LIVES IN MEDICINE John Scales Avery September 28, 2019 Introduction1 Cultural history We need to reform our educational systems, particularly the teaching of history. As it is taught today, history is a chronicle of power struggles and war, told from a biased national standpoint. We are taught that our own country is always heroic and in the right. We urgently need to replace this indoctrination in chauvinism by a re- formed view of history, where the slow development of human culture is described, giving credit to all who have contributed. When we teach his- tory, it should not be about power struggles. It should be about how human culture was gradually built up over thousands of years by the patient work of millions of hands and minds. Our common global culture, the music, sci- ence, literature and art that all of us share, should be presented as a precious heritage - far too precious to be risked in a thermonuclear war. Human nature has two sides: It has a dark side, to which nationalism and militarism appeal; but our species also has a genius for cooperation, which we can see in the growth of culture. Our modern civilization has been built up by means of a worldwide exchange of ideas and inventions. It is built on the achievements of many ancient cultures. China, Japan, India, Mesopotamia, Egypt, Greece, the Islamic world, Christian Europe, and the Jewish intellectual traditions all have contributed. Potatoes, corn, squash, vanilla, chocolate, chilli peppers, and quinine are gifts from the American Indians. Culture is cooperative, not competitive! Our modern civilization has been built on the achievements of all the peo- ples of the world throughout history. The true history of humanity is not the history of power struggles, conflicts, kings, dictators and empires. The true history of humanity is a history of ideas, inventions, progress, shared knowledge, shared culture and cooperation. Our cultural heritage is not only immensely valuable; it is also so great that no individual comprehends all of it. We are all specialists, who un- 1This book makes use of articles and book chapters that I have previously written about the history of medicine, but most of the material is new 1 derstand only a tiny fragment of the enormous edifice. No scientist under- stands all of science. Perhaps Leonardo da Vinci could come close in his day, but today it is impossible. Nor do the vast majority people who use cell phones, personal computers and television sets every day understand in detail how they work. Our health is preserved by medicines, which are made by processes that most of us do not understand, and we travel to work in automobiles and buses that we would be completely unable to construct. The sharing of scientific and technological knowledge is essential to mod- ern civilization. The great power of science is derived from an enormous concentration of attention and resources on the understanding of a tiny frag- ment of nature. It would make no sense to proceed in this way if knowledge were not permanent, and if it were not shared by the entire world. Science is not competitive. It is cooperative. It is a great monument built by many thousands of hands, each adding a stone to the cairn. This is true not only of scientific knowledge but also of every aspect of our culture, history, art and literature, as well as the skills that produce everyday objects upon which our lives depend. Civilization is not competitive. It is cooperative! Lives in Medicine With the aim of writing cultural history in mind, I have started to write a series of books about the lives of women and men who have contributed importantly to various fields. The completed books are: Lives in Physics • Lives in Economics • Lives in Ecology • Lives in the Peace Movement • The present book, Lives in Medicine, is part of this series, and others are planned. I hope that they will make a small contribution to cultural his- tory. The books may be freely downloaded and circulated from the following links: http://eacpe.org/about-john-scales-avery/ https://wsimag.com/authors/716-john-scales-avery 2 4 Contents 1 HYPOCRATES AND GALEN 9 1.1 Medicine in ancient India . .9 1.2 Mesopotamian medicine . 10 1.3 Medicine in ancient Egypt . 11 1.4 Hippocrates . 12 1.5 Galen . 14 2 THE BUKHT-YISHU FAMILY 23 2.1 The Hellenistic era . 23 2.2 Burning of the Great Library of Alexandria . 24 2.3 The Nestorians and Islam . 25 3 AVICENNA 31 3.1 The Persian Leonardo . 31 3.2 The Canon of Medicine . 31 4 LEONARDO'S ANATOMICAL STUDIES 39 4.1 East-west contacts during the Renaissance . 39 4.2 Leonardo da Vinci . 41 5 EPIDEMICS OF PLAGUE AND CHOLERA 55 5.1 The \Black Death" . 