A Pictorial History of Medicine, by Otto Bettmann

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Ed. Charles C. Thomas Publisher, 1956. Hard cover. Size 27,5 x 22 cm. With more than 500 photographs in black and white. State: Used, very good. 318 pages

By Philip Hench

Former President Truman once wrote me: “The best education for a President of the United States come from an intimate study of the lives, letters, and papers of his predecessors”. The study of history can be of as great spiritual and practical value to a physician as to a president.

Dr. Otto Bettmann’s “Pictorial History of medicine” shows the whole extraordinary pageant of healing. If within it are vivid colorings reflecting the scarlet terror of epidemics, the white stillness of death, the gray fog of dark eyes, there is also the golden brilliance of discovery. The emotional texture is dramatic, appealing, rich in contrasts: great earnestness and compassion, sometimes cold erudition, and much wishful thinking. If the chronicle of medicine reveals follies, frauds, and foofaraw, one also finds here unsurpassed dedication, integrity, effort incredibly sustained, often heroism and total sacrifice, and thousands of victories wherein no man was loser. In this book Dr. Bettmann has traced the art and science of healing -from the medicine man of ancient times up to the medical man of the twentieth century -in a manner that is both fascinating and scholarly. As a historian he can stand among the peers.

The young doctor of today never meets the greatest of his teachers in person. To be exposed to this incomparable faculty he must go to the pages of medical history: to Hippocrates, paré, Pasteur, Lister and Osler. These great men are present in everything the doctor does -a fact illustrated by the story of the young physician faced with a difficult case. To bolster the confidence of a patient who was seriously ill, he said, “Why, Mrs. Jones, this morning Pasteur and Roentgen briefed me before I left home; Sydenham and Osler came here with me, and Domagk and Fleming are standing by”. To which she replied, “Dear me, won’t they cost a lot?”

They will cost nothing. The book of history is open -and free

Our work rests -more, perhaps, than that of any other profession- on the accomplishments of our predecessors. A knowledge of what they have given to medicine and to humanity should therefore be part of our background, and not for reasons of professional sentiment alone, but for reasons of good common sense.

Pursuing his career, the physician must of course strive to maintain a forward look; for it is ahead that both opportunity and difficulties lie. Yet despite modern complexities, most of our practical problems resemble those of our predecessors. The problems ahead are recurrences, minor variants of those in the past -the past of our elders if not our own. From our point of view they seem to come at us from in front, and to bear a fresh label. But beneath the wrappings there is usually an old problem, already examined and even, sometimes, disposed of. By borrowing experience and wisdom from predecessors we can view certain situations as if in retrospect, and view them with enormous profit.

Physicians will do well, then, to look ahead for problems. Paradoxically, however, they should look “behind” for guidance, and a study of medical history provides an excellent rear-view mirror. Most physicians are unfortunately not conscious of their medical heritage, because few find time to study it. This may not be their fault alone. It must be admitted that many medical histories, however erudite, are not very readable. The author of this book, Dr. otto Bettmann, has spent a life-time to remedy this situation. In years of research in art centers all over Europe he has assembled a vast library of medical illustrations, studying, analyzing, and authenticating them so that they could become part of a new medical history: a history of medicine in pictures. This book was designed less for medical historians than for the practicing physician or layman who wishes to inform himself of the background of this profession at a glance.

What is the panorama that opens up before our eyes?

Dr. Bettmann’s vista of 50 centuries clearly reveals that the course of medicine has not always been one of advance. If there are volumes of hard-won facts, life-saving ingredients and conclusions, and galaxies of truths and half truths, there are also despairs, superstitions, and sophistries. Although the over-all direction of medicine has been, at least since the Renaissance, one of improvement, its progress toward betterment has been on countless occasions retarded, or even reversed. Thus it is more accurate to speak of the “history” or the “development” of medicine, rather than of its “progress” or “advance”. And for the reader, a chronicle which recounts the ebb as well as the flow of medical art and science is both more accurate and more entertaining than a mere description of clinical and technical advances.

To what extent have physicians, individually or collectively, been responsible of the course of medicine, for it forward spurts or its backward shifts? One view has it that medical progress depends chiefly on discoveries; hence the rate at which medicine advances is determined largely by the appearance of medical leaders and the results of their researches. Another view is that man is more servant of Fate than master, the product rather than the maker of environment. Thus great physicians are not “born medical leaders”, but become leaders through the circumstances of their lives. Each period of travail generates its own saviors; each crisis produces discoveries.

Of these two views Dr. Bettmann supports neither extreme wholly. Because the physician is only one of many factors that have influenced the direction of medicine, the story cannot be told in terms of the medical man alone. Our medical benefactors must not be nameless, of course; but they must be seen in perspective, in the company of non-medical contemporaries -friendly, indifferent, or hostile- whose ambitions and attitudes also require elaboration. Thus the author presents the course of medicine as part of general history. He views is not as a chronology of discoveries, but as only one of the great social forces -a continuing force, but one mof fluctuating potency, now dominant, now recessive. This absorbing book shows what impact the physician has had upon each of the great cultural and political areas, and vice versa.

