The Growth of Medical Thought (review)

Book Reviews The Growth of Medical Thought. By Lester S. King. (Chicago: University of Chicago Press, 1963. Pp. ix + 254. $5.50.) The author of this book is "a pathologist with a background in history and philosophy," to quote from the jacket. This combination of interests is reflected in the Preface itself, where it is stated, "The history of medicine is part of the history of ideas." However, the text itself, unfortunately, is too episodic in treatment and too homiletic in tone to do justice to the explicit goal the author sets for himself at the very outset, which is "to indicate the growth of medical science and the patterns of medical doctrine," by a consideration of a few key figures in the history of Western medicine who represent certain distinct trends in medical theory. In his previous book, The Medical World of the 18th Century (1958), the author likened the historian to the photographer, but he forgot to bring out that a good historian needs (to exploit his own analogy) a movie camera in order to exhibit adequately the growth of things. An ordinary camera will not do for historiography. The volume opens with ancient Greek medicine and ends with the pioneers in molecular pathology. In the present reviewer's opinion, the most effective chapters of the book are the ones dealing with two of the most controversial figures in the whole history of medicine, namely, Galen and Paracelsus. For there more than anywhere else in the book, we learn the sobering lesson that just because, say, Galen's "doctrine of faculties" in Roman medicine is "wrong" (that is, false in fact), from the standpoint of modern science, is no reason for calling it "foolish" (that is, false in theory) --Moli~re to the contrary notwithstanding (p. 77). While Galen's Aristotelian "modes of thought may seem somewhat strange to us," Dr. King insists, "we must preserve a judicious historical attitude" (p. 49) towards them just the same, if our objective is to understand their raison d'etre in the first place. He uses the same criterion with respect to Paracelsus, even though he spoils his case a bit by contradicting himself concerning that bombastic figure of Renaissance medicine, describing him on one page as "essentially a poet and not a scientist or philosopher" (p. 125), and then declaring on another that he "was at heart a philosopher" (p. 137). Now, no matter whether we agree with the author's interpretation of Paracelsus as a "Neo-Platonist" in medicine, he deserves credit for discussing [2s7] 238 HISTORY OF PHILOSOPHY that enigmatic Swiss iatrochemist sympathetically. In any event, Dr. King's sympathetic approach to Paracelsus manages to throw considerable light on the Paracelsian advice to all future physicians: Don't read books! Read the stars, but read them "in Neo-Platonic fashion" (p. 114)! While the author is "judicious" about Galen and Paracelsus in particular, he is far from being so when it comes to Friedrich Hoffmann, a medical materialist and "systematist" from Halle in the eighteenth century. Paradoxically enough, Dr. King has a marked antipathy for the doctor of "sympathy " himself (p. 173). Incidentally, the only other physician in the book who is not liked--apparently for his being polemical (p. 215)--is a famous fellow-pathologist of the last century, Rudolf Virchow. Still, it is only fair to add that the author acknowledges fully Virchow's important contributions to the field of cellular pathology. Finally, Dr. King not only has his likes and dislikes as to the medical men he actually selects from modern medicine to represent changes in theory of disease, but he seems also to have a definite bias in another and more serious sense. With the exception of the Epilogue and Chapter IV, which includes Vesalius and Harvey as well as Hoffmann, all the episodes of modern medicine deemed worthy of study derive from the Germanic world. Curiously enough, although there is no discussion of the germ theory of disease as such in the book, there is mention of Koch, but not of Pasteur. And French physiologist Claude Bernard, the great medical philosopher who tried to do in the nineteenth century for scientific medicine what...