Chapter XXI: Book IV: , Chapter I., section 4

If a person wears, during the waning of the moon, a wreath
of polygonum on his head, he will obtain relief from his
headache.... If one drinks of the water from which an ox has
just drank, he will be relieved of the pain in his head.... If
a loadstone be held upon the head it will draw out the hidden
pain, and the same effect may be obtained by rubbing over the
forehead a swallow’s nest thoroughly mixed with vinegar.

In Book I, paragraph 2, Priscianus draws a picture of the rude and uncivilized behavior of the practitioners of his day in the sick-room. The following are his words as translated from the German of Meyer-Steineg:--

As the patient lies on his bed prostrated by the severity of
the disease, there quickly comes into the room a crowd of us
physicians. No feeling of sympathy for the sick man have we,
nor do we realize how impotent we all are in the presence of
these forces of nature. Instead, we struggle to the utmost of
our ability to obtain charge of the case; one depending for
success on his powers of persuasion, a second on the strength
of the arguments which he is able to bring forward, a third on
his readiness to agree with everything that is said, and the
fourth on his skill in contradicting the opinion of everybody
else. And, as this quarrel goes on, the patient continues to lie
there in a state of exhaustion. “For shame!” Nature seems to
say, “you men are an ungrateful lot! You do not even permit the
patient to die quietly; you simply kill him. And then, moreover,
you accuse me of not furnishing sufficient means of effecting a
cure. Illness is certainly a painful affair, but I have provided
plenty of remedies. Poisons, I admit, are hidden in some of the
plants, but the healing agents which may be extracted from them
are much more numerous. Away, then, with your angry disputes and
your self-glorifying chatter; for in these are not to be found
the remedial agents which I have bestowed upon man, but rather
in the powerful forces which reside in the seeds, fruits, plants
and other objects which I have created in his interests.”

_Aëtius._--Aëtius was a native of Amida, in Mesopotamia, and he lived during the early part of the sixth century A. D., under the Emperor Justinian I. He studied medicine at Alexandria and then settled in Constantinople, where he was appointed to the double office of private physician to the emperor and commanding officer of his body-guard (_Comes obsequii_),--an arrangement which made it practicable for the emperor to have his physician near his person on all possible occasions. Almost nothing is known about the subsequent private life and professional career of Aëtius beyond the facts that he was a Christian and that he wrote a treatise on medicine in sixteen books, which together form a large volume. The work, says Le Clerc, is almost entirely a compilation from the treatises of earlier writers on medicine and surgery; the best parts of the book being those which relate to the pathology and treatment of internal diseases, to materia medica, and to ophthalmology. The Christianity of Aëtius, like that of Alexander of Tralles, and other physicians of a later period, appears to have permitted a belief in magical remedies. For example, Aëtius gives formulae containing the names of the Saviour and the Holy Martyrs for exorcising certain maladies, and he recommends the employment of amulets. The subject of baths is treated by him quite thoroughly, and he lays stress upon the importance of physical exercise as a means of maintaining one’s health. Freind, the author of an English history of medicine which was very popular in its day,[44] quotes the following remedy for gout from the treatise of Aëtius:--

In September to drink milk;
in October to eat garlick;
in November to abstain from bathing;
in December not to eat cabbage;
in January to take a glass of pure wine in the morning;
in February to eat no beet;
in March to mix sweet things both in eatables and drinkables;
in April not to eat horseradish;
nor in May the fish called Polypus;
in June to drink cold water;--and so on through the remainder of
the year.

At the end of the French version of “_Les Oeuvres de Rufus d’Éphèse_” (translated from the Greek by Daremberg and Ruelle) will be found fragments of some of the books of Aëtius; in 1899 J. Hirschberg translated into German Book VII. (eye diseases) of the same author; and, two years later (1901) Max Wegscheider published a German version of Book XVI. (obstetrics and gynaecology). No other translations of the writings of Aëtius into either French, German or English are--so far as I am able to learn--available.

_Alexander of Tralles._--Alexander of Tralles, a city of Lydia, in Asia Minor, was born about 525 A. D. His father Stephanus was highly esteemed as a practicing physician, and his four brothers, all of them older than himself, were men of distinction in their several callings; Anthemius, the oldest, being one of the greatest mathematicians and mechanicians of his day and the man to whom the Emperor Justinian intrusted the rebuilding of the church of St. Sophia in Constantinople;[45] Metrodorus, a celebrated grammarian and the honored teacher of the youth belonging to the highest circles of that metropolis; Olympius, a leading authority in jurisprudence; and Dioscorus, a prominent physician in his native city. Alexander received his first instruction in medicine from his father, but he obtained his real training from a physician who was the father of his most intimate friend Cosmas, and who, throughout Alexander’s entire subsequent career, proved most helpful in advancing his interests. At first he traveled extensively, visiting in succession--probably in the capacity of a military surgeon--Italy, Northern Africa, Gaul and Spain. Afterward, he settled permanently at Rome and practiced medicine there during the remainder of a long life. Puschmann, the translator of his writings, seems disposed to believe that he was both a teacher and a practitioner of medicine during his residence in that city. When he became too old to bear the heavy burdens of medical practice, he wrote an account of his life,--a life which was rich in professional experience,--and thus built for himself “a monument more striking and more durable than the splendid temple erected by his eldest brother.” (Meyer, quoted by Puschmann.)

