After Hippocrates

Professor Arturo Castiglioni, 66, of the University of Padua in Italy, is a refugee teaching at Yale. The son of a rabbi, he was born in Trieste, brought up an Austrian. After World War I, when Italy acquired Trieste, Dr. Castiglioni became an ardent Italian. But he never joined the Fascist Party, and, despite his tremendous popularity at Padua, was forced out by anti-Semitic laws.

Last week Dr. Castiglioni's History of Medicine, originally published in Italy in 1927, was republished in a new translation in English by Professor Edward Bell Krumbhaar of the University of Pennsylvania, who incidentally toned down some of the claims made for Italian doctors (Knopf, $8.50). Dr. Castiglioni's book is remarkable for his account of medical philosophies, his love for the art and literature of medicine, his flashes of Roman fire. The book is crammed with pictures from Chinese, Arabian and Egyptian texts, including many ingenious forms of primitive therapy (see cut). It records medical progress up to and including the discovery of the new sulfa-drugs. Among the important European physicians whom Dr. Castiglioni discusses:

> The "greatest physician of all times" was Hippocrates of Cos, a Greek who lived in the golden Age of Pericles. He was the first doctor in Western history to: 1) take the practice of medicine out of the realm of magic, the hands of priests; 2) draw up a set of lofty ethical rules for doctors (among them the Hippocratic oath,* still followed by physicians today); 3) make careful scientific observations (he published a classic description of tuberculosis); 4) let nature take its course, instead of using drastic purges and operations. Nevertheless, he strayed from the scientific path in originating the universally popular doctrine of "humors" (blood, phlegm, yellow and black bile). Imbalance of humors, he claimed, caused all disease.

> The naturalism of Hippocrates was frozen into a dogmatic system by the Roman physician Galen, who lived in the early days of the Christian era. A great showman, Galen often performed experiments on animals in public theatres. He wrote over 400 books. Because of his enormous practice, he was hated by other Roman doctors. Galen believed that the body was a perfect machine, dominated by the soul, set in motion by God. "Galen," said Dr. Castiglioni, "knows everything, has an answer for everything; he confidently pictures the origin of all diseases and outlines their cure." He perpetuated "fundamental errors," and "produced a long arrest in medical evolution." Yet he "recognized seven of the twelve pairs of cerebral nerves . . . and knew most of the gross structures of the brain as we know them today."

> The "Luther of Medicine," who violently attacked the authority of Galen, was Philippus Aureolus Theophrastus Bombastus Paracelsus von Hohenheim. He was born in Switzerland in 1493. (Last week in Manhattan the New York Academy of Medicine celebrated the 400th anniversary of Paracelsus' death.) A hotheaded youth, Paracelsus doffed his doctor's biretta for a slouch hat, wandered through Western Europe, treating workmen and peasants. Because he believed in experience rather than in Galen's laws, he was hounded by his fellow doctors. No university would employ him, no printer would publish his books. But his motley disciples followed him from town to town. Once he even got away with a public burning of orthodox medical texts. Today Paracelsus is famed as the great-grandfather of chemotherapy, for he was the first to use chemicals in combating disease. He also made important observations on epilepsy, took acute notes on miners' consumption, wrote two treatises on syphilis. He died, at the age of 48, probably from cancer.

* Most significant section: "Whatever in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge."

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