Chapter LI: Introduction

The Greek science of medicine was one which reached a high degree of development. As early as the fifth century B.C. it appears in the school of Hippocrates, divested of nearly all trace of its origin in superstition and magic, and largely relying on careful observation and interpretation of symptoms. This school already possessed a considerable body of recorded observations. At Alexandria, later, further progress was made, especially in the subject of anatomy. At this time the dissection—and even vivisection—of the human body was practiced, though there are few traces of it earlier, and later it was forbidden. The last great land-mark in the history of ancient medicine is to be found in the works of Galen (second century A.D.) who summed up, extended, and interpreted the medical knowledge of preceding times.

In medicine, however, as in Greek science generally, theoretical and philosophical elements often prevailed to the detriment of the pragmatical. Examples of this are to be seen in the theory of the four humors, first found in the Hippocratic writings; in the belief of the Methodist school, which held that disease consisted in the contraction and relaxation of the pores (πόροι); and in the doctrines of the Pneumatic school, which maintained that health and disease resulted from the influence of the universal soul (πνεῦμα). A reaction against this tendency is evidenced by the empirics, who professed to reject all general notions and to rely on experience alone. However, the increasing predominance of the theoretical is shown in the case of Galen, who secured his ascendency over succeeding ages by his extravagant theoretical system rather than by his really great practical knowledge.

No contribution to medicine was made by the Romans. Although the profession appeared among them in the second century B.C., it remained a thing apart, in the hands of Greek physicians.[277] Of the three chief writers on the subject in the Latin language, two, Celsus and Pliny, were not physicians but encyclopedists, who were necessarily compilers rather than scientists.[278] The only writer of importance who approached his work from a professional standpoint was Caelius Aurelianus, and his book is of importance chiefly because its Greek original is lost.[279] This neglect of medicine is explained in part by the fact that physicians stood low in the social scale. Another more powerful influence was the increasing fashionableness of Oriental religions with their superstition and addiction to magic practices. Toward the close of the empire the decline was rapid in medicine as in other fields. Abridgements, which cut down quality unconsciously as much as they did quantity consciously, held the field. Itinerant quacks and “folk-medicine” gradually ousted the lay profession until finally what little science remained was in the hands of priests and monks, who needed a smattering of the subject for the people of their parishes, and the inmates of monasteries and hospitals.[280]

[277] Galen was one of these.

[278] Max Neuberger, _Geschichte der Medizin_ (Stuttgart,
1906–1911), vol. i, pp. 310–321.

[279] _Ibid._, vol. ii, p. 61 _et seq._

[280] Neuberger, _op. cit._, vol. ii, pp. 240–278 for an account
of medicine in the early middle ages.

Isidore does not say for what purpose he wrote his _De Medicina_, whether to serve as a text-book to aid in the education of the clergy in the way indicated above, or merely in the spirit of the encyclopedist. A number of considerations point strongly to the former conclusion. In the first place, medicine is placed in juxtaposition with the seven liberal arts, and is separated from subjects more nearly akin to it. Secondly, the attitude which Isidore displays in speaking of medicine is one which remembers that this subject was once classed with the liberal arts. He feels called upon to explain why “the art of medicine is not included among the liberal disciplines”, and his explanation is one drawn from the pedagogical sphere; he tells us that medicine is “a second philosophy”, by which he means to say that it belongs to the highest stage of education, but plays therein a minor part. Finally, we must remember that Cassiodorus, whose comprehensive plan of education had great influence with Isidore, had recognized the need of medical knowledge in the education of the clergy, as shown in his chapter “On monks having the care of the infirm”.

It is not known what were the immediate sources of Isidore’s _De Medicina_. The ultimate authority for his account of diseases is the work of the Methodist Caelius Aurelianus, whose eight books containing a classification of diseases into acute and chronic are reproduced by Isidore in two chapters that occupy the greater part of the space that he devoted to medicine.

EXTRACTS

Chapter 1. On medicine.

1. Medicine is that which guards or restores the health of the body, and its subject-matter deals with diseases and wounds.

2. And so it includes not only those things which are presented in the art (_ars_) of those who are called _medici_ in the proper sense, but food, drink, and covering as well; in short, all the guarding and defence by which our body is protected against blows and accidents from the outside.

Chapter 2. On its name.

1. Its name is believed to have been given to medicine from _modus_, that is, moderation, so that not enough but a little be used. For nature is made sorrowful by much and rejoices in the moderate. Whence also they who drink in quantities and without ceasing of herb juices (_pigmenta_) and antidotes, are troubled. For all immoderation brings not welfare but danger.

Chapter 3. On the founders of medicine.

1. Apollo is called among the Greeks the author and founder of the art of medicine. His son, Aesculapius, enlarged it by his fame and work. But after Aesculapius perished by a thunder-bolt, the business of curing is said to have been forbidden and the art disappeared with its author.

2. And it remained unknown for nearly five hundred years down to the time of Artaxerxes, king of the Persians. Then Hippocrates, born in the island of Cos, his father being Asclepius, brought it back to the light of day.