the evolution of modern medicine-第9章

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er　of　Cyrus　and　wife　of　Darius；　of　a　severe　abscess　of　the　breast；　but　on　condition　that　she　help　him　to　escape；　and　she　induced　her　husband　to　send　an　expedition　of　exploration　to　Greece　under　the　guidance　of　Democedes；　but　with　the　instructions　at　all　costs　to　bring　back　the　much　prized　physician。　　From　Tarentum；　Democedes　escaped　to　his　native　city；　but　the　Persians　followed　him；　and　it　was　with　the　greatest　difficulty　that　he　escaped　from　their　hands。　Deprived　of　their　guide；　the　Persians　gave　up　the　expedition　and　sailed　for　Asia。　　In　palliation　of　his　flight；　Democedes　sent　a　message　to　Darius　that　he　was　engaged　to　the　daughter　of　Milo；　the　wrestler；　who　was　in　high　repute　with　the　King。＇6＇


＇6＇　The　well…known　editor　of　Herodotus；　R。　W。　Macan；　Master　of　University　College；　Oxford；　in　his　Hellenikon。　　A　Sheaf　of　Sonnets　after　Herodotus　（Oxford；　1898）　has　included　a　poem　which　may　be　quoted　in　connection　with　this　incident：

　NOSTALGY　　Atossa；　child　of　Cyrus　king　of　kings；　　healed　by　Greek　science　of　a　morbid　breast；　　gave　lord　Dareios　neither　love　nor　rest　　till　he　fulfilled　her　vain　imaginings。　　〃Sir；　show　our　Persian　folk　your　sceptre's　wings！　　Enlarge　my　sire's　and　brother's　large　bequest。　　This　learned　Greek　shall　guide　your　galleys　west；　　and　Dorian　slave…girls　grace　our　banquetings。〃　　So　said　she；　taught　of　that　o'er…artful　man；　　the　Italiote　captive；　Kroton's　Demokede；　　who　recked　not　what　of　maladies　began；　　nor　who　in　Asia　and　in　Greece　might　bleed；　　if　heso　writes　the　guileless　Thurian　　regained　his　home；　and　freedom　of　the　Mede。


Plato　has　several　references　to　these　state　physicians；　who　were　evidently　elected　by　a　public　assembly：　　〃When　the　assembly　meets　to　elect　a　physician；〃　and　the　office　was　yearly；　for　in　〃The　Statesman〃　we　find　the　following：＇7＇　〃When　the　year　of　office　has　expired；　the　pilot；　or　physician　has　to　come　before　a　court　of　review〃　to　answer　any　charges。　The　physician　must　have　been　in　practice　for　some　time　and　attained　eminence；　before　he　was　deemed　worthy　of　the　post　of　state　physician。

＇7＇　Jowett：　　Dialogues　of　Plato；　3d　ed。；　Statesman；　Vol。　IV；　p。　502　（Stephanus；　II；　298　E）


〃If　you　and　I　were　physicians；　and　were　advising　one　another　that　we　were　competent　to　practice　as　state…physicians；　should　I　not　ask　about　you；　and　would　you　not　ask　about　me；　Well；　but　how　about　Socrates　himself；　has　he　good　health？　and　was　anyone　else　ever　known　to　be　cured　by　him　whether　slave　or　freeman？〃＇7a＇

＇7a＇　Jowett：　　Dialogues　of　Plato；　3d　ed。；　Gorgias；　Vol。　II；　p。　407　（Stephanus；　I；　514　D）。


All　that　is　known　of　these　state　physicians　has　been　collected　by　Pohl；＇8＇　who　has　traced　their　evolution　into　Roman　times。　　That　they　were　secular；　independent　of　the　AEsculapian　temples；　that　they　were　well　paid；　that　there　was　keen　competition　to　get　the　most　distinguished　men；　that　they　were　paid　by　a　special　tax　and　that　they　were　much　esteemed　are　facts　to　be　gleaned　from　Herodotus　and　from　the　inscriptions。　The　lapidary　records；　extending　over　1000　years；　collected　by　Professor　Oehler＇8a＇　of　Reina；　throw　an　important　light　on　the　state　of　medicine　in　Greece　and　Rome。　　Greek　vases　give　representations　of　these　state　doctors　at　work。　Dr。　E。　Pottier　has　published　one　showing　the　treatment　of　a　patient　in　the　clinic。＇8b＇

＇8＇　R。　Pohl：　　De　Graecorum　medicis　publicis；　Berolini；　Reimer；　1905；　also　Janus；　Harlem；　1905；　X；　491…494。

＇8a＇　J　Oehler：　　Janus；　Harlem；　1909；　XIV；　4；　111。

＇8b＇　E。　Pottier：　　Une　clinique　grecque　au　Ve　siecle；　Monuments　et　Memoires；　XIII；　p。　149。　Paris；　1906　（Fondation　Eugene　Piot）。


