MEDICINE AND LITERATURE. H. S. CARTER, M.D., D.P.H. The advantage of an inclusive title for an essay is that it allows a wide field for exploration by the writer, and in this survey will permit consideration not only of references to doctors and medical matters in literature, but of glances at literary achievements by doctors no less than at such medical men who have been used as prototypes for characters in imaginative writings. Thus we may, for example, refer to Moliere's repeated satires upon the medicine of his time, the immortal verse of Dr. Keats and the supposed portrait of Dr. Allbutt in Middlewareh. Plato discussed Greek physicians and physic, and regarded Hippo- crates as a master, but makes little allusion to him. He has no definite description of the methods of healing in Aesculapian temples. He speaks of epidemics as due to the anger of departed souls. He placed the liver little below the brain in importance and regarded the spleen as a mopper- up of noxious humours. There is a substratum of biology in his writings which his pupil Aristotle was to expand. In the Symposium he makes Eriximachus, a physician who talks a good deal, give a prescription for hiccough to Aristophanes, who, no doubt, had laughed too much at his own satires. It was that sneezing will cure the most persistent hiccough. Plato fathered some grotesque notions upon medical teaching, though sneezing will sometimes stop a hiccough ; but amyl nitrite is better. Aristotle, who studied medicine, never practised it. He was an all- round philosopher with an interest in natural science, and while laying the foundations of Zoology in his Historia animalium, did not disdain ethics and politics. He thought the heart the seat of the soul and was aware of its importance ; he believed in a spontaneous generation, so that the problem of Aphrodite rising from the foam was no problem to him : but he also believed that a child was of its father. His biological studies were deep and covered a large field. The Stagirite was the ancestor of modern biologists and the medical atmosphere of his times pervades his writings. Let us jump the centuries to Chaucer, Comptroller of Customs at ' ' the Port of London, and according to Q the greatest story-teller in the power of visualising all sorts and conditions of men and limning them in swift short strokes, before Charles Dickens. Chaucer drew a Doctor of Medicine in his tale of the Doctor of Physick. He is supposed to have been John of Gaddesdon, who among other things was a Pre- bendary of St. Paul's and physician to Edward II. He wrote a book 144 MEDICINE AND LITERATURE?CARTER 145 Rosa Anglica (1314) which was described by his critics as a hotch-potch of quackery and superstition ; it was much denigrated by de Chauliac and later by Haller. It was strong in countryside and domestic lore, but said to contain a reference to the treatment of smallpox by red light. Chaucer's tale is more in the style of the cleric of vSt. Paul's than in that of a physician, but it contains good counsel. In the Prologue to Ids tales Chaucer describes a mediaeval physician, presumably he who told the tale. This good man kept his patient wonderfully well at all times by his natural magic. He knew Hippocrates, Galen and Avicenna? ' and was, in short, a very parfit' practitioner who, once he knew the cause ?f a patient's sickness, made haste to apply suitable remedies. Poggio, the great Florentine scholar of the Renaissance, pilloried the doctors in his facetious stories, which are often indecent. It is fair to say that he attacked the monks also. He wrote moral essays, and his worst stories often point a moral. It is no great step from Chaucer to laughter-loving Francois Rabelais, monk, physician, teacher, editor of Hippocrates, and creator of a marvel of literary art. He was born at Chinon about 1495, and was a practiser of medicine and a vagabond in literature. He is so various in his writings that even scholars are at a loss to interpret him ; for some he is the great humanist, theologian and moralist, but for most a teller of tales and an artist in the shameless exaggeration of the ludicrous, riotously displayed in coarsest caricature With torrents of words. His characters are humanity in the warm flesh. ?His Panurge is next to Falstaff as a comic figure, and his whole book one vast roaring superabundance. It is spattered with strange medical erudition. He attacks the quackery and superstition of his time, but as became a Greek scholar, he followed the Greek ideal and believed and taught that the welfare of the patient is the good physician's prime concern. He was a Doctor of Montpellier and practised in Lyons and elsewhere in the South. Towards the