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SKETCHES
FROM
THE HISTORY OF MEDICINE
Ancient and Modern.
=AN ORATION=
DELIVERED BEFORE
THE HUNTERIAN SOCIETY,
AT THE LONDON INSTITUTION,
ON THE 13TH FEBRUARY, 1867,
BY
W^M. SEDGWICK SAUNDERS, M.D.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS, EDINBURGH.—VICE-PRESIDENT
OF THE HUNTERIAN SOCIETY.—TREASURER TO THE NEW SYDENHAM SOCIETY.—
EXAMINING PHYSICIAN TO THE EAST INDIAN—SCINDE AND DELHI—BOMBAY
AND BARODA—GREAT SOUTHERN OF INDIA—CALCUTTA AND SOUTH EASTERN
—AND OUDE AND ROHILKUND RAILWAY COMPANIES.—MEDICAL OFFICER
TO THE CITY OF GLASGOW LIFE ASSURANCE CORPORATION AND THE
METROPOLITAN FIRE BRIGADE, &c.—AUTHOR OF THE “CAUSES
AND PREVENTION OF CHOLERA” AND “REPORTS ON
CHOLERA IN THE CITY OF LONDON, 1866.”
PRINTED AT THE REQUEST OF THE COUNCIL.
_For Private Circulation._
LONDON:
PRINTED BY M. & W. COLLIS. 50, BOW LANE, CHEAPSIDE, E.C.
1868.
ORATION.
Mr. President,
I purpose to devote the time, which your indulgence has placed at my
disposal this evening, to laying before you the results of some
inquiries into the origin and history of medicine and of the medical
profession; regarding the subject rather from a _social_ than from a
_scientific_ point of view.
My scheme will introduce you to some of your old acquaintances; not for
instruction, but to remind you of those passages in their lives which
may have been pressed out of your memories by the sterner realities of
professional duties.
An inquiry into the origin of medicine must begin with the history of
man himself, since pain and death are the inevitable conditions of his
existence; and the desire to mitigate the former, and postpone the
triumphs of the latter arose from, and has kept pace with, the
development of the various diseases to which time and circumstances have
subjected him.
The _primal man_, we know, was created pure and innocent, free from
liability to pain, and possessed of unmixed capacity for the enjoyment
of the pleasures that surrounded him; glowing with health, and with
every emotion redolent of new delight. At sight of him,
Each hill gave sign of gratulation,
Joyous the birds; fresh gales and gentle airs
Whisper’d it to the woods; and from their wings
Flung rose, flung odours from the spicy shrub:—
Apprehension of the miseries to which his progeny were doomed, would
have marred this happiness; hence his ignorance of evil, and his belief
that the felicity he enjoyed would be as permanent as it was perfect.
But our business is with man in his _actual_ condition; the sport of
“All maladies
Of ghastly spasm, or racking torture, qualms
Of heart-sick agony, all feverous kinds,
Convulsions, epilepsies, fierce catarrhs,
Intestine stone, and ulcer, colic pangs,
Demoniac phrensy, moping melancholy,
And moon-struck madness, pining atrophy,
Marasmus and wide wasting pestilence,
Dropsies and asthmas, and joint-racking rheums,
And over them triumphant Death his dart
Shook, but delayed to strike.”——
Undertaking to examine the subject _ab initio_, we must take into
account the sources of our information, and as our knowledge of every
event _antecedent to the discovery of writing_ must have been
transmitted by oral or traditional agencies, we have to settle, in some
degree, how far such evidence is worthy of credence.
According to popular belief, the Noahic flood destroyed the whole human
race, with the exception of Noah and his family; who were therefore the
sole depositories of the traditions of the events which had occurred
between the time of Adam and themselves. The great longevity of these
antediluvian fathers made this oral transmission easy; and we know, that
the sons of Noah lived to see the birth of Abraham, whom, as the founder
of circumcision, we claim as the first operative surgeon on record.
In dealing with dates, I adopt the commonly accepted chronology, unmoved
by those refined speculations so much in favour at this time.
I begin with Moses, for whatever evidence may be urged upon us in the
shape of marbles, or monuments, claiming an antiquity anterior to the
advent of the Jewish lawgiver, it is a positive and unimpeachable fact,
that no _writings_ are in existence, which in point of age reach within
many centuries of the Pentateuch; indeed, as we shall presently see, the
oldest of the Greek writers are, in comparison with Moses, but as the
children of yesterday.
The five books of Moses were written 1500 years before Christ. Hesiod,
the father of Greek literature, flourished 500 years later; and Homer,
the next in succession, nearly a century after Hesiod.
Herodotus places Homer 400 years before himself; thus bringing the
“father of history,” as he is termed by Cicero, to about 500 years
before the advent of our Saviour, so that the difference of date between
the author of the Pentateuch and the oldest Greek historian cannot be
much less than 1000 years.
I pass over the pretended antiquity of the Chinese and Parsis records:
these have been disposed of very satisfactorily, and however much
_fancy_ may dwell upon the losses to literature inflicted by the Caliph
Omar, when he destroyed the Alexandrian library,[1] in the year 640, a
very little reflection will convince us that as these treasures, real or
assumed, had been ransacked for ages, by the brightest spirits of Greece
and Rome, everything worthy of note has been handed down to us.
