Chapter IV: , VII (170)

"It is well known that the oldest documents which we possess
relative to the practice of Medicine, are the various
treatises contained in the Collection which bears the name of
Hippocrates. Their great excellence has been acknowledged in
all ages, and it has always been a question which has
naturally excited literary curiosity, by what steps the art
had attained to such perfection at so early a period. … It
is clearly established that, long before the birth of
philosophy, medicine had been zealously and successfully
cultivated by the Asclepiadæ, an order of priest-physicians
that traced its origin to a mythical personage bearing the
distinguished name of Æsculapius. Two of his sons, Podalirius
and Machaon, figure in the Homeric poems, not however as
priests, but as warriors possessed of surgical skill in the
treatment of wounds, for which they are highly complimented by
the poet. It was probably some generations after this time (if
one may venture a conjecture on a matter partaking very much
of the legendary character) that Æsculapius was deified, and
that Temples of Health, called 'Asclepia,' presided over by
the Asclepiadæ, were erected in various parts of Greece, as
receptacles for the sick, to which invalids resorted in those
days for the cure of diseases, under the same circumstances as
they go to hospitals and spas at the present time. What
remedial measures were adopted in these temples we have no
means of ascertaining so fully as could be wished, but the
following facts, collected from a variety of sources, may be
pretty confidently relied upon for their accuracy. In the
first place, then, it is well ascertained that a large
proportion of these temples were built in the vicinity of
thermæ, or medicinal springs, the virtues of which would no
doubt contribute greatly to the cure of the sick. At his
entrance into the temple, the devotee was subjected to
purifications, and made to go through a regular course of
bathing, accompanied with methodical frictions, resembling the
oriental system now well known by the name of shampooing.
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Fomentations with decoctions of odoriferous herbs were also
not forgotten. A total abstinence from food was at first
prescribed, but afterwards the patient would no doubt be
permitted to partake of the flesh of the animals which were
brought to the temples as sacrifices. Every means that could
be thought of was used for working upon the imagination of the
sick, such as religious ceremonies of an imposing nature,
accompanied by music, and whatever else could arouse their
senses, conciliate their confidence, and, in certain cases,
contribute to their amusement. … It is also well known that
the Asclepiadæ noted down with great care the symptoms and
issue of every case, and that, from such observations, they
became in time great adepts in the art of prognosis. … The
office of priesthood was hereditary in certain families, so
that information thus acquired would be transmitted from
father to son, and go on accumulating from one generation to
another. Whether the Asclepiadæ availed themselves of the
great opportunities which they must undoubtedly have had of
cultivating human and comparative anatomy, has been much
disputed in modern times. … It is worthy of remark, that
Galen holds Hippocrates to have been a very successful
cultivator of anatomy. … Of the 'Asclepia' we have mentioned
above, it will naturally be supposed that some were in much
higher repute than others, either from being possessed of
peculiar advantages, or from the prevalence of fashion. In the
beginning of the fifth century before the Christian era the
temples of Rhodes, Cnidos, and Cos were held in especial
favour, and on the extinction of the first of these, another
rose up in Italy in its stead. But the temple of Cos was
destined to throw the reputation of all the others into the
background, by producing among the priests of Æsculapius the
individual who, in all after ages, has been distinguished by
the name of the Great Hippocrates. … That Hippocrates was
lineally descended from Æsculapius was generally admitted by
his countrymen, and a genealogical table, professing to give a
list of the names of his forefathers, up to Æsculapius, has
been transmitted to us from remote antiquity. … Of the
circumstances connected with the life of Hippocrates little is
known for certain. … Aulus Gellius, … in an elaborate
disquisition on Greek and Roman chronology, states decidedly
that Socrates was contemporary with Hippocrates, but younger
than he. Now it is well ascertained that the death of Socrates
took place about the year 400 A. C., and as he was then nearly
seventy years old, his birth must be dated as happening about
the year 470 A. C. … It will readily occur to the reader,
then, that our author flourished at one of the most memorable
epochs in the intellectual development of the human race. …
From his forefathers he inherited a distinguished situation in
one of the most eminent hospitals, or Temples of Health, then
in existence, where he must have enjoyed free access to all
the treasures of observations collected during many
generations, and at the same time would have an opportunity of
assisting his own father in the management of the sick. Thus
from his youth he must have been familiar with the principles
of medicine, both in the abstract and in the concrete. …
Initiated in the theory and first principles of medicine, as
now described, Hippocrates no doubt commenced the practice of
his art in the Asclepion of Cos, as his forefathers had done
before him. Why he afterwards left the place of his nativity,
and visited distant regions of the earth, whither the duties
of his profession and the calls of humanity invited him,
cannot now be satisfactorily determined. … According to all
the accounts which have come down to us of his life, he spent
the latter part of it in Thessaly, and died at Larissa, when
far advanced in years. … As a medical author the name of
Hippocrates stands pre-eminently illustrious. … Looking upon
the animal system as one whole, every part of which conspires
and sympathises with all the other parts, he would appear to
have regarded disease also as one, and to have referred all
its modifications to peculiarities of situation. Whatever may
now be thought of his general views on Pathology, all must
admit that his mode of prosecuting the cultivation of medicine
is in the true spirit of the Inductive Philosophy; all his
descriptions of disease are evidently derived from patient
observation of its phenomena, and all his rules of practice
are clearly based on experience. Of the fallaciousness of
experience by itself he was well aware, however. … Above all
others Hippocrates was strictly the physician of experience
and common sense. In short, the basis of his system was a
rational experience, and not a blind empiricism, so that the
Empirics in after ages had no good grounds for claiming him as
belonging to their sect. What he appears to have studied with
particular attention is the natural history of diseases, that
is to say, their tendencies to a favorable or fatal issue. …
One of the most distinguishing characteristics, then, of the
Hippocratic system of medicine, is the importance attached in
it to prognosis, under which was comprehended a complete
acquaintance with the previous and present condition of the
patient and the tendency of the disease. … In the practice
of surgery he was a bold operator. He fearlessly, and as we
would now think, in some cases unnecessarily, perforated the
skull with the trepan and the trephine in injuries of the
head. He opened the chest also in empyema and hydrothorax. His
extensive practice, and no doubt his great familiarity with
the accidents occurring at the public games of his country,
must have furnished him with ample opportunities of becoming
acquainted with dislocations and fractures of all kinds; and
how well he had profited by the opportunities which he thus
enjoyed, every page of his treatises 'On Fractures,' and 'On
the Articulations,' abundantly testifies."