That　dissections　were　practiced　by　this　group　of　nature　philosophers　is　shown　not　only　by　the　studies　of　Alcmaeon；　but　we　have　evidence　that　one　of　the　latest　of　them；　Diogenes　of　Apollonia；　must　have　made　elaborate　dissections。　In　the　〃Historia　Animalium〃＇9＇　of　Aristotle　occurs　his　account　of　the　blood　vessels；　which　is　by　far　the　most　elaborate　met　with　in　the　literature　until　the　writings　of　Galen。　　It　has；　too；　the　great　merit　of　accuracy　（if　we　bear　in　mind　the　fact　that　it　was　not　until　after　Aristotle　that　arteries　and　veins　were　differentiated）；　and　indications　are　given　as　to　the　vessels　from　which　blood　may　be　drawn。

＇9＇　The　Works　of　Aristotle；　Oxford；　Clarendon　Press；　Vol。　IV；　1910；　Bk。　III；　Chaps。　II…IV；　pp。　511b…515b。


ASKLEPIOS

No　god　made　with　hands；　to　use　the　scriptural　phrase；　had　a　more　successful　〃run〃　than　Asklepiosfor　more　than　a　thousand　years　the　consoler　and　healer　of　the　sons　of　men。　Shorn　of　his　divine　attributes　he　remains　our　patron　saint；　our　emblematic　God　of　Healing；　whose　figure　with　the　serpents　appears　in　our　seals　and　charters。　　He　was　originally　a　Thessalian　chieftain；　whose　sons；　Machaon　and　Podalirius；　became　famous　physicians　and　fought　in　the　Trojan　War。　　Nestor；　you　may　remember；　carried　off　the　former；　declaring；　in　the　oft…quoted　phrase；　that　a　doctor　was　better　worth　saving　than　many　warriors　unskilled　in　the　treatment　of　wounds。　　Later　genealogies　trace　his　origin　to　Apollo；＇10＇　as　whose　son　he　is　usually　regarded。　〃In　the　wake　of　northern　tribes　this　god　Aesculapiusa　more　majestic　figure　than　the　blameless　leech　of　Homer's　songcame　by　land　to　Epidaurus　and　was　carried　by　sea　to　the　east…ward　island　of　Cos。。。。　Aesculapius　grew　in　importance　with　the　growth　of　Greece；　but　may　not　have　attained　his　greatest　power　until　Greece　and　Rome　were　one。〃＇11＇

＇10＇　W。　H。　Roscher：　　Lexikon　der　griechischen　und　romischen　Mythologie；　Leipzig；　1886；　I；　p。　624。

＇11＇　Louis　Dyer：　　Studies　of　the　Gods　in　Greece；　1891；　p。　221。

A　word　on　the　idea　of　the　serpent　as　an　emblem　of　the　healing　art　which　goes　far　back　into　antiquity。　　The　mystical　character　of　the　snake；　and　the　natural　dread　and　awe　inspired　by　it；　early　made　it　a　symbol　of　supernatural　power。　There　is　a　libation　vase　of　Gudea；　c。　2350　B。C。；　found　at　Telloh；　now　in　the　Louvre　（probably　the　earliest　representation　of　the　symbol）；　with　two　serpents　entwined　round　a　staff　（Jastrow；　Pl。　4）。　From　the　earliest　times　the　snake　has　been　associated　with　mystic　and　magic　power；　and　even　today；　among　native　races；　it　plays　a　part　in　the　initiation　of　medicine　men。

In　Greece；　the　serpent　became　a　symbol　of　Apollo；　and　prophetic　serpents　were　kept　and　fed　at　his　shrine；　as　well　as　at　that　of　his　son；　Asklepios。　　There　was　an　idea；　too；　that　snakes　had　a　knowledge　of　herbs；　which　is　referred　to　in　the　famous　poem　of　Nikander　on　Theriaka。＇12＇　You　may　remember　that　when　Alexander；　the　famous　quack　and　oracle　monger；　depicted　by　Lucian；　started　out　〃for　revenue；〃　the　first　thing　he　did　was　to　provide　himself　with　two　of　the　large；　harmless；　yellow　snakes　of　Asia　Minor。

＇12＇　Lines　31；　etc。；　and　Scholia；　cf。　W。　R。　Halliday：　Greek　Divination；　London；　1913；　p。　88。


The　exact　date　of　the　introduction　of　the　cult　into　Greece　is　not　known；　but　its　great　centres　were　at　Epidaurus；　Cos；　Pergamos　and　Tricca。　　It　throve　with　wonderful　rapidity。　　Asklepios　became　one　of　the　most　popular　of　the　gods。　　By　the　time　of　Alexander　it　is　estimated　that　there　were　between　three　and　four　hundred　temples　dedicated　to　him。

