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20 - Evolution of Modern Medicine by Sir William Osler · Evolution of Modern Medicine

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Speaker 1: Section nineteen of the Evolution of Modern Medicine. This is
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Speaker 1: a LibriVox recording. All LibriVox recordings are in the public domain.
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Speaker 1: For more information or to volunteer, please visit LibriVox dot org.
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Speaker 1: Recording by Rita Buttros. The Evolution of Modern Medicine by
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Speaker 1: Sir William Osler, Section nineteen, The Renaissance and the Rise
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Speaker 1: of Anatomy and Physiology. Paracelsus Paracelsus is dergeiss der stets vernant.
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Speaker 1: He roused men against the dogmatism of the schools, and
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Speaker 1: he stimulated enormously the practical study of chemistry. These are
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Speaker 1: his great merits, against which must be placed a flood
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Speaker 1: of hermetical and transcendental medicine, some his own, some foisted
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Speaker 1: in his name, the influence of which is still with us.
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Speaker 1: With what judgment, ye judge, it shall be judged to
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Speaker 1: you again is the verdict of three centuries on Paracelsus.
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Speaker 1: In return for unmeasured abuse of his predecessors and contemporaries,
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Speaker 1: he has been held up to obloquy as the arch
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Speaker 1: charlatan of history. We have taken a cheap estimate of
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Speaker 1: him from Fuller and Bacon and from a host of
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Speaker 1: scurrilous scribblers who debased or perverted his writings. Fuller picked
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Speaker 1: him out as exemplifying the drunken quack, whose body was
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Speaker 1: a sea, wherein the tide of drunkenness was ever ebbing
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Speaker 1: and flowing. He boasted that shortly he would order Luther
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Speaker 1: and the Pope, as well as he had done Gallon
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Speaker 1: and Hippocrates. He was never seen to pray, and seldom
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Speaker 1: came to church. He was not only skilled in natural
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Speaker 1: magic the utmost bounds whereof border on the suburbs of hell,
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Speaker 1: but is charge to converse constantly with familiars. Guilty he
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Speaker 1: was of all vices, but wants Francis Bacon too, says
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Speaker 1: many hard things of him to the mystics. On the
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Speaker 1: other hand, he is Paracelsus, the Great, the divine, the
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Speaker 1: most supreme of the Christian magi, whose writings are too
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Speaker 1: precious for science, the monarch of secrets, who has discovered
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Speaker 1: the universal medicine. This is illustrated in Browning's well known
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Speaker 1: poem Paracelsus, published when he was only twenty one, than
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Speaker 1: which there is no more pleasant picture and literature of
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Speaker 1: the man and of his aspirations. His was a searching
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Speaker 1: and impetuous soul that sought to win from nature some
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Speaker 1: startling secret, a tincture of force, to flush old age
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Speaker 1: with youth, or breed gold, or imprison moonbeams till they
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Speaker 1: change to opal shafts. At the same time, with that
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Speaker 1: capacity for self deception which characterizes the true mystic, he
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Speaker 1: sought to cast life on a darkling race. Save for
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Speaker 1: that doubt, I stood at first where all aspire at
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Speaker 1: last to stand. The secret of the world was mine.
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Speaker 1: I knew. I felt perception, unexpressed, uncomprehended by our narrow thought,
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Speaker 1: but somehow felt and known in every shift and change
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Speaker 1: in the spirit, nay, in every pore of the body,
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Speaker 1: even what God is, what we are, what life is?
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Speaker 1: Robert Browning, Paracelsus closing speech. Much has been done of
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Speaker 1: late to clear up his story and his character. Professor
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Speaker 1: Suhoff of Leipzig has made an exhaustive bibliographical study of
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Speaker 1: his writings. There have been recent monographs by Julius Hartmann
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Speaker 1: and Professors Franz and Karl Struntz, and a sympathetic summary
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Speaker 1: of his life and writings has been published by the
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Speaker 1: late Miss Stoddart. Indeed, there is at present a cult
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Speaker 1: of Paracelsus. The hermetic and alchemical writings are available in English,
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Speaker 1: in the addition of A. E. Waite, London, eighteen ninety four.
