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Title: The Evolution of Modern Medicine

A Series Of Lectures Delivered At Yale University On The

Silliman Foundation In April, 1913

Author: William Osler

Release Date: February 21, 2006 [EBook #1566]

Language: English

Character set encoding: ASCII

*** START OF THIS PROJECT GUTENBERG EBOOK THE EVOLUTION OF MODERN MEDICINE

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Produced by Charles Keller and David Widger

THE EVOLUTION OF MODERN

MEDICINE

A SERIES OF LECTURES DELIVERED AT YALE

UNIVERSITY

ON THE SILLIMAN FOUNDATION

IN APRIL, 1913

by William Osler

THE SILLIMAN FOUNDATION

IN the year 1883 a legacy of eighty thousand dollars was left to the President and Fellows of

Yale College in the city of New Haven, to be held in trust, as a gift from her children, in

memory of their beloved and honored mother, Mrs. Hepsa Ely Silliman.

On this foundation Yale College was requested and directed to establish an annual course of

lectures designed to illustrate the presence and providence, the wisdom and goodness of God,

as manifested in the natural and moral world. These were to be designated as the Mrs. Hepsa

Ely Silliman Memorial Lectures. It was the belief of the testator that any orderly presentation

of the facts of nature or history contributed to the end of this foundation more effectively than

any attempt to emphasize the elements of doctrine or of creed; and he therefore provided that

lectures on dogmatic or polemical theology should be excluded from the scope of this

foundation, and that the subjects should be selected rather from the domains of natural science

and history, giving special prominence to astronomy, chemistry, geology and anatomy.

It was further directed that each annual course should be made the basis of a volume to form

part of a series constituting a memorial to Mrs. Silliman. The memorial fund came into the

possession of the Corporation of Yale University in the year 1901; and the present volume

constitutes the tenth of the series of memorial lectures.

Contents

THE SILLIMAN FOUNDATION

PREFACE

CHAPTER I — ORIGIN OF MEDICINE

INTRODUCTION

ORIGIN OF MEDICINE

EGYPTIAN MEDICINE

ASSYRIAN AND BABYLONIAN MEDICINE

HEBREW MEDICINE

CHINESE AND JAPANESE MEDICINE

CHAPTER II — GREEK MEDICINE

ASKLEPIOS

HIPPOCRATES AND THE HIPPOCRATIC WRITINGS

ALEXANDRIAN SCHOOL

GALEN

CHAPTER III — MEDIAEVAL MEDICINE

SOUTH ITALIAN SCHOOL

BYZANTINE MEDICINE

ARABIAN MEDICINE

THE RISE OF THE UNIVERSITIES

MEDIAEVAL MEDICAL STUDIES

MEDIAEVAL PRACTICE

ASTROLOGY AND DIVINATION

CHAPTER IV — THE RENAISSANCE AND THE RISE OF ANATOMY AND

PHYSIOLOGY

PARACELSUS

VESALIUS

HARVEY

CHAPTER V — THE RISE AND DEVELOPMENT OF MODERN MEDICINE

INTERNAL SECRETIONS

CHEMISTRY

CHAPTER VI — THE RISE OF PREVENTIVE MEDICINE

SANITATION

TUBERCULOSIS

PREFACE

THE manuscript of Sir William Osler's lectures on the "Evolution of Modern Medicine,"

delivered at Yale University in April, 1913, on the Silliman Foundation, was immediately

turned in to the Yale University Press for publication. Duly set in type, proofs in galley form

had been submitted to him and despite countless interruptions he had already corrected and

revised a number of the galleys when the great war came. But with the war on, he threw

himself with energy and devotion into the military and public duties which devolved upon

him and so never completed his proof-reading and intended alterations. The careful

corrections which Sir William made in the earlier galleys show that the lectures were dictated,

in the first instance, as loose memoranda for oral delivery rather than as finished compositions

for the eye, while maintaining throughout the logical continuity and the engaging con moto

which were so characteristic of his literary style. In revising the lectures for publication,

therefore, the editors have merely endeavored to carry out, with care and befitting reverence,

the indications supplied in the earlier galleys by Sir William himself. In supplying dates and

references which were lacking, his preferences as to editions and readings have been borne in

mind. The slight alterations made, the adaptation of the text to the eye, detract nothing from

the original freshness of the work.

