words and by applying to them the methods of Whitney and of Marsh
follow them back to their early forms and significances, and then
construct from them ideographs of the customs, habits and superstitions
of the men who used them. Such a plan systematically carried out
might furnish both a fitting and a novel introduction to the history
of medicine. Coleridge, you know, said we might often derive more
useful knowledge from the history of a word than from the history of a
campaign.
Take, for instance, our word _idiocy_. The Greeks, especially the
Athenians, were a race of politicians. Private citizens who cared
little or naught for office were the _idiotai_, as distinguished from
the public officials and office holders. It came about in time that
men of such retiring habits and modest tastes were regarded as persons
of degraded intellect and taste. And so the _iviwrai_ were considered
of inferior intellectual capacity. In other words, the idiot of those
days was the man content with private life. How different from the
present day when conditions seem so nearly reversed.
Our kindred word _imbecile_ has also present reference to those of
feeble, dwarfed or perverted intellect, and refers rather to mental
than physical defects, though both must often be associated. But
originally the lame and the deformed who were obliged to use artificial
support, walked as it was said, _in bacillum_, upon a stick or crutch,
and from this expression we derive our word imbecile.
Let us trace, for instance, again, the etymology of our word _palate_.
The Latin _palatum_ is the same as _balatum_, that is, the bleating
part. The ancient shepherds of the region of the Campagna watched the
sheep as they went bleating (_balatans_) over those hills, one of which
subsequently became the _Palatine_.
Or take again our word _mania_. It is derived from _unv_ the moon,
meaning the moon-sickness, and corresponds to lunacy from _luna_. You
see the ancient superstition concerning the influence of the moon
abides in the name. This brings up again the old ideas concerning
the metal silver which was sacred alike to Diana and the moon, and
consequently feminine in sex and attributes. Hence comes the mediæval
alchemistic term _lunar caustic_, and hence, too, comes its use in the
treatment of epilepsy for which it was formerly much in use, since
epilepsy was regarded as a form of mania caused by the evil influence
of the moon.
By the way, this may also remind us of the peculiar views of the
alchemists of the middle ages, who believed that the property of sex
inhered in the metals. They believed, for example, that arsenic was
masculine in sex, and so named it from _arsen_, male, and _arsenikos_,
masculine. Medical, like comparative philology, is the more or less
direct outcome of the earth's physical features as they have influenced
the commingling of races and the conquest of nations.
Medicine seems a science of Aryan parentage; in the Sanscrit the
literature of medicine is rich; it was cultivated by the Greeks, but it
lost much of its original significance by virtue of Roman supremacy, as
the Latin races took it over. Under the Arabians it flourished after a
fashion. With the revival of Greek learning there was a restoration of
much that had been lost, but the supremacy of the Church kept it within
extremely narrow limits, though the clericals could not eliminate all
the Arabian words which had crept into its terminology. Greek is to-day
the language to which we turn for aid when it becomes necessary to
invent new terms by which to indicate fresh discoveries or concepts.
The debt of medicine to our Aryan forefathers is great. Surgery was
then a dignified branch of the science. Their autoplastic methods
were conceived with great ingenuity and carried out with much, albeit
with crude skill. The so-called Indian method of reconstructing a
nose bears witness to their ability in plastic art. Their itinerant
surgeons performed many capital operations; i. e., lithotomy and
coeliotomy. There is good reason to believe that Hippocrates knew
nothing of practical anatomy, whereas, long before him Susruta urged
that all physician priests should dissect the human body in order
that they might know its structure; and gave, moreover, directions
for the selection of suitable subjects. The Sanscrit writers knew
the properties of many plants and of at least five of the metals.
Many Greek names of drugs are derived from the Sanscrit, or else they
had a common Aryan origin. Thus the Greek equivalents for our words
castor, musk, cardamon, chestnut, hemp, mace, pepper, sandal-wood,
ginger, nerve, marrow, bone, heart, and head, are unmistakably of much
older, i. e., Sanscrit or Aryan stock, several of them coming down
in Romanized form, but almost unchanged--e. g., os, cor, moschus,
cannabis, castorion.
