Age of Enlightenment: Cultural movement of intellectuals

emphasizing reason and individualism rather than tradition.

18th century 1689 (death of Thomas Sydenham)
1789 (beginnings of the French Revolution)
Enlightenment doctors inherited Hippocratic medicine,
searched for principles that would integrate medical
theories to understand better how bodies behave in health
and disease.
There was a marked demand for medical services &
expansion of the medical profession, and growth of medical
quakery.

Medical contributors:
Hermann Boerhaave (1668-1738)
Dutch Hippocrates
Father of physiology
central figure of European medicine
greatest clinical teacher of his time
Boerhaave syndrome
( Iatrogenic/ vomiting)

profound knowledge of chemistry:

discovered urea from urine in his
experiments

Friedrich Hoffmann (1660-1742)

German chemist and physician

Phlogiston theory: combustion
Supporter of vitalism: soul or

anima maintains the body in a

state of tonic equilibrium
Disease resulted from excess or
deficiency of tonus

John Brown (1735-1788)

Scotish physician
Conceived that diseases

were either too much

(sthenic) or too little
(asthenic) of a nervous
stimulae
Treatments stimulant &
sedatives (alcohol &
opium)
Brunonian system

Carolus Linnaeus (1707-1778)

Sweddish biologist
Classified living organism into

2 kingdoms basing on
morphologic features
Binomial nomenclature:
giving scientific names to
biologic organisms by its genus
& species.
Ex. Human beings are Homo
sapiens

Samuel Hahnemann (1755-1843)

German physician
Originator of Homeopathy

(psuedoscience), a system of
alternative medicine based on the
doctrine like cures like.
System of treatment involving the

administration of minute doses of

drugs whose effects resemble the
effects of the disease being treated
Disease is cause by miasma

Anatomy continued to be the central concern of medical

education, research & publication. Although there was
shortage of bodies for dissection, teachers offered hands
on dissection as priority.
Legal corpses were those of condemned criminals or
coming from Resurrection men (robbed bodies from
graves & sold them to anatomy teachers).

William Cheselden (1688-1752)

English surgeon
Pioneered the use of camera for

accurate depiction of all bones in

the human body (Osteographica
1733)
1st to perform iridectomy
Attended to Isaac Newton and

Alexander Pope

William Hunter (1718-1783)

Scotish anatomist and physician
1st great teacher of anatomy
A natural orator & story teller
Built a museum: anatomical

preparations, collection of
specimens, coins & minerals

Anatomy of the Gravid Uterus

(1774) life size illustrations of

women who died in various
stages of pregnancy

Antonio Scarpa (1747-1832)

Italian anatomist, opthalmologist
Scarpas triangle of the thighs
Scarpas canal
Scarpas fascia
Wrote treatise on hernia & eye

diseases
Originated the procedure for
iridodialysis

Drawing of the left femoral

triangle - shows superior
portion of the femoral vein

Right femoral sheath laid

open to show its three
compartments

Frederick Ruysch (1638-1731)

Dutch anatomist
Discovered technique of preserving organs by arterial

embalming secret liquor (balsamicum)

Injected blood vessels & the lungs w/ wax and

produced beautiful engravings of the vascular &

pulmonary systems

Creation of dioramas incorporating human parts

Albrecht von Haller (1708-1777)

Swiss, anatomist, physiologist
Father of Modern Physiology
Properties of living bodies:

a. sensitivity: response to pain

b. irritability: the capacity to react
by muscle contraction
Theory of Preformation: every

individual is fully & completely

preformed in the germ.

Robert Whytt (1714-1766)

Scottish physician
Localized the seat of reflex

action in the spinal cord &

demonstrated that it was
independent of the brain
Differentiated voluntary from
involuntary movements
Described components of the
light reflects.

Rene Reaumur (1683-1757)

French scientist, physicist,

inventor
Water and alcohol
thermometer-temperature scale
were the freezing and
boiling
points of water were
set at 0
and 80 degrees
Investigated gastric juices
designed an egg incubator

John Hunter (1728-1793)

Scottish surgeon
Researches in Anatomy &

Physiology
Discovered the collateral
circulation of the blood
operating in aneurysms
Raised status of surgery in
Britain
Orthopedic Surgery

Leading authority on venereal

diseases (Treatise in VD)

Antoine Lavoisier (1743-1794)

French biologist and chemist
Father of the modern chemistry
Identified oxygen & showed that oxygen was
fundamental to respiration

Francois Xavier Bichat (1771-1802)

French anatomist and physiologist
Father of modern histology
Stressed the importance of

autopsy

Opinion: Pathological changes

initially occurred within the

tissues rather than the organ

Giovanni Battista Morgagni

(1682-1771)
Italian anatomist
Father of modern anatomical

pathology
Adapted the traditional head to
toe presentation
Described appearances of post
mortem findings & correlated them
w/ the clinical picture
Published De Sedibus et Causis
Morborum (The Seats & Causes of
Diseases)

