A Short History of Medicine

If Western medicine is unique, it is because it made the body an object of systematic, scientific study. This is not stating the obvious. The human body has innumerable symbolic meanings, all emotionally charged and often contradictory. Turning it into an object of orderly inquiry and meticulous investigation was no small achievement. It seems that for some cultures, the body hardly exists at all. Certain aborigines of New Caledonia, in the South Pacific, use the same words to name the parts of the body and the plants or other objects of their natural environment, between which they perceive a resemblance. For instance, the skin of the body and the bark of trees are designated by the same term; the identical word is used for the flesh of human limbs and the pulp of fruits; and the various inner organs share names with the produce that they outwardly resemble. In this society the body is not thought of as an independent entity but is indistinguishable from its surroundings. Similarly, in European societies during the Middle Ages and in certain communities in more recent times, alchemical notions have linked various parts of the body to the constellations of the sky: Aries ?rules? the head; Leo, the heart; Scorpio, the genitals; and so on. The body lacks a clear border; in the elemental imagination, it merges with the rest of the cosmos. To cut or incise the body, as in anatomical dissection, would have seemed an aggression against the continuum that linked man and his environment, an attempt against the unity of the world. The impulse to study the body?s anatomy could hardly have arisen in a society in which such concepts prevailed. Other societies surrounded the body with religious sentiments. In the Judeo-Christian tradition, in which man was created in God?s image, the body is a temple. Thus, it deserves solemn respect. On the other hand, the same tradition gave rise to ascetic movements in which the body was a repository of sin, a despicable, filthy thing that ought not to be made the center of an honest man?s concerns, much less an object of serious study. Either stance was contrary to anatomical investigation. In the Middle Ages, all intellectual activity resided in the Catholic Church, but no clergyman ever distinguished himself as a surgeon or even as a barber (the profession which was then in charge of minor surgical procedures), due to the severe ecclesiastical prohibition against all forms of bloodshed. For all their admirable medical insights, ancient India and China did not make the interior of the body the basis of their medical systems. And neither the ancient Egyptians nor the ancient Mexicans contributed anything of substance to the knowledge of anatomy. It is astonishing that the opening of innumerable human bodies in ritual practices?the Egyptians embalmed tens of thousands of human and animal cadavers; the Aztecs sacrificed countless victims by opening the chest and extracting the heart?should not have sparked curiosity about the structure of the organs they exposed. Yet their attitude was different: they looked at the world from a mythicoreligious perspective that was incompatible with an impersonal regard of objective reality. Thus, conceiving of the body as an autonomous object and deeming it worthy of study?these are the signal achievements of Western medicine. The Greeks, as is often the case in the history of Western civilization, take the palm for intellectual curiosity. Still, Hippocrates (c. 460?c. 377 b.c.) knew very little anatomy and did not seem interested in correcting his ignorance: there is no record in the entire Corpus Hippocraticum?his own writings and those of his followers?of any mention of anatomical dissection. Aristotle (384?322 b.c.) constructed a remarkable system of anatomical knowledge, all the more admirable when one reflects that he