Although many of the ancient Greeks visited India, it appears that but
relatively few words have come to us from this ancient source.
Our word sulphur, though, is of Sanscrit origin, the Greek word
_theion_ indicating its divine or god-given purifying power, with
possible allusion to its utility in that lower world with which the
theologians most often associate it. The Greek word appears in our
chemical nomenclature as dithionic, trithionic, etc.
We note also an almost complete absence of Egyptian words, though many
cultured Greeks visited Egypt. Nevertheless, the latter looked with
small favor on barbarisms of speech, and our word pyramid is one of the
very few which they thus adopted. The term surgery is of very distinct
Greek origin, and meant handwork as distinguished from the action of
internal remedies. Medicine seems to be derived from _medeo_ to take
care of, to provide, and physic and physician from _phusis_, i. e.,
nature. The physici were originally naturalists, or scientists, like
Aristotle, medical science being but a part of their study. Campbell
in his book ("The Language of Medicine") gives a list of at least two
dozen common terms of to-day which were employed by Homer. In addition
to these, many other Homeric terms are still in use, but with more or
less altered or perverted meanings; for example, æther, when used in
the sense of its being a narcotic agency; astragalus, which originally
meant a die, since the analogous bones of the sheep were used for
dice; amoeba, from _amoibe_, change or alteration, alluding to
constant change of shape. Ammon originally meant a young lamb, iris a
halo, meconium has reference to the juice of the poppy, from _mekon_,
opium; molybdenum was so named from its resemblance to lead, narcosis
originally meant numbness; the pleura was the side; the original phial
was a saucer; the phalanges were so called because they were arranged
side by side as it were in a phalanx; our troche was at first a wheel;
and our tympanum was the original Greek drum, the word still persisting
in musical terminology. The arteries were so named because they
were supposed to contain air, while the veins were the gushers, from
_phleo_, to gush or flow. The original confusion of nerves and tendons
appears in the term aponeurosis.
Long ago there were two rival medical factions among the Greeks, the
Empirics, from _empeirikos_, meaning experimental--who believed there
were no philosophic underlying principles of medical science, and
that experience alone was the safe guide,--and the Methodists, from
_methodos_, who believed it better to follow the _hodos_, or "middle of
the road." The present use of the word empiric shows the contempt with
which the former came to be regarded.
As cure (_curo_) meant to care for, so did medicus have the same
meaning, as already remarked, while the Greek slave, _therapon_, who
waited on his master, became later the therapeutist who cared for his
ailments. Our word to heal has also a somewhat similar dislocated
meaning, since originally it meant protection, i. e., covering. The
same root persists in hell, i. e., hades, referring to a certain
supposititious locality so well covered that from it there is no escape.
Note, too, the influence of ancient mythology in medical phraseology.
Jupiter Ammon, the horned god, is recognized in hartshorn or ammonia.
Mars, the god of war, whose symbol is iron, persists in the so-called
martial preparations or ferruginous tonics. Venus and Aphrodite
naturally appear in venereal and aphrodisiac, while Vulcan's rôle is
indicated in the heat to which caoutchouc is subjected in vulcanizing
rubber. Mercury appears not only in Roman form as a metal, but in
his Greek rôle as Hermes, not to be forgotten when receptacles are
hermetically sealed. Let us cut short a longer list by simply noting in
passing how the Greek Cupid Eros and his mate Psyche are perpetuated
in our terms erotic and psychiatry, while Morpheus, the god of sleep,
can never be forgotten so long as morphine is in use. That the wrath
of the gods was to be dreaded is indicated in our word plague, from
_plege_, meaning a _blow_ from that source, that is their vengeance.
You thus see the antiquity of the notion that epidemics were a divine
visitation, and not due to bad sanitation.
