B OOKS.
DR. RUSSELL ON THE HISTORY AND HEROES OF THE ART OF MEDICINE.*
* The History and Heroes of the Art of Medicine. Withpurtrults. Murray. THIS interesting and amusing book resembles in its style aclever phy- sician's account of a difficult case which he has brought to a success- ful issue—graphic and shrewd, digressive enough while all centring on one point, throughout complacent, and in the end slightly triumphant. We can scarcely regret that the author is a homoeopathist, whatever the error of his theory, for it is this which inspires him with courage to pursue this dismal history withoutng from the days of De- anocedes and Herodotus to those of flagging and Russell. It may be a scientific loss, but it is a literary gain that the author has a theory, a clue by which to measure what seems to him the real progress of this desperately winding path. Without a point of light, i as it seems to him, in the foreground, without his private belief in the new prophet of medicine, he would have had no courage to tell the dismal tale of the so-called healing .art. If his homceopathicfancy be all delirious, as to many minds eseems, still it has a useful lite- rary function in lending at the least an artificial unity of form, and some, if only an arbitrary, principle of selection to the man who is groping for indications of progress =long. the confusion of medical authorities and medical traditions. It is clear that had not Dr. Russell had the delightful secret of Hahnemann's discoveries in store for his readers, he would never have had sufficient motive to detail the raw theories of Galen, the complicated prescriptions of Avicenna, the extravagant transcendentalisms of Paracelsus, or the systematized intemperance of Brown and Rasori. It was the glad prospect of Jenner's homeopathic resource of vaccination, and of Hahnemanu's vast generalization of that method, that led on Dr. Russell through
the wilds and mazes of the previous history. Those alone who see in vision the end of the age, can bear to face its short-comings and its dreary flats. And his little hoinceopathic fanaticism has cheered on Dr. Russell through his sketches of the many ancient and modern practitioners whose mastery of the art of medicine was founded in little better than a long familiarity with violent and mischievous remedies more dangerous than disease.
By this, however, we by no means mean to imply that homceo- patine propagandism is the aim of the book. Quite otherwise. Without the joy of a scientific secret and dogma of this kind, the spring and elasticity of this pleasant history would be wanting, but the substance of it would be little changed. Dr. Russell writes like a fair and shrewd historian, putting forth his private creed only where it is impossible to conceal it; but fully determined to estimate great men of different schools impartially. And he succeeds. His book marks distinctly enough the different phases through which the prac- tice of medicine has passed between the time of Herodotus and our own. And it is little better than malignity to affirm, as it has been affirmed, that this work is a merepuff or advertisement of the author's private practice. Of this there is no trace whatever. Dr. Russell, believing ardently as he evidently does in homoeopathy, of course measures the sagacity of his different heroes in some degree by the nearness of their approach to the honweopathic dogmas ; but beyond this he is scrupulously fair in his delineation of the representative physicians whom he has chosen. The general public who have not learned to take a passionate side as between the two schools at all, and are quite willing to be cured either by the principle of similia ainrilibara curantur, or by that of contraria conlrariis, or by any eclectic system constructed out of both which may seem to be most successful in effecting eare,—this general public, we say, will read Dr. Russell's agreeable sketches with considerable interest, and pro- nounce them to be the efforts of a fair man -who has not written the worse for having chosen his side, but who has no wish to misjudge his opponents. Without some visionary faith in a coming revolution for the art of medicine, it is difficult to imagine how any man could have gone through Dr. Russell's task, for, in fact, attractive as is the conception of a healing art, nothing can be more dismal than its history. The physician is partly a naturalist, a student of the natural types of dis- ease, partly a practical man, who has to choose a policy for battling with disease. As a naturalist in recognizing and in classifying dis- eases, he has as much scientific light as he can expect, but by no means an attractive subject on which to work ; as a practical man in exorcising disease he has a very fascinating task, but by no means much light to assist him in discharging it rightly. Almost all reme- dies were for centuries empirical guess-work, mere gropings in the dark. On the other hand the definition