the evolution of modern medicine-第17章
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jority of investigators and practitioners should have fallen under the spell of this consummation of formalism and should have regarded the 'Canon' as an infallible oracle； the more so in that the logical construction was impeccable and the premises； in the light of contemporary conceptions； passed for incontrovertible axioms？〃＇13＇
＇12＇ Withington： Medical History； London； 1894； pp。 151…152。
＇13＇ Neuburger： History of Medicine； Vol。 I； pp。 368…369。
Innumerable manuscripts of it exist： of one of the most beautiful； a Hebrew version （Bologna Library）； I give an illustration。 A Latin version was printed in 1472 and there are many later editions； the last in 1663。 Avicenna was not only a successful writer； but the prototype of the successful physician who was at the same time statesman； teacher； philosopher and literary man。 Rumor has it that he became dissipated； and a contemporary saying was that all his philosophy could not make him moral； nor all his physic teach him to preserve his health。 He enjoyed a great reputation as a poet。 I reproduce a page of a manuscript of one of his poems； which we have in the Bodleian Library。 Prof。 A。V。W。 Jackson says that some of his verse is peculiarly Khayyamesque； though he antedated Omar by a century。 That 〃large Infidel〃 might well have written such a stanza as
From Earth's dark centre unto Saturn's Gate I've solved all problems of this world's Estate； From every snare of Plot and Guile set free； Each bond resolved； saving alone Death's Fate。
His hymn to the Deity might have been written by Plato and rivals the famous one of Cleanthes。＇14＇ A casual reader gets a very favorable impression of Avicenna。 The story of his dominion over the schools in the Middle Ages is one of the most striking in our history。 Perhaps we feel that Leclerc exaggerates when he says： 〃Avicenna is an intellectual phenomenon。 Never perhaps has an example been seen of so precocious； quick and wide an intellect extending and asserting itself with so strange and indefatigable an activity。〃 The touch of the man never reached me until I read some of his mystical and philosophical writings translated by Mehren。＇15＇ It is Plato over again。 The beautiful allegory in which men are likened to birds snared and caged until set free by the Angel of Death might be met with anywhere in the immortal Dialogues。 The tractate on Love is a commentary on the Symposium； and the essay on Destiny is Greek in spirit without a trace of Oriental fatalism； as you may judge from the concluding sentence； which I leave you as his special message： 〃Take heed to the limits of your capacity and you will arrive at a knowledge of the truth！ How true is the saying：Work ever and to each will come that measure of success for which Nature has designed him。〃 Avicenna died in his fifty…eighth year。 When he saw that physic was of no avail； resigning himself to the inevitable； he sold his goods； distributed the money to the poor； read the Koran through once every three days； and died in the holy month of Ramadan。 His tomb at Hamadan； the ancient Ecbatana； still exists； a simple brickwork building； rectangular in shape； and surrounded by an unpretentious court。 It was restored in 1877； but is again in need of repair。 The illustration here shown is from a photograph sent by Dr。 Neligan of Teheran。 Though dead； the great Persian has still a large practice； as his tomb is much visited by pilgrims； among whom cures are said to be not uncommon。
＇14＇ 〃L'hymne d'Avicenne〃 in： L'Elegie du Tograi； etc。； par P。 Vattier； Paris； 1660。
＇15＇ Traites mystiques d'Abou Ali al…Hosain b。 Abdallah b。 Sina ou d'Avicenne par M。 A。 F。 Mehren； Leyden； E。 J。 Brill； Fasc。 I…IV； 1889…1899。
The Western Caliphate produced physicians and philosophers almost as brilliant as those of the East。 Remarkable schools of medicine were founded at Seville； Toledo and Cordova。 The most famous of the professors were Averroes； Albucasis and Avenzoar。 Albucasis was 〃the Arabian restorer of surgery。〃 Averroes； called in the Middle Ages 〃the Soul of Aristotle〃 or 〃the Commentator；〃 is better known today among philosophers than physicians。 On the revival of Moslem orthodoxy he fell upon evil days； was persecuted as a free…thinker； and the saying is attributed to him〃Sit anima mea cum philosophic。〃
Arabian medicine had certain very definite characteristics： the basis was Greek； derived from translations of the works of Hippocrates and Galen。 No contributions were made to anatomy； as dissections were prohibited； nor to physiology； and the pathology was practically that of Galen。 Certain new and important diseases were described； a number of new and active remedies were introduced； chiefly from the vegetable kingdom。 The Arabian hospitals were well organized and were deservedly famous。 No such hospital exists today in Cairo as that which was built by al…Mansur Gilafun in 1283。 The description of it by Makrizi； quoted by Neuburger；＇16＇ reads like that of a twentieth century institution with hospital units。
