the evolution of modern medicine(现代医药的演变)-第20节
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from these Alexandrines； who described the valves of the heart；the
duodenum； and many of the important parts of the brain； they recognized
the true significance of the nerves （which before their day had been
confounded with the tendons）； distinguished between motor and sensory
nerves； and regarded the brain as the seat of the perceptive faculties and
voluntary action。 Herophilus counted the pulse； using the water…clock for
the purpose； and made many subtle analyses of its rate and rhythm； and；
influenced by the musical theories of the period； he built up a rhythmical
pulse lore which continued in medicine until recent times。 He was a skilful
practitioner and to him is ascribed the statement that drugs are the hands
of the gods。 There is a very modern flavor to his oft…quoted expression that
the best physician was the man who was able to distinguish between the
possible and the impossible。
Erasistratus elaborated the view of the pneuma； one form of which he
believed came from the inspired air； and passed to the left side of the heart
and to the arteries of the body。 It was the cause of the heart…beat and the
source of the innate heat of the body； and it maintained the processes of
digestion and nutrition。 This was the vital spirit； the animal spirit was
elaborated in the brain； chiefly in the ventricles； and sent by the nerves to
all parts of the body； endowing the individual with life and perception and
motion。 In this way a great division was made between the two functions
of the body； and two sets of organs： in the vascular system； the heart and
arteries and abdominal organs； life was controlled by the vital spirits； on
the other hand； in the nervous system were elaborated the animal spirits；
controlling motion； sensation and the various special senses。 These views
on the vital and animal spirits held unquestioned sway until well into the
eighteenth century； and we still； in a measure； express the views of the
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great Alexandrian when we speak of 〃high〃 or 〃low〃 spirits。
GALEN
PERGAMON has become little more than a name associated in our
memory with the fulminations of St。 John against the seven churches of
Asia； and on hearing the chapter read； we wondered what was 〃Satan's
seat〃 and who were the 〃Nicolaitanes〃 whose doctrine he so hated。
Renewed interest has been aroused in the story of its growth and of its
intellectual rivalry with Alexandria since the wonderful discoveries by
German archaeologists which have enabled us actually to see this great
Ionian capital； and even the 〃seat of Satan。〃 The illustration here shown is
of the famous city； in which you can see the Temple of Athena Polis on the
rock； and the amphitheatre。It s interest for us is connected with the greatest
name； after Hippocrates； in Greek medicine； that of Galen； born at
Pergamon A。 D。 130； in whom was united as never before and indeed
one may say； never sincethe treble combination of observer；
experimenter and philosopher。 His father； Nikon； a prosperous architect；
was urged in a dream to devote his son to the profession of medicine； upon
which study the lad entered in his seventeenth year under Satyrus。 In his
writings； Galen gives many details of his life； mentioning the names of his
teachers； and many incidents in his Wanderjahre； during which he studied
at the best medical schools； including Alexandria。 Returning to his native
city he was put in charge of the gladiators； whose wounds he said he
treated with wine。 In the year 162； he paid his first visit to Rome； the scene
of his greatest labors。 Here he gave public lectures on anatomy； and
became 〃the fashion。〃 He mentions many of his successes； one of them is
the well…worn story told also of Erasistratus and Stratonice； but Galen's
story is worth telling； and it is figured as a miniature in the manuscripts of
his works。 Called to see a lady he found her suffering from general
malaise without any fever or increased action of the pulse。 He saw at once
that her trouble was mental and； like a wise physician； engaged her in
general conversation。 Quite possibly he knew her story； for the name of a
certain actor； Pylades； was mentioned； and he noticed that her pulse at
once increased in rapidity and became irregular。 On the next day he
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arranged that the name of another actor； Morphus； should be mentioned；
and on the third day the experiment was repeated but without effect。 Then
on the fourth evening it was again mentioned that Pylades was dancing；
and the pulse quickened and became irregular； so he concluded that she
was in love with Pylades。 He tells how he was first called to treat the
Emperor Marcus Aurelius； who had a stomach…ache after eating too much
cheese。 He treated the case so successfully that the Emperor remarked； 〃I
have but one physician； and he is a gentleman。〃 He seems to have had
good fees； as he received 400 aurei （about 2000） for a fortnight's
attendance upon the wife of Boethus。
He left Rome for a time in 168 A。 D。 and returned to Pergamon； but
was recalled to Rome by the Emperor； whom he accompanied on an
expedition to Germany。 There are records in his writings of many journeys；
and busy with his practice in dissections and experiments he passed a long
and energetic life； dying； according to most authorities； in the year 200
A。D。
A sketch of the state of medicine in Rome is given by Celsus in the
first of his eight books； and he mentions the names of many of the leading
practitioners； particularly Asclepiades； the Bithynian； a man of great
ability； and a follower of the Alexandrians； who regarded all disease as due
to a disturbed movement of the atoms。 Diet； exercise； massage and bathing
were his great remedies； and his mottotuto； cito et jucundehas been the
emulation of all physicians。 How important a role he and his successors
played until the time of Galen may be gathered from the learned lectures
of Sir Clifford Allbutt＇32＇ on 〃Greek Medicine in Rome〃 and from Meyer…
Steineg's 〃Theodorus Priscianus und die romische Medizin。〃＇33＇ From
certain lay writers we learn that it was the custom for popular physicians
to be followed on their rounds by crowds of students。 Martial's epigram （V；
ix） is often referred to：
Languebam： sed tu comitatus protinus ad me Venisti centum；
Symmache； discipulis。 Centum me tegigere manus Aquilone gelatae Non
habui febrem； Symmache； nunc habeo。
＇32＇ Allbutt： British Medical Journal； London； 1909； ii； 1449； 1515；
1598。
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＇33＇ Fischer； Jena； 1909。
And in the 〃Apollonius of Tyana〃 by Philostratus； when Apollonius
wishes to prove an alibi； he calls to witness the physicians of his sick
friend； Seleucus and Straloctes； who were accompanied by their clinical
class to the number of about thirty students。＇34＇ But for a first…hand sketch
of the condition of the profession we must go to Pliny； whose account in
the twenty…ninth book of the 〃Natural History〃 is one of the most
interesting and amusing chapters in that delightful work。 He quotes Cato's
tirade against Greek physicians；corrupters of the race； whom he would
have banished from the city；then he sketches the career of some of the
more famous of the physicians under the Empire； some of whom must
have had incomes never approached at any other period in the history of
medicine。 The chapter gives a good picture of the stage on which Galen
（practically a contemporary of Pliny） was to play so important a role。
Pliny seems himself to have been rather disgusted with the devious paths
of the doctors of his day； and there is no one who has
