the evolution of modern medicine(�峇�匳勞議處延)-及34嫗
梓囚徒貧圭�鮗� ○ 賜 ★ 辛酔堀貧和鍬匈��梓囚徒貧議 Enter 囚辛指欺云慕朕村匈��梓囚徒貧圭�鮗� ● 辛指欺云匈競何��
!!!!隆堋響頼��紗秘慕禰厮宴和肝写偬堋響��
continually ebbed and flowed for the nourishment of the body�察。�2�� the vital�察�
containing another blood and the spirits�察�ebbed and flowed from the heart�察�
distributing heat and life to all parts。 Like a bellows the lungs fanned and
cooled this vital blood。 Here and there we find glimmering conceptions of
a communication between these systems�察 �but practically all teachers
believed that the only one of importance was through small pores in the
wall separating the two sides of the heart。 Observationmerely looking at
and thinking about thingshad done all that was possible�察 �and further
progress had to await the introduction of a new method�察�viz。�察�experiment。
Galen�察�it is true�察�had used this means to show that the arteries of the body
contained blood and not air。 The day had come when men were no longer
content with accurate description and with finely spun theories and dreams。
It was reserved for the immortal Harvey to put into practice the
experimental method by which he demonstrated conclusively that the
blood moved in a circle。 The ;De Motu Cordis; marks the final break of
the modern spirit with the old traditions。 It took long for men to realize the
value of this ;inventum mirabile; used so effectively by the Alexandrians´
´by Galenindeed�察�its full value has only been appreciated within the past
century。 Let me quote a paragraph from my Harveian Oration。��33�А �To the
age of the hearer�察�in which men had heard and heard only�察�had succeeded
the age of the eye in which men had seen and had been content only to see。
But at last came the age of the hand the thinking�察 �devising�察 �planning
hand�察�the hand as an instrument of the mind�察�now re´introduced into the
world in a modest little monograph from which we may date the beginning
of experimental medicine。;
��33�А�Osler�此�An Alabama Student�察�etc。�察�pp。 329´330。
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Harvey caught the experimental spirit in Italy�察 �with brain�察 �eye and
hand as his only aids�察�but now an era opened in which medicine was to
derive an enormous impetus from the discovery of instruments of
precision。 ;The new period in the development of the natural sciences�察�
which reached its height in the work of such men as Galileo�察�Gilbert and
Kepler�察 �is chiefly characterized by the invention of very important
instruments for aiding and intensifying the perceptions of the senses�察 �by
means of which was gained a much deeper insight into the phenomena
than had hitherto been possible。 Such instruments as the earlier ages
possessed were little more than primitive hand´made tools。 Now we find a
considerable number of scientifically made instruments deliberately
planned for purposes of special research�察�and as it were�察�on the threshold
of the period stand two of the most important�察�the compound microscope
and the telescope。 The former was invented about 1590 and the latter
about 1608。;��34�А�It was a fellow professor of the great genius Galileo who
attempted to put into practice the experimental science of his friend。 With
Sanctorius began the studies of temperature�察�respiration and the physics of
the circulation。 The memory of this great investigator has not been helped
by the English edition of his ;De Statica Medicina�察─ �not his best work�察�
with a frontispiece showing the author in his dietetic balance。 Full justice
has been done to him by Dr。 Weir Mitchell in an address as president of
the Congress of Physicians and Surgeons�察 �1891。��35�А �Sanctorius worked
with a pulsilogue devised for him by Galileo�察 �with which he made
observations on the pulse。 He is said to have been the first to put in use the
clinical thermometer。 His experiments on insensible perspiration mark him
as one of the first modern physiologists。
��34�А �Dannemann�此 �Die Naturwissenschaften in ihrer Entwickelung。。。�察�
Vol。 II�察�p。 7�察�Leipzig�察�1911。
��35�А�See Transactions Congress Physicians and Surgeons�察�1891�察�New
Haven�察�1892�察�II�察�159´181。
But neither Sanctorius nor Harvey had the immediate influence upon
their contemporaries which the novel and stimulating character of their
work justified。 Harvey's great contemporary�察�Bacon�察�although he lost his
life in making a cold storage experiment�察 �did not really appreciate the
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enormous importance of experimental science。 He looked very coldly
upon Harvey's work。 It was a philosopher of another kidney�察 �Rene
Descartes�察�who did more than anyone else to help men to realize the value
of the better way which Harvey had pointed out。 That the beginning of
wisdom was in doubt�察�not in authority�察�was a novel doctrine in the world�察�
but Descartes was no armchair philosopher�察�and his strong advocacy and
