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alize these facts forming a system like that of Ptolemy or Copernicus. The next to formulate these generalizations as laws, as was done by Kepler. The final step to proceed to some principles or force accounting for these laws. Usually by the aid of mathematical analysis as was done by Newton, in his theory of universal gravitation.
In this brief discussion of some of the scientific aspects of medicine, I shall by no means attempt to prove that medicine is all scientific; nor that it's development has been strictly along classical lines, but simply to call attention to some of the features by which it may claim, at least scientific consideration.
In his address on Morgagni at Rome Prof. Virchow said, "That medicine is remarkable for it's unbroken development for twenty-five centuries," in fact from Hippocrates to Virchow himself. The great pathalogist's opinion, however, seems to need severe qualification; if it be so, the stream has more than once flowed long underground. The discontinuity of medicine from Egypt to Crotona and Ionia is scarcely greater than from Calen to Avicenna, during which period, in spite of a few emminent teachers in the Byzantine empire, it sank, in the west at any rate, into a sterile, foul and superstitious routine.
It is difficult to say just when the practice of medicine began, for the lower animals when sick or wounded, instinctively lessen or alter their diet, seek seclusion and rest and even sometimes seek out peculiar herbs, which are beneficial. The savage too, does much the same thing, but tradition and experience have led to a little more set rules regarding it.
The Egyptians exposed their sick in public places that all who observed them might give them the benefit of past experiences and observations, all of which the victim was supposed to try, (much as they do now days). Then if healed, he was required to go to the temple and record the history and symptoms of his illness and what cured him. This information soon became very vast in quantity and was open to the public. These records, however, were soon appropriated by the priests, who formed a monopoly and by the addition of myth and superstition, soon caused it to degenerate into a system of mere quackery, though they possessed many rules of hygiene which were really valuable.
The medicine of the Hebrews as known to us through the scriptures. especially that of Moses, embraced many rules of the highest sagacity, but it was strongly tinctured with demonology.
The early East Indian races possessed a considerable amount of recorded medical fact, but it was not systematically arranged and in it myth and tradition predominated. They located the pulse in a reservoir behind the umbilicus; the physician examined not only the pulse of the patient, but the dejecta; consulted the stars, the flight of birds and made his prognosis from a multitude of varying circumstances.. They
were, however, said to have had some really valuable remedies, such as cures for the bites of venomous serpents, and etc.
Things remained in this mystical state for nearly one thousand years, to about 300 to 400 years B. C., when the Greek philosophers appeared upon the scene. With their appearance we pass from the mystical to the so-called philosophical period, with which the names of Hippocrates stands out most prominently and that of Pythagoras, Empedocles, Plato and Aristotle are inseperably connected. It is impossible to separate the medical from the other sciences in this period-as in fact, it is at ali times.
In the earliest of these periods their practices were still attributed to the probably mythical Aesculapius of whom it is related that Pluto, god of hell, alarmed at the diminishing number of his daily arrivals, complained to Jupiter, who destroyed the audacious healer, on which account some wit has said, "The modern children of Aesculapius abstain from performing prodigious cures."
During this philosophic period the religious tenets of the people prevented the dissection of the human body, without which no truly scientific progress in medicine could be possible; but considering the facilities which they possessed, it is really remarkable the amount of accurate medical observation which they gave to the world. But on the other hand they made the fatal mistake of too much generalizing and philosophizing on a few facts.
Hippocrates, however, in spite of his meager anatomical and physiological knowledge, gave some surprising and accurate discriptions of various lessions, such as those of the heart, head, glands and the bones. And his work upon epidemic diseases was remarkable. He recognizezd the meteorological and unsanitary conditions with which they were connected, but of course failed to divine the real cause thereof. One of his theories which prevailed throughout the hippocratic era was that of "coction and crisis." By coction was meant thickening or elaboration of the humor of the body which were supposed to be necessary for their proper elimination in some tangible form. Disease was regarded as an association of phenonema, resulting from efforts made by the conservative principles of life to effect a coction. Upon the formation of this and the successful elimination known as the crisis, recovery depended. He believed that there were four universal elements, namely: earth, water, air and fire, four elementary qualities, heat, cold, dryness and moisture, and four cardinal humors, blood, bile, atrabile (or yellow bile) and phlegamon.
Owing to the poverty of knowledge of physics and chemistry possessed by the ancients, the doctrine of dogmatism founded upon the theory of coctions and humors, was the most intelligible and complete among the medical doctrines of antiquity responding better, as it did,
to the demands of the science of that day than did any other.
That Hippocrates was a profound thinker and close observer, is shown in this: that he reminds both philosophers and physicians that the nature of men cannot be well known without the aid of accurate observation and that nothing should be affirmed concerning nature until by our senses we have become certain of it. In this maxim he took the position opposed to the pythagorean doctrine and included therein the germ of a new philosophy, of which Plato misconceived and which Aristole had a very faint glimpse. Another theory throughout the hypocratie books was that of fluctions, meaning thereby, about what we would call congestions, or conditions which we would say were ordinarily caused by cold, though certain fluctions were supposed to be caused by heat, because the tissues thereby became rarified, the pores enlarged and their humor attenuated, so that it flowed easily when compressed. The whole theory of fluctions was founded upon densest ignorance of tissues and laws of physics, the body of man being sometimes likened to a sponge and some times to a seive. The treatment recommended was often almost as absurd as the theory.
