Edward Berdoe

CHAPTER I.
THE MEDICINE OF THE GREEKS BEFORE THE TIME OF HIPPOCRATES.

Apollo, the God of Medicine.—Cheiron.—Æsculapius.—Artemis.—Dionysus.—Ammon.—Hermes.—Prometheus.—Melampus.—Medicine of Homer.—- Temples of Æsculapius.—The Early Ionic Philosophers.—Empedocles.—School of Crotona.—The Pythagoreans.—Grecian Theory of Diseases.—School of Cos.—The Asclepiads.—The AliptÆ.

Gods of Medicine.

The origin of Greek medicine is intermixed with the Hellenic mythology. We must begin, not with Æsculapius (Asclepios), but with the sun itself. Apollo (PÆan), as the god who visits men with plagues and epidemics, was also the god who wards off evil and affords help to men. He was constantly referred to as “the Healer,” as Alexicacus, the averter of ills. He is the saviour from epidemics, and the pÆan was sung in his honour (Iliad, I. 473, XXII. 391).

Apollo promoted the health and well-being of man, and was the god of prolific power, the trainer of youth, and thus he was the chief deity of healing. As the god of light and purity he was truly the health-god; and as light penetrates the darkness, he was the god of divination and the patron of prophecy, acting chiefly through women when in a state of ecstasy. Homer says that PÆan329 was the physician of the Olympian gods (Iliad, V. 401, 899).

Next we find Cheiron, the wise and just centaur (Iliad, XI. 831), who had been instructed by Apollo and Artemis, and was famous for his skill in medicine. He was the master and instructor of the most celebrated heroes of Greek story, and he taught the art of healing to Æsculapius (B.C. 1250). This god of medicine was said to be the son of Apollo. Pausanius330 explains the allegory thus: “If Asclepius is the air—indispensable to the health of man and beast, yet Apollo is the sun, and rightly is he called the father of Asclepius, for the sun, by his yearly course, makes the air wholesome.”

In the Homeric poems Æsculapius is not a divinity, but merely a human being. Homer, however, calls all those who practise the art of healing descendants of PÆan; his healing god is Apollo, and never Æsculapius.

Legend tells that Æsculapius was the son of Apollo by Coronis, who was killed by Artemis for unfaithfulness, and her body was about to be burnt on the pyre, when Apollo snatched the boy out of the flames and handed him over to the centaur Cheiron, who taught him how to cure all diseases. Pindar tells the story of his instruction in the art of medicine:—

“The rescued child he gave to share

Magnesian Centaur’s fostering care;

And learn of him the soothing art

That wards from man diseases’ dart.

Of those whom nature made to feel

Corroding ulcers gnaw their frame;

Or stones far hurled, or glittering steel,

All to the great physician came.

By summer’s heat or winter’s cold

Oppressed, of him they sought relief.

Each deadly pang his skill controlled,

And found a balm for every grief.

On some the force of charmed strains he tried,

To some the medicated draught applied;

Some limbs he placed the amulets around,

Some from the trunk he cut, and made the patient sound.”331

It was believed that he was even able to restore the dead to life. According to one tradition, Æsculapius was once shut up in the house of Glaucus, whom he was to cure, and while he was absorbed in thought there came a serpent, which twined round his staff, and which he killed. Then he saw another serpent, which came carrying in its mouth a herb, with which it recalled to life the one that had been killed; and the physician henceforth made use of the same herb to restore dead men to life, the popular belief, even in these early times, evidently being that what would cure serpents would be equally efficacious for men. We may therefore consider the snake-entwined staff of the healing god as the symbol of the early faith in the efficacy of experiments on animals, though in this instance the experiment was on a dead one.

Æsculapius was only too successful a practitioner; for when he was exercising his art upon Glaucus, Zeus killed the physician with a flash of lightning, as he feared that men might gradually escape death altogether. Others say the reason was that Pluto complained that by such medical treatment the number of the dead was too much diminished. On the request of Apollo, Zeus placed Æsculapius amongst the stars. His wife was Epione (the soother). Homer mentions Podalirius and Machaon as sons of Æsculapius, and the following are also said to have been his sons and daughters—Janiscus, Alexenor, Aratus, Hygeia, Ægle, Iaso, and Panaceia. Most of these, as Hygeia, the goddess of health, and Panaceia, the all-healing, it will be seen, are merely personifications of the powers ascribed to their father. There is no doubt that facts are the basis of the Æsculapian story. The divinity was worshipped all over Greece. His temples were for the most part built in mountainous and healthy places, and as often as possible in the neighbourhood of a medicinal spring; in a sense they became the prototypes of our hospitals and medical schools. Multitudes of sick persons visited them, and the priests found it to their interest to study diseases and their remedies; for though faith and religious fervour may do much for the sick, the art of the physician and the hand of the surgeon are adjuncts by no means to be despised even in a temple clinic. The chief of the Æsculapian temples was at Epidaurus; there no one was permitted to die and no woman to give birth to a child. The connection of the serpent with the divinity probably arose from the idea that serpents represent prudence and renovation, and have the power of discovering the secret virtues of healing plants.

The idea of the serpent twined round the rod of Æsculapius is that “as sickness comes from him, from him too must or may come the healing.”332 The knots on the staff are supposed to symbolize the many knotty points which arise in the practice of physic.

Minerva was the patroness of all the arts and trades; at her festivals she was invoked by all who desired to distinguish themselves in medicine, as well as by the patients whom they failed to cure. As the goddess of intelligence and inventiveness, she was the Greek patroness of physicians, and was the same deity as Pallas Athene, who bestows health and keeps off sickness.

Artemis, or Diana, as the Romans called the Greek goddess, was a deity who, inviolate and vigorous herself, granted health and strength to others. She was the sister of Apollo, and though a dispenser of life could, like her brother, send death and disease amongst men and animals. Sudden deaths, especially amongst women, were described as the effect of her arrows. She was ?e? s?te??a, who assuaged the sufferings of mortals. When Æneas was wounded, she healed him in the temple of Apollo.333 Yet Artemis ta???p???? produced madness in the minds of men.334

She was the Cretan Diktynna, and that goddess wore a wreath of the magic plant diktamnon or dictamnus, called by us dittany (dictamnus ruber, or albus); it grows in abundance on Mounts DictÉ and Ida in Crete.

The Cretan goddess Britomartis was sometimes identified with Artemis. She too was a goddess of health as also of birth, and was supposed to dispense happiness to mortals.

Bacchus, or, as he was called by the Greeks, Dionysus, as the god of wine, and an inspired and an inspiring deity, who revealed the future by oracles, cured diseases by discovering to sufferers in their dreams their appropriate remedies. The prophet, the priest, and the physician are so often blended in one in the early history of civilization, that the same ideas naturally clustered round Bacchus as around Apollo, and other great benefactors of mankind. The giver of vines and wine was the dispenser of the animating, exalting, intoxicating powers of nature. As wine restores the flagging energies of the body and mind, and seems to have the power of calling back to life the departing spirit, and inspiring the languishing vitality of man, Bacchus would naturally enough be a god of medicine. The intoxicating properties of wine would be connected with inspiration, and so Bacchus had a share in the oracles of Delphi and Amphicleia. He was invoked as a ?e?? s?t?? against raging diseases.

Ammon was an Ethiopian divinity whose worship spread over Egypt, and thence to Greece, and was described as the spirit pervading the universe, and as the author of all life in nature.

Hermes Trismegistus of the Greeks was identified in the time of Plato with Thoth, Thot, or Theut of the Egyptians.335

The Egyptian Thoth was considered the father of all knowledge, and everything committed to writing was looked upon as his property; he was therefore the embodied eek: ?????, and so t??? ???st??, or the superlatively greatest. He was identified by the Greeks more or less completely with their own Hermes, or Mercury as he was known to the Romans; he was the messenger of the gods; as dreams are sent by Zeus, it was his office to convey them to men, and he had power to grant refreshing sleep or to deny the blessing. As the gods revealed the remedies for sickness in dreams, Hermes became a god of medicine.

Thoth, the ibis-headed, was the Egyptian god of letters, the deity of wisdom in general, who aided Horus in his conflict with Seth, and recorded the judgments of the dead before Osiris. Hermes ????f????, the averter of diseases, was worshipped in Boeotia. Hermes, the Greek deity, was king of the dead and the conductor of souls to their future home. Probably, therefore, we may rightly look upon Thoth, Hermes, and Hermes Trismegistus as the same person. By many Thoth is considered to be the Egyptian Æsculapius, as he was the inventor of the healing art; the Phoenician god Esmun, one of the ancient Cabiri, was invested with similar attributes, and was worshipped at Carthage and Berytus. The authorship of the oldest Egyptian works on medicine is ascribed to Thoth. These were engraved on pillars of stone. The works of Thoth were ultimately incorporated into the so-called “Hermetic Books.” Clement of Alexandria, who is our only ancient authority on these Hermetic works, says they were forty-two in number.

Prometheus (the man of freethought) is considered by Æschylus as the founder of human civilization.

Æschylus, in his Prometheus Chained, makes the god say how he had taught each useful art to man. As regards medicine, he says:—

“Hear my whole story; thou wilt wonder more

What useful arts, what science I invented.

This first and greatest; when the fell disease

Preyed on the human frame, relief was none,

Nor healing drug, nor cool, refreshing draught,

Nor pain-assuaging unguent; but they pined

Without redress, and wasted, till I taught them

To mix the balmy medicine, of power

To chase each pale disease, and soften pain.”336

Melampus, who was famous for his prophetic powers, was believed by the Greeks to have been the first mortal who practised the art of medicine, and established the worship of Dionysus in Greece. As doctors are frequently expected to exercise the art of prophecy in conjunction with their profession, it is unfortunate that we have retrograded from the Melampian type. The eminent physician who tells the over-inquisitive friends of his patients that he is “a doctor and not a prophet,” might be answered that originally the two functions were combined. Melampus taught the Greeks to mix their wine with water. He is fabled to have learned the language of the birds from some young serpents who had been reared by him, and who licked his ears when he was asleep. When he awoke he found that he understood what the birds said, and that he could foretell the future.

Iphiclus had no children, and he asked Melampus to tell him how he could become a father. He advised him to take the rust from a knife, and drink it in water during ten days. The remedy was eminently successful, and is the first instance in which a preparation of iron is known to have been prescribed in medicine. He cured the daughters of Proetus by giving them hellebore (which has been called Melampodium by botanists), and he received the eldest of the princesses in marriage. He cured the women of Argos of a severe distemper which made them insane, and the king showed his gratitude by giving him part of his kingdom. He received divine honours after his death, and temples were raised to him.

The Medicine of Homer.

As Homer is supposed to have lived about 850 B.C., a study of such references as are to be found in the Iliad and Odyssey which relate to medicine and surgery will throw an important light on the state of the healing art as it was practised at that early period of Greek history.

There is little mention of disease in Homer. We read of sudden death, pestilence, and the troubles of old age, but there is hardly any fixed morbid condition noticed.

Although the poet exhibits considerable acquaintance with medical lore, and the human body in health and disease, he could have had little or no acquaintance with anatomy, because amongst Greeks, as amongst Jews, it was considered a profanation to dissect or mutilate the human corpse.

It was not till the rise of the Alexandrian school in the golden age of the Ptolemies that this sentiment was overcome. Still Homer must have known that it was the custom of the Egyptians to embalm their dead, as he refers to the process in the Iliad,337 where Thetis poured into the nostrils of the corpse red nectar and ambrosia to preserve it from putrefaction. Ambrosia is referred to by Virgil as useful for healing wounds, and nectar was supposed to preserve flesh from decay. Homer’s heroes seem to have been singularly healthy folk; their only demand for the services of the army surgeons arose from the accidents of war. Machaon distinguished himself in surgery, and Podalirius is reputed to have been the first phlebotomist. Their services would be chiefly required for extracting arrow-heads and spear-heads, checking hÆmorrhage by compression and styptic applications, and laying soothing ointments on wounded and bruised surfaces. Beyond these minor duties of the army surgeon, we find little record of their work. Mention is not made of amputations, of setting of fractures, or tying of arteries. Wounds were probed by Machaon, surgeon to Menelaus (Book IV.).

Whatever may have been the surgical skill of Machaon, we have proof that the art of dieting the wounded was not at all understood in the Homeric days. The wine and cheese was not the kind of refreshment which found favour in Plato’s time with the Greek physicians. Plato, in the Republic (Book III.), deals with the question at some length. He says that the draught of Pramnian wine with barley meal and cheese was an inflammatory mixture, and a strange potion for a man in the state of Eurypylus.

But he excuses the sons of Asclepius for their treatment, explaining that their method was not intended for coddling invalids, but for such as had not time to be ill, and that the healing art was revealed for the benefit of those whose constitutions were naturally sound, and that doctors used to expel their disorders by drugs and the use of the knife without interrupting their customary avocations, declining altogether to assist chronic invalids to protract a miserable existence by a studied regimen.

Le Clerc says338 that Plato is wrong in this explanation of the Homeric treatment, and that the true one is that in those days the dietary of the sick was not understood. Modern medicine will decline to accept either theory. The fact is, Homer’s physicians were right. Good old wine was the best thing possible to restore a man fainting from the loss of blood; as for the cheese it was grated fine, and therefore was a peculiarly nutritious food in a fairly digestible condition. The barley water at all times was at least irreproachable. Although there is little evidence in the Homeric poems of any medical treatment which passes the limits of surgery, this is by no means conclusive against the possession of the higher art by Podalirius. In an epic poem, as Le Clerc points out, the subject is altogether too exalted to admit of medical discourses on the treatment of colic and diarrhoea.

Neither must we be surprised, that when the pestilence appeared in the camp of Agamemnon, Podalirius and Machaon did nothing to avert it. Such a disease was at that time considered beyond all human skill, and as the direct visitation of the gods. Homer clearly explains that the pestilence was due to their anger. Galen adduces evidence to prove that Æsculapius did really practise medicine, by music and by gymnastics, or exercises on foot and horseback.

As Le Clerc says,339 this may have been patriotic exaggeration on the part of Galen. To Podalirius is attributed the invention of the art of bleeding. As he returned from the Trojan war, he was driven by a tempest on the shores of Caria, where a shepherd, having learned that he was a physician, took him to the king, whose daughter was sick. He cured her by bleeding from both arms; the king gave her to him in marriage, with a rich grant of land. This is the oldest example which we have of bleeding.

Podalirius had a son Hippolochus, of whom the great Hippocrates was a descendant. Le Clerc devotes a chapter of his History of Medicine to reflections on the antiquity of the practice of venesection, and speculates on the manner of its discovery. He says, the fact that Homer is silent on the subject makes neither for nor against the theory that it was known in his time; in such works as those of the poet he was under no obligation to specify particularly the remedies employed by the doctors. He speaks, for example, of soothing medicines and bitter roots without further definition. It would be as reasonable to agree that purgation was unknown from Homer’s silence on the matter.

Homer knew something of the parts of the body where wounds are most fatal. He says (Book IV., l. 183), “The arrow fell in no such place as death could enter at,” and (Book VIII., l. 326), where the arrow struck the right shoulder ’twixt the neck and breast, “the wound was wondrous full of death.”

He knew much of drugs and medicinal plants: f??a??? (pharmakon) in the Iliad is a remedy, an unguent or application, and is mentioned nine times; in the Odyssey it is a drug or medicinal herb, and is referred to twenty times. In Book XI., Eurypylus, when wounded, is treated with the “wholesome onion,” a potion is confected with good old wine of Pramnius, with scraped goat’s-milk cheese and fine flour mixed with it. Later on in the same book, we read of the bruised, bitter, pain-assuaging root being applied to a wound; it was some strong astringent bitter plant, probably a species of geranium.

Then in the Odyssey (Book IV. 200) occurs the reference to nepenthe, a drug which has puzzled commentators exceedingly; some say it was poppy juice, others hashish; we have also the magic moly, which Mercury gave to Ulysses against the charms of Circe. By some this is thought to have been the unpoetical garlic, by others to be wild rue, such as Josephus refers to. It was more probably the mandrake.

There is a very curious and important reference to sulphur, as a disinfectant fumigation in the Odyssey (Book XXII. 481):—

“Bring sulphur straight, and fire” (the monarch cries).

“She hears, and at the word obedient flies,

With fire and sulphur, cure of noxious fumes,

He purged the walls and blood-polluted rooms.”

This is precisely what the sanitary authorities do with fever dens at the present day.

Homer several times refers to Machaon:—

“And great Machaon to the ships convey.

A wise physician, skilled our wounds to heal,

Is more than armies to the public weal.”

(Iliad, XI. 614.)

With Podalirius, his brother, also a “famed surgeon,” he went to Troy with thirty ships. Homer calls them “divine professors of the healing arts” (Iliad, II. 728), and to them was committed the care of the medical work of the expedition.

When Menelaus had been wounded by the spear of Pandarus, Machaon, we are told by Homer (Iliad, IV. 218)—

“Sucked the blood, and sovereign balm infused,

Which Cheiron gave, and Æsculapius used.”

Agamede is referred to by Homer (Iliad, XI. 739) as acquainted with the healing properties of all the plants that grow on the earth. She was a daughter of Augeias, and wife of Mulius. The poet refers to her as—

“She that all simples’ healing virtues knew,

And every herb that drinks the morning dew.”340

Hesiod lived about the same time as Homer. He wrote the famous Works and Days, a species of farmer’s calendar, and the Theogony.

On account of the knowledge he possessed of the properties of plants, Theophrastus, Pliny, and others ranked him amongst the physicians.341

Both Podalirius and Machaon were held in great honour, not only as combatants, but as medical advisers, and Homer’s account of them exhibits the medical profession of his time as one that was very highly esteemed. In the fragment of Arctinus which remains to us, we find thus early the distinction made between the arts of medicine and surgery, the two principal divisions of medical science: “Then Asclepius bestowed the power of healing upon his two sons; nevertheless, he made one of the two more celebrated than the other; on one did he bestow the lighter hand, that he might draw missiles from the flesh, and sew up and heal all wounds; but he other he endowed with great precision of mind, so as to understand what cannot be seen, and to heal seemingly incurable diseases.”342

This very interesting extract not only shows the early separation of the arts of medicine and surgery, but it exhibits very clearly how it arose that the former was always held to be the higher branch of the medical profession. To sew up a laceration, or extract an arrow or a thorn from the flesh, demanded only manual dexterity; but “to understand that which cannot be seen,” and heal internal organs that cannot even be touched, required a skill and a mental precision that men even in those early times were able to appreciate as much the higher of the two arts. There seems, however, some confusion of the two branches in the lines:—

“A wise physician, skilled our wounds to heal,

Is more than armies to the public weal.”

If we suppose that the account of venesection which attributes its discovery to Podalirius is fabulous, this would only serve to prove the antiquity of the practice. Hippocrates is said to be the first medical writer who has spoken of bleeding,343 yet we must not suppose it was unknown before his time. He advises blood-letting from the arm, from the temporal vessels, from the leg, etc., in some cases even to fainting. He is familiar with cupping and other methods of abstracting blood; it is not probable, therefore, that the operation was a new one in his day.

The discovery of the practice of purging as a remedy was attributed to Melampus. But we know that the Egyptians made use of purgative and emetic medicines. There were many purgatives in use in the time of Hippocrates, as hellebore, elaterium, colocynth, and scammony. All these medicines could not have been discovered at once, as Le Clerc points out; mankind, therefore, must have gradually acquired their use. When persons were overloaded in the stomach and constipated, nothing was more natural than that they should seek relief by removing the mechanical causes of their distress. Some one had taken some herb which had caused him to vomit or to be purged, and had experienced the benefit of the evacuation; he told his friends, and they perhaps had been aided by similar means. Or again, some illness had been alleviated by the supervention of diarrhoea, and art was called in to imitate the beneficial effect of nature’s cure. In this way, says Le Clerc, bleeding may reasonably have been discovered: a severe headache is often relieved by bleeding from the nose, what more natural than that the process of relief should be imitated by opening a vein?

Pliny, indeed, in his usual manner, introduces a fable to account for the discovery of venesection. He says344 that the hippopotamus having become too fat and unwieldy through over-eating, bled himself with a sharp-pointed reed, and when he had drawn sufficient blood, closed the wound with clay. Men have imitated the operation, says Pliny. This is matched by the story of the ibis with her long bill being the inventor of the clyster. Most of the medical beast stories are probably on a level with these.

Hygeia, the wife of Æsculapius, and her children, bore names which show the same poetic fancy as that which constituted Apollo the author of medicine. Æsculapius is the air. Hygeia is health; Ægle is brightness or splendour, because the air is illumined and purified by the sun. Iaso is recovery, Panacea the universal medicine, Roma is strength.

The ancients everywhere believed that the healing art was taught to mankind by the gods. “The art of medicine,” says Cicero, “has been consecrated by the invention of the immortal gods.”345

Hippocrates346 attributed the art of medicine to the Supreme Being. As the Greeks believed that the arts in general were invented by the gods, it was a natural belief that the knowledge of medicine should have been taught by the heavenly powers. The mysteries of life, disease, and death were peculiarly the province of supernatural beings, and man has ever attributed to such powers all those things which he could not comprehend.

The Temples of Æsculapius.

The worship of Asclepius or Æsculapius is so closely associated with the practice of Greek medicine that it is impossible to understand the one without knowing something of the other. Sick persons made pilgrimages to the temples of the god of healing, just as now they go to Lourdes, St. Winifred’s Well, or other famous Christian shrines for the recovery of their health. After prayers to the god, ablutions, and sacrifices, the patient was put to sleep on the skin of the animal offered at the altar, or at the foot of the statue of the divinity, while the priests performed their sacred rites. In his sleep he would have pointed out to him in a dream what he ought to do for the recovery of his health. Sometimes the appropriate medicine would be suggested, but more commonly rules of conduct and diet would suffice. When the cure took place, which very frequently happened by suggestion as in modern hypnotism, and by the stimulus to the nervous system consequent upon the journey, and the hope excited in the patient, a record of the case and the cure was carved on the temple walls. Thus were recorded the first histories of cases, and their study afforded the most valuable treatises on the healing art to the physicians who studied them. The priests of Æsculapius were sometimes called Asclepiads, but they did not themselves act as physicians, nor were they the actual founders of Greek medicine. The true Asclepiads were healers and not priests. Anathemata (????ea, anything offered up) were offerings of models in gold, silver, etc., of diseased legs, feet, etc., or of deformed limbs consecrated to the gods in the temples by the devotion of the patients who had received benefit from the prayers to the deities who were worshipped therein. The priests of the temples sold these again and again to fresh patients.

The Early Ionic Philosophers.

The various schools of Greek philosophy were intimately associated with the study of medicine. They endeavoured to fathom the mystery of life, and the relationship of the visible order of things to the unseen world. The philosophers were therefore not only physicists, but metaphysicians, and the unhappy science of medicine, a homeless wanderer, had to shelter herself now with the natural philosophers and again with the metaphysicians. Probably the philosophers never really practised physic, but merely speculated about it, as did Plato. A brief notice of the various philosophers of the Ionic, Italian, Eleatic, and Materialistic schools who were more or less associated with the study of medicine must suffice as an introduction to Greek medicine proper, which had its origin with Hippocrates.

Thales of Miletus (about 609 B.C.), the Ionian philosopher, introduced Egyptian and Asiatic science into Greece. He had probably in his travels in the land of the Pharaohs devoted himself to mathematical pursuits, and if not a scientific inquirer was a deep speculator on the origin of things. He held that everything arises from water, and everything ultimately again resolves itself into water. Everything, he said, is full of gods; the soul originates motion (the magnet has a soul, according to him), and so the indwelling power or soul of water produces the phenomena of the natural world. He must not, however, be understood as teaching the doctrine of the Soul of the Universe, or of a Creating Deity. Thales was the first writer on physics and the founder of the philosophy of Greece. Le Clerc connects him with medicine by his converse with the priest-physicians of Egypt, and that he had performed certain expiatory or purifying ceremonies for the LacedÆmonians which could only be done by such as were divines and physicians.347

Pherecydes, the Syrian, a philosopher who lived about the same time as Thales, is said by Galen to have written upon diet.

Epimenedes was a sort of Greek Rip Van Winkle, who purified Athens in the time of a plague by means of mysterious rites and sacrifices. He excelled as a fasting man, so that he was said to have been exempt from the ordinary necessities of nature, and could send out his soul from his body and recall it like the Mahatmas. He was of the class of priestly bards, a seer and prophet who was well acquainted with the virtues of plants for medicinal purposes, and as he was believed to have gone to sleep in a cave for fifty-seven years, he was credited with the possession of supernatural medicinal powers.348

Anaximander, born B.C. 610, is said to have been a pupil of Thales. He taught that a single determinate substance having a middle nature between water and air was the infinite, everlasting, and divine, though not intelligent material from which all things had their origin. This he called the ?pe????, the chaos. All substances were derived thence by the conflict of heat and cold and the electric affinities of the particles. The atomic theory is foreshadowed here.

Anaximenes was the friend of Thales and Anaximander, and all three were born at Miletus. He considered that air was the first cause of all things, or primary condition of matter; all finite things were formed from the infinite air by compression or rarefaction produced by eternal motion. Heat and cold are produced by the varying density of the primal element. He held the eternity of matter like his brother philosophers, and believed that the soul itself is merely a form of air. He held no Divine Author of the Universe, motion being a necessary law of the universe, and with motion and air he required nothing else for the constitution of all things.

Heracleitus of Ephesus, born about 556 B.C., embodied his system of philosophy in his work On Nature. He held that the ground of all phenomena is a physical principle, a living unity, pervading everything, inherent in all things—fire, that is, as he explains, a clear light fluid “self-kindled and self-extinguished.” The world was not created by God, but evolved from the rational intelligence which guides the universe—fire. Fire longs to manifest itself in various forms; from its pure state in heaven it descends, assumes the form of earth, passing in its progress through that of water. Man’s soul is a spark of the divine fire.

Anaxagoras, born about 499 B.C., was the friend of Pericles and Euripides at Athens. Seeking to explain the world and man by a higher cause than the physical ones of his predecessors, he postulated nous—that is, mind, thought, or intelligence. As nothing can come out of nothing, he did not attribute to this nous the creation of the world, but only its order and arrangement. Matter is eternal, but existed as chaos till nous evolved order from the confusion. Baas349 says his physiological and pathological views may be thus described: “The animal body, by means of a kind of affinity, appropriates to itself from the nutritive supply the portions similar to itself. Males originate in the right, females in the left side of the uterus. Diseases are occasioned by the bile which penetrates into the blood-vessels, the lungs, and the pleura.” He undertook the dissection of animals, remarked the existence in the brain of the lateral ventricles, and was the first to declare that the bile is the cause of acute sickness.350

Diogenes of Apollonia, the eminent natural philosopher, lived at Athens about 460 B.C. He was a pupil of Anaximenes, and wrote a work entitled On Nature, in which he treated of physical science generally. Aristotle has preserved for us some of the few fragments which remain. The most important is the description of the origin and distribution of the veins, and is inserted in the third book of Aristotle’s History of Animals. Diogenes Laertius gives an account of the philosophical teaching of the philosopher: “He maintained that air was the primal element of all things; that there was an infinite number of worlds, and an infinite void; that air, densified and rarefied, produced the different members of the universe; that nothing was produced from nothing, or was reduced to nothing; that the earth was round, supported in the middle, and had received its shape from the whirling round of the warm vapours, and its concretion and hardening from cold.”351

Diogenes recognised no distinction between mind and matter, yet he considered air possessed intellectual energy.

We find in this philosopher many indications that the vascular system was in some degree beginning to be understood.352 Mr. Lewes and Mr. Grote agree that Diogenes deserves a higher place in the evolution of philosophy than either Hegel or Schwegler.

Empedocles of Agrigentum, born about 490 B.C., now bears forward the flaming torch of medical science, and in his hands it burns more brightly still. Aristotle mentions him among the Ionian physiologists, and ranks him with the atomistic philosophers and Anaxagoras. These all sought to discover the basis of all changes and to explain them. According to Empedocles: “There are four ultimate kinds of things, four primal divinities, of which are made all structures in the world—fire, air, water, and earth. These four elements are eternally brought into union, and eternally parted from each other, by two divine beings or powers, love and hatred—an attractive and a repulsive force which the ordinary eye can see working amongst men, but which really pervade the whole world. According to the different proportions in which these four indestructible and unchangeable matters are combined with each other is the difference of the organic structure produced; e.g., flesh and blood are made of equal parts of all four elements, whereas bones are one-half fire, one-fourth earth, and one-fourth water. It is in the aggregation and segregation of elements thus arising that Empedocles, like the atomists, finds the real process which corresponds to what is popularly termed growth, increase, or decrease. Nothing new comes or can come into being; the only change that can occur is a change in the juxtaposition of element with element.”353

He considered that men, animals, and plants are demons punished by banishment, but who, becoming purified, may regain the home of the gods. It is hardly necessary to say that he held the demoniacal possession theory of disease, and treated all complaints by means appropriate to the theory. Anticipating the modern opinions of the bacteriologists, he banished epidemics by building great fires and draining the water from marshy lands. He understood something of the causes of infectious diseases, and in their treatment usurped the province of the gods who had sent them.354 He believed the embryo was nourished through the navel. We owe to him the terms amnion and chorion (i.e., the innermost and outer membranes with which the foetus is surrounded in the womb). He believed that death was caused by extinction of heat, that expiration arose from the upward motion of the blood, and inspiration from the reverse. He is said to have raised a dead woman to life.355

Empedocles believed in the doctrine of re-incarnation. “I well remember,” he says, “the time before I was Empedocles, that I once was a boy, then a girl, a plant, a glittering fish, a bird that cut the air.” To his disciples he said: “By my instructions you shall learn medicines that are powerful to cure disease, and re-animate old age—you shall recall the strength of the dead man, when he has already become the victim of Pluto.”356 Further speaking of himself, he says: “I am revered by both men and women, who follow me by ten thousands, inquiring the road to boundless wealth, seeking the gift of prophecy, and who would learn the marvellous skill to cure all kinds of diseases.”357

The School of the Pythagoreans at Crotona.

