History of medicine

“ The real history of medicine in the Middle Ages—that is, of scientific medicine—is eclipsed by the [Pg 22] story of popular medicine. So much has been said of the medical superstitions, many of which were rather striking, that comparatively little space has been left for the serious medical science and practice of the time, which contain many extremely interesting details. It is true that after the Crusades mummy was a favourite pharmacon, sometimes even in the hands of regular physicians ”

“ Instructive, indeed, are the lessons to be gained from a study of the History of Medicine, but perhaps none more so than those which point out to us the advantage of studying disease with special regard to its ultimate consequences, rather than with respect alone to its more prominent symptoms. ”

“ If in this brief article, which does not purport to be more than a sketch of the tremendous strides made by medicine in the Nineteenth Century, so much space has been given to the germ theory of disease, it is because the demonstration of the truth of that theory has been absolute, and has constituted the very marrow of almost all the medical progress of the century that has been the outcome of continuous thought and study as opposed to chance discovery. ”

“ He also called attention to the important bearing which the history of the disease has toward its products, and found his discoveries of advantage, even when they were unable to promote the cure of disease, because of the light which they threw upon physiology and normal anatomy, and because they prevented incurable patients from being continually tormented with drugs intended to cure them; also because pathological investigations alone could settle disputes in diagnosis and matters of honor among physicians. ”

“ Among the physicians belonging to the latter half of the thirteenth and the first quarter of the fourteenth century there is one whose proper place in the history of medicine is by no means easy to determine, and who yet played a part of no small importance. ”

“ The sixteenth century cannot be said to have added much of importance in the field of practical medicine, and, as in the preceding and succeeding centuries, was at best only struggling along in the wake of anatomy, physiology, and surgery. In the seventeenth century, however, at least one discovery in therapeutics was made that has been an inestimable boon to humanity ever since. ”

“ An inquiry into the origin of medicine must begin with the history of man himself, since pain and death are the inevitable conditions of his existence; and the desire to mitigate the former, and postpone the triumphs of the latter arose from, and has kept pace with, the development of the various diseases to which time and circumstances have subjected him. ”

“ This phase of medicine, the development of instruments and means of studying diseases of the internal organs and the organs of the special senses—the history of the stethoscope, the ophthalmoscope, the laryngoscope, and like instruments—is a most fascinating subject and one worthy of extended treatment, but it must suffice here to state that the new methods of direct exploration brought about a complete revolution in the knowledge of disease and had "more influence on the development of modern medicine than all the 'systems' evolved by the most brilliant intellects of the eighteenth century." ”

“ The use of our instruments of precision, our knowledge, of pathology, all tend to narrow that bridge which must extend as a connecting link between empirical treatment, and treatment depending for its success upon a comprehensive knowledge of the natural history of disease. ”

“ 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. ”

“ Then, when favorable conditions had developed again, Christian schools and scholars gave it the opportunity to burn brightly for several centuries at the end of the Middle Ages. This medieval age is probably the most difficult period of medical history to understand properly, but it is worth while taking the trouble to follow out the thread of medical tradition from the Greeks to the Renaissance medical writers, who practically begin modern medicine for us. ”

“ I venture once more to repeat my lifelong declaration of faith that every art must exist before its associated science, and that, how much soever each may illustrate the other, both are essentially independent. Neither botany, nor chemistry, nor pharmacy, nor pharmaco-dynamics, nor physiology, nor bacteriology, is an essential part of therapeutics. Its true and only foundation is clinical medicine, the medicine which recognizes and treats diseases. Medicine, in this sense, is an art and not a science; its laws are rules established, not by theory, but by observation and experience. ”

“ 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? ”

“ The physician is, alas! too often powerless to contend against the ills that are raging around us. But, really, we can not expect physiology to cure incurable diseases and make men immortal; its mission is to discover the truth, and it is for the physician to apply the lessons of the new truth to the treatment of diseases. Who can say seriously that modern medicine, enlightened by the great physiological discoveries of this and former centuries, is not superior to the medicine of the middle ages? The circulation of the blood was discovered by vivisection. ”

“ I have no doubt, that some diseases not yet understood may in time be transferred to the table of those known. But, were I a physician, I would rather leave the transfer to the slow hand of accident, than hasten it by guilty experiments on those who put their lives into my hands. The only sure foundations of medicine are, an intimate knowledge of the human body, and observation on the effects of medicinal substances on that. ”

“ Strange as it may at first appear, the science of medicine from this time onward made no further conspicuous progress until the middle of the seventeenth century of the present era. In certain branches of practical medicine—as, for example, pharmacology, obstetrics and general surgery, and also in certain special departments—the Empirics made a number of material additions to our knowledge ”

