Jean Denis and Transfusion of Blood, Paris, 1667-1668 Author(s): Harcourt Brown Reviewed work(s): Source: Isis, Vol.

39, No. 1/2 (May, 1948), pp. 15-29 Published by: The University of Chicago Press on behalf of The History of Science Society Stable URL: http://www.jstor.org/stable/226765 . Accessed: 20/03/2012 00:45
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Preface to Volume 39

15

of the world in Utopian, they will convince nobody but themselves. If they wish to persuade the Republic of Letters, they must use a language which the citizens of that Republic are likely to understand. Isis is deeply concerned with the unification of mankind, and therefore it will devote most of its attention to the writings published in the international languages and pay much less attention, if any at all, to those published in the smaller languages. This policy is not inspired by the dislike of small countries and of small languages but by the love of science and the love of humanity. GEORGE SARTON

October1947

Jean Denis and Transfusion of Blood, Paris, I667-I668.

BY HARCOURT BROWN
A

LTHOUGH has long been knownthat bloodwas conveyedinto humanveins it

in Paris in I667 by Jean Denis, historians of medicine and anatomy have never described these experiments in detail, nor evaluated their outcome, nor even suggested their importancein the medical and intellectual world of their day. The lack of positive success of these trials led to their being buried under a mass of unfavorable comment by both contemporaries and later writers on medical history; and as a result, an episode which attracted much attention in its time, and which therefore offers a vivid insight into the changing atmosphere of the I7th century in France, has been almost completely forgotten. The modern scholar, interested in recording the development of a technique, has found little of value in the pamphlets; from the height of our modern knowledge of the nature and varieties of blood, these early efforts seem premature, Denis 2 and his associate the surgeon Paul Emerez3 appear to be rash and foolhardy triflers with the living human body, callous to suffering, and negligent of the interests of the profession. By trying this device so early, before many other factors were clearly understood, these men appear to have made the surgeon's art the object of ridicule, the medical profession the subject of profane discussion and abuse.
1A preliminary form of this paper was read before the Boston Medical History Club on I7 November I947. A layman's thanks are due to various members of the profession who have expressed a desire to see this discussion in print, and especially to Mr Geoffrey Keynes who in 1932 encouraged me to continue my collection of this material. The reader will see that evaluation of this story from the point of view of a modern scientist is not attempted here; attention is focussed on the documents, assuming, as a layman must, that a scientist tells the truth. 2Jean Denis (d. I704), Doctor of the Faculty of Medicine at Montpellier, Physician in Ordinary on the large staff attached to the person of Louis XIV, taught various branches of science in semi-public confeFrences in his house in Paris from about I664 to I673 or I674. In I672-74 his Me-moires et *Confirences sur les Arts et les Sciences supplemented the dormant Journal des Savants. Denis is listed by J. Astruc in his M6moires pour servir a l'histoire de la Facultg de Mgdecine de Montpellier. 'Paul Emerez or Emmerez, born in Saint Quentin, is described by Eloy as a prudent and skilful surgeon, and as a remarkably effective teacher of anatomy and surgery. "Il etait meme considere depuis longtemps comme un des premiers chirurgiens de France lorsqu'il mourut le 7 septembre i690." At one time he was Pr&e v8t de la communaute des Chirurgiens de Paris. (Eloy, Dict. Hist. de la M6decine, i778, 2, 138).

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Yet it may be that, even if they were therapeutically useless, these trials served a valid purpose in the education of the public to the nature of scientific methods of proof, demonstrating, at a moment when it was desperately needed, that science advances not by systems and syllogisms, but by the active intervention of the hands and skills of the scientist in the processes of nature itself. The period in which these debates occurred was marked by rapid changes in opinion and thought; a review of the documents suggests that, as in other controversies of the day, this particular skirmish made for truth and understanding, and served, as did the Quarrel of the Ancients and Moderns in literary affairs, the physicists' argument over the Cartesian plenum and the Gassendist atom, and other medical debates over circulation and chemical remedies, to turn the mind of the reading public to the criteria of experience, bringing scientific problems to the unprejudiced mind of the interested layman in a manner not unlike that achieved today in the more serious periodical press. Some, at least, of the men who took part in this discussion knew that questions of this nature cannot be settled privately and in the dark; the view that prevails is the view that in the long run can be rendered most credible to a sceptical public, through cogent argument, logical presentation, and a fair examination of alternative opinions. c*d The age was one of insurgent investigation, both speculative and experimental. Innumerable new devices had extended the range of possible inquiry, in all the old and many new fields of study, opening large areas for the scientist to explore and consolidate into the sum of knowledge. Communications had improved enormously, chiefly through the facilities offered by the scientific societies in Florence, London, and Paris. A public awaited his work; it was learning to read it for its intent, to measure it for its achievement, and gradually to forget about consistency with received opinions, the dogmas of the past, and the limits imposed by tradition. The literary work of Moliere, La Fontaine, La Rochefoucauld and others writing in the 6o's in Paris, even including Racine, suggests that an author had to reckon with a strong vein of scepticism, perhaps even incredulity, in his audience and readers, who would be satisfied with nothing short of rigid standards of plausibility, precise argument, and temperate conclusions. "Rien n'est beau que le vrai, le vrai seul est aimable." The warmth, and the explicit purpose, of much of the religious writing of the time, of Pascal and of Bossuet alike, suggest to the modern reader the strength of the sceptical spirit such authors felt it necessary to combat, and encourage the belief that in their eyes the age needed guidance towards revived faith in the scriptures, in miracles, and the principles of revealed religion. If religion was on the defensive, so were the chief organs of intellectual authority, the universities, with their faculties of theology, law and medicine, who saw that their traditional ground could be held only by the exercise of the utmost vigilance in every skirmish with freethought and innovations. The monarchy itself and some at least of its officerswere none too certain as allies of the old faculties; the conservative leaders of the Paris Medical Faculty were to have reason to be disturbed by the attitude of some of the King's ministers in the ramificationsof this affair. The uneasiness arising from the presence of unregulated novelty was intensified in the period of this debate by the founding of the Academie des Sciences, whose clear intent of studying physics and other branches of natural science on a non-Aristotelianbasis was an obvious threat to a school consecrated to the exposition of an unchanging and universal philosophy on traditional lines. That Faculty could of course keep its monopoly of professional teaching on the higher levels, and its degree-givingprivileges; and minimize the cooperation between the doctors of Paris and their provincial colleagues by enforcement of one part of the