-----
Footnote 1:
The library destroyed by the Caliph Omar, was situated in the temple
of Serapis, and consisted of 300,000 volumes; in addition to which
there existed in the Bruchion quarter of the city of Alexandria, a
second collection of 400,000 books, which was accidentally lost by
fire during the war with Julius Cæsar.
Alexandria (founded 332 B.C.) stood in an intermediate position
between the east and west, and united the commerce of Europe, Aralia,
and India; here came first into collision the Greek and Oriental mind;
here the Septuagint translation of the Old Testament was written; and
the collections formed by the ancient kings of Egypt were rapidly
enriched and enlarged by the interchange of ideas with the Greek
philosophers.
-----
The _learned_ talk about the writings of the Assyrians, the Babylonians,
and the Egyptians; but they do not produce a single scrap of tangible
evidence in support of these pretensions.
It may, however, be contended, that although there are no _writings_
extant, _traditional_ evidence is very strong; and this establishes a
high antiquity for Lycurgus, who lived 900 years before the Christian
era. The more, therefore, we inquire, the stronger the proof becomes,
that Moses as a lawgiver flourished 600 years before the highest
claimant to our veneration on the grounds of primitiveness; and thus we
are entitled to assume that the Greek legislator took much that is
excellent, in the laws ascribed to him, from his Jewish predecessor.
Lycurgus lived about the time that Shishak, king of Egypt, destroyed the
temple of Solomon, and carried away many captives: it is therefore no
very extravagant supposition, that the Pentateuch of Moses was known to
the great lawgiver. During the peaceful reign of king Solomon, the
intercourse between the Jews and the Egyptians was frequent and
extensive, for the great monarch, needing the assistance of skilful
artificers for the construction of the Temple at Jerusalem, broke down
that barrier of exclusiveness that had previously isolated his people.
Now the _learned_ of that day were seekers after wisdom wherever it was
to be found; and moreover, as the fame of Solomon was co-extensive with
the then existing world, so acute an observer as the _founder_ of the
Grecian law could not fail to use the materials which the wide spread
knowledge of the Jewish kings sayings and doings had placed within his
reach.
Every Jew was required to read the law, or hear it read, once a
year—each individual therefore became a living depository of its truths,
and, consequently, a somewhat competent teacher of those who might
desire to be instructed in such matters.
_Moses_ then comes before us as the first _writer_, and the first
_lawgiver_; and we shall now proceed to show that to these titles he
added the still greater distinction of being the first _physician_, and
promulgator of sanitary precautions.
At present, however, I will not further intrude upon your patience, but
leaving his claims where I have placed them, pass on to the
consideration of the character of the laws themselves;—and here we
arrive at a body of enactments so excellent, so well adapted, not only
to the requirements of a nomadic people wandering in a wild country, but
to that _same_ people when they subsequently became dwellers in cities,
and suffered all the encumbrances of a more advanced civilization.
_Moses_ made laws for _all_ times and for _all_ communities, _general_
as well as _particular_, reaching the _nation_ through every individual
member thereof; his rules for the preservation of health embraced the
consideration of personal cleanliness enforced as a _religious_
obligation in order that he might thereby enlist the unvarying
co-operation of the priesthood.
In a climate incentive to animal enjoyments he placed strict barriers
for the preservation of _chastity_, and decreed that matters relating to
sexual intercourse should be under the surveillance of the priest;
directions were also given to the _menstruous_ woman, and for her
conduct during _pregnancy_ and in _childbed_. The ordinance of
circumcision was devised not alone for ablutionary purposes, but for
_other well understood_ objects conducive to purity. Further, it was
directed how the man should order himself in affections of the virile
organs; and more emphatically, what he was bound to observe when the
terrible _leprosy_ afflicted him. In such a calamity he was compelled to
withdraw from his house, to be separated from society, and present
himself to the priest at various periods during the progress of the
disease; he was also to remain in a cheerless exclusion, where, if by
chance any unwary passenger came in sight, the sufferer was commanded to
cry aloud, _unclean! unclean!_ When convalescence and health returned,
the _priest_ pronounced him cured of his leprosy, and he was then
permitted to return to his home; but if the leprosy was supposed to
cling to the _habitation_, _that_, too, was subjected to isolation, and
in some instances to total destruction.
The _same precautions_ obtain in our own times, although nearly 3400
years have elapsed since they were first insisted upon by Moses.
Thus, we are told by Dr. Thompson, an eminent American writer on the
Holy Land (where he resided many years), that lepers are everywhere
regarded as unclean, and that at Jerusalem (where there is always a
considerable number of them) a separate quarter in the city is assigned
to them, to which they are rigidly confined. Dr. Thompson says: “I have
seen them cast out of the villages where they resided, and no healthy
person would touch them, eat with them, or use any of their clothes or
utensils, and even the Arab tent dwellers cast them out of camp. The
leper beggars stand apart, and never attempt to touch you, even as it
was in the time of the Saviour, when the ten lepers stood afar off and
lifted up their voice of entreaty.”
