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Heirs of Hippocrates

Heirs of Hippocrates

Heirs of Hippocrates: The Development of Medicine in a Catalogue of Historic Books
in the Hardin Library for the Health Sciences, the University of Iowa

Foreword

The bibliography you are holding in your hands is much more than an arid list of books contained in a particular library interesting as such a list would be for a bibliophile, and representing, as it does, the interests and enthusiasm of a knowledgeable collector, Dr. John Martin. Scholarly annotations contained in almost every entry bring to life the history of medical practice and scientific knowledge, as reflected in notable publications of the last two thousand years. The numerous illustrations included were, I know, chosen with great care as graphic evidence (in earliest times) of the human imagination and (later) the accomplishments of medical science. Through these illustrations we can sense, often more easily than by reading their words, the way our forebears viewed themselves and their surroundings, and we can measure the vast advances made since the time of Hippocrates.

Books such as these are a summary of our culture, our progress as rational beings, our developing spirit of humanism, and our desire to aid our fellow men and women. That books were as revered by the ancients as they are today is shown by the rich legacy of medical history from Hippocrates (ca. 460 B.C.-ca.368 B.C.) through the middle of the fifteenth century, when carefully written and preserved manuscripts were finally put into printed book form. The great Greek library at Alexandria, founded during the fourth century B.C., and nurtured by the Ptolemies, was the world’s first great medical library. From there, and from later works of Celsus, the voluminous outpourings of Galen, Oribasius, Dioscorides, Alexander of Tralles and many others, the written word was translated, expanded by much commentary, and sometimes re-interpreted by great Arab scholars in the ninth, tenth, and eleventh centuries. These translations were, in turn, put into the Latin of the Middle Ages by such men as Gerard of Cremona, Stephen of Antioch, and Arnold of Villanova. Thus after more than two millennia of the written word, the Western world at last was given the printed book, and the spread of knowledge gained momentum with each generation.

Today we feel closer to the great medical figures of the past five hundred years. Indeed, our records of their work are direct, untranslated, just as they wrote it. Among them are giants too numerous to mention here, but of whom you will find account in Heirs of Hippocrates. In the miserable social and political conditions of the fifteenth, sixteenth, and seventeenth centuries, how could such a man as Leonardo da Vinci appear? How could Andreas Vesalius and William Harvey be products of such an age? Leonardo was a genius who ranged widely in his intellectual probings, but he published nothing. Vesalius, brilliant, bold, self-assured, arrogant and single-minded in his pursuit of anatomical truth, produced in his youth what remains the most beautiful and significant work of anatomy of all time. His other works are relatively unimportant. Once De Humani Corporis Fabrica Libri Septem was published, he for all purposes practical to medicine left the scene. William Harvey, poles apart from Vesalius in personality – shy, reticent and reserved, proud, thin-skinned, quick of temper, reluctant to publish, is forever immortalized by his one great work, De Motu Cordis. It is a shabby little pamphlet of only seventy-two pages of text and has but one indifferent illustration, which was actually taken from a work by his teacher at Padua, Hieronymous Fabricius ab Aquapendente. After the book’s publication in 1628, the new discipline of physiology was firmly established and medical progress blossomed. Two vastly different men, two totally different works, each a beacon to guide their followers with everlasting effect. Their lives and their works are a part of our lives and our works, and it is all there for us to enjoy in books.

In the engaging story of the struggle of medicine, progressing from the primitive to the modern, there were hundreds of unsung scholars who added their own smaller but significant share to the increase of medical knowledge. As lesser lights they had less individual impact, and often the mistake is made of overlooking their smaller gifts. But the accumulation of their works is a very significant part of medical history. For instance, John Woodall’s Surgions [sic] Mate (1617) described scurvy and recommended citrus fruit as a remedy long before James Lind wrote his better-known treatise on the same subject in 1753. Yet Woodall is all but forgotten. In 1710, in the French provincial town of Namur, a man little noted in medical history, Francois Pourfour du Petit, described the decussation of the pyramids in the medulla, thereby establishing one of the main neurological facts for the localization of function and pathology in the nervous system. Many other examples could be cited. Fortunately, all these smaller treasures are not lost; they are forever preserved in books.

Medical history is replete with the names of men of various pursuits besides medicine. Oribasius, as well as being a successful practitioner, compiler of earlier works, and a remarkable scholar, was personal physician to Emperor Julian the Apostate. Niels Stensen was physician, priest, anatomist, geologist, and one of the early microscopists. Many physicians were political activists who found themselves in trouble, as Paracelsus, John Freind, and Rudolph Virchow. Michael Servetus, gad-fly, meddler, scholar, sometime physician, and always his own worst enemy, published his Christianismi Restitutio in 1553, in which he gave the first description of the pulmonary circulation. Because of the heretical nature of the book and his own lack of caution, he was hounded to death by Calvin and was burned at the stake in Geneva in the same year. There were vocal patriots who overstepped their own safety lines, as did Lavoisier, who lost his head to the guillotine in the French Revolution. Great men were not above bickering and quarreling, a good example of which was the long controversy between Charles Bell and Francois Magendie. Struggles for power and prestige occurred in the great hospitals and medical schools two or three hundred years ago even as they do today. All this is a part of the rich broth of medical history.

In these days of the computer it is well to reflect on the still, and I believe enduring, intellectual value as well as aesthetic delight we get from savoring such a collection of books as you will find in Heirs of Hippocrates. Long ago Lord Bacon wrote, “But the images of men’s wits and knowledges remain in books, exempted from the wrong of time, and capable of perpetual renovation. Neither are they fitly to be called images, because they generate still, and cast their seeds in the minds of others, provoking and causing infinite actions and opinions in succeeding ages. So that the invention of the ship was thought noble, which carrieth riches and commodities from place to place, how much more are letters to be magnified, which as ships pass through the vast seas of time, and make ages so distant to participate of the wisdom, illuminations, and inventions, the one of the other?”

Science requires language, grammar, books, libraries, and laboratories. Medicine adds a requirement of understanding and truly caring for the sick person. The waves of learning which spread from the ancient libraries, from the medieval monasteries, from Baghdad and Cordova, from Salerno and Padua, still continue to wash upon our modern shores. One book can teach a multitude of men and women, for books are man’s memory, classic, scientific, historic and cultural. The wisdom we gain from books leads us to act as though we were building our ideas for eternity. They remind us, too, of the nature of life and death. We must have good and beautiful books, for the love of books has no substitute. They are the unbroken thread which secures for all of us the past experience of mankind bringing us to our present condition.

“Of making many books there is no end.”
(Ecclesiastes 12:12)

William B. Bean, M.D.*

[Editor’s note: At the University of Iowa, Dr. Bean was professor of internal medicine and Sir William Osler Professor of Medicine. He served as head of the Department of Internal Medicine from 1948 to 1970 and, at the time of his death, was emeritus professor of internal medicine. Dr. Bean completed the Foreword in December, 1988, only a few months before he died on March 3, 1989.]