Part 180

"The school of the Asclepiadæ has been responsible for certain theories which have been more or less prominent during the earlier historical days. One of these which prevailed throughout the Hippocratic works is that of Coction and Crisis. By the former term is meant thickening or elaboration of humors in the body, which was supposed to be necessary for their elimination in some tangible form. Disease was regarded as an association of phenomena resulting from efforts made by the conservative principles of life to effect a coction, i. e., a combination, of the morbific matter in the economy, it being held that the latter could not be properly expelled until thus united and prepared so as to form excrementious material. {2126} This elaboration was supposed to be brought about by the vital principles which some called nature (Phusis), some spirit (Psyche), some breath (Pneuma), and some heat (Thermon). The gradual climax of morbid phenomena has, since the days of Hippocrates, been commonly known as Crisis. All this was regarded as the announcement of the completion of this union by coction. The day on which it was accomplished was termed 'critical,' as were also the signs which preceded or accompanied it, and for the crisis the physician anxiously watched. Coction having been effected and crisis occurring, it only remained to evacuate the morbific material, which nature sometimes spontaneously accomplished by the critical sweat, urination, or stools; or sometimes the physician had to come to her relief by the administration of diuretics, purgatives, et cetera. The term 'critical period' was given to the number of days necessary for coction, which in its perfection was supposed to be four, the so-called quaternary, while the septenary was also held in high consideration. … This doctrine of crisis in disease left an impress upon the medical mind not yet fully eliminated."

_Roswell Park, Lectures on the History of Medicine (in MS.)._

"Making no pretension … to describe the regular medical practice among the Greeks, I shall here, nevertheless, introduce some few particulars more or less connected with it, which may be regarded as characteristic of the age and people. Great were the virtues which they ascribed to the herb alysson, (biscutella didyma,) which, being pounded and eaten with meat cured hydrophobia. Nay, more, being suspended in the house, it promoted the health of its inhabitants; it protected likewise both man and cattle from enchantment; and, bound in a piece of scarlet flannel round the necks of the latter, it preserved them from all diseases. Coriander-seed, eaten in too great quantity, produced, they thought, a derangement of the intellect. Ointment of saffron had an opposite effect, for the nostrils and heads of lunatics being rubbed therewith they were supposed to receive considerable relief. Melampos the goatherd was reported to have cured the daughters of Prætos of their madness by large doses of black hellebore, which thereafter received from him the name of Melampodion. Sea-onions suspended over the doors preserved from enchantment, as did likewise a branch of rhamnus over doors or windows. A decoction of rosemary and of the leaves and stems of the anemone was administered to nurses to promote the secretion of milk, and a like potion prepared from the leaves of the Cretan dittany was given to women in labour. This herb, in order to preserve its virtues unimpaired, and that it might be the more easily transported to all parts of the country, was preserved in a joint of a ferula or reed. A plaster of incense, Cimolian earth, and oil of roses, was applied to reduce the swelling of the breasts. A medicine prepared from mule's fern, was believed to produce sterility, as were likewise the waters of a certain fountain near Pyrrha, while to those about Thespiæ a contrary effect was attributed, as well as to the wine of Heraclea in Arcadia. The inhabitants of this primitive region drank milk as an aperient in the Spring, because of the medicinal herbs on which the cattle were then supposed to feed. Medicines of laxative properties were prepared from the juice of the wild cucumber, which were said to retain their virtues for two hundred years, though simples in general were thought to lose their medicinal qualities in less than four. The oriental gum called kankamon was administered in water or honeyed vinegar to fat persons to diminish their obesity, and also as a remedy for the toothache. For this latter purpose the gum of the Ethiopian olive was put into the hollow tooth, though more efficacy perhaps was attributed to the root of dittander which they suspended as a charm about the neck. A plaster of the root of the white thorn or iris roots prepared with flour of copper, honey, and great centaury, drew out thorns and arrow heads without pain. An unguent procured from fern was sold to rustics for curing the necks of their cattle galled by the yoke. A decoction of marsh-mallow leaves and wine or honeyed vinegar was administered to persons who had been stung by bees or wasps or other insects; bites and burns were healed by an external application of the leaf smeared with oil, and the powdered roots cast into water caused it to freeze if placed out during the night in the open air; an unguent was prepared with oil from reeds, green or dry, which protected those who anointed themselves with it from the stings of venomous reptiles. Cinnamon unguent, or terebinth and myrtle-berries, boiled in wine, were supposed to be a preservative against the bite of the tarantula or scorpion, as was the pistachio nut against that of serpents. Some persons ate a roasted scorpion to cure its own bite; a powder, moreover, was prepared from sea-crabs supposed to be fatal to this reptile. Vipers were made to contribute their part to the materia medica; for, being caught alive, they were enclosed with salt and dried figs in a vase which was then put into a furnace till its contents were reduced to charcoal, which they esteemed a valuable medicine. A. considerable quantity of viper's flesh was in the last century imported from Egypt into Venice, to be used in the composition of medicinal treacle. From the flowers of the sneezewort, a sort of snuff appears to have been manufactured, though probably used only in medicines. The ashes of old leather cured burns, galls, and blistered feet. The common remedy when persons had eaten poisonous mushrooms was a dose of nitre exhibited in vinegar and water; with water it was esteemed a cure for the sting of a burncow, and with benzoin it operated as an antidote against the poison of bulls' blood."