and classification of diseases, while constituting a very distinct and intelligible science, did not lay the foundation of any very helpful or beneficent art. The conse- quence has been that the higher order of medical intellects have always shown a tendency to rest satisfied with understanding their case, and explaining what is going to happen to the patient. They seen new variety of morbid symptoms. They classify them triumph- antly, as a naturalist would a new insect. They say cheerfully to themselves, " Pleurisy complicated with nephritic symptoms, the pa- tient will probably die," and they feel that they have solved the case. They have referred it to a class, and predicted the usual course of the phenomena ; and what is medicine that it should arrest the course of nature ? As Robert Boyle, quoted by our author, remarks : "The great error to which the scientific and learned physicians of all times were liable, was to take greater pleasure in ascertaining the certainties of diseases, their propagation, mutual affinities, natural termination, and morbid alterations of the body, than in attempting to obtain the greatest possible command over the ancertainties on which the re- storation of the siek and the relief of the ,suffering depend." The reason is obvious. The one pleasure was a scientific pleasure in skilful and just classification. The attempt to care was a mere doubtful ex- periment for which no intelligible general principle could be laid down, and which a thorough scientific intellect knew to be a v blind kind of chance—firing at a hidden mark. A thorough-bred physician looks on the regular evolution of a disease with a kind of friendly satisfaction, as one after another of the well-known and clearly predicted stages set in. Re watches it as Mr. Waterton would watch the habits of a familiar rattlesnake, scarcely liking. to disturb the regular course of nature even on the chance of destroying it. On the other hand, the practitioners, whose chief interest is in the remedial process, have usually been einpirics groping in the dark. They believe m their own favourite talisman only, because they very inadequately appreciate the power of their enemy. They have sonic raw theory of their own as to the origin of disease, or blind faith in the universal virtues of some favourite antidote of their own, and have not sufficient insight into the difficulties of the task into which they plunge. Between these two opposite dangers, the art of medi- cine has been anything but a fortunate discipline for the intellect. The scientific minds are injured by the necessity of adopting practi- cal rules and traditions of treatment for which no ground or reason can be given, not even that of general success. And the unscientific minds are confirmed in unscientific habits by the consciousness that any distinct classification of diseases would teach them to distrust half if not, all their weapons.
Dr. Russell has given us striking examples of both these classes of physicians. The first and greatest of the calmly classifying medical men was Hippocrates. He seems to have been fully aware of the difficulty of combating disease, and to have chronicled, with as much scientific interest, the course of the disease, in failure as in success. The history of medicine is a history of degeneration, almost from his time to that of Boyle and Harvey. Hippocrates had no supersti- tious theory of medicine, such as sprang up so soon after his time. He was a true naturalist of diseases, and had the calmness and simplicity of a naturalist.
"He took the suffering human race, He read each wound, each weakness clear; He struck his finger in the place, And said, Thou idlest here, and here."
But lie did not profess to do very much as a healer, and certainly did not do very much. His successors professed more, and did more mischief.
It is very difficult to understand why it is that special physicians, such as Galen, and Avicenna, and Cardan, should have gained a vast repute, nay a vaster repute as successful physicians, than is ever gained in our time. Were their prescriptions to be now used, it is certain that far more patients would be killed by them than by dis- ease; and yet there was a time when they were supposed, at least, to save life with marvellous success.
Galen's principle is described in the following words
" Given a disease, determine its character as hot or cold, moist or dry, by an effort of imagination ; having done so, select a remedy which has been catalogued as possessing opposite qualities."
And here is one of his prescriptions :
" For example, under the head of dysentery,' he gives for indiscriminate selec- tion, according to taste, nine recipes, most of which are incorporated in the formulae of Paulus /Egineta, of which the following are specimens: Of the ashes of snails, p. iv.; of galls, p. ii. ; of pepper, i. Reduce to a fine powder, and sprinkle upon the condiments, or give to drink in water, or a white, watery wine.'
