dicine. geons, When a pestilential fever thinned the Grecian ranks, Podalirius and Machaon were not called. The disease was ascribed to the resentment of Apollo, and his anger was deprecated, and the disease removed, by restoring the captive daughter of his favourite priest. But when any of the Grecian heroes. was wounded in battle these medical men immediately attended, and displayed their skill in extracting the dart, stopping the blood, and healing the wound. India, Chaldea, and Egypt, being the most ancient and the first civilized Origin of me kingdoms, medicine no doubt made its first appearance among them. Apollo and Esculapius, to whom the origin of the art is ascribed by the Greeks, appear to have been both Egyptians. But what progress the science had made in these countries is altogether unknown. It is from the Greeks that we have derived all our arts and sciences, and that people have given us no information respecting the state of medicine in Egypt. It was probably very low, entirely unconnected with philosophy and science, and depending upon the delusive practices of magic and superstition. Even in Greece, which obviously derived its first medical knowledge from Hippocrates. the Egyptians, the art continued long in a very low state. And Hippocrates is acknowledged by the universal voice of antiquity to have been the first who connected medicine with philosophy, and who established his practice upon rational and scientific principles. He has therefore been universally considered as the true and legitimate founder of medicine, and has always enjoyed a higher reputation than any other medical man whatever. He is the first physician whose writings still exist. With him therefore commences the science as far as our knowledge of the subject extends. In all probability he borrowed much of his knowledge of the symptoms of the diseases, and of the effect of various medicines, from his predecessors; but as we have no information concerning the knowledge of his predecessors, the whole of the science, as far as he has delivered it in his writings, has been ascribed to him. On Hippocrates was born in the Isle of Cos, in the first year of the 80th Olympiad, about 30 years before the commencement of the Peloponnesian war. the father's side he was of the family of the Asclepiades, or the descendants of Esculapius, a family in which the knowledge of the medical art had descended without interruption from the illustrious founder. The Asclepiades were all physicians, and the knowledge of diseases was confined to their family. Thus he was at an early period initiated in all the medical knowledge of the times. He added to this the study of philosophy, which he considered as essential to the physician, a keen, constant, and accurate observation, the knowledge of anatomy as far as it was in his power to attain it without dissecting human subjects, and an industry and sagacity upon which medical celebrity, in all ages and countries, in a great measure depends. A considerable part of the works His physiology. His practice. of Hippocrates still remains, from which a pretty accurate estimate may be formed of his knowledge and practice. His description of diseases is very accurate and complete, and has not been surpassed by any succeeding writer. His knowledge of symptoms was wonderfully precise, and his prognosis, founded on that knowledge, though in some cases it appears to us absurd, was upon the whole so exact that it must have been, in a great measure, drawn from the observations of his predecessors. For it is impossible for one man, however busy and acute, to make so many observations during the course of a short life time as his aphorisms obviously require. His philosophy, founded upon the Pythagorean, led him to put much confidence in the value of numbers. Upon this was founded his faith in odd numbers, and his opinion respecting the periods and revolutions of diseases, and certain days on which all the important changes took place. These memorable days were called critical, and he lays down his regulations respecting them with much pains and precision. Though the philosophy upon which these critical days were founded has been long banished from medicine, the belief in critical days is by no means laid aside. We find it still taught by some of the most recent and most celebrated medical writers. It is an opinion however that can neither be supported by reasoning nor observation; and would not have been allowed to affect medical opinions for so long a period, had it not been for the unbounded reputation and real merit of the original introducer of it. For it may be said with truth, that no man is able permanently to injure a science by the introduction of absurdities, excepting one who has contributed essentially to its progress and celebrity. His physiological opinions deserve to be mentioned, because they have had considerable influence upon the opinions of his successors, and because his language still continues to be used by modern physiologists; even when they are unacquainted with, or do not believe, the philosophy of Hippocrates. He conceived that there was implanted in man a living principle, or soul, which was only a part of quais, or nature, concerning which he speaks in the highest terms. Nature," says he, "is alone sufficient to animals for all things. It knows of itself all that is necessary for them, without requiring any instruction or information." It governs the body by means of certain duvapes, or faculties, which are subordinate to it, act from necessity, and perform the various functions of the body, such as hearing, seeing, digesting, &c. rr The medical practice of Hippocrates was regulated by these opinions: Nature, in all cases, performed the cure; the business of the physician was only to look on, and register her operations. Accordingly, in his treatment of acute diseases, he seldom administered any powerful remedies, at least at first, but trusting entirely to the influence of nature, satisfed himself with regulating the diet and the dress of the patient. The body, according to Hippocrates, con- The surgery of Hippocrates, (for he practised at once all the different parts His surgery of the medical art,) was as violent as his medical treatment was mild. The actual cautery was very frequently applied on five or six parts of the body at once, and the ulcers produced by this cruel remedy were kept open for a considerable time by corrosive dressings. It is not necessary to describe his mode of purging the head by violent sternutatories; nor of evacuating matter from the lungs by exciting violent coughing.