Part 1. Humorism
Henri Mamert Onésime Delafond was one of the
more important veterinarians of 19th century France. He obtained
within a few years after his graduation as a vet a chair in pathology and
therapeutics at Alfort and during almost his whole professional life he was a
member of the board of the Receuil de
Médecine Vétérinaire, in which he frequently published. In 1860 he was
appointed director of the Veterinary School of Alfort, but he died, too early,
soon after.(1)
In this blogpost and the next I want to present
an overview of his ideas about the doctrines of pathology, taken from his book Traité de Pathologie Vétérinaire,
published in 1838. (2) For several reasons this is an interesting chapter in
his book. First, it is a description of the principles of pathology by an
expert who himself made active use of these principles in his teachings and
veterinary practice; the knowledge we have been taught of these doctrines is
most of the time presented by historians of medicine who have never lived in
the middele of them. Second, Delafond presents a short history of the way these
doctrines have been modified, adapted and received, and gives comments on them,
as a person who has contributed to their use in veterinary practice.
Paragraph 5 of the first chapter of this book
(p 24-24) then is devoted to the nature and seat of disease and the doctrines
of pathology. The discussion concerns of course the doctrines that were current
in his time. The principles of pathology as given by Hippocrates and Galen were
slowly mingled with, or replaced by, new ideas. Delafond treats them in a clear
way, indicating their strenght and weakness, and suggests how a veterinarian in
the third decennium of the 19th century may use them for his own benefit.
Delafond states that ever since learned men
have tried to find what constitutes the essence, or the inner nature (nature intime) of diseases, that is,
whether it is the liquids or the solids that are altered. Those who adhered to
the principle that the humors (the liquids) were the first seat of disease have
only tried to remedy the alterations of the liquids. The others have only seen
alterations of the solids and have tried to cure accordingly. These opinions,
collected in systems, have received the name of medical doctrines.
Delafond promises us that we are going to learn which of the current doctrines
are in vogue and which has the most adherents. Not unexpectedly, he
distinguishes two categories of doctrines, the humorism, or doctrine humoral, and solidism and
vitalism.
Here I want to summarize Delafond's description
of humorism; I will write about his solidism and vitalism in a subsequent
blogpost.
Humorism is the Hippocratic doctrine that attributes
all diseases to something that is wrong in the body fluids. Delafond is rather
short about it. The body fluids, the humors, are the well known blood, phlegm
(slime), yellow bile and black bile. Diseases are related to a deficiency,
overabundance or a disproportion of these humors. The repair of the equilibrium
of humors that reigned between them is the recovery of health. The other main
theme in the doctrines of Hippocrates is, according to Delafond, the idea of
the three periods in the diseases of the humors. They are: crudity, coction and
crisis. In the period of crudity the morbific element is present in its most
forceful form; in the period of coction this element either causes death or it
recedes under the influence of nature; in the period of crisis it is driven out
of the economy of the body. Therapy consists of observing the progress of
disease and modify it in a way that accords with each of the three periods. Observation is the main characteristic of
Hippocratism.
Next Delafond gives a short overview of all
kinds of different doctrines that grew out of the Hippocratic doctrine;
dogmatic and ecletic theories giving rise to ideas that lost sight of the old
Hippocratic tradition until the latter was restored more or less by the
empirism that rested on observation, history and analogy. But other
theoreticians appeared on the stage who were trained in chemistry and physics
and added their expertise to the humoral doctrine. They were interested in the
chemical and physical properties of fluids; these could be more condense or
more fluid, acid or alkaline or acrimonious which were properties that could be
treated therapeutically. A humoral physiological pathology developed, in which
symptoms like a violent pulse and the force of the heartbeat were due to
tension of the humors and in which changes in the color of the urine and its consistency
such as sediments and stones were the consequence of the expulsion of altered
urine.
Delafond enumerates many examples of changes in
properties of blood or lymph and accumulations of liquids that the body cannot
get rid of, or, in Hippocratic terms, that the crisis could not expulsate. All
changes are due to liquids that are modified by heat, cold, bad digestions,
influence of poisons and morbific elements in the air. All therapies are aiming
at restoring the old situation of balance in each of the three periods of
disease progress.
In the end of his overview of the Hippocratic
doctrine Delafond sums up the Greek, Roman and French hippiatrics (horse vets) and
founders of the French veterinary school "who adopted the doctrines
brought forward by the humorists thereby making a bizar mixture of the Hippocratic
doctrine and the explications of the great humorists Galen and Boerrhave [sic]". But yet, he states
(relieved, it seems), one may find in the later writings of Bourgelat and in
all the works of Chabert an autocracy (unlimited reign) of nature united with
vitalism and the strictum and laxum of the solidists.
1. Source of biographical details and portrait:
Neumann,
Louis George. Biographies vétérinaires,
avec 42 portraits dessinés par l'auteur. Paris, 1896. p 86
2. O.Delafond, Traité de
Pathologie et de Thérapeutique Générales Vétérinaires, Bruxelles, 1838.