_F. Adams,
Preliminary Discourse (Genuine Works of Hippocrates),
section 1._

"The school of the Asclepiadæ has been responsible for certain
theories which have been more or less prominent during the
earlier historical days. One of these which prevailed
throughout the Hippocratic works is that of Coction and
Crisis. By the former term is meant thickening or elaboration
of humors in the body, which was supposed to be necessary for
their elimination in some tangible form. Disease was regarded
as an association of phenomena resulting from efforts made by
the conservative principles of life to effect a coction, i.
e., a combination, of the morbific matter in the economy, it
being held that the latter could not be properly expelled until
thus united and prepared so as to form excrementious material.
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This elaboration was supposed to be brought about by the vital
principles which some called nature (Phusis), some spirit
(Psyche), some breath (Pneuma), and some heat (Thermon). The
gradual climax of morbid phenomena has, since the days of
Hippocrates, been commonly known as Crisis. All this was
regarded as the announcement of the completion of this union
by coction. The day on which it was accomplished was termed
'critical,' as were also the signs which preceded or
accompanied it, and for the crisis the physician anxiously
watched. Coction having been effected and crisis occurring, it
only remained to evacuate the morbific material, which nature
sometimes spontaneously accomplished by the critical sweat,
urination, or stools; or sometimes the physician had to come
to her relief by the administration of diuretics, purgatives,
et cetera. The term 'critical period' was given to the number
of days necessary for coction, which in its perfection was
supposed to be four, the so-called quaternary, while the
septenary was also held in high consideration. … This
doctrine of crisis in disease left an impress upon the medical
mind not yet fully eliminated."

_Roswell Park,
Lectures on the History of Medicine (in MS.)._

"Making no pretension … to describe the regular medical
practice among the Greeks, I shall here, nevertheless,
introduce some few particulars more or less connected with it,
which may be regarded as characteristic of the age and people.
Great were the virtues which they ascribed to the herb
alysson, (biscutella didyma,) which, being pounded and eaten
with meat cured hydrophobia. Nay, more, being suspended in the
house, it promoted the health of its inhabitants; it protected
likewise both man and cattle from enchantment; and, bound in a
piece of scarlet flannel round the necks of the latter, it
preserved them from all diseases. Coriander-seed, eaten in too
great quantity, produced, they thought, a derangement of the
intellect. Ointment of saffron had an opposite effect, for the
nostrils and heads of lunatics being rubbed therewith they
were supposed to receive considerable relief. Melampos the
goatherd was reported to have cured the daughters of Prætos of
their madness by large doses of black hellebore, which
thereafter received from him the name of Melampodion.
Sea-onions suspended over the doors preserved from
enchantment, as did likewise a branch of rhamnus over doors or
windows. A decoction of rosemary and of the leaves and stems
of the anemone was administered to nurses to promote the
secretion of milk, and a like potion prepared from the leaves
of the Cretan dittany was given to women in labour. This herb,
in order to preserve its virtues unimpaired, and that it might
be the more easily transported to all parts of the country,
was preserved in a joint of a ferula or reed. A plaster of
incense, Cimolian earth, and oil of roses, was applied to
reduce the swelling of the breasts. A medicine prepared from
mule's fern, was believed to produce sterility, as were
likewise the waters of a certain fountain near Pyrrha, while
to those about Thespiæ a contrary effect was attributed, as
well as to the wine of Heraclea in Arcadia. The inhabitants of
this primitive region drank milk as an aperient in the Spring,
because of the medicinal herbs on which the cattle were then
supposed to feed. Medicines of laxative properties were
prepared from the juice of the wild cucumber, which were said
to retain their virtues for two hundred years, though simples
in general were thought to lose their medicinal qualities in
less than four. The oriental gum called kankamon was
administered in water or honeyed vinegar to fat persons to
diminish their obesity, and also as a remedy for the
toothache. For this latter purpose the gum of the Ethiopian
olive was put into the hollow tooth, though more efficacy
perhaps was attributed to the root of dittander which they
suspended as a charm about the neck. A plaster of the root of
the white thorn or iris roots prepared with flour of copper,
honey, and great centaury, drew out thorns and arrow heads
without pain. An unguent procured from fern was sold to
rustics for curing the necks of their cattle galled by the
yoke. A decoction of marsh-mallow leaves and wine or honeyed
vinegar was administered to persons who had been stung by bees
or wasps or other insects; bites and burns were healed by an
external application of the leaf smeared with oil, and the
powdered roots cast into water caused it to freeze if placed
out during the night in the open air; an unguent was prepared
with oil from reeds, green or dry, which protected those who
anointed themselves with it from the stings of venomous
reptiles. Cinnamon unguent, or terebinth and myrtle-berries,
boiled in wine, were supposed to be a preservative against the
bite of the tarantula or scorpion, as was the pistachio nut
against that of serpents. Some persons ate a roasted scorpion
to cure its own bite; a powder, moreover, was prepared from
sea-crabs supposed to be fatal to this reptile. Vipers were
made to contribute their part to the materia medica; for,
being caught alive, they were enclosed with salt and dried
figs in a vase which was then put into a furnace till its
contents were reduced to charcoal, which they esteemed a
valuable medicine. A. considerable quantity of viper's flesh
was in the last century imported from Egypt into Venice, to be
used in the composition of medicinal treacle. From the flowers
of the sneezewort, a sort of snuff appears to have been
manufactured, though probably used only in medicines. The
ashes of old leather cured burns, galls, and blistered feet.
The common remedy when persons had eaten poisonous mushrooms
was a dose of nitre exhibited in vinegar and water; with water
it was esteemed a cure for the sting of a burncow, and with
benzoin it operated as an antidote against the poison of
bulls' blood."

