Onésime Delafond (1805-1861) and the doctrines of pathology. Part 2.

The doctrines of solidism and vitalism: Brown, Razori and Pinel.

Delafond opens his overview of solidism and vitalism with a description of the ideas of Themison, 1^st century BC, a member of the methodist school that concentrated on treatments of disease rather than on treatment of individual patients. The methodist doctrine dominated the medical practice in the Roman empire for three centuries. Themison established, according to Delafond, the principle in which the fibres, which constituted the organs, were present in two states, tension (strictum) or relaxation (laxum). The fibres are the solid parts of the body: nerves, muscles, etc. Tension of the fibres is connected to their sensibility and relaxation to their debility or weakness. An excess of one of the two determined the diseases.

These ideas were later, in the 18^th century, elaborated and joined with ideas about vital properties derived from the anatomical and physiological findings of Haller and, eventually, raised, enlarged and fortified into a doctrine of solidism in which diseases have their seats in solid organs.

The solidists agree that the organism has a vital property called sensibiblity (excitability, irritability) which belongs to the solid parts exclusively. The sensibility is in equilibrium with the impressionability; this equilibrium may be disturbed by morbid agents and disease will then originate in the solids. In the course of the disease the circulating liquids play a passive role; if they are altered it is a consequence of alterations of solids.

Before I continue with Delafond's discussion of the ideas of four solidists I want to remark that, when looked at it in more detail, the doctrine of solidism is much more complex than described by Delafond, but, on the other hand, he wanted to treat the subject in not more than half a page. It is also important to realise that much of the ideas of solidism were developed shortly before or even during his own lifetime, and he may have tried to find an easy way to inform his readers about how to deal with recent and sometimes controversial opinions about animal disease.

After explaining solidism Delafond gives a review of the four great doctrines that are based on solidism and vitalism, because he wants to investigate the influence these may have had on veterinary medicine. These doctrines are named after the persons who proposed them: Brownism, Razorism, Pinelism and Broussaisism. I will treat here the first three, and will postpone the discussion of the ideas of Broussais to the next blogpost.

Brownism, or the doctrine of the Scottish doctor John Brown, (nowadays called the "Brunonian doctrine of medicine") is, according to Delafond, the idea that life is maintained by stimulants. They may exert an impression by excitability (the capacity of being brought into a reaction upon a stimulus) or incitability (the aptitude to be stimulated) of the fibers. In my view both ex-and incitability are more or less the same, but in the opinions of 19^th century they were different. Stimulants may be internal (nervous influx; excersising function; muscular activity) or external (external bodies, either weightless or with some weight; solids, liquids; gases). These stimulants may be general or local. Life and health may be dependent on the stimulants. Too much stimulants result in sthenic diseases, too little stimulants give asthenic diseases.

The Scottish doctor John Brown (1735-1788)

Delafond goes on describing the various details of the Brownian doctrine, but we may omit them without problems, because his own conclusion is that it may be an attractive theory but that it is difficult to apply in practice. It has numerous followers in medical and veterinary Germany and Italy, but has been neglected in England and France; Delafond states that he does not know a single veterinarian in France who had adopted or tried to propagate the Brownian doctrine.

Razorism, is the doctrine of the Italian medical doctor Razori (of whom I had never heard before). According to Delafond, Razori should be remembered because of his practical approach of the principles of Brown. He tried to find agents that might reduce the excess of incitation that causes sthenic diseases; he called those counter-stimulants. These agents, chemical or physical, had a special power with a sedative capacity with which sthenic diseases could be cured. Some of these counter-stimulants could be used for certain categories of disease: purgatives, emetics, cold and, especially, blood-letting. In the same sense Razori argued that asthenic diseases may be due to an excess of counter-stimulants and he tried therefore to find agents capable of restoring the excitability; these he called stimulants. Among them we may find alcohols, tonics and opium.

According to Delafond, Razorism connects Brownism (emphasis on fibers) with vitalism (emphasis on (counter)-stimulants). He deplores the neglect Razori and his followers showed for insights from anatomy and physiology that led them to several erroneous theories, but he praises them for their empirical skills which brought them to the therapeutic applications of the large dose of emetics as a counter-stimulant in the beginning of certain diseases that gives such uncontested cures.

Pinelism, a doctrine developed by the French doctor Pinel, famous for his absurdly detailed disease classification, (but nowadays considered the founder of modern psychiatry) is only shortly discussed by Delafond.

Philippe Pinel (1745-1826),

 Pinel, Delafond tells us, made a bizar mixture of Brownism, humourism, vitalism and solidism, which is easily seen when you open his book of Nosographie Philosophique and read about his essential fevers, the phlegmasies, the neuroses and active and passive hemorrhages. In Pinel's doctrine vitalism may be seen as predominant in this doctrine; nature is transformed or perverted, and therefore needs the medical doctor to be saved.

Pinelism had not much impact in veterinary medicine, is Delafond's conclusion, at least less than in human medicine; a few professors taught it in schools, but it was soon abandoned by the veterinary profession.