Jean Denis and Transfusion of Blood

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professional oath. Publication could be kept under control through the approbation and privilegedu Roi required on all books, and, in the case of periodical literature, through the pernicious system of limiting each field to a single approved journal under an editorial board controlled by the ministers of the King. The policy of absolute control failed in its objectives in very few cases; the subjection of the surgeons which was supposed to result from their enforced union with the barbers led in fact to their increased strength, and the dissections and teaching which the revitalized school of operators now carried out was in large part beyond supervision or hindrance. The Faculty could even less effectively reach into the innumerable semipublic lectures and confgrences, private academies and cabinets, meetings in libraries, salons, and coffee-houses, where ideas in all fields and books on every subject circulated with a growing disregard of police prohibitions and the decisions of minor officials. Even in the journals, supervised as they were, the letter of the decrees against innovation could readily be evaded; a number of the Journal des Savants will open with a literal and straight-faced account of a new astronomy on geocentric and ptolemaic lines, by a Jesuit whose theological titles are fully displayed, while a few pages over an account of a new discovery in the heavens, or a new means of measuring the diameter of a planet will be set out with a clarity and enthusiasm whose implications are clear to any alert reader. This review of circumstances is necessary for the understanding of the debate to which these apparently insignificant and fruitless experiments gave rise. The pamphlets under review were written with definite aims, clearly understood by their authors; some of them serve the cause of science,4 especially those from the pen of Jean Denis, while others by his opponents were mixed productions, full of the emotions of those who serve a jealous and conservative faculty unable to distinguish between the moral values of tradition and the inertia of dogmatic authority. In this way, what seems to be a discussion of a minor point of practice becomes on closer study an interesting episode in the long-drawn-out fight waged on the Paris Medical Faculty by the arrayed forces of medical innovation, the provincial doctors, especially of Montpellier; the surgeons, the corps of physicians attached to the person of the King, and the unseen ally, found in the minds of a steadily increasing number of the reading public, the experimental method itself. The Paris Faculty won a battle, but not the war; this quarrel helped to lay the ground for a notable victory to be won in I686, when Louis XIV's famous fistula, after resisting every possible alternative, finally yielded to the surgeon's knife. to4 There is little doubt that the sudden stir of interest in the uses of intravenous injection in the i66o's resulted directly from the general acceptance of Harvey's discovery of the circulation of the blood. Superstition and irrational associations were breaking down, the magical view was yielding gradually to a surer knowledge of the relation of the blood to the phenomena of life, as well as of the functions of the heart and the liver. However, bleeding still dominated the therapy of the practicing physician, and scepticism about this ancient method would be for long regarded as the mark of a dangerous freak. From I656, trials of intravenous injection had occurredwith increasing frequency; after Wren's experiments on a dog at Oxford, and the trial on a human subject in
' The scepticism of scientists with whom I have discussedsome aspects of the experiments describedby Denis remainsa troublesomefactor in presenting this episode. The modem reader would welcome a critical discussion of the various proceduresinvolved, their difficulties and their probable success in the light of the descriptionsoffered by Denis, Lower, and others. If the truth of these accounts can be successfullychallengedby the modem physiologist or surgeon, then the historian of science faces a serious and novel problem, the evaluation of the extent and the reason for the error or deception involved, in the light of all the circumstances under which the work was said to have been done.

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I657 in London,other tests had been made by Elsholz, Fracassati,and Schmiedt

(Fabricius).6A first transfusion fromone animalto anotherwas made by Richard in Lower in I665, and reportedin the PhilosophicalTransactions Novemberand
December i666.6

The developments Londoncould be followedin Paris only as they were comin and municatedabroadin correspondence in print, and it was not before the early weeks of 1667 that Frenchdoctorsbegan to see a possible future in this line of for thought. The intellectualpositionof the Faculty could offer no encouragement of of imitationor improvement the Londonexperiments; disapproval the trials on dogs wouldbecomesheerhorrorat the thoughtof extensionof the methodto man. in without the sancInvestigations Paris would have to be carriedout unofficially, tion of the leadersof the Faculty,by privateenterprise, with the supportof suchpersons as might have the necessary curiosity,the moralcourageto flout authorityand tradition;and the money and prestige to assure the operatorsof protectionwhen and if the mattercame to light and possibleprosecution.It should be noted that therewas nothingvery strangein the spirit shownby the surgeons;the really venturesomeparticipants were, after those of the patients who knew what they were about, such figuresas Henri Louis Habert de Montmor,whose role as patron of the new sciencesandprivateinvestigation rankshigh in the not very inspiring history of the uses to which wealthwas put in Franceof the Ancien Regime. Whoeverit
was who took the matter up in France, the doctor involved was Jean Denis, who read in the Journal des Savants of 3I January I667 about Lower's experiments, and who began his own trials with the aid of Paul Emerez just over a month later. In the first of his series of publications recounting the successive stages of his work on transfusion7, Denis states his belief that the fact that blood can be transferred from one living animal to another is convincing proof of circulation. His first tests had been made on 3 March using a small dog "resembling a fox," and a spaniel bitch; while Lower's method was to draw all the blood from one animal, Denis tried from the first to manage the operation so as to save the lives of both animals. His technique is described in considerable detail, and follows Lower, except that the blood used is drawn from the crural artery rather than from the carotid, a change which should reduce considerably the convulsions and risk of death to the donor. The style of this document is factual, with measurements so far as his devices permitted them; the procedure is told in full, with analysis of the results. The second test is described in the same letter; on 8 March blood is drawn from the previous recipient, transferred to a third dog by an improved technique, in a warm room. From these two trials, limited conclusions are drawn; the operators feel justified in using the crural artery, they note the need of skillful preparation of the animals to be used, and careful treatment after operation; the warmth of the room was especially valuable. Shorter, thinner tubes are recommendedas less likely to produce coagulation and stoppage. The operation is less dangerous than they had feared; the blood used had served three dogs in a very few days with inconvenience to none; each is now well, friendly and strong. A physician who had been present was very much impressed, confessing frankly that he never would have thought it possible if he had not seen and examined the circumstances himself. In closing. Denis announces a further trial for IQ March. in his public conferences on
'H. Buess, Die Historische Grundlagen der Intravendsen injektion. Aarau, Switzerland, I946.
7"Extrait d'une Lettre de M. Denis, Professeur de Philosophie et de Mathematique, a M. * * * touchant la Transfusion du Sang. De Paris ce 9 mars i667." In Journal des Savants, 14 March I667. Probably not published separately.

Reviewed, Isis, 38, ciety, 2,

I947,

111-114.

'Cf. also Birch, T., History of the Royal So26 Sept. i666. II5;

