His wealth was employed for the elevation of the craft, and he founded no less than ten different surgical professorships at his own expense. In 1743 he effected the separation of the surgeons from the barbers. He died in 1747, dedicating his estate to the purpose for which he had lived. The most famous of the earlier surgeons of this century was J. L. Petit (16741750), inventor of the screw tourniquet, and who was called to treat Augustus the Strong, of Poland; indeed, several other crowned heads became his patients. Garen-geot (1688-1759), a professor in the College of St. Come, published a work on operative surgery. Morand (1697-1773) and le Dran were distinguished surgeons of Paris, the former especially noted for the number of times he performed paracentesis. Famous lithotomists were le Cat and FrÈre Come,—whose real name was Baseilhac, and who operated by means of the lithotome cachÉ, Astruc (1685-1766) was a syphilographer of extensive attainments; Quesnay (1694-1774), an eminent and undaunted surgeon of Louis XV, who wrote on the history and progress of surgery in France; Brasdor (1721-1776) was best known for his method of distal ligation in aneurism; Sabatier (1732-1811) wrote a famous treatise on operations, in which he recommended resection of the head of the humerus.

One of the most celebrated surgeons was P, J. Desault (1744-1795), the son of a poor farmer, originally designed for the priesthood, but who, after obtaining a thorough mathematical education, began the study of surgery with an ignorant master of his native town. Subsequently he went to Paris, and here supported himself by teaching, gradually rising, step by step, until, without collegiate education, he became professor and chief-surgeon at the HÔtel-Dieu, where he established the first surgical clinic. He opposed violently the prevalent abuse of the trephine, and was also a champion of healing by first intention. A trusted friend of Desault was Ghopart, well known because of the amputation of the foot that bears his name. Another well-known surgeon, likewise a friend of Desault, was Doublet; and it is somewhat remarkable that Desault, Ghopart, and Doublet suffered persecution and perhaps martyrdom in connection with the supposed death of the Dauphin of France,—properly Louis XVII,—in 1795. There is evidence that the child who died in the temple was not the dauphin, but a substitute, and these three surgeons, who examined the corpse, had the hardihood to express their doubts. The same day that Desault reported upon the evidence he was invited to dinner by some members of the Convention, was taken ill at the table, and died almost immediately after his return home, A few days later Chopart and Doublet died, also under mysterious circumstances.

Daviel (1796-1862) is remembered among French surgeons chiefly for extraction of the lens as an independent method of treating cataract; Tenon (172-4-1816), for his writings on the anatomy and diseases of the eye; and Anel for originating the operation for aneurism, mistakenly attributed to Hunter. There were also many others, of lesser note, who distinguished themselves through special services to surgery or some of its branches.

Among the Italians of this century may be mentioned Scarpa (1772-1832), of Motta, professor successively in Modena and Pavia, and who advanced our knowledge of hernia, diseases of the eyes, aneurism, and general anatomy.

The most famous Spanish surgeon was Gimbernat, of Madrid (1742-1790), for a time professor in Barcelona, who also became distinguished through anatomical researches.

German surgeons did not rank high during the earlier half of the last century, owing to the contempt engendered by the church for this branch of the medical art. The fashion of imitating the French, however, led to some surgical development. The first German surgeon of scientific education was Heister (1683-1758), of Frankfort-on-the-Main, who, unable to obtain honorable employment in the military service of his own country, entered that of Holland, where he remained until the experience of his own nation had brought about a healthy reaction. In 1720 he came to HelmstÂdt, where he developed great activity in anatomy, surgery, and botany; also distinguished himself as a dentist and oculist, and discussed the whole range of surgical topics from the least to the greatest.

Bilguer (1720-1796), of Chur, became surgeon-general in Berlin, and performed the first resection of the wrist in 1762; he was an opponent of amputation, which at that time was altogether too frequently practiced.

Von Siebold (1736-1807) was the founder of an institution for surgical instruction, where, for the first time in Germany, surgery was taught clinically. He became one of the most famous teachers, and was first in his native land to perform the operation of symphysiotomy, so recently revived.