Other Discoveries
Ren Laennec (1781-1826)
French physician
Invented a simple stethoscope (cylinder)
Wrote De L Auscultation Mediate (On Mediate
Auscultation)
Specialized in diseases of the chest

Leopold Auenbrugger (1772-1809)

Austrian physician
Inventum Novum (The New Invention)
Percussion as a diagnostic technique
Application: tapping chest & abdomen distinguished
tumors, enlargements, & collection of fluid
Auenbrugger's sign - bulging of the epigastrium seen in
severe pericardial effusion

James Lind (1716-1794)

British surgeon
Treatise of the Scurvy (Vit.
C deficiency)
Experimented treating
sailors afflicted w/ scurvy
by eating fresh fruits,
lemon & vegetables

William Withering (1741-1799)

English physician, botanist and chemist
Infusion of the purple fox glove (Digitalis purpura)

treated dropsy (edema) & irregularities of the heart

Wrote guidelines, on its use, indications,
contraindications, side effects, dosages

John Floyer (1649-1734)

English physician
Introduced Pulse watch, recorded in seconds on the
dial
Enthusiasm for cold salt water bathing

William Smellie (1697-1763)

Scottish physician
1st systematic discussion on the

mechanisms of labor

Designed the safe use of obstetrical

forceps

Established obstetrics as a medical

discipline

Treatise on the Theory & Practice of

Midwifery

Placed midwifery on a sound

scientific footing

Lady Mary Wortley Montagu

(1689-1762)
Wife of British Ambassador to

Turkey
Introduced Inoculation against

small pox in England

1st tried inoculation to the

convicted criminals successfully

Successfully inoculated members

of the Royal family

Edward Jenner (1749-1823)

English physician
Noticed that milkmaids who had

been infected w/ cowpox were

insusceptible to small pox.
An Inquiry into the Cases &

Effects of the Variolae

Vaccinae, known by the name
of Cow Pox Vaccine
Vaccination proved its merits &

the use of it rapidly spreads

John Pringle (1707-1782)

Scottish physician
Wrote Observations on the

Diseases of the Army

Recommendations for the
health & comfort of the troops
by creating hospitals for
wounded soldiers on both sides
of the fighting troops
This became the forerunner of
the Red Cross in 1864

Pringle cont

Philippe Pinel (1745-1826)

French psychiatrist
Father of Psychiatry
Great change in the management

of the mentally ill

Replaced cruelty &
inhumanitarian treatment to
understanding & compassion
Ordered removal of the chains
that contained the disordered
psychiatric patients

Franz Anton Mesmer (1734-1815)

German physician
Believed in animal magnetism called mersmerism or
hypnosis
Therapeutic value in giving suggestions while the patient
was under hypnosis

Franz Joseph Gall

(1758-1828)
German physician
Founder of phrenology
Skull contours were guides to
mental faculties & character
traits
Mental functions are localized in
specific regions of the brain

Research and Publications

This century started to be statistically conscious. Lind &
Withering examined their therapies successful &
unsuccessful submitting them to the test of numbers.
By the 18th century doctors started publishing papers on
series of cases rather than individual successes. This
started the test of significance by the use of placebo.

 The Enlightenment witnessed concerns relating to health

& health care. Although some countries introduced

regulatory measures to control the practice of healing,
the marketplace for quakery prevailed.

This was the golden age of medical quakery (peddlers,

swindlers, quakers of all descriptions).

Marketplace cont.
Venereal diseases (syphilis or lues & gonorrhea) were

common & the anxiety they instilled made sufferers easy

prey to offers of secret cures.

The growth of newspapers provided outlets for health

caregivers to advertise.

Recipe books were sources of information (self

medication, treatment, prevention)

Medical men competed within the medical marketplace.

3 Categories of Doctors
1. Physicians: medical degree from universities; wore
powdered wigs & carried gold headed canes; true heirs
of Hippocrates; diagnosed disease
2. Surgeons: trained by apprenticeship, attended extra
classes on anatomy; minor operations
Surgeon-apothecary: general practitioners supplying
compounded medicines; serving the rural areas
3. Apothecaries: sold medicines along with other products
(soap, spices, herbs, minerals)

***

A doctor in the 18th century

Powdered wigs

Gold headed canes

Summary:

Emphasis on Reason and Individualism

Simple ways of healing continued (Hippocrates & Syndenhan)

Advanced knowledge through Scientific Method
Health became prized, demand for medical services
Rise of medical quakery
Anatomy & physiology continued to be the concern of medical

education
Famous doctors with their contributions were presented