_J. A. St. John,
The Hellenes,
book 6, chapter 6 (volume 3)._

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MEDICAL SCIENCE:
The Hippocratic Oath.

"Medical societies or schools seem to have been as ancient as
Hippocrates. The Hippocratic oath, as it is called, has been
preserved, and is one of the greatest curiosities we have
received from antiquity:

'I swear by Apollo the physician, by Æsculapius, by Hygeia, by
Panacea, and by all gods and goddesses, that I will fulfil
religiously, according to the best of my power and judgment,
the solemn vow which I now make.

I will honour as my father the master who taught me the art of
medicine; his children I will consider as my brothers, and
teach them my profession without fee or reward.

I will admit to my lectures and discourses my own sons, my
master's sons, and those pupils who have taken the medical
oath; but no one else.

I will prescribe such medicines as may be best suited to the
cases of my patients, according to the best of my judgment;
and no temptation shall ever induce me to administer poison.

I will religiously maintain the purity of my character and the
honour of my art.

I will not perform the operation of lithotomy, but leave it to
those to whose calling it belongs.

Into whatever house I enter, I will enter it with the sole
view of relieving the sick, and conduct myself with propriety
towards the women of the family.

If during my attendance I happen to hear of anything that
should not be revealed, I will keep it a profound secret.

If I observe this oath, may I have success in this life, and
may I obtain general esteem after it; if I break it, may the
contrary be my lot.'"

_Ancient Physic and Physicians
(Dublin University Magazine, April, 1856)._

MEDICAL SCIENCE: 1st Century.
Greek physicians in Rome.
Pliny's Picture.

Pliny's account of the Greek physicians in Rome in his time
(first century) is not flattering to the profession. He says:
"For the cure of King Antiochus—to give our first
illustration of the profits realized by the medical
art—Erasistratus received from his son, King Ptolemæus, the
sum of one hundred talents. … I pass over in silence many
physicians of the very highest celebrity, the Cassii, for
instance, the Calpetani, the Arruntii, and the Rubrii, men who
received fees yearly from the great, amounting to no less than
250,000 sesterces. As for Q. Stertinius, he thought that he
conferred an obligation upon the emperors in being content
with 500,000 sesterces per annum; and indeed he proved, by an
enumeration of the several houses, that a city practice would
bring him in a yearly income of not less than 600,000
sesterces. Fully equal to this was the sum lavished upon his
brother by Claudius Cæsar; and the two brothers, although they
had drawn largely upon their fortunes in beautifying the
public buildings at Neapolis, left to their heirs no less than
30,000,000 of sesterces! such an estate as no physician but
Arruntius had till then possessed. Next in succession arose
Vettius Valens, rendered so notorious by his adulterous
connection with Messalina, the wife of Claudius Cæsar, and
equally celebrated as a professor of eloquence. When
established in public favour, he became the founder of a new
sect. It was in the same age, too, during the reign of the
Emperor Nero, that the destinies of the medical art passed
into the hands of Thessalus, a man who swept away all the
precepts of his predecessors, and declaimed with a sort of
frenzy against the physicians of every age; but with what
discretion and in what spirit, we may abundantly conclude from
a single trait presented by his character—upon his tomb,
which is still to be seen on the Appian Way, he had his name
inscribed as the 'Iatronices'—the 'Conqueror of the
Physicians.' No stage-player, no driver of a three-horse
chariot, had a greater throng attending him when he appeared
in public: but he was at last eclipsed in credit by Crinas, a
native of Massilia, who, to wear an appearance of greater
discreetness and more devoutness, united in himself the
pursuit of two sciences, and prescribed diets to his patients
in accordance with the movements of the heavenly bodies, as
indicated by the almanacks of the mathematicians, taking
observations himself of the various times and seasons. It was
but recently that he died, leaving 10,000,000 of sesterces,
after having expended hardly a less sum upon building the
walls of his native place and of other towns. It was while
these men were ruling our destinies, that all at once,
Charmis, a native also of Massilia, took the City by surprise.
Not content with condemning the practice of preceding
physicians, he proscribed the use of warm baths as well, and
persuaded people, in the very depth of winter even, to immerse
themselves in cold water. His patients he used to plunge into
large vessels filled with cold water, and it was a common
thing to see aged men of consular rank make it a matter of
parade to freeze themselves; a method of treatment, in favour
of which Annæus Seneca gives his personal testimony, in
writings still extant. There can be no doubt whatever, that
all these men, in the pursuit of celebrity by the introduction
of some novelty or other, made purchase of it at the downright
expense of human life. Hence those woeful discussions, those
consultations at the bedside of the patient, where no one
thinks fit to be of the same opinion as another, lest he may
have the appearance of being subordinate to another; hence,
too, that ominous inscription to be read upon a tomb, 'It was
the multitude of physicians that killed me.' The medical art,
so often modified and renewed as it has been, is still on the
change from day to day, and still are we impelled onwards by
the puffs which emanate from the ingenuity of the Greeks. …
Cassius Hemina, one of our most ancient writers, says that the
first physician that visited Rome was Archagathus, the son of
Lysanias, who came over from Peloponnesus, in the year of the
City 535, L. Æmilius and M. Livius being consuls. He states
also, that the right of free citizenship was granted him, and
that he had a shop provided for his practice at the public
expense in the Acilian Cross-way; that from his practice he
received the name of 'Vulnerarius'; that on his arrival he was
greatly welcomed at first, but that soon afterwards, from the
cruelty displayed by him in cutting and searing his patients,
he acquired the new name of 'Carnifex,' and brought his art
and physicians in general into considerable disrepute. That
such was the fact, we may readily understand from the words of
M. Cato, a man whose authority stands so high of itself, that
but little weight is added to it by the triumph which he
gained, and the Censorship which he held. I shall, therefore,
give his own words in reference to this subject. 'Concerning
those Greeks, son Marcus, I will speak to you more at length
on the befitting occasion. I will show you the results of my
own experience at Athens, and that, while it is a good plan to
dip into their literature, it is not worth while to make a
thorough acquaintance with it. They are a most iniquitous and
intractable race, and you may take my word as the word of a
prophet, when I tell you, that whenever that nation shall
bestow its literature upon Rome it will mar everything; and
that all the sooner, if it sends its physicians among us. They
have conspired among themselves to murder all barbarians with
their medicine; a profession which they exercise for lucre, in
order that they may win our confidence, and dispatch us all
the more easily. They are in the common habit, too, of calling
us barbarians, and stigmatize us beyond all other nations, by
giving us the abominable appellation of Opici.
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I forbid you to have anything to do with physicians.' Cato,
who wrote to this effect, died in his eighty-fifth year, in
the year of the City 605; so that no one is to suppose that he
had not sufficient time to form his experience, either with
reference to the duration of the republic, or the length of
his own life. Well then—are we to conclude that he has
stamped with condemnation a thing that in itself is most
useful? Far from it, by Hercules! … Medicine is the only one
of the arts of Greece, that, lucrative as it is, the Roman
gravity has hitherto refused to cultivate. It is but very few
of our fellow-citizens that have even attempted it."

_Pliny,
Natural History
(Bohn's translation),
book 29, chapters 3-8 (volume 5)._

MEDICAL SCIENCE: 2d Century.
Galen and the development of Anatomy and Pathology.

"In the earliest conceptions which men entertained of their
power of moving their own members, they probably had no
thought of any mechanism or organization by which this was
effected. The foot and the hand, no less than the head, were
seen to be endowed with life; and this pervading life seemed
sufficiently to explain the power of motion in each part of
the frame, without its being held necessary to seek out a
special seat of the will, or instruments by which its impulses
were made effective. But the slightest inspection of dissected
animals showed that their limbs were formed of a curious and
complex collection of cordage, and communications of various
kinds, running along and connecting the bones of the skeleton.
These cords and communications we now distinguish as muscles,
nerves, veins, arteries, &c.; and among these, we assign to
the muscles the office of moving the parts to which they are
attached, as cords move the parts of a machine. Though this
action of the muscles on the bones may now appear very
obvious, it was, probably, not at first discerned. It is
observed that Homer, who describes the wounds which are
inflicted in his battles with so much apparent anatomical
precision, nowhere employs the word muscle. And even
Hippocrates of Cos, the most celebrated physician of
antiquity, is held to have had no distinct conception of such
an organ. … Nor do we find much more distinctness on this
subject even in Aristotle, a generation or two later. … He
is held to have really had the merit of discovering the nerves
of sensation, which he calls the 'canals of the brain' … ,
but the analysis of the mechanism of motion is left by him
almost untouched. … His immediate predecessors were far from
remedying the deficiencies of his doctrines. Those who
professed to study physiology and medicine were, for the most
part, studious only to frame some general system of abstract
principles, which might give an appearance of connexion and
profundity to their tenets. In this manner the successors of
Hippocrates became a medical school, of great note in its day,
designated as the Dogmatic school; in opposition to which
arose an Empiric sect, who professed to deduce their modes of
cure, not from theoretical dogmas, but from experience. These
rival parties prevailed principally in Asia Minor and Egypt,
during the time of Alexander's successors,—a period rich in
names, but poor in discoveries; and we find no clear evidence
of any decided advance in anatomy. … The victories of
Lucullus and Pompeius, in Greece and Asia, made the Romans
acquainted with the Greek philosophy; and the consequence soon
was, that shoals of philosophers, rhetoricians, poets, and
physicians streamed from Greece, Asia Minor, and Egypt, to
Rome and Italy, to traffic their knowledge and their arts for
Roman wealth. Among these was one person whose name makes a
great figure in the history of medicine, Asclepiades of Prusa
in Bithynia. This man appears to have been a quack, with the
usual endowments of his class. … He would not, on such
accounts, deserve a place in the history of science, but that
he became the founder of a new school, the Methodic, which
professed to hold itself separate both from the Dogmatics and
the Empirics. I have noticed these schools of medicine,
because, though I am not able to state distinctly their
respective merits in the cultivation of anatomy, a great
progress in that science was undoubtedly made during their
domination, of which the praise must, I conceive, be in some
way divided among them. The amount of this progress we are
able to estimate, when we come to the works of Galen, who
flourished under the Antonines, and died about A. D. 203. The
following passage from his works will show that this progress
in knowledge was not made without the usual condition of
laborious and careful experiment, while it implies the curious
fact of such experiment being conducted by means of family
tradition and instruction, so as to give rise to a caste of
dissectors. In the opening of his Second Book on Anatomical
Manipulations, he speaks thus of his predecessors: 'I do not
blame the ancients, who did not write books on anatomical
manipulation; though I praise Marinus, who did. For it was
superfluous for them to compose such records for themselves or
others, while they were, from their childhood, exercised by
their parents in dissecting, just as familiarly as in writing
and reading; so that there was no more fear of their
forgetting their anatomy, than of forgetting their alphabet.
But when grown men, as well as children, were taught, this
thorough discipline fell off; and, the art being carried out
of the family of the Asclepiads, and declining by repeated
transmission, books became necessary for the student.' That
the general structure of the animal frame, as composed of
bones and muscles, was known with great accuracy before the
time of Galen, is manifest from the nature of the mistakes and
deficiencies of his predecessors which he finds it necessary
to notice. … Galen was from the first highly esteemed as an
anatomist. He was originally of Pergamus; and after receiving
the instructions of many medical and philosophical professors,
and especially of those of Alexandria, which was then the
metropolis of the learned and scientific world, he came to
Rome, where his reputation was soon so great as to excite the
envy and hatred of the Roman physicians. The emperors Marcus
Aurelius and Lucius Verus would have retained him near them;
but he preferred pursuing his travels, directed principally by
curiosity. When he died, he left behind him numerous works, an
of them of great value for the light they throw on the history
of anatomy and medicine; and these were for a long period the
storehouse of all the most important anatomical knowledge
which the world possessed. In the time of intellectual
barrenness and servility, among the Arabians and the Europeans
of the dark ages, the writings of Galen had almost unquestioned
authority; and it was only by an uncommon effort of
independent thinking that Abdollatif ventured to assert, that
even Galen's assertions must give way to the evidence of the
senses. In more modern times, when Vesalius, in the sixteenth
century, accused Galen of mistakes, he drew upon himself the
hostility of the whole body of physicians."