practice of experimentation had a profound influence in directing men to
;la nouvelle methode。; He brought the human body�察�the earthly machine�察�
as he calls it�察�into the sphere of mechanics and physics�察�and he wrote the
first text´book of physiology�察 �De l'Homme。; Locke�察 �too�察 �became the
spokesman of the new questioning spirit�察 �and before the close of the
seventeenth century�察�experimental research became all the mode。 Richard
Lower�察 �Hooke and Hales were probably more influenced by Descartes
than by Harvey�察 �and they made notable contributions to experimental
physiology in England。 Borelli�察 �author of the famous work on ;The
Motion of Animals; ��Rome�察�1680´1681���察�brought to the study of the action
of muscles a profound knowledge of physics and mathematics and really
founded the mechanical�察�or iatromechanical school。 The literature and the
language of medicine became that of physics and mechanics�此�wheels and
pulleys�察�wedges�察�levers�察�screws�察�cords�察�canals。 cisterns�察�sieves and strainers�察�
with angles�察�cylinders�察�celerity�察�percussion and resistance�察�were among the
words that now came into use in medical literature。 Withington quotes a
good example in a description by Pitcairne�察�the Scot who was professor of
medicine at Leyden at the end of the seventeenth century。 ;Life is the
circulation of the blood。 Health is its free and painless circulation。 Disease
is an abnormal motion of the blood�察 �either general or local。 Like the
English school generally�察�he is far more exclusively mechanical than are
the Italians�察�and will hear nothing of ferments or acids�察�even in digestion。
This�察�he declares�察�is a purely mechanical process due to heat and pressure�察�
the wonderful effects of which may be seen in Papin's recently invented
'digester。' That the stomach is fully able to comminute the food may be
proved by the following calculation。 Borelli estimates the power of the
flexors of the thumb at 3720 pounds�察 �their average weight being 122
grains。 Now�察�the average weight of the stomach is eight ounces�察�therefore
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it can develop a force of 117��088 pounds�察�and this may be further assisted
by the diaphragm and abdominal muscles the power of which�察�estimated in
the same way�察 �equals 461��219 pounds� �Well may Pitcairne add that this
force is not inferior to that of any millstone。;��36�А �Paracelsus gave an
extraordinary stimulus to the study of chemistry and more than anyone
else he put the old alchemy on modern lines。 I have already quoted his
sane remark that its chief service is in seeking remedies。 But there is
another side to this question。 If�察�as seems fairly certain�察�the Basil Valentine
whose writings were supposed to have inspired Paracelsus was a hoax and
his works were made up in great part from the writings of Paracelsus�察�then
to our medical Luther�察�and not to the mythical Benedictine monk�察�must be
attributed a great revival in the search for the Philosopher's Stone�察�for the
Elixir of Life�察�for a universal medicine�察�for the perpetuum mobile and for
an aurum potabile。��37�А �I reproduce�察 �almost at random�察 �a page from the
fifth and last part of the last will and testament of Basil Valentine ��London�察�
1657���察�from which you may judge the chemical spirit of the time。
��36�А �Withington�此 �Medical History from the Earliest Times�察 �London�察�
1891�察�Scientific Press�察�p。 317。
��37�А �See Professor Stillman on the Basil Valentine hoax�察 �Popular
Science Monthly�察�New York�察�1919�察�LXXXI�察�591´600。
Out of the mystic doctrines of Paracelsus arose the famous ;Brothers
of the Rosy Cross。; ;The brotherhood was possessed of the deepest
knowledge and science�察�the transmutation of metals�察�the perpetuum mobile
and the universal medicine were among their secrets�察�they were free from
sickness and suffering during their lifetime�察 �though subject finally to
death。;��38�А�
��38�А�Ferguson�此�Bibliotheca Chemica�察�Vol。 II�察�p。 290。 For an account of
Fludd and the English Rosicrucians see Craven's Life of Fludd�察�Kirkwall�察�
1902。
A school of a more rational kind followed directly upon the work of
Paracelsus�察�in which the first man of any importance was Van Helmont。
The Paracelsian Archeus was the presiding spirit in living creatures�察�and
worked through special local ferments�察 �by which the functions of the
organs are controlled。 Disease of any part represents a strike on the part of
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the local Archeus�察�who refuses to work。 Though full of fanciful ideas�察�Van
Helmont had the experimental spirit and was the first chemist to discover
the diversity of gases。 Like his teacher�察�he was in revolt against the faculty�察�
and he has bitter things to say of physicians。 He got into trouble with the
Church about the magnetic cure of wounds�察�as no fewer than twenty´seven
propositions