the evolution of modern medicine(现代医药的演变)-第14章
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the sick； and will abstain from every voluntary act of mischief and
corruption； and；further； from the abduction of females or males； of
freemen and slaves。 Whatever； in connection with my professional
practice； or not in connection with it；I see or hear； in the life of men； which
ought not to be spoken of abroad； I will not divulge； as reckoning that all
such should be kept secret。
While I continue to keep this Oath unviolated； may it be granted to me
to enjoy life and the practice of the art； respected by all men； in all times！
But should I trespass and violate this Oath； may the reverse be my lot！
（Adams； II； 779； cf。 Littre； IV； 628。）
In his ideal republic； Plato put the physician low enough； in the last
stratum； indeed； but he has never been more honorably placed than in the
picture of Athenian society given by this author in the 〃Symposium。〃 Here
the physician is shown as a cultivated gentleman； mixing in the best； if not
always the most sober； society。 Eryximachus； the son of Acumenus；
himself a physician； plays in this famous scene a typical Greek part＇22a＇
a strong advocate of temperance in mind and body； deprecating； as a
physician； excess in drink； he urged that conversation should be the order
of the day and he had the honor of naming the subject〃Praise of the God
of Love。〃 Incidentally Eryximachus gives his view of the nature of disease；
and shows how deeply he was influenced by the views of Empedocles：〃。 。 。
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so too in the body the good and healthy elements are to be indulged； and
the bad elements and the elements of disease are not to be indulged； but
discouraged。 And this is what the physician has to do； and in this the art of
medicine consists： for medicine may be regarded generally as the
knowledge of the loves and desires of the body and how to satisfy them or
not； and the best physician is he who is able to separate fair love from foul；
or to convert one into the other； and he who knows how to eradicate and
how to implant love； whichever is required； and can reconcile the most
hostile elements in the constitution and make them loving friends； is a
skilful practitioner。〃
＇22a＇ Professor Gildersleeve's view of Eryximachus is less favorable
（Johns Hopkins University Circular； Baltimore； January； 1887）。 Plato； III；
186Jowett； I； 556。
The second great note in Greek medicine illustrates the directness
with which they went to the very heart of the matter。 Out of mysticism；
superstition and religious ritual the Greek went directly to nature and was
the first to grasp the conception of medicine as an art based on accurate
observation； and an integral part of the science of man。 What could be
more striking than the phrase in 〃The Law；〃 〃There are； in effect； two
things； to know and to believe one knows； to know is science； to believe
one knows is ignorance〃？＇23＇ But no single phrase in the writings can
compare for directness with the famous aphorism which has gone into the
literature of all lands： 〃Life is short and Art is long； the Occasion fleeting；
Experience fallacious； and Judgment difficult。〃
＇23＇ Littre： OEuvres d'Hippocrate； Vol。 IV； pp。 641…642。
Everywhere one finds a strong； clear common sense； which refuses to
be entangled either in theological or philosophical speculations。 What
Socrates did for philosophy Hippocrates may be said to have done for
medicine。 As Socrates devoted himself to ethics； and the application of
right thinking to good conduct； so Hippocrates insisted upon the practical
nature of the art； and in placing its highest good in the benefit of the
patient。 Empiricism； experience； the collection of facts； the evidence of the
senses； the avoidance of philosophical speculations； were the
distinguishing features of Hippocratic medicine。 One of the most striking
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contributions of Hippocrates is the recognition that diseases are only part
of the processes of nature； that there is nothing divine or sacred about
them。 With reference to epilepsy；which was regarded as a sacred disease；
he says； 〃It appears to me to be no wise more divine nor more sacred than
other diseases； but has a natural cause from which it originates like other
affections； men regard its nature and cause as divine from ignorance。〃 And
in another place he remarks that each disease has its own nature； and that
no one arises without a natural cause。 He seems to have been the first to
grasp the conception of the great healing powers of nature。 In his long
experience with the cures in the temples； he must have seen scores of