The same writer furnishes us with the following graphic description,
which, as coming from an eye witness, we have deemed worthy of notice:—
“Sauntering down the Jaffa road, on my way to the Holy City, I was
startled by the sudden apparition of a crowd of beggars, sans eyes, sans
nose, sans hair, sans everything; they held up their handless arms,
unearthly sounds gurgled through throats without palates, and, in a
word, I stood horrified, when, for the first time, I found myself face
to face with a leper.” He then goes on to say: “For many years I have
sought to get at the mystery of its origin, but neither books nor
learned physicians have thrown any light upon it. I have suspected that
this remorseless enemy originates in some self-propagating animalcules,
and thus I can conceive the possibility of the contagion reaching the
walls of a dwelling. No one has spoken with authority, as to what it
proceeds from or how it is generated.
“New born babes of leprous parents are often as pretty and healthy in
appearance as other children, but the ‘_scab_’ comes on by degrees, the
hair falls off, joint after joint of the fingers and toes shrink up, the
gums are absorbed, and the teeth fall out and disappear; the nose, the
eyes, the palate are slowly consumed, and finally the wretched victim
sinks into the earth under a disease beyond the control of medicine,
which cannot even mitigate its tortures.
“To my mind there is no conceivable manifestation of Divine power more
triumphantly confirmatory of Christ’s divinity than the cleansing of a
leper with a word.”[2]
-----
Footnote 2:
The contagiousness of Leprosy was held in universal belief up to the
seventeenth century, when certain writers on the subject began to
question the validity of a doctrine which had been handed down to them
through successive ages, by all the early observers of the Jewish,
Egyptian, Arabian, Grecian, and Hindoo countries, and the view then
advanced has been confirmed by the report of the Committee recently
appointed by the College of Physicians, who state that:—“The all but
unanimous conviction of the most experienced observers in different
parts of the world, is quite opposed to the belief that leprosy is
_contagious_ or _communicable_ by _proximity_ or _contact_.”
On the other hand we have to consider the testimony afforded us by the
shrewd and intelligent teachers of ancient times. Thus, Aretæus
believed it to be as contagious as the _plague_, and like _it_
communicable by respiration; and _Œtius_, following _Archigenes_,
thought that “the air became contaminated through the effluvia of the
sores.” _Avicenna_ believed leprosy to be contagious in the _general_
sense of that term; _Avenzoar_ by contact; _Haly Abbas_ and
_Alsaharavius_ through the respiration; and _Rogerius_ “_per coitum_.”
[These interesting facts are taken from an able article in the Lancet,
February 9, 1867.]
-----
The initiatory rite of circumcision was, by Divine command, first
performed by Abraham in the year of the world 2107, or about 1897 years
before Christ:—At the age of 99 years, Abraham, together with his son
Ishmael and all his dependents were circumcised.
Ishmael at this time was thirteen years old, and, as we are informed by
Josephus, was the founder of the Arabian nation, who to this day do not
circumcise until after the thirteenth year.
Isaac, the child of promise, the heir who was to carry on the race of
the patriarch, was circumcised on the eighth day after his birth, and
this, among the Hebrews, became a law, and a statute for ever.
One of the tapestries at Hampton Court, in the time of Holbein,
represents the operation being performed upon Isaac, with what appears
to be a knife made of stone, which was the instrument used for many ages
for this purpose.
By the kindness of my friend, the Rev. William Sparrow Simpson, the
learned Librarian and Minor Canon of St. Paul’s Cathedral, I am enabled
to show you some of these knives of stone; and further evidence of the
employment of such implements will be found in Exodus 4th chapter and
25th verse, where it is written—“Then Zipporah took a sharp stone and
cut off the foreskin of her son and cast it at his (Moses) feet.”[3]
-----
Footnote 3:
_Pliny_ tells us that the priests of _Cybele_, the mother of the gods
had sharp stones with which they cut themselves in their extasies.
_Catullus_ says, that _Atys_ emasculated himself with such an
instrument.
The Rabbinical law stands thus: “we may circumcise with anything, even
with a flint, with crystal (glass) or with anything that cuts, _except
with the sharp edge of a reed_, because the _enchanters_ make use of
that, or it may bring on a disease.” Again we have the evidence of
_Leutholf_ that the Æthopians used _stone knives_ for circumcision in
his time, 1581. Speaking of the _Alnajah_, an Æthopian race, he
says:—“Alnajah gens Æthiopum cultris lapideis circumcisionem peragit.”
Mr. E. B. Tylor in his “Researches into the Early History of Mankind,”
has suggested as the probable reason why stone was used as a cutting
instrument, that it was less likely to cause inflammation than either
bronze or iron. And _Pliny_ states that the mutilation of the priests
of _Cybele_ was done with a sherd of Samian ware to avoid the same
danger.
-----
Some writers believe that the practice of circumcision existed for ages
amongst the Heathens before the time of Abraham, whilst others have not
hesitated to date its origin as far back as our first fathers, asserting
that Adam was taught by the angel Gabriel to satisfy an oath he had made
to cut off that flesh, which after his fall had rebelled against his
spirit.