“ To those who have chosen the profession of medicine, a knowledge of chemistry, and of some branches of natural history, and, indeed, of several other departments of science, affords useful assistance. ”

“ This universal and acknowledged rule is Pathology, the science which unfolds and exhibits the nature and character of disease, and "dictates the maxims of rational practice." It is the foundation and only base of rational medicine, which proceeds on the assumption that the nature and character of disease is fully known and appreciated. This knowledge is not only rational, but indispensable, in order to understand and apply the principles which ought to govern in the medication and cure of disease. ”

“ Thus, for the proper perfection of medicine as a rational science, two things are in the main needed: the first is a right understanding of the causes and symptoms of disease; the second, a correct knowledge of the action of medicines. [Pg 15] Should our acquaintance with these two subjects be complete, we should then be able to do all that man could by any possibility effect in the alleviation of human suffering. This sublime problem is already being unravelled at one end. Diagnosis and Nosology are making rapid strides; and perhaps we shall soon know what we have to cure. ”

“ Early Attempts to Dissect the Human Body.—Already as early as during the first half of the fourteenth century physicians began to appreciate the fact that further progress in the knowledge of medicine was not to be attained otherwise than by a more profound study of human anatomy than had been made up to that time ”

“ There can be no question, then, as to the nature or the value of the connection between medicine and the biological sciences. There can be no doubt that the future of pathology and of therapeutics, and therefore that of practical medicine, depends upon the extent to which those who occupy themselves with these subjects are trained in the methods and impregnated with the fundamental truths of biology. ”

“ 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. ”

“ Even from this passing glance at the conditions that must modify every plan of treatment, it is evident that to assert of a particular medicine or method that it is the most efficient in a given disease is to convey very little information. ”

“ The seventeenth century was not to close, however, without another discovery in science, which, when applied to the causation of disease almost two centuries later, revolutionized therapeutics more completely than any one discovery. ”

“ During this period the science of medicine has been completely revolutionized, for the use of traditional and empirical remedies has been largely replaced by a systematic search for the causes of diseases and the experimental determination of methods of avoiding or counteracting them. ”

“ Probably most readers are aware that physiology is that science which treats of the various functions of life, such as digestion, respiration and the circulation of the blood, while therapeutics is that department of medicine which relates to the discovery and application of remedies for disease. Now I venture to assert that, during the last quarter of a century, infliction of intense torture upon unknown myriads of sentient, living creatures, has not resulted in the discovery of a single remedy of acknowledged and generally accepted value in the cure of disease. ”

“ It is a common proverb, that one extreme often follows another. It is sometimes so in medicine. As soon as physicians had let go the absurd idea that diseases were the work of demons, had given up their useless mysticisms, and begun to look upon disease as the effect of natural causes—when Anatomy, Physiology and Pathology had helped to explain morbid phenomena, and rational means had come to be employed, practitioners commenced a course of active treatment and went to work with all their might to cure all diseases by positive medication. ”

“ And our plan of treatment will become rational, when on the one hand, from an accurate knowledge of the symptoms of diseases, we are better enabled to meet each by its appropriate remedy, and on the other hand, from some acquaintance with the general action of a medicine, we are fitted to wield it with more skill and effect, and to apply it even in cases where it has not yet been proved beneficial. ”

“ The biological healing system, based on the laws of nature and the acknowledgment of the fact that no two cases of disease are exactly alike, requires much broader knowledge and much deeper insight on the part of the physician than did the old-school of medicine with its search for symptoms of special diseases and its occult prescriptions. ”

“ Sanitary science, though in its infancy, has already profoundly affected medical science in many directions. Perhaps the most important effect that as yet appears is the leading medicine away from its old, blind, absolute faith in remedial agents, in therapeutics, toward greater faith in right living, proper diet, dress, and drainage. ”

“ Dr FRANK, an eminent author and practitioner.
"Our actual information or knowledge of disease does not increase in proportion to our experimental practice. Every dose of medicine given is a blind experiment upon the vitality of the patient." ”

“ How weak appears the reasoning of many great physicians, when we examine it, not in their works, but on the dead body. Medicine was for a long time excluded from the circle of the exact sciences; it will have a right to be associated with them, at least in the diagnostics of diseases, when we shall every where unite to accurate observation, an examination of the changes our organs undergo. ”

“ Modern medicine would be a fragile structure without its basis of comparative anatomy, physiology, materia medica and therapeutics, which have for long years furnished a basis for rational methods in surgery and medication. ”