Jean Denis and Transfusion of Blood

19

the Quai des Grands Augustins, where all interested may come to see an operation in which blood will be transferredfrom a healthy young dog into the vein of a mangy old cur. There is little doubt that at this time Denis was thinking of the application of transfusion to man, and acquiring the techniques and knowledge necessary for that final step. A little later, another letter was written by Denis 8, to describe the continuation of his experiments, in the most notable of which the blood of three calves has been used in three dogs, who are none the worse for it. Indeed one dog reduced by loss of blood on a previous day has recoveredhis strength and shows surprising liveliness. Emerez is now using a type of venesection like that used in phlebotomy, avoiding the elaborate system of ligatures which had been suggested by Lower's description. On I3 June the Journalreviews a pamphlet by Claude Tardy9, who sees various possibilities in the procedure, especially on man, and suggests transfusion from vein to vein. and the limiting of the quantity of blood to be taken from the donor. From this the old may be rejuvenated, and cures obtained in diseases arising from the "acrimoniousstate of the blood," such as ulcers and erysipelas, on which ordinary medicines work slowly because their strength is lost before they reach the blood stream. A fresh, well-temperedblood going directly into the affected parts, he thinks, should work much more effectively than anything else yet suggested; nor is it necessary to rely on human blood, as that of a calf or other animal is likely to produce a similar effect. This may be the first published text seriously presenting a technique and a function for human transfusion; neither the French nor the English journals had suggested this logical outcome, although, according to Oldenburg (Phil. Trans., 2I Oct. 1667, pp. 522-3), the English scientists "had practised it long agoe upon Man, if they had not been so tender in hazarding the Life of Man, . . nor so scrupulous to incurre the Penalties of the Law, which in England, is more strict and nice in cases of this concernment, than those of many other Nations are." Oldenburg adds that he himself saw the instruments ready for this operation on Man, and heard the method agreed on; and he inserts a letter from Dr Edmund King, who writes that "we have been ready for this experiment these six months, and wait for nothing but good opportunities, and the removal of some considerations of a moral nature," adding details of the technique proposed. Denis's next pamphlet 10, reviewed in the Journaldes Savants of 28 June, 1667, discusses the background of debate and controversy, and indicates reasons for the application of the method to human beings; he points out that successful use of transfusion would produce agreement between the doctors who favor bleeding and those who do not. We can pass over his argument that animal blood is less likely to be rendered impure by passion and vice; the early literature on this subject is recommendedto those who wish to explore the curious methods proposed by speculative thinkers for the removal of unfortunate traits of character and the resolution of moral and social conflicts in differing types of personality. More important and interesting is the description of the first two cases in which transfusion was tried on human beings. The first patient, a boy of I5 or I6, had suffered for two months from a stubborn fever, for which he had been bled some twenty times; now heavy and lethargic, he had lost his memory, and become quite
8 "Extrait d'une Lettre de M. Denis, Professeur de Philosophieet de Mathematique,& M. * * * touchant la Transfusion du Sang. Du In Journal des Savants, 25 2 Avril i667." April I667. Probably not publishedseparately. 9Traite de l'icoulementdu sang d'un Homme dans les veines d'un autre et de ses utilitez, par M. C. Tardy, Doct. en Med. Paris, du Bray and Barbin, ig pp. I Lettreecritea M. de Montmorpar J. Denis,

plusieurs maladies par la transfusion du sang, confirmee par deux experiencesfaites sur des hommes. 25 June I667. Paris, Cusson, ig pp., 4t0. A long extract in the Journal, 28 June; and an English translation in Phil. Trans., 22 July; published while Oldenburg was in the Tower, this is not regardedas a regularnumber of the Transactions,and some obscurity surrounds its appearance.

. . . touchant une nouveUe maniere de guarir

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stupid. He fell asleep at meals, which seemed to show that the small amount of blood remaining in his veins had been thickened by the fever; in general, Denis thought a transfusion might be advantageous. The surgeon, Emerez, drew off about three ounces from a vein at the elbow, the blood being dark and thick; and the patient received about eight ounces of arterial blood from a lamb's carotid. The boy immediately felt relieved from the pain of a bruise suffered on the day before falling from a ladder; his lethargy passed, he became gay and cheerful as he had been before his illness, ate well, and slept in more reasonable proportions. The success of this trial led at once to a second operation, "more by curiosity than by necessity," on a healthy man of 45, by occupation a carrier of sedan-chairs, to whom a fee was paid. Ten ounces were drawn off, and twenty transfused from a lamb, this time from the crural artery. Denis remarks on the cheerful nature of the patient, his comments "suivant sa portee" on this new way of bleeding, which he very much admired; his only complaint was a feeling of warmth from the incision in the vein to the armpit. Far from being reduced to inactivity, he dressed the lamb whose blood he had received, spent most of the money he had received for drink, rested for part of the morning, and went about his business all afternoon, returning next day to ask that he be called in if other trials were to be made.1" A final paragraph indicates the motivation for these trials, and for their publication; although priority in transfusion on animals, as also in infusion of liquids, must be granted to the English, the French, who are claimed to have thought about this procedure as early as I657, now are the first to have practiced transfusion with success on man. c e Although neither the Journal des Savants nor the unpublished correspondence which I have seen has anything to tell us about the trials made in the last half of I667, we know that tests continued in Paris, and also began in England. A letter written by Henry Oldenburg to Robert Boyle on 8 October mentions the use of the method on the Swedish Baron Bond, in which the fatal results could reasonably be attributed to other causes than the transfusion itself. This is the third use of the device; it is now "hugely disputed abroad pro and con." The baron seems to have been in a hopeless state before Denis was called in; Oldenburg says that "his intestines were found all gangrened, so that it was not possible to have recovered him by any known natural means." It is doubtful if his death can reasonably be laid at the door of surgical optimism; the documents show that Denis took great care to clear his responsibility before he intervened at all.12 We come now to the most important of the cases treated by Denis, the one that broke the series of tests, and which put the method on the shelf for over a hundred years. The documents are full, especially for the early stages of the affair; many of the persons involved in it are named, witnesses are brought forward, and
.U Christian Huygens wrote to 29 July I667, his brother Lodewijk on this case: "La raison pourquoi ni moy ni aucun autre n'ont assiste a l'experience de la Transfusion sur les hommes, est que ces deux Messieurs mentionnez dans la Lettre imprim&e ont voulu veoir comment la chose succederoit auparavant que la rendre publique, et de plus ils veulent tenir secrette la methode dont ils se servent. Mais l'un d'eux m'a dit qu'il n'y a plus & souffrir qu'a une saignee. Et que le porteur de chaise sur qui le dernier s'est fait, leur a demande souvent depuis s'ils n'avoient pas envie d'y retourner encore, et qu'il estoit tousjours A leur service moyenant Ies 2 escus. II s'est tres bien trouve et entreprit le mesme jour de porter un homme fort pesant quoyqu'on le Iuy eust defendu. II adjoute en-

core qu'il avait fait merveilles la nuict ensuivante aupres de sa femme. Laquelle derniere particularite s'estant repandue parmy les dames, fait qu'elles commencent fort a favoriser cette nouvelle pratique, et il ne s'en trouverait que trop qui voudroient faire transfuser leurs maris." (Huygens, Oeuvres, 6, I35). '2This case is mentioned in a general article on Transfusion in Phil. Trans., 2I October 1667, pp. 519-520, and described at greater length 9 December, pp. 562-564, the details in the latter article being drawn from Claude Gadroys's Lettre a' M. I'Abbe Bourdelot . . . pour servir de rnponse au Sr Lamy, et confirmer la Transfusion du sang par de nouvelles exp&riences. Paris, I667, 4t0.

