Albert H. Buck

“ He who doth, with the greatest exactness imaginable, weigh every individual thing that shall happen or hath happened [442] to his patient and may be known from the observations of his own or of others, and who afterward compareth all these with one another, and puts them in an opposite view to such things as happen in an healthy state; and lastly, from all this, with the nicest and severest bridle upon his reasoning faculty, riseth to the knowledge of the very first cause of the disease, and of the remedies fit to remove them; he, and only he, deserveth the name of a true physician. ”

“ But the mere fact that one must give some thought to questions of this nature and must exercise prudence does not justify the immediate rejection of a method of treatment like that of venesection. For is it not the very essence of our art, not merely to consider the factors of age and the pregnant state, but also to form an estimate of that other and more important factor, viz., the patient’s strength,—be that patient an infant, an aged person, or a woman advanced in pregnancy,—and then to decide whether it is, or is not, great enough to bear the loss of blood? ”

“ As I devoted myself with all possible zeal to the work in hand it was not long before I realized thoroughly that the best way of increasing one’s knowledge of medicine is to begin applying, in actual practice, such principles as one may already have acquired; and thus I became convinced that the physician [421] who earnestly studies, with his own eyes,—and not through the medium of books,—the natural phenomena of the different diseases, must necessarily excel in the art of discovering what, in any given case, are the true indications as to the remedial measures that should be employed. ”

“ GENERAL REMARKS ON THE DEVELOPMENT OF SURGERY IN EUROPE DURING THE FIFTEENTH AND SIXTEENTH CENTURIES
In the early period of the Renaissance surgery was apparently the first of the practical branches of medicine to spring forward into active life. Anatomy,—that is, human anatomy,—the foundation that is absolutely necessary to the solid growth of surgery, scarcely existed before the beginning of the sixteenth century; and it is therefore not surprising that the records of the past reveal to us so very few instances of men who attained any eminence as surgeons. ”

“ During thousands of years China has suffered severely from the blighting tyranny of superstition, priestcraft and selfish bureaucracy, and, now that the sunlight of truth and genuine liberty is beginning to search every nook and cranny of that great country, we who have had the advantage of this beneficent influence for so many scores of years truly rejoice over the change that is taking place in China. ”

“ It is plain, therefore, that a history of the primitive period of medicine, if written to-day, may have to be modified to-morrow in some important respects. On the other hand, the facts relating to the later periods are now so well established that a fair-minded writer should experience no serious difficulty in judging correctly with regard to their value and with regard to the claims of the different men to be honored for the part which each has played in bringing the science and art of medicine to their present high state of completeness and efficiency. ”

“ If Galen had been a simple physician, one of the great body of medical practitioners in Rome, no one would be disposed to question the justice of the criticism which the distinguished Viennese historian makes of his decision to abandon that city at the moment of her distress and peril. But, as a matter of fact, Galen was not a practitioner of medicine in the full sense of that term. He treated cases of illness because in no other way would it be possible for him to acquire the necessary familiarity with disease ”

“ EARLY EVIDENCES OF THE INFLUENCE OF THE RENAISSANCE UPON THE PROGRESS OF MEDICINE IN WESTERN EUROPE
In previous chapters we have seen how the Arabs, inspired with an extraordinary zeal for acquiring knowledge of the different sciences, devoted time and money freely, throughout a period of several centuries, to the accomplishment of this purpose. They were fired with ambition to become a great nation, and their studies of the world’s history taught them that the ancient Greeks had accumulated in their literature vast stores of the very knowledge which they were so anxious to acquire. ”

“ My professional brethren must not expect to find any new and startling facts [Paré is speaking here of his treatise on surgery] , but simply here and there some little addition to our previous stock of knowledge; for the good Guy de Chauliac has taught us that we are like the child who sits astride the giant’s neck; that is, we can see all that he sees and just a little more—or, in other words, we are able, through the aid afforded by the writings of our predecessors, to learn all that they have learned, and may at the same time acquire a little further knowledge through our own observations. ”

“ He maintained that he was both a physician and an astrologer, and claimed that he could restore the dead to life, and could predict future events from a mere inspection of fire, air and water.”
But although the persistent and wonderfully energetic activities of the alchemists failed to find the philosophers’ stone, or to transmute the baser metals into silver and gold, they placed in the hands of man the key to a knowledge of chemistry, that branch of science which was destined in later years to play such an important part in pharmacy, in agriculture and in other industries. ”

