« PreviousContinue »
care. That Hippocrates availed himself of all his powers, his whole works attest; whilst that he did not reject the means of cure, or the treatment of diseases, such as are now dissevered from the “ pure” physician's office, is abundantly proved in the following treatises :—On Injuries of the Head,' • The Physician's Establishment,' On Fractures, * Articulations,” “Mochlicus, Ulcers,' 'Fistulæ,' and · Hæmorrhoids.
The testimony of Celsus, in his eight books, ' De Re Medica,' is equally conclusive upon this point. The preface to Book I thus recounts the early and systematic arrangement of all the acknowledged means of cure comprised in the three divisions of his work :
“During this period”--the times of Herophilus and Erasistratus—“physic was divided into three parts; the first cured by diet, the second by medicines, the third by manual operations; the first they termed in Greek dialTntin, the second, papua Kevtikn, and the third yelpovpyika."
Having, in the first four books, considered Dietetics as a means of cure, he devotes alike two to Pharmaceutics, and two to Chirurgics, as successive means to the same end. In his preface to the second part, or fifth book, he says,* “ Having gone through those disorders of the body which are principally relieved by diet, we must now proceed to that branch of physic which depends more upon medicines.* The ancient authors put great confi. dence in them; so did Erasistratus, and those who styled themselves empirics. Their efficacy was still more extolled by Herophilus and his followers, insomuch that they attempted to cure no distemper without them. They have wrote a good deal too concerning the virtues of medicines : such are the treatises of Zeno, or Andreas, or Apollonius, who was surnamed Mus. Not without reason Asclepiades, in a great measure, laid aside the use of them; and, because almost all medicines offend the stomach and afford bad juices, he chose to apply all his care to the management of the diet. But though this be most useful in most distempers, yet many disorders are incident to our bodies which cannot be totally removed without medicines. 'Tis fit to observe, in the first place, that all the branches of medicine are so connected together, that they cannot be entirely separated ; but each derives the appellation from that which is made use of in it. And, therefore, as that which cures by diet sometimes employs medicines, so the other, which chiefly works by medicines, ought also to take in the diet, which is of great service in all disorders of the body.”
* Grieve's translation.
* In this division are included wounds, ulcers, gangrenes, bites, and a long list of “external diseases proceeding from internal causes," as carbuncle, cancer, scrofula, furuncle, &c., all since rejected by the modern physician. See Book VI, chaps. xxvi-xxviii.
The relation of Dietetics and Pharmaceutics being thus defined, he proceeds, in his preface to the seventh book, to speak of the third acknowledged means of cure, or Chirurgics, in the following terms:
- This does not, indeed, discard medicines and a proper regimen, but yet the principal part is accomplished by the hand. And the effect of this is the most evident of all the parts of medicine ; for as fortune contributes a good deal to the cure of distempers, and the same things are often salutary, often fruitless, it may be doubted whether the recovery be owing to physic or the constitution. In those diseases also in which we chiefly make use of medicines, although their success be pretty evident, nevertheless it is plain that health is both sought for by their means in vain, and often restored without them. As may be observed with regard to the eyes, which, after having long suffered from the applications of physicians, sometimes recover of themselves. But in surgery, it is manifest that the success, though it may be somewhat promoted by other means, is chiefly to be ascribed to this. Now this branch, though it be most ancient, yet has been more cultivated by Hippocrates, the father of all medicine, than by his predecessors; afterwards being separated from the other parts, it began to have its peculiar professors, and received considerable improvements in Egypt, as well as elsewhere, principally from
Philoxenus, who has treated of this part fully and with great accuracy in several volumes.”
After naming other writers on surgery, and the necessary qualifications for a good operator, as regards age, &c., he adds—“Now, it may be asked, what peculiarly belongs to this branch ? because surgeons assume to themselves the curing of many wounds and ulcers, which I have treated of elsewhere.* I can very well suppose the same person capable of performing all these; and since they are divided, I esteem him most whose skill is most extensive. For my part, I have left to this branch those cases in which the physician makes a wound where he does not find one; and those wounds and ulcers, in which I believe manual operations to be more useful than medicines; lastly, whatever relates to the bones.”
Thus has Celsus given indisputable proof that these several means of cure were equally a part of the physician's office; some selecting one or more of the above branches, as time, talent, or opportunity inclined them; some claiming especially to make use of pharmaceutics, as Erasistratus and Herophilus ; some of dietetics, as Asclepiades; some of chirurgics, as Philoxenus and Gorgias. Yet were all physicians ; from none was the honoured name withheld, and on none was a prescribed limit enjoined ; the same generic term attached to him who used “chirurgics," as well as any other of the acknowledged means of cure founded on reason and experience, in opposition to the superstitious practices from which medicine had then but recently emerged.*
* The word “ Chirurgus” is used here and in one or two other places to denote the special part of the physician's office, to which he is then referring; but in the following passage, and throughout the seventh and eighth books on Chirurgics, as in the other six on Dietetics and Pharmaceutics, the generic term “ Medicus” is constantly used. When speaking of Diocles, who invented an instrument for extracting arrows from the wounds thereby inflicted, he says, “Quem inter priscos maximosque medicos fuisse, jam posui.” — Book vii, sec. 5.
Galen also extends, rather than contracts, the means of cure and amount of disease worthy the physician's care. He strongly condemns even the distinctions made by the great sects into which the profession was divided in ancient times—of empirics, dogmatics, methodics, and others--as leading to interminable hypotheses and disputes, each individual supporting his own theory to the disparagement of others, and the great injury of medicine in general.
Further extracts would be as irksome as unnecessary_Scribonius Largus, Oribasius, Aëtius, Paulus Ægineta, and all other ancient writers, testify to the same effect. It may be questioned how much of originality, or how much of compilation only, was due to each of these later authorities; yet no difference can exist as to the one object and the one title pertaining to all, though the object may have
* The time of Herophilus and Erasistratus.