the evolution of modern medicine(现代医药的演变)-第10章
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dwell in the brief sketch of the rise of scientific medicine among this
wonderful people。
We have seen that the primitive man and in the great civilizations of
Egypt and Babylonia； the physician evolved from the priestin Greece he
had a dual origin； philosophy and religion。 Let us first trace the origins in
the philosophers； particularly in the group known as the Ionian
Physiologists； whether at home or as colonists in the south of Italy； in
whose work the beginnings of scientific medicine may be found。 Let me
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quote a statement from Gomperz：
〃We can trace the springs of Greek success achieved and maintained
by the great men of Hellas on the field of scientific inquiry to a remarkable
conjunction of natural gifts and conditions。 There was the teeming wealth
of constructive imagination united with the sleepless critical spirit which
shrank from no test of audacity； there was the most powerful impulse to
generalization coupled with the sharpest faculty for descrying and
distinguishing the finest shades of phenomenal peculiarity； there was the
religion of Hellas； which afforded complete satisfaction to the
requirements of sentiment； and yet left the intelligence free to perform its
destructive work； there were the political conditions of a number of rival
centres of intellect； of a friction of forces； excluding the possibility of
stagnation； and； finally； of an order of state and society strict enough to
curb the excesses of 'children crying for the moon；' and elastic enough not
to hamper the soaring flight of superior minds。。。。 We have already made
acquaintance with two of the sources from which the spirit of criticism
derived its nourishmentthe metaphysical and dialectical discussions
practiced by the Eleatic philosophers； and the semi…historical method
which was applied to the myths by Hecataeus and Herodotus。 A third
source is to be traced to the schools of the physicians。 These aimed at
eliminating the arbitrary element from the view and knowledge of nature；
the beginnings of which were bound up with it in a greater or less degree；
though practically without exception and by the force of an inner necessity。
A knowledge of medicine was destined to correct that defect； and we shall
mark the growth of its most precious fruits in the increased power of
observation and the counterpoise it offered to hasty generalizations； as
well as in the confidence which learnt to reject untenable fictions； whether
produced by luxuriant imagination or by a priori speculations； on the
similar ground of self…reliant sense…perception。〃＇3＇
＇3＇ Gomperz： Greek Thinkers； Vol。 I； p。 276。
The nature philosophers of the Ionian days did not contribute much to
medicine proper； but their spirit and their outlook upon nature influenced
its students profoundly。 Their bold generalizations on the nature of matter
and of the elements are still the wonder of chemists。 We may trace to one
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of them； Anaximenes； who regarded air as the primary principle； the
doctrine of the 〃pneuma；〃 or the breath of lifethe psychic force which
animates the body and leaves it at death〃Our soul being air； holds us
together。〃 Of another； the famous Heraclitus； possibly a physician； the
existing fragments do not relate specially to medicine； but to the
philosopher of fire may be traced the doctrine of heat and moisture； and
their antitheses； which influenced practice for many centuries。 There is
evidence in the Hippocratic treatise peri sarkwn of an attempt to apply this
doctrine to the human body。 The famous expression； panta rhei；〃all
things are flowing；〃expresses the incessant flux in which he believed and
in which we know all matter exists。 No one has said a ruder thing of the
profession； for an extant fragment reads： 〃。 。 。 physicians； who cut； burn；
stab； and rack the sick； then complain that they do not get any adequate
recompense for it。〃＇4＇
＇4＇ J。 Burnet： Early Greek Philosophy； 1892； p。 137； Bywater's no。
LVIII。
The South Italian nature philosophers contributed much more to the
science of medicine； and in certain of the colonial towns there were
medical schools as early as the fifth century B。C。 The most famous of
these physician philosophers was Pythagoras； whose life and work had an
extraordinary influence upon medicine； particularly in connection with his
theory of numbers； and the importance of critical days。 His discovery of
the dependence of the pitch of sound on the length of the vibrating chord