“ So great, as they believed, was his power over disease, so wonderful were the cures which he accomplished, and so noble and pure was his character, that they made him a god and erected temples in his honor—not mere places where a barren worship might be carried on, but veritable sanatoria—termed Asclepieia—where the extraordinary healing powers of him whom they had made a god might be perpetuated for the benefit of succeeding [51] generations. ”

“ Although it is true that certain important anatomical and physiological facts are found recorded for the first time in the works of Galen, this must not be accepted as evidence that Galen himself is the real discoverer of these facts. The most that can be claimed for him is that he is the first writer to bring the facts in question to the knowledge of us moderns. When the ancient books that have been lost are once more brought to light, as they very well may be at any time, we shall be able, perhaps, to give credit where credit is due. ”

“ Could a man who had no knowledge of Harvey’s discovery, who did not possess a microscope, and who at the same time believed—as did all the ancients—that air circulated in the arteries and blood in the veins, come any nearer to the actual truth than did Asclepiades? ”

“ I have founded this institution for people of my own class and for those who occupy an humbler station in life—for the king and for the servant, for the common soldier and for the Emir, for the rich man and for the poor, for the freeman and for the slave, for men and also for women. ”

“ So far as is now known, he wrote very little concerning medicine, and—strange to say—he seems to have attached considerable importance to astrology; indeed, he went so far as to blame the physicians of his day for their ignorance regarding this science, “as a result of which they neglect the best part of medicine.” In strange contrast with these views, which to-day we characterize as foolishness, is Bacon’s famous dictum: “Experiment is a firmer and more trustworthy basis of knowledge than argument”—a maxim which is the guiding principle of modern medicine. ”

“ Despite the great care which Harvey took to back up his scheme of the circulation of the blood with unimpeachable proofs of its correctness, he was obliged to pass through the same sort of experience as that to which Vesalius and scores of other pioneers in the field of scientific inquiry had been subjected. Two hostile forces stood constantly ready, during that fruitful period of the Renaissance, to attack with merciless bitterness all those who ventured to add new facts to our stock of knowledge in the domain of medicine. ”

“ So far as power and discernment shall be mine, I will carry out regimen for the benefit of the sick and will keep them from harm and wrong. To none will I give a deadly drug even if solicited, nor offer counsel to such an end; likewise to no woman will I give a destructive suppository; but guiltless and hallowed will I keep my life and mine art. I will cut no one whatever for the stone, but will give way to those who work at this practice. ”

“ The physician should be the handy man of Nature, and he should strive to aid and to imitate her efforts to effect a cure. His first care should be to remove, so far as is possible, the causes of the disease; and then, in the conduct of the treatment, he should keep in view at all times the special circumstances of the case, giving closer attention to the patient than to the disease itself. In short, he should aim at being useful, or at least he should be careful not to do any harm. ”

“ He wrote that at birth the human soul is like a clean sheet of paper upon which all the objects perceived by the senses are recorded as experiences, and there they remain until by the aid of reflexion—i.e., by the aid of the understanding, which Locke calls the inner sense—they are combined into conceptions or ideas. Locke, it should be remembered, was educated as a physician, but he never took his degree, nor did he ever practice medicine. ”

“ Those who were opposed to such examinations upon human beings expressed their disapproval in [108] the following terms: “This practice is not only cruel, but useless, and at the same time it derogates from the dignity of the healing art, which is intended to be a blessing and not a source of pain to man; for those in whom the abdominal cavity is first opened and then the diaphragm divided, die before it is possible to make the scientific examination ‘during life’ which constitutes, as it is claimed, the justification for the entire procedure.” ”

“ The ability to restore all his patients to health would of course be a greater power than that of correctly predicting the future behavior of a malady in any particular case. This ability, however, is clearly unattainable. One patient dies by reason of the severity of the disease itself, even before the physician is called in; a second one, shortly after the latter’s visit; and a third lingers on for a day or two after the doctor’s arrival, dying before the latter’s art has had time to produce a beneficial effect in hindering the advance of the malady. ”

“ There is nobody who has the power to loosen what I shall bind. I am the oldest daughter of Cronos, the youngest of the gods. I am the wife and at the same time the sister of King Osiris. To me is due the credit of having been the first to teach men agriculture. I am the mother of King Horus. I shine in the dog-star. It is I who built the city of Bubastis. Farewell, Egypt, my native land.
The discovery of the art of medicine, says Le Clerc, was attributed to Osiris and Isis, and they were also credited with having taught it to Aesculapius. ”