_W. Whewell,
History of the Inductive Sciences,
book 17, chapter 1, section 1 (volume 2)._

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"Galen strongly denied being attached to any of the sects of
his day, and regarded as slaves those who took the title of
Hippocratists, Praxagoreaus, or Herophilists, and so on.
Nevertheless his predilection in favor of the Hippocratic
writings is well marked, for he explains, comments upon them,
and amplifies them at length, refutes the objections of their
adversaries and gives them the highest place. He says, 'No one
before me has given the true method of treating disease;
Hippocrates, I confess, has heretofore shown the path, but as
he was the first to enter it he was not able to go as far as
he wished. … He has not made all the necessary distinction,
and is often obscure, as is usually the case with ancients
when they attempt to be concise. He says very little of
complicated diseases; in a word, he has only sketched what
another was to complete; he has opened the path, but has left
it for a successor to enlarge and make it plain.' This implies
how he regarded himself as the successor of Hippocrates, and
how little weight he attached to the labors of others. He held
that there were three sorts of principles in man—spirits,
humors, and solids. Throughout his metaphysical speculations
Galen reproduces and amplifies the Hippocratic dogmatism.
Between perfect health and disease there were, he thought,
eight kinds of temperaments or imperfect mixtures compatible
with the exercise of the functions of life. With Plato and
Aristotle he thought the human soul to be composed of three
faculties or parts, the vegetive, residing in the liver; the
irascible, having its seat in the heart, and the rational,
which resided in the brain. He divided diseases of the solids
of the body into what he called distempers; he distinguished
between the continued and intermittent fevers, regarding the
quotidian as being caused by phlegm, the tertian as due to
yellow bile, and the quartan due to atrabile. In the doctrine
of coction, crises, and critical days, he agreed with
Hippocrates; with him he also agreed in the positive statement
that diseases are cured by their contraries."

_Roswell Park,
Lectures on the History of Medicine (in MS.)._

MEDICAL SCIENCE: 7-11th Centuries.
Medical Art of the Arabs.

