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The nineteenth century Paper

The nineteenth century is the century of the industrial revolution and early capitalism. It is also the century of the origin of modern empirical-experimental science and medicine, the development of pharmacology, cell pathology and bacteriology (Pasteur). New instruments allowed new scientific investigations, diagnosis and a rationalisation of therapies. During this period the physical and psychical body were further separated and medicine became more and more the science of the material body. With the evolving knowledge of the different body organs, physicians started to specialise in different disciplines according to the corresponding body organs or functions. Medical treatment became available to almost the whole population and medical health and accident insurance institutions were established.

The successes booked in physic and chemistry more and more influenced and determined the medical science, methods and therapies, however did not hinder the appearance of different theoretical schools such as :

* The natural philosophical physiology with the vegetative (growth, nourishment and reproductive forces), animistic (irritability of the organs and muscles) and sensitive (sensory, nerves and soul) dimension.

* The natural scientific physiology which was completely based on the scientific investigation of body functions.

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* The cell-pathological theory of Virchow (1821-1902), who declared that all diseases resulted out of changes in the cells, and that the cell was the true organic unity of the body and the part of departure for all life. His theories were transmitted to society and resulted in the development of bio-socialism.

The development of bacteriology by Louis Pasteur (1822-1885) and Robert Koch (1843-1910) for the first time proved the ill making potency of micro-organisms which initiated the science of microbiology, modern vaccination and the development of disinfecting agents to be used during surgery.

Not all physicians accepted the scientific developments in medicine and out of vitalistic and life force theories of the eighteenth century alternatives arose like the homeopathy of F.S.Hahnemann (1755-1843). According to Hahnemann disease is an affection of the life force by pathogenic disturbers and has to be seen as a holistic body phenomenon. Instead of supporting the body’s resistance, a homeopathic physician applies low or lowest doses of substances which evoke the same symptoms as caused by the disease itself. The so provoked artificial disease stimulates the life force to increased resistance.

In addition to homeopathy naturopathy developed with hydrotherapy to support the natural discharge of

The separation between body and psychic illness proceeded during this century and the brain became more and more the object of investigation for psychic illness and abnormalities (pathological- and somatic psychiatry). As for body medicine, alternatives to the scientific views were established like the psychoanalysis of S.Freud (1856-1939).

The age of Enlightenment

During the past period, thinking and handling was strongly dominated by doctrines and religion. This changed during the eighteenths century where thinking and reason became independent from the church and state. The scientific leitmotiv changed to empirism and rationalism, with systematic observations and planned experiments. Different old health and disease concepts were renewed or replaced by new ones.

Many theories were postulated which can be divided in two categories: the physical/mechanical theories and the spiritual theories as listed in Table 2. All these different theories initiated the separation between a material body orientated medicine and a soul/mind orientated medicine.

The eighteenth century is also the age of the founding of the modern hospital with inner medicine, surgery and pharmacology.

Table 2 Overview of health and disease theories in the eighteenths century

Physical/mechanical theories

Spiritual life force theories

Bio-mechanics of Friedrich Hoffmann (1660-1742)

All body states in health and disease are dependent on the tonus of the fibre parts of the body, in particular those of the fluid transporting system. The living is created by God, who rules over all mechanical processes.

Psycho-dynamics or animistic theory of Georg Stahl (1660-1734)

The causing principle of health and disease is the feeling, perceiving, willing and acting soul. All body systems get their energy from the soul, the soul rules and the body serves the soul.

Mesmerism of Franz Anton Mesmer (1734-1815)

Every organism has a magnetical fluid which can be influenced

Vitalism

The animistic theory was further developed by some French physicians, who postulated a “Principle of Life” responsible and causing all living. The “Principle of Life” was in charge of fundamental and acting forces and disease was seen as disturbance of the “Principle of Life”.

Irritability or sensibility of Glisson (1597-1677) and Haller (1708-1777)

Provocative nature of the muscles determines perception

Life force theory of Chr.W.Hufeland (1762-1836)

Life force as life preserving principle of the organism is closely related to natural healing forces.

Brownianism of J.Brown (1735-1788)

The stimulating impuls is life promoting. Internal and external stimuli excite and uphold life. Health and disease are determined by the irritability of an organism.

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