Volume I Part 34 (2/2)

It thus appears that the practice of medicine in the hands of Hippocrates had reference rather to the course or career of disease than to its special nature. Nothing more than this masterly conception is wanted to impress us with his surprizing scientific power. He watches the manner in which the humours are undergoing their fermenting coction, the phenomena displayed in the critical days, the aspect and nature of the critical discharges. He does not attempt to check the process going on, but simply to a.s.sist the natural operation.

When we consider the period at which Hippocrates lived, B.C. 400, and the circ.u.mstances under which he had studied medicine, we cannot fail to admire the very great advance he made. His merit is conspicuous in rejecting the superst.i.tious tendency of his times by teaching his disciples to impute a proper agency to physical causes. He altogether discarded the imaginary influences then in vogue. For the G.o.ds he subst.i.tuted, with singular felicity, Impersonal Nature. It was the interest of those who were connected with the temples of aesculapius to refer all the diseases of men to supernatural agency; their doctrine being that every affliction should be attributed to the anger of some offended G.o.d, and restoration to health most certainly procured by conciliating his power. So far, then, as such interests were concerned, any contradiction of those doctrines, any subst.i.tution of the material for the supernatural, must needs have met with reprehension. Yet such opposition seems in no respect to have weighed with this great physician, who developed his theory and pursued his practice without giving himself any concern in that respect. He bequeathed an example to all who succeeded him in his n.o.ble profession, and taught them not to hesitate in encountering the prejudices and pa.s.sions of the present for the sake of the truth, and to trust for their reward in the just appreciation of a future age.

[Sidenote: His doctrine is truly scientific.]

With such remarks we may a.s.sert that the medical philosophy of Hippocrates is worthy of our highest admiration, since it exhibits the scientific conditions of deduction and induction. The theory itself is compact and clear; its lineaments are completely Grecian. It presents, to one who will contemplate it with due allowance for its times, the characteristic quick-sightedness, penetration, and power of the Greek mind, fully vindicating for its author the t.i.tle which has been conferred upon him by his European successors--the Father of Medicine--and perhaps inducing us to excuse the enthusiastic a.s.sertion of Galen, that we ought to reverence the words of Hippocrates as the voice of G.o.d.

[Sidenote: The school of Cnidos.]

[Sidenote: Is destroyed by Constantine.]

[Sidenote: Cla.s.ses of physicians.]

The Hippocratic school of Cos found a rival in the school of Cnidos, which offered not only a different view of the nature of disease, but also taught a different principle for its cure. The Cnidians paid more particular attention to the special symptoms in individual cases, and pursued a less active treatment, declining, whenever they could, a resort to drastic purgatives, venesection, or other energetic means. As might be expected, the professional activity of these schools called into existence many able men, and produced many excellent works: thus Philiston wrote on the regimen for persons in health; Diocles on hygiene and gymnastics; Praxagoras on the pulse, showing that it is a measure of the force of disease. The Asclepion of Cnidos continued until the time of Constantine, when it was destroyed along with many other pagan establishments. The union between the priesthood and the profession was gradually becoming less and less close; and, as the latter thus separated itself, divisions or departments arose in it, both as regards subjects, such as pharmacy, surgery, etc., and also as respects the position of its cultivators, some pursuing it as a liberal science, and some as a mere industrial occupation. In those times, as in our own, many who were not favoured with the gifts of fortune were constrained to fall into the latter ranks. Thus Aristotle, than whom few have ever exerted a greater intellectual influence upon humanity, after spending his patrimony in liberal pursuits, kept an apothecary's shop at Athens.

Aristotle the druggist, behind his counter, selling medicines to chance customers, is Aristotle the great writer, whose dictum was final with the schoolmen of the Middle Ages. As a general thing, however, the medical professors were drawn from the philosophical cla.s.s. Outside of these divisions, and though in all ages continually repudiated by the profession, yet continually hovering round it, was a host of impostors and quacks, as there will always be so long as there are weak-minded and shallow men to be deluded, and vain and silly women to believe.

[Sidenote: Egyptian medicine. The Museum.]

[Sidenote: Philadelphus founds medicine on anatomy.]

[Sidenote: He authorizes dissection and human vivisection.]

[Sidenote: Physicians of the Alexandrian school.]