There seems to be no special “climate” for medical “discovery”; great discoveries have been made almost anywhere and everywhere. Mo desolate military outpost is too small and disorganized, no research center too large and too organized, to prevent them. Wherever there is a physician, in that place are the potentials for discovery of new medical truths.

To be useful, however, medical truth must be put to work; it must serve. In the last analysis, that can happen only when the informed, dedicated physician and a single patient who needs him actually meet. It is in this place, a sick room, where the thruthful dreaming of the theorist, the demonstrations of the experimentalist, the magic of the chemist, the guidance of the laboratory, and the wisdom of the practitioner finally come together for the critical testing.

Such is the story that Dr. Bettmann’s book reveals. The product of the author’s 30-year pictorial treasure hunt -plus his lifelong study of medical texts- the material displays a richness and variety which stamp it as part of a “collector’s collection”. Included are previously unpublished original photographs, and many ancient illustrations not heretofore published outside their land of origin.

In view of his vast array of graphic material, the author must have been sorely tempted to appeal chiefly to the eye; to construct his own medical art gallery within cardboards; to let most of the pictures speak for themselves, with mere captions and program-notes for the less articulate of his selections. But Bettmannthe specialist in medical art is not subordinate to Bettmann the textual historian. The two combine harmoniously to create a superior form; and the lucid text is brightened by the instructive anecdote, the humorous twist.

Many readers will, I believe, be fascinated by this book without pausing to analyze its special appeal. But those who disregard the identity of tha appeal are depriving themselves of what is, in my opinion, an important bonus. Almost daily the physician has to do some teaching of patients, medical school and hospital personnel, fellow-physicians, or public groups. The public’s avid interest in health is greatly increasing the physician’s responsabilities and opportunities as a teacher and lecturer. He is not often as effective as he could be because he seldom appreciates, or employs fully, the power of visual instruction. “A picture may instantly present what a book could set forth only on a hundred pages”. Today’s doctor will do well to heed this century-old dictum of Turgeniev -a dictum convincingly exemplified in Dr. Bettmann’s Pictorial History of Medicine.

Its chapters are subdivided into compact thematic units of text and illustration. Each unit covers a particular subject -perhaps one gret leader, an important controversy, or the development of some specialty. But the units keep their logical places in the general text, never losing their connection with related events. Thus there is no break in the continuity of interest and the sense of progression.

A Pictorial History of Medicine, then, is no “pictorial souvenir” for the physician to inspecto casually and the consign to the patient’s waiting room. Instead it should become a permanent member of his small, desk-side privy council: as dependable as the latest medical book or journal. In order to keep the size and cost of the book practicable, Dr. Bettmann concludes his chronicle as the twentieth century begins.