The greatest German surgeon of the eighteenth century, however,—one eminent both as writer and operator,—was August Gottlieb Richter (1742-1812), of Zorbig, a descendant of a ministerial family, who wrote a famous work on hernia, and greatly improved all branches of surgery; he it was that enunciated the principle of dressing wounds "quickly, easily, and rarely."

Among English surgeons of the century must be mentioned, first of all, Cheselden (1688-1752). wrhose name is inseparably connected with anatomy and pathology as well as surgery At first a warm advocate of the high operation for stone, his dexterity in lithotomy excited the wonder of his contemporaries. He published a treatise on anatomy, and one on the suprapubic section.

Alexander Monro, Sr. (1697-1767), of Edinburgh, was also eminent in both anatomy and surgery, and contributed more than any other one man to the success and reputation of the Scottish medical school. His sons, Alexander and Donald, and his grandson, Alexander (3d), w'ere equally celebrated in anatomy.

Charles White, of Manchester, is generally credited with having performed, in 1768, the first subperiosteal resection of the head of the humerus, although, as a matter of fact, this was not done until 1774, and then by Bent, of Newcastle. He also performed resection of the hip-joint upon the cadaver—another of the same name, Anthony White, having done the operation on the living subject in 1721. He invented the method of reducing dislocation of the humerus with the foot in the axilla,—a procedure that is ordinarily ascribed to Sir Astley Cooper; also operations for false joint by the removal of the involved surfaces of the bone.

It will be seen that the excision of the joints was peculiarly an English method, the elbow-joint having been first excised in 1758, by Wainman, and the knee-joint by Filkin, of Northwich. The man who permanently attracted the attention of surgeons to these new operations was Henry Park, a bold surgeon, who wrote in 1782. The merits of these methods were then soon forgotten, however, and were revived in the present century by Liston and Syme.

One of the best-known London surgeons was Percival Pott (1749-1787), who became especially eminent through his studies upon hernia, spinal disease, and diseases of the bones and joints; his complete chirurgical works appeared in London in 1771.

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William Hunter (1718-1783), of Scotch parentage, originally a theological student, and a pupil of Cullen, went to London in 1741, began to lecture on anatomy and surgery in 1746, and soon acquired a great reputation as a surgeon, obstetrician, and anatomist. He achieved enormous success in practice, and spent £100,000 upon his house, library, and private collections. The latter now form the Hunterian Museum in the University of Glasgow. His magnificent plates illustrating the gravid uterus required the labors of twenty years and appeared in 1774.

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John Hunter (1728-1793), younger brother of William, enjoyed even greater reputation than the latter. He was a pupil not only of his brother, but also of Cheselden and Pott. Beginning the practice of surgery in 1763, he became surgeon to St. George's Hospital in 1768, and Surgeon-general of the English forces in 1790. So memorable were the labors and services of this man that at the Royal College of Surgeons, of London, there is given annually an "Hunterian Oration," intended in some way to commemorate his labors or to draw some lesson from his life and work, To do justice to John Hunter would require a volume, hence we must at present dismiss the subject with this brief reference.

Almost equally famous as a surgeon, though by no means such an omnivorous student as Hunter, was Benjamin Bell, of Edinburgh, who died in 1806. He employed tubes of lead and silver for the purpose of drainage. Sir Charles and John Bell, also of Edinburgh, are eminent names pertaining to the latter part of the eighteenth and first part of the nineteenth century. The latter was Professor of Anatomy, Surgery, and Obstetrics, a busy practitioner, a fertile writer, and not only one of the most successful operators of his day, but an excellent classical scholar; his Principles of Surgery appeared from 1801 to 1807. Sir Charles, who died in 1842, belongs more to the present century, but was equally distinguished as an operator, surgeon, and writer, and best known, perhaps, lor his Bridgewater Treatise on the Hand.

Among the Dutch an eminent surgeon was Peter Camper (1722-1789), who, in order to acquire manual dexterity, learned to use various mechanical tools. He was a fruitful author, and did not consider it beneath his dignity to write a treatise about the best form of shoes, published in Vienna in 1782, but recently translated and republished in England as something new. Sandifort, of Leyden, discussed ruptures, dislocations, etc., and reported the first observation of downward dislocation of the femur.