* Hippocrates having taught the art of medicine to all persons without distinction, who chose to become his pupils, medicine was no longer, as formerly, confined to a particular family, but spread itself, like philosophy, over all the states of Greece. Thessalus and Draco, the two sons, and Polybius, the sonin-law of Hippocrates, exercised the profession with eclat after the death of their father; especially Polybius, who acquired a high reputation, and intro- Polybius. duced, it is supposed, considerable changes into the practice of medicine, as taught by his father-in-law. A considerable period elapsed after the death of these men, before any physician of great eminence made his appearance. Diocles indeed, who seems to have flourished not many years after the death of that father of medicine, acquired such celebrity, that he was distinguished by the Athenians by the name of the second Hippocrates; but as none of his writings remain, we know little of his method of practice, or of his opinions. Herophilus, who was a physician in Alexandria, during the reign of Ptolemy Herophilus & Soter; and Erasistratus, physician to Antiochus, King .of Syria, made great improvements in anatomy, or rather indeed laid the foundation of the science. * The reader will find a very detailed account of the practice of Hippocrates, with a list of the diseases that he describes, and all the medicines which he employed, in Le Clerc's Histoire de la Medicine, p. 112—253. Erasistratus. Division of medicine. Being permitted by their respective sovereigns to inspect the bodies of criminals, a practice before that time considered as impious, and never allowed; they acquired, in consequence, a high reputation, and became in some measure the founders of sects, which bore their name and followed their opinions. But as their writings have not come down to our times, all our knowledge of their opinions and practice is derived from Galen. About this period, or a little after, as we are informed by Celsus, medicine, which had hitherto been all practised by one individual, came to be divided into three distinct professions, namely, dietetics, pharmaceutics, and surgery. Those who practised dietetics confined themselves to regulating the food of their patients; upon a strict attention to which, they made the whole of medicine depend. Those who practised pharmaceutics administered internal medicines; while the practitioners of surgery confined their attention to wounds, fractures, dislocations, ulcers, and other external diseases, to which surgeons confine themselves at present. It is hardly possible that dietetics and pharmaceutics should have been practised exclusively by different individuals; for, in many cases, physicians would find it necessary both to regulate the food of their patients, and to administer some medicines, in order to obviate certain symptoms. Soon after this period the Grecian physicians separated into two sects, as we are informed by Celsus, who regulated their practice on quite different principles. These were the empirics and the dogmatists. Both considered Hippocrates as their founder, and both seemed to do so with considerable justice. The empirics. The empirics discarded philosophy from medicine, and made the art depend upon experience alone. According to them, the physician has nothing to do with the causes of diseases; he ought only to make himself acquainted with the symptoms, and to determine by experience what is the proper method of cure. The dogma- The dogmatists, on the other hand, considered philosophy and medicine as inseparably connected. They began always by investigating the cause of every disease; and this cause, once known, led them, they conceived, to the only rational and efficacious mode of cure. tists. Celsus gives us, in his preface, the reasoning by which these two sects supported their different opinions, at considerable length; and, in the conclusion which he draws, he holds a medium between both; acknowledging that the practice of medicine has been chiefly promoted by experience, but affirming that reasoning, and even an investigation of the causes of disease, as far as possible, ought not to be neglected by medical men. By this sensible decision every person, we presume, will be disposed to abide; for though it must be granted that reasoning goes but a very little way in guiding the practical physician; though it will hardly be denied that absurd attempts at philosophizing, and inaccurate physiological theories, have much more frequently led physicians astray, and deranged their practice, than contributed to the advancement of the medical art; though the improvements in anatomy, in chemistry, and in science in general, have not contributed so much as might have been expected to the improvement of medicine; yet we presume, that there is no person so hardy or inconsiderate as to maintain that the science has made no progress since the days of Hippocrates; or that no part of this progress has been owing to the reasoning and investigations of medical men. Various important and indisputable improvements might be mentioned, sufficient to rescue the profession from such severe stigmas; as for example, the use of mercury in the venereal disease; the cool regimen in fevers; the use of bark in intermittents; the method of preventing the spreading of contagion, and the diffusion of pestilential diseases. Even in those maladies which medicine can do but little to assuage, the progress of knowledge has made itself conspicuous, and has at least contributed to alleviate the afflictions, and to sooth the distresses, of those whom it cannot completely relieve. These two sects continued to divide the medical world of Greece for several centuries. Meanwhile Rome was advancing with gigantic steps to the empire of the world. That city increased enormously in opulence and extent, and held out a tempting bait to the needy literary men of Greece, who flocked to it in great numbers. Among these was Asclepiades, of Praso, who came to Asclepiades. Rome, as Pliny informs us, during the Mithridatic war. He at first attempted to distinguish himself by teaching rhetoric, but was unsuccessful. He then thought of commencing physician; and, having studied the art for some time, considered his abilities as sufficient to raise him to distinction. Archagathus, a Grecian physician, who had settled some time before at Rome, had been driven from the city in consequence of the severity of his remedies. This was sufficient to induce Asclepiades to adopt a contrary method. According to him, patients ought to be cured safely, quickly, and agreeably. His medical project succeeded beyond his hopes; he speedily rose to the highest reputation, overturned the method of practice established by his predecessors, and raised himself to the rank of a second Esculapius. His philosophy appears to have been that of Epicurus and Democritus; and his remedies, according to Pliny, were reducible to five kinds; namely, abstinence from animal food, abstinence from wine, friction, walking, and riding, or gestation. His practice, as it has been transmitted to us by the writings of Celsus, Galen, and Cælius Aurelianus, hardly corresponds with the pretensions of Asclepiades, and appears scarcely less severe than that of his predecessors. * Asclepiades seems rather entitled to be considered as an expert quack, than Tutè, celeriter, et jucunde. Id votum est (says Celsus, Lib. III. Cap. 4.); sed fere periculosa esse nimia, et festinatio, et voluptas solet. |