Melancholia, _melas_ and _chole_, meant originally black bile. In
ancient physiology the bile played a very important part, and the
results of hepatic insufficiency were not only indicated by this name,
but the advantages of the use of calomel were amply emphasized by its
name, _kalos_ and _melas_, for it was a beautiful remedy for this
blackness. Another condition indicating trouble with the liver, which
we call jaundice to-day (from the French _jaunisse_), was known as
icterus from _ikteros_, a yellow bird. The poultice which the average
housewife of to-day is so fond of using, was originally a _poltos_, or
pudding, or perhaps a bean porridge.
In the days of ancient sacrifices one part of the animal was not
placed upon the altar as an offering to delight the gods. It was
that now known as the _sacrum_, which is usually defined to have been
considered the sacred bone. The adjective _sacer_ (sacrum), had not
only the meaning generally ascribed to it, but meant also execrable,
detestable, accursed. The sacrum meant then rather the part that was
not acceptable to those to whom it was offered. The word _calculus_,
like the term to calculate, must remind us of the presence of pebbles
and their early use in facilitating reckoning, while our common terms
testimony, testify, must necessarily recall the ancient sacred but
phallic methods of oath-taking. Another superstition connected with
deity is perpetuated in the term _iliac passion_, formerly applied to
volvulus, or one form of acute bowel obstruction with its violent pain,
which has been compared to that produced by the spear-point as part of
the suffering upon the cross.
A keen analysis of the situation at the beginning of the Christian
Era reveals the subtlety of the Greek character. The names of those
organs which called for deep investigation or dissection are taken
directly from the Greek, e. g., hepatic, sphenoid, ethmoid, the aorta,
while many of the superficial parts have Latin names, e. g., temporal,
frontal.
It is to the Greek that all nations almost invariably turn when they
seek to fashion new terms with which to characterize or name new
discoveries. The Romans showed their appreciation of that which was
good when they so readily adopted the science and learning of the
Greeks, and were willing to take over even their gods. The Latin
races have always been good imitators but poor originators, save
perhaps in war and politics. Had they been willing to imitate the
Greeks in these their history might have been very different. When the
Latin translators of Greek medical literature lacked for a word they
cheerfully took the original, sometimes giving it a Latin dress. For
instance, that which we now call the duodenum, meaning only twelve, was
originally the dodekadaktulon, meaning that it was of a length equal to
the width of twelve fingers, while they twisted the name _eileon_, the
twisted intestine, into _ileum_. But the names of most diseases, like
those of the more concealed parts, they copied almost exactly.
While in later ages the Church completely dominated, then subordinated,
and then finally almost terminated the study of the natural sciences,
it is yet of no small interest to note the effect of the rise of
Christianity upon the study of medicine. It has been well said that
the same "cross which brought light to religion cast a gloom over
philosophy" (Campbell). Certain it is that the creed and the tenets
which were for centuries the mainstay of Christianity, and which did so
much for the uplifting of mankind, were made the excuse for the gradual
suppression of all tendency toward investigation of natural phenomena,
and the monasteries, where scholars congregated, became the graves of
scientific thought and study. And so in time knowledge was exiled from
Christian domiciles and transplanted to a Mohammedan environment. With
Christian mythology and mysticism soon came also Christian demonology,
and disease was generally regarded as an evidence of diabolical
possession. This gave rise then, as even now, to the imposters who
pretended to cure it by exorcism of evil spirits or invocation of
divine or superhuman aid. It has always been a sorry time for rational
medicine when superstition is rife. Even under the Arabians science
flourished to but a limited extent. Their religion forbade the
portrayal of any living object, animal or vegetable, consequently their
works contained mere descriptions, never any illustration of any kind.
This, by the way, is the explanation of their fondness for geometric
tracery and of the richness of their ornamental designs. They professed
the same horror of the dead body that was later inculcated by the
Church and most of them scorned dissection. What wonder then that under
Christianity and Islam alike our profession fared badly.