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the sequence of events, from the first contact of patient and surgeon almost to the last stages in the lawcourts, is nearly complete. The first document to be cited is a letter, apparently unpublished, preserved in a volume of pamphlets mostly concerned with transfusion, in the Bibliotheque Nationale.13 Written by Antoine de la Poterie, a rather conservative amateur of the sciences, formerly employed as a secretary by Habert de Montmor, the letter is addressed to Samuel de Sorbiere, at this time in Rome with the embassy of the Duc de Chaulnes, but who will be remembered as the secretary of the Montmor Academy, and one of the earliest French visitors to the Royal Society of London. A marginal note describes this letter as in the hand of La Poterie himself; it is dated from Paris 28 December I667, and reads as follows:
Monsieur, Je ne scaurois m'empescherde vous faire scavoir l'Experiencede la Transfusiondu Sang que Monsieurde Montmora fait faire ces jours passes sur un frenetiquepar MessieursDenis et Emerez en presence de Monsieur le Comte de Frontenac, de Monsieur l'Abb6 Bourdelot, de plusieurs scavans medecins de cette ville et dautrespersonnesconsiderables.1' Ce frenetiqueest un nomme Saint Amant age d'environ 45 ans, qui estoit valet de Chambre chez Madame la Marquise de Sevigny pres l'Echelledu Temple, et qui estoit fort adroit et de bon sens a ce qu'on assure,lequel est tomb6 en demencedepuisenviron4 ans qui s'est accrue a un tel point qu'il couroit les rues jour et nuit de et faisoit des actions de furie, accompagnees sales et vilains discours. Ce qui a oblige cette dame de le laissercourir,c'est que souventesfois il vouloit mettrele feu dans sa maison,dechiroit ses habits, alloit nud dans les rues, mais parmy une infinite de ses folies dont je n'ay pas loisir de vous entretenir,il faut que je vous en conte une qui vous faira rire et qui fit dernierement une peur epouvantableaux Cavaliers du Guet qui vont la nuit parmy nos rues. Cet insens6 estant nud sestoit envelop6avec du foin a cause du grand froid et sestoit couche dans une porte ou ces Cavalierssarrestans,leurs chevaux mangerent de ce foin, et approchansleurs dens un peu trop pres du corps de ce fol, il se leva aussitot tout debout, et criant horriblementse jetta a la queue d'un cheval, ce qui estonna tellementtous ces gens du Guet qu'ils prirentla fuite au grand galop, pensans que c'estoit un Diable qui les poursuivoit. Il en a fait bien d'autresencoreplus risibles, mais pour revenir a nostre Transfusionje vous diray que Monsieur de Montmor en ayant eu des 18D6partement Imprimes, Te13 42, contains 21 printed pamphletson transfusion;between the I7th and i8th are these two letters, a sonnet, and a Latin epigram. No. 20 is Sorences de la Tranfusion du Sang, dated from Rome i Decemberi668, and publishedin Paris by Cusson, avec permission,in the same year; it is based in part on these letters, and contains the followingsentence:"Lespremiersqui se sont avises de faire la Transfusiondu Sang ont este de les Academiciens Londres,et MonsieurOldcompassionsimagina que le sang dun veau le pouroit soulageret peutestrele remettreen son bon sens, il communiquace dessein a Madame de Sevigny et a Messieursdenis et Emerez qui trouverent cette proposition tres a propos, et pour cet effet le dimancheI8? decembredernier il fit cherchercet Insense par la Ville et commanda qu'on l'amenastdans sa maison pour le plus attentivementet pour remarquer considerer tout ce qui seroit necessaire. Cela fut aussitot execute par apres il le fit conduire dans une chambreen la rue Beaubourgpour le faire bien nourrir et le bien garder, ou le lendemain ige on commenca sur luy l'operation environ 6 heuresdu soir. MonsieurEmerezouvrit la veine au bras de cet homme, d'ou il laissa sortir plus d'une pinte de sang et ayant prepare l'artere du veau il en fit couler dans cette veine par le moyen de ses petites canules d'argent environ d'apreson recomchopine. Le 23ejour Mercredy manca l'operationenviron la mesme heure avec un autre veau, ayant remarqu6que cet homme extravaguoitainsy qu'auparavant. On luy tira preschopinede sang et on luy infusapresde deux pintes de celuy du veau. M. Emerez fit si bien que toute la Compagnieen demeura satisfaite. Le Patient ressentit de la chaleur par tout le corps, de la douleuraux reins pendant que des Medecinstastoient son poulx diversementagit6, il ses veines paroissoientenfl&es, falut lui detacher l'aiguilletteparce quil disoit quil estoufoit, et de fait on luy tira aussitot un peu de sang pour le soulager,enapresil vomit, urina et lacha le ventre, puis on le mit dans son lict, ou il a reposedoucementla nuit sans aucune agitation, ny marquede folie, le matin il a demand6 son confesseurqui est un des Vicairesde Saint Nicolas des Champs, lequel a receu sa confession agreablementet nous a dit qu'il l'avoit
enburg leur Secretaire en donna le premier advis Monsieur de Montmor qui fit tout incontinent essayer cette operation par Monsieur Denis. . . ." (p. 9). " From Denis's own pamphlet of 12 January i668, we learn that Noel Vallant, L'Allier, Dodart, and de Bourges were the "ssavans m6decins" present. Vallant rented rooms from Denis on the Quai des Grands-Augustins at this time; like Denis, he was a Montpellier doctor. The others were of the Paris Faculty. Frontenac was the famous governor of Canada.
i

biere's Discours . . . touchant diverses expgri-

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reconnu capable de recevoir le Saint Sacrament, qui peut provenir des grandes fatigues quil a qu'on a neanmoins differe pour attendre une fait de couchertant de nuits sur le pav6, et ce preuve plus constante. I1 a passe tout le jour qui fait croire qu'en ressentant ses douleurs il de jeudy avec un peu d'assoupissement, mais n'est plus dans sa demence. I1 a pass6 les festes avec un fort bon jugement a ce qu'ont rede Noel dans le mesme estat, ce qui fait esperer marque plusieurs personnes qui le sont a116 que cette nouvelle invention de guerir les malvoir aussi bien que moy par curiosite, le soir adies du corps et de I'espritpourra servir au on luy tira un peu de sang et la nuit de vendredy public. Monsieur de Montmor ny epargnera il a encor asses bien dormy, durant le jour il rien principalement pour la joye qu'il a d'avoir na pas temoigne d'extravagance, l'apres-disner veu que cet homme se soit bien confesse de ses on luy a baille un lavement refrigeratif quil a pechez et quil ait receu devotement le Saint bien receu, et le samedy matin apres avoir bien Sacrement. Je ne manqueraypas de vous faire repos6 la nuit un des vicaires de St. Mederic scavoir la continuation du progrez de cette de la Paroisse ou il est loge a present, n'a trouve Transfusionqu'on ne peut encore tenir assur6e aucun sujet de retarder a luy faire recevoir la comme un article de Foy, mais le temps nous Ste Communion laquelle il luy a apporte apres le dira et les diversesexperiences qu'on en fera l'avoir auparavant bien reconcilie et l'a receue donneront sans doute beaucoup de gloire aux devotement a la grande satisfaction de ce Vicaire, Inventeurset aux Operateurs, cependantje suis et a tous ceux qui le sont alle voir il a declare de tout mon coeur, Monsieur . . . quil ressentoit de grandes douleurs par tout son De La Poterie corps et qu'il luy sembloit estre tout rompu, ce

