Popular Science Monthly/Volume 67/November 1905/Physicians and Philosophers
| PHYSICIANS AND PHILOSOPHERS. |
By Professor CHARLES WILLIAM SUPER,
OHIO UNIVERSITY.
ALTHOUGH the initial assonance of physician with philosopher is purely accidental, it is nevertheless a fact that philosophy and the healing art or medical science have been closely associated with each other from their earliest beginnings. It can not but be regarded as a singular coincidence that for two and a half millenniums physic and philosophy, the practitioners of the healing art and the real or professed lovers of knowledge, have been more or less intimate friends. At the beginning they seem to have found themselves in each other's company almost by chance; then by a sort of elective affinity like that which often springs up between persons of opposite sex whose paths in the ordinary course of events incidentally crossed each other, to have discovered that they could make the rest of the journey together to reciprocal advantage.
Herodotus, the Father of History, was a native of Halicarnassus, and Hippocrates, the Father of Medicine, his younger contemporary, first saw the light on the island of Kos, only a few leagues distant. Born in the same year with Hippocrates was the philosopher Diogenes, of Apollonia in Crete, whose few literary remains not only attest his interest in human anatomy, but also furnish proof that he early came under the influence of the Ionian thinkers. Though never regarded as a physician, but only as a philosopher, he tells us in one of the very brief fragments that have been preserved that the veins of the human body are divided into two branches; that they pass through the abdominal cavity along the backbone, one on the right side, the other on the left, into the legs; and that two branches pass into the head. He then goes on to describe the course of the blood vessels and their ramifications as far as the ends of the toes, the fingers, and so on. It may safely be assumed from this fragment that Diogenes gave much attention to the structure of the human body.
In the southwestern portions of Asia Minor, the disciples of Asclepias or Æsculapius had several therapeutic establishments, and it is in connection with these that we discover the first signs of what may be called the healing art in the entire ancient world.
It was especially the priests of the temples of Kos and Knidos who cultivated a primitive and simple medical science in connection with their service of the god. In this part of Asia, also, philosophy took its rise. For not only was Hippocrates a philosopher as well as a physician, but the same affirmation can be made of a considerable number of Greek thinkers. Diogenes has just been mentioned. Moreover the two lines of investigation were often parallel in other parts of the ancient world. Empedocles who was a full generation older is supposed to have been a physician. Pythagoras, who lived still earlier, though perhaps not a physician in the strict sense of the word, gave, according to tradition, no little attention to the laws of health and formulated a number of precepts supposed to be conducive to its preservation. Plato, though not a special student of the healing art, shows in many passages of his Dialogues, a considerable degree of familiarity with the subject. Aristotle was the son of a physician and was indebted to his father not only for much of his knowledge, but also for his interest in natural history; while his pupil Theophrastus is regarded as the father of medical botany. Among the Romans we find Pliny paying a good deal of attention to facts or supposed facts in the realm of medicine. The same thing is true of Seneca and still more of Vitruvius, though it would perhaps be as far astray to call him a philosopher as a physician in the strict significance of the terms. Toward the latter part of the second century we are carried back again to Asia Minor to find in Galen of Pergamus, not only a distinguished writer on philosophical subjects, but a man whose reputation as a physician is fully equal to, if not greater than, that of Hippocrates, notwithstanding that he was a man of less native capacity. It may be confidently affirmed that Hippocrates, Celsus and Galen represent the entire healing art until modern times. With respect to Cornelius Celsus, who lived in the reign of Tiberius and who occupies an important place in the history of ancient medicine, it must be said that it is uncertain whether he was really a physician. It is rather more than probable that he was a savant. On the other hand, the question is raised, Why would any one but a practical physician compile a medical work? Could any other person do it successfully? Another singular fact that has added to the difficulty of defining Celsus' position is that even as late as the age in which he lived nearly all the physicians in Rome were Greek freedmen. At any rate the work of Celsus at once sprang into prominence, and though it is only part of an encyclopedic compilation, nothing else remains at the present day. As is the case with not a few other works of antiquity, its connection with modern times hangs by the slender thread of a single manuscript from which all later copies have been made. This portion of the encyclopedia of Celsus has also an important historical value since it gives brief sketches of more than seventy physicians who had lived before his time and had attained a certain degree of eminence. It had not escaped his observation that only persons of mediocre ability are loth to admit errors, while the reverse is true of genius, since there still remains a large residuum of truth in its possession.