Various circumstances justify the conclusion that Alexander of Tralles was a Christian. His style of writing is simple and direct, and he states his views with a degree of modesty which wins for him at once the sympathy and confidence of his readers. He gives full and generous recognition to the great physicians who lived and wrote before his time, and more especially to Hippocrates. On the other hand, he does not hesitate, when he believes that he is right, to put forward views which are in direct antagonism with those of even so great an authority as Galen. In the domain of therapeutics, says Puschmann, Alexander was decidedly superior to Galen. His teachings are based on experience gained in actual practice, whereas Galen was very often disposed to trust to considerations of a theoretical nature; for he was chiefly interested in establishing the pathology of the different diseases and in opening up new territories in medicine in which the human mind might display its activity.

The twelve books of which the treatise of Alexander of Tralles consists, were printed in the original Greek for the first time in 1548, by Robert Étienne, the celebrated printer of Francis I., King of France. The last and most perfect edition of the Greek text is that of the late Dr. Theodore Puschmann, which was published in Vienna in 1878 (two Vols.). It contains, in addition to the Greek version, a careful analysis of the twelve individual books, and an admirable German translation of the entire work. It is from the latter that the following brief extracts (translated into English) are taken:--

_Introduction to the writings of Alexander of
Tralles._--Upon a certain occasion, my dearest Cosmas, thou
didst urge me to publish my rich experiences in the domain of
practical medicine, and I am now gladly complying with thy wish,
for I feel under deep obligations to both thyself and thy father
for the kindness which you have shown to me on every possible
occasion in the past. Thy father was always a most helpful
patron to me, not only in my practice, but also in all other
relations of life. And thou also, even when thou wert living
abroad, stood staunchly by me through all the trials which I
experienced and the severe blows dealt me by Fate. For these
reasons I will now in my old age, when it is no longer possible
for me to endure the labor and worries of practice, do as thou
desirest, and will write a book in which shall be set forth the
experience which I have gained during my long service in the
treatment of disease. I hope that many of those who read what
is here written, with minds free from jealousy, will experience
real pleasure in noting the well-founded and scientific
character of the rules which I have laid down and the brevity
and preciseness of my descriptions. For I have done my very best
always to employ simple words, in order that everybody may find
it easy to understand my book.

_Some Magical Remedies or Amulets Recommended by Alexander
of Tralles, as Effective in the Treatment of Colic._--The
Thracians remove the heart from a lark while the bird is still
alive, and wear it, prepared as an amulet, on the left thigh.

Procure a little of the dung of a wolf, preferably some which
contains small bits of bone, and pack it in a tube which the
patient may easily wear as an amulet on his right arm, thigh, or
hip during the attack. He must be very careful, however, not to
allow the parts around the seat of the pain to come in contact
with the earth or with the water of a bath. This amulet is, in
my experience, an unfailing remedy, and almost all physicians of
any celebrity have commended its virtues.

Remove the nipple-like projection from the caecum of a young
pig, mix myrrh with it, wrap it in the skin of a wolf or dog,
and instruct the patient to wear it as an amulet during the
waning of the moon. Striking effects may be looked for from this
remedy.

Let the design of Hercules throttling a lion be engraved upon a
Median stone, and then instruct the patient to wear it on his
finger after it has been properly set in a ring of gold.

Take an iron ring and have the hoop made eight-sided. Then
engrave upon the eighth side these words: “Flee, flee, oh
Gaul! the lark has sought thee out.” On the under surface of
the head or seal of the ring engrave the letters J. C., thus:
I have often made use of this amulet; and, while
I should consider it wrong to keep silence about a remedial
agent of such extraordinary efficacy in cases of colic, I
feel bound to say that it should not be recommended to the
first comer, but only to believers and to those individuals
who know how to guard it carefully. The Great Hippocrates,
with remarkable insight, gave the advice that things which are
holy should be intrusted only to those who are of a religious
character, and should be withheld from the profane. As regards
the ring, however, the patient must be careful, before wearing
it, to have a sketch made of it on either the seventeenth or the
twenty-first day of the moon.

Alexander has been severely criticised for his advocacy of the employment of amulets in the treatment of diseases; but he defends himself against such criticism by saying that physicians owe it as a duty to their patients to study carefully what he calls the hidden forces of nature, and to pay unprejudiced attention to the effects produced by amulets and other magical remedies. He reminds his critics that Galen and other eminent medical authorities have insisted that a place be given to this class of agents in the list of authorized remedies; and he adds that Galen further emphasizes the duty of the physician to employ them when other measures fail, or when the patients themselves frankly confess that they have faith in their efficacy and therefore wish them to be tried. Alexander also makes the statement that Galen, after treating for a long time all reports about the beneficial results obtained from the employment of magical measures as old women’s tales, had finally decided that these benefits were at times marvelous and should be accepted as genuine by physicians even if they are unable to explain them.