end of his life he was the famous ' Cure of Meudon. Trajan was a fisher of frogs,' he shouts, and the Great Bell of Notre Dame told him that ' Mieulx est de ris que de larmes escrire.' His book can be understood only by those versed in the bypaths of ancient literature and an archaic vocabulary, but we have him in the magic transmutation of Urquhart, whose laughing ebullience sometimes ahnost o'ertops the Master. It is little wonder that in his plays Shakespeare shows much acquain- tance with medicine, for his life almost bridged the gap between the death of Vesalius and the publication of Harvey's thesis 011 the circulation of the blood. The Italian schools were then very active and the estab- lished conclusions of the human mind, that slave of life, were being modi- fied by the influence of men of guiding genius thrown up during the Renaissance. Galen's ideas were being questioned and the teaching of 14<> GLASGOW MEDICAL JOURNAL Paracelsus was still discussed. Although the planets moved, the common belief was not dissipated that the stars were fixed, revolving with the rolling vault of the heavens on the inner sphere enclosing that product of Nature, man. John Caius, student of the sweating sickness, who enlarged a college foundation at Cambridge, was dead when the poet was a little boy. He was undoubtedly the prototype, in the guise of a French physician, for the Dr. Caius of The Merry Wives of Windsor. There are references in the plays to almost every branch of medicine and surgery. In Troilus and Cressida there is a long list of diseases patently connected with syphilis. Venereal disease is often alluded to. Aesculapius, Hippocrates, Galen, Paracelsus are all mentioned, some more than once. Falstaff got his knowledge of apoplexy from Galen. There are many physicians and surgeons in the plaj^s, and the apothecary in Romeo and Juliet is drawn as a poor sort of fellow dwelling among strange simples in an atmosphere of alchemy. Shakespeare, who described politicians as ' scurvy is not more polite to the doctors. He wrote, the patient dies ' while the physician sleeps,' and advises, trust not the physician ; his antidotes are poison.' That strange sixteenth century swaggering compound of philosopher and charlatan, Paracelsus, whose real contribution to medicine in pharma- cology and therapeutics is overlaid by the turgidity of his writing, was the subject of a poem by Browning. Although there were queer things in Paracelsus' arcana, and he believed in astral influences and a life-force lie called Archaeus, yet according to old Robert Burton, he used to tell his patients that faith and a strong imagination would work wonders. But he does not appear to have been the cultured mystic of Browning's poem. He was a strong rumbustious disputatious character and had little of the lofty spirit with which the poet endows him. The blank verse of the poem is relieved by lyrics, one of which is redolent with the odour of oriental spices which might well have found place in Paracelsus' pharmacy- ' Heap cassia, sandal-buds and stripes Of labdanum, and aloes balls, Smeared with dull nard, an Indian wipes ' From out her hair : From all accounts there was nothing lyrical about Paracelsus. Browning is credited with using another eminent doctor of this period in poetic fancy: Thomas Iyinacre, physician to Henry VII, who did service by producing scholarly versions of the early medical masters. He was a classicist, and it is upon the opinion of his pupil, Erasmus, that he was a better grammarian than physician (which was also Thomas Fuller's view) that he is alleged to be the subject of A Grammarian's Funeral, ' He settled Hoti's business?-let it be !?- Properly based Oun? Gave us the doctrine of the enclitic De,' MEDICINE AND LITERATURE?CARTER 147 The closing lines of this poem, wrote Arthur Symons, is one of the noblest requiems ever chanted over the grave of a scholar. Fuller called lyinacre and Caius the Phoenixes of our Profession, in that the latter had in some sort sprung from the ashes of the former. Their joint memorial in Old St. Paul's was crowned by a phoenix. The life of Robert Burton spanned the bridge of these centuries and produced for us what Osier called the greatest treatise on medicine ever written by a layman?The Anatomy of Melancholy. While no apostle of cheerfulness, the author was no misanthropic pessimist. He was not a doctor, but a clerk in holy orders, of Christ Church, Oxford, full of zeal and charity, and a bit of an astrologer. His book is a strange medley of learning?theology, medicine, classical lore, superstition and common- sense, with not a little psychology are mixed into a literary brew, in Wordy but orderly profusion.