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MEDICINE IN THE ENCYCLOPÆDIABRITANNICA.
I.-HISTORY OF ANATOMY.
IN our issue of Feb. llth we referred in general terms tothe new edition of the Encyclo[: aedia BritaLnic2 and to themanner in which the special requirements of the medicalprofession were provided for. It is our intention in this and
succeeding issues to consider more in dt tail the varicusarticles in the Enc3cloxdia which deal with medicalsubjects. Medicine is dealt with as a whole in one article,which has not yet been issued, but the volimes containa number of articles dealing with the causes, symptoms, andtreatment of specific maladies. Among the contributors inthe field of Medicire and Surgery are Sir Clifford Allbutt,Sir Lauder Brunton, Professor Robert Muir of Glasgow, ’’
Professor Sims Woodhead, Sir John Broadbent, Mr. EdmundOwen, and Mr. Stephen Paget, while Mr. F. G. Parsons haswritten the article on Anatomy which we deal with below.and has also planned the treatment of the subject throughout Ithe volumes upon a comparative method.Of Mr. Parsons’s contribution we may say that the method
of arrangement in this edition hows a marked contrast tothat of earlier issues. The whole subject has been brokenup from two articles into about 30, the anatcmical descrip.tions of various parts of the bocy being found under suchrespective headings as arteries, heart, ear, eye, liver, skull,urinary system, &c. This arrangement has the advantagefor the general reader of throwing all the information given
Iabout one organ or group of organs into one chapter-in effecta treatise on the biology of certain organs or functiors. Fora book of general reference this methcd is undoubtedlysound. The article on "anatomy" " is therefore limitc d toan historical sketch and a few pages on the artistic aspect ofthe subject with which we are not concerned. The historical’J’ésu’IJlé forms a valuable monograph thrcwing importantlights on the growth of scientific thought.The history of anatomy as known to the Giseco-Roman
world is so far crystallised that it has not been deemednecessary to alter in any substantial details the articlewritten by the late Dr. Craigie of Edinburgh for the ninth ),edition of the Encyclo[ aedia. The number of extantauthorities is small, and their writirgs have been submittedto minute criticism for at least three centuries. But thenumber of extant writers does rot represent the sum totalof workers in the anatomical field. Anatomy was a smallexcrescence on the art of healirg, and that art was an
hereditary priestcraft, handed on in families of distincticn,attached to well-known temple shrikes. Such was thefamily of the Hippocrates, for seven members of the race ofthe Heracleicas bore this r ame in the Island of Cos, theI- Father of Medicine himself being Hippocrates theSecond. We may reasonably look for future light on theorigins of medicine in Crete when we remember that theIonian population of the north-eastern lEgean was thrownout from the Mycenean cities of the Peloponnesus underthe stress of the successive wars of the Dorian imasions.A curious hint is also afforded by the fact that the earliestanatomical treatise extant is an Egyptian papyrus of thesixteenth century B c., at the probable zenith of the Minoancivilisation in Crete, just 200 years before the "destructionof the Palace " and the dismemberment of the great CretanEmpire.
It is undoubtedly wise not to attach too much importance Ito Hippocrates and his school as authorities cn anatomy, in ispite of the encomiums bestowed upon this branch of attain-ments by enthusiastic and learned admirers. His knowledge ]was necessarily defective owing to the impossibility of dis- knowledge section, for the Greek feeling of respect for the dead offered ca bar to its practice as complete as that presented ten 1centuries after by the Moslem religion. This estimate of iHippocrates’ anatomical knowledge is confirmed in the short (
biographical article under his name from the pen of Sir John r
Batty Tuke. Hippocrates was one of the master minds of (
the world, a mind which was part of the huge intellectual s
output of post-Mycenean Greece, part of an output certainly c
never surpassed and possibly never equalled. Whatever his c
defects in anatomy may have been he remains a master at the ibedside ; Laennec admitted that Hippocrates had taught him I" 1’auscultation immediate." " If not the first to held, he was E
the first to express, the conviction that diseases must be-scientifically treated as subject to natural laws, however theymay be regarded from the religious point of view. Nor was.he anxious, as the author reminds us, to maintain the con-nfxion betweEn philosophy and medicine, for, accordirg toCelsus, Hippocrates of Cos was I I lrimqis qmde’fll ex om7til?i,memoria dig’m/s, ab studi(ivapierititr disciplinam hanc separa1it,vir tt arte et facundia digrzcs" (De Medicina). The articlecloses with a valuable note on the Hippocratic collection andthe reasons for acceptirg some of the treatises as gennineaLdothers as not so. There is no difficulty now in assigning aproper portion of the various Hippocratic writings to thegreat physician of Cos, for few writers have been exposed tosuch continuous criticism in the course of many centuries.
