the evolution of modern medicine-第11章

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　works；　shall　flow　into　the　eye　and　ear　like　a　health…giving　breeze　from　a　purer　region；　and　insensibly　draw　the　soul　from　earliest　years　into　likeness　and　sympathy　with　the　beauty　of　reason。〃　The　glory　of　this　zeal　for　the　enrichment　of　this　present　life　was　revealed　to　the　Greeks　as　to　no　other　people；　but　in　respect　to　care　for　the　body　of　the　common　man；　we　have　only　seen　its　fulfilment　in　our　own　day；　as　a　direct　result　of　the　methods　of　research　initiated　by　them。　Everywhere　throughout　the　Hippocratic　writings　we　find　this　attitude　towards　life；　which　has　never　been　better　expressed　than　in　the　fine　phrase；　〃Where　there　is　love　of　humanity　there　will　be　love　of　the　profession。〃　This　is　well　brought　out　in　the　qualifications　laid　down　by　Hippocrates　for　the　study　of　medicine。〃Whoever　is　to　acquire　a　competent　knowledge　of　medicine　ought　to　be　possessed　of　the　following　advantages：　a　natural　disposition；　instruction；a　favourable　position　for　the　study；　early　tuition；　love　of　labour；　leisure。　　First　of　all；　a　natural　talent　is　required；　for　when　nature　opposes；　everything　else　is　vain；　but　when　nature　leads　the　way　to　what　is　most　excellent；　instruction　in　the　art　takes　place；　which　the　student　must　try　to　appropriate　to　himself　by　reflection；　becoming　a　nearly　pupil　in　a　place　well　adapted　for　instruction。　He　must　also　bring　to　the　task　a　love　of　labour　and　perseverance；　so　that　the　instruction　taking　root　may　bring　forth　proper　and　abundant　fruits。〃　And　the　directions　given　for　the　conduct　of　life　and　for　the　relation　which　the　physician　should　have　with　the　public　are　those　of　our　code　of　ethics　today。　Consultations　in　doubtful　cases　are　advised；　touting　for　fees　is　discouraged。　〃If　two　or　more　ways　of　medical　treatment　were　possible；　the　physician　was　recommended　to　choose　the　least　imposing　or　sensational；　it　was　an　act　of　'deceit'　to　dazzle　the　patient's　eye　by　brilliant　exhibitions　of　skill　which　might　very　well　be　dispensed　with。　The　practice　of　holding　public　lectures　in　order　to　increase　his　reputation　was　discouraged　in　the　physician；　and　he　was　especially　warned　against　lectures　tricked　out　with　quotations　from　the　poets。　Physicians　who　pretended　to　infallibility　in　detecting　even　the　minutest　departure　from　their　prescriptions　were　laughed　at；　and　finally；　there　were　precise　by…laws　to　regulate　the　personal　behaviour　of　the　physician。　He　was　enjoined　to　observe　the　most　scrupulous　cleanliness；　and　was　advised　to　cultivate　an　elegance　removed　from　all　signs　of　luxury；　even　down　to　the　detail　that　he　might　use　perfumes；but　not　in　an　immoderate　degree。〃＇22＇　But　the　high…water　mark　of　professional　morality　is　reached　in　the　famous　Hippocratic　oath；which　Gomperz　calls　〃a　monument　of　the　highest　rank　in　the　history　of　civilization。〃　It　is　of　small　matter　whether　this　is　of　Hippocratic　date　or　not；　or　whether　it　has　in　it　Egyptian　or　Indian　elements：　its　importance　lies　in　the　accuracy　with　which　it　represents　the　Greek　spirit。　　For　twenty…five　centuries　it　has　been　the　〃credo〃　of　the　profession；　and　in　many　universities　it　is　still　the　formula　with　which　men　are　admitted　to　the　doctorate。

＇21＇　Oxford。　　Clarendon　Press；　2d　ed。；　1911。

＇22＇　Gomperz：　　Greek　Thinkers；　Vol。　I；　p。　281。


I　swear　by　Apollo　the　physician　and　AEsculapius　and　Health　（Hygieia）　and　All…Heal　（Panacea）　and　all　the　gods　and　goddesses；　that；　according　to　my　ability　and　judgment；　I　will　keep　this　oath　and　this　stipulationto　reckon　him　who　taught　me　this　art　equally　dear　to　me　as　my　parents；　to　share　my　substance　with　him；　and　relieve　his　necessities　if　required；　to　look　upon　his　offspring　in　the　same　footing　as　my　own　brothers；　and　to　teach　them　this　art；if　they　shall　wish　to　learn　it；　without　fee　or　stipulation；　and　that　by　precept；lecture；　and　every　other　mode　of　instruction；　I　will　impart　a　knowledge　of　my　art　to　my　own　sons；　and　those　of　my　teachers；　and　to　disciples　bound　by　a　stipulation　and　oath　according　to　the　law　of　medicine；　but　to　none　others。　I　will　follow　that　system　of　regimen　which；　according　to　my　ability　and　judgement；I　consider　for　the　benefit　of　my　patients；　and　abstain　from　whatever　is　deleterious　and　mischievous。

I　will　give　no　deadly　medicine　to　anyone　if　asked；　nor　suggest　any　such　counsel；　and　in　like　manner　I　will　not　give　to　a　woman　a　pessary　to　produce　abortion。

With　purity　and　with　holiness　I　will　pass　my　life　and　practice　my　art。

＇I　will　not　cut　persons　labouring　under　the　stone；　but　will　leave　this　to　be　done　by　men　who　are　practitioners　of　this　work。＇

Into　whatsoever　houses　I　enter；　I　will　go　into　them　for　the　benefit　of　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：〃。　。　。　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　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　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　introduce