a history of science-2-第6章

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nt。　This　was　the　field　of　medicine。　The　Byzantines　of　this　time　could　boast　of　two　great　medical　men；　Aetius　of　Amida　（about　502…575　A。D。）　and　Paul　of　Aegina　（about　620…690）。　The　works　of　Aetius　were　of　value　largely　because　they　recorded　the　teachings　of　many　of　his　eminent　predecessors；　but　he　was　not　entirely　lacking　in　originality；　and　was　perhaps　the　first　physician　to　mention　diphtheria；　with　an　allusion　to　some　observations　of　the　paralysis　of　the　palate　which　sometimes　follows　this　disease。　Paul　of　Aegina；　who　came　from　the　Alexandrian　school　about　a　century　later；　was　one　of　those　remarkable　men　whose　ideas　are　centuries　ahead　of　their　time。　This　was　particularly　true　of　Paul　in　regard　to　surgery；　and　his　attitude　towards　the　supernatural　in　the　causation　and　treatment　of　diseases。　He　was　essentially　a　surgeon；　being　particularly　familiar　with　military　surgery；　and　some　of　his　descriptions　of　complicated　and　difficult　operations　have　been　little　improved　upon　even　in　modern　times。　In　his　books　he　describes　such　operations　as　the　removal　of　foreign　bodies　from　the　nose；　ear；　and　esophagus；　and　he　recognizes　foreign　growths　such　as　polypi　in　the　air…passages；　and　gives　the　method　of　their　removal。　Such　operations　as　tracheotomy；　tonsellotomy；　bronchotomy；　staphylotomy；　etc。；　were　performed　by　him；　and　he　even　advocated　and　described　puncture　of　the　abdominal　cavity；　giving　careful　directions　as　to　the　location　in　which　such　punctures　should　be　made。　He　advocated　amputation　of　the　breast　for　the　cure　of　cancer；　and　described　extirpation　of　the　uterus。　Just　how　successful　this　last　operation　may　have　been　as　performed　by　him　does　not　appear；　but　he　would　hardly　have　recommended　it　if　it　had　not　been　sometimes；　at　least；　successful。　That　he　mentions　it　at　all；　however；　is　significant；　as　this　difficult　operation　is　considered　one　of　the　great　triumphs　of　modern　surgery。　But　Paul　of　Aegina　is　a　striking　exception　to　the　rule　among　Byzantine　surgeons；　and　as　he　was　their　greatest；　so　he　was　also　their　last　important　surgeon。　The　energies　of　all　Byzantium　were　so　expended　in　religious　controversies　that　medicine；　like　the　other　sciences；　was　soon　relegated　to　a　place　among　the　other　superstitions；　and　the　influence　of　the　Byzantine　school　was　presently　replaced　by　that　of　the　conquering　Arabians。

THIRTEENTH…CENTURY　MEDICINE　The　thirteenth　century　marks　the　beginning　of　a　gradual　change　in　medicine；　and　a　tendency　to　leave　the　time…worn　rut　of　superstitious　dogmas　that　so　long　retarded　the　progress　of　science。　It　is　thought　that　the　great　epidemics　which　raged　during　the　Middle　Ages　acted　powerfully　in　diverting　the　medical　thought　of　the　times　into　new　and　entirely　different　channels。　It　will　be　remembered　that　the　teachings　of　Galen　were　handed　through　mediaeval　times　as　the　highest　and　best　authority　on　the　subject　of　all　diseases。　When；　however；　the　great　epidemics　made　their　appearance；　the　medical　men　appealed　to　the　works　of　Galen　in　vain　for　enlightenment；　as　these　works；　having　been　written　several　centuries　before　the　time　of　the　plagues；　naturally　contained　no　information　concerning　them。　It　was　evident；　therefore；　that　on　this　subject；　at　least；　Galen　was　not　infallible；　and　it　would　naturally　follow　that；　one　fallible　point　having　been　revealed；　others　would　be　sought　for。　In　other　words；　scepticism　in　regard　to　accepted　methods　would　be　aroused；　and　would　lead　naturally；　as　such　scepticism　usually　does；　to　progress。　The　devastating　effects　of　these　plagues；　despite　prayers　and　incantations；　would　arouse　doubt　in　the　minds　of　many　as　to　the　efficacy　of　superstitious　rites　and　ceremonies　in　curing　diseases。　They　had　seen　thousands　and　tens　of　thousands　of　their　fellow…beings　swept　away　by　these　awful　scourges。　They　had　seen　the　ravages　of　these　epidemics　continue　for　months　or　even　years；　notwithstanding　the　fact　that　multitudes　of　God…fearing　people　prayed　hourly　that　such　ravages　might　be　checked。　And　they　must　have　observed　also　that　when　even　very　simple　rules　of　cleanliness　and　hygiene　were　followed　there　was　a　diminution　in　the　ravages　of　the　plague；　even　without　the　aid　of　incantations。　Such　observations　as　these　would　have　a　tendency　to　awaken　a　suspicion　in　the　minds　of　many　of　the　physicians　that　disease　was　not　a　manifestation　of　the　supernatural；　but　a　natural　phenomenon；　to　be　treated　by　natural　methods。　But；　be　the　causes　what　they　may；　it　is　a　fact　that　the　thirteenth　century　marks　a　turning…point；　or　the　beginning　of　an　attitude　of　mind　which　resulted　in　bringing　medicine　to　a　much　more　rational　position。　