The religious motive perceptible in the latter part of the letter was introduced presumably to strengthen the position of the proponents of transfusion in the not impossible circumstance of a serious struggle with the Paris Faculty, of Theology as well as of Medicine. Sorbiere'sposition with the embassy of Louis XIV in Rome, his known and oldstanding support of circulation, and his long association with the amateurs of the new sciences, made him a desirable ally, particularly as he could be counted on to plead the case of Montmor, Denis, and Emerez with persons having access to the highest levels of authority in the Catholic Church. The same volume in the Bibliotheque Nationale contains another similar letter, written by La Poterie to Sorbiereon 20 January i668:
Monsieur, Croyant que vous aurez receu la lettre que je me suis donne i'honneur de vous escrire vers la fin de P'annee derniere touchant 1'Experience de la Transfusion du Sang que Monsieur de Montmor a fait faire en presence de plusieurs scavans Medecins et personnes de qualite par Mrs Denis et Emerez sur un homme frenetique furieux qui couroit les rues et faisoit une infinite de folies, ie ne vous parleroy maintenant que du progrez de cette operation, que j'ay observ6 fort diligemment, m'estant donne la curiosite d'aller voir presque tous les jours cet homme 1a. Je vous diray donc que depuis que cette Transfusion du Sang arteriel jugulaire de veau luy a este faite de plus de deux pintes et l'effusion du sien venal cephalique d'environ chopine nous avons veu son bon sens luy revenir avec ses forces tous les jour insensiblement. La grande douleur quil nous disoit ressentir partout son corps qui luy sembloit estre tout rompu, nous a fait connoitre qu'il n'estoit plus en sa demence et que cela ne provenoit que des grandes fatigues qu'il avoit faites d'avoir couche tant de nuits sur le pave dans les rues. Et quant a sa douleur des reins il nous a dit quantesfois il y avoit est6 blesse et qu'au moindre accident cette partie luy estoit douloureuse. Cette facon de guarir les malades est sans doute admirable puisqu'on ne s'est icy servy d'aucune medecine ny purgation, et que nous le voyons en bonne sant6 avec un bon jugement, et n'avoir ressenty aucune atteinte de folie dans meme la pleine Lune auquel temps il avoit coutume d'estre en sa plus grande extravagance. Plusieurs de nos medecins et de nos scavans sont fort estonnez de ce Remede naturel, les uns en sont bien aises, les autres en disent tout le mal qu'ils peuvent, mais ce quils avancent que des saignees seules peuvent guarir de semblables frenetiques ne se trouve point veritable en celuy cy, puisquil y a deux ans que Madame de Commartin en ayant eu compassion apres avoir appris quil estoit en une furie [extreme] et quil avoit attache une corde au haut bout de l'Echelle du Temple pour se pendre, elle le fit prendre, et le fit saigner i8 a 20 fois et luy donna 4o bains sans quil eust le jugement aucunement remis car on le vit aussitot apres courir les rues et le meme qu'auparavant. Enfin la louange de cette Operation seroit facilement etoufee par les discours de telles gens qui sont jalouses' de la sante des hommes et qui ne songent qu'au sordide interest, sil ne se rencontroit des personnes contraires a cet interest, et zelees pour l'avantage du genre humain. Le bruit de cette Transfusion court partout la ville, les gens de bien sont aises d'avoir veu que cet homme par ce seul remede sest trouve capable

Jean Denis and Transfusion of Blood

de sestre bien confess6de ses pechez au Prestre et d'avoir receu devotement son Createur pendant le Jubile. Monseigneurle Duc d'Anguien, dont il avoit est6 Garde, a voulu le voir, M. Denis le lui mena hyer a midy et l'interrogea long temps avec satisfaction. Et dimanche dernier il vint remercierMonsieur de Montmor des soins charitablesquil luy avoit pleu et quil luy plaisoit encor de prendrepour luy, il estoit dans une posture convenablea un Cavalier et son Compliment ne fut que de paroles fort raisonnablesdont toute la Compagnie demeura estonnee, voyant une metamorphosesi soudaine d'un fol en un sage, tous les jours il fait des visites de la meme facon. Monsieur de Montmor a envie de faire faire un de ces jours une semblable experiencesur un paralytique,je ne manqueraypas de vous en informer, cependantje suis toujours, Monsieur. De La Poterie.

A few days later another pamphlet came from the pen of Jean Denis; 15 the present data are taken from the summary printed in the Philosophical Transactions of io February. The patient is described as a man of 34 years of age, whose "phrensy began first of all to appear 7 or 8 years agoe," brought on by an unhappy love affair; after a mental lapse of some ten months, he returned to stability of mind, and was married to another "young Gentlewoman." After another lapse, alternating with lucidity and then recurring for ten-month periods, he broke away from his home and ran to Paris where he obtained employment and help, but kept a succession of employers in fear of fire. Denis says that his advice as given to Montmor was that transfusion would not kill the man, but that a cure could not be guaranteed, and that transfusion from a calf might allay the heat and ebullition of his blood. The man assigned as guardian to the patient was the porter on whom the trial had been made successfully some seven months before. Denis proceeds to describe the immediate effects of the first two transfusions, as recounted above, then he adds that "his wife, that had sought him from town to town, came to Paris, and having found him out, when he saw her, he soon expressed much joy to see her." Her comment, on hearing of the transfusion and seeing its effect, was that at such a time as this, the full moon, he was usually most violent and beat her, so that his present kindness was surprising. Denis remarks on the patient's calm mind, normal functions, good sleeping, and discreet behavior; and his letter ends with the remark that he will not answer his critics with conjecture and hypothesis, but let the facts speak for themselves. The various symptoms observed have been explained in many ways, but Denis declares that in 50 transfusions on animals he has not seen more than two in which the urine was affected. He now has definite ideas about the preparation of the patient for transfusion, as well as for post-operative care, for he adds, "we hear of many other sick persons, who may possibly find relief from this experiment." The serenity in which this pamphlet was written was soon to be shattered. At the end of January the madness of Saint Amant returned, and before long Paris was full of rumors that the patient had died in the very hands of the operators, as they were carrying out a third transfusion. Justel wrote in these terms about it to Oldenburg, adding that "without the credit of Monsieur de Montmor, they would be in trouble, having acted rashly. This will decry Transfusion, and now no one will dare to perform it on man." 16 His attitude was common enough among the general public, and raised the questions which have to be answered in any account of the episode: first, whether the trial of transfusion on human beings at this time was rash and premature, and secondly, whether Saint Amant died because of transfusion or from other complications not as yet envisaged.
'5Lettre icrite d Monsieur* * * par J. Denis . . .touchant une f olie invitirle qui a este guirie depuis peu par la Transfusiondu
Sang.
I2

(Paris, I2 Jan. i668) J. Cusson, 4to. pp. ' MS Letter of 3 February in the Guardbooks of the Royal Society of London.

