n MEDICAL HISTORY MEDICAL 76 ES IT-IT TET-NEW OK CITY YORK W E N - STREET FIFTY-NINTH EAST 67-69 UBIHE QUARTERLY B PUL- HOEBER O H - B - L PAU BY Y L R E T R A U Q [PHILADELPHIA] ED ' EDITOR BLISH 'D PU 'M R' PACKARD FRANCIS Entered aa second class matter June 2,1917, at the post office at New York, N. Y „ under the Act of March March of Act the under „ Y N. York, New at office post the at 2,1917, June matter aasecondclass Entered NA S OF ANNALS Yearly Subscription Subscription Yearly 86.00. Single numbers numbers Single 82.00. 3,1879. UBR 4 NUMBER
ANNALS OF MEDICAL HISTORY
Volume i Winter 1917 N umber 4
THE FIRST PRINTED DOCUMENTS RELATING TO MODERN SURGICAL ANESTHESIA1
By SIR WILLIAM OSLER, M.D., F. R. S.
Oxford, England.
HE story of surgical perspective and a failure to realize just anaesthesia illustrates what priority means in the case of a great how long it takes an discovery. idea to become effect Why do we not give the credit to Dios ive. The idea of pro corides, who described both general and ducing insensibility local anaesthesia, or to Pliny, or Apuleius to pain during a cut or to Hiotho, the Chinaman, who seems ting operation is of to be next in order, or to the inventor of great antiquity, e. g., in Chapter II, 21, of the spongia somnifera, or to Master Mazzeo the Book of Genesis. Nor is the word Montagna, in Boccaccio, or to any one of anaesthesia modern, as is sometimes said, the score or more of men in the Middle and invented by Oliver Wendell Holmes. It Ages who are known to have operated on occurs, Withington tells me, first in Plato patients made insensible by drugs or vapors? (Timaeus) and is used by Dioscorides in Why do we not give the credit to Davy, the modern sense. who had the idea, or to Hickman, who had The extraordinary controversy which has both idea and practice, or to Esdaile, who raged, and which re-rages every few years, operated on hundreds of patients in the on the question as to whom the world is hypnotic state, or to Elliotson, who did indebted for the introduction of anaesthesia, the same; or to Wells, who, in 1844, oper illustrates the absence of true historical ated under nitrous oxide, or to Long, who frequently practised ether anaesthesia? 1 Remarks made on presenting Morton’s original papers to the Royal Society of Medicine, London, Why? Because time out of mind, patients May 15, 1918, had been rendered insensible by potions 330 Annals of Medical History or vapors, or by other methods, without In the same journal for December 9th, any one man forcing any one method into Dr. J. Collins Warren (Primus) gives an general acceptance, or influencing in any account of the first operation at the Massa way surgical practice. chusetts General Hospital. These four Before October 16, 1846, surgical anaes papers stand out in the literature of sur thesia did not exist— within a few months gical anaesthesia as fundamental, and truly it became a world-wide procedure; and the epoch-making. full credit for its introduction must be Morton called the drug letheon and given to William Thomas Green Morton, applied for letters patent to secure his who, on the date mentioned, demonstrated rights— not an unethical procedure in the at the Massachusetts General Hospital dental profession of America. This led the simplicity and safety of ether anaes to the publication of his first pamphlet thesia. On the priority question let me called “ Letheon,” the bibliography of quote two appropriate paragraphs— “ He which some one should undertake. “ The becomes the true discoverer who estab medium through which Dr. Morton com lishes the truth; and the sign of the truth municated the results of experiments on is the general acceptance. Whoever, there etherization to the public, was a ‘circular’ fore, resumes the investigation of neglected which he had printed, at his own expense, or repudiated doctrine, elicits its true almost every week. It was at first, as its demonstration, and discovers and explains name imports, a mere letter of advice; the nature of the errors which have led but, as it became the receptacle of news to its tacit or declared rejection, may paper articles, and correspondence from certainly and confidently await the acknowl every portion of the Union, announcing the edgements of his right in its discovery.” success of etherization, it was necessarily (Owen, “ On the Archetype and Homologies enlarged into a large and closely-printed of the Vertebrate Skeleton,” p. 26.) “ In sheet of four pages. Soon this ‘Circular’ science the credit goes to the man who became a pamphlet, and of this five differ convinces the world, not to the man to ent editions were published, under Dr. whom the idea first occurs” (Francis Dar Morton’s immediate supervision, embody win, The Eugenics Review, 1914). Morton ing a digest of all the authentic information, convinced the world: the credit is his. both from Europe and America, on Morton’s original essays are among the Anaesthesia.” (Rice, “ Trials of a Public rarissima not existing, so far as I can Benefactor,” 1859, p. 114.) ascertain, in any of the general or special The Index Catalogue of the Surgeon libraries of this country. I have been General’s Library only mentions a four looking for them in vain for many years. teen-page pamphlet, 1846, printed by In a parcel of his father’s papers recently Dutton and Wentworth, Boston. The early received from William J. Morton of New form of the circular may be seen on the York there were duplicates of “ Letheon” back page of The Boston Medical and and “ Remarks on the Proper Mode of Surgical Journal, for December 9th. In Administering Sulphuric Ether by Inhala the number for November 18th with Bige tion,” which I have great pleasure in pre low’s paper, there is only an advertisement senting to the Library. Also a duplicate of Morton’s courses of instruction in dentis copy of The Boston Medical and Surgical try. The circular appeared first November Journal of November 18, 1846, which 26th, and is copied on pages 14-15 of the contains the first printed account of the Letheon pamphlet, fifth edition. This new procedure, by Dr. Henry J. Bigelow. pamphlet is made up of more than eighty First Printed Documents Relating to Modern Surgical Anesthesia 3 3 1
short articles from medical journals and by Inhalation,” and after referring to the newspapers, and is of special value in early cases of Warren and of Hayward at giving the popular first-hand impressions the Massachusetts General Hospital, he relating to the great discovery. There is gives fuller details of the dental cases which very little of Morton’s— only the circular he had seen with Dr. Morton. No small already referred to, and on page 16 the share. of the early confidence inspired in terms for the “Apparatus, a bottle of the the profession is due to this temperate Preparation, instruction, etc.” statement by Dr. Bigelow, who fully realized In 1847 Morton published a forty-four the enormous value of the discovery. page pamphlet on “The Proper Mode of In the literature of anaesthesia these are Administering Sulphuric Ether by Inha the three fundamental contributions. With lation,” Boston, Dutton and Wentworth, them should be placed Collins Warren’s printers, in which the original apparatus account of the first operation, The Boston (now a treasured relic at the Massachusetts Medical and Surgical Journal, December General Hospital) is described. In the early 9th, and Vol. x x x v of this publication, part of April he found that a sponge would which contains some twenty-two papers on serve the same purpose and was less danger the subject, illustrating the rapid spread of ous. The greater part of the pamphlet is the practice. taken up with general directions, the out The opportunity here offers to suggest come of the author’s experience. the arrangement of certain subjects in our The claims of Morton were very fully libraries on an educational basis. For stated in a pamphlet published in Paris example, why should not the members of in 1847 with the title “ Memoire sur la the Section on Anaesthesia of this Society decouverte du novel emploi de I’ether undertake to collect and classify their Sulphurique.” literature on historical lines? Start with In 1859 he published a small work the documents that magnetized into life “ On the Physiological Effects of Sulphuric an antique practice, these pamphlets of Ether and its Superiority to Chloroform,” Morton, Bigelow’s paper, Warren’s paper, Boston. So far as I can ascertain, this is and Volume xxxv of The Boston Medical his complete output on the subject of and Surgical Journal. Put these together— anaesthesia, except a posthumous pam all in vellum and lettered in gold!— as the phlet on “The Use of Ether as an Anaes blastoderm from which the enormous litera thetic at the Battle of the Wilderness.” ture has developed, which might be ar (Journal of the American Medical Asso ranged on the shelves in ten or more ciation, April 23, 1904.) sections. The Index Catalogue of the Sur The third item is No. 16 of Vol. xxxv geon General’s Library has a good classi of The Boston Medical and Surgical Journal fication, but for my own collection I have (then as now, issued weekly) for November used the following: 18th, which introduces to the profession I. The general story, as given in such modern surgical anaesthesia. Henry J. Bige publications as the Jubilee numbers of the low, the distinguished surgeon, had been British Medical Journal and The Boston interested in Morton’s private dental cases, Medical and Surgical Journal; and the and read a paper before the American text books in which the history of the Academy of Sciences, November 3rd, and subject is well given, as Snow, Foy, and so at the Boston Society of Medical Improve forth. ment, November 9th. It was called “ Insen II. Pre-ether period. On cards, references sibility during Surgical Operation Produced to Gurlt’s “Geschichte der Chirurgie,” Bd. 332 Annals of Medical History
III, p. 621; and Volume I of Simpson’s the subject of anaesthesia under the word works, from which sources most of the chloroform, which led to the sharp Bigelow- textbook and other descriptions are taken; Simpson controversy— the Hyderabad Re and to Dioscorides, Pliny, and Apuleius, ports, the B. M. A. and other reports and to the spongia somnifera, to Boccaccio and documents. the numerous other early writers. Brief VI. Local anaesthesia from Dioscorides descriptions could be written on the cards. and Bartholinus to Kohler, Corning, Hal- Then, in order, would follow the words of sted, Cushing, and others. Davy, of Beddoes, the tragic story of VII. Agents other than ether and chloro Hickman, the remarkable documents relat form used for inducing anaesthesia, arranged ing to anaesthesia produced by compression in order of introduction. of arteries, veins, and nerves, Bartholinus’ VIII. Technique, including the various use of cold for local anaesthesia, and the methods of administration— intravenous, section would conclude with the writings intratracheal— and the literature of ap of Esdaile and of Elliotson on hypnotism paratus. in surgery. What an education, even to IX. Physiology. glance at this literature in due sequence X. Pathology. on the shelves! I speak as an amateur. Doubtless experts III. The modern period, beginning with could easily arrange a more comprehensive Morton, Wells and Jackson; the story of scheme. To separate in literature the quick the miserable priority claims, the congres from the dead is one of the functions of a sional reports, the publications of the well-ordered library; but much that we Morton association, the topical literature, carelessly regard as dead is magnetized showing the introduction of the practice into life when put in its historical relation. into different countries, the Long literature, The plan here suggested— which could be and so forth. applied in other directions— sustains that IV. In chronological order the subject of continuity, to the study of which this anaesthesia in midwifery, embracing every Section is devoted. You remember the rings thing from Simpson’s original pamphlet to of Lucretius— well, there is a vis et vincula the latest popular magazine article on librorum, binding together books, a force twilight sleep. just as potent as the Vis et vincula lapidis, V. Chloroform and its introduction. The which supports the rings, and in the litera papers of the discoveries, Guthrie, and so ture of anaesthesia this force is derived forth, the Simpson pamphlets— his famous from the works here presented to the British Encyclopaedia article, dealing with Library. BYZANTINE MEDICAL FRAGMENTS
By CHARLES SINGER
OXFORD, ENGLAND
NDER the title of Byzantine 1. A GREEK FOURTEENTH-CENTURY PROGNOS Medical Fragments we propose TIC FROM THE BLOOD to publish in these pages a series A large part of mediaeval medical lore, of short texts in later Greek both Eastern and Western, was made up of dialects.U Each will be accompanied by prognosis, the methods of which were drawn a translation as literal as possible and by from the most diverse sources. Scraps of brief notes. the genuine science of antiquity, sentences Of late years there has been a wide and aphorisms, frequently modified and spread revival of interest in the Middle misunderstood, from the writings of Hip Ages, and a considerable part of the energies pocrates and Galen, often stand side by of medical historians has been directed to side with astrological precepts, with the collecting the material for a consecutive and ridiculous mechanical devices of Hermetism coherent history of mediaeval medicine. or with fragments of primitive folk medicine. Except for the purely astrological material, Among the most favorite forms of prog Byzantine sources have, however, been large nosis were the examination of the urine and ly neglected. A great store of medical frag of the blood. Urinoscopy and hsematoscopy ments must still lie in the monastic libraries occupied a large part of the attention of the of the East, where enthusiastic collectors physician, and perhaps even more that of have for centuries been seeking the more the partially trained or untrained pretenders fairly written and valuable copies of known to whose guardianship the people largely writers, rejecting those scribbled fragments trusted its health. Urinoscopy was fre of medical lore which yet give us a far quently a specialist’s occupation and figures truer view of the real contemporary outlook illustrating it are common enough in the than the magnificent volumes of Dioscorides MSS. and have been frequently reproduced. or Galen that are among the treasures of Blood-letting was no less specialized and the the great European libraries. It is to be barber, having performed his venesection, hoped that in future more copies or was frequently called upon to give an opin photographs of such fragments may be ion as to the patient’s health and prospects secured. of life from the appearance and behavior The expert palaeographer in his just of the shed blood. The formation of buffy scientific desire to demonstrate continuity coat, the separation of serum and clot, the has tended always to reproduce the hand distinction between arterial and venous writing of the professional scribe rather blood, the alteration in color after exposure than the more careless and less typical to and mixture with air, the process of work of the monastic scribbler. The read Iaking, the rate and character of putrefac ing and dating of our fragments may tion, all phenomena now easily distinguished thus often present special difficulty. In from one another, were then confused to view of this and of the scarcity of fac gether and the resultant held to indicate the similes of Byzantine medical palaeography, present and future nosological state of the we shall in each case reproduce a photo patient. Curiously enough figures illustrating graph of the transcribed text. hsematoscopy appear to be much rarer in 333 334 Annals of Medical History MSS.1 than figures of urinoscopy, though We may conclude with a few notes on miniatures of the actual process of blood our English rendering of the contents of the letting are very frequently encountered. MS. The text here transcribed gives a fair fywp we have left as “ ichor.” It refers idea of the kind of opinion that would thus to a puslike appearance in the blood and be formed. It consists of a single page and is probably used to denote the buffy coat. was written in the late fourteenth or early plyoq, which here implies some form of fifteenth century, probably in the monastery continued fever with chills and not a mere of the Holy Trinity in Chalchis, whence it rigor, we have here translated by the in was brought to the Bodleian Library. The definite term “ ague.” language is that of a well-instructed writer Xo)vY] we render “ choler” rather than at but it is sometimes confused, and in places tribute a conception of modern medicine to inaccurate. Thus a'tpia is written for alpux, a writer immersed in the humoral pathology 1 The only figure of a true hsematoscopy that we 2 Henry O. Coxe, “ Catalogi Codicum Manuscrip- can recall is in a fifteenth-century German astro torum Bibliothecae Bodleianae Pars Prima, Recen- logical calendar in the British Museum, MS. addi sionem Codicum Praecorum continens. ” Sec. 469, tional 17987, folio 101 recto. Oxford, 1853. ,v . •«■ *• /> f t ' *3 0 t y * ' Ih *%* • * «A C ^ W ^ p - I ****** *rtl*P** $ ^i*>c6‘K»Uf*hPi h m ^ I + m—•* * j • » ■■■ j * ■ „ ,? r» S«L>vrin> 09i*i^9 *ullAmdb‘>«vt4vJ&\g f / **jvr ^ r t u 9jL\AaiLppm£ AOt»)/nnhf%S u fa /» Mtf w »4M a p u j ^ N ? ! W " . w f //; ■ y # « | \ ) " " • / -», , •?,- * I „ . f ^ . xft* at* i v y /V» m nty/Jbiyi.fa. rt art, irw t^e* :A&\A ' *Av fL9<*isp*(aM>ii>A -Avto unpht%pA*U>* » - r <<> w r)f, | i n i A Y* . i a t \ \. i* t * i‘ Jj' * “ V ; : f § j, %S*li9Llptt«bA<9U** m&faA*t*lilMftlL^/0> Q 'A 0 ktb* 9 •l*1'*” ?!!:,ji v 'utyffZti*# **o ■ H * ~J ' f t wi*9i I +?:* i*Ats^t i 1 f * r t. i U v 'yy«< ISS ^ JjbdAr;. j, nfaly/'faV**/y** nefls** (“fth * ■ tyyr^n. 1 (jHtuehs -fa i 3 yfyr- ‘V’ ' 3 Vif/v* Jwyj, %i yffa y c*.c’k ifJ* "!>’] ! 'h.fahr**- // '-ivj, »xj'v 4 * 4 * \iy^.v 4.$/** ’ 4 4 ^ a s 1 iX >> i 'K e ■<- n /< >1 ** y f 5 i f l^ 4<4 ■hV * ■i- X > | * n'l'-,!' » y<% Vs* w .v "•5 vy'f,' .,fl| ’‘-'P yfa" • 4 7vi“,, 1 v •$ ’I in in *a V i/xs -v'yfr?’, <* I f a ♦ s^faSSSa^teS^^ J l l and places, in the long monotonous history of of names and numbers than that which is the Byzantine world, in which there was a here fathered on the proto-scientist, Pythag better comprehension of the wisdom of the oras. ancients; but there were no true intellectual Our MS. is illiterate, sufficiently illiterate revivals such as took place in the West in to puzzle and shock one trained in classical the twelfth century with the arrival of Ara Hellenic standards, yet not more illiterate bian science, in the thirteenth century dur than is to be expected in a document of ing that long process that resulted in the the last years of Greek degradation, ema erection of the majestic edifice of Scholas nating from that stronghold of ignorance ticism, or in the fifteenth century with the and fanaticism, the Holy Mountain, where great ferment of the Renaissance. The out the sole attempt at reform— the foundation look of a Greek monk of the eighth century of a monastic academy2—so disturbed opin was in essence identical with that of his ion that it was abandoned as too revolu representative of the eighteenth. Less tionary. But though illiterate, our MS. is change was wrought by a thousand years of history in the Byzantine intellectual world 2 This event took place in 1749 in the monastery of Vathopedi. A short account of it and of the general than by a hundred years in the West. history and state of the Holy Mountain may be During this long slumber of a thousand found in Alfred Smidtke, “ Das Klosterland des years the visions of Greece were always of Athos,” Leipzig, 1903. Byzantine M edical Fragments 339 not without linguistic interest. Thus for in trary use of accents. The script is difficult, stance the curious Italianate word croupuxptffov and there still remain one or two doubtful (Italian summare) reflects for us the Venetian readings. These I have indicated in the dominance in the fourteenth century. notes. For suggestions with reference to Our MS. represents but one of the hun these I have to thank Dr. E. T. Withington, dred forms in which the belief is expressed Mr. J. S. Scott of Emanuel College, Cam that simple mathematical relationships gov- bridge, and Mr. Peckham, till lately the J v<. 4 ' •< 7 " 1 T ~ * ■j ' v/ o'1 » 3 7r'' / J a ~ ^ /tj y* a 'y v/.ij,. ^ Y ^ v /'7v5t w O. .V V/..%£ 5 v" \ - ^ xVJ/1 \ V* v/. V* cc ,u^ S ‘ \» ^ v ' * -(Jr* ifi*j A. T V/ d 'cc * V'Ahk X ,5m V 't ' . 1 - ■ ‘ , _ £ j ^ f v/‘V «- y j ‘ X a. v / i J i d ^ T t \I ^ 'T >, «■jay*,/, /i 1 5- ^ T V if v ^ ^ ‘ /'Vn* •Z ;.j 9 <"0 v /,:y T 1 ■r~ w 'vf , ' V ~y • - V 3 # T -*1H a! X v/^lV y i '\J f ' v/'M*- V <1^ r, 'A J" V'rttw r y X< v < P \ j ‘ M '4 ^ y S' ^ T a T y m i ' j ’ t X ' p v/r«« T *j 9 f V t v/^. J 3 ^ ’ f ern not only the phenomena of nature but British vice-consul at Uskub. In the trans also the events— both great and small— of lation I have been compelled to omit the human life. That idea, fathered frequently last sentence of the text. The defective on Pythagoras, became especially popular grammatical construction of that phrase with the spread of Hermetic and Neo makes a faithful rendering impossible, platonic doctrines. It was very widely held though its general meaning is clear from the throughout the Dark and Middle Ages and, context. encouraged by all kinds of mystical and cabalistic writings, it is still commonly Transcription, Monastery of St. Gregory on encountered among the ignorant and super Mt. Athos, MS. ioy (12), folio i8yv stitious in every country. With the Greeks xovtoc >ta( Ta IvaxoXEt^GIvTa xpaTEaov, x,at a B t ty tC tG xg X£ XY) Xa XB a AI xe Iv T(p opyavw oxou elvac ypapiptivo) xaTtoOev, /.ai st piv EupY)<; Iv T(p uxepysfw * e £ Y) ta tB X xy xC xG Xe ? ■fjB! Iv tw uxoyettp dxoBvrjaxer t^v Bl %p T i ve6tepo?—r 5 6 iraXatb^ 1 Y xa! S xb 5 vtxa 1 xa! X Tb 7 vtxdt folio i 88r Y xa! 6 xb T vtxd S xa! C Tb 7 vtxd: Y xa! C xb b vtxa S xa! ; Tb I vtxi 'F'rjtpoc; BtayvtoUTtxoc; xspt dcrG£VY)p.lv(ov Y xa! xb vtxA 8 xa! T) Tb 8 vtxd: tpY) Translation all up and subtract from 36, and refer that Pythagorean Diagnostic Calculation of which remaineth to the table [below]. Life and also of Death. Now if thou findest it in the 1 it is full Ascertain what day the patient took to well, if in the 2 of middling sort, but if in his bed and how many days the moon had, the 3 it is ill and mortal above all. and reckoning [the numerical value of] 1 10 16 22 28 their names and that of the sick man, put 4 7 13 19 25 3 i 34 them together and add ten. And having 2 5 8 11 14 17 20 23 26 29 32 35 summed them up, subtract, take away and divide by thirty [lit. cast out all the thir 3 6 9 12 15 18 21 24 27 30 33 36 ties].12 /Then taking the remainder, look where [the number] is in the table written If thou wishest to find or to know whether below. And if thou findest it in the super- one unknown to thee [still] walks in life terranean section he lives, but if in the sub or is without lot among the living, do thus: terranean he dies. But do not reckon the Cipher out their names, and having ci first day of the illness but the second; for phered them divide them by nine [lit. cast the first is not regarded as [a day of the] out all the nines from the ciphers] and seek disease but as [the day of] taking to bed. the remaining numbers of the two names among the aforesaid ciphers overleaf and Superterranean Table if...... the one is alive, but the other is dead. I 11 20 26 7 L The table is overleaf and examine it well. I 2 21 28 9 13 F folios i 88v and i 8gr E 3 10 14 23 16 1 the . . ( 13) victory (hath) i 2. The elder (is) 2. 1 and 2 . The 2 (hath) victory 2 and 3. The 3 (hath) victory 1 and 3. The 3 (hath) victory 2 and 4. The 4 (hath) victory Subterranean 1 and 4. The 4 (hath) victory 2 and 5- The 5 (hath) victory 1 and 5. The 1 (hath) victory 2 and 6. The 6 (hath) victory D 1 and 6. The 6 (hath) victory 2 and 7. The 7 (hath) victory A 4 8 18 25 19 1 and 7. The 1 (hath) victory 2 and 8. The 8 (hath) victory R 1 and 8. The 8 (hath) victory 2 and 9. The 9 (hath) victory 1 and 9. The 9 (hath) victory K 12 22 27 N 5 30 3. The younger (is) 3 4. The ancient (is) 4 E 3 and 4. The 4 (hath) victory 4 and 5. The 5 (hath) victory S 6 15 24 29 17 3 and 5. The 3 (hath) victory 4 and 6. The 4 (hath) victory S 3 and 6. The 6 (hath) victory 4 and 7. The 7 (hath) victory 3 and 7. The 7 (hath) victory 4 and 8. The 4 (hath) victory 3 and 8. The 8 (hath) victory 4 and 9. The 9 (hath) victory Diagnostic calculation of those who have 3 and 9. The 3 (hath) victory been taken sick. Reckon the day in which the patient 5- The young (is) 5. 7. The chief victor (is) 7 took to his bed, or fell into some urgent S and 6. The 6 (hath) victory 7 and 8. The 8 (hath) victory 5 and 7. The 7 (hath) victory 7 and 9. The 9 (hath) victory need, or [on which] he was born, or on 5 and 8. The 8 (hath) victory which a man wishes to do something. 5 and 9. The 9 (hath) victory 8. The ancient (is) 8 Reckon also [the number of days] from the 8 and 9. The 9 (hath) victory first day of the month until the given day. 6. The ancient (is) 6. 6 and 7. The 7 (hath) victory Then putting these days together add them 6 and 8. The 6 (hath) victory 9. The younger 6 and 9. The 9 (hath) victory 9 and 9. The 9 (hath) victory 121 am indebted to Dr. Withington for this inter pretation, which fits in well with the tables. 13 See note 11 to text. THE LEGISLATIVE AND ADMINISTRATIVE HISTORY OF THE MEDICAL DEPARTMENT OF THE UNITED STATES ARMY DURING THE REVOLUTIONARY PERIOD (1776-1786) By COLONEL W ILLIAM O. OWEN, U. S. A R M Y CURATOR, ARMY MEDICAL MUSEUM, WASHINGTON, D. C. SECTION III I ntroduction three months’ salary and wages due to the officers and others employed in the HIS, the third installment of the hospital . . .” history of the medical department The regulation under date of September during the revolutionary period, 28, 1780, might well obtain in our own time: deals almost entirely with the es “ That no person concerned in trade, on his T tablishment of hospitals, their personnel,own account, shall be suffered to act as and expenditures. an officer in the hospital or medical depart It is interesting to compare the conditions ment of the army:” then existing with those obtaining in our Upon dismissal of a soldier from the hos time. The medical department does not pital there seems to have been difficulty in seem to have been regularly incorporated locating his proper clothing as evidenced with the Army until May 28, 1781, when by the following extract: “The Steward the Medical Committee was discontinued shall also receive the spare regimental arms and its business handled by the Board and accoutrements and cloathing of each of War. It was even considered necessary soldier admitted into the Hospital keeping as late as September 30, 1780, to state entries of and giving receipts for every that hospital and medical officers “ shall article received, which when the soldier be subjected to trial by courts-martial for shall be discharged, shall be accounted for all offences, in the same manner as officers by the said Steward, with the Commanding of the line of the army.” Officer of the regiment to which such Those acquainted with the organization soldier belonged, or other proper person, of the present military hospital, will read and shall also take charge of the hospital with interest the report of the Medical cloathing.” Committee for March 22, 1781. For the sake of comparison we might Even in those days much red tape was note under date of July 24, 1781, the required in the procuring of medicines and mildness of the enemy’s cruelty toward instruments, as evidenced by the resolution one Robert Henry who, on being taken of July 23, 1782. However, the apothecary prisoner by the enemy, was only “stripped evidently held a more important position of all his cloathing.” than under the present regime. Generous provision was made for the A strong contrast is struck in the salary invalided by a resolution of May 1, 1783, of the nurses— four dollars per month and and, by the order of September 30, 1780, one ration per day. But how familiar is medical officers were entitled to grants the motion of April 13, 1781, ordering that of land equal to those of officers in the a certain sum of money be placed in the army. hands of one Nathan Brownson “ to pay —E d i t o r . 342 History of the A rmy M edical D epartment D uring the Revolution 343 II. FROM JOURNALS OF THE CONTINENTAL Iished as above, except the clerks and stewards, shall at the end of the war be entitled to a certain provi congress (1774-83) (Continued) sion of land in the proportion following, viz. The director to have the same quantity as a briga August 22, 1780. 755 dier general. Chief physicians and surgeons and A letter from Doctor W. Shippen, director general, apothecary the same as a colonel. Physicians and was read: surgeons and apothecary the same as lieutenant Ordered, That it be referred to a committee of colonel. Regimental surgeons and assistants to the three: purveyor and apothecary, the same as a major. Hos August 28, 1780. 787-8 pital and regimental surgeons’ mates, the same as a captain.” The committee, to whom was referred the letter, A motion was made by Mr. (Frederick A.) Muh of 22d, from Doctor W. Shippen, D(irector)* G en lenberg, seconded by Mr. (Theodorick) Bland, to eral), brought in a report; Whereupon, amend the paragraph by inserting after the words, The Committee to whom, D. Shippen Direc1 “ intitled to” the words following, viz. “half pay in Genls letter of the 22 nd instant was referred, Re the same manner and under like restrictions as offi port, cers of the line” ; and on the question to agree to That that part of the letter which respects sup the amendment, the yeas and nays being required plies of Forage for the Horses belonging to officers by Mr. (John) Fell,...... of the Hospital Department, together with two let So it was resolved in the affirmative. ters received by the Committee since, from the Di rector General, be referred to the Board of War to September 23, 1780. 853 take order. The committee, to whom was re-committed part The Committee ask leave to sit again. of the report on the hospital department, having Extract of a letter of D. Shippen Aug. 22nd 1780 brought in a farther report, Congress resumed the “ I am informed to day by the Depty* Quarter consideration thereof, and made some progress. Master of this State that he will not supply our de Ordered, That the director general report the partment with any more Forage, unless he is au names of all the officers in the hospital department thorised so to do by an order of Congress, which from the director to the junior surgeons inclusive, I flatter myself will be given immediately.” 107 with the dates of their respective commissions.108 Resolved, That that part of the letter, which re spects supplies of forage for the horses belonging to September 25, 1780. 854 officers of the hospital department, together with The director general, having made a return of two letters received by the committee from the the officers of the hospital;109 director general, be referred to the Board of War to Ordered, That it be referred to the Medical Com take order. mittee. September 9, 1780. 814 September 28, 1780. 871 The committee, to whom was referred the letter of 22 August, from Doctor Shippen, director general, The Medical Committee, to whom was referred brought in a report, which was read: the return made by Doctor Shippen, delivered in a Ordered, That a member be added to the Medical report. Committee, in the room of Mr. (Samuel) Holton, September 30, 1780. 876-88 who is absent: The member chosen, Mr. (Theodorick) Bland. Congress resumed the consideration of the report on the hospital department, when a motion was September 11, 1780. 819 made by Mr. (Roger) Sherman, seconded by Mr. Ordered, That Wednesday next be assigned for (Nicholas) Van Dyke, to reconsider that part of the the consideration of the report of the committee on report, viz. “ That the several officers whose pay is Doctor W. Shippen, director general’s letter, re established, except the stewards and ward masters, specting the hospital department. be intitled to half pay, in the same manner and un der like restrictions as officers of the line;” September 19, 1780. 837 And on the question for reconsideration, the yeas A letter, of this day, from Doctor W. Shippen, and nays being required by Mr. (Roger) Sherman, director general, was read: Ordered, That it be referred to the Medical Com So it was resolved in the affirmative. mittee. A motion was made by Mr. (John) Fell, seconded by Mr. (William Churchill) Houston, to strike out September 22, 1780. 847 the words, “ half pay in the same manner and under Congress resumed the consideration of the report like restrictions as officers of the line.” of the committee on the medical department, and And on the question shall those words stand, the on the consideration of the following paragraph, viz. “That the several officers whose pay is estab- 108 Here were inserted the resolutions on the hospital service, but Thomson noted in the margin “ reconsidered and amended 30th.” * Material placed in parentheses appeared in brackets in the They are printed under September 30, 1780, post, where the original MS. changes are noted. i°7 This report, in the writing of Frederick A.Muhlenberg, is in 109 Dr. Shippen’s letter transmitting the return is in the Papers the Papers of the Continental Congress, No. 136, IV, folio 541. of the Continental Congress, No. 78, X X , 567. 344 Annals of Medical History yeas and nays being required by Mr. (Roger) Sher timates of hospital stores, medicines, instruments, man, ...... dressings, and such other articles as may be judged So it passed in the negative and the words were necessary for the use of the hospitals; also direct struck out. the apothecary or his assistant, to prepare and de Congress proceeded in the consideration of the liver medicines, instruments, dressings, and other report, and the same being amended, was agreed to, articles in his possession to the hospitals and sur as follows:110 geons of the army and navy, as he or they may Whereas, the late regulations for conducting the judge necessary: affairs of the general hospital are in many respects That the director authorise and instruct the pur defective; and it is necessary that the same be re veyor and apothecary to supply, for the use of the vised and amended, in order that the sick and regimental surgeons, such medicines and refresh wounded may be properly provided for and attend ments as may be proper for the relief of the sick and ed, and the business of the hospitals conducted with wounded, before their removal to a general hospital, regularity and economy; therefore, and to be dispensed under the care, and at the di Resolved, That there be one director of the mili rection of the chief physician of the army: tary hospitals, who shall have the general direction That the director, or, in his absence, the chief and superintendance of all the hospitals to the hospital physicians, respectively, be empowered oc northward of North Carolina; that, within the afore casionally to employ second mates, when the num said limits, there be three chief hospital physicians, ber of the sick shall increase so as to make it neces who shall also be surgeons; one chief physician, who sary, and to discharge them as soon as the circum shall also be a surgeon, to each separate army; fif stances of the sick will admit: teen hospital physicians, who shall also be surgeons; That the director, or, in his absence, the chief twenty surgeons’ mates for the hospitals: one pur hospital physicians, respectively, shall appoint a veyor, with one assistant; one apothecary; one as ward master for each hospital, to receive the spare sistant apothecary; [and to each hospital one clerk regimental cloathing, arms, and accoutrements of who shall also be paymaster,]* a steward,matron, each soldier admitted therein, keeping entries of orderly men, and nurses, as heretofore: and giving receipts for every article received, which, That the director, or, in his absence, one of the when the soldier shall be discharged, shall be ac chief hospital physicians, be empowered and re counted for by the said ward master with the com quired, with the advice and consent of the Com manding officer of the regiment to which such sol mander in Chief, or commander of a separate army, dier belonged, or the officer directed to take charge to establish and regulate such a number of hospi of the convalescents from the said hospital; or, in tals, at proper places, for the reception of the sick case of the death of the soldier, shall be accounted and wounded of the army, as may be found neces- for with, and delivered to the quartermaster of the sary: regiment to which the said soldier belonged; and the That the director be authorised and instructed to ward master shall receive and be accountable for enjoin the several chief hospital physicians, and the hospital cloathing, and perform such other ser other officers of the hospitals under his superintend vices as the chief hospital physician shall direct. ance, to attend at such posts or stations as he may That the director shall make returns of all the judge proper, and also to attend and perform such sick and wounded in the hospitals, once every duties, at any post or place, as a change of the posi month, to the medical committee, together with the tion of the army, or other circumstances, may from names and ranks of all the officers and others em time to time make necessary, and shall be required ployed in the several hospitals: by the Commander in Chief; and that, in case of That the director be required to employ such part any dispute concerning their seniority or precedence, of his time as may be spared from the duties before the director shall determine the same in the first pointed out to him, in visiting and prescribing for instance, the party supposing himself aggrieved be the sick and wounded of the hospitals; and that he ing at liberty to appeal for redress to the Medical pay particular attention to the conduct of the sev Committee: eral officers in the hospital department, and arrest, That in time of action, and on any other emer suspend and bring to trial, all delinquents within gency, when the regimental surgeons are not suffi the same: cient in number to attend properly to the sick and That the duty of the chief hospital physician shall wounded that cannot be removed to the hospitals, be, to do and perform all the duties herein before en the director, or, in his absence, the nearest chief joined them to do in the absence of the director; to hospital physician, be empowered and required, upon receive and obey the orders of the director, made request of the chief physician and surgeon of the and delivered to them in writing, to superintend the army, to send from the hospitals under his care, to practice of physick and surgery in the hospitals put the assistance of such sick and wounded, as many under their particular care by the director, or which, surgeons as can possibly be spared from the neces by the order of the commander in chief or the com sary business of the hospitals: mander of a separate army, may be by them estab That the director, or, in his absence, two of the lished; to see that the hospital physicians and other chief hospital physicians, shall make out and de officers attending the same, do their duty; and make liver, from time to time, to the purveyor, proper es monthly returns to the director, of the state and number of the sick and wounded in the hospitals 110 From here the entries are in Thomas Edison’s writing. under their care; and also make to the director, and *Material in brackets was cancelled in the original MS. to the medical committee, of all delinquent officers, History of the A rmy M edical D epartment D uring the R evolution 345 in order that they may be speedily removed or pun sick and wounded under his care. He shall cause ished; and to take measures that all such sick and daily returns to be made to him of all the sick and wounded as are recovered and fit for duty be deliv wounded which have been removed to the hospitals, ered weekly to the officer of the guard, to be con all that remain in the hospital tents, all that are be ducted to the army: when present at any hospital, come fit for duty, all that are convalescent, and all to issue orders to the proper officers for supplying who may have died, specifying the particular mala them with necessaries; and generally, in the absence dies under which the sick and wounded labour, and of the director, to superintend and controul the busi shall make a monthly return thereof to the director, ness of such hospitals, suspend delinquent and re who shall add it to his general hospital returns, to move unnecessary non-commissioned officers, mak be transmitted monthly to the Medical Committee. ing report to the director; and, when in their power, That whenever any regimental surgeon or mate to attend and perform or direct all capital opera shall be absent from his regiment, without leave tions : from the chief physician and surgeon or commander That the hospital physicians shall take charge of of the army where his duty lies, the said chief physi such particular hospitals as may be assigned them cian and surgeon shall have power to remove such by the director: They shall obey the orders of the surgeon or mate and forthwith appoint another in director, or in his absence, of the chief hospital phy his stead. sician: They shall have power to suspend officers That the purveyor provide, or cause to be pro under them, and to confine other persons serving in vided, all hospital stores, medicines, instruments, the hospitals under their charge, for negligence or dressings, utensils, and such other articles as shall ill-behaviour, until the matter be regularly inquired be prescribed by the written order of the director, into: They shall diligently attend to the cases of the or two of the chief hospital physicians, and deliver, sick and wounded of the hospitals under their care, or cause the same to be delivered, upon written or administering at all times proper relief, as far as ders, under the hands of the director, or chief hospi may be in their power: They shall respectively give tal physician, or one of the hospital physicians, hav orders, under their hands, to the assistant purveyor ing the charge of a particular hospital, or of a chief or steward at the hospital, for the issuing provisions physician and surgeon of the army, which, with re and stores, as well as for the procuring any other ceipts thereon for delivery of the same, shall be his articles that the exigencies of the hospital may re sufficient vouchers. He shall be allowed a clerk, and quire, and which the store is not provided with, hav as many store keepers as occasion may require, and ing always a strict regard to economy, as well as the the director shall approve of. He shall also pay the welfare of the sick then to be provided for: They salaries of the officers, and all other expences of the shall make weekly returns to the nearest chief hos hospitals. He shall render his accounts every three pital physician, of the state of the hospitals under months to the Board of Treasury for settlement, and their respective care. make application for money to the Medical Com The mates shall each take charge of and attend mittee, before whom he shall lay estimates of arti the patients assigned them, and perform such other cles necessary, which shall previously have been ap duties as shall be directed by the director, chief or proved and signed by the director or two of the other physicians and surgeons. chief hospital physicians; at the same time he shall The chief physician and surgeon of the army shall render to them an account of the expenditure of the be subject to the orders and controul of the direc last sum of money advanced to him; and the said tor: His duty shall be to superintend the regimental Medical Committee shall lay such estimates before surgeons and their mates, and to see that they do Congress, with their opinion thereon: their duty: To hear all complaints against the said That the assistant purveyor shall procure such regimental surgeons and mates, and make report of supplies, and do and perform such parts of the pur them to the director, or, in his absence, to the Com veyor’s duty, as by him shall be particularly as mander in Chief or commanding officer of a separate signed to him. army, that they may be brought to trial by court- That the apothecary and his assistant receive, martial for misbehaviour: To draw for and receive prepare and deliver medicines, instruments and from the purveyor a suitable number of large strong dressings, and such other articles of his depart tents, beds, bedding and hospital stores, and from ment, to the hospitals and army, on orders in writ the apothecary, or his assistant, proper medicines, ing from the director, or either of the chief hospital for such sick and wounded persons as can not be physicians, or chief physician and surgeon of the removed to the general hospital with safety, or may army; and that he be allowed as many mates as oc be rendered fit for duty in a short time. He shall casion may require, and the director shall approve of: also see that the sick and wounded, while under his That the director, or in his absence, the chief hos care, are properly attended and provided for, and pital physician, shall appoint a steward for each hos conveyed, when fit to be removed, to the general pital, whose duty it shall be to purchase vegetables hospital; for which last purpose, he shall be sup and other small articles, under the direction of the plied by the quartermaster general, with a proper purveyor, and to receive hospital stores from the number of convenient wagons and drivers; he shall purveyor, and provisions from the commissary gen have a steward, which he is to appoint, to receive eral, and issue the same for the use of the sick and and properly dispense such articles of diet and re wounded, agreeably to the order of the physician freshment as shall be procured for the sick; and also and surgeon attending such hospital; the steward to shall appoint such a number of nurses and orderly account with the purveyor for all such issues: men as may be necessary for the attendance of the That the director, or, in his absence, the chief 346 Annals of Medical History hospital physician, appoint a proper number of ma one hundred and twenty dollars per month, one ra trons, nurses, and others, necessary for the regular tion per day, and forage for one horse: management of the hospitals, and fix and ascertain Assistant purveyors and apothecaries, each, sev their pay, not exceeding the sums heretofore allowed; enty-five dollars per month: and point out and prescribe their particular duties Regimental surgeons, each, sixty-five dollars per and employments, in writing, which they are en month, one ration per day, and forage for one horse: joined to observe and obey: Surgeons’ mates in the hospitals, fifty dollars per That the director, with two chief hospital physi month, one ration per day: cians, be empowered to fix the pay of second mates, Surgeons’ mates in the army, forty-five dollars and of such clerks, store keepers, and other persons, per month, one ration per day: as may occasionally be employed; and also make Steward for each hospital, thirty-five dollars per such regulations, and point out and enjoin, in writ month, one ration per day: ing, such further particular duties for the several Ward master for each hospital, twenty-five dol officers in the hospital department, as they may lars per month, one ration per day. judge necessary for the regular management of the Resolved, That none of the aforesaid officers, or same; which duties shall always be consistent with, other persons employed in any of the hospitals, be and in no wise contradictory to any of the duties entitled to rations of provisions or forage when on herein before particularly enumerated, and which furlough. being reported to, and approved of by the Medical Resolved, That the chief physician of the army be Committee, shall thereupon become obligatory to allowed a two horse covered wagon for transport all those concerned: ing his baggage: That the quartermaster general furnish the hos That the several officers above mentioned shall re pital department, from time to time, as occasion ceive their pay in the new currency, emitted pursu may require, with such a number of horses and ant to a resolution of Congress of the 18th day of wagons as may be necessary for removing the sick March last; and that they be allowed and paid at and wounded, and for transporting the hospital the rate of five dollars of said currency per month stores; but that no other horses than those belong for every retained ration; and shall each be entitled ing to the officers of the department, for which for annually to draw cloathing from the stores of the age may be herein allowed, be kept separately and cloathier general, in the same manner and under at the expence of the department: the same regulations as are established for officers That no person concerned in trade, on his own of the line, by a resolution of Congress of the 25th account, shall be suffered to act as an officer in the November, 1779: hospital or medical department of the army: That the returns for cloathing for officers in the That no officer or other person in the hospital de medical staff (regimental surgeons and their mates, partment, except the sick and wounded, be permit who are to draw with the regimental staff, excepted) ted to use any of the stores provided for the sick: be signed by the directors, or one of the chief hos That the director, chief hospital physicians, and pital physicians; and such cloathing shall be deliv the chief physicians and surgeons of the army, phy ered either by the cloathier general or any sub- sicians and surgeons, purveyor, apothecary, assist cloathier in the state in which the officer to receive ant purveyor, and assistant apothecary, be appoint cloathing shall reside, in the same manner as is pro ed and commissioned by Congress; the regimental vided in the cases of other staff officers not taken surgeons and mates to be appointed as heretofore: from the line: That the director, with the advice and concur That the several officers whose pay is established rence of two of the chief hospital physicians, appoint as above (except the stewards and ward masters) all hospital mates, which appointments shall be cer shall at the end of the war be entitled to a certain tified by warrants under the hand of the director; in provision of land, in the proportion following, viz. which appointments no person shall be admitted The director to have the same quantity as a briga under the age of twenty-one years: dier-general; Chief physicians and purveyor, the same as a That all the officers in the hospital or medical de colonel; partments, shall be subjected to trial by courts-mar Physicians and surgeons and apothecary, the same tial for all offences, in the same manner as officers of as a lieutenant colonel; the line of the army. Regimental surgeons and assistants to the pur Resolved, That the pay and establishment of the veyor and apothecary, the same as a major; officers of the hospital department, and medical Hospital and regimental surgeons’ mates, the staff, be as follows: same as a captain; Director, one hundred and fifty dollars per month, That the former arrangements of the hospital de two rations for himself, and one for his servant, per partment, and all resolutions heretofore passed day, and forage for two horses: touching the same, so far as they are inconsistent Chief physicians and surgeons of the army and with the foregoing, be repealed, excepting that the hospitals, each, one hundred and forty dollars per hospitals in the southern department, from North month, two rations per day, and forage for two Carolina to Georgia, inclusive, be continued under horses: the same regulations as heretofore, until the further Purveyor and apothecary, each, one hundred and order of Congress.111 thirty dollars per month: Physicians and surgeons of the hospitals, each, 111 Here Charles Thomson resumes the entries. History of the A rmy M edical D epartment D uring the R evolution 347 October 2, 1780. 