is one of the most fundamental in acoustics。 Among the members of the
school which he founded at Crotona were many physicians。 who carried
his views far and wide throughout Magna Graecia。 Nothing in his teaching
dominated medicine so much as the doctrine of numbers； the sacredness of
which seems to have had an enduring fascination for the medical mind。
Many of the common diseases； such as malaria； or typhus； terminating
abruptly on special days； favored this belief。 How dominant it became and
how persistent you may judge from the literature upon critical days； which
is rich to the middle of the eighteenth century。
One member of the Crotonian school； Alcmaeon； achieved great
distinction in both anatomy and physiology。 He first recognized the brain
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as the organ of the mind； and made careful dissections of the nerves；
which he traced to the brain。 He described the optic nerves and the
Eustachian tubes； made correct observations upon vision； and refuted the
common view that the sperma came from the spinal cord。 He suggested
the definition of health as the maintenance of equilibrium； or an
〃isonomy〃 in the material qualities of the body。 Of all the South Italian
physicians of this period； the personality of none stands out in stronger
outlines than that of Empedocles of Agrigentumphysician； physiologist；
religious teacher； politician and poet。 A wonder…worker； also； and magician；
he was acclaimed in the cities as an immortal god by countless thousands
desiring oracles or begging the word of healing。 That he was a keen
student of nature is witnessed by many recorded observations in anatomy
and physiology； he reasoned that sensations travel by definite paths to the
brain。 But our attention must be confined to his introduction of the theory
of the four elementsfire； air； earth and waterof which； in varying
quantities； all bodies were made up。 Health depended upon the due
equilibrium of these primitive substances； disease was their disturbance。
Corresponding to those were the four essential qualities of heat and cold；
moisture and dryness； and upon this four…fold division was engrafted by
the later physicians the doctrine of the humors which； from the days of
Hippocrates almost to our own； dominated medicine。 All sorts of magical
powers were attributed to Empedocles。 The story of Pantheia whom he
called back to life after a thirty days' trance has long clung in the
imagination。 You remember how Matthew Arnold describes him in the
well…known poem； 〃Empedocles on Etna〃
But his power Swells with the swelling evil of this time； And holds
men mute to see where it will rise。 He could stay swift diseases in old days；
Chain madmen by the music of his lyre； Cleanse to sweet airs the breath of
poisonous streams； And in the mountain…chinks inter the winds。 This he
could do of old＇5＇
a quotation which will give you an idea of some of the powers
attributed to this wonder…working physician。
＇5＇ Poetical Works of Matthew Arnold； Macmillan & Co。； 1898； p。
440。
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But of no one of the men of this remarkable circle have we such
definite information as of the Crotonian physician Democedes； whose
story is given at length by Herodotus； and his story has also the great
importance of showing that； even at this early period； a well…devised
scheme of public medical service existed in the Greek cities。 It dates from
the second half of the sixth century B。C。fully two generations before
Hippocrates。 A Crotonian； Democedes by name； was found among the
slaves of Oroetes。 Of his fame as a physician someone had heard and he
was called in to treat the dislocated ankle of King Darius。 The wily Greek；
longing for his home； feared that if he confessed to a knowledge of
medicine there would be no chance of escape； but under threat of torture
he undertook a treatment which proved successful。 Then Herodotus tells
his storyhow； ill treated at home in Crotona； Democedes went to AEgina；
where he set up as a physician and in the second year the State of AEgina
hired his services at the price of a talent。 In the third year； the Athenians
engaged him at 100 minae； and in the fourth； Polycrates of Samos at two
talents。 Democedes shared the misfortunes of Polycrates and was taken
prisoner by Oroetes。 Then Herodotus tells how he cured Atossa； the
daughter of Cyrus and wife of Darius； of a severe abscess of the breast； but
on condition that she help him to escape； and she induced her husband to
send an expedition of exploration to Greece under the guidance of
Democede