24

Harcourt Brown

The famous names attached to the case of Saint Amant, the distinction of the men and women interested in the patient, made it necessary for the Faculty of Medicine to act promptly if their prestige and their intellectual position were to be maintained. A first attack had already come from G. Lamy, in two letters17 addressed to J.-B. Moreau, a Paris doctor, in which the operation is described as he knew it, with appropriate reflections. His scepticism about transfusion is complete, but in the process of argument he shows very clearly how little he or his contemporaries knew about the nature of blood. This, and the numerous pamphlets now flowing from the pen of the credulous and ignorant Martin de la Martiniere, give rise to the last publication on this subject by Jean Denis, his letter to Henry Oldenburg "concerning the debates which have arisen on the occasion of Transfusion of Blood," 18 reprinted almost complete in the Philosophical Transactions of 15 June i668. Denis recounts the means taken to confuse the issue by the enemies of innovation, and describes the various causes which led to the fatal result, blaming the patient for "too frequent company with his wife," for "his debauches in Wine, Tobacco, and Strong Waters," which made it possible for the enemies of surgery to blame the outcome on the treatment rather than on the patient's folly. The most important element in the story is introduced at this point; Zola himself can hardly rival its moral depths. Denis asserts that the wife had begun to find her husband's recovery somewhat onerous and irksome. Saint Amant had accused her of trying to poison him; and he had undertaken to inquire into her activities and associates in the years of his madness. Denis goes on to assert positively that the third and final transfusion had been undertaken only after the most urgent request of the wife; she had made the preparations, obtained the calf, and the services of Emerez and entreated them to operate. Finally, the surgeon opened the vein in the arm but could draw no blood, "which obliged M. Emerez to take out the pipe put in the arm, without opening the artery of the calf, and so without any transfusion." Saint Amant died that night, and the two operators returned with another surgeon next morning to examine the organs, a step deemed necessary in view of the talk of poison. Permission was refused by the wife, who hastened to make arrangements for burial.
But being in an indigent condition, she could not compass it that day. Meantime a famous Physician of Paris, hapning to be that night at the house of a lady who was solicited for charity towards this burial, was of the same mind with us that his body should be open'd and therefore sent instantly for surgeons to execute. But she being resolv'd against it, used lyes and other arts to elude this design. And when we threatened her, that we would return next morning, and do the thing by force, she caused her husband to be buried an hour before day to prevent our opening of him.

This result could have brought triumph to the Faculty, and so Denis was not surprised to hear very soon that there were three physicians eager to get the widow to lodge formal complaint against Denis for malpractice; however, not offering her enough, she came to Denis with her story, asking money for her silence. Denis
" Lettre . . . contre les pritendues utilitis de la transfusion du sang, pour la guirison des maladies, avec la riponse aux raisons et expiriences de M. Denis; and Lettre . . . dans laquelle il confirme les raisons qu'il avoit apporties dans sa premiere lettre, contre la transfusion du sang. . . . Both, Paris, I667. ' Lettre Ecrite a Monsieur Oldenburg Gentilhomme Anglois et Secretaire de l'Acadimie Royalle d'Angletterre. Par Jean Denis . . . Touchant les differents qui sont arrive's a l'occasion de la Transfusion du Sang. Paris, Cusson, [i668]. In Phil. Trans. I5 June, i668, pp. 7Io-7I5. -At this point in the main narrative, some reference might have been made to the various cases whose outcome La Martiniere describes as unsuccessful: "La mort d'un seigneur suedois, la mort d'une dame du faubourg Saint Germain, la mort de Louvet de la rue de Berry, la mort du cheval de Louvet, celle d'une procureuse, de chiens, de veaux, moutons, d'un perroquet." The list is taken from J. Nomblot, Pierre Martin de La Martiniare, z634-z676, midecin empirique . .Paris, ThUse . . en m6decine, I932. As I have not been able to examine the original pamphlets, it is impossible to say what importance should be attached to these accusations; neither La Martiniere nor his biographer seem to have a gift for critical evaluation of facts.

Jean Denis and Transfusion of Blood

25

refused, very properly, and went to the Lieutenant des Causes Criminelles to complain in due form. He was able to bring forward five witnesses who convinced D'Ormesson of the justice of his case; judgment was rendered at the Chatelet I7 April i668; it was taken as proved that she had given powders to her husband in his food, had uttered the alleged threats, had refused to permit examination of the body, and finally had had dealings with the three mysterious physicians. On these grounds it was therefore ordered that there should be further inquiry into the source of the powders, the reason for their use, the person who had prescribed them, and the reason for the refusal of a post-mortem. The woman was to be kept in custody, the unnamed doctors produced in court, and the whole matter inquired into by trial, when Denis's full bill of particulars would be examined. Finally, it was decreed that transfusions in Paris should be performed henceforth only with the approval of doctors of the Paris Faculty. Denis adds that late testimony has shown that the powder used in the food was arsenic; and that Saint Amant had fed some of his broth to a cat which had died a few days later. He remarks that a number of doctors practicing in Paris are disturbed by a decision which gives supremacy in matters of practice to the Paris Faculty, when it may easily occur that provincial doctors attached to the royal households, to various princes, chief magistrates, and other persons of quality, may find it necessary to use the method for purposes of curing appropriate ailments; it will be recalled that the Paris doctors regularly took an oath not to consult with doctors from other faculties. Finally, he has at the moment a patient, a paralytic woman "a neighbor and friend to her that was cured of the palsy this way," who wishes to have the operation even if she has to go before the magistrates with her plea. The case dragged on, with little public notice. There were, so far as we know, no more transfusions in Paris; and we have only secondary information about the final trial in the courts. On I3 December i669, the PhilosophicalTransactions(pp. 1075-77) published a letter "written by an Intelligent and Worthy English Man from Paris, to a Considerable Member of the R. Society in London, concerning some Transactions there, relating to the Experiment of Transfusion of Blood." This document, about a page long, describes the trial, in which Denis was defended by a son of the First President of the Parlement de Paris, Lamoignon, and mentions that "that which Mr. Denys His Advocate very much gloried in, was, that . . . there were two persons, a Man and a Woman, present in the Audience, that had received a benefit to admiration from the Experiment, after they had been abandon'd by all Physitians and other helps." He adds that the young lawyer performed admirably, that the Ducs d'Enghien, de Luynes, de Mortemar, and de Chaulnes, with many other "great persons, men and women" were present, and he concludes: "The Pleading for the Widow Plaintiff will be on Thursday next; but any odds would be laid on the Defendants side; though some partial Men here are more than suspected to set on the Widow." 19 The case ended with exoneration for Denis. The fires resulting from the Commune of I87i destroyed the archives of the Chatelet, and we have therefore no definite knowledge either of the terms of the sentence or the fate of the wicked widow. She disappears into anonymous obscurity, while Denis, with singularly appropriate logic, takes up the development of a styptic fluid. tae It is hardly necessary, after this record of the facts which seem to stand even after the contemporary critics have done their worst, to apologize for placing Jean Denis in the centre of this account. He was the chief figure in the early trials of
9The availabledocumentsdo not explainthe reversal of r8les of plaintiff and defendant in

this account.