889 Ordered, That Dr. Rickman be informed, that Congress took into consideration the report of pursuant to his former request, he is left out in the the Medical Committee on the letter, of 24 Septem new arrangement of the hospital department. ber, from the director general, together with the re October 30, 1780. 992 turns of the officers in the hospital department; and thereupon, That as Major General Greene has expressed an The Medical Committee, to whom the Director earnest desire to have Doctor James McHenry as General’s letter of the 24th inst. together with the an aid de camp upon the southern command, the Return of the Officers in the Hospital Department said Major General Greene be authorised to employ was referred, beg leave to report: the said Doctor James McHenry as one of his aids, That they have conferred with the Director Gen on his command in the southern department; and eral and other officers of the Department, and have that the said Doctor McHenry while so employed made out a new Return, of the General Officers, the be intitled to the rank of major by brevet. Senior and Junior Surgeons, together with the Dates November 1, 1780. 1002 of their respective Commissions, which they submit The Medical Committee delivered in a report; to Congress. Whereupon, Resolved, That on Thursday next Congress will The Medical Committee beg leave to Report— proceed to the election of the director, chief physi That they have had under consideration an esti cians, purveyor-apothecary and their respective as mate of Hospital Stores, laid before them by the sistants, and the physicians of the military hospi Purveyor by order of the Director of the Hospital: tals.112 of which estimate, such parts as are approved of by October 6, 1780. 908 the Committee, and in their opinion necessary to Congress proceeded to the election of officers in be procured they now lay before Congress, amount the hospital department, and the ballots being taken, ing by estimation to 4276 2/3 dollars in specie: Doctor William Shippen, jr. was elected director- Whereupon they offer the following Resolution. general; Doctor John Cochran, chief physician and Ordered, That the sum of four thousand two hun surgeon of the army; Doctor James Craik, Doctor dred and seventy six dollars and sixty ninetieths of Malachi Treat, Doctor Charles M ’Knight, chief hos a dollar, in bills emitted pursuant to the resolution pital physicians. of the 18th of March last, be advanced to Thomas Bond, purveyor of the general hospital, to enable October 7, 1780. 909-10 him to purchase the stores mentioned in an esti Congress proceeded in the election of officers in mate approved by the Medical Committee; and that the hospital department, and the ballots being the Board of Treasury report a draught or draughts taken, Thomas Bond, jun. was elected purveyor; for that purpose.114 Isaac Ledyard, assistant purveyor; Doctor Andrew Craigie, apothecary; William Johonot, assistant November 6, 1780. 1024 apothecary; Doctors James Tilton, Samuel Adams, Ordered, That a warrant issue on Joseph Borden, David Townshend, Henry Latimer, Francis Hagan, commissioner of the continental loan office in the Philip Turner, William Burnet, John Warren, Moses State of New Jersey, in favour of Thomas Bond, Scott, David Jackson, Bodo Otto, Moses Bloom purveyor of the general hospital, for four thousand field, William Eustis, George Draper, Barnabas Bin- two hundred and seventy six dollars and 60/90, in ney, hospital physicians and surgeons. bills of credit emitted pursuant to the act of Con On motion of the medical committee, gress of the 18 of March last; for which sum the Resolved, That Doctor Matthew Maus be ap said Thomas Bond is to be accountable. pointed surgeon to the regiment of invalids com November 13, 1780. 1049 manded by Colonel L. Nicola, and that Colonel A letter, of 5, from Doctor James Tilton was read. Nicola be authorised to appoint a proper surgeon’s A letter from Doctor James Fallon was laid be mate to the said regiment, when the number of sick fore Congress:115 shall make it necessary. Ordered, To lie on the table. October 17, 1780. 935 November 17, 1780. 1066 On motion of the Medical Committee, The Board further report, Ordered, That Doctor Isaac Forster and Doctor That they have considered the letter from Doc Jonathan Potts deliver all public stores in their pos tor William Rickman of the 4th of October last (re session to Doctor Thomas Bond, purveyor of the ferred to them by Congress) and are of opinion, hospitals, or his order, taking duplicate receipts for That the medical committee only are competent the same, and transmitting one of each to the Board to determine the expediency of accepting the resig of Treasury. nation of Doctor Rickman. No account is open in the public books against Doctor Rickman, but Ben October 21, 1780. 962 jamin Harrison Depy Pay Master General in the A letter, of 4, from W. Rickman, was read; Where Southern department has advanced considerable upon,113 sums of money, for the use of the Hospitals, and 112 This report is in the Papers of the Continental Congress, No. 114 This report, in the writing of Abraham Clark, is in the P a 22, folio 27. pers of the Continental Congress, No. 22, folio 29. 113 This letter is in the Papers of the Continental Congress, No. 115 Letter of Fallon, dated November 3, 1780, is in the Papers 78, X IX . folio 319. of the Continental Congress, No. 78, IX , folio 347. 348 Annals of Medical History that until the said Depy Pay Master General ren furnish the Purveyor with a sum of money. That it ders his accounts, no account with Doctor Rickman be referred to the Treasury to report a Warrant can be settled at the Treasury.116 without delay that will insure a speedy supply.120 November 24, 1780. 1090-1 December 8, 1780. 1128 The Medical Committee laid before Congress a That a warrant issue on Thomas Smith, commis letter, of 21, from Doctor Shippen, director [general], sioner of the continental loan office for the State of which was read; Whereupon, Pensylvania, in favour of Thomas Bond, Junior, [A motion was made by Mr. Duane, seconded by] purveyor of the hospitals, on the recommendation Ordered, That Doctor Shippen, director of the hos of the Medical Committee, for fifteen thousand dol pitals, [be directed to] repair to head quarters and lars, to be paid out of the proceeds of a bill of ex put himself under the orders of the Commander in change for two hundred dollars, part of those here Chief.117 tofore ordered to be drawn on the honorable Benja min Franklin, minister plenipotentiary of the United November 27, 1780. 1095 States at the Court of Versailles, at ninety days’ A letter, of this day, from Doctor Shippen.118 sight, to be placed in the hands of the commissioner aforesaid, by order of the Board of Treasury, to en able the said purveyor to make provision for some December 4, 1780. 1118 sick soldiers in immediate want in the barracks in A letter, of 30 November, from B. Binney, hos this city; for which sum the said Thomas Bond is to pital surgeon; and be accountable.121 One, of this day, from M. Maus, surgeon of the Ordered, That it be referred to the Board of invalid regiment, were read:119 Treasury, and that they report without delay, a warrant that will ensure a speedy supply of neces December 5, 1780. 1120 saries wanted for the sick and enable the physicians A letter, of 4, from D(avid) Jackson, hospital sur to perform their duty. geon, was read, requesting leave to resign: Ordered, That leave be granted. December 9, 1780. 1132 On motion of Mr. (Theodorick) Bland, a member December 6, 1780. 1125-6 of the Medical Committee, The Medical Committee, to whom were referred Ordered, That the purveyor and apothecary be the letters from Doctor Binney and Doctor Maus, directed to issue medicines and refreshments neces delivered in a report: sary for the transient sick which may be, from time The Medical Committee to whom was committed to time, under the care of Doctor Maus, as is done the letters from B. Binney and M. Maus beg leave in the general hospital, he making returns of such to report— sick in the manner directed in the hospital regula That on the 21st day of July last a warrant issue tions to the director, and signing receipts for such on the Treasury in favor of Dr. Jonathan Potts, stores as are issued to him. Purveyor of the Hospital for 200,000 dollars for pro Ordered, That Doctor Maus report to the com curing Hospital Stores, and paying the Physicians manding officer at the barracks such officers as are and surgeons in that Department, a part only of appointed to act under him as surgeon to the tran which Warrant, owing to a deficiency of money in sient sick, in case of misdemeanor, in order that the Treasury, hath been received— they be tried for misconduct or neglect of duty by That on the 6th November last a warrant issued a garrison court martial.122 on the Continental Loan Officer of the State of New Jersey in favor of Thomas Bond Jr. the present December 13, 1780. 1149 Purveyor for a certain sum of money for procuring A letter, of 6, from Doctor Bloomfield and Doc supplies necessary for the hospital, no part of which tor Scott, two hospital physicians, was read, enclos the Purveyor informs the Committee he hath been ing their commissions, and desiring that their resig able to receive. That on account of the failures in nations be accepted.123 obtaining money, the sick are in a suffering condi Ordered, That their resignations be accepted. tion; the physicians unable to proceed to their re spective charges, and the business of the Depart ment greatly impeeded in every part. December 26, 1780. 1194 That in order to procure supplies immediately A letter, of 7, from John Warren was read, signi wanted for the relief of the sick and to enable the fying his acceptance of the office of hospital physi Physicians to perform their duty, it is necessary to cian. 116 This report is in the Papers of the Continental Congress, No. 120 This report, in the writing of Abraham Clark, is in the P a 136, IV, folio 713a. pers of the Continental Congress, No. 22, folio 31. 117 This motion, in the writing of James Duane, is in the Papers 121 This report is in the Papers of the Continental Congress, No. of the Continental Congress, No. 36, IV, folio 499. 136, IV, folio 745. 118 Shippen’s letter is in the Papers of the Continental Congress, 122 This motion, in the writing of Theodorick Bland, is in the No. 78, X X , folio 575. Papers of the Continental Congress, No. 36, IV, folio 435. 119 Binney’s letter is in the Papers of the Continental Congress, 123 This letter is in the Papers of the Continental Congress, No. No. 78, IV, folio 97. 78, IV, folio 53. History of the A rmy M edical D epartment D uring the R evolution 349 EXPENDITURES FOR THE YEAR 1780124 the committee on the letter of 5 of November last, from General Washington, enclosing a memorial Hospital Department. Page 143. 260. 562. from the officers in the hospital department; and, 589. 648. Jonathan Potts, purveyor gen thereupon, came to the following resolutions: eral, &c. accountable:...... 376,900 Whereas, by the plan for conducting the hospital Page 330. Isaac Forster, deputy direc department, passed in Congress the 30th day of tor general hospitals, eastern department, September last, no proper establishment is provided accountable:...... 40,000 for the officers of the medical staff, after their dis Page 1 1 2 8 ...... 15,000 mission from public service, which, considering the And Page 1024, in new emission, 4,276 custom of other nations and the late provision made dollars. Thomas Bond, jun. purveyor gen for the officers of the army, after the conclusion of eral, &c. accountable:...... the war, they appear to have a just claim to; for remedy whereof, and also for amending several parts Total 431,900 of the above mentioned plan: Resolved, That all officers in the hospital depart STANDING COMMITTEES 125 ment, and medical staff, hereinafter mentioned, who shall continue in service to the end of the war, or Medical be reduced before that time as supernumeraries, 4 May, 1780. James Henry shall be entitled to, and receive, during life, in lieu 7 July, 1780. Abraham Clark in place of of half-pay, the following allowance, viz. Henry The director of the hospital equal to the half-pay 9 September, 1780. Theodorick Bland in place of of a lieutenant colonel: Holten Chief physicians and surgeons of the army and 23 October, 1780. Isaac Motte hospitals, [each equal to the half-pay of major] and hospital physicians and surgeons, purveyor, apothe January 3, 1781. 15 cary, and regimental surgeons, each equal to the A letter, of this day, from Doctor William Ship- half-pay of a [lieutenant] captain: [and regimental pen, director general of the hospital, was read, re mates each equal to the half-pay of a] lieutenant. questing leave to resign:126 That there be allowed to the purveyor, apothe Ordered, That his resignation be accepted. cary, and assistant purveyors, each, forage for one Two papers, signed Patrick Garvey, were laid be horse: fore Congress and read: That the power given in the before-mentioned Ordered, That the same be referred to the Medi plan, to the chief physician and surgeon of the army, cal Committee. to remove regimental surgeons and mates in case of absence without leave, shall in future extend no fur January 4, 1781. 20 ther than a power of suspension, until such delin . . . . A letter, of November 29, from Doctor quent shall be reported to a proper officer for bring Forster to the Medical Committee, were read:127 ing him to trial by court martial: That the apothecary may deliver medicines, in January n , 1781. 47-8 struments and dressings, and other articles of his Resolved, That Monday next be assigned for elect department, to the hospitals, on orders in writing ing a director [general] of the hospital, and a paymas from a physician and surgeon having the care of ter general to the army. any particular hospital, where the director or one Doctor J. Cochran was nominated by Mr. (James of the chief physicians and surgeons shall not be Mitchell) Varnum for the office of director [general]; present to give the same: Doctor Brown, by Mr. (Joseph) Montgomery; That the power given to the director and chief Dr. Craig, by Mr. (Abraham) Clark. hospital physicians, with respect to the appoint January 13, 1781. 56 ment of matrons, nurses, and other persons neces sary for the regular management of the hospitals, be Doctor J. Morgan was nominated by Mr. (George) extended to each of the physicians and surgeons of Walton, for the office of director of the hospitals. the hospitals, in the absence of the director and chief January 17, 1781. 65, 68 physicians and surgeons. Congress proceeded to the election of a director [That notwithstanding the prohibition against offi of the military hospital; and the ballots being taken, cers of the hospitals using any of the Stores provided Dr. John Cochran was elected, having been previ for the sick, the said officers may occasionally draw ously nominated by Mr. (James Mitchell) Varnum. out of the hospital Stores under their particular di Congress took into consideration the report of rection by written orders on the Stewards of the same, such small articles for their comfortable sub- 124 This Appendix appears only in the first edition of the Jour Ne tived sistence as they may stand in need of, nals, Vol. VI. (Claypoole imprint: See Bibliographical Notes No. 353.) The paging has been altered to correspond with the pages ° provided such articles are not imme of the present edition. diately wanted for the use of the sick: of which arti 125 See pages 1445-1447 of Vol. XV. I now give such appoint cles so issued, the Stewards shall keep regular ac ments only as were made in 1780. counts, charging each officer with the articles drawn 126 This letter is in the Papers of the Continental Congress, No. 78, X X I, folio 1. at the current price the same bears at that time, 127 Forster’s letter is in the Papers of the Continental Congress, which shall be deducted out of his pay in the settle No. 78, IX , folio 491. ment of his account, copies of which accounts, each 350 Annals of Medical History respective Steward, under obligation of his oath of February 8, 1781. 130 Office, shall transmit every six months to the Pur A letter, of 7, from B. Otto, physician and sur veyor, Which being charged in a general account by geon, was read; Whereupon, him, shall be lodged in the Treasury Office— Ordered, That the letter of Doctor Otto be refer That the Director, Chief Physicians of the army red to the Board of War to take measures for pre and hospitals, and other Physicians and officers in venting any interruption being given to the hospi the hospital department, as well those lately dis tal at the yellow springs, the same being provided missed from service, as those re-appointed in the solely for the reception of proper hospital subjects. last arrangement who were in office between the first day of Sept. 1777, and the 30th day of September February 16, 1781. 155 last, shall have the depreciation of money made The Medical Committee laid before Congress a good to them on their pay for such part of the above letter, of January 12, from Doctor J. Browne, acting mentioned time as they were actually employed in as surgeon general in the southern army, which was public service.]128 read: Ordered, That it be referred to the Medical Com January 25, 1781. 86 mittee. A letter, from Doctor Gould, was read: Ordered, That Mr. (William) Burnett be added Ordered, That it be referred to the Medical Com to the Medical Committee. mittee. February 19, 1781. 160 February 1, 1781. 103-4 A letter, of 3, from J. Cochran, was read, signify A letter, of 31 January, from Doctor Gould, was ing his acceptance of the office of director general of read: 129 the hospital.132 On motion of the medical committee, A memorial of John Bartlet was read:133 Resolved, That the purveyor of the hospital be, Ordered, That it be referred to the Medical Com and hereby is empowered and directed to collect, or mittee. cause to be collected and secured under care, until properly issued, all public hospital stores and medi February 22, 1781. 187 cines in Virginia, late under the direction of Dr. A letter, from Doctor B. Binney, was read:134 Rickman, or others acting under the United States, Ordered, That it be referred to a committee of and all persons in possession of such public stores three. or medicines, are hereby required to deliver the same February 24, 1781. 191 to the said purveyor, or his order, upon demand. On motion of the Medical Committee: [That the medical committee be authorised during Ordered, That a warrant issue on Thomas Smith, the absence of the director to direct a number of commissioner of the continental loan office for the the hospital physicians and mates to repair imme State of Pensylvania, in favour of Doctor Thomas diately to Virginia and take the charge of the hos Bond, purveyor of the hospital, for forty thousand pitals in that state.]130 dollars of the old emissions, to be applied towards A motion was made by Mr. (Theodorick) Bland, paying the officers of the medical department in seconded by (Mr. George) Walton, respecting the part of their salaries due since their appointment hospitals for the southern army: under the present arrangement, for which sum the Ordered, That it be referred to the Medical Com said purveyor to be accountable. mittee. February 27, 1781. 199 February 5, 1781. 115 A letter, of 10, from James Craig, chief hospital A letter, of 3, from Doctor B. Binney, was read:131 physician, was read: February 6, 1781. 118 Ordered, That it be referred to the Medical Com On motion of Mr. (Theodorick) Bland, mittee. Resolved, That Thomas Bond, jun. purveyor to March 3, 1781. 230 the general hospital, be, and hereby is, authorised The report of the committee on the letter of the to settle the accounts for salaries, and pay the offi 28th February from Dr. W. Burnet, was taken into cers of the hospital established in Virginia, under consideration; Whereupon, the direction of Dr. Gould, which have accrued Ordered, That Dr. James Craik, chief hospital since the new arrangement of the medical depart physician and surgeon, be, and he is hereby ap ment; and that Dr. William Rickman, late deputy pointed chief physician and surgeon of the army, in director, settle and return the accounts of salaries the room of Dr. J. Cochran, elected director of the due the officers of the said hospital, prior to that hospital; and that Monday next be assigned for date, to the present purveyor. electing a chief hospital physician and surgeon, in the room of Dr. Craik, removed to the army.135 128 This report, in the writing of Abraham Clark, is in the Pa pers of the Continental Congress, No. 19, VI, folio 331. 132 This letter is in the Papers of the Continental Congress, No. 129 This letter is in the Papers of the Continental Congress, No. 78, VI, folio 11. 78, X , folio 285. 133 Bartlett’s memorial is in No. 19, I, folio 241. 130 This motion, in the writing of Abraham Clark, is in the Pa 134 This letter, dated February 20, 1781, is in the Papers of the pers of the Continental Congress, No. 36, I, folio 121. Continental Congress, No. 78, IV, folio 89. 131 Binney’s letter is in the Papers of the Continental Congress, 135 This report, in the writing of Abraham Clark, is in the No. 78, IV, folio 93. Papers of the Continental Congress, No. 19, I, folio 473. History of the A rmy M edical D epartment D uring the R evolution 351 March 5, 1781. 233 having before he received the hurt in his arm de According to the order of the day, Congress pro clared repeatedly to the other officers of that depart ceeded to the election of a chief physician and sur ment that he was too old and infirm to perform the geon of the hospital, in the room of Dr. Craik, re duties belonging to that office and at his particular moved to the army; and, the ballots being taken, request exchanged with Dr. Thomas Tillotson an Dr. William Burnet was elected, having been pre Hospital Surgeon, That before he went home he ob viously nominated by Mr. (John) Witherspoon. tained a certificate from Dr. Potts and Dr. Treat recommending him for an appointment to any hos March 7, 1781. 237 pital that might be established near his own home. A memorial of Francis Hagan, a physician and That this notwithstanding, he repaired to the army surgeon in the hospital, was read;136 at the White Plains some time in the year 1778, but was not considered or treated as Physician and Sur March 14, 1781. 259 geon General nor did he do any of the duties of that The committee on Doctor B. Binney’s letter, of office, Dr. Tillotson having been appointed by Gen1 20 February: Gates in his room and being then with the army and The Committee to whom was referred the letter doing the duties of that office. of Doctor B. Binney on the 22d Feby. report, That That on the first of July 1779 Dr. Shippen the Doctor Binney’s services are useful and necessary late Director General at the particular request of in the medical department, and that he ought to be Dr. Bartlett’s friends directed him to repair to Fish retained in that department, Kill and superintend the Hospital at that place, That it is the opinion of the Committee Doctor where he accordingly came and the officers of that Binney should immediately repair to the State of Hospital refusing to do duty under him he request Virginia, according to the order he hath received ed and obtained permission from Dr. Shippen on from the Director General of the hospitals; and that the 28th September 1779 to return home, an order issue to the Treasury to furnish on account That he received pay for the time he was with the sum of forty thousand dollars of the old emis the northern army in 1777 and six months pay be sions of Congress, to enable him to bear the expences sides after he went home and also that he received of himself and two Mates, and to establish and fur three months pay for the time he was at Fish Kill nish hospitals in the said State.137 in 1779. Since which time your Committee cannot find that Dr. Bartlett hath either done duty or re March 16, 1781. 273 ceived pay. Upon which State of facts your Commit The Medical Committee also delivered in a re tee beg leave to report, port for arranging the hospital for the southern That Dr. John Bartlett, at his own request, and army. with the consent of the commanding officer of the The Medical Committee, to whom was referred department, and the deputy director and other offi the memorial of Doctor J. Bartlet: delivered in their cers thereunto belonging, left the service to which several reports. he was appointed, in a manner which clearly indi cated his intention of relinquishing his office; and March 19, 1781. 275-7 having received pay for all the time he spent with The report of the Medical Committee on the the army, and six months while he was at home, memorial of Dr. John Bartlett, late physician and cannot be entitled to any farther pay or allowance.138 surgeon general of the army in the northern depart ment, was taken into consideration; and it appear March 22, 1781. 292-4 ing, A letter, of January 14, from Major General The medical committee to whom was referred the Greene, was read, with sundry papers enclosed: memorial of Dr. John Bartlett late Physic11 and Ordered, That it be referred to the Medical Com Surgn Gen1 of the army in the northern department, mittee. beg leave to lay before Congress the following State The report of the Medical Committee, delivered of Facts respecting the memorialist. the 15, was taken into consideration, and it was That on the n th of April 1777 he was appointed thereupon resolved as follows: Physic11 and Surgn Gen1 to the army in the northern Whereas the late regulations for conducting the department, to which he repaired some time in July medical department and military hospitals passed following and with which he continued until the 23d the 30th day of September last, and amended by of October following when he was permitted by Gen1 several subsequent acts of Congress, extends no far Gates to return home on account of his inability to ther southward than to include the State of Virginia; perform the duties of the office by reason of the in and whereas the present operations of the war to firmities of age and more especially on account of the southward, make it necessary that the hospital an accidental injury received in his arm, That it department, in that district, be rendered as uni appears to your committee that at the time Dr. form to that in the northern army as circumstances Bartlett left the army it was generally understood will permit, that no inconveniences may arise to the that he had no design of returning to that post, he army in general from different and opposite sys tems, as its operations may eventually be inter 136 Hagan’s memorial is in the Pa-pers of the Continental Congress, changeable from one district to another in a short No. 41, IV, folio 173. space of time; therefore, 137 This report, in the writing of Meriwether Smith, is in the Papers of the Continental Congress, No. 19, I, folio 361. It is in 138 This report, in the writing of William Burnet, is in the P a dorsed: “ Aug. 24, 1781, not to be acted upon.” pers of the Continental Congress, No. 19, I, folio 229. 352 Annals of Medical History Resolved, That there be one deputy director of April 12, 1781. 375 the military hospitals, [in the Southern district sub On motion of the Medical Committee: ject to the general control of the director] who shall, Ordered, That a warrant issue on Thomas Smith, in the absence of the director, have the general commissioner of the continental loan office for the control and management of all the military hospitals State of Pensylvania, in favour of Thomas Bond, that are or may be established [to the Southward of junr, purveyor of the hospital, for thirty thousand Virginia] under the orders of the commander of the dollars of the old emissions, twenty thousand dol southern army for the time being. lars of which to be delivered to Nathan Brownson, When the foregoing resolution was under debate, deputy purveyor, to be applied to the use of the a motion was made by Mr. (John) Mathews, second hospitals established for the southern army and the ed by Mr. (Thomas) Bee, after the words “the di remaining ten thousand to be applied by the pur rector,” to insert “ for the southern army;” and on veyor towards the paying persons necessarily em the question, shall those words be inserted? the ployed in the general hospital northward of Virginia, yeas and nays being required by Mr. (Thomas) for which sum of thirty thousand dollars the pur B e e , ...... veyor to be accountable.140 So it passed in the negative. Resolved, That [within the] for the army aforesaid, April 13, 1781. 388 [district] there shall be one chief physician of the hos On motion of the Medical Committee: pital, who shall also be a surgeon; one chief physician Ordered, That a warrant issue on John Hopkins, to the said army, who shall also be a surgeon; two commissioner of the continental loan office for the hospital physicians, who shall also be surgeons; and State of Virginia, in favor of Thomas Bond, Junr., four surgeons’ mates for the hospitals; one deputy purveyor of the hospital, for five thousand dollars purveyor with an assistant, one deputy apothecary of the new emission, to be by him put into the with an assistant; and to each hospital, a steward, hands of Nathan Brownson, deputy purveyor, to matron, orderly men and nurses as is directed in the pay three months’ salary and wages due to the offi arrangement of the [northern] hospital, passed the 30 cers and others employed in the hospital established day of September aforesaid. for the southern army and to procure supplies for That the deputy director, deputy purveyor and said hospital, for which sum the said purveyor is to deputy apothecary, have and exercise the same be accountable. powers which are exercised by the director, pur veyor and apothecary respectively, agreeably to the April 30, 1781. 464 arrangement above-mentioned: A memorial of sundry officers late of the hospital That the pay of the deputy director be one hun staff was read:141 dred and forty dollars per month, that of the deputy Ordered, That it be referred to a committee of purveyor and deputy apothecary, each one hundred three: and twenty dollars per month; and they shall sever The members, Mr. (James) Duane, Mr. (William ally be entitled to the same emoluments, and sub Churchill) Houston, Mr. (Isaac) Motte. ject to the same regulations and restrictions as their respective principals are entitled or subjected to by May 2, 1781. 467 the above-mentioned arrangement and the amend Treasury Office, May 1st, 1781 ments thereto: The Board of Treasury upon the petition of Lieu That all the other officers of the hospital and med tenant Andrew Lee of Col. Hazen’s regiment refer ical staff for the southern [district] army, exercise the red to them 27th ultimo, beg leave to report to the same powers, perform the same duties, receive the United States in Congress Assembled, That for the same pay and emoluments, and be subject to the payment of the said L4. Lee’s account (inclosed in regulations and restrictions laid down in the afore the said petition) of expences incurred, from the said arrangement for officers of like description: time he was wounded at Springfield New Jersey in Provided nevertheless, that the powers therein June 1780 to the 3rd of January 1781 to the amount directed to be exercised by the director, and any of 3820 dollars old emissions, a warrant issue on two chief physicians and surgeons of the hospital, Thomas Smith Esq. Commissioner of the Continen shall, in the absence of the deputy director, be vest tal Loan Office for the State of Pennsylvania in ed in and exercised by the next officer in the hospi favour of Dr. Thomas Bond purveyor of the Gen tal department for the southern army, and so on in eral Hospital for 3820 dollars of the old emissions to succession, in conjunction with the two next enable him to pay the account of the said Iieut4. Lee, seniors.139 for which sum the said Dr. Thos. Bond is to be ac countable.142 March 27, 1781. 316 Ordered, That a warrant issue on Thomas Smith, The United States in Congress assembled pro commissioner aforesaid, in favour of Thomas Bond, ceeded to the election of a deputy purveyor of the purveyor of the general hospital, for fifty dollars and hospital for the southern army, and, the ballots be eighty-four ninetieths of a dollar of the new emis- ing taken and counted, Dr. Nathan Brownson was elected, he having been previously nominated by 140 This report, in the writing of Abraham Clark, is in the Pa Mr. (Samuel) Adams. pers of the Continental Congress, No. 22, folio 37. 141 This memorial, dated April 22, 1781, is in the Papers of the Continental Congress, No. 41, VII, folio 292. 139 xhis report, in the writing of Theodorick Bland, is in the 142 This report is in the Papers of the Continental Congress, No. Papers of the Continental Congress, No. 22, folio 33. 136, V, folio 289. History of the A rmy M edical D epartment D uring the R evolution 353 sion, to enable him to discharge the account of Lieu paid to Joseph Eaker late Surgeons Mate to the tenant Lee for expences incurred from the time he Hospital on discharge of the pay and rations due was wounded at Springfield, New Jersey, in June, the said Eaker as appears by the aforesaid Certified 1780, to the 3 January, 1781, for which sum the acct.145 said Thomas Bond, purveyor, is to be accountable. May 28, 1781. 570 May 4, 1781. 475 Ordered, That the Medical Committee be discon Ordered, That Mr. (John) Witherspoon be added tinued, and that the Committee lodge with the to the committee on the memorial of sundry officers Board of War all the returns and papers in their pos late of the hospital staff; session, and then be discharged; and that the busi May 23, 1781. 529 ness heretofore entrusted to them, and the powers with which they were invested, be transferred to the The report from the Medical Committee was read; Board. Whereupon, The Medical Committee report, July 11, 1781. 624-5 That the Purveyor has certified to them that A report from the Board of War, on the letter from there is due to Dr. Peter Fayssoux for his pay as the director (of the hospitals, was read; Whereupon, Physician and Surgeon General of the Hospitals in Ordered, That the sum of eight thousand five the Southern Department, a balance of 2599 dollars hundred and forty five dollars and one-third of a therefore submit the following resolve: dollar in specie or [Bills of the new Emissions] Ordered, That a warrant issue in favour of Thomas other money equivalent, be immediately put into Bond, purveyor of the hospitals, for one thousand the hands of the purveyor of the military hospitals dollars of the new emission to be by him paid to in part of the estimate laid before Congress by the Doctor Peter Fayssoux in part of his arrearages of medical committee, to enable him to purchase an pay, to enable the said Doctor P. Fayssoux to re immediate supply for the use of the sick, and to pair to the southern army [to take charge of the prepare for the immediate exigencies of the cam hospital].143 paign in the hospital department: May 25, 1781. 534 That the sum of sixteen thousand one hundred That so much of the letter, of 25, from J. Coch and sixteen dollars, in specie or [Bills of the new ran, director general, as respects the hospital sur Emissions] other money equivalent, be advanced to geons, stores and farther appointments, be referred the said purveyor, for three months’ pay, to be to the Medical Committee; paid by him on account to the officers of the That such parts of the same as respects deprecia medical department: tion and the pay of surgeons be referred to the That a warrant be drawn on the treasurer of the Board of War; and State of New York, for six thousand dollars, and That such parts of the same as respects the post another warrant on the treasurer of Virginia for four age of letters to and from surgeons be referred to thousand dollars, in specie or [Bills of the new Emis the committee on the Post Office; sions] other money equivalent, in part of the above That the resignation of Doctor Hagan be accept sum of sixteen thousand one hundred and sixteen dol ed; 144 lars, in favour of the said purveyor or his order; and that the residue, viz. six thousand one hundred and May 25, 1781. 541 sixteen dollars be paid him at Philadelphia, in specie Resolved, That Dr. James McHenry receive the or [Bills of the new Emissions] other money equiv commission of major in the army of the United alent: States, to take rank from the 30th of October last: That four thousand two hundred dollars, in specie or [Bills of the new Emissions] other money equiva May 26, 1781. 544 lent, be paid to the said purveyor, to be put into The Medical Committee; delivered in their re the hands of stewards at established hospitals, to spective reports. purchase milk and vegetables and discharge small The Medical Committee report that from a Cer incidental charges at fixed hospitals).146 tified account of Joseph Eaker, Surgeon’s Mate, That the Treasury Board be and they are hereby under the hands of Doctor William Shippen, late p d directed to devise ways and means for supply- Director General and Thomas Bond Purveyor, and ^ ing the foregoing sums of eight thousand five a letter from the said Joseph Eaker, referred to hundred and forty five and one third, six thousand them, it appears to your Committee that the said one hundred and sixteen, and four thousand two Eaker has been lately released from captivity where hundred dollars. he had remained for seven months, that he is in That all vacancies of regimental Surgeons and much distress, and that there is due to him the said Mates in any regiments of the several State Lines Eaker on account of pay and rations £444- 13s- 3d be filled up by the respective States in whose Lines —-Your Committee therefore report, that a warrant the vacancies shall happen in the same manner with issue in favour of D' Tho? Bond, Purveyor of Gen vacancies happening in the Line of the State. eral Hospital for a sum equal to £444- 13s- 3d to be That all vacancies of regimental Surgeons and 148 This report, in the writing of Theodorick Bland, is in the 145 This report, in the writing of Theodorick Bland, is in the Papers of the Continental Congress, No. 19, II, folio 267. Papers of the Continental Congress, No. 19, II, folio 191. 144 Copies of extracts from Cochran’s letter are in the Papers of 146 The portion in parentheses was entered in the Journal by the Continental Congress, No. 78, VI, folios 33-35. George Bond. 354 Annals of Medical History Mates happening in regiments or Corps not belong shire Regiment hath represented to the Board, that ing to the Line of any State be filled up by the Di he was taken prisoner by the enemy (at the time rector or Deputy Director of the Hospitals with the Col. Greene was killed) and stripped of all his cloth Army in which such regiments or Corps shall serve ing. He hath since obtained his parole, for a limited the said Director or Deputy Director reporting the time to procure some necessaries. He further repre same to the Commander in Chief or commanding sents that he hath received but two months’ pay in General of a separate Army that information there twenty, that before he belonged to this regiment he of may be given to the Board of War who shall was mate in the General Hospital, and there ap fill up Commissions accordingly. pears due to him by Doctor Bond’s certificate for The filling up the vacancies in the Medical De that service £101.5. specie, which sum there is no partment we leave to the wisdom of Congress with provision made to pay, and he further saith, that this observation that the Director represents to us he is at this time destitute of cash. Upon consider that this measure is necessary.147 ing the foregoing representation, the Board submit the following resolution: June 18, 1781. 668 Ordered, That the Board of War draw on the pay Ordered, That the Board of War report a plan of master general in favour of Robert Henry, surgeon succession to vacancies in the hospital and medical of the second New Hampshire regiment for one lines of the army. hundred and ninety-five dollars of the new emis June 22, 1781. 690 sions on account of his p ay;152 a n d ...... The Committee of the Week report, September 20, 1781. 979-81 That the memorial of G. Glentworth, W“ Smith The report of the Board of War respecting the and James Fallon, supernumerary senior physicians hospital department was taken into consideration; and surgeons of the general hospital for themselves and Thereupon, and in behalf of other supernumeraries praying At a Board of War September 17th, 1781. “ That Congress will please to grant them, in com Present Mr. Peters mon with supernumerary judges advocate, regimen Mr. Cornell tal surgeons and chaplains, their depreciation and The Board do themselves the honor to report to half pay” ought to be referred to a special Commit Congress on the medical department, and beg leave tee.148 to observe that they have taken every measure in July 3, 1781. 718 their power to procure the necessary information to enable them to do justice to the United States as The committee of the week made report; Where well as individuals. upon, First. For settling the line of promotions in the Ordered, That a letter of this day from Doctor medical staff they have obtained a plan fixed by a James Tilton be referred to the Board of Treasury Board of General Officers under the orders of the to take order thereon to settle depreciation and Commander in Chief with his approbation, Copies grant a certificate as prayed; 149 of which No. 1 and 2 are enclosed, the plan they beg July 17, 1781. 756 leave to recommend to be established by Congress A report from the Board of War was read; Where as reported by the General Officers for a rule of pro upon, motion in the medical staff in future. Resolved, That the Board of War be authorised to Secondly. In consequence of General Greene’s Re draw on the paymaster general in favour of Captain quest for assistance in the Medical Department, Patrick Cams of Lieutenant Colonel Lee’s legion, they have consulted the Commander in Chief on the for two hundred and ten dollars in bills of the new propriety of filling up the vacancies under the Di emission;150 and of Doctor Morris, surgeon of Colo rector General and requesting him to send the neces nel Armand’s legion, for two hundred and twenty- sary assistance to the Southern Army. He was not five dollars in bills aforesaid in part of their pay, and able to determine the question, but on his arrival at for which sums they are respectively to be account the head of Elk he obtained Dr. Craik’s opinion on able.151 that subject which is contained in the enclosed paper No. 3, but as it appears from the tenor of Dr. Coch July 24, 1781. 785 ran’s letter to the Board (an extract of which is en A report from the Board of War was read; Where closed in No. 4) that he entertains different senti upon, ments, the Board take the liberty to recommend to War Office, July 24, 1781 Congress that appointments be made agreeable to Sir, Dr. Cochran’s recommendation contained in the en Robert Henry, Surgeon of the 2nd New Hamp- closed paper No. 5 to serve with the main army and 147 This report is in the Papers of the Continental Congress, No. its dependencies. And those contained in Doctor 147, V, folio 273. It is indorsed: “ August 23, 1781, not to be Oliphant’s recommendation contained in the en acted upon.” closed paper No. 6, to be appointed for the Southern 148 This report, in the writing of Thomas Rodney, is in the Pa Army under the Command of General Greene. pers of the Continental Congress, No. 32, folio 177. 149 This report, in the writing of Samuel Livermore, is in the The Board are the more induced to recommend Papers of the Continental Congress, No. 32, folio 185. the appointment of those Gentlemen to the South 160 This clause is in the Papers of the Continental Congress, N o . ward as it appears to them absolutely necessary 148, II, folio 49. 151 This clause is in the Papers of the Continental Congress, No. 152 This report is in the Papers of the Continental Congress, No. 148, II, folio 55. 148, II, folio 85. H istory of the A rmy M edical D epartment D uring the R evolution 3 55 they should be with the army immediately and October 16, 1781. 1055 could they possibly be spared from their quarter a Ordered, That Thursday next be assigned for considerable sum of money must be advanced to electing a deputy purveyor for the military hospi defray their travelling Expences which it is to be tal, in the room of Doct Brownson, who is elected feared would cause a considerable delay.153 governor of Georgia. Resolved, That the present vacancies of hospital physicians and surgeons be filled up by the senior October 25, 1781. 1072 surgeons of the hospital lately deranged, the eldest A report from the committee of the week was hospital mates or regimental surgeons, as shall be read; Whereupon, recommended by the director and chief physician The Committee of the week report, and surgeon to the army: That a letter of Robt. Johnson Deputy Purveyor That all future vacancies of hospital physicians of the Southern Department requesting relief for and surgeons be filled by the eldest regimental sur the Gentlemen of his Department; the Petition of geons and hospital mates, who shall be reckoned of Capt. Joseph Traversier praying for the pay and equal grades, who shall upon examination be found subsistance due to him; the letter of R. G. Living qualified and obtain a certificate of recommendation ston praying for so much pay as will enable him to from the director and chief physician and surgeon join his Regt-; the Petition of Thomas Bond and of the army, or of the deputy-director and chief others officers of the medical Department; the Peti physician in a separate department: tion of John Dealy praying for a discharge from the That the persons requisite to fill the higher grades army; the Letter from Doctor Hailing requesting in the hospital and medical departments, be ap the pay due to him, and to know whether he is con pointed, from time to time, by Congress, according sidered as retiring from the service; be referred to to merit and abilities: the Board of War. [That the states shall nominate regimental surgeons November 3, 1781. 