"It probably sounds paradoxical (though it is not) to affirm
that, throughout the first half of the Middle Ages, science
made its home chiefly with the Semites and Græco-Romans (its
founders), while, in opposition to the original relations,
faith and its outgrowths alone were fostered by the Germans.
In the sterile wastes of the desert the Arabians constructed a
verdant oasis of science, in lands to-day the home once more
of absolute or partial barbarism. A genuine meteor of
civilization were these Arabians. … The Arabians built their
medicine upon the principles and theories of the Greeks (whose
medical writings were studied and copied mostly in
translations only), and especially upon those of Galen, in
such a way, that, on the whole, they added to it very little
matter of their own, save numerous subtle definitions and
amplifications. But Indian medical views and works, as well as
those of other earlier Asiatic peoples (e. g., the Chaldeans),
exercised demonstrably, but in a subordinate degree, an
influence upon Arabian medicine. The Arabians interwove too
into their medical views various philosophical theorems,
especially those of Aristotle, already corrupted by the
Alexandrians and still further falsified by themselves with
portions of the Neo-Platonic philosophy; and finally they
added thereto a goodly share of the absurdities of astrology
and alchemy. Indeed it is nowadays considered proven that they
even made use of ancient Egyptian medical works, e. g., the
papyrus Ebers. Thus the medicine of the Arabians, like Grecian
medicine its parent, did not greatly surpass the grade of
development of mere medical philosophy, and, so far as regards
its intrinsic worth, it stands entirely upon Grecian
foundations. … Yet they constantly advanced novelties in the
sciences subsidiary to medicine, materia medica and pharmacy,
from the latter of which chemistry, pharmacies and the
profession of the apothecary were developed. … The mode of
transfer of Greek medicine to the Arabians was probably as
follows: The inhabitants of the neighboring parts of Asia,
including both the Persians and Arabians, as the result of
multifarious business connexions with Alexandria, came, even
at an early date, in contact with Grecian science, and by
degrees a permanent alliance was formed with it. In a more
evident way the same result was accomplished by the Jewish
schools in Asia, the great majority of which owed their
foundation to Alexandria. Such schools were established at
Nisibis, at Nahardea in Mesopotamia, at Mathæ-Mechasja on the
Euphrates, at Sura, &c., and their period of prime falls in
the 5th century. The influence of the Nestorian universities
was especially favorable and permanent, particularly the
school under Greek management founded at Edessa, in
Mesopotamia, where Stephen of Edessa, the reputed father of
Alexander of Tralles, taught (A. D. 530). …. Still more
influential in the transfer of Grecian science to the Arabians
was the banishment of the 'heathen' philosophers of the last
so-called Platonic school of Athens, by the 'Christian' despot
Justinian I. (529). These philosophers were well received at
the court of the infidel Chosroës, and in return manifested
their gratitude by the propagation of Grecian science. …
From all these causes it resulted that, even as early as the
time of Mohammed (571-632), physicians educated in the Grecian
doctrines lived among the Arabians. … Arabian culture (and
of course Arabian medicine) reached its zenith at the period
of the greatest power and greatest wealth of the Caliphate in
the 9th and 10th centuries. At that time intellectual life was
rooted in the schools of the mosques, i. e., the Arabian
universities, which the great caliphs were zealous in
founding. Such Arabian universities arose and existed in the
progress of time (even as late as the 14th century) at Bagdad,
Bassora, Cufa, Samarcand, Ispahan, Damascus, Bokhara,
Firuzabad and Khurdistan, and under the scholastic Fatimides
(909-1171) in Alexandria. Under the Ommyiades (755-1031),
after the settlement of the Arabians in Spain in the beginning
of the 8th century, were founded the famous universities of
Cordova (possessing in the 10th century a library of 250,000
volumes), Seville, Toledo, Almeria and Murcia under the three
caliphs named Abderrahman and Al Hakem.
{2130}
Less important were the universities of Granada and Valencia,
and least important of all, those founded by the Edrisi
dynasty (800-986) in the provinces of Tunis, Fez and Morocco.
In spite of all these institutions the Arabians possessed no
talent for productive research; still less, like the ancient
Semites, did they create any arts, save poesy and
architecture. Their whole civilization bore the stamp of its
foreign origin. … 'The Prince of Physicians' (el Sheik el
Reis—he was also a poet) was the title given by the Arabians
to Abu Ali el Hossein ebn Abdallah ebn Sina (Ebn Sina,
Avicenna), 980-1037, in recognition of his great erudition, of
which the chief evidences are stored in his 'Canon.' This
work, though it contains substantially merely the conclusions
of the Greeks, was the text-book and law of the healing art,
even as late as the first century of modern times."

_J. H. Baas,
Outlines of the History of Medicine,
pages 216-229._

"The Saracens commenced the application of chemistry, both to
the theory and practice of medicine, in the explanation of the
functions of the human body and in the cure of its diseases.
Nor was their surgery behind their medicine. Albucasis, of
Cordova, shrinks not from the performance of the most
formidable operations in his own and in the obstetrical art;
the actual cautery and the knife are used without hesitation.
He has left us ample descriptions of the surgical instruments
then employed; and from him we learn that, in operations on
females in which considerations of delicacy intervened, the
services of properly instructed women were secured. How
different was all this from the state of things in Europe: the
Christian peasant, fever-stricken or overtaken by accident,
hied to the nearest saint-shrine and expected a miracle; the
Spanish Moor relied on the prescription or lancet of his
physician, or the bandage and knife of his surgeon."

_J. W. Draper,
History of the Intellectual Development of Europe,
volume 2, chapter 2._

"The accession of Gehwer to the throne of Mussulman Spain,
early in the eleventh century, was marked by the promulgation
of regulations so judiciously planned, touching medical
science and its practice, that he deserves the highest
commendation for the unwavering zeal with which he supervised
this important branch of learning taught in the metropolis.
Those evils which the provinces had suffered previous to his
rule, through the practice of medicine by debased empirics,
were quickly removed by this sagacious Caliph. Upon the
publication of his rescripts, such medical charlatans or
ambulatory physicians as boldly announced themselves to be
medici, without a knowledge of the science, were ignominiously
expelled from the provincial towns. He decreed that a college
of skilled surgeons should be forthwith organized, for the
single specified function of rigidly examining into the
assumed qualifications of applicants for licenses to exercise
the curative art in municipal or rural departments, or sought
professional employment as physicians in the numerous
hospitals upon the Mahometan domains."

