Hardin News

 

Gerardus Blasius (1626?-1692?).  Anatome animalium.  Amsterdam, 1681.

 Although Blasius was a practicing physician in Amsterdam, his real interest lay in anatomy and, in particular, comparative anatomy.  He worked closely with philosophers and scientists such as John Locke, Jan Swammerdam, and Niels Stensen to promote the study of anatomy and to widen the availability of both animal and human remains for closer study.  Balsius’ 1681 work  is his most ambitious project and, according to historian Francis J. Cole, is the “first comprehensive manual of comparative anatomy based on the original researches of a working anatomist…”  While the author provides meticulously detailed descriptions of 119 species, it is the eye-catching images that capture the reader’s attention.  

Anatome animalium

As usual during this period, the artists and engravers receive no recognition and remain unknown, with the exception of the highly emblematic frontispiece which is the work of the Dutch illustrator and engraver Jan Luyken (1649-1712).

 Daniel Le Clerc (1652-1728). Histoire de la médecine. Nouvelle ed. Amsterdam: Aux depens de la Compagnie, 1723.

Swiss physician, Daniel Le Clerc was born at Geneva and studied medicine at Montpellier and Paris. He received the M.D. degree at Valencia in 1670 and returned to Geneva to enter private practice. Although successful as a physician, and later as a politician, Le Clerc expended great energy in writing and scholarship. Considered by many authorities to be the father of the history of medicine, Le Clerc is best known for his monumental Histoire de la médicine. The first edition was published in 1696 and, after the second edition had been exhausted, Le Clerc found it expedient to write a third edition, which he updated to the middle of the seventeenth century. Most striking is his inclusion of ten finely executed engravings depicting various personalities associated with medical history.

But she has taen the broken lance,
And washed it from the clotted gore,
And salved the splinter o’er and o’er.
—Sir Walter Scott: Lay of the Last Minstrel—1805

The notion that wounds can be healed from a distance dates back hundreds, perhaps thousands of years and is retained in some folk remedies today. However, the idea reached its zenith in the form of weapon salve or , Unguentum armariu, the origin of which goes back at least as far as the Swiss physician-iconoclast Paracelsus (1493-1541). The idea was simple: rather than dressing the wound, the physician applies salve to the weapon that caused it while the wound is simply washed and left unattended. Among the many variants of the recipe is the following:

Take skull-mosse, two ounces, mummy, halfe an ounce, mans fat, two ounces, mans blood, halfe an ounce, linseed oyle, two drames, oyle of roses, and bole armoniack, of each one ounce. Mixe them together and make an oybtment: into the which hee puts a stick, depp’d in the blood of the woundd person, and dryed, and bindeth up the wound with a rowler dept every day in the hot urine of the of the wounded person. The annoointing of the weapon hee addes moreover; honey, one ounce, bulls fat, one drame.”

While the treatment appears farcical to the modern mind, there was considerable support among many serious philosophers of the 16^th and 17 centuries. Even Francis Bacon (1561—1626), while skeptical, stopped well short of dismissing the idea out of hand.

Robert Fludd

The firmest adherent was Robert Fludd (1574-1637), English physician and mystic who explained that the salve worked as a result of the “mystical anatomy of the blood.”

Some of Fludd’s contemporaries pronounced the salve to be nonsensical while others condemned it as the devil’s work. Later writers, most notably, Oliver Wendell Holmes, have suggested that anointing the weapon rather than the wound simply allowed the tissue the chance to heal naturally.

The weapon salve fell out of favor by the 18^th century it but remains as one of the more curious episodes in the history of medicine.

In the sixteenth century the same spirit which inspired Vesalius and others in the field of anatomy served also as the inspiration for the study of flora from actual specimens, culminating in what is certainly the most celebrated and probably the most beautiful herbal ever published, Fuchs’ De historia stirpium commentarii Basel, 1542.

