How could a huge industry have offered almost exclusively ineffective drugs and procedures for thousands of years? There were several reasons, but a significant role was played by the selection of treatment by logical reasoning, the starting point for which was a mistaken understanding of the body, the mechanisms of the disease and the principles of action of certain substances.
Cognition is a sequential process, it is impossible to jump over a few steps. To understand the causes of fever, you need to at least know about the existence of microorganisms. And this is impossible until the microscope is created. The creation of the microscope should be preceded by the development of optics and the emergence of technologies to create lenses of the desired strength and quality.
Then you need to establish a link between a particular bacterium and the disease, and this is a separate, not always easy task. Then to study the physiology and biochemistry of the pathogen, to understand how it feeds and reproduces, and only then can we assume that a certain substance is able to stop its reproduction or kill it. And the assumption is not necessarily correct, to obtain a reliable result there are still a lot of steps. Even now, when we know the causative agents of most infectious diseases and have studied them well, the development of new antimicrobial and antiviral substances is extremely difficult and more often fails than succeeds.
If we waited until we had gone through all these steps and were able to propose an antibacterial formula based on a deep knowledge of the biology of pathogens, we might have lived the twentieth century without antibiotics. Accident helped discover penicillin, and for him and other drugs. But we were ready for this accident: Microbiology helped to understand the meaning of what happened, the level of development of chemistry and physics allowed us to first isolate the drug from natural raw materials, and then synthesize it. The ancient Egyptians, who treated inflamed wounds with moldy bread crusts, probably encountered a similar accident. But the level of knowledge and technology did not allow to interpret it correctly and create antibiotics thousands of years earlier.
However, each generation lives in the present, using the tools and knowledge that are already at its disposal. The patient will not wait for several centuries: treat patients and teach new doctors need now. Therefore, from century to century, medicine is based on modern ideas about the mechanisms of disease, no matter how far from reality they may be.
For teaching medicine medieval universities resorted to the help of scholasticism (from the same Greek root as the “school”) – a method based on the study of the works of the great philosophers of the past. Students studied the text of a famous author, such as Aristotle, and then other works on the same subject, and made a list of the contradictions found. This list was analyzed until the contradictions found could not be eliminated. It is noteworthy that the contradiction could not be removed by stating that both authors were wrong: the authorities of the past could not be wrong. Instead, for example, they studied alternative meanings of the words used in the texts. As a result, it was possible to come to the conclusion that the author had in mind something quite different and contradiction – apparent. Or by logical analysis one of the conflicting points of view was refuted.
So, a popular task for medical students was to discuss where and how the seed arises. The emphasis was on the views of Aristotle, who argued that the seed-the final waste of digestion. An alternative point of view was presented by the same Aristotle – in another text he wrote that the seed descends into the perineum from the brain. The answer ” we do not know” or the refutation of both points of view were unacceptable, the possibility of practical verification was not discussed. Only the invention of the microscope in the XVII century allowed to get the correct answer to this question.
Aristotle was not just the main authority: the scholastic method relied on the formal logic he described-the art of correct reasoning-and his philosophy. Although the latter and claimed to be a universal tool of knowledge, it is not very helpful in understanding the surrounding reality. The style of ancient philosophy reflects well the famous Aristotelian concept of the four causes. It says that everything springs from matter, form, external influence, or the purpose of change. So, one of the reasons for the table is wood, because it is made of wood, and the other is the shape of the table, because it is the shape that it has, another is its purpose: the table is needed to sit at it.
Moliere remarkably parodied Aristotelian philosophy in the play “Imaginary patient”: doctors profoundly explain the hypnotic effect of opium that he has virtus dormitiva (lat. “sleeping essence”). Parody is not far from the truth. In Aristotle’s time, such verbal exercises were more a form of art and demonstration of eloquence than a way of knowing the world, but later medicine forgot about it and began to take such “logical constructions” seriously. There was nothing to replace them at that time, and, as a consequence, such constructions, supported by the unshakable authority of doctors and thinkers of the past, turned into complete and internally consistent systems, resisting not only new knowledge, but also any criticism, verification and the attempt to create a new method.