His　worship　was　introduced　into　Rome　at　the　time　of　the　Great　Plague　at　the　beginning　of　the　third　century　B。C。　（as　told　by　Livy　in　Book　XI）；　and　the　temple　on　the　island　of　Tiber　became　a　famous　resort。　If　you　can　transfer　in　imagination　the　Hot　Springs　of　Virginia　to　the　neighborhood　of　Washington；　and　put　there　a　group　of　buildings　such　as　are　represented　in　these　outlines　of　Caton's＇13＇　（p。　52）；　add　a　sumptuous　theatre　with　seating　capacity　for　20；000；　a　stadium　600　feet　long　with　a　seating　capacity　of　12；000；　and　all　possible　accessories　of　art　and　science；　you　will　have　an　idea　of　what　the　temple　at　Epidaurus；　a　few　miles　from　Athens；　was。　　〃The　cult　flourished　mostly　in　places　which；　through　climatic　or　hygienic　advantages；　were　natural　health　resorts。　Those　favoured　spots　on　hill　or　mountain；　in　the　shelter　of　forests；　by　rivers　or　springs　of　pure　flowing　water；　were　conducive　to　health。　The　vivifying　air；　the　well　cultivated　gardens　surrounding　the　shrine；　the　magnificent　view；　all　tended　to　cheer　the　heart　with　new　hope　of　cure。　Many　of　these　temples　owed　their　fame　to　mineral　or　merely　hot　springs。　To　the　homely　altars；　erected　originally　by　sacred　fountains　in　the　neighbourhood　of　health…giving　mineral　springs；　were　later　added　magnificent　temples；　pleasure…grounds　for　festivals；　gymnasia　in　which　bodily　ailments　were　treated　by　physical　exercises；　baths　and　inunctions；　also；　as　is　proved　by　excavations；　living　rooms　for　the　patients。　Access　to　the　shrine　was　forbidden　to　the　unclean　and　the　impure；　pregnant　women　and　the　mortally　afflicted　were　kept　away；　no　dead　body　could　find　a　resting…place　within　the　holy　precincts；　the　shelter　and　the　cure　of　the　sick　being　undertaken　by　the　keepers　of　inns　and　boarding…houses　in　the　neighbourhood。　　The　suppliants　for　aid　had　to　submit　to　careful　purification；　to　bathe　in　sea；　river　or　spring；　to　fast　for　a　prescribed　time；　to　abjure　wine　and　certain　articles　of　diet；　and　they　were　only　permitted　to　enter　the　temple　when　they　were　adequately　prepared　by　cleansing；　inunction　and　fumigation。　This　lengthy　and　exhausting　preparation；　partly　dietetic；　partly　suggestive；　was　accompanied　by　a　solemn　service　of　prayer　and　sacrifice；　whose　symbolism　tended　highly　to　excite　the　imagination。〃＇14＇

＇13＇　Caton：　　Temples　and　Ritual　of　Asklepios；　2d　ed。；　London；　1900。

＇14＇　Max　Neuburger：　　History　of　Medicine；　English　translation；　Oxford；　1910；　p。　94。


The　temples　were　in　charge　of　members　of　the　guild　or　fraternity；　the　head　of　which　was　often；　though　not　necessarily；　a　physician。　The　Chief　was　appointed　annually。　　From　Caton's　excellent　sketch＇15＇　you　can　get　a　good　idea　of　the　ritual；　but　still　better　is　the　delightful　description　given　in　the　〃Plutus〃　of　Aristophanes。　　After　offering　honey…cakes　and　baked　meats　on　the　altar；　the　suppliants　arranged　themselves　on　the　pallets。

＇15＇　Caton：　　Temples　and　Ritual　of　Asklepios；　2d　ed。；　London；　1900。


　　　　　　　　　　Soon　the　Temple　servitor　Put　out　the　lights　and　bade　us　fall　asleep；　Nor　stir；　nor　speak；　whatever　noise　we　heard。　So　down　we　lay　in　orderly　repose。　And　I　could　catch　no　slumber；　not　one　wink；　Struck　by　a　nice　tureen　of　broth　which　stood　A　little　distance　from　an　old　wife's　head；　Whereto　I　marvellously　longed　to　creep。　Then；　glancing　upwards；　I　beheld　the　priest　Whipping　the　cheese…cakes　and　figs　from　off　The　holy　table；　thence　he　coasted　round　To　every　altar　spying　what　was　left。　And　everything　he　found　he　consecrated　Into　a　sort　of　sack＇16＇

a　procedure　which　reminds　one　of　the　story　of　〃Bel　and　the　Dragon。〃　　Then　the　god　came；　in　the　person　of　the　priest；　and　scanned　each　patient。　He　did　not　neglect　physical　measures；　as　he　brayed　in　a　mortar　cloves；　Tenian　garlic；　verjuice；　squills　and　Sphettian　vinegar；　with　which　he　made　application　to　the　eyes　of　the　patient。

＇16＇　Aristophanes：　　B。　B。　Roger's　translation；　London；　Bell　&　Sons；　1907；　Vol。　VI；　ll。　668；　etc。；　732　ff。


　　　　　　　　　　　　　　　Then　the　God　clucked；　And　out　there　issued　from　the　holy　shrine　Two　great；　enormous　serpents。。。。　And　underneath　the　scarlet　cloth　they　crept；　And　licked　his　eyelids；　as　it　seemed　to　me；　And；　mistress　dear；　be