When the Alexandrian Museum was originated by Ptolemy Philadelphus, its studies were arranged in four faculties--literature, mathematics, astronomy, medicine. These divisions are, however, to be understood comprehensively: thus, under the faculty of medicine were included such subjects as natural history. The physicians who received the first appointments were Cleombrotus, Herophilus, and Erasistratus; among the subordinate professors was Philo-Stepha.n.u.s, who had charge of natural history, and was directed to write a book on Fishes. The elevated ideas of the founder cannot be better ill.u.s.trated than by the manner in which he organized his medical school. It was upon the sure basis of anatomy.

Herophilus and his colleagues were authorized to resort to the dissection of the dead, and to ascertain, by that only trustworthy method, the true structure of the human body. The strong hand of Ptolemy resolutely carried out his design, though in a country where popular sentiment was strongly opposed to such practices. To touch a corpse in Egypt was an abomination. Nor was it only this great man's intention to ascertain the human structure; he also took measures to discover the mode in which its functions are carried forward, the manner in which it works. To this end he authorized his anatomists to make vivisections both of animals, and also of criminals who had been condemned to death, herein finding for himself that royal road in physiology which Euclid once told him, at a dinner in the Museum, did not exist in geometry, and defending the act from moral criticism by the plea that, as the culprits had already forfeited their lives to the law, it was no injury to make them serviceable to the interests of humanity. Herophilus had been educated at Cos; his pathological views were those known as humouralism; his treatment active, after the manner of Hippocrates, upon whose works he wrote commentaries. His original investigations were numerous; they were embodied, with his peculiar views, in treatises on the practice of medicine; on obstetrics; on the eye; on the pulse, which he properly referred to contractions of the heart. He was aware of the existence of the lacteals, and their anatomical relation to the mesenteric glands.

Erasistratus, his colleague, was a pupil of Theophrastus and Chrysippus: he, too, cultivated anatomy. He described the structure of the heart, its connexions with the arteries and veins, but fell into the mistake that the former vessels were for the conveyance of air, the latter for that of blood. He knew that there are two kinds of nerves, those of motion and those of sensation. He referred all fevers to inflammatory states, and in his practice differed from the received methods of Hippocrates by observing a less active treatment.

[Sidenote: Improvements in surgery and pharmacy.]

By these physicians the study of medicine in Alexandria was laid upon the solid foundation of anatomy. Besides them there were many other instructors in specialties; and, indeed, the temple of Serapis was used for a hospital, the sick being received into it, and persons studying medicine admitted for the purpose of familiarizing themselves with the appearance of disease, precisely as in similar inst.i.tutions at the present time. Of course, under such circ.u.mstances, the departments of surgery and pharmacy received many improvements, and produced many able men. Among these improvements may be mentioned new operations, for lithotomy, instruments for crus.h.i.+ng calculi, for reducing dislocations, etc. The active commerce of Egypt afforded abundant opportunity for extending the materia medica by the introduction of a great many herbs and drugs.

[Sidenote: Decline of Alexandrian medicine.]

The medical school of Alexandria, which was thus originally based upon dissection, in the course of time lost much of its scientific spirit.

But the influence of the first teachers may be traced through many subsequent ages. Thus Galen divides the profession in his time into Herophilians and Erasistratians. Various sects had arisen in the course of events, as the Dogmatists, who a.s.serted that diseases can only be treated correctly by the aid of a knowledge of the structure and functions, the action of drugs, and the changes induced in the affected parts; they insisted, therefore, upon the necessity of anatomy, physiology, therapeutics, and pathology. They claimed a descent from Hippocrates. Their antagonists, the Empirics, ridiculed such knowledge as fanciful or unattainable, and relied on experience alone. These subdivisions were not limited to sects; they may also be observed under the form of schools. Even Erasistratus himself, toward the close of his life, through some dispute or misunderstanding, appears to have left the Museum and established a school at Smyrna. The study of the various branches of medicine was also pursued by others out of the immediate ranks of the profession. Mithridates, king of Pontus, thus devoted himself to the examination of poisons and the discovery of antidotes.

What a fall from this scientific medicine to the miracle-cure which soon displaced it! What a descent from Hippocrates and the great Alexandrian physicians to the shrines of saints and the monks!

[Sidenote: The Jewish physicians.]

To the foregoing sketch of the state of Greek medicine in its day of glory, I must add an examination of the same science among the Jews subsequently to the second century; it is necessary for the proper understanding of the origin of Saracen learning.

[Sidenote: Their emanc.i.p.ation from the supernatural.]

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