Leonhart Fuchs (1501-1566) was a German physician, professor of medicine at Tübingen, a practicing pharmacologist, a fervid Hippocratist, and writer of numerous works, the most famous of which is his herbal in which he describes 400 German plants as well as 100 foreign ones. The 512 woodcut illustrations are neatly colored by hand in pleasing tones and include a full-page hand-colored woodcut of Fuchs (see left) as well as portraits of the three illustrators, one of the first instances of such a tribute being paid to artists in a printed book (see lower rightl).

This first edition of this lavish herbal is characterized by spacious design and layout, by fine printing, and by the sheer number of illustrations. Its popularity was immediate and it was issued in many subsequent editions and translations, but the first edition was never equaled.

 William Beaumont (1785-1853).  Experiments and Observations on the Gastric Juice and the Physiology of Digestion, Plattsburgh, 1833.

When U.S. Army Surgeon William Beaumont saw the gaping hole in Alex St. Martin’s side, he had every reason to believe the wound was fatal.  The 28 year old Canadian voyager was accidentally shot in the stomach by a musket ball at close range.  In 1822, on the isolated fur-trading post in Mackinac Island he was given little chance to survive but Beaumont dressed the wound as best he could and his patient held on despite the fist sized fistula that remained on his left side.  “I saw him in twenty-five or thirty minutes after the accident occurred, and on examination, found a portion of the lung, as large as a Turkey’s egg, protruding through the external wound, lacerated and burnt; and immediately below this, another protrusion, which, on further examination, proved to be a portion of the stomach, lacerated through all its coats, and pouring out the food he had taken for his breakfast…”  After 17 days, St. Martin’s digestion was partially restored but the fistula became permanent.  Three years later, now stationed in Fort Niagara with St. Martin employed as his handyman, Beaumont seized upon the opportunity to observe the digestive process as no one had before and, with his patient’s permission,  performed various experiments within this living gastric laboratory.
     Over the next eleven years, Beaumont carried out an assortment of tests, including dangling various kind of foodstuffs  in the digestive cavity and pulling them out at intervals to observe and record the results.  In 1833, Beaumont published his research in his highly regarded, “Experiments and Observations on the Gastric Juice and the Physiology of Digestion,” now a medical classic and a book that marks the beginning of the field of gastric physiology.  St. Martin outlived Beaumont by 27 years, the latter dying from a fall in 1853 and the former dying at the age of 86 in Quebec of “natural causes.”  The location of his grave was not revealed until 1962 at which time a plaque was placed nearby, briefly describing his contribution to medical science.

GREGOR REISCH (ca. 1467-1525). Margarita philosophica. 2nd ed., 1504].

Long before there was Google and Britannica, there was Margarita philosophica, which might be called the first modern encyclopedia. Its twelve divisions cover the trivium (grammar, logic and rhetoric), the quadrivium (arithmetic, geometry, music and astronomy), and the natural and moral sciences. Of particular fascination are the many woodcuts which include early music notation, a large folding map of the Eurasian continent and parts of Africa, and astronomical, astrological, and zoological figures.  Several of the plates are of great interest to the history of anatomical and medical  illustration, including a man with dissected thoracic and abdominal cavities; two figures of the eye; a phrenological head showing the brain; a lying-in room showing a woman in childbed with infant and midwife; and a mineral spring bath.

Reisch was a Carthusian prior at Freiburg and confessor to Emperor Maximilian I, as well as assistant to Erasmus. Much more could be said of this immensely fascinating book; the music and the map (often missing from copies of all editions) make extremely interesting studies in themselves. The book was very popular, as attested to by its sixteen editions in the seventeenth century. This edition, the second authorized edition, was preceded by the first edition of 1503 and a “pirated” reprinting of the first edition which appeared the month before this second edition.

Activities of Daily Living–

While fads and fancies in health and medicine come and go, the underlying essentials of wellbeing, including, rest, nutrition, exercise, and moderation have gone unchallenged for millennia.

One of the more popular works outlining keys to basic fitness is the Tacuini sanitatis by the eleventh century Iraq physician, Ibn Butlān (d. ca. 1068). Before the age of printing, Ibn Butlān’s writings were incorporated into stunning illuminated manuscripts.  However, the early printed editions are attractive in their own way.