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Speaker 1: The main facts of his life you can find in
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Speaker 1: all the biographies. Suffice it here to say that he
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Speaker 1: was born at Einsiedeln, near Zurich in fourteen ninety three,
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Speaker 1: the son of a physician, from whom he appears to
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Speaker 1: have had his early training both in medicine and in chemistry,
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Speaker 1: under the famous abbot and alchemist Trithemisov Wurzburg. He studied
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Speaker 1: chemistry and occultism. After working in the mines at Schwatz,
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Speaker 1: he began his wanderings, during which he professes to have
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Speaker 1: visited nearly all the countries in Europe, and to have
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Speaker 1: reached India and China. Returning to Germany, he began a
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Speaker 1: triumphal tour of practice through the German cities, always in
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Speaker 1: opposition to the medical faculty and constantly in trouble. He
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Speaker 1: undoubtedly performed many important cures and was thought to have
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Speaker 1: found the supreme secret of alchemistry in the pommel of
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Speaker 1: his sword. He was believed to carry a familiar spirit.
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Speaker 1: So dominant was his reputation that in fifteen twenty seven
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Speaker 1: he was called to the chair of physic in the
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Speaker 1: University of Basel. Embroiled in quarrels after his first year,
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Speaker 1: he was forced to leave secretly and again began his
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Speaker 1: wanderings through German cities, working, quarreling, curing, and dying prematurely
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Speaker 1: at Salzburg in fifteen forty one. One of the most
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Speaker 1: tragic figures in the history of medicine, Paracelsus is the
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Speaker 1: Luther of medicine, the very incarnation of the spirit of revolt.
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Speaker 1: At a period when authority was paramount and men blindly
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Speaker 1: followed old leaders, when to stray from the beaten track
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Speaker 1: in any field of knowledge was a damnable heresy, he
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Speaker 1: stood out boldly for independent study and the right of
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Speaker 1: private judgment. After election to the chair at Basel, he
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Speaker 1: at once introduced a startling novelty by lecturing in German.
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Speaker 1: He had caught the new spirit and was ready to
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Speaker 1: burst all bonds, both in medicine and in theology. He
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Speaker 1: must have startled the old teachers and practitioners by his
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Speaker 1: novel methods. On June fiveth fifteen twenty seven, he attached
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Speaker 1: a program of his lectures to the blackboard of the university,
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Speaker 1: inviting all to come to them. It began by greeting
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Speaker 1: all students of the art of healing. He proclaimed its
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Speaker 1: lofty and serious nature, a gift of God to man,
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Speaker 1: and the need of developing it to new importance and
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Speaker 1: to new renown. This he undertook to do, not retrogressing
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Speaker 1: to the teaching of the ancients, but progressing whether nature
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Speaker 1: pointed through research into nature, where he himself had discovered
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Speaker 1: and had verified by prolonged experiment and experience. He was
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Speaker 1: ready to oppose obedience to old lights, as if there
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Speaker 1: were oracles from which one did not dare to differ.
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Speaker 1: Illustrious doctors might be graduated from books, but books made
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Speaker 1: not a single physician. Neither graduation, nor fluency, nor the
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Speaker 1: knowledge of old languages, nor the reading of many books
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Speaker 1: made a physician, but the knowledge of things themselves and
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Speaker 1: their properties. The business of a doctor was to know
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Speaker 1: the different kinds of sicknesses, their causes, their symptoms, and
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Speaker 1: their right remedies. This he would teach, for he had
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Speaker 1: won this knowledge through experience, the greatest teacher, and with
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Speaker 1: much toil. He would teach it as he had learned it,
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Speaker 1: and his lectures would be founded on works which he
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Speaker 1: had composed concerning inward and external treatment, physic and surgery.
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Speaker 1: Shortly afterwards, at the feast of Saint John, the students
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Speaker 1: had a bonfire in front of the university. Paracelsus came out,
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Speaker 1: holding in his hands the Bible of Medicine, Avicenna's cannon,
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Speaker 1: which he flung into the flames, saying, into Saint John's fire,
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Speaker 1: so that all misfortune may go into the air with
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Speaker 1: the smoke. It was, as he explained afterwards, a symbolic act.
