the evolution of modern medicine-第3章
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Minerva； there were scores of lesser ones who could be invoked for special diseases。 It is said that the young Roman mother might appeal to no less than fourteen goddesses； from Juno Lucina to Prosa and Portvorta （Withington）。 Temples were erected to the Goddess of Fever； and she was much invoked。 There is extant a touching tablet erected by a mourning mother and inscribed：
Febri divae； Febri Sancte； Febri magnae Camillo amato pro Filio meld effecto。 Posuit。
It is marvellous what a long line of superhuman powers； major and minor； man has invoked against sickness。 In Swinburne's words：
God by God flits past in thunder till his glories turn to shades； God by God bears wondering witness how his Gospel flames and fades； More was each of these； while yet they were； than man their servant seemed； Dead are all of these； and man survives who made them while he dreamed。
Most of them have been benign and helpful gods。 Into the dark chapters relating to demonical possession and to witchcraft we cannot here enter。 They make one cry out with Lucretius （Bk。 V）：
O genus infelix humanum； talia divis Cum tribuit facta atque iras adjunxit acerbas！ Quantos tum gemitus ipsi sibi； quantaque nobis Vulnera； quas lacrimas peperere minoribu' nostris。
In every age； and in every religion there has been justification for his bitter words； 〃tantum religio potuit suadere malorum〃〃Such wrongs Religion in her train doth bring〃yet； one outcome of 〃a belief in spiritual beings〃as Tylor defines religion has been that man has built an altar of righteousness in his heart。 The comparative method applied to the study of his religious growth has shown how man's thoughts have widened in the unceasing purpose which runs through his spiritual no less than his physical evolution。 Out of the spiritual protoplasm of magic have evolved philosopher and physician； as well as priest。 Magic and religion control the uncharted spherethe supernatural； the superhuman： science seeks to know the world； and through knowing； to control it。 Ray Lankester remarks that Man is Nature's rebel； and goes on to say： 〃The mental qualities which have developed in Man； though traceable in a vague and rudimentary condition in some of his animal associates； are of such an unprecedented power and so far dominate everything else in his activities as a living organism； that they have to a very large extent； if not entirely； cut him off from the general operation of that process of Natural Selection and survival of the fittest which up to their appearance had been the law of the living world。 They justify the view that Man forms a new departure in the gradual unfolding of Nature's predestined scheme。 Knowledge； reason； self…consciousness； will； are the attributes of Man。〃＇1＇ It has been a slow and gradual growth； and not until within the past century has science organized knowledge so searched out the secrets of Nature； as to control her powers； limit her scope and transform her energies。 The victory is so recent that the mental attitude of the race is not yet adapted to the change。 A large proportion of our fellow creatures still regard nature as a playground for demons and spirits to be exorcised or invoked。
＇1＇ Sir E。 Ray Lankester： Romanes Lecture； 〃Nature and Man；〃 Oxford Univ。 Press； 1905； p。 21。
Side by side； as substance and shadow〃in the dark backward and abysm of time；〃 in the dawn of the great civilizations of Egypt and Babylon； in the bright morning of Greece； and in the full noontide of modern life； together have grown up these two diametrically opposite views of man's relation to nature； and more particularly of his personal relation to the agencies of disease。
The purpose of this course of lectures is to sketch the main features of the growth of these two dominant ideas； to show how they have influenced man at the different periods of his evolution； how the lamp of reason； so early lighted in his soul； burning now bright； now dim； has never； even in his darkest period； been wholly extinguished； but retrimmed and refurnished by his indomitable energies； now shines more and more towards the perfect day。 It is a glorious chapter in history； in which those who have eyes to see may read the fulfilment of the promise of Eden； that one day man should not only possess the earth； but that he should have dominion over it！ I propose to take an aeroplane flight through the centuries； touching only on the tall peaks from which may be had a panoramic view of the epochs through which we pass。
ORIGIN OF MEDICINE
MEDICINE arose out of the primal sympathy of man with man； out of the desire to help those in sorrow； need and sickness。
In the primal sympathy Which having been must ever be； In the soothing thoughts that spring Out of human suffering。
The instinct of self…preservation； the longing to relieve a loved one； and above all； the maternal passionfor such it isgradually softened the hard race of mantum genus humanum primum mollescere coepit。 In his marvellous sketch of the evolution of man； nothing illustrates more forcibly the prescience of Lucretius than the picture of the growth of sympathy： 〃When with cries and gestures they taught with broken words that 'tis right for all men to have pity on the weak。〃 I heard the well…known medical historian； the late Dr。 Payne； remark that 〃the basis of medicine is sympathy and the desire to help others； and whatever is done with this end must be called medicine。〃
The first lessons came to primitive man by injuries； accidents； bites of beasts and serpents； perhaps for long ages not appreciated by his childlike mind； but； little by little； such experiences crystallized into useful knowledge。 The experiments of nature made clear to him the relation of cause and effect； but it is not likely； as Pliny suggests； that he picked up his earliest knowledge from the observation of certain practices in animals； as the natural phlebotomy of the plethoric hippopotamus； or the use of emetics from the dog； or the use of enemata from the ibis。 On the other hand； Celsus is probably right in his account of the origin of rational medicine。 〃Some of the sick on account of their eagerness took food on the first day； some on account of loathing abstained； and the disease in those who refrained was more relieved。 Some ate during a fever； some a little before it； others after it had subsided； and those who had waited to the end did best。 For the same reason some at the beginning of an illness used a full diet； others a spare； and the former were made worse。 Occurring daily； such things impressed careful men； who noted what had best helped the sick； then began to prescribe them。 In this way medicine had its rise from the experience of the recovery of some； of the death of others； distinguishing the hurtful from the salutary things〃 （Book I）。 The association of ideas was suggestivethe plant eyebright was used for centuries in diseases of the eye because a black speck in the flower suggested the pupil of the eye。 The old herbals are full of similar illustrations upon which； indeed； the so…called doctrine of signatures depends。 Observation came； and with it an ever widening experience。 No society so primitive without some evidence of the existence of a healing art； which grew with its growth； and became part of the fabric of its organization。
With primitive medicine； as such； I cannot deal； but I must refer to the oldest existing evidence of a very extraordinary practice； that of trephining。 Neolithic skulls with disks of bone removed have been found in nearly all parts of the world。 Many careful studies have been made of this procedure； particularly by the great anatomist and surgeon； Paul Broca； and M。 Lucas…Championniere has covered the subject in a monograph。＇2＇ Broca suggests that the trephining was done by scratching or scraping； but； as Lucas…Championniere holds； it was also done by a series of perforations made in a circle with flint instruments； and a round piece of skull in this way removed； traces of these drill…holes have been found。 The operation was done for epilepsy； infantile convulsions； headache； and various cerebral diseases believed to be caused by confined demons； to whom the hole gave a ready method of escape。