Apropos of the intimate relationship existing between the study of nature and the healing art, we find that the Romans as early as the time of Cicero called a natural philosopher physicus, while the science itself was called physica, both words having been borrowed from the Greek physikos, that which pertains to nature, from physis, nature, in the somewhat restricted sense of the term as used in antiquity. But in medieval Latin physica had become the equivalent of medecina and physicus that of medicus. In the older English, physic means both natural philosophy, the modern physics, and the medical art as well as drugs. The restricted signification 'to purge' and 'a purge' is comparatively recent.
Shakspere uses both doctor and physician, the former generally in the sense of teacher. Doctor also occurs in Middle English and later Chaucer speaks of a 'doctour of Phisik.' In classical Latin the term doctor means teacher, a sense in which it is used by Cicero, Horace and others. It had no connection with medicine. In modern French physicien means one who occupies himself with physics, but in the older language it had the signification of the English physician. The French médecin, physician, is evidently from the Latin medicinus a derivative from medicus, while our medicine, a remedial drug, is from the same word in the feminine gender. In German the connection with the English physician is preserved by Physikus alone, a term used to designate an official whose functions correspond in the main with our health-officer. Here too the term Doktor has long since usurped the more specific Artzt, and Doktorei is occasionally used for medicine, 'doctor's stuff.' The Gothic word lèkeis, which is the Anglo-Saxon laece and the English 'leech' has nothing in common with either except the meaning. This term doctor again brings to the physician the same title that is borne by the scholar. Although it is given in several departments such as law, theology, music, philosophy, and so on, to the common man both in German and in English countries the doctor represents only the physician. This is explained by the fact that in most communities the only man or men bearing the title were physicians. Of late years, however, especially in the United States, doctors of divinity have become so common, not to mention other doctors, that the designation has reached the stage of painful uncertainty. What it now represents can only be determined by an investigation of each individual on whom it has been conferred.
No more convincing testimony to the small progress made in the healing art from the earliest times until a little more than a century ago need be asked for than is offered by a comparison of the average length of human life as given by Herodotus and that currently accepted until quite recently—three generations to a century. In fact most life insurance associations have not yet learned that this average is above forty years. Anatomy had made great progress and the structure of the body was minutely known, but until the germ theory of disease and antisepsis were established, therapeutics was largely a matter of tradition and routine; of empiricism and individual skill. When one reads of the incessant wars that kept a portion of the male inhabitants constantly occupied in military enterprises, directly or indirectly, one is inclined to believe that the average of human life must have been shorter than it was held to be twenty or twenty-three centuries ago. There is no room to enter upon a discussion of the problem here; suffice it to say, the loss from disease was probably no greater, and the losses in the armies probably much less relatively than in modern times. For it is well known that the killed in battle are but a small portion of those whom war deprives of life. It is probable that never before or since has any country suffered such ravages as did Germany during what is called the thirty years war. That the sanitary condition of ancient Greece must for the most part have been fairly good is attested by the rapid recuperation of most of the city-states after a disastrous war. But then there were no large cities like those of modern times, in which the population increases much faster than the adoption and enforcement of sanitary measures.
It will hardly be considered surprising that disease in any form should early have stimulated men to reflection. This is true at least of those living under conditions where there was more or less freedom of action and where affairs had not yet settled down into the lethal routine that characterized the social life of most of the people of the ancient world anterior to the appearance of the Greeks. The succession of day and night; the changes of season that follow each other regularly, and the meteorological conditions that accompany them, would be taken as a matter of course. But the vicissitudes of the human system, whether gradual, rapid or sudden, when not the result of accident or attributed to the malevolence of evil spirits, naturally led to inquiry as to their causes. The next step was in quest of prophylactics and curatives. This sort of reasoning, of philosophy, was not obnoxious to the charge that Socrates brought against the philosophy of his day, namely, that it was concerned wholly with things that were of no benefit to any one and with problems to which no answer could be found.