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Speaker 1: What has perished must go to the fire. It is
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Speaker 1: no longer fit for use. What is true in living
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Speaker 1: that the fire cannot burn. With abundant confidence in his
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Speaker 1: own capacity, he proclaimed himself the legitimate monarch, the very
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Speaker 1: Christ of medicine. You shall follow me, cried he you, Avicenna,
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Speaker 1: galen Rasus, Montagnana, messuus, you gentlemen of Paris, montpet Germany, Cologne, Vienna,
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Speaker 1: and whomsoever the Rhine and Danube nourish you who inhabit
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Speaker 1: the isles of the sea, You likewise Dalmatians, Athenians, thou Arab,
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Speaker 1: thou Greek, thou jew all shall follow me, and the
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Speaker 1: monarchy shall be mine. This first great revolt against the
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Speaker 1: Slavish authority of the schools had little immediate effect, largely
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Speaker 1: on account of the personal vagaries of the reformer, but
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Speaker 1: it made men think. Paracelsus stirred the pool, as had
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Speaker 1: not been done for fifteen centuries. Much more important is
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Speaker 1: the relation of Paracelsus to the new chemical studies and
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Speaker 1: their relation to practical medicine. Alchemy, he held, is to
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Speaker 1: make neither gold nor silver. Its use is to make
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Speaker 1: the supreme sciences and to direct them against disease. He
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Speaker 1: recognized three basic substances sulfur, mercury, and salt, which were
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Speaker 1: the necessary ingredients of all bodies, organic or inorganic. They
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Speaker 1: were the basis of the three principles out of which
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Speaker 1: the Archaeus, the spirit of Nature, formed all bodies. He
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Speaker 1: made important discoveries in chemistry zinc, the various compounds of mercury, calomel,
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Speaker 1: flowers of sulfur, among others, and he was a strong
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Speaker 1: advocate of the use of preparations of iron and antimony
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Speaker 1: in practical pharmacy. He has perhaps had a greater reputation
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Speaker 1: for the introduction of a tincture of opium labdinum or laudanum,
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Speaker 1: with which he affected miraculous cures, and the use of
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Speaker 1: which he had probably learned in the East. Through Paracelsus,
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Speaker 1: a great stimulus was given to the study of chemistry
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Speaker 1: and pharmacy, and he is the first of the modern iotrochemists,
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Speaker 1: in contradistinction to galen medicines, which were largely derived from
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Speaker 1: the vegetable Kingdom. From this time on we find in
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Speaker 1: the literature references to spagaric medicines, and a Spagorist was
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Speaker 1: a Paracelsian who regarded chemistry as the basis of all
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Speaker 1: medical knowledge. One cannot speak very warmly of the practical
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Speaker 1: medical writings of Paracelsus Gout, which may be taken as
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Speaker 1: the disease upon which he had the greatest reputation, is
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Speaker 1: very badly described. And yet he has one or two
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Speaker 1: fruitful ideas singularly mixed with medieval astrology. But he has
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Speaker 1: here and there very happy in sights, as where he
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Speaker 1: remarks nec praeter synovium loquum, alium olumpu dagra occupat in
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Speaker 1: the tract on phlebotomy, I see nothing modern, and here
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Speaker 1: again he is everywhere dominated by astrological ideas sapiens dominatur astris.
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Speaker 1: As a antagonist of occult philosophy, Paracelsus has had a
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Speaker 1: more enduring reputation than as a physician. In estimating his position,
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Speaker 1: there is the great difficulty referred to by Sutthoff in
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Speaker 1: determining which of the extant treatises are genuine. In the
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Speaker 1: two volumes issued in English by Weight in eighteen ninety four,
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Speaker 1: there is much that is difficult to read and to
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Speaker 1: appreciate from our modern standpoint. In the book concerning Long Life,
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Speaker 1: he confesses that his method and practice will not be
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Speaker 1: intelligible to common persons, and that he writes only for
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Speaker 1: those whose intelligence is above the average, to those fond
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Speaker 1: of transcendental studies, they appeal and are perhaps intelligible. Everywhere
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Speaker 1: one comes across shrewd remarks, which prove that Paracelsus had
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Speaker 1: a keen belief in the all controlling powers of nature
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Speaker 1: and of man's capacity to make those powers operate for
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Speaker 1: his own goods. The wise man rules nature, not nature.
