A Short History of Medicine

Part 1

Ἢν γὰρ παρῇ φιλανθρωπίη πάρεστι καὶ φιλοτεχνίη.

Where the love of man is, there also is love of this Art.

Παραγγελίαι, i.e. Precepts (Hippocratic Collection), § 6

A SHORT HISTORY OF MEDICINE

INTRODUCING MEDICAL PRINCIPLES TO STUDENTS AND NON-MEDICAL READERS

CHARLES SINGER M.A., M.D., D.LITT., OXFORD

FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON LECTURER ON THE HISTORY OF MEDICINE IN THE UNIVERSITY OF LONDON

Scire potestates herbarum usumque medendi Maluit et mutas agitare inglorius artes

It was his part to learn of the power of Medicine and of the manner of healing and, heedless of glory, to exercise that quiet art. Virgil, Aeneid xii, 396-7

NEW YORK OXFORD UNIVERSITY PRESS AMERICAN BRANCH 1928

COPYRIGHT, 1928 BY OXFORD UNIVERSITY PRESS AMERICAN BRANCH

PRINTED IN THE UNITED STATES OF AMERICA

PREFACE

The position that Medical Science has now assumed in the social polity demands that all educated men and women should have some knowledge of the subject, whether they have had a medical training or no. In these pages the author seeks to place before the reader, who is without special knowledge, some account of Medicine as a Science. For this purpose the historical method is peculiarly suited, since it recapitulates, in some measure, the actual stages through which each learner must pass. Though the story told here opens with Greek times, the narrative of the earlier period is so condensed that more than half the book is devoted to modern Medicine, which is presented as a natural outgrowth of an ancient tradition. An attempt has been made to keep the account as simple and as elementary as possible and to make the smallest demands on the scientific equipment of the reader. The slight divergence, in some matters, of the interests of American and of English readers, has been held in mind, so that, it is hoped, the book may be useful to both classes.

Throughout the work two particular aims have been steadily kept in view: first, to stress the principles of Medicine rather than the details of practice; second, to treat of those principles in as small a space as may be. For ‘principles’ the author has substituted at times the word ‘Philosophy.’ He would, however, beseech the timid reader to take no alarm at a word, for he employs the term ‘Philosophy’ in a time-honored fashion, and he undertakes not to plunge deep into the labyrinth of Metaphysic. The Philosophy of Medicine stands here for the disinterested study of the theory of the subject, without reference to its application to particular instances.

Certain omissions in the book are justified by the author’s forthcoming publication of a history of the biological sciences treated along somewhat similar lines. It has thus, for example, seemed superfluous to include here any but casual references to such highly important topics as the study of hereditary characters or the experimental investigation of developmental defects. It is, however, the duty of the author to direct attention to certain other omissions necessitated by the compression of the work into a small compass. The history of Medicine, as here treated, is essentially a history of ideas. The personal element has been kept wholly in the background and very little space has been allotted to biographical matter. Nor do the limits of the book permit any discussion of the status of medical men, and very little even of their training. On this account many who in their day were remarkable rather for the influence they exerted than for the advances in knowledge which they initiated find no commemoration here. This line of treatment has involved omission of reference to those teachers to whom the author himself owes most, Sir William Osler and Sir Clifford Allbutt.

A work on Medicine must be colored, in some degree, by its author’s conception of the nature of Life. On this theme there are divers views, for the full discussion of which there is here no place. The author professes himself, however, an adherent of a school of thought that is not, at present, greatly in fashion. He ranges himself as a vitalist under the banner of Aristotle and as a follower in the goodly company of Harvey, Hunter and Virchow, of Claude Bernard and Johannes Müller. He believes that there is a principle in living things that cannot be expressed in chemical or physical terms. He believes that this principle works to an intelligible end, that it is an Entelechy, an indwelling purposiveness, and that it is as real a thing as anything that is.

They are right who hold ‘soul’ to be not independent of body and yet not a kind of body. ‘Soul’ is not body but something pertaining to the body and dwelling therein, and, what is more, specific to each body. Our forebears erred in seeking to fit the ‘soul’ into a body without regard to the nature and qualities of the body, for the association of ‘soul’ and body is by no means thus at random. And so indeed we might expect, for the ‘Entelechy’ of each being comes naturally to be developed in the potentiality of each being, that is to say in the matter proper to it. Whence is manifest that the ‘soul’ is a certain ‘Entelechy’, a notion or form of that which has capacity to be endowed with ‘soul’. Aristotle, Περὶ Ψυχῆς, II, § 2.

The author is well aware that this conception is neither useful nor helpful for physiological research in the present state of our knowledge. That is a very good reason for excluding it, as the vitalist Claude Bernard excluded it, from the physiological laboratory. But it is not a good reason for abandoning a point of view which does something to make existence intelligible. On the contrary, turning from the physiological laboratory to the living being as a whole, it is just the indwelling purposiveness that is, before all things, most worthy of consideration. Every function, every structure, every instinct, habit, or reflex, every mental activity that is related to health--and which is not?--may throw some light thereon. It appears to the author that the scientific method is by far the mightiest weapon that has as yet come within man’s grasp, for the illumination of these multitudinous entities. The searching accuracy and power of that superb instrument, wielded by human reason in the quest of human health, is the theme of this volume. And yet, notwithstanding its triumphs, the experimental method, as applied in the separate sciences, has, of its nature, certain limitations with reference to living beings in general and living human beings in particular.

It is the business of each of the sciences--it is indeed an essential part of the method of Science--to separate a circumscribed part of the Universe for consideration in and for itself. Men of Science must thus perforce become Chemists, Physicists, Astronomers, Botanists, Cytologists, Statisticians, and the like. In this respect modern Science differs most profoundly from medieval Scientia and from ancient Philosophia. ‘Specialization’ follows modern Science as shadow follows substance. The new method has triumphed wonderfully in these last centuries and it is mere folly and obscurantism to seek to place intellectual stumbling-blocks in its path. Nor must we be afraid of shadows. The author does plead, however, that, while the Man of Science must, from the very nature of his method, cut off part of his universe of experience from all other parts, he should bear in mind, when not employed on his special task, that he has so cut off and isolated his special experience, of deliberate and set intent. To bear this fact in mind should not mean and must not mean that Science fails to influence our view of the world as a whole, but it should mean and must mean the basing of our view of the world as a whole on experience as a whole, and not on an artificially separated fragment of experience. For Man is neither a walking test-tube, nor a living anatomy, nor a colony of cells, nor a self-repairing machine that carries its own spare parts, nor a mere summation of the factors of heredity and environment, nor, for that matter, is he a disembodied spirit. But he is a being with a purpose. Of that purpose he, of his nature, can know very little, since it is a part of that through which he knows. Yet some glimpse of that purpose, though seen through a mist and ever so dimly, we may perhaps gain from the view-point on which the stony tracks of the separate sciences do ultimately converge. If the separate sciences did not so conspire to one end, why should we ever bother our heads or weary our limbs over their steep ascents? Are there not rosier paths that we might tread?

Throughout this book, then, the ideal kept in view is the description of Medicine as a Rational Discipline involving many and perhaps all the sciences. Medicine is not now and never has been followed wholly in the scientific spirit. But it is the story of the scientific elements in Medicine which is here to be told, and other aspects are passed over with a silence which must not be interpreted as the silence of contempt.

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