Noi 



,883] 



NATURE 



51 



upon the skilful and intelligent conduct of the captain 

 mu-^t necessarily depend in a great degree the safety and 

 success of the vessel during her career. In order that 

 the best results may be obtained in face of the difficulties 

 incidental to the design and management of many 

 modern types of ships, the standard of knowledge must 

 be raised in all three classes. W. H. White 



THE ''ENCYCLOPAEDIA BRITANNICA" 

 EitcyclopcedlaBiiiannica. Ninth Edition. Vol. xv. Loo- 

 Mem. Vol. xvi. Men-Mos. (Edinburgh : A. and C. 

 Black, 1S83.) 



AMONG the most important scientific articles in 

 vol. XV. of the new edition of the " Britannica" arc 

 those on Medicine, Mechanics, and Mammalia. 



The concise but comprehensive epitome of the his- 

 tory of medicine which Dr. Payne has contributed 

 is the only history of the kind in the language. In 

 Germany there are in this subject, as in almost every other 

 branch of learning, excellent text-books ; and the author 

 acknowledges his obligations to Haser's " Lehrbuch der 

 Geschichte der Medicin und der epidemischen Krank- 

 heiten." In France, Daremberg's "Histoire des Sciences 

 Medicales " is also well knjwn. But in England there 

 has been no serious attempt to write a history of medicine 

 since the publication of Freind's letters to Mead (1725); 

 even these only dealt with a portion of the subject, and 

 were written or at least begun under the disadvantage of 

 confinement in the Tower. There have been a few valu- 

 able contributions to the subject, such as Dr. Greenhill's 

 articles in Smith's " Dictionary of Classical Biography,'' 

 and Dr. Munk's RoU of the College of Physicians, but 

 nothing more.' 



Is this neglect justifiable ? In other branches of natural 

 history and natural philosophy an acquaintance with the 

 successive steps by which mo lern knowledge has been 

 won is almost necessary for clearly comprehending the 

 result. A history of astronomy, of electricity, or of 

 physiology would be not only of interest but of practical 

 value to the student of each of these subjects. But a 

 history of medicine, however important as a chapter in 

 the development of human intellect and the progress of 

 civilisation, is scarcely any help towards understanding 

 either the principles or the practice of the art of healing. 

 A modern physician finds some knowledge of chemistry 

 and of physics indispensable ; botany and zoology are 

 not without important bearing on his profession il studies; 

 a knowledge of German is of great practical use ; but 

 he may be i.^uorant of all medical literature above fifty 

 years old without any lo,s, except the loss of the intel- 

 lectual pleasure which every educated man should take in 

 the past history of his profession. 



That this is the case seems evident from the utter 

 neglect of the older medical classics in medical education, 

 notwithstanding occa-iunal murmurs from the few who 

 have earned the right to murmur by having read them, 

 and from others — a neglect which exists not only in practi- 



* Dr. Edward Meryon's ** Hist -ry of iVIedicine " was never finished- Dr. 

 Adams's editions of Hippocrates and of Paulus iE^ineta, t'ruke's of tlie 

 " Regimen Saniiatis Salcrniianuiii," and Payne's of Linacre's translation. 

 " De Tcniperamentis." are scholarly works •' Lives of British Phy-iciaiis " 

 and " The Gold-iieaded Can.: " are not un^ racefully written '" The History 

 and Heroes of the .Art of Medicine " is a very poor coinpdation. A brilliant 

 essay on the subject will be fnind at the end of " Poems " and othe 

 of the late Dr. 1 ranit Smith (Smith and Elder, 1879). 



cal England and America, but no less in the learned 

 German and the conservative French schools. This 

 neglect is only confirmed by occasional glimpses of the 

 said classics, and it is illustrated by the fact that we owe 

 even the sketch of the labours of two thousand years 

 which forms the subject of this review to the demands of 

 an encyclopaedia. 



Nor is the reason far to seek. Mo lern medicine has 

 scarcely anything but its aim in common with the art of 

 the ancients. The attempt of the older physicians was to 

 find some comprehensive explanation which would ac- 

 count for all the diseases of mankind, and their practical 

 method was the application of certain remedies, recom- 

 mended by the crudest experience, or more often by some 

 such dogmatic criterion as that of " signatures." The 

 authority of the ancients was regarded as independent of 

 proof. In like manner naturalists used to study the 

 worthless gossip of Pliny, and Milton recommended 

 Columella as a school-book because of the practical im- 

 portance of husbandry ; indeed in England we still teach 

 geometry from an ancient Greek text-book, and Euclid 

 will be the last to follow .Aristotle and Galen, Dioscorides 

 and Celsus, into learned oblivion. But the object of 

 modern medicine is not to explain but to investigate, to 

 ascertain what is amiss, and to deal with it as directly 

 as possible, on the principles of physics and of chemistry, 

 guided by experiment an 1 checked by skilled statistics. 

 Homoeopathy is only the last of the " systems " of medi- 

 cine ; not more arbitrary than many others, and, like the 

 rest, not so much a wrong solution of a scientific problem 

 as an answer to a question which cannot reasonably be 

 put. 



The art of rational medicine must therefore depend 

 upon a knowledge of the body and its functions, on the 

 power of discovering its physical conditions, and on 

 acquaintance with the physico-chemical laws to which it 

 is subject ; just as the art of navigation depends on a 

 knowledge of astronomy and of meteorology. But even 

 the rough outlines of anatomy vvereonly made out during the 

 sixteenth and seventeenth centuries, and the discovery of 

 its minuter dt tails, so well begun between 1650 and 1700, 

 was only resumed and carried to its present degree of 

 completion by the achromatic microscopes of the last 

 fifty years. Morbid anatomy dates from Morgagni. 

 Physiology had no true existence before Harvey's dis- 

 covery of the muscular contraction of the heart and the 

 circulation of the blood in 1628. It was retarded rather 

 than helped by premature application of mechanical laws, 

 and did not make important progress again until the birth 

 of chemistry in the last thirty years of the eighteenth 

 century. If anatomy may be dated from the dissections 

 of Vesalius, physiology from the vivisections of Harvey, 

 and chemistry from the laboratory of Lavoisier, we can- 

 not fix the beginning of modern medicine earlier than 

 the introduction of mediate auscultation by Laennec in 

 1819. 



Interest, however, will always belong to the history of 

 medicine, apart from the practical value of the older 

 medical literature. The study of the dreary succession 

 of the Greek "sects," of the Galenical and Arabian 

 "schools," and of the subsequent iatro-chemical, iatro- 

 mechanical, Brunonian, and other "systems," is of 

 service to warn too eager speculation from the errors of 