CONTENTS
Foreword, by Philip S. Hench
I- EGYPT AND THE ANCIENT EAST
Medical Life Along the Nile
Embalming Gives Clues to Surgeons
Egyptians Suffered Like Moderns
Prescriptions Come on Papyrus
Babylonia-Assyria: Priest Physicians Chase Disease Demons
Tell-tale Liver
Surgeon in Trouble
Medicine in the Bible: “I God Am The Physician”
Moses: Public Health Leader
II- THE GREEKS
Homer’s Battle Surgeons
Aesculapius: His Temples Were Centers of Faith Healing
Dream and Get Well
Greeks Link Man to Laws of Universe
Hippocrates
Men of Honor
Greek Doctors Vie for Patients
Aristotle Explores Man, Beasts, Plants
Alexandria -New Capital of Medicine
III- THE ROMANS
Aesculapius Comes to Rome
Caesar Welcomes Doctors
Compilers and Compounders
Rome Gives to the World: Public Hygiene – Army Medicine
Quacks Overun Rome
Clarissimus Galenus: the Last of the Ancients
IV- THE EARLY MIDDLE AGES
The Church Prescribes Faith
Christ the Healer
St. Luke the Beloved Physician
Monastic Medicine
Patients Pray for Cures to Saints Who Are Fellow Sufferers
Hospitals: Monastic Medicine´s Chief Glory
V- MOSLEM MEDICINE
Light from the East
Rhazes: Bedside Clinician
Avicenna: Textbook Writer
Cure by Fire
The Arabian Druggist
The First Drugstore
Arabs and Jews Allied in Medicine
VI- THE LATE MIDDLE AGES
Medicine Moves West
Salerno’s School for Doctors and Surgeons
The Art of Sensible Living
“Four Temperaments Rule Mankind Wholly”
“Bloodletting Is the Beginning of Health”
Medicine Stymied by Logic
New WAys to Treat Wounds
Inside Out: Anatomy Advances
Surgery Resurgent
Woman’s Trouble – AD 1400
John of Arderne Suggests: Test for Anal Cancer
Rise of Towns: Doctors Cope with New Health Hazards
Aging Successfully
City Life – Beware of Contagion!
Leprosy Conquered
The Black Death
Plague Dazes Doctors
VII- THE RENAISSANCE
New Vistas for Man and Medicine
Artists Spearhead Medical Advance: Da Vinci and Dürer
Syphilis Floors Europe
Von Hutten: A Syphilis Diary; Fracastorius: A Syphilis Poem
A Day with the Doctors
Deeper Wounds – Better Surgeons
A Child is Born AD 1540
Medical Meddlers
England Set up College of Physicians
Paraselsus: Medicine a Divine Mission
Paracelsean Alchemy: Metals into Drugs
In Search of Diagnosis: Doctor Consults Stars
Laughter at the Bedside
Andreas Vesalius
Paré: His Knife Saves Thousands
Horrors of Cautery Curbed
New-found Remedies – Pharmacy Prospers
Surgeon’s Diary
Oculist to the Rescue
Tagliacozzi: Mastermaker of New Noses
The Insane: Patients, not Witches
The Doctor`s Three Faces
VIII- THE SEVENTEENTH CENTURY
Age of Measurement
Gilbert explores Magnetism
Sanctorius Measures Metabolism
William Harvey: “Truth Is My Trust”
The Mystery and the Chemistry of Life
Holland’s Rise to Medical Fame
Dutch Doctors on Canvas
Locksmith Frees Himself of Bladderstone
Frederick Ruysch Exhibits Strange Specimen; De Graaf Taps Pancreatic Juice
As Scientific Factions Fight, a Doctor Goes Back to Bedside
Thomas Sydenham Treats Gout, Concedes Cinchona Cures Fever
London Plague, 1665: A Medical Fiasco
Faith Healers and Fake Healers
Microscopes Reveal: Little “Animals”
Blood Transfusions Possible
Lamb’s Blood Infused into Ailing Humans
Paris Shuns “New Medicine”
The Sun King: A Picture of Misery
Surgeons Operate for Cancer
Mad Poison Mixers: Garth and the Dispensary War
Colonial America: Priest-Physicians Pray and Cure
IX- THE EIGHTEENTH CENTURY
Reason Reigns – Charity is Reborn
Dr. Stahl Declares: Soul Runs the Body
Boerhaave of Europe
The Monros Mold a Great New School
Frayed Nerves Cause Sickness (Cullen); Sickness Depends on Excitability (Brown)
London’s Cane-carrying Physicians Are Well-heeled, Well-wheeled
Peppery Radcliffe>; Princely Mead
The Neglected Little Ones
Stop Tight Swaddling!
Cadogan Teaches Sensible Child Care
Correct Faulty Posture
André Asks Preventive Orthopedics
John Howard Demands Prison Reform
Stephen Hales: Gauges Blood Pressure
Cures for Workers, Sailors, Soldiers
1761: Year of Two Great Books
Doctors
Surgeons Become Gentlemen
Rise of the Male Midwife
John Hunter, Giant of Experimental Surgery
Healing Electrically
Foxglove Plant Yields Stimulant
The Quacker Doctors of London
Laughter Shoos Devils of Pain
The New World: From Stableboy to Surgeon
Philadelphia First Medical School in America
New York Awards a First M. D. Pinel Unshackles the Insane
Jenner: Vaccination Works
X- THE NINETEENTH CENTURY I
Medicine Marches on with Napoleon
Paris: New Center of Science
Laennec: the First Stethoscope
Rising Specialism: Surgery, Orthopedics, Dermatology
The Bells of Scotland
“Sack-‘Em-Up-Men”
Pioneer Interlude: McDowell Performs Ovariotomy; Beaumont Peeks into Human Stomach
Phlebotomy Killed by Statistics
The English and Irish Clinicians
Fads of the Thirties
Daumier and the Doctors
Pain Put to Sleep: Ether used in Surgery
Blissful Insensibility
Saviors of Mothers
XI- THE NINETEENTH CENTURY II
Triumph of Medical Science
Reveille in Germany
Bernard and Virchow
Backwoods Doctors
New Tools for Diagnosis
Florence Nightingale
Civil War Medicine
Psychiatry Takes Root
Lister Curbs Sepsis
“Therapy in Bloomers”
In Praise of the Country Doctor
“For All These Ills…”
Sanitation for Cities – at Last!
Yellow Fever Rips the South
Pasteur, Peer of Preventive Medicine
Koch Tracks Down Tuberculosis
The Aseptic Method
Nurses are Needed
Childcare Made a Science
Johns Hopkins: Great Doctors – Great Teachers
Osler: Giant of the Wards
Rays of Hope
Towards Chemo-Therapy
BIBLIOGRAPHY