In a letter to one of the editors, Osler described these lectures as "an aeroplane flight over the

progress of medicine through the ages." They are, in effect, a sweeping panoramic survey of

the whole vast field, covering wide areas at a rapid pace, yet with an extraordinary variety of

detail. The slow, painful character of the evolution of medicine from the fearsome,

superstitious mental complex of primitive man, with his amulets, healing gods and disease

demons, to the ideal of a clear-eyed rationalism is traced with faith and a serene sense of

continuity. The author saw clearly and felt deeply that the men who have made an idea or

discovery viable and valuable to humanity are the deserving men; he has made the great

names shine out, without any depreciation of the important work of lesser men and without

cluttering up his narrative with the tedious prehistory of great discoveries or with shrill claims

to priority. Of his skill in differentiating the sundry "strains" of medicine, there is specific

witness in each section. Osler's wide culture and control of the best available literature of his

subject permitted him to range the ampler aether of Greek medicine or the earth-fettered

schools of today with equal mastery; there is no quickset of pedantry between the author and

the reader. The illustrations (which he had doubtless planned as fully for the last as for the

earlier chapters) are as he left them; save that, lacking legends, these have been supplied and a

few which could not be identified have with regret been omitted. The original galley proofs

have been revised and corrected from different viewpoints by Fielding H. Garrison, Harvey

Cushing, Edward C. Streeter and latterly by Leonard L. Mackall (Savannah, Ga.), whose zeal

and persistence in the painstaking verification of citations and references cannot be too highly

commended.

In the present revision, a number of important corrections, most of them based upon the

original MS., have been made by Dr. W.W. Francis (Oxford), Dr. Charles Singer (London),

Dr. E.C. Streeter, Mr. L.L. Mackall and others.

This work, composed originally for a lay audience and for popular consumption, will be to the

aspiring medical student and the hardworking practitioner a lift into the blue, an inspiring

vista or "Pisgah-sight" of the evolution of medicine, a realization of what devotion,

perseverance, valor and ability on the part of physicians have contributed to this progress, and

of the creditable part which our profession has played in the general development of science.

The editors have no hesitation in presenting these lectures to the profession and to the reading

public as one of the most characteristic productions of the best-balanced, best-equipped, most

sagacious and most lovable of all modern physicians.

F.H.G.

BUT on that account, I say, we ought not to reject the ancient Art, as if it were not, and had

not been properly founded, because it did not attain accuracy in all things, but rather, since it

is capable of reaching to the greatest exactitude by reasoning, to receive it and admire its

discoveries, made from a state of great ignorance, and as having been well and properly made,

and not from chance. (Hippocrates, On Ancient Medicine, Adams edition, Vol. 1, 1849, p.

168.)

THE true and lawful goal of the sciences is none other than this: that human life be endowed

with new discoveries and powers. (Francis Bacon, Novum Organum, Aphorisms, LXXXI,

Spedding's translation.)

A GOLDEN thread has run throughout the history of the world, consecutive and continuous,

the work of the best men in successive ages. From point to point it still runs, and when near

you feel it as the clear and bright and searchingly irresistible light which Truth throws forth

when great minds conceive it. (Walter Moxon, Pilocereus Senilis and Other Papers, 1887, p.

4.)

FOR the mind depends so much on the temperament and disposition of the bodily organs that,

if it is possible to find a means of rendering men wiser and cleverer than they have hitherto

been, I believe that it is in medicine that it must be sought. It is true that the medicine which is

now in vogue contains little of which the utility is remarkable; but, without having any

intention of decrying it, I am sure that there is no one, even among those who make its study a

profession, who does not confess that all that men know is almost nothing in comparison with

what remains to be known; and that we could be free of an infinitude of maladies both of

body and mind, and even also possibly of the infirmities of age, if we had sufficient

knowledge of their causes, and of all the remedies with which nature has provided us.

(Descartes: Discourse on the Method, Philosophical Works. Translated by E. S. Haldane and

G. R. T. Ross. Vol. I, Cam. Univ. Press, 1911, p. 120.)

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