26

Harcourt Brown

transfusion, a technique which was so long to lie undeveloped and to have such a remarkable growth once the conditions were ripe. He operated on at least five persons, including the sleepy boy, the porter, Baron Bond, the woman with palsy, and Saint Amant; there may have been others, who flit unrecognizably through the pages of the endless pamphlets of the time. In England, Lower operated only on Arthur Coga, who, like Saint Amant, fell into low company and was no credit to his surgeons. The two or three Italian trials seem rather to have been sporadic efforts after Denis' efforts had become known rather than part of a systematic scheme to perfect a technique and apply it to human patients only after elaborate tests on animals under varying conditions. From all this, I think it may be possible to draw a few conclusions: If we accept the published records of the experimenter, we must conclude i) that, contrary to the usual statements, found even in such a work as Dionis' Cours d'Operations de Ckirurgie,20none of Denis' patients died of the transfusion operation itself. Of the five cases listed above, two ended fatally, the Baron Bond and Mauroy de Saint Amant. All agree that Bond was in bad shape before Denis was called in; Saint Amant has been discussed in full, and there seems no reason for disagreeing with D'Ormesson. One notes that neither Denis nor Emerez suffered as a result of the affair, Denis going for a short period to England as physician to Charles II, and Emerez becoming one of the finest surgeons in France, if we may believe Eloy. 2) In the light of all the circumstances, I do not think we can regard these efforts of I667-I668 as unnaturally rash or premature. Surgeons of the day undertook much more drastic tasks, and the materia medica included many stranger doses than fresh lamb's blood. We cannot write history if we insist that the surgery of our ancestors be carried out with the precautions suggested by Lister and Pasteur. Science is sometimes made in part through mistakes which horrify posterity, and if Denis's carefree mingling of the blood of different species shocks the modern reader, he should recall that there was much else in all fields of life that would seem equally strange, distasteful, and dangerous. In the light of the knowledge possessed by his contemporaries, Denis seems to have done good and useful work, with an interest in his ideas definitely short of fanaticism. He writes in an honest and workmanlike style; a modern doctor would not describe his cases thus, but Denis seems to this layman to express himself clearly, factually, unemotionally, and yet persuasively. He seems to have been moved by a sincere belief in the need of testing this type of treatment; he was interested in the results of his work, not only in terms of physiological knowledge, but also in terms of the effect on the general condition of the patient, whether the little spaniel bitch, the Baron Bond, or Saint Amant. In contrast, a reading of Lower's De Corde suggests that that experimentalist was much less interested in the possibilities of the technique for cure than in the light it would throw on the structure and function of the circulatory system.2' 3) It is significant that the lack of positive results leads to a rejection of the technique until new conditions make it possible to take it up in the early igth century. Denis apparently had no choice but to accept the opinion of the objective observer of his day, as recorded by Christiaan Huygens in a letter to his brother Lodewijk, 20 April i668, in which he gives the conclusion reached by members of the Academie des Sciences:
Nos messieurs, qui n'ayant pas eu grande opinion des le commencement de l'utilite de la transfu' Paris, I740; 4th edition. Huitieme demonstration, pp. 728-73I. 'R. Lower, Tractatus de Corde, London,
I669.

sion, ne voient rien dans ces observations qui les fasse changer de sentiment, puisqu'elles font Cited from reprint and translation by K. J. Franklin, in Early Science in Oxford, 9, Oxford,
I932.

Chapter iv, de transfusione sanguinis.

Jean Denis and Transfusion of Blood

voir seulement qu'apr6sla transfusionfaite les animaux et hommes ne s'en portent pas plus mal qu'auparavant.Car l'importanceseroit de
icy...

27

faire voir que les maladesse peuvent guerir par cette operation, comme l'on a voulu es'saier

4) I am aware that the view of the case here presented is not in entire accord with the version repeated without much insight from Elsholz, Mercklin, Lower, and others down through the modern histories and periodicals. The original documents are rare, and not easy to evaluate; and it is difficult to resist the combined effect of a dozen authors, even if they all stem from a single not very critical source. None of the early writers seem to have recognized the difference between Montmor's amateurish desire to claim priority for French science, and Denis' desire to achieve sound results for the good of mankind and the enlightenment of the medical profession. Lower and other English writers were irritated at the claims made for a lost discourse delivered by Dom Robert Des Gabetz in I657; and that irritation made it difficult for them to read Denis with patience and an understanding of his position in a Paris where radical experimentation was not only discouraged but well-nigh impossible. The issue is still further befogged by Shadwell and his amusingly misguided Virtuoso; a text like that, however, has no weight in the history of ideas or medicine, and is better neglected when one's eye is on the historical fact. 5) The immediate result in Paris was a reinforcement of the dominant position of the Medical Faculty, and a temporary defeat for the surgeons, as well as for the large number of provincial doctors in the service of individual patrons of all ranks. The surgeons regained esteem with the famous operation for fistula in I686, with Frere Jacques's technique for lithotomy, and with the lectures on anatomy which reached a high degree of popularity at the Jardin des Plantes at the end of the century. The doctors from the provinces could not recover so quickly; the efforts of Charles de Saint-Germain in i668 to set up a Royal Chamber to represent provincial practitioners would doubtless have benefited if there had been significant positive results from Denis' efforts on transfusion, for along with Noel Vallant, Jean Pecquet, Cureau de la Chambre, and the group of men who led the Royal physicians, Vallot, and the two D'Aquins, Denis was active in this effort to achieve a counterpoise to the conservative Paris Faculty. Various minor successes were wiped out when the Faculty prevented ratification of the royal edict, and when Colbert was forced to have the approval annulled by action of the council of state. The ambiguous position of the provincial doctors was resolved when they were admitted to membership in the Paris Faculty by diploma on relatively equal terms but only after payment of a heavy initiation fee.23 6) It is significant that all parties to this debate recognize the need for reaching public opinion by means of inexpensive pamphlets produced at fairly frequent intervals. Denis brought his out through Jean Cusson, publisher of the Journal des Savants, and thus they benefit by appearing in company with the chief organ of intellectual interest in Paris, remaining at the same time free of the supervision to which the periodical was subject. The Journal des Savants returns to the subject with some frequency, devoting a whole number, 6 February i 668, to a review of recent publications for and against. Claude Tardy wrote at least twice in favor of transfusion while Pierre Martin de la Martiniere wrote nine or ten adverse pamphlets at intervals through the first half of i668. It is clear that there was a public to be reached, one interested in the discussion of ideas over which not very long before authoritarian views would have reigned unquestioned. The interest in a new approach to the problem of disease and its cure made a better publishing venture than the contemporary discussions over the constitution of matter or air pressure; the transfusion of blood was for a moment as exciting as comets and eclipses.
OeuvresCompletes,6, 209. ' For this not very edifying story see Paul Delaunay, La Vie mddicale aux z6e, z7e, et z8e
22 Huygens,

siecles.
3II,

Paris, Coll. "Hippocrate," especially 306-307.