It is unnecessary to reclaim the title of the Father ofMedicine. The treatise IIepl à/pwv, iÓ6.TWV, Kai Tr,7rWP (Air8,Waters, and Places) is always the first treatise on publichealth. There is little to be said anew on such a hero ofmedicine, but the remark that Hippocrates advccates the useof the trelhine with more boldness than the experience oflater times has warranted, may suggest that the operation was-
i still a survival of a practice of the Neolithic age. Amongthe followers and jui3i]s of Hippocrates the most noted ishis son-in-law, Polybius, to whcm has been ascribed the whole-of the book on the 11 nature of the Child," and most of that" On Man." There is abundant anatcmical matter in both,largely grotesque and inaccurate. The opinions of SyennesisofCyprus and of Diogenes of Apollonia have been preserved forus briefly by Aristotle, and they indicate no more exactobservation. With Aristotle himself anatomy, as a sciencebased on direct observation, really began. The first threebooks of the history of Animals "survive cut of ten, andthe four books of the , Parts of Animals." Frcm then welearn that the errors of the three writers given above on thesubject of the distributien of the bleed-vessels were beccmiugrecognised. Though Aristotle distinguished between arteriesand veins, he confused the vena cava and the pulmonaryartery.The error, which died so hard and so late, that the arteries
were air-vessels appears to have originated with Praxagorasof Cos, the last of the Asclepianae. The article before usseems to implythat Diocles of Carystus foUcwcd Aristotle indate ; it was usually supposed that Diodes was a con.
temporary of Darius Hystaspes, who died in 4E5 B.C.
The real study of human anatomy began in Alexandria.
during the reign of Ptdcrny Soter and his successors.
Heropbilus and Erasistratus undoubtedly dissected anddescribed the human body and were largely responsible forthe high reputation of the Alexandrian medical schookNone of their writings have come down, but St.i8cient refer-ences have been made to them by Galen, Oribasius, ardothers for us to realise the value of their work. Erasistratusdescribed and D1J me d the valves of the heart, the division,cavities, and membranes of the brain, and the folds of thejejunum. Both he and Hercphilus described the brain, itssbare, cavities, and convolutions, and the latter was the firstanatomist to give his name to a part of the body. Mr.Parsons is perhaps wise in not assigning a date to Arelxus,as his exact historical position is not certain, though it wa&
clearly in the first century A.D.The scanty centributions of the Greek practitioners of the
early Empire, who preceded Galen, have received all theattention they deserve. The work of Marinus and Rufus ofEphesus is chiefly conserved in Galen’s writings, and withGalen’s death in 2CO A D. classical anatcmical ki2ow](dgeended. Soranus (the anaton ist) and Oribasius, Miletiusand Theophilus (chief medical (fewer to Heraclius), strove invain to wear the mantle. The languid (fforts of these com.pilers did little to improve the standard wcrk carried out andpersonally recorded by Galen. Whatever value may beclaimed for originality of clinical observation on thepart of the Arabian physicians, their anatomical Jearn.ing was borrowed frcm the Greeks, ard Mor.dir.us)f Bolcgna, about 1315, laid the foundation stone ofncdern anatomy. But even in the Republican cities)f Northern Italy the irfluence of the Church was too
itrcrg to permit such original workers as Gabriel de Zerbis)f Verona or Achillini of Bologna, at the close of the fifteenth;entury, to gain a proper hearing in the schools. Thenfallibility of Galen was a tenet of faith upon which thepowers of the Lateran insisted. Even such mental freedomts Sixtus V. afforded to science was a century away. We
531
recognise, with Mr. Parsons, the immense stimulus which ‘
