THE GLASGOW MEDICAL JOURNAL. No. Y. November, 1913. ORIGINAL ARTICLES.] BYZANTINE MEDICINE: THE FINLA^g^r- MEMORIAL LECTURE.1 By Sir THOMAS CLIFFORD ALLBUTT, K.C.B., LL.D., D.Sc., M.D.r Regius Professor of Physic, Cambridge. Mr. Chairman, Ladies, and Gentlemen,?We are gathered together to-day in memory of James Finlayson, a wise physician and a gentle scholar. More than once, with the art of the scholar and the love of the benefactor, he displayed to me some of the treasures of your library. I would that my lecture to-day were more worthy of him. It was a fine saying of that great historian and physician, Charles Daremberg, that in the domain of mind, as in that of matter, we cannot believe in spontaneous generation. The springs of life and the development of life; its order in variety; its integrations of ever new and broader functions of the world around it; its compass and comprehension; 1 Delivered in the Faculty Hall on Friday, 6th June, 1913. No. 5. X Vol. LXXX. 322 Sir Clifford Allbutt?Byzantine Medicine: these growing powers, these rich and manifold qualities have their lineage ; they have their origin in the past; they have their ancestry, their laws of tradition, their channels of nurture; and if animal development cannot spring directly from the clay into high wrought organs and various functions, neither likewise can the spiritual life. It, too, must have its lineage, its race; from parent to parent the social life is engendered and nurtured; from generation to generation it dwells upon its gradual houses, families, tribes, and rejoices in its children; it learns to reflect upon its history in the past, and from that vantage to reach forth into its future and to imagine its destiny. Societies have their pedigrees as men have; like men they may be true or false to them ; they may make themselves greater than their fathers, or they may waste their patrimonies in sloth, perversity, or folly. Thus, when the Germans swarmed about Rome and broke or penetrated into the city, of themselves they were barren; they were as the formless clay of which I have spoken, out of which there can be no spontaneous generation. Rich the new soil may have been, rich as the ooze of the sea; but there was no past, no spiritual lineage, no political, no intellectual heritage; no ideas, no tradition, no law, or but rudiments of them. Even Theodoric's kingdom was not the framing of a new world; it was but an ark wrought out of the old timbers. Then the Franks, they again had built nothing, and therefore knew not yet how to build. The Merovingians' rule was a bare survival of decrepit forms of the Lower Empire; its rudimentary feudalism was for Rome alien and disintegrating. The Empire in its old form was perishing. The great landowners of Rome could no longer govern or fight; unhappily, for the invaders were not without reverence for the old mother. But authority was waning, fighting was left to the fair-haired Celts from the north, the rude Illyrian warriors, and misery and disease, more cruel than the conquerors, were corrupting the civic body. And what disorder and rapine had begun pestilence finished. Not only was the populace destitute?this was an old if I may use such a the "middle story?but," phrase, classes also had fallen into misery. Out of the loins of the old body the New Rome on the Bosphorus and, by the Donation of Constantine, the Papacy were born; but the period of gestation was dark and savage. To turn back for a moment to an earlier period, let us glance at the drift in the policy of the Empire of the first The Finlayson Memorial Lecture. 323 century. In the early Empire provincial government was more or less by consent ; by much concession to local races, customs, and even governments, and with some contemptuous tolerance, Rome often ruled but nominally from the centre. She kept the peace without crushing local rule and privilege; but a change, which had been progressing from Julian times, matured under Diocletian, and, under later emperors, stiffened into a calcareous shell. As Dr. Reid1 says, in place of an Augustus came a kind of Sultan wearing that oriental diadem, the mere dread of which had brought Caesar to his end; the Emperor was approached with adoration as a living god, and law7yers buttressed his throne with an absolutist theory of the constitution which was universally accepted. By the material grandeur and might of Byantium, which drew7 its sustenance from both east and west, this splendid despotism was strengthened and glorified. And, as Europe then was, this transformation may have been inevitable; almost from the end of the Republic it crept on steadily, degree by degree, as if implicit in the nature no of things. Perhaps in other way