_J. A. St. John, The Hellenes, book 6, chapter 6 (volume 3)._

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MEDICAL SCIENCE: The Hippocratic Oath.

"Medical societies or schools seem to have been as ancient as Hippocrates. The Hippocratic oath, as it is called, has been preserved, and is one of the greatest curiosities we have received from antiquity:

'I swear by Apollo the physician, by Æsculapius, by Hygeia, by Panacea, and by all gods and goddesses, that I will fulfil religiously, according to the best of my power and judgment, the solemn vow which I now make.

I will honour as my father the master who taught me the art of medicine; his children I will consider as my brothers, and teach them my profession without fee or reward.

I will admit to my lectures and discourses my own sons, my master's sons, and those pupils who have taken the medical oath; but no one else.

I will prescribe such medicines as may be best suited to the cases of my patients, according to the best of my judgment; and no temptation shall ever induce me to administer poison.

I will religiously maintain the purity of my character and the honour of my art.

I will not perform the operation of lithotomy, but leave it to those to whose calling it belongs.

Into whatever house I enter, I will enter it with the sole view of relieving the sick, and conduct myself with propriety towards the women of the family.

If during my attendance I happen to hear of anything that should not be revealed, I will keep it a profound secret.

If I observe this oath, may I have success in this life, and may I obtain general esteem after it; if I break it, may the contrary be my lot.'"

_Ancient Physic and Physicians (Dublin University Magazine, April, 1856)._

MEDICAL SCIENCE: 1st Century. Greek physicians in Rome. Pliny's Picture.

