The Herbalist: Nicholas Culpeper and the Fight for Medical Freedom. Benjamin Woolley
Чтение книги онлайн.

Читать онлайн книгу The Herbalist: Nicholas Culpeper and the Fight for Medical Freedom - Benjamin Woolley страница 11

СКАЧАТЬ Underlying this system was a view of the body as a system of fluids in a state of constant flux. There were four such fluids or ‘humours’: blood, phlegm, choler (yellow bile), and melancholy (black bile). The relative proportions of these humours in different parts of the body determined its temperament, and an imbalance produced illness. A runny nose was a result of excess phlegm, diarrhoea of choler, a nosebleed or menstruation of blood, particles of black material in vomit or stools of melancholy (the most elusive of the humours). The identification of these four humours provided a convenient way of tying the workings of the body in with the prevailing view of how the universe worked. Everything in the cosmos was understood to have a character defined by its place in a quadrilateral scheme: the four seasons, the four ages of man (infancy, youth, middle age, old age), the four points of the compass, the four ‘elements’ that make up all matter (fire, air, water, and earth), the four ‘qualities’ that determine their character (hot, dry, moist, cold). Each humour had its place in this scheme: phlegm was cold and moist, combining the character of winter, frozen by northerly winds, and the wet weather of the westerlies that blew in spring, which explained why so many people suffered runny noses during those seasons; choler was hot and dry, excessive during summer and autumn, the seasons of stomach disorders, when it would flow most copiously.

      The treatment of disease involved trying to rebalance the humours, achieved through diet or eliminating the surplus humour. A fever, for example, might be caused by an excess of blood in a particular part of the body, which, unable to escape, putrefies, producing heat (just as organic material in a compost heap becomes warm as it rots). The solution, therefore, was to drain off the superfluity by such methods as blood-letting or, in the case of other humours, prescribing ‘purgatives’, medicines that provoke the evacuation of bile through vomiting or diarrhoea, or herbs that produce a runny nose.

image

      Galen’s understanding of disease was supplemented by an equally systematic understanding of the body, derived from his own dissection and vivisection experiments, as well as prevailing philosophical ideas. He saw the body as a system for extracting from the environment the life force or pneuma, an ‘airy substance, very subtle and quick’, and modifying it into three spirits or ‘virtues’: vital, which vivified the body; natural, which fed it; and animal, which produced sensation and movement. According to this view, ‘chyle’, a milky substance derived from the digestion of food in the intestine, is carried to the liver via the portal vein, where it is manufactured into blood imbued with natural spirit. This dark nutritive blood passes through the veins into the body, where it is consumed, feeding the muscles and creating tissue. Some of this blood also reaches the right chamber or ‘ventricle’ of the heart, from where it either passes into the lungs, which filter and cool it, or seeps into the left ventricle via invisible pores in the septum, the membrane separating the heart’s two chambers. Thus the heart ‘snatches and, as it were, drinks up the inflowing material, receiving it rapidly in the hollows of its chambers. For [think if you will] of a smith’s bellows drawing in the air when they are expanded [and you will find] that this action is above all characteristic of the heart; or if you think of the flame of a lamp drawing up the oil, then the heart does not lack this facility either, being, as it is, the source of the innate heat, or if you think of the Herculean stone [a loadstone or magnet] attracting iron by the affinity of its quality, then what would have a stronger affinity for the heart than air for its refrigeration? Or what would be more useful than blood to nourish it?’15 Like nutritive blood in the veins, the bright red blood vitalized by the heart ebbs and flows through the pulsing arteries, like tidal water through rivers and streams, irrigating the body. The brain produces the animal virtue, which is distributed through the body via the nerves, producing feeling and movement. In addition to these three virtues, the male body also produces procreative spirit in the testicles that is distributed as sperm through the ‘spermatic vessels’ to the woman’s womb (whether the ovaries produced procreative material in a similar manner was to remain a matter of controversy for centuries to come).16

image

      Galen was very pleased with this theory, and considered it definitive. ‘I have done as much for medicine as Trajan did for the Roman Empire, when he built bridges and roads through Italy,’ he wrote. ‘It is I, and I alone, who have revealed the true path of medicine. It must be admitted that Hippocrates already staked out this path … he prepared the way, but I have made it passable.’17

      Galen underestimated his influence. His ideas survived not only Trajan’s Rome, but the sacking of the great Library of Alexandria, the birth and spread of Christianity and Islam, the Black Death, the invention of printing, and the Reformation – a millennium and a half of history – with barely any adjustment. As late as 1665, one medical reformer was complaining that ‘an Extreme Affection to Antiquity [has] kept Physic, till of late years as well as other Sciences, low, at a stay and very heartless, without any notable Growth or Advancement’. Galenism held sway over the College of Physicians from the day it was founded. Everyone who wanted to practise medicine in London had to conform to its principles. This was still the case on 4 May 1603 when the twenty-five-year-old William Harvey presented himself to the Censors of the College of Physicians to apply for a licence to practise.18

      Little did the Censors appreciate what the young man who sat before them would do for their profession. William Harvey went on to become a colossus of the medical world, hailed as one of the world’s greatest anatomists and England’s first true scientist. Sir Geoffrey Keynes, author of the definitive 1967 biography of Harvey, was so overcome with admiration for his subject, he concluded that ‘even if we wished to do so, it would be difficult, from the evidence in our possession, to find any serious flaw in Harvey’s character’. One contemporary wrote that his ‘Sharpness of Wit and brightness of mind, as a light darted from Heaven, has illuminated the whole learned world’.19

      Harvey was born on 1 April 1578 to Joan, ‘a Godly harmless Woman … a careful tender-hearted Mother’, and Thomas Harvey, mayor of Folkestone in Kent, a rich landowner with properties not far from Isfield.20 After attending King’s School in Canterbury, he was sent to Gonville and Caius College Cambridge, where its benefactor Dr Caius was Master. Caius had made medicine a core part of his college’s curriculum, securing a royal charter allowing two bodies of criminals executed in Cambridge to be used for anatomical demonstrations. Harvey’s own education benefited from this arrangement as he later recalled seeing ‘a frightened person hanged on a ladder’ at Cambridge, and presumably witnessed the subsequent dissection.21 The variety of medicine taught was, of course, devoutly Galenic. Caius had studied at Padua with Andreas Vesalius, the father of modern anatomy, whose discoveries based on human dissections had challenged many of Galen’s, which had relied upon animals. Despite this, when Vesalius later suggested to Caius that an obsolete passage should be dropped from a collection of Galen’s writings Caius was editing, Caius refused on the grounds it would be too dangerous to tamper with such an ancient work.

      In 1600, Harvey himself went to Padua and studied anatomy under one of Vesalius’ successors, Hieronymus Fabricius. Fabricius had designed the first modern anatomy theatre, a wooden structure set up in the university’s precincts, which featured a stone pit surrounded by five concentric oval terraces. Harvey gazed from those terraces and into that blood-spattered pit on many anatomical, and in particular venereal, marvels that he would later memorably recall in his lectures, including syphilitic ulcers that had gnawed into the stomach of a prostitute, a boy whose genitals had been bitten off by a dog, and a man without a penis who was apparently still capable of sex.22

      Harvey СКАЧАТЬ