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the evolution of modern medicine(�峇�匳勞議處延)-及12何蛍

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!!!!隆堋響頼��紗秘慕禰厮宴和肝写偬堋響��




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�察�the physician evolved from the priestin Greece he 

had a dual origin�察�philosophy and religion。 Let us first trace the origins in 

the    philosophers�察      �particularly    in   the    group    known      as   the    Ionian 

Physiologists�察  �whether   at   home   or   as   colonists   in   the   south   of   Italy�察  �in 

whose work the beginnings of scientific medicine may be found。 Let me 



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quote a statement from Gomperz�此�

     ;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�察�there was the most powerful impulse to 

generalization       coupled     with    the   sharpest    faculty    for   descrying     and 

distinguishing the finest shades of phenomenal peculiarity�察�there was the 

religion      of   Hellas�察   �which      afforded     complete       satisfaction     to   the 

requirements of sentiment�察�and yet left the intelligence free to perform its 

destructive work�察�there were the political conditions of a number of rival 

centres   of   intellect�察  �of   a   friction   of   forces�察  �excluding   the   possibility   of 

stagnation�察 �and�察 �finally�察  �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�察    �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�察�

the beginnings of which were bound up with it in a greater or less degree�察�

though practically without exception and by the force of an inner necessity。 

A knowledge of medicine was destined to correct that defect�察�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�察  �as 

well as in the confidence which learnt to reject untenable fictions�察�whether 

produced   by   luxuriant   imagination   or   by   a   priori   speculations�察  �on   the 

similar ground of self´reliant sense´perception。;��3�А�

     ��3�А�Gomperz�此�Greek Thinkers�察�Vol。 I�察�p。 276。 

     The nature philosophers of the Ionian days did not contribute much to 

medicine proper�察�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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                        THE EVOLUTION OF MODERN MEDICINE 



of   them�察   �Anaximenes�察      �who    regarded    air  as   the  primary    principle�察   �the 

doctrine   of   the   ;pneuma�察─  �or   the   breath   of   lifethe   psychic   force   which 

animates   the   body   and   leaves   it   at   death;Our   soul   being   air�察  �holds   us 

together。;   Of   another�察  �the   famous   Heraclitus�察  �possibly   a   physician�察  �the 

existing     fragments      do   not   relate   specially    to   medicine�察    �but   to   the 

philosopher of fire may be traced the doctrine of heat and moisture�察�and 

their   antitheses�察  �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�察    �panta    rhei�察�all 

things are flowing�察�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�察�for an extant fragment reads�此 ─� 。 。 physicians�察�who cut�察�burn�察�

stab�察�and rack the sick�察�then complain that they do not get any adequate 

recompense for it。;��4�А�

     ��4�А  �J。   Burnet�此  �Early   Greek   Philosophy�察  �1892�察  �p。   137�察  �Bywater's   no。 

LVIII。 

       The South Italian nature philosophers contributed much more to the 

science     of  medicine�察    �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�察�whose life and work had an 

extraordinary influence upon medicine�察�particularly in connection with his 

theory of numbers�察�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�察�the sacredness of 

which   seems   to   have   had   an   enduring   fascination   for   the   medical   mind。 

Many   of   the   common   diseases�察  �such   as   malaria�察  �or   typhus�察  �terminating 

abruptly on special days�察�favored this belief。 How dominant it became and 

how persistent you may judge from the literature upon critical days�察�which 

is rich to the middle of the eighteenth century。 

     One     member      of  the   Crotonian     school�察   �Alcmaeon�察      �achieved     great 

distinction in both anatomy and physiology。 He first recognized the brain 



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                         THE EVOLUTION OF MODERN MEDICINE 



as   the   organ   of   the   mind�察  �and   made   careful   dissections   of   the   nerves�察�

which      he  traced    to  the   brain。   He   described     the   optic   nerves    and   the 

Eustachian tubes�察�made correct observations upon vision�察�and refuted the 

common view   that the   sperma   came from  the   spinal cord。   He   suggested 

the    definition     of   health    as   the   maintenance       of   equilibrium�察     �or   an 

;isonomy;   in   the   material   qualities   of   the   body。   Of   all   the   South   Italian 

physicians   of   this   period�察  �the   personality   of   none   stands   out   in   stronger 

outlines than that of Empedocles of Agrigentumphysician�察�physiologist�察�

religious teacher�察�politician and poet。 A wonder´worker�察�also�察�and magician�察�

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�察�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�察     �air�察 �earth   and   waterof     which�察   �in   varying 

quantities�察    �all  bodies    were     made    up。   Health     depended      upon    the   due 

equilibrium  of   these   primitive   substances�察  �disease   was   their   disturbance。 

Corresponding to those were the four essential qualities of heat and cold�察�

moisture and dryness�察�and upon   this four´fold division was engrafted   by 

the   later   physicians   the   doctrine   of   the   humors   which�察  �from   the   days   of 

Hippocrates almost to our own�察�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�察 �Empedocles on Etna; 

       But his power Swells with the swelling evil of this time�察�And holds 

men mute to see where it will rise。 He could stay swift diseases in old days�察�

Chain madmen by the music of his lyre�察�Cleanse to sweet airs the breath of 

poisonous   streams�察�And   in   the   mountain´chinks   inter the   winds。 This   he 

could do of old��5�А�

     a   quotation     which     will  give    you   an   idea   of  some     of  the   powers 

attributed to this wonder´working physician。 

     ��5�А  �Poetical 
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隆堋響頼��紗秘慕禰厮宴和肝写偬堋響��
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