Physic, by Francisco Sanz de Dios y Guadalupe, a graduate of Salamanca, a tolerable compendium of the medical knowledge of the time, drawn up with greater attention to foreign authorities, and among them to our Willis under the guise of Uvilis, than is usual with the Spanish writers of the period. If the first edition of this work, as appears from Morejon, was published in 1730, it must have passed rapidly into favour; for that which we have examined is the third,* and dates in 1739. An important document, in relation to the existing state of medicine in Spain, our inspection of which has not exalted our notions regarding it, was the Pharmacopoeia of Madrid, first issued by State authority in 1739,† in the form of a quarto volume of four hundred and eighty pages. A more remarkable specimen of polypharmacy than it contains, in the shape of the Aqua Polychresta, will not easily be discovered anywhere; while the retention of such articles as the cranium humanum, bufo exsiccata, album græcum, secundina mulieris, and a host of the like, shows, at all events, no advance beyond the lowest of the then prevailing conditions of this department of medicine. We need make no especial reference to the considerable, though misapplied, ingenuity of Miguel Rodriguez, a physician of the mechanical school, in his work entitled Medicina Palpable,' published in 1743; nor to the Medicina Experimentada' of Ignacio Catalàn, which appeared in 1745; nor to the treatise on the Plague, by Juan Diaz Salgado, published in 1756; nor give more than a passing tribute to the learning displayed in the PhysicoMedical Dissertations by Ramon Brunet de la Selva, published in 1755 and 1758; nor dwell upon the insignificant work by Vicente de Lardizabal on the Diseases of Seamen, which appeared in 1769; nor on the more deserving Medicina Hippocratica' of Francisco Rubio, of which we have consulted the second edition, dating in 1774; nor on the History of Contagions by Antonio Perez de Escobar, published in 1776, which is not, however, without its points of interest; nor on the several treatises on Small-pox, Typhus Fever, and Pleurisy, by Joseph Amar, published between 1774 and 1777; nor on the dissertation on the virtues of the American Agave and the Begonia in Syphilis and Scrofula, by Francisco Xavier Bálmis, which, when published in 1794, excited some attention and controversy; nor, lastly, on the treatise on the Diseases of the Mouth, which is in fact a work on dentistry, the production in 1795 of Francisco Antonio Pelaez; although, with certainly greater labour than profit, we have examined the whole of these for the purposes of this sketch. It is, in truth, first in the works of Andres Piquer that we encounter any very prominent proofs of the better spirit which infused itself into Spanish medicine during the eighteenth century. Nor did this better spirit, with the sole exception of its display in the writings of that author himself, actually rise, during the remainder of the century, anywhere beyond an even mediocrity; only praiseworthy because better

* Medicina Practica de Guadalupe. Folio. Madrid, 1739.

+ Pharmacopoeia Matritensis, Regii, ac supremi Hispaniarum Protomedicatus auctoritate, nunc primum elaborata. 4to. Matriti, 1739.

than what had gone before, but too insignificant, with the majority, to win a place for them in European fame, though doubtless there were those, within the narrower limits of Spain, who attained often that fleeting notoriety which men miscall fame.

Andres Piquer was born in 1711, at Fernoles, in Aragon, and studied philosophy and medicine in Valencia, where he graduated in 1734. Confessedly, however, he profited little by the instruction which he received from his alma mater; for what was then taught there rested upon the jealously maintained, or even revived, traditions of the Middle Ages, futile as to philosophy, and as to medicine, illusory and clinging to arbitrary fictions and fallacies. He became, therefore, like many other great men, his own preceptor, struck out his own course, and earned, as the customary reward of such independence, the opposition of his immediate colleagues, who assailed, with the keenness of a personal animosity, the merits both of his doctrines and his practice. In 1742, however, he received the appointment of the Professorship of Anatomy in the school of Valencia, and in 1751 had conferred upon him the office of physician to the king. He died in 1772, when in his sixty-first year; having achieved, at home and abroad, a high reputation, not less for learning and philosophy than for eminence in the proper science of the physician. In the latter capacity he was acute, judicious, and of exact methods of thought and observation; bringing these qualities to bear on the study of nature, from which, as we have seen, the Spanish physicians had gradually receded since the era of Valles and the other revivers of the Hippocratic doctrines. The writings of Piquer were numerous, and so inspired, could not fail to be important. His first work, under the title of Medicina Vetus et Nova,' published in 1734, was received with high favour, and passed through six editions. Afterwards, there appeared in rapid succession from his pen treatises on natural philosophy, on logic, and on moral philosophy; with several monographs on medical subjects, and two systematic works, one on the theory and the other on the practice of medicine. In all of these there was much to reflect credit upon the writer and to improve the public mind: in the last, especially, amid much else that was valuable, the remarks on chronic inflammations were peculiarly worthy of attention. We regret that of his works none have fallen under our own immediate observation, with the exception of his dissertation on fevers, and his illustrated version of part of the writings of Hippocrates. The former of these works was originally published in 1751, and Morejon mentions three editions of it which appeared subsequently, the latest being in 1788. This, however, is in reality a fifth edition; that now before us,* purporting on its title-page to be the fourth, and published in 1777, having escaped the attention of the usually accurate and able bibliographer. The work, in which the author shows himself well acquainted with the investigations of Sydenham, Morton, Torti, and many other physicians of the best, and to him kindred school of observation, was