How was it that such principles and such remedies ever gained even the modest reputation of being better than nothing ? Here again is a grand prescription of the Arabian school: " One of the most favourite of their preparations, which went by the name of Theriacum, was composed of the following substances :—Squills, hedychroum, cin- namon, commonpepper, juice of poppies, dried roses, water-germander, rape seed, Illyrian iris, agaric, liquorice, opobalsam, myrrh, saffron, ginger, rhaponticum, cinquefoil, calamine, horehound, stone-parsley, cassidony coatis, white and long pepper, dittany, flowers of sweet rush, male frankincense, turpentine, mastich, black cassia, spikenard, flowers of poley, storax, parsley seed, seseli, shepherd's pouch, bishop's weed, germander, ground pine, juice of hypocistis, Indian leaf, Celtic nard, spignel, gentian, anise, fennel-seed, Lemnian earth, roasted chalcitis, amomum, sweet flag, balsamum, Pontic valerian, St. John's wort, acacia, gum, cardamom, carrot seed, galhanum, sagapen bitumen, oposonax, castor, centaury, clematis, Attic honey, and Falernian wine. Sixty-six ingredients composed this mixture, and with the exception of the last, we may safely affirm that the phy- sicians who prescribed it were entirely ignorant of the effects of any one of them, either taken by those in health, or given to the sick." The following passage in the chapter on Harvey, the great dis- coverer of the circulation of the blood, will give a fair specimen of Dr. Russell's descriptive powers : "In his capacity of physician to the king, Harvey was at Edgehill upon Sun- day, the 23rd of October, 1642. Had a man, looking upon the scene that presented itself on the afternoon of that day, been suddenly endowed with a know- ledge of the future, what strange reflections he must have made! There was King Charles I., with his handsome, melancholy face, anxiously watching the uncertain battle raging between his position and the small town of Marton; while beyond lay the vast expanse of woody Warwickshire, richly coloured by the sharp -frost which was to chill many a poor wounded man before the sun rose on the follow- ing morning. A little aside, under a hedge,' might be seen an elderly man reading a book. This was Harvey ; and beside him were two boys, of whom be had charge: the elder was afterwards Charles II., the younger James H. What a singular group on this battle-field I It was no affectation on the part of the physician, nor any indifference to the fate of his sovereign, that induced Harvey to read his book while the fight, which was to begin the decision of the fate of his royal friend and patron. was going on within his view; it was simply, that at the time he was more interested in the subject of generation than in any po- j;ty j. giugerfura !ideal catastrophe whatever. Had be not been so possessed with Love fur the sub- ject of his investigation, the great, open secret of the circulation would Rot have been revealed to him. Troth demands the devotion of a whole life for such a revelation in return. The politician and man of science have nothing in common: to be great in either spheres of action, a man must disown the other. Harvey, and men of his stamp, are not in their nature indifferent to ordinary human affairs ; they are simply always preoccupied; they are so intent on the int towards which they are pressing, as to be unconscious of the scenery. The k Harvey was reading on the battle-field of Edgehill was very likely his favourite, Fabricius' Treatise upon Generation' For a few days after the battle, he accompanied the king and army to Oxford, and during his very brief stay there, Aubrey says, I remember he came several times to our College (Trinity), to George Bathurst, B.D., who had a hen to hatch eggs in his chamber, whicb they opened daily, to see the progress and way of generation.' This, doubtless, was the sal jest of his study and meditation, when, before his eyes, a king was fight- ing for his kingdom, and the king's sons were looking on."
We cannot follow Dr. Russell through his many amusing sketches. We can only say that his volume gives us a very unfavourable im- pression of the art of medicine as an instrument of culture for the mind. All the greatest "heroes " of medicine, if they can be so called, appear to have been painfully conscious that the art of medi- cine interfered with the science. They did not, as a rule, dare to experiment freely on man, in order to derive some scientific principle. They were obliged to accept the empirical traditions of ignorant ages, rather than take the responsibility of tentative experiments on human life. And yet they felt that many of their traditions were unmixed guess-work. The result has been that we seldom find a more injurious class of influences affecting the intellectual growth of great than those which beset the education of the great physicians. Raw and hasty theory allied with fierce dogmatism in practice has had fuller swing among medical men, even up to the present day, than among any class of artists who profess that their principles are deter- mined by positive science.
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