1092, 3-8 to the regiments of their respective lines, who shall be examined by the director and chief physician A memorial and petition of Barn: Binney was and surgeon to the army and one of the chief read.156 hospital physician or of the deputy director and of The committee to whom the letters from the su the chief Physician in a separate department, and perintendent of finance relative to the hospital de upon their certificates of approbation shall receive partment; and tfie appointment.] The committee to whom the letters from the Su That all surgeons to regiments or corps not be perintendent of Finance relating to the Hospital De longing to the line of any particular State, be nomi partment was referred do report that they have fully nated by the director of the hospitals, and the chief considered the present state of the Hospital or Medi physician and surgeon of the army, subject to the cal Department in the Army, and the several papers approbation of the Commander in Chief, and shall referred to them, and having taken the best advice be equally entitled to promotion to hospital physi and information in their power are of opinion that cians and surgeons with the regimental surgeons of great economical advantages to the public and very states lines.154 useful alterations to the sick and wounded, may be On recommendation of the director approved by obtained by a regulation of the said Department in the Board of War: the following principles. By destroying all distinctions between Hospitals Resolved, That Dr. Joseph Young, a deranged and forming the whole Medical Department into senior surgeon, and doctors Goodwin Wilson, Daniel one uniform Corps. Jenifer, Samuel Edmondson and George Campbell, By establishing the direction of practice and Pur- eldest surgeon’s-mates, be promoted to the rank of veyorship entirely distinct and separate vesting it hospital physicians and surgeons, to fill the vacan in different hands. cies occasioned by the resignations of doctors Bloom By establishing the Superintendance of the De field, Scott, Hagan and Jackson, and the promotion partment in a Board of Surgeons, properly organized of Dr. Burnet. for that purpose and not in a single person. On the recommendation of the deputy director, By the promoting the use of regimental Hospitals, approved by the Board of War: and preventing the crowding the sick together in Resolved, That doctors Thomas Tudor Tucker, General Hospitals. and Vickars, be appointed physicians and surgeons By preventing every person concerned in Hospi in the hospital for the southern department: tals from trading and speculating in any manner That Daniel Smith be appointed assistant deputy whatever for private advantage and emolument. purveyor, and John Carns assistant deputy apothe By reducing the number of Surgeons and Mates cary, in the southern department.155 of the General Hospitals. Under the influence of these principles your Com 163 This report is in the Papers of the Continental Congress, No. mittee beg leave to Report the following Ordinance 148, II, folio 259. for constituting and arranging the Hospital Depart 154 A copy of this report of the Board of General Officers, refer red to, in the Board of War report, as No. 2, is in the Papers ment. of the Continental Congress, No. 148, II, folio 269. An Ordinance for regulating the General Hospital, 155 A copy of the recommendation of the director (John Coch and Surgeons of the Army. ran) dated June 4, 1781, is in the Papers of the Continental Con gress, No. 148, II, folio 273; a copy of the recommendation of 156 This memorial and petition, dated November 3, 1781, is in the deputy director (David Olyphant) is on folio 263. the Papers of the Continental Congress, No. 41, I, folio 375. 356 Annals of Medical History Be it ordained by the United States in Congress Every Surgeon shall direct his own hospital agree Assembled, That there shall be one Physician in able to the regulations, from time to time adopted Chief to the Army and Director of the Military Hos by Congress or the Medical Board, and communi pitals: [Thirteen] Twelve Surgeons and twenty [six] cated to him by the Director. He is hereby author four Mates, for the General Hospital, a Surgeon ized to order from the Purveyor or his Assistant, or and one Mate to every regiment; an Apothecary and from the Commissaries and Quarter Masters of the two Assistants; and a Purveyor and one assistant. Army, or to be purchased from the neighborhood, The Physician in Chief and the hospital Surgeons whatever is necessary and convenient for the sick: or any three of such Surgeons shall make a Medical and shall be accountable for his conduct and success Board, of which a field Officer to be appointed in in practice, to the director; but shall not be dis the usual form shall sit as President; it shall meet missed the service without due form of trial. regularly once a month, by General order, or often- When two or more Surgeons are on duty in one er if requisite. They shall examine regimental and hospital, each shall act independently with respect examine and appoint all hospital Mates; and shall to all matters relating to his own particular charge, examine and recommend the [regimental and] hospital and shall be accountable to the director only, or the Surgeons, [and none but those recommended by the Surgeon presiding in his stead. In case of dispute, Board shall be appointed by Congress to vacancies,] with regard to any matter respecting the whole hos and no person under the age of 21 years shall be ap pital, the Surgeon of senior appointment shall con pointed a Mate: It shall be the special duty of the trol, until the matter in dispute can be decided by said Board from time to time, to settle the propor the Director, or in his absence, the presiding Sur tions of regimental and hospital practice, and to geon. make regulations accordingly. They shall prescribe The regimental Surgeon shall give diligent atten the measures for supplying the sick effectually with tion to such regulations as may be established re medicines, stores, provisions &c. It shall also be specting their conduct, and shall manage the sick of their duty to make out proper estimates for the their respective regiments accordingly: and shall also Purveyor, inspect his accounts and transactions, be accountable to the Physician in Chief as the com and regulate his plan of issues so as to prevent mon head of the Medical Department. waste and extravagance. As often as required, the The Hospital and regimental Mates shall observe Director shall report to the Board a full state of all the director of the Surgeons, and shall diligently per the Hospitals under his direction, and receive their form all the reasonable duties required of them, for Instructions. This Board shall enquire into all com the recovery of the sick. They shall also make out plaints brought against Officers of the Department: returns of the sick, for the Surgeons respectively, and present to a Court Martial, such as they may agreeable to such forms as the director shall re think deserving of censure. And this Board shall be quire. authorized to digest rules and carry into execution, The Apothecary and his Assistants shall receive, every thing relative to the Medical Department: prepare and deliver Medicines, Instruments and Provided nevertheless, that no regulation of theirs dressings, and other articles of his department, to be valid and take effect until issued in orders, with the hospitals and Army, on orders, in writing, from the consent and approbation of the Commander in the director or Surgeons. He shall appoint a proper Chief or the Commanding Officer of a separate De number of Mates to assist him in his duty, and shall partment. furnish one to every Hospital, where one is required The Physician in Chief and Director shall have a by the Director. general Superintendency and direction of practice, All the Instruments delivered by whose order so both in Camp and in hospitals. He shall always ever obtained, shall be paid for, at prime cost, by maintain an office near Head Quarters, so as to be the Surgeon or Mate receiving them. ready, at all times, to consult and advise with the The Purveyor shall provide all necessary medi Commander in Chief: and to distribute the neces cines, utensils and stores of every kind, that may be sary advice and direction to the Surgeons with whom ordered by the Medical Board, for the delivery of it shall be his duty to correspond. With the concur which a written order from the Director of a hospi rence of the Commander in Chief he may establish tal Surgeon shall be his voucher. It shall also be his such Hospitals as service requires: and he shall dis duty to pay all the Officers of the Hospital and every pose of the officers necessary to conduct them. In debt and expence of the sick after being duly certi time of engagement or any emergency, he shall call fied. For these purposes he shall draw money from into the field as many hospital Surgeons as the occa the Treasury agreeable to the estimates given him sion requires; and by order of the General, may by the Medical Board. He shall settle his accounts have assistance in hospitals, from the regimental of expenditure in money every three months, with Surgeons. the Auditors of accounts, and once a month, he It shall also be the special duty of the Director, shall lay a state of the expenditure of stores with the frequently to inspect all the hospitals under his di stock on hand, before the Medical Board. rection; to see that they are managed with economy The Purveyor shall direct the conduct of his As and success: to correct all abuses; to suspend and sistant, and by advice and order of the Medical bring to trial, delinquent Officers: and to make Board shall appoint such other Assistants, Store monthly returns of the sick to the Commander. keepers and Clerks as the service may require. In the absence of the Director from Camp, the In every hospital the purveyor or his Assistant shall Surgeon eldest in appointment, who is present, shall appoint a steward: whose duty it shall be to pur do his duty. chase vegetables, straw and other small articles, to H istory of the A rmy M edical D epartment D uring the R evolution 357 receive the stores and provisions for the use of the That no officer or other person in the hospital or hospital and deliver them agreeable to the orders of Medical Department except the sick or wounded, the prescribing Surgeons. And although in his pur be permitted to use any of the stores provided for chases and Issues he is to obey the orders of the the sick. prescribing Surgeons: yet for the faithful discharge That the Physician in Chief, the Surgeons of the of his Office, he is to be accountable to the Purveyor, Hospital, Purveyor, Apothecary, Assistant Purveyor and for this purpose he shall keep separate accounts and Assistant Apothecary be appointed and Com of all he receives from the Purveyors, Quarter Mas missioned by Congress. The Regimental Surgeons ters and Commissaries, and of what he purchases and Mates to be appointed as heretofore. himself from the country; and shall render an ac That all the Officers in the Hospital or Medical count of all his Issues monthly, with his stock on Department shall be subject to trial by Courts Mar hand, to the Purveyor; thus to enable the Purveyor tial for all offences in the same manner as officers of to lay the whole monthly expence of the hospital, the Line of the Army. before the Medical Board. The Steward’s vouchers That the pay and establishment of the Officers of shall express not only by whom ordered, but by the hospital Department and Medical Staff be as whom received also. The Steward shall also receive follows, payable in silver Spanish Milled dollars a the spare regimental arms, accoutrements and 7/6 a dollar [or other money equivalent.] cloathing of each soldier admitted into the Hospi Physician in Chief and Director of the Military tal keeping entries of and giving receipts for every Hospitals 125 dollars per month 2 rations for him Article received, which when the soldier shall be dis self and 1 for his servant per day and forage for 2 charged, shall be accounted for by the said Steward, horses. with the Commanding Officer of the regiment to Surgeons of the General Hospital 90 dollars per which such soldier belonged, or other proper person, month and 2 rations per day and forage for two and shall also take charge of the hospital cloathing. horses. In every Hospital, the director or Senior Surgeon Purveyor and Apothecary each 100 dollars per present, shall appoint a Matron and a proper num month. ber of nurses to be under the direction of the pre Assistant Purveyor and Apothecary 50 dollars scribing Surgeons, and paid by the Purveyor. per month each. During the summer, when the Army is in the Regimental Surgeons each 60 dollars per month, field, the Director shall institute a flying or field 1 ration per day and forage for one horse. Hospital, in the rear of Camp, and appoint proper Surgeons’ Mates in Hospitals 40 dollars per month Surgeons to take direction of it, considering it al and 1 ration per day. ways as a branch of the General Hospital and to Do. in the Army 40 dollars per mo. and 1 ration have one common regulation and interest with it. per day. One Surgeon at least, whom the General may Steward for each Hospital 30 dollars per mo. and choose, shall always reside near head Quarters, to 1 ration per day. attend the General and Staff Officers, and to be in That none of the aforesaid Officers or other per readiness for any emergency when a division or de sons employed in and of the Hospitals be entitled to tachment of the Army is sent off, or in any manner rations of provision or forage, when on furlough. becomes a distinct and separate body from the Main That the Physician in Chief be allowed a two Army, the Medical board shall nominate its propor horse covered wagon for transporting his baggage. tion of Medical Staff of which the Surgeon eldest in That the same allowance be made to the afore appointment shall preside, with all the powers of said Officers for retained rations as is allowed to Physician in Chief and director; and shall form a officers of the line of the army; and also that each Medical board, to be authorized as before men of them be annually entitled to draw Cloathing from tioned: and when two Armies unite, having each a the Stores of the Cloathier General in the same man separate Board, one shall dissolve of course by di ner and under the same regulations as are estab rection of the Commanding Officer of the whole. lished for Officers of the Line by a resolution of Con When Officers of the Line do duty in hospitals, gress of the 25 Nov. 1779 and in like manner as has the Medical board shall make rules for their conduct, heretofore been used. that they may not interfere with the Surgeons, and That the several Officers above mentioned (ex they shall receive their instructions by General cept Stewards) shall at the end of the War be en order. titled to a provision of Land in the proportions fol That the Quarter Master General furnish the hos lowing viz: Physician in Chief to have the same pital Department, from time to time, as occasion quantity as a Brigadier General; the Surgeons, Pur may require with such a number of horses and wag veyor and Apothecary of the Hospital the same as a ons as may be necessary for removing the sick and Colonel; Regimental Surgeons and assistants to the wounded and for transporting the hospital stores, Purveyor and Apothecary the same as a Major; Hos but that no other horses than those [allowed to be pital and regimental Surgeons’ Mates the same as a kept by] for which forage may be herein allowed to Captain. the Officers of the Department, be kept separately That all former arrangements of the Hospital De and at the expence of the Department. partment and all resolutions heretofore passed touch That no officer or other person employed in the ing the same be repealed.157 hospital or Medical Department shall on any ac count whatever, be concerned in trade for his pri 167 This report is in the Papers of the Continental Congress, No. vate emolument and advantage. 22, folio 45. 3 5 8 Annals of Medical History December 20, 1781. 1182 of physician, with the pay and emoluments hereto (Note) A memorial of George Glentworth and fore allowed to a chief hospital physician: others, supernumerary physicians and surgeons of That the number of surgeons to all the military the general hospital, was presented this day and re hospitals of the United States, be reduced so as not ferred to the Secretary at War, as the indorsement to exceed fifteen: shows. It is dated December 17, 1781, and is in the That the director have the general superintend- Papers oj tbe Continental Congress, No. 41, III, ance and direction of all the military hospitals, and folio 483. of practice both in camp and in hospitals: That in the absence of the director, his duty de December 24, 1781. 1183 volve on the deputy director or physician, and in An ordinance respecting the hospital department their absence on the hospital surgeons, according to was read the first time: seniority: Ordered, That Wednesday next be assigned for That the director, or in his absence the senior the second reading of this ordinance. medical officer, with the approbation of the Com mander in Chief, or commanding general of a sep STANDING COMMITTEES 158 arate army, be, and hereby is authorized and em powered, as often as may be judged necessary, to Medical call a medical board, which shall consist of the three 16 February, 1781. William Burnett senior medical officers then present; and it shall be the duty of such board to appoint all hospital mates, January 3, 1782. 4-7 to examine all candidates for promotion in the hos On a report of the Secretary at War, to whom pital department, and recommend to the Secretary was referred a memorial of Dr. Glentworth and at War such as they judge best qualified; and gen others: erally to take cognizance of, and give their opinion Resolved, That it be, and hereby is recommended and advice on every matter relative to the depart to the State of Pensylvania, to settle the balance of ment, which may be submitted to them by the pay and depreciation due to Doctors G. Glent Commander in Chief, or commanding general of a worth, W. Smith, J. Fallon, S. DufField and S. Hail separate army: provided always, that no regulation, ing, late physicians and surgeons in the general hos plan or order of the board, shall be valid and take pital, on the same principles they settled with the effect, until approved by the Commander in Chief, other physicians and surgeons of the army, citizens or commanding general of a separate army, and is of that State.159 sued in general orders: On a report of a committee, consisting of Mr. That all returns heretofore ordered to be made (Abraham) Clark, Mr. (Ezekiel) Cornell and Mr. by the director or deputy director, to the medical (Isaac) Motte, to whom was referred an arrange committee, be made to the Secretary at War: ment of the medical department: That the stewards may, in the first instance, when The Committee to whom was referred the ordi the purveyor or his assistant is at a distance, be ap nance respecting the Hospital Department, beg pointed by the director or senior medical officer, but leave to report— shall be removeable at pleasure, and others substi That they have considered the same, and are of tuted in their stead, by the purveyor or his assist opinion that any ordinance for a new establishment ant. And although in their purchases and issues, of the hospital, (on) the plan proposed, is unneces they are to obey the order of the prescribing sur sary and at this time for many considerations im geons, yet for the faithful discharge of their duty, proper they have therefore returned the same in they are to be accountable to the purveyor, who the manner they received it.— Your Committee are shall in like manner be accountable to the United nevertheless of opinion that sundry alterations and States. Wherefore, the said stewards shall keep sep amendments are necessary to be made to the plan arate accounts of all they receive, and of what they for conducting the General Hospital, passed on the themselves purchase; and shall render an account 30th day of September, 1780, and accordingly have monthly of all their issues, with their stock on hand, herewith submitted such alterations and amend to the purveyor, who shall render the said accounts, ments for the consideration of Congress, in case together with a particular account of the supplies they shall be of opinion with the Committee, that a furnished by himself or his assistants to each re new regulation of the Hospital by an Ordinance is spective hospital, once every three months to the at this time unnecessary or improper.— Superintendant of finance: Resolved, That for the more regular conducting That the Secretary of War be, and he is hereby the general hospital, the offices of chief physician empowered and directed, on or before the first day and surgeon of the army, and of chief hospital phy of February next, and hereafter, from time to time, sician, be, and hereby are abolished; and that the as the service may require, to arrange the depart chief physician and surgeon to the army, eldest in ment agreeably to the foregoing resolutions, and to appointment, be continued in service, under the title issue his orders to such as he thinks proper to re main, paying a due regard in his first arrangement 158 See pages 1229 and 1230 of Vol. X V III. I now give such ap to such of the chief physicians and surgeons as may pointments only as were made in 1781. 169 This report is in the Papers of the Continental Congress, No. Resolved, That the Comptroller be and he is hereby directed 149, I, folio 63. So far as Hailing is concerned it superseded the to adjust the accounts of Doctor Hailing for pay and deprecia following resolution sent to Congress by the Secretary at War tion on the same principles as the accounts of Doctor Allison December 18: were settled. This resolution is on folio 53. H istory of the A rmy M edical D epartment D uring the R evolution 359 choose to continue in service in the rank of sur hereby, authorized and directed to settle the depre geons, and in his subsequent arrangements to such ciation of pay of officers in the late general hospital, of the senior officers as may choose to remain in who resigned or became supernumerary as aforesaid, service: and who do not belong to any particular State, in That such of the officers as shall not be called the same manner as hath been provided for the into service agreeably to the foregoing resolution, officers of the late Colonel Hazen’s regiment. be considered as reduced by Congress, and be en Ordered, That the account of Dr. Frinke, for tak titled to the emoluments granted by the Act of Con ing care of the sick and wounded in the retreat from gress of the 17 January, 1781: Ticonderoga, in 1777, and for furnishing supplies for That when by reason of vacancies or otherwise, the same, be returned to Dr. Frinke, and the settle any officer hereafter to be appointed in the hospital ment suspended, until authentic vouchers shall be department, and whose appointment is reserved to produced respecting such services and expendi Congress, [it shall be the duty of the secretary at tures.161 war to recommend the person or persons best quali February 26, 1782. 100 fied, provided that, in the recommendations for director, deputy director and physician] due regard (Note) On this day, according to the indorsement, be paid to the officers next in rank; and that the a memorial of Joseph Eaker, of the same date, was appointment of hospital surgeons be from among read. It is in the Papers of tbe Continental Congress, the regimental surgeons and hospital mates; pro No. 41, III, folio 71. vided that no regimental surgeon shall be so ap April 10, 1782. 179 pointed, who shall not have submitted himself to an That the petition of L1 Morris praying for a set examination by the medical board, and obtained tlement of his accounts, incurred by his being or from them a certificate that he is well qualified for dered to take the charge of an hospital in Litchfield the office of regimental surgeon, by which certificate in Connecticut, be referred to the Superintendent of the regimental surgeon shall be considered as sup Finance.162 erior in rank to an hospital mate, but not otherwise. Resolved, That the director, deputy director, phy April 23, 1782. 209 sician, surgeons and mates, as well hospital as regi War Office, March 23rd, 1782. mental, receive their pay out of the military chest, Sir, at the same time and in the same manner as the There are frequent applications for the discharge army with which they serve; the abstracts to be of soldiers whose wounds and sickness incapacitate signed by the director, deputy director or physician, them for all farther duty even in garrison. They pre or in their absence by the senior hospital surgeon; fer a dismission from the service, which shall entitle and the warrants to issue in the same manner as for them to a pension equal to half of their pay, to be the pay of the army.160 ing classed with the invalids where full pay and every emolument of a soldier would be continued to February 20, 1782. 81-2 them. The committee, consisting of Mr. (Abraham) Was public economy the only consideration in Clark, Mr. (Ezekiel) Cornell, Mr. (Thomas) Mc this matter, there would not I think remain a doubt Kean, to whom were referred the report of the Sec respecting the propriety of adopting this mode of retary at War, on a petition of Dr. Hagan, and the discharge generally. But as it becomes necessary memorials of Dr. Jackson, Dr. Williams, Dr. Eaker, equally to guard against future inconveniences as to and Dr. Frinke, delivered in a report; Whereupon, Resolved, That the comptroller be, and he is here 161 This report, in the writing of Abraham Clark, is in the Pa by, authorized and directed to adjust the accounts pers of the Continental Congress, No. 22, folio 65. Eaker’s memorial, dated February 18, is in No. 41, III, folio of all the officers of the late general hospital for pay 69; Hagan’s, undated, is in No. 41, IV, folio 193; Jackson’s, dated and subsistence, up to the time the arrangement took January 28, is in No. 41, IV, folio 426. place in [October] September, 1780, or for so much The Secretary at War’s report is in No. 149, I, folio 119, and of the preceding time as they continued in service, is as follows: War Office, January 16th, 1782. upon their producing proper documents of the time Sir, of their respective services. Resolved, That it be, and hereby is, recommend On the petition of Dr. Francis Hagan referred, the following 1 resolve is submitted to the consideration of Congress: ed to the legislatures of the several states, to settle That the Comptroller be and he is hereby authorized and di and discharge on account of the United States, the rected to adjust the account of Dr. Francis Hagan late Physi depreciation of pay of such officers in the late gen cian and Surgeon in the General Hospital for pay and deprecia eral hospital as are inhabitants of, or belong to their tion in the same manner as have been provided for the officers of General Hazen’s Regiment. respective states, who resigned their appointments The following report, without date, is in No. 149, I, folio 117: after the 10th day of April, 1780, or became super There being a number of officers who by former acts of Con numerary by the new arrangement in [October] gress are entitled to pay or additional pay, and who cannot ob September, 1780. tain a settlement of the depreciation due thereon from the re spective States of which they are Inhabitants. Resolved, That the comptroller be, and he is Therefore, Resolved, That the Comptroller be directed to set tle the accounts of all such officers on the same principles as he wo This report is in the Papers of the Continental Congress, No. settled with the officers of Colonel Hazen’s Regiment. 22, folios 43 and 63. The paragraphs preceding the resolutions 162 This report, in the writing of Joseph Montgomery, is in the are in Abraham Clark’s writing, the rest is in that of Charles Papers of the Continental Congress, No. 32, folio 347. It is un Thomson. dated but belongs to this period. 360 Annals of Medical History accommodate the wishes of individuals I beg leave on the 10th instant and that the surgeon be entitled to submit the following resolve, which as it only re [from that day to receive the same emoluments as spects those whose private circumstances will en heretofore allowed to surgeons and mates retiring able them when discharged to live independent of under the resolves of the 3d and 21st October 1780] any other gratuity than their pension, I think will to all the emoluments heretofore allowed to reduced obviate the possibility of an imputation against the regimental surgeons.164 public that they have dismissed such of their ser vants as could be no longer useful without provi June 6, 1782. 319 sion being made to prevent them suffering individ Congress proceeded to the election of a deputy ually or becoming burthensome to the societies purveyor for the southern hospital; and, the ballots where they might live. being taken, Dr. N. Brownson was elected, having [Congress came to the following resolutions:] been previously nominated by Mr. (William) Few. Resolved, That all such sick and wounded soldiers of the armies of the United States, who shall in fu (June 10, 1782.) 322 ture be reported by the inspector general, or the in (Report of Secretary at War, on the arrangement spector of a separate department, and approved by of the Hospital Department.) the Commander in Chief, or commanding officer of War Office, June 7th, 1782. a separate department, as unfit for farther duty Sir, either in the field or in garrison, and who apply for I have, in obedience to the orders of Congress, a discharge in preference to being placed or con conferred with the Superintendant of Finance on the tinued in the corps of invalids, [and who can give report of your Committee respecting the Hospital authentic proof that they either have the means to Department and find it is agreeable to him— support themselves, or that their friends will provide As the Purveyor wishes that the Officers acting for them and prevent them becoming burthensome immediately under him should be of the same grade to the society where they really belong or reside. — he requests that he may be allowed to appoint In that case all such persons shall be discharged, three clerks, one of whom will have the charge of and be entitled to receive as a pension, [the value of the store to be kept near the Army— half their pay,] five dollars per month, in lieu of all He also requests that there may be no distinct al pay and emoluments. lowance of subsistence for himself and the Apothe Resolved, That it be, and hereby is, recommend cary, but that the sum intended as subsistence be ed to the several states to discharge such pensions added to their pay— annually, and draw on the Superintendant of finance I wish the Purveyor’s requisitions may be com for the payment of the money they shall advance plied with and that the system, as it will then stand, And that the foregoing resolution take effect so should be adopted 165 soon as the Superintendant of the Finances shall sig nify to the several states, that he has made provi July 23, 1782. 408-12 sion for answering such draughts.163 On the report of a committee, consisting of Mr. (Joseph) Montgomery, Mr. (Abraham) Clark, and May 3, 1782. 235 Mr. (David) Ramsay, to whom were recommitted On a report from the Secretary at War: their report respecting the hospital department, and the amendments and observations thereon by the War Office, May 3rd, 1782. Secretary at War: Sir, Resolved, That in conducting the business of the To the two companies of Artificers now in this general hospital, there shall be an invariable stand City (making the whole about fifty men) there are ard of prices established by which the apothecary attached a Surgeon and a Surgeon’s mate. As part shall be charged with every article (received into his of these companies will be detained in this town, department, and at which he shall be credited for part are now at Fort Pitt, part will be sent to Vir every article)166 he shall issue the standard to be es ginia and part of them will join the army under tablished by the medical board, or such person or General Greene, this dispersion will render it un persons as they shall appoint, which shall only be necessary to retain the Surgeon and mate longer in considered as a certain ratio whereby to keep the the service. accounts; but that, in the settlement of all accounts Should Congress be of this sentiment, and deem in that department, all deficient articles, not issued some compensation due to their past services they or returned, shall be accounted for at such real will please to resolve, value as shall be estimated by the medical board, Resolved, That as the dispersed situation of the and approved of by the Secretary at War. corps of artificers commanded by Captain Wyley, An account shall be taken as soon as possible, of will no longer require the services of Dr. A. McCos- all the medicines, instruments and property in the key, surgeon, and Dr. W. McCoskey, his mate, they be considered as reduced and retiring from service June 5 from General W. Smallwood, enclosing one of same date from Lieutenant Levacher de Vaubrun, asking for a furlough to 163 This report is in the Papers of the Continental Congress, No. visit France. They were referred to the Secretary at War. Gen 149, I, folios 161-163. eral Smallwood’s letter is in No. 161, folio 183, and de Yaubrun’s 164 This report is in the Papers of the Continental Congress, No. is in No. 78, X X III, folio 191. 149, I, folio 303. Also a memorial dated June 5 from Oliver Hanchett was re 165 This report is in the Papers of the Continental Congress, No. ferred to the Secretary at War. It is in No. 149, I, folio 447. 22, folio 81. The indorsement says it was read on this date. 186 The words in parentheses are in the report but not in the On June 10, according to the indorsement, was read a letter of Journal. H istory of the A rmy M edical D epartment D uring the R evolution 361 apothecary’s department belonging to the public, [one] two to the purveyor, shall hereafter be discon in the hands of the apothecary, the deputies, assist tinued.167 ants, and mates, the surgeons of hospitals, and sur [The committee to whom was referred the letter of geons of regiments, for which they shall severally the Secretary of War respecting the rank of the sur be charged at the standard value ascertained by geons in the hospital department submit the follow the board as aforesaid, and for all they may here ing resolutions:] after receive, but to account for deficiencies at the That all surgeons of the hospital shall take rank real value, to be estimated as aforesaid. after the director of the hospital, deputy director The apothecary shall be accountable for all arti and physician to the army, in the following order, cles in his department to the purveyor throughout viz. those surgeons of the hospital, who have been the states, until they come into the hands of the either deputy director, physician general, surgeon prescribers; and all deputies, assistants, and mates, general, chief physician, or chief surgeon to the hos shall make returns, and be accountable to the pital or army, shall take rank next to the above apothecary for the medicines, instruments and other mentioned officers: and their relative rank to each property belonging to the public in the department, other shall be according to the date of their respect now in their hands, and of such as they may here ive appointments to either of the above offices. after be possessed of. That all such as were regimental surgeons, when The apothecary shall make up his accounts at the appointed senior physician or surgeon to the hospi expiration of every year, and settle them as soon tal, shall take rank with such senior physicians and after as possible, and before the expiration of six surgeons, agreeably to the date of their first appoint months. He shall, at the same time, make out two ment, whether to the regiment or hospital. returns for the director of the hospital, one specify All surgeons, the date of whose first appointments, ing what has been received and issued, and the either to regiments or hospitals, shall have been on amount of what remains on hand; the other exhibit the same day, shall decide their rank by lot. ing a particular amount of the value of the medi [That the pay and subsistance of the officers of the cines, and other public property, each prescriber has Hospital department and medical staff be as fol received within the year. lows: All losses which may happen by the events of Director of the Hospital 122 dollars per month war, and other circumstances unavoidable, shall be four rations per day for himself and servants, for borne by the public. In cases of losses by fraud or age for two horses and twenty-five dollars per month neglect in any deputy, assistant or mate, the apothe subsistance. cary shall not be accountable for such losses, pro Deputy Director and Physician each 117 dollars vided the delinquent be convicted thereof before a per month three rations per day for himself and Ser court-martial appointed to try the same. vants, and forage for two horses, and twenty dollars The hospital prescribers shall be supplied, upon per month Subsistance. their own application, with medicines and instru Hospital Surgeons each 965/6 dollars per month ments necessary for the sick and wounded under two rations for himself and servant forage for two their care. horses and fifteen dollars per month Subsistance. Every regimental surgeon shall receive yearly Purveyor and Apothecary each 105 dollars per from the apothecary, a supply of medicines to such month, one ration and forage for one horse, and fif amount, by the above standard, as the medical teen dollars per month subsistance. board shall judge necessary. Deputy purveyor and Deputy apothecary each Every prescribing surgeon or physician, either in 101 5/6 dollars per month, one ration, and forage for hospital or with the army, shall be supplied by the one horse, and ten dollars per month Subsistance. apothecary with such a set of capital instruments Hospital Mates each 45 dollars per month, one as the medical board shall judge necessary, and shall ration per day, and five dollars per month Subsist be accountable for all losses in medicines and in ance. struments not arising from the events of war and Stewards each 30 dollars per month, one ration other circumstances unavoidable. Duplicates of all per day and five dollars per month Subsistance. returns made by the apothecary to the director, shall Ward Masters each 23 dollars per month, one ra be lodged in the war office. tion per day and three dollars per month Subsist Resolved, That in the army of the United States, ance. excepting the southern army, at present under the That all former Acts of Congress, so far as re command of Major General Greene, the offices of spects the pay Subsistance rations and forage grant assistant purveyor, and assistant apothecary, and ed to the before mentioned Officers, shall be and the storekeepers under the purveyor and apothecary, they are hereby repealed.]168 except one storekeeper under the purveyor to keep That for the more convenient subsistance of the a store near the army, and all the clerks, except officers of the hospital department, they be allowed, 167 The recommitted report had it:...... “ and all the clerks except two to the purveyor one of whom to have the care of the In the Papers of the Continental Congress, No. 22, folio 79, on store near the army and all the mates of the apothecary except a separate sheet in Charles Thomson’s hand, is a copy of this three be hereafter discontinued.” part of the report relating to pay and subsistence, with the fol 168 The recommitted report allowed 119 dollars per month to lowing variations in amounts: deputy director 111 dollars per the director; 116 75/100 dollars to the deputy director and phy month; hospital surgeons 93K dollars per month, three rations sician; 93 45/90 dollars to hospital surgeons, three rations for for himself and servant; purveyor and apothecary 106}^ dollars himself and servant and 15 dollars for subsistance; 106 60/90 per month; deputy purveyor and deputy apothecary 101K dol dollars for purveyor and apothecary. lars per month. 362 Annals of Medical History including their former allowance of rations and for The first is whether he is entitled to half pay al age as follows: lowed to other retiring hospital officers of his rank The director of the hospital, four rations a day — the second whether he is entitled to pay for his for himself and servants, forage for two horses, and attendance on the hospital in Virginia, and the third twenty-five dollars per month subsistance. what allowance will be made for his expences while The deputy director and physician, each three ra attending the sick in Charlestown. tions a day for himself and servants, forage for two There cannot be a doubt with respect to the first. horses, and twenty dollars per month subsistance. The resolves of Congress of the I7td of January 1781 Hospital surgeons, each two rations per day, for fully secure to him the half pay allowed to other himself and servant, forage for two horses, and fif officers of his rank as he was not deranged until the teen dollars per month subsistance. 15td of May following. Deputy purveyor and deputy apothecary, each On the second question I would observe that by one ration per day, forage for one horse, and ten the resolves of Congress passed May 15*? 1781 it dollars per month subsistance. is ordered that all officers of the Medical depart Hospital mates, each one ration per day, and five ment appointed under the directorship of Doctor dollars per month subsistance. Olyphant who were then in captivity in South Caro Ward masters, each one ration per day, and three lina and Georgia, and had the charge of sick prison dollars per month subsistance. ers in those States be continued in their respective That the above allowance of rations, forage, and offices as heretofore— and be considered as vested subsistance to the officers of the hospital depart with the same privileges and emoluments as they ment, over and above what they severally were en had enjoyed before their captivity, to extend no far titled to, at the time of passing this act, shall be ther than to the troops and hospitals within the charged to them respectively, as advances in part enemy’s lines. of their monthly pay. The Continental Hospitals on the first of July, That in the future the pay and allowance of the 1781, removed from Charlestown to Williamsburg purveyor and apothecary be the same each as that in Virginia. The hospital was there continued under of a hospital surgeon. the care of Doctor Tucker by order of the Marquis That none of the aforesaid officers, or other per de la Fayette as the sick could not at that time be sons employed in any of the hospitals, be entitled to removed into the country. The Commander in chief, rations, forage or subsistance, when on furlough. on his arrival in Virginia, directed the gentlemen in That the regulation respecting officers’ servants, the Medical Department from South Carolina to do contained in the Act of Congress of the n th day of duty in the general hospital at Williamsburg. These March, 1780, shall not be construed to extend to the are facts which appear from the enclosed papers. hospital department.169 With respect to the last question which relates to an allowance for the extraordinary expences while October n , 1782. 645 detained in Charlestown attending the hospital, I Pursuant to the resolution of the 27 of February suppose they were necessarily great, but he has not last, the Superintendant of finance reports, that he rendered any account of them. has appointed Mr. Edward Fox, a commissioner for On the whole of his request I beg leave to submit settling the accounts of the hospital department, to the consideration of Congress the following draft desiring to be favoured with the orders of Congress of a resolve, if they should disapprove the appointment.170 That Doctor Thomas T. Tucker, late a senior November 12, 1782. 722 Surgeon of the hospital under the directorship of Doctor Olyphant, enjoy all the emoluments of his The Committee of the Week, (Mr. Ralph Izard, office from the date of his appointment to the time Mr. Ezra L’Hommedieu, Mr. William Hemsley) re he retired from actual service in the hospital in Vir port, That the petition of Etienne Halbon on behalf ginia, and that a reasonable compensation be made of his wife, setting Jortb that there is £12, 10s due to him for his extra expences while acting as senior Sur her from the general hospital for wages as the resi geon in Charlestown after its surrender.172 due of her pay while nurse in the hospital [as by Dr. Binney’s certificate directed to Dr. Bond, Jun., December 3, 1782. 759 doth appear] be referred to the [Superintendant of Finance] Secretary of War.171 Resolved, That after the fore-mentioned period, in lieu of the pay and rations allowed to the officers of November 25, 1782. 752 the hospital department, including rations for ser War Office, Novr 23rd, 1782. vants, they shall be entitled to the following month Sir, ly pay and subsistance; provided in like manner, The request of Doctor Tucker referred to me in that where the said subsistance money shall not be volves three questions. 170 This report is in the Papers of the Continental Congress, No. 169 This report, in the writing of a clerk, except the part in 137, I, folio 817. parentheses which is in Abraham Clark’s writing, is in the Papers 171 This report, in the writing of Ralph Izard, is in the Papers of of the Continental Congress, No. 22, folios 69 and 85. The report the Continental Congress, No. 32, folio 413. It was passed this day, was delivered May 15, and on May 30 was referred to the Sec as the indorsement shows. retary at War to confer with the Superintendent of finance to 172 This report is in the Papers of the Continental Congress, No. report, and recommitted. A copy of the recommitted report is 151, folios 39-43. It is indorsed: Recommitted That the secretary in No. 22, folio 73. The few changes made in their report by the may include in the resolution all those in similar circumstances Committee are noted. The portion in parentheses was not in the and to report a reasonable allowance for expenses while in recommitted report. Charlestown. H istory of the A rmy M edical D epartment D uring the R evolution 363 paid, they shall be entitled to draw an equivalent officers than what they may receive by annexing number of rations, at the rate of four dollars for themselves to the Corps of Invalids. each ration per month, viz. This is distressing to the individuals, and expen The director, one hundred and two dollars pay sive to the public. and sixty dollars subsistance. I beg leave to suggest the propriety of permitting The deputy director and physician, each one hun those officers, who have been wounded in service, dred dollars pay and forty-eight dollars subsistance. and who wish to leave the army, to retire to their re The surgeons, each ninety dollars pay and forty spective homes with allowances proportioned in dollars subsistance. some measure to their inability.175 Apothecary and purveyor, each ninety-two dol lars pay and thirty-two dollars subsistance. March 22, 1783. Deputy apothecary and deputy purveyor, each That all officers belonging to the hospital depart fifty-nine dollars pay and sixteen dollars subsist ment, who are entitled to half pay by the resolution ance. of the 17th day of January, 1781, may collectively Mates, each forty-two dollars pay and twelve agree to accept or refuse the aforesaid commutation, dollars subsistance. signifying the same through the Commander in Stewards, each thirty-one dollars pay and eight Chief within six months from this time: that [the dollars subsistance. deranged] such officers [what] as have retired at dif Ward masters, each twenty-one dollars pay and ferent periods, intitled to half pay for life, [shall be eight dollars subsistance.173 intitled to the same commutation] may collectively, in each State of which they are inhabitants, accept or BIBLIOGRAPHICAL NOTES refuse the same; their acceptance or refusal to be sig nified by agents authorised for that purpose, within January 3, 1782. 885 six months from this period; that with respect to such Hospital Department. retiring officers, the commutation, if accepted by 375. By the United States in Congress assembled, them, shall be in lieu of whatever may be now due January 3, 1782. to them since the time of their retiring from service 4.0 Broadside in two columns. as well as of what might hereafter become due; and Report of Clark, Cornell and Motte. A copy is in the that so soon as their acceptance shall be signified, John Carter Brown Library. It measures 20.5 x 21 cm. the Superintendant of Finance be directed to take measures for the settlement of their accounts accord July 23, 1782. 887 ingly, and to issue to them certificates bearing in Hospital Department. terest at six per cent. That all officers intitled to 384. By the United States / in Congress assem half pay for life not included in the preceding reso bled, July 23d, 1782. / lutions, may also collectively agree to accept or Resolved, / That in conducting the business of the refuse the aforesaid commutation, signifying the General Hospital, . . . same [by their agents authorized for that purpose] F°. Broadside of two columns. within six months from this time.176 Report of Montgomery, Clark and Ramsay. A copy is in the Library of Congress, Washington Papers. It measures March 26, 1783. 40.5 x 30.5 cms. Resolved, That Dr. Charles Mortimer’s account be February 28, 1783. settled for pay and rations on the same principle as The committee of the week (Mr. William Hemsley, a junior surgeon, for the term of nine months, dur Mr. Benjamin Hawkins, and Mr. Phillips White) ing which he appears to have been in the public ser report: That the memorial of Charles Mortimer of vice: Virginia Doctor of Physic, praying payment of his That the director-general in the hospital depart account, and the usual wages and rations allowed ment, take order for delivering to Dr. Mortimer a to others; for attending the hospital at Fredericks quantity of medicines equal to what he has expend burg^ for nine months be referred to a special com ed in the public hospital.177 mittee.174 March 31, 1783. March 6, 1783. War Office, March 27th, 1783. War Office, March 5*?, 1783. Sir, Sir, On the petition of the late sergeant Menerson re There are many officers, who have been wounded ferred to me, I beg leave to report that there are in the service of the United States, who are thereby more than twenty thousand men who have similar rendered incapable of farther duty either in the field pretensions to be supplied with clothing from the or in garrison, and who wish to retire from the army. No other provision has been made for such 175 This report is in the Papers of the Continental Congress, No. 149, II, folio 315. According to the indorsement it was referred 173 This report, in the writing of Alexander Hamilton, is in the on this day to Mr. (Alexander) Hamilton, Mr. (Richard) Peters Papers of the Continental Congress, No. 21, folio 309. and Mr. (Daniel) Carroll. See ante, December 19, 1782. 