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knowledge of the day, especially in anatomy, “the key, compass, and foundation of medicine," a science which should be studied not only by physicians and surgeons, but by the clergy and magistrates; in short, by all who have to guide or govern mankind. The surgeon should also study botany and chemistry, "for metallic remedies are of great value in medicine, as we daily experience, though when given by quacks and idiotæ,' they are like a sharp sword in the hands of a fool, or a lighted torch held by a child"; probably a reference to the Paracelsists, who were his special abomination. At Bern, where Fabricius was appointed city surgeon, he kept a private hospital, and gave clinical instruction to students and practitioners, while, like Hunter, he founded a museum containing not only anatomical and pathological preparations made by himself, but archæological specimens, the thigh bone of a mammoth and other curiosities. He was specially skilful in inventing new instruments, such as aural specula, splints, and forceps for removing foreign bodies, and he even made an artificial eye, which he presented to his pupils, to encourage them in their anatomical studies. But the reader should refer elsewhere for an account of the life and works of one who is perhaps the most attractive of the four great surgeons here briefly noticed, and we must conclude with a few extracts from his chief work, the Six Hundred Surgical Cures and Observations. On 25th April 1624, he writes to a Dr. Hagenbach, regretting that an attack of gout prevented him from going to the latter's wedding, and relates the following case as an example of the advantages of being married : "A countryman, Benedict Barquin, bought some iron, and was striking two pieces together to prove its quality, when a splinter flew into his eye and stuck in the cornea, causing him great pain. The local surgeons tried everything for many days to no purpose, and the pain and inflammation so increased that he came to me at Bern on 5th March. I used all means I could think of for some days, but the splinter was so small that it could not be removed by instruments. When behold! my wife

hit on the very thing. I kept the eye open with both hands, while she held a magnet as close as possible to it, and after several trials (for he could not stand the necessary light long) we saw the iron leap from the eye to the stone." This ingenious lady was a French Swiss from Geneva, named Marie Colinet, who, in her husband's absence, could not only treat diseases of her own sex, but even cases of fractured ribs and legs.

The following is an interesting example of nose making: "When the Duke of Savoy waged war against Geneva, A.D. 1590, there fell into the hands of the soldiers a modest and pious maiden, Susannah N——, quam cum stuprare frustra tentâssent, et hâc de re maxime irâ exciti essent, they cut off her nose. Two years later John Griffonius, a most ingenious surgeon, and very fortunate in his practice, came to Lausanne and undertook to make her a new nose, which he did to the greatest admiration of all men. I myself have often seen and examined it, for she is now living (1611) at Lausanne with a pious and honourable widow, Judith Mace. The nose has undergone no change, and the marks of operation are hardly visible; but in winter when it is very cold the tip turns a little blue. The inventor of this noble operation was the famous and learned C. Tagliacottius, professor of medicine at Bologna. Master Griffonius heard of it from an Italian who passed through Lausanne, and who had been cured by Dr. T., and he performed the operation before the latter published his work on the subject.”

Fabricius is probably most widely known through his method of amputating with a red-hot knife. This plan had been used, or at least recommended, by Arabic and mediæval surgeons, but Fabricius improved it, as he considered, by increasing the thickness of the instrument, so that it could retain the heat throughout the operation. The method has, he declares, three great advantages: (1) It is less painful (!) ; (2) the muscles are more completely retracted, and therefore the bone may be divided higher up; (3) the loss of blood is very much less than when either a separate cautery or

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ligature is employed; and he narrates how, by means of this cauterium cultellare he successfully amputated the leg above the knee, in a patient attacked by gangrene following dysentery, who was so prostrated that even a moderate loss of blood would have been fatal.

NOTES.

I am indebted for the reference to Brassavola's tracheotomy to Dr. Holmes' History of the Progress of Laryngology. Paré A., Euvres Complètes by Malgaigne, Paris, 1840 (with valuable introduction and biography).

Franco: what is known of his life, and a reprint of the excessively rare, Petit Traité, etc., may be found in Rohlfs' Archiv, 1881-82 by Prof. Albert of Vienna. Tagliacozzi, De Chirurgia Curtorum, Venice, 1597. The story of his exhumation is given by Haeser, II. 197, on the authority of Corradi. Calentino's letter is printed by Gourmalen, also in Velhagen und Klassing, Neue Monatshefte, 1889, p. 604; Fabricius Hildanus, Opera Omnia, Frankfort, 1646; Müller, Des Berner Stadtartzes Wilhelm Fabricius Hildanus Leben und Wirken, Rohlfs' Archiv, 1883.

