Wednesday, February 8, 2012

Vivian Nutton "The Rise of Medicine" Analysis


Neal Hogg
Health Rhetoric
Feb 5, 2012

Style Analysis: “The Rise of Medicine”

In his essay “The Rise of Medicine” Vivian Nutton presents a brief history of the emergence of medicine in ancient cultures.  In conveying the changes to medical traditions from the times of the ancient Egyptian and Greek societies Nutton focuses on the relationships between these societies and their political, social and philosophical tendencies to resist or create change in medical services and science.
            Vivian Nutton carries a high degree of situational ethos on the subject at hand, as he is a Professor Emaritus of Cambridge.   His specialization was focused on “the history of classical rhetoric, from Antiquity to the present, and particularly on Galen” (UCL web).  With this expertise to give his writing credibility, Nutton sets out to outline the focus of the history presented in “The Rise of Medicine” in a chronological order when possible, and cross-references cultures and their institutions to bring the reader closer to his level of awareness of the subject.  The writing is clear and well-developed enough that the reader gains a high degree of insight to the ancient medical traditions and their relation to our understanding of modern medicine.  Since this essay appears as part of a collection in The Cambridge History of Medicine it can be assumed that this text will be read by individuals with an interest in the subject, but the composition of this work as more of a history, with less technical illustration suggests that the audience is not confined to medical professionals or specialized historians.
            Nutton begins his essay with a nod to Theodore Zwinger, a medical professor from the 16th century, whom Nutton credits with a feeble attempt at creating a history of medicine based on “historical fictions” which Nutton claims are valuable as a reminder that  “the evidence for healing and medicine antedates any literary text or historical event” (Nutton 46).  It seems Nutton is softening up the reader in hopes they will keep an open mind about the potential success of studies of the history of medicine.  This serves the reader well when the topic of discussion contains over four thousand years of often obscure history which has been developed simultaneously and separately between and among several societies and cultures on several continents.
            Nutton bases his accounts of the history of medicine chronologically, which, as a writer, makes sense when chronicling a history of changing ideas.  At every step of the way Nutton references relevant texts and speakers whom even readers with a limited background on the subjects will be able to identify.  He begins with descriptions of ancient healers of Babylonia and Egypt.  Nutton cites the 18th century B.C. “law code of Hammurabi” which “specified the fees paid to a healer for a particular operation on a sliding scale” (Nutton 48).  Here the reader gains insight into this ancient code through Nutton’s framing of this scale with regards to social standing and doctor error, two concerns which still effect our perception of the level of quality care in modern medicine.  Nutton then references the Egyptian practice of mummification as a possible equal to anatomy during ancient times, and suggests the “taboo” regarding handling a corpse was not present in Egypt and offered opportunity for possible medical research into the internal organs  (51).   Throughout his essay Nutton notes the successes and failures of various societies, and sometimes shows a sharing of knowledge between cultures.  This helps readers who have studied a predominantly Western history to appreciate the contributions of cultures outside the Greek tradition.
Of course the Greeks are heavily influential on modern philosophy and medicine and Nutton covers their impact next.   Contrasting his point regarding the Egyptians, Nutton suggests one failing of Greek medicine was a misunderstanding of internal organs from a lack of study of the human body, as the Greeks relied on “comparisons with animals and everyday objects” instead of “careful observation” (52).   Nutton then references notable historical Greek figures whose work benefitted the field of medicine.  He also highlights the work of Hippocrates, and his “Hippocratic Oath” which is a tradition still present in modern medicine (50).  Nutton then presents the work of another recognizable Greek, Aristotle, claiming his “massive programme of zoological and biological exploration” paved the way for Diocles of Carystos to compile the first book on animal dissection (52).  Nutton then claims the Greeks were able to explore human anatomy when the Greek Empire expanded to include the new city of Alexandria, which held attitudes more resembling Egyptian attitudes regarding corpse handling than the greeks.  These attitudes allowed a new avenue of exploration for ancient doctors and helped advance medical theory from the philosophical to the scientific.
Nutton then describes the development of medicine with regard to religious motivation.  He exhibits the hospital as a new “product of Jewish and Christian ideas on charity” around the turn of the first century A.D. (56).  While this may seem to be an ethnocentric claim of discovery, Nutton does not project either religion as more influential than the other, and then credits the Arab influence as influential during this time period as well.  Nutton doesn’t rank any society as more influential in his analysis, but continues to illuminate the ways the three major epicenters of culture influenced perceptions of each other’s medical canons.  Nutton’s greatest example of this melting pot of philosophy comes from the history of creation of medical texts and translations across societies and time.  Nutton highlights the translation of the Galen writings on medicine into Syriac as immensely beneficial to the spread of advanced medical concepts during the 5th century B.C. (57).  He then follolws the translation of these works into Arabic, which preserved the writings more completely than the Greek record and allowed Arab scholars to identify the “psychic spirit, vital spirit, and natural spirit,” all of which had been missing from medical philosophy until the sharing of these cross-cultural writings (59).
As texts amassed, the amount of medical knowledge swelled and medicine became a focused, scholarly endeavor.  The limited number of doctors initially involved in University Medicine around 1250 were “graduating at a rate of 1 or 2 every ten years” and immediately imposed  a “textual examination” to supplement and sometimes replace apprenticeship (64).  This historical moment brought doctors into a highly-specialized and self-regulated group, much like our current medical tradition.
Nutton’s essay “The Rise of Medicine” presents a history of the impact of medical traditions and developments, and acknowledges how the failures and successes of medical pioneers reveals medicine to be an ever-evolving subject enhanced by collaboration and consensus wherever possible.  Through his ability to relate Ancient medicine of various cultures to our modern concepts Nutton is able to show the reader that the developments in medicine have led to a more effective system of health care, the development of which has never been static and shaped by influences from various societies and philosophies over time.  Rather than writing a tired history of the subject, Vivian Nutton engages the reader with identifiable authorities from the historical context, presentations of the convergence of societies in a historical context, and references to the philosophy of those who developed the tradition of medicine.
         

Works Cited:

"Professor Vivian Nutton (Emeritus)." UCL - London's Global University. Tue 05 Feb. 2012. <http://www.ucl.ac.uk/histmed/people/academics/nutton>.

Nutton, Vivan.  “The Rise of Medicine” Porter, Roy. The Cambridge History of Medicine. Cambridge: Cambridge UP, 2006. Print. (p. 46-70)

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