174 This report, in the writing of William Hemsley, is in the Pa 176 This report, in the writing of Alexander Hamilton, is in the pers of the Continental Congress, No. 32, folio 449. The indorse Papers of the Continental Congress, No. 21, folios 332 and 315. ment gives at this date. The memorial is in No. 41, VI, folio 297. The vote was transcribed by Thomson on the report. It was referred, the indorsement states, to Mr. (John Lewis) 177 This report, in the writing of Hugh Williamson, is in the Gervais, Mr. (Hugh) Williamson, and Mr. (Theodorick) Bland. Papers of the Continental Congress, No. 19, IV, folio 445. 364 -Annals of Medical History United States, and with whose claims it is alto tain the different classes above described, ]and to gether impossible to comply. report a list of them respectively to Congress.] If it shall appear upon a Surgeon’s examining his That the officers who shall retire on full pay, may wounds, that he has been thereby incapacitated at their option collectively accept in lieu of such from earning his bread, I would beg leave to recom full pay for life the amount of years full pay [in mend him to the provision made for disabled sol money or securities] on the terms of the resolutions diers by the resolves of Congress of April 22nd, of the last. 1782.178 That at the reduction of this Corps all the officers and men shall receive one month’s pay and shall April 22, 1783. share in any further payments which may be made On the report of a committee, consisting of Mr. to the other parts of the army when reduced.181 (Oliver) Ellsworth, Mr. (Hugh) Williamson and Mr. (Abraham) Clark, to whom was referred a letter of May 12, 1783. 22 June, 1781, from Dr. George Gilmer: That the accounts of Doct. Jonathan Arnold be Resolved, That the account of Dr. G. Gilmer for liquidated and settled by the commissioner for set pay and rations, be settled on the same principles as tling the accounts of the hospital department, who the accounts of other hospital surgeons of the same is hereby authorised to allow him pay and rations as rank, according to the time he shall appear to have an Assistant Deputy Director General in the said de been employed in the public service; and that the partment from the 7 day of Jany. 1778 the time to purveyor general return to Dr. George Gilmer a d v. r which his accounts were settled by quantity of medicine equal to what he expended Recommitted ^ State of Rhode IsIand> t0 the out of his private stores, for the use of the conti of May 1779 when he was discharged, charging him nental hospital under his care.179 with the monies advanced him for the use of that Department by the State of Rhode Island and cred April 30, 1783. iting the said State for the same in account with On a report from the Superintendent of Finance, the United States. to whom was referred a letter of the 17th from That the claim of the officers of a Brigade raised Darius Stoddard: in the State of Rhode Island in Feby., 1779 for one Ordered, That the commissioner for settling the year, with the approbation of Congress, for depre accounts of the hospital department, adjust and ciation of their pay, is inadmissible, no allowance of liquidate those of Dr. Darius Stoddard.180 that kind having been made or approved by Con gress to any officers or soldiers discharged from ser May 1, 1783. vice before the 10th of April 1780.182 Resolved, That the corps of Invalids be reduced, such officers as have lost a leg or been [otherwise] equal May 16, 1783. ly disabled in service to retire on full pay for life, [or Resolved, That the Commissioner for settling the at their option collectively to the amount of seven accounts of the Hospital department be and he is years full pay in gross] such officers as may not be in hereby authorized and directed to audit and settle cluded in this description to retire on [half pay for life] the accounts of Dr. Jonathan Arnold, as Assistant the same principles with other officers of the army, Deputy Director in the Eastern Department from such non commissioned officers and soldiers as be 7th January, 1778, to May 9th, 1779, as well for ing strangers in the country and having been dis all supplies and expenditures as for pay and rations, abled in service are incapable of providing for their and that he also settle the accounts of all those who own subsistence and are proper subjects for a hos were necessarily employed in hospital service by pital, to be received into some fixed hospital, to be ap the said Dr. Arnold within the term aforesaid. That propriated for the purpose, and there supported dur their pay and other allowances be the same as by ing life on such provision as may be hereafter deter the resolutions of Congress are allowed to those of mined, to be entitled in the meantime to their usual similar stations in the hospital department. And rations and cloathing; and such non commissioned that the said commissioner allow in such settlement officers and soldiers disabled in service as may have for depreciation upon all advances and sums due to homes to which they can retire, to be discharged on each respectively, with an interest of six per cent, the principles of the resolution of the 23rd of April per annum from the times they became due.183 last. That the Secretary at War be directed to take May 23, 1783. proper measures previous to the reduction to ascer That the petition of William Stevens and others, mates to the general hospital in the Southern de- 178 This report is in the Papers of the Continental Congress, No- 149, II, folio 407. According to the indorsement it was read on this day. pers of the Continental Congress, No. 19, I, folio 179. The indorse 179 This report, in the writing of Hugh Williamson, is in the ment states that it was reported this day, and on “ September, Papers of the Continental Congress, No. 19, II, folio 417. 9, 1785, Arnold’s accounts referred to the committee for set iso Tin8 order is in the Papers of the Continental Congress, No. tling hospital accounts. This to be filed.” See post, June 10. 137, II, folio 387. 183 This motion, in the writing of Jonathan Arnold, is in the 181 This report, in the writing of Alexander Hamilton, is in the Papers of the Continental Congress, No. 42, VI, Folio 485. Com Papers of the Continental Congress, No. 31, folio 273. The indorse mittee Book, No. 186, gives it this date. It was referred to Mr. ment states that it was delivered this day. (Oliver) Ellsworth, Mr. (Hugh) Williamson, and Mr. (John 182 This report, in the writing of Oliver Ellsworth, is in the Pa- Lewis) Gervais. See post, June 10, 1783. H istory of the A rmy M edical D epartment D uring the R evolution 365 partment, praying to be allowed half pay or com United States with the State of South Carolina who pensation be referred to a special committee.184 will enter it in those accounts to the Credit of the United States. Office of Finance 8 July, 1783.187 June 10, 1783. Resolved, That the commissioner for settling the July 23, 1783. accounts of the hospital department audit and set On the report of a committee, consisting of Mr. tle the accounts of Doc!- Jonathan Arnold, as as (Richard) Peters, Mr. (Abraham) Clark, and Mr. sistant deputy director in said department from the (Stephen) Higginson, to whom was referred a report 7th day of Jany. 1778 to the 9th day of May 1779, of the Superintendant of finance, on a petition of as well for all supplies and expenditures as for Mrs. Grace Mercer: pay and rations charging him with the monies ad The Committee to whom was referred a memorial vanced him for the use of said department by the of Mrs. Grace Mercer, relict of Mercer, late State of Rhode Island and crediting the said State Purveyor of the hospital in South Carolina, report, for the same in account with the U. States, And that That the time when the particular purpose for he also settle the accounts of all those who were which the said money was received or the reason necessarily employed in hospital service by the said why the same was not applied to the use intended Doctor Arnold within the term aforesaid, and that do not appear; and as a permission granted to pub their pay and other allowances be the same as by the lic Officers to return paper money received at peri resolutions of Congress are allowed to those of simi ods of depreciation would establish a Precedent lar stations in the said department.185 which may be productive of many ill consequences July 4, 1783. Your Committee are of opinion, The committee of the week, (Mr. William Ellery, Ordered, That the superintendant of finance trans Mr. Jacob Read and Mr. Jonathan Arnold) report mit to the commissioner for settling the accounts of that the petition of the Rev? William Plumb late the hospital department, a copy of the memorial of chaplain to the Northern Hospital praying for an Mrs. Grace Mercer, and in the settlement of the adjustment and payment of his accounts be read in accounts of the late Mr. Mercer, due enquiry be Congress with the papers accompanying the same. made by the said commissioner, into the causes of That the petition of Grace Mercer Widow of the detention of the money therein mentioned; and Richard Mercer Esqh late of Charles Town in the that the said commissioner report the result of such State of South Carolina deceased Purveyor to the inquiry to the superintendant of finance, who is Hospitals of the army of the United States in the hereby authorised to take order therein as shall ap said State of South Carolina be referred to the Su pear to him just, on such report being made.188 perintendent of Finance to report.186 August 5, 1783. July 11, 1783. The Superintendant of Finance to whom was re The Superintendent of Finance to whom was re ferred the Petition of Grace Mercer, widow of Rich ferred the petition of Grace Mercer Widow of Rich ard Mercer Esqh Purveyor to the Hospitals of the ard Mercer Esq^ Purveyor to the Hospitals of the United States in South Carolina, begs leave to re United States in South Carolina begs leave to re port. port That if, as is alledged, the paper money therein That if, as is alledged, the Paper Money therein mentioned remained in the Hands of the said Rich mentioned remained in the Hands of the said Rich ard Mercer from the time in which he received it ard Mercer .from the time in which he received it until his Death and from that time to the present in until his Death and from that time to the present the hands of his widow the Delivery of it ought to in the Hands of his widow the Delivery of it ought discharge the said Richard Mercer’s estate in ac to discharge the said Richard Mercer’s Estate in count with the United States from the value which account with the United States from the value which so much money was of at the time it was received so much money was of at the time it was received by him— and the Delivery of the said money into by him. And the Delivery of the said Money into the State Treasury of South Carolina ought in like the State Treasury of South Carolina ought in like manner to discharge the United States from the like manner to discharge the United States from the like value in account with the said State. value in account with the said State. That the commissioner for settling the Hospital That the Commissioner for Settling the Hospital accounts will therefore on proper Proof made to Accounts will therefore on proper Proof made to him of the facts above stated receive the said money him of the Facts above stated receive the said money and Credit the same in the account of the said Rich and credit the same in the account of the said Rich ard Mercer and will transmit the money and the ard Mercer and will transmit the money and Proof Proof to the commissioner for settling the accounts to the Commissioner for Settling the accounts of the of the United States with the State of South Caro lina who will enter it in these accounts to the Credit 184 This report, in the writing of Thomas Fitzsimmons, is in the Papers of the Continental Congress, No. 42, V, folio 290. Stevens’ 187 This report is in the Papers of the Continental Congress, No. petition is in folio 287. The indorsement shows the action taken. 137, II, folio 607. The indorsement shows that it was read this 185 This report, in the writing of Oliver Ellsworth, is in the day and on July 16 referred to Mr. (Richard) Peters, Mr. (Abra Papers of the Continental Congress, No. 19, I, folio 181. The in ham) Clark and Mr. (Stephen) Higginson. dorsement states that it was delivered and read this day. 188 This report, in the writing of Richard Peters, is in the Pa 186 This report, in the writing of Jacob Read, is in the Papers pers of the Continental Congress, No. 19, IV, folio 55. The in of the Continental Congress, No. 32, folio 509. dorsement states that it was passed on this day. 366 Annals of Medical History of the United States. Office of Finance, 31 July, To be entitled to draw each a ration of provisions 1783.189 per day, but to no other allowance. The invalids to receive one dollar per month, and August 12, 1783. the provisions and cloathing of a common soldier The committee, consisting of Mr. (James) Mc during life. Henry, Mr. (Hugh) Williamson and Mr. (Abraham) The total expence of this es- 359,530 Clark, to whom was referred a petition of Dr. Dirk tablishment [if complete] as Van Ingen, praying that depreciation may be al N o t quite reduced in peace, would lowed him in the settlement of his account, report, exact but amount to about . . . [531,950] “ That as Dr. Van Ingen, who served for some very near Deduct the product of the years as surgeon, in the continental hospital, ap the truth manufactories which is esti pears by his petition to have [resigned or to have mated a t ...... 131,950 been left out of promotion] been reduced as a super numerary before the 10th of April, 1780, [deprecia $227,580 tion, therefore, cannot be allowed him without de Balance an annual charge parting from the rule hitherto adopted and opening k upon the United States192 . [400,000] an account which may occasion much trouble and October 31, 1783. be a precedent for a variety of claims of officers in different departments,] and as no depreciation [to The Secretary at War reported, that the following officers in every department] has been allowed to lines, corps and individuals, have agreed to accept officers who left the service before that period, [has the commutation of five years’ pay, in lieu of the been constantly refused,] Dr. Van Ingen’s claim can half pay for , as appears by the papers ac not be admitted without infringement of the rule companying his report: .... established by Congress.” 190 . . . . hospital department, and Dr. Tilton, Dr. Bodo Otto, Dr. Frederick Otto, Dr. Martin. September 2, 1783. November 4, 1783. The committee of the Week (Mr. Jacob Read, Mr. The Committee to whom was referred the letter Abiel Foster and Mr. William Ellery) on considera of Major General Lincoln of the have ex tion of the petition of Ebenezer Augustus Smith for amined the list of bills drawn by him whilst com merly a Surgeon in the General Hospital praying manding in the Southern Department, and find suf that depreciation may be allowed him, report as ficient vouchers to support charges against the Com their opinion that the request of the said Ebenezer missary of purchases, the Quarter Master, the Cloth Augustus Smith being similar to that of D? Dirk ier, the Pay Master, Purveyor of the Hospital and Van Ingen lately determined by Congress can not the Navy, for five millions four hundred and twenty be granted without infringing the rule established four thousand one hundred and nine dollars; and by Congress of the io1? day of April 1780.191 that bills to a considerable amount are yet out September 10, 1783. standing, which when presented for payment ought also to be charged to the Departments in whose The same reason which makes it proper to have favor they were respectively drawn. Wherefore your two Serjeant Majors &c. in each Regiment of In Committee submit the following resolution: fantry, will make it equally necessary to have two Resolved, That Major General Lincoln be credited, Surgeon’s Mates, in the books of the treasury, the sum of five mil October 23, 1783. lions four hundred and twenty four thousands one hundred and nine dollars, and that the several de No Regiment to be allowed to draw rations for partments be charged with the amount of the bills more than four women to serve as nurses in the drawn in their favor. And that all such bills as may Regimental Hospitals and to receive four dollars per hereafter be presented for payment, be charged to month in addition to a ration per day. the departments in whose favor, from the face of General Hospital the bill, they shall appear to have been drawn; and A general hospital for the reception of the inval that Major General Lincoln be credited for the ids of the army and navy will be necessary to con amount thereof.193 sist for the present of the following persons: 1 Director to have at the same time the Super June 2, 1785. intendance of the Regimental Hospitals . .8 0 Resolved, That those officers of the hospital de 1 S u r g e o n ...... 50 partment in the southern army, who were detained 4 M a t e s ...... each 25 in Charleston, after its surrender to the British 1 Purveyor andAp o th e c a r y ...... 50 troops, for the purpose of attending the sick and 1 S t e w a r d ...... 15 wounded of the army of the United States, which, 4 N u rses...... each 5 in consideration of the extra expences which they in- 189 This report is in the Papers of the Continental Congress, No. of the Continental Congress, No. 32, folio 517. According to the 137, II, folio 731. According to the indorsement it was delivered indorsement it was agreed to on this day. Smith’s petition, dated this day. It was ordered to be filed among obsolete reports. Mr. Wilmington, April 10, 1783, is in No. 42, VII, folio 161. Mercer’s petition is on folio 735. 192 This report, in the writing of Alexander Hamilton, is in the 19° This report, in the writing of James McHenry, is in the Pa Papers of the Continental Congress, No. 38, Folios 413-442. pers of the Continental Congress, No. 19, VI, folio 109. 193 This report, in the writing of Samuel Osgood, is in the Pa 191 This report, in the writing of Jacob Read, is in the Papers pers of the Continental Congress, No. 19, III, folio 577. H istory of the A rmy M edical D epartment D uring the R evolution 3 6 7 curred by the performance of the said duty, be al of the commissioners for the hospital, marine and lowed the sums affixed to their respective names con clothier’s departments be exercised by one other tained in a return deposited in the war-office, which commissioner, to be elected annually by Congress: was transmitted and signed by David Oliphant, dep and that the salary of each of the said commission uty director of the southern hospital. ers be at the rate of 1250 dollars per annum. June 20, 1785. June 28, 1786. On the report of a committee, consisting of Mr. The commissioner for settling of the accounts of Williamson, Mr. Stewart, and Mr. Howell, to whom Robert Johnson, the commissioner for settling the was referred the petition of Dr. J. Morgan, hospital accounts &c. be directed to examine strict Resolved, That when ever Dr. J. Morgan, shall ly into the propriety of all extra expenses incurred have accounted for the stores delivered to his care, in the executing their duties, and where it shall ap or when the several charges against his former de pear that such expenses were necessarily and un partment shall have been delivered in, and it shall avoidably incurred, and that the subsistance allowed appear to the commissioner for settling the hospital was not adequate thereto, the surplus be allowed. accounts, that the doctor’s papers and books are un That, as it appears from the deposition of the said avoidably destroyed, or that he has rendered the Dr. Robert Johnson, that the sum of money and cer best account of the stores committed to his care, of tificates stated in his memorial, were public monies which the circumstances of the case would admit he stolen from him, without any negligence on his part, shall obtain a certificate for the balance due him. and that the balance of money remaining in his hands has not been applied to any use since it came May 8, 1786. into his possession, the commissioner for settling ac Resolved, That the powers and duties heretofore counts of the hospital department, be directed to exercised by the commissioners for the quarter mas pass the amount of those sums to his credit, on his ter’s and the commissary’s departments be exercised returning to the commissioner the said balance and by one commissioner, and that the powers and duties a list of the certificates so stolen. EXPERIMENTAL SECTION AND HEMI-SECTION OF THE SPINAL CORD When the whole body experiences a loss of nerves arise from the dorsal part of the spina junction in the nerves it indicates that they cord. . . . You have seen that the motor themselves are affected, which can be proved by nerves controlling the chest have their origin dissection. When all the nerves lose sensation from the cervical part of the cord, and further and motion at once, the affection is called Ap you have been taught that a transverse incision oplexy. If one-half, whether the right or the of the entire cord deprives all parts of the body left, is attacked, we call it Paralysis (Hemi below it of sensation and motion, seeing that plegia) of the right or left side. In like man the cord derives the faculty of sensation and of ner, as it occurs in one of the extremities, it voluntary motion from the brain. You have is a paralysis of that part. Paralysis, in fact, seen further in our dissection that transverse sometimes attacks a whole arm or leg, some hemi-sections, which do not cut deeper than times only the foot and the parts below the the centre of the cord, do not paralyze all the knee or the corresponding parts in the arm. inferior parts of the body but only those di Dissection has taught us that for all the parts rectly underneath the incision, the right when of an animal below the neck which are capable the right side of the cord has been cut and vice of voluntary motion, the corresponding motor versa. Galen de locis affectibus THE NEW YORK MEDICAL COLLEGE 1782-1906 By ABRAHAM JACOBI N E W Y O R K HE end of the first half of the bridge on September 19, 1782. Two full nineteenth century saw wonder courses of lectures were required, as at ful changes in medicine. Nitrous Philadelphia. As the course was only one of oxide and ether in America, four months, it was expected that the re T chloroform in Great Britain, the breakmaining sixteen months of the two years ing away of German medicine from were to be filled with private instruction. metaphysics and nature philosophy, the The Harvard School which conveyed a Vienna school, the foundation by Virchow degree of Bachelor of Medicine only, which of the Archiv fur patbologiscbe Anatomie might be converted into Doctor of Medi und Pbysiologie, the teachings of Louis and cine after an interval of three years, changed Broussais in France— all of them were its degree to that of M.D. in 1811. In 1871, destined to work what seemed the miracu Dr. Francis Minot was given, in addition lous in our art and science. Those of us to his title of Assistant Professor of the who have lived at or since that time, and Theory and Practice of Physic, that of certainly those who were fortunate enough Clinical Lecturer on the Diseases of Women to see it all, have experienced evolutions and Children. Both he and Dr. Calvin and emotions which stirred the hearts, for Ellis, the Professor of Clinical Medicine, tified the minds, and roused hopes for the aided pediatrics by being made special future. Among the few, if there be any, instructors. They, however, were replaced advantages we older men have over you by Dr. Charles Pickering Putnam who was who are our juniors, is the very fact that appointed Lecturer on Diseases of Children we have lived, and in a measure partici in 1873. He retired from the school in 1878. pated, in the revolution passing over these From time to time, though rarely, questions five or six or seven decades; it was not al referring to pediatrics appeared on the ex ways a smooth revolution. amination papers until 1879, when Dr. I learn that the first law to prevent the Joseph Pearson Oliver and Dr. Thomas introduction of adulterated pharmacological Morgan Rotch were appointed clinical in medicines into the United States was passed structors. The latter was placed in entire as late as 1848. Dr. Bailey, the first incum charge of pediatrics, teaching as Instructor bent of a new office, in a report to the New in Diseases of Children, in 1885; in 1888 he York Academy of Medicine, stated that over was given the title of Assistant Professor 90,000 pounds of false and adulterated drugs of Diseases of Children, and a seat in the were rejected during the first nine months faculty. Dr. Rotch asserted that this hap at the single port of New York. Forty pened only in consequence of the strong years later my learned and revered friend, suggestion expressed in the introduction to Squibb, complained to me of the difficulties the five volumes of Keating’s “Cyclopedia of encountered in meeting the demands of an the Diseases of Children” . Finally, in 1893, honest and conscientious supply of drugs. he was made full professor of that branch. An additional retrospect, brief and summa A full professorship of that branch had ry, may be permitted for a few paragraphs. meanwhile been held, since 1888, in the A medical school was formed at Cam Medical School of Denver by Dr. Herbert T he N ew Y ork M edical C ollege (1782-1906) 369 P. Whitney who had been an assistant at idential celebration of 1907 of the two Harvard from 1887 t° 1888. This latter famous presidents of Harvard. Within a position has since been filled by Edward single hour Eliot spent all his eloquence on Marshall Buckingham until his death, which the elective methods of study he had ren occurred a few years ago. dered popular among the young men of the Up to 1840 there were thirty-two medical University, and Lowell, on the contrary, schools in the whole country, with 2,500 praised the exact methods of restrictive students. In 1876 there were sixty-four teaching as the source of correctness and schools with 6,650 students. Sixteen of fundamental solidity. these, sixty-four offered hardly anything At all events, the official section-teaching which looked like clinical instruction. of 1890 did not arrive early and syste Dr. Harold C. Goodwin, the Superin matically, or uniformly. It arrived thirty tendent of the Albany Hospital, says:1 “ It years after that which I shall now refer to as is recorded that the first step taken by any the systematic bedside teaching of the New hospital toward teaching was in 1762 when York Medical College, which was first es the Pennsylvania Hospital founded a medi tablished in 1850. Now thirty years seems cal library. It was not until 1765 that, to mean a great deal in this young country through the efforts of Thomas Bond, bed of ours. side instructions were given. The New York From the pages of history and from what Hospital, in 1776, did the same.” The author I personally know, and particularly from adds that “ a medical library is more neces “ A Short Sketch of the New York Medical sary to a student than a stethoscope”— College” , by Edwin Hamilton Davis, A.M., which would prove that in the eyes of a M.D., New York, 1883, I cull the following: mere superintendent, bedside instruction is The subjects which especially interested of a doubtful character. Tastes differ. the profession seventy and sixty years ago According to Thomas F. Harrington,2 were certain reforms in medical education. section-teaching in clinical surgery was in The medical profession became more and augurated in 1890 by Professor Charles B. more aware of the fact that the medical Foster at Harvard. The same method of schools followed their old indolent methods systematic individual teaching has been of instruction. These schools were private extended to clinical medicine and ob enterprises, being mostly founded and main stetrics. In and after 1902, the fourth tained for private purposes and gain. The year of study was left to electives under instruction gathered in them did not satisfy certain regulations, so as to enable a student those few men who meant to become ac to perfect himself in the “ line of work he complished physicians; they went abroad, intends to practice” . This doubtful method no longer exclusively to Edinburgh, as in was highly praised by many. Still all men the eighteenth century, but also to France and classes enjoy the privilege of mistakes where Broussais and Louis taught Jack- they make and those they find in others. For son, Holmes, Bowditch, Francis, and others. instance: The elective way of study was County and state medical societies, methodically praised and fostered by Charles which means the profession at large, urged Eliot of Harvard; and abrogated by his im the schools to change their methods in re mediate successor, Dr. Lowell. I well remem gard to the quality and quantity of their ber the almost comical impression caused by teaching, but in vain. Then it was that the the discrepancy of the happenings atthepres- Medical Society of the State of New York— 1 Albany M. Ann., Jan., 1918. 2 St. Paul M. J., April, 1906. 370 Annals of Medical History founded in 1806— called a convention of the As not a single one of the existing schools prominent medical men of the whole coun saw fit to adopt a single one of these try to consider these defects and to urge recommendations, the reform element in improvements in the schools. The second the profession established a few new schools. call proved successful. One hundred dele Dr. Davis reports: “ Thus the New York gates from thirteen states assembled in Medical College was called into existence.” New York in 1846. Many schools, remember It was chartered April 8, 1850. Its corner the schools were the organized schools, were stone was laid July 31, 1850, and the build bitterly opposed to the movement— un ing was inaugurated on the 16th of October. fortunately, not for the last time; for even The first Commencement of the new school when thirty and more years afterward the was held in March, 1851. fight was up for increased medical require It was the first to wholly conform to ments of matriculation in medical schools the changes advised by the American Medi and of state requirements before the license cal Association. Its building, 112 East to practice should be granted, it was the 13th Street, the most convenient for the organized schools that opposed it openly; comfort of the teachers and the public, and when public opinion became too strong of any in the country, contained three large and demoralized to be openly thwarted, lecture rooms, so that the classes were never two of the three great schools of medicine compelled to occupy the same hall during in New York City sent their strongest men two consecutive hours. The entire front with their influence to Albany for clandes of the building was devoted to the chemical tine wire-pulling. They were, I am sorry to laboratory and museums. Here in 1850 say, A. L. Loomis and Austin Flint, Jr. was founded the first chemical laboratory They did not succeed,' however, in their in the United States in connection with a endeavors. It is now conceded that the wis medical college established for the instruc dom of the New York State Medical So tion of students in medicine in analytical ciety, displayed in 1882 in its modification researches important in medical practice. of the Code of Ethics of the American Medi- Each candidate for graduation was ex ical Association and in cooperation with all amined before a Board of Censors. classes of legal graduates and practitioners, The lecture term was lengthened and a secured for us, and for most of the states summer course was established. The num of the Union which followed our example, ber of professors was gradually increased to laws which raised the standard of medical ten, in place of the familiar seven, or less. education, gave our students greater facil The charter strictly separated the power ities, and protected the public by restricting of granting degrees from the Board of ignorance or quackery. Trustees, as Section V., “ provides for the In the Convention of 1846, committees appointment of a Board of Censors to be had been appointed to report in 1847. In taken from the profession not connected that year the Convention met in Phila with the College, without whose consent delphia; it was there that the American no degree could be conferred” . Medical Association was founded. For years To remove all pecuniary temptation to after, it urged the schools to adopt, among increase the number of graduates, the same others, the following changes: 1st, to in section provided that no fee should be crease the length of the lecture term; 2nd, charged for granting a degree. Finally, the to increase the number of professorships; Faculty, realizing the vast importance of 3rd, to separate the granting of degrees combining more clinical with didactic from the Board of Official Teachers. instruction, procured a charter for a 372 Annals of Medical History 21, i860. In it were Doremus and Carno- Horace Green of Vermont died in 1867 chan of the former faculty, I. Meredith at Sing Sing, at the age of sixty-five years. Reese, A. K. Gardner, B. I. Raphael, John He taught medicine in Castleton for several O. Bronson, Charles A. Budd, Bern L. years, and in 1850 was one of the founders Budd, R. K. Brown, and A. Jacobi. Two of the New York Medical College in East thoroughly new departments were created. Thirteenth Street. There he taught until Toxicology was taught independently of i860. When the reorganization took place, chemistry by Bern L. Budd, and the posi he remained in the faculty as emeritus. It tion of Teacher of the Diseases of Children was through his presence in the faculty that was made a full professorship. It has taken I made his acquaintance and enjoyed his Harvard twenty-eight years, and Columbia confidence. He settled in New York in forty years to follow the example of the 1835. As early as 1846 he published a treat struggling little school in East Thirteenth ise on “ Diseases of the Air Passages” ; in Street. In Columbia even the great names of 1849, his “ Pathology and Treatment of Otis and Agnew were permitted to add to, or Croup” ; in 1852, the “ Surgical Treatment in part to make, the renown of the school as of Polypi of the Farynx, and (Edema of the mere “ clinicals” until their death. The Glottis” . These books were followed by a “ seven” , that sacred close corporation, few others, mainly one on “ Pulmonary willed it so. Both in Harvard and Columbia Tuberculosis” in 1864, and a number of the Diseases of Children are now, however, articles in journals. They might be studied taught by full professors. Rotch must not to advantage by those who, because they be forgotten by either Harvard or America, are only half as old as his books and unac and Holt’s acknowledged high rank in his quainted with them, prefer to rediscover profession and specialty will always be re part of what was then known. His studies membered. taught him that the larynx was accessible, During the years 1861 and 1863 a few and this accessibility made him catheterize names were added, some of which were those that organ. His skill was such as to tempt of then, or afterwards, famous men. These him to make laryngeal and sublaryngeal were Noeggerath, S. R. Percy, Frederic Hol applications with nitrate of silver and other combe, and David S. Conant. Of all the substances, for croup and tuberculosis of men whose names I have mentioned only the lungs. In the New York Academy of one is alive to-day— myself. I doubt not, Medicine he was bitterly attacked. The or hope that many, aye most, of the names great men of those days proved to their full called up before you are well known to satisfaction that the thing could not be you. Still in these days our historical inter done. Still, he exhibited his instruments est in things and men gone by, is not well and did it. But the overwhelming vote was developed, as yet— neither in the history of that it could not be done. Meanwhile, I science nor of the country. That is why we had the privilege of seeing him do his resec meet with so much immaturity in both tion of tonsils and his catheterization of the scientific and political life, and why there larynx in his own office. I was shy and bash is so much waste of industry and of energy ful, and averse to raising my voice, but the in rediscovering facts that could easily be treatment of Horace Green, of whom the gathered from our own or foreign literature. profession in America had every reason to Still, names like Green, Barker, Peaslee, be proud, was one of the things that made Doremus, Flint, and Carnochan stand out me compare his fate with that of Bouchut like so many illuminating lights on the bat of Paris who was the first intubator of the tlefields of American scientific labors. larynx in croup. The latter was unfortunate T he N ew Y ork M edical C ollege (1782-1906) 37i hospital to be located alongside of the lent storm blew off a skylight and soaked a College. number of documents. When new ones were While awaiting the raising of funds to procured, the old ones were left uncanceled build, they organized and opened a charity and misused. The wrinkled specimens were ward in the College itself. In that ward I taken away when the janitor was dismissed taught in i860 and after, until both the a few months later. He disposed of them ward and the college were discontinued— in this country and also in London. From for discontinued they were. That is the London a few were sent to New York for brief history of the first attempt at establishing certification. This caused an opportunity a regular daily bedside clinic for all branches for eliciting the facts that a number of the of instruction in the indispensable parts of forged diplomas appeared in the market. medical teaching. The twenty-seven beds In the first faculty of 1850, there sat were ours, and in daily, almost hourly, use. Horace Green, Professor of Theory and This should be recognized and remembered Practice; Abram L. Cox, of Surgery; Edwin as a new and systematic teaching, the first Hamilton Davis, of Materia Medica and one in America, and should be remembered Therapeutics; B. Fordyce Barker, of Mid as one of the progressive steps in American wifery and the Diseases of Women and medical instruction. When it was discon Children; and K. Ogden Doremus, of tinued in 1864, it had no successor until in Chemistry and Toxicology. In 1851, John 1898, when bedside instruction was estab Murray Carnochan took the place of Dr. lished for the students of the College of Cox, and Edward R. Peaslee the chair of Physicians and Surgeons. In that year, Dr. Physiology, Pathology, and Microscopy. Francis Huber, my friend and assistant, In 1852, two additional chairs were created: furnished to Columbia University a capital that of Medical Jurisprudence, occupied the interest of which enabled the College of by Judge Joel Parker of Boston, and that of Physicians and Surgeons to facilitate a Dental Pathology and Surgery, for Dr. C. C. regular pediatric clinic with exclusive bed Allen. This was the first dental chair in an side instruction in Roosevelt Hospital. American medical school. Very few changes The nefarious example of rival schools took place after that. H. G. Cox was elect that kept on granting diplomas after two ed Professor of Theory and Practice in 1855; short winter courses, and the iniquitous Timothy Childs, Professor of Anatomy in tendency of the students to rush into prac 1856; Austin Flint, Jr., Professor of Physi tice with the least possible expenditure of ology and Pathology in 1859. I have men money, time, brains, and knowledge, and tioned here only such men as before and the additional disadvantage of the Medical since their appointment have made a name College caused by the fact that very many for themselves and have played a prominent of our students were Southerners who ran role in American medicine. or strayed away during the Civil War, In i860 Southern students began their made the life of the institution hard, and exodus from New York. The New York Med finally impossible. The last class was gradu ical College was not persona grata with the ated in 1864. South nor with the other New York schools. Dr. Edwin Hamilton Davis, the Pro These had not mended their ways during fessor of Materia Medica, reports one of the whole decade of the existence of the the ways in which the small Medical College New York Medical College; and the ma was injured by a combination of the clouds jority of the faculty of the college became and a thief. Our very blank diplomas— discouraged. thirty-odd in number— were stolen. A vio A new faculty was appointed April T he N ew Y ork M edical C ollege (1782-1906) 373 enough to exaggerate his results; that was of the Unimpregnated Uterus” in 1865 and why his adversaries in the Paris Academy of 1866; and in 1872 “The History of Ovario Medicine—the great Trousseau among tomy in This Country” and “Sketch of Dr. them— succeeded in postponing intubation E. McDowell’s Life” . While a Professor in until our own O’Dwyer, without any the New York Medical College and during knowledge of what had been accomplished his co-editorship of the American Medical twenty-five years earlier, rediscovered and Monthly, he published a number of his lec improved upon Bouchut’s manipulation. tures and reports. He was one of the most It was altogether an unfortunate time for erudite men in the American profession. great discoveries. Bouchut was not appre Austin Flint, Jr., was born March 28, ciated; Horace Green was suppressed. For 1836, in Northampton, Mass., and died in instance, you also know that Holmes was New York in 1915. He began the study of ridiculed by Meigs and Hodge; and Sem- medicine at Louisville in 1856, and gradu melweiss was driven into a lunatic asylum ated from Jefferson in 1857. At an early by Braun and Scanzoni. date he began physiology as a special study, Fordyce Barker was born on May 2, 1817, experimented in and wrote on that branch in Maine, practiced in Norwich, Conn., of medicine in Paris under Robin. In 1859 graduated in Paris, France, in 1844, and was he taught in the New York Medical Col Professor of Midwifery in Bowdoin in 1845 lege, in i860 at New Orleans, and in 1863 in and in New York Medical College in 1850. the Bellevue Hospital Medical College, with His principal book is one on puerperal which he remained in the same capacity for diseases. He died in 1886. many years until he changed his position John Murray Carnochan was born in into that of a consultant in medicine and Savannah, Ga., July 4, 1817, and died in finally in psychiatry. Most of his literary New York October 28, 1887. He studied six work remained physiological; the study of years in Paris. In 1850 he was placed in the liver occupied much of his attention, charge of the newly established hospital and his extensive text-book of physiology for immigrants on Ward’s Island, and added in five volumes— the last of which appeared to the surgical literature of the femur and in 1874— first familiarized the profession many other subjects. with his work. Edward Randolph Peaslee was born in This may suffice. What I want to im New Hampshire January 22, 1814, and died press upon you is the knowledge of the fact in New York on January 12, 1878. He grad that one of our small medical schools, the uated from Yale in 1840, continued his stud New York Medical College, was a principal ies in London and Paris, and became pro cause of our national medical progress. fessor in Dartmouth College in 1841. He pub This was to a great extent caused by the in lished “ Human Histology in its Relations to itiative in and the gradual taste for bedside Descriptive Anatomy, Physiology, and Path instruction in practical medicine. British ology” in 1857, the first systematic book on and American medicine has always been that subject in English; a complete mono founded upon its practice, and the nation’s graph on ovariotomy in 1865; “Statistics of health and felicity is the outcome of the Ovariotomy for the Years 1860-61, ’62 and people’s sanitation based upon the labors ’63, Including 150 Cases” ; “Retroflexion and energy and successes of its doctors. STUDIES IN PALEOPATHOLOGY I. GENERAL CONSIDERATION OF THE EVIDENCES OF PATHOLOGICAL CONDITIONS FOUND AMONG FOSSIL ANIMALS By ROY L. MOODIE, Ph.D. Department of Anatomy, College of Medicine, University of Illinois CHICAGO, ILLINOIS DEFINITION AND SCOPE OF PALEOPATHOLOGY HE study of the evidences of The present paper deals mainly with the disease among ancient man and so-called prehistoric,5 and especially pre fossil animals is known as paleo human, evidences of disease (prior to pathology, the term having first 500.000 b .c .) of the extinct vertebrates. T been applied by Sir Marc Armand Ruffer1It is in interesting to note that the history 19142 to methods he had developed in of disease, from the first geological evi studying the pathological anatomy of the dences at present obtainable down to the ancient Egyptian mummies. He defined it historical data contained in August Hirsch’s as follows: “Handbook of Geographical and Historical “ Paleopathology is the science of the Pathology” (circa 600 b .c . to 1875 A-D-)> diseases which can be demonstrated in will be seen as a series of consecutive human and animal remains of ancient events from the introduction of diseased times.” conditions among animals and plants down The significance of the term has been to the present time. There can be no doubt dwelt upon by Klebs,3 and a further exten that many of the diseases existing today sion of its meaning to include, not only the are of very great antiquity, having a history diseases of the ancient Egyptians but those extending back into geological time for many of prehistoric man and fossil animals as millions of years. well, has been suggested by the writer.4 It is not necessary nor pertinent to review The field thus involved includes the re in this place the studies of Ruffer, Elliot sources of anthropology and paleontology, Smith, Wood Jones, Rietti, Fouquet and as well as some details contained in archeo other writers on the pathological anatomy logical studies. of the ancient Egyptian mummies, since 1 Sir Marc Armand Ruffer, distinguished for his their results are so readily accessible. Their work in preventive medicine and for his studies on the pathology of the Egyptian mummies, lost the region under discussion. Thus in Egypt any his life while engaged in Red Cross work. See: grave earlier than the time of the first dynasty is “ Memorial Notice of Sir Marc Armand Ruffer,” often called prehistoric. This implies an age of by F. H. Garrison, Ann. Med. History, 1917, vol. 6.000 years or more. In France LeBaron defines i, No. 2, pp. 218-220, with portrait. the prehistoric period as closing at about 222 2 Ruffer: “Studies in Palaeopathology in Egypt,” b . c ., and several centuries later in Algeria. To J. Path. & Bacteriol. 1914, vol. 18, p. 149. the paleontologist the term is meaningless. Klebs 3 Klebs: Johns Hopkins Hosp. Bull. 1917, vol. has said: “ The adjective ‘prehistoric,’ used so 28, pp. 261-266. often, would seem a misnomer, because the dis 4Moodie: Am. J. Sc. 1916, vol. 41, pp. 530-531; tinction of a history read in written records from Science, N. S. 1916, vol. xliii, p. 425. one seen and studied in equally characteristic 5 The term prehistoric, of course, usually refers objects, chronologically determinable, is purely to events prior to the details of recorded human arbitrary and artificial and it would do no harm history, and is variously designated according to to drop it altogether.” 