Physiology 1850–1923. The view from Michigan

cerned with all organic phenomena and thus embraced pathology. Furthermore, fever was seen by R6schlaub not as disease per se as hitherto but as a symptom of an anomaly in the normally balanced relationship between the organism and its external environment. But above all, Brown's theory of excitability offered an intellectual basis for therapy. Tsouyopoulos shows convincingly that the crisis of conflicting medical philosophies at the end of the eighteenth century was largely caused by a failure to relate the practice of clinical medicine to theory with the result that the eclectic school were able to pay lip-service to innumerable contradictory theories while adhering to a conservative case-based therapy in the name of the Hippocratic tradition. Following Kant's critical philosophy, however, an acute need was felt to provide medicine with a general scientific foundation that would give both satisfactory theoretical explanation and consistent guidelines for treatment. R6schlaub believed that the excitability theory provided that basis with its underlying notion of a biological continuum both in analogy with and in counter-distinction to the physical continuum of the exact sciences. This independent biological continuum afforded medicine the possibility of producing adequate theories of pathogenesis and a concept of the individual as "a totality of life processes rather than as previously a mere sum of physical properties" (p. 219). Physiology was thus the unifying and primary discipline for medicine. Roschlaub's reputation could possibly have withstood intellectual controversy and perhaps even the dissolution in 1805 of his friendship with Schelling, whose eventual analogy of the magnetic , electrical, and chemical processes with three "dimensions" of the organism, reproduction , irritability, and sensibility, he found medically unhelpful. But behind the growing hostility between the two exponents of the early Naturphilosophie were the machinations of others who felt threatened by Roschlaub, his former allies Walther, D6llinger, and Marcus, while beyond them were the vested interests of practitioners whose livelihood would have been endangered by R6schlaub's demands for proper clinical treatment of illness on a social scale. If all this were not enough, Romantic medicine itself was to fall into disfavour as the positivist approach from France gained ground, to the point where Karl August Wunderlich in 1859 dismissed it as mere hollow theory divorced from all empiricism, a myth that survived for nearly a century. As far as Roschlaub is concerned, that myth is now finally dispelled by Dr Tsouyopoulos's book. It is, however, to be …