Among　the　thirteenth…century　physicians；　two　men　are　deserving　of　special　mention。　These　are　Arnald　of　Villanova　（1235…1312）　and　Peter　of　Abano　（1250…1315）。　Both　these　men　suffered　persecution　for　expressing　their　belief　in　natural；　as　against　the　supernatural；　causes　of　disease；　and　at　one　time　Arnald　was　obliged　to　flee　from　Barcelona　for　declaring　that　the　〃bulls〃　of　popes　were　human　works；　and　that　〃acts　of　charity　were　dearer　to　God　than　hecatombs。〃　He　was　also　accused　of　alchemy。　Fleeing　from　persecution；　he　finally　perished　by　shipwreck。　Arnald　was　the　first　great　representative　of　the　school　of　Montpellier。　He　devoted　much　time　to　the　study　of　chemicals；　and　was　active　in　attempting　to　re…establish　the　teachings　of　Hippocrates　and　Galen。　He　was　one　of　the　first　of　a　long　line　of　alchemists　who；　for　several　succeeding　centuries；　expended　so　much　time　and　energy　in　attempting　to　find　the　〃elixir　of　life。〃　The　Arab　discovery　of　alcohol　first　deluded　him　into　the　belief　that　the　〃elixir〃　had　at　last　been　found；　but　later　he　discarded　it　and　made　extensive　experiments　with　brandy；　employing　it　in　the　treatment　of　certain　diseasesthe　first　record　of　the　administration　of　this　liquor　as　a　medicine。　Arnald　also　revived　the　search　for　some　anaesthetic　that　would　produce　insensibility　to　pain　in　surgical　operations。　This　idea　was　not　original　with　him；　for　since　very　early　times　physicians　had　attempted　to　discover　such　an　anaesthetic；　and　even　so　early　a　writer　as　Herodotus　tells　how　the　Scythians；　by　inhalation　of　the　vapors　of　some　kind　of　hemp；　produced　complete　insensibility。　It　may　have　been　these　writings　that　stimulated　Arnald　to　search　for　such　an　anaesthetic。　In　a　book　usually　credited　to　him；　medicines　are　named　and　methods　of　administration　described　which　will　make　the　patient　insensible　to　pain；　so　that　〃he　may　be　cut　and　feel　nothing；　as　though　he　were　dead。〃　For　this　purpose　a　mixture　of　opium；　mandragora；　and　henbane　is　to　be　used。　This　mixture　was　held　at　the　patient's　nostrils　much　as　ether　and　chloroform　are　administered　by　the　modern　surgeon。　The　method　was　modified　by　Hugo　of　Lucca　（died　in　1252　or　1268）；　who　added　certain　other　narcotics；　such　as　hemlock；　to　the　mixture；　and　boiled　a　new　sponge　in　this　decoction。　After　boiling　for　a　certain　time；　this　sponge　was　dried；　and　when　wanted　for　use　was　dipped　in　hot　water　and　applied　to　the　nostrils。　Just　how　frequently　patients　recovered　from　the　administration　of　such　a　combination　of　powerful　poisons　does　not　appear；　but　the　percentage　of　deaths　must　have　been　very　high；　as　the　practice　was　generally　condemned。　Insensibility　could　have　been　produced　only　by　swallowing　large　quantities　of　the　liquid；　which　dripped　into　the　nose　and　mouth　when　the　sponge　was　applied；　and　a　lethal　quantity　might　thus　be　swallowed。　The　method　was　revived；　with　various　modifications；　from　time　to　time；　but　as　often　fell　into　disuse。　As　late　as　1782　it　was　sometimes　attempted；　and　in　that　year　the　King　of　Poland　is　said　to　have　been　completely　anaesthetized　and　to　have　recovered；　after　a　painless　amputation　had　been　performed　by　the　surgeons。　Peter　of　Abano　was　one　of　the　first　great　men　produced　by　the　University　of　Padua。　His　fate　would　have　been　even　more　tragic　than　that　of　the　shipwrecked　Arnald　had　he　not　cheated　the　purifying　fagots　of　the　church　by　dying　opportunely　on　the　eve　of　his　execution　for　heresy。　But　if　his　spirit　had　cheated　the　fanatics；　his　body　could　not；　and　his　bones　were　burned　for　his　heresy。　He　had　dared　to　deny　the　existence　of　a　devil；　and　had　suggested　that　the　case　of　a　patient　who　lay　in　a　trance　for　three　days　might　help　to　explain　some　miracles；　like　the　raising　of　Lazarus。　His　great　work　was　Conciliator　Differentiarum；　an　attempt　to　reconcile　physicians　and　philosophers。　But　his　researches　were　not　confined　to　medicine；　for　he　seems　to　have　had　an　inkling　of　the　hitherto　unknown　fact　that　air　possesses　weight；　and　his　calculation　of　the　length　of　the　year　at　three　hundred　and　sixty…five　days；　six　hours；　and　four　minutes；　is　exceptionally　accurate　for　the　age　in　which　he　lived。　He　was　probably　the　first　of　the　Western　writers　to　teach　that　the　brain　is　the　source　of　the　nerves；　and　the　heart　the　source　of　the　vessels。　From　this　it　is　seen　that　he　was　groping　in　the　direction　of　an　explanation　of　the　circulation　of　the　blood；　as　demonstrated　by　Harvey　three　centuries　later。　The　work　of　Arnald　and　Peter　of　Abano　in　〃reviving〃　medicine　was　continued　actively　by　Mondino　（1276…1326）　of　Bologna；　the　〃restorer　of　anatomy；〃　and　by　Guy　of　Chauliac：　（born　about　1300）；　the　〃restorer　of　surgery。〃　All　through　the　early　Middle　Ages　dissections