It will scarcely be denied by those best qualified to judge that of the three learned professions that of medicine is still the best fitted to stimulate thought and investigation. It is less hemmed in by tradition, and is of immediate public interest. The man who conquers a dangerous disease or who performs a difficult surgical operation needs no other endorsement. Unless he allows avarice to draw him into a practise more extensive than his constitution will bear, he will have a fair degree of leisure for liberalizing his mind by the study of subjects outside of bis particular sphere. The history of modern times no less than that of antiquity offers many examples of medical men whose interests were almost coextensive with those of mankind. That the physician, the investigator, the philosopher and the litterateur may be happily blended in one person is finely illustrated by the latest, though it is to be hoped not the last, volume either of the man or of his kind, the 'Aequanimitas' of Dr. Osler.
No one who is acquainted with human nature will be surprised when he learns that the class of medical practitioners known as 'quacks' flourished among the comparatively enlightened Greeks of ancient times. Often, however, the quack is one who strives after results by a method that has been tabooed by the corporation to whose regulations it is assumed that he ought to have subscribed. Though he is an outlaw, before the tribunal of mortals he may be just as good as if he were an in-law. That mysterious and apparently inscrutable part of our being known as the nervous system has always presented problems which medical practitioners have been unable to solve. Why should not a faith-cure be as legitimate as any other cure, provided it is genuine? And there have been faith-cures time out of mind. When persons can not control their own imaginations, the task would seem to be doubly difficult for any one else. Often the most important part of the physician's business is to arouse in his patient the will to get well, and whatever will accomplish this can not be stigmatized as fraud. When hope is lost all is lost. I have known not a few persons who died because they did not want to live or were at least indifferent; and probably an equal number who materially lengthened their lives by the mere determination not to die. My attention was drawn to this phase of pathology many years ago by a curious incident that came under my observation when I was a mere lad. I did not hit upon the explanation until long afterwards. I have seen the same thing repeated many times since then. A vender of medicaments of his own concoction used to visit our neighborhood about twice a year. One day as he was driving along he began to feel unwell, and, contrary to the proverb that doctors never take their own medicines, picked from his chest a vial containing what he believed would afford him relief, and drank some of its contents without looking at the label. Having occasion shortly afterward to leave his wagon to visit one of his customers, it occurred to him that he had drunk from a bottle containing a strong poison. He at once began to feel very sick. A sort of stupor seized him and lie became so weak that he could hardly walk. As soon as he could get back to his medicine-chest he looked at his bottles again, when, to his great joy and greater relief, he found that he had taken just what he intended. The man declared afterwards that he believed he would have died if he had not had the means of ascertaining the facts in the case.
Though the ancients knew little of the structure of the nerves, they were well aware of the influence of the imagination as a therapeutic agency. The walls of many of their temples were covered with tablets and votive offerings in testimony of gratitude to the god by whom the sick were healed. Faith-cures and christian science are therefore by no means a new thing under the sun, but something very old under new names. Though the ancients rarely, or not at all, dissected human bodies, they had a fairly definite knowledge of anatomy derived from the inspection of brutes. The bony structure could be readily studied with the aid of the skeletons that were plentiful enough in countries dotted with battlefields. The Persian invasion alone probably left tens of thousands of corpses strewn along the retreat of the great king. The aversion to the dissection of cadavers that was felt by many of the Greeks seems to have been connected with their reverence for the human form. It was regarded as a sacrilege to mutilate even a corpse. The treatment which the dead body of Leonidas received at the hands of Xerxes was due, as Herodotus expressly informs us, to the extraordinary exasperation he felt against the Spartan king for his fierce resistance to the Persian advance. Though Achilles had dragged the dead body of Hector many times around the walls of Troy, yet Apollo preserved it uninjured. This reverence for the 'human form divine,' like many other superstitions, interfered seriously with the progress of science. The favorite gods, Zeus and Apollo, were represented as physically perfect men. The effects of this sentiment are especially evident in the manner by which those condemned to death were executed. There seems to be no other explanation of the singular custom of administering the hemlock juice than the desire to leave the body after death as nearly as possible as it appeared in its living state. That the rule was departed from under special circumstances and in times of great excitement is no valid argument against the correctness of the explanation.