_G. F. Fort,
Medical Economy during the Middle Ages,
chapter 17._

"Anatomy and physiology, far from making any conquests under
Arabian rule, followed on the contrary a retrograde movement.
As those physicians never devoted themselves to dissections,
they were under the necessity of conforming entirely to the
accounts of Galen. … Pathology was enriched in the Arabian
writings by some new observations. … The physicians of this
nation were the first … who began to distinguish eruptive
fevers by the exterior characters of the eruption, while the
Greeks paid but little attention to these signs. Therapeutics
made also some interesting acquisitions under the Arab
physicians. It owes to them, among other things, the
introduction of mild purgatives, such as cassia, senna, and
manna, which replaced advantageously, in many cases, the
drastics employed by the ancients; it is indebted to them,
also, for several chemical and pharmaceutical improvements, as
the confection of syrups, tinctures, and distilled waters,
which are very frequently and usefully employed. Finally,
external therapeutics, or surgery, received some minor
additions, such as pomades, plasters, and new ointments; but
these additions were very far from compensating for the
considerable losses which it suffered by their abandoning a
multitude of operations in use among the Greeks."

_P. V. Renouard,
History of Medicine,
page 267._

MEDICAL SCIENCE: 12-17th Centuries.
Mediæval Medicine.

"The difficulties under which medical science laboured may be
estimated from the fact that dissection was forbidden by the
clergy of the Middle Ages, on the ground that it was impious
to mutilate a form made in the image of God. We do not find
this pious objection interfering with such mutilation when
effected by means of the rack and the wheel and such other
clerical rather than medical instruments. But in the reign of
Philip the Second of Spain a famous Spanish doctor was
actually condemned by the Inquisition to be burnt for having
performed a surgical operation, and it was only by royal
favour that he was permitted instead to expiate his crime by a
pilgrimage to the Holy Land, where he died in poverty and
exile. This being the attitude of the all-powerful Church
towards medical progress, it is not surprising that medical
science should have stagnated, and that Galen and Dioscorides
were permitted to lay down the law in the sixteenth century as
they had done since the beginning of the Christian era. Some
light is thrown upon the state of things here from resulting
by a work translated from the German in the year 1561, and
entitled 'A most excellent and perfecte homish apothecarye or
physicke booke, for all the grefes and diseases of the bodye.'
The first chapter is 'Concerning the Head and his partes.'
'Galen sayth, the head is divided into foure partes: in the
fore part hath blood the dominion; Colera in the ryght syde,
Melancholy in the left syde, and Flegma beareth rule in the
hindermost part. If the head doth ake so sore by reason of a
runninge that he cannot snoffe hys nose, bath hys fete in a
depe tub untill the knees and give him this medicine … which
riseth into hys head and dryeth hys moyst braynes. Galen sayth
He that hath payne in the hindermost part of hys head, the
same must be let blood under the chynne, specially on the
right side; also were it good ofte to burn the heyre of a man
before hys nose. The braynes are greved many wayes; many there
are whom the head whyrleth so sore that he thinketh the earth
turneth upsydedoune: Cummin refraineth the whyrling,
comforteth the braynes and maketh them to growe agayne: or he
may take the braynes of a hogge, rost the same upon a grede
yron and cut slices thereof and lay to the greved parts.'
{2131}
This doctrine of like helping like was of universal
application, and in medical works of the Middle Ages we meet
constantly with such prescriptions as these:—'Take the right
eye of a Frogg, lap it in a peece of russet cloth and hang it
about the neck: it cureth the light eye if it bee en flamed or
bleared. And if the left eye be greved, do the like by the
left eye of the said Frogg." Again—'The skin of a Raven's
heel is good against the gout, but the right heel skin must be
laid upon the right foot if that be gouty, and the left upon
the left. … If you would have a man become bold or impudent
let him carry about him the skin or eyes of a Lion or a Cock,
and he will be fearless of his enemies, nay, he will be very
terrible unto them. If you would have him talkative, give him
tongues, and seek out those of water frogs and ducks and such
creatures notorious for their continuall noise making.' On the
same principle we find it prescribed as a cure for the
quartane ague to lay the fourth book of Homer's Iliad under
the patient's head; a remedy which had at least the negative
merit of not being nauseous. … For weak eyes the patient is
to 'take the tounge of a foxe, and hange the same about his
necke, and so long it hangeth there his sight shall not wax
feeble, as sayth Pliny.' The hanging of such amulets round the
neck was very frequently prescribed, and the efficacy of them
is a thing curiously well attested. Elias Ashmole in his diary
for 1681 has entered the following—'I tooke this morning a
good dose of elixir, and hung three spiders about my neck, and
they drove my ague away. Deo gratias!' A baked toad hung in a
silk bag about the neck was also held in high esteem, as was a
toad, either alive or dried, laid upon the back of the neck as
a means of stopping a bleeding at the nose: and again, 'either
frogg or toade, the nails whereof have been clipped, hanged
about one that is sick of quartane ague, riddeth away the
disease forever, as sayth Pliny.' We have even a striking
instance of the benefit derived from an amulet by a horse, who
could not be suspected of having helped forward the cure by
the strength of his faith in it. 'The root of cut Malowe
hanged about the neck driveth away blemishes of the eyen,
whether it be in a man or a horse, as I Jerome of Brunsweig,
have seene myselfe. I have myselfe done it to a blind horse
that I bought for X crounes, and was sold again of XL
crounes'—a trick distinctly worth knowing."

_E. A. King,
Mediæval Medicine
(Nineteenth Century, July 1893)._

"If we survey the social and political state of Europe from
the twelfth to the sixteenth century, in its relation to the
development of medical art, our attention is at once arrested
by Italy, which at this period was far ahead of the rest of
the world. Taking the number of universities as an index of
civilization, we find that, before the year 1500, there were
sixteen in Italy,—while in France there were but six: in
Germany, including Hungary, Bohemia, Bavaria, &c., there were
eight: and in Britain, two; making sixteen in all,—the exact
number which existed in Italy alone. The Italian Universities
were, likewise, no less superior in number than in fame to
those of the north. … In many of the Italian republics,
during the twelfth, thirteenth, and fourteenth centuries, the
power was chiefly in the hands of the middle classes; and it
is probable that the physicians occupied a high and
influential position among them. Galvanis Flamma describes
Milan in 1288, as having a population of 200,000, among whom
were 600 notaries, 200 physicians, 80 schoolmasters, and fifty
transcribers of manuscripts or books. Milan was about this
period at a pitch of glory which has not been equalled since
the Greek republics."