This 1531 edition, for instance, shows the early use of tabular formatting to codify items such as trees, foods, and flowers. However, its most charming feature is the fanciful set of miniature woodcuts showing everyday activities involved in the maintenance of health.

Ibn Bultān practiced in Mossul, Egypt, Constantinople and Antioch where he entered a monastery and converted to Christianity.

The John Martin Rare Book Room also includes facsimiles of early brilliantly colored codices based on Ibn Butlān’s texts.

Birthing in the 16th Century

Jakob Rüff (1500-1558) was not the first physician to write a birthing manual for midwives but his book, De conceptu et generatione hominis, first published in 1554 in both Latin and German was certainly one of the most famous and widely used. Lithotomist, surgeon, obstetrician and playwright, was the town physician of Zurich where his book was obligatory reading for anyone delivering a child in the canton.

To modern eyes, the crude woodcuts used to illustrate the position and placement of the fetus appear somewhat whimsical but the anatomical drawings of the reproductive organs (many based on Vesalius) are often quite accurate.

Rüff covers every aspect of labor, delivery, and postnatal care, including advice for treating the newly pregnant:

“Before all things let them be of a merry heart, …them give their endevour to moderat joyes and sports …them use moderate exercise, let them not leape, or rise up suddenly, let them not runne also, neither dance nor ride, neither let them lace or gird in themselves hard or straight, or lift up any heavie burden with their hands.”

All images from 1580, Frankfurt edition. Book is available for view in the John Martin Rare Book Room.

*Orthopaedia: or the Art of Correcting and Preventing Deformities in Children.

In naming his book, Andry (1658-1742) coined the word “orthopaedics.”

Born in Lyon, Andry was a physician and administrator at the College of Medicine in Paris but was eventually forced to resign as dean because of his spiteful and irascible nature. Much of his scorn was directed at the barber-surgeons of his day whom he forbade to operate unless in the presence of a physician.

Andry’s earlier and somewhat curious work on worms in humans (a book also in the Martin collection) while earning him the title of the “father of parisitology” in some circles, also prompted his detractors to label him the “worm man.”

L’orthopédie is more overview than original. It includes sections on surface anatomy, postural and limb deformities and abnormalities of the head. The accompanying engravings give the work an added measure of charm.

JOHN MARTIN RARE BOOK ROOM

Pierre Louis’ 1835, Recherches sur les effets de la saignée dans quelques maladies inflammatoires, et sur l’action de l’émétique et des vésicatoires dans la pneumonie is one of the less impressive looking books in the John Martin Rare Book Room, but it was instrumental in laying the foundation for what we now term, “evidence based medicine.” For over 2000 years the practice of bloodletting (phlebotomy) was a mainstay of therapeutics. In fact it is difficult to identify a disease for which this practice was not recommended at some time. Bleeding had its roots in the classical Hippocratic/Galenic medical paradigm which held that the cause of illness was the result of an imbalance of humors (blood, phlegm, bile, and black bile). Just as important as the volume of blood removed was the site of the bleeding; some of the earliest medical illustrations depict the most appropriate bleeding points for various ailments. When Pierre Louis (1787-1872) placed the practice under statistical scrutiny, using “la methode numerique” he was thus swimming against the tide of centuries of tradition and authority. In Recherches sur les effets de la saignée…, Louis measured the effectiveness of bloodletting in pneumonia in 77 previously healthy patients and came to the general conclusion that bloodletting had no benefit and was even deleterious in certain groups. Just as importantly, Louis lays down in a few simple sentences the rationale large scale evaluation and in so doing paves the way for the modern clinical trial:

“Let us further remark that the objection made to the numerical method, to wit, the difficulty or impossibility of forming classes of similar facts, is alike applicable to all the methods that might be substituted. It is impossible to appreciate each case with mathematical exactness, and it is precisely on this account that enumeration becomes necessary. By so doing, the errors (which are inevitable) being the same in the two groups of patients subjected to different treatments, mutually compensate each other, and they may be disregarded without materially affecting the exactness of the results”

Louis’ methods and conclusions were lambasted by the medical establishment and it was several decades before bloodletting stopped for good and statistical analysis found its way into mainstream medical thinking.