According to Homer and Herodotus, the healing art was discovered or invented in Egypt. The Odyssey tells us that there every man is a physician skilled beyond human kind. Mention is also made of the many plants possessing medicinal properties. Oculists are said to have been particularly numerous, and many prescriptions for diseases of the eye have been found among the papyri. Artificial and gold-filled teeth have also been met with both in Egypt and in Etrurian tombs. The practise of medicine was, however, purely empirical, and the rules followed in the treatment of particular diseases were often of great age. The second king of Egypt is said to have been a physician, and another is reported to have written a book on anatomy. The private physicians of both Cambyses and of Darius were Egyptians. The name of the latter brings to mind that of his son Artaxerxes whose private physician was a man of considerable importance in his day, outside of his profession. Ktesias was a native of Knidos, a contemporary of Hippocrates, and no doubt personally known to him. Here we have again the philosopher and the physician in the same person. After acquiring considerable reputation in his own country he had the misfortune to fall into the hands of the Persians. Subsequently he was introduced at court, which proved the beginning of his good fortune. After the battle of Cunaxa he healed the wound inflicted upon his master by the brother of the latter. Later he was employed on a diplomatic mission to his native land; and thus after an absence of seventeen years returned home about 398 b.c., to remain for the rest of his life. That he was well treated by the master whose slave he became, according to Persian parlance, and had abundant opportunities for study, is evident from the fact that he compiled a 'History of Persia,' a work in which he charged Herodotus with frequent falsehoods in what he relates about that country. His scholarly tastes are evinced by this extensive collection, as it must have been, since it was divided into twenty-three books. He also composed a small work on India and one on geography. He is not known to have left any medical writings, and his reputation for impartiality as a historian is not very good. Still it must be regarded as a great misfortune that his extant remains are so meager.
In later times many Egyptian physicians practised in Rome; for to have studied in the land of the Nile, or, still better, to have been born there, was regarded as a special recommendation. Here too magic formulas of all kinds were in frequent use, not only in the compounding of medicines, but in their application. According to Pliny cadavers were dissected by order of the Ptolemies for the purpose of studying fatal diseases. But it can hardly be inferred from this statement that anatomy was regularly pursued in this way, or that dissection was a common practise.
Pliny, who had no very high opinion of the medical fraternity for reasons that will appear farther on, makes the assertion that Rome managed to get along six hundred years without physicians. This is manifestly an exaggeration, since many Greeks professed the healing art in the imperial city much earlier than 150 B. C. But neither did Rome produce a philosopher in the proper sense of the term; certainly no man who loved wisdom for its own sake. The Romans were, however, an exceptionally healthy people, owing to their fondness for outdoor life. This is demonstrated by the rapidity with which they recovered from repeated disasters. Once in a while their capital was invaded by a contagious disorder, then all who could do so left it until the scourge had spent its force, when affairs resumed their natural channel. In fact this was the usual course everywhere until very recently, when the real nature of such diseases was discovered. The ancient Romans were also a singularly hard-headed and practical people; consequently they were almost entirely free from the long list of complaints that are more or less due to the uncontrolled or uncontrollable imagination. Shortly after the Punic wars, but especially under the empire when luxurious habits due to the influx of wealth from the east had debilitated the naturally robust constitutions of the higher classes, nervous disorders, along with many others, were inevitable. Then quacks, charlatans, medicasters, soothsayers, magicians, astrologers and what not found a ready market for their wares. They played upon the credulity of the populace and preyed upon their purses because there was money in both the playing and the preying. No small portion of them probably were shrewd enough to disguise some real medical knowledge under a mass of hocus pocus in order to influence the imaginations of their patients. Well might Ovid say as others had said before him—and since, too—mundus vult decipi (people like to be deluded). Physicians still give to their patients who insist 'on taking something' bread pills, colored water and other equally potent or impotent remedies. It would be manifestly unfair to charge a physician with dishonesty because he practises a harmless ruse upon a patient who can be helped in no other way so easily.
