the evolution of modern medicine-第15章

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rent　is　it　where　the　desolation　has　overtaken　a　brilliant　and　flourishing　product　of　man's　head　and　hand。　To　know　that

　　　　　　　　　　。　。　。　the　Lion　and　the　Lizard　keep　　The　Courts　where　Jamshyd　gloried　and　drank　deep

sends　a　chill　to　the　heart；　and　one　trembles　with　a　sense　of　human　instability。　　With　this　feeling　we　enter　the　Middle　Ages。　Following　the　glory　that　was　Greece　and　the　grandeur　that　was　Rome；　a　desolation　came　upon　the　civilized　world；　in　which　the　light　of　learning　burned　low；　flickering　almost　to　extinction。　How　came　it　possible　that　the　gifts　of　Athens　and　of　Alexandria　were　deliberately　thrown　away？　　For　three　causes。　The　barbarians　shattered　the　Roman　Empire　to　its　foundations。　When　Alaric　entered　Rome　in　410　A。　D。；　ghastly　was　the　impression　made　on　the　contemporaries；　the　Roman　world　shuddered　in　a　titanic　spasm　（Lindner）。　The　land　was　a　garden　of　Eden　before　them；　behind　a　howling　wilderness；　as　is　so　graphically　told　in　Gibbon's　great　history。　Many　of　the　most　important　centres　of　learning　were　destroyed；　and　for　centuries　Minerva　and　Apollo　forsook　the　haunts　of　men。　The　other　equally　important　cause　was　the　change　wrought　by　Christianity。　　The　brotherhood　of　man；　the　care　of　the　body；　the　gospel　of　practical　virtues　formed　the　essence　of　the　teaching　of　the　Founderin　these　the　Kingdom　of　Heaven　was　to　be　sought；　in　these　lay　salvation。　　But　the　world　was　very　evil；　all　thought　that　the　times　were　waxing　late；　and　into　men's　minds　entered　as　never　before　a　conviction　of　the　importance　of　the　four　last　thingsdeath；　judgment；　heaven　and　hell。　One　obstacle　alone　stood　between　man　and　his　redemption；　the　vile　body；　〃this　muddy　vesture　of　decay；〃　that　so　grossly　wrapped　his　soul。　　To　find　methods　of　bringing　it　into　subjection　was　the　task　of　the　Christian　Church　for　centuries。　In　the　Vatican　Gallery　of　Inscriptions　is　a　stone　slab　with　the　single　word　〃Stercoriae；〃　and　below；　the　Christian　symbol。　It　might　serve　as　a　motto　for　the　Middle　Ages；　during　which；　to　quote　St。　Paul；　all　things　were　〃counted　dung　but　to　win　Christ。〃　　In　this　attitude　of　mind　the　wisdom　of　the　Greeks　was　not　simply　foolishness；　but　a　stumbling…block　in　the　path。　Knowledge　other　than　that　which　made　a　man　〃wise　unto　salvation〃　was　useless。　　All　that　was　necessary　was　contained　in　the　Bible　or　taught　by　the　Church。　　This　simple　creed　brought　consolation　to　thousands　and　illumined　the　lives　of　some　of　the　noblest　of　men。　But；　〃in　seeking　a　heavenly　home　man　lost　his　bearings　upon　earth。〃　Let　me　commend　for　your　reading　Taylor's　〃Mediaeval　Mind。〃＇1＇　I　cannot　judge　of　its　scholarship；　which　I　am　told　by　scholars　is　ripe　and　good；　but　I　can　judge　of　its　usefulness　for　anyone　who　wishes　to　know　the　story　of　the　mind　of　man　in　Europe　at　this　period。　Into　the　content　of　mediaeval　thought　only　a　mystic　can　enter　with　full　sympathy。　　It　was　a　needful　change　in　the　evolution　of　the　race。　Christianity　brought　new　ideals　and　new　motives　into　the　lives　of　men。　The　world's　desire　was　changed；　a　desire　for　the　Kingdom　of　Heaven；　in　the　search　for　which　the　lust　of　the　flesh；　the　lust　of　the　eye　and　the　pride　of　life　were　as　dross。　　A　master…motive　swayed　the　minds　of　sinful　men　and　a　zeal　to　save　other　souls　occupied　the　moments　not　devoted　to　the　perfection　of　their　own。　The　new　dispensation　made　any　other　superfluous。　　As　Tertullian　said：　Investigation　since　the　Gospel　is　no　longer　necessary。　（Dannemann；　Die　Naturw。；　I；　p。　214。）　The　attitude　of　the　early　Fathers　toward　the　body　is　well　expressed　by　Jerome。　　〃Does　your　skin　roughen　without　baths？　　Who　is　once　washed　in　the　blood　of　Christ　needs　not　wash　again。〃　　In　this　unfavorable　medium　for　its　growth；　science　was　simply　disregarded；　not　in　any　hostile　spirit；　but　as　unnecessary。＇2＇　And　a　third　contributing　factor　was　the　plague　of　the　sixth　century；　which　desolated　the　whole　Roman　world。　On　the　top　of　the　grand　mausoleum　of　Hadrian；　visitors　at　Rome　see　the　figure　of　a　gilded　angel　with　a　drawn　sword；　from　which　the　present　name　of　the　Castle　of　St。　Angelo　takes　its　origin。　On　the　twenty…fifth　of　April；　590；　there　set　out　from　the　Church　of　SS。　Cosmas　and　Damian；　already　the　Roman　patron　saints　of　medicine；　a　vast　procession；　led　by　St。　Gregory　the　Great；　chanting　a　seven…fold　litany　of　intercession　against　the　plague。　The　legend　relates　that　Gregory　saw　on　the　top　of　Hadrian's　tomb　an　angel　with　a　drawn　sword；　which　he　sheathed　as　the　plague　abated。

＇1＇　H。　O。　Taylor：　　The　Mediaeval　Mind；　2　vols。；　Macmillan　Co。；　New　York；　1911。　　＇New　edition；　1920。＇

＇2＇　Ibid。；　Vol。　1；　p。　13：　〃Under　their　action　＇the　Christian　Fathers＇　the　peoples　of　Western　Europe；　from　the　eighth　to　the　thirteenth　century；　passed　through　a　homogeneous　growth；　and　evolved　a　spirit　different　from　that　of　any　other　period　of　historya　spirit　which　stood　in　awe　before　its　monitors　divine　and　human；　and　deemed　that　knowledge　was　to　be　drawn　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　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　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　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　follo