“ The guiding principle of these men was to study natural phenomena and to learn, if possible, their causes and the laws of their action. Physiology, therefore, became one of their special studies, and thus they contributed to the laying of one of the most important foundation-stones of medicine. Thanks to the good quality of the work of instruction that had thus far been carried on at Cos, Cnidus, and other Asclepieia, medicine had by this time reached a sufficient degree of development for its devotees to derive a full measure of benefit from the new teaching of the philosophers. ”

“ Certain Branches of Medical Work Begin to Assume more Distinctly the Character of Specialties.—At the time of Hippocrates there were no specialists, or at least none who received any sort of official recognition from the general body of physicians; and yet, there were, even then, a few practitioners who devoted themselves preferably to the treatment of certain maladies, like the affections of the eye and the teeth; and, beside these, there were undoubtedly, in the larger communities, men who were ready and competent to undertake the more serious surgical operations. ”

“ No better evidence of the true greatness of a man can be furnished than that which is afforded by the praise of his contemporaries in the same rank or walk of life; and when the appreciation comes from such men as Plato and Aristotle, it constitutes an absolute guarantee that it is well and honestly earned. To Hippocrates belongs the singular honor of having won unstinted praise from both of these great philosophers, Aristotle giving him the title of “Hippocrates the Great,” and Plato comparing him [83] to those famous sculptors, Polyclytus and Phidias. ”

“ The physicians, many of whom received their training in the best schools of Europe and the United States, are contributing to-day their full share toward advancing the science of medicine. That China is following in the footsteps of Japan is already plainly evident, and no intelligent observer entertains the slightest doubt of her ultimately—probably at no distant day—possessing a corps of medical men as well educated, as efficient in the treatment of disease, and as practical in public hygiene as their European and American confrères. ”

“ When we consider that these experiments are the first of their kind of which history makes mention, that they were carried out nearly seventeen hundred years ago, and that—so far as we know—they sprang entirely from the brain of the experimenter, we may well express unlimited admiration for Claudius Galen.
Daniel Le Clerc says that Galen’s principal treatise on human physiology, entitled “Utility of the Different Parts of the Human Body,” constitutes a chef-d’oeuvre which has challenged the admiration of physicians and philosophers in all ages. ”

“ One naturally hesitates about giving any measure of credit to a physician whose professional conduct, as revealed in his relations to Mauriceau’s patient, is clearly that of a charlatan. At the same time we are obliged to bear in mind that in 1670 it was still possible for a physician or surgeon to own a secret method of treatment and yet not forfeit all consideration on the part of his professional brethren. ”

“ Soranus was not only a great obstetrician,—admitted by all the authorities to have been the greatest in ancient times,—he was also in high repute for the work which he did in other departments of medicine—in gynaecology, for example, in the instruction of midwives, in the management of children’s diseases, in the diagnosis and treatment of both acute and chronic diseases, in surgery, etc. While in general he adhered to the fundamental teachings of the Methodists, he did not hesitate to depart from the beaten pathway of that sect in his explanations of certain pathological conditions ”

“ We do not, however, brand a general in the army a coward because he endeavors to protect himself as much as possible from danger during a battle, that he may be able, to the very end, to direct the soldiers under his command. Similarly, was not Galen justified in avoiding every risk which was likely to imperil the performance of duties which were of far greater value to medicine and to humanity at large than that of acting as a mere soldier in the ranks of medical men? ”

“ The following proverb, although it originated in India, is well worthy of acceptance in every part of the world: “When you are ill the physician will be to you a father; when you have recovered from your illness you will find him a friend; and when your health is fully re-established he will act as your protector.”
On a previous page the statement has been made that the science and art of medicine developed in ancient Greece quite independently of any influence that might have been exerted by the teachings of the physicians of India. ”

“ Many centuries had still to elapse before medicine could gain that freedom of action, that rich equipment of tools, and that stock of accumulated knowledge which enable her in these days to make such giant strides forward as we have witnessed during the past twenty or thirty years.
The question will naturally arise, How did the Methodists decide, in the presence of an actual case of illness, which one of these abnormal states (the laxum, the strictum, or the mixtum) was the condition that called for medical treatment? ”