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Speaker 1: The wise man. The difference between the saint and the
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Speaker 1: madjus is that the one operates by means of God
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Speaker 1: and the other by means of nature. He had great
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Speaker 1: faith in nature and the light of nature, holding that
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Speaker 1: man obtains from nature according as he believes. His theory
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Speaker 1: of the three principles appears to have controlled his conception
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Speaker 1: of everything relating to man spiritually, mentally, and bodily, and
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Speaker 1: his threefold genera of disease corresponded in some mysterious way
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Speaker 1: with the three primary substances salt, sulfur, and mercury. How
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Speaker 1: far he was a believer in astrology, charms, and devination,
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Speaker 1: it is not easy to say. From many of the
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Speaker 1: writings in his collected works, one would gather, as I
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Speaker 1: have already quoted, that he was a strong believer. On
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Speaker 1: the other hand, in the Perimurum, he says, stars control
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Speaker 1: nothing in us, suggest nothing, incline to nothing, own nothing.
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Speaker 1: They are free from us, and we are free from
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Speaker 1: them Stoddart, page one eighty five. The Archaeus, not the stars,
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Speaker 1: controls man's destiny. Good fortune comes from ability, and ability
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Speaker 1: comes from the spirit Archaeus. No one has held more
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Speaker 1: firmly the dualistic conception of the healing art. There are
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Speaker 1: two kinds of doctors, those who heal miraculously and those
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Speaker 1: who heal through medicine. Only he who believes can work miracles.
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Speaker 1: The physician has to accomplish that which God would have
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Speaker 1: done miraculously had there been faith enough. In the sick
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Speaker 1: man Stoddart, page one ninety four, he had the hippocratic
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Speaker 1: conception of the viz medicatrix naturae. No one keener since
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Speaker 1: the days of the Greeks. Man is his own doctor
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Speaker 1: and finds proper healing herbs in his own garden. The
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Speaker 1: physician is in ourselves, in our own nature, are all
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Speaker 1: things that we need. And speaking of wounds with singular prescience,
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Speaker 1: he says that the treatment should be defensive, so that
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Speaker 1: no contingency from without could hinder nature in her work Stoddart,
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Speaker 1: page two thirteen. Paracelsus expresses the healing powers of nature
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Speaker 1: by the word mummia, which he regarded as a sort
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Speaker 1: of magnetic influence or force, and he believed that any
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Speaker 1: one possessing this could arrest or heal disease in others.
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Speaker 1: As the lily breaks forth in invisible perfume, so healing
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Speaker 1: influences may pass from an invisible body upon these views
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Speaker 1: of Paracelsus was based the theory of this sympathetic cure
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Speaker 1: of disease, which had an extraordinary vogue in the late
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Speaker 1: sixteenth and seventeenth centuries, and which is not without its
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Speaker 1: modern counterpart. In the next century. In Van Helmond, we
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Speaker 1: meet with the Archaeus everywhere, presiding, controlling and regulating the
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Speaker 1: animate and inanimate bodies, working this time through agents local ferments.
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Speaker 1: The Rosicrucians had their direct inspiration from his writings, and
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Speaker 1: such mystics as the English Rosicrucian Flood were strong Paracelsians.
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Speaker 1: The doctrine of contraries, drawn from the old Greek philosophy,
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Speaker 1: upon which a good deal of the treatment of Hippocrates
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Speaker 1: and Gallon was based dryness expelled by moisture, cold by heat,
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Speaker 1: et cetera, was opposed by Paracelsus in favor of a
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Speaker 1: theory of similars, upon which the practice of homeopathya is based.
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Speaker 1: This really arose from the primitive beliefs to which I
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Speaker 1: have already referred as leading to the use of eyebright
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Speaker 1: in diseases of the eye and cyclomen in diseases of
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Speaker 1: the ear. Because of its resemblance to that part, and
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Speaker 1: the Egyptian organithotherapy had the same basis. Spleen would cure
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Speaker 1: spleen heart, heart, et cetera. In the sixteenth and seventeenth centuries,
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Speaker 1: these doctrines of sympathies and antipathies were much in vogue.