374 Studies in Paleopathology 3 75 material might be regarded, from a certain pathological processes which are so familiar standpoint, as fossil, meaning something to us today. If we can trace the known “dug up.” The term fossil, however, as used lesions to any definite cause among the ex in this paper refers to material which is tinct animals it will be a step toward the erec thoroughly petrified, the age of which must tion of the newest branch of pathology, deal be reckoned by geological standards. The ing with the oldest aspects of that science. studies of the above-mentioned writers have In regard to the importance of this branch been briefly reviewed and summarized by of study, Klebs11 says: Garrison,6 Klebs,7 and Sudhoff,8 and will be “ We need only consider what definite extensively referred to elsewhere by the writer. influence diseases exert in our individual The studies of Ales Hrdlicka and Lang- lives, what profound social upheavals don9 on the pathological anatomy of the were brought about through the incidence North American Indians, and of Hrdlicka, of epidemics, less perceptibly perhaps Eaton10 and other writers on the ancient but none the less strongly, through wide* Peruvians, must also be neglected, as spread chronic ailments, through profes well as the meager details of fossil man as sional diseases, how whole districts and they are recounted in the various works on countries are forsaken because disease anthropology. The subject of the diseases made them uninhabitable, how disease of ancient human races has never been affecting early childhood and others systematically studied. The writer will pre producing sterility led to the gradual sent a consideration of this subject at extinction of whole peoples. . . . For some future time. the grasp of such problems, the study of disease as it appears to us now does not PALEONTOLOGICAL EVIDENCES OF DISEASE suffice; the traces left during immense periods of time have to be taken into The study of paleopathology is still in its account and it is in just such questions, initial stages, and especially is the applica not approachable by other methods, that tion of pathological methods to fossil lesions paleopathology in time to come may a new field. But the comparative scanti furnish important solutions.” ness of facts so far brought out and the difficulties of research should not hinder its The attitude of students of paleontology successful prosecution. What the final re toward this subject has been negative. Even sults may be remains to be seen. The imme men like Leidy, a trained anatomist and an diate results are certain to bring attention eminent medical man, paid scant attention to the presence of characteristic lesions of to the subject, although he did describe an disease far back in geological time, and it example of caries in a mastodon tooth12 is very interesting, if not important, to from Florida. Cuvier too, eminent as he was find in past geological ages evidences of in the field of comparative anatomy, failed to recognize the importance of this phase 6 Garrison: “ History of Medicine,” 1917, 2nd ed., p. 50; Ann. Med. History, 1917, vol. 1, No. Figs. 1-22. Good discussion of pathology of early 2, p. 219. North American Indians. 7 Klebs: Johns Hopkins Hosp. Bull. 1917, vol. 10 Eaton: “The Collection of Osteological Material 28, pp. 261-266. from Machu Picchu,” Mem. Connect. Acad. Arts & 8Sudhoff: J. L. Pagel’s “ Einfiihrung in die Ge- Sc. May, 1916, vol. v. schichte der Medizin,” p. 33. 11 Klebs: Johns Hopkins Hosp. Bull., 1917, vol. 9Langdon: “ The Madisonville Prehistoric Ceme 28, pp. 261-266. tery. Anthropological Notes,” J.Cincin. Soc. Nat. 12 Leidy: Proc. Acad. Nat. Sc., Philadelphia, 1886, Hist. 1880, vol. iii, p. 40; 1881, vol. iv, p. 250, p. 38. 376 Annals of Medical History of paleontology. His discussions of the few knowledge of recent diseases, all of the lesions he recognized were meager and in lesions which are preserved in a fossil condi adequate. He has described a fractured tion. In the extinction of the ancient races skull of a Pleistocene Hyaena and a frac of animals, certain diseases, without doubt, tured femur of Anoplotherium. became extinct with them,13 and it is Paleontology lends considerable light to partly the purpose of this paper to inaugu the study of the antiquity of disease. The rate an inquiry into the nature of the dis study of the lesions so far known among eases of fossil vertebrates. No one has yet fossil animals indicates nothing new in the made a study of the evidences of disease nature of pathological processes but simply among fossil animals, since these conditions, extends our knowledge of disease to a vast whenever noted, have been referred to only ly earlier period than had previously been in an incidental way, by writers on paleon known. It seems quite probable that some tological subjects. of the diseases exhibited by the extinct Geological evidences of the diseased state vertebrates went out of existence with the of animals are necessarily restricted to path race of animals which were afflicted. If this ological lesions on the hard parts of fossil proves to be true it will be an interesting animal remains. Soft parts14 are seldom opportunity to study the details of lesions fossilized, and the few specimens known of extinct diseases. There seems to be little have not been subject to disease. Since the possibility of determining the fundamental pathological changes which affect the hard cause of disease other than is already known; parts of animals today are relatively few for disease is apparently one of the mani when compared to the diseases which afflict festations of life, and has followed the same the body as a whole, it is to be supposed lines of evolution as have plants and ani that the paleontological evidences of disease mals, and is possibly directed by the same are but partial indications of the prevalence factors. Such a study as the present may, of pathological conditions in geological time. however, throw light on the origin of many The following account, too, must be read in of the diseases to which the human race is the light of the paucity of evidence available a prey. A knowledge of the pathological for discussion. The details are meager, but processes which have taken place in animals since they are all we have, they may be of geological antiquity will aid in an un deemed worthy of consideration. derstanding of the general nature of disease. It will be clearly evident, after a consid The literature of vertebrate paleontology eration of geological matters, that all paleon contains a number of incidental references tological evidence is of relative value, since to the diseased nature of the fossilized bones such small portions of the ancient faunas of fishes, reptiles, birds, and mammals, the and flora are preserved in the rocks. How lesions described indicating a variety of ever, we are safe in stating, from such diseases, some of which are not uncommon evidence as we have, the probabilities of the today. It is manifestly impossible to diag occurrence of numerous diseases among ex nose correctly, on the basis of our modern tinct animals, just as it is safe for us to 13 Among diseases which have become extinct with state, on the basis of a single tooth in a in historical times may be mentioned the sweating of Kansas, with a Review of Other Fossil Brains,” sickness described by Hecker in “ Epidemics of the J. Comp. Neurol, April, 1915, vol. 25, No. 2, Middle Ages,” 1846, pp. 181-353. where an annotated bibliography of fifty papers 14 The soft parts of fossil vertebrates have been will enable the interested reader to see just how discussed by a number of writers. Our knowledge meager is our knowledge of the soft parts of extinct of the entire subject is reviewed in the author’s vertebrates. Many of the softer structures are paper, “A New Fish Brain from the Carboniferous represented by impressions on the stone. Studies in Paleopathology 377 definite geological horizon, that such and probably be detectable at much earlier such an animal existed at the time the for horizons if petrified material of greater mation was being deposited, provided, of age were available for study, since the course, the deposit is a primary one and the bacteria appear to be among the earliest fossil was not moved by shifting in a sec forms of life. Material preserved as im ondary deposition. pressions at all horizons, more especially All that we know of the earliest land the post-Paleozoic ones, show abundant vertebrates, prior to the Pennsylvanian, for leaf-spot fungi, and such remains from the instance, is a single footprint from the Cretaceous and Tertiary show abundant Devonian, and a few series of footprints insect galls and leaf cutting by cater from the Mississippian. On the basis of pillars or bees; but this class of material these footprints we are able to say definitely is usually more or less indefinite. When that there existed in North America a di ever one handles much petrified mater versified fauna of vertebrates, probably ial, one is struck with traces of fungal amphibian, which preceded the well-known ravages and bacterial action.” amphibian faunas of the great Coal Period. EVIDENCES OF DISEASE IN FOSSIL PLANTS DEFINITION OF DISEASE AS USED IN It is often difficult to decide whether the THIS STUDY ravages of fungi and bacteria are pre- or Disease, as the term is used in this study, post-mortem. The agents of decay are well may be defined as any deviation from the known to have existed early in geological healthy or normal state of the body which time. During the Carboniferous there ex has left a visible impress upon the fossilized isted conditions which were especially favor skeleton. The evidence may take the form able to the growth of a mycological flora, of broken bones, tumors, necroses, hyper and much of it was probably on dead plasias and arthritides of various kinds. plant material. Only the diseases of animals have been Professor Berry writes further16 con considered. This is done with a full realiza cerning the primitive fungi: tion of the enormous domain of phyto “Among the relics of former vegetation pathology and is a confession of a limitation that carry the record back many millions to a restricted field. Some of the paleo- of years the remains of fungi are so rarely botanical literature has been read, but ap found that their presence is always ex parently no attempt has been made to ceptional, although it is obvious that trace the rise and progress of phytopathol many times during the long history of the ogy from fossil material. earth the environment has offered opti This is doubtless due to the unsatisfactory mum conditions for their abundant de condition of fossil plant material which is velopment. To mention but one such usually quite fragmentary. Some idea of the occasion, that of the formation of the nature of plant diseases of the past may be Coal Measures must have witnessed an had from the following brief summary15 for exceedingly abundant mycological flora. which I am indebted to Professor Edward That these plants were present thus early W. Berry: is indicated by the abundance of hyphse, “ Bacterial and fungus activity are and other traces of fungal activity such known in Carboniferous plants, and would as butyric fermentation, in the tissues of 15 Berry: Letter to author, Jan. 4, 1918. 1916, vol. 8, No. 2, pp. 73-78, plates 180-182, con 16 Berry: “ Remarkable Fossil Fungi,” Mycologia, taining 16 figures. 378 Annals of Medical History Carboniferous vascular plants, and the METCHNIKOFF ON DISEASES IN scarcity of described forms must be attri REMOTE EPOCHS buted to the perishable nature of most The possible presence of disease among fungal tissues and to the lack of syste animals of remote epochs of the earth’s his matic work by experienced mycologists tory was suggested by Elie Metchnikoff on the more or less obscure material avail in the following words: able. To be sure, quite a considerable number of fossil forms referred to Fungi “ Diseases in general and infective dis have been recorded from various geologic eases in particular were developed on the horizons but the vast majority of these earth at a very remote epoch. Far from are leaf-spot types based upon real or being peculiar to man, animals and the fancied resemblances, and found on im higher plants, they attack inferior forms pressions of foliage and without definite and are widely distributed among uni botanical characters. Some doubtless rep cellular organism, Infusoria and Algae. resent fungal ravages, others are due to Diseases undoubtedly play an important insects, some are glandular, and others role in the history of life on our planet, and are purely imaginary.” it is very probable that they have con tributed in a marked degree to the ex Professor Berry refers to A. Meschinelli’s tinction of certain species.18 When we “ Fungorum Fossilium Omnium Iconograph- observe the ravages produced by para ia,” (1902, 144 pp., 31 plates), for a rather sitic Fungi among the young fish which complete illustrated list of all of the forms we are trying to rear, or the destruction referred to down to the year 1900. Other of cray-fish in certain countries in con and more complete studies on the bacteria sequence of the rapid increase of epizootic and fungi of the Coal Measures of France germs, we are involuntarily led to the particularly have been made by Van Tieg- conclusion that pathogenic micro-organ hem and Renault. A fairly complete list of isms must have brought about the dis their numerous papers is to be found in appearance of certain animal and vegeta Smith’s bibliography.17 Other information ble species.” 19 may be gleaned from the memoirs and text books dealing with Paleobotany. It would be interesting in this connection 17 Erwin F. Smith: “ Bacteria in Prehistoric to know Metchnikoff’s sources of informa Times.” In “ Bacteria in Relation to Plant Diseases,” tion relative to the presence of diseases at 1905, vol. 1, p. 262. remote epochs. Virchow’s studies on the 18 The question of extinction is still one of the unsolved problems of paleontology. The importance kinds, but none of them, so far as the fossil lesions of those diseases which leave an impress on the may be interpreted, were sufficiently severe to skeleton has been referred to by the author in the have played a part in the extinction of any of the following words: known groups of fossil vertebrates. They are to be “ It is not my intention to contend that disease regarded rather as chronic infectious or constitu has not been influential in the extinction of races tional diseases which may have played a part in (or species); it probably has been; but those diseases extinction, but there must have been some other which have left an impress on the fossilized skeleton and more powerful ally which is at present un certainly cannot be regarded as among those known.” (“The Influence of Disease in the Ex diseases which would produce widespread extinc tinction of Races,” Science, N. S., Jan. 19, 1917, tion. Some other has been the dominant factor. vol. xlv., No. 1151, pp. 63-64. The present results of the study of fossil pathology 19 Elie Metchnikoff: “ Immunity in Infective indicate the early appearance in geological time Diseases,” 1915. Translated from the French by and widespread distribution of diseases of many Francis G. Binnie, p. 8. Studies in Paleopathology 379 cave bears of Europe20 were well known, Abel,22 and a much fuller review is planned and his characterization of the arthritic for a memoir on paleopathology, now in lesions of the fossorial animals as the preparation. “Hohlengicht,” was certainly famous at the time Metchnikoff wrote. The studies of APPARENT ABSENCE OF DISEASE AMONG Mayer21 on the lesions of the cave bears EARLY PALEOZOIC ANIMALS and cave lions of Europe as well as the A careful study of the literature of pale writings of Cuvier (1820), Esper (1774), ontology shows that, so far as present ob Goldfuss (1810), Walther (1825), Schmerl- servations are concerned, the animals of ing (1835), Owen (1842), Schaafhausen the earlier periods of the earth's history (1858), Newton and Parker (1870), Graff were free from disease. Although bacteria23 (1885) and Leidy (1886) may, any or all are known to have occurred in the algal of them, have been known to Metchni deposits of the Newland limestone, a for koff. They all suggest the pathology of mation of the Beltian series of Algonkian ancient times and some deal entirely rocks in central Montana, they are not with the pathological anatomy of fossil re known to have been of a pathogenic nature, mains. None, however, are studies which but rather are supposed to have been active deal with remains older than the middle in the deposition of limestones, together Tertiary, and to a paleontologist the term with the algae with which they were as “ remote epoch” hardly applies, when com sociated. No lesions due to accident or to pared to lesions known from the Carboni infection have been described among either ferous, for example. I am, therefore, forced the vertebrates or invertebrates of the early to conclude that Metchnikoff simply fore geological periods, prior to the Carbonifer casted what would be discovered, on the ous. This lack of knowledge concerning the basis of what he knew in modern plants and evidence of disease may be due to ignorance animals. All of the literature in paleontology on our part, for the lesions may have been dealing with pathological evidences of any seen but were not deemed worthy of de great antiquity, prior to the mid-Tertiary, scription. Or, it may be due to the fact has appeared since 1900. The literature is that the invertebrates of the Proterozoic meager and unsatisfactory. Paleontological and Paleozoic, which were the predominant studies seldom deal specifically with dis types of animal life during these periods, eased conditions, so that the field is still were free from disease which affected the to be explored. The studies in paleontology skeleton, as are, in general, the inverte dealing with pathological evidences among brates of today, although many of the fossil vertebrates have been reviewed by Wirbelthiere,” 1912; “Spuren von Kampfen,” pp. 20 Rudolf Virchow: “ Ueber einen Besuch der 88-91; “ Knochenerkrankungen,” pp. 91-95. west-fallischen Knochenhohle,” Ztschr. J. Ethnol. 23 These bacteria are described and figured by 1870, Bd. 2, p. 365, footnote; “ Knochen vom C. D. Walcott and H. F. Osborn. Hohlenbaren mit krankhaften Veranderungen,” C. D. Walcott: “Discovery of Algonkian Bac Ibid., 1895, Bd. 27, pp. 706-708, figs. 1-4; “ Beitrag teria,” Proc. Nat. Acad. Sc., April 1915, p. 256; zur Geschichte der Lues,” Dermat. Ztschr., 1896, “ Evidences of Primitive Life,” Smithsonian Rep. for Bd. 3, p. 4. 1915, pp. 235-255, illustrated. 21 Mayer: “ Ueber krankhafte Knochen vorwelt- H. F. Osborn: “Origin and Evolution of Life,” Iicher Thiere. In “ Nova Acta Leopoldina (Novorum 1917, p. 153; Science, N. S., 1917, vol. 46, No. Actorum Academia Caesarese Leopoldino-Caro- 1192, pp. 432-434. Iinse Naturae Curiosum)” , Bd. xxiv, pt. II, pp. Their discovery was forecasted by Walcott in 673-689, pi. 30. his “Pre-Cambrian Algal Flora,” Smithsonian Misc. 22 O. Abel: “ Grundziige der Paleobiologie der Collect, 1914, vol. 64, No. 2, p. 95. 380 Annals of Medical History recent forms are highly parasitized and are infection25 is well known, and the classical occasionally subject to disease. It appears example of the mosquito-borne infections probable that vertebrates have been more will suffice, although it is well known that liable to diseases which afflict the hard insects of many kinds are subject to fatal parts than have the invertebrates, and this diseases. Kowalevsky has discussed the liability to pathologic processes has been anthrax of crickets and many other students increased with the passage of geologic time. have studied the problem. The entire ques tion of immunity in its relation to all forms IMMUNITY IN MODERN INVERTEBRATES of extinct animals is of course a new and The greater immunity of early Paleozoic unsolved, probably an insolvable, problem. animals to disease, based on the evidences But it seems certain that if the early ani of paleontological material, is probably not mals were diseased, the ensuing pathology a true index to actual conditions, though it was of such a nature as to leave no impress may be so. It is probably not safe to con upon the fossilized part; or else we have not clude from present-day conditions what the yet learned to recognize these lesions. state of Paleozoic animals may have been as regards disease. At any rate the paleon THE ORIGIN OF DISEASE tological evidences are not wholly sub stantiated by conditions found in modern Phagocytosis26 doubtless began very early forms. Metchnikoff24 has called attention in the history of animal life, and it is prob to the occurrence of epidemics of a severe able that the natural immunity of the nature among protozoa, such as diseases early animals was sufficiently strong to in Amoebae caused by the Microsphaera and resist the invasion by any pathogenic organ the disease in Actinophrys attributed to isms in sufficient numbers to produce dis Fungi allied to the genus Pythium. Pasteur’s ease. The breaking down of this immunity studies on the pebrine and flacherie of the may possibly be correlated with the develop silkworms will be remembered as instances ment of senescence27 among the early races of severe epidemics in an invertebrate of animals, which reached a climax in some group. Molluscs, however, are apparently forms— the trilobites, for instance,— at largely immune to infection, and since the about the time when we find the first indi molluscous animals formed such a large cations of disease among fossil animals. percentage of the preserved faunas of the The breaking down of the immuity, due early periods of the earth’s history we may to the development of race senescence and attribute our ignorance of the presence of the introduction of disease, doubtless was disease to this factor, in part at least. The of very great importance in the extinction immunity of many intermediate hosts to of the trilobites and other great groups 24 Metchnikoff: “ Immunity in Infective Diseases,” 27 The studies of Charles Emerson Beecher (1856- translated from the French by Francis G. Binnie, 1904), an American paleontologist, upon evolu 1905, P* ffl; also Chap. iii. tionary phases of the early fossil brachiopods and 25 Edward Hindle: “ Flies in Relation to Disease trilobites are especially important to consider in (Blood sucking Flies),” 1914. connection with the question of race senescence and G. S. Graham-Smith: “ Flies in Relation to the extinction of animal groups. His papers have Disease (Non-Blood sucking Flies),” 1914. been collected into a volume: “ Studies in Evolution,” 26 Elias Metchnikoff: “ Die Lehre von den Phy- New York, 1901. gocyten und deren experimentelle Grundlagen.” The entire subject of senescence in the recent In “ KoIIe und Wassermann’s Handbuch der patho- lower animals is discussed by Child in “ Senescence genen Mikroorganismen,” 1913, Bd. ii, erste Halfte, and Rejuvenescence,” University of Chicago Press, pp. 655-731, with an excellent bibliography. 1915. Studies in Paleopathology 38i of animals which have disappeared from tain crinoids were afflicted in their stems the earth.28 with tumor-like lesions, possibly due to the I do not intend to assert that senility or parasitic action of myzostomids such as senescence is a disease, but that age weakens commonly attack crinoid stems today. A the organism and the race and allows the careful description of the enlarged stems of ingress of disease. Minot has stated: recent crinoids and the parasitic action of the myzostomids is to be found in the “ Old age is not a disease and cannot be reports of the Challenger Exploring Ex cured; it is an accumulation of changes pedition. A comparison of the ancient and which begin during earliest youth and recent lesions on the stems of crinoids leads continue throughout the entire life of one to accept the enlargements of fossil the individual.” crinoid stems as due to the parasitic action It may be said that disease in the past of the myzostomids or some similar form. has often attacked the races of animals The evidences for such a conclusion are, which showed senescence. Many of the apparently, incontrovertible, and have been virile races of animals in the past were also established by a number of writers on fossil subject to disease. The paleontological in crinoids. Parasitized crinoid stems are dications of senescence are the reduction in known from the Carboniferous of Scotland, size, the loss of vigor and the production of Germany (Fig. 1) and the Keokuk beds apparently useless spines as seen in the (Fig. 4) of North America. Graff29 found races of animals which have become re the carbonized remains of the parasite in duced or extinct, such as the crinoids, one of the enlargements (Fig. 2) which he trilobites, brachiopods, ammonites and the studied and which he referred to as the dinosaurs. Other examples of senescence may fossilized integument of the myzostomid. be seen among some of the Permian reptiles The presence of this soft-bodied animal so which assumed bizarre forms. The tendency early in the geological history of the world of many races of animals to acquire spinous is not surprising, since from the researches and other useless excrescences of the hard of Walcott30 we know that jellyfishes, parts shortly before the extinction of the sea cucumbers, many types of annulates, group is noteworthy, and this tendency has and soft-bodied crustaceans lived during been regarded by paleontologists as an the Cambrian, many millions of years indication of senescence. earlier. The parasitism of animals during the Carboniferous was preceded by partial parasitism or commensalism of the earlier LESIONS OF PARASITISM IN CAR periods, and is known to have occurred BONIFEROUS CRINOIDS among fossil corals (Fig. 3) of the Devonian. Our knowledge of the history of disease, The intimate association of animals and the as it is based on paleontological evidence, origin of parasitism and commensalism dur begins with the Carboniferous, when cer ing the early part of the Paleozoic has been studied by Clarke.31 The reader is referred 28 This suggestion has been discussed by Rene to his paper for further details. Larger in his paper “ La contre-evolution ou degen- 6resence par I’heredite pathologique cause naturelle 30 C. D. Walcott: “ Evidences of Primitive Life,” de I’extinction des groupes animaux. Essai de pale- Smithsonian Rep. for 1915, pp. 235-255, with plates. opathologique generale comparee,” 1916, Bull, 31 John M. Clarke: “ The Beginnings of Dependent et mem. Soc. d’anthrop. de Par. Life,” Fourth Ann. Rep., Director of Science Div., 29 Graff: “ Paleontographica,” 1885, Bd. 31, pp. New York State Education Dept., 1908, pp. 1-28. 183-192, Taf. xvi. PI. 1-13. 382 Annals of Medical History The remains of the early vertebrates laterally compressed fishes preserved in the prior to the Permian have shown no note attitude of the opisthotonos and pleuro- worthy pathological lesions. There may thotonos in horizons prior to the Permian. These attitudes may have been due to spastic distress induced by cerebrospinal infections or to some form of poisoning. Since this subject will be more fully treated elsewhere nothing more need be said than that these attitudes possibly represent dis eased conditions of the central nervous system. PATHOLOGY OF THE PERMIAN VERTEBRATES Several pathological conditions are indi cated among the vertebrates of the Per mian. Renault32 has described caries of certain fish bones preserved in coprolites from the Autun basin. He concludes that this type of caries is due to several types of bacteria which he has described and figured. A left radius of Dimetrodon, a primitive reptile, from the Permian of Texas shows an incompletely healed fracture (Fig. 5) with abundant osteosclerosis and some in termediary callus. This is the oldest known case of fracture. It was a simple fracture cutting the bone at right angles, and the healing process has taken place with very little shortening. The bone has no medullary Fig. 1. Parasitized stem of a crinoid, from the Carboniferous of Germany, showing the tumor cavity, so that attempts to study the nature like mass produced by the action of the myzostomid. of the fracture by means of the x-ray have (After Graff.) Fig. 2. Portion of parasitized crinoid stem, show been a failure. The Texas red beds, from ing carbonized remains of the myzostomid. (After which the bone comes, are impregnated Graff.) with iron, and the radius reacts to the Fig. 3. Section through a fossil coral, Pleurodic- tyum problematicum from the Lower Devonian of x-rays much as a bar of iron would. A Eifel, showing the worm tube near the center. fractured rib with an old callus is also An example of ancient commensalism. (After Stromer von Reichenbach.) known from the Permian of Texas. A Fig. 4. An enlarged stem of a crinoid from the description of this lesion with illustrations Keokuk beds of North America, showing that is to be found in The Surgical Clinics of the enlargement has involved the plates of the stem. This specimen was thoroughly mineralized Chicago, April, 1918. Von Huene has de into a geode, so that no evidences of the parasite scribed the skull of a phytosaur from the were seen. One-half natural size. Triassic of Germany, showing a fractured snout with many necrotic sinuses. have been diseases among these early 32 B. Renault: “ Microorganismes des combustibles forms, but the lesions have not yet been fossiles,” Bull. Soc. de ITndustrie minerale a Saint- discovered. We find, to be sure, certain Etienne, 1899-1900, Ser. Ill, with atlas of plates. Studies in Paleopathology 383 DISCUSSION OF GRAPH SHOWING INCREASE curve gradually rises until, during the OF DISEASE IN GEOLOGICAL TIME Cretaceous, at “ c,” diseases and accidents— It is not necessary at this time to go into such as caries, osteoperiostitis, deforming further details concerning the progress of arthritides, necroses, hyperostosis, oste- disease, since the details are to be given in a later paper. The accompanying graph (Fig. 6) will show how, according to present evidences, disease has progressed during the geological history of the earth. The twenty-five divisions on the base line a-d (Fig. 6) represent as many periods of the earth’s history. The divisions on the vertical line d-b represent the approximate number of diseases present in each period, as indi cated by the known fossil lesions. The F i g . 6. Graph showing increase of disease in time intervals in the graph are shown as of geological time. The d.visions on the base line, equal value, but the geological periods are a-d, represent geological periods, and on the vertical line prevalence of pathological conditions. not at all of equal duration nor of equal character. This should be kept in mind in studying the graph. ophytes, osteomata, fractures— and many At the point “a” we may say that organic infective processes, reached a maximum of life is first known. It will be seen that the development among the dinosaurs, mosa- line “ a-b,” representing the history of dis saurs, crocodiles, plesiosaurs, and turtles. ease, follows a base level for the first twelve The curve suddenly and sharply descends periods of the earth’s history. Then the from “ c.” For with the close of the Creta ceous and the sudden extinction of large groups of the giant reptiles, the incidence of disease also decreased. It seems quite prob able that many of the diseases which afflicted the dinosaurs and their associates became extinct with them. The mammals of the Cretaceous and early Tertiary periods (Fig. 7) do not seem to have been so generally afflicted with dis ease as were the preceding groups of giant reptiles, nor as were the later mammals. The ascending curve therefore is not so abrupt as one might expect. Certain proc esses of disease seem to have been acquired by the mammals from preceding forms, for caries and other primitive diseases are evi dent (Fig. 8) among early Tertiary mam mals. The curve rises rapidly, however, and F i g . 5. Callus and fracture in left radius of reaches the highest point at “ b,” indicat Dimetrodon, a reptile from the Permian of Texas. ing that disease is much more prevalent The specimen belongs to the Paleontological Col lections in Walker Museum, University of Chicago. at the present time than ever before in the One-half natural size. history of the world. 384 Annals of Medical History The geological development of disease has geological antiquity a few can certainly be certain curious characteristics which parallel called ^persistent or primitive types which facts in the evolution of animals and plants. have remained the same since the close of Huxley many years ago called attention the Paleozoic. Other diseases arose and F ig. 7. The skeleton of an eady Tertiary mammal, Titanotherium robustum, from the White River Oligocene of South Dakota, as it is mounted in the American Museum of Natural History. The fifth rib on the right side has been fractured and has healed with a pseudarthrosis and considerable callus. The details are shown in the enlarged sketch in the lower right hand corner. One-sixteenth natural size. (Courtesy of Dr. W. K. Gregory.) to certain persistent types of animals which became extinct, but some of them have had existed almost unchanged from early retained the same characteristics, as seen geological periods down to the present. in the resulting changes of structure. Among the known diseases (Figs. 9-12) of According to present evidences, disease F i g . 8 . Two views of the mandible of a three-toed horse, Merychippus campestris, from the Miocene, about one and one-half million years old. The figures show in the absorbed alveolar margins pathological processes similar to alveolar pyorrhea of the present day. A left premolar shows evidences of caries, and the swelling in the left ramus, so evident in the right-hand figure, is indicative of a fistula, possibly indicating the presence of actinomycosis in the early stages. (Courtesy of Dr. W. D. Mathew) Studies in Paleopathology 385 F i g . 10. Posterior view of a dorsal vertebra of a cave bear, Ursus spelxus, from Europe, showing characteristic lesions of spondylitis deformans. Nat ural size. About 250,000 years old. (After Mayer.) F i g . 9. Lateral view of a dorsal vertebra of a saber-toothed cat, Smilodon, from the Rancho la Brea asphalt beds, Pleistocene, of California, show ing the characteristic lesions of spondylitis defor mans. Natural size. About 500,000 years old. F i g . 1 1 . Spondylitis in the lumbar vertebra of an ancient Egyptian. About 5,000 years old. (After F i g . 1 2 . Spondylitis deformans in a recent human Ruffer.) vertebra. Natural size. These four figures show the characteristic lesions of this osteoarthritis at different periods of the history of animals and man. So far as external appearances go there has been no change in the pathological pro cesses producing these lesions since the Pleistocene at least. Similar lesions of greater antiquity have not yet been seen. 386 Annals of Medical History is, from the geological standpoint, of rela estimates given in the first column of the tively recent origin and has afflicted the table are extremely conservative. I have inhabitants of the earth for only the last followed Osborn in this column. In the one-quarter of the earth’s history— that second column a much greater estimate is is, for the last 25,000,000 out of a possible given. The table will show the relative antiquity of various diseases, whatever values are assigned to the time estimates. FOSSIL PATHOLOGICAL LESIONS The following annotated list and illustra tions of fossil lesions will indicate the extent of diseases among fossil vertebrates. The Fig. 13. The mandible of a cave bear, Ursus study of these lesions is by no means com spelxus, Pleistocene of Europe, showing the ravages plete, and other pathological processes will of disease. Caries and the absorption of alveolar processes, as well as necrotic sinuses are evident doubtless be indicated as the study of them in this mandible. (After Mayer.) progresses. 1. C aries is very common among fossil 100,000,000 years. Future discoveries will vertebrates and has been described by doubtless modify our present conceptions, Renault as occurring among Permian fishes, but the above outline is a summary of our 20,000,000 years ago. A large marine reptile, present knowledge of the rise and develop from Belgium, one of the Cretaceous mosa- ment of disease among animals. saurs, according to Abel, shows in the left mandibular ramus extensive evidences of TABULATION OF GEOLOGICAL EVIDENCES the ravages of this disease. In an early The table given below will show at a Tertiary species of the three-toed horse glance the antiquity of pathological evi (Fig. 8), the mandible has been affected dences in geological history. The estimates by caries and possibly also by actinomycosis, of time are based upon the relative thick as well as some necrotic process which has ness of the pre-Cambrian and post-Cam resulted in the exposure of the roots of the brian rocks, after Walcott and Schuchert, teeth and the absorption of the alveolar as given by Osborn in his “Origin and margins, similar to the results of pyorrhea Evolution of Life.”33 The estimates of the alveolaris. Caries has been noted also in the duration of the geological periods vary tooth of a mastodon, and in the early cave greatly. The duration of the Proterozoic bears (Fig. 13) of Europe. The early races was as great, probably, as all post-Cam of men were singularly free from this disease brian time, which has been estimated as as evidenced by the fossil remains. high as 100,000,000 years. A study of radio 2. Pyorrhea A lveolaris, or some sim active substances gives estimates as high ilar pathologic process, is especially evident as 1,600,000,000 years for the duration of in the absorbed alveolar margins and in the the Archeozoic, although Walcott esti loosened teeth of a three-toed horse (Fig. 8) mates that only 70,000,000 years have from the Miocene of North America. It is elapsed since the beginning of sedimenta also extensively indicated in the mandibles tion. While authors vary greatly in their of the European cave bears (Fig. 13), and estimates, they all agree that the duration of in a Cretaceous mosasaur from France. geological time has been very great, run 3. D eforming A rthritides are fairly ning into many millions of years. The common among fossil vertebrates and indi 33 Osborn: “Origin and Evolution of Life,” p.153. cate a variety of pathologic conditions. Studies in P aleopathology 387 GEOLOGICAL EVIDENCES OF PALEOPATHOLOGY M illions G eological C hief A nimal E vidences of of Y ears T ime E ras P eriods G roups Pathology 3.000. 000 Quaternary Age of Man Abundant lesions on fossil and sub to C eno- fossil human remains 10.000. 000 zoic years Tertiary Age of Mam Numerous diseases represented on mals animal remains from the deposits of the period 5 Cretaceous Fesions on the bones of mosasaurs, dinosaurs, plesiosaurs, turtles, croco- 6.000. 000 Age diles, phytosaurs and other reptiles to M eso Comanchian of representing diseases similar to the 12.000. 000 zoic Reptiles modern forms of periostitis, hemangi years oma, necrosis, caries, pyorrhea alveo- 10 Jurassic Iaris, arthritides, fracture with cal lus, pachyostosis, osteoma, opisthot onos and other lesions which cannot Triassic be interpreted. 15 Permian The lesions known represent dental Age caries, pyorrhea alveolaris, fracture, Pennsylvanian of callus and parasitism. These peri Amphibians ods witnessed the beginnings of dis 20 Mississippian ease. Bacteria and fungi were abun 12.000. 000 dant. to P aleo 19.000. 000 zoic Devonian Age No evidences of disease are known years of from these periods. Beginning of 25 Silurian Fishes dependent life. Ordovician Age 30 of Invertebrates Cambrian Keweenawan First Bacteria (non-pathogenic) Animikian known 35 31.000. 000 fossils to P rotero Huronian 50.000. 000 zoic years Algomian 40 Sudburian 45 45,000,000 Laurentian to A rcheo- No life known 1,600,000,000 zoic Paleolauren- 50 years tian 55 60----- 388 A r m a i s of Medical History Arthritides are especially common in Pleis the middle of the tumor-like mass is 38.5 tocene mammals. The most prominent case cm. The lesion has involved a length of of a deformed joint is the case of two caudal 12 cm. Its surface generally is rather deeply vertebrse (Fig. 14) of a large dinosaur, the pitted. There is an unusual ventral growth, interarticular surfaces of which have been which is shown in its normal condition in extensively deformed and surrounded by a Fig. 15 at “A.” This bony process, “ the huge exostosial growth. chevron,” which served to protect the cau- Fig. 14 Two caudal vertebrae of a sauropodous dinosaur, possibly Apatosaurus, exhibiting a pathological lesion which may be interpreted as a haemangioma, as a callus, as due to osteomyelitis or some unknown cause. This is one of the most interesting evidences of disease among fossil animals so far studied. A detailed account of it will be given later. Other lesions of a similar nature are fairly common among the dinosaurs of North America and Europe. One-half natural size. The specimen is from the Como Beds, Comanchian, of Wyoming, and is the property of the Kansas University Museum of Natural History. The mass resembles closely the tumor dal vein and artery, is commonly present in like masses seen on oak trees. It entirely the tail of these reptiles. The growth of the encircles the vertebrse and has involved diseased portion is unequal and has in fully half of the two bones. The dark line volved more of the vertebrse on one side running vertically in the middle of Fig. than on the other; likewise, the growth 14 indicates the point where the normal has attained greater lateral dimensions on union of the two vertebrse would occur, one side. but all evidences of separate structures are The enlargement is somewhat suggestive obliterated, and the two vertebrse are fused of the lesion of chronic osteomyelitis. It into a single mass. The specimen has a may be a callous growth, possibly due to length of 26.5 cm. and a weight of 5.1 kg. a fracture of the caudal vertebrse; or it The circumference of the normal articular may be a bone tumor. The character of the surface of one of the vertebrse measures lesion is naturally problematic, but it is 27 cm., and the same measurement around interesting that pathological growths in the Studies in Paleopathology 3 8 9 early geological periods so closely resemble the lesions of today. Section of the tumor mass shows the presence of numerous vascu lar spaces, so that in this respect it re sembles a haemangioma. Microscopic study of the periphery (Fig. 16) shows the pres ence of well-developed Haversian systems of osseous lamellae. F i g . 1 6 . This figure will show the possibilities in the microscopic study of fossil bones. The drawing, 300 diameters, shows the osseous lacunae, with short canaliculi arranged around a large vascular opening, thus simulating an Haversian system. The lacunae F ig. 15. Outline sketch showing normal appear of dinosaur bones are much smaller than are the ance of the two vertebrae, based on Diplodocus and lacunae in other extinct forms. The dark areas Apatosaurus. A = chevron. This process in the are due to the staining of iron with which the pathological specimen has been shoved far ventral- bones are infiltrated. The section was taken from ward and involved in the tumor-like mass. the periphery of the specimen shown in Fig. 14. The bones exhibiting these interesting vegetation, and are said to have been ca indications of Mesozoic pathology are the pable of attaining the ripe age of 1,000 years. caudal vertebrae of a huge land reptile, one Diseases are rarely seen on fossil dinosaur of the sauropodous dinosaurs, possibly Apa bones, in spite of the great abundance of tosaurus. The position of these bones in the their remains. body of the animal is indicated by the The tail in some of these large animals was arrow in Fig. 17. The sauropodous dino very long and slender, and it may have saurs were the most gigantic of all land been used in swimming, as a muskrat uses vertebrates, although not nearly so large his today. The terminal caudals in some as some of the modern whales. The largest species were reduced to mere slender rods of these reptiles attained a length of nearly of bone, so that a fracture or an injury of 70 feet and an estimated weight of 39 tons. The head was approximately the size of that of a modern draft horse and the con tained brain was no larger than one’s fist. The lumbar intumescence, however, was ten times the size of the cephalic portion of the nervous system, or at least the subdural space F ig. 17. Outline figure with skeleton,'of Bron was. Whether the nervous material filled tosaurus, showing at the arrow the location of the the entire cavity or not is unknown. The vertebrae shown in Fig. 14. This animal attained a length of nearly 70 feet, a height of 15 feet and a animals lived, possibly, in the swamps and weight of many tons. (Based on a figure by Mat low-lying rivers, feeding on the succulent thew.) 390 Annals of Medical History any kind in this region could easily occur. skeletons, in the famous Lansing man of Aside from possible blows from the head, Kansas,35 and it is probably indicated in the dinosaur to which the above described the Cretaceous mosasaurs, where a well- vertebrae belonged was entirely defenseless. developed osteoma accompanied the arthri The tail, for example, might be seized by tic inflammation. one of the carnivorous dinosaurs and vig 4. Osteomyelitis is probably indicated orously chewed for some time before the in the dinosaurian caudals figured herewith owner of the tail was able to turn his huge and i n certain phalangeal elements of a gian body and knock the offender away. wolf from the Pleistocene of California. Lesions of a similar nature, but not so well 5. Eosxtoses due to trauma, indicated developed, are known to occur in the tail of as callous growths around fractures of ribs Cetiosaurus Leedsi, an English dinosaur; and and limb bones, or as outgrowths due to Hatcher has described the same lesions in chronic irritation or infection, are fairly the tail of Diplodocus. A fuller discussion of common among fossil vertebrates. Healed these lesions is reserved for another time. fractures (Fig. 7) are very common among The nature of the above-described lesion mammals and are occasionally seen among is such that it may have been due to bac fossil reptiles. Dinosaurs exhibiting broken terial activity, and suggests, at any rate, ribs, vertebrae, and horn cores attest the the presence of pathogenic bacteria in the accidents or fights which caused these early part of the Cretaceous period. Bacteria traumatic conditions, and has led Abel to and primitive fungi have, indeed, been infer that the males of these animals con described from much older periods. The tested during the breeding season for the best account of their occurrence is con female. An exostosis which is especially tained in “ Microorganism.es des combusti clearly marked is evident on the inner or bles fossiles,” by B. Renault.34 Renault has visceral surface of a dinosaur scapula, where described and figured many forms of bac it takes the form of a hook-like process, teria and fungi in the fossilized feces evidently due to chronic irritation. An (coprolites) of fishes, in fossil wood, and in exact duplicate of this lesion may be seen coal. He has also discovered in the teeth on a recent human femur. One of the most of some ancient fishes what he regards as perfect exostoses is seen in a mosasaur from indications of the activity of organisms the Cretaceous of Kansas where there is a which have produced results similar to decided lump at the articular surface be caries. He shows in one of his plates photo tween the third and fourth dorsal vertebrae, micrographs of fossil bone from the petrified resulting in what is probably the only known feces in which the ravages of the bacteria, fossil osteoma. Curious exostoses which are Micrococcus are evident in the canaliculi bilaterally symmetrical occur on the radii and the bone corpuscles, which appear in of an Oligocene dog, the skeleton of which various stages of destruction. is in the Carnegie Museum of Pittsburgh. Other deforming arthritides are repre 7. Osteosarcomata have not been posi sented by the arthritic condition sometimes tively identified among extinct animals, but spoken of as rheumatoid arthritis which has the condition is suggested in several in been noted by Virchow in the cave bears, stances. Esper, in 1774, described what he by other observers in certain fossil human thought was an osteosarcoma in the femur of a cave bear, but Mayer, who studied 34 B. Renault: “ Microorganismes des combustibles fossiles,” Bull. Soc. de l’Industrie miner ale Saint- 35 Charles A. Parker: “ Evidences of Rheumatoid Etienne, Paris, 1899-1900, Tomes 13-14, with folio Arthritis in the Lansing Man,” Amer. Geol., 1904, atlas of 20 plates of photomicrographs. vol. xxxiii. pp. 39-42. fig. 1. Studies in Paleopathology 39i the specimen later, suggested that it might Museum in Washington. A mosasaur bone have been a fracture with callus and from the Cretaceous of Kansas and certain necrosis. crocodile limb bones from the Jurassic of 8. Fistula are evident in the lower jaw England show lesions of a necrotic nature. of an ancient and The assignment of primitive whale any of the lesions from the Eocene of to a definite cause Egypt, and an en is manifestly im largement of the possible, and while mandible of a tu b e rcu lo sis has three-toed horse been suggested as from the Miocene a p ossib le cause, of North America the diagnosis is so indicates the pres uncertain as to be ence of a fistula, n ea rly worthless. possibly due to In the cro co d ile actinomycosis, i n skeleton, above its early stages. referred to, there Dental fistulse are is abundant evi occasionally seen dence that the in among the known fection, the focus rem ains of fossil of which was in man, often result the pelvis, was ing in the loss of carried by metas teeth. tasis to the bones 9. Rickets is in of the palate which dicated, according were also involved, to Abel, among the as well as other apes which are parts of the body. found mummified 11. Hyperosto in the old Egyptian sis Or PACHYOSTO- graves. sis, which is similar 10. N ecroses, to the enlargement due possibly to a of the bones in variety of causes, Gigantism, is indi and attributed by F ig. 18. The arm bones of a mosasaur from the Cretaceou cated as thickened certain French of Kansas, showing lesions resembling osteoperiostitis. The and enlarged por Ia^ge bone is the humerus, the other probably a radius. writers to tuber The rough surface of the bone indicates its pathology. tions of the skel culosis, are fairly Normal well-preserved specimens of these bones are quite eton. This condi common among smooth. The lesions have an arthritic nature also, though tion has been de they are not confined to the articular surfaces, x fossil vertebrates. The specimens are the property of the University of tected in certain A marked necrosis Kansas Museum of Natural History. fossil Paleozoic of the ilium of a fishes and Mesozoic large dinosaur, accompanied by expansion reptiles, some of them of great geological and thickening of the bone, is evident antiquity. A genus of fossil whales, known in the mounted skeleton of Campto- as Pachycanthus, has the neural, vertebral saurus on exhibition at the National spines very greatly enlarged and swollen. 