instances in which the god had worked the miracle through the vis
medicatrix naturae； and to the shrewd wisdom of his practical suggestions
in treatment may be attributed in large part the extraordinary vogue which
the great Coan has enjoyed for twenty…five centuries。 One may appreciate
the veneration with which the Father of Medicine was regarded by the
attribute 〃divine〃 which was usually attached to his name。 Listen to this
for directness and honesty of speech taken from the work on the joints
characterized by Littre as 〃the great surgical monument of antiquity〃： 〃I
have written this down deliberately； believing it is valuable to learn of
unsuccessful experiments； and to know the causes of their non…success。〃
The note of freedom is not less remarkable throughout the Hippocratic
writings； and it is not easy to understand how a man brought up and
practicing within the precincts of a famous AEsculapian temple could have
divorced himself so wholly from the superstitions and vagaries of the cult。
There are probably grounds for Pliny's suggestion that he benefited by the
receipts written in the temple； registered by the sick cured of any disease。
〃Afterwards；〃 Pliny goes on to remark in his characteristic way； 〃hee
professed that course of Physicke which is called Clinice Wherby
physicians found such sweetnesse that afterwards there was no measure
nor end of fees〃 （〃Natural History；〃 XXIX； 1）。 There is no reference in the
Hippocratic writings to divination； incubation sleep is not often mentioned；
and charms； incantations or the practice of astrology but rarely。 Here and
there we do find practices which jar upon modern feeling； but on the
whole we feel in reading the Hippocratic writings nearer to their spirit than
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to that of the Arabians or of the many writers of the fifteenth and sixteenth
centuries A。 D。 And it is not only against the thaumaturgic powers that the
Hippocratic writings protested； but they express an equally active reaction
against the excesses and defects of the new philosophy； a point brought
out very clearly by Gomperz。＇24＇ He regards it as an undying glory of the
school of Cos that after years of vague； restless speculation it introduces
steady sedentary habits into the intellectual life of mankind。 〃 'Fiction to
the right！ Reality to the left！' was the battle…cry of this school in the war
they were the first to wage against the excesses and defects of the nature…
philosophy。 〃Though the protest was effective in certain directions； we
shall see that the authors of the Hippocratic writings could not entirely
escape from the hypotheses of the older philosophers。
＇24＇ Gomperz： Greek Thinkers； Vol。 I； p。 296。
I can do no more than indicate in the briefest possible way some of the
more important views ascribed to Hippocrates。 We cannot touch upon the
disputes between the Coan and Cnidian schools。＇25＇ You must bear in
mind that the Greeks at this time had no human anatomy。 Dissections were
impossible； their physiology was of the crudest character； strongly
dominated by the philosophies。 Empedocles regarded the four elements；
fire； air； earth and water； as 〃the roots of all things；〃 and this became the
corner stone in the humoral pathology of Hippocrates。 As in the
Macrocosm the world at large there were four elements； fire； air； earth；
and water； so in the Microcosmthe world of man's bodythere were four
humors （elements）； viz。；blood； phlegm； yellow bile （or choler） and black
bile （or melancholy）；and they corresponded to the four qualities of matter；
heat； cold； dryness and moisture。 For more than two thousand years these
views prevailed。 In his 〃Regiment of Life〃 （1546） Thomas Phaer says：〃。 。 。
which humours are called ye sones of the Elements because they be
complexioned like the foure Elements； for like as the Ayre is hot and
moyst： so is the blooud； hote and moyste。 And as Fyer is hote and dry： so
is Cholere hote and dry。 And as water is colde and moyst：so is fleume
colde and moyste。 And as the Earth is colde and dry： so Melancholy is
colde and dry。〃＇26＇
＇25＇ The student who wishes a fuller account is referred to the histories
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of （a） Neuburger； Vol。 1； Oxford； 1910； （b） Withington； London； 1894。
＇26＇ Thomas Phaer： Regiment of Life； London； 1546。
As the famous Regimen Sanitatis of Salernum； the popular family
hand…book of the Middle Ages； says：
Foure Humours raigne within our bodies wholly； And these compared
to foure elements。＇27＇
＇27＇ The Englishman's Doctor； or the Schoole of Salerne； Sir John
Harington's translation； London； 1608； p。 2。 Edited by Francis R。 Packard；
New York； 1920； p。 132。 Harington's book originally appeared dated：
London 1607。 （Hoe copy in t