Much has been written with regard to the comparative _antiquity_ of this
custom among the Egyptians and Ethiopians; a point upon which the
erudite Herodotus leaves us in doubt.
Circumcision of _both_ sexes exists amongst the Abyssinians, Nubians,
Egyptians (both ancient and modern), Hottentots, and probably many other
nations. But in Turkey, Persia, and in the South Sea Islands, and those
of the Indian Seas, the practice is confined to the _male_ sex. The
Mohammedans adopt the rite of circumcision, and Mahomet himself was
circumcised, although no mention is made of the fact in the Koran.
Doubtless, the so-called circumcision of women, as it is practised in
some countries, is a modification of what _we_ understand by the term,
and involves structures other than the clitoris or nymphæ; and it is
equally true that the custom is adopted by many races totally
irrespective of any religious significance.
Sonnini de Manoncourt, a distinguished traveller and naturalist of the
eighteenth century “having examined a young girl of Egyptian origin,
about eight years old, found a thick, flabby, and fleshy excrescence,
covered with skin, which grew above the commissure of the labia, and
hung down half an inch, resembling in size and shape the caruncle
pendent from the bill of a turkey cock.”
Conditions of a similar nature are said to exist among the women of the
interior of Africa, and are probably due to climatic influences, but the
more common forms of disease are those of simple hypertrophy of the
external parts of generation; and it is not unreasonable to suppose that
the surgical interference necessary for their removal has given rise to
the general term of circumcision.
“Simple _excision_ of the _clitoris_ has been practised for very many
centuries by certain nations,” and I purpose quoting some interesting
observations just published by Dr. T. H. Tanner, upon the subject. His
first extract is from Strabo, the geographer, A.D. 21, who, in speaking
of the Egyptians, says:—“They _circumcise_ the males and _excise_ the
females, as is the custom also among the Jews, who are of Egyptian
extraction.” The custom appears to have been continued down to a recent
period, and Mr. W. G. Brown,[4] who resided for some time at Darfour,
North Africa, writing in 1779, thus alludes to it:—“The excision of
females is a peculiarity with which the northern nations are less
familiar; yet it would appear that this usage is more evidently founded
on physical causes, and is more clearly a matter of convenience, than
the circumcision of males, as it seems not to have been ordained by the
precept of any inspired writer.”
-----
Footnote 4:
Travels in Africa, Egypt, and Syria, from the year 1792 to 1798, p.
347. London, 1799.
-----
“This excision is termed in Arabic ‘_chafadh_.’ It consists of cutting
off the clitoris a little before the period of puberty, or at about the
age of _eight_ or _nine_ years.”
Again, the Nubian traveller[5] _Burckhardt_ tells us—“The daughters of
the Arabs _Ababde_, and _Djaafere_, who are of Arabian origin, and
inhabit the western bank of the Nile from Thebes, as high as the
cataracts, and generally those of all the people to the south of _Kenne_
and _Esne_ (as far as Sennaar) undergo circumcision, or rather
_excision_ (excisio-clitoridis,) at the age of from _three_ to _six_
years: Girls thus treated are called _mukhaeyt_.”
-----
Footnote 5:
Travels in Nubia, by the late John Lewis Burckhardt, p. 332. London,
1819.
-----
But perhaps the most trustworthy account of the circumcision of females
in Western Africa is that given by the late Mr. W. F. Daniel, who was a
distinguished member of our own profession. He tells us that “The
excisive process in Western Africa is variously performed in accordance
with the usages of the different districts where it is resorted to. The
operation consists either of:—
“1. Simple excision of the clitoris; 2. excision of the nymphæ; 3.
excision of both nymphæ and clitoris; 4. excision of a portion of the
labia pudendi, with either or all of the preceding structures.
“The history of the operation is involved in obscurity; that it was
secretly inculcated as one of those gloomy rites which the female
proselyte had to undergo, as a preliminary measure, prior to her
initiation into those dread mythological creeds, which, in Egypt and the
adjoining countries were swathed in the folds of an allegorical and
almost impenetrable mysticism, is the most likely inference.”
_Eventually_ the progressive decay of the religious institutions,
gradually led to its promulgation and practice among the masses of the
people; for the _priests_, who, independent of their scientific
attainments, were also well versed in medicine, might have advocated its
use both in a moral and hygienic point of view, as conducive to the
welfare of the female population.
I have been led into this digression by reflecting over the barbarous
and unphilosophical meddling of certain practitioners of our metropolis
who are, in effect, degrading our practice of surgery to the level of
that of the savages we have just described, without possessing the same
claim to our consideration on the score of ignorance, barbarism, and
superstition. The modern antic yclept “_clitoridectomy_” (to which I
refer), is, as the “Lancet” says, “a proceeding which, if it be
_useless_, is a _lamentable mistake_, and if it be _unnecessary_, _a
cruel outrage_.”
The next proposition we may fairly look for will be to imitate still
further the customs of these Western Africans who, in certain tribes,
whenever a girl shows any very strong indication of sexual feeling
(before she is betrothed), at once proceed to produce an obliteration of
her vagina by the intense inflammatory action set up by the forcible
introduction of a mass of the “capsicum fructescens,” or bird pepper—to
my mind not one shade more inhuman or barbarous than unsexing a woman
for ever, upon an assumption which grossly libels our female population.