Pliny's account of the Greek physicians in Rome in his time (first century) is not flattering to the profession. He says: "For the cure of King Antiochus—to give our first illustration of the profits realized by the medical art—Erasistratus received from his son, King Ptolemæus, the sum of one hundred talents. … I pass over in silence many physicians of the very highest celebrity, the Cassii, for instance, the Calpetani, the Arruntii, and the Rubrii, men who received fees yearly from the great, amounting to no less than 250,000 sesterces. As for Q. Stertinius, he thought that he conferred an obligation upon the emperors in being content with 500,000 sesterces per annum; and indeed he proved, by an enumeration of the several houses, that a city practice would bring him in a yearly income of not less than 600,000 sesterces. Fully equal to this was the sum lavished upon his brother by Claudius Cæsar; and the two brothers, although they had drawn largely upon their fortunes in beautifying the public buildings at Neapolis, left to their heirs no less than 30,000,000 of sesterces! such an estate as no physician but Arruntius had till then possessed. Next in succession arose Vettius Valens, rendered so notorious by his adulterous connection with Messalina, the wife of Claudius Cæsar, and equally celebrated as a professor of eloquence. When established in public favour, he became the founder of a new sect. It was in the same age, too, during the reign of the Emperor Nero, that the destinies of the medical art passed into the hands of Thessalus, a man who swept away all the precepts of his predecessors, and declaimed with a sort of frenzy against the physicians of every age; but with what discretion and in what spirit, we may abundantly conclude from a single trait presented by his character—upon his tomb, which is still to be seen on the Appian Way, he had his name inscribed as the 'Iatronices'—the 'Conqueror of the Physicians.' No stage-player, no driver of a three-horse chariot, had a greater throng attending him when he appeared in public: but he was at last eclipsed in credit by Crinas, a native of Massilia, who, to wear an appearance of greater discreetness and more devoutness, united in himself the pursuit of two sciences, and prescribed diets to his patients in accordance with the movements of the heavenly bodies, as indicated by the almanacks of the mathematicians, taking observations himself of the various times and seasons. It was but recently that he died, leaving 10,000,000 of sesterces, after having expended hardly a less sum upon building the walls of his native place and of other towns. It was while these men were ruling our destinies, that all at once, Charmis, a native also of Massilia, took the City by surprise. Not content with condemning the practice of preceding physicians, he proscribed the use of warm baths as well, and persuaded people, in the very depth of winter even, to immerse themselves in cold water. His patients he used to plunge into large vessels filled with cold water, and it was a common thing to see aged men of consular rank make it a matter of parade to freeze themselves; a method of treatment, in favour of which Annæus Seneca gives his personal testimony, in writings still extant. There can be no doubt whatever, that all these men, in the pursuit of celebrity by the introduction of some novelty or other, made purchase of it at the downright expense of human life. Hence those woeful discussions, those consultations at the bedside of the patient, where no one thinks fit to be of the same opinion as another, lest he may have the appearance of being subordinate to another; hence, too, that ominous inscription to be read upon a tomb, 'It was the multitude of physicians that killed me.' The medical art, so often modified and renewed as it has been, is still on the change from day to day, and still are we impelled onwards by the puffs which emanate from the ingenuity of the Greeks. … Cassius Hemina, one of our most ancient writers, says that the first physician that visited Rome was Archagathus, the son of Lysanias, who came over from Peloponnesus, in the year of the City 535, L. Æmilius and M. Livius being consuls. He states also, that the right of free citizenship was granted him, and that he had a shop provided for his practice at the public expense in the Acilian Cross-way; that from his practice he received the name of 'Vulnerarius'; that on his arrival he was greatly welcomed at first, but that soon afterwards, from the cruelty displayed by him in cutting and searing his patients, he acquired the new name of 'Carnifex,' and brought his art and physicians in general into considerable disrepute. That such was the fact, we may readily understand from the words of M. Cato, a man whose authority stands so high of itself, that but little weight is added to it by the triumph which he gained, and the Censorship which he held. I shall, therefore, give his own words in reference to this subject. 'Concerning those Greeks, son Marcus, I will speak to you more at length on the befitting occasion. I will show you the results of my own experience at Athens, and that, while it is a good plan to dip into their literature, it is not worth while to make a thorough acquaintance with it. They are a most iniquitous and intractable race, and you may take my word as the word of a prophet, when I tell you, that whenever that nation shall bestow its literature upon Rome it will mar everything; and that all the sooner, if it sends its physicians among us. They have conspired among themselves to murder all barbarians with their medicine; a profession which they exercise for lucre, in order that they may win our confidence, and dispatch us all the more easily. They are in the common habit, too, of calling us barbarians, and stigmatize us beyond all other nations, by giving us the abominable appellation of Opici. {2128} I forbid you to have anything to do with physicians.' Cato, who wrote to this effect, died in his eighty-fifth year, in the year of the City 605; so that no one is to suppose that he had not sufficient time to form his experience, either with reference to the duration of the republic, or the length of his own life. Well then—are we to conclude that he has stamped with condemnation a thing that in itself is most useful? Far from it, by Hercules! … Medicine is the only one of the arts of Greece, that, lucrative as it is, the Roman gravity has hitherto refused to cultivate. It is but very few of our fellow-citizens that have even attempted it."

_Pliny, Natural History (Bohn's translation), book 29, chapters 3-8 (volume 5)._

MEDICAL SCIENCE: 2d Century. Galen and the development of Anatomy and Pathology.