How much Alexander of Tralles really believed in these supernatural agents, or to what extent he relied upon their effect in influencing the imagination, we may not know; but his was an age of superstition, and the conditions governing society at that time were very different from those which control the world at the present day.

_Paulus Aegineta._--Paulus Aegineta[46] was born in the Island of Aegina, not far from Athens, in the early part of the seventh century A. D., and practiced medicine in Alexandria, Egypt. He is known to us as the author of a compend of medicine which was very popular during a long period of time, especially among the Arabs, who, as early as two hundred years after his death, translated his work from the Greek into their own language. At a still later period it was also translated into Latin, the two best versions in this language which we now possess being those of Guintherus Andernacus (Paris, 1532) and of J. Cornarius (Basel, 1556). There is also an English translation by F. Adams (“The Seven Books of Paulus Aegineta,” London, 1845–1847), which is favorably spoken of by Neuburger, and which is apparently at the present time the only existing version of the work of Paulus of Aegina in a modern European language; for the French translation by René Briau (“_La Chirurgie de Paul d’Égine_,” Paris, 1855) comprises only Book VI.

The contents of the entire work are as follows: _Book I._--Dietetics of Pregnant Women and of Children; Children’s Diseases; Massage, Gymnastics, Sexual Hygiene, Bathing, etc.; _Book II._--General Pathology, the Doctrine of Fevers, Semeiology; _Book III._--Diseases of the Hair, Diseases of the Brain and Nerves, Diseases of the Eyes, Ears, Nose, Mouth, Teeth and Face; _Book IV._--Leprosy, Skin Diseases, Inflammations, Swellings, Tumors, Wounds, Ulcers, Fistulae, Hemorrhage, Worms, Affections of the Joints, etc.; _Book V._--Toxicology; _Book VI._--Surgery; _Book VII._--Materia Medica.

To furnish even a very superficial analysis of the contents of this treatise would call for more space than can well be given up here to such a purpose. I shall therefore simply mention a few points of special interest to which Neuburger calls attention in the course of his very full analysis of the work. He states, for example, that Paulus mentions several instances in which patients affected with lung disease, coughed up calculi or small stone-like masses. He also states that the same author was familiar with the fact that in the course of “phthisis,” the pus may find its way into the bladder and there cause ulceration [in other words, that pus containing tubercle baccilli may flow down by way of the ureters and cause tuberculous ulceration of the bladder]. Paulus’ theory regarding the origin of gout, adds Neuburger, is quite remarkable for that early period. He maintains, for example, that in persons who lead a rather inactive life and who are often affected with digestive disorders, there is produced, through the inadequate power of the tissues of the body to assimilate the excess of nutriment brought to them, a _materies morbi_ which is drawn first to the parts that are weakest or least capable of resistance (the joints, for example) and then also to other structures, as the liver, spleen, throat, ears and teeth. These ideas--let it be remembered--were set down in writing in 650 A. D.

At the beginning of his analysis of Book VI., Neuburger makes this remark: “Although the description given by Paulus of the surgery of the ancients is based upon the writings of Hippocrates and Galen, as well as upon those of Leonides, Soranus and Antyllus, one finds at every step ample evidence that the writer possessed both independence of judgment and the manual skill which belongs to a physician who is familiar with surgical work.” He calls particular attention to the section (No. 88) which deals with the manner of removing the heads of arrows from wounds, and he gives special praise to Paulus for his most instructive account of the diagnostic signs to be looked for in a case of suspected wounding of a vital organ. He is extremely thorough, says Neuburger, in his teachings about fractures and dislocations, and he not infrequently differs from the views expressed by his predecessors.

In the section devoted to gynaecological operations Paulus makes it perfectly clear that he was in the habit of using a speculum of a very practical form. Here are his words:--

... and, while the operator is holding the instrument in
position, an assistant turns the screw until the blades of the
instrument have been separated to the distance desired.

In other chapters of Book VI., Paulus furnishes most interesting and minute descriptions of a great variety of operations in general surgery and also in obstetrics, ophthalmology, otology and rhinology. Those who desire to learn further details about these surgical matters should consult the English version mentioned on a previous page.

It is not at all unlikely that at some future day it will be found desirable--by reason of the discovery of the treatises which they are known to have written, but which have been lost--to add to this short list of ancient medical authors the names of the following men who are frequently quoted by them in their works: Antyllus, who made some really valuable additions to our knowledge of the proper manner of treating aneurysms, and who must have been a surgeon of great resourcefulness; Leonides, the Alexandrian, who lived about the time of Galen, and who appears to have been highly considered for his practical common sense in the choice of surgical measures; Hesychios of Byzantium and his distinguished son, Jacobus Psychrestus, who was highly spoken of by his contemporaries (fifth century A. D.), in whose honor a public statue was erected (Haller), and to whom is attributed the saying: “A good physician should either decline at the start to take charge of a patient, or else he should not leave him until he shall have brought about some measure of improvement”; finally, Heliodorus, and perhaps a few others who are less well known.