1935,

pp. 303-

Harcourt Brown Finally, it seems clear that there was more on trial than a particulardevice, a techniquethat was mechanically possible,even though it was to remaintherapeutically uselessfor many decades. It servedthe cause of science,in an age of loveand philtresand the black mass, belief in magic,horoscopes, witchcraft,that Denis and Emerezshould be seen followingan argumentsuggestedby the experiments of RichardLower, perfectinghis technique,and seeking the crucial test without undue haste and without hesitation. Many of his contemporaries were weary of and appreciated need of experimentand proof. the and rationalizing, controversy It was becomingclear that the intellectualsloth of the Universityof Paris could not be moved by street-fights over cadaversfor dissectionor the comic efforts of in had Moliere. Even in literature, imagination lost momentum the dead centre the of classicism;the constantreferenceto authorityhad destroyedoriginalityand the sense of fact in all but the most vigorousof minds. very largely to The work of the innovatorsin medicineand science contributed of the destruction the self-complacent miasmainto which a merely eruditehumanism had declined.24 Suchmen as Denis broughta vivid appealto reality to bear on of the phenomena illness and human misery; his work illustratesthe charm that the new scienceshad for the readerand thinkertired of dogmaticdefinitionsand of academic distinctions.It is kin, in its smallerway, to the announcement Huygens' drawingroom in discoveryof the rings of Saturnread by Chapelainin Montmor's I658, to the contemporary discussionsover the animals from the royal zoo disof sected by the Academyof Sciences,over the description the behaviorof insects of in swarmsand hives, or the circulation sap in trees, as of the blood in man and to animals;and all of thesecontribute the turningaway fromsterileimitationof the classics, and to the arrival of lively and empiricalinventions from the pens of Lesage and Defoe, Addisonand Marivaux,Fieldingand Voltaire,Swift, Rousseau, Diderot,and ultimatelyLessingand Goethe. Perhapsthe next centurywill be too muchobsessedby materialfact, too much enslavedto surfacesand solids, mechanto ism and mass. Freedom,however,is not achievedthroughfatalistic resignation of of tradition,but by strenuous understanding the processes naturearoundus; and the spirit which seems to have movedJean Denis is kin to that which in the long run will controlthe framework the world and tear the sting from decay, disease of and early death.
28

BrownUniversity.
BIBLIOGRAPHY
A critical bibliography of literature concerning the history of transfusion would make a substantial treatise in itself. Most of the items, from the point of view of the present paper, suffer from two defects; they accept earlier commentators and historians without re-examination of the original documents, and they concentrate on how the errors of earlier workers have been eradicated, without looking at the relationship of the early work to the general ideas of the time or evaluating incidental positive gains which do not contribute to the main interest of the modern reader. Thus the work of Denis, which grew in a controversial atmosphere, has been discussed with neither fullness nor insight. Dr A. Chereau devoted two articles in L'Union medicale (8, 12 Sept.,
24

i874, pp. 373ff., 397ff.) to an attempt to prove (i) French priority in the idea, and (2) that the sentence of I7 April i668 did not forbid transfusion, but rather limited its use to fully accredited practitioners. Not drawing on the periodicals of the day, he misses the process of gradually improved technique by which Emerez approaches the use of the method on man; he does, however, reprint the text of the sentence of I7 April. This, the best of the secondary sources, is available at the Boston Medical Library. The disrepute into which transfusion fell after i668 has meant that such works as James's Dictionary offers little valuable comment or information; only such authors as Portal, His-

toire de l'Anatomieet de la Chirurgie, have any

Paris, I943.

Described in R. Pintard, Le Libertinage

irudit dans la pr6mimre moiti6 du i7e sikcle,

Jean Denis and Transfusion of Blood

idea of the problemsinvolved. However, treating the publicationsby author rather than by topic, Portal does not give any view of the episode as a whole. Dionis has been referred to in the text of the article. It is unfortunate that the historical thesis occasionally accepted in recent years by the Paris Medical Faculty shows a low standard of critical scholarship. Inadequate references, a worthless bibliography,no criteriain the use of citations,and a lack of contact with the historical work already done, usually make these productionsdreary and almost profitless reading. J. Nomblot wrote (I932) on La Martiniere

20

with very little knowledge of this episode in which his subject'spamphletsplayed a considerable part. A fairly good account of early transfusions and speculations may be found in a twelve page note appendedto John W. Ogle'sHarveianOration z88o, (London, i88i). M. W. Hollings-

worth's article on "Blood Transfusion by R.

Lower, i665" in Annals of Medical History,
I928, IO, 2I3, promises much in spite of an error of date, but offers only an unannotatedtranslation of De Corde,4, in which Denis is referred to as "M. Dionys."

Some

General
in

Aspects Middle

of Ages*

Physics

the

BY MARSHALL CLAGETT 1
T

HOSEworkingin the field of medievalscienceuse the term "physics"in at

least two different senses. It is used in its modern meaning to cover the activity of the medieval schoolmen in those special branches which are considered a part of physics today: heat, magnetism, optics, mechanics, etc. It is also used in a medieval sense as the science of nature, or natural philosophy, which by the thirteenth century is equivalent to its Peripatetic definition, namely, "the study of the material world in so far as it is carried in the stream of change, motus." 2
OF WORKS FREQUENTLY CITED IN FOOTNOTES Kitdb ih;d al-'ulum, AraACLC = Al-F&r&b1, bic edition from Escorial manuscript by Angel Gonzalez Palencia, Alfarabi Catalogo de las ciencias, Madrid, I932. Includes also two medieval Latin and one modem Spanish translation. = Al-Firdbl, De ortu scientiarum, edited AOS by C. Baeumker in Beitrdge zur Geschichte der Philosophie des Mittelalters. Texte und Untersuchungen, Band I9, Heft 3, Munster, I9I6. CLMP = M. Clagett, Giovanni Marliani and Late Medieval Physics, New York,
*ABBREVIATIONS

GDP

Domingo Gundisalvo, De divisione philosophie, edited by L. Bauer in Beitrdge zur Geschichteder Philosophie des Mittelalters. Texte und Untersuchungen, Band 4, Heft 2-3, Munster, I903. This includesa long essay on medieval classificationtheory by Bauer. GGSM = M. Grabmann,Geschichteder scholastische Methode, vol. 2, Freiberg,
=
I91I.

DHP DOS DSM

= P. Duhem, "Physics-History of" in Catholic Encyclopedia. = P. Duhem, Les origines de la statique, vol. i, Paris, I905. = P. Duhem, Le systUme du monde,
vols. I-5, Paris, I9I3-I7.

I94I.

HSVD = Hugo de Sancto Victore,Didascalicon de studio legendi, edited by C. H. Buttimer, Washington,D.C., I939. LAL = G. Lacombe, Aristoteles Latinus, Rome, I939. SIHS = G. Sarton, Introduction to the History of Science, vol. I-2, Baltimore,
I927-I93 I.

THME = L. Thorndike,History of Magic and

Experimental Science, vols. i-6, New

York.

121-IOAI.

The nucleus of this paper was containedin an address delivered to the Medieval Club of New York at ColumbiaUniversity,April I947.

2M. de Wulf, Philosophy and Civilizationin the Middle Ages, Princeton,I922, p. 9I.