the laborious compendium of Berenger afforded to students (
of anatomy, a stimulus assisted by the illustrations with i
which it was furnished. Poor as works of art, these pl ttes Jwere more useful to the student of the day than the artistic (
but useless drawings of Mondino, or the magnificent studies i
of Leonardo da Vinci or Albrecht Durer. (
Vesalius has always been claimed as the founder of t
modern anatomy, and no attempt is made in Mr. Parsons’s rarticle to depose him; bat the admirable sketch of the work Eof Jacques Dabois, who was the original master of Vesalius Iin the science, shows how much the pupil owed. He was <
not the untaught heaven-born genius that some of his bio-
graphers have made him. I
From the time of Vesalius to the time of Harvey the namesof the greater anatomists seem like the names of the greatnavigators: they have been attached to bays and promon- t
tories, where instead of the titles of Hudson or Magellan we J
recognise Eustachi of San Severino, Fallopi of Pisa (pupil of (
Vesalius), Constantio Varoli (physician to Gregory XIIL), (
Fabricio, who first described the valves of veins, and his fpupil, Casserius of Piacenza, with whom closed the illustrious Iline of Italian anatomists. ;
Proper space is given to the consideration of the question i
of provision by the State of subjects for dissection in I
authorised schools. The necessity of practical dissectionwas forced upon medical teachers in Great Britain by :William Hanter about 1750, with the result that in 1793there were 200 students studying regular anatomy, and by1823 the numbers reached at least a thousand. The legalised ’supply of subjects was confined by a statute of Henry VI 11. ;to the bodies of executed murderers, which happily formorals if not for science was limited even in those cruel
days. The practice of 11 body-snatching " was the natural,if deplorable, outcome of an insuffioient supply of subjects.The article under review gives an excellent summary of thedifficulties which preceded the passage of the AnatomyAct" of 1833. There was official opposition on the part ofthe Royal College of Surgeons of England, whose Fellowswere jealous of any advantage which might possibly accrueto private teachers, who formed the majority of the ana-tomical schools. Other opposition came from parliamentarianslike Orator" Hunt, Michael Sadler, and Sir R. R. Vyvian(then Member for Bristol). Macaulay, in one of his mostincisive speeches, illuminated by incidents of medimval
surgery, supported the Bill as one " which tends to the goodof the people, and which tends especially to the good of thepoor." It is to be regretted that in his final sentence onthis subject Mr. Persons shows that the same sentimentalitywhich influenced Hunt and Sadler in 1832 is influencingboards of guardians to-day ; for the Anatomy Act is not
compulsory on such boards but only permissive.Space forbids our entering on a consideration of that part
of the article that deals with modern anatomy ; suffice it to
say that the ground is fully covered and the subject amplytreated.
RECORDS FROM MEDIÆVAL CORONERS’ COURTS.
(FROM A CORRESPONDENT.)
IN THE LANCET of Dec. l7ch last there were discussedsome features of the Coroners’ Law and Death CertificationAmendment Bill, and an outline was given of the history ofthe office of coroner and the duties of that officer. It waspointed out that the coroner was closely connected withjudicial matters, and that therefore in the beginning hemight be expected to be a lawyer. To pursue the subjectsomewhat further, it may be added that the essentialfunction of the early coroners was to guard the rights ofthe Crown. Criminals were sought out and deaths by violenceand misadventure were inquired into, not so much becausesomeone had died or had been killed, but because the deathor the crime was a source of revenue to the Crown.