could the citadel of " culture" have been held against the vast and turbulent hordes which had yet to be tamed and moulded into modern civilisation; in no other w7ay, perhaps, could the soul of the ages have been saved. But the price was a heavy one; the heirlooms of the past were carried into fortress, and for a millennium were immured in a sumptuous, almost a spell- bound treasure house. The calcareous shell was of mother of pearl; the walls and towers of the casket shone in the sun with such splendour as Jeremy Taylor conceived of the Kingdom of Heaven. Exalted in the wilderness of Europe, shining like a sun, radiant with gold and gems, pompous with priests and men of war, Byzantium guarded the precious germs of which a new7 world was in due time to" be born. But meanwhile this very pomp w7hich, to the hordes which beset it, made it seem invulnerable, stiffened the sinews of the defenders. In their serried regiment there w7as no play for personal freedom, no play for varieties of temperament or diversities of creed. A rigid uniformity- of array, an absolute. subordination of rank to rank, an unbending orthodoxy of belief were the cement of the fortress, the conditions of its solidity and immunity, and the protection of its sacred store.. We shall anticipate, then, that within its walls there would be no expansion, no breathing of the human spirit, but the immobility of a great 1 J. S. Reid, Cambridge Mediaeval Hist., vol. i. 324 Sir Clifford Allbutt?Byzantine Medicine: rock, the silent watch of its sentinels, the enslavement of the poor and the needy, and the bondage of the human mind. And what was this treasure so jealously guarded ? Much, many ways; but for our part to-day it was the records of that spirit which we call Greek. In Greece?that is to say, in Attica?this spirit became embodied in forms of beauty which have since commanded the admiration of the world. But regarding this spirit in its full story, we find Greece too narrow a name for its domain. We have but to think for a moment of the gifts of Ionia to the mind of man to perceive that this spirit animated a territory wider far than the land of Greece in its stricter sense. Even Apollo, our own medical god, goes back through his Dorian days to his birth in Lycia. iEgean it is also called, yet even this name is not wide enough. You will be ready, I think without argument, to speak of it as Eastern Mediterranean. We find it in vivid life long before the palmy days of Athens,, and on many an after age it shed its blessings. We find it in its rudiments in Crete, in its beauty in Homer; and we trace its shining steps in Arcadia, in Thrace, in Magna Grecia, in Latium, and in many another island and peninsula of this inland sea. The earliest Greek medical schools of which we have any record were at Rhodes, Cyrene, and Croton. Those of us who have visited the wonderful museum of the Villa Papa Giulio in Rome, in which, as we hear from Mrs. Strong, the collections have now been displayed in a larger room, marvel to see from Latium evidences so exquisite of this civilisation; in Latium which, in early Roman days, had become not only indifferent to Greek culture but actively hostile to it. In my Fitzpatrick lectures I endeavoured to sketch the fortunes of Greek medicine in Rome, where its penetrative power expanded against all thwarting and contempt; in Rome, notwithstanding the blight of the medical tradition of Alexandria, Greek physicians did good and even brilliant work until under Marcus Aurelius medicine culminated in Galen. From that time, although jurisprudence kept its high place, for jurisprudence was Roman rather than Greek, medicine ceased to bloom or to fruit; the harvest for a thousand years was over, and for this art and science the Greek spirit sank into sleep and, but for one man's life perhaps, Alexander of Tralles, lay dormant until towards the eleventh century. If Galen still had lip'service it was rather for the more extravagant and fantastic than for the sober The Finlayson Memorial Lecture. 325 and fruitful products of his genius, as testified by his experimental physiology; moreover, he was cherished by the Christian Church for his monotheism,1 for his teleology, and for his generous and humane defence of the Christians.2 From the time of the elder it, indeed, as we " Pliny?before know from Cato's Commentary "?there had been in Rome a strong bent to mere recipe medicine ; a semi-superstitious belief in strangely overloaded compounds such as mithridatics, theriacs, and other traditional blends of many drugs; and after Galen this cruder therapeutics almost drove out the intelligent hygienic methods of the school of Hippocrates, and of Alexandria as made known to us by Celsus.