6l2 



NATURE 



[January 6, 192 1 



howuvcr, judge of liiiii iiioru Jireclly. It is cirtain that 

 only a small part of the Hippocratic treatises which 

 have come down to us are from the pen of the master 

 himself, but we may reasonably take them, as a 

 whole, to represent his teaching, and they give us a 

 fair idea of the stage at which the best Greek medical 

 science had arrived in the fifth century B.C. It was 

 a simple and rational medicine based on careful 

 clinical observation and on a watchful study of the 

 results which followed hygienic treatment. The 

 healing powers of Nature formed a leading tenet of 

 the Coan school; we mav almost regard Hippocrates 

 as the founder of sanatorium treatment. Perusal of 

 those of the Books of Epidemics which are most cer- 

 tainly by Hippocrates himself shows that he was an 

 admirable case-taker; in the light of our present 

 knowledge we can readily make a diagnosis from 

 many of his descriptions. His medicine shows, of 

 course, the natural limits of a purely observational 

 science ; it knows little of anatomy and less of physio- 

 logy ; its crude pathology is based on the doctrine of 

 " opposites " ; the idea of experiment as a means of 

 investigation has not yet arisen. Yet in spite of this, 

 the school of Cos is a landmark in the history of 

 rational medicine. 



The centre of interest now shifts elsewhere, and 

 especially to Alexandria, but it remains Greek. 

 .Alexandrian culture represents a sort of continuation 

 of that of Athens, though, perhaps, in comparison 

 smacking somewhat of Wardour Street. The great 

 creative age in art and poetry had gone by ; it was a 

 period of imitation in art, and in literature largely a 

 time of scholiasts and commentators on the better 

 work that had been done before. But here we have 

 an excellent illustration of Prof. Flinders Petrie's 

 dictum that in each period of culture science reaches 

 its prime long after art and literature have begun to 

 decline. For all the branches of science then extant 

 continued to advance in Alexandria. 1 need scarcely 

 recall how mathematics and astronomy flourished 

 under the Ptolemies, and in medical science the 

 .Alexandrian school maintained its premiership for 

 many hundred years. 



.Anatomv and physiology form a necessary basis for 

 medical science, and much as the earlier Greeks had 

 done for medicine, they had lacked any adequate 

 knowledge of these subjects. The later Greeks pro- 

 ceeded to remedy this defec,t. The practice of dissec- 

 tion becam.e established, and anatomists must look 

 back to the Alexandrian school for the foundation of 

 their science. I must pass over Herophilus and 

 Erasistratus and commemorate the later Greek school 

 in the person of its most distinguished alumnus, 

 Galen. Roman medicine, like its art, was whoUv 

 Greek in origin ; its great phvsicians received their 

 training in Greek schools, and Celsus. the best-known 

 writer on medical subiects, was not himself a practi- 

 tioner of medicine. Thus, though we associate Galen 

 with Rome, I must commemorate him as a Gceek — 

 the last and, in many ways, the greatest of the Greek 

 physicians. 



Nearly six hundred years had passed between 

 Hippocrates and Galen, and when we compare the 

 two it must be remembered that Galen had the advan- 

 tage of that six hundred years of medical experience. 

 It gave him a wider outlook, and thus made him a 

 better physician, though I conceive Hippocrates, con- 

 sidering his times, to have been the bigger man. I 

 do not propose to dwell on Galen's eminence as a 

 physician, though he stood far above all others of 

 his age. His real claim to immortality may be put 

 into a few \vords : he was the first to make systematic 

 use of the experimental method in medicine, and he 

 founded the science of physiology. His experimental 

 discoveries in physiology, and particularly in the 

 NO. 2671, VOL. 106] 



domain of the nervous system, entitle him to be called 

 the father of that science. Galen must also be 

 credited with a great advance in pathology. The 

 earlier Greeks had regarded internal medicine from 

 a purely humoral aspect ; the later Greeks began to 

 recognise affections of certain definite organs, but 

 Galen developed this conception beyond any of his 

 predecessors. 



With Galen we come to the end of the great age 

 of classical civilisation, and it will be fitting, before 

 leaving it, to summarise what Greek genius had 

 accomplished in medical science. An atmosphere of 

 intellectual liberty essential to the birth and growth 

 of science had been established by the Greeks ; they 

 had developed the love of knowledge for its own sake. 

 Their shrewd observation had transformed medicine 

 from a medley of traditional empiricism and super- 

 stition into a natural science ; they freed it from 

 magic and laid the foundations of a rational treatment 

 of disease. Towards the close of their epoch they 

 devised the experimental method, and used it to 

 found the science of physiology. Indirectly we owe 

 to them the laws of clear thinking in medicine and in 

 the other sciences, and the development of mathe- 

 matics and mechanics. 



When the Minoan civilisation passed away the 

 Greeks had been compelled to begin again almost 

 from the beginning. There was no such complete 

 break between the classical period and our mcKJern 

 civilisation; much was handed on by direct tradition, 

 and vastly more by written manuscript. Neverthe- 

 less, after the fall of the Roman Empire, Europe had 

 to be remade, and to pass through its dark ages 

 before the dawn of a new culture. The new mixture 

 of races seems to have been incapable of intellectual 

 achievement until the ordained incubation period was 

 over, and that period was at its darkest from the 

 fifth to the tenth centuries a.d. Medicine shared the 

 fate of the other sciences, and what was not forgotten 

 became debased by admixture with Eastern magic 

 and superstition. 



'I'he dominant power in Europe during this period 

 was the Church, and, although its conser\'atism had 

 a wholly deadening influence as regards the advance 

 of scieiice, it did much to preserve the culture of 

 classical tijiies. In the seventh century occurred the 

 last of the four known Arab migrations which have 

 overwhelmed neighbouring peoples ; it spread not only 

 over Western Asia, but also round the Mediterranean. 

 Whatever may have been the primitive culture of these 

 Arab invaders, they presently acquired a high degree 

 of civilisation. They were a keen-witted race, quick 

 to assimilate the culture with which they came in 

 contact, and this was largely Greek in origin. For 

 some hundreds of years the Moorish Empire in Spain 

 was far in advance of the rest of Europe in literature, 

 in science, and in medicine. The best medical works 

 of classical antiquity were translated into .Arabic, and 

 it is by this strange route that much has come down 

 to us which would otherwise have been irretrievablv 

 lost. Their chief share in medicine was to absorb 

 and transmit the knowledge of the Greeks. Medicine 

 reflects the spirit of the Dark .Ages in Europe ; the 

 traditions of the past were still supreme, and Galen 

 was the god of the medical world. Men felt him to 

 have been a better inan than themselves, as in truth 

 he was, and it was enough that Galen said this or 

 that, or that his writings could be interpreted in such 

 and such a sense, and there the matter ended. 



Then, in the fullness of time, after more than a 

 thousand years of intellectual slumber, men again 

 began to think for themselves, just as the Ionian 

 Greeks had done twenty- centuries before. The 

 Renaissance was at first literally a revival of learninfc 

 due to the renewed study of the Greek language ana 



