A History of Science
Tome I
Tome II
Tome III Tome IV

Book 4, chapter VII
Eighteenth-century medicine
Animists, vitalists, and organicists
Besides Hoffman's system of medicine, there were numerous others during the eighteenth century, most of which are of no importance whatever; but three, at least, that came into existence and disappeared during the century are worthy of fuller notice. One of these, the Animists, had for its chief exponent Georg Ernst Stahl of "phlogiston" fame; another, the Vitalists, was championed by Paul Joseph Barthez (1734-1806); and the third was the Organicists. This last, while agreeing with the other two that vital activity cannot be explained by the laws of physics and chemistry, differed in not believing that life "was due to some spiritual entity," but rather to the structure of the body itself.

The Animists taught that the soul performed functions of ordinary life in man, while the life of lower animals was controlled by ordinary mechanical principles. Stahl supported this theory ardently, sometimes violently, at times declaring that there were "no longer any doctors, only mechanics and chemists." He denied that chemistry had anything to do with medicine, and, in the main, discarded anatomy as useless to the medical man. The soul, he thought, was the source of all vital movement; and the immediate cause of death was not disease but the direct action of the soul. When through some lesion, or because the machinery of the body has become unworkable, as in old age, the soul leaves the body and death is produced. The soul ordinarily selects the channels of the circulation, and the contractile parts, as the route for influencing the body. Hence in fever the pulse is quickened, due to the increased activity of the soul, and convulsions and spasmodic movements in disease are due, to the, same cause. Stagnation of the, blood was supposed to be a fertile cause of diseases, and such diseases were supposed to arise mostly from "plethora"--an all-important element in Stahl's therapeutics. By many this theory is regarded as an attempt on the part of the pious Stahl to reconcile medicine and theology in a way satisfactory to both physicians and theologians, but, like many conciliatory attempts, it was violently opposed by both doctors and ministers.

A belief in such a theory would lead naturally to simplicity in therapeutics, and in this respect at least Stahl was consistent. Since the soul knew more about the body than any physician could know, Stahl conceived that it would be a hinderance rather than a help for the physician to interfere with complicated doses of medicine. As he advanced in age this view of the administration of drugs grew upon him, until after rejecting quinine, and finally opium, he at last used only salt and water in treating his patients. From this last we may judge that his "system," if not doing much good, was at least doing little harm.

The theory of the Vitalists was closely allied to that of the Animists, and its most important representative, Paul Joseph Barthez, was a cultured and eager scientist. After an eventful and varied career as physician, soldier, editor, lawyer, and philosopher in turn, he finally returned to the field of medicine, was made consulting physician by Napoleon in 1802, and died in Paris four years later.

The theory that he championed was based on the assumption that there was a "vital principle," the nature of which was unknown, but which differed from the thinking mind, and was the cause of the phenomena of life. This "vital principle" differed from the soul, and was not exhibited in human beings alone, but even in animals and plants. This force, or whatever it might be called, was supposed to be present everywhere in the body, and all diseases were the results of it.

The theory of the Organicists, like that of the Animists and Vitalists, agreed with the other two that vital activity could not be explained by the laws of physics and chemistry, but, unlike them, it held that it was a part of the structure of the body itself. Naturally the practical physicians were more attracted by this tangible doctrine than by vague theories "which converted diseases into unknown derangements of some equally unknown 'principle.' "

It is perhaps straining a point to include this brief description of these three schools of medicine in the history of the progress of the science. But, on the whole, they were negatively at least prominent factors in directing true progress along its proper channel, showing what courses were not to be pursued. Some one has said that science usually stumbles into the right course only after stumbling into all the wrong ones; and if this be only partially true, the wrong ones still play a prominent if not a very creditable part. Thus the medical systems of William Cullen (1710-1790), and John Brown (1735-1788), while doing little towards the actual advancement of scientific medicine, played so conspicuous a part in so wide a field that the "Brunonian system" at least must be given some little attention.

According to Brown's theory, life, diseases, and methods of cure are explained by the property of "excitability." All exciting powers were supposed to be stimulating, the apparent debilitating effects of some being due to a deficiency in the amount of stimulus. Thus "the whole phenomena of life, health, as well as disease, were supposed to consist of stimulus and nothing else." This theory created a great stir in the medical world, and partisans and opponents sprang up everywhere. In Italy it was enthusiastically supported; in England it was strongly opposed; while in Scotland riots took place between the opposing factions. Just why this system should have created any stir, either for or against it, is not now apparent.

Like so many of the other "theorists" of his century, Brown's practical conclusions deduced from his theory (or perhaps in spite of it) were generally beneficial to medicine, and some of them extremely valuable in the treatment of diseases. He first advocated the modern stimulant, or "feeding treatment" of fevers, and first recognized the usefulness of animal soups and beef-tea in certain diseases.





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© Serge Jodra, 2006. - Reproduction interdite.