Although in ancient Greece the art of medicine, as we have already shown, was closely connected with the temples, if not actually with religion, its entanglement with philosophy was a scarcely less unfortunate connection, and it was not able to make any real progress till Hippocrates liberated it from both priests and philosophers. 582 years before Christ Pythagoras was born, the ideal hero or saint whom we faintly discern through the mythical haze which has always enveloped him. Philosopher, prophet, wonder-worker, and physician, he gathered into his mind as into a focus the wisdom of the Brahmans, the Persian Magi, the Egyptians, the Phoenicians, the ChaldÆans, the Jews, the Arabians, and the Druids of Gaul, amongst whom he had travelled, if we may believe what is reported of him. He may have visited Egypt,358 at any rate, besides acquainting himself with the countries of the Mediterranean. His authentic history begins with his emigration to Crotona, in South Italy, about the year 529. There he founded a kind of religious brotherhood or ethical-reform society, and “appeared as the revealer of a mode of life calculated to raise his disciples above the level of mankind, and to recommend them to the favour of the gods.”359 Grote believes that the removal to Crotona was prompted by the desire to study medicine in its famous school, probably combined with the notion of instructing the pupils in his philosophy. He rendered great services to the healing art by insisting on the necessity of a thorough comprehension of the organs, structure, and functions of the body in their normal, healthy condition; this must be conceded, though his visionary philosophy did much to destroy the scientific value of his medical teaching.

The founder of the healing art amongst the Greeks and Hellenic peoples generally was Pythagoras. He was imbued with Eastern mysticism, teaching that the air is full of spiritual beings, who send dreams to men and cause to men and cattle disease and health. He taught that these spirits must be conciliated by lustrations and invocations. Pliny says360 that he taught that holding dill (anethum) in the hand is good against epilepsy. The health of the body is to be maintained by diet and gymnastics. It is interesting to find that this great philosopher recommended music to restore the harmony of the spirits. Besides the magic virtues of the dill, he held that many other plants possessed them, such as the cabbage (a food in great favour with the Pythagoreans), the squill, and anise. He held that surgery was not to be practised, as it is unlawful, but salves and poultices were to be permitted. His disciples attributed the union between medicine and philosophy to him.

The Pythagorean philosophy turns upon the idea of numbers and the mathematical relations of things. “All things are number;” “number is the essence of everything.” The world subsists by the principle of ordered numbers. The spheres revolve harmoniously; the seven planets are the seven golden chords of the heavenly heptachord. As a corollary to this notion we have the theory of opposites. We have the odd and even, and their combinations. The even is the unlimited, the odd the limited; so all things are derived from the combination of the limited and the unlimited. Then we get the limited and the unlimited, the odd and the even, the one and many, right and left, masculine and feminine, rest and motion, straight and crooked, light and darkness, good and evil, square and oblong. When opposites unite, there is harmony. The number ten comprehends all other numbers in itself; four was held in great respect, because it is the first square number and the potential decade (1 + 2 + 3 + 4 = 10). Pythagoras was the discoverer of the holy tet?a?t??, “the fountain and root of ever-living nature.” Five signifies marriage, one is reason because unchangeable, two is opinion, seven is called pa?????? and ?????, because within the decade it has neither factors nor product.361

The doctrine of transmigration of souls, metempsychosis, is Pythagoras’s. He probably borrowed it from the Orphic mysteries; originally no doubt it came from Asia. Asceticism, mysticism, and Neoplatonism sprang from this noble and lofty philosophy. Closely connected with his theory of numbers he held that from these points are produced, from these lines, from lines figures, and from figures solid bodies. The elements fire, water, earth, and air, account in his conception for the formation of the world. He understood the structure of the body, its procreation and development. He believed that the animal soul is an emanation from the world-soul; the universal soul is God, author of himself. Demons are an order of beings between the highest and the lowest. Striving for the good brings moral health. Bodily health means harmony, disease means discord. Diseases are caused by demons, and are to be dispelled by prayers, offerings, and music. He first among the Greeks taught the immortality of the soul; he held a doctrine of rewards and punishments, and taught that of metempsychosis. For many succeeding ages the Pythagorean doctrine had the greatest influence on the art of medicine.362

Le Clerc says that Pythagoras obtained his ideas of the climacteric years from the ChaldÆans. The term is applied to the seventh year of the life of man, and it was anciently believed that at each change we incur some risk to life or health, on account of the bodily changes undergone at that time.363 Celsus says that the medical sentiment with respect to the septenary number in diseases, and that of the odd and even days, is of Pythagorean origin.364 The Pythagoreans had a great respect for the number four. The quaternary number was sacred to the Egyptians; they burned in the temples of Isis a kind of resinous gum, myrrh, and other drugs, in the preparation of which they had regard to the number four. The Israelites imitated them in this respect (Exod. xxx. 2).365

The sacred bean of Pythagoras was the object of religious veneration in Egypt; the priests were commanded not to look upon it. It is thought to have been the East Indian Nelumbium.366

Zamolxis, who was a god to the Getans, is supposed by some to have been a slave and disciple of Pythagoras; by others he is considered an altogether mythical personage. He is credited by those who believe him to have been a physician with having said that “A man could not cure the eyes without curing the head, nor the head without all the rest of the body, nor the body without the soul.” Plato said much the same thing when he remarked, “To cure a headache you must treat the whole man.” Zamolxis cured the soul, not by the enchantments of magic, but by wise discourse and reasonable conversation. “These discourses,” said Plato, “produce wisdom in the soul, which having once been acquired it is easy after that to procure health both for the head and all the rest of the body.”

Democedes was a celebrated physician of Crotona, in Magna Grecia, who lived in the sixth century B.C. He went to practise at Ægina, where he received from the public treasury a sum equal to about £344 a year for his services. The next year he went to Athens at a salary equal to £406, and the following year he went to the island of Samos. The tyrant Polycrates gave him the salary of two talents. He was carried prisoner to Susa to the court of Darius, where he acquired a great reputation and much wealth by curing the king’s foot and the breast of the queen. It is recorded that Darius ordered the surgeons who had failed to cure him to be put to death, but Democedes interceded for and saved them. He ultimately escaped to Crotona, where he settled, the Persians having in vain demanded his return.367 He wrote a work on medicine.

Democritus, of Abdera, was a contemporary of Socrates; he was born between 494 and 460 B.C., and was one of the founders of the Atomic philosophy. He was profoundly versed in all the knowledge of his time. So ardent a student was he, that he once said that he preferred the discovery of a true cause to the possession of the kingdom of Persia. The highest object of scientific investigation he held to be the discovery of causes. He wrote on medicine, and devoted himself zealously to the study of anatomy and physiology. Pliny says that he composed a special treatise on the structure of the chameleon.368 He wrote on canine rabies, and on the influence of music in the treatment of disease. He is, however, best known to science on account of his cosmical theory. All that exists is vacuum and atoms. The atoms are the ultimate material of all things, even of spirit. They are uncaused and eternal, invisible, yet extended, heavy and impenetrable. They are in constant motion, and have been so from all eternity. By their motion the world and all it contains was produced. Soul and fire are of the same nature, of small, smooth, round atoms, and it is by inhaling and exhaling these that life is maintained. The soul perishes with the body. He rejected all theology and popular mythology. Reason had nothing to do with the creation of the world, and he said, “There is nothing true; and if there is, we do not know it.” “We know nothing, not even if there is anything to know.” He died in great honour, yet in poverty, at an advanced age (some writers say at 109 years). His knowledge of nature, and especially of medicine, caused him to be considered a sorcerer and a magician. There was a tradition that he deprived himself of his sight in order to be undisturbed in his intellectual speculations. He probably became blind by too close attention to study. Another story was that he was considered to be insane, and Hippocrates was sent for to cure him.

The great philosophers of ancient Greece believed that all the elements are modifications of one common substance, called the primary matter, which they demonstrated to be devoid of all quality and form, but susceptible of all qualities and forms. It is everything in capacity, but nothing in actuality. Matter is eternal; the elements are the first matter arranged into certain distinguishing forms. Some of the early philosophers held that all the materials which compose the universe existed in a fluid form; they understood by fire, matter in a highly refined state, and that it is the element most intimately connected with life, some even considering it the very essence of the soul. “Our souls are fire,” says Phornutus. “What we call heat is immortal,” says one of the Hippocratic writers, “and understands, sees, and hears all things that are or will be.”369

Bacon explains the ancient fable of Proteus as signifying matter, a something which, being below all forms and supporting them, is yet different from them all.

Sir Isaac Newton is not widely different from Strabo when he says that all bodies may be convertible into one another.

Commenting upon these opinions of the Greek philosophers, Dr. Adams says, in his introduction to the works of Hippocrates:370 “If every step which we advance in the knowledge of the intimate structure of things leads us to contract the number of substances formerly held to be simple, I would not wonder if it should yet turn out that oxygen, carbon, hydrogen, and nitrogen are—like what the ancients held the elements to be—all nothing else but different modifications of one ever-changing matter.”

The theories of the Greek philosophers on the elements are poetically summed up in Ovid’s Metamorphoses:—

As the Greeks believed that all diseases were the consequences of the anger of the gods, it was in their temples that cures were most likely to take place. Faith was the sine qu non in the patient, and everything about the temple and its ceremonies was calculated to excite religious awe and to stimulate faith. Preliminary purifications, fasting, massage, and fomentations with herbs, were necessary parts of the initiatory ceremonies, and the imagination was excited by everything that the sufferer saw around him. He heard the stories of the marvellous cures which had taken place at the sacred fane. Tablets round the walls, placed there by grateful worshippers who had been cured in the past,372 served to fill the mind with hope, when, as was the practice, the patient lay down in the holy place by the image of the healing god, that in the incubatory sleep the remedies which were to cure him might be revealed. Sometimes no such revelation was vouchsafed, then sacrifices and prayers were offered; if these failed, the priests themselves would appear in the mask and the dress of the healing god, and in the darkness and mystery of the night reveal the necessary prescriptions. To interpret the dreams was the task of the priests at all times, just as it was in the temples of ancient Egypt. Divination, magic, and astrology largely assisted in the work of discovering the requisite remedies. If all failed, it was due not to any defect on the part of the divinity or his servants, but simply to the want of faith on the part of the patient. The festivals of Æsculapius were called Asclepia, and the presiding priests of the healing god were named Asclepiades. The schools of the Asclepiades were a sort of medical guild, and their doctrines were divided into exoteric and esoteric. They naturally became possessed of a great body of medical teaching, which was preserved as a precious secret and handed down from generation to generation. The AsclepiadÆ thus became the hereditary physicians of Greece. Medicine at this period was not a science to be taught to all comers, but was a mystery to be orally transmitted. These men pretended to be descendants of Æsculapius, just as now the imitators of medicines, perfumes, etc., which have become celebrated, give out that they belong to the family of the inventor, and thus know the secrets of the preparation.373

This professional class was quite distinct from the priests of the Æsculapian temples, though many writers have confused them. Probably the truth is this:—Certain students from reading the votive tablets in the temples, and examining the persons who came to be cured, gave their attention to the art of medicine, and established themselves as physicians in the neighbourhood of the temples; for it does not appear that the priests themselves pretended to medical skill. They were the instruments of the divine revelation, the mediums of the healing power of the god; they suggested remedies, but did not attempt their application or the treatment of cases. In process of time the pilgrims to the temples would require human aid to supplement the often disappointing divine assistance, and this the AsclepiadÆ were appointed to supply. Hypnotism was probably practised; music, and such drugs as hemlock were also employed which soothe the nervous system and relieve pain. The AsclepiadÆ took careful notes of the symptoms and progress of each case, and were particular to observe the effect of the treatment prescribed; they became, in consequence, exceedingly skilful in prognosis. Galen says that little attention was paid to dietetics by the Asclepiads; but Strabo speaks of the knowledge which Hippocrates derived from the documents in the Asclepion of Cos.374 Exercise, especially on horseback, was one of the measures used by the Asclepiads for restoring the health.375

Schools of the Asclepiades.

The three most famous schools of the Asclepiades were those of Rhodes, Cos, and Cnidos. There were also that of Crotona, in Lower Italy, established by Pythagoras, and the school of Cyrene, in the North of Africa. Famous temples of Æsculapius existed at TitanÆ, Epidaurus, Orope, Cyllene, Tithorea, Tricca, Megalopolis, Pergamus, Corinth, Smyrna, and at many other places.376

A spirit of healthy emulation existed in these different schools, which was most advantageous for the progress of medical science. The tone existing at this early period amongst the different medical societies at these institutions is shown in the famous oath which the pupils of the AsclepiadÆ were compelled to subscribe on completing their course of instruction in medicine. It is the oldest written monument of the Greek art of healing.377

The Oath.

“I swear by Apollo, the physician, and Æsculapius, and Health, and Panacea,378 and all the gods and goddesses, that, according to my ability and judgment, I will keep this oath and this stipulation—to reckon him who taught me this art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patient, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practise my art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work.379

“Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen or slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this oath, may the reverse be my lot!”

Ancient authorities differ as to the respective order in which the schools of the Asclepiads should be esteemed. Rhodes, Cos, and Cnidos continually disputed for the pre-eminence, Cos and Cnidos acquiring great fame by their conflicting opinions. According to Galen, the first place must be conceded to Cos, as having produced the greatest number of excellent disciples, amongst whom was Hippocrates; he ranks Cnidos next. Cos (B.C. 600) was the objective school, and devoted its studies chiefly to symptomatology. It asked, what can we see of the patient’s disorder? of what does he complain? what, in fact, are his symptoms? This is practical medicine, though not so much in accordance with modern scientific medicine as the method of Cnidos, the subjective school. There the aim was to make a correct diagnosis; to find out what was behind the symptoms, what caused the morbid appearances; what it was that the sensations of the patient indicated; and its aim was not to treat symptoms so much as to treat vigorously the disorder which caused them. Auscultation, or the art of scientifically listening to the sounds of the chest, those of the lungs in breathing, and of the heart in beating, was to some extent understood and practised at Cnidos. The medical school of Crotona was in the highest repute 500 B.C., probably on account of its connection with the Pythagoreans. The school of Rhodes does not seem to have had a long life.

That of Cyrene was famous on account not only of its medical teaching, but from the fact that mathematics and philosophy were industriously pursued there. The teaching in all these schools must have been of a very high order; for, though unfortunately little of it has descended directly to us, we have sufficient evidence of its importance in such fragments as are to be found incorporated with the works of Hippocrates, such as the Coan Prognostics and the Cnidian Sentences; the former, a miscellaneous collection of the observations made by the physician of Cos, and the latter, a work attributed to Euryphon, a celebrated physician of Cnidos (about the former half of the fifth century B.C.).

Experiment and observation were insisted upon in the study of anatomy and physiology. Galen tells us in his second book, On Anatomical Manipulations: “I do not blame the ancients, who did not write books on anatomical manipulations; 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 their 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.”

The method of the AsclepiadÆ was one of true induction; much was imperfect in their efforts to arrive at the beginning of medical science. They had little light, and often stumbled; but they made the best use of what they had, and with all their deviations they always returned to the right path, and kept their faces towards the light. Hippocrates was of them; and Bacon of Verulam, in the centuries to come, followed and developed the same method. Dr. Adams remarks the assiduous observation and abundant rational experience which led them to enunciate such a law of nature as this: “Those things which bring alleviation with bad signs, and do not remit with good, are troublesome and difficult.”

---

Ctesias, of Cnidus, in Caria, was a physician at the court of King Artaxerxes Mnemon. He may be called a contemporary of Herodotus. It is possible that, according to Diodorus, he was a prisoner of war while in Persia, though the well-known fact that Greek physicians were in great request, and were always received there with favour, is quite sufficient to account for his presence in that country. He wrote a history of Persia and a treatise on India, containing many statements formerly considered doubtful, but now proved to be founded on facts.

The persons who anointed the bodies of the athletes of ancient Greece, preparatory to their entering the gymnasia, were called AliptÆ. These persons taught gymnastic exercises, practised many operations of surgery, and undertook the treatment of trifling diseases. The external use of oil was intended to close the pores of the skin, so as to prevent excessive perspiration. The oil was mixed with sand, and was well rubbed into the skin. After the exercises, the athletes were again anointed, to restore the tone of the muscles. The aliptÆ would naturally acquire considerable knowledge of the accidents and maladies to which the human body was subject; accordingly, we find that they not only undertook the treatment of fractures and dislocations, but became the regular medical advisers of their patrons. Iccus of Tarentum devoted himself to dietetics. They were probably a superior class of trainers. Herodicus of Selymbria, a teacher of Hippocrates, treated diseases by exercises. He is said to have been the first to demand a fee in place of the presents which were given by patients formerly to their doctors.380 The gymnasia were dedicated to Apollo, the god of physicians.381 The directors of the institutions regulated the diet of the young men, the sub-directors prescribed for their diseases.382 The inferiors, or bathers, bled, gave clysters, and dressed wounds.383

---

CHAPTER II.
THE MEDICINE OF HIPPOCRATES AND HIS PERIOD.

Hippocrates first delivered Medicine from the Thraldom of Superstition.—Dissection of the Human Body and Rise of Anatomy.—Hippocrates, Father of Medicine and Surgery.—The Law.—Plato.

Hippocrates, the “Father of Medicine,” was born at Cos,384 460 B.C. On his father’s side he was believed to be descended from Æsculapius, and through his mother from Hercules. A member of the family of the AsclepiadÆ, of a descent of three hundred years, he had the advantage of studying medicine under his father, Heraclides, in the Asclepion of Cos. Herodicus of Selymbria taught him medical gymnastics, and Democritus of Abdera and Gorgias of Leontini were his masters in literature and philosophy. He travelled widely, and taught and practised at Athens, dying at an age variously stated as 85, 90, 104, and 109. Fortunate in the opportunities offered by his birth and position, he was still more fortunate in his time—the age of Pericles—in which Greece reached its noblest development, and the arts and sciences achieved their greatest triumphs. It was the age of Socrates, Plato, Xenophon, Euripides, Sophocles, Æschylus, Pindar, Aristophanes, Herodotus, Thucydides, and Phidias. Philosophy, poetry, literature, and sculpture found in these great minds their most perfect exponents. Medicine, in the person of Hippocrates, was to find its first and most distinguished author-physician.

The Father of Medicine was therefore the worthy product of his remarkable age. The genius which culminated in the works of the golden age of Greece could scarcely have left medicine without her Hippocrates; the harmony otherwise would have been incomplete.

The following genealogy of Hippocrates has been given by Tzetzes, but Mr. Grote says it is wholly mythical:—

Æsculapius was the father of Podalirius, who was the father of Hippolochus, who was the father of Sostratus, who was the father of Cleomyttades, who was the father of Theodorus, who was the father of Sostratus II., who was the father of Theodorus II., who was the father of Sostratus III., who was the father of Nebrus, who was the father of Gnosidicus, who was the father of Hippocrates I., who was the father of Heraclides, who was the father of Hippocrates II., otherwise called the Great Hippocrates.

Hippocrates was the first physician who delivered medicine from the thraldom of superstition and the sophistries of philosophers, and gave it an independent existence. It was impossible that our science should make progress so long as men believed that disease was caused by an angry demon or an offended divinity, and was only to be cured by expelling the one or propitiating the other. Hippocrates, with a discernment and a courage which was marvellous, considering his time, declared that no disease whatever came from the gods, but was in every instance traceable to a natural and intelligible cause. Before the AsclepiadÆ there was no medical science; before Hippocrates there was no one mind with vision wide enough to take in all that had been done before—to select the precious from the worthless and embody it in a literature which remains to the present time a model of conciseness and condensation, and a practical text-book on all that concerns the art of healing as it was understood in his time. The minuteness of his observations, his rational, and accurate interpretation of all he saw, and his simple, methodical, truthful, and lucid descriptions of everything which he has recorded excite the admiration and compel the praise of all who have studied the works which he has left. Nor are his candour, honesty, caution, and experience less to be extolled. He confesses his errors, fully explains the measures adopted to cure his cases, and candidly admits that in one series of forty-two patients whom he attended only seventeen recovered, the others having perished in spite of the means he had proposed to save them. He was probably the first public teacher of the healing-art; his counsels were not whispered in the secret meetings of sacerdotal assemblies. He was the first to disclose the secrets of the art to the world; to strip it of the veil of mystery with which countless generations of magicians, thaumaturgists, and priestly healers had shrouded it, and to stand before his pupils to give oral instruction in anatomy and the other branches of his profession. Had he not been the Father of Medicine, he would have been known as one of the greatest of the philosophers. He first recognised F?s??—Nature in the treatment of disease. Nature, he declared, was all-sufficient for our healing. She knows of herself all that is necessary for us, and so he called her “the just.” He attributed to her a faculty, ???a??; physicians are but her servants. The governing faculty, ???a??, nourishes, preserves, and increases all things.

Galen states that the greater part of Aristotle’s physiology was taken from Hippocrates. It has been the custom to make light of his anatomical knowledge, and to say that in face of the difficulty, if not impossibility, of procuring subjects for dissection, he could have had but little exact knowledge of the human body; but it is certain that by some means or other he must have dissected it. In proof of this it is only necessary to mention his treatise On the Articulations, especially that part of it which relates to the dislocation of the shoulder joint. Dr. Adams, in one of his valuable notes on the works of Hippocrates,385 says: “The language of our author in this place puts it beyond all doubt that human dissection was practised in his age.” In Ashurst’s International EncyclopÆdia of Surgery386 his descriptions of all dislocations are declared to be wonderfully accurate; and the writer adds that it is the greatest error imaginable to suppose, with the common conceit of our day, that all ingenious and useful improvements in surgery belong to the present age. In the treatise on the Sacred Disease (epilepsy), his description of the brain in man proves that he was acquainted with its dissection.

In the treatise on the heart, again, the construction of that organ in the human body is referred to. Other allusions to the internal structure of the human frame in the Hippocratic treatises serve to confirm our opinion; and if it be objected that some of these are probably not genuine, they must at least be as old as his period, and it was far more likely that he should have written or inspired them than that they should have emanated from an inferior source. Those who argue to the contrary do so on the same grounds as the Greek commentators, who say that the Iliad and Odyssey were not written by Homer, but by some other poet of the same name. Dr. Adams is confident, from his familiarity with the works of Hippocrates, that the knowledge of human anatomy exhibited therein had its origin in actual dissection, and he adds that: “I do not at present recollect a single instance of mistake committed by him in any of his anatomical descriptions, if we except that with regard to the sutures of the head, and even in that case I have endeavoured to show that the meaning of the passage is very equivocal.”387 There is no doubt, in fact, that a great deal more human dissection went on than the Greek doctors dared to acknowledge for fear of exciting popular prejudice. Less than a hundred years after the death of Hippocrates there was abundant and open dissection of the human body in the schools of Alexandria, and it is incredible that the practice only received popular sanction at that particular time. Yet the anatomy of Hippocrates was very imperfect. The nerves, sinews, and ligaments were confounded together, all being classed as ?e???? or t????.

The blood-vessels were supposed to contain both blood and air, and were called f??e?; the trachea was called an “artery.”

The brain was considered as merely a gland which condenses the ascending vapours into mucus. The office of the nerves was to convey the animal spirits throughout the body. We must not forget that the science of anatomy was extremely imperfect even at the beginning of the present century.

“When,” says LittrÉ,388 “one searches into the history of medicine and the commencement of the science, the first body of doctrine that one meets with is the collection of writings known under the name of the works of Hippocrates. The science mounts up directly to that origin, and there stops. Not that it had not been cultivated earlier, and had not given rise to even numerous productions; but everything that had been made before the physician of Cos has perished. We have only remaining of them scattered and unconnected fragments. The works of Hippocrates have alone escaped destruction; and by a singular circumstance there exists a great gap after them as well as before them. The medical works from Hippocrates to the establishment of the school of Alexandria, and those of that school itself, are completely lost, except some quotations and passages preserved in the later writers; so that the writings of Hippocrates remain alone amongst the ruins of ancient medical literature.”

It is vain to inquire how Hippocrates acquired a knowledge which seems to us so far in advance of his age. Was Greek wisdom derived from the East, or was its philosophy the offspring of the soil of Hellas? Such questions have often been discussed, but to little purpose. There would seem to be every reason to suppose that Greek medicine was indigenous. We have no means of knowing how long philosophy and medicine had been united before the time of Hippocrates. The honour of affecting the alliance has been ascribed to Pythagoras.

Several of the Greek philosophers speculated about medicine. We have seen that besides Pythagoras, Empedocles and Democritus did so, although it is not probable that they followed it as a profession. The AsclepiadÆ probably brought medicine to a high state of perfection, but the work these priest-physicians did is a sealed book to us. All was darkness till Hippocrates appeared.

In his treatise On Ancient Medicine, he says that men first learned from experience the science of dietetics; they were compelled to ascertain the properties of vegetable productions as articles of food. Then they learned that the food which is suitable in health is unsuitable in sickness, and thus they applied themselves to the discovery of the proper rules of diet in disease; and it was the accumulation of the facts bearing on this subject which was the origin of the art of medicine. “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.”389

He assiduously applied himself to the study of the natural history of diseases, especially with the view to determine their tendencies to death or recovery. In every case he asked himself what would be the probable end of the disorder if left to itself. Prognosis, then, is one of the chief characteristics of Hippocratic medicine. He hated all charlatanism, and was free from all popular superstition. When we reflect on the medicine of the most highly civilized nations which we have considered at length in the preceding pages, and remember how full of absurdities, of magic, amulet lore, and other things calculated to impose on the credulity of the people, were their attempts at healing, we shall be inclined to say, that the most wonderful thing in the history of Hippocrates was his complete divorce from the evil traditions of the past. Although he forsook philosophy as an ally of medicine, his system was founded in the physical philosophy of the elements which the ancient Greeks propounded, and which we have attempted to explain. There was an all-pervading spiritual essence which is ever striving to maintain all things in their natural condition; ever rectifying their derangements; ever restoring them to the original and perfect pattern. He called that spiritual essence Nature. “Nature is the physician of diseases.”390 Here, then, we have the enunciation of the doctrine of the Vis Medicatrix NaturÆ. In his attempts to aid Nature, the physician must regulate his treatment “to do good, or at least, to do no harm”;391 yet he bled, cupped, and scarified. In constipation he prescribed laxative drugs, as mercury (not the mineral, of course, but Mercurialis perennis), beet, and cabbage, also elaterium, scammony, and other powerful cathartics. He used white hellebore boldly, and when narcotics were required had recourse to mandragora, henbane, and probably to poppy-juice.

He is said to have been the discoverer of the principles of derivation and revulsion in the treatment of diseases.392

Sydenham called Hippocrates “the Romulus of medicine, whose heaven was the empyrean of his art. He it is whom we can never duly praise.” He terms him “that divine old man,” and declares that he laid the immovable foundations of the whole superstructure of medicine when he taught that our natures are the physicians of our diseases.393

He was Father of Surgery as well as of medicine. Eight of his seventeen genuine works are strictly surgical. By an ingenious arrangement of apparatus he was enabled to practise extension and counter-extension. He insisted on the most exact co-aptation of fractured bones, declaring that it was disgraceful to allow a patient to recover with a crooked or shortened limb. His splints were probably quite as good as ours, and his bandaging left nothing to be desired. When the ends of the bones projected in cases of compound fractures, they were carefully resected. In fracture of the skull with depressed bone the trepan was used, and in cases where blood or pus had accumulated they were skilfully evacuated. He boldly and freely opened abscesses of the liver and kidneys. The thoracic cavity was explored by percussion and auscultation for detection of fluids, and when they were discovered paracentesis (tapping) was performed. This was also done in cases of abdominal dropsies. The rectum was examined by an appropriate speculum, fistula-in-ano was treated by the ligature, and hÆmorrhoids were operated upon. Stiff leather shoes and an admirable system of bandaging were employed in cases of talipes. The bladder was explored by sounds for the detection of calculi; gangrenous and mangled limbs were amputated; the dead foetus was extracted from the mother. Venesection, scarification, and cupping were all employed.394

He resected bones at the joints. In the treatment of ulcers he used sulphate of copper, sulphate of zinc, verdigris, lead, sulphur, arsenic, alum, etc. He came very near indeed to the antiseptic system in surgery when he made use of “raw tar water” (a crude sort of carbolic acid, in fact) in the treatment of wounds. Suppositories were employed.