392 Annals of Medical History osteoid tissue developed in a human humer us in a case of osteomyelitis. Other areas, such as the one figured (Fig. 19), show per forating fibers of Sharpey, as seen in the dark bundles, and the nature of the osseous lacunae. The whole section is filled with vascular spaces. An especially large one, filled with calcite crystals, is seen in the upper portion of the picture. There are no apparent Haversian systems or canals. Whether this is due to the pathology of the bone or whether it is an occurrence in nor mal bone of the mosasaurs will be deter mined later by microscopic study of the normal tissues. 13. Opisthotonos and the allied phe nomena, pleurothotonos and emprostho- F ig. 19. Microscopic section of one of the lesions tonos, are quite frequently seen among from the surface of the humerus, Fig. 18, showing fossil vertebrates. It has been suggested bundles of perforating fibers of Sharpey, osseous lacunae, and vascular openings. The large clear elsewhere that these attitudes represent space at the upper portion of the picture is a vascu possible cerebrospinal infections or other lar opening filled with calcite crystals. 300 diameters. neurotoxic conditions, and they must be considered in connection with the study A similiar condition is seen in the skeleton of disease among fossil animals.36 The skele of a Triassic nothosaur. We are not justified ton of the small dinosaur, Struthiomimus in stating on these evidences the presence of altus (Fig. 20), described by Osborn,37 pituitary disturbances in ancient animals, shows a very well-developed condition of but further studies in this line may add opisthotonos, with the head thrown sharply very interesting data. back, the tail strongly flexed, and the toes 12. Osteoperiostitis or some similar dis contracted and appressed. The whole atti turbance is the result seen in the arm bones tude strongly suggests a spastic distress, of mosasaur from the Cretaceous of possibly brought on by some form of Kansas (Fig. 18). The articular surfaces poisoning of the central nervous system, are very greatly roughened and the surfaces from infection or the deglutition of some of the bones are covered with smooth, poisonous substance. somewhat flattened excrescences, possibly 14. Osteomalacia is evidently the cause due to a subperiosteal irritation. The lesions of the hypertrophy of the bones of Lim- have been observed in no other instances, nocyon potens, an early carnivore from the so that no comparative statements can be Washakie Eocene of Wyoming, nearly made. Microscopic study of the peripheral 3,000,000 years old. lesions reveals many interesting histological details. One area shows typical osteoid tis MATERIALS AND METHODS sue, similar in all essential respects to The material described in the present paper has been loaned the writer for de 36 This subject has been discussed at length by the writer, in “Opisthotonos and Allied Phenomena scription by the Field Museum of Chicago, among Fossil Vertebrates,” American Naturalist, 37 Osborn: Bull. Amer. Mus. Natl. Hist., 1917. 1918. vol. 35, p. 733, pi. 28. Studies in Paleopathology 393 by the American Museum of Natural His- made by the well-known petrographic meth- tory of New York City, by Walker Museum ods so common in all geological Iabora- of the University of Chicago, and by the Uni- tories. The diagnoses, where they are at- versity of Kansas Natural History Museum. tempted, are made from comparisons of the F ig. 20. The skeleton of Struthiomimus altus, a small dinosaur from the Belly River series (Cretaceous), Red Deer River, Alberta, Canada, now regarded as of approximately the same age as the Judith River series. The unique feature of the skull is the total absence of teeth, with a size of skull one-third larger than the ostrich and a length of body of about fifteen feet. The position of the skeleton is decidedly that of the opisthotonos which may be regarded as an indication of disease. (After Osborn). A beautiful specimen of an osteoma, the material with similar lesions in recent hu only one known so far, on the vertebra of a man material; but strict diagnosis has not Kansas Cretaceous mosasaur, was given the been attempted. We must have some name writer by Dr. J. M. Armstrong of St. Paul. for the lesions, so the terms used must be The writer expresses his obligations to the regarded as suggestive rather than an ac gentlemen connected with the above-men curate statement of conditions. The inter tioned institutions and to Dr. Armstrong. pretation of the lesions in the fossil material The methods used are a combination of is a matter of experience with fossil remains. procedures in the various lines involved. The author feels that twelve years experi Microscopic sections, which can be made ence in the study of fossils should be suffi thin enough for immersion lens study, are cient to avoid most of the usual pitfalls. PLAGUE TRACTATES By DOROTHEA WALEY SINGER AND REUBEN LEVY Oxford, England I. Introduction ...... By D orothea Wa ley Singer II. Sir John Mandeville, Jean d’ Oultremeuse and the Physi cian, Bearded John of Burgundy...... By D orothea Wa ley Singer III. Translation of Hebrew Versions of John of Burgundy’s Tractate in Bibl. Nat. Fonds hebreu 1191 (VIII) and Bibl. Nat. Fonds hebreu 1124 (Via). With Notes By R euben L evy Appendix I. References to Tomb of John of Burgundy in Liege. Appendix II. Text of Hebrew Versions of John of Burgundy’s Tractates. Bibl. Nat, Fonds hebreu 1191 (VIII) and Bibl. Nat. Fonds hebreu 1124 (Via) with facsimiles from both MSS. I. Introduction written in 1365, which professes to be the U R IN G the later middle ages work of John of Burgundy, otherwise known and earlier renaissance, and as John a la Barbe.3 This has been printed especially during the one hun several times, and recently a French version dred and fifty years that suc has been published from a manuscript dated ceededD the visitation of the Black Death of 1371— only six years after the original issue 1348, Europe was repeatedly devastated by of the work.4 waves of pestilence that swept over the The tractate professes to be the third by continent, usually in the direction from the its author on the same subject. He gives East and South towards the West and the “ incipit” and subject matter of his NoFth. These terrible epidemics left deep previous works on the plague, which he their stamp on the literature of the period— describes as well known, but so far they theological, political, and medical. The con have not been satisfactorily identified, if, temporary medical writings on the plague indeed, they ever existed outside the imag consist mainly of short treatises or tractates.1 ination of the old physician. They are to be found in every European After an astrological introduction to the language and several of them have been work, the author describes himself as “ Jo translated into Hebrew.2 han de Bourgogne, otherwise called a la Among the most influential and widely Barbe, citizen of Liege and professor of the circulated of the plague tractates was one art of medicine, though the least of all physicians”. This last tribute to modesty 1 Cf. K. Sudhoff “ Pestschriften aus den ersten 150 Jahren nach der Epidemie des Schwarzen Todes M. Steinschneider in “ Die Hebraischen Uebersetz- 1348,” in Arch. f. Gesch. d. Med., Leipzig, 1909-16 ungen des Mittelalters und die Juden als Dolmet- (in progress), vols. ii-ix;and Dorothea Waley Singer scher” , Bedin, 1893, pp. 790-1, 799-800, 804, 818, “ Some Plague Tractates (14th and 15th centuries)” etc.; and in II Buonarotti, Rome, 1876, vol. xi, in Proc. Roy. Soc. Med., London, 1916, vol. ix. pp. 113-114. Doubtless an examination of the man (Section of the History of Medicine). uscripts of the great libraries would reveal more of 2 Besides the plague tractate, of which the Hebrew these Hebrew versions and translations. version forms the subject of this paper, Hebrew 3 Not to be confused with Giovanni Borgondio of versions of the plague writings of Antonio Cermisone, Pisa (died 1190), who translated Galen’s “ De Francesco da Gagnili, Gentile da Foligno, Antonio Regimine Sanitatis” . Guainerio and Pietro de Tussignano are noted by 4 Dorothea Waley Singer, loc. cit., Appendix. 394 Plague T ractates 395 he takes care to discount by frequent allu astery at Liege (completely destroyed in sions to his success and long experience. 1798), there existed indeed a tombstone, The influence of this text may be traced bearing the following inscription: directly and indirectly in many fourteenth “ Hie iacet vir nobilis Dominus Joannes and fifteenth century works on the plague. de Mandeuil alias dictus ad Barbam, One, that was immensely popular through miles, Dominus de Campdi, natus in out England, bears in most versions the Anglia, Medicinse Professor, devotis- name “ John of Bordeaux, a noble physi simus Orator et bonorum suorum Iargis- cian” . 5 This “ John of Bordeaux” is often simus pauperibus, erogator qui toto confused with the above-mentioned “ John quasi orbe Iustrato, Leodii vitee sue of Burgundy”, whose work appears to diem clausit extremum Anno Domini constitute his sole source. 1372, Mensis Novembris die 17” Five Hebrew texts have been described as versions of the tractates, either of John and around the coat of arms were inscribed of Burgundy or of John of Bordeaux. Be the words: fore examining these texts we will sum “ Vos Ki passeis sor mi, pour Iamour marize for the reader the evidence as to the Deix proi pour mi.” 6 identity of John of Burgundy, who, it will The evidence from the tombstone is sup be shown, had almost certainly a share in plemented by an extract from a fourteenth the authorship of the “ Travels of Sir John century manuscript of the “ Myreur des His- Mandeville” . tors” of Jean des Preis, dit d’Oultremeuse, clerk and notary at Liege, and Audencier II. Sir John Mandeville, Jean D espreis in the Court of Justice (born 1338). It is D it d’Oultremeuse, and the Physician, here recounted that on his death-bed the Bearded John of Burgundy physician, Jean de Bourgogne called a la Barbe, revealed himself to d’Oultremeuse, From the fifteenth to the eighteenth cen declaring that he was none other than Sir tury the identity of the author of the famous John Mandeville, the famous English trav “ Travels of Sir John Mandeville” , with a eler, and that he had left his native land certain Liege physician described as Bearded owing to having “ had the misfortune” to John, Johannes ad Barbara, or Jehan a la kill a nobleman. The passage cited is from Barbe, was too universally accepted to the fourth part of the “ Myreur des Histors” , excite discussion. In the Guillelmite mon now unluckily lost.7 5This work, arranged in four chapters, was cur 7 “ L’ an M CCCLXXII mourut a Liege, Ie 12 rent in England about the year 1390, when the Novembre, un homme fort distingue par sa nais- country was attacked by plague. It is based entirely sance, content de s’y faire connoitre sous Ie nom de on our text, and the problem remains unsolved Jean de Bourgoyne, dit a la Barbe. II s’ouvrit nean- whether “ John of Bordeaux” was indeed the au moins au lit de la mort a Jean d’Oultremeuse, son thor’s name or was a version of the name “ John of compere et institue son executeur testamentaire. De Burgundy”. But the incipit and subject matter vrai il se titra dans Ie Precis de sa derniere volonte described in our text do not quite correspond with Messire Jean de Mandeville, chevalier, comte de those either of this work or of a further abbreviated Montfort en Angleterre et seigneur de I’isle de Camp version in the form of an attractive little “ Epistle di et du Chateau Perouse. Ayant cependant eu Ie on the Plague” from about the same date, of which malheur de tuer, en son pays, un comte qu’il ne copies are only known to exist in England. See D. nomme pas, il s’engagea a parcourir Ies trois parties Waley Singer, loc cit., p. 172 et seq. du monde. Vint a Liege en 1343. Tout sortie qu’il 6 The evidence for the existence of this tomb is etoit d’une noblesse tres distinguee, il aima de s’y summarized in Appendix I. tenir cache. II etoit, au reste, grand naturaliste, pro- 396 Annals of Medical History Further circumstantial evidence seems length, thus urged and with [his] help to be offered by the “ Travels” themselves. this treatise was composed. Nor indeed In the final chapter of the earliest Latin did I propose to write aught of it until version we find a curious story which may at least I should have reached my be translated here: native England. “And I believe that by the providence “ In the year 1355 of the birth of the and grace of God I attained that which Lord Jesus Christ I was staying in the was ordained for me. For from the time city of Liege, and owing to the severity that I wrote it down our two kings of of my arthritic gout I lodged then in England and France have not ceased the street called Bassesauenyr. And I each in turn to perpetrate great destruc consulted various doctors of the town tions, depredations, ambuscades and as to my convalescence, and it hap slaughter, so that unless defended by pened by the will of God that there God I should never have passed over came one physician more venerable without death or danger of death and than the others by reason of his age many accusations. And now behold in and grey hairs, and evidently expert the thirty-third year since my depar in his art. He was known there as ture I am established in the city of Master Johannes ad Barbam. And Liege which is but two days’ journey when I would have spoken also with from the English sea, and I hear that him he intervened, and after some the hostile words of our rulers are by words he at length renewed the acquain the grace of God reconciled. Wherefore tance that we previously had at Cairo I hope and propose for the rest, as befits in Egypt, at [the court of] the Soldan my ripe age, to be enabled to turn to Calalxlich as I mentioned above, in my own land for the ease of my body Chapter VII of this book. And when he and the health of my soul.” had most excellently demonstrated up on me his experience in his art, he urged If we turn to Chapter VII of the work we me and did most instantly entreat me find a description of the first meeting be that I should set down in writing some tween Mandeville and the physician in what of those things that I had seen Cairo, and we are assured “ Long after during my travels throughout the world, wards and in a far distant place, viz., the that they might be, read and heard for town of Liege, exhorted by this venerable the benefit of posterity. So that at man and with his help, I composed the fond philosophe et astrologue, y joint en particulier manuscript was known to exist as late as 1750. Our une connoissance tres singuliere de la physique se extract was first made from the manuscript by Louis trompant rarement Iorsqu’il disoit son sentiment a d’Abry (1643-1726), Herald and Archaeologist of I’egard d’un malade, s’il reviendroit ou pas. Mort Liege who, however, modernized the language. enfin, on I’enterra aux F. F. Guillelmins, au fau Bormans states that this modernized version of bourg d’Avroy, comme vous avez vu plus amplement d’Abry is to be found in the Library of Count au dessus.” d’Outrement, where it bears the number “ 66” . It See S. Bormans in La Bibliophile Beige, Brussels, was copied by Jean Gilles LeFort, Herald of Liege 1866, vol. i, p. 236, and in the “ Chronique et Geste from 1682 until 1718 or perhaps by Jean Henri Le de Jean des Preis dit d’OuItremeuse” , Brussels, 1887, Fort who occupied the office until his death in 1751. vol. i. Intr. p. cxxxn, et seq. The passage is cited by Bormans from the “ Le Fort The passage is derived from a complete manu Manuscripts” , Series ii, vol. xxvii, p. 102, forming script of the “ Myreur des Histors”, written by part of the Liege archives. For details of the Lefort Jean de Stavelot, a friend of d’OuItremeuse and monk family, see S. Bormans in Bull, de I’lnst. Archeo- of the Abbe de St. Laurence at Liege, where this logique Liegois, vol. iv, Liege, i860, p. 319. Plague T ractates 397 present treatise as I will narrate fuller at main Lambert Ie clers, pour et on nom the end of this work.8” de mon tres vailliant et tres honoreis With the exception of a few medical signour mon damoysiaux Lovuy, sig- recipes at Heidelberg and in the Bodleian neurs de Rochefort et d’Agymont, etc., Library, the only work, besides the “ Trav sur Fan de graace de la sainte nativiteit els,” hitherto known as bearing the name Nostre Signeur Jhesu Criste milhe of “ Sir John Mandeville” is a lapidary.9 quatre cens et sissante et unck, en In the Amiens fifteenth century manu moy de may, etc.” 11 script of the “ Travels”,10 this “ Lapidary” The manuscript thus supplements the is given as a sort of postscript under the already-known evidence that in the fifteenth name, not of “ Mandeville” , but of “ Johans century Sir John Mandeville and John a la a la Barbe”. Thus immediately after the Barbe were regarded as one and the same Explicit of the “ Travels” we find: person. “ Chy comenche Ie Iapidare maistre In the latter part of the nineteenth cen Johans a la Barbe” , tury the long-forgotten belief in Bearded while the explicit at the end of the whole John’s authorship of the “Travels” was codex runs: again brought forward by Bormans,12 Nich “ Chis Iibre est appelleis Ie Livre Johans olson,13 Warner,14 and later writers.15 Re de Mande Ville, chevalier qui fut fait, cently the subject has been carefully in- escrit, copileit et extrais hors Tune aultre en la ville de Hotton, par Ie ville’s flight from England and for the composition of the “ Travels” . We have not had the opportunity 8 These quotations are translated from folios i.vii. of examining this manuscript, and these passages recto and verso, chap. I and folio b.iii, verso, chap, vii are cited from the Catalogue General des Manuscrits of the printed Latin version (Brit. Mus. 66,700) des Bibliotheques Publiques de France, Departements, described in a manuscript note on its first page as “ Amiens” by E. Coyecque, Paris, 1893, Tome xix, the first printed Latin edition, dating probably from p . 493. about 1480. Cf. G. W. Warner. “ The Duke of 9“ Le Lapidaire en fran^oys” , compose par John Mandevill, Knight, 1322-1356, a hitherto un messire jehan de Mandeville (?) Lyons (?), 1531; published English version from the unique copy Paris, 1561; s. L et d., probably before 1580, and (Egerton MS. 1892) in the British Museum, edited “ Le Grand Lapidaire,” Paris, 1561. This latter together with French texts, notes and introduc edition was republished with notes by Y del Sotto, tion.” Pub. by Roxburgh Club, Westminster, 1889, “ Le lapidaire du quatorzieme siecle. Descriptions p. vii. Warner mentions 12 manuscripts and 5 des pierres precieuses et de Ieurs vertus magiques printed editions of this Latin version. d’ apres Ie traite du Chevalier Jean de Mandeville” , Henaux, Bull, de 1’Inst. Archeologique Liegois, Vienne, 1862. Liege, i860, vol. iv, p. 159, quotes a similar passage 10 Amiens Public Library. Manuscripts Fonds Les from a French manuscript since lost (No. 360 of calopier 94 (5200). Liege University Public Library, fob 118). This 11E. Coyecque, loc. ext. French version described the physician as “ maistre 12 S. Bormans, loc. cit. Johans de Bourgogne dit ale barbe” . It gives 1356 13 E. W. B. Nicholson and Sir Henry Yule. Article: for the year of the composition of the “ Travels,” “ in “ Sir John Mandeville” , in “ Encyclopaedia Britan- the 34th year of my wandering” . Henaux also cites nica” , 1883 ed. Cf. E.W.B. Nicholson in Academy, a Latin version of Martins de Alost, of the year 1491, xxv, p. 261, 12 April, 1884. as describing the same incident. The story appears 14 G. F. Warner: loc. cit. See also G. F. Warner again in a fifteenth century French manuscript in the “ Dictionary of National Biography” , art.: version of the “ Travels” in the Public Library of “ Sir John Mandeville.” Amiens, manuscript Fonds Lescalopier 94 (5200). 15 Cf. A. Bovenschen in Ztschr. d. Gelsellsch. j. Erd- Our physician is here described as “ uns venerable kunde, xxiii, p. 194, Berlin, 1888, and “ Quellen fiir homme et discreit, maistre Johans a la Barbe, phi- die Reisebeschreibung des Johann von Mandeville” , sechiens” , and the same dates are given for Mande- Berlin, 1888. 39§ Annals of Medical History vestigated by Professor Paul Hamelius,16 des Histors” of the “ noble homme, seigneur whose weighty opinion supports the sugges Jehan de Mandeville, chevalier, seigneur de tion first made by Warner, that Jean des Montfort, de Castelperouse et de I’isle de Preis, dit d’OuItremeuse, was himself largely Campdi18 qui fut en Orient et es parties responsible for the “ Travels” . Professor par della par Iongtemps, si en fist unq Hamelius concedes, however, that the tomb Iappidaire selon I’oppinion des Indois” . stone in the Guilelmite monastery can May we not perceive the Liege notary hardly have been erected to a wholly ficti enjoying a quiet chuckle as he penned these tious character, and he accepts the hypoth lines? esis that most probably our physician, It would be interesting to compare the Bearded John, collaborated in the produc two manuscripts of the Lapidaire d’OuItre tion with his friend and fellow townsman, meuse with the “ Lapidary of Mandeville” , Jean d’OuItremeuse. This hypothesis per with a view to ascertaining whether the haps gains further support by the fact that internal evidence for common authorship, d’OuItremeuse was himself the author of “ Le as well as common sources, is as strong in tresorier de philosophic Naturelle des pierres the case of the “ Lapidaries” as in that of precieuses”.17 At the end of this work is a the “Travels” and the “ Myreur des list of philosophers in which we read, in Histors” . Professor Hamelius19 suggests that almost the same words used in the “ Myreur the joke of d’OuItremeuse was perhaps 16 Prof. P. Hamelius: “ Transactions, Bibliographic Riley, “ Chronica Monasterii S. Albano a Johanne Society” , London, 1916, xiii, p. 193, and Quart. Rev., Amundesham monacho” , London, 1871, vol. ii, 1917. p. 306. Appendix E from a number of tracts, probably 17 The “ Lapidary” of d’OuItremeuse survives in a by Thomas Walsingham who continued the Chron- fifteenth or sixteenth century manuscript in Paris, icon. Both the works of Bond and Riley form part of Bibliotheque Nationale, Fond Franfais 12,326, pub the “ Chronicles and Memorials of Great Britain and lished by A. Michelant in “ Notice sur un manuscrit Ireland during the Middle Ages” , published by de Jean d’OuItremeuse” , in Bull, de l’Inst. Archeolo- the Master of the Rolls.) gique Liegois, Liege, 1870, x, 39. Another sixteenth In the seventeenth century John Weever, while century copy formed Barrois ccclxviii in the Ash- recording the claim and setting down the St. Albans burnham Collection. (See Sotherby, “ Auction Cata epitaph, remarks of Mandeville “ That he was born logue”, 1901, Item 439.) here in this towne I cannot much deny; but I am 18 No such places as Campdi or Chateau Perouse sure that within these few yeares, I saw his tombe have been traced, but as regards the title “ Comte de in the City of Leege, within the church of the reli Montfort” , Warner makes the ingenious suggestion gious house of the “ Guilliamites. . . ” (John Weever that perhaps this was a misinterpretation for “ du “ Ancient Funeral Monuments within the United Comte de Hertford” . Mandeville calls himself in Monarchic of Great Britain, Ireland and the Islands the prologue to the “ Travels” a “ chiualer . . . neez adjacent” , London, 1631, p. 567.) Speaking ap ex norriz Denglaterre de la ville Seint Alban” . The parently of St. Albans, Weever adds: “ The church monastery of St. Albans in Hertfordshire used to men will shew you here his knives, the furniture of show precious jewels which it claimed to have re his horse, and his spures, which he used in his ceived from the author of the “ Travels” and of trauells” . F. Henaux, loc. cit., tells us on the other the “ Lapidarium” . Early records of the monastery hand that the knight’s trophies of travel had been claim “ Johannis de Mandevilla, miles Anglicus, in treasured and exhibited at their convent by the Guil- villa Sancti Albani oriundus” (E. A. Bond, “ Chron Ielmite brothers. ica Monasterii de Melsa a fundatione usque ad We may indeed concur with the opinion of Charles annum 1396 auctore Thoma de Burton abbate Ellis, who wrote in 1699: “ At Leige is Sir John accedit ad annum 1406” , London, 1868, vol. iii, p. Mandeuil’s Tomb, whose Epitaph is also at St. Albans 158), and “ Dominus Johannis de Mandeville, Miles, with us, which may be hard to be reconciled” (Phil. pervagator poene totius orbis . . . hie in villa de Tr. Roy. Soc. 1703., vol. xxiii, No. 286, p. 1418). Sancto Albano materno utero fusus est” . (H. T. 19 Quart. Rev., loc. cit. Plague T ractates 399 taken seriously by pious descendants of voked in May, 1322, there occur the follow our Liege physician, who may have erected ing three names: “ Johan Ie Barber de Cat- the Guillelmite tombstone in a mistaken thorp,” “Johan Mangevilayn . . . ”, and belief in their exalted ancestry.20 “ Johan de Burgoyn, Chamberlayn” . These Are we then to place no credence in the and similar names indeed dog one another “ knight’s ” romantic story of his flight from in English annals of the period as though England? Perhaps it may have at least for our special confusion.23 been suggested by the experience of John But on the whole, the great balance of of Burgundy himself. evidence does point to a real John of Bur The internal evidence of the “ Travels” gundy, otherwise known as La Barbe, as indicates a certain knowledge of the middle having shared with d’OuItremeuse in the English language of the period.21 More authorship of the work attributed to Sir John over, it is remarkable that a certain “ Johan Mandeville, while it seems not improb de Burgoyne, chamberlain” (to John de able that this physician of Liege did origin Mowbray), does figure in the civil dis ally hail from England. It is not without turbances in England during Edward II’s interest to recall that it was during the latter reign, and that the pardon previously half of the fourteenth century that Queen granted to him was revoked in May, 1322,22 Philippa’s weavers were established in Eng the very year, according to the “ Travels” , land. Already we may observe industry of the author’s departure from England. sharing with scholarship in the slow task The author of the “Travels” speaks of of pioneering international amenity, and 4 anno egressionis mee 33” . during the years when our physician was a On referring, however, to the records in figure of some little importance in the town the Parliamentary Writs, we find a curious of Liege, the Low Countries, on their part, coincidence. Among the list of those whose were laying the foundation of a new industry pardon, granted in August, 1321, was re- in Great Britain. 20 It has even been surmised that possibly the vob 1, p. 240, and Morant: “ History and Antiquities name “ Mandeville” was suggested to the authors of Essex” , London, 1768, vob 2, p. 123.) of the “ Travels” by the contemporary work of J. Hutchins: “ History of Dorset” , 1864, p. 261, Jean du Pin, “ Mandevie,” which describes a voyage etc. “ Inquisitiones Post Mortem” , vob 1, pp. 59, of exploration through the moral world, somewhat 81, 126 and 202; vob 2, p. 219. “ Patent Rolls” , pp. parallel to Sir John Mandeville’s journeyings over 142, 361; “ Parliamentary Writs” , vob 2, div. 2, part the terrestrial globe. I, p. 727; part 2, pp. 380, 82, vob 2, div. 3, p. 1138). 21 Warner, loc. cit., p. 71; British Museum MSS. We do not give details of the later confusion of Egerton 1892, fob 60; Harley No. 4383; chap, xv, “ Mandeville” with “ John Manduith” , fellow of Cotton MSS., Titus, cxvi, fob 60. Merton College, Oxford. The source of this error is 22 “ Parliamentary Writs,” vob 2, div. 2, Part 2, probably the entry under Mandeville’s name in Appendix pp. 167, 168, London, 1830; and vob 2, J. A. Fabricius Bibliotheca Latina Mediae et Infimae div. 3, p. 619, London, 1834. “ Parliamentary Writs ” , etatis, Hamburg, 1734, vob iv, p. 289, and subsequent vob 2, div. 2, Part 2, Appendix p. 69; vob 2, div. editions. Three works of Manduith are, probably by 3> P- 1138. a printer’s carelessness, here attributed to Mandevill: 23 Thus in a list of horses and their owners, in 1298, tabulae astronomicae we find “ Johannes de Maundevill . . . habet unum de chorda recti et umbra badium,” and “ Dominus Johannes Bourdun habet de doctrina theologica. 3 equum” (H. Gough, “ Scotland, in 1298” , Paisley, 1888, p. 163). But if we identify this “ Johann de There is a quite separate entry for Manduith him Mandeville” with the bearer of that name recorded self and the three works are duly given in it as his in other contemporary documents, we find that he productions. Subsequent copyists overlooked the could hardly have survived until 1372. (Cf. C. Rob entry under “ Manduith” and attributed the works erts: “ Calendarium Genealogicum” , London, 1865, to Mandeville. The error is perpetuated by Bormans. 400 Annals of Medical History III. Hebrew Versions, now in the that the air becomes corrupt in its essence—- Bibliotheque Nationale, of the Plague for it is an elementary substance— but it is T ractate of Bearded John 24 because of vapours which are mingled there with that the air is called corrupt. Plague Paris Bibliotheque Nationale, Fonds hebreu results therefrom in many countries, and iiq i (viii) and Fonds hebreu 1124 in many places there still remain traces of (vi a) the Plague. And this is clear from the fact Both the manuscripts here translated are that many men die, being full of evil humors. now in the Bibliotheque Nation ale, at Paris. Though each con • ' ' " tains only a fragment of John « 4, Wm of Burgundy’s Treatise, it will •* T5» f» m be seen that the two combined present an almost complete ver AiVlP* 'fhto *17 ■ * 2u h sion of the work. We have been f i r t u n t f s J b > s i unable to obtain any informa tion as to R. Benjamin ben Isaac of Carcassonne, described as the translator of MS. 1191 r 1 »>t» p^tbp *»♦ &»?* (viii). Both manuscripts are ■ ' • • "V V ■ ^ : ' ; • ’ i; 7 on paper. Zotenberg ascribes fifth V*ryij\ p h /mp p 'p'ts yA arns’ r'J thy • TH7LPGJ* MS. 1191 (viii) to the fifteenth f v p %hy * century, and MS. 1124 (vi a) to p pfh vifnp a&” iy W P*r the sixteenth century. We re •yhfj/jjiwjpp ivn& jifr to jfh t*&np vyhrp pi • produce the first page of each: p rv tyith*) ty6jyp t)n* p*TV& w p h Paris Bibliotheque Nationale l Fonds hebreu 1191 (viii) f vAfjt*Att*h*V0p u) t> * w w xwO *6*71 •• J x s r ^ p [Ancien Fonds 404] folio II I 141 Verso titht * w x * * * J jJ rTV&VXK* O xrJJ A Very Noble Treatise on Cor y *b'*r*P77> UipCD thjJp*v'S> ruption of the Air and on the '■* jlh:yph j)t6h p oth fj'fifr Pestilence (Fol. 141, Verso) GENERAL INTRODUCTION m >j f * (Fol. 97, recto line if)* In 25 the course of time air is cor P l a t e I. Facsimile from Bibliotheque Nationale, MS. Fonds rupted, and it becomes plague- Hebreu 1191 (VIII) fob 141, verso. stricken. However, I do not say 24 A copy of our extract from Paris Bib. Nat. first to Dr. Berliner, then to Giinzburg. A. Neubauer Fonds Hebreu, Ms. 1124, as well as of the next item (.Israelitische Letterbode, vol. ii, pp. 84), suggests in the MS., appears to exist in Vienna, Kon.-Kais.- that there is at Leeuwarden another copy of this Hof-Bibliothek, Heb. MS. 158 (ii), while a copy of work, but this we have been unable to identify, in our extract from Paris Bib. Nat. Fonds hebreu, spite of the kind help of Dr. V. F. Buchner, of the 1191, is cited by Steinschneider as belonging Leyden University Library. * The references to the original manuscript which appear in this article in italics are to the French version of the Treatise, dating from 1371, published in Proc. Roy. Soc. Med., loc. cit. The references in lower case letters are to the Hebrew MSS. Plague T ractates 401 The corrupt air alone is not the cause of Just as fire does not burn any matter save pestilence, but it is the mixture of hu that which is prepared for burning, so the mours which fill the men that die. And Galen plague-stricken air does not harm the body testifies thereto in his Book of Fevers, his unless it finds the matter prepared for words being: “ know that the air receives corruption; so that bodies which are clean no corruption, if the matter of the body be and have not neglected purging continue not prepared for the corruption or if it be healthy. So, too, they continue healthy not subjected to any corruptible thing. whose complexion 26 is contrary to that of the affected air. For if it were not so, the people would sicken and die wherever the air is plague-stricken. For the air so corrupted generates various dis > w ? n w • m z d r w eases according to the variety of humours, for the agents always work according to the disposi ysvpw £ /■*■' s ■ tion of matter in the patient.” Now there are many physicians f -4: ' 'f : w ^xjv 'jm w ? MJfcoowrr ym; MV* who work with abstract wisdom pal. ok* JsaiSS ( noon) but are little skilled in r h a d i •, practice and are innocent and A A r ■■ m<■■; bare of the science of astrology, as ■ *» " f t .: : % | y ih ph*P 1 ! w*® that science (Fol. 97, verso) being ml v-.v* of supreme importance to the ■* M 'd m * V * *** “ t f r - physician. As Hippocrates says h n p y ti 1y in the book on Epidemics: &vtwp w r v ^ 3S iflV: “ The physician that is innocent -frp'opj of astrology is worthless, [Fob 142, recto] and no man should p» fafpvf3#* 'P* trust himself to be healed at his ; l i l i ^ hands. ” For in a man possessing r* jmkpM'do’jw xiy kvt o-vNivbi both the science of astrology and the art of healing, the one Uni mmwf'm ^ p> corrects the other and each Ith i ’W i 9 tun WWW) o M f c m > ? science derives much support 2 £ / 4 • 1 < ' “ ; 1 ■' • ; % - b- > b from the other, for not every late II. Facsimile from Bibliotheque Nationale, MS. Fonds thing can be explained in the Hebreu 1124 (Via) fob 122, verso. same way. For further references to these manuscripts see schneider, Hebraische Bibliographie, v. 69, xvii, Zotenberg, “ Catalogue des MSS. Hebreux et Samari- 57, xxi, 98; M. Steinschneider, Zeitschrift der deut- tains de la Bibliotheque Imperiale” , Paris, 1866; M. schen Morgenlandischen Gesellschaft, vol. xxix, p. 165; Steinschneider, “ Die Hebraischen Uebersetzungen A. Krafft & S. Deutsch, “ Katalog der Handschrif- des Mittelalters” , pp. 803 et seq.; M. Steinschneider, ten der Hebraischen Werke der K. K. Hof. Bibl. Navorscher, 1862, Part ii, p. 50; M. Steinschneider, Wien” , Vienna, 1847, p. 167. “ Jewish Literature” , pp. 198, 368, note 41; M. 25 Our Hebrew translation starts just after the Steinschneider, Magazin fur die Wissenschaft des opening of the Introduction, omitting the astrology. Judenthums, Berlin, 1885, xii, p. 183; M. Stein 26 Complexio — mixture of humours = tempera schneider, II Buonarotti, 1876, p. 114; M. Stein ment (temperare— to mix). 402 Annals of Medical History And I have proved, having been occupied the year 22 of the Short Era,29 when it came in physic for forty years or more, that a on our borders, wrote a short treatise on remedy administered under an adverse astrology, together with this treatise of constellation, even though it be according mine concerning the causes and the nature to the art of medicine and correctly com of this Plague, and many took copies of it. pounded and ordered, will not act according It begins thus: “ M y God, my God, etc.” 30 to the purpose of the practitioner nor to 31And when I saw that this Plague returned the benefit of the patient. A case in point is anew and was destined in course of time to that if a remedy be given as a laxative, the appear again continually— for no end of it patient will vomit it even though in the had been reached, and being grieved at the ordinary course he would not reject the dying of people and eager to make some remedy. attempt for their benefit, I composed (Fob So that he that has not drunk fully of the 142, verso) this work and called it “ Ezer waters of astrology cannot help a sufferer, Elohim” [the Help of God].31 especially not against pestilential diseases. My aim is to set out the prevention and As the prince of physicians says: “ How can cure of these diseases with completeness, so I heal when I know not the cause of the that scarcely any man may need a physician illness?” So, too, Avicenna in his “ Cures and that each may be his own physician, of Fevers” says: “ He that is ignorant of protector, guardian and guide. the cause cannot use the correct remedy.” First then we will speak of the fitting This, too, is what Averroes intends when treatment. he says in his “ Physica” that knowledge He that desires to know my meaning is the recognition of near and remote causes. with regard to the influence of the Heavenly That being so, since the heavenly matters matters and also of the terrestrial condi are amongst the primary causes, one must tions let him see the aforementioned treatise endeavour to acquire knowledge of them; which has been composed for these things. and it will therefore be plain that with And I, the least in quality and impor out astrology the healing process will be tance, Benjamin son of Isaac of Carcas inadequate. For this reason many are de sonne,32 the translator, when I saw this feated owing to lack of counsel.27 treatise hidden away and sealed up in their stores, though tried and proved by noble PERSONAL INTRODUCTION (.Fol. g8, recto) Therefore I, Giovanni of Era” . This emended reading would give the year Bourgogne, of the province of Liege,28 pro 1362 A.D. The Latin versions of the treatise, fessor of the lore of medicine and the least however, usually bear the date 1365 and we have among physicians, in the days at the begin encountered no other MS. of this text bearing an ning of this Plague which came about in earlier date (except perhaps the Hebrew versions in Vienna), cf. Page 405, note 55. 27 Our Hebrew translator here omits a passage in 30 Original has “ Deus Deorum” ; hence MS. here which Bearded John recommends the recipe of a probably for D’1?** or certain Liege pharmacist. 31Latin and French versions omit this sentence but describe a second work in addition to the present 28 m w * = Leuvensis or Leodicensis (Liege not Lyons). See H. Gross; “ Gallia Judaica” , Paris, treatise. 1897, p. 306. 32Gross “ Gallia Judaica” , declares this MS. con 29 M. Steinschneider: “ Die Hebraischen Ueber- tains the only known mention of this personage. So setzungen des Mittelalters und die Juden als Dol- too the “ Jewish Encyclopedia” , vol. iii, p. 28. Car metscher” , Berlin, 1889-1893, p. 8 0 4 , suggests that cassonne is not far from Marseilles and near “ 22” may be a copyist’s error for “ 122 of the Short Narbonne and Montpellier. 404 Annals of Medical History destroyed. The liver too discharges it into open the vein of the foot which is called the groin. So also does the brain [to its saphena,4631 near to the little toe and the next. emunctory]. Or else apply cupping-glasses to the legs close to the ankle. THERAPEUSIS If [the symptoms] appear in the parts be longing to the brain, at the back of the ear (Fol. gg, verso.) By these following symp or at the throat, bleed on the same side toms the physician may recognize these from the cephalic4°b vein, which is above the diseases and whence they arise. If the symp middle or median460 [vein], or in the hand tom is seen in the arm-pit the cure is to between the thumb and the first finger. bleed speedily from that vein of the heart Make deep ( ? ) scarifications and [apply] which is called median39 on the same side cupping glasses in order to remove the and not the one opposite. For through poison from the principal members. (Fol. bleeding on the opposite, two incon 100, recto.) Strengthen nature with cold veniences40 arise; the first that it empties cordial electuaries, such as the following: out the good blood which has not yet been Take powder of diarrhodonre, abbatis, harmed, and the second that the poisoned dragaganth, triasandal and powder of [?] blood41 crosses over by the sound channels litharge,47 together with sucrum rosarum. and poisons the sound parts.42 The powders to be taken day and night.48 If it be in the liver, then bleed the basilic43 The diet must be meager and the patient vein of the right arm; that is from the vein of feed on small fowl and occasionally eat the liver or from the vein of the arm which small fish roast on a griddle,49 and also is called salvatella,44 and which lies between green grapes. Tisane,491 too, is beneficial. If the little finger called Zeretb and the ring- there is severe thirst give cold water and finger called Qemisah. vinegar well mixed, and occasionally it is If these superfluities travel within the good to give a little more food and some body towards the groin45 and the mem- pure white wine well mixed.00 On the af brum virile— that is the male member— fected spot put this unguent: Take trimi- and towards the glandular40 surfaces of tina5014 ounces, seed of rue5°b 1 ounce, root of the groin, then bleed the vein of the foot calaminthm‘ and sambucus50d of each 1 on the same side— that is between the big drachm, root of semerion503—which is a kind toe and the next. For if you bleed from the of parsley— 5 drachms. Pound them all to- arm on that side you bring up the poison to the noble organs, that is the upper organs. And this would be a grievous error, for you 46a fO’Str transliterates saphena. would increase and not abate the plague. 46b HKH’O transliterates cephalica. 46C Np'b'ss transliterates media. (Fob 134, recto.) But if the symptom is 47 transliterates lithuria for litharge. far removed from the membrum virile, then 48 A second recipe is omitted in the Hebrew trans lation. 39 'iioip transliterating commune. 49 tenpiatru transliterates graticula. 40 transliterating inconveniences. 49a njNtym transliterates tissue tisane. 41 r i i i perhaps transliterates issue. 50 The Hebrew translator omits the contingency: 42 The explanatory passage lines 16-19 of the “ If the patient presses with instancy for wine.” The French version is omitted in our translation. recipe again is not identical in the various versions. 43 Npi'jtrn transliterating basilica. 5°a Niia’ana transliterates trimitina. 44 transliterates saluila. 5°b nan transliterates ruta. 45 I'buaN transliterates inguila for inguina. 500 lai’a^p transliterates calaminta. 46 rccu^t transliterates glandula. Perhaps mean 5°d ipniD transliterates sanbucu for sambucus. ing inner? Cf. French vers. fol. 99V., line 21. 5°e pun’iD transliterates senerion for semerion. P l a g u e T r a c t a t e s 403 physicians, applied all my energies to re PATHOLOGICAL THEORY, ETC. deem it from their hands and to translate it (.FoL 99, recto, line 79). If anyone fall from their tongue into the Holy Tongue into the sickness of the plague through the that it might be a help and glory to us and ill manner of his living, it is necessary to them that follow us. Praise be to the speedily to give him some remedy because Helper. Amen.33 such epidemic sicknesses become confirmed PROPHYLAXIS after twenty-four hours. It is therefore (.Fol. g8, recto line 24.) I will begin by necessary speedily to give some remedy setting out the treatment as follows: It is and medicine. good to guard against plethora of food and You know that there are three principal drink, to avoid baths and all such things organs in man’s body, namely the heart, that desiccate the body and open the pores; the brain, and the liver. Each of these, as for the corrupt air enters by way of the you know, has an emunctory through which open pores and so penetrates the body and it discharges its superfluities; that of the corrupts it. For this reason also it is abso brain is behind the ears, that of the heart lutely necessary to avoid coitus and to be is the arm-pit,37 and that of the liver in the ware of eating fruits— if they are eaten they groin. should be exiguous in quantity except they You also know that the property of poison be sour fruits. It is good to partake only of is to distress man’s nature, as you know you easily digestible foods and wine of good can see in the bite of poisonous creatures. flavour well diluted. This poisonous air becomes mingled with Every confection of honey must be the blood and with the vital spirit which is avoided and every dish should be seasoned in the body and then immediately makes with vinegar. for the heart which is the foundation of In rainy and misty weather a fire should our nature, in order to destroy and exhaust be made in the bed-chamber, and before he it. When the heart perceives this, it exerts leaves the house in the morning or goes into itself violently to empty out the poisonous an airy place the patient should use some blood at its emunctory, and nature again fragrant medicament such as diambra, dia- attempts to send it into closed passages musk, or dianthus with musk philaris arqu- that it may not reach the heart.38 And ticon, together with musk or the like. If he sometimes it labours to discharge it and to is too poor for this he should use cloves, send it on to the liver, which is the funda macis, nux muscada, zedoary and other mental source of all the natural spirits; substances. He should take . . . 34 whereby nature would be exhausted and Paris, Bibliotheque Nationale. Fonds He- breu 1124 (Via) [Ancien fonds 417] 35 This version starts in the middle of the work and fob 133, verso 35 finally reveals the part of the beginning. Counsel by Maestro Giovanni de Cenobarba 36 “ He it is who has ordained times” ; i.e., times of sickness and also, no doubt, times of healing. But Concerning the Plague (Fol. 133, verso) the author is thinking of the plague and has in mind Blessed be the Lord. Amen. He hath n i s i n in y of Psalms 9 and 1 0 . ordained times.36 3 7 »6»to»tfi, Ditellus or Titillium of the Arabists Joseph HyrtI: Das Arabische und Hebraische in 33 This passage is not in the original French or der Anatomie, Wien, 1 8 7 9 . P - 64b Latin. 38 This and the following sentence are rather dif 34 The text breaks off here and is followed on the ferently turned in the French version, which omits next folio by a series of recipes written in the same the characterization of the liver as “ the fundamental hand. source of all natural spirits” . P l a g u e T r a c t a t e s 405 gether with oil of camomile5°f and a little taken internally or applied to the affected wax, pitch (here Hamm of the text is left spot they draw out the poison as blood is untranslated) and resin.50g Make a little stiff drawn out by bleeding. This has been unguent and apply to the spot three or four proved often and by many people; and times a day. This plaister draws out the although the men who understand these poisoned matter from the humours so that herbs have died out, there are said to be they do no harm to the principal members. some people still in Leotida530 (Liege) who Sometimes galbanum5°h is added. understand the herbs.54 There is another tried and excellent pow der for this, and one which is of greater ASTROLOGICAL EPILOGUE benefit than theriac.501 It is (Fol. 100, recto, (Fol. 100, verso, line 13.) Others say that line 30) called amongst the infidels 51 “ the the cause of the pestilence is the conjunction Emperor’s powder”, which the Arabian of Saturn with Jupiter and other planets emperors used in times of plague and also which came into conjunction in the past against all venom and poison and against year. But the real cause is the conjunction snake bite and against any poison in the which occurred in the year 22 ;55 from which world. It is called in Arabic, Zinwar ^mean there are still effects remaining. For in the ing “ The Deliverer from Death.” This pow course of time many evils will still be brought der is compounded of the herb palamenon,blh about by these stars, such as famines, that is [?] tigice51C, from another herb called plagues and dearth. philadiabld (some call it osilla nigra,510 others call it [?] gentian52 and still others clove53)— p o s t s c r i p t 56 some suggest turmintellab3a or (here ioibbk n of the text is left untranslated) latipha- (Fol. 101, recto, line 8.) The remedy men ron,b3h or bola armenic,b3C or terra sigillata. It tioned should be carried out speedily and can be said of all these herbs that they are there should be no delays after the time we most beneficialb3d; they repel all poisons inju have mentioned, and the bleeding should rious to mankind and against snake bite, also be done from the places mentioned. (Fob 134, verso) they are helpful. If they are If it be impossible to carry out the bleed ing immediately, at least do it within six 5°f xvaiop transliterates camomila. hours, that the poison may not penetrate 80g u >d*i transliterates resin. and strengthen its hold. The patient must 5°h transliterates galbana. 501 npxntax transilterates athriaca, the Arabic refrain from food and drink until the phle form of theriaca. botomy is performed, but after it they must 81 I'ji'psnx transliterating infidels. The French be taken together with cordial remedies version describes the powder as used by “ Ii imperial that he may gain strength. des pay (n)s” , the emperor of the pagans. (Fol. 101, verso, line 13.) We have noticed, 5ia “IX1JU and it is a fact proved by our experience 5lb transliterates Palamenon. 51C transliterates tigice. 53e transliterates Leotida, cf. Latin Leodia. 5ld nxnx'ne transliterates pbiladia. 84 Cf. in French version the “ apothecary in 516 xrnp x’vnx transliterates osilla cruda. Liege” . 52 transliterates gentiana. 85 A marginal gloss in the same hand as text 53 transliterates giroflata = giroflee. emends “ 22” to “ 52” . This, without Stein- 53a transliterates tormentilla. schneider’s emendation would give the year 1292. 53d pvB'tDX1? transliterates latipbaron. See above, note 29. 