Praxagorous, one of the followers of Hippocrates, was said to have really dissected the human body and initiated the study of the pulse, since Hippocrates had seldom mentioned it, and then referred to it as only of secondary importance. Unfortunately his studies were not followed up. The predominating theory during this era was that health was dependent upon the exact mixture of the four cardinal humors: blood, bile, atrabile and phlegm. This is commonly referred to as the hyppocratic dogma and it held full sway until the foundation of the Alexandrian school.
The hypocratic period was said to have formed a transition between mythology and history.
From the foundation of the Alexandrian library, 300 years before Christ, to the death of Galen, 200 A. D., is spoken of as the Anatomic period, because during the reign of Alexander as well as that of the Ptolemies, as governors of Egypt, the dissection of the human body was not only allowed, but encouraged, and every facility and opportunity was offered for the study of the sciences including medicine. However, the statement sometimes made that the Ptolemies knew more about anatomy than the present day anatomist, is not borne out by history.
It was under these influences that Galen was born and he left an immortal record of his careful and painstaking anatomical study.
Much of his classification and momenclature is still used to this day. He combatted much of the unfounded philosophy of Hippocrates and may be said to have taken for his motto: "Let us see." The Greek period of medicine ended with the burning of the Alaxandrian library in 640 A. D.
After the death of Galen anatomical and other methods of accurate work ceased and much that was already known seemed to have been forgotten.
These periods of lethargy lasted till Avicenna, about 1,000, A. D., but even he added nothing new to medical knowledge. He wrote the Canon, which was simply a commentary upon the teachings of Galen and Hippocrates.
Part of this lack of progress is due to the coming into power of the church, which again prohibited the dissection of the human body. During this period the priest again assumed the function of physician.
The Salernian school, which flourished during the 12th and 13th centuries, also did very little to advance medicine-its principle merit being in its unswerving devotion to ancient doctrines and reviving to a certain extent, the knowledge of that age, and it also broke the fetters which bound medicine to the church. It was only toward the close of the 15th and the early part of the 16th century that the predjudices against the dissections of the human body abated sufficiently that the prohibition of it was removed by the church.
The first who dared to dispute the authority of Galen was Vesalius. He was persistent in his anatomical labors and at the age of twenty-nine he wrote his great work on anatomy which far excelled anything previously written. His opposition to Galen's authority caused an avalanche of vehement opposition to him, but truth soon prevailed. He asked the question, "Which more nearly represents the truth, Galen's books or the human body?"
Columbus, who succeeded him, appreciated the systole and diastole of the heart and the connection thereof with the dilation and contraction of the arteries-coming so near to the solution of the mystery of the circulation of the blood that it is hard to see how he missed it. He even outlined accurately the lesser circulation-the course of the pulmonary artery and veins, but failed to divine its real significance.
Eustachivis and Fallopius followed him and added much to anatomical knowledge. Nerves, tendons and ligaments were no longer confounded with each other, but traced as far as possible from their origin. to their ramifications. Ancient errors in general were corrected.
In the middle of the 16th century Ambrose Pare, who was called the father of surgery, first applied the ligature to vessels to control hemorrhage this was a great advance in surgery. He made great improvements in the treatment of gunshot wounds and dispensed with the boiling oil for amputations. It was about this time that Caesarian section. became common, though it was reputed to have been performed by the Greek physicians. Still disease-especially epidemics-was attributed to astrological influence or the anger of God.
In the 17 century physicists and chemists began to be original in
stead of followers of the past. About the middle of this century came a discovery which probably did more than all else to revolutionize physiology, it was the discovery of the circulation of the blood by Wm. Harvey of England. Strange to say, the theory was for a long time bitterly combatted, but unlike Columbus, he had the good fortune to live to see his discovery generally accepted.
Malphighi then demonstrated the connection between the arteries. and veins, i. e., the capillaries. He also described-in 1665-the corpuscles in the blood, the lung cells, the cutaneous glands, certain portions of the kidney and the pigmentary layer of the skin, accounting for the different colors in the different races. Haller took up Harvey's discovery and developed a new physiology. About this time, also, the antidotal effect of Peruvian bark to malaria was discovered-probably the first therapeutic specific. Soon afterward Sydenham proved the efficacy of mercury in syphilis. He also elaborated the doctrine of the healing power of nature. Hypodermic and intravernous medication was introduced.
We will hurry through the 17th and 18th centuries as there were few decided steps made after Harvey's discovery until near the close of the 18th century when Edward Jenner introduced the inoculation with cowpox as a preventative of small pox. This process, though not at all understood, was probable the first work in immunity.
During these centuries, however, there had been a gradual development in the chemistry, physiology, anatomy and surgery, as well as general medicine. Haller's work on the irritability of protoplasm and the numerous physiological developments to which this led, were perhaps second in its influence on medicine to the great work of Chas. Darwin only. He gave, by it, the death blow to vitalistic spirits. This age was not without its systems and pathies. There were anamists, realists, vitalist, alchemists, animalculists and homeopathists each of which flourished for a time, regardless of the absurdities of their theories. Charlatans and Quacks were even more numerous and financiially successful than in our own time.
But in spite of all this, there was a vast army of earnest workers who labored for the upbuilding of science and alleviation of human suffering. Strange as it may seem it was not until late in the 18th century that the rate and quality of the pulse was studied intelligently, percussion and auscultation applied and the clinical thermometer invented and even then not commonly used or apppreciated until near the middle of the 19th century, and not until late in the 18th that the study of pathological anatomy-that is the post mortem findings of disease was really begun.
The methods of the early part of the 19th century were practically a continuation of those of the preceeding century, but about this time,