The Growth of Medicine From the Earliest Times to About 1800

CHAPTER I. Development of the Science and Art of Medicine

DEVELOPMENT OF THE SCIENCE AND ART OF MEDICINE

Friedlaender says that “in the temple of history, now hoary with age, medicine also possesses its own chapel, not an accidental addition to the edifice but a large and important part of the noble building.” In this chapel is preserved the record of the efforts made by man, through the ages, to maintain his body in good condition, to restore it to health when it has become affected by disease or damaged by violence, and to ward off the various maladies to which it is liable. It is a record, therefore, in which every practitioner of medicine should take a deep interest. Rokitansky, the famous pathologist of Vienna, expressed the same idea very tersely when he said: “Those about to study medicine and the younger physicians should light their torches at the fires of the ancients.” Members of the medical profession, however, are not the only persons in the community who take an interest in the origin and growth of the science of medicine and the art of healing the diseased or damaged body; the educated layman is but little less interested than the physician, being ever ready to learn all he can about the progress of a branch of knowledge which so profoundly affects his welfare. But hitherto the only sources of information available for those who are not familiar with French or German have been treatises of so technical a character that even physicians have shown relatively little disposition to read them.

The science of medicine developed slowly from very humble beginnings, and for this earliest period the historian has no records of any kind which may be utilized for his guidance. It is reasonably certain, furthermore, that this prehistoric period lasted for a very long time, probably several thousand years; and when, finally, some light on the subject appeared, it was found to emanate from several widely separated regions--e.g., from India, Mesopotamia, Egypt and Greece. Then, after the lapse of additional hundreds or even thousands of years, there was inaugurated the practice of making written records of all important events, and, among others, of the different diseases which affect mankind, of the means employed for curing them or for relieving the effects which they produce, and of the men who distinguished themselves in the practice of this art. While the “science of the spade” and that of deciphering the writing of the papyri, monuments and tablets thus brought to light, have already during the last half century greatly altered our ideas with regard to ancient medicine, there are good reasons for believing that much additional information upon this subject may be looked for in the not distant future. It is plain, therefore, that a history of the primitive period of medicine, if written to-day, may have to be modified to-morrow in some important respects. On the other hand, the facts relating to the later periods are now so well established that a fair-minded writer should experience no serious difficulty in judging correctly with regard to their value and with regard to the claims of the different men to be honored for the part which each has played in bringing the science and art of medicine to their present high state of completeness and efficiency.

The subdivision of the history of medicine into separate periods is certainly desirable, provided it be found practicable to assign reasonably well-defined limits to the periods chosen. But, when the attempt is made to establish such subdivisions, one soon discovers that the boundaries pass so gradually the one into the other at certain points, or else overlap so conspicuously at other points, that one hesitates to adopt any fixed plan of classification. Of the four schemes which I have examined--viz., those of Daremberg, of Aschoff, of Neuburger, and of Pagel--that of Neuburger seems to me to be the best. That which has been adopted, however, in the preparation of the present outline sketch combines some of the features of both the Pagel and the Neuburger schemes.

Periods in the History of Medicine.--There are nine more or less distinctly defined periods in the history of medicine, to wit:--

FIRST EPOCH: Primitive medicine.--This period extends through prehistoric ages to a date which differs for different parts of the world. The duration of this period, in any case, is to be reckoned by thousands of years.

SECOND EPOCH: The medicine of the East--that is, of the cultivated oriental races of whose history we possess only a very fragmentary knowledge.

THIRD EPOCH: The medicine of the classical period of antiquity--the pre-Hippocratic period of Greek medicine.

FOURTH EPOCH: The medicine of the Hippocratic writings--the most flourishing period of Greek medicine.

FIFTH EPOCH: The medicine of the period during which the centre of greatest intellectual activity was located at Alexandria, Egypt.

SIXTH EPOCH: The medicine of Galen--an author whose teachings exerted a preponderating influence upon the thought and practice of physicians in every part of the civilized world up to the seventeenth century of the Christian era. This period is also characterized by the gradual diminution of the influence of Greek medicine.

SEVENTH EPOCH: The medicine of the Middle Ages--a period which includes a large part of the preceding epoch. Its most characteristic feature is the important part played by the Arabs in moulding the teachings and practice of the medical men of that time (ninth to fifteenth century).

EIGHTH EPOCH (fifteenth and sixteenth centuries): The medicine of the Renaissance period--characterized chiefly by the adoption of the only effective method of studying the anatomy of man--the actual dissection of human bodies.

NINTH EPOCH (from the beginning of the seventeenth century to the present time): Modern medicine.--This epoch may with advantage be divided into two periods--the first extending to about the year 1775, soon after which time Jenner began his important work on the subject of vaccination; and the second to the present time. No attempt will be made in the following account to cover this second period.

The Beginnings of Medicine.--In the early period of man’s existence upon this earth he must have possessed an exceedingly small stock of knowledge with regard to the maintenance of his body in health and with regard to the means which he should adopt in order to restore it to a normal condition after it had been injured by violence or impaired in its working machinery by disease. With the progress of time, utilizing his powers of observation and his reasoning faculty, he slowly made additions to his stock of facts of this nature. Thus, for example, he gradually learned that cold, under certain circumstances, is competent to produce pain in the chest, shortness of breath, active secretion of mucus, etc., and his instinct led him, when he became affected in this manner, to crave the local application of heat as a means of affording relief from these distressing symptoms. Again, when he used certain plants as food he could scarcely fail to note the facts that some of them produced a refreshing or cooling effect, that others induced a sensation of warmth, and finally that others still, by reason of their poisonous properties, did actual harm. Sooner or later, such phenomena as nausea, vomiting and diarrhoea would also be attributed by him to their true causes. In due course of time his friends and neighbors, having made similar observations and having tried various remedial procedures for the relief of their bodily ills, would come together and compare with him their several experiences; and so eventually the fact would be brought out that the particular method adopted by one of their number for the relief of certain symptoms had proved more effective than any of the others. Thus gradually this isolated community or tribe of men must have learned how to treat, more or less successfully, the simpler ills to which they were liable.

Lucien Le Clerc quotes from the Arab historian Ebn Abi Ossaïbiah the following account of the manner in which bloodletting probably first came to be adopted as a remedial measure:--

Let us suppose that in the earliest period of man’s history somebody experienced the need of the medical art. He may, for example, have felt a general sense of heaviness in his body (plethora), associated perhaps with redness of the eyes, and he probably did not know what he should do in order to obtain relief from these sensations. Then, when his trouble was at its worst, his nose began to bleed, and the bleeding continued until he experienced decided relief from his discomfort. In this way he learned an important fact, and cherished it in his memory.

On a later occasion he experienced once more the same sense of heaviness, and he lost no time in scratching the interior of his nose in order to provoke a return of the bleeding. The nosebleed thus excited again gave him entire relief from the unpleasant sensations, and upon the first convenient occasion he told his children and all his relatives about the successful results obtained from this curative procedure. Little by little this simple act, which was a first step in the healing art, developed into the intelligently and skilfully performed operation of venesection.

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