"In the earliest conceptions which men entertained of their power of moving their own members, they probably had no thought of any mechanism or organization by which this was effected. The foot and the hand, no less than the head, were seen to be endowed with life; and this pervading life seemed sufficiently to explain the power of motion in each part of the frame, without its being held necessary to seek out a special seat of the will, or instruments by which its impulses were made effective. But the slightest inspection of dissected animals showed that their limbs were formed of a curious and complex collection of cordage, and communications of various kinds, running along and connecting the bones of the skeleton. These cords and communications we now distinguish as muscles, nerves, veins, arteries, &c.; and among these, we assign to the muscles the office of moving the parts to which they are attached, as cords move the parts of a machine. Though this action of the muscles on the bones may now appear very obvious, it was, probably, not at first discerned. It is observed that Homer, who describes the wounds which are inflicted in his battles with so much apparent anatomical precision, nowhere employs the word muscle. And even Hippocrates of Cos, the most celebrated physician of antiquity, is held to have had no distinct conception of such an organ. … Nor do we find much more distinctness on this subject even in Aristotle, a generation or two later. … He is held to have really had the merit of discovering the nerves of sensation, which he calls the 'canals of the brain' … , but the analysis of the mechanism of motion is left by him almost untouched. … His immediate predecessors were far from remedying the deficiencies of his doctrines. Those who professed to study physiology and medicine were, for the most part, studious only to frame some general system of abstract principles, which might give an appearance of connexion and profundity to their tenets. In this manner the successors of Hippocrates became a medical school, of great note in its day, designated as the Dogmatic school; in opposition to which arose an Empiric sect, who professed to deduce their modes of cure, not from theoretical dogmas, but from experience. These rival parties prevailed principally in Asia Minor and Egypt, during the time of Alexander's successors,—a period rich in names, but poor in discoveries; and we find no clear evidence of any decided advance in anatomy. … The victories of Lucullus and Pompeius, in Greece and Asia, made the Romans acquainted with the Greek philosophy; and the consequence soon was, that shoals of philosophers, rhetoricians, poets, and physicians streamed from Greece, Asia Minor, and Egypt, to Rome and Italy, to traffic their knowledge and their arts for Roman wealth. Among these was one person whose name makes a great figure in the history of medicine, Asclepiades of Prusa in Bithynia. This man appears to have been a quack, with the usual endowments of his class. … He would not, on such accounts, deserve a place in the history of science, but that he became the founder of a new school, the Methodic, which professed to hold itself separate both from the Dogmatics and the Empirics. I have noticed these schools of medicine, because, though I am not able to state distinctly their respective merits in the cultivation of anatomy, a great progress in that science was undoubtedly made during their domination, of which the praise must, I conceive, be in some way divided among them. The amount of this progress we are able to estimate, when we come to the works of Galen, who flourished under the Antonines, and died about A. D. 203. The following passage from his works will show that this progress in knowledge was not made without the usual condition of laborious and careful experiment, while it implies the curious fact of such experiment being conducted by means of family tradition and instruction, so as to give rise to a caste of dissectors. In the opening of his Second Book on Anatomical Manipulations, he speaks thus of his predecessors: 'I do not blame the ancients, who did not write books on anatomical manipulation; 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 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.' That the general structure of the animal frame, as composed of bones and muscles, was known with great accuracy before the time of Galen, is manifest from the nature of the mistakes and deficiencies of his predecessors which he finds it necessary to notice. … Galen was from the first highly esteemed as an anatomist. He was originally of Pergamus; and after receiving the instructions of many medical and philosophical professors, and especially of those of Alexandria, which was then the metropolis of the learned and scientific world, he came to Rome, where his reputation was soon so great as to excite the envy and hatred of the Roman physicians. The emperors Marcus Aurelius and Lucius Verus would have retained him near them; but he preferred pursuing his travels, directed principally by curiosity. When he died, he left behind him numerous works, an of them of great value for the light they throw on the history of anatomy and medicine; and these were for a long period the storehouse of all the most important anatomical knowledge which the world possessed. In the time of intellectual barrenness and servility, among the Arabians and the Europeans of the dark ages, the writings of Galen had almost unquestioned authority; and it was only by an uncommon effort of independent thinking that Abdollatif ventured to assert, that even Galen's assertions must give way to the evidence of the senses. In more modern times, when Vesalius, in the sixteenth century, accused Galen of mistakes, he drew upon himself the hostility of the whole body of physicians."

_W. Whewell, History of the Inductive Sciences, book 17, chapter 1, section 1 (volume 2)._

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