* Tratado de Calenturas. 4to. Madrid, 1777.

one of great value for its time, and may be consulted with advantage still. His translation of the selected writings of Hippocrates, with its ample and judicious comments, included the 'Prognostics,' and the three first books of Epidemics, though he was aware that the second of these was of more than doubtful authenticity. His introductions and illustrations to this performance are written with great elegance, learning, and judgment; and we encounter, at frequent intervals, remarks which, from their general truth, or their special appositeness, one would gladly retain in the memory. This work also passed into its second edition; and the first volume, containing the Prognostics, even into its third. The first editions of the several volumes, three in number, appeared in 1756, 1761, and 1770: those before us appeared also separately, and bear the dates of 1769, 1770, and 1774.

What Piquer was to scientific medicine in Spain, Pedro Virgili, his contemporary, was to scientific surgery; but in this not so much by his writings, as through the powerful impetus he gave for its advancement by his successful organization of those separate surgical schools to which we have already referred. One work by Virgili, which we ought not to neglect to mention, is his Compendium of Midwifery,' composed for the use of the new surgical colleges; and we direct observation towards it the more willingly, that this department of medicine has generally received in Spain infinitely less than its due share of attention. The posthumous work of Gaspar Casal, on the 'Natural and Medical History of the Principality of the Asturias,' published in 1762, deserves commemoration for his account of the leprosy as it prevailed in that province. The same interesting subject, as it refers to a more southern division of the kingdom, was taken up by Bonifacio Jimenez y Lorite, in a medico-legal dissertation which appeared at Seville in 1766; while only last year, we may add, Francisco Mendez Alvaro, in a little treatise published at Madrid, has shown to what degree the disease is still extant in Spain in the middle of the nineteenth century. Juan de Herrera, in 1766, entered into a critical examination of the plan recommended for the treatment of erysipelas by the application of caustics, and sought to restrict their use to cases occurring in patients of weak habit, or to those in whom the attacks were recurrent and without marked fever. Some observations on Medical Education,' which appeared anonymously in the Portuguese language in 1773, but which are understood to have been the production of Dr. Riveiro Sanchez, have attracted and rewarded our attention by the account which they give of the prevailing methods and topics of instruction at the University of Coimbra in the eighteenth century, and by the valuable suggestions for improvement of which they are made the vehicle. The fact that a translation into Spanish, from the French version of the works of Cullen, by Bartolomé Piñera y Siles, was published in eight quarto volumes in 1791,

Las obras de Hippocrates mas selectas, traducidas en Castellano é illustradas. Tomos iii. 4to. Madrid, 1769, 1770, 1774.

† Metodo para aprender e estudar a Medicina. Svo. 1773.

and passed into a second edition, carries with it some significance. Antonio Gimbernat, an excellent anatomist and skilful surgeon, who effected much, along with Virgili, for the advancement of surgical studies in Spain, became well known throughout Europe for his account of the structure of the crural arch, and especially for his description of the ligament or aponeurotic fold which retains his name, and with which he connected a plan for an improved operation in hernia. Gimbernat signalized himself by various other improvements in surgery, and among the rest, invented and used successfully an apparatus for the cure of aneurism by compression. The description, by Juan Manuel de Arejula, of the yellow fever as it prevailed in Cadiz and Malaga at the beginning of the nineteenth century, is a work of high character,* which we have consulted with advantage, and in which the question of contagion, in particular, is treated with great acumen.

