The Evolution of Modern Medicine [81]
1800 was any more skilful in recognizing a case of pneumonia than was Aretaeus in the second century A. D. But disease had come to be more systematically studied; special clinics were organized, and teaching became much more thorough. Anyone who wishes to have a picture of the medical schools in Europe in the first few years of the century, should read the account of the travels of Joseph Frank of Vienna.[10] The description of Corvisart is of a pioneer in clinical teaching whose method remains in vogue today in France--the ward visit, followed by a systematic lecture in the amphitheatre. There were still lectures on Hippocrates three times a week, and bleeding was the principal plan of treatment: one morning Frank saw thirty patients, out of one hundred and twelve, bled! Corvisart was the strong clinician of his generation, and his accurate studies on the heart were among the first that had concentrated attention upon a special organ. To him, too, is due the reintroduction of the art of percussion in internal disease discovered by Auenbrugger in 1761.
[10] Joseph Frank: Reise nach Paris [etc.], Wien, 1804-05.
The man who gave the greatest impetus to the study of scientific medicine at this time was Bichat, who pointed out that the pathological changes in disease were not so much in organs as in tissues. His studies laid the foundation of modern histology. He separated the chief constituent elements of the body into various tissues possessing definite physical and vital qualities. "Sensibility and contractability are the fundamental qualities of living matter and of the life of our tissues. Thus Bichat substituted for vital forces 'vital properties,' that is to say, a series of vital forces inherent in the different tissues."[11] His "Anatomic Generale," published in 1802, gave an extraordinary stimulus to the study of the finer processes of disease, and his famous "Recherches sur la Vie et sur la Mort" (1800) dealt a death-blow to old iatromechanical and iatrochemical views. His celebrated definition may be quoted: "La vie est l'ensemble des proprietes vitales qui resistent aux proprietes physiques, ou bien la vie est l'ensemble des fonctions qui resistent a la mort." (Life is the sum of the vital properties that withstand the physical properties, or, life is the sum of the functions that withstand death.) Bichat is another pathetic figure in medical history. His meteoric career ended in his thirty-first year: he died a victim of a post-mortem wound infection. At his death, Corvisart wrote Napoleon: "Bichat has just died at the age of thirty. That battlefield on which he fell is one which demands courage and claims many victims. He has advanced the science of medicine. No one at his age has done so much so well."
[11] E. Boinet: Les doctrines medicules, leur evolution, Paris, 1907, pp. 85-86.
It was a pupil of Corvisart, Rene Theophile Laennec, who laid the foundation of modern clinical medicine. The story of his life is well known. A Breton by birth, he had a hard, up-hill struggle as a young man--a struggle of which we have only recently been made aware by the publication of a charming book by Professor Rouxeau of Nantes--"Laennec avant 1806." Influenced by Corvisart, he began to combine the accurate study of cases in the wards with anatomical investigations in the dead-house. Before Laennec, the examination of a patient had been largely by sense of sight, supplemented by that of touch, as in estimating the degree of fever, or the character of the pulse. Auenbrugger's "Inventum novum" of percussion, recognized by Corvisart, extended the field; but the discovery of auscultation by Laennec, and the publication of his work--"De l'Auscultation Mediate," 1819,--marked an era in the study of medicine. The clinical recognition of individual diseases had made really very little progress; with the stethoscope begins the day of physical diagnosis. The clinical pathology of the heart, lungs and abdomen was revolutionized. Laennec's book is in the category of the eight or ten greatest contributions to
[10] Joseph Frank: Reise nach Paris [etc.], Wien, 1804-05.
The man who gave the greatest impetus to the study of scientific medicine at this time was Bichat, who pointed out that the pathological changes in disease were not so much in organs as in tissues. His studies laid the foundation of modern histology. He separated the chief constituent elements of the body into various tissues possessing definite physical and vital qualities. "Sensibility and contractability are the fundamental qualities of living matter and of the life of our tissues. Thus Bichat substituted for vital forces 'vital properties,' that is to say, a series of vital forces inherent in the different tissues."[11] His "Anatomic Generale," published in 1802, gave an extraordinary stimulus to the study of the finer processes of disease, and his famous "Recherches sur la Vie et sur la Mort" (1800) dealt a death-blow to old iatromechanical and iatrochemical views. His celebrated definition may be quoted: "La vie est l'ensemble des proprietes vitales qui resistent aux proprietes physiques, ou bien la vie est l'ensemble des fonctions qui resistent a la mort." (Life is the sum of the vital properties that withstand the physical properties, or, life is the sum of the functions that withstand death.) Bichat is another pathetic figure in medical history. His meteoric career ended in his thirty-first year: he died a victim of a post-mortem wound infection. At his death, Corvisart wrote Napoleon: "Bichat has just died at the age of thirty. That battlefield on which he fell is one which demands courage and claims many victims. He has advanced the science of medicine. No one at his age has done so much so well."
[11] E. Boinet: Les doctrines medicules, leur evolution, Paris, 1907, pp. 85-86.
It was a pupil of Corvisart, Rene Theophile Laennec, who laid the foundation of modern clinical medicine. The story of his life is well known. A Breton by birth, he had a hard, up-hill struggle as a young man--a struggle of which we have only recently been made aware by the publication of a charming book by Professor Rouxeau of Nantes--"Laennec avant 1806." Influenced by Corvisart, he began to combine the accurate study of cases in the wards with anatomical investigations in the dead-house. Before Laennec, the examination of a patient had been largely by sense of sight, supplemented by that of touch, as in estimating the degree of fever, or the character of the pulse. Auenbrugger's "Inventum novum" of percussion, recognized by Corvisart, extended the field; but the discovery of auscultation by Laennec, and the publication of his work--"De l'Auscultation Mediate," 1819,--marked an era in the study of medicine. The clinical recognition of individual diseases had made really very little progress; with the stethoscope begins the day of physical diagnosis. The clinical pathology of the heart, lungs and abdomen was revolutionized. Laennec's book is in the category of the eight or ten greatest contributions to