The Times History of the World. Richard Overy

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СКАЧАТЬ of disease, and if possible cure it, goes back to the very earliest periods of recorded history. Classic Chinese medicine (now usually described as Traditional Chinese Medicine or TCM) is thought to date back almost 5,000 years. The standard text on ‘Basic Questions of Internal Medicine’ (known as Neijing Suwen) was written, according to legend, by the Yellow Emperor around 2,600 BC; the earliest surviving version dates from at least 2,000 years ago. Early Chinese medicine was rooted in a broader philosophical system based in one case on Confucianism, in the second on Taoism. Confucianism rejected the idea of anatomical or surgical invasion in the belief that the body was sacred; instead the use of acupuncture or massage was preferred, influencing internal disease by external means. Taoism saw health related entirely to achieving harmony between the different elements of the world, the Yin and the Yang. Disease was a consequence of lack of harmony. Chinese medicine focused on herbal remedies and acupuncture as means to restore that harmony rather than more violent medical intervention. Close observation of morbid symptoms was regarded as essential to understand what combination of remedies was needed. During the brief Sui dynasty (581–618 AD) a group of doctors composed The General Treatise on the Causes and Symptoms of Disease which comprised 50 volumes and described some 1,700 conditions. The classic texts retained an enduring influence down to the 20th century when successive modernising regimes tried to substitute Western medicine with only limited success.

      The other classic tradition arose in Greece from the 5th century BC based on the teachings of the secular theorist Hippocrates, born around 460, whose famous ‘oath’, that doctors should at the least do no harm, is still sworn by Western doctors today. Like Chinese medicine, Greek medicine relied on explaining disease as an absence of harmony in the body between four elements or ‘humours’ that composed it. The elements were blood, choler (yellow bile), phlegm and black bile. These humours corresponded to the elements identified by Greek science as universal components—air (blood), fire (choler), water (phlegm) and earth (black bile). Cure for any imbalance was based on a range of options—bleeding, diet, exercise and occasional surgery. These views, revived in medieval Europe, exercised a continuing influence down to the time when modern medical science made its first appearance in the European Renaissance, and even beyond it. The problem for Greek as for Chinese medicine was the strong prejudice against direct anatomical research on human cadavers. In all pre-scientific medical systems an absence of proper understanding of the function of the body and the cause of disease meant that cures were largely accidental. Recent tests on 200 Chinese traditional herbal remedies for malaria found that only one, by chance, contained anything that might contribute to a cure.

      Only the onset of serious research on how the body worked—perhaps the most famous example was William Harvey’s discovery of the circulation of the blood, published in 1628—made it possible to understand how the body was affected by particular conditions and to suggest prophylaxis. Even then the growing understanding of the body did little to help prevent epidemics until the onset of vaccination (introduced in late-18th-century Britain for smallpox) and the path-breaking research of the French chemist, Louis Pasteur, and the German doctor Robert Koch, which by the 1880s had confirmed that disease was caused by bacteria, each different micro-organism responsible for a particular disease. The discovery of antibiotic properties in penicillin mould in 1928 completed the therapeutic revolution. From the mid-19th century onwards the older medical traditions, which had limited or no medical efficacy, were superseded by a science-based medicine which has pushed the frontiers of biochemistry, neurology, physiology and pharmacology almost to their limits and has, at least temporarily, conquered almost all known diseases and a large number of internal medical disorders.

      Only the identification of the HIV virus in the 1980s, which attacks the body’s immune system, made it clear that even the most scientifically advanced medicine may not in the future be able to stem new and unexpected forms of epidemic. For the fortunate few generations in the West who have been the full beneficiaries of the medical revolution, the transformation has been extraordinary. For all the rest of recorded human history there was no effective cure for most diseases and humans survived only because of a complex struggle between the micro-organisms and the human immune system. Death was ever-present and social attitudes and religious beliefs had to be rooted in the expectation of high levels of mortality. For those who survived there were disfiguring illnesses, crippling medical conditions, poor eyesight, chronic toothache, and so on. For women throughout history there was the debilitating cycle of births and the ever-present risk of maternal death. Pain, like premature death, was a permanent visitor.

      To make matters worse, throughout human history both death and pain have been inflicted unnaturally, the product of deliberate violence on the part of human communities. Man, and almost always the male of the species, is a uniquely aggressive and punitive creature. Although attempts have been made over the past century to demonstrate that other animal species indulge in deliberate violence, animal violence is instinctive, not conscious. Mankind, on the other hand, has throughout recorded history, and evidently long before that, been able to premeditate the use of violence directed at other humans. Some anthropologists, following the 18th-century French philosopher Jean-Jacques Rousseau, have tried to argue that early man was most likely peaceable, and that only the tensions generated by more complex forms of social life introduced higher levels of violence. But the range and sophistication of pre-historic weapons, first stone, then iron and bronze, makes the idea of a pacific prehistoric state implausible. It is of course true that with settled communities, centred on cities, violence came to be organized through the use of armies. The evolution of a specialized human function for organising and legitimating the use of violence is evident in the very earliest recorded history. The soldier, armed with an ever more lethal armoury, runs in an unbroken line from all corners of the ancient world where complex civilizations arose. In tribal communities, without settled urban life, inter-tribal and intra-tribal violence was often ritualized, the young males of the tribe using violence as a rite of passage or a sacred obligation.

      There is no single answer to the question of why violence should be such a hallmark of world history, but it can be found on almost every page. The German legal theorist Carl Schmitt, writing in the 1920s, claimed that the human community has always been divided between ‘friend’ and ‘foe’, those who are included in the group and those who are excluded. Simplistic though the distinction might seem, the concept of the alien, the other, the barbarian, the enemy, or the excluded also runs as a thread through all history. Treatment of the ‘other’ has always been harsh, even in the modern age with its vain efforts to impose some kind of restraints or norms on military behaviour and state violence. Yet even this distinction leaves a great deal unexplained. Human beings do not just fight each other in pitched battles using soldiers who know what to expect. They punish human victims in hideously painful and savage ways. Coercive social relationships have been far more common than consensual ones. Victims, even those from among ‘the included’ who are guilty of crime, have been tortured, executed, beaten, imprisoned in ways so ingeniously atrocious and gratuitously cruel that it is difficult not to assume that violence is the normal human condition and the very recent and limited experience of peace and respect for the individual a merciful historical anomaly. Violence is also universal, not some characteristic of ‘savage society’ as self-righteous Victorian imperialists like to think. Civilizations, however sophisticated, have indulged in violence of every kind. Religions have often led the way in devising grotesque ways to seek out heresies and exorcize devils. At the Museum of Torture Instruments in Guadalest in Spain (by no means the only such museum) are displayed roomfuls of fearful devices designed to extract confessions from across early-modern Europe, including the unhappy victims of the notorious Spanish Inquisition—iron crowns with spikes which tighten around the victim’s head, sharp stakes that could impale the whole length of a human body without killing the victim immediately. Human beings have devoted a deplorable amount of effort to inflicting suffering, and seem to have done so with few moral qualms.

      There have been many attempts to explain why wars happen, or why human history is so soaked in blood. There is no single concept of war (though there is ‘warfare’, the art of fighting) that can embrace all the many forms of war or the thousands of separate historical reasons why particular wars break out, evident from the pages that follow. Early-20th-century anthropologists СКАЧАТЬ