_J. R. Russell,
History and Heroes of the Art of Medicine,
chapter 5._

"Three schools, as early as 1158, had a reputation which
extended throughout the whole of Europe: Paris for theological
studies, Bologna for Roman or civil law, and Salerno as the
chief medical school of the west."

_G. F. Fort,
Medical Economy during the Middle Ages,
chapter 24._

"In 1215 Pope Innocent III. fulminated an anathema specially
directed against surgery, by ordaining, that as the church
abhorred all cruel or sanguinary practices, no priest should
be permitted to follow surgery, or to perform any operations
in which either instruments of steel or fire were employed:
and that they should refuse their benediction to all those who
professed and pursued it. … The saints have proved sad
enemies to the doctors. Miraculous cures are attested by
monks, abbots, bishops, popes, and consecrated saints. …
Pilgrimages and visits to holy shrines have usurped the place
of medicine, and, as in many cases at our own watering places,
by air and exercise, have unquestionably effected what the
employment of regular professional aid had been unable to
accomplish. St. Dominic, St. Bellinus, and St. Vitus have been
greatly renowned in the cure of diseases in general; the
latter particularly, who takes both poisons and madness of all
kinds under his special protection. Melton says 'the saints of
the Romanists have usurped the place of the zodiacal
constellations in their governance of the parts of man's body,
and that "for every limbe they have a saint." Thus St. Otilia
keepes the head instead of Aries; St. Blasius is appointed to
governe the necke instead of Taurus; St. Lawrence keepes the
backe and shoulders instead of Gemini, Cancer, and Leo: St.
Erasmus rules the belly with the entrayles, in the place of
Libra and Scorpius; in the stead of Sagittarius, Capricornus,
Aquarius, and Pisces, the holy church of Rome hath elected St.
Burgarde, St. Rochus. St. Quirinus, St. John, and many others,
which governe the thighes, feet, shinnes, and knees.' This
supposed influence of the Romish saints is more minutely
exhibited, according to Hone, in two very old prints, from
engravings on wood, in the collection of the British Museum.
Right hand: the top joint of the thumb is dedicated to God,
the second joint to the Virgin; the top joint of the
fore-finger to St. Barnabas, the second joint to St. John, the
third to St. Paul: the top joint of the second finger to Simon
Cleophas, the second joint to Tathideo, the third to Joseph;
the top joint of the third finger to Zaccheus, the second to
Stephen, the third to the evangelist Luke; the top joint of
the little finger to Leatus, the second to Mark, the third to
Nicodemus. Left hand: the top joint of the thumb is dedicated
to Christ, the second joint to the Virgin: the top joint of
the fore-finger to St. James, the second to St. John the
Evangelist, the third to St. Peter; the first joint of the
second finger to St. Simon, the second joint to St. Matthew,
the third to St. James the Great; the top joint of the third
finger to St. Jude, the second joint to St. Bartholomew, the
third to St. Andrew; the top joint of the little finger to St.
Matthias, the second to St. Thomas, the third joint to St.
Philip. …
{2132}
"The credulity of mankind has never been more strongly
displayed than in the general belief afforded to the
authenticity of remarkable cures of diseases said to have been
effected by the imposition of royal hands. The practice seems
to have originated in an opinion that there is something
sacred or divine attaching either to the sovereign or his
functions. … The practice appears to be one of English
growth, commencing with Edward the Confessor, and descending
only to foreign potentates who could show an alliance with the
royal family of England. The kings of France, however, claimed
the right to dispense the Gift of Healing, and it was
certainly exercised by Philip the First; but the French
historians say that he was deprived of the power on account of
the irregularity of his life. Laurentius, first physician to
Henry IV, of France, who is indignant at the attempt made to
derive its origin from Edward the Confessor, asserts the power
to have commenced with Clovis I, A. D. 481, and says that
Louis I, A. D. 814, added to the ceremonial of touching, the
sign of the cross. Mezeray also says, that St. Louis, through
humility, first added the sign of the cross in touching for
the king's evil. … If credit is to be given to a statement
… by William of Malmesbury, with respect to Edward the
Confessor, we must admit that in England, for a period of
nearly 700 years, the practice of the royal touch was
exercised in a greater or lesser degree, as it extended to the
reign of Queen Anne. It must not however be supposed that
historical documents are extant to prove a regular continuance
of the practice during this time. No accounts whatever of the
first four Norman kings attempting to cure the complaint are
to be found. In the reign of William III, it was not on any
occasion exercised. He manifested more sense than his
predecessors, for he withheld from employing the royal touch
for the cure of scrofula; and Rapin says, that he was so
persuaded he should do no injury to persons afflicted with
this distemper by not touching them, that he refrained from it
all his reign. Queen Elizabeth was also averse to the
practice, yet she extensively performed it. It flourished most
in the time of Charles II, particularly after his restoration,
and a public register of cases was kept at Whitehall, the
principal scene of its operation."

_T. J. Pettigrew,
Superstitions connected with the History and Practice
of Medicine and Surgery,
pages 34-37, and 117-121._

MEDICAL SCIENCE: 16th Century.
Paracelsus.