The Evolution of Modern Medicine [78]
years of age, who for a long time, had been a valetudinarian, and within the same period, on using pretty quick exercise of body, she was subject to attacks of violent anguish in the upper part of the chest on the left side, accompanied with a difficulty of breathing, and numbness of the left arm; but these paroxysms soon subsided when she ceased from exertion. In these circumstances, but with cheerfulness of mind, she undertook a journey from Venice, purposing to travel along the continent, when she was seized with a paroxysm, and died on the spot. I examined the body on the following day.... The aorta was considerably dilated at its curvature; and, in places, through its whole tract, the inner surface was unequal and ossified. These appearances were propagated into the arteria innominata. The aortic valves were indurated...." He remarks, "The delay of blood in the aorta, in the heart, in the pulmonary vessels, and in the vena cave, would occasion the symptoms of which the woman complained during life; namely, the violent uneasiness, the difficulty of breathing, and the numbness of the arm."[6]
[6] Cooke's Morgagni, Vol. 1, pp. 417-418. I cannot too warmly commend to young clinicians the reading of Morgagni. English editions are available--Alexander's three-volume translation of 1769 and Cooke's Abridgement (London, 1822), of which there was an American edition published in Boston in 1824.
Morgagni's life had as much influence as his work. In close correspondence with the leading men of the day, with the young and rising teachers and workers, his methods must have been a great inspiration; and he came just at the right time. The profession was literally ravaged by theories, schools and systems--iatromechanics, iatrochemistry, humoralism, the animism of Stahl, the vitalistic doctrines of Van Helmont and his followers-- and into this metaphysical confusion Morgagni came like an old Greek with his clear observation, sensible thinking and ripe scholarship. Sprengel well remarks that "it is hard to say whether one should admire most his rare dexterity and quickness in dissection, his unimpeachable love of truth and justice in his estimation of the work of others, his extensive scholarship and rich classical style or his downright common sense and manly speech."
Upon this solid foundation the morbid anatomy of modern clinical medicine was built. Many of Morgagni's contemporaries did not fully appreciate the change that was in progress, and the value of the new method of correlating the clinical symptoms and the morbid appearances. After all, it was only the extension of the Hippocratic method of careful observation-- the study of facts from which reasonable conclusions could be drawn. In every generation there had been men of this type--I dare say many more than we realize--men of the Benivieni character, thoroughly practical, clear-headed physicians. A model of this sort arose in England in the middle of the seventeenth century, Thomas Sydenham (1624-1689), who took men back to Hippocrates, just as Harvey had led them back to Galen. Sydenham broke with authority and went to nature. It is extraordinary how he could have been so emancipated from dogmas and theories of all sorts. He laid down the fundamental proposition, and acted upon it, that "all disease could be described as natural history." To do him justice we must remember, as Dr. John Brown says, "in the midst of what a mass of errors and prejudices, of theories actively mischievous, he was placed, at a time when the mania of hypothesis was at its height, and when the practical part of his art was overrun and stultified by vile and silly nostrums" ("Horae Subsecivae," Vol. I, 4th ed., Edinburgh, 1882, p. 40).
Listen to what he says upon the method of the study of medicine: "In writing therefore, such a natural history of diseases, every merely philosophical hypothesis should be set aside, and the manifest and natural phenomena, however minute, should be noted with the utmost exactness. The usefulness of this procedure cannot be easily overrated, as
[6] Cooke's Morgagni, Vol. 1, pp. 417-418. I cannot too warmly commend to young clinicians the reading of Morgagni. English editions are available--Alexander's three-volume translation of 1769 and Cooke's Abridgement (London, 1822), of which there was an American edition published in Boston in 1824.
Morgagni's life had as much influence as his work. In close correspondence with the leading men of the day, with the young and rising teachers and workers, his methods must have been a great inspiration; and he came just at the right time. The profession was literally ravaged by theories, schools and systems--iatromechanics, iatrochemistry, humoralism, the animism of Stahl, the vitalistic doctrines of Van Helmont and his followers-- and into this metaphysical confusion Morgagni came like an old Greek with his clear observation, sensible thinking and ripe scholarship. Sprengel well remarks that "it is hard to say whether one should admire most his rare dexterity and quickness in dissection, his unimpeachable love of truth and justice in his estimation of the work of others, his extensive scholarship and rich classical style or his downright common sense and manly speech."
Upon this solid foundation the morbid anatomy of modern clinical medicine was built. Many of Morgagni's contemporaries did not fully appreciate the change that was in progress, and the value of the new method of correlating the clinical symptoms and the morbid appearances. After all, it was only the extension of the Hippocratic method of careful observation-- the study of facts from which reasonable conclusions could be drawn. In every generation there had been men of this type--I dare say many more than we realize--men of the Benivieni character, thoroughly practical, clear-headed physicians. A model of this sort arose in England in the middle of the seventeenth century, Thomas Sydenham (1624-1689), who took men back to Hippocrates, just as Harvey had led them back to Galen. Sydenham broke with authority and went to nature. It is extraordinary how he could have been so emancipated from dogmas and theories of all sorts. He laid down the fundamental proposition, and acted upon it, that "all disease could be described as natural history." To do him justice we must remember, as Dr. John Brown says, "in the midst of what a mass of errors and prejudices, of theories actively mischievous, he was placed, at a time when the mania of hypothesis was at its height, and when the practical part of his art was overrun and stultified by vile and silly nostrums" ("Horae Subsecivae," Vol. I, 4th ed., Edinburgh, 1882, p. 40).
Listen to what he says upon the method of the study of medicine: "In writing therefore, such a natural history of diseases, every merely philosophical hypothesis should be set aside, and the manifest and natural phenomena, however minute, should be noted with the utmost exactness. The usefulness of this procedure cannot be easily overrated, as