Project Gutenberg #1566
The Evolution of Modern Medicine
William Osler
1921Osler's lectures tracing medicine from antiquity to modern scientific practice, prepared chapter by chapter from Project Gutenberg HTML.
Project Gutenberg #1566 Public domain in the United States Cover source Local typographic cover created for MojiMori from public-domain source metadata
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gardens, with a wonderful dispensation by nature that they should "neither lack a sufficient quantity of blood for absorption nor be overloaded at any time with excessive supply." The function of respiration was the introduction of the pneuma, the spirits which passed from the lungs to the heart through the pulmonary vessels. Galen went a good deal beyond the idea of Aristotle, reaching our modern conception that the function is to maintain the animal heat, and that the smoky matters derived from combustion of the blood are discharged by expiration.
I have dwelt on these points in Galen's physiology, as they are fundamental in the history of the circulation; and they are sufficient to illustrate his position. Among his other brilliant experiments were the demonstration of the function of the laryngeal nerves, of the motor and sensory functions of the spinal nerve roots, of the effect of transverse incision of the spinal cord, and of the effect of hemisection. Altogether there is no ancient physician in whose writings are contained so many indications of modern methods of research.
Galen's views of disease in general are those of Hippocrates, but he introduces many refinements and subdivisions according to the predominance of the four humors, the harmonious combination of which means health, or eucrasia, while their perversion or improper combination leads to dyscrasia, or ill health. In treatment he had not the simplicity of Hippocrates: he had great faith in drugs and collected plants from all parts of the known world, for the sale of which he is said to have had a shop in the neighborhood of the Forum. As I mentioned, he was an eclectic, held himself aloof from the various schools of the day, calling no man master save Hippocrates. He might be called a rational empiricist. He made war on the theoretical practitioners of the day, particularly the Methodists, who, like some of their modern followers, held that their business was with the disease and not with the conditions out of which it arose.
No other physician has ever occupied the commanding position of "Clarissimus" Galenus. For fifteen centuries he dominated medical thought as powerfully as did Aristotle in the schools. Not until the Renaissance did daring spirits begin to question the infallibility of this medical pope. But here we must part with the last and, in many ways, the greatest of the Greeks—a man very much of our own type, who, could he visit this country today, might teach us many lessons. He would smile in scorn at the water supply of many of our cities, thinking of the magnificent aqueducts of Rome and of many of the colonial towns—some still in use—which in lightness of structure and in durability testify to the astonishing skill of their engineers. There are country districts in which he would find imperfect drainage and could tell of the wonderful system by which Rome was kept sweet and clean. Nothing would delight him more than a visit to Panama to see what the organization of knowledge has been able to accomplish. Everywhere he could tour the country as a sanitary expert, preaching the gospel of good water supply and good drainage, two of the great elements in civilization, in which in many places we have not yet reached the Roman standard.