The position taken by the early Christians in reference to the practice
of circumcision was decidedly antagonistic, so far as any value, in a
_religious_ point of view, should be ascribed to it; nevertheless, their
apostles and teachers permitted it to continue, at the discretion or
inclination of those who chose to submit to it.
It is an interesting fact to note that the Copts, whose Christianity
dates back from the persecution of Diocletian (called the era of
martyrs) in 303, and the Abyssinian Christians, who also reckon from the
fourth century, adopt the custom to this day, from a belief that it
gives them a further chance of entering Paradise, beyond the baptism
they receive as Christians. It is also singular that these sects accept
several other doctrines and precepts of the Mohammedans and Jews, among
whom they dwell.
The precise mode of operating upon males varies in different countries.
In Madagascar three separate and distinct operations are inflicted upon
the individual. In the South Sea Islands the natives simply slit up the
prepuce on its dorsal aspect, and in earlier times the practice was to
cut the prepuce all round the corona, avoiding the frœnum. In the Fiji
Islands the instrument used is a sharp splinter of bamboo.
Upon females the process of excision is performed by aged women. In
Egypt the custom is still maintained; and the women of the _Said_ travel
about from town to village, crying out “Circumcisor! who wants a
circumcisor?” In Old Calabar, Mr. Daniel had the opportunity of
witnessing the operation, which is likewise performed _there_ by aged
females. The girl having been placed on the knees of a woman, with the
legs apart, the clitoris was seized, _forceps-like_, by two pieces of
bamboo or palm-sticks, and being gently drawn forth, was severed with a
sharp razor.
Among the Jews the peculiar and distinctive mark of circumcision is
perpetuated in our days, and without any material change of ceremonial.
The _modus operandi_ is as follows:—The godfather being seated, takes
the child on his knees, and the operator (who may be the father of the
child, if capable, or some friend of the family, or a professed expert)
takes up with his fingers, or a pair of tweezers, as much of the prepuce
as he intends to cut off, and, on applying the knife, says—“Blessed be
Thou, O God, who hast commanded us to use circumcision.” He then sucks
the blood, and spits it into a cup of wine, and having applied styptics
to the wound, retakes the cup, and having blessed _it_ and the child,
pronounces the name of the child, and moistens his lips with the
contents of the cup. Various prayers are then said, and the ceremony is
concluded.
Though the modern Jews generally use a steel instrument, there is this
remarkable exception—that, when a male child dies before the eighth day,
it is circumcised prior to burial, and this is done, not with the
ordinary instrument, but with a fragment of glass or flint.
The practice extended to the Ishmaelites, and, as we have already
stated, was subsequently adopted by Mahomet, so that a very large
section of the human race are to this day, participators of a rite
established considerably more than 3000 years ago.
The subject cannot be dismissed without noticing the fact that the Jews
under their various captivities, subjugations, and persecutions,
endeavoured, in some instances, to obliterate the marks of circumcision.
This is abundantly proved, not only by contemporary writers, but by the
evidence of Epiphanius, Celsus, Galen, Paulus Ægineta, Fallopius, and
others, who have enlarged upon the means adopted for the accomplishment
of this object. It is, further, a noteworthy circumstance that the Jews
_entirely_ suspended the practice of circumcision during the forty years
of their wanderings in the wilderness.
In contemplating the sufferings of this unfortunate race, the heart
sickens at the punishments which resulted from their resistance to
foreign usurpation. Unable to discern the hand of God in their
humiliation, their struggles were, indeed, hopeless, but not the less
heroic. Captives in Babylon, after a long and cruel servitude, they were
restored only to be again scattered by the destruction of Jerusalem,
under Titus. Through the varying fortunes of the Romans, no
resting-place seems to have been vouchsafed to them; plundered and
disgraced, the fall of Rome only eventuated, as far as _they_ were
concerned, in a change of masters. Ruthless persecutors tracked them
through the dark ages, and what Heathenism spared, Christianity
despoiled; our pious ancestors praising God when they had a chance of
maltreating an Israelite.
For these reasons, and with such incentives, can we doubt that the timid
amongst them would endeavour to remove the means of identity which
circumcision afforded.
We have so refined away the simplicity of the patriarchal times, that it
is almost necessary to apologise for alluding to the reverential awe
with which all matters relating to the seed of Abraham were regarded. It
was a solemn and impressive act when the Patriarch, believing that the
time was come for his son Isaac to have a wife, sent for his chief
servant, and said, “Put, I pray thee, thy hand under my thigh, and swear
by the Lord that thou wilt choose a wife for my son out of mine own
kindred;” and the servant, with his hand on his master’s genitals, took
the required oath; and we all know how faithfully he performed it.
Whilst this simple, but deeply significant ceremony was being enacted,
the heart of the father of the faithful was doubtless filled with
contemplations of the great purposes for the accomplishment of which the
organs of generation were appropriately considered as the direct agents.
This mode of taking the oath is further adverted to in the 47th chapter
of Genesis, when Jacob is taking his farewell of his children.