But very little now remains in our terminology to remind us of the
period of Arabian supremacy. The Arabic words naphtha, sumach, alkali,
alcohol, elixir and _nucha_ (neck) are almost the only ones which have
survived the renaissance. How different the monkish Latin sometimes is
from the classic may appear in the use of the two words os and bucca
for mouth, or os frontis and glabella for the frontal bone.
But this enumeration must not be prolonged unduly. Let us select three
or four more examples almost at random and then pass on. But few will
associate Christianity with cretinism. The early Christian inhabitants
of the Pyrenees were known as _Christaas_, or in French, as to-day,
as Chretiens. A mountainous region did for them what it has done in
Switzerland for the races of to-day, and dwarfed the intellects of many
while their thyroids underwent great enlargement. Such degenerates are
known everywhere to-day as cretins, i. e., Christians.
Tarentum was the old Calabrian city later known as Tarento, where
during the middle ages the dancing mania appeared in aggravated form.
The frenzy was known in consequence as _tarantism_, while the spider
whose bite was supposed to cause it was called _tarantula_, and a rapid
dance music which alone would suit such rapid movements is still known
as the _tarantella_.
Nightmare has reference to the old Norse deity or demigod Mara, who was
supposed to strangle people during sleep.
The Sardonic grin has reference to a tradition that in Sardinia was
found a plant which when eaten caused people to laugh so violently that
they died.
But turn we now from words to those deeds which are reputed to proclaim
yet more loudly the manner and the worth of their authors. Where may
one look for a profession which shall afford greater opportunities? And
where may he find one in which incentives are so small? The world's
great rewards have been paid to the great destroyers of our race rather
than to its saviors. Do you suppose that if Napoleon had saved as many
lives as he lost he would have figured in history with his present
lustre? It is true that Lister's discovery has saved many more lives
than Napoleon took. If so, the Hôtel des Invalides should, when the
time comes, contain Lister's monument and not that of a great murderer.
Personal courage is one of the noblest characteristics which any
man can display, particularly so when it combines the moral and the
physical type. Public bravery brings nearly always its meed of public
recognition. In fact, publicity is often the stimulus to a kind of
bravery which without it would hardly respond to the tests. But your
really courageous man is he who cares not for a search-light to reveal
his deeds, one who dares and does within the quietude of his own
environment that from which his weaker brothers would shrink.
The soldier stirred to frenzy by the intensity of his passion will
accomplish with but little dread that which might easily baffle the
resolution of a reasoning man in a calm mood. The religious fanatic,
be he Mussulman or Christian, may permit himself to be rent asunder
rather than recant; but his motives are essentially selfish, since he
looks forward to the Mohammedan's or the Christian's paradise, and so
they are far from altruistic. But for that quiet heroism which shuns
publicity, which calls for the highest quality of both mental and
physical courage, which looks forward neither to the golden present
nor the mystical yet sensuous future, commend me daily, yes hourly,
to the sick rooms of patients suffering from diseases which menace the
welfare of others, the infectious, the dangerous, the loathsome. One
may read of late many stories of army surgeons doing heroic deeds under
fire, and one's heart naturally thrills with emotion as he imagines the
scenes and wonders what manner of daring may lead a man to risk his
life after this fashion. But I submit to you, that brave as is such a
deed and worthy of all possible honor, it has been hundreds of times
for one exceeded in the actual devotion to duty and the resolution
required to brave the elements, or to face death elsewhere than on the
battlefield, or to surrender strength or mayhap life itself, or to
invite disaster by infection, or to wear out and work out life in the
constant grinding altruistic work of doing for others, who perhaps have
violated every known sanitary law and forfeited their every right to
live.
Here is a theme that might well stir the most eloquent poet or orator
that ever lived. How then shall I do it justice? Joanna Bailie has well
put it:
"The brave man is not he who feels no fear,
For that were stupid and irrational;
But he whose nobler soul its fear subdues,
And bravely dares the danger Nature shrinks from."
