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remained on medical topics, whether of a Greek or Alexandrian origin, from the writings of Hippocrates, called, with affectionate veneration by his successors, “ The Divine Old Man," down to those of the Ptolemaic school.
Greek medicine arose in the temples of Æsculapius, whither the sick were in the habit of resorting for the assistance of the god. It does not appear that any fee was exacted for the celestial advice; but the
Origin of gratitude of the patient was frequently displayed Greek meby optional gifts, and votive tablets presented dicine--As
clepions. to the temple, setting forth the circumstances of the case, were of value to those disposed to enter on medical studies. The Asclepions thus became both hospitals and schools. They exercised, from their position, a tendency to incorporate medical and ecclesiastical pursuits. At this time it was universally believed that every sickness was due to the anger of some offended god, and especially was this supposed to be the case in epidemics and plagues. Such a paralyzing notion was necessarily inconsistent with any attempt at the relief of communities by the exercise of sanitary measures. In our times it is still difficult to remove from the minds of the illiterate classes this ancient opinion, or to convince them that under such visitations we ought to help ourselves, and not expect relief by penance and supplications, unless we join therewith rigorous personal, domestic, municipal cleanliness, fresh air, and light. The theological Hippocrates doctrine of the nature of disease indicated its destroys the means of cure. For Hippocrates was reserved theory of the great glory of destroying them both, re- disease. placing them by more practical and material ideas, and, from the votive tablets, traditions, and other sources, together with his own admirable observations, compiling a body of medicine. The necessary consequence of hisgreat success was the separation of the pursuits of the physician from those of the priest. Not that so great a revolution, implying the diversion of profitable gains from the ancient channel, could have been accomplished without a struggle. We should reverence the memory of Hippocrates for the complete manner in which he effected that object.
Of the works attributed to Hippocrates, many are doubtless the production of his family, his descendants, or Writings of
his pupils. The inducements to literary forgery Hippocrates. in the times of the Ptolemies, who paid very high prices for books of reputation, have been the cause of much difficulty among critics in determining such questions of authorship. The works indisputably written by Hippocrates display an extent of knowledge answering to the authority of his name; his vivid descriptions have never been excelled, if indeed they have ever been equalled. The Hippocratic face of the dying is still retained in our medical treatises in the original terms, without any improvement.
In his medical doctrine, Hippocrates starