the evolution of modern medicine-第2章
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ime which modern studies demand for his life on the earth。 For two millions （some hold even three millions） of years man lived and moved and had his being in a world very different from that upon which we look out。 There appear； indeed； to have been various types of man； some as different from us as we are from the anthropoid apes。 What upstarts of yesterday are the Pharaohs in comparison with the men who survived the tragedy of the glacial period！ The ancient history of manonly now beginning to be studied dates from the Pliocene or Miocene period； the modern history； as we know it； embraces that brief space of time that has elapsed since the earliest Egyptian and Babylonian records were made。 This has to be borne in mind in connection with the present mental status of man； particularly in his outlook upon nature。 In his thoughts and in his attributes； mankind at large is controlled by inherited beliefs and impulses； which countless thousands of years have ingrained like instinct。 Over vast regions of the earth today； magic； amulets； charms； incantations are the chief weapons of defense against a malignant nature； and in disease； the practice of Asa＇*＇ is comparatively novel and unusual； in days of illness many millions more still seek their gods rather than the physicians。 In an upward path man has had to work out for himself a relationship with his fellows and with nature。 He sought in the supernatural an explanation of the pressing phenomena of life； peopling the world with spiritual beings； deifying objects of nature； and assigning to them benign or malign influences； which might be invoked or propitiated。 Primitive priest； physician and philosopher were one； and struggled； on the one hand； for the recognition of certain practices forced on him by experience； and on the other； for the recognition of mystical agencies which control the dark； 〃uncharted region〃 about himto use Prof。 Gilbert Murray's phrase and were responsible for everything he could not understand； and particularly for the mysteries of disease。 Pliny remarks that physic 〃was early fathered upon the gods〃； and to the ordinary non…medical mind； there is still something mysterious about sickness； something outside the ordinary standard。
＇*＇ II Chronicles xvi； 12。
Modern anthropologists claim that both religion and medicine took origin in magic； 〃that spiritual protoplasm；〃 as Miss Jane Harrison calls it。 To primitive man； magic was the setting in motion of a spiritual power to help or to hurt the individual； and early forms may still be studied in the native races。 This power； or 〃mana；〃 as it is called； while possessed in a certain degree by all； may be increased by practice。 Certain individuals come to possess it very strongly： among native Australians today it is still deliberately cultivated。 Magic in healing seeks to control the demons； or forces； causing disease； and in a way it may be thus regarded as a 〃lineal ancestor of modern science〃 （Whetham）； which； too； seeks to control certain forces； no longer； however； regarded as supernatural。
Primitive man recognized many of these superhuman agencies relating to disease； such as the spirits of the dead； either human or animal； independent disease demons； or individuals who might act by controlling the spirits or agencies of disease。 We see this today among the negroes of the Southern States。 A Hoodoo put upon a negro may； if he knows of it； work upon him so powerfully through the imagination that he becomes very ill indeed； and only through a more powerful magic exercised by someone else can the Hoodoo be taken off。
To primitive man life seemed 〃full of sacred presences〃 （Walter Pater） connected with objects in nature； or with incidents and epochs in life； which he began early to deify； so that； until a quite recent period； his story is largely associated with a pantheon of greater and lesser gods； which he has manufactured wholesale。 Xenophanes was the earliest philosopher to recognize man's practice of making gods in his own image and endowing them with human faculties and attributes； the Thracians； he said； made their gods blue…eyed and red…haired； the Ethiopians； snub…nosed and black； while； if oxen and lions and horses had hands and could draw； they would represent their gods as oxen and lions and horses。 In relation to nature and to disease； all through early history we find a pantheon full to repletion； bearing testimony no less to the fertility of man's imagination than to the hopes and fears which led him； in his exodus from barbarism； to regard his gods as 〃pillars of fire by night； and pillars of cloud by day。〃
Even so late a religion as that of Numa was full of little gods to be invoked on special occasionsVatican； who causes the infant to utter his first cry； Fabulinus； who prompts his first word； Cuba； who keeps him quiet in his cot； Domiduca； who watches over one's safe home…coming （Walter Pater）； and Numa believed that all diseases came from the gods and were to be averted by prayer and sacrifice。 Besides the major gods； representatives of Apollo； AEsculapius and Minerva； there were scores of lesser ones who could be invoked for special diseases。 It is said that the young Roman mother might appeal to no less than fourteen goddesses； from Juno Lucina to Prosa and Portvorta （Withington）。 Temples were erected to the Goddess of Fever； and she was much invoked。 There is extant a touching tablet erected by a mourning mother and inscribed：
Febri divae； Febri Sancte； Febri magnae Camillo amato pro Filio meld effecto。 Posuit。
It is marvellous what a long line of superhuman powers； major and minor； man has invoked against sickness。 In Swinburne's words：
God by God flits past in thunder till his glories turn to shades； God by God bears wondering witness how his Gospel flames and fades； More was each of these； while yet they were； than man their servant seemed； Dead are all of these； and man survives who made them while he dreamed。
Most of them have been benign and helpful gods。 Into the dark chapters relating to demonical possession and to witchcraft we cannot here enter。 They make one cry out with Lucretius （Bk。 V）：
O genus infelix humanum； talia divis Cum tribuit facta atque iras adjunxit acerbas！ Quantos tum gemitus ipsi sibi； quantaque nobis Vulnera； quas lacrimas peperere minoribu' nostris。
In every age； and in every religion there has been justification for his bitter words； 〃tantum religio potuit suadere malorum〃〃Such wrongs Religion in her train doth bring〃yet； one outcome of 〃a belief in spiritual beings〃as Tylor defines religion has been that man has built an altar of righteousness in his heart。 The comparative method applied to the study of his religious growth has shown how man's thoughts have widened in the unceasing purpose which runs through his spiritual no less than his physical evolution。 Out of the spiritual protoplasm of magic have evolved philosopher and physician； as well as priest。 Magic and religion control the uncharted spherethe supernatural； the superhuman： science seeks to know the world； and through knowing； to control it。 Ray Lankester remarks that Man is Nature's rebel； and goes on to say： 〃The mental qualities which have developed in Man； though traceable in a vague and rudimentary condition in some of his animal associates； are of such an unprecedented power and so far dominate everything else in his activities as a living organism； that they have to a very large extent； if not entirely； cut him off from the general operation of that process of Natural Selection and survival of the fittest which up to their appearance had been the law of the living world。 They justify the view that Man forms a new departure in the gradual unfolding of Nature's predestined scheme。 Knowledge； reason； self…consciousness； will； are the attributes of Man。〃＇1＇ It has been a slow and gradual growth； and not until within the past century has science organized knowledge so searched out the secrets of Nature； as to control her powers； limit her scope and transform her energies。 The victory is so recent that the mental attitude of the race is not yet adapted to the change。 A large proportion of our fellow creatures still regard nature as a playground for demons and spirits to be exorcised or invoked。
＇1＇ Sir E。 Ray Lankester： Romanes Lecture； 〃Nature and Man；〃 Oxford Univ。 Press； 1905； p。 21。
Side by side； as substance and shadow〃in the dark backward and abysm of time；〃 in the dawn of the great civilizations of Egypt and Babylon； in the bright morning of Greece； and in the full noontide of modern life； together have grown up these two diametrically opposite views of man's relation to nature； and more particularly of his personal relation to the agencies of disease。
The purpose of this course of lectures is to sketch the main features of the growth of these two dominant ideas； to show how they have influenced man at the different periods of his evolution； how the lamp of reason； so early lighted in his soul； burning now bright； now dim； has never； even in his darkest period； been wholly extinguished； but retrimmed and refurnished by his indomitable energies； now shines more and more towards the perfect day。 It is a glorious chapter in history； in which those who have eyes to see may read the fulfilment of the promise of Eden； that one day man should not only possess the earth； but that he should have dominion over it！ I propose to take an aeroplane flight through the centuries； touching only on the tall peaks from which may be had a panoramic view of the epochs through which we pass。
ORIGIN OF MEDICINE
MEDICINE arose out of the primal sympathy of man with man； out of the desire to help those in sorrow； need and sickness。
In the primal sympathy Which having been must ever be； In the soothing thoughts that spring Out of human suffering。
The instinct of self…preservation； the longing to relieve a loved one； and above all； the maternal passionfor such it isgradually softened the hard race of mantum genus humanum primum mollescere coepit。 In his marvellous sketch of the evolution of man； nothing illustrates more forcibly the prescience of Lucretius than the picture of the growth of sympathy： 〃When with cries and gestures they taught with broken words that 'tis right for all men to have pity on the weak。〃 I heard the well…known medical historian； the late Dr。 Payne； remark that 〃the basis of medicine is sympathy and the desire to help others； and whatever is done with this end must be called medicine。〃
The first lessons came to primitive man by injuries； accidents； bites of beasts and serpents； perhaps for long ages not appreciated by his childlike mind； but； little by little； such experiences crystallized into useful knowledge。 The experiments of nature made clear to him the relation of cause and effect； but it is not likely； as Pliny suggests； that he picked up his earliest knowledge from the observation of certain practices in animals； as the natural phlebotomy of the plethoric hippopotamus； or the use of emetics from the dog； or the use of enemata from the ibis。 On the other hand； Celsus is probably right in his account of the origin of rational medicine。 〃Some of the sick on account of their eagerness took food on the first day； some on