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Speaker 1: A Scotchman Sylvester Ratree edited in the Theatrum Sympatheticum all
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Speaker 1: the writings upon the sympathies and antipathies of Man with animal,
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Speaker 1: vegetable and mineral substances, and the whole art of physics
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Speaker 1: was based on this principle. Upon this theory of mummia
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Speaker 1: or magnetic force, the sympathetic cure of disease was based.
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Speaker 1: The weapons salve, the sympathetic ointment, and the famous powder
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Speaker 1: of sympathy were the instruments through which it acted. The
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Speaker 1: magnetic cure of wounds became the vogue. Van Helmut adopted
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Speaker 1: these views in his famous Treaties to Magnetica Vulnerum Curatione,
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Speaker 1: in which he asserted that cures were wrought through magnetic influence.
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Speaker 1: How close they came to modern views of wound infection
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Speaker 1: may be judged from the following Upon the solution of
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Speaker 1: unity in any part the ambient air repleated with various
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Speaker 1: evaporations or apparreeas of mixed bodies, especially such as are
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Speaker 1: then suffering. The act of putrefaction violently invadeth the part,
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Speaker 1: and thereupon impresseth an exotic miasm or noxious diathesis, which
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Speaker 1: disposeth the blood, successively arriving at the wound to putrefaction.
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Speaker 1: By the intervention of fermentation. With his magnetic sympathy, Van
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Speaker 1: Helmont expressed clearly the doctrine of immunity and the cure
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Speaker 1: of disease by immune sarah. For he who has once
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Speaker 1: recovered from that disease hath not only obtained a pure
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Speaker 1: balsamical blood, whereby for the future he is rendered free
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Speaker 1: from any recidivation of the same evil, but also infallibly
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Speaker 1: cures the same affection in his neighbor, and by the
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Speaker 1: mysterious power of magnetism, transplants that balsam and conserving quality
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Speaker 1: into the blood of another. He was rash enough to
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Speaker 1: go further and say that the cures effected by the
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Speaker 1: relics of the saints were also due to the same cause,
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Speaker 1: a statement which led to a great discussion with the
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Speaker 1: theologians and to van Helmont's arrest for heresy and small
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Speaker 1: wonder when he makes such bold statements as let the
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Speaker 1: divine inquire only concerning God. The naturalist concerning nature and
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Speaker 1: God in the production of miracles, does for them the
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Speaker 1: most part, walk hand in hand with nature. That wandering
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Speaker 1: genius Sir Kenelm Digby did much to popularize this method
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Speaker 1: of treatment by his lecture on the Powder of Sympathy.
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Speaker 1: His powder was composed of copperas alone or mixed with
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Speaker 1: gum tragacanth. He regarded the cure as effected through the
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Speaker 1: subtle influence of the sympathetic spirits, or, as Heimore says,
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Speaker 1: by atomical energy wrought at a distance, and the remedy
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Speaker 1: could be applied to the wound itself, or to a
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Speaker 1: cloth soaked in the blood or secretions, or to the
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Speaker 1: weapon that caused the wound. One factor leading to success
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Speaker 1: may have been that in the directions which Digby gave
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Speaker 1: for treating the wound in the celebrated case of James Howell,
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Speaker 1: for instance, it was to be let alone and kept clean.
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Speaker 1: The practice is alluded to very frequently by the poet.
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Speaker 1: In the Lay of the Last Minstrel, we find the following,
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Speaker 1: but she has tain the broken lance and washed it
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Speaker 1: from the clotted gore, and salved the splinter ore. And
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Speaker 1: o'er William of Delraine in trance, whene'er she turned it
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Speaker 1: round and round, twisted as if she'd galled his wound.