53C lpousnx transliterates bola armenica. 86 Both the Astrological Epilogue and the Post 53d naiDiDitoDKUi k>d“u transliterates gracia, gracio- script are shortened in the Flebrew translation and cissimo. vary somewhat from the Latin and French versions. 406 Annals of Medical History over a long period of more than twenty diabra, diamusk and [ ? ] diacodi. If he is years in which this change [in the position poor let him use cloves, nux muscata and of the planets] has taken place in these mace, and_once or twice a week some [pestilential] districts, that a great number theriac. He should carry in his hand a of cases are cured by phlebotomy alone. pomander or other {Fol. 135, recto) fragrant For the poisonous matter is by this method substance and smell it frequently. expelled, the vitality aiding to evacuate the In the evening 61_he must return home evil matter; and the heart also endeavours speedily and go close to the fire, throwing to evacuate the evil from the body. This upon the coals some fragrant wood or ol evacuation of the poisonous matter relieves the following powder: Take of olibanum him [the patient] and he is thereby delivered and storax 1 ounce, of storax and mint 2 from the pestilence.561* drachms, of aloe-wood 1 drachm. Put it on the coals and it will produce a smoke. PROPHYLAXIS 67 Let him do this also when he perceives an evil odour. And, by the help of God, if he (Fol. 98, recto, line 23.) It is necessary to act in this wise. . ,62 In summer he must be sparing in food and drink, avoid frequent take much vinegar and green grapes— he bathing and heavy labour and all such must not use hot spices. If in the morning he things that open the pores in the body. For is warm or perceives an evil odour, then let when they are open the heated 58 air easily him make a practice of smelling roses, penetrates, and so the vital and the natural violets, cloves, sandal-wood and aloes. Also and the animal spirits are dissipated and he should hold a sponge dipped in vinegar decayed. Fruits must be avoided except to his nostrils when the weather is hot.63 they be acid, and at all costs coitus must be avoided, for it weakens the heart. 61 French version “ a Ientree du lit.” Take easily digestible foods and aromatic 62 The copyist has omitted a line here, probably wines. Avoid confections and particularly through “ homoioteleuton” . It no doubt began: such that contain honey, and all dishes “ in time of cold” , as in the French which runs should be seasoned 59 with strong vinegar. (Fol. 98 verso, line 15 ff.): “ alaide de dieu en temps In cold weather and on rainy days a fire froit bruyneus, on corru(m)pu effect de mauvais accide(n)t pourra estre preseruez” . should be lighted in the bed-chamber. In 63 This passage is briefer than in the French and summer the patient should eat something Latin versions which, however, do not mention the in the morning before rising and afterwards sponge dipped in vinegar. The use of this device go out into the open air.60 He should take was common. Our translator may have util aromatic {Fol. 98, verso) remedies such as ized here the popular plague treatise of Bengt Knutsson (two Latin editions of this work are be 56a A marginal gloss in the same hand as text lieved to have been printed by Gheen, Antwerp, gives which Dr. Cowley suggests is perhaps 1485 and a third by Arnaldus de Colonia, Leipzig, a transliteration of infetto. 1495). Two English translations are ascribed to 57 We here revert to the passage on Prophylaxis, Machlin, London, 1480, another to the same pub with which this version closes. It will be observed lisher dating from 1483 (reprinted by Jan van Dois- that it is a portion of this passage of which MS. bosih, Antwerp, early in the 16th century) while Fonds Hebreu 1191 (viii) provides a version. another was published by Wynkin de Worde, about 68 D»in» no doubt copyist’s error for doidb 1510. Many of these editions have survived only in “ poisoned.” fragmentary copies, but one of the Machlin editions 59 nip transliterates conditi = prepared. Cf. of 1480 has been reprinted from a copy in the John ptanaip = condition, spiced wine or spice to put into Rylands Library at Manchester: Guthrie Vine “ A wine (condiment). Litel boke . . . for . . . the . . . Pestilence” : John 60 This sentence does not occur in the French or Rylands Facsimile 3, Manchester, 1911. See also Latin versions. Dorothea Waley Singer, loc. cit., pp. 183-185. P l a g u e T r a c t a t e s 40 7 He must avoid onions, garlic and leek, and in the poem addressed to the Arch but parsley and cinnamon are allowed him, duchess Mechtild of Austria in 1462 by for they are not excessively hot. (Fol. gg, Jacob Piiterich and published from a six recto.) It is good to drink cold water with teenth century manuscript of Herzogenburg vinegar and also to drink tisane, for it is of by Moriz Haupt, in Zeitschrijt fiir deutsches great benefit to people of a hot dry nature.64 Alterthum, Leipzig, 1848, p. 55. Both The house should be sprinkled several Ortellius and Piiterich give detailed de times a day with cold water mixed with scriptions of the tomb and of the coat vinegar and rose-water. Pills of Rhazes too of arms which it bore. These arms have are of great good taken once a week. They been traced by G. F. Warner to two are beneficial to all complexions of men and families, the Lamonts and the Tyrells at all seasons. Avicenna and all the other or Tyrrells, of counties Somersetshire, Here authors praise them greatly. They disperse fordshire and Hertfordshire. Possibly our all corrupt matter and their formula is:— hero had seen the arms of the Hertfordshire Take cicotri aloes 3 drachms; myrrh and family at St. Albans. The epitaph on the saffron of each 1 drachm; make into a paste tombstone is also quoted by Pits, who with syrup of fumo terra drachms, and says it was sent to him by the English form into pills which should be taken in the priest Edmundus Lewknerus, who saw it evening before sleeping. before his death in Liege. See John Pits, “ Relationum Historicarum de Re t r a n s l a t o r ’ s e p i l o g u e bus Anglicis” , Paris, 1619, vol. 1, p. 511. And if a man, with God’s help, employ John Weever, “ Ancient Funeral Monu the means which I have set forth he will ments within the United Monarchic of Great Britain, Ireland and the Islands stand secure in a season of pestilence. Adjacent” , London, 1631, found (p. This treatise was completed here, in the year 65 one thousand three hundred and 567) an epitaph to Mandeville in the ninety-nine by Maestro Giovanni of Ceno- church of St. Albans, and a legend current barba. And this reckoning is according to of his burial there. He explains that he has himself seen the tomb at Liege with the the reckoning of the Nazarenes. epitaph. The epitaph in our text is here given verbatim from Pits. Ortellius and A p p e n d i x I Weever give the date 1371, but almost Early Evidence for the Former Existence all later references confirm the “ 1372” at Liege of the Tomb of the Author of of Pits and Piiterich. Piiterich, however The Travels of Sir John Mandeville has also modified the name and title to The epitaph from the Liege tomb is trans “ Monteuilla” and “ Compredi”. The only cribed by Abraham Ortellius and Joannis other differences in the versions of the Vivianus, “ Itinerarium per nonnullas Gal epitaph that we have seen are the omission lic Belgicae partes,” Antwerp, 1584, p. 15, by Ortellius and Weever of the word “ suorum” after “ bonorum”. The various 64 The Hebrew version here omits the warning abbreviations, etc., in spelling we have that a sensation of “ pricking or motion in the blood ignored. should be treated by instant phlebotomy” “ on the Mandeville is mentioned as an eminent same side and in the nearest vein. ” physician and great traveller, buried in the 65 No other version we have encountered gives this date. The usual date is 1365. The treatise “ in 4 Guillelmite convent at Liege, by so early a chapters” of “ John of Bordeaux” especially current writer as Radulpho de Rivo, Dean of Ton- in England, usually bears the date 1390. gres (ten miles from Liege), who died in 408 Annals of Medical History 1403. See Joannes Chapeauville, “ Gesta Equestris Ordinis Anglum nobilem, vivis Pontificum Leodiensium, scripserunt auc- excessisse Leodii, Sepulcrumque in Subur- toris precipui” , Liege, 1616, vol. 3, p. i. bana Guilielmitarum Aede elegisse, scribit (For the life of Rivo see P. C. Mohlberg, Radulfus” . He corrects both Rivo and Ortel- “ Radulph de Rivo: der Ietzte Vertreter Iius as to the date, commending the greater der altromischen Liturgie” , Louvain, Paris accuracy of Guicciardini; also he notes the and Brussels, 1911.) De Rivo gives the sentence carved “ in the dialect of Liege as date of the tomb as 1367, a mistake ex used to this day” . plained by Warner as probably due to the easy confusion between a Latin X and A p p e n d i x II V, supposing the real date to have been 1372. Similar references to our author Paris, Bibliotheque Nationale Fonds he- are given by Cornelius Zantfliet, monk at breu 1191 (VIII), (Ancien Fonds 404) folio the convent of St. Jacques at Liege, in his 141, verso “ Chronicon ab anno 1230 ad 1461” , edited 1 2 D 2 by de Louvron and published by Martene tsn sy i “TKa “ I D K D .nm m v iK n and Durand, “ Veterum scriptum et Monu- D'nn d ' c nnna'n viKn “oman naK mentorum, documentorum, moralium, am- t i k ntryai tysiya Kin plissima collectis” , vol. 5, p. 67; John Bale, trsyrv viKnty naiK t k DaaK .^ a a 5 “ Illustrium Maioris Britannicse Scrip- torum” (Ipswich?), 1548, Centurion iii, p. im a x yn 149b; Jacob Meyer, “Commentarii sive An- im ynat? n n y n bnK nm Kin sn nales rerum Flandricarum” , Antwerp, 1561, nnnnn neaa ma “pan .tysiya t i k tnpa Lib. xiii, p. 165; Lodovico Guicciardini, ?n nnpy niaipa nnnnn nKtsa p y i mrna “ Descrittione Di Tutti i Paese Bassi Altri- ntrK lm a* c b u k nnnn 'n nKnatr ian n w a n menti detti Germania inferiore” , Antwerp, treiyan T'lKn k^ m yn m n P d^kP b nn 10 1567, p. 281c; F. X. de Feller, “ Dictionnaire ’iynn mnPn cpTxn ^nK nm^ nn 12 nn^ Historique” , Liege, 1781, vol. 4 p. 329 D'K^Bt? (quoted by Henaux; we have ourselves nnon Din^^n Tyaa* ian a v ia n D'tWKn seen only the edition of Paris and Lyon, hm pn 1822, vol. 8, p. 395); P. Lambinet trisy mty T iK n <7np*» v yn nn “ Recherches sur L’Origine de Tlmprimerie K^ DK Brussels, ann. VII de here franchise” , p. 299. n :ia n\T>a> ik trisy'i? p i a span nam nnTiy J. Leland, “ Commentarii de Scriptoribus pj-ntr*’ k^> tin ts ' ian .trsiyan nnnn n n n 15 Britannicis” , Oxford, 1709, p. 366, has a K^K lengthy notice of Mandeville. He does not nfijan T»iKn p ian .nsnts^ plan nann give the name “ ad Barbam” but describes K 1? the knight as “ ex fano Albani oriundus” . .tsnsy^ p i a nainn k x b' k5> dk span pn*> He says that he studied first theology, then p D K medicine, and that finally, owing to his mpnnn an na ^rPnn D^pan 'nn a v ia n thirst for knowledge, he became a great a n a iy traveler. Leland devotes much space to na>K a^traKn D'K*>nn a v a i y p i .cK 'n n praise of this latter pursuit. Data R. P. FouIIon, “ Historia Leodiensis . . . nnKn p k1? DKt? nan wan TiKn ata^ a^nsn 20 ab origine populi usque ad Ferdinandi lman awaKn tin' ^eaan nnsvi n\Tts> aipa Bavari tempora” , Liege, 1735, V°I- pars. mn^n mtsnnnn tpeiya m TiKn v 2, lib. 5, p. 436, mentions “ Mandevillium, tnn*' P l a g u e T r a c t a t e s 409 D'byie D'byisn Dbiyb 'a .D'sbnna D"bn uaa jwne mpb D'am nsjan nRra yaam 25 Dm? 'sbi .byanan namn nmn mb nRT 'a miRnai .’iai 'bR 'bR ja bmnai naRbaai naana D'byien D'Rsnn D'an 25 m'ny jam ■jtyanai anna nat? nsjan wai D'aay roiann naanai .D'bma aya 'jri .mb nsp y'm Rb 'a oys nnR ays aitrb bob 2Ra mmaan R'nn naann 'a .D'bb romaa sjoiai D'tWRn nn'a by jRiaa wan ’t 'naan onbyin V 'a'a'BRn neon anpiaR aaRt? iaa ip'tns (fol. 142, verso) j'Ri roiana bbwan Rann oiba mt? u'Rt? n aRab 'nya .mbR any imRnpi aiann nr 1 Tn"b'trn (fol. 142, recto) Rb ayaa jy' ma'bao D"bnn nbRa 'isnni naan tnab 'a it by Rsn't? aaRb 'iRn 1 ncro roiann iaxyb Ran nimb baa' dir baa Ran oaRb naanm nr hr nr Dntn'a nRisnn naRbai wi Ymn roronna naai nbnn ja dr .j'roai anraa aa in ba 13 mnRn naanna nmn naan nroia \n nystsm 'sb 'roia ya'b nxnw 'ai .rowan 5 mma nn .onaan baa m an' Rb ana D"xaRn D'j"jyna oaa D"a'aa*n D'aaan poyna ry - roman nannn 'a ani' ir ro» 'a nRisaa 5 'jri mr by aaman aann aaRaa aa pns' ’aa j'a'ja nbyaai ma'Ra japn "maRban “paa R'ntr '"ayR "asn aa aiJD oaaJipn nr 'niRaa pmyan mtypap naaaia ’mm Rann naia mb nbyis nnm Rb jama naaiaai ’naaa D'Rsn 'a' by namai noua onnxiRa 10 ;ron dr nyab hrt .nbmn nbymb Rbi dt nnna lR'xmb mibant^n ba matr ’Risnn lp'nynbi Rb “lyaaa^ '"ayR R'p' nbmn ron btrbti'b anbi aryb ub nm' jy' tsnpn jit^b bR oaat^ba BRB' .jaR anyb nbnnm unnR D'Rab dji naR roiann 'am row Rbtr 'a ja dr .nRisnn 10 ..aaiRi ronann jnara b'nnRi ansai jaa .nntyam baRan 'iba ja anmb ' l r a 15 'awt? iaa .'binb mryb bav> Rb D"a:an D"bna an D'aaan baa jmaan p'nanb 'iRa naD yiR Rb dr nRsnb baiR *j'r D'Rsnn at? an a'iRn Dja' 'a D'apjn D'nmai cjun d'jsd ’n treyai rjaan apui D'mnsn D'apjn -jan trsiy 'a 'br nmnpn nRisna 'j'D p on .'bmn nb'aRa aatynbi bJts^aa p'nanb aRa 'ma jai Rbtr Rb dr aya n'n' ana baR' dri nn'sn 20 .'bmn nRisna nRisnn lb yjaa naan yn' ’n'sna biayn 'bp D'j'jy b'nnb 'iRai .D'siann nauw yatso am pR ron' p dj nn 15 j"i ny'amtp traan mpn ba pman .'iRaa aara n'an aia p dr .mpinnm manpn maa man Rm ■ty; jaraa .pama D'jpma D'ayoan ba nmi WRnn ’laona im' D"B'Btsm a'naamp nnRa apaai .uatya aana t^R ntyy' "aR "atra nRT5 .onn Dnaan man bR Rab -pas'm: raipa DR a'iRn Dipaa aay'ty ir n'ana mRx oaa 25 mbi nRisnn nan man Rb roiann nbiraty p b'ja' 'a R'a RaaaR R'a raa mmtyan msnnn m j a b 1 .D'an lmro' nxyn |nana 20 ’a ptna naana jdir traiR'b truaa Rroumaa jri’j oy jip'aipaR trn'b's ptyia ay t^'DJR R'a d ' b ' 'b nr D'Ranaty jap nmm nRisnn ptna nbnna 'bisiR'aj b'n' njt^a n' j'R dri .Dn'am ron p"sb a"a nw nnmt? nRtn naaan np'i .onbrn nRia'? 'aptyia 'du ir'DRa unnaa aya nraana nr 'man oy roiana jap man mwy 1 Read 410 Annals of Medical History Paris Bibliotheque Nationale, Fonds nan ynrna r»pn dn t m ap yamn psi hebreu 1124 (Via) (Ancien Fonds 417) ''pft1? Di«n ntya nn« fob 133, verso t nyi naatr nmni Dmftyn ftn onaaan 25 dni nain iDnn Nft ftian pny ty NaiNawn pia 'db” nb t “?y nxy 1 pr Nin nny N'na .in n (fob 134, recto) inanan yn naa1? in n ftina fts** 2 3nnN bn m i nns tn ftnn DnaNna pnin*1 pan dni mft *px nina i p n -paD NaTty 'pan ftin i"a id n D’n n n Dftmn 3iftN iw n m a ft niDia D^pit^a n'w in .inN.m ppn yaxN^> ■pix pft la^pm myt? naiaiN^ anp nxTan t|iaa t nymty mNi .nNisn m a nn^ nine piaa in onrNn mnN man pftia int« dni anaN 'a r» bind ixn iniNa rpn tn ft ty ana inN fti naam mam aft ft'i 5 n'N'TD n'yxaNna nfta^ Nina> Npftsxa nnvr 1a iwn nymt? iaa “ptra pa ma in 'yft nins man p iann i 3 Nn p nnman niDiai D^pm DTian ntryi nnNm ftian 5 Nft&'&n aftai .onTNn DiNn pmim nxTan mftaaa DiNn t yin nnNi .ts^aaNn laanai oy yaan pmi D^tyNin onaNna ••tin n nty«a ^lann yaa ixft ia^ni oaa1? onp DTipi miNn m " din n"a na'tra n«n win nym aaaftnNn tyaNaN pmnNn paw np ain oy anya 'TiN.n NTNiaft paN ftiao nNna iid' Hint? aft yaa ma ppaaty nnnn mini .nftfti d it DpaNn aman iNtrn npir oy inma' ip n laft yaan npi mnn nanann fta yyiana ma ■p n«n afttrai .in1?an 10 Dnapn omna 'Tysft onap msiy ainan " bind D i n pnn1? inft' NftpTNiaa 'nft Dmao DftTtsr lpnrft yaan imai ipna^ tn NBxn prnn dni naNt^an ftym naian ay 10 'Tysft .aft ya' n^ ns yam oy onp d t p ft na' «intn iaa1? lnfttn ipnift tys' inn aya pra nn^ na DTysft aiaa ana yaan man nftn nnysan mnnn aiaa ana ftft p 1? p*» p i ntriy pi .ffftNftaanft mom a"a laani np .n^iannn m d^ NDiian Dipa ^yi Nsnn ms' anaon iftsi .man yir 'npaiN ’1 Na'a^ana pT n nni*> dn .liftin'* pmai D'ftinn lfta 'n 'Na lpiaao laaT^p 'paiN 'n nan n\i nwism ifta'aa pa Nin jiNnnD 'tnt^ 'an 'a"iaip lyxBK 'pan aft t u b tpift nina 15 Dyi Nftaiap jaty ay aft npim 'a n 'n osia Nft ixn iniNa 'yft Nts^Ni nsr myty aya 'a lifttp ixn *pn^ npft> t .naasaft Dipan ty d^ i rw p n^iann aya ntryi iami 15 '«n tyDa'NTTipa'N t ana '*«ays 'a in 'i t 'a .pna T f t last? aian Din pnn t DftNna *>t i n 'ainn “jit^an 'ran nnftDNn 'yft ityft DDiDan D in 'i^Nin onaN1? lpn^ Nft* maipan oacn niNnsn nnayas may noiaa paN nft ny . naaft d t t id 'Tysft mm dni .niNnsn inn ftyn it^N Nftai nam ynrna Npftarn ftp' tn laan T ft icpn paN iftiTa^Nn pa 'ipai npNnaNna laan t u b ianm anoipn it^N ysxNn pa Ninty nftNfto 'pan mn mma in 20 ft naa oai lain pra D'ftaia nn DTiyn psi rnn 'pan ppn ft^ n a naa 4din^ dd nnman ftN dni .mnap 'pan nyaan ysxN ftxa iNian Tiya 'pai aftyat? din ft naai 20 T ft span *yma isft nr npnn man p miatn ft'i ftnn ansN.n Tfti fti"aaN.i NT'a^a la^ni paTifts 'pan atry oy paNn ftnaftn ns Tfti nNftNfts 'pan ihn at^ya ixn iniKa ftin m i rpn tn ftmaa^na D'Niip annNi Ninp NftriN ft pup dthni ftina ftian pa lanm onnNi naNTa'a ft 2 Supply DTK. 4 Read dtki . 3 Read i^k. 6 Read o^na. P l a g u e T r a c t a t e s 4 1 1 ’dim amoKi KBK^siKnKa i*? pup iPm .aP tyipi m ans P te Ptyan tfn idibsrii (?) ik K^iaaiana ’ann pn .Pynn1? a^p diP kb n ,ai^ tew ainn am lpiamiK i^ia pirnm ana aaaity aniKi 8niKisin lpmm P m 20 an 'tan 6antyinn te nm p^tsann te .train p W D1K te lpinmi laiDiDIKiDKia K"mia 25 mami npn pra .pm pain cy lamaip D^run pra^i dik1) nna trK ntyp c^awn ^dks inaaa Dip^ amp ipaa ppai .naan (fol. 134, verso) -ft' inKi la i nnK P'bbiik niKiain ^ai11! a^iyn t ik ^ aipan te amity ik ana nntyity ik tfiyr» 1 nKm ipDia Km- KiaKm: nrprna Din laa aiKn mpDia naK ^am *»ay Kin dki mipK ip s"yKi amni 'mya naai naa naia nn nnK cysi .t^sKai 'naran amtyyn annan ina men ima T^V'i .npKma yiata^a amity ik 25 annaty kiidiki‘?3 pny iKsaa te 'bik a^anm a^a^ayai Kiaa-Ka ’aw annKi .anaran amtyyn (fol. 135, recto) amam pis oy iKnaty nan lain raa te mayty natya nannaty 'nnK n te1? mna mm1* aiya .man nm*1! a«anm 1 pny m6ba"a natya ityyaty ananaSnpn 5 te ^ 'manna p*»iy ityK tyi nnma 'k np paKn nta ik a^anm amy a^nan nv»aiayi Dmaaa pm “jiiKa man niyi tywKiiaffK ^Ka^iKa ^paiK 'ran nKisim .ipm msaai /a n 'k '•ki^k py 'a n 'a 'k'b naa'a^p pra nnysann aw ^ai mna ntyynty ■»i«n pi ptyy ntyyi amnan te ctyi laiaKty iaa rprty iiki mryai .yi nm tyai^ ityKa “|iin nr te ntyy te nityy^> Pin k1? dki .laiaKty maipanai 'mam n^Ka ntyy dk aty.n ntyy nins1? mna ■Ja trial1' k1? .laiai pain ai ^ai1' ppn prai 5 prnnn aaai k1? aiKnty na myty tyty anp an Kin ipaa dki .a^an a^atya nPnn prnnn .ansa amnn nmn^ ^ai*» rK nmn yi miK ik nr mm nrpnn ntyynty ny nntyai P kdb 10 iki^k mmaa mania ty^iKaiiKm prna mm^ niKsi ay .ainn pra ammaa pnni pain ay aisai an pr nm 'a m a Kim w k i nam .mnnn .aiaitym a^san pmii antyya inn mn mm naya a^ai.n ^aii paapm asian miam ikb nanm m^Pn i^k i *»iatrn mnty naty mnty^ .ikd aian aaiK n a p nrpna iKSinaty la'Ki mnty^ aiai .amia pain ay amp amn nan te ksi “pin nr te miKn nainn m I'bya1? ^yii nam m naKtyian .ynn 'ann ts^ia^ yunaa amp aia ay nmn tj^sii tyam ann Kaan 10 pi tyiaai span p yin tyia^ pi pmna aPi amys naa amn mi paim 7 n p n pina lasan aiKn a^ain^ ikd amia 'mKi i^i'rmn aai .aim iiki nanann main p i^sn^i lasy 15 ‘m^ l^iym yiatya nnK ays pining nntyaai PKaa minty iKty ^>ai a/;aKi pr teh amia am aiKn ara mpa ammsn Pi nanan nnam pman aniK amatya amanan ityKa m span annaa ityK .nasa lain te i^ty^tyi .nam mini nans aaai aaina t ik i npaa inns*' maipiD iki^k np nr ntysam iyaam mmi isnty ay tyi1? 'a n 'kb aaia nma .'an 'a ia^> lpnim aP m in i .tysynn aaaani 'a n 'k Kiiaiaisi pm i^i annan mms nm dk .pity anp aiya inpmi tyWm ntyyi mm 15 n"ya nr ntyyi itr«an 6 Read D*awyn. main pra nay1? tev iniarty aianayn ay ®a Marginal gloss in same hand as text; mpi, te te ta’styi tj^K natya 'aKan nr ns a^tya- ®b Marginal gloss in some hand as text: n"j. Kaiaiami iaKia 'atyiKa See note 29 and 55 of the translation. .amsian patyn^ Kin patynn nn 7 Marginal gloss in same hand as text: ib’sj’ n. See note 56a of the translation. 8 Read mmpin. THE MEDICAL PHRASES OF VICTOR HUGO* By HUBERT ASHLEY ROYSTER, M.D. RALEIGH, NORTH CAROLINA ITERATU RE is not lacking in medi doctor. He merely writes into his works cal characters: many great writers his wide and accurate knowledge of the of drama and fiction have intro- whole science of medicine. An astounding mJ duced doctors into their narratives. mastery was his of every branch of science TheI doctors of Shakespeare and of Dickens as it existed both before and during his have furnished themes for interesting day; his books fairly teem with evidences studies, while much of Moliere’s satire is of it. Most of his medical expressions are in heaped upon the doctor and his foibles. the form of figures of speech. In the stories of innumerable lesser writers It is not uncommon, however, for speak of fiction may be found physicians as ers and writers to employ medical similes; major or minor characters; some play now and then they add strength to the the parts of heroes, others the parts of ordinary discourse and enliven the usual villains. In each instance the authors dis occasion. The ability to use such expres play more or less knowledge of doctors and sions wisely and well constitutes an art, familiarity with their work, according as even if it does not attest a profound knowl they have had opportunity for personal edge of medical subjects. But when one observation of or association with them. illumines one’s pages over and over again Usually scant justice is done the doctor in with deep-rooted ideas of all that pertains his attitude and service, but, on the other to a great science, as Hugo does, it is hand, much effort at mock heroics is nothing short of genius. And genius he was wasted in attempts to give him more than in the truest measure of the term. he deserves. The average fictionist is glar There was apparently nothing in Victor ingly ignorant of medical men and their Hugo’s early life or his education to give ways and even more so of medical science him such knowledge, except that in the itself. The hero or heroine is still dying year 1818, in a general yearly competition of of “brain fever,” and peculiar pathology all French scholars for University prizes, is often developed from sensational he obtained fifth place for physics. At six injuries. teen he left the school for good, determined Conversely the comparatively few phy not to try for admission to the Ecole Poly sicians who have gone in for literature rarely technique or to be a soldier, as was his use their works for displaying their profes father before him. Instead, he began to sional learning. It appears certain that write. We know also that he began to read Keats and Goldsmith actually avoided med widely; only omnivorous reading can ac ical ideas, if, indeed, they had many; and count for his omniscient writing. A t least very little of the best thought of Holmes I shall claim that he read greedily and re and Mitchell contains medical allusions. membered tenaciously all science, and medi In lay literature one author— Victor Hugo cal science in particular, for without this — stands forth supreme in his medical preparation he could hardly have set down knowledge. Yet not one of Hugo’s leading the wonderfully true and interesting scien characters is a physician. He makes no tific observations which enrich all his works. attempt to portray the personality of the Whether in figure of speech, running illus- * Read at a meeting of the Harvard Medical History Club, Boston, Mass., April 4, 1917. 412 T h e M e d i c a l P h r a s e s o f V i c t o r H u g o 4i3 tration or homely simile, the details are per one of his letters he calls the Strait of Mau- fectly presented and the meaning is exact. musson “ one of the navels of the sea” ; and M y purpose, then, will be to pass in in proving how divinity adheres to the review the phrases which give evidence of “ rough draught” he shows “ how the solar the profound medical knowledge of this ray is an umbilical cord,” how the “ disfig man of letters and of his artistic perception ured becomes transfigured.” Walking the in weaving this knowledge into his narra corridor of a dungeon gives rise to a com tive. Let me hope that my account may not parison: “This gut made circuits; all entrails be a tiresome catalogue of quotations. are tortuous, those of a prison as well as Beginning with the fundamentals, let us those of a man. . . . The stone pavement first find the anatomical references. With of the corridor had the viscousness of an his wonderful power of description Hugo intestine.” refers to “ a row of great piles set upright in Hugo exhibits his peculiar talent in no way the sand against a wall” as “dry, gaunt, better than in his strictures upon the de knotty logs resembling an array of leg struction of the marvelous art of the Middle bones and knee-caps afflicted with anky Ages by modern architects. “ They have,” losis.” Indeed he carries the figure further he says, “audaciously adjusted, in the name and suggests that “ revery . . . might of ‘good taste,’ mounds of Gothic architec inquire to what race of men these three- ture, their miserable gewgaws of a day, their fathom tibias had belonged.” One of his ribbons of marble, their pompons of metal, philosopher characters (Combeferre in “ Les a veritable leprosy of egg-shaped ornaments. Miserables” ) is said to have been “ enrap . . . Three sorts of ravages today disfigure tured with a lecture in which Geoffroy Saint- Gothic architecture. Wrinkles and warts on Hilaire had explained the double function the epidermis; this is the work of time. of the exterior carotid artery and the Deeds of violence, brutalities, contusions, interior carotid artery, one of which supplies fractures; this is the work of the revolutions the face, the other the brain.” This same from Luther to Mirabeau. Mutilations, am philosopher was said to believe in “the putations, dislocations of the joints, restora suppression of suffering in surgical opera tions; this is the Greek, Roman and bar tions.” Anatomical figures are vividly set out barian work of professors.” Bemoaning the in the experience of children hidden in the fate of the “charming little bell tower” of elephant of the Bastile:. “ Above a long dusty the Cathedral, he tells us that “an architect beam, from which projected at regular dis of good taste amputated it and considered tances, massive encircling timbers repre it sufficient to mask the wound with a large, senting the vertebral column with its ribs, leaden plaster, which resembles a pot cover.” stalactites of plaster hung down like the Our author’s familiarity with physiology, viscera, and from one side to the other pathology, chemistry and allied subjects is huge spider webs made dusty diaphragms.” striking. Here is a contrast between pathol Similar anatomical description is seen in ogy and anatomy: “The simplicity which this passage from “The Toilers of the Sea” : is short-winded is a case for pathology. A “Over his head was a roofing not unlike the hospital ticket suits it better than a ride insides of a vast skull; the vault was the on the hippogriff. . . . I admit that cranium; the arch was the mouth; the eye the hump of Thersites is simple; but the sockets were lacking. . . . The vault with pectoral muscles of Hercules are simple its cerebral lobes, and its crawling ramifi also. I prefer this simplicity to the other.” cations, similar to outspreading nerves, had How does the logic of the following physio a tender reflection of the chrysoprase.” In logical chemico-pathological study appeal to 4 14 Annals of Medical History you? It is selected from the postprandial swelleth with the leanness of all the other remarks of a reveller: “Now listen atten members.” Then there is this illuminating tively! Sugar is a salt. Every salt is desic antithesis: “ The foreign war is a scratch one cating. Sugar is the most desiccating of all gets on the elbow; civil war is the ulcer salts. It sucks up the liquids from the blood which eats up the liver.” through the veins; thence comes the coagu Hugo’s chemistry comes in for its share lation; then the solidification of the blood; in his figures of speech. He is not very com thence tubercles in the lungs; thence death. plimentary to the products of the metropolis And this is why diabetes borders on con when he writes: “ The mud of Paris is par sumption. Crunch no sugar, therefore, and ticularly stinking; it must contain a great you shall live.” In 1862 through the mouth deal of volatile and nitric salts.” Then a of Grantaire, who is “perfectly boozy,” glimpse of cloacal chemistry: “ Death in the Hugo gives vent to this strange physiology mire under a cover! the slow stifling by the of the nations: “ If I do not admire John Bull filth, a stone box in which asphyxia opens shall I admire Brother Jonathan then? I its claws in the slime and takes you by the have little use for this brother with his throat; fetidness mingled with the death slaves. Take away ‘time is money,’ and rattle; mire instead of sand, sulphuretted what is left of England? Take away ‘cotton hydrogen instead of the hurricane; ordure is King,’ and what is left of America? instead of the ocean.” The grandeur of Germany is the lymph; Italy is the bile. scenery is used to bring out further details: Shall we go into ecstasies over Russia? “ The oxides of the rock had placed here and Voltaire admired her. He admired China there upon the cliffs red patches resembling also. I confess that Russia has her beauties, pools of clotted blood.” The toxicology of among others a strong despotism; but I character is expressed when he makes am sorry for the despots. They have very Gilliatt say: “ I test the quality of a scoun delicate health.” Did this keen observer drel as a doctor will test a poison.” have any inkling then of the greatest world For true science this great man had the crisis now at its acme? Speaking in “ Les profoundest respect, but he could not con Miserables” of the grosser interests of cer ceal his utter disdain for all spurious and tain states, he hits the nail squarely: “ Some quasi-forms of learning. Satire and ridicule times the stomach paralyzes the heart. The were effective weapons in his hands. All grandeur and the beauty of France are that through his monograph on Shakespeare, in she cares less for the belly than other which he hales into court the world’s people; she knots the rope about her loins greatest men, of whatever branch of learn more easily.” The physiology of digestion ing, he gives examples which prove his re was a favorite theme of illustration with markable acquaintance with the history of Victor Hugo. Of a shipwreck scene he says science, the real and the sham. He believed that “the deck underwent the convulsions that long advances had been made, and of a diaphragm, which is seeking to vomit.” quite as confidently looked for more. “ Look Ursus cries: “ I have toiled today, empty at the point,” he states, “ at which sperma- stomach, plaintive throat, my pancreas in tology and ovology have already arrived and distress, my bowels ruined, far into the recall Mariana reproaching Arnaud de Vil- night my recompense is to watch another Ieneuve (who discovered alcohol and the eat.” Gringoire, the impecunious man of oil of turpentine) with the strange crime of letters, thus figures the King: “ He is a having attempted human generation in a sponge, to soak money raised from the peo pumpkin.” This is vivi-genesis with a ven ple. His saving is like the spleen which geance. Were there other “antis” in those T h e M e d i c a l P h r a s e s o f V i c t o r H u g o 4 1 5 days besides Mariana? In the following the choice of subjects for writing by a genius, passage one can hardly decide whether the he asks: “What is the Iliad? A collection author is serious or satirical. At any rate of plagues and wounds— not an artery cut here is an unusual cause of death: “ Chrysip- which is not complacently described.” pus of Tarsus forms an era in science. This In the realm of internal medicine and philosopher (the same who died— actually diagnosis we find the great author demon died— of laughter caused by seeing a donkey strating the same capacity for critical illus eat figs out of a silver basin) had studied tration. What an observant attitude is pic everything, gone to the bottom of every tured in this passage: “The pedestrian thing. . . . He condensed in his brain all bathed in sweat finds in this vault [tower human knowledge/* But we do definitely rock on the road to the Rigi] an abundance perceive, further on, the insight Hugo had of chilling shade, and a little cool water into the scientific pretense of his day. “ Five falling all about him; a treacherous bench hundred years before Jesus Christ it was has been placed there, and on it pleurisies perfectly scientific, when a King of Meso are in wait!” General manifestations of potamia had a daughter possessed of the disease are thus brought into service: “ The devil, to send to Thebes for a god to cure her. revolutionary fever, however, was increas It is not exactly our way of treating epi ing. No point of Paris or of France was lepsy. In the same way we have given up exempt from it. The artery pulsated every expecting the Kings of France to cure where. Like those membranes which are scrofula.” Substituting “eminent specialist” born of certain inflammations and formed for “ god” and remembering that most cases in the human body, the net-work of the possessed of the devil are afflicted with secret societies spread over the country.” hysteria, these words have a very familiar In this connection, when the young men, sound at this day. Neither have we by lapse enthusiastic over the Revolution, were sent of time or more diffuse education entirely about to organize their several branches, outlived those who still believe in the Royal Joly, the medical student, was to “ go to Touch and the laying on of hands— except Dupuytren’s clinique and feel the pulse of that the Royal Touch is now frequently the medical school.” Joly, by the way, was given by a famous physician; we have a typically latter-day neurasthenic. He is places of pilgrimage, too. depicted as a “young malade imaginaire. Hugo draws on his knowledge of digestion What he had learned in medicine was rather and dietetics for an argument against for to be a patient than a physician. At 23 he mal, stilted writing. This is his point: “ It thought himself a valetudinarian and passed seems that the only question [with the his time in looking at his tongue in a mirror.” ‘serious’ school] should be to preserve liter Discriminating knowledge of special dis ature from indigestion. Formerly the device eases is constantly exhibited: “There is was ‘fecundity and power’; today it is something of the cholera in that sort of barley gruel.’ . . . Be of the temper tempest” ; and, “The breath of the cholera ance society. A good critical book is a was felt in those winds”— evidently the treatise on the dangers of drinking. Do you prevailing idea of the epidemiology of chol wish to compose the Iliad, put yourself on era in those days. With the same figure in diet.” Again: “ He does not stop, he does mind, Hugo finds the origin of storms: not feel fatigue, he is without pity for the “ Tempests are nervous attacks and fits of poor weak stomachs that are candidates for delirium on the part of the sea. The sea has the Academy. The gastritis called ‘good its sick headaches.” A similar figure is taste’ does not afflict him.” In describing employed to explain an unobserved leak 416 Annals of Medical History during shipwreck: “ They had not noticed fication and our danger; it contains appe it amid the convulsive violence of the wind tite, satiety, and putrefaction. The devotion, which had shaken them. In a fit of tetanus the tenderness which seize us are liable to one does not feel a prick.*’ Describing the death. . . . The belly is to humanity condition of a little child, he thought “ a a formidable weight; it breaks at every nurse would have reckoned her five or six moment the equilibrium between the soul months old, but she was, perhaps, a year old, and the body. It fills history; it is responsible for in poverty growth undergoes heart for nearly all crimes; it is the matrix of all breaking reductions which sometimes ex vices. . . . It is perhaps obesity, per tends to the rickets.” The etiology is some haps dropsy. . . . The large intestine is what mixed, as is the metaphor, but the king; all that old world feasts and bursts; kernel of knowledge is there. Further along and Rabelais (doctor and priest) enthrones Ursus “ listened to the other child eating,” a dynasty of bellies.” and exclaimed: “ It will be a task, if I must On a lonely journey through the Alps, henceforth nourish this glutton who is get Hugo wrote letters to his wife. During one ting his growth. He will be a tapeworm of these tramps he had an opportunity to which I shall have in the belly of my indus indulge his fancy in speculation on the try.” I dare say that no one could express etiology of goitre. The following quotation more clearly the relation of certain degen is worth reading: “ There was one witness erative diseases to the life we live than is in reality, only one. . . . In a cleft in found in the following paragraph: “ His the crag, seated on a huge stone with rheumatism came to him about the time legs hanging down, was an idiot with a when he had gotten into easy circumstances. goitre, his body slim and his face enormous, These two products of labor are fond of laughing with a stupid laugh. . . . The keeping one another company. At the mo Alps were the spectacle, the spectator was ment when one becomes rich, one is paral an idiot. I forgot myself in this frightful yzed. This crowns life.” The sclerosis of age antithesis. . . . Nature in her superbest is well presented in the personification of aspect, man in his most miserable de the cathedral door which yielded but slowly basement. What could be the significance to the attack of the vagabonds; one of them of this mysterious contrast? What was the said: “ It is old, and its gristles have become sense of this irony in a solitude? Have I the bony.” The following gives his diagnosis in right to believe that the landscape was the crowd: “ Persons who wore cravats that designed for him— the cretin, and the irony hid their chins were called the scrofulous.” for me— the chance visitor? However, the A really remarkable excerpt is the one I goitrous idiot paid no attention to me. . . . am now about to quote. Well might we ask, At this height the convexity of the globe did Victor Hugo know of gall-stones and confuses to a certain extent all lines and de duodenal ulcer? Portraying a man in the full ranges them. The mountains take extraor vigor of life, he says: “ This vision is splendid dinary postures. . . . The landscape and astounding; but a little gravel in the is crazy. With this inexpressible spectacle liver or an abrasion of the pylorus— six feet before your eyes you begin to understand of earth, and all is over.” Not less remark why Switzerland and Savoie swarm with able is his broad prophecy of fecal infection stunted minds. The Alps make many idiots. contained in a longer extract. Did Hugo an It is not granted to all intelligences to ticipate Metchnikoff’s theory and foresee cohabit with such marvels and to keep from Lane’s operation when he wrote: “The morning till evening, without intoxication belly being the centre of matter is our grati and without stupor, turning a visual radius T h e M e d i c a l P h r a s e s o f V i c t o r H u g o 4 1 7 of fifty leagues across the earth around a wayfaring tree, slatern, viburnum, buck circumference of three hundred.” thorn. He treated phthisis with sundew; on Materia medica and therapeutics form the appropriate occasions he used the leaves of basis of certain comparisons which were the the tithymal, which plucked from the root beliefs of the times. Some of these reflected are a purgative, and plucked from the top the serious side of the author. Witness: are an emetic; he took away your sore “ Many will remember that great epidemic throat by means of the vegetable excres of croup which desolated, thirty-five years cence called ‘Jew’s ear’ ; he knew which ago, the quarters bordering on the Seine at rush cures the ox and which mint cures the Paris, and of which science took advantage horse; he was acquainted with the beauties to experiment on a large scale as to the and virtues of the herb mandragora, which, efficacy of insufflations of alum, now so as every one is aware, is both male and happily replaced by the tincture of iodine female. He had receipts. He cured burns externally applied.” On the other hand he with the wool of the salamander, of which takes occasion at times to berate the Nero, according to Pliny, had a napkin.” ignorance both of the physician and of the A more modern example of botanical super layman. The archdeacon showed the in stition may be recalled. An old woman, scription, “ Medicine is the daughter of (whether male or female I do not know) dreams,” to his doctor, who immediately once asked the celebrated Abernethy: “ Doc had his ire aroused and exclaimed: “ Medi tor, do you believe that poplar bark scraped cine a dream! I suspect that the pharmacop- ‘up the tree’ is an emetic and scraped olist and the master physician would insist ‘down the tree’ is a purgative?” “Certainly,” upon stoning you if they were here. So you replied the doctor, “ and don’t ever take deny the influence of philters upon the any scraped around the tree, for, if you do, blood, and unguents on the skin! You deny it will fly through your ribs and kill you.” that external pharmacy of flowers and Hugo tells us that Ursus “ correctly pre metals, which is called the world, made ferred Galen to Cardan; Cardan, learned expressly for that eternal invalid called man as he is, being only a worm of the earth man!” The cleric replied: “ I deny neither in comparison with Galen.” But in his pharmacy nor the invalid. I reject the “ Shakespeare” he violently asserts that “ a physician.” “ Then it is not true,” replied country horse-doctor would not inflict on the doctor hotly, “ that gout is an internal horses the remedy with which Galen treated eruption; that a wound caused by artillery the indigestions of Marcus Aurelius.” What is to be cured by the application of a young the remedy was we are left to conjecture. mouse roasted; that young blood, properly Obstetric references are few but pointed. injected, restores youth to aged veins; it The family of nations is thus to be nour is not true that two and two make four and ished: “ France bears within her the sublime that emprosthotonos follows opisthotonos.” future. This is the gestation of the nine Which being said, the debate ended in surli teenth century. That which was sketched ness on the part of the priest and anger on for Greece is worth being finished by the part of the physician. But, “ Ursus, in France.” The channel islands are described his capacity of physician healed, because, as the “ puritanical archipelago, where the or in spite of. He made use of aromatics. Queen of England has been blamed for vio He was versed in simples. He took advan lating the Bible, because she gave birth tage of the profound power which is con while under influence of chloroform.” When tained in a mass of disdained plants,— Dom Claude rails at a fellow by shouting, hazel twigs, white alder, guelderrose, the “ What means of safety have you found, 418 Annals of > Medical History knave? Must your idea be extracted with that “ we are deprived of the progress which forceps?” , one is at a loss to know whether the executioner caused surgery to make,” to classify this metaphor with obstetrics or for “ by cutting the limbs of living men, by with dentistry. Idiopathic Cesarean section, opening their bellies and tearing out their amid rather warm surroundings, is thus entrails, they [of the olden days] caught described: “Under Mary Tudor a mother phenomena in the very moment, and made and two daughters were burned. . . . discoveries.” Hearing this, let the women One of the daughters was with child. She rage and the anti-vivisectionists imagine a brought forth the child in the coals of fagots. vain thing. Hugo’s phrases on wounds are The chronicle says: ‘Her belly burst. A living interesting. Combating the idea that “ emo child came forth; the new born infant rolled tion grows dull” he argues that “ it is as out of the fiery furnace; a certain House though one were to say a wound is assuaged picked it up. [The] bailiff . . . caused and become calm beneath nitric acid falling the child to be flung back into the fire.’ ” drop by drop.” The wounds of Marius af Maternal impressions are hinted at when forded ample opportunity for descriptive the populace hoots the hunchback of Notre talent: “ The doctor examined Marius and, Dame: “ The monster! a face to make a after having determined that the pulse beat, woman miscarry better than all the drugs that the sufferer had no wound penetrating and medicines. . . . ’Twas you that his breast, and that the blood at the corners made my wife, simply because she passed of his mouth came from the nasal cavities, near you, give birth to a child with two he had him laid flat upon the bed, without heads! And my cat bring forth a kitten with a pillow, his head on a level with his body, six paws!” and even a little lower, with his chest bare, Two or three figures of speech must suf in order to facilitate respiration. . . . fice to convince us of Hugo’s knowledge of The head . . . was covered with hacks; the eye and its diseases. Hardly could there what would be the result of these wounds be expressed a more beautiful figure than on the head? Did they stop at the scalp? this: “The pupil dilates at night, and at last Did they affect the skull?” Does not the finds day in it, even as the soul dilates in following observation show marked dis misfortune and at last finds God in it.” crimination? “ Fie had for several weeks a Another is keenly suggestive: “ He suffered fever, accompanied with delirium, and seri the strange pangs of a conscience suddenly ous cerebral symptoms resulting rather from operated upon for the cataract. He saw what the concussion produced by the wounds in he revolted at seeing.” Ocular therapeutics the head than from the wounds themselves.” is brought into play upon literary diseases: And this also: “The suppuration of large “ Let us not, then, be surprised . . . at wounds always being liable to re-absorption the poultices applied by a certain school and consequently to kill the patient under of criticism to the chronic ophthalmy of certain atmospheric influences.” Further, academies.” “the dressings were complicated and dif It may not be surprising to realize that ficult, the fastening of cloths and bandages the great Frenchman was well versed in with sparadrap not being invented at that surgical science and practice. He certainly period” . . . “they used for lint a sheet writes of times when surgery was often in ‘as big as a ceiling’ ”... and “it was demand and when the average citizen was not without difficulty that the chloruretted necessarily familiar with its practices. His lotions and the nitrate of silver brought the exact knowledge of surgical pathology is gangrene to an end.” The convalescence evident. As an introduction Hugo regretted was delayed “on account of the accident T h e M e d i c a l P h r a s e s o f V i c t o r H u g o 419 resulting from the fracture of the shoulder canvas became larger. It grew more and blade. There is always a last wound like more distorted like a frightful abscess ready this which will not close, and which pro to burst.” The diagnosis in the following longs the dressings, to the great disgust of case is not plain, but the plan of treatment the patient.” Can it be doubted that the admits of no uncertainty: “One day . . . author of these lines, only a part of which a man was dying, choked by a tumor in I have transcribed, had himself seen and his throat, a horrible fetid abscess, possi attended such wounds? Even the King had bly contagious and which had to be emptied pretensions, for we are told that he was at once. . . . [The priest] applied his “ something of a doctor; he bled a postilion mouth to the tumor, sucked it, spitting who fell from his horse; Louis Phillipe no out as his mouth filled, emptied the abscess more went without his lancet than Henry and saved the man’s life.” Physical dis III without his poniard.” ability has always furnished a plea for clem Of wounds in special regions we note an ency in crime. “ The old punishment,” instance here and there. “ There was a writes Hugo, “ which our ancient laws of wound in the shoulder blade . . . but as torture called ‘extension’ and which Car the lungs were not touched she might re touche escaped because of a hernia, this Prom cover.” “ Wounds in the breast demand etheus undergoes.” The question is how did silence.” Surgical diseases are the particular Hugo find that Cartouche had a hernia. care of Ursus, who thus addresses the popu Nor does our observant genius overlook lace: “ I think and I dress wounds. Chirurgus the question of anaesthesia. Referring to the sum...... Almost all our local in time of Queen Anne he recalls “ that even flammations and sufferings are issues and, at that day the means of putting a patient if well cared for, rid us gently of other ills to sleep and of suppressing pain was known. which are worse. Nevertheless I would not Only at that epoch it was called magic. counsel you to have an anthrax, otherwise Nowadays it is called anaesthesia.” He called a carbuncle. ’Tis a stupid malady speaks at another place of “a stupefying which serves no end. One dies of it and that powder . . . which suppressed pain,” is all.” He also gives a much needed caution: and, whether accurately or not, thus relates “An awkward movement, a fright, and there its history: “ This powder has always been you have a rupture of aneurysm. I have known in China and it is still employed seen instances of it.” Arterial ligation was there at the present day. China had all our evidently much in Hugo’s mind. Over and inventions before us, printing, artillery, over again he indulges his imagination in aerostation, chloroform. Only the discovery this sort of figure. For example: “ It was which in Europe immediately acquires life time that the artery should be bound up. and growth, and becomes a prodigy and a He had suffered a loss of virtue . . . and marvel, remains an embryo in China, and he felt something like a generous transfus is there preserved in a dead condition. ion in his veins.” A geographical reference China is a jar of foetus.” is inspiring: “ French blood is largely mixed Victor Hugo was certainly not ahead of with Spanish blood. . . . The Pyrenees his times in sanitary science. What would are simply a ligature efficacious only for a our trained public health officers think of time.” History furnished this: “ Revolu his ideas on the following question? He tions such as the revolution of July are says “that strong mental excitement is a arteries cut; a prompt ligature is necessary.” preservative against all ailments. In times Other affections appeal to the figurative of pestilence, while sanitary and hygienic nature within him: “ The bulging of the measures should not be neglected, the people 420 Annals of Medical History should be entertained by grand fetes, grand powers, the more efficacious the remedy. performances, noble impressions. If no one Gilliatt had prescriptions of his own, which troubled about the epidemic it would dis he had inherited from the old dead woman; appear.” At least he knew the value of the he bestowed them upon those who asked nurse and paid her this tribute: “ It is the and would take no pay. He cured whitlow physician who prescribes, it is the nurse by the application of herbs, the liquor from who saves.” one of his phials cut short the course of a Humor at the expense of the doctor is fever; the chemist . . . thought that it found in spots. It is not biting. “A funeral was probably a decoction of cinchona. . . . is passing. There is a doctor in the proces Gilliatt was a very good fellow for sick sion. ‘Hullo!’ shouts a gamin, ‘how long is people where his ordinary remedies were it since the doctors began to take home concerned. . . . He absolutely refused to their work?’ ” And the physician to Louis XI perform miracles, which was ridiculous is spoken of as “ the brave man [who] had in a sorcerer. Do not be a sorcerer; but no other farm than the King’s bad health. if you are one fulfill your profession.” He speculated on it to the best of his ability.” Do we not now meet those of this kind? After obtaining from his Majesty in one And is it not all true to our own life and day an appointment for his nephew and a times— except the “ no pay” feature? Ursus, new roof for his house, the doctor had the man, represents the peripatetic patent applied to the royal loins “ the great de medicine vendor in all his glory, and, with fensive cerate composed of Armenian bole, out doubt is one of the cleverest and queer white of egg, oil, and vinegar” and retired est characters in fiction. “ Regarded as a followed by the raillery of the attendants: good mountebank and a good physician” “ ’tis easy to see that the King is ill today; he was everything else that it was necessary he giveth all to the leech.” Louis’ retort to to be. He describes himself: “ I am neither the barber closed the scene: “ The physician an Englishman nor a man, having the honor has more credit than you. ’Tis very simple; to be a doctor. That goes together. Gentle he has taken hold upon us by the whole men, I teach. What? Two sorts of things; body, and you hold us only by the chin.” those which I know and those which I do Below the rank of royalty a bit of dialogue not know. I sell drugs and I give away between notables may bring a smile: “ Good ideas.” That stamps Ursus as an out-and- morning, Marat,” said Chabot. “ You rarely out quack.' The real physician sells his attend our meetings.” “ M y doctor has ideas, and may or may not give away his ordered me baths,” answered Marat. “ One drugs. Being a quack he proceeds to de should beware of baths,” returned Chabot, nounce other quacks: “ Gentlemen,” says “ Seneca died in one.” The following refer he, “distrust false savants who speculate ence includes the social problem along with upon the briony root and white adders, and its grim humor: “ If he is rich, let him have who make eye salves from honey and cock’s a doctor. If he is not rich, let him not have blood. Learn to see clearly through his lies. any. If he doesn’t have a doctor, he will die. . . . It is not true that Adam had a And if he does have one, he will die.” navel. . . . Oh, gentle friends who listen Hugo was hard on the quack. He knew the to me, if any one tells you that whoever brand instantly. Of Gilliatt he relates: smells of the herb valerian will have a “ Peasants came with fear and trembling, to lizard born in his brain, . . . that a man tell him about their maladies. This fear weighs more dead than alive, that buck’s begets confidence; and in the country the blood dissolves the emerald, . . . that more the physician is suspected of magical the falling sickness is cured by means of a T h e M e d i c a l P h r a s e s o f V i c t o r H u g o 421 worm which is found in the brain of a bared the gums, distended the ears, removed kid, believe it not; these are errors. But here the partitions of the cartilages, disarranged are truths: The skin of a sea-calf is pre the eyebrows and the cheeks, enlarged the servative against lightning; the toad is muscles of the cheek bones, softened down nourished upon earth, which makes a stone the seams and scars, brought the skin back grow in his head; . . . the elephant has over the wounds, still maintaining the face no joints and is forced to sleep standing in the gaping state, and from that powerful erect against a tree; make a toad hatch a and profound sculpture, that mask, Gywn cock’s egg, and you will have a scorpion plaine, had emerged.” A full, if not clear, which will make you a salamander; a blind exposition of the principles of plastic surgery! man recovers sight by placing one hand on Quasimodo I do not attempt to explain. the left of the altar and the other on his He might be dismissed, according to one eyes. . . . Good people, feed yourselves reviewer, as follows: “An animal with a turn on these evidences.” for bell-ringing and, apart from his deform Hugo’s interest in deformities is shown by ity and deafness, not entitled to much his creation of these two freaks in human sympathy.” But whatever the classification shape— Gywnplaine and Quasimodo. No of his misshape, it was congenital, not other writer in our knowledge has succeeded acquired. M y feeling is that Hugo must in producing such hideous and repulsive have received the impression of this monster deformities— the one artificial, the other through a bad dream. At any rate he put natural. Much has been brought against down no figure of speech in which Quasi Hugo for giving these characters sentiment, modo is involved. one critic going so far as to say that he has Hugo has been accused of being theatri made “fatherhood sanctifying physical de cal, of straining after effect. Perhaps so, but formity; motherhood sanctifying moral de he got the effect. Poet, dramatist, novelist, formity.” Marzials says of the “Laughing publicist; he stood apart— the great French Man” : “ To me it is simply a preposterous, man. His espousal of the Republic and the an impossible book.” Assuredly it is a weird Revolution was his absorbing passion. He conception. But the details are admirably came down and remained close to the worked out. Very briefly the method of people— a circumstance that caused him to producing the deformity of Gywnplaine study them deeply, to live with them in may be stated by Hugo himself: “ This timately. This naturally may have directed artificial production of teratological cases him to those homely medical illustrations, had its rules. It was a complete science. Let of which he was so full. Coppee’s estimate the reader imagine orthopedy reversed. is not wide of the mark: “Among all the Where God had placed a glance, they put poets of mankind Victor Hugo is the one strabismus. Where God had placed har who has invented the greatest number of mony, they put deformity. . . . It seemed similes, and those the best carried out, the evident that a mysterious science, probably most striking, the most significant.” What occult, which was to surgery what alchemy need to tell his life story? Study the man in was to chemistry, had chiselled that flesh, his writings— there he reveals himself. A assuredly at a very early age, and de characteristic piece of his imagery may liberately created this visage. This science, form a fitting close to our study: “An idea skilful in cuttings, obtusions and ligatures, is a balm; a word may be a dressing for had split that mouth, opened those lips, wounds; poetry is a physician.” EDITORIALS Franciscus Dela Boe Sylvius was a physi He saw the fissure of Sylvius as an anatom cian whose character and career have an ical entity and described it so definitely unusual interest. He was a famous and that it received his name. He called the iter original teacher; and while holding a chair in e tertio ad quartam ventriculam an aqueduct, medicine, he was an industrious student of and it became the aqueduct of Sylvius. chemistry and anatomy, particularly that He discovered or rediscovered the fifth ven of the brain. In this latter line of work, tricle, sometimes called the ventricle of Syl his descriptions were so vivid and accurate vius. Naturally, the artery of the Sylvian that his name became identified with four fissure became the Sylvian artery. So, different portions of the nervous system. through his power of perceiving acutely, Sylvius was a handsome man and has left describing clearly, and emphasizing his us an unusually fine engraving of himself, units, the name of Sylvius dominates all done by C. van Dalen. This is one reason, others in cerebral nomenclature. Herophe- perhaps, why we celebrate his memory here. Ius, Galen, Varolius, Viessens, and Rolan Of recent years we have been made famil do have each one part, but Sylvius has four. iar with his work through an article by By his happy art, Sylvius has made him Prof. Frank Baker in the Johns Hopkins self anatomically immortal; though he was Bulletin of November 1909, and one by Dr. not a great discoverer or a man of the very Smith Ely Jelliffe in The Charaka Club highest type, but an able “ runner-up” of Book, Vol. III. greatness. Indeed, Prof. Frank Baker as Sylvius was born in 1614 of French par serts that he was one of the great original ents in Hanau, Germany. He studied in thinkers of the seventeenth century. several universities, took his medical de He was interested in chemistry and phys gree in Basle, Switzerland, went to Paris iology, and he had a chemical theory of for a time, settled in practice in Amster vital action and disease, but it had no more dam, till he was called to be Professor of merit than other theories of those and Medicine in the University of Leyden in later days. However, he was a masterly 1658, when he was 44 years old. He made a clinical teacher and his greatest real achieve definite success there as a lecturer, teacher, ments were along this line. investigator, and practitioner. Here he first Sylvius was a man of handsome presence, instituted bedside instruction. fine personal qualities; benevolent, sincere, Sylvius had admirable powers of descrip and kindly; making and retaining friend tion with a gift to see things correctly and ships. He was a serious-minded person and to individualize what he saw. He had, one seemed rather to court than shun contem might say, a synthetic and epitomic mind. plation upon death. Before he was fifty 422 FRANCISCUS DELEBOE SYLVIUS , M ED ICIN E PRACTICE IN ACADEMIA LUGDUN O-BATAVA PROFESSOR C yon Q&akti 3 unior~dclinm.vit efr fculfint* E d i t o r i a l s 4 23 years old, he prepared a sepulchre for him and of the often stealthy approach of death, self in the choir of St. Peter’s Church at bethought him to prepare against that time Leyden, and had a very modest inscription a quiet sepulchre for his remains, placed on it. a house for his mortal body. FRANCISCUS DELEBOE SYLVIUS At Leyden, MEDICINE PRACTICE PROFESSOR, 1665. TAM HUMANA FRAGILITATIS It would be interesting to know what de QUAM OBREPENTIS PLERISQUE MORTIS struction Sylvius had in mind when he pre MEMOR, pared this “ sepulchrum” for his “ instans DE COMPARANDO TRANQUILLO INSTANTI cadaver” and a “ domus” for his “ ruens CADAVERI corpus.” I should guess that he believed SEPULCHRO the house was to hold the body for the AC DE CONSTITUENDA RUENTI CORPORE resurrection. DOMO When taken ill with a fever in 1672, Syl 7EQUE COGITABAT SERIO. vius said to a friend: “ I know the gravity LUGDUNI BATAVORUM of this disease. I escaped three years ago; MDCXLV this time I shall die.” His prediction proved Franciscus de Ie Boe Sylvius, true. His death occurred November 14, Professor of the Practice of Medicine, 1672. mindful of human infirmity C harles L. D ana THE TUBERCLE OF CARABELLI AND CONGENITAL SYPHILIS The diagnosis of congenital syphilis on The tubercle of Carabelli was described the basis of the condition of the teeth is by the noted dentist of Vienna in 1842, as well known in the case of Hutchinson’s a Tuberculus anomalus,2 which frequently teeth, where the central incisors or occa occurs on the anterior lingual surface of sionally the canines show a sharply marked the first, second and, also, the third upper cleft. A diagnosis of this condition on the molars. Since aberrant cusps may develop presence of an aberrant cusp which occurs at any one of three places along the lingual often on the upper molars is perhaps not margin of the molar, there has often been so well known, but, according to Jeanselme,1 confusion in the proper identification of treatment for congenital syphilis has often the tubercle of Carabelli. The fact that this been made on the basis of such a diagnosis. cusp occurs more frequently in children Jeanselme points out that, since this cusp is than in adults and in primitive races more present in molar teeth of man from the frequently than in civilized races is of great neolithic, paleolithic and later periods, there importance. is no basis for using such a condition in This tubercle is often seen in neolithic the diagnosis of congenital syphilis. The and in paleolithic man. Gorjanovic-Kram- case is of even wider import than Jeanselme berger3 says that it occurs in nearly all of suggests. 2 George C. Carabelli: “ Systematisches Hand- buch der Zahnheilkunde,” 1842, Bd. II, Anatomie 1 E. Jeanselme: “ De Pexistence du tubercle de des Mundes, p. 107. Carabelli aux epoques paleolithique et neolithique, 3 Gorjanovi6-Kramberger: “ Die Kronen und dans Pantiquite classique et au moyen age.” Bull, Wurzeln der Mahlzahne des Homo primigenius und et mim. Soc. med. de hop. de Par., 24 Janvier, 1918, ihre genetische Bedeutung.” Anat Anz., 1907, Bd. pp. 51-52. 31. pp. 118-120, Fig. 13. 424 Annals of Medical History the first and second upper molars of the bildet ist, als phyletisch wichtig bezeichnen fossil human skeletons from Krapina, which und fiiglich fur ein den Homo primigenius represent a race of men who lived about mit dem H. sapiens verbindendes Merkmal 75,000 years ago. He has given an excellent ansehen.” Adloff and others have taken photograph of the tubercle of Carabelli on exception to this view. The entire subject the molar of a fossil man, and, for com of the evolution of the primates, of which parison, similar cusps on the molars of a the question of the tubercle of Carabelli is native of Java are shown. Batujeff4 has a part, has been recently reviewed by shown that the presence of this cusp in the Gregory.5 primitive races of man and many genera Since the tubercle of Carabelli has such of apes is of wide distribution. I do not an ancient history, being demonstrable doubt that a careful study of the upper many, many thousands of years prior to molars of fossil primates would reveal the the knowledge of the presence of syphilis, presence of similar cusps. it is difficult to see that the two have any This cusp arises from the cingulum near thing to do with each other. The presence the hypocone and may be regarded as of of this tubercle may be regarded as the phylogenetic significance. Gorjanovi6- persistence of an ancient character, and, Kramberger says: “ Den Carabellischen while it is often said to be hereditary, it Hocker kann man als ein in Entwickelung seems improbable that it has any connec begriffenes Gebilde, welches beim rezenten tion whatever with congenital syphilis. Menschen bereits in hoheren Masse ausge- Roy L. M oodie THE ANATOMIE UNIVERSELLE OF AMBROISE PARE The early works of the Father of French theque Nationale or in the library of the Surgery were in the vernacular, and so Ecole de Medicine. popular that, like school books, they were Not long ago in a Paris catalogue, a “ thumbed” away, and few copies remain. copy was advertised, and after a hurried Among the rarest is the “ Anatomie Uni- look at Malgaigne and the Index Catalogue verselle” of 1501, of which Malgaigne knew of the St. Genevieve Library, I sent a tele of only two copies— one imperfect in the gram and was delighted to get the book St. Genevieve Library and the other at within forty-eight hours. The provenance is Bar-Ie-duc in private hands. The St. Gene uncertain. It had come in with a number of vieve Library is the fortunate possessor of unbound volumes and was sent to Cham- six of the nine works which preceded the boIIe-Duru, in whose famous morocco and great surgery of 1575; but the Anatomie is unmatched gilding it is now adorned— a not at Washington, nor in the British Mu small octavo of 277 pages. The work must seum or Bodley, nor, so far as I can ascer have been a boon to the surgical students tain, in any of the special collections, ex of St. Corne, very few of whom, like Pare cept the Hunterian at Glasgow. Dr. Hahn himself, had had a classical training. Both writes (1918) that it is not in the Biblio- editions of the great “ Fabrica” had been published, and the text and plates, particu larly the latter, are largely Vesalian. 4 N. Batujeff: “ Carabelli’s Hockerchen und andere unbestandige Hocker der oberen Mahlzahne 5 W. K. Gregory: “ Studies on the Evolution of bei dem Menschen und Affen.” Bull. Acad. imp. des the Primates.” Bull. Amer. Mus. Nat’l Hist., 1916, Sc., St. Petersburg, T. 5, 1896 No. 1, pp. 93-109. vol. xxxv, pp. 239-355. E d i t o r i a l s 425 The gem of the book is a copper engrav pression is unusually clear, much more s o ing, the earliest known portrait of Pare at than the copies from “ La methode cura the age of forty-five, a wood-cut of which, tive” and the “ Dix Iivres...” just referred t o . tJ N tJ T IE VNIVERSELLE DV Corps hiunain,com pofee par A . Pare? Chirurgien ordinaire du R o .y ,& lure a P aris: reueue S c augtnenree par ledic au - theur auec I. R oftaingd u Bignofc Pro- uen$al aufsi C h iru rgien lu re a Paris. VePtmprimcrie de lehan ie RnyerJ Itnprimeur du Rgy is flldthemdttyties} demeurattt Early Instruction in Bacteriology in the Biological Laboratory the previous the United States.— Following the publi year. Later on Dr. George H. F. Nuttall cation by Pasteur of the results of his in also became his assistant, and was asso vestigations on the relations of the bacteria ciated with Dr. Welch in the discovery to fermentation and to disease, several and study of the “gas” bacillus. scientists in this country took up, indepen Dr. T. Mitchel Prudden at the College dently, the study of bacteria by Pasteur’s of Physicians and Surgeons in New York methods. These men were interested in also taught the staining of bacteria in the bacteria from either the broad biological sections of tissues and in sputum, to his standpoint or from the standpoint of students in pathology, and commenced the pathology. cultivation of bacteria on solid media Probably the first name in the list of about 1883. Dr. Prudden, aside from his early teachers is that of the late Dr. T. J. interest in the pathological action of bac Burrill who introduced the study of the teria, also very early interested himself bacteria into his course on the fungi, in the relation of bacteria to air, water, during the “seventies.” He discovered the and ice, which were subjected to critical organism of pear blight in 1879, and study, the results forming the basis of the following years conducted extensive valuable monographs. inoculation experiments with this organism Beginning about 1879, Dr- D. E. Salmon on a large orchard of young pear trees, commenced his important studies on the thereby definitely establishing the etio relation of bacteria to animal diseases in logical relation of the organism to the the Bureau of Animal Industry at Wash disease. ington, and while Dr. Salmon is not known The late Surgeon General George M. generally as a teacher of bacteriology, there Sternberg, whose investigations on the is every evidence that he was the instructor causation of yellow fever, malaria, syphilis of assistants in the Bureau and was the and other diseases are well known, also leading inspiration for many of the early discovered the pneumococcus in normal discoveries made by the Bureau staff; sputum, and laid the foundations for our notably the epoch-making work which he knowledge of the value of a large number of did in association with Dr. Theobald Smith chemical substances as disinfectants. on Texas cattle fever, work which in a Dr. William H. Welch from 1878 on was broad sense can be included here, even interested in the bacteria and their relation though the organism responsible for the to disease. On returning from Europe in disease is not a bacterium, but a protozoon. 1885 Hr- Welch became the head of the In addition to those early teachers the Pathological Institute at Johns Hopkins following also deserve special mention: University, and had for his assistant in the Dr. Henry Formad, at the University of instruction in bacteriology Dr .A. C. Abbott, Pennsylvania; Dr. W. T. Councilman, who had been Dr. Sternberg’s assistant in known particularly as a pathologist; Dr. H i s t o r i c a l N o t e s 427 Herman M. Biggs, in charge of the Carnegie T he Evolution of D ermatology— The Laboratory when that was attached to the impulse to specialization during the last Bellevue Hospital Medical College; Dr. E. quarter of the nineteenth century grew so A. Birge, who inspired some of our noted strong that the intercommunicating bonds biologists who studied under him; Dr. C. T. among the various fields of medicine be Cheesman, who began the first systematic came obscured. Dermatology suffered with instruction in bacteriological technique; Dr. the rest. The apostles of the newer creed John E. Weeks, at the Ophthalmic and worshipped most devoutly in Vienna at the Aural Institute; Dr. Harold, at the Harvard shrine of Hebra. A scientific priesthood Medical School in 1885; Dr. Theobald evolved, speaking a language incomprehen Smith; Dr. L. H. Pammel, in the veterinary sible to other physicians, and often vague school at the Iowa State College of Agri enough to the anointed. A technical vul- culture; Dr. Bayard Holmes, at the Chicago gate flourished at the expense of scientific Medical College in 1888 and later at the dermatology. Thereupon, the latter entered Post Graduate Medical School at Chicago its dark ages, but the renaissance is at and at the College of Physicians and hand. Surgeons; Dr. Victor C. Vaughn and Dr. It was the thundering of the Southern F. G. Novy, at the University of Michigan Teutonic school that effected the division in 1889; Dr. H. W. Conn, who has directed between dermatology and general medi his interest principally to the activities of cine. In France and England, although un the bacteria of milk and soil in their bearing noticed in the general din, the influence of on agriculture; Dr. W. T. Sedgwick, at the Willan and of his disciples still sustained Massachusetts Institute of Technology in the substantial principle that the anatomical 1888-1889; Dr. Joseph MacFarland, at the envelope of the human body was an inte Medical School of the University of Penn gral physiological part thereof, and not a sylvania in 1892 and following years; and vestment that could be taken off, mended, Dr. William H. Park, at Bellevue Hospital laundered, and replaced. In northern Ger Medical College in 1895. many Unna and his pupils opposed the From these simple beginnings the teach Viennese orthodoxy by attempting to bring ing of bacteriology has come in a com the study of cutaneous maladies in line paratively brief time to play a very impor with Virchow’s ideas of cell pathology. tant part in the scientific education of Thus, the Hamburg faction, upon a basis many persons, and bacteriology is to-day of microscopy and microchemistry, made a being taught in a large number of educa definite contribution to dermatology as a tional institutions in this country. Courses biological science rather than a dialect. In are given, not only in elementary bac the late eighties America was invaded by teriology to general science students but alien votaries of all cults, and Americans to students in domestic science, agriculture, themselves returned from abroad, having dairying, water and sewage purification, studied at the various centers, some hav public hygiene and sanitation, medicine, ing studied at all of them. Thus, without dentistry, veterinary medicine, pharmacy, bias, American dermatologists founded an brewing and fermentation industries, food eclectic school upon the best that Europe production and preservation and plant could offer. pathology. Europe is now understanding that Amer David H. Bergey, ica is to be regarded seriously. So far as Major M. R. C., U. S. Army, Americans are concerned, Europe has ceased University of Pennsylvania to be Mecca in dermatology, and such pil 428 Annals of Medical History grimages as they may deign to make in the to the newness of the work, and the fact future will not be with the idea of obei that we must embark timidly upon un sance, but with the full knowledge that they charted seas. In Teuton Europe dermatolo will bring abroad at least as much as they gists are still classifying, labelling and mak receive. In general, European medical op ing histological studies in order to create an portunities excel ours, because the clinical illusion of science. In America a small but material is concentrated, and is more read ever increasing group of men is studying ily employed for investigation. This stimu metabolism, the endocrinous glands, ana lated medical research in the old world ear phylaxis, and clinical medicine in relation lier than here, but now we are fast closing to skin diseases. It is the object of this ex the gap. Considering Europe’s research ad position to set forth the little that has been vantages, and this holds particularly true accomplished, but that little is the result of in Germanic countries, there has been vir scarcely ten years of effort and a genera tually no creative dermatology abroad. In tion of dermatological independence. This our country, on the other hand, and against seems most encouraging to those of us who the utmost opposition and with the scanti do not believe that the royal road to der est of equipment, very earnest original work matology is Alserstrasse. has been attempted. That it has not yet led Walter James Heimann, M. D. to anything definite is due almost entirely New York City THE CHARMS OF PRECEDENCE Such is my theme, which means to prove, That though we drink, or game, or love, As that or this is most in fashion Precedence is our ruling passion. When college-students take degrees, And pay the beadle’s endless fees, What moves that scientific body, But the first cutting at a gaudy? And whence such shoals, in bare conditions That starve and languish as physicians, Content to trudge the streets, and stare at The fat apothecary’s chariot? But that, in Charlotte’s chamber— see Moliere’s Medecin malgre Iui— The leech, howe’er his fortunes vary, Still walks before the apothecary. William Shenstone (1714-1763). j BOOK REVIEWS Studies in the H istory and M ethod of Sci crocosm.” There are wonderful reproduc en ce. Edited by Charles Singer, Oxford, at the tions in color showing “ The Celestial influ Clarendon Press, 1917. 40, 304 pp., 41 plates, 23 ences on men, animals and plants” ; “ The illustrations. Fate of the elements at the last judgment, ” This impressive and beautifully illus “ The relationships of human and cosmic trated book opens with an introduction by phenomena,” “ The birth of the soul, its Sir William Osier, who presents a lucid and trials and departure after death.” There is interesting explanation of the object of the also an impressive colored illustration of work. This is to contribute to the story of “ The Fall of the Angels” which is sugges how human knowledge was gained, and tive of William Blake, or whatever form of how scientific methods were evolved and most modern art it is that aims to tell a their results sytematized. (We just venture story by means of weird symbolisms. It is to say passim that we do not believe Sir better than the Picassoes, and Matisses, and William could construe his first sentence.) Cezannes of New York shops. In fine we The volume is made up of a series of his are shown that in the dark days of the torical and critical studies, which are richly good Saint, there were definite attempts illustrated and which, for the most part, made, out of the scriptures, and legends represent the results of original investiga and visions and some serious thinking, to tions. It is not at first apparent why the explain the plan of the universe and man’s title “ Studies in the History and Method relation to it and his Maker. of Science” should be given to such a col Dr. J. W. Jenkenson has a well-written lection, for most of the articles deal with essay on “ Vitalism” in which he does not persons who did not follow scientific meth believe. He touches only briefly on the od as we know it to-day. We infer, how newer physiological interpretation of vital ever, that the subjects dealt with represent phenomena; hence his argument and arti various historical examples in which knowl cle do not seem complete or convincing. edge was sought for by means of rational Dr. Singer contributes a study in “ Early observation, rather than accepted as from Renaissance Anatomy with a new Text: inspiration or tradition. The Anothomia of Hieronymo Manfredi The Editor opens with a very elaborate, (1490).” It contains much original and in original and beautifully illustrated article teresting material with many illustrations. on the scientific views and interpretative Manfredi (1430-1493) was Professor of visions of St. Hildegarde. The author has Medicine in Bologna and wrote a good used the Saint and her activities as a me many treatises on astrology and medicine. dium for describing the condition of natu A manuscript copy of a short treatise on ral knowledge at the period in which she anatomy is in the Bodleian Library. This is lived, 1098-1180. He depicts Hildegarde’s reprinted and parts of it are translated in schemes of the Universe, her allegorical the present article. Dr. Singer states that conception of “ The Soul pervaded by the Manfredi’s Anatomy is more complete than Godhead,” and again of this God-pervaded that of Saliceto or that of Mondino. Soul “ embracing the macrocosm and mi “ The Blessing of Cramp-rings— a chap 43° Annals of Medical History ter in the History of the Treatment of logic. Many years ago Macaulay in an Es Epilepsy, ” by Raymond Crawford is an in say on Mill’s Theory of Government, at teresting and well-illustrated story of the tacked the validity of logic in a less elabo blessing of rings for the cure of epilepsy by rated but more winsome way than does Dr. the kings and queens of England. Schitler, but Dr. Schitler pursues the meth The article on Dr. John Weyer and the od of science, and he is more convincing if Witch Mania by Dr. E. T. Wellington is a less readable than Macaulay. careful historical study of this abnormal C harles L. Dana phase of human deviation. Witches and witchcraft form a curious phase of life among savages and early civilizations. Prob T he O ld P hysiology in E nglish L iterature. By P. Ansell Robin, D. Litt. A thesis submitted ably witchcraft added somewhat to the pic to the University of London for the degree, Doc turesque and dramatic side of savage and tor of Literature. J. M. Dent & Sons, Ltd., Lon semi-civilized life. In early mediaeval times don, and E. P. Dutton & Co., New York, 1911. witchcraft was a harmless and unimportant 8vo, cloth, 183 pages. $3.00. factor, but in the fifteenth and sixteenth This essay is delightful reading for those centuries Europe became obsessed with fear conversant with the older physiology. It of witches and a zeal to destroy them. It recalls the four elements of Empedocles seems incredible to us now that in those (470 b.c.)— air, earth, fire and water, each years so many persons should have been of which was compounded with two of the tortured and burned as this account avers. properties, hot, cold, wet or dry. Galen The real number is not even approximately (a.d. 200) in Medical Definitions says: known. It ranged from 40,000 to over a “ The elements of medicine, as some of the million, and we are told that the mania for ancients thought, are hot and cold, moist burning supposed witches caused more and dry,” and also “ Of what are our pass deaths than the wars or pestilence of those ive bodies composed? Of four things, blood, two centuries. The author might have light phlegm, bile and melancholy humour, which ened his article by inserting some of the some also call passive elements. Or (put old cuts which filled Reynard’s book on ting the question in another way) of what this same subject— published twenty odd do our material bodies consist? Of the four years ago. Reynard took the matter less elements, fire, air, earth and water.” seriously and more journalistically. As we Chaucer’s doctor, from this ancient in read Dr. Wellington’s article and its de formation, knew the causes of diseases: scriptions of epidemic fear, we realize that even civilized countries to-day often get “ He knew the cause of every malady, touches of this same outrageous obsession. Were it of cold or hot or moist or dry More often, now the fear is of some disease And where engendered and of what humour, He was a very perfect practisour.” like tuberculosis or influenza, or in wartime, of enemy spies. And this tradition persisted despite the We have not space specially to discuss Dr. warning of Hippocrates, the Father of Levy’s brief but learned article, “ Tractatus Medicine (c. b.c. 430),. “ Whoever having de Causis et Indiciis Morborum.” He undertaken to speak or write on medicine shows that the tractate was not written by have first laid down for themselves some Maimonides. hypothesis to their argument such as hot F. C. S. Schitler’s contribution, “ Scien or cold or moist or dry or whatever else tific Discovery and Logical Proof,” is de they choose (thus reducing their subject voted to showing the limitations of formal within a narrow compass and supposing B o o k R e v i e w s 43 i only one or two original causes of disease In the fourteenth century medical stu or of death among mankind) are clearly dents at the University of Cambridge still mistaken in much that they say.” attended two full courses of lectures on Moliere satirizes physicians who are his Galen’s “ Commentaries on Hippocrates.” contemporaries as follows: The author believes that the Galenic physi “ First doctor: ‘ Do you eat well, sir?’ ology was currently known among educated “ Pourceaugnac: ‘Yes and drink still bet people of the sixteenth century. He states ter/ “ In the case of Shakespeare, however, the “ First Doctor: ‘ So much the worse! This number and accuracy of his illusions war great craving for cold and moist is an indi rant the belief that he had made acquaint cation of heat and dryness within.’ ” ance with medical writings at first hand.” Phlegm is described by Galen as “ cold He does not believe that Shakespeare an and moist, applied by nature to the swal ticipated Harvey’s discovery in 1620, of lowing of food and the movements of the which Dryden speaks: limbs.” Phlegm included saliva, mucus of “ The circling streams, once thought but the respiratory tract and the synovial fluid. pools of blood, Thus Pope speaks of the stomach after ex (Whether life’s fuel or the body’s food) cessive eating as: From dark oblivion Harvey’s name shall save.” “ A tomb of boiled and roast, and flesh and These few selected fragments are taken fish, Where bile and wind and phlegm and acid as illustrative of a scholarly and interest jar ing effort. And all the man is one intestine war.” Graham Lusk. CORRESPONDENCE To the Editor:— passage on the plague in Moses Narboni’s Bibliographical N otes on Plague medical work "o»n mn<„, written in 1350, T ractates.—The article “ Plague Trac was published with the omission of the tates” appearing in this issue of the Annals, technical medical points by Steinschneider by Dorothea Singer and Reuben Levy has in the Hebrew periodical tonan. VII, interested me very much as a welcome con p. iio - i i . (See further on this book, of tribution to a much neglected branch of me which the same library possesses two MSS diaeval Jewish literature. Aside from some representing different versions, in Stein publications of medical works of Maimon- schneider, Ioc. cit. 746-47; Histoire Iitte ides by Kroner nothing has been done in this raire, Ioc. cit. 676-78.) The treatise on field since the death of Steinschneider, and this subject by Abraham Caslari, which it is seldom that competent medical students precedes that of John of Burgundy in the favor us with the edition and interpretation Paris MS 1191, reads almost like a trans of Hebrew texts. May I be permitted to add lation according to Steinschneider, “ Cata- a few bibliographical notes which occurred Iogus codicum hebrseorum bibliothecae aca- to me when reading the article. demiae Lugduno Batavae”, Leyden 1858, In amplification of Note 2, I would p. 159. mention that of Hebrew tracts on the Concerning the identity of the two MSS plague, two are printed. A translation of which is discussed in Note 24, it should be Valesus de Taranta “ de peste” (a part noticed that the beginning of Vienna MS of his Philonium), appeared in Constan in “ Hebraeische Bibliographic” XVII, 57, tinople circa 1510 under the title “ runan, note 1, shows the identity with Paris MS, imn 9 leaves 4, see Steinschneider 1124, but omits the three puzzling words “ Hebraeische Uebersetzungen” , p. 819. (A which are rather arbitrarily interpreted in copy of this extremely rare booklet as Note 36. The Berliner-Giinzburg MS of well as the MS formerly belonging to the other version while literally agreeing Steinschneider may be found in the library with the Paris MS, 1191, as can be seen of the Jewish Theological Seminary of from the extracts in Magazin XII, 183, America, New York.) An original treatise has a complete ending before the astrological by Isaac ben Todros, written at Avignon epilogue (fob 134 verso line 1 of MS 1124) after 1373, was published by David de with the variant Montpellier for Liege. Giinzburg from a MS in his possession The title of the other tract of John on the in the “ Jubelschrift zum neunzigsten subject (deus deorum) reads here also Geburtstag des Dr. L. Zunz” , Berlin, 1884, ’to ’to; in consequence the correction in Hebrew part, pp. 104-26; compare D. Kauf- Note 30 becomes rather doubtful, the trans mannin “ Goettingische gelehrte Anzeigen” , lator possibly having chosen this term. 1885, pp. 451-56, Histoire Iitteraire de la Cod. Hebr. 2 of the Leeuwarden library France, X X X I, pp. 699-700. An interesting contains, according to De Goeje, “ Catalogus C orrespondence 433 Cod. Orientalium Bibliothecae Academiae is the case with the line over an fol. 141 verso LugdunoBatavae” Vol. V. p. 305, as the last line 18; the copyist began to write when piece a treatise on dietetics by Isaac Israeli! he noticed that he had omitted a word. Neubauer, however, when examining the All such letters might just as well have MS found instead three tracts on the plague, been omitted in the edition.— Fol. 141 see Letterbode II, p. 84. Of these the verso line 26 read ansny for 0*005?; see facsimile. third by John of Tornamira is written in — Fol. 142 recto line 1 perhaps no1? ought to Spanish with Hebrew characters, the other be read for mb. two are Hebrew; the first is ascribed to a MS 1124 is corrupt in many places. In still unidentified Paul of (Sophia? addition to the corrections proposed by the Steinschneider, “ Hebraeische Uebersetzun- editors the following may be suggested: gen” , p. 816); the second, which is anony Fol. 133 verso line 8 read: na*»aa n«n nn» mous, Neubauer thinks might be identical whs n**DiK n«a; 16 line 22 and 134 recto with that of John of Burgundy, Paris MS, line 1 read nann; fol. 134 recto line 5-6 1191. A glance at the first words which he read imnn for **din« Data (comp. line 16 and 134 communicates permits us now to definitely verso line 13); **D*mn ib. line 6 for dm1? perhaps deny this identity. The text accordingly n»ib (comp, nm1? 134 verso line 10) ib. line requires further investigation. 25 k’diji seems to be dittography from the The articles by Renan-Neubauer in the following word; fol. 134 verso line 9 for “ Histoire Iitteraire de la France”, XXXI, pmnn better inn; ib. line 10 for ptno perhaps pp. 723-25 and by Moise Schwab, “ Revue ptrfc; ib. line 14 read icuri nan for o-ixn; the des Etudes Juives” , X LI, pp. 154-55, should marginal glose “ Infetto” probably refers to be noted as giving some data about Ben inn; line 15 add ann after rrrtntr; fol. 135 recto jamin of Carcassone, who is described as line 9 read aus There still remain some translator of MS 1191, (viii). passages in need of emendation. As to the anonymous translator of MS Alexander M arx. 1124, Steinschneider’s hypothesis that it might be the same Joshua of Bologna who T ranslation of Galen’s Entire Works translated another tract on the subject into English—C ataloguing Scientific following ours in the Paris and Vienna M anuscripts.— The following extract from MSS deserves mention. A linguistic exami a letter of Dr. Charles Singer to Dr. Dana nation of the names of medicaments in the should greatly interest students of medical text might show whether the translator history. was an Italian. There are two projects that we have in In conclusion a few remarks may be added hand which I think would interest you and about the Hebrew texts. other American scholars, and to which I The copyist of MS 1191 frequently di should like to call your attention. vides the words if he lacks the space at the 1. The first is a scheme for complete end of a line to finish them, a very uncom translation into English of the entire works mon procedure in Hebrew texts. For the of Galen. The Germans are gradually bring convenience of the reader these cases might ing out the Corpus Medicorum Graecorum, have been indicated by a hyphen. The which will include Galen in his entirety. practice to fill the empty space at the end As they come out, volume by volume, of a line by the first one or two letters of we hope to have them rendered into English. the next word is very common. The line With this end in view, we propose to found on top of these letters is not an abbreviation a Galen Society, in which we hope to include mark but stands for “ deleatur.” The same American men. 434 Annals of Medical History The services of Dr. Withington are avail C atalogue of M anuscripts of Scientific Inter est, Up to the Y ear 1500, in the B ritish Isles. able for the purpose. Dr. Withington, I E dited by C harles and D orothea Singer. On may say, is an absolutely first class Greek press. scholar and, for reasons of health, is entirely unavailable for military purposes. I believe The Catalogue will be arranged primarily the Oxford University Press could be per under subjects, and subdivided chronologi suaded to publish the translation, and the cally, by centuries, and by the localities only burden on the Galen Society would in which the MSS are found. be some recompense to the translator for There will be a very brief excursus on his time and trouble. each text so far as is possible. I should be glad to hear what your There will also be two indices. view, and that of other Americans, may be Index i .— Alphabetical combined list of: on the subject, and should you be interested authors; places; scribes; languages (giving I would let you know of the progress of our subject, collection, MS number and folia scheme. tion, and catalogue page). 2. The other undertaking which I would Index 2.— Alphabetical list of manuscript like to mention to you is the Catalogue of collections with the MSS arranged in nu Scientific MSS in the libraries of Great merical order, and giving the library1 in Britain and Ireland, which is in process of which each collection is preserved, the preparation by Mrs. Singer and by myself, subject and the catalogue page. or rather by Mrs. Singer, for she, with HEADINGS OF THE CATALOGUE several helpers, has been responsible for the whole work in my absence. A lchemy Hem atoscopy It is our hope, when the Catalogue reaches Chemistry Blood-inspection A natomy H erbaria a serviceable stage, which should be by the A ristotle (Secretum H ospitals end of the summer, that it will place the Secretorum Aris H usbandry totle to Alexander) Lapidaries worker who cares to use it in quite as favor A rts and C rafts M athematics (Pure) able a position for the study of medical and A strology M easures and W eights scientific MSS as those of us who are living Menology M edicine (General) A stronomy M elothesia in touch with the great European libraries. B estiaries M iscellaneous The Catalogue will include all MS ma Monstrosities M usic Fables Harmony terial up to the year 1500. It will be in card C alendar (Scientific Aspects) form, and will be classified according to C omputus O phthalmology the subject, Anatomy, Astronomy, and so C harm P estilence Magic Contagion forth. It will contain about 40,000 entries. C hildren Epidemic By its means a worker, in the United C osmology Plague De Rerum Natura Infection States for instance, will be able to see at De Elementis P hlebotomy a glance what MSS there are that are of D iet Blood-letting interest to him, and he could procure roto- F ermentation and P hysics G eneration P hysiognomy graphic or photographic copies of them by F evers Chiromancy communicating with the library where they G eography P hysiology (Four Travel temperaments, etc.) are to be found. G yn eco lo g y P rognostics Yours sincerely, 1 Under Bodleian Library, it will be necessary to print also a list of the MSS in numerical order according to the old numbers (retained in the New C harles Singer Summary Catalogue) giving the present pressmark, i. e., collection and number. C orrespondence 435 CATALOGUE HEADINGS (CONT.) MS is cited (and in brackets their Bodley P ulses pressmarks, if known, otherwise leave space R ecipes for pressmarks). If the Catalogue is the R egimen (Other than Secretion) Science (General) only work, it need not be cited. Encyclopaedias of General O n Body of Card— Knowledge, (e. g., Bartholomseus) Surgery 1. If the work is printed, in bold letters U rine printed, followed by a list of works in V eterinary which the MS is printed (and in brackets C olors of C ards their Bodley pressmark, if known; other wise leave space for pressmark). W h ite...... British Museum Yellow...... Others 2. Followed by name of Scribe and any R ed ...... Oxford important note or remark. Blue ...... Cambridge G r e y ...... Cathedrals 3. Any figures or illustrations will be noted Sunset...... Foreign in bold letters. Purple...... Cross Reference2 4. Followed by full title, incipit, explicit, and any other quotation given in Catalogue. CONTENTS OF CARDS OF SKELETON CATA LOGUE OF HAND-LIST To the Editor:— (This should be ready by about A Modernist’sView of M edleval Science September, 1918) — I should hate you to misunderstand my The cards will give: attitude towards Mediaeval Science. I al On Left Hand Side— ways feel towards it as Huxley did towards Above line.— Collection and number of Ghosts. He used to say, you know, that MS (Roman figures in brackets signify the “ he didn’t believe in ghosts because he number of the item in the MS). On Bodley had seen too many of them.” I don’t think cards, ordinary figures in brackets signify there are many mediaevalists who feel less the numbers in the summary and 1697 mediaeval than I do. But the Middle Ages, catalogues. like the Germans, are there, and we have Below line.— Foliation, i. e., number and just got to consider them. The important side of first and last sheet. (Nomenclature: question is, to my mind, not whether “ recto” and “ verso” of sheets.) mediaeval science made any advance on In C entre— Above line.— Subject, in bold letters, and knowledge, for it clearly did not, but under subject, author,3 if known. whether the point of view and the intellec Below line.— Language, if not Latin, and tual processes which gave rise to the Middle below language, short title, if any. Ages have or have not had a deep and lasting On Right Hand Side— effect. To my mind they have. To my mind Above line.—Date and place of MS. modern thought is the descendant of mediae (Leave space above for exact size and val and not of classical thought. To my material.) mind the classics have never been, and can Below line.— List of works in which the not now be studied from the inside by the 2 Cross reference to every author and scribe and Western nations. If the men of the Middle place, giving subject, library, collection, MS number Ages were children, then the men of Greece and foliation. were foreigners. It is, of course, possible 3 When citing any printed work, be sure to give to appreciate the beauties and the meaning all initials, or, when known, Christian names, of authors. of the Greek and Roman writers, but to