As already noted, the surgeons of the eighteenth century were often obstetricians,—William Hunter conspicuously. The most important obstetrician of his time was William Smellie (1680-1763), of London, who invented numerous instruments, wrote a large treatise on the theory and practice of midwifery, and greatly advanced our knowledge of deformed pelves. He was the first to distinguish one diameter from the other, and to point out the importance of cephalic version and version of the breech. Parenthetically, it may be remarked that William Hunter, great as he was, was the uncompromising foe of instrumental midwifery, and was in the habit of showing his forceps, covered with rust, as evidence that he never resorted to such aids. A rival of Smellie and Hunter was Thomas Denman (1753-1815), best known, perhaps, because of his demonstration of the portability of puerperal infection.

The researches of anatomists during the eighteenth century were, for the most part, directed toward the minute, more difficult, and less striking parts, and to increased thoroughness and accuracy of description. Microscopical anatomy suffered a relative quiescence. Pathological and general anatomy, which were destined to control the medicine of the succeeding century, were newly created and not yet regarded as sciences by themselves, but merely as special branches. The most important feature was the revival and more accurate study of experimental physiology, which had been scarcely resorted to since the time of Galen, except for Harvey's discoveries. This revival, which really seemed an epoch in the history of medicine, was effected by the great Haller (1708-1777), of Berne,—a man who really deserved the title of "Great," as he was a universal and indefatigable savant, possessed of thorough conscientiousness, marvelous capacity for work, great ingenuity, natural endowments, and an inextinguishable love for art and science; he was certainly one of the most versatile scholars and thinkers of any time, distinguished not only in his chosen field of medicine, but as a poet, botanist, and statesman. Like all Swiss poets, he never passed beyond the didactic and the homely in his versification. From his tenth year he wrote poems in Latin and German, and even when eight years old had made most extensive compilations from Bayle's dictionary. At fifteen he went to the University of Tubingen, where, in the second year of his sojourn, he disputed with one of his teachers. In 1725 he went to Leyden, where Boerhaave and Albinus found in him a most indefatigable follower. At nineteen he received the degree of doctor. In the excess of his zeal for anatomy he purchased for a considerable sum, from Albinus, half of a corpse, the other half of which his teacher had dissected; and, while in Paris, he even engaged in grave-robbing, and, being betrayed by his own carelessness, was compelled to save himself by flight. In many other States, and in more than one country, he studied with the best of teachers, lecturing at times himself. At the age of twenty-six he became professor and hospital director at Berne, and in 1752 published his famous researches on irritability. Three years later he accepted a call to Gottingen as Professor of Anatomy, Surgery, Chemistry, and Botany. He was the founder of a botanical garden; for many years was so busy that he slept and lived in his library; and, in spite of his enormous and unique correspondence with the savants of the world, he never left a letter unanswered. Strange to say, his permanent influence upon the practice of medicine was only indirect; and, although he was professor of surgery, and performed many vivisections, he was never able to persuade himself to perform a single surgical operation upon the living human being. He it was that introduced into Germany the use of the watch in counting the pulse. Like Hunter, Haller demands a special historian, and it is possible here to outline only a few of the services he rendered to medicine. He enriched the anatomy of the heart, of the brain and dura, and pointed out the venous nature of the sinuses; taught that the uterus should be regarded as a muscle: advanced the knowledge of the lymphatic system, and believed in and taught a developmental theory that every individual is descended or derived from a preceding one. In the mechanism of the heart his doctrine of irritability especially maintained itself. He administered the death-blow to the doctrine of vital spirits, and was, in fact, the father of modern nerve-physiology. His doctrine of irritability moved the minds of his century in a way that has no parallel, unless we compare it with the doctrine of Darwin. Glisson had established the general principles of irritability, and Haller followed, teaching it by the inductive method, and proving its existence by experiments,—proving, moreover, that it is a peculiarity of the muscular substance and not governed by ordinary sensation. His researches deserve the more credit because he lacked modern aids to physiological study. The first physiological institute was founded in Breslau by Purkinje, some fifty years ago. Haller had no such opportunity; even his successor, the great MÜller, possessed no such advantages. The profound impression made by Haller's teachings may be measured by the number of his supporters and opponents; he was a great man, second only in wide-spread influence to Boerhaave, and one who left a more lasting impress upon the world than even the latter.