"Dismissing faith in the confused creeds of the heathen world, he reposed the greatest faith in the power of human wisdom. He did not know (perhaps no one in that age distinctly did) the limits which nature imposes on our discoveries. Seeing that the higher we mount in knowledge the more wonders we behold, he imagined that nature not only worked miracles in her ordinary course, but that she might, by the cabala of some master soul, be diverted from that course itself. Thus he pursued science across her appointed boundaries into the land of perplexity and shadow. Prom the truths of astronomy he wandered into astrological fallacy: from the secrets of chemistry he passed into the spectral labyrinth of magic; and he who could be skeptical as to the power of the gods was credulously superstitious as to the power of man." Such are the thoughts that Bulwer-Lytton, in the Last Days of Pompeii, puts into the mind of one of his characters, the Egyptian Arbaces. The reasoning by which such men justified the employment of their superior knowledge and insight to dupe the credulous was half philosophy, half knavery. If a man is the possessor of power unknown to the multitude except in its effects, why has he not the right to use it?—to use it first of all to enhance his authority and to draw from such authority the advantages that seem to him most desirable? We may well admit that a man of this stamp may have had an inward feeling akin to what we call conscience that would justify his attitude toward Ms fellows—yet he did not consider these Romans fellow men of his—but it was wholly of the intellect. Such a man is as much a philosopher as were the sophists of an earlier age, and, we may add, of our own day. They apprehend clearly certain superficial verities, but cease to inquire farther after they have discovered what they think needful and sufficient for their own aggrandizement. Far different was the class of witches, one of whom is introduced in the same novel. Against these Horace frequently raises his voice, as do also others of the rationalizing Romans. They are ignorant, and, in most instances, as much the dupes of their own juggleries as their victims. Every man who goes through the world with his mind alert can see specimens without especially looking for them. It is doubtful whether any man has ever lived who had not at least a modicum of superstition in him. However much we may know and however far we may be able to pry into nature in some directions, there are others in which our vision is barred and the unknown is literally within arm's length. The mystery of life and death has always been so profound, as it still is though in a different way, that we need not wonder at the strange aberrations which so many persons fell into, who were in most matters little likely to be carried away by delusions. Sleep, 'the twin brother of death,' has from time out of mind been regarded as an excursion into the realm of departed spirits. If, as many believe, our consciousness is never coextensive with our personality, there are yet many discoveries to be made not dreamt of in the philosophy of most of us. Our will as an integral part of ourselves is the resultant of so many forces and, with the majority, is so little under control of rational motives, that it often plays fantastic tricks, not before high heaven alone, but almost anywhere.
The will of each individual as modified, at least in action from moment to moment, is like a ball thrown into a grove. It strikes one tree, then another and another, and no one can predict with certainty where it will come to rest. This element of chance, of Tyche, in the affairs of men, this incalculable calculus of probabilities, pervades in a remarkable degree the literature of ancient Greece and Rome. It made many feel that, do what they would, they were doomed to be thwarted in their plans. It was only those who, like Socrates, Epictetus and a few others, maintained that the chief end of man is to be found in motives rather than in outward results, who were never thrown out of their philosophical poise by the strange vicissitudes of life.
It is a far cry from the Greeks to the Saracens, though farther in time than in space. Here we find philosophy, or rather metaphysics, and medicine more intimately associated than at any other time or among any other people. Every one of the ten or twelve men who became prominent in Arabian philosophy was a physician. In fact the Arabs treated philosophy as a branch of astronomy and the healing art. The latter served a practical purpose, as did also the former in so far as it was dealt with as astrology. Arab philosophy was, however, something very different from the science that bore the same name among the Greeks. They studied philosophy, or rather they philosophized, as a man would study navigation on a ship lying at anchor. Albeit they were in this respect at no greater disadvantage than the schoolmen. The one party was chiefly concerned to make any discoveries they might light upon harmonize with the Koran and Aristotle; the other with the Bible and Aristotle, with a little spice from Ptolemy thrown in. Al-kindi, the philosopher par excellence of the Arabs, flourished in the tenth century. He wrote on almost every imaginable subject from arithmetic to astronomy, though under the former he discusses the unity of God; his arithmetic was therefore something totally different from that which forms the schoolboy's triangle with readin' and 'ritin'. So far as is at present known all his works are lost, except those on medicine and astrology. Eoger Bacon ranks him in some respects close to Ptolemy. Al-farabi was a contemporary of the preceding and is generally regarded as the earliest of the Arabian philosophers. However, medical science and even surgery could make little progress where the knowledge of human anatomy was so inadequate. The Koran denounces as unclean every person who touches a dead body, and an article of Mohammedan faith forbids dissection. We should remember, nevertheless, that the founder of anatomy, Vesalius, was sentenced to death by the Inquisition as a magician, and only pardoned