Part 14 (1/2)
”Ideo Medico id in priro circuat, intellectas consideret, ut inter curandum media illa adhibeat, quae tollendo morbo apta sunt, ne ex medicina nocumentum proveniat”
--Basil Valentine, _Triumphal Chariot of Antimony_
[The physician must therefore especially take care that he understand all the circu the his treatment he may use those means which are especially suited to control the disease, lest any harm should come from his medicine]
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UNIVERSITY MEDICAL SCHOOLS [Footnote 25]
[Footnote 25: Address to the graduates of St Louis University Medical and Dental Schools, May 31, 1910, at the Odeon, St Louis]
It affords reat pleasure to accept the invitation of your Faculty to address the graduates of a university medical school here in the Middle West I wondered, of course, what I should talk to you about, and have come to the conclusion that as an historian of e I may have for you is likely to coinning to realize that the history of nificance for us than we have usually been accustomed to think, and, above all, that itand raising of standards in medical education In recent years there has come a very decided improvement in medical education in the United States It is not hard to understand that the foreigner lifts his eyebrows in surprise when he is told that o required but two ter to be a demand for a little e nuraduates every year with the degree {378} of doctor of medicine, which was a license to practise in every state in the Union, for there were no state or federal laws regulating the practice of medicine As for preliminary requirements the less said the better If a man could write his name and, indeed, he did not have to write it very plainly, he found it easy to raduated at the end of two scant terht come from the mines, or from the farm, or from before the mast, or fro of chelish and, above all, of English grammar, and he was at once adraduated when he had served his time
Practically no one was plucked The desire of the faculty for numbers of students forbade that in most cases The two terms in medicine were not even successive courses The second-year student listened, as a rule, to the sa year
We all know the reason now for this extremely low standard of medical education Proprietary medical schools made it their one business in life to make just as much out of medical education as possible and the historic septennate of professors, or so spoils) every year, and robbed medical Aht have for the real training of young men in the science and art and practice offeature of this maintenance of extremely low standards in medical education, however, is the fact that in spite of it, ood foundation in medicine and then by personal work afterwards came to be excellent practitioners ofsince: ”One can decry the system of those days, the inadequate preliminary requirements, the short courses, the dore appliances for demonstrative and practical instruction, but the results were better than the system Our teachers were men of fine character devoted to their duties; they inspired us with enthusiasm, interest in our studies and hard work, and they imparted to us sound traditions of our profession”
Nothing that I know is a better co the difficulties of the situation than the life stories of some of the men who came from these co and incoo Anity of the profession to a noteworthy degree, but also developed many men who made distinct contributions to world medicine, e not do now that {380} ourlifted up out of the slough of despond in which it was and the preliminary education for hly scientific character can be looked for, fro of the medical course?
Is it any wonder, then, that those of us who have the best interests of A with careful solicitude themedical education in this country? The one hope of anic connection with a university Real University Medical Schools, that is enuine Post-Graduate Departive, have opened our eyes to what is needed in medical education in this country Some of the old-time medical schools here in the United States had been connected by name with universities but this was more apparent than real, and the medical faculty ruled absolutely in its own department and throttledthe as little as possible to equipment, to laboratories, to all that was needed for medical education
Now has come the epoch of universityAet that the Spanish-A adopted their educational systems from the anic connection of the medical school with their universities, and as a consequence a good prelie ith us, is required and has always been, and then some four years in the medical school and, indeed, in most of the countries five or six years and in one at least seven years of ht, however, that this story of medical education in connection with universities and real university ill be especially interesting to the graduates of this thorough Western university, whose work in ed as up to some of the best standards of professional attainreat university assures not only the continuance, but the future develop lines that shall place this aressive medical schools of the world
The first university medical school that well deserves that name is the one that came into existence in connection with the University of Alexandria I have been at so, to point out how closely the University of Alexandria resembles our reat conqueror, who had gone forth to conquer the world, and having attained alhed for more worlds to conquer Then he set about the foundation of {382} a great city that was to be the capital of his e in that capital that was to attract students from all over the world When he died prematurely the Ptolemys, who inherited the African portion of his vast dominions, carried out his wishes Money was no object at Alexandria: they put up ht a lot of first editions of books in the shape of author's original manuscripts, stole the archives at Athens, used Alexander's collection (made for Aristotle) as the foundation of ould call a museum, paid professors better salaries than they received at that tiely familiar sound all this has! Then Alexandria proceeded to do scientific work
Euclid wrote his geoed, it has coes Archi up Euclid's work, laid the foundation, of mechanics in his study of the lever and the screw, and of hydrostatics and of optics in his studies of specific gravity and burning mirrors and lenses Hethat he was a practical as well as a theoretic genius, ould be gladly welcoht for, as a hest rank or largest income in our modern times Ptolemy elaborated the system of astronomy that had been so ably {383} developed by teachers at Alexandria before his tiines, which we have had as toys in our laboratories for centuries
We realized the true significance of one of theine was invented and we found that the principle of it was in the toy engine of this old natural philosopher of Alexandria They even did their literature scientifically at the University of Alexandria
We have no great original works from them in literature, but they invented coint translation of the Holy Scriptures and doing the sa nations for comparative study
It is rather easy to understand, then, that a medical school arose in connection with this scientific university, and that it did excellent work The collections of Aristotle contained y, botany, coy The Ptolemys were very liberal and allowed dissection of the human body, so that human anatomy developed from a definite scientific standpoint better then ever before The nuers in the town and the rather unhealthy cliypt left many unclai bodies ainst the violation of the hueneral principle, that has been the reason {384} for the absence of human dissection inthe bodies of friends cut up, but we do not mind much if the bodies of those who are unknown to us are treated in that way So long as men did not travel much there were few unclaimed bodies With the advent of travel came abundant material for dissection and the Ptolereat anatomists built up the structure of scientific huood foundation that had been laid on animal anatomy in the foretime After all, the anatomy of the anie had been gained froes These two anatomists were Erasistratos and Herophilos Both of theht have been expected For just as soon as the opportunity for dissecting man was provided, this, his most complex structure, attracted instant attention Herophilos has naave the curious appearance in the floor of the fourth ventricle--the _calamus scriptorius_--is still retained He describes the membranes of the brain, the various sinuses, the choroid plexuses, the cerbral ventricles and traced the origin of the nerves fro to well-grounded tradition, the distinction between nerves of sensation and motion {385} He described the eye and especially the vitreous body, the choroid and the retina He did not neglect other portions of anatomy, however, and his power of exact observation, as well as his detailed study, ed from his remark that the left spermatic vein in certain cases joins the renal
Erasistratos, his colleague, was perhaps even a ator than Herophilos He represented the best tradition of Greek uished teachers, one of them Metrodoros, the son-in-law of Aristotle It was probably through this influence that Erasistratos received his invitation from the first Ptolemy to come to Alexandria The scientific work of Alexandria was founded on Aristotle's collections, on his books, for his library was brought to Alexandria as the foundation of the great University Library, and then best of all on the direct tradition of his scientific teaching through this pupil of his son-in-law
Erasistratos' other great teacher was the well-known Chrysippos of Cnidos Cnidos was the great rivalto the reputation of Hippocrates we know of Cos, but we nore Cnidos
Erasistratos' discoveries wereelse He ca the circulation His description of the valves and of their function is very clear He looked for large-sized {386} anastomoses between veins and arteries and, of course, did not discover the hi's microscope to reveal them nearly 2,000 years after Like Herophilos, Erasistratos also studied the brain very faithfully
One story that we have of Erasistratos deserves to be in the raduates in medicine, because it illustrates the practical character of the man and also how much more important at times it may be in the practice of medicine to know men well rather than to know medical science alone Erasistratos was su Seleucus Seleucus was one of the four of Alexander's generals who, like Ptole conqueror's death His portion of the Eastern world, with its capital at Antioch, was probably the richest region of that time There had been no happiness, however, in the royal household for months because the scion of the Seleucidae, the heir to the throne, was ill and no physician had been able to tell as the matter with hi to awaken hi him quite incapable of the ordinary occupations ofhi in weight, he looked miserable, he seemed really to have been stricken by one of {387} the serious diseases as yet undifferentiated at that time which were expressed by the word phthisis, which referred to any wasting disease
As a last hope then almost, Erasistratos was summoned fro Seleucus The proceeding, after all, is very similar to what happens in our own time The head of an io a long distance to see the son of a reigning monarch, or of a millionaire prince in industry, or perhaps a coal baron, or a railroad king, and a special train is supplied for hi Erasistratos over the desert to Antioch It is such consultations that count in a physician's life I hope sincerely that you shall have many of them and that you shall conduct the prince's case proved as puzzling to Erasistratos for a time as it had to so many other physicians before him Like the experienced practitioner he was, he did not nosis at once, however
Will you re case? It is e do not take tinosis that it often proves erroneous Not ignorance, but failure to investigate properly, is responsible for most of our errors He asked to see the patient a nu conditions Finally, one day, while he was {388} exa man's pulse--and I may tell you that Erasistratos s about it that it is unfortunate that the ave a sudden leap and then continued to go one before At the sa man's cheek Erasistratos looked up to see as the cause of this striking change, and found that the young wife of the King Seleucus, the prince's stepmother, had just come into the roo wo ard, and that here was the cause of the trouble Erasistratos did not proclaim his discovery at once He did announce that now he knew the cause of the trouble, that it was an affection of the heart that would be cured by travel, and he proposed to take young Seleucus back with hi patient that he had discovered his secret, and then persuaded hi for hi ivings he consented to go to Alexandria, and as has happened many times before and since, in spite of the patient's assurance to the contrary, the travel cure proved effective even for the heart affection