In the last year of the eighteenth century, an attempt was made to unite, under a single class of professors, the courses of clinical instruction in medicine and surgery which had been thrown separate by the establishment of the surgical colleges; but already, in 1801, the study and advancement of surgery appearing to suffer, the separation was again directed and accomplished. During the eighteenth century, the doctor in Spain was still, as antecedently, educated and regarded as a man qualified to teach, and so ranked in a class above that of the licentiate, who was merely certified as qualified to practise; thus recognising the very obvious distinction between the knowledge and intelligence which was necessary to devise and to interpret rules, and that which was simply necessary to comprehend and to follow them. The doctorship was thus a post of honour towards which a career of ambition was opened; and the distinction between the grades was not the less real that the teacher failed in his functions, for the effect of this was only to reduce the licentiate proportionately lower in the scale. It was evidently still in harmony with the idea of this distinction that in 1821 the Cortes directed the division of the entire scope of medical studies into four compartments, arranging what were to be held as indispensable studies in the first, those qualified as necessary studies in the second, those substantially useful in the third, and the merely accessory in the fourth. Great fluctuations, however, still continued to occur in the ordinances for medical education, and in the resulting relations of the profession, among the members of which there consequently prevailed much discontent and dissension. There was an unhappy interfusion of merely political motives, when, in 1830, Ferdinand VII. issued a royal ordinance, creating medicochirurgical colleges in ten different chief cities of the kingdom. With the intervention of a few minor changes, there was again, in 1843, a fundamental alteration, according to which two principal faculties were appointed, one at Madrid and another at Barcelona; with five subordinate colleges, at Seville, Valencia, Saragossa, Valladolid, and * Breve Descripcion de la Fiebre Amarilla padecida en las Andalucias. 4to. Madrid, 1806. † Sámano, Compendio Histórico de la Medicina Española: Apendice, p. 13.

Santiago. Each of the Faculties was to be endowed with no fewer than twenty medical chairs, with a body in addition of twelve agrégés or assistant-professors. The colleges, on the other hand, were to have each only five chairs, with three agrégés, and were destined for the training of a secondary order of practitioners.

The reduction or the annihilation of the privileges of the medical faculties of certain universities, with other provisions of this ordinance, was not fitted to calm the dissatisfaction which still subsisted extensively on all topics relating to medical education and to the distribution of qualifications for practice; hence once more there was vacillation, ending again in an important subversion of the arrangements, which was definitively announced in 1847. According to the ample curriculum, partly newly laid down, and partly merely confirmed, at this period, the licentiateship in medicine was not conferred till after a period of study of seven years: and for the doctorate two additional years were demanded, to be devoted to the pursuit of certain departments of medical knowledge not required for the mere licence, among which was a more extended acquaintance with chemistry and practical chemical analysis, including its application to medico-legal inquiries, as well as with comparative anatomy and certain other branches of natural science, and, lastly, with medical history and literature, and the most approved methods of imparting professional instruction. 1849, there was still discontent, and still change. The Faculties for medical instruction of the first class were now to be those of the Universities of Madrid, Barcelona, and Seville, the medical faculty of the latter having its seat in Cadiz; while for that of the second class, provision was made in the Universities of Valencia, Santiago, Salamanca, and Granada.* The regulations for the first class remained as before for the second class, it was a first provision that no one should enter on the study of medicine who, along with a competent knowledge of Latin,† did not possess the degree of Bachelor in Science, to be conferred upon examination after a course of study of at least two years in logic, the elements of arithmetic, geometry and algebra, the elements of natural history, and the elements of inorganic chemistry. The course of purely medical education, extending over a period of five academical years, each of nine months, having been next completed, the candidate was to be subjected to three successive examinations; when, if found qualified, the title of physician of the second class was to be conferred upon him, under which he attained merely to the right of general medical practice, but could hold no place, and exercise no functions, in relation to medical administration, or to matters of medical jurisprudence, unless in the absence of a physician of the higher order. The physician of the first class was not necessarily to be a doctor of medicine; but he was held debarred from no description of function, with the exception of that of teaching, to be still reserved to the doctorate, a grade for the acquirement of which, as already men

*

Sámano: Apendice, p. 53.

In 1854, Greek appears noted as added to the other requirements, prior to matriculation as a student of medicine. Semanario Medico Español, 1854, p. 111.