55 5.2 Control of plague by quarantine . 58 5.3 Discovering the connection between cholera and sanitation . 58 6 JENNER 65 6.1 Smallpox . 65 6.2 Edward Jenner and the milkmaid . 68 6.3 Some other discoveries of Edward Jenner . 71 6.4 The complete eradication of smallpox . 71 7 PASTEUR 75 7.1 Semmelweis . 75 7.2 Pasteur: artist or chemist? . 78 5 6 CONTENTS 7.3 Saving the French wine industry . 79 7.4 The germ theory of disease . 82 7.5 Vaccines . 86 8 EHRLICH, MECHNIKOV AND JERNE 93 8.1 The language of molecular complementarity . 93 8.2 Paul Ehrlich, the father of chemotherapy . 94 8.3 Mechnikov . 99 8.4 Burnet, Jerne and the clonal theory of immunity . 101 8.5 K¨ohler,Milstein and monoclonal antibodies . 105 9 FLEMING, FLOREY AND CHAIN 107 9.1 Fleming . 107 9.2 Florey and Chain . 111 9.3 War between micro-organisms . 115 9.4 Overuse of antibiotics in agriculture . 120 10 SZENT-GYORGYI¨ 123 10.1 Summer work at Szent-Gy¨orgyi'slaboratory . 123 10.2 Muscle contraction . 127 10.3 Mitochondria . 127 10.4 The photosynthetic unit . 130 10.5 Some of Albert Szent-Gy¨orgyi'spersonal reflections . 132 11 CRICK AND WATSON 135 11.1 The structure of proteins . 135 11.2 What is Life? . 140 11.3 The structure of DNA . 144 11.4 The structure of DNA . 150 11.5 RNA and ribosomes . 152 11.6 The genetic code . 156 12 THE ORIGIN OF LIFE 171 12.1 Formation of the Sun and the Earth . 171 12.2 Theories of chemical evolution towards the origin of life . 174 12.3 Molecular evidence establishing family trees in evolution . 180 12.4 Symbiosis . 185 12.5 Timeline for the evolution of life on the Earth . 190 12.6 Life elsewhere in the universe . 192 13 HODGKIN, HUXLEY AND ECCLES 203 13.1 The flow of information between and within cells . 203 13.2 Nervous systems . 205 13.3 The giant squid axon . 207 CONTENTS 7 13.4 Chemical synapses . 215 13.5 Neurotransmitters . 215 13.6 Transmission of signals across synapses . 216 13.7 Are matter and mind separate? . 219 13.8 Jakob von Uexk¨ulland Umwelt . 221 13.9 Biosemiotics . 228 14 PATHFINDING 237 14.1 The 2014 Nobel Prize in Physiology or Medicine . 237 14.2 Paths in cell differentiation . 244 14.3 Paths in package address systems . 244 14.4 Paths in the organization of computer memories . 246 14.5 Pattern abstraction . 246 14.6 Abstraction of concepts and natural laws . 250 15 SOME MODERN DEVELOPMENTS 263 15.1 The World Health Organization . 263 15.2 Gene splicing . 264 15.3 Bioinformation technology and artificial life . 270 8 CONTENTS Chapter 1 HYPOCRATES AND GALEN 1.1 Medicine in ancient India According to an article by Tejraj Aminabhavi in Asian Review1, \Among India's many claims to fame is the ancient medical science known as Ayurveda (from the Sanskrit words ayur, or life, and veda, science). This is a healing method that relies on herbs as medicines for maintaining good health. The 5,000-year-old system of natural healing is originated in India's ancient Vedic culture. It was suppressed during the years of foreign occupation, but its medical practices have been enjoying a resurgence both in its native land and throughout the world. \Early Greek medicine embraced many concepts originally described in classical Ayurvedic texts dating back thousands of years. Traditional Tibetan and Chinese medicine also have roots in Ayurveda. Over time, Ayurveda has become the science of life, encompassing body, mind and spirit. This body of knowledge is believed to have been originally deliv- ered by God to sages and seers, who were yogis renowned in their insight, intuition and keen observation of human behavior. They handed down their knowledge to their disciples. An important goal of Ayurveda is to identify the ideal state of balance of a person and offer solutions using diet, herbs, music, massage treatments and meditation to restore the body's balance. \The key concepts of Ayurvedic medicine are based on universal interconnections among people, their health, the universe, the body's constitution and life forces that are often com- pared to the "humors" of the ancient Greek system. Using these concepts, Ayurvedic physi- cians prescribe individualized treatments that include herbs, diet and exercise along with lifestyle recommendations. The majority of the Indian population today uses Ayurvedic medicine, combined with conventional Western medicine, a practice popular all over South- east Asia as well." 1https://asia.nikkei.com/Business/Science/Ayurveda-the-ancient-Indian-medical-practice 9 10 HYPOCRATES AND GALEN 1.2 Mesopotamian medicine In medicine, the Mesopotamians believed that disease was a punishment inflicted by the gods on men, both for their crimes and for their errors and omissions in the performance of religious duties.