the evolution of modern medicine-第23部分
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James J。 Walsh of New York has written a book of extraordinary interest called 〃The Thirteenth； Greatest of Centuries。〃 I have not the necessary knowledge to say whether he has made out his case or not for art and for literature。 There was certainly a great awakening and； inspired by high ideals； men turned with a true instinct to the belief that there was more in life than could be got out of barren scholastic studies。 With many of the strong men of the period one feels the keenest mental sympathy。 Grosseteste； the great Clerk of Lincoln； as a scholar； a teacher and a reformer； represents a type of mind that could grow only in fruitful soil。 Roger Bacon may be called the first of the modernscertainly the first to appreciate the extraordinary possibilities which lay in a free and untrammelled study of nature。 A century which could produce men capable of building the Gothic cathedrals may well be called one of the great epochs in history； and the age that produced Dante is a golden one in literature。 Humanity has been the richer for St。 Francis； and Abelard； Albertus and Aquinas form a trio not easy to match； in their special departments； either before or after。 But in science； and particularly in medicine； and in the advance of an outlook upon nature； the thirteenth century did not help man very much。 Roger Bacon was 〃a voice crying in the wilderness；〃 and not one of the men I have picked out as specially typical of the period instituted any new departure either in practice or in science。 They were servile followers； when not of the Greeks； of the Arabians。 This is attested by the barrenness of the century and a half that followed。 One would have thought that the stimulus given by Mundinus to the study of anatomy would have borne fruit； but little was done in science during the two and a half centuries that followed the delivery of his lectures and still less in the art。 While William of Wykeham was building Winchester Cathedral and Chaucer was writing the Canterbury Tales； John of Gaddesden in practice was blindly following blind leaders whose authority no one dared question。
The truth is； from the modern standpoint the thirteenth was not the true dawn brightening more and more unto the perfect day； but a glorious aurora which flickered down again into the arctic night of mediaevalism。
To sum upin medicine the Middle Ages represent a restatement from century to century of the facts and theories of the Greeks modified here and there by Arabian practice。 There was； in Francis Bacon's phrase； much iteration； small addition。 The schools bowed in humble； slavish submission to Galen and Hippocrates； taking everything from them but their spirit and there was no advance in our knowledge of the structure or function of the body。 The Arabians lit a brilliant torch from Grecian lamps and from the eighth to the eleventh centuries the profession reached among them a position of dignity and importance to which it is hard to find a parallel in history。
CHAPTER IV
THE RENAISSANCE AND THE RISE OF ANATOMY AND PHYSIOLOGY
THE 〃reconquest of the classic world of thought was by far the most important achievement of the fifteenth and sixteenth centuries。 It absorbed nearly the whole mental energy of the Italians。。。。 The revelation of what men were and what they wrought under the influence of other faiths and other impulses； in distant ages with a different ideal for their aim； not only widened the narrow horizon of the Middle Ages； but it also restored self…confidence to the reason of humanity。〃＇1＇
＇1＇ J。 A。 Symonds： The Renaissance in Italy； the Revival of Learning； 1877； p。 52。
Everywhere throughout the Middle Ages learning was the handmaid of theology。 Even Roger Bacon with his strong appeal for a new method accepted the dominant mediaeval convictionthat all the sciences did but minister to their queen； Theology。 A new spirit entered man's heart as he came to look upon learning as a guide to the conduct of life。 A revolution was slowly effected in the intellectual world。 It is a mistake to think of the Renaissance as a brief period of sudden fruitfulness in the North Italian cities。 So far as science is concerned； the thirteenth century was an aurora followed by a long period of darkness； but the fifteenth was a true dawn that brightened more and more unto the perfect day。 Always a reflex of its period； medicine joined heartily though slowly in the revolt against mediaevalism。 How slowly I did not appreciate until recently。 Studying the earliest printed medical works to catch the point of view of the men who were in the thick of the movement up to 1480 which may be taken to include the first quarter of a century of printing one gets a startling record。 The mediaeval mind still dominates： of the sixty…seven authors of one hundred and eighty…two editions of early medical books； twenty…three were men of the thirteenth and fourteenth centuries； thirty men of the fifteenth century； eight wrote in Arabic； several were of the School of Salernum； and only six were of classical antiquity； viz。； Pliny （first 1469）； Hippocrates （1473） ＇Hain ＇*＇7247＇； Galen （1475） ＇Hain 7237＇； Aristotle （1476）； Celsus （1478）； and Dioscorides （1478）。＇**＇
＇*＇ This asterisk is used by Hain to indicate that he had seen a copy。Ed。
＇**＇ Data added to a manuscript taken from the author's summary on 〃Printed Medical Books to 1480〃 in Transactions of the Bibliographical Society； London； 1916； XIII； 5…8； revised from its 〃News…Sheet〃 （February； 1914）。 〃Of neither Hippocrates nor Galen is there an early edition； but in 1473 at Pavia appeared an exposition of the Aphorisms of Hippoerates； and in 1475 at Padua an edition of the Tegni or Notes of Galen。〃 Ibid。； p。 6。 Osler's unfinished Illustrated Monograph on this subject is now being printed for the Society of which he was President。Ed。
The medical profession gradually caught the new spirit。 It has been well said that Greece arose from the dead with the New Testament in the one hand and Aristotle in the other。 There was awakened a perfect passion for the old Greek writers； and with it a study of the original sources； which had now become available in many manuscripts。 Gradually Hippocrates and Galen came to their own again。 Almost every professor of medicine became a student of the MSS。 of Aristotle and of the Greek physicians； and before 1530 the presses had poured out a stream of editions。 A wave of enthusiasm swept over the profession； and the best energies of its best minds were devoted to a study of the Fathers。 Galen became the idol of the schools。 A strong revulsion of feeling arose against the Arabians； and Avicenna； the Prince； who had been clothed with an authority only a little less than divine； became anathema。 Under the leadership of the Montpellier School； the Arabians made a strong fight； but it was a losing battle all along the line。 This group of medical humanistsmen who were devoted to the study of the old humanities； as Latin and Greek were called has had a great and beneficial influence upon the profession。 They were for the most part cultivated gentlemen with a triple interestliterature； medicine and natural history。 How important is the part they played may be gathered from a glance at the 〃Lives〃 given by Bayle in his 〃Biographic Medicale〃 （Paris； 1855） between the years 1500 and 1575。 More than one half of them had translated or edited works of Hippocrates or Galen； many of them had made important contributions to general literature； and a large proportion of them were naturalists： Leonicenus； Linacre； Champier； Fernel； Fracastorius； Gonthier； Caius； J。 Sylvius； Brasavola； Fuchsius； Matthiolus； Conrad Gesner； to mention only those I know best； form a great group。 Linacre edited Greek works for Aldus； translated works of Galen； taught Greek at Oxford； wrote Latin grammars and founded the Royal College of Physicians。＇*＇ Caius was a keen Greek scholar； an ardent student of natural history； and his name is enshrined as co…founder of one of the most important of the Cambridge colleges。 Gonthier； Fernel； Fuchs and Mattioli were great scholars and greater physicians。 Champier； one of the most remarkable of the group； was the founder of the Hotel Dieu at Lyons； and author of books of a characteristic Renaissance type and of singular bibliographical interest。 In many ways greatest of all was Conrad Gesner； whose mors inopinata at forty…nine； bravely fighting the plague； is so touchingly and tenderly mourned by his friend Caius。＇2＇ Physician； botanist； mineralogist； geologist； chemist； the first great modern bibliographer； he is the very embodiment of the spirit of the age。＇2a＇ On the flyleaf of my copy of the 〃Bibliotheca Universalis〃 （1545）； is written a fine tribute to his memory。 I do not know by whom it is； but I do know from my reading that it is true：
＇*＇ Cf。 Osler： Thomas Linacre； Cambridge University Press； 1908。Ed。
＇2＇ Joannis Caii Britanni de libris suis； etc。； 1570。
＇2a＇ See J。 C。 Bay： Papers Bibliog。 Soc。 of America； 1916； X； No。 2； 53…86。
〃Conrad Gesner； who kept open house there for all learned men who came into his neighborhood。 Gesner was not only the best naturalist among the scholars of his day； but of all men of that century he was the pattern man of letters。 He was faultless in private life； assiduous in study； diligent in maintaining correspondence and good…will with learned men in all countries； hospitablethough his means were small to every scholar that came into Zurich。 Prompt to serve all； he was an editor of other men's volumes； a writer of prefaces for friends； a suggestor to young writers of books on which they might engage themselves； and a great helper to them in the progress of their work。 But still； while finding time for services to other men； he could produce as much out of his own study as though he had no part in the life beyond its walls。〃
A large majority of these early naturalists and botanists were physicians。＇3＇ The Greek art of observation was revived in a study of the scientific writings of Aristotle； Theophrastus and Dioscorides and in medicine； of Hippocrates and of Galen； all in the Greek originals。 That progress was at first slow was due in part to the fact that the leaders were too busy scraping the Arabia