Coroners had a much wider field of inquiry in early daysthan they now have, for in addition to the duties mentioned inthe article in question they were obliged to hear appeals" orcriminal accusations brought by one person against another.The final trial of the causes was reserved for hearing at the i" eyre"—i.e., at the visit of the justices on circuit, the term I
"eyre" being derived from "in itinere." It was thecoroner’s duty to be present at the eyre ; he held animportant position, for he was the link between the itinerantjustices and the local administration, and so between theCrown and the people. I propose to cite a few cases bothfrom the records of coroner’s courts and from those of theCrown pleas at the eyre, between 1200 and 1413, which Ithink will be found interesting both from a medical and froma historical point of view. Sundry expressions in the reportsare somewhat puzzling unless the reader is aware of theprocedure, so I have explained technicalities in the courseof this article.To begin with the inquest jury, the composition of this
body varied in different places and at different dates, butabout the thirteenth century it commonly consisted of repre-sentatives from four neighbouring townships-namely, fromthat in which the death occurred or in which the body wasfound, and from the three nearest townships. The numberof jurymen varied, but was often, as it is now, 12. Personsdeclared guilty by the jury, those who were present when thesudden death occurred, and the finders of the dead body wereall attached to appear at the eyre before the itinerantjustices. Tne finder of the body was not, however, attachedif the deceased had received the last rites of the church,because presumably he would then have been able to statewho had attacked him Thus we have the following entryin the coroners’ rolls of Northamptonshire :-
It happened at Little Houghton that Richard le Muleward was founddead on Saturday next after the feast of St. Dunstan in the sixth yearof King Edward 111. (May 23rd, 1332). An inquest was held beforeJohn de Tuwe the coroner on the aforesaid day and year by the oath oftwelve jurors who say that Richard quarrelled with two men who killedhim. There was no tinler because he had the rites of the church.
That is to say, that no record of the finder of the body waskept because Richard had survived long enough to say whowere his assailants and to receive the last rites.The finder of a person feloniously slain had to raise the
hue, and one method of doing this was for the finder toinform his four nearest neighbours, who then notified thebailiff of the hundred, who in turn sent for the coroner. Atthe inquest the chattels of the person indicted were appraised,and the property thus appraised was placed, as a rule, in thecharge of the township in which the death occurred, to beaccounted for at the next eyre. If the accused was foundguilty his chattels were forfeit to the king. Sometimes theonly chattel which a murderer possessed seems to have beenthe weapon with which he committed the crime. Thus on
July 2nd, 1410, Richard Barber killed John Taylor with asword at Weston in Staffordshire. He was found to have no
goods or chattels, but the sword was valued at 2s., forwhich the township of Weston is to account."Murder was, as might be expected, a much simpler affair
in the Middle Ages than nowadays. Poisoning was almostunknown, or possibly was never discovered as such, for thedeaths by violence which are reported in the coroners’ rollsare all due to injury by weapon and are often characterisedby extreme brutality. On April 23rd, 1271, John Rede,Matilda his wife, and their two servants were sitting at
supper in the town of Ravensden in Bedfordshire whencertain felons and thieves came to the house. They hit Johnon the head with an axe and also stabbed him to the heart,so that he died immediately. Then they wounded Matildain the head, nearly cut off her left hand, and, having heateda trivet, placed her upon it. Having bound the two
servants, they despoiled the house and departed, leavingMatilda for dead. One of the servants unbound himself andraised the hue. At the inquest certain persons were orderedto be arrested, Matilda, despite her serious injuries,being able to attend and to give evidence. Our fore-fathers must have been a hardy race, for they had awonderful power of recuperation. Witness the followingcase. At Barford in Bedfordshire, on Oct. 10th, 1271, Johnof Bretteville was walking with his wife Emma on the King’shighway. To them appeared one Simon, who struck Johnwith a sword of iron and steel on the top of his head, on theleft side between the parting of the hair and the ear, makinga wound 5 inches long, 3 inches wide, and extending downto the brain, so that 13 pieces of bone afterwards came outfrom the said wound. He also with the sword divided thetendons of the little finger of John’s left hand and fracturedthe third finger of the same hand. Nor did his malice stop
I there, for he also struck John on the right side of his headwith the flat of the sword, many blows which did not bleed