In our blind adoration of classical heathenism we undervalue the sublime
and not less poetical incidents which mark the rise, progress,
culmination, and decay of that people with whom our highest interests
are identified. If, for instance, the Book of Job had not been written
under inspiration, and had been accidentally discovered among the ruins
of the _first_ Babylon, our antiquarians would have regarded it as the
loftiest of epics; and especially so if, instead of inculcating the
worship of the true God, its subject had been the glorification of
whatever false deity might have been in the ascendant when this most
ancient poem was composed.
The prejudices of education subjugate the judgment, and the gross and
sensual attributes with which the Greek poets invested their deities,
are accepted with complacency, if not with admiration; even Pope, their
great panegyrist, describes their heroes thus:—
“Gods, partial, changeful, profligate, unjust,
Whose attributes were _rage_, _revenge_, and _lust_.”
This, of course, will be set down for rank blasphemy against the canons
of taste. We are exuberant in our praises of the _genius_ of Homer, and
not to worship his _inventive_ powers is an offence of the deepest dye;
but when we are barbarous enough to critically examine this wonderful
mythology, and to determine the claims to applause—say of supreme
Jove—we are rather troubled by the difficulty of reconciling the ways of
the first intelligence with our commonplace notions of decency. The
intrigues of the father of the gods, the artifices by which he eludes
the jealousy of his wife Juno, his incestuous, and, if they were not
classical, we should call them filthy debaucheries, draw largely upon
our faith in the beauties of these records of high Olympus; and our
admiration for the poet is sadly tinctured with disgust for the images
in which his creative powers are developed.
Thus much of the ceremonial laws. Of the moral law, the law of God, it
becomes me not to speak; its obligations are as eternal as its author;
the everlasting truths of the decalogue have been incorporated more or
less into every system of religion and ethics which has been enunciated
during the ages interposing between us and the period in which they were
first promulgated on Mount Sinai.
In dismissing Moses and his times, I crave your particular attention to
the manner in which the characters of priest and physician met in the
same person. As we proceed we shall find that this junction of
attributes continues through all the variations of time and
circumstances. The terrors of the _unseen_, overawing the ignorant,
placed them at the mercy of those daring minds which in every age have
assumed the office of interpreters of the will of the _demon_, or the
behests of the benign Deity. To deal as a mediator between the threats
of the terrible avenger and the awe-stricken victim of his own
bewildered imagination, to avert the consequences of the threatened
storm, or to turn aside any other manifestation of approaching evil is
the office of the _medicine-man_ of the North American Indian and the
_Obeah_ doctor of the African. Shrewd observers of nature, these
wretched impostors monopolize the whole of the intelligence, such as it
is, of the hordes of the human race upon whom the light of reason has
never dawned, or has dawned in vain.
There is yet another aspect of the medical character, infinitely more
agreeable and important, and the consideration of it will bring us to
the times immediately preceding the days of the father of medicine. I do
not propose to penetrate into the story of Esculapius and his divine
origin, which probably, in an esoteric sense, merely meant that the
Giver of all good had inspired him with a knowledge of the healing art;
but (with a passing glance at Homer, the greatest poet of his own or any
subsequent age), proceed to offer some general observations on the
position which the study of medicine acquired under the tutorship of the
philosophers.
The siege of Troy is supposed to have taken place about three hundred
years before the _Iliad_ was sung, and in that early time it appears
that the cultivation of our art formed part of the general education of
kings and warriors.[6]
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Footnote 6:
“As for Medicine, something of it must have been understood in that
age, though it was so far from perfection, that, according to Celsus,
(book i.) what concerned _diet_ was invented long after by
Hippocrates. The accidents of life make the search after remedies too
indispensable a duty to be neglected at any time; accordingly, he
tells us, that the Egyptians, who had many medicinal plants in their
country, were all Physicians, and perhaps he might have learnt his own
skill from his acquaintance with that nation.
“The state of war in which Greece lived, required a knowledge in the
healing of wounds, and this might make him breed his princes,
Achilles, Patroclus, Podalirius and Machaon, to the science; what
Homer thus attributes to others he himself knew, and he has given us
reason to believe, not slightly, for if we consider his insight into
the structure of the human body, it is so nice, that he has been
judged by some to have wounded his heroes with too much science; or,
if we observe his cure of wounds, which are the accidents proper to an
epic poem, we find him directing the chirurgical operations, sometimes
infusing lenitives, at other times bitter powders, when the effusion
of blood required astringent qualities.”—_Pope’s Essay on the
Character of Homer._
-----
Homer introduces us to Machaon the son of Esculapius, who, when Menelaus
was treacherously wounded by Pandarus, is called to his aid:
“When the wound appeared in sight, where struck
The stinging arrow, from the clotted blood
He cleansed it, and applied with skilful hand
The healing ointments, which, in friendly guise,
The learned _Chiron_ to his father gave.”[7]
-----
Footnote 7:
Lord Derby’s Translation.