on condition that he make a pilgrimage of penance to Jerusalem. This journey cost him his life. And it is probable that he would not have got off even on these relatively hard terms had he not enjoyed the favor of Philip II. of Spain, who esteemed him highly for his medical skill. We have the name of one Arab physician, Abdallatif of Bagdad, who was well aware that anatomy could not be learned from books, strange as it may seem that historians have thought it worth while to place to any man's credit a truth so easily apprehended. The same authority avers that Moslem doctors studied that branch of anatomy known as osteology by examining the bones of the dead found in cemeteries. Averroes of Cordova fills a large place in the history of Moorish philosophy in Spain about the middle of the twelfth century. But in medical renown he ranks far below Avicenna of Bokhara, who flourished about a century and a half earlier. He was teacher of both philosophy and medicine in Ispahan. His medical works seem to have been the chief guide in this branch in Europe for almost five centuries; their sway was not broken until the beginning of the seventeenth century. It is strong and yet painful testimony to the inherent stupidity of mankind, physicians not excepted, that the doctrines of Avicenna are little more than what is found in Galen somewhat modified by Aristotle; and, as wc have seen, Galen represents no great advance upon Hippocrates. Alas for the human race that it has always been so much easier to memorize than to think and to investigate! The medical science and practise of the Arabs was confined chiefly to surgery and the empirical treatment of internal diseases. There was no lack of victims in view of the constant wars in which the califs were engaged, and no lack of opportunity for the study of disease in its various forms in the hospitals which some of them founded in various parts of their domains. Both medical science and philosophy, though not metaphysics, had run their course by the time the Alexandrian era opened. A not inconsiderable number of new facts were collected in Alexandria, but the ability or the will to arrange them into an orderly system was lacking; at least we must adopt this view with the scant evidence to the contrary before us. For more than a thousand years the one question asked was not, What does nature say? What are the facts in the case? but, What does the master say? Beginning with the first christian centuries, Europe and western Asia more and more became organized into a society to suppress the increase of knowledge. It would not be easy to say in which century this organization did the most effective work, though there is no doubt that its most effective instrument was the inquisition. As everybody knows, it was not theology alone that was conservative; law and medicine were equally so. Geothe pays his respects to this attitude of mind when he says in Faust:
Hear, therefore, one alone, for that is best, in sooth,
And simply take your master's words for truth.
On words let your attention center!
Then through the safest guide you'll enter
The temple-halls of certainty.
And again:
Prepare beforehand well your part
With paragraphs all got by heart,
So you can better watch and look
That naught is said but what is in the book:
Yet in this writing as unwearied be
As did the Holy Ghost dictate to thee.
This conservatism was a characteristic of the times; the protestant revolution was hardly more than the beginning of a struggle for emancipation in a single direction. It did not enlarge the intellectual horizon of the lawyer or the physician. There is much evidence to show that with the rise of the belief in witchcraft, medical science, using the term in a very loose sense, received a distinct check. What was the advantage of familiarizing one's self with the nature or usual progress of a disease if its course was constantly liable to be interrupted by the will of some malevolent being possessed of supernatural power? What was to be gained by administering remedies that might at any time be rendered nugatory by the same demoniacal interference? Those who embraced the new faith promulgated by Luther were in some respects worse off than those who clung to the old religion. While catholics and protestants alike believed in witches and other agents of the devil, the former had also their saints and the virgin, to whom they could appeal in time of temptation and distress and who were rarely appealed to in vain. For the latter, Satan and his emissaries were no less real; but he had given up his faith in the efficacy of the intercession of the saints and the virgin. His only resource, therefore, was to protect himself as best he might by dealing mercilessly with those who had anything to do with the black art.
The late Herbert Spencer is said to have reached the conclusion toward the close of his life that man is not a rational being. One can hardly help subscribing to this creed when he learns the attitude of the public toward medical practise. We can understand why there should be a great deal of hazy thinking in matters of law and theology, since they have to do with problems that are at best more or less abstract. But why the public should willfully shut its eyes to practical benefits in every-day matters, matters that so vitally concern its life and health, is hard to understand. Yet it is no harder to understand than why a stone will not of itself roll up hill. We can only realize this mental asphyxiation in the face of overwhelming evidence. It is explicable only from the standpoint of the universal belief in the utter powerlessness of man in the presence of the spirits that surround him and dwell within him. Though the scriptures have much to say about casting out devils, the belief in them is human rather than christian, since it is found among all the peoples of the globe, except among that small class who may be called rationalists; or who, if not themselves entitled to this designation, have inherited a rationalistic creed; for a rationalist is simply one who refuses to believe anything except on such evidence as his reason approves.