L.-MEDICAL PRACTICE IN THE SIXTEENTH

CENTURY.

THE noisy controversies, new systems, and important anatomical discoveries which mark the medical history of the Reformation age, tempt the historian to neglect what is after all his main object, the description of the actual practice of the period. But he has little excuse for so doing, for the "Hippocratic" physicians justified their title by composing many volumes of clinical histories and observations, which give us a vivid picture of the best aspect of our art at that epoch. Besides these, the consilia, or letters of advice, still continued, though the writers are careful to assert that a physician is only justified in exceptional cases in prescribing for a patient he has never seen. As an in

teresting example of such a consilium, we may take the twenty-first Medical Epistle of the already-mentioned Dr. John Lange. "You complain to me, as to a faithful Achates, that your eldest daughter, Anna, is now marriageable, and has many eligible suitors, all of whom you are obliged to dismiss on account of her ill-health, the cause of which no doctor can discover: for one calls it cardialgia, a second palpitation, a third dyspnoea, a fourth hysteria, nor are there wanting who say that her liver is out of order. Wherefore you entreat me by our ancient friendship to give an opinion on her case, with advice as to marriage, and you send me an excellent account of her symptoms. Her face, which last year showed rosy cheeks and lips, has become pale and bloodless, her heart palpitates at every movement, and the pulse is visible in the temporal arteries; she loses her breath when dancing or going upstairs, she dislikes her food, especially meat, and her legs swell towards evening, particularly about the ankles. I marvel that your physicians have not diagnosed the case from such typical symptoms. It is the affection, which the women of Brabant call the 'white fever,' or love sickness, for lovers are always pale, but there is very rarely any fever." He then discusses the pathology of the disease with copious Greek quotations from the Hippocratic treatise, De Morbis Virginum, points out that Hippocrates recommends marriage, and says that, with the addition of simple purgatives and emmenagogues, he never knew it to fail. "So be of good cheer, marry your daughter, and I shall be glad to come to the wedding."

Among the earliest writers of 'Observations' was Antony Benivieni, whose work On the Hidden Causes of Diseases and Cures, quoted in a preceding chapter, though it strictly belongs to the fifteenth century, may best be considered here. Of the two following extracts, the first is the earliest known description of senile gangrene, while the second is a case perhaps unique in medical history.

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(1) Those who suffer from the black ulcer, which the Greeks call gangrene, if it begins from the toe, and the

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patients are old or in broken health, die rapidly. I knew Cambinus, Charles, and Thomas, citizens of Florence, and very many others affected by this disease, and they all died in a short time. The flesh gradually turns dark or livid, and sometimes dries up. The adjacent skin loses its sensibility, becomes pale or livid, and covered with black swellings. The disease creeps on till it affects the bone, and if you amputate, even through healthy flesh it will return again in the stump." (2) "A monk of the Order of St. Augustine at Florence came to me and complained that the bone of his head was wearing away daily. Surprised at this I felt his head, and found that the fore part was almost entirely boneless; and what was most amazing, there was no disease of the skin or flesh. Nothing did him any good, and in a few years he died, having lost nearly all his skull." Benivieni suggests that it may have been due to some fine acrid humour which, passing through the pores of the flesh, eroded the harder bone, just as a flash of lightning may melt the gold in a purse without injuring the latter.

One of the most famous physicians of the sixteenth century was Amatus Lusitanus, a Portuguese Jew, who, with some hundreds of his nation, had been forcibly baptised in childhood. He continued, however, to practise the religion of his ancestors in secret, and might perhaps have done so in security had he not published a commentary on Dioscorides, pointing out the mistakes in the famous edition of that author, by Matthioli of Siena; and the enraged botanist, unable to refute his adversary, loudly accused him of apostasy. We have seen how Saladin's judges treated a similar charge in the case of Maimonides; but the Christian theologians thought differently, and they hunted the unfortunate Amatus from place to place like a wild animal, till he found refuge at last among the Turks at Salonica. one of his many flights he lost all his manuscripts, but fortunately recovered the most important, the first five "Centuries" of his Medical Cures, to which he afterwards added 200 more. The following are among the more in

In