A TREATISE ON GALL-STONES, &c. &c. CHAPTER I. DIGEST OF HISTORICAL LITERATURE. THE earliest notice of concretions in the liver, which, with certain reservations, may be explained as gall-stones, occurs in the work of a Greek physician of the name of Alexander, who, from his birthplace, Tralle, a state in Lydia, received the surname of Trallianus. He seems to have lived subsequently to Oribasius (360 p. Chr. n.) and Ætius, but before Paulus Ægineta; but it is, perhaps, not possible to fix the exact time and place of his existence. His work, written in the Greek language, entitled 'Twelve Medical Books,' was missed for upwards of a thousand years, and after having been discovered, it was for the first time published at Paris, by Stephanus, in the year 1548, in folio, together with a Latin translation. In the following year, 1549, was published another translation, by J. G. Andernacus, and dedicated to Cranmer, Archbishop of Canterbury, who, as will be remembered, had then been constituted by Henry VIII one of the principal licensing authorities for the practice of physic. This translation, of which the full title is Alexandri Tralliani, Libri Medicinales XII. De graeco nunc primum conversi per J. G. Andernacum, Argent.,' 1549, 12mo, contains, in the second chapter of the eighth book—which treats of the obstruction of the liver the following passage:-" Nam humores nimium exiccati assatique, lapidum instar concreverunt, adeo 、 ut non amplius discuti potuerint." This notice of dried-up humours, concreted like stones, leaves little doubt that its author was aware, either from personal observation or from information derived from others, that stones are now and then found in the liver, and the occurrence of the passage in the chapter on obstruction of the liver, makes it clear that he must have considered these "concretions like stones" as possible causes of the obstruction of which he treats. If we admit Alexander Trallianus to have lived in the fifth century after Christ, we have four centuries to pass over before we meet with another notice of gall-stones in medical literature. About 900 p. Chr. Rhazes wrote (Rasis; Arabice, Muhamed Arrasi), and amongst the great number of articles which constituted his pharmacy he enumerates the gall-stone of the ox. Gesner, in his work, 'De quadrupedibus, Bos et Vacca,' G., lib. i, Francofurti, 1602, p. 64 (the edit. princ. was published in 1551), has thus quoted what the Arabian says about the concretion :-" In the gall of the ox something resembling a stone, of the shape of a ring, is found, which philosophers call alcheron; ground and drawn into the nostrils, it promotes the sharpness of the eyes, &c. If this alcheron cannot be had, a sesquidenarius of the bile of a black bull may be substituted. -Rasis." And lower down, voce Taurus, G., lib. i, p. 96, Gesner says, "That alcheron, a hard, stone-like substance, which is found in the bile of cattle, is useful to those who suffer from epilepsy, and promotes the sharpness of the eyes, and prevents that any humour collects in the eyes, we have taught above, in speaking of the ox, according to Rasis." About a century after Rhazes, the Armenian Avicenna began his practical and literary career. He knew the gallstones of the ox, and used them as a remedy in various complaints. I quote the passage referring to them from the following magnificent edition of his works which is in the library of the Royal College of Surgeons :- Avicennæ, Arabum medicorum principis (opera), Ex Gerardi Cremonensis versione, et Andreæ Alpagi Bellunensis castigatione,' &c., Venetiis, 1608, lib. ii, p. 314:-" Gall-stone of the ox.-What is an ox-gall-stone? It is a stone which is found in the gall-bladder of the ox, of the size of a hen's egg, and of a citron-yellow colour, drawing towards the red; and it has a bitter taste, biting the tongue; and it is of a light weight; and if it remains for a long time, it becomes broken up." After this definition follows a statement regarding its medical value in various complaints. This is serviceable as containing references, first to Europus, who is said to have recommended gall-stones in epilepsy, and next to Galenus, who is reported to have found them of little use, except for the head. The calculus was evidently looked upon as an accidental formation, without any reference to disease. The four chapters of which the last concludes with the above notice of ox-gall-stones only exist in the Hebrew codices; at least Andreas Bellunensis (a physician at Damascus, who had devoted thirty years to the study of the Arabian language, for the purpose of qualifying himself for the task he so eminently accomplished) could not find them in any Arabian codex. In the edition which Gesner refers to, these four chapters were inserted at the beginning of the second book; in the edition, however, from which I have been quoting these chapters are appended, not premised, to |