There are grounds for believing that Aristotle dissected human bodies; at least on no other grounds can his correct information with regard to certain points in anatomy be explained. But for prudential reasons he did not deem it wise to make public how this knowledge was obtained. Salerno seems to have been the first medical school in Italy outside of Spain, that is, the earliest in charge of christians, and the probability is that its origin has some connection with the Arab domination. Bologna came into prominence in the thirteenth century and retained its preeminence for a long time. Here we have some definite statements by Mondino that he dissected several cadavers. But his writings also furnish the proof that he was not able to emancipate himself wholly from the authority of Galen and the Arabians. For some reason there were fewer obstacles in the way of the anatomist in Italy than in any other country in Europe; Berenger of Carpi is said to have performed more than a hundred dissections. In Italy too we meet with a number of names that are immortalized by their discoveries in the human body. The chief merit of Vesalius lies in the fact that he clearly recognized for the first time many of the errors that had come into current belief by the authority of Galen.
Hippocrates, Celsus, Galen, these three names sum up the science of ancient medicine; but the greatest of these is Hippocrates. It is perhaps not putting the case too strong if we say that they embrace substantially the entire healing art until not much over a century ago. The medical works of these three authors were printed in Italy before the end of the fifteenth century in Latin translations from the Arabic. This is striking testimony to the completeness of the rupture between ancient Greece and dawning era of modern times. When these Latin translations from the Arabic were made is not known; but it is known that they were very imperfect and that they were as blindly followed as were the writings of Aristotle. Galen's prestige was more due to his ambition and industry than to his individual merit. The great mass of medical knowledge was still accessible in manuscripts. This he carefully examined, and wrote comments upon much of it with remarkable discrimination for his age. Like Aristotle he would have been the first to repudiate the utterly senseless homage paid to his writings. One can not read the works of Hippocrates without being impressed with the extraordinary acumen of the man. Much that now passes current under his name is doubtless not genuine, in the strict sense of the word; but is at least evidence to the prestige of the master's name. The thinker constantly appears along with the practitioner. And we must always keep in mind that chemistry was unknown and the microscope non-existent. He tells us, among other things, that rain water is the purest, while ice and snow water are the worst for all purposes. He had carefully noted the radical differences between the people of Asia and of Europe, so far as he knew these parts of the world. What he says concerns the physician but little, the philosopher a great deal. He directly contravenes popular belief when he tells his readers more than once that there is no such a thing as a sacred disease; that no disorder is sent by a god, and that all ailments are due to natural causes. How heterodox this was may be seen by any one who reads the first book of the Iliad, where Apollo is represented as having sent a pestilence upon the Greek host. In his discourse on ancient medicine—a singular title for a book written more than four centuries before the christian era, whether by Hippocrates or some one else—we find the idea of the survival of the fittest clearly indicated; in fact, many of the Greeks had more than an inkling of it. His apprehension of gradual evolution is also shown by the assertion that the vegetables used for food are the outcome of experiments with coarser kinds and the deleterious effects upon the health of those that were rejected. He takes the ground that a man can not understand the medical art unless he knows, as far as that is possible, what man is. He holds that the physician should be skilled in nature; but what he defines as 'nature' is not cosmological, it is rather the etiology of disease and the laws of hygiene. He also speaks of the 'common herd of physicians.' Evidently professional pride is not the latest born of time's offspring. Among the most interesting documents included among the writings of Hippocrates is the physician's oath. While it may not have been formulated by the master, it undoubtedly represents the principles of his school. Thus early had Greek physicians formed themselves into a guild and pledged themselves to certain rules of conduct. These guilds were, however, not secret associations or fraternities and had no professional arcana different from those of the present day. The novitiate pledged himself to regard his teacher as equally dear with his own parents; to hold his sons in equal esteem with his own brothers; to teach them and his own sons the medical art without fee, if they desired to learn it; to keep aloof from whatever is detrimental to health; to give no deadly drug even when asked; to pass his life in purity and holiness; to abstain from any harmful act in whatsoever house he might enter for the benefit of the sick; to divulge no secrets connected with his professional practise, and to refuse to administer to any woman a drug that will produce abortion. It is evident from the oath here given in substance that the morals of the medical fraternity were, at least in theory, far in advance of those of the general public and of many well-known philosophers by profession.