＇16＇ 〃I have founded this institution for my equals and for those beneath me； it is intended for rulers and subjects； for soldiers and for the emir； for great and small； freemen and slaves； men and women。〃 〃He ordered medicaments； physicians and everything else that could be required by anyone in any form of sickness； placed male and female attendants at the disposal of the patients； determined their pay； provided beds for patients and supplied them with every kind of covering that could be required in any complaint。 Every class of patient was accorded separate accommodation： the four halls of the hospital were set apart for those with fever and similar complaints； one part of the building was reserved for eye…patients； one for the wounded； one for those suffering from diarrhoea； one for women； a room for convalescents was divided into two parts； one for men and one for women。 Water was laid on to all these departments。 One room was set apart for cooking food； preparing medicine and cooking syrups； another for the compounding of confections； balsams； eye…salves； etc。 The head…physician had an apartment to himself wherein he delivered medical lectures。 The number of patients was unlimited； every sick or poor person who came found admittance； nor was the duration of his stay restricted； and even those who were sick at home were supplied with every necessity。〃Makrizi。
〃In later times this hospital was much extended and improved。 The nursing was admirable and no stint was made of drugs and appliances； each patient was provided with means upon leaving so that he should not require immediately to undertake heavy work。〃 Neuburger： History of Medicine； Vol。 1； p。 378。
It was in the domain of chemistry that the Arabs made the greatest advances。 You may remember that； in Egypt； chemistry had already made considerable strides； and I alluded to Prof。 Elliot Smith's view that one of the great leaps in civilization was the discovery in the Nile Valley of the metallurgy of copper。 In the brilliant period of the Ptolemies； both chemistry and pharmacology were studied； and it seems not improbable that； when the Arabs took Alexandria in the year 640； there were still many workers in these subjects。
The most famous of those early Arabic writers is the somewhat mythical Geber； who lived in the first half of the eighth century； and whose writings had an extraordinary influence throughout the Middle Ages。 The whole story of Geber is discussed by Berthelot in his 〃La chimie au moyen age〃 （Paris； 1896）。 The transmission of Arabian science to the Occident began with the Crusades； though earlier a filtering of important knowledge in mathematics and astronomy had reached Southern and Middle Europe through Spain。 Among the translators several names stand out prominently。 Gerbert； who became later Pope Sylvester II； is said to have given us our present Arabic figures。 You may read the story of his remarkable life in Taylor；＇17＇ who says he was 〃the first mind of his time； its greatest teacher； its most eager learner； and most universal scholar。〃 But he does not seem to have done much directly for medicine。
＇17＇ The Mediaeval Mind； Vol。 I； p。 280。
The Graeco…Arabic learning passed into Europe through two sources。 As I have already mentioned； Constantinus Africanus； a North African Christian monk； widely travelled and learned in languages； came to Salernum and translated many works from Arabic into Latin； particularly those of Hippocrates and Galen。 The 〃Pantegni〃 of the latter became one of the most popular text…books of the Middle Ages。 A long list of other works which he translated is given by Steinschneider。＇17a＇ It is not unlikely that Arabic medicine had already found its way to Salernum before the time of Constantine； but the influence of his translations upon the later Middle Ages was very great。
＇17a＇ Steinschneider： Virchow's Arch。； Berl。； 1867； xxxvii； 351。
The second was a more important source through the Latin translators in Spain； particularly in Toledo； where； from the middle of the twelfth till the middle of the thirteenth century； an extraordinary number of Arabic works in philosophy； mathematics and astronomy were translated。 Among the translators； Gerard of Cremona is prominent； and has been called the 〃Father of Translators。〃 He was one of the brightest intelligences of the Middle Ages； and did a work of the first importance to science； through the extraordinary variety of material he put in circulation。 Translations； not only of the medical writers； but of an indiscriminate crowd of authors in philosophy and general literature； came from his pen。 He furnished one of the first translations of the famous 〃Almagest〃 of Ptolemy； which opened the eyes of his contemporaries to the value of the Alexandrian astronomy。＇18＇ Leclerc gives a list of seventy…one works from his hand。
＇18＇ For an account of that remarkable work see German translation by Manitius； Leipzig； 1912。
Many of the translators of the period were Jews； and many of the works were translated from Hebrew into Latin。 For years Arabic had been the learned language of the Jews； and in a large measure it was through them that the Arabic knowledge and the translations passed into South and Central Europe。
The Arab writer whose influence on mediaeval thought was the most profound was Averroes； the great commentator on Aristotle。
THE RISE OF THE UNIVERSITIES
THE most striking intellectual phenomenon of the thirteenth century is the rise of the universities。 The story of their foundation is fully stated in Rashdall's great work （Universities of Europe in the Middle Ages； Oxford； 1895）。 Monastic and collegiate schools； seats of learning like Salernum； student guilds as at Bologna； had tried to meet the educational needs of the age。 The word 〃university〃 literally means an association； and was not at first restricted to learned bodies。 The origin appears to have been in certain guilds of students formed for mutual protection associated at some place specially favorable for studythe attraction generally being a famous teacher。 The University of Bologna grew up about guilds formed by students of law； and at Paris； early in the twelfth century； there were communities of teachers；