The two best known of Haller's opponents were: Wolf (1733-179-4), of St. Petersburg, who regarded each generation as an actual new creation, and was the first to teach the doctrine of the blastodermic membranes; and Blumenbach (1752-1840), of Gotha, who did great service by investigations in general anthropology, of which he was, in fact, the founder, and whose researches in comparative anatomy and the history of development have rendered him famous.

Of the famous anatomists of the century may be mentioned Sommerring (1755-1830), of Frankfort,—the first to distinguish the facial and auditory nerves from eacli other, and whose published works are well known, because of the beautiful illustrations furnished him by the well-known artist, Koeck.

The ablest French anatomist of the century was Winslow (1669-1760),—a man of Danish birth, but who became a professor in Paris, and is best known by the foramen named for him. There were, also, Portal (1742-1832), physician to Louis XVIII, who wrote a famous history of anatomy and surgery; and Vicq d'Azyr (1748-1794), known equally well for his labors in the department of anatomy, especially of the brain, nervous system, and the vocal organs. Bichat (already mentioned) would deserve to be placed at the head of French anatomists were it not for his superior rank in clinical medicine.

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The founder of pathological anatomy as a science was Morgagni, born in 1682, in Forli, Italy,—a pupil of Valsalva, and, at the age of nineteen, the assistant of the latter. It was not until his seventy-ninth year, after he had published several works, that he allowed his famous work on pathological anatomy to appear. This is the historical classic, De Seclibus et Causis Morborum, published in Venice in 1761. Its famous author did not cease work, even when he became blind, and to him we owe the maxim that observations should be "weighed, not counted." He was very versatile, and well informed in all branches of science and literature, and possessed a remarkable memory; likewise was the first to devote attention extensively and thoroughly to the anatomical products of common diseases, since, before his time, little had been regarded but rare discoveries in the body. He also called attention to the important bearing which the history of the disease has toward its products, and found his discoveries of advantage, even when they were unable to promote the cure of disease, because of the light which they threw upon physiology and normal anatomy, and because they prevented incurable patients from being continually tormented with drugs intended to cure them; also because pathological investigations alone could settle disputes in diagnosis and matters of honor among physicians. He died in 1772.

Morgagni's legitimate successors in Great Britain were Baillie ( 1761-1823), a son of John Hunter's sister, and Sir Everard Home,—Hunter's brother-in-law,—who became professor in the Royal College of Surgeons, and was intrusted by Hunter with the work of describing his collection. Home, however, in a most discreditable way, burned several volumes of Hunter's own descriptions, in order to appropriate to himself the sole credit of the work. He has gone down to fame especially because of his book on the prostate.

One of the most notable events in the history of medicine was the introduction of the systematic practice of preventive inoculation against small-pox. It is so generally taught that this is entirely due to the efforts of Jenner—or, rather, we are so often allowed to think it, without being taught otherwise—that the measure deserves an historical sketch. The communication of the natural disease to the healthy, in order to afford protection,—or, in other words, the communication of small-pox to prevent the same,—reaches back into antiquity. It is mentioned in the Sanscrit Yedas as performed by Brahmins, who employed pus procured from small-pox vesicles a year before. They rubbed the place selected for operation until the skin was red, then scratched with a sharp instrument, and laid upon it cotton soaked in the variolous pus, moistened with water from the sacred Ganges. Along with this measure they insisted upon careful hygienic regulations, to which, in large measure, their good results were due. Among the Chinese was practiced what was known as "pock-sowing," and ten centuries before Christ the Celestials introduced into the nasal cavities of young children pledgets of cotton saturated with variolous pus. The Arabians inoculated with needles, and so did the Circassians, while in North Africa incisions were made between the fingers, and among some of the negroes inoculation was performed in or upon the nose. In Constantinople, under the Greeks, the custom had long been naturalized, and was practiced by old women, instructed in the art, who regarded it as a revelation of Saint Mary. The first accounts of this practice were given to the Royal Society by Timoni, a physician of Constantinople, in 1714. The actual introduction of the practice into the West, however, was due to Lady Mary Wortley Montagu, who died in 1762, and who was wife of the English Ambassador to the Porte in 1717. She had her son inoculated in Constantinople, by Maitland, and on her return to London, in 1721, her daughter also was inoculated. During the same years experiments were undertaken by Maitland upon criminals, and, as these turned out favorably, the Prince of Wales and his sisters were inoculated by Mead. The practice was then more or less speedily adopted on this side of the Atlantic, but suffered occasional severe blows, because of unfortunate cases here and there, such as never can be avoided. The clergy, especially, using the Scripture, as designing men can always do, became warm opponents of the practice, and stigmatized it as an atrocious invasion of the divine prerogative. Nevertheless, in 1746 the Bishop of Worcester recommended it from the pulpit, established houses for inoculation, and thus made it again popular. In Germany it was generally favored, and a little later came into vogue in France and Italy. In 1757 Robert Sutton, near London, professed to have made fifteen thousand inoculations without a single fatal case; he kept his patients on a strict diet for nine days, then inoculated with the smallest possible quantity of virus. The operation was not prohibited in England until the year 1840, although it involved much greater dangers than vaccination with cow-pox.