In Dr. Adams’ Life of Hippocrates,395 he says: “In 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. In fact, until within a very recent period, the modern plan of treatment in such cases was not at all to be compared with his skilful mode of adjusting fractured bones, and of securing them with waxed bandages. In particular, his description of the accidents which occur at the elbow and hip-joints will be allowed, even at the present day, to display a most wonderful acquaintance with the subject. In the treatment of dislocations, when human strength was not sufficient to restore the displacement, he skilfully availed himself of all the mechanical powers which were then known. In his views with regard to the nature of club-foot, it might have been affirmed of him a few years ago that he was twenty-four centuries in advance of his profession, when he stated that in this case there is no dislocation, but merely a declination of the foot; and that in infancy, by means of methodical bandaging, a cure may in most cases be effected without any surgical operation. In a word, until the days of Delpech and Stromeyer, no one entertained ideas so sound and scientific on the nature of this deformity as Hippocrates.”

Dr. Adams, recapitulating the general results of the investigations as to the genuineness of the Hippocratic books, states that a considerable portion of them are not the work of Hippocrates himself. The works almost universally admitted to be genuine are: The Prognostics, On Airs, etc., On Regimen in Acute Diseases, seven of the books of Aphorisms, Epidemics, I. and III., On the Articulations, On Fractures, On the Instruments of Reduction, The Oath.

The following are almost certainly genuine: On Ancient Medicine, On the Surgery, The Law, On Ulcers, On FistulÆ, On HÆmorrhoids, On the Sacred Disease.396

The Law.

1. Medicine is of all the arts the most noble; but owing to the ignorance of those who practise it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts. Their mistake appears to me to arise principally from this, that in the cities there is no punishment connected with the practice of medicine (and with it alone) except disgrace, and that does not hurt those who are familiar with it. Such persons are like the figures397 which are introduced in tragedies, for as they have the shape, and dress, and personal appearance of an actor, but are not actors, so also physicians are many in title but very few in quality.

2. Whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages: a natural disposition; instruction; a favourable position for the study; early tuition; love of labour; leisure. First of all, a natural talent is required; for when nature opposes, everything else is vain; but when nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place well adapted for instruction. He must also bring to the task a love of labour and perseverance, so that the instruction taking root may bring forth proper and abundant fruits.

3. Instruction in medicine is like the culture of the productions of the earth. For our natural disposition is, as it were, the soil; the tenets of our teacher are, as it were, the seed; instruction in youth is like the planting of the seed in the ground at the proper season; the place where the instruction is communicated is like the food imparted to vegetables by the atmosphere; diligent study is like the cultivation of the fields; and it is time which imparts strength to all things and brings them to maturity.

4. Having brought all these requisites to the study of medicine, and having acquired a true knowledge of it, we shall then, in travelling through the cities, be esteemed physicians not only in name but in reality. But inexperience is a bad treasure, and a bad friend to those who possess it, whether in opinion or reality, being devoid of self-reliance and contentedness, and the nurse both of timidity and audacity. For timidity betrays a want of power, and audacity a want of skill. There are, indeed, two things, knowledge and opinion, of which the one makes its possessor really to know, the other to be ignorant.

5. Those things which are sacred are to be imparted only to sacred persons; and it is not lawful to impart them to the profane until they have been initiated in the mysteries of the science.

The “Hippocratic collections” of works which have been attributed to Hippocrates, but the greater part of which were neither written by him, nor compiled from notes taken by his students, consists of eighty-seven treatises.

Hippocrates believed in the influence of the imagination of pregnant women on the child in the womb. He forbad nurses to eat food of an acrid, salt, or acid nature, and observed that infants during the period of dentition were liable to fevers, bowel troubles, and convulsions, especially if there was constipation. He mentions thrush as one of the diseases of dentition (De Dent.). He recommends friction for contracting or relaxing the body according as it is applied in a hard or soft manner. Very fully he discourses on the evil effects of plethora, and recommends purging, emetics, warm baths, and bleeding, for reducing the system (De Dietol., iii. 16 et seq.). He constantly advises gentle purgatives as a means of keeping the body in health. His favourite laxative medicine was the herb mercury. The administration of clysters is recommended; this treatment was evidently derived from the Egyptians. What are called errhines or sternutatories—i.e., medicines which, applied to the nose, excite sneezing—were described by Hippocrates as medicines which purge the head. Though he fully describes the effects of baths, he speaks unfavourably of thermal springs as being hard and heating. He insists that the diet should be full in winter and spare in summer (Aphor., i. 18). He disapproves of the habit of eating a full dinner (De Vet. Med.). He condemns the use of new bread. The nutritious properties of pulse in general are insisted upon. He calls the flesh of fowls one of the lightest kinds of food (De Affect., 46), and says that eggs are nutritious, and strengthening, but flatulent. He remarks that the flesh of wild animals is more digestible than that of domesticated. He objects to goat’s flesh as having all the bad qualities of beef, which he calls a strong, astringent, and indigestible article of diet. Milk, he says, sometimes causes the formation of stones in the bladder (De Ær. Aquis et Locis, 24). Dr. Francis Adams says this opinion was adopted by all the ancient physicians. Cheese he considers flatulent and indigestible. Fishes are light food; sea fish are lighter and better for delicate persons than fresh-water fish (De Affect., 46). Honey, when eaten with other food, is nutritious, but is injurious when taken alone.

Hippocrates opposed all hypothesis in medicine, and grounded his opinions on disease on actual observation. He insisted that the essence of fever is heat mixed up with noxious qualities. He was the great master of prognostics. His work Prorrhetica and CoacÆ, says Dr. Francis Adams, “contains a rich treasure of observations which cannot be too much explored by the student of medicine. His prognostics are founded upon the appearance of the face, eyes, tongue, the voice, hearing, the state of the hypochondriac region, the abdomen, the general system, sleep, respiration, and the excretions. We can do little more, in this place, than express our high sense of the value of the Hippocratic Treatises on Prognostics, and recommend the study of them to all members of the profession who would wish to learn the true inductive system of cultivating medicine.” (The Seven Books of Paulus Ægineta, by Francis Adams.) The state of the countenance which immediately precedes death is called by physicians the Facies Hippocratica, because Hippocrates described it, calling it p??s?p?? d?af???? (Coac. PrÆnot., 212). The nose is sharp, the eyes hollow, the temples sunk, the ears cold and contracted, and their lobes inverted; the skin about the forehead hard, tense, and dry; the countenance pale, greenish, or dark. In fevers he was greatly attached to the importance of the critical days. Galen adopted his list of critical days with little alteration. Hippocrates does not seem to have paid much attention to the pulse, or if he did he attached little importance to it; even in describing epidemical fevers he neglects to mention the characteristics of the pulse. Galen, however, affirms that he was not altogether ignorant of it. He quite correctly described the characteristics of healthy stools, and pointed out that they should in colour be yellowish, if too yellow there is too much bile, if not yellow at all there was a stoppage of the passage of bile to the intestines. His indications from the state of the urine are not less valuable. How wise are his observations on the treatment of febrile diseases! “To be able to tell what had preceded them; to know the present state and foretell the future; to have two objects in view, either to do good or at least do no harm” (Epidem., i. 7). He it was who formulated the rule all physicians have since followed that a fluid diet is proper in all febrile affections. He advised cold sponging in ardent fevers—a method of treatment recently revived and of great value (De Rat. Vict. Acut.). He laid it down that diseases in general may be said to arise either from the food we eat or the air we breathe. In cases of fever he allowed his patients to drink freely of barley-water and cold acidulated drinks. In this he was much in advance of the medical science of the time. He has described cases of “brain fever,” one of the few complaints which novelists permit their heroes to suffer from. They appear to have been cases of remittent fever rather than true inflammation of the brain. We may estimate the wonderful extent of the medical science of Hippocrates by the fact that he vigorously opposed the popular belief of the period, that epilepsy was due to demoniacal influence. He explains that the lower animals are subject to the same disorder, and that in them it is often associated with water in the brain. There is really no doubt that the morbus sacer of the ancients and the cases of demoniacal possession of which we read were cases of epilepsy (Hippoc. de Morbo Sacro). Concerning apoplexy he says that a slight attack is difficult to cure, and a severe one utterly incurable. The cause of the attack he considered was turgidity of the veins. We know it to be often associated with cerebral hÆmorrhage or sanguineous apoplexy and sometimes with effusion of serum = serous apoplexy. Hippocrates therefore came very near the truth. He advised bleeding, which is still recommended but is not often practised in England; and he very justly said that the malady occurs most frequently between the age of forty and sixty (Aphoris., ii. 42). In certain forms of ophthalmia he advises free purgation, bleeding, and the use of wine; and this accords with the best modern practice, if for venesection, we substitute vesication. His treatment of nasal polypus by the ligature is not unlike our own; and nothing could be better than his plan for dealing with quinsey and allied complaints, viz., hot fomentations, warm gargles and tinctures, with free purgation. He disapproves of a practice too often followed by surgeons to-day, of scarifying the tonsils when swollen and red. In cases of inflammation of the lungs he advised bleeding, purging, and cooling drinks. LaËnnec, the great French physician, who invented the stethoscope, highly praises Hippocrates for his knowledge of phthisis, and the diagnostic value of his tests of the nature of the sputa in that disease. In cases of empyema, or the formation and accumulation of pus in the chest, he directs us to make an incision into the pleural cavity—an operation which has been revived in modern times under the name of “paracentesis thoracis.”

He declares the loss of hair and the diarrhoea of phthisis to be fatal signs, and his description of hydrothorax, or dropsy of the chest, has been highly praised by the greatest authorities. He says that phthisis is most common between the ages of eighteen and thirty-six (see Hippoc. de Morbis, ii. 45; CoacÆ PrÆnat., et alibi). For pleurisy his treatment is practically the same as that followed at the present day. He advised the administration of flour and milk in diarrhoea—an exceedingly useful remedy—and treated the pains of colic by warm injections, warm baths, fomentations, soporifics and purgatives, as the case might require. He was wise enough to know that stone of the bladder was a product of a morbid condition of the urine, and said that when it had fairly formed nothing but an operation for its removal was of any value. He recognised the disease known as hydatids of the liver, and directed that abscesses of that organ should be opened by the cautery. His account of the causes and treatment of dropsy is fairly accurate according to our present knowledge. He approved of paracentesis abdominis (tapping) in cases of ascites, and describes the operation. He recognised the incurability of true cancer. Many of his treatises on the disorders of women prove that they were well understood in his day, and on the whole were properly treated. Difficult labour was managed not so differently from our modern methods as might be supposed. His account of hip-joint disease is remarkably accurate. Gout was well understood by our author, and probably his treatment by purgation and careful dieting was on the whole as successful as our own.

Hippocrates speaks of leprosy as more a blemish than a disease; it is probable, however, that the works in which he is supposed to allude to it are not genuine. He points out the danger of opening the round tumour on tendons, called a ganglion. In his book called Prognostics, he refers to the danger of an erysipelas being translated to an internal part. Cold applications, he says, are useful in this disease when there is no ulceration, but prejudicial when ulceration is present. Struma or scrofula is described by Hippocrates (De Glandulis) as being one of the worst diseases of the neck. In the treatise (De Ulceribus) on ulcers, he particularly praises wine as a lotion for ulcers, and there is good reason to believe that we might advantageously revert to this treatment. Some of the drugs which he recommends for foul ulcers, such as frankincense and myrrh, are excellent, and owe their efficacy to their “newly discovered” antiseptic action. He recommends also arsenic and verdigris. The actual cautery or burning applied freely to the head is recommended in diseases of the eyes and other complaints. He describes water on the brain in the treatise De Morbis, ii. 15, and even recommends perforation of the skull or trephining quite in the modern way. Opening the temporal veins is advised for obstinate headaches. Although no express treatise on bleeding is found amongst the works of Hippocrates, he practised venesection freely in various diseases. He forbids the surgeon to interfere with non-ulcerated cancers, adding that if the cancer be healed the patient soon dies, while if let alone he may live a long time (Aph., vi. 38). He warns us that the sudden evacuation of the matter of empyema or of the water in dropsy proves fatal. He speaks of evacuating the fluid with an instrument similar to that which we call a trochar. He approves of scarification of the ankles in dropsy of the lower extremities; this is quite modern treatment. In cases of dislocation of the hip-joint from the formation of a collection of humours, he recommends burning so as to dry up the redundant humours. He minutely describes the cure of fistula with the ligature in his work De Fistulis, which, even if not a genuine treatise of Hippocrates, is extremely ancient, and was considered authentic by Galen. HÆmorrhoids or piles are to be ligatured with very thick thread, or destroyed with red-hot irons. Varicose veins are to be treated by small punctures, not freely opened (De Ulceribus, 16). Hippocrates considered the extraction of weapons to be one of the most important departments of surgery. In his treatise De Medico, he says that surgery can only be properly learned by attaching one’s self to the army. Homer said,—

“The man of medicine can in worth with many warriors vie,

Who knows the weapons to excise, and soothing salves apply.”

Hippocrates treats of fractures in his books De Fracturis (De Articulis; De Vulner. Capit.; Officina Medici). He insists that no injuries to the head are to be considered as trifling; even wounds of the scalp may prove dangerous if neglected. Fissures, contusions, and fractures of the cranium are minutely explained and appropriate treatment suggested. He describes the trephine under the name of t??pa???, i.e. the trepan. He says that convulsions are the frequent consequence of head injuries, and that they occur on the opposite side of the body to that in which the brain injury is seated. One of the most valuable legacies of the ancients is this profoundly learned treatise of the Father of Medicine, and it proves to us how high a point the surgery of ancient Greece had reached. He noticed a certain movement of the brain during respiration, a swelling up in expiration and a falling down during inspiration; and although several great authorities of the past denied the accuracy of this observation, it has since been shown to be perfectly correct. (See Paulus Ægineta, Dr. F. Adams’ edit., vol. ii. p. 442.) In cases of fracture of the lower jaw, our author directs that the teeth separated at the broken part are to be fastened together and bound with gold wire. So accurately does he describe this fracture that Paulus Ægineta transcribes it almost word for word from the De Articulus. His method of treating fracture of the clavicle is admirable; in fracture of the ribs he observes that when the broken ends of the bone are not pushed inwards, it seldom happens that any unpleasant symptoms supervene. In fractures of the arm he minutely and precisely indicates the correct principles on which they are to be treated, and insists strongly on the necessity of having the arm and wrist carefully suspended in a broad soft sling, and that the hand be placed neither too high nor too low. Hippocrates could learn very little from our modern surgeons in the treatment of such injuries. In cases of broken thigh he has indicated all the dangers and difficulties attending the management of this accident; his splints and bandages are applied much as we apply them at the present time, and his suggestions for ensuring a well-united bone without deformity of the limb are invaluable. In fractures of the thigh and leg-bones he lays great stress on the attention necessary to the state of the heel. In those of the foot he warns against the danger of attempting to walk too soon. In compound fractures compresses of wine and oil are to be used, and splints are not to be applied till the wound puts on a healthy appearance. He is fully aware of the peculiarly dangerous character of such injuries, and his observations read like extracts from a modern text-book of surgery. “No author,” says Dr. Francis Adams, the learned translator of the works of Paulus Ægineta, “has given so complete a view of the accidents to which the elbow joint is subject as Hippocrates.”

Plato (B.C. 427-347) in its philosophical aspect studied medicine, not with any idea of practising the art, but merely as a speculative contemplation. The human soul is an emanation from the absolute intelligence. The world is composed of the four elements. Fire consists of pyramidal, earth of cubical, air of octagonal, and water of twenty-sided atoms. Besides these is the Æther. Everything in the body has in view the spirit. The heart is the seat of the mind, the lungs cool the heart, the liver serves the lower desires and is useful for divination. The spleen is the abode for the impurities of the blood. The intestines serve to detain the food, so that it might not be necessary to be constantly taking nourishment. The inward pressure of the air accounts for the breathing. The muscles and bones protect the marrow against heat and cold. The marrow consists of triangles, and the brain is the most perfect form of marrow. When the soul is separated from the marrow, death occurs. Sight is caused by the union of the light which flows into and out of the eyes, hearing in the shock of air communicated to the brain and the blood. Taste is due to a solution of sapid atoms by means of small vessels, which vessels conduct the dissolved atoms to the heart and soul. Smell is very transitory, not being founded on any external image. The uterus is a wild beast exciting inordinate desires. Disease is caused by a disturbance of the quantity and quality of the fluids. Inflammations are due to aberrations of the bile. The various fevers are due to the influence of the elements. Mental diseases are the results of bodily maladies and bad education. Diseases fly away before appropriate drugs. Physicians must be the rulers of the sick in order to cure them, but they must not be money-makers.398

In the Republic of Plato, Book III., we find that medical aid was largely in request in Greece to relieve the indolent and voluptuous from the consequences of self-indulgence. It was thought by Socrates disgraceful to compel the clever sons of Asclepius to attend to such diseases as flatulence and catarrh; it seemed ridiculous to the philosopher to pay so much attention to regimen and diet as to drag on a miserable existence as an invalid in the doctor’s hands. When a carpenter was ill, he expected his doctor to cure him with an emetic or a purge, the cautery or an operation; if he were ordered a long course of diet, he would tell his doctor that he had no time to be ill, and he would go about his business regardless of consequences. Æsculapius, it was maintained, revealed the healing art for the benefit of those whose constitutions were naturally sound; he expelled their disorders by drugs and the use of the knife, without interfering with their usual avocations; but when he found they were hopelessly incurable, he would not attempt to prolong a miserable life by rules and diet, as such persons would be of no use either to themselves or the state. Constitutionally diseased persons and the intemperate livers were to be left to be dealt with by Nature, so that they might die of their diseases.

---

CHAPTER III.
POST-HIPPOCRATIC GREEK MEDICINE.—THE SCHOOLS OF MEDICINE.

The Dogmatic School.—Praxagoras of Cos.—Aristotle.—The School of Alexandria.—Theophrastus the Botanist.—The great Anatomists, Erasistratus and Hierophilus, and the Schools they founded.—The Empiric School.

The Dogmatic School.

It was only natural that the philosophical Greeks should discuss medicine at as great a length as they discussed philosophy; accordingly, we find that no sooner had our art taken its place amongst the subjects worthy of being seriously considered by the Greek intellect, than it was as much talked about as practised, and wrangled over as though it were a system of religion. Sects arose which opposed each other with the greatest vehemence; and Hippocrates had not long formulated his teaching when his disciples elevated his principles into a dogmatism which challenged, and shortly provoked, opposition of various kinds. Then arose the schools of medicine which ultimately became famous, as those of the Dogmatists, Empirics, Methodists, Pneumatists, etc. The Dogmatists boasted of being the Rational and Logical school. They held that there is a certain connection between all the arts and sciences, and that it is the duty of the physician to avail himself of all sorts of knowledge on every subject which bears any relationship to his own. They made, therefore, the most careful inquiry into the remote and proximate causes of disease. They examined the influence on the human body of airs, waters, places, occupations, diet, seasons, etc. They formulated general rules, not of universal application, but modified their treatment according to circumstances, availing themselves of whatever aid they could obtain from any source. Hippocrates had said, “The physician who is also a philosopher is equal to the gods,” and the Dogmatists elevated this into an article of their creed. Hippocrates, Galen, Oribasius, Ætius, Paulus Ægineta, and the Arab physicians were dogmatists. The founders of the school were the sons of Hippocrates—Thessalus and Draco. The former was the eldest son of the great physician, and was the more famous of the two. He passed a great part of his life as physician in the court of Archelaus, king of Macedonia.399 His brother, Draco, was physician to Queen Roxana, wife of Alexander the Great.

We may say, therefore, that the oldest, most famous, and worthy of the ancient medical sects arose about 400 B.C., and retained its power over the medical profession till the rise of the Empirical sect in the Alexandrian school of philosophy. We are indebted to Celsus for a lucid and admirable exposition of the doctrines professed by these two medical parties.400

The Dogmatists maintained that it was not enough for the physician to know the mere symptoms of his patient’s malady. It does not suffice to know the evident causes of the disorder, but he must acquaint himself with the hidden causes. To acquire this knowledge of the hidden causes, he must study the hidden parts, and the natural actions and functions of the body in health. He must know the principles on which the human machinery is constructed before he can scientifically treat the accidents and disturbances to which it is liable. It was not, therefore, a mere subject of philosophical interest to hold with some physicians that diseases proceed from excess or deficiency of one or other of the four elements, or with others, that the various humours or the respiration were at fault. It was not of merely academic interest to suppose that the abnormal flow of the blood caused inflammations, or that corpuscles blocked up the invisible passages. The doctor must do more than speculate on these things in his discussions. He must have a theory upon them which he could apply to the treatment of his patients, and the best physician would be the one who best knew how the disease originated. Experiments without reasoning were valueless; their chief use was to inform the experimenter whether he had reasoned justly or conjectured fortunately. When the physician is confronted by a new form of disease for which no remedy has been discovered, he must know its cause and origin, or his practice will be mere guess-work. Anybody can discover the evident causes—heat, cold, over-eating. These things the least instructed physician will probably know. It is the knowledge of hidden causes which makes the superior man. He who aspires to be instructed must know what we now call physiology—why we breathe, why we eat, what happens to the food which we swallow, why the arteries pulsate, why we sleep, etc. The man who cannot explain these phenomena is not a competent doctor. He must have frequently inspected dead bodies, and examined carefully their internal parts; but they maintained that it was much the better way to open living persons, as Herophilus and Erasistratus did, so that they could acquaint themselves in life with the structures whose disturbance or disease causes the sufferings which they were called upon to alleviate. What is known as the “Humoral Pathology” formed the most essential part of the system of the Dogmatists.

Humoral pathology explains all diseases as caused by the mixture of the four cardinal humours; viz., the blood, bile, mucus or phlegm, and water. Hippocrates leaned towards it, but it was Plato who developed it. The stomach is the common source of all these humours. When diseases develop, they attract these humours. The source of the bile is the liver; of the mucus, the head; of the water, the spleen. Bile causes all acute diseases, mucus in the head causes catarrhs and rheumatism, dropsy depends on the spleen.

Diocles Carystius, a famous Greek physician, said by Pliny401 to have been next in age and fame to Hippocrates himself, lived in the fourth century B.C. He wrote several treatises on medicine, of which the titles and some fragments are preserved by Galen, CÆlius Aurelianus, Oribasius, and others. His letter to King Antigonus, entitled “An Epistle on Preserving Health,” is inserted at the end of the first book of Paulus Ægineta, and was probably addressed to Antigonus Gonatus, king of Macedonia, who died B.C. 239. This treatise is so valuable a summary of the medical teaching of the time that it will be useful to insert it in this place. “Since of all kings you are the most skilled in the arts, and have lived very long, and are skilled in all philosophy, and have attained the highest rank in mathematics, I, supposing that the science which treats of all things that relate to health is a branch of philosophy becoming a king and befitting to you, have written you this account of the origin of diseases, of the symptoms which precede them, and of the modes by which they may be alleviated. For neither does a storm gather in the heavens but it is preceded by certain signs which seamen and men of much skill attend to, nor does any disease attack the human frame without having some precursory symptom. If, then, you will only be persuaded by what we say regarding them, you may attain a correct acquaintance with these things. We divide the human body into four parts: the head, the chest, the belly, and the bladder. When a disease is about to fix in the head, it is usually announced beforehand by vertigo, pain in the head, heaviness in the eyebrows, noise in the ears, and throbbing of the temples; the eyes water in the morning, attended with dimness of sight; the sense of smell is lost, and the gums become swelled. When any such symptoms occur, the head ought to be purged, not indeed with any strong medicine, but, taking the tops of hyssop and sweet marjoram, pound them and boil them in a pot, with half a hemina of must or rob; rinse the mouth with this in the morning before eating, and evacuate the humours by gargling. There is no gentler remedy than this for affections of the head. Mustard in warm, honied water also answers the purpose very well. Take a mouthful of this in the morning before eating, gargle and evacuate the humours. The head also should be warmed by covering it in such a manner as that the phlegm may be readily discharged. Those who neglect these symptoms are apt to be seized with the following disorders: inflammations of the eyes, cataracts, pain of the ears as if from a fracture, strumous affections of the neck, sphacelus of the brain, catarrh, quinsy, running ulcers called achores, caries, enlargement of the uvula, defluxion of the hairs, ulceration of the head, pain in the teeth. When some disease is about to fall upon the chest, it is usually announced by some of the following symptoms: There are profuse sweats over the whole body, and particularly about the chest, the tongue is rough, expectoration saltish, bitter, or bilious, pains suddenly seizing the sides or shoulder-blades, frequent yawning, watchfulness, oppressed respiration, thirst after sleep, despondency of mind, coldness of the breast and arms, trembling of the hands. These symptoms may be relieved in the following manner: Procure vomiting after a moderate meal without medicine. Vomiting also when the stomach is empty will answer well; to produce which first swallow some small radishes, cresses, rocket, mustard and purslain, and then by drinking warm water procure vomiting. Upon those who neglect these symptoms the following diseases are apt to supervene: pleurisy, peripneumony, melancholy, acute fevers, frenzy, lethargy, ardent fever attended with hiccough. When any disease is about to attack the bowels, some of the following symptoms announce its approach: In the first place, the belly is griped and disordered, the food and drink seem bitter, heaviness of the knees, inability to bend the loins, pains over the whole body unexpectedly occurring, numbness of the legs, slight fever. When any of these occur, it will be proper to loosen the belly by a suitable diet without medicine. There are many articles of this description which one may use with safety, such as beets boiled in honeyed water, boiled garlic, mallows, dock, the herb mercury, honied cakes; for all these things are laxative of the bowels. Or, if any of these symptoms increase, mix bastard saffron with all these decoctions, for thereby they will be rendered sweeter and less dangerous. The smooth cabbage boiled in a large quantity of water is also beneficial. This decoction, with honey and salt, may be drunk to the amount of about four heminÆ, or the water of chick-peas and tares boiled may be drunk in the same manner. Those who neglect the afore-mentioned symptoms are apt to be seized with the following affections: diarrhoea, dysentery, lientery, ileus, ischiatic disease, tertian fever, gout, apoplexy, hÆmorrhoids, rheumatism. When any disease is about to seize the bladder, the following symptoms are its usual precursors: A sense of repletion after taking even a small quantity of food, flatulence, eructation, paleness of the whole body, deep sleep, urine pale and passed with difficulty, swellings about the privy parts. When any of these symptoms appear, their safest cure will be by aromatic diuretics. Thus, the roots of fennel and parsley may be infused in white fragrant wine, and drunk every day when the stomach is empty in the morning, to the amount of two cyathi, with water in which carrot, myrtle, or elecampane has been macerated (you may use any of these you please, for all are useful); and the infusion of chick-peas in water in like manner. On those who neglect these symptoms the following diseases are apt to supervene: dropsy, enlargement of the spleen, pain of the liver, calculus, inflammation of the kidney, strangury, distension of the belly. Regarding all these symptoms, it may be remarked that children ought to be treated with gentler remedies, and adults with more active. I have now to give you an account of the seasons of the year in which each of these complaints occur, and what things ought to be taken and avoided. I begin with the winter solstice. Of the winter solstice: This season disposes men to catarrhs and defluxions until the vernal equinox. It will be proper then to take such things as are of a heating nature, drink wine little diluted, or drink pure wine, or of the decoction of marjoram. From the winter solstice to the vernal equinox are ninety days. Of the vernal equinox: This season increases phlegm in men, and the sweetish humours in the blood, until the rising of the pleiades. Use therefore juicy and acrid things, take labour, ... To the rising of the pleiades are forty-six days. Of the rising of the pleiades: This season increases the bitter bile and bitter humours in men, until the summer solstice. Use therefore all sweet things, laxatives of the belly.... To the summer solstice are forty-five days. Of the summer solstice: This season increases the formation of black bile in men, until the autumnal equinox. Use therefore cold water, and everything that is fragrant.... To the autumnal equinox are ninety-three days. Of the autumnal equinox: This season increases phlegm and thin rheums in men until the setting of the pleiades. Use therefore remedies for removing rheums, have recourse to acrid and succulent things, take no vomits, and abstain from labour.... To the setting of the pleiades are forty-five days. Of the setting of the pleiades: This season increases phlegm in men until the winter solstice. Take therefore all sour things, drink as much as is agreeable of a weak wine, use fat things, and labour strenuously. To the winter solstice are forty-five days.”402

Praxagoras of Cos, who lived in the fourth century B.C., shortly after Diocles, was a famous physician of the Dogmatic sect, who especially excelled in anatomy and physiology. He placed the seat of all diseases in the humours of the body, and was one of the chief supporters of what is known as the “humoral pathology.” Sprengel403 and others state that he was the first who pointed out the distinction between the arteries and the veins; but M. LittrÉ denies this, and seems to prove that the differences were known to Aristotle, Hippocrates, and other writers.404 His knowledge of anatomy must have been very considerable, and his surgery was certainly bold; so that he even ventured, in cases of intussusception of the bowel, to open the abdomen in order to replace the intestine. In hernia he practised the taxis,405 i.e. replaced the bowel by the hand; and he amputated the uvula in affections of that organ. He had many pupils, amongst others Herophilus, Philotimus, and Plistonicus.

