PREFACE

THE manuscript of Sir William Osler's lectures on the "Evolution of Modern Medicine," delivered at Yale University in April, 1913, on the Silliman Foundation, was immediately turned in to the Yale University Press for publication. Duly set in type, proofs in galley form had been submitted to him and despite countless interruptions he had already corrected and revised a number of the galleys when the great war came. But with the war on, he threw himself with energy and devotion into the military and public duties which devolved upon him and so never completed his proof-reading and intended alterations. The careful corrections which Sir William made in the earlier galleys show that the lectures were dictated, in the first instance, as loose memoranda for oral delivery rather than as finished compositions for the eye, while maintaining throughout the logical continuity and the engaging con moto which were so characteristic of his literary style. In revising the lectures for publication, therefore, the editors have merely endeavored to carry out, with care and befitting reverence, the indications supplied in the earlier galleys by Sir William himself. In supplying dates and references which were lacking, his preferences as to editions and readings have been borne in mind. The slight alterations made, the adaptation of the text to the eye, detract nothing from the original freshness of the work.

In a letter to one of the editors, Osler described these lectures as "an aeroplane flight over the progress of medicine through the ages." They are, in effect, a sweeping panoramic survey of the whole vast field, covering wide areas at a rapid pace, yet with an extraordinary variety of detail. The slow, painful character of the evolution of medicine from the fearsome, superstitious mental complex of primitive man, with his amulets, healing gods and disease demons, to the ideal of a clear-eyed rationalism is traced with faith and a serene sense of continuity. The author saw clearly and felt deeply that the men who have made an idea or discovery viable and valuable to humanity are the deserving men; he has made the great names shine out, without any depreciation of the important work of lesser men

and without cluttering up his narrative with the tedious prehistory of great discoveries or with shrill claims to priority. Of his skill in differentiating the sundry "strains" of medicine, there is specific witness in each section. Osler's wide culture and control of the best available literature of his subject permitted him to range the ampler aether of Greek medicine or the earth-fettered schools of today with equal mastery; there is no quickset of pedantry between the author and the reader. The illustrations (which he had doubtless planned as fully for the last as for the earlier chapters) are as he left them; save that, lacking legends, these have been supplied and a few which could not be identified have with regret been omitted. The original galley proofs have been revised and corrected from different viewpoints by Fielding H. Garrison, Harvey Cushing, Edward C. Streeter and latterly by Leonard L. Mackall (Savannah, Ga.), whose zeal and persistence in the painstaking verification of citations and references cannot be too highly commended.

In the present revision, a number of important corrections, most of them based upon the original MS., have been made by Dr. W.W. Francis (Oxford), Dr. Charles Singer (London), Dr. E.C. Streeter, Mr. L.L. Mackall and others.

This work, composed originally for a lay audience and for popular consumption, will be to the aspiring medical student and the hardworking practitioner a lift into the blue, an inspiring vista or "Pisgah-sight" of the evolution of medicine, a realization of what devotion, perseverance, valor and ability on the part of physicians have contributed to this progress, and of the creditable part which our profession has played in the general development of science.

The editors have no hesitation in presenting these lectures to the profession and to the reading public as one of the most characteristic productions of the best-balanced, best-equipped, most sagacious and most lovable of all modern physicians.

F.H.G.

BUT on that account, I say, we ought not to reject the ancient Art, as if it were not, and had not been properly founded, because it did not attain accuracy in all things, but rather, since it is capable of reaching to the

greatest exactitude by reasoning, to receive it and admire its discoveries, made from a state of great ignorance, and as having been well and properly made, and not from chance. (Hippocrates, On Ancient Medicine, Adams edition, Vol. 1, 1849, p. 168.)

THE true and lawful goal of the sciences is none other than this: that human life be endowed with new discoveries and powers. (Francis Bacon, Novum Organum, Aphorisms, LXXXI, Spedding's translation.)

A GOLDEN thread has run throughout the history of the world, consecutive and continuous, the work of the best men in successive ages. From point to point it still runs, and when near you feel it as the clear and bright and searchingly irresistible light which Truth throws forth when great minds conceive it. (Walter Moxon, Pilocereus Senilis and Other Papers, 1887, p. 4.)

FOR the mind depends so much on the temperament and disposition of the bodily organs that, if it is possible to find a means of rendering men wiser and cleverer than they have hitherto been, I believe that it is in medicine that it must be sought. It is true that the medicine which is now in vogue contains little of which the utility is remarkable; but, without having any intention of decrying it, I am sure that there is no one, even among those who make its study a profession, who does not confess that all that men know is almost nothing in comparison with what remains to be known; and that we could be free of an infinitude of maladies both of body and mind, and even also possibly of the infirmities of age, if we had sufficient knowledge of their causes, and of all the remedies with which nature has provided us. (Descartes: Discourse on the Method, Philosophical Works. Translated by E. S. Haldane and G. R. T. Ross. Vol. I, Cam. Univ. Press, 1911, p. 120.)