-----
Making due allowance for the debasing fable with which every great name
or talent is overlaid, it is rational to suppose that Chiron, the
teacher of Esculapius, was one of those shepherd philosophers, who like
their Babylonian brethren absorbed all the knowledge of the times; but
Homer gives us other examples in support of this idea. Chiron was the
preceptor of Achilles, and when Machaon is himself wounded, Patroclus is
sent by Achilles to his assistance; on his arrival he is urged by
Eurypylus, to
“Draw the deadly dart,
With luke-warm water wash the gore away:
With healing balm the raging smart allay,
Such as sage _Chiron_, sire of pharmacy,
Once taught Achilles, and Achilles thee.”—_Pope._
He also complains that
“Of two great _surgeons_, Podalirius stands
This hour surrounded by the Trojan bands,
And great _Machaon_ wounded in his tent
Now wants the succour which so oft he lent.”
Then
“Patroclus cut the forky steel away,
And in his hand a bitter root he pressed,
The wound he washed and styptic juice infused,
The closing flesh that instant ceased to glow,
The wound to torture and the blood to flow.”
Machaon seems to have largely shared the goodwill of the Grecian hosts.
Nestor, in his anxiety, says:—
A wise Physician skilled in wounds to heal,
Is more than _armies_ to the public weal.
Military leaders in our days have no such weakness as this. Studied
neglect seems to them the befitting recompense of those on whom they
must necessarily rely for the health and sanitary welfare of their
troops.
As we are still in the age of fable, it may not be out of place to
notice with what tenacity the human mind clings to those delusions which
fear engenders, and weak hopes sustain: with all our boasted
enlightenment, the _marvellous_ and the _incredible_ have more
worshippers than the _real_ and the _true_. Let us not wonder then, that
the pure monotheism enunciated in the Holy Scriptures had so little
charm for the sensuous and imaginative Greeks. Socrates, who, by the
simple force of reason and philosophy had reached the very portals of
the temple in which was enshrined the idea of the unity of God, in his
_last hour_ “sacrifices a cock to Esculapius.” The reputed offspring of
an impure deity, History is unhappily more abundant in records of human
folly and superstition, than in examples of purity of thought and
action—simplicity is everywhere despised—facts are distorted or made
subservient to sensations; for example:—It is not enough to tell us that
Chiron was skilled in physic, but to suit the depraved appetites of the
vulgar he is a _centaur_, and Esculapius a _god_. It is therefore with
something like relief that the name of Hippocrates comes before us, for
in him we have a _reality_, and in his works a remarkable record of the
condition of medical science in the fifth century before Christ. He was
born at Cos, a small island off the coast of Caria, not in Greece
proper, in the first year of the 80th Olympiad.
Hippocrates was descended from Esculapius by his father’s side, and from
Hercules by his mother’s, and was the son of Heraclides, a physician of
the family of the Asclepiadæ, who furnish us with the very earliest
instance of a body of philosophers devoting themselves to the healing
art; for, although Pythagoras, who lived immediately before Hippocrates,
and Democritus, who was his contemporary, were both learned physicians,
yet, whatever fame they acquired, was ascribed to their powers as mental
philosophers and rhetoricians.
It has been urged by way of apology for the mystery in which the
philosophers shrouded their wisdom, that “science, like modesty, should
cover itself with a veil to increase the charms of the treasure it
conceals;” and this principle has been, throughout all ages, more
generally acted upon than avowed.
The character of Hippocrates is at once a study for the physician and
the moralist; the former will appreciate the astonishing evidences which
his works afford, of a deep acquaintance with the whole subject of
medicine, and his admiration will be increased by the remembrance that
all the principles laid down by this great and good man, were the
results of his own experience.
No treatises on disease existed anterior to his time to aid him in his
investigations of the phenomena of nature, although it is true that in
the Asclepion or temple of Esculapius at Cos, records were kept and
votive tablets preserved commemorative of cures performed, and of the
remedies by which they were effected. But if the physician admires his
talents, the moralist does honour to the qualities of his mind and the
goodness of his heart. Benevolent and disinterested, pious towards the
gods, and incorruptibly devoted to his country, he instructed his fellow
men, not by shedding maudlin tears over their follies, like Heraclides,
nor by the coarse laughter of his friend Democritus, but by a calm and
even walk of life, mitigating sorrow by his skill, and showing the form
and beauty of virtue by his example.
His portrait of a worthy physician may well serve for his own likeness,
and in its description we shall observe that the exalted principles of
professional ethics therein inculcated, are as strictly applicable to
our own times as they were to those which he himself enlightened and
adorned. His words are:—“The physician who is an honour to his
profession, is he who has merited the public esteem by profound
knowledge, long experience, consummate integrity, and irreproachable
life; who, esteeming all the wretched as equals in the eyes of the
Divine Being, hastens to their assistance, speaks with mildness, listens
with attention, bears with their impatience, and inspires that
confidence which sometimes of itself restores life; sensibly alive to
their sufferings, carefully studies the causes and progress of the
complaint; not disconcerted by unforseen accidents, but, in emergencies,
having exhausted his own resources, holds it a duty to call in his
brethren of the healing art to assist him with their advice. Having
struggled with all his strength against the malady, he is happy and
modest in success, and in failure congratulates himself that he has, at
least, alleviated the sufferings of his patient.”