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Speaker 1: Then to her maidens she did say that he should
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Speaker 1: be hull man and sound. And in Dryden's tempest, Ariel says,
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Speaker 1: anoint the sword which pierced him, with the weapon, salve,
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Speaker 1: and rapid clothes from air till I have time to
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Speaker 1: visit him again. From van Helmont comes the famous story
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Speaker 1: of the new nose that dropped off in sympathy with
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Speaker 1: the dead arm from which it was taken, and the
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Speaker 1: source of the famous lines of Houdibras. As I have
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Speaker 1: not seen the original story quoted of late years, it
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Speaker 1: may be worth while to give it. A certain inhabitant
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Speaker 1: of Bruxels, in a combat, had his nose mowed off,
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Speaker 1: addressed himself to Taglia Causas, a famous Georgian living in Bononia,
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Speaker 1: that he might procure a new one, And when he
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Speaker 1: feared the incision of his own arm, he hired a
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Speaker 1: porter to admit it out of whose arm having first
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Speaker 1: given the reward agreed upon at length, he digged a
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Speaker 1: new nose. About thirteen months after his return to his
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Speaker 1: own country, on a sudden the ingrafted nose grew cold, putrefied,
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Speaker 1: and within few days drops off. To those of his
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Speaker 1: friends that were curious in the exploration of the cause
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Speaker 1: of this unexpected misfortune, it was discovered that the porter
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Speaker 1: expired nearer about the same punctilio of time, wherein the
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Speaker 1: nose grew frigid and cadaverous. There are at Bruxels yet
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Speaker 1: surviving some of good repute that were eye witnesses of
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Speaker 1: these occurrences. Equally in the history of science and of medicine,
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Speaker 1: fifteen forty two is a starred year, marked by a
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Speaker 1: revolution in our knowledge, alike of macrocosm and microcosm. In Frauenberg,
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Speaker 1: the town physician and a canon, now nearing the palmist
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Speaker 1: limit and his end, had sent to the press the
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Speaker 1: studies of a lifetime, their revolutionibus orbium coalstium. It was
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Speaker 1: no new thought, no new demonstration, that Copernicus thus gave
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Speaker 1: to his generation. Centuries before men of the keenest scientific
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Speaker 1: minds from Pythagoras on had worked out a heliocentric theory,
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Speaker 1: fully promulgated by Aristarchus and very generally accepted by the
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Speaker 1: brilliant investigators of the Alexandrian school, But in a long
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Speaker 1: interval lapped in Oriental lethargy, Man had been content to
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Speaker 1: acknowledge that the heavens declare the glory of God, and
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Speaker 1: that the firmament sheweth his handiwork. There had been great
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Speaker 1: astronomers before Copernicus. In the fifteenth century Nicholas av Cuza
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Speaker 1: and Reggiomontanus had hinted at the heliocentric theory, but fifteen
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Speaker 1: twelve marx and epoch in the history of science since
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Speaker 1: for all time, Copernicus put the problem in a way
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Speaker 1: that compelled acquiescence. Nor did Copernicus announce a truth perfect
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Speaker 1: and complete, not to be modified. But there were many
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Speaker 1: contradictions and lycune which the work of subsequent observers had
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Speaker 1: to reconcile and fill up. For long years. Copernicus had
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Speaker 1: brooded over the great thoughts which his careful observation had compelled.
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Speaker 1: We can imagine the touching scene in the little town
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Speaker 1: when his his friend Ossiander brought the first copy of
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Speaker 1: the precious volume hot from the press, a well enough
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Speaker 1: printed book. Already on his deathbed, stricken with a long illness,
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Speaker 1: the old man must have had doubts how his work
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Speaker 1: would be received, though years before Pope Clement the seventh
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Speaker 1: had sent him encouraging words. Fortunately, death saved him from
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Speaker 1: the rending, which is the portion of so many innovators
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Speaker 1: and discoverers. His great contemporary, reformer, Luther, expressed the view
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Speaker 1: of the day when he said, the fool will turn
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Speaker 1: topsy turvy the whole art of astronomy. But the Bible
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Speaker 1: says that Joshua commanded the sun to stand still, not
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Speaker 1: the earth. The scholarly Melanchthon, himself, an astronomer, thought the
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Speaker 1: book so godless that he recommended its suppression Daniman Grundrus.
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Speaker 1: The Church was too much involved in the Ptolemaic system
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Speaker 1: to accept any change, and it was not until eighteen
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Speaker 1: twenty two that the works of Copernicus were removed from
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Speaker 1: the index. End of section nineteen