the evolution of modern medicine(现代医药的演变)-第19章
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from the storehouse of the past； which seemed to rely on everything
except its sin…crushed self； and trusted everything except its senses； which
in the actual looked for the ideal； in the concrete saw the symbol； in the
earthly Church beheld the heavenly； and in fleshly joys discerned the
devil's lures； which lived in the unreconciled opposition between the lust
and vain…glory of earth and the attainment of salvation； which felt life's
terror and its pitifulness； and its eternal hope； around which waved
concrete infinitudes； and over which flamed the terror of darkness and the
Judgment Day。〃
Galen died about 200 A。D。； the high…water mark of the Renaissance；
so far as medicine is concerned； was reached in the year 1542。 In order to
traverse this long interval intelligently； I will sketch certain great
movements； tracing the currents of Greek thought； setting forth in their
works the lives of certain great leaders； until we greet the dawn of our own
day。
After flowing for more than a thousand years through the broad plain
of Greek civilization； the stream of scientific medicine which we have
been following is apparently lost in the morass of the Middle Ages； but；
checked and blocked like the White Nile in the Soudan； three channels
may be followed through the weeds of theological and philosophical
speculation。
SOUTH ITALIAN SCHOOL
A WIDE stream is in Italy； where the 〃antique education never stopped；
antique reminiscence and tradition never passed away； and the literary
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matter of the pagan past never faded from the consciousness of the more
educated among the laity and clergy。〃＇3＇ Greek was the language of South
Italy and was spoken in some of its eastern towns until the thirteenth
century。 The cathedral and monastic schools served to keep alive the
ancient learning。 Monte Casino stands pre…eminent as a great hive of
students； and to the famous Regula of St。 Benedict＇4＇ we are indebted for
the preservation of many precious manuscripts。
＇3＇ H。 O。 Taylor： The Mediaeval Mind； Vol。 I； p。 251。
＇4＇ De Renzi： Storia Documentata della Scuola Medica di Salerno； 2d
ed。； Napoli； 1867； Chap。 V。
The Norman Kingdom of South Italy and Sicily was a meeting
ground of Saracens； Greeks and Lombards。 Greek； Arabic and Latin were
in constant use among the people of the capital； and Sicilian scholars of
the twelfth century translated directly from the Greek。
The famous 〃Almagest〃 of Ptolemy； the most important work of
ancient astronomy； was translated from a Greek manuscript； as early as
1160； by a medical student of Salerno。＇5＇
＇5＇ Haskins and Lockwood： Harvard Studies in Classical Philology；
1910； XXI； pp。 75…102。
About thirty miles southeast of Naples lay Salernum； which for
centuries kept alight the lamp of the old learning； and became the centre of
medical studies in the Middle Ages； well deserving its name of 〃Civitas
Hippocratica。〃 The date of foundation is uncertain； but Salernitan
physicians are mentioned as early as the middle of the ninth century； and
from this date until the rise of the universities it was not only a great
medical school； but a popular resort for the sick and wounded。 As the
scholar says in Longfellow's 〃Golden Legend〃：
Then at every season of the year There are crowds of guests and
travellers here； Pilgrims and mendicant friars and traders From the Levant；
with figs and wine； And bands of wounded and sick Crusaders； Coming
back from Palestine。
There were medical and surgical clinics； foundling hospitals； Sisters
of Charity； men and women professorsamong the latter the famous
Trotulaand apothecaries。 Dissections were carried out； chiefly upon
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animals； and human subjects were occasionally used。 In the eleventh and
twelfth centuries； the school reached its height； and that remarkable genius；
Frederick II； laid down regulations for a preliminary study extending over
three years； and a course in medicine for five years； including surgery。 Fee
tables and strict regulations as to practice were made； and it is specifically
stated that the masters were to teach in the schools； theoretically and
practically； under the authority of Hippocrates and Galen。 The literature
from the school had a far…reaching influence。 One book on the anatomy of
the pig illustrates the popular subject for dissection at that time。＇6＇ The
writings； which are numerous； have been collected by De Renzi。＇7＇