One of the great obstacles to the advancement of anatomy and physiology
was the universal reverence for the dead which the Greeks and Romans
shared in common with all the people of antiquity. Among the Jews, to
touch a dead body exposed the offender to a penance of seven days’
exclusion and privation from the ordinary comforts of life; and it is
almost superfluous to add, that the Egyptians made this reverence a part
of their religion.
He, then, who ventured on the dissection of the human body, did so at
great personal risk, and for more than 600 years after the foundation of
Rome, no instance is known of the existence of any public professor of
anatomy. About that time Archagathus, a Greek, practised surgery in
Rome; and it appears that his use of the knife, and the actual cautery,
was so abhorrent to the general feeling, that he was saluted with the
opprobrious title of “Carnifex.” Even in later days the learned
Tertullian classed anatomists and butchers together in a philippic he
pronounced against Herophilus, whom he charged with having tried
experiments on the living body. He commences:—“Herophilus, the
physician, or butcher, whichever you please, who to become better
acquainted with men, ripped them up alive,” &c. &c.
Of this same Herophilus, who appears to have been a man of humour, as
well as genius, there is an excellent story told:—A certain _Diodorus_,
a contemporary philosopher and teacher of paradoxes, declared that there
was no such thing as _motion_. “If a body _moves_,” says he, “it moves
into the place where it _is_, _or_ into the place where it _is not_; now
it does not move into the place where it _is_, for what is _in_ a place
_remains_ there, and, consequently, one cannot say that _it moves_. It
also cannot move in a place where _it is not_; and therefore, it does
not move at all.” This acute gentleman having dislocated his arm, begged
the services of Herophilus, who, smiling, said:—“Either the bone of your
arm is moved into the place where it _was_, or into the place where it
_was not_; now it cannot move, according to your principles, either in
one place or another, consequently it is not displaced at all.” The poor
teacher of paradoxes saw that Herophilus was laughing at him, and in an
agony cried out:—“Leave, I pray you, _dialectics_ and _sophisms_ to me,
and treat me according to the laws of medicine.”
The inference that dissection was not openly allowed, will be
strengthened by a short reference to the subject of the embalmment of
the dead—the first mention of this custom is found in the 50th Chapter
of Genesis; where, at the second verse, we read:—That “Joseph commanded
his servants, the physicians, to embalm his father, and the physicians
embalmed Israel;” and at 26th verse of the same chapter it is
written:—“So Joseph died, being an hundred and ten years old, and they
embalmed him.”
The Egyptians believed that so long as the human body could be saved
from putrefaction or decay, the soul of that body continued in
existence; and from this feeling arose the custom of embalming, so
common in remote ages. The embalmer was, in a certain sense, a _sacred_
functionary; nevertheless, it was the fashion to make a show of
resistance, when he began his operation, in order to mark the innate
horror of any, however necessary, profanation of the dead body.
Herodotus relates that in Egypt the mummy embalmers made the incision in
the side of the corpse with a sharp æthiopic stone. Of these stones two
varieties have been found in the tombs in Egypt, both of chipped flint,
and very neatly made. One kind is like a very small cleaver; the other
has more of the character of a lancet. The account given by Diodorus
Siculus of the resistance offered to the embalmer is, as follows:—“And
first, the body being laid on the ground, he who is called the scribe
marks on its left side how far the incision is to be made; then the
so-called slitter (paraschistes) having an æthiopic stone, and cutting
the flesh as far as the law allows, instantly runs off, the bystanders
pursuing him, and pelting him with stones, cursing him, and, as it were,
turning the horror of the deed upon him, for he who hurts a citizen is
held worthy of abhorrence.”[8] Immediately after death the corpse was
put into the hands of the embalmer, who in the presence of the friends
of the deceased, made an incision into the left side, as above
described, through which he extracted all the intestines, leaving the
heart and kidneys; the intestines were then washed in palm wine, and a
solution of astringent gums. The _brain_ was removed through the
nostrils by means of a hooked instrument, contrived for the purpose, and
the cavity filled with aromatic oils. The body was now anointed with
spice-oils and balsamic gums (frankincense being prohibited), and
allowed to remain for thirty days, after which it was immersed in a
solution of nitre for from forty to seventy days (the latter being the
extreme limit allowed); it was then enveloped in aromatised cere-cloths,
and all being ready, consigned to the coffin, on which were painted
emblems indicative of the condition of the deceased. The process is said
to have cost £300 of our money, and was, of course, only applicable to
the rich. The fee for embalmment alone, varied from a _Talent_ (which
has been estimated by some as equivalent to £193 15s., and by others to
£243 15s. of our present money) to a _Mina_, in value about £3 4s. 7d.
-----
Footnote 8:
Taken from E. B. Tylor—“Early History of Mankind,” p. 217.
-----
The embalmment of the middle classes was, in some degree, regulated by
their means; the simplest form being, the destruction of the intestines
with strong oil of tar, and after their removal soaking the body in a
strong solution of nitre for a period not exceeding seventy days.
Some have ascribed the practice of embalming to the fact of the
periodical inundations of the Nile rendering interment impossible at
such seasons, and hence have thought that necessity had quite as much to
do with the custom as the religious principle: but this idea is not well
founded, for although the Nile continues to overflow, embalmings have
ceased for ages.