The first inoculation with cow-pox seems to have been performed in 1774: by a farmer of Gloucester, named Jesty, though the pioneer in the extensive and general introduction of this method was Edward Jenner (1749-1823), of Berkeley, in Gloucestershire, who, therefore, is generally known as the "Father of Vaccination." The son of a clergyman, he began early the study of medicine and surgery, and during his apprenticeship received from a milkmaid information of the protective power of cow-pox against variola, as established by popular observation. (Sutton and others had proved that inoculation of sheep-pox was not efficient.) This communication so struck Jenner as a means of affording protection to the whole human race that the subject never afterward left his mind. In 1770 he became a pupil of John Hunter, and when he communicated to him this idea the great surgeon said: "Do not think; investigate!" Accordingly he went to Berkeley and performed the little operation which has made him famous; and from 1778 until 1788 he communicated to Sir Everard Home such observations as he had made. But the first vaccination was performed in 1796, upon a boy, with matter from the hand of a maid who had contracted cow-pox in milking.

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In 1798 he published his memorable work, and afterward removed to London. He died full of fame and honor, in his native place, having-received rewards from the government amounting to one hundred and fifty thousand dollars, besides being made an honorary citizen of the city of London. The subsequent wide-spread practice of the method, and the formation of societies for the promotion of vaccination are matters of recent history.

The first vaccinations in the United States were performed by Doctor Waterhouse, Professor of Medicine in Harvard College, in 1800, upon four of his own children. The transmission of humanized virus through the system of the cow, and its subsequent employment in vaccination of human beings, was first practiced by Troja (1747-1827), of Naples, shortly after the introduction of human vaccination; but in 1810 this was prohibited in Italy. Compulsory vaccination was first extensively introduced in Germany in 1807; in England it was first legalized in 1827. The occasional temporary character of the protection thus afforded was first taught by ElsÂsser in 1814. Schoenlein was the first to call attention to the distinction between variola and varioloid.

Another matter in which the eighteenth century witnessed great reform was the treatment of the insane, which continued in very bad condition until toward the close of the century, when a movement for improvement began. From and after this lunatics were liberated from their fetters and from the hands of brutal keepers, and regarded as actually ill, while so-called schools of psychiatry were founded. While the first impulse in this direction was given by Lorry, the true reformer was Pinel, already mentioned, who did away with corporeal punishment and abuse, separated the insane from convicts, limited the employment of drugs and especially venesection, placed the unfortunates in special institutions under the charge of physicians, and classified patients according to their symptoms. Yet, in spite of his humane teachings, lunatics were found incarcerated in cages in some of the French cities as late as 1834. Pinel was followed by Esquirol (1772-1840), who in 1818 established the first clinic for mental diseases.

It is well known what a conspicuous part public baths played in the social life of the ancient Greeks and Romans, but the first public resort for sea-bathing was established in Germany in 1794. The cold-water epoch of this century, however, began with the researches of Hahn (16961773), a Silesian, who introduced a systematic and almost exclusive hydrotherapeutic method. The modern method of using cold water as an antipyretic agent was first employed in England, in 1797, by Currie, who originally was an American merchant. In France the method found little sympathy, but it made its way even to Spain later, where it was adopted by the famous Sangrado, who is well known to readers of Gil Blas.

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