Aristotle, the founder of comparative anatomy and the father of the science of natural history, was the son of Nichomachus, physician to Amyntas II., king of Macedonia. He was born at Stageira, B.C. 334. His father was a scientific man of the race of the Asclepiads, and it was the taste for such pursuits and the inherited bent of mind which early inclined the son to the investigation of nature. He went to Athens, where he became the disciple of Plato, and remained in his society for twenty years. In his forty-second year he was summoned by Philip of Macedon to undertake the tuition of Alexander the Great, who was then fifteen years old. Of his philosophical works it is not here necessary to speak; it is his scientific labours, which had so important an influence on medical education, which chiefly concern us. He wrote Researches about Animals, On Sleep and Waking, On Longevity and Shortlivedness, On Respiration, On Parts of Animals, On Locomotion of Animals, On Generation of Animals. Aristotle inspired Alexander with a passion for the study of natural history, and his royal pupil gave him abundant means and opportunity to collect materials for a history of animals. The science of comparative anatomy, so important in relation to that of medicine, was thus established. He pointed out the differences which exist between the structure of men and monkeys; described the organs of the elephant, and the stomach of the ruminant animals. The anatomy of birds and the development of their eggs during incubation were accurately described by him; he dissected reptiles, and studied the habits of fishes. He investigated the action of the muscles, regarded the heart as the origin of the blood-vessels, named the aorta and the ventricles, described the nerves which he thought originated in the heart, but he confused the nerves with the ligaments and tendons. The heart he considered as the centre of movement and feeling406 and nourishment, holding that it contains the natural fire, and is the birthplace of the passions and the seat of the soul; the brain he thought was merely a mass of water and earth, and did not recognise it as nervous matter. The diaphragm he considered had no other office than to separate the abdomen from the thorax and protect the seat of the soul (the heart) from the impure influences of the digestive organs. Superfoetation (or the conception of a second embryo during the gestation of the first) he held to be possible, and he first pointed out the punctum saliens.

Theophrastus, whose real name was Tyrtamus, was born at Eresa in the island of Lesbos, 371 B.C., fourteen years after Aristotle. He was the originator of the science of plants; he first learned the details of their structure, the uses of their organs, the laws of their reproduction,—in a word, the physiology of the vegetable world. When Aristotle retired to Chalcis, he chose Theophrastus, to whom he gave that name, signifying “a man of divine speech,” as his successor at the Lyceum. This distinguished philosopher devoted himself alike to the exact and speculative sciences. The greater part of his works have perished; what is preserved to us consists of treatises on the history of the vegetable kingdom, of stones, and some fragments of works on physics, medicine, and some moral works. His History of Plants enumerates about five hundred different kinds, many of which are now difficult to identify. He made some attempts at a vague kind of classification, and has chapters on aquatic, kitchen, parasite, succulent, oleaginous, and cereal plants. He carefully explains the principles of the reproduction of vegetables, and the fecundation of the female flowers by the pollen of the male. He recognises hermaphrodite and unisexual flowers, and points out how the fecundation of the latter is effected by the wind, insects, and by the water in the case of aquatic plants. He knew that double flowers were sterile. He devotes a chapter to the diseases of the vegetable kingdom; he almost recognised the characteristics which distinguish the monocotyledonous from the dicotyledonous plants. In a word, he laid the foundations on which our modern botanists have erected their science.407

The School of Alexandria.

“In the year 331 B.C.,” says Kingsley,408 “one of the greatest intellects whose influence the world has ever felt, saw, with his eagle glance, the unrivalled advantages of the spot which is now Alexandria; and conceived the mighty project of making it the point of union of two, or rather of three worlds. In a new city, named after himself, Europe, Asia, and Africa were to meet and to hold communion.” When Greece lost her intellectual supremacy with her national independence, the centre of literature, philosophy, and science was shifted to this unique position. With all the treasures of Egyptian wisdom around her, with all the stores of Eastern thought on the one hand and those of Europe on the other, Alexandria became in her schools the rallying-point of the world’s thought and activity. If we turn to an atlas of ancient geography, we shall be struck with the unrivalled facilities possessed by this city for gathering to itself the treasures, intellectual and material, of the conquered world of Alexander the Great. From the Danube, Greece, Phoenicia, Palestine, Persia, Asia Minor, India, Italy, and the Celtic tribes, there came embassies to Egypt to seek the protection and alliance of Alexander of Macedon, and each must have contributed something to the greatness of the city which he had founded. Just as every traveller in after years who passed through the place was compelled to leave a copy of any work which he had brought with him, to the Alexandrian library, so from the first foundation of the town was every visitor a donor of some idea to its stores of thought.

At the dismemberment of Alexander’s vast empire, after his death, the Egyptian portion fell to the share of Ptolemy Soter. It was this sovereign who founded the famous Alexandrian Library; a great patron of the arts and sciences, he placed this institution under the direction of Aristotle. He also established the Schools of Alexandria, and encouraged the dissection of the human body.

Chrysippus, the Cnidian, who lived in the fourth century B.C., was the father of the Chrysippus who was physician to Ptolemy Soter, and he was tutor to Erasistratus. Pliny says that he reversed the practice of preceding physicians in the most extraordinary manner. He would not permit bleeding, because the blood contains the soul; did not practise purging, though he sometimes permitted the use of enemata and emetics. He wrote on herbs and their uses, and drove the blood out of limbs previous to their amputation on the principles recently re-introduced by Esmarch. He introduced the use of vapour baths in the treatment of dropsy. As there were several physicians of the name of Chrysippus, and as their works are lost, it is very difficult to distinguish their maxims. Amongst the disciples of the Cnidian physician of this name were Medius, Aristogenes, Metrodorus, and Erasistratus, as we have said.

Herophilus, of Chalcedon in Bithynia, a pupil of Chrysippus of Cnidos and Praxagoras of Cos, was one of the most famous physicians of the ancient world. He was a great anatomist and physiologist, and a contemporary of the philosopher Diodorus Cronos, and of Ptolemy Soter in the fourth and third centuries B.C. He settled at Alexandria, which under Ptolemy I. became the most famous centre of the science of the ancient Greeks. Here Herophilus founded with other physicians of the city the great medical school which ultimately became distinguished above all others, so that a sufficient guarantee of a physician’s ability was the fact that he had received his education at Alexandria. The foundation of the Alexandrian School formed a great epoch in the history of medicine. The dissection of the human body was of the utmost importance to the healing art. While the practice was forbidden, it could only have been performed furtively and in a hasty and unsatisfactory manner. The science of anatomy, on which that of medicine to be anything but quackery must be founded, now took its proper place in the education of the doctor. The bodies of all malefactors were given over for the purposes of dissection.409 Herophilus is accused of having also dissected alive as many as six hundred criminals. This fact has been denied by some of his biographers, and others have attempted to explain it away; but it is charged against him by Tertullian,410 and Celsus mentions it411 as though it were a well-known fact, and without the least suspicion that it was an unjust accusation.

Asked who is the best doctor, he is said to have replied, “He who knows how to distinguish the possible from the impossible.”

In the course of his anatomical researches he made many discoveries and gave to parts of the human body names which remain in common use to this day. Dr. Baas thus sums up his anatomical and physiological knowledge. He knew the nerves, that they had a capacity for sensation, and were subject to the will, were derived from the brain, in which he discovered the calamus scriptorius, the tela choroidea, the venous sinuses, and torcular Herophili. He believed the fourth ventricle to be the seat of the soul. He discovered the chyliferous and lactiferous vessels. He described accurately the liver and Fallopian tubes, the epididymis and the duodenum, to which he gave its name, and also the os hyoides, the uvea, the vitreous humour, the retina, and the ciliary processes. He called the pulmonary artery the vena arteriosa, and the pulmonary vein the arteria venosa. He distinguished in respiration a systole, a diastole, and a period of rest. He founded the doctrine of the pulse, its rhythm, the bounding pulse and its varieties according to age. The pulse is communicated by the heart to the walls of the arteries. He distinguished between arteries and veins, and admitted that the arteries contain blood. He taught that diseases are caused by a corruption of the humours. Paralysis is due to a lack of nerve influence. He laid great stress upon diet, bled frequently, and practised ligation of the limbs to arrest bleeding. He was the first to administer cooking salt as a medicine. A good botanist, he preferred vegetable remedies, which he termed the “Hands of the gods.” He possessed considerable acquaintance with obstetric operations,412 and wrote a text-book of midwifery.413

Erasistratus, of Iulis in the island of Cos, a pupil of Chrysippus was one of the most famous physicians and anatomists of the Alexandrian school. Plutarch says that when he was physician to King Seleucus, he discovered that the young prince Antiochus had fallen in love with his step-mother Stratonice by finding no physical cause for the illness from which he was suffering, and that his heart palpitated, he trembled, blushed, and perspired when the lady entered the room. By adroit management he induced the king to confer on the prince the object of the young man’s passion. Similia similibus curantur. So successful was the treatment that the physician received a fee of 100 talents, which supposing the Attic standard to be meant would amount to £24,375, perhaps the largest medical fee on record.414 He lived for some time in Alexandria, and gave up medical practice in his old age, that he might devote his whole time to the study of anatomy.

Dr. Baas, in his account of the Anatomy, Physiology, and Medicine of Erasistratus, says that he divided the nerves into those of sensation and those of motion. The brain substance is the origin of the motor and the brain membranes that of the sensory nerves.415 Like Herophilus, he confounded the nerves and ligaments. He described accurately the structure, convolutions, and ventricles of the brain. He thought that the convolutions, especially those of the cerebellum, are the seat of thought, and located mental diseases in the brain. He knew the lymph and chyle vessels, and the chordÆ tendineÆ of the heart. He assumed the anastomoses of the arteries and veins. The pneuma in the heart is vital spirits, in the brain is animal spirits. Digestion is due to the friction of the walls of the stomach. He thought that the bile is useless, as is the spleen and other viscera. He shows some acquaintance with pathological anatomy, as he describes induration of the liver in dropsy. His idea of the cause of disease is plethora and aberration of the humours. Inflammation is due to the detention of the blood in the small vessels by the pneuma driven from the heart into the arteries; fever occurs when the pneuma is crowded back to the heart by the venous blood, and blood gets into the large arteries. Dropsy always proceeds from the liver. He discarded bleeding and purgation; recommended baths, enemeta, emetics, friction, and cupping. He was, thinks Dr. Baas, a forerunner of Hahnemann in the doctrine of small doses, as he prescribed three drops of wine in bilious diarrhoea. He opened the abdomen to apply remedies directly to the affected part, and invented a kind of catheter.416

Erasistratus was the first to describe a species of hunger, to which he gave the name Boulimia—a desire for food which cannot be satisfied. In his account of the complaint he mentions the Scythians, who, when obliged to fast, tie bandages round their abdomens tightly, and this stays their hunger.417

The ancient apologists for the human vivisections of Herophilus and Erasistratus used to say that these anatomists were thus “enabled to behold, during life, those parts which nature had concealed, and to contemplate their situation, colour, figure, size, order, hardness or softness, roughness or smoothness, etc. They added that it is not possible, when a person has any internal illness, to know what is the cause of it, unless one is exactly acquainted with the situation of all the viscera; nor can one heal any part without understanding its nature: that when the intestines protrude through a wound, a person who does not know what is their colour when in a healthy state cannot distinguish the sound from the diseased parts, nor therefore apply proper remedies; while, on the contrary, he who is acquainted with the natural state of the diseased parts will undertake the cure with confidence and certainty; and that, in short, it is not to be called an act of cruelty, as some persons suppose it, to seek for the remedies of an immense number of innocent persons in the sufferings of a few criminals.”418

Ammonius of Alexandria, surnamed Lithotomus, probably lived in the reign of Ptolemy Philadelphus (B.C. 283-247). He is celebrated as having been the first surgeon who thought of crushing a stone within the bladder when too large for extraction entire; for this reason he was called ????t???. Celsus describes his method.419

Of the Herophilists we may mention Demetrius of ApamÆa (B.C. 276), who named and described diabetes, and was distinguished as an obstetrician.

Mantias, who, B.C. 250, first collected the preparations of medicines into a special book.

Demosthenes Philalethes, who, under Nero, was the most celebrated oculist of his time, wrote a work on diseases of the eye, which was the standard authority until about A.D. 1000. The work has perished, but Ætius and Paulus Ægineta have preserved some fragments of it. He wrote also on the pulse.

Hegeton was a surgeon of Alexandria who was mentioned by Galen as having lived there as a contemporary of several physicians who were known to have resided in that city at the end of the second or the beginning of the first century B.C. He was a follower of Herophilus, and wrote a book on the causes of diseases entitled ?e?? ??t???, which has perished.

Of the school of Erasistratus we may mention Xenophon of Cos, who wrote a work on the names of the parts of the human body, and on botany and the diseases of women. Nicias of Miletus, a friend of the poet Theocritus; Philoxenos, who, according to Celsus, wrote several valuable books on surgery; and Martialis the Anatomist, who visited Rome about A.D. 165. He knew Galen, and wrote works on anatomy which were in great repute long after his death.

The followers of Herophilus and Erasistratus, though they founded schools, did not greatly influence the art of medicine, nor did they contribute much to its advancement beyond the point in which it was left by their great masters. They fell into fruitless speculations instead of pursuing their science by accumulating facts; in the words of Pliny, it was easier “to sit and listen quietly in the schools, than to be up and wandering over deserts, and to seek out new plants every day.”420 So Dogmatism fell into disrepute and made way for the advent of Empiricism.

School of the Empirics.

The School of the Empirics was the outcome of the system of Scepticism, introduced by Pyrrho and extended by Carneades, who taught that there is no certainty about anything, no true knowledge of phenomena, and that probability alone can be our guide. Ænesidemus carried this scepticism into the medicine of the Empirics, but the school was originally established under the title of the Teretics or Mnemoneutics. The Empirics rested their system on what was called the “Empiric tripod,”—that is, accident, history, and analogy. Remedies have come to us by chance, by the remembrance of previous cures, and by applying them to similar cases.

The sect of the Empiricists was founded by Serapion of Alexandria and Philinus of Cos in the third century B.C. They were in opposition to the Dogmatists, professing to derive their knowledge only from experience; they held that the whole art of medicine consisted in observation, experiment, and the application of known remedies which have constantly proved valuable in the treatment of one class of diseases to other and presumably similar classes. Celsus,421 in his account of the principles of this sect, says that “they admit that the evident causes are necessary, but deprecate inquiry into them because nature is incomprehensible. This is proved because the philosophers and physicians who have spent so much labour in trying to search out these occult causes cannot agree amongst themselves. If reasoning could make physicians, the philosophers should be the most successful practitioners, as they have such abundance of words. If the causes of diseases were the same in all places, the same remedies ought to be used everywhere. Relief from sickness is to be sought from things certain and tried, that is from experience, which guides us in all other arts. Husbandmen and pilots do not reason about their business, but they practise it. Disquisitions can have no connection with medicine, because physicians whose opinions have been directly opposed to one another have equally restored their patients to health; they did not derive their methods of cure from studying the occult causes about which they disputed, but from the experience they had of the remedies which they employed upon their patients. Medicine was not first discovered in consequence of reasoning, but the theory was sought for after the discovery of medicine. Does reason, they ask, prescribe the same as experience, or something different? If the same, it must be needless; if different, it must be mischievous.

“But what remains is also cruel, to cut open the abdomen and prÆcordia of living men, and make that art, which presides over the health of mankind, the instrument, not only of inflicting death, but of doing it in the most horrid manner; especially if it be considered that some of those things which are sought after with so much barbarity cannot be known at all, and others may be known without any cruelty: for that the colour, smoothness, softness, hardness, and such like, are not the same in a wounded body as they were in a sound one; and further, because these qualities, even in bodies that have suffered no external violence, are often changed by fear, grief, hunger, indigestion, fatigue, and a thousand other inconsiderable disorders, which makes it much more probable that the internal parts, which are far more tender, and never exposed to the light itself, are changed by the severest wounds and mangling. And that nothing can be more ridiculous than to imagine anything to be the same in a dying man, nay, one already dead, as it is in a living person; for that the abdomen may indeed be opened while a man breathes, but as soon as the knife has reached the prÆcordia, and the transverse septum is cut, which by a kind of membrane divides the upper from the lower parts (and by the Greeks is called the diaphragm), the man immediately expires; and then the prÆcordia, and all the viscera, never come to the view of the butchering physician till the man is dead; and they must necessarily appear as such of a dead person, and not as they were while he lived; and thus the physician gains only the opportunity of murdering a man cruelly, and not of observing what are the appearances of the viscera in a living person. If, however, there can be anything which can be observed in a person which yet breathes, chance often throws it in the way of such as practise the healing art; for that sometimes a gladiator on the stage, a soldier in the field, or a traveller beset by robbers, is so wounded that some internal part, different in different people, may be exposed to view; and thus a prudent physician finds their situation, position, order, figure, and the other particulars he wants to know, not by perpetrating murder, but by attempting to give health; and learns by compassion that which others had discovered by horrid cruelty. That for these reasons it is not necessary to lacerate even dead bodies; which, though not cruel, yet may be shocking to the sight; since most things are different in dead bodies; and even the dressing of wounds shows all that can be discovered in the living” (Futvoye’s Translation).422

Philinus of Cos, the reputed founder of the school, was a pupil of Herophilus, and lived in the third century B.C. He declared that all the anatomy his vivisecting master had taught him had not helped him in the least in the cure of his patients. He has been compared with Hahnemann.

Serapion of Alexandria was also of the third century B.C. He must not be confounded with the Arabian physician of this name. He wrote against Hippocrates. He discarded all hypotheses. He was the first to prescribe sulphur in chronic skin diseases; and he used some singular and disgusting remedies in his treatment. One of these was crocodiles’ dung, which in consequence became scarce and costly. Glaucias, who invented the “Empiric Tripod,” Zeuxis and Heraclides of Tarentum, lived about this period. The latter wrote commentaries on Hippocrates, and used opium to procure sleep. He mentions strangulated hernia in one of his treatises.

Many commentaries were written about this time on Hippocrates; and the art of pharmacy, especially the preparation of poisons, was much studied in the second century B.C. Botanic gardens were established, and men began to experiment with antidotes for poisons. “Mithridaticum,” so called after Mithridates the Great of Pontus, was a famous antidote which was used even to recent times. Nicander of Colophon wrote poems on poisons, and antidotes, leeches, and emetics for the first time appeared in poetry, and the symptoms of opium and lead-poisoning were not beneath the attention of the muse. Attalus III., king of Pergamos, was in constant fear of being poisoned, says Plutarch,423 amused himself with planting poisonous herbs, not only henbane and hellebore, but hemlock, aconite, and dorycnium. He cultivated these in the royal gardens, gathered them at the proper seasons, and studied their properties and the qualities of their juices and fruits.

Cleopatra is said by Baas424 to have written a work on the diseases of parturient and lying-in women, etc. She paid special attention, it would seem, to maladies of a specific character.

Le Clerc gives a list of the women who have exercised the profession of medicine in ancient times.425

Cleopatra treated the diseases of women. Artemisia, Queen of Caria, Isis, Cybele, Latona, Diana, Pallas, Angita, Medea, Circe, Polydamna, Agameda, Helen, Œnone, Hippo, Ocryoe, Epione, Eriopis, Hygeia, Ægle, Panacea, Jaso, Rome, and Aceso are the ladies of classic story who had more or less acquaintance with medicine for good or evil purposes. That women, subject to many disorders for which in any state of society their natural modesty would make it difficult for them to consult men, should become proficient in the treatment of complaints which are peculiar to their sex, is the most natural thing in the world, and it is probable that very much of our knowledge of the treatment of these cases may be due to feminine wisdom. An ancient law of the Athenians forbade women and slaves to exercise the art of medicine, so that even midwifery, which they considered a branch of it, could only be practised by men. Some Athenian ladies preferred to die rather than be attended by men in their confinements. Women acted as accoucheuses in Egypt, Greece, and Rome, and some of them in classic times wrote books on medicine. Ætius gives some fragments in his works from a doctress named Aspasia.

Although the Greek physicians did not know anything of the circulation of the blood as we understand it, they were not wholly ignorant of the phenomena of the vascular system.

The arteries were so called by the ancients because they thought they contained air, as they were always found empty after death. Hippocrates and his contemporaries called the trachea an artery. Some of the ancient anatomists, however, knew that they contain blood, and they knew that when an artery is divided it is more dangerous and entails a longer recovery than the division of a vein. They knew also of the pulsation in the arteries which does not exist in the veins, and they were fully aware of the importance of this fact in its relation to diagnosis and treatment.

“The ancients chiefly regarded the odd days, and called them critical (???s???), as if on these a judgment was to be formed concerning the patient. These days were the third, fifth, seventh, ninth, eleventh, fourteenth, and twenty-first; so that the greatest influence was attributed to the seventh, next to the fourteenth, and then to the twenty-first. And therefore, with regard to the nourishment of the sick, they waited for the fits of the odd days; then afterwards they gave food, expecting the approaching fits to be easier; insomuch that Hippocrates, if the fever had ceased on any other day, used to be apprehensive of a relapse.”426

These critical days were believed by Hippocrates and most of the other ancient physicians to be influenced by the moon.

Greek medicine was divided into five parts, and to this day these divisions are still maintained. They were (1) Physiology and Anatomy considered together; (2) Ætiology, or the doctrine of the causes of disease; (3) Pathology; (4) Hygiene, or the art of preserving the health; (5) Semeiology, or the knowledge of the symptoms of disease and diagnosis, and Therapeutics, or the art of curing diseases.

As to the contending claims of the various Greek schools of medicine, Dr. Adams says,—

“There is no legitimate mode of cultivating medical knowledge which was not followed by some one or other of the three great sects into which the profession was divided in ancient times.”427

With respect to the professional income of Greek physicians, Herodotus states428 that the Æginetans, about 532 B.C., paid Democedes one talent a year from the public treasury for his services, i.e. about £344. From the Athenians he afterwards received a sum amounting to about £406 per annum. When he removed to Samos, Polycrates paid him a salary of two talents, or £487 10s. A difficulty arises, however, as to this statement of Herodotus, and there may have been an error in the sums mentioned.429

The procuring of abortion was not in ancient Greece always considered a very great crime, and amongst the Romans it seems to have been unnoticed originally. It is related by Cicero that he knew of a case in Asia where a woman was put to death for having procured the abortion of her own child. Under the emperors, the punishment was exile or condemnation to the mines.

The Scythians.

Of medicine as practised amongst the Scythians, little is known.

Herodotus says430 that when the king of the Scythians was sick he sent for three soothsayers, who proceeded to discover by divination the cause of his majesty’s malady. The prophets generally said that such or such a citizen had sworn falsely by the royal hearth, mentioning the name of the citizen against whom they brought the charge. The accused, having been arrested, was charged with causing the king’s illness. When he denied it, the king sent for twice as many more prophets; if these confirmed the charge, the offender was promptly executed; if they failed to do so, the first prophets were put to death. Abaris, the Hyperborean priest of Apollo, cured diseases by incantations, and delivered the world from a plague, according to Suidas. Anarcharsis, the Scythian philosopher, flourished 592 B.C.; if he knew anything of medicine, as has been said, he was probably acquainted with such knowledge of the art as was possessed by the Greeks.

The ancient physicians seemed to have had no idea of the necessity for observing any order in their interpretation of diseases; even in the middle ages, says Sprengel,431 they merely followed the position of the parts of the body, “passing from the head to the chest, from the thorax to the abdomen, and from the belly to the extremities.”

In that branch of modern medical science which treats of the classification of diseases, and which is termed Nosology, a systematic arrangement is followed, and the prominent symptoms are taken as the basis of that classification.

Greek Medical Literature.

The following is Dr. Greenhill’s probably complete list of the ancient treatises on Therapeutics now extant.432

Hippocrates: Seven Books (see p. 178 of this work). AretÆus, ?e?? Te?ape?a? ????? ?a? ??????? ?a???, De Curatione Acutorum et Diuturnorum Morborum, in four books. Galen, ????? ?at????, Ars Medica; Id. Te?ape?t??? ????d??, Methodus Medendi; Id. ?? p??? G?a????a Te?ape?t???, Ad Glauconem de Medendi Methodo; Id. ?e?? F?e?t??a? p??? ??as?st?at??, De VenÆsectione adversus Erasistratum; Id. ?e?? F?e?t??a? p??? ??as?st?ate???? t??? ?? ???, De VenÆsectione adversus Erasistrateos RomÆ Degentes; Id. ?e?? F?e?t??a? Te?ape?t???? ??????, De Curandi Ratione per VenÆsectionem; Id. ?e?? ?de????, ??t?spas???, S???a?, ?a? ???a???e??, ?a? ?ata?as??, De Hirudinibus, Revulsione, Cucurbitula, Incisione, et Scarificatione. Alexander Aphrodisiensis, ?e?? ???et??, De Febribus. Great part of the S??a???a? ?at???a?, Collecta Medicinalia, of Oribasius, and also of his S??????, Synopsis ad Eustathium, treat of this subject. Palladius, ?e?? ???et?? S??t??? S??????, De Febribus Concisa Synopsis. Ætius, ????a ?at???? ???a?de?a, Libri Medicinales Sedecim. Alexander Trallianus, ????a ?at???? ????a?de?a, Libri de Re Medica Duodecim. Paulus Ægineta, ?p?t??? ?at????? ????a ?pta, Compendii Medici Libri Septem, of which great part relates to this subject. Theophanes Nonnus, ?p?t?? t?? ?at????? ?p?s?? ??????, Compendium Totius Artis MediciÆ. Synesius, ?e?? ???et??, De Febribus. Joannes Actuarius, Methodus Medendi. Demetrius Pepagomenus, ?e?? ??d???a?, De Podagra. Celsus, De Medicina, in eight books. CÆlius Aurelianus, Celerum Passionum, Libri iii. Id. Tardarum Passionum, Libri v. Serenus Samonicus, De Medicina PrÆcepta Saluberrima, a poem on the art of Healing. Theodorus Priscianus, Rerum Medicarum, Libri iv.

EXAMPLES OF ANCIENT SURGERY.

Fig. 1.
Representation of the mode of reducing dislocation of the thigh outwards, as given by M. LittrÉ.

CHAPTER IV.
THE EARLIER ROMAN MEDICINE.

Disease-Goddesses.—School of the Methodists.—Rufus and Marinus.—Pliny.—Celsus.

How medical instruction was first given to the Romans cannot be ascertained with certainty; the want of it must have frequently been forced upon the attention of the authorities. It was the practice of the soldiers to dress each other’s wounds; they carried bandages with them for this purpose; but their surgery must have been very indifferent, for Livy tells us that, after the battle of Sutrium (B.C. 309), more soldiers were lost by dying of their wounds than were killed by the enemy.

As the Etruscans were famous for their knowledge of philosophy and medicine, the Romans probably acquired something of these sciences from this ancient people; but that they were more apt at learning their superstitions than their arts of healing, we have proof enough. Whether the Romans were more indebted to the Etruscans or to the Sabine people for their religion is a question which has been discussed. It would seem that Numa Pompilius, the legendary king of Rome, was of Sabine origin, and that he possessed some acquaintance with physical science and philosophy. He dissuaded the Romans from idolatry. Livy’s account of his experiments, in consequence of which he was struck by lightning, has been considered by some writers as evidence that he was acquainted with electricity.433

How intellectually inferior the ancient Romans were in comparison with the Greeks, may be learned from the fact that Pliny tells us that “The Roman people for more than 600 years were not, indeed, without medical art, but they were without physicians.” Such mental culture as the Romans possessed was imported from Greece, and until the Greeks instructed them in medicine they possessed nothing but a theurgic system of treating disease by prayers, charms, prescriptions from the Sibylline books, and the rude surgery and domestic medicine of the barbarians. Guilty of degrading superstitions unknown to the Greeks, the list of their gods and goddesses of disease reads like the accounts of the healing art from some savage nation. Fever and stench were worshipped as the goddesses Febris and Mephitis; Fessonia helped the weary, says St. Augustine,434 and “sweet Cloacina” was invoked when the drains were out of order.435

The itch patients invoked the goddess Scabies and the plague-stricken the goddess Angeronia; women sought the aid of Fluonia and Uterina, and Ossipaga was goddess of the navel and bones of children. There were many goddesses of midwifery; Carna presided over the abdominal viscera, and sacrifices of beans and bacon were offered to her. St. Augustine pours his satire and contempt on the women’s goddesses in the eleventh chapter of the book from which we have quoted. The Romans were cosmopolitan in the way of divinities; Isis and Serapis were imported from Egypt, the Cabiri from the Phoenicians, and the worship of Æsculapius was commenced by the Romans, B.C. 294.436

Certain facts in the history of the Romans prove that there was a profession of medicine in Rome even in very early times. Plutarch, in his Life of Cato the Censor, speaks of a Roman ambassador who was sent to the king of Bithynia, and who had his skull trepanned. By the Lex Aquilia a doctor who neglected a slave after an operation was responsible if he died in consequence, and in the Twelve Tables of Numa mention is made of dental operations.

