Scot Moo J 1991;36: 023-026
0036-9330191/13090/023/$2.00 in USA 1991Scottish Medical Journal
@
CHANGING THEORIES IN 18th-CENTURY MEDICINE THE INHERITANCE AND LEGACY OF WILLIAM CULLEN Edward M. McGirr and *William Stoddart Anchorage House, Bothwell, Lanarkshire G718NF *11450Riverside Drive East, Windsor, Ontario N8P lA41 Canada
Introduction HE changes in European thought and culture that started with the 15th century Renaissance and culminated in the 18th century Enlightenment were reflected in the development of medical ideas over the same period. The life and work of the Scottish physician William Cullen (1710-1790) provide a suitable vehicle for the study of this historical process. In this article we call attention to the revolutionary nature of the change in perspective that occurred during that period, and seek to understand its meaning. Cullen's main works, Synopsis Nosologiae Methodicae, The Treatise of the Materia Medica, The Institutions of Medicine and The First Lines of the Practice of Physic, were the products of more than 40 years' experience of medical practice and of much reading and reflection. In the preface to a later edition of The First Lines, dated November 1789, he states his reasons for publishing it. His motivation was twofold. Initially it was chiefly intended for those gentlemen who attended his lectures. Later he also used it as a vehicle to ventilate and vindicate his theories.
T
Brief synopsis of the history of medicine The upsurge of interest in inquiry and investigation which took place in the 15th century is known to historians of art and philosophy as the Renaissance. This was linked with a newly acquired access to classical literature, and physicians, like others, read and interpreted for themselves the works of the Greek philosophers. The Greeks conceived of medicine as both a science and an art and gave to it its principles and ethics. There was the school of Hippocrates (c. 460-357 BC) and the school of Galen (AD 131-201). Greek medicine in one or other of its forms was dominant throughout the Middle Ages. With the onset of the Renaissance, however, the new humanistic spirit subjected its principles and practice to scrutiny and challenge. When we survey, on a worldwide basis, the whole expanse of medical history, we can perhaps summarise the different types or branches of medicine, modern and pre-modern, as follows: 1. The various systems of traditional medicine i. Ayur-Vedic medicine (India) ii. Acupuncture (China) iii. Shamanistic medicine (Tibetans, North American Indians, and other Hyperborean peoples) iv. Spagyric medicine (Greco-Arab) v. Animistic medicine (sub-Saharan Africa) 2. Homoeopathy (19th century) 3. Modern technological medicine
Greek medicine was based on the theory of the four humours: black bile, yellow bile, phlegm, and blood. The four humours pertained more to the subtle or psychic realm than to the corporeal or physical one, and the adjectives deriving from them are used to this day when human temperaments are described as melancholic, choleric, phlegmatic, or sanguine. An echo of the Greek theory is also to be heard when someone is described as being
'good-humoured' or 'in a bad humour'. The practical side of Greek medicine was called 'spagyric', a term derived from the alchemical formula: Solve et coagula (the Greek equivalent being: span = to separate or dissolve, and ageirein = to assemble or coagulate. The theory of the four humours was first expounded by Empedocles (c. 490-430 BC), and was an integral part of the systems of Hippocrates and Galen. It was also espoused by both Plato (427-347 BC), who referred to it in the Timaeus, and Aristotle (384-322 BC). To Plato the body was the organ of the immaterial soul, and disease arose when the body and the soul were in conflict. Galen endorsed the pre-eminence of the soul, and the subordination of the body to it. Disease was conceived of as a rupture of equilibrium or as a deviation from normality. The traditional scheme of correspondence is as follows:
N cold (winter)
WATER (PHLEGMATIC) ......
EARTH (MELANCHOLIC)
/'
......
......
0036-9330191/13090/023/$2.00 in USA 1991Scottish Medical Journal
@
CHANGING THEORIES IN 18th-CENTURY MEDICINE THE INHERITANCE AND LEGACY OF WILLIAM CULLEN Edward M. McGirr and *William Stoddart Anchorage House, Bothwell, Lanarkshire G718NF *11450Riverside Drive East, Windsor, Ontario N8P lA41 Canada
Introduction HE changes in European thought and culture that started with the 15th century Renaissance and culminated in the 18th century Enlightenment were reflected in the development of medical ideas over the same period. The life and work of the Scottish physician William Cullen (1710-1790) provide a suitable vehicle for the study of this historical process. In this article we call attention to the revolutionary nature of the change in perspective that occurred during that period, and seek to understand its meaning. Cullen's main works, Synopsis Nosologiae Methodicae, The Treatise of the Materia Medica, The Institutions of Medicine and The First Lines of the Practice of Physic, were the products of more than 40 years' experience of medical practice and of much reading and reflection. In the preface to a later edition of The First Lines, dated November 1789, he states his reasons for publishing it. His motivation was twofold. Initially it was chiefly intended for those gentlemen who attended his lectures. Later he also used it as a vehicle to ventilate and vindicate his theories.
T
Brief synopsis of the history of medicine The upsurge of interest in inquiry and investigation which took place in the 15th century is known to historians of art and philosophy as the Renaissance. This was linked with a newly acquired access to classical literature, and physicians, like others, read and interpreted for themselves the works of the Greek philosophers. The Greeks conceived of medicine as both a science and an art and gave to it its principles and ethics. There was the school of Hippocrates (c. 460-357 BC) and the school of Galen (AD 131-201). Greek medicine in one or other of its forms was dominant throughout the Middle Ages. With the onset of the Renaissance, however, the new humanistic spirit subjected its principles and practice to scrutiny and challenge. When we survey, on a worldwide basis, the whole expanse of medical history, we can perhaps summarise the different types or branches of medicine, modern and pre-modern, as follows: 1. The various systems of traditional medicine i. Ayur-Vedic medicine (India) ii. Acupuncture (China) iii. Shamanistic medicine (Tibetans, North American Indians, and other Hyperborean peoples) iv. Spagyric medicine (Greco-Arab) v. Animistic medicine (sub-Saharan Africa) 2. Homoeopathy (19th century) 3. Modern technological medicine
Greek medicine was based on the theory of the four humours: black bile, yellow bile, phlegm, and blood. The four humours pertained more to the subtle or psychic realm than to the corporeal or physical one, and the adjectives deriving from them are used to this day when human temperaments are described as melancholic, choleric, phlegmatic, or sanguine. An echo of the Greek theory is also to be heard when someone is described as being
'good-humoured' or 'in a bad humour'. The practical side of Greek medicine was called 'spagyric', a term derived from the alchemical formula: Solve et coagula (the Greek equivalent being: span = to separate or dissolve, and ageirein = to assemble or coagulate. The theory of the four humours was first expounded by Empedocles (c. 490-430 BC), and was an integral part of the systems of Hippocrates and Galen. It was also espoused by both Plato (427-347 BC), who referred to it in the Timaeus, and Aristotle (384-322 BC). To Plato the body was the organ of the immaterial soul, and disease arose when the body and the soul were in conflict. Galen endorsed the pre-eminence of the soul, and the subordination of the body to it. Disease was conceived of as a rupture of equilibrium or as a deviation from normality. The traditional scheme of correspondence is as follows:
N cold (winter)
WATER (PHLEGMATIC) ......
EARTH (MELANCHOLIC)
/'
......
......