＇6＇ 〃And dissections of the bodies of swine As likest the human form
divine。〃Golden Legend。
＇7＇ S。 de Renzi： Collectio Salernitana； 5 vols。； Naples； 1852…1859； P。
Giacosa： Magistri Salernitani； Turin； 1901。
The 〃Antidotarium〃 of Nicolaus Salernitanus； about 1100； became
the popular pharmacopoeia of the Middle Ages； and many modern
preparations may be traced to it。
The most prominent man of the school is Constantinus Africanus； a
native of Carthage； who； after numerous journeys； reached Salernum about
the middle of the eleventh century。 He was familiar with the works both of
the Greeks and of the Arabs； and it was largely through his translations
that the works of Rhazes and Avicenna became known in the West。
One work above all others spread the fame of the schoolthe Regimen
Sanitatis； or Flos Medicinae as it is sometimes called； a poem on popular
medicine。 It is dedicated to Robert of Normandy； who had been treated at
Salernum； and the lines begin： 〃Anglorum regi scripsit schola tota
Salerni 。 。 。 〃 It is a hand…book of diet and household medicine； with many
shrewd and taking sayings which have passed into popular use； such as
〃Joy； temperance and repose Slam the door on the doctor's nose。〃 A full
account of the work and the various editions of it is given by Sir
Alexander Croke；＇8＇ and the Finlayson lecture （Glasgow Medical Journal；
1908） by Dr。 Norman Moore gives an account of its introduction into the
British Isles。
＇8＇ Regimen Sanitutis Salernitanum； a Poem on the Preservation of
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Health in Rhyming Latin Verse； Oxford； D。A。 Talboys； 1830。
BYZANTINE MEDICINE
THE second great stream which carried Greek medicine to modern
days runs through the Eastern Empire。 Between the third century and the
fall of Constantinople there was a continuous series of Byzantine
physicians whose inspiration was largely derived from the old Greek
sources。 The most distinguished of these was Oribasius； a voluminous
compiler； a native of Pergamon and so close a follower of his great
townsman that he has been called 〃Galen's ape。〃 He left many works； an
edition of which was edited by Bussemaker and Daremberg。 Many facts
relating to the older writers are recorded in his writings。 He was a
contemporary； friend as well as the physician； of the Emperor Julian； for
whom he prepared an encyclopaedia of the medical sciences。
Other important Byzantine writers were Aetius and Alexander of
Tralles； both of whom were strongly under the influence of Galen and
Hippocrates。 Their materia medica was based largely upon Dioscorides。
From Byzantium we have the earliest known complete medical
manuscript； dating from the fifth centurya work of Dioscoridesone of
the most beautiful in existence。 It was prepared for Anicia Juliana；
daughter of the Emperor of the East； and is now one of the great treasures
of the Imperial Library at Vienna。＇9＇ From those early centuries till the fall
of Constantinople there is very little of interest medically。 A few names
stand out prominently； but it is mainly a blank period in our records。
Perhaps one man may be mentioned； as he had a great influence on later
agesActuarius； who lived about 1300； and whose book on the urine laid
the foundation of much of the popular uroscopy and water…casting that had
such a vogue in the sixteenth and seventeenth centuries。 His work on the
subject passed through a dozen Latin editions； but is best studied in
Ideler's 〃Physici et medici Graeci minores〃 （Berlin； 1841）。
＇9＇ It has been reproduced by Seatone de Vries； Leyden； 1905； Codices
graeci et latini photographice depicti； Vol。 X。
The Byzantine stream of Greek medicine had dwindled to a very tiny
rill when the fall of Constantinople （1453） dispersed to the West many
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Greek scholars and many precious manuscripts。
ARABIAN MEDICINE
THE third and by far the strongest branch of the Greek river reached
the West after a remarkable and meandering course。 The map before you
shows the distribution of the Graeco…Roman Christian world at the
beginning of the seventh century。 You will notice that Christianity had
extended far eastwards； almost to China。 Most of those eastern Christians
were Nestorians and one of their important centres was Edessa； whose
school of learning became so celebrated。 Here in the fifth century was
built one of the most celebrated hospitals of antiquity。
Now look at another map showing the same countries about a century
later。 No such phenomenal change ever was made within so short space of
time as that which t