A college of Æsculapius and of Health was established in Rome 154 B.C. An inscription has been discovered in the excavations of the Palatine which has preserved the memorial of its foundation.437 The medical profession of ancient Rome was quite free, and such instruction as its followers considered it necessary to acquire could be obtained how and where they chose. There was no uniform system of education; the training was private in early times, and was imparted by such physicians as cared to take pupils for a certain specified honorarium. It was not till later times that the Archiatri in their colleges, which were somewhat on the model of the mediÆval guilds, took pupils for instruction in medicine and surgery. Pure medical schools did not exist amongst the Romans.438 Pliny complained439 “that people believed in any one who gave himself out for a doctor, even if the falsehood directly entailed the greatest danger.” “Unfortunately there is no law which punishes doctors for ignorance, and no one takes revenge on a doctor if, through his fault, some one dies. It is permitted him by our danger to learn for the future, at our death to make experiments, and, without having to fear punishment, to set at naught the life of a human being.”

Cato hated physicians, partly because they were mostly Greeks, and, partly because he was himself an outrageous quack, who thought himself equal to a whole college of physicians. Plutarch tells us440 that he had heard of the answer which Hippocrates gave the king of Persia, when he sent for him and offered him a reward of many talents: “I will never make use of my art in favour of barbarians who are enemies of the Greeks.” He affected to believe that all Greek physicians took a similar oath, and therefore advised his son to have nothing to do with them. But there is no doubt his objection to the faculty arose from the fact that he had “himself written a little treatise in which he had set down his method of cure.” Cato’s guide to domestic medicine was good enough for the Roman people; what did they want with Greek physicians? His system of diet, according to Plutarch, was peculiar for sick persons; he did not approve of fasting, he permitted his patients to eat ducks, geese, pigeons, hares, etc., because they are a light diet suitable for sick people. Plutarch adds, that he was not in his own household a very successful practitioner, as he lost his wife and son. Pliny441 tells us all about Cato’s book of recipes, which the Roman father of a family consulted when any of his family or domestic animals were ill. The family doctor of those days was the father or the master of the household, and no doubt Cato was a very generous, if not a very skilful practitioner. Seneca sums up the healing art of the time thus: “Medicina quondam paucarum fuit scientia herbarum quibus sisteretur fluens sanguis, vulnera coirent.”442

Cato attempted to cure dislocations by magic songs (carmina): “Huat, hanat, ista, pista sista damniato damnaustra,” or nonsense simply. What his success in the treatment of luxations on this principle we are not informed. The practice of medicine and surgery before the time of CÆsar was not an honourable one in Rome. This may possibly have arisen from the fact that the only professors of the art were Greeks, who for the most part left their country for their country’s good and went to Rome merely to make money, honestly if possible—perhaps—but at all events to make it. Rome offered greater facilities for doing this than their native land, and the process was doubtless very similar to that with which our own colonies and the United States of America have in the past been only too familiar.443

During the severe epidemics which often raged in ancient Rome the oracles were consulted as to the means to be adopted to be rid of them; prayers were offered up to the Greek gods of healing as well as those of the state. But Greece had done more for the art of healing by her physicians than her gods could do, and in process of time the Romans found this out, and the native doctors were compelled to yield before the advance of Greek science. The works of the Greek physicians and surgeons, who had done so much for medical knowledge and advancement, gradually made their way amongst the Romans. These paved the way for Hellenic influence, in spite of the disreputable behaviour of some of the professors of the art of medicine, on whom the Romans with good excuse looked as quacks and foreigners whose only object was gain. We read of the erection at Rome of a temple in honour of Apollo the healer, 467 B.C., and of the building of a temple to Æsculapius of Epidaurus, 460 B.C. Ten years later the Romans built a temple to the goddess Salus when the pestilence raged in their city. Lucina was first worshipped there 400 B.C. In 399 B.C. the first lectisternium, a festival of Greek origin, was held in Rome by order of the Sybilline books; it was held on exceptional occasions, the present being a time of fresh public distress on account of a pestilence which was raging. The images of the gods were laid on a couch; a table spread with a meal was placed before them, and solemn prayers and sacrifices were offered. A third lectisternium was held at Rome 362 B.C. That he might obtain a cessation of the pestilence then raging in Rome, L. Manlius Imperiorus fixed a nail in the temple of Jupiter, B.C. 360. This holding of lectisternes and driving nails in the temple walls became the recognised method of dealing with such scourges, and painfully exhibits the powerlessness of mankind to deal with disease by theurgic means. Science alone can combat disease, the bed and board offered to the gods who cannot use them are now bestowed on health officers who can; we no longer drive nails in temple walls to remind deities that we are in trouble, but we send memorials to our colleges of physicians demanding suggestions for escaping a visitation of cholera; it is not sufficient to fix “a nail in a sure place,” it must be fixed in the right one. In the year 291 B.C., on the occasion of a pestilence in Rome, ten ambassadors were sent to Epidaurus to seek aid from the temple of Æsculapius. The god was sent to the afflicted city under the figure of a serpent. He comes to our towns now under the figure of a cask of carbolic acid.

Archagathus was the first person who regularly practised medicine in Rome. He was a Peloponnesian who settled in the city B.C. 219, and was welcomed with great respect by the authorities, who purchased a surgery or shop for him at the public expense, and gave him the “Jus Quiritium.”

As he treated his patients chiefly with the knife and powerful caustics, his severe remedies gave great offence to the people and brought the profession of surgery into contempt. He was called a “butcher,” and had to leave the city.444

Alexander Severus (225-235 A.D.) was the first who established public lecture rooms for teachers of medicine and granted stipends to them. In return they were compelled to teach poor state-supported students gratuitously. Constantine demanded like services from the doctors in return for certain immunities.445

There was no regular curriculum, nor period of studentship; everything depended upon the ability and industry of the individual pupil. Clinical instruction was given by the teachers, as Martial tells in a satirical verse:—

(Dr. Handerson’s Trans.)

Anatomy had been pretty thoroughly taught in the Roman Empire. Rufus of Ephesus, who lived probably in the reign of Trajan, A.D. 98-117, was a very famous anatomist. He considered the spleen to be absolutely useless: a belief which lasted to quite modern times. The nerves we call recurrent were probably then only recently discovered. He proved that the nerves proceed from the brain, and divided them into those of sensation and those of motion. He considered the heart to be the seat of life, and remarked that the left ventricle is smaller and thicker than the right. He discovered the crossing (decussation) of the optic nerves, and made several important researches in the anatomy of the eye. He wrote on diseases of the mind, and discussed medicines in poetry.

Marinus, a celebrated physician and anatomist, lived in the first or second century of our era. He wrote many anatomical treatises, which Galen greatly praised, and he commented upon Hippocrates. He knew the seven cranial nerves, and discovered the inferior laryngeal nerve and the glands of the intestines.

Quintus, Galen’s tutor, was one of his pupils. Lycus was a pupil of Quintus, who wrote anatomical books of some reputation. Pelops was also one of Galen’s earliest tutors, and was a famous anatomist and physician at Smyrna. Æschryon, a native of Pergamos was another of Galen’s tutors, and had a great knowledge of pharmacy and materia medica. He was the father of all those who invent superstitious remedies for the bite of a mad dog by means of cruelty. For this he directs crawfish to be caught at a time when the sun and moon were in a particular position, and to be baked alive. A worthy combination, it will be perceived, of superstition, astrology, and purposeless cruelty.

Although anybody might practise medicine in Rome without let or hindrance, the Lex Cornelia ordered the arrest of the doctor if the patient died through his negligence (88 B.C.).

There was a public sanitary service and other Government employments which demanded properly instructed doctors in ancient Rome, and the practice of specialism in the treatment of disease was carried to even greater lengths than at present. Martial satirises this.446

In the time of Strabo and in that of Trajan there were public medical officers in Gaul, Asia Minor, and in Latium. In Rome there were district medical officers for every part of the city. They were permitted to engage in private practice, but were compelled to attend the poor gratuitously. Their salary, according to Puschmann,447 was paid chiefly in articles of natural produce.

The archiatri populares were the district physicians. The court physicians were called archiatri palatini. The archiatri municipales were municipal physicians. Their guild was the Collegium Archiatrorum, which in constitution was not unlike our Royal College of Physicians.

Different societies employed doctors; the theatres, gladiators, and the circus retained surgeons.

The art of ophthalmic surgery first became a separate branch of the medical profession in the city of Alexandria. Celsus states that Philoxenus, who lived two hundred and seventy years before Christ, was the most celebrated of the Alexandrian oculists.448

Oculists were a numerous but ignorant class of practitioners in ancient Rome; their treatment was almost always by salves, each eye-doctor having his own specialty. Nearly two hundred seals with the proprietors’ names have been discovered which have been attached to the pots containing the ointments. Galen speaks contemptuously of the science of the eye-doctors of his time. Martial satirises them. “Now you are a gladiator who once were an ophthalmist; you did as a doctor what you do as a gladiator.” In another epigram he says, “The blear-eyed Hylas would have paid you sixpence, O Quintus; one eye is gone, he will still pay threepence; make haste and take it, brief is your chance, when he is blind he will pay you nothing.” Under Nero, Demosthenes Philalethes, the famous doctor of Marseilles, was a celebrated oculist, whose work on eye diseases was the chief authority on the subject until about A.D. 1000. Paulus Ægineta, in his treatise on Ophthalmology, recommends crocodile’s dung in opacity of the cornea, and bed-bugs’ and frogs’ blood in trichiasis; yet with all this absurdity he distinguished between cataract and amaurosis.

The ophthalmological literature of the Greeks and Romans has for the most part perished. Puschmann says that this branch of surgery must have been able to show remarkable results. “Not only trichiasis, hypopyon, leucoma, lachrymal fistula, and other affections of the external parts of the eye were subjected to operative treatment, but even cataract itself.”449

Although the surgeons of the time were ignorant of the true nature of some of the diseases which they treated, they could cure them. Cataract was treated by “couching,” or depressing the diseased lens by means of a needle, in order to extract it.450

A patient would sometimes require a consultation, when several doctors would meet and discuss his case, with much difference of opinion more or less violently expressed. Regardless of the sufferings of the patient, they wrangled over his symptoms, and behaved as if they were engaged in a pugilistic encounter, each man far more anxious to exhibit his parts and display his dialectical skill than to alleviate the sufferings of the unfortunate client. Pliny, Galen, and Theodorus Priscianus have left realistic descriptions of these medical encounters.

With respect to the professional income of the early Roman physicians, Pliny says451 that Albutius, Arruntius, Calpetanus, Cassius, and Rubrius gained 250,000 sesterces per annum, equal to £1,953 2s. 6d.; that Quintus Stertinius made it a favour that he was content to receive from the emperor 500,000 sesterces per annum, or £3,906 5s., as he might have made 600,000 sesterces, or £4,687 10s., by his private practice. He and his brother, also an Imperial physician, left between them at their death the sum of thirty millions of sesterces, or £234,375, notwithstanding the large sums they had spent on beautifying Naples.452 Galen’s fee for curing the wife of the consul Boethus, after a long illness, was about equal to £400 of our money.

Manlius Cornutus, according to Pliny, paid his doctor a sum amounting to £2,000 for curing him of a skin disease; and the doctors Crinas and Alcon, according to the same authority, were immensely rich men. But these were all exceptional cases, and there is no reason to suppose that Roman doctors made on the average more than sufficient to keep them decently.453

School of the Methodists.

Asclepiades, of Prusa, in Bithynia, was a physician of great celebrity and influence, who flourished at Rome in the beginning of the first century B.C. He passed his earlier years at Alexandria, then went to Athens, where he studied rhetoric and medicine. He is said to have travelled much. He ultimately settled at Rome as a rhetorician. He was the friend of Cicero. Being unsuccessful as a teacher of rhetoric, he devoted himself to medicine. He was a man of great natural ability, but he was quite ignorant of anatomy and physiology; so he decried the labours of those who studied these sciences, and violently attacked Hippocrates. His conduct was that of an early Paracelsus. He had many pupils, and the school they founded was afterwards called that of the Methodists. His system was original, though it owed somewhat to the Epicurean philosophy. He conceived the idea that disease arose in the atoms and corpuscles composing the body, by a want of harmony in their motion. Harmony was health; discord, disease. Naturally his treatment was as pleasant as that of the most fashionable modern physician. He paid great attention to diet, passive motions, frictions after the method now called massage, and the use of cold sponging. He entirely rejected the humoral pathology of Hippocrates, and totally denied his doctrine of crises, declared that the physician alone cures, nature merely supplying the opportunities. His famous motto was that the physician should cure “tuto, celeriter, ac jucunde.” In the beginning of fevers he refused his patients permission even to rinse the mouth. He originated the method of cyclical cures by adopting certain methods of treatment at definite periods. He first applied the term “phrenitis” in the sense of mental disturbance. In drugs he was a sceptic, but he allowed a liberal use of wine. He was said to have experimented in physiology, though he knew nothing of it. Tertullian ridicules him thus: “Asclepiades may investigate goats, which bleat without a heart, and drive away flies, which fly without a head.”

Asclepiades must have been a great deal more than a charlatan, for many of his fundamental ideas have persisted even to the present time. He was the first to distinguish diseases into acute and chronic.454 Acute diseases he supposed to depend “upon a constriction of the pores, or an obstruction of them by a superfluity of atoms; the chronic upon a relaxation of the pores, or a deficiency of the atoms.” Asclepiades was the inventor of many new methods in surgery and medicine. Amongst these was bronchotomy for the relief of suffocation.455 He practised tracheotomy in angina, and scarification of the ankles in dropsy, and recommended tapping with the smallest possible wound. He also observed spontaneous dislocation of the hip joint.456 Such things do not emanate from mere quacks.

It may be remarked that there were many physicians of the name of Asclepiades. It was a way they had of assuming a connection with the famous medical family of that name.

The disciples of Asclepiades were called Asclepiadists. A few of them became celebrities in their day.

Philonides of Dyrrachium lived in the first century, and wrote some forty-five works on medicine.

Antonius Musa lived at the beginning of the Christian era, and was a freedman and physician to the Emperor Augustus. When his Imperial patient was seriously ill and had been made worse by a hot regimen and treatment, Antonius cured him with cold bathing and cooling drinks. Augustus rewarded him with a royal fee and permission to wear a gold ring, and a statue was erected to him near that of Æsculapius by public subscription. He wrote several works on pharmacy. He was also physician to Horace.

Musa introduced into medicine the use of adder’s flesh in the treatment of malignant ulcers; he discovered some of the properties of lettuce, chicory, and endive. Many of his medicines continued in use for ages. For colds he used the over-potent remedies henbane, hemlock, and opium. He was also celebrated for various antidotes which he discovered.457

His brother, named Euphorbius, was a physician also, and gave his name to a genus of plants, the EuphorbiaceÆ (Plin., lib. xxv., c. 7).

Themison of Laodicea (B.C. 50) was the founder of the school known as the Methodical. This was a rival to that of the Hippocratic system, which had hitherto been the dominant one. Themison was the most important pupil of Asclepiades. He wrote on chronic diseases, and was the first to describe elephantiasis in a treatise. He would have written upon hydrophobia, but having in his youth once seen a case, it so frightened him that he was attacked with some of the symptoms, and dreaded a relapse if he set himself to write about it.458 He invented several famous remedies, such as diacodium, a preparation of poppies, and diagrydium, a purgative of scammony. Asclepiades had his “atoms,” Themison had his “pores.” You cannot found a medical system without flying a particular flag. Themison’s “flag” was the “status strictus,” or “laxus” of the pores; that is to say, disease is either a condition of increased or diminished tension. He was the first who described rheumatism, and probably the first European physician who used leeches.459

He is said to have been attacked with hydrophobia, and to have recovered. Juvenal satirised him (probably) in the lines—

Themison’s principles differed from those of his master in many respects, and besides rectifying his errors he introduced a greater precision into his system.461

He chose a middle way between the doctrines of the Dogmatists and Empirics. Writing of the Methodists, Celsus says: “They assert that the knowledge of no cause whatever bears the least relation to the method of cure; and that it is sufficient to observe some general symptoms of distempers; and that there are three kinds of diseases, one bound, another loose, and the third a mixture of these.”462 Sometimes the excretions of the sick are too small, sometimes too large; one particular excretion may be in excess, another deficient; the observation of these things constitutes the art of medicine, which they defined as a certain way of proceeding, which the Greeks called Method. They deduced indications of treatment from analogies in symptoms, and made a bold classification of diseases; accurate as a rule in their diagnosis, they were usually successful and rational in their therapeutics. They entirely ignored any consideration of the remote causes of diseases; their only object was to cure their patients without speculating as to the reasons why they had become sick. They repudiated the Vis medicatrix theory.

Eudemus (B.C. 15) was a disciple of Themison. CÆlius Aurelianus says of him that in his practice he used to order clysters of cold water for patients suffering from the iliac passion. It is probable that he was the friend and physician of Livilla, and the man who poisoned her husband Drusus. Tacitus speaks of him, saying that he made a great parade of many secret remedies, with a view to extol his own abilities as a doctor. It is possible, however, that this may not have been the same Eudemus as the disciple of Themison the Methodist, as there were several other physicians of that name. Our Eudemus made many observations on hydrophobia, and remarked how rarely any sufferer recovered who was attacked by it. He was put to death by order of Tiberius.

Meges, of Sidon (B.C. 20), was a famous surgeon, and a follower of Themison. He invented instruments used in cutting for the stone. He made observations on tumours of the breast and forward dislocations of the knee. He was regarded by Celsus as the most skilful of those who exercised the art of surgery.

Vectius Vallens (circ. A.D. 37) was a pupil of Apuleius Celsus, and was well known for his connection with Messalina, the wife of Claudius. He belonged to Themison’s sect, and is introduced by Pliny in fact as the author of an improvement upon it. It was the practice of all the adherents of the Methodist school of medicine to pretend that by the changes they had introduced into the system they had originated a new one.463

Scribonius Largus (A.D. 45) is said to have been physician to Claudius, and to have accompanied him to Britain. He wrote several medical works in Latin. He was the first to prescribe the electricity of the electric ray in cases of headache.464

A. Cornelius Celsus, who flourished between B.C. 50 and A.D. 7, was a celebrated patrician Roman writer on medicine, and an encyclopÆdic compiler of a very high order. It is disputed whether he was or was not a physician in actual practice; probably he was not. He practised certainly, but on his friends and servants, and not professionally. The medical practice of the period was for the most part in the hands of the Greeks. We owe little to the Romans that was original or important in connection with the healing art, yet in Celsus we have an elegant and accomplished historian of the medical art as it was practised in ancient Rome; he wrote not so much for doctors as for the instruction of the world at large. His works were not studied by medical men, at any rate, as anything more than mere literature. No medical writer of the old world quotes Celsus. Pliny merely refers to him as an author. Very probably he merely compiled his treatises, of which the most celebrated is his De Medicina, in the introductions to the 4th and 8th books of which there is evidence of his considerable knowledge of anatomy. He seems to have understood the anatomy of the chest and the situation of the greater viscera especially well, though of course in this respect falling far short of our present knowledge of the science, and not in every case fully up to that of the Greeks. His knowledge of surgery was considerable, especially that of the pelvic organs of the female. In osteology, or the science of the bones, he excelled. He accurately describes the bones of the skull, their sutures, and the teeth. His descriptions of the vertebrÆ and ribs, the bones of the pelvis and the upper and lower extremities, are accurate and careful. He understood the articulations, and is careful to emphasize the fact that cartilage is always found in their formation. He must have been acquainted with the perforated plate of the ethmoid bone, as he speaks of the many minute holes in the recess of the nasal cavities, and it is even inferred by Portal that he knew the semicircular canals.465

The 7th and 8th books of the De re Medicina relate entirely to surgery; this is of course Greek, which in its turn was probably of Egyptian and Indian origin. He describes operations such as we now call “plastic,” for restoring lost or defective portions of the nose, lips, and ears. These are constantly claimed as triumphs of modern surgery, and have been asserted to have been successful as the result of information derived from experiments on living animals. His description of lithotomy is that which was anciently practised in Alexandria, and was doubtless derived from India. Trephining the skull is described, and this again is proved not to have been invented in modern times, as some have thought. Even subcutaneous urethrotomy was a practice followed in the time of Celsus. We have also the first detailed description of the amputation of an extremity. Many ophthalmic operations are described according to the methods followed by the eye specialists of Alexandria.466

In his eight books on medicine the first four deal with internal complaints, such as usually yield to careful dieting. The fifth and sixth are concerned with external disorders, and contain many prescriptions for their treatment. The seventh and eighth, as we have seen, are exclusively surgical. Celsus followed principally Hippocrates and Asclepiades as his authorities. He transfers many passages from the Father of Medicine word for word. His favourite author was Asclepiades, and it is for that reason that he is held to be of the Methodical school of medicine. He was no believer in the mysterious numbers of the Pythagorean, and was evidently quite free from slavish devotion, even to his great authorities in medicine.

He recommends that dislocations should be reduced before inflammation sets in. When fractures fail to unite, he recommends extension and rubbing together of the ends of the bone. He goes so far as to advise cutting down to the bone, and letting the fracture and wound heal together. He cautions against the use of purgatives in strangulated hernia, and gives directions for extracting foreign bodies from the ears.

Had it not been for the works of Celsus, many operations of ancient surgery would have remained to us undescribed. He writes at length on bleeding, and describes the double ligation (or tying) of bleeding vessels, and the division of the vessels between the ligatures: an operation which the defenders of experiments on animals claim to have been discovered by vivisection. His method of amputation in gangrene by a single circular cut was followed down to the seventeenth century. He describes the process of catheterization, operations for goitre (or Derbyshire neck), the resection of the ribs, the use of enemas, and artificial feeding by them, an operation for cataract, ear diseases which are curable by the use of the ear syringe, extraction of teeth by forceps, fastening loose teeth by means of gold wire, and bursting hollow teeth by peppercorns pressed into them. He describes many of the most difficult subjects of operative midwifery, and discriminates in various mental diseases. Sleep must be induced, he says, in cases of insanity, by narcotics, if it is absent. He treats eye diseases with mild lotions and salves, and is the first writer to distinguish hallucinations of vision. He copies from Asclepiades his valuable rules of diet and simple methods of treatment, and from Hippocrates his methods of recognising the signs of diseases and their prognosis.

(I am indebted to the great work of Dr. Hermann Baas467 for much of the above digest of the writings of Celsus.)

At the time when Celsus described the practice of medicine in Europe, bleeding was practised more freely than was the custom in the days of the great Greek physicians. The Romans went far beyond these. “It is not,” said Celsus, “a new thing to let blood from the veins, but it is new that there is scarcely any malady in which blood is not drawn. Formerly they bled young men, and women who were not pregnant, but it had not been seen till our days that children, pregnant women, and old men were bled.” And it would seem that already doctors had begun to bleed in almost every case, in every time of life, with or without reason, the unfortunate people who were under their care. They bled for high fever, when the body was flushed and the veins too full of blood; and they bled in cachexia and anÆmia, when they had not enough blood, but were full of “ill humours.” They bled in pleurisy and pneumonia, and they bled in paralysis, and cases where there was severe pain.

Celsus has given us a good description of the qualities which a surgeon ought to possess: he should be young, or at any rate not very old; his hand should be firm and steady, and never shake; he should be able to use his left hand with as much dexterity as his right; his sight should be acute and clear; his mind intrepid and pitiless, so that when he is engaged in doing anything to a patient, he may not hurry, nor cut less than he ought, but finish the operation just as if the cries of the patient made no impression upon him.468

Celsus said,469 “It is both cruel and superfluous to dissect the bodies of the living, but to dissect those of the dead is necessary for learners, for they ought to know the position and order, which dead bodies show better than a living and wounded man. But even the other things, which can only be observed in the living, practice itself will show in the cures of the wounded, a little more slowly, but somewhat more tenderly.”

He wrote on history, philosophy, oratory, and jurisprudence, and this in the most admirable style.

Thessalus of Tralles (A.D. 60) was the talented son of a weaver, who became a “natural” doctor. He was an utterly ignorant, bragging charlatan, with great natural ability. Had Paracelsus received no education, he might have practised medicine as a second Thessalus of Tralles. He scorned science as much as Paracelsus loved it, but like him he abused in the most violent manner all the physicians of antiquity. He called them all bunglers, and himself the “Conqueror of Physicians” (?at??????). He declared to Nero that his predecessors had contributed nothing to the progress of the science. He flattered the great and wealthy, and vaunted his ability to teach anybody the healing art in six months. He surrounded himself with a great crowd of disciples—rope-makers, cooks, butchers, weavers, tanners, artisans of all sorts. All these he permitted to practise on his patients, and to kill them with impunity. Since his time, says Sprengel, the Roman physicians gave up the custom of visiting their patients when accompanied by their pupils.470 He used colchicum in the treatment of gout.

Philumenus (about A.D. 80) was a famous writer on obstetrics, and described the appropriate treatment for the various kinds of diarrhoea.

Andromachus the Elder (A.D. 60) of Crete was the inventor of a famous cure-all called Theriaca. It was compounded of some sixty drugs. He was physician to Nero, and his two works pe?? s???es??? fa????? were greatly praised by Galen.

Soranus of Ephesus, the son of Menandrus, was educated at Alexandria. He practised at Rome in the reigns of Trajan and Hadrian. He was one of the most eminent physicians of the Methodical school, and was mentioned with praise by Tertullian and St. Augustine. He wrote the only complete treatise on the diseases of women which antiquity has given to us. We find from this work that a valuable instrument used in gynÆcology, and thought by many to be of modern invention—the speculum—was mentioned by Soranus as used by him. Amongst the articles used by surgeons which have been recovered from the ruins of Pompeii, these instruments have been discovered, showing that they were in regular use in ancient times. He seems to have had a complete knowledge of human anatomy, for he describes the uterus in such a manner as to show that his knowledge was acquired by dissecting the human body, and not merely from that of animals. He explained the changes induced by pregnancy, and spoke of the sympathy existing between the uterus and the breasts, which is so important for the physician to know. He must have had a greater knowledge of the scourge of leprosy than his contemporaries.

Soranus, in his work on gynÆcology, advises that midwives should be temperate, trustworthy, not avaricious, superstitious, or liable to be induced to procure abortion for the sake of gain. They were to be instructed in dietetics, materia medica, and minor surgical manipulations. Soranus did not think it was requisite for them to know much about the anatomy of the pelvic organs, but they were to be able to undertake the operation of turning in faulty presentations. Only when all attempts to deliver a living child had failed was embryotomy to be performed. Juvenal and other writers intimate that these accomplished accoucheuses often developed into regular doctresses. In difficult cases they called in the assistance of physicians or surgeons.

Julian (A.D. 140) was the pupil of Apollinides of Cyprus. He was at Alexandria when Galen studied there. He wrote an introduction to the study of medicine, and opposed the principles of Hippocrates. Like the greater number of the Methodists he was ill-read, and Galen blamed him for having neglected the humoral pathology.471

CÆlius Aurelianus was a celebrated Latin physician, who is supposed to have lived in Rome about the first or second century. Very little is known about him, but the fact that he belonged to the Methodical school, and showed great skill in the art of diagnosis.

He wrote treatises on acute and chronic diseases, and a dialogue on the science of medicine. Next to Celsus, he is considered the greatest writer of his school. His works are based entirely on the Greek of Soranus.

He was a popular writer, as is proved by the fact that in the sixth century his works were text-books on medicine in the Benedictine monasteries. He has well described gout and hydrophobia, and, according to Baas, was the inventor of condensed milk (!). Even auscultation is hinted at in his works, and he recommends the air of pine forests in chest diseases. His suggestions for the treatment of nervous and insane patients were far in advance of his age, as he disapproves of restraint.472

Greek and Roman Pharmacy.

It is very difficult to decide with certainty what the ancients actually intended by the names they gave their medicines. Exact as Hippocrates and Galen usually are in their terminology, we are often at a loss to know precisely what was the nature of the remedies they employed. Alum, for example, as we understand it, is a very different thing from the alum of the ancients. What the Greeks and Romans called alumen and st?pt???a, says Beckmann, was vitriol, or rather a kind of vitriolic earth. They were very deficient in the knowledge of saline substances. Hemlock, which is called also Conium, ???e???, or Cicuta, was probably not the poison employed at Athenian executions. Pliny says that the word Cicuta did not indicate any particular species of plant, but was used for vegetable poisons in general. Dr. Mead473 considers that the Athenian poison was a combination of deadly drugs; it killed without pain, and probably opium was combined with the hemlock.474 Hellebore was of two kinds, white and black, or Veratrum album and Helleborus niger respectively. Galen says we are always to understand veratrum when the word ???????? is used alone. White hellebore was used by the Greeks, says StillÉ,475 in the treatment of chronic diseases, especially melancholy, insanity, dropsy, skin diseases, gout, tetanus, hydrophobia, tic doloureux, etc. It was mixed with other drugs to moderate the violence of its action. It fell into disuse, and is now hardly ever employed internally. It is an exceedingly dangerous drug, and was doubtless used on the “kill or cure” principle. Black hellebore was given as a purgative. Healthy people took the white variety to clear and sharpen their faculties. It fell into disuse about the fifth century after Christ. A very celebrated medicine in popular use even in modern times was Theriaca. Galen says that the term was properly applied to such medicines as would cure the bite of wild beasts (??????), as those which were antidotes to other poisons (t??? d???t??????) were properly called ??e??f??a?a.476

Andromachus, physician to the emperor Nero, invented the most celebrated of these preparations; it was known as the Theriaca Andromachi, and was very similar to that of Mithridates, king of Pontus, the recipe for which was said to have been found amongst his papers after his death by Pompey. This was known to the Roman physicians under the name of Antidotum Mithridatium. The composition of this medicine was varied greatly in the hands of its different preparers, and it underwent considerable alterations from age to age. Celsus first described it, with its thirty-six ingredients; then Andromachus added to it the flesh of vipers, and increased the number of ingredients to seventy-five. He described the whole process of manufacture in a Greek poem, which has been handed down to us by Galen. Damocrates varied some of the proportions of the compound, and wrote another poem upon it, also preserved by Galen.

