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the evolution of modern medicine-第13章

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dicine so much as the doctrine of numbers; the sacredness of which seems to have had an enduring fascination for the medical mind。 Many of the common diseases; such as malaria; or typhus; terminating abruptly on special days; favored this belief。 How dominant it became and how persistent you may judge from the literature upon critical days; which is rich to the middle of the eighteenth century。

One member of the Crotonian school; Alcmaeon; achieved great distinction in both anatomy and physiology。  He first recognized the brain as the organ of the mind; and made careful dissections of the nerves; which he traced to the brain。 He described the optic nerves and the Eustachian tubes; made correct observations upon vision; and refuted the common view that the sperma came from the spinal cord。  He suggested the definition of health as the maintenance of equilibrium; or an 〃isonomy〃 in the material qualities of the body。 Of all the South Italian physicians of this period; the personality of none stands out in stronger outlines than that of Empedocles of Agrigentumphysician; physiologist; religious teacher; politician and poet。  A wonder…worker; also; and magician; he was acclaimed in the cities as an immortal god by countless thousands desiring oracles or begging the word of healing。 That he was a keen student of nature is witnessed by many recorded observations in anatomy and physiology; he reasoned that sensations travel by definite paths to the brain。 But our attention must be confined to his introduction of the theory of the four elementsfire; air; earth and waterof which; in varying quantities; all bodies were made up。 Health depended upon the due equilibrium of these primitive substances; disease was their disturbance。  Corresponding to those were the four essential qualities of heat and cold; moisture and dryness; and upon this four…fold division was engrafted by the later physicians the doctrine of the humors which; from the days of Hippocrates almost to our own; dominated medicine。 All sorts of magical powers were attributed to Empedocles。  The story of Pantheia whom he called back to life after a thirty days' trance has long clung in the imagination。 You remember how Matthew Arnold describes him in the well…known poem; 〃Empedocles on Etna〃

                    But his power Swells with the swelling evil of this time; And holds men mute to see where it will rise。 He could stay swift diseases in old days; Chain madmen by the music of his lyre; Cleanse to sweet airs the breath of poisonous streams; And in the mountain…chinks inter the winds。 This he could do of old'5'

a quotation which will give you an idea of some of the powers attributed to this wonder…working physician。

'5' Poetical Works of Matthew Arnold; Macmillan & Co。; 1898; p。 440。


But of no one of the men of this remarkable circle have we such definite information as of the Crotonian physician Democedes; whose story is given at length by Herodotus; and his story has also the great importance of showing that; even at this early period; a well…devised scheme of public medical service existed in the Greek cities。 It dates from the second half of the sixth century B。C。fully two generations before Hippocrates。  A Crotonian; Democedes by name; was found among the slaves of Oroetes。  Of his fame as a physician someone had heard and he was called in to treat the dislocated ankle of King Darius。  The wily Greek; longing for his home; feared that if he confessed to a knowledge of medicine there would be no chance of escape; but under threat of torture he undertook a treatment which proved successful。  Then Herodotus tells his storyhow; ill treated at home in Crotona; Democedes went to AEgina; where he set up as a physician and in the second year the State of AEgina hired his services at the price of a talent。 In the third year; the Athenians engaged him at 100 minae; and in the fourth; Polycrates of Samos at two talents。 Democedes shared the misfortunes of Polycrates and was taken prisoner by Oroetes。  Then Herodotus tells how he cured Atossa; the daughter 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。  Gre
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