This recognition of our profession was accorded much more unstintingly
nearly two thousand years ago, at a time when it was much less
deserved, when Cicero wrote (_De Natura Deorum_) "_Homines ad Deos
nulla re propius accedunt, quam salutem hominibus dando._" (Men are
never more godlike than when giving health to mankind).
But we can hardly delay longer here and at this time with the subject
of heroism in medicine. I shall not have completed the matters which
I wish to present to you to-day until I invite your attention to a
short sketch of the careers of four or five of the men who, during the
past two or three hundred years have set the example for men of all
times and most climes, whose lives are so replete with that which is
interesting, instructive or important that they may be well held up
before a graduating class as illustrations of everything which may be
advantageously imitated. They belong to that class of whom Longfellow
wrote:
"Lives of great men all remind us
We can make our lives sublime."
One of those was Jean Fernel, who was born in France about 1497 and
died in 1558. I do not know that his life history offers anything so
very startling, although he came to be regarded as the most memorable
physiologist of his generation, but he adopted a motto which I think
we all might well select for our own, and it was because of this motto
that I have mentioned his name at this point. It was this: "_Destiny
reserves for us repose enough._" If each of you will take this
individually to himself he will find in it stimulus enough for all
kinds of hard work.
The first of the eminently great men now to be mentioned in this
connection was Herman Boerhaave, born in 1668 and died in 1738. He
enjoyed the reputation of being perhaps the most eminent physician who
ever lived. The eldest son of a poor clergyman with a large family, he
was originally intended for theology, and with this in view studied
philosophy, history, logic, metaphysics, philology and mathematics,
as well as theology. A mere accident, resulting from intense party
spirit and doctrinal differences, prevented his devoting his life to
theology, and he turned next to mathematics and then to chemistry and
botany, subsequently studying anatomy and medicine. He graduated in
1693 and began at once to practice in Leyden, with such success that
he was early offered the position of ordinary surgeon to the king,
which, however, he had the moral courage to decline. Subsequently
he taught medicine and botany, to which chairs was also added later
that of chemistry. This fact of itself will show to you something
of the condition of medical science of that day, when one man could
teach chemistry, botany and medicine. His rarest talents, however,
were developed in the direction of clinical instruction, and in this
particular field he won such repute that hearers were attracted to
Leyden from all quarters of the world and in such numbers that no
university lecture-room was large enough to contain them. His practice
grew in extent and remunerativeness in pace with his reputation, and
when he died he left an estate of two millions. So famous was he that
it is said of him that a Chinese official once sent to him a letter
addressed simply "To the Most Famous Physician in Europe." That he had
fixed convictions and practices may be better understood from the fact
that so little difference did he make between his patients that he
kept Peter the Great waiting over one night to see him, declining to
regulate his visiting list by the means or position of his patients.
Boerhaave was universally regarded as a great student and a great
physician, but it was probably his qualities as a man which led to
the astonishing extent of his reputation. Essentially modest, not
disputatious nor belligerent, he had a remarkable influence over
the young men who came near him, while he had a habit of speaking
oracularly or in aphorisms, which are not always so profound as they
sound and yet often make a man's dicta celebrated. Save that he
introduced the use of the thermometer and the ordinary lens in the
examinations of his patients, his teachings do not form any really new
system. In the classification of men he would be regarded as a great
eclectic, in the purer sense of the term. Probably his greatest service
to medicine was in the permanent establishment of the clinical method
of instruction, and perhaps his next greatest real claim to glory is
the character of the instruction and the inspiration which he gave to
two of his greatest scholars, viz.: Haller and Van Swieten. He was
not the founder of a school. He left no great nor memorable doctrines
for which others should contend, but he left a name for studiousness,
honest and logical thinking, which was a priceless heritage for the
university with which he was connected.