The medicines prescribed by the Greek and Roman physicians were all prepared by themselves. At that time materia medica consisted chiefly of herbs; some of these plants were used not only for medicinal, but also for culinary purposes, and were collected by other than practitioners of medicine. Many plants were used also for cosmetic purposes and in the baths, so that there must have been numerous collectors and dealers in herbs. Just as in our time dispensing chemists and others have acquired a certain knowledge of the medicinal virtues of the things they sell, so the pigmentarii, seplasiarii, pharmacopolÆ, and medicamentarii possessed themselves of medical secrets, and thus invaded the territory of the doctors.

Beckmann says477 that the pigmentarii dealt in medicines, and sometimes sold poison by mistake.

The seplasiarii sold veterinary medicines and compounded drugs for physicians.478

The pharmacopolÆ, according to Beckmann, were an ignorant and boasting class of drug-sellers. The medicamentarii seem to have been a still more worthless class, for in the Theodosian code poisoners are called medicamentarii.

A great number of the medical plants mentioned by Pliny, Dioscorides, and other writers on materia medica were used for quite other purposes than those for which we employ them now. Some drugs, however, were apparently given on what we must admit to be correct scientific principles. Thus Melampus of Argos, one of the oldest Greek physicians of whom we have any knowledge, is said to have cured Iphiclus of sterility by administering rust of iron in wine for ten days.

He gave black hellebore as a purgative to the daughters of Proetus when they were afflicted with melancholy. Preparations of the poppy were known to have a narcotic influence, and the uses of prussic acid—in the form of cherry laurel water—stramonium, and lettuce-opium were well understood. Squill was employed as a diuretic in dropsy by the Egyptians.

The following list from the article on “Pharmaceutica” in Smith’s Dictionary of Greek and Roman Antiquities contains probably the titles of all the ancient treatises on drugs that are extant: “1. ?e?? Fa?????, De Remediis Purgantibus; 2. ?e?? ???e???s??, De Veratri Usu (these two works are found among the collection that goes under the name of Hippocrates, but are both spurious); 3. Dioscorides, ?e?? ???? ?at?????, De Materia Medica, in five books (one of the most valuable and celebrated medical treatises of antiquity); 4. id. ?e?? ??p???st??, ?p??? te ?a? S????t??, Fa?????, De Facile Parabilibus, tam Simplicibus quam Compositis, Medicamentis, in two books (perhaps spurious); 5. Marcellus Sideta, ?at???? pe?? ??????, De Remediis ex Piscibus; 6. Galen, ?e?? ???se?? ?a? ????e?? t?? ?p??? Fa?????, De Simplicium Medicamentorum Temperamentis et Facultatibus, in eleven books; 7. id. ?e?? S????se?? Fa????? t?? ?at? ??p???, De Compositione Medicamentorum secundum Locos, in ten books; 8. id. ?e?? S????se?? Fa????? t?? ?at? G???, De Compositione Medicamentorum secundum Genera, in seven books; 9. id. ?e?? t?? t?? ?a?a????t?? Fa????? ????e??, De Purgantium Medicamentorum Facultate (perhaps spurious); 10. Oribasius, S??a???a? ?at???a?, Collecta Medicinalia, consisting originally of seventy books, of which we possess now only about one third; 11. id. ??p???sta, Euporista ad Eunapium, or De facile Parabilibus, in four books, of which the second contains an alphabetical list of drugs; 12. id. S??????, Synopsis ad Eustathium, an abridgment of his larger work in nine books, of which the second, third, and fourth are upon the subject of external and internal remedies; 13. Paulus Ægineta, ?p?t??? ?at????? ????a ?pta, Compendii Medici Libri Septem, of which the last treats of medicines; 14. Joannes Actuarius, De Medicamentorum Compositione; 15. Nicolaus Myrepsus, Antidotarium; 16. Cato, De Re Rustica; 17. Celsus, De Medicina Libri Octo, of which the fifth treats of different sorts of medicines; 18. Twelve books of Pliny’s, Historia Naturalis (from the twentieth to the thirty-second), are devoted to Materia Medica; 19. Scribonius Largus, Compositiones Medicamentorum; 20. Apuleius Barbarus, Herbarium, seu de Medicaminibus Herbarum; 21. Sextus Placitus Papyriensis, De Medicamentis ex Animalibus; 22. Marcellus Empiricus, De Medicamentis Empiricis, Physicis, ac Rationalibus.”

Although the Greeks and Romans knew little of chemistry as we understand the term, they must have possessed considerable skill in the art of secret poisoning, either with intent to kill or to obtain undue influence over certain persons.

Poisonous drugs were used as philtres or love-potions, and we know from Demosthenes479 that drugs were administered in Athens to influence men to make wills in a desired manner. Women were most addicted to the crime of poisoning amongst the Greeks. They were called fa?a??de? and fa?a?e?t??a?. By the Romans the crime of poisoning was called Veneficium; and here again, as in other times and places, it was most usually practised by women. It lent itself to the weakness of the gentler sex, who could not avenge their injuries by arms, and there is little doubt that many women were as unjustly suspected of poisoning as we know they were of witchcraft in an ignorant age when pestilence and obscure diseases filled the minds of the people with fear and suspicion. Thucydides tells us480 the Athenians in the time of the great pestilence believed that their wells had been poisoned by their enemies. When the city of Rome was visited by a pestilence in the year 331 B.C., a slave girl informed the curule aediles that the Roman matrons had caused the deaths of many of the leading men of the State by poisoning them. On this information about twenty matrons, some of whom, as Cornelia and Sergia, belonged to patrician families, were detected in the act of preparing poisonous compounds over a fire. They protested that they were innocent concoctions; the magistrates compelling them to drink these in the Forum, they suffered the death they had prepared for others. Locusta was a celebrated female poisoner under the Roman emperors. She poisoned Claudius at the command of Agrippina, and Britannicus at that of Nero, who even provided her with pupils to be instructed in her deadly art. Tacitus tells the story,481 Suetonius says,482 that the poison she administered to Britannicus being too slow in its action, Nero forced her by blows and threats to make a stronger draught in his presence, which killed the victim immediately. She was executed under the emperor Galba.

Clement of Alexandria refers to the Susinian ointment in use in his time, which was made from lilies, and was “warming, aperient, drawing, moistening, abstergent, antibilious, and emollient,” a truly marvellous unguent indeed if it possessed only half of these virtues. He tells of another ointment called the Myrsinian, which was made from myrtle berries, and was “a styptic, stopping effusions from the body; and that from roses is refrigerating.”483

Rufus of Ephesus, the anatomist, has left us in his works interesting details concerning the state of anatomical science at Alexandria before the time of Galen. In one of his works he says, “The ancients called the arteries of the neck carotids, because they believed that, when pressed hard, the animal became sleepy and lost its voice; but in our age it has been discovered that this accident does not proceed from pressing upon these arteries, but upon the nerves contiguous to them.” He is said to have practised the twisting of arteries for arresting hÆmorrhage, a method universally followed at the present day. It is curious that though the ligature and this valuable method of torsion were both known to the ancients, they fell into abeyance in favour of the actual cautery.

Seneca, the philosopher (A.D. 3-65), had a very high opinion of the healing art. Perhaps no one has said truer and kinder things of doctors than this philosopher. “People pay the doctor for his trouble; for his kindness they still remain in his debt.” “Thinkest thou that thou owest the doctor and the teacher nothing more than his fee? We think that great reverence and love are due to both. We have received from them priceless benefits: from the doctor, health and life; from the teacher, the noble culture of the soul. Both are our friends, and deserve our most sincere thanks, not so much by their merchantable art, as by their frank good will.”484

Apollonius of Tyana, the Pythagorean philosopher, was born four years before Christ. His reputation as a miracle-worker and healer was used by the enemies of the Christian faith in ancient times to bring him forward as a rival to the Author of our Religion.485 The attempt to make him appear a pagan Christ has since been revived.486 He adopted the Pythagorean philosophy at the age of sixteen. He renounced animal food and wine, used only linen garments and sandals made of bark, suffered his hair to grow, and betook himself to the temple of Æsculapius, who appears to have regarded him with peculiar favour. He observed the silence of five years, which was one of the methods of initiation into the esoteric doctrines of the Pythagoreans. He travelled in India, and learned the valuable theurgic secrets of the Brahmans; in the cities of Asia Minor he had some interviews with the Magi; visited the temples and oracles of Greece, where he sometimes exercised his skill in healing; then he went to Rome, where he was brought before Nero on the charge of magical practices, which was not sustained. In his seventy-third year he attracted the notice of Vespasian. Afterwards he travelled in Ethiopia. Returning to Rome, he was imprisoned by Domitian, and had his hair cut short, because he had foretold the pestilence at Ephesus. He died at the age of an hundred years. It is to be remarked that he never put forward any miraculous pretensions himself; he seems merely to have been a learned philosopher who had travelled widely and acquired vast information from distant sources. The history manufactured for him is plainly an imitation from that of our Lord, concocted by persons interested in degrading the character of Christ.487

Pliny the Elder (23-79 A.D.), the author of the immense encyclopÆdic work, his famous Natural History, was not a man of genius, nor even an original observer, his work is but a compilation, and contains more falsehood than fact, and more absurdities than either. He cannot be called a naturalist, though he wrote on natural history; nor a physician, though he wrote of diseases and their remedies. His work is valuable chiefly as a picture of the general knowledge of his time. The following is an example of the medical lore of the period. Pliny says that a woman dreamt that some one was directed to send to her son, a soldier in Spain, some roots of the dog-rose. It happened that exactly at that time her son had been bitten by a mad dog, and had received a letter from his mother, who had dreamt about him, and she begged him to use these roots as she directed. He did so, and was “protected” from hydrophobia, as were many others of his friends who adopted the same treatment. Thus it was that the wild-rose was called the dog-rose.

Dioscorides lived in the first or second century of our era. He was a physician who rendered greater services than any other to Materia Medica. His work on this subject was the result of immense labour and research, and remained for ages the standard authority; it contained a description of everything used in medicine, and is a most valuable document for the historian of the healing art of the period. Galen highly valued the work of Dioscorides, which must have been of the greatest use to the doctors of the time, who were obliged to prepare their own medicines. Drugs were so much adulterated that it was unsafe to procure them from the stores in Rome.

Marinus was a famous anatomist, who lived in the first and second centuries after Christ. Galen’s tutor Quintus was one of his pupils. He wrote many works on anatomy, which Galen abridged and praised, saying that he was one of the restorers of anatomical science.

Quintus, an eminent Roman physician of the second century, was a pupil of Marinus. He was celebrated for his knowledge of anatomy.

Zenon lived in the fourth century, and taught medicine at Alexandria. Julian (A.D. 361 circ.) wrote in very high terms of the medical skill of this physician.

Magnus of Alexandria was a pupil of the above, who lectured on medicine at Alexandria, where he was very famous. He wrote a work on the urine.

Ionicus of Sardis studied under Zenon. He was not only distinguished in all branches of medicine, but was versed in rhetoric, logic, and poetry.

Theon of Alexandria, of very uncertain period, probably in the fourth century after Christ, wrote a celebrated book on Man, in which he treated of diseases in a systematic order, and also of pharmacy.

CHAPTER V.
LATER ROMAN MEDICINE.

The Eclectic and Pneumatic Sects.—Galen.—Neo-Platonism.—Oribasius and Ætius.—Influence of Christianity and the Rise of Hospitals.—Paulus Ægineta.—Ancient Surgical Instruments.

The Sect of the Pneumatists.

AthenÆus of Cilicia about A.D. 69 founded at Rome the Sect of the Pneumatists, at the time when the Methodists enjoyed their greatest reputation.

They admitted an active principle of an immaterial nature, to which they gave the name of p?e?a, spirit. This principle caused the health or the diseases of the body, and the sect was named from it. AthenÆus was a Stoic, who had adopted the doctrines of the Peripatetics. In addition to the pneuma, he developed the theory of the elements, and in them recognised the positive qualities of the animal frame. The union of heat and moisture is necessary for the preservation of health. Heat and dryness cause acute diseases, cold and moisture produce phlegmatic disorders, cold and dryness give rise to melancholy. At death, all things dry up and become cold.488

Great services to pathology were rendered by the Pneumatic sect. Several new diseases were discovered by them; but they over refined their doctrines, especially that of fevers and the pulse; they thought this alternate contraction and dilatation of the arteries was the operation of the pneuma, or spirit passing from the heart. Diastole or dilatation pushes forward the spirit, the systole or contraction draws it back.489

The Sect of the Eclectics

Derived their name from the fact that they selected from each of the other sects the opinions that seemed most probable. They seem to have agreed very nearly, if they were not actually identical with the sect known as the Episynthetics. They endeavoured to join the tenets of the Methodici to those of the Empiric and Dogmatic sects, and to reconcile their differences.490

Amongst the most famous of the school were Agathinus of Sparta (1st cent. A.D.), who founded the Episynthetic sect, though Galen refers to him as among the Pneumatici. He was a pupil of AthenÆus, and the tutor of Archigenes. None of his writings are extant. Theodorus was a physician mentioned by Pliny.491

Archigenes of ApamÆa, who practised in Rome (A.D. 98-117), was exceedingly famous. He is mentioned several times by Juvenal,492 and was the most celebrated of the sect. He wrote on the pulse, and attempted the classification of fevers. Very few fragments of his works remain. He was the first to treat dysentery with opium.

AretÆus of Cappadocia (1st cent, A.D.) was a celebrated Greek physician who wrote on diseases, detailing their symptoms with great accuracy and displaying great skill in diagnosis. He was very little biased by any peculiar opinions, and his observations on diseases and their treatment have stood the light of our modern medical science better than those of many of the ancient authorities. He was acquainted with the fact that injuries to the brain cause paralysis on the opposite side; and his classification of mental diseases is as good as our own. His knowledge of anatomy was considerable, and in his physiology he shows how much more the ancients knew of this branch of science than is generally supposed. He was acquainted with the operation of tracheotomy, and remarked its partial success.493

He considered elephantiasis to be contagious, and gives this caution: “That it is not less dangerous to converse and live with persons affected with this distemper, than with those infected with the plague; because the contagion is communicated by the inspired air.”494

Herodotus (there were several of the name) was a physician of repute in Rome (about A.D. 100). He was a pupil of AthenÆus or Agathinus, and wrote several medical books which are quoted by Galen and Oribasius. He first recommended pomegranate root as a remedy for tape-worm, and described several infectious diseases.495

Heliodorus (about A.D. 100) was a famous surgeon, and wrote on amputations and injuries of the head. His operation for scrotal hernia is described by Haeser as “a brilliant example of the surgical skill of the Empire.” He treated stricture of the urethra by internal section.

Cassius Felix lived in the first century after Christ, and was the author of a curious set of eighty-four medical questions and their answers. He was also called Cassius Iatrosophista.

Leonidas of Alexandria lived in the second or third century after Christ, was a distinguished surgeon, who operated on strumous glands, and amputated by the flap operation.

Claudius Galenus, commonly called Galen, or, as mediÆval writers named him, Gallien, was a very celebrated physician and philosopher, who was born at Pergamos in Asia, A.D. 131, under Hadrian. His father, Nicon, was an architect and geometrician, a highly cultivated and estimable man. His mother was a passionate scold, who led her husband a worse life than Xantippe led Socrates. Nicon spared no pains to give his son an education which should fit him to be a philosopher, and in his fifteenth year he was a pupil of the Stoic, Platonist, Peripatetic, and Epicurean philosophies. In his seventeenth year his father, in consequence of a dream, changed his intentions concerning his son’s profession, and determined that he should study medicine. His first tutors were Æschrion, Satyrus, and Stratonicus. He studied the doctrines of all the sects of medicine in the school of Alexandria, and travelled in Egypt, Greece, Asia, and Italy. He devoted himself to none of the schools of medicine whose doctrines he had studied, but struck out a path for himself. On his return to Pergamos, he was selected to take charge of the wounded gladiators, a position which afforded him opportunities for studying surgical operations. He filled this post with great reputation and success. When he was thirty-four years old he went to Rome for the first time, remaining there four years, and acquiring a great reputation for his knowledge of anatomy, physiology, and medicine. He was connected with many persons of great influence, and his popularity at last became so great that it excited the ill-will of his professional brethren, especially as by his lecturing, writing, and disputing, his name was constantly before them. So great was the ill-feeling they bore towards him that he was afraid of being poisoned. He was called the “wonder speaker” and the “wonder worker.”

“The greatest savant of all the ancient physicians,” says Sprengel, “was Galen. He strove to introduce into medicine a severe dogmatism, and to give it a scientific appearance, borrowed almost entirely from the Peripatetic school. The enormous number of his works, the systematic order which distinguishes them, and the elegance of their style, won over, as by an irresistible charm, the indolent physicians who succeeded him, so that during many ages his system was considered as immovable.”496

For thirteen centuries his name and influence dominated the medical profession in Europe, Asia, and Africa; and this influence, under the name of Galenism, was paramount in the eighteenth century, notwithstanding the discovery of the circulation of the blood and other great advances in science. Galen collected and co-ordinated all the medical knowledge which previous physicians and anatomists had acquired. He was no mere collector of, or compiler of other men’s works; but he enriched previous acquirements by his own observation, and was in every way a man greatly in advance of his time. “A great and profound spirit,” says Daremberg, “he was philosopher as well as physician, realising the aspiration of Hippocrates when he said that the physician who should be also a philosopher must be the equal of the gods. A dialectician like Aristotle, a psychologist like Plato, who glorified his work by his genius for interpreting nature and life, his position as philosopher would have been beside those men, if his devotion to medicine had not called him to another sphere of intellectual activity.” Nevertheless, Galen did in fact occupy an exalted position in the history of philosophy, not only in the West, but amongst the Arabians. His encyclopÆdic knowledge, his spirit of observation, and his influence on the thought of the middle ages, compel a comparison with Aristotle. It was thus that the vast body of medical material collected by the various sects and schools was analysed by the penetrating genius of Galen, whose philosophical and scientific mind was able to extract the good and permanent from the worthless and ephemeral material, which encumbered the literature of the healing art. He fell under the domination of none of the schools, though in one sense he may be said to have leaned towards the Dogmatists, “for his method was to reduce all his knowledge, as acquired by the observation of facts, to general theoretical principles.”497 He endeavoured to draw the student of medicine back to Hippocrates, of whom he was an admirer and expounder. The labours of Galen had the effect of destroying the vitality of the old medical sects; they became merged in his system, and left off wrangling amongst themselves to imitate the new master who had arisen. A crowd of new writers found in the works of Galen abundant material for their industry.

Partly in consequence of this jealousy, and partly from the fact that in A.D. 167 a pestilence broke out in Rome, he left the city privately, and returned to his native country.

Galen, as a profound anatomist and physiologist, recognised final causes, a purpose in all parts of the bodies which he dissected; and it is, as Whewell points out,498 impossible for a really great anatomist to do other than recognise these. He cannot doubt that the nerves run along the limbs, in order that they may convey the impulses of the will to the muscles: he cannot doubt that the muscles are attached to the bones, in order that they move and support them.

The development of this conviction, that there is a purpose in the parts of animals of a function to which every organ is subservient, greatly contributed to the progress of physiology; it compelled men to work till they had discovered what the purpose is. Galen declared that it is easy to say with some impotent pretenders that Nature has worked to no purpose. He has an enthusiastic scorn of the folly of atheism.499 “Try,” he says, “if you can imagine a shoe made with half the skill which appears in the skin of the foot.” Somebody had expressed a desire for some structure of the human body over that which Nature has provided. “See,” he exclaims, “what brutishness there is in this wish. But if I were to spend more words on such cattle, reasonable men might blame me for desecrating my work, which I regard as a religious hymn in honour of the Creator. True piety does not consist in immolating hecatombs, or in bearing a thousand delicious perfumes in His honour, but in recognising and loudly proclaiming His wisdom, almighty power, love and goodness. The Father of universal nature has proved His goodness in wisely providing for the happiness of all His creatures, in giving to each that which is most really useful for them. Let us celebrate Him then by our hymns and chants! He has shown His infinite wisdom in choosing the best means for contriving His beneficent ends; He has given proof of His omnipotence in creating everything perfectly conformable to its destination.”

Anatomy must have reached a high standard before Galen’s time, as we learn from his corrections of the mistakes and defects of his predecessors. He remarks that some anatomists have made one muscle into two, from its having two heads; that they have overlooked some of the muscles in the face of an ape in consequence of not skinning the animal with their own hands. This shows that the anatomists before Galen’s time had a tolerably complete knowledge of the science. But Galen greatly advanced it. He observes that the skeleton may be compared to the pole of a tent or the walls of a house. His knowledge of the action of the muscles was anatomically and mechanically correct. His discoveries and descriptions even of the very minute parts of the muscular system are highly praised by modern anatomists.500

He knew the necessity of the nerve supply to the muscle, and that the brain originated the consequent motion of a muscle so supplied, and proved the fact experimentally by cutting through some of the nerves and so paralysing the part.501 Where the origin of the nerve is, there, he said, it is admitted by all physicians and philosophers is the seat of the soul. This, he adds, is in the brain and not in the heart. The principles of voluntary motion were well understood, therefore, by Galen, and he must have possessed “clear mechanical views of what the tensions of collections of strings could do, and an exact practical acquaintance with the muscular cordage which exists in the animal frame:—in short, in this as in other instances of real advance in science, there must have been clear ideas and real facts, unity of thought and extent of observation, brought into contact.”502

He observed that although a ligature on the inguinal or axillary artery causes the pulse to cease in the leg or in the arm, the operation is not permanently injurious, and that even the carotid arteries may be tied with impunity. He corrects the error of those who, in tying the carotids, omitted to separate the contiguous nerves, and then wrongly concluded that the consequent loss of voice was due to compression of the arteries.

Galen was the first and greatest authority on the pulse, if not our sole authority; for all subsequent writers simply transferred his teaching on this subject bodily to their own works.503

Briefly it was as follows: “The pulse consists of four parts, of a diastole and a systole, with two intervals of rest, one after the diastole before the systole, the other after the systole before the diastole.”504

His therapeutics were based on these two principles:—“1. That disease is something contrary to nature, and is to be overcome by that which is contrary to the disease itself; and 2. That nature is to be preserved by that which has relation with nature.”505

The affection contrary to nature must be overcome, and the strength of the body has to be preserved. But while the cause of the disease continues to operate, we must endeavour to remove it; we are not to treat symptoms merely, for they will disappear when their cause is removed, and we must consider the constitution and condition of the patient before we proceed to treat him.

“Such as are essentially of a good constitution are such in whose bodies heat, coldness, dryness, and moisture are equally tempered; the instruments of the body are composed in every part of due bigness, number, place, and formation.”506 He gives in succeeding chapters the signs of a hot, cold, dry, moist, hot and dry, hot and moist, cold and dry, and cold and moist brain; of a heart overheated, of a heart too cold, of a dry and of a moist heart, of a heart hot and dry, hot and moist, cold and moist, cold and dry heart. The liver is described under the same conditions.

Galen’s surgery is not of very great importance, but he is credited with the resection of a portion of the sternum for caries and with ligature of the temporal artery.507

He applied the doctrine of the four elements to his theories of diseases. “Fire is hot and dry; air is hot and moist; for the air is like a vapour; water is cold and moist, and earth is cold and dry.”

Galen’s pathology is explained by Sprengel thus: when the body is free from pain, and performs its functions without obstacle, it is in a state of health; when the functions are disturbed, there is a state of disease. The effect of disturbed functions is the affection (p????); that which determines this injury is the cause of the disease, the sensible effects of which are the symptoms.

Diseases (d???es??) are unnatural states either of the similar parts or of the organs themselves. Those of the similar parts proceed in general from the want of proportion among the elements, of which one or two predominate. In this manner arise eight different dyscrasies, or ill states of the constitution. Symptoms consist either in deranged function or vicious secretions. The internal causes of disease depend almost always on the superabundance or deterioration of the humours. Galen calls every disorder of the humours a putridity; it is due to a stagnant humour being exposed to a high temperature without evaporating. Thus suppuration and the sediment of urine are proofs of putridity. In every fever there is a kind of putridity which gives out an unnatural heat, which becomes the cause of fever, because the heart and the arterial system take part in it.

Choulant enumerates eighty-three works of Galen which are acknowledged as genuine, nineteen which are doubtful, forty-five spurious, nineteen fragments; and fifteen commentaries on different books of Hippocrates; and more than fifty short pieces and fragments for the most part probably spurious, which are still lying unpublished in the libraries of Europe. Besides these Galen wrote many other works, the titles of which only remain to us; so that it is estimated that altogether the number of his different books cannot have been less than five hundred.508 He wrote, not on medicine only, but on ethics, logic, grammar, and other philosophical subjects; he was therefore amongst the greatest and most voluminous authors that have ever lived.509 His style is elegant, but he is given to prolixity, and he abounds in quotations from the Greek writers.

Philip of CÆsarea was a contemporary of Galen about the middle of the second century after Christ. He belonged to the sect of the Empirici, and defended their doctrines. It is probable that he wrote on marasmus, on materia medica, and on catalepsy; but as there were other physicians of the same name, there is much uncertainty as to their identity.

After the death of Galen came the Gothic invasions over the civilized world, and all but extinguished the learning of the times. Medicine lingered still in Rome, Constantinople, and Alexandria, but individuals rather than schools and sects kept it alive; it struggled to exist amidst the grossest ignorance, superstition, and magical practices, till it was re-invigorated by the Saracens.

Saints Cosmas and Damian (circ. 303) were brothers who studied the sciences in Syria, and became eminent for their skill in the practice of medicine. As they were Christians, and eager to spread the faith which they professed, they never took any fees, and thus came to be called by the Greeks Anargyri (without fees). The two brothers suffered martyrdom under the Diocletian persecution, and have ever since been famous as workers of miracles of healing and patrons of medical science. Their relics were everywhere honoured, and a church built in Rome by St. Gregory the Great preserves them to this day.

Dr. Meryon points out510 that Gregory the Great enunciated one great doctrine of homoeopathy: “Mos medicinÆ est ut aliquando similia similibus, aliquando contraria contrairiis curet. Nam sÆpe calida calidis, frigida frigidis, sÆpe autem frigida calidis, calida frigidis sanare consuevit.”

Alexander of Tralles, though one of the most eminent ancient physicians, believed in charms and amulets. Here are a few specimens. For a quotidian ague, “Gather an olive leaf before sunrise, write on it with common ink ?a, ???, a, and hang it round the neck” (xii. 7, p. 339); for the gout, “Write on a thin plate of gold, during the waning of the moon, e?, ??e?, ??, f??, te??, a??, ????” (xi. l. p. 313). He exorcised the gout thus: “I adjure thee by the great name ?a? Saa??,” that is, ??????? ???????? and a little further on: “I adjure thee by the holy names ?a?, Saa??, ?d??a?, ????,” that is ??????? ???????? ??????? ???????.511

Neoplatonism had its influence on medicine. Plotinus (A.D. 205-270), its great father, said, when dying, “I am striving to bring the God which is in us into harmony with the God which is in the Universe.” The early Christians began to tell the world that the God within the soul of man and the God which is in the Universe are one and the same being, of absolute righteousness, power and love. Plotinus preached a gospel to the philosophic world; the first Christians preached theirs to every creature. Neoplatonism taught the world that spirit was meant to rule matter: it was not enough that the early Christian exhibited to mankind man transformed as the result of his intimate relationship to the Divine, the philosophic world demanded wonders, something above nature, as a proof of the Divine character of the revelation; then, as Kingsley explains,512 we begin to enter “the fairy land of ecstasy, clairvoyance, insensibility to pain, cures produced by the effect of what we now call mesmerism. They are all there, these modern puzzles, in those old books of the long bygone seekers for wisdom.” Thus mankind, for ever wandering in a circle, began by these ecstasies and cures to retrace its steps towards the ancient priestcraft. These wonders were nothing to the Egyptian, Babylonian, and Jewish sorcerers; they had traded in them for ages.

Antyllus (circ. 300 A.D.) is mentioned by Oribasius, and is said by HÄser to have been one of the greatest of the world’s surgeons; for aneurism he tied the artery above and below the sac, and evacuated its contents; for cataract, and for the cure of stammering, he invented appropriate treatment; and he employed something very much like tenotomy for contractures. He is the earliest writer whose directions are extant for performing the operation of tracheotomy. He must have been a man of great talent and originality. He practised the removal of glandular swellings of the neck and ligatured vessels before dividing them, giving directions for avoiding the carotid artery and the jugular vein. It is a striking proof of the high state which surgery had reached at this period that bones were resected with freedom; the long bones, the lower jaw, and the upper jaw were dealt with in a manner generally considered to be brilliant examples of modern surgery.

Oribasius (A.D. 326-403) was born at Pergamos. By command of the Emperor Julian the Apostate he made a summary from the works of all preceding physicians who had written upon the Healing Art. Having made a collection of some seventy medical treatises, he reduced them into one, adding thereto the results of his own observations and experience. He also wrote for his friend Eunapius two books on diseases and their remedies, besides treatises on anatomy and an epitome of the works of Galen.513 He was called the Ape of Galen, and Freind says the title was not undeserved. He wrote in Greek, and though a mere compiler was capable of better things. His pharmacy was that of Dioscorides. He did some original work, as he was the first to write a description of the drum of the ear and the salivary glands. In his works also, we find the first description of the wonderful disease called lycanthropy, a form of melancholia, or insanity,514 in which the affected persons believe themselves to be transformed into wolves, leaving their homes at night, imitating the behaviour of those animals, and wandering amongst the tombs. His great work he entitled Collecta Medicinalia. When Julian died, Oribasius fell into disgrace, and was banished. He bore his misfortunes with great fortitude, and so gained the esteem and love of the “barbarians” amongst whom he lived that he was almost adored as a god. He was ultimately restored to his property and honour.

Jacobus Psychristus lived in the time of Leo I. Thrax (A.D. 457-474), was a very famous physician of Constantinople, who was called “the Saviour,” on account of his successful practice.

Adamantius of Alexandria, an Iatrosophist, was a Jewish physician, who was expelled, with his co-religionists, from Alexandria, A.D. 415. He embraced Christianity at Constantinople. He wrote on physiognomy.

Iatrosophista was the ancient title of one who both taught and practised medicine.

Archiater (chief physician) was a medical title under the Roman Empire, meaning “the chief of the physicians,” and not “physician to the prince,” as some have explained.515

Meletius (4th cent. A.D.), a Christian monk, wrote on physiology and anatomy.

Nemesius, Bishop of Emissa (near the end of the fourth century), wrote a treatise on the Nature of Man, which is remarkable for a proof that the good Churchman came very near to two discoveries which were made long after his time. He says that the object of the bile is to help digestion, to purify the blood, and impart heat to the body. Freind says516 that in this we have the foundation of that which Sylvius de la BoË with so much vanity boasted he had invented himself. He adds that “if this theory be of any use in physic, Nemesius has a very good title to the discovery.”

The Bishop described the circulation of the blood in very plain terms considering the state of physiology at that time.

“The motion of the pulse takes its rise from the heart, and chiefly from the left ventricle of it; the artery is, with great vehemence, dilated and contracted by a sort of constant harmony and order. While it is dilated it draws the thinner part of the blood from the next veins, the exhalation or vapour of which blood is made the aliment for the vital spirit. But while it is contracted it exhales whatever fumes it has through the whole body and by secret passages. So that the heart throws out whatever is fuliginous through the mouth and the nose by expiration.”517

Lucius wrote on pharmacy in the first century.

Marcellus Empiricus (4th cent.) wrote a work on pharmacy, in Latin, which contains many charms and absurdities.

Ætius was a Greek medical writer, who probably was a Christian of the sixth century. He was a native of Amida in Mesopotamia, and studied medicine at Alexandria. He wrote the Sixteen Books on Medicine, one of the most valuable medical treatises of antiquity; though containing little original matter, it includes numerous extracts from works which have since perished.518

Many of the opinions of Ætius on surgery are excellent; he recommended the seton, and lithotomy for women. Bleeding arteries he treated by twisting, as we do now, and by tying. He advised irrigation with cold water in the treatment of wounds. In lithotomy he recommends that the knife should be guarded by a tube. He treated worms with pomegranate bark, as has been recently revived.519 He was the first Greek medical writer amongst the Christians who gives specimens of the spells and charms so much used by the Egyptian Christians in surgical cases; thus, in case of a bone sticking in the throat, the physician was to cry out in a loud voice, “As Jesus Christ drew Lazarus from the grave, and Jonah out of the whale, thus Blasius, the martyr and servant of God, commands, ‘Bone, come up or go down!’”520

Influence of Christianity

At the time when the civilizations of Greece and Rome had reached their highest perfection, the poison of sensual indulgence, elevated into a religion, had instilled itself into the whole social life of the people: in every incident of life, in business, in pleasure, in literature, in politics, in arms, in the theatres, in the streets, in the baths, at the games, in the decorations of his home, in the ornaments and service of his table, in the very conditions of the weather and the physical phenomena of nature521 it met the Roman, and tainted every action of his life. Archdeacon Farrar, in the first chapter of his Early Days of Christianity, draws an awful picture of the corruption of the old world at the moment when it was confronted by Christianity. The parent had absolute power over the person of his child, and could destroy its life at its pleasure. Unfortunate children were exposed on the roadside or left to perish in the waters of the Tiber. The slave was the mere chattel of his master, and Roman women treated their servants with the utmost barbarity. Juvenal has painted for us in terrible colours the vices and shameless conduct of the women, and the selfish luxury and degrading pleasures of the men; the nameless crime, which was the disgrace of Greek and Roman civilization, was looked upon as merely a question of taste; and St. Paul, in the first chapter of the Epistle to the Romans, has recorded for all time what was the highest the most perfect civilization Paganism has ever produced was able to effect for the moral condition of the people. To the Roman and Greek world, saturated with the most perfect philosophy the world has ever known, and adorned by the art which has ever since been the despair of its imitators, there presented itself the Catholic Church, and before the sun’s embrace sublime

The enemies of Christianity have affected to lament the effects produced by the religion of Jesus on the art and science of the pagan world; it has been said that the early Christians became so indifferent to the welfare of their bodies that they no longer sought medical aid when sick, but either resigned themselves to death or sought remedies in prayers. It is quite possible that, at the soul’s awakening at the first revelation of the infinite importance of the spiritual life, men did somewhat neglect the ailments of the flesh and forget them in the effort to realize the things of the spirit. It is perfectly true that the natural sciences were not likely to make much progress in such a condition of things. But if Christians were careless of their own health, it is not less certain that they were intensely solicitous for that of their poor and friendless neighbours. The peculiar constitution of the Roman Empire, which was but a military tyranny, greatly contributed to its fall, and the collapse would have come earlier had it not been for Christianity. The Empire had very little cohesion; the Church had a cohesive force, such as the world had never experienced before, and the Church availed herself of all the facilities which the Empire possessed of keeping up, from centre to circumference, the circulation of the spirit of solidarity which has ever animated the Catholic body. Of course there was little reason to expect the Church to be very favourably disposed towards the philosophies of old Greece and Rome; they had done little for the moral and social welfare of the people, and the Church had a better system than these could exhibit: but when St Augustine appeared, there was found a modus vivendi between the noblest Platonism and the purest and loftiest Christian theology. He pointed the way towards a Christian science, and Europe ultimately realized it. It was found in the Schoolmen. Modern science is the legitimate child of Scholasticism, though it is unsparing in its abuse of its parent.

The slave to the ancient Roman was simply a beast who was able to speak. When such beasts became unprofitable, because through sickness or old age they could no longer work, they were frequently turned out to perish. Cato advised the agriculturists to sell their old and sick slaves when no longer able to work, just as he recommended them to dispose of worn-out and diseased cattle and worthless implements of husbandry.523

The Emperor Claudius caused slaves who were thus cruelly treated to be proclaimed freemen. It was the merciful and charitable conduct of the early Christians towards slaves, of whom such vast numbers helped to people the Roman Empire, that caused the doctrines of the Gospel to spread so rapidly throughout the Roman world. The slave found in the Gospel of Christ the first system of religion and philosophy which took any account of the poor, the helpless, and the slave; the rich and cultured saw in the teachings of the Church of Christ the only system which embraced mankind as a whole. Juvenal524 has indicated for us the value of a slave’s life in these times.

Although there is evidence that hospitals for the reception and treatment of sick and destitute persons were established in India in very early times,525 and though we know that these were attached to some of the temples of ancient Greece, and the Romans had convalescent institutions for sick slaves and soldiers, it cannot be doubted that we owe to Christianity the hospital as it exists amongst us at the present day.

Christianity taught the world not only that God is the Father of mankind, the pagan world already knew Him as Zeus pater, but that as His children we are the brethren and sisters of each other. The Church in Rome, in the third century, says Eusebius,526 supported “widows and impotent persons, about a thousand and fifty souls who were all relieved through the grace and goodness of Almighty God.” St. Basil the Great (A.D. 379) founded at CÆsarea a vast hospital, which Nazianzen calls a new city, and was named after him Basiliades. The same author thought “it might deservedly be reckoned among the miracles of the world, so numerous were the poor and sick that came thither, and so admirable was the care and order with which they were served.”527 In this institution St. Gregory of Nazianzus said, “disease became a school of wisdom, and misery was changed into happiness.”

Chastel relates that (A.D. 375) Edessa possessed a hospital with 300 beds, and there were many similar institutions in the East. St. Jerome says that the widow Fabiola founded the first Christian infirmary in Rome, at the end of the fourth century. St. Paula, a Roman widow, in whose veins ran the blood of the Scipios, the Gracchi, and Paulus Æmilia, and of Agamemnon, was born in 347 A.D., and was one of the many noble Christian women who devoted their wealth and their lives to the poor, the suffering, and the helpless, in the early days of Christianity. She distributed immense alms, and built a hospital on the road to Jerusalem, and also a monastery for St. Jerome and his monks, whom she maintained, besides three monasteries for women;528 she carried the sick to their beds in her arms, and with her own hands washed their wounds, as St. Jerome tells us. In Italy, Gaul, and Spain, many asylums for sick and poor persons were built and maintained. Nor were their benefits confined to Christians; for Jews, slaves, and freemen were welcomed to these temples of charity. It is impossible in the limits of this work to trace fully the progress of the hospital movement; enough has been said to prove, as Baas, the Agnostic historian of medicine, admits,529 that “Hospitals proper, in our sense of the term, did not originate till Christian times.”

When the plague raged at Alexandria, Eusebius tells us,530 “Many of our brethren, by reason of their great love and brotherly charity, sparing not themselves, cleaved one to another, visited the sick without weariness or heed-taking, and attended upon them diligently, cured them in Christ, which cost them their lives, and being full of other men’s maladies, took the infection of their neighbours.” Such was the initial impulse which Christian charity applied to the healing art; trace we now its splendid results in mediÆval times.

In the Middle Ages almost all the monasteries and religious houses had a hospital of one kind or another attached to them; they had not only places of entertainment for pilgrims, but institutions for the treatment and care of the sick and poor. This care of the diseased and helpless was not left to the civil administration alone, but formed part of the regular work of the Church of the middle ages, and by ancient regulation this was placed under the control of the Bishops. The Council of Vienne ordained that if the administrators of a hospital, lay or clerical, became relaxed in the exercise of their charge, proceedings should be taken against them by the Bishops, who should reform and restore the hospital of their own authority.

The Council of Trent granted to Bishops the power of visiting the hospitals. This connection between the hospitals and the ecclesiastical power was acknowledged by the Christian sovereigns of Europe from the earliest times. The Emperor Justinian, for example, gave authority over the hospitals to the Bishops; the property of the hospitals was considered as Church property, and thus was protected in troublous times by the sanctity of religion.531

The Council of Chalcedon placed such clergy as lived in establishments where orphans, the aged, and infirm were received and cared for under the authority of the Bishops, and makes use of the expression that this regulation was according to ancient custom.

In the time of the Council of Chalcedon a hospital (?e??d??e???) seems to have been a common adjunct of a church.532 Originally appropriated to the reception of strangers, its use was afterwards extended to the relief of the poor and also of the sick, as at Alexandria, where, in A.D. 399, we read that “the priest Isidore being four-score years old, was at that time governor of the hospital.”533

In connection with the story of Hypatia at Alexandria, we learn that the Parabolani was the name given to the clergy of the lowest order, who were appointed to attend to the sick, particularly in contagious disorders, from which circumstance, says Fleury,534 their name was derived, because it signifies persons who expose themselves.

Moschion Diorthortes (about the 6th cent.) was a specialist in diseases of women. He wrote a manual for midwives based on the work of Soranus. His description of the uterus is similar to the treatise of that physician. He refutes the opinion of the ancients on the situation of male infants on the right, and of females on the left. He has well indicated the signs of imminent abortion. He made a great number of observations on the physical education of children which must have been of great importance to his time. He justly explained the reason for the cessation of the catamenia after severe diseases: the system cannot afford the waste. He anticipated the modern discovery that sterility is a disease common to women and men. He adhered to the principles of the Methodical school, and the doctrines of strictum and laxum.535

Paulus Ægineta, one of the most famous of the Greek writers on medicine, was born in the island of Ægina, probably in the latter half of the seventh century after Christ. He was an Iatrosophist, and a Periodeutes, or one who travelled about in the exercise of his profession. He wrote several books on medicine, of which one has come down to us, called De re Medica Libri Septem, or “Synopsis of Medicine in seven books.” Dr. Adams, in his translation of this famous work for the Sydenham Society, gives us the original introduction to the treatises of this physician, who informs us that:—

“In the first book you will find everything that relates to hygiene, and to the preservation from, and correction of, distempers peculiar to the various ages, seasons, temperaments, and so forth; also the powers and use of the different articles of food, as is set forth in the chapter of contents. In the second is explained the whole doctrine of fevers, an account of certain matters relating to them being premised, such as excrementitious discharges, critical days, and other appearances, and concluding with certain symptoms which are the concomitants of fevers. The third book relates to topical affections, beginning from the crown of the head, and descending down to the nails of the feet. The fourth book treats of those complaints which are external and exposed to view, and are not limited to one part of the body, but affect various parts. Also, of intestinal worms and dracunculi. The fifth treats of the wounds and bites of venomous animals; also of the distemper called hydrophobia, and of persons bitten by dogs which are mad, and by those which are not mad; and also of persons bitten by men. Afterwards it treats of deleterious substances, and of the preservatives from them. In the sixth book is contained everything relating to surgery, both what relates to the fleshy parts, such as the extraction of weapons, and to the bones, which comprehends fractures and dislocations. In the seventh is contained an account of the properties of all medicines, first of the simple, then of the compound, particularly of those which I have mentioned in the preceding six books, and more especially the greater, and as it were, celebrated preparations; for I did not think it proper to treat of all these articles promiscuously, lest it should occasion confusion, but so that any person looking for one or more of the distinguished preparations might easily find it. Towards the end are certain things connected with the composition of medicines, and of those articles which may be substituted for one another, the whole concluding with an account of weights and measures.”

The most valuable and interesting part of this work is the sixth book. The whole treatise is chiefly a compilation from the great physicians who preceded Paulus, but the sixth book contains some original matter.

This great Byzantine physician must have possessed considerable skill in surgery. His famous treatise on midwifery is now lost; it procured for him amongst the Arabs the title of “the Obstetrician,” and entitles him to be called the first of the teachers of the accoucheur’s art. Celebrated equally in the Arabian and Western schools, he exercised an enormous influence in the development of the medical arts. Throughout the Middle Ages he maintained his great popularity, and his surgical teaching was the basis of that of Abulcasis, which afforded to Europe in the Middle Ages her best surgical knowledge. He was the first writer who took notice of the cathartic properties of rhubarb.536

After the time of Paulus of Ægina the art of surgery slept for five hundred years; imitators of the ancient masters and compilers of their works alone remained to prove that it was still alive, but no progress was made. The religious orders employed the best methods they knew for the relief of physical suffering, but naturally it was not their work to perfect the healing art. In the Middle Ages, when so much of the medical and surgical practice was in the hands of the monks, particularly of the Benedictine order, many abuses crept in; and at last the practice of surgery by the clergy was forbidden in 1163 by the Council of Tours.

The office of royal physician in the Frankish court in the sixth century was not unattended with risk. When Austrigildis, wife of King Guntram, died of the pestilence in the year 580, she expressed in her last moments a pious desire that her doctors, Nicolaus and Donatus, should be put to death for not having saved her; and her husband, feeling it incumbent upon him to carry out her wishes, had them duly executed.537

Ancient Surgical Instruments.

Bramhilla, surgeon to Francis II. of Austria, said that surgical instruments were invented by Tubal Cain, because the Bible says he was “the instructor of every artificer in brass and iron.”

The saw is a tool of great antiquity. Pliny attributes its invention to DÆdalus, or to his nephew Perdix, who was also called Talos; he was supposed to have imitated it from the jaw of a serpent, with which he had been able to cut a piece of wood. The invention of forceps was attributed to Vulcan and the Cyclopes. When used for extracting teeth, the Greeks called them ?d??t???a; for extracting arrow-heads and other weapons from the wounded in battle, the particular form employed was called ??d?????a.

In the collection of domestic objects discovered by M. Petrie in the Egyptian ruins of Kahun, flint saws close upon 5,000 years old may be seen.538

Pincers and tweezers are made by the natives of Timor-laut from the bamboo; they are used for pulling out the hair from the face. The natives of the Darling River, New South Wales, use fine bone needles for boring through the septum of the nose.

The book on Wounds of the Head is admitted by the best critics to be a genuine work of Hippocrates. We find in that treatise that he used the trepan, as he speaks of a s????? t??pa???, a small trepan. There must also have been a larger one, a p????, or saw, which had a pe???d??, or circular motion, and which was probably the trephine, and a p???? ?a?act??, or jagged saw, which is held to be the trepan; and he gives instructions to the operator to withdraw the instrument frequently and cool both it and the bone with cold water, and to exercise all vigilance not to wound the living membrane.539

Splints were used by the Greeks for fractured limbs; they were called ??????a?. Cutting for the stone is spoken of in the ?????, which is attributed to Hippocrates. Celsus describes lithotrity, or crushing the stone by the instrument invented by Ammonios the ????t???, i.e. lithotomist.

Asclepiades practised tracheotomy. Many surgical instruments have been discovered in Herculaneum and Pompeii. There is a speculum vaginÆ with two branches and a travelling yoke for them driven by a screw, and a speculum ani opening by pressure on the handles; there is a forceps of curious construction for removing pieces of bone from the surface of the brain in cases of fracture of the skull. Mr. Cockayne says:540—

“It has been specially considered by Prof. Benedetto Vulpes [1847], who thinks it may also have been intended to take up an artery. The Greeks, he observes, as appears by an inscription dug up near Athens, were able to tie an artery in order to stop hÆmorrhage, and words implying so much are found in a treatise of Archigenes (A.D. 100), existing in MS. in the Laurentian library at Florence, ‘the vessels carrying (blood) towards the incision must be tied or sewed up.’ Near the end of the sixteenth century a French surgeon was the first to recover the ligature of the artery, and the instrument he used was very similar to the forceps in the Museum at Naples.”

A curious pair of forceps has also been found, without a parallel among modern surgical instruments; the blades have a half turn, and the grip is toothed and spoon-shaped when closed. By construction it is suited for introduction into some internal cavity, and for holding firm and fast some excrescence there. Professor Vulpes finds it well calculated for dealing with the excrescences which grow upon the Schneiderian membrane covering the nasal bones, or such as come on the periphery of the anus, or the orifice of the female urethra; especially such as having a large base cannot be tied.541

There is further an instrument for tapping the dropsical, described by Celsus542 and Paulus Ægineta. It was somewhat altered in the middle of the seventeenth century by Petit.

An instrument suited to carry off the dropsical humours by a little at a time on successive days, as Celsus and Paulus Ægineta recommended, has also been dug up. Rust and hard earth, which cannot safely be removed, have blocked up the canal of the relic, and rendered conclusions less certain.543

“The probe, ‘specillum,’ ???, is reputed by Cicero to have been invented by the Arcadian Apollo, who also was the first to bind up a wound. Seven varieties are figured in the work of Professor Vulpes in one plate, with ends obtuse, spoon-shaped, flat and oval, flat and square, flat and divided. The catheter of the ancients is figured by the same writer. It was furnished with a bit of wood to be drawn out by a thread, to prevent the obstructive effects of capillary attraction, and to fetch the urine after it when withdrawn. It is of bronze, and elastic catheters seem to be of modern invention.” There are, or were in 1847, eighty-nine specimens of pincers in the Naples Museum.

Hooks, hamuli, cauterising instruments, a spatula, a silver lancet, a small spoon for examining a small quantity of blood after venesection. There are cupping vessels of a somewhat spherical shape, from which air was exhausted by burning a little tow. A fleam for bleeding horses just like that used at the present time, a bent lever of steel for raising the bones of the head in cases of depressed fracture. Professor Vulpes gives figures of eight steel or iron knives used for various surgical purposes, and of a small plate to be used as an actual cautery.

Fig. 1. The Saw used by Carpenters. Fig. 2. A Small Saw. Fig. 3. The Modiolus, or Ancient Trephine. Fig. 4. The Terebra, or Trepan, called Abaptiston. Fig. 5. The Augur used by Carpenters. Fig. 6. The Terebra, or Trepan, which is turned round by a thong bound tight about its middle. Fig. 7. The Augur, or Trepan, which is turned round by a bow. Fig. 8. A Terebra, or Trepan, which is turned round by a thong on a cross-beam. Fig. 9. A Terebra, or Trepan, which has a ball in its upper end, by which it is turned round. Fig. 10. A Terebra, or Trepan, which is turned round by a cross piece of wood, or handle, on its upper end. (From Adams’ Hippocrates, vol. i.)

[Face p. 246.

CHAPTER VI.
AMULETS AND CHARMS IN MEDICINE.

Universality of the Amulet.—Scarabs.—Beads.—Savage Amulets.—Gnostic and Christian Amulets.—Herbs and Animals as Charms.—Knots.—Precious Stones.—Signatures.—Numbers.—Saliva.—Talismans.—Scripts.—Characts.—Sacred Names.—Stolen Goods.

In the ancient world, as with savages, the whole art of medicine was in many cases the art of preparing and applying amulets and charms.

An amulet (probably the word is derived from the Arabic hamalet, a pendant) is anything which is hung round the neck or attached to any other part of the body, and worn as an imagined protection against disease, witchcraft, accidents, or other evils. Stones, metals, bits of parchment, portions of the human body, as parings of the finger nails, may constitute these charms. Substances like stones, gems, or parchment may have certain words, letters, or signs inscribed upon them. In the East amulets have from the earliest ages been associated with the belief in evil spirits as the causes of diseases. A talisman may for our purpose be considered as the same thing as an amulet. In Scott’s Tales of the Crusaders, there is one of these charms which has the power of stopping blood and protecting the wearer from hydrophobia. Charms, enchantments, the ceremonial use of words as incantations, songs, verses, etc., have all been used either with a view of causing, preventing, or curing diseases, and their use of course arose from the belief of primitive, or savage man his present representative, that our maladies have a supernatural origin. An amulet may consist merely of a piece of string tied like a bracelet round the wrist, as in India, where such a charm is commonly worn by school children; it is a talisman against fever, which has been blessed by a Brahman, has been sold for a half-rupee, and is highly esteemed by the wearer. Our word carminative (a comforting medicine, like tincture of cardamoms) means really a charm medicine, and is derived from the Latin carmen, a song-charm. This word enshrines the fact that magic and medicine were once united. The charm, i.e. song, was a spell, whether of words, philtres, or figures, as thus:—

—Gower.

Charms, amulets, characts, talismans, and the like, are found amongst all peoples and in all times. They unite in one bond of superstitious brotherhood the savage and the philosopher, the Sumatrans and the Egyptians, the Malay and the Jew, the Catholic and the Protestant. The charm differs from the amulet merely in the fact that it need not be suspended. “There is scarcely a disease,” says Pettigrew, “for which a charm has not been given.”544 And it is well to note that their greatest effect is always produced on disorders of the nervous system, in which the imagination plays so important a part. Charms are also used to avert diseases and other evils; so that the man, sufficiently protected as he supposes by these objects, not only will escape plague and pestilence, but will be invulnerable to bullet and sword. The Sumatrans practise medicine chiefly by charms; when called in to prescribe, they generally ask for “something on account,” under the pretext of purchasing the appropriate charm.545

The hoof of the elk is used by the Indians and Norwegians and other northern nations as a cure for epilepsy. The patient must apply it to his heart, hold it in his left hand, and rub his ear with it.546

“Medicine” amongst primitive folk is a synonym for fetich; anything wonderful, mysterious, or unaccountable, is called “medicine” by the North American Indians. The medicine-bag is a mystery bag, a charm. In fetiches primitive man recognises something which has a power of a sort he cannot understand straightway; therefore it becomes to him a religious object. “Why are any herbs or roots magical?” asks Mr. Lang; and he correctly answers the question, not by any far-fetched explanations, but by the observation that herbs really do possess medicinal properties (some of them indeed of extreme potency), and the ignorant invariably confound medicine with magic.547 On this theory it is, of course, not necessary to swallow the medicine or apply it as we apply lotions and liniments; it is enough to carry it about as an amulet or charm, for it is the life of the thing which is efficacious, the spirit, which resides in the outward form, which possesses the virtue, not the material object itself. Of course, it may be necessary to take the charm internally; but then it is not the physiological action which is looked for, but the magical. Dapper, in his Description of Africa (p. 621), tells of savages who wear roots round their necks as amulets when they sleep out; they chew the roots, and spit the juice round the camp to keep off the wild beasts. At other times they burn the roots, and blow the smoke about for the same purpose. The Korannas carry roots as charms against bullets and wild animals. If successful in war, and obtaining much booty, they say, “We thank thee, our grandfather’s root, that thou hast given us cattle to eat.”

The Bongoes and Niam-Niams have similar customs.548

General Forlong, referring to the serpent Buddhism of Kambodia, says, that “Fetish worship was the first worship, and to a great extent is still the real faith of the great mass of the ignorant, especially about these parts.”549 “Probably one-quarter of the world yet deifies, or at least reverences, sticks and stones, ram-horns and charms.”550

The Abyssinians are sunk in the grossest superstition; their medical practice is, to a large extent, based on the use of amulets and charms. Even leprosy and syphilis are treated by these means, and eye diseases by spitting in the affected organs.551

“Fetiches” are claws, fangs, roots, or stones, which the Africans believe to be inhabited by spirits, and so powerful for good or evil. The word is derived from the Portuguese feitiÇo, a charm or amulet.

The Tibetans wear amulets upon their necks and arms; they contain nail-parings, teeth, or other reliques of some sainted Lama, with musk, written prayers, and other charms.552

Barth, travelling in Africa, found an English letter which had not reached its destination, used as a charm by a native.553

Leaving primitive folk and savage peoples, and turning to the great civilized nations of the past, we find the Egyptians, the ChaldÆans, Assyrians, and Babylonians not less addicted to the use of amulets, charms, talismans, and philters than their untutored progenitors (assuming with the anthropologists that the savage of to-day represents the primitive people who must have preceded the founders of civilization). The Magi, according to Pliny,554 prescribed the herb feverfew, the Pyrethrum parthenium, to be pulled from the ground with the left hand, that the fevered patient’s name must be spoken forth, and that the herborist must not look behind him. He tells us also that the Magi and the Pythagoreans ordered the pseudo-anchusa to be gathered with the left hand, while the plucker uttered the name of the person to be cured, and that it should be tied on him for the tertian fever.555

Of the aglaophotis, by which some commentators understand the peony (PÆonia officinalis), and others the “Moly” of Homer, Pliny says, “by means of this plant, the Magi can summon the deities into their presence when they please.” Concerning the achÆmenis, he says the root of it, according to the Magian belief as expressed by Democritus, when taken in wine, torments the guilty to such a degree during the night, by the various forms of avenging deities, as to extort from them a confession of their crimes. He tells, amongst other marvels, of the adamantis, a plant found in Armenia, which, when presented to a lion, will make the beast fall upon its back and drop its jaws. The Magi said if any one swallowed the heart of a mole palpitating and fresh, he would at once become an expert diviner. An owl’s heart placed on a woman’s left breast while she is asleep will make her tell all her secrets. For quartan fevers they recommended a kind of beetle taken up with the left hand to be worn as an amulet.556 The use of scarabs or beetles made of steatite, lapis-lazuli, cornelian, etc., as amulets, dates from the most ancient periods of Egyptian history. In the fourth Egyptian room of the British Museum there are specimens of scarabs, with the names of kings and queens dating B.C. 4400-250. The objects are not in all cases as old as the dates of the sovereigns whose names they bear. “The beetle was an emblem of the god Khepera, the self-created, and the origin and source from whence sprang gods and men. Ra, the Sun-god, who rose again daily, was, according to an Egyptian myth, a form of Khepera; and the burial of scarabs with mummies probably had reference to the resurrection of the dead.”557

Some large scarabs which were fastened on the breasts of mummies had inscriptions from the 30th chapter of the Book of the Dead. The deceased person prays: “Let there be no obstruction to me in evidence; let there be no obstacle on the part of the Powers; let there be no repulse in the presence of the Guardian of the Scale.” Other amulets consist of papyrus sceptres, buckles of Isis, hearts, fingers, etc., in gold and precious stones. They are laid between the bandages of mummies to guard the dead from evil.

Professor Lenormant explains the magical incantations which were used in connection with these talismans; they had to be “pronounced over the beetle of hard stone, which is to be overlaid with gold and to take the place of the individual’s heart. Make a phylactery of it anointed with oil, and say magically over this object, ‘My heart is my mother; my heart is in my transformations.’”558

The ancient Egyptians were buried with their amulets as a protection against the evil powers of the other world. Mr. Flinders Petrie, excavating at the Pyramid of Hawara, discovered on the body of Horuta a great number of these charms. He says: “Bit by bit the layers of pitch and cloth were loosened, and row after row of magnificent amulets were disclosed, just as they were laid on in the distant past. The gold ring on the finger which bore his name and titles, the exquisitely inlaid gold birds, the chased gold figures, the lazuli statuettes, delicately wrought, the polished lazuli and beryl, and carnelian amulets finely engraved, all the wealth of talismanic armoury, rewarded our eyes with a sight which has never been surpassed to archÆological gaze. No such complete and rich a series of amulets has been seen intact before.”559

Anodyne necklaces, made of beads from peony roots, are worn by children in some parts to assist them in teething. The ancient Greeks held the peony in great repute; they believed it to be of divine origin, and it was for many centuries held to have the power to drive away evil spirits.560

Abydemis, a Greek historian who wrote a history of Assyria, says that the inhabitants made amulets from the wood of the ash, and hung them round their necks as a charm against sorcery.

In the Sanskrit Atharvaveda are found charms for diseases, which are influenced by colours. Saffron and the yellow-hammer are prescribed for jaundice; red remedies, and especially red cows, for blood diseases.

The extremity of the intestine of the ossifrage, says Pliny, if worn as an amulet, is well known to be an excellent remedy for colic. Another cure is for the patient to drink the water in which he has washed his feet!561 A tick from a dog’s left ear, worn as an amulet, will allay all kinds of pains, but we must be careful to take it from a dog that is black.562

“Pliny says that any plant gathered from the bank of a brook or river before sunrise, provided that no one sees the person who gathers it, is considered as a remedy for tertian ague, when tied to the left arm, the patient not knowing what it is; also, that a person may be immediately cured of the headache by the application of any plant which has grown on the head of a statue, provided it be folded in the shred of a garment, and tied to the part affected with a red string.”563

The cyclamen was cultivated in houses as a protection against poison. Pliny remarks that it was an amulet.564 Vivisection was practised in connection with charms. “If a man have a white spot, as cataract, in his eye, catch a fox alive, cut his tongue out, let him go, dry his tongue and tie it up in a red rag and hang it round the man’s neck.”

Alexander Trallianus was not able to rise above the absurdities of the amulet. He recommends bits of old sailcloth from a shipwrecked vessel to be tied to the right arm and worn for seven weeks as a protection against epilepsy. He advises the heart of a lark to be fastened to the left thigh as a remedy for colic; for a quartan ague, the patient must carry about some hairs from a goat’s chin. He admits that he has no faith in such things, but merely orders them as placebos for rich and fastidious patients who could not be persuaded to adopt a more rational treatment.565

Dr. Baas tells us that “a regular pagan amulet was found in 1749 on the breast of the prince bishop Anselm Franz of WÜrzburg, count of Ingolstadt, after his death.”566

Gnostic and Christian Amulets.

Gnosticism is responsible for the introduction of many wonder-working amulets and charms. This system of philosophy was a fantastical combination of Orientalism, Greek philosophy, and Christianity. The teaching was that all natures were emanations of the Deity, or Œons. On some of the gnostic amulets the word Mythras was inscribed, on others Serapis, Iao, Sabaoth, Adonai, etc.

Notwithstanding the fact that the spirit of Christianity in its early days was strenuously opposed to all magical and superstitious practices, the nations it subdued to the faith of Christ were so wedded to their ancient practices that they could not be entirely divorced from them, and thus in the case of amulets and charms it was necessary to substitute Christian words and emblems in place of the heathen words and symbols previously in use.

Anglo-Saxon charms and amulets were used by the monks of Glastonbury Abbey, who treated disease. In the “Leech book”567 we find a holy amulet “against every evil rune lay,568 and one full of elvish tricks, writ for the bewitched man, this writing in Greek letters: Alfa, Omega, Iesvm, Beronikh. Again, another dust and drink against a rune lay; take a bramble apple,569 and lupins, and pulegium, pound them, then sift them, put them in a pouch, lay them under the altar, sing nine masses over them, put the dust into milk, drip thrice some holy water upon them, administer this to drink at three hours.... If a mare570 or hag ride a man, take lupins, and garlic, and betony, and frankincense, bind them on a fawn skin, let a man have the worts on him, and let him go into his house.” For typhus fever the patient is to drink of a decoction of herbs over which many masses have been sung, then say the names of the four gospellers and a charm and a prayer. Again, a man is to write in silence a charm, and silently put the words in his left breast and take care not to go indoors with the writing upon him, the words being Emmanuel, Veronica.

Mr. Cockayne, the editor of Saxon Leechdoms, has pointed out that the greatest scientific men of antiquity, even those who set themselves against the prevailing medical superstitions of their times, and did their utmost to establish observation and experiment in opposition to speculation and old wives’ fables, were by no means liberated from a belief in magic and incantations. Chrysippus believed in amulets for quartan fevers.571 Serapion, one of the chiefs of the Empiric school, prescribed crocodile’s dung and turtle’s blood in epilepsy. Soranos will not use incantations in the cure of diseases, yet he testifies that they were so employed. Pliny has an amulet for almost every disorder. He tells of a chief man in Spain who was cured of a disease by hanging purslane root round his neck; he teaches that an amulet of the seed of tribulus cures varicose veins; that the longest tooth of a black dog cures quartan fevers; or you may carry a wasp in your left hand or half a dozen other equally absurd things for the same purpose. A holly planted in the courtyard of a house keeps off witchcrafts; an herb picked from the head of a statue and tied with a red thread will cure headache, and so on.572

Josephus tells a tale which was probably the foundation of what was afterwards told about the mandrake. Xenocrates had a fancy for advising people to eat human brains, flesh or liver, or to swallow for various complaints the ground bones of parts of the human frame. Alexander of Tralles says that even Galen did homage to incantations.573 He gives his words: “Some think that incantations are like old wives’ tales; as I did for a long while. But at last I was convinced that there is virtue in them by plain proofs before my eyes. For I had trial of their beneficial operations in the case of those scorpion-stung, nor less in the case of bones stuck fast in the throat, immediately, by an incantation thrown up. And many of them are excellent, severally, and they reach their mark.” Yet Galen is angry with Pamphilos for “his babbling incantations,” which were “not merely useless, not merely unprofessional, but all false: no good even to little boys, not to say students of medicine.”574

Alexander of Tralles frequently prescribes amulets and the like. Mr. Cockayne calls them periapts. “Thus for colic, he guarantees by his own experience, and the approval of almost all the best doctors, dung of a wolf, with bits of bone in it if possible, shut up in a pipe, and worn during the paroxysm, on the right arm, or thigh, or hip, taking care it touches neither the earth nor a bath. A lark eaten is good. The Thracians pick out its heart, while alive, and make a periapt, wearing it on the left thigh. A part of the cÆcum of a pig prepared with myrrh, and put in a wolf’s or dog’s skin, is a good thing to wear. A ring with Hercules strangling a lion on the Median stone575 is good to wear.

“A bit of a child’s navel, shut up in something of gold or silver with salt, is a periapt which will make the patient at ease entirely. Have the setting of an iron ring octagonal, and engrave upon it, ‘Flee, Flee, Ho, Ho, Bile, the lark was searching’; on the head of the ring have an N576 engraved; this is potent, and he thinks it must be strange not to communicate so powerful an antidote, but begs it may be reserved from carnal folk, and told only to such as can keep secrets and are trusty. For the gout he recommends a certain cloth—?? t?? ?ata?????; also the sinews of a vulture’s leg and toes tied on, minding that the right goes to the right, the left to the left; also the astragali of a hare, leaving the poor creature alive; also the skin of a seal for soles??a], on gold-leaf, when the moon is in Libra; also a natural magnet found when the moon is in Leo. Write on gold-leaf, in the wane of the moon, ‘mei, threu, mor, for, teux, za, zon, the, lou, chri, ge, ze, ou, as the sun is consolidated in these names, and is renewed every day; so consolidate this plaster as it was before, now, now, quick, quick, for, behold, I pronounce the great name, in which are consolidated things in repose, iaz, azuf, zuon, threux, bain, chook; consolidate this plaster as it was at first, now, now, quick, quick.’577

“Then bits were to be chopped off a chameleon, and the creature living was to be wrapped up in a clean linen rag, and buried towards the sunrise, while the chopped bits were to be worn in tubes; all to be done when the moon was in the wane. Then again for gout, some henbane, when the moon is in Aquarius or Pisces, before sunset, must be dug up with the thumb and third finger of the left hand, and must be said, I declare, I declare, holy wort, to thee; I invite thee to-morrow to the house of Fileas, to stop the rheum of the feet of M. or N., and say I invoke thee, the great name, Jehovah, Sabaoth, the God who steadied the earth and stayed the sea, the filler of flowing rivers, who dried up Lot’s wife and made her a pillar of salt, take the breath of thy mother earth and her power, and dry the rheum of the feet or hands of M. or N. The next day, before sunrise, take a bone of some dead animal, and dig the root up with this bone, and say, I invoke thee by the holy names, Iao, Sabaoth, Adonai, Elai; and put on the root one handful of salt, saying, ‘As this salt will not increase, so may not the disorder of N. or M.’ And hang the end of the root as a periapt on the sufferer,” etc.578

Although Alexander of Tralles was an enlightened and skilful physician, he recommended for epilepsy a metal cross tied to the arm; and went to the Magi for assistance in his art, and was recommended to use jasper and coral with root of nux vomica tied in a linen cloth as an amulet. It seems strange that, although Hippocrates and the scepticism of the Epicureans had apparently destroyed the faith in magicians amongst the learned, that men should have so soon reverted to the absurdities from which they had been delivered; but there is an element in our nature which can only be satisfied by that which magic represents, and even in the present age of science we have reverted to the same things under the names of Spiritualism, Theosophy, and Occultism.

It would be grossly unfair to the Catholic Church to complain of the slavery in which it kept the minds of the ignorant barbarians whom it had converted from paganism to Christianity. When we read of medicine masses, of herbs and decoctions placed under the altar, of holy water mixed with drugs, and the sign of the cross made over the poultices and lotions prescribed, we are apt to say that the priests merely substituted one form of superstition for another, which was a little coarser. A little reflection will serve to dispel this idea. A belief in magic influence is, as we have abundantly shown, inseparable from the minds of primitive and savage man. It is as certain that a savage will worship his fetish, pray to his idol, and believe in disease-demons, and their expulsion by charms and talismans, as that he will tattoo or paint his body, stick feathers in his hair, and rings in his nose and ears; it is part of the evolution of man on his way to civilization. To suddenly deprive a savage or barbarian of all his magic remedies, his amulets and charms, would be as foolish as it would be futile: foolish, because many amulets and charms are perfectly harmless, and help to quiet and soothe the patient’s mind; futile, because whatever the ecclesiastical prohibition, the obnoxious ceremonies would certainly be practised in secret. It was therefore wiser for the Church to compromise the matter, to wink at innocent superstitions, and endeavour to substitute a religious idea such as the sign of the cross would imply, for the meaningless, if not idolatrous, ceremonies of a pagan religion. Let us never forget that the Church delivered the nations from “the tyranny and terror of the poisoner and the wizard.”

Herbs, Animals, etc., as Amulets.

Burton, in his Anatomy of Melancholy, mentions several “amulets and things to be borne about” as remedies for head-melancholy, such as hypericon, or St. John’s wort, gathered on a Friday in the hour of Jupiter, “borne or hung about the neck, it mightily helps this affection, and drives away all fantastical spirits.” A sheep or kid’s skin whom a wolf worried must not be worn about a man, because it is apt to cause palpitation of the heart, “not for any fear, but a secret virtue which amulets have.” “Peony doth cure epilepsy, precious stones most diseases; a wolf’s dung borne with one helps the colic; a spider an ague, etc. Being in the country,” he says, “in the vacation time, not many years since, at Lindley, in Leicestershire, my father’s home, I first observed this amulet of a spider in a nut-shell lapped in silk, etc., so applied for an ague by my mother; whom, although I knew to have excellent skill in chirurgery, sore eyes, aches, etc., and such experimental medicines, as all the country where she dwelt can witness, to have done many famous and good cures upon diverse poor folks that were otherwise destitute of help; yet among all other experiments, this, methought, was most absurd and ridiculous; I could see no warrant for it—Quid aranea cum febre? For what antipathy?—till at length rambling amongst authors (as I often do), I found this very medicine in Dioscorides, approved by Matthiolus, repeated by Alderovandus, cap. de aranea, lib. de insectis, and began to have a better opinion of it, and to give more credit to amulets, when I saw it in some parties answer to experience.”579

The common fumitory (Fumaria capreolata) is said to derive its name from fumus, smoke, “because the smoke of this plant was said by the ancient exorcists to have the power of expelling evil spirits.”580

The elder had many singular virtues attributed to it; if a boy were beaten with an elder stick, it hindered his growth; but an elder on which the sun had never shined was an amulet against erysipelas.581

Knots as Charms.

Marcellus, a medical writer, quoted by Mr. Cockayne in his preface to Saxon Leechdoms, vol. i, p. xxix., gives an example of knots as charms. “As soon as a man gets pain in his eyes, tie in unwrought flax as many knots as there are letters in his name, pronouncing them as you go, and tie it round his neck.”

Precious Stones as Charms.

The origin of the superstitious belief in the magic power of precious stones has always been traced to ChaldÆa. Pliny582 refers to a book on the subject which was written by Lachalios, of Babylon, and dedicated to Mithridates.

The Eagle stone (Ætites) is a natural concretion, a variety of argillaceous oxide of iron, often hollow within, with a loose kernel in the centre, found sometimes in an eagle’s nest. This was a famous amulet, bringing love between a man and his wife; and if tied to the left arm or side of a pregnant woman it ensured that she should not be delivered before her time. Women in labour were supposed to be quickly delivered if they were girded with the skin which a snake casts off.583

The Bezoar stone had a great reputation in melancholic affections. Manardus says it removes sadness and makes him merry that useth it.584

“Of the stone which hight agate. It is said that it hath eight virtues. One is when there is thunder, it doth not scathe the man who hath this stone with him. Another virtue is, on whatsoever house it is, therein a fiend may not be. The third virtue is, that no venom may scathe the man who hath the stone with him. The fourth virtue is, that the man, who hath on him secretly the loathly fiend, if he taketh in liquid any portion of the shavings of this stone, then soon is exhibited manifestly in him, that which before lay secretly hid. The fifth virtue is, he who is afflicted with any disease, if he taketh the stone in liquid, it is soon well with him. The sixth virtue is, that sorcery hurteth not the man who has the stone with him. The seventh virtue is, that he who taketh the stone in drink, will have so much the smoother body. The eighth virtue of the stone is, that no bite of any kind of snake may scathe him who tasteth the stone in liquid.”585

Signatures.

Colours have always had a medical significance, from their connection with the doctrine of “signatures.” White was cooling; red was hot. Red flowers were given in disorders of the blood; yellow in bile disturbance. The bed-hangings in small-pox and scarlet-fever cases were commonly of a red colour; the unhappy patient’s room was hung about with red drapery. He had to drink infusions of red berries, such as mulberries. Avicenna said that as red bodies move the blood everything of a red colour is good for blood disorders.

Numbers.

Magic numbers as charms were in use in Anglo-Saxon medicine. “If any thing to cause annoyance get into a man’s eye, with five fingers of the same side as the eye, run the eye over and fumble at it, saying three times, ‘tetunc resonco, bregan gresso,’ and spit thrice. For the same, shut the vexed eye and say thrice, ‘in mon deromarcos axatison,’ and spit thrice; this remedy is ‘mirificum.’ For the same, shut the other eye, touch gently the vexed eye with the ring finger and thumb, and say thrice, ‘I buss the gorgon’s mouth.’ This charm repeated thrice nine times will draw a bone stuck in a man’s throat. For hordeolum, which is a sore place in the eyelid of the shape of a barley-corn, take nine grains of barley and with each poke the sore, with every one saying the magic words, ????a ????a ?assa??a s????f?; then throw away the nine, and do the same with seven; throw away the seven, and do the same with five, and so with three and one. For the same, take nine grains of barley and poke the sore, and at every poke say, ‘fe??e, fe??e ????? se d???e?, flee, flee, barley thee chaseth.’ For the same, touch the sore with the medicinal or ring finger, and say thrice, ‘vigaria gasaria.’ To shorten the matter, blood may be stanched by the words, ‘sicycuma, cucuma, ucuma, cuma, uma, ma, a.’ Also by ‘Stupid on a mountain went, stupid, stupid was;’ by socnon socnon; s??s??a s???a; by ?a ?e ?? ?e ?? ?a ?e. For toothache say, ‘Argidam margidam sturgidam;’ also, spit in a frog’s mouth, and request him to make off with the toothache. For a troublesome uvula catch a spider, say suitable words, and make a phylactery of it. For a quinsy lay hold of the throat with the thumb and the ring and middle fingers, cocking up the other two, and tell it to be gone.”

Nine is the number consecrated by Buddhism, three is sacred among Brahminical and Christian people. Pythagoras held that the unit or monad is the principle and the end of all. One is a good principle. Two, or the dyad, is the origin of contrasts and separation, and is an evil principle. Three, or the triad, is the image of the attributes of God. Four, or the tetrad, is the most perfect of numbers and the root of all things. It is holy by nature. Five, or the pentad, is everything; it stops the power of poisons, and is redoubted by evil spirits. Six is a fortunate number. Seven is powerful for good or evil, and is a sacred number. Eight is the first cube, so is man four-square or perfect. Nine, as the multiple of three, is sacred. Ten, or the decad, is the measure of all it contains, all the numeric relations and harmonies.586

Cornelius Agrippa wrote on the power of numbers, which he declares is asserted by nature herself; thus the herb called cinquefoil, or five-leaved grass, resists poison, and bans devils by virtue of the number five; one leaf of it taken in wine twice a day cures the quotidian, three the tertian, four the quartan fever. He believed that every seventh son born to parents who have not had daughters is able to cure the king’s-evil by touch or word alone.587

Girdles.

Amongst the ancient Britons, says Meryon,588 when a birth was attended with difficulty or danger, girdles were put round the woman, which were made for the purpose, and which gave her immediate relief. Many families in the highlands of Scotland kept such girdles until quite recently. They were marked with cabalistic figures, and were applied with certain ceremonies, which came originally from the Druids.

Spittle.

Levinus Lemnius says of saliva: “Divers experiments show what power and quality there is in man’s fasting spittle, when he hath neither eat nor drunk before the use of it; for it cures all tetters, itch, scabs, pushes, and creeping sores; and if venomous little beasts have fastened on any part of the body, as hornets, beetles, toads, spiders, and such like, that by their venome cause tumours and great pains and inflammations; do but rub the places with fasting spittle, and all those effects will be gone and dismissed.”589

Sir Thomas Browne is not quite sure that fasting saliva really is poisonous to snakes and vipers.590

In Saxon Leechdoms a cure for the gout runs thus: “Before getting out of bed in the morning, spit on your hand, rub all your sinews, and say, ‘Flee, gout, flee, etc.’”591

Spittle was anciently a charm against all kinds of fascination. Pliny says it averted witchcraft. Theocritus says,—

Fishermen and costermongers often spit on the first money they take, for good luck.592

Talismans.

Talismans, says Fosbrooke,593 are of five classes, 1. The Astronomical, with celestial signs and intelligible characters. 2. The Magical, with extraordinary figures, superstitious words, and names of unknown angels. 3. The Mixed, of celestial signs and barbarous words, but not superstitions, or with names of angels. 4. The Sigilla Planetarum, composed of Hebrew numeral letters, used by astrologers and fortune tellers. 5. Hebrew Names and Characters. These were formed according to the cabalistic art. Pettigrew gives a Hebrew talisman,594 which runs thus: “It overflowed—he did cast darts—Shaddai is all sufficient—his hand is strong, and is the preserver of my life in all its variations.”

Scripts.

Sir John Lubbock says that “The use of writing as a medicine prevails largely in Africa, where the priests or wizards write a prayer on a piece of board, wash it off, and make the patient drink it. Caillie met with a man who had a great reputation for sanctity, and who made his living by writing prayers on a board, washing them off, and then selling the water, which was sprinkled over various objects and supposed to protect them.”595

Mungo Park relates similar facts.596

Sir A. Lyall says that a similar practice exists in India, where, however, the native practitioner may sometimes be seen mixing croton oil in the ink with which he writes his charms. “In Africa,” says Lubbock, “the prayers written as medicine or as amulets are generally taken from the Koran.” It is admitted that they are no protection against firearms; but this does not the least weaken faith in them, because, as guns were not invented in Mahomet’s time, he naturally provided no specific against them.597

Among the Kirghiz Atkinson says that the Mullas sell such amulets at the rate of a sheep for each scrap of written paper,598 and similar charms are in great request among the Turkomans599 and in Afghanistan.600

The very curious account of the trial of jealousy in Numbers vi. 11-31 may be studied in this connection as showing the extreme antiquity of the writing charm. In the case of the woman suspected of having committed adultery “the priest shall bring her near, and set her before the Lord: and the priest shall take holy water in an earthen vessel; and of the dust that is in the floor of the tabernacle the priest shall take, and put it into the water: and the priest shall set the woman before the Lord, and uncover the woman’s head, and put the offering of memorial in her hands, which is the jealousy offering: and the priest shall have in his hand the bitter water that causeth the curse: and the priest shall charge her by an oath, and say unto the woman, If no man have lain with thee, and if thou hast not gone aside to uncleanness with another instead of thy husband, be thou free from this bitter water that causeth the curse: but if thou hast gone aside to another instead of thy husband, and if thou be defiled, and some man have lain with thee beside thine husband: then the priest shall charge the woman with an oath of cursing, and the priest shall say unto the woman, The Lord make thee a curse and an oath among thy people, when the Lord doth make thy thigh to rot, and thy belly to swell; and this water that causeth the curse shall go into thy bowels, to make thy belly to swell, and thy thigh to rot: and the woman shall say, Amen, amen. And the priest shall write these curses in a book, and he shall blot them out with the bitter water: and he shall cause the woman to drink the bitter water that causeth the curse: and the water that causeth the curse shall enter into her, and become bitter. Then the priest shall take the jealousy offering out of the woman’s hand, and shall wave the offering before the Lord, and offer it upon the altar: and the priest shall take an handful of the offering, even the memorial thereof, and burn it upon the altar, and afterward shall cause the woman to drink the water. And when he hath made her to drink the water, then it shall come to pass, that, if she be defiled, and have done trespass against her husband, that the water that causeth the curse shall enter into her, and become bitter, and her belly shall swell, and her thigh shall rot: and the woman shall be a curse among her people. And if the woman be not defiled, but be clean; then she shall be free, and shall conceive seed. This is the law of jealousies, when a wife goeth aside to another instead of her husband, and is defiled; or when the spirit of jealousy cometh upon him, and he be jealous over his wife, and shall set the woman before the Lord, and the priest shall execute upon her all this law. Then shall the man be guiltless from iniquity, and this woman shall bear her iniquity.”

This is quite evidently taken from the customs of African tribes. As the Egyptians gave the Jews their knowledge of the medical arts, and as this knowledge was doubtless largely intermingled with African ideas, it is easy to see how the ordeal of the bitter curse-water found its way into the Mosaic ritual.

Of scripts as amulets we find that anything written in a character which nobody could read was worn as an amulet against disease or danger. Thus the Anglo-Saxon MS., known as the Vercelli MS., by some means found its way to a place near Milan, where no one could decipher it. When that discovery was made, the next step was to cut up its precious pages for amulets, and so many of its leaves have perished.

After the death of Pascal, the philosopher, a writing was found sewn into his doublet. This was a “profession of faith” which he wore as a sort of amulet or charm, and his servants believed that he always had it stitched into a new garment when he discarded the old one.601

“Mais ce qui montre que ce n’est par un simple engagement tel qu’on en peut prendre avec soi-mÊme, c’est la forme Étrange que Pascal lui a donnÉe. Pour quiconque a vu les Écrits de ce genre de la part d’hallucinÉs, le premier coup d’oeil montre que l’Écrit de Pascal appartient À cette catÉgorie. D’ailleurs, il porte l’Énonciation manifeste d’une vision en ces termes: ‘Depuis environ dix heures et demie du soir jusque environ minuit et demi, feu.’ Ainsi, ce jour-lÀ, le lundi 23 Novembre, 1654, pendant environ deux heures, Pascal eut la vision d’un feu qu’il prit pour une apparition surnaturelle, et sa conviction fut si forte qu’elle le dÉtermina À entrer plus avant qu’il n’avait fait jusqu’alors dans les voies de la dÉvotion et du rigorisme jansÉniste.”602

Characts.

Of the species of charms known as characts we have many examples in the practice of Anglo-Saxon physicians. In the preface to the Herbarium of Apuleius, used at Glastonbury, Mr. Cockayne, the editor, gives the following from Marcellus, 380 A.D., to avoid inflamed eyes: “Write on a clean sheet of ??a??, and hang this round the patient’s neck, with a thread from the loom.” In a state of purity and chastity write on a clean sheet of paper f??fa?a?, and hang it round the man’s neck; it will stop the approach of inflammation. The following will stop inflammation coming on, written on a clean sheet of paper: ?????, ????e??a? ??e???? ??· ?a?tef??a· ?a? pa?te? ?a??te?; it must be hung to the neck by a thread; and if both the patient and operator are in a state of chastity, it will stop inveterate inflammation. Again, write on a thin plate of gold with a needle of copper, ???? ????d?; do this on a Monday; observe chastity; it will long and much avail.

Characts are amulets in the form of inscriptions, and are to be found in all the old houses still existing in Edinburgh.603 The name of God is one of the commonest characts.

Rabbi Hama gives a sacred seal with divine names written in Hebrew, which he declares will cure not only all kinds of diseases, but heal all griefs whatsoever. The seals are figured in Morley’s Life of Cornelius Agrippa.604

When a charact or charm lost its original meaning, it came to bear that of something worn for its supposed efficacy in preserving the wearer from danger in mind or body, and now means a mere trinket to hang on a watch chain. One of the most famous of ancient charms was the name of the supreme deity of the Assyrians. This was the Abracadabra, which was supposed to have a magical efficacy as an antidote against ague, fever, flux, and toothache.605 It was written on parchment, and arranged as follows:—

A B R A C A D A B R A
A B R A C A D A B R
A B R A C A D A B
A B R A C A D A
A B R A C A D
A B R A C A
A B R A C
A B R A
A B R
A B
A

This was suspended round the neck by a linen thread. The word Abraxas, or Abrasax, was engraved on antique stones, and used as amulets or charms against disease. Sometimes mystical characters and figures were added, as the head of a fowl, the arms and bust of a man terminating in the body and tail of a serpent. It is of Egyptian origin, and is referred to by the Greek Fathers. The Egyptians used it to dispossess evil spirits and to cure diseases.606

Abraxas is the president of the 365th heaven, and is thus evidently a sun myth. Apollo is the sun in mythology, and he was the god of physic or healing.607

Brande, in his Popular Antiquities, gives the following charm from a manuscript of the date of 1475:608—

“Here ys a charme for wyked Wych. In nomine Patris, et Filii, et Spiritus Sancti. Amen. Per Virtutem Domini sint Medicina mei pia Crux ? et passio Christi ?. Vulnera quinque Domini sint Medicina mei ?. Virgo Maria mihi succurre, et defende ab omni maligno Demonio, et ab omni maligno Spiritu. Amen. ? a ? g ? l ? a ? Tetragrammaton. ? Alpha, ? oo, ? primogenitus, ? vita, vita. ? Sapiencia, ? Virtus, ? Jesus Nazarenus rex judeorum, ? fili Domini, miserere mei. Amen. ? Marcus ? Matheus ? Lucas ? Johannes mihi succurrite et defendite. Amen. ? Omnipotens sempiterne Deus, hunc N. famulum tuum hoc breve Scriptum super se portantem prospere salvet dormiendo, vigilando, potando, et precipue sompniando ab omni Maligno Demonio, eciam ab omni maligno spiritu ?.”

One of the most famous charms of this kind is the “Solomon’s Seal.”

Amongst the Cabalists an amulet, with the names “Senoi, Sansenoi, Semongeloph,” upon it, was fastened round the neck of the new-born child.609

The first Psalm, when written on doeskin, was supposed to help the birth of children; but the writer of such Psalm amulets, as soon as he had written one line, had to plunge into a bath. “Moreover,” says Mr. Morley, “that the charm might be the work of a pure man, before every new line of his manuscript it was thought necessary that he should repeat the plunge.”610

Sacred Names as Charms.

Some of the Jews accounted for the miracles of healing wrought by our Saviour by declaring that He had learned the Mirific Word, the true pronunciation of the name Jehovah; this word stirs all the angels and rules all creatures. They said that He had gained admission to the Holy of Holies, where He learned the sacred mystery, wrote it on a tablet, cut open His thigh, and having put the tablet in the wound, closed the flesh by uttering the mystic Name. The names of angels and evil spirits were also held to be potent by the Cabalists. The name of a bad angel, Schabriri, was used when written down as a charm to cure ophthalmia.

Stolen Property as a Charm.

In Mr. Andrew Lang’s delightful Custom and Myth he says that he once met at dinner a lady who carried a stolen potato about with her as a cure for rheumatism. The potato must be stolen, or the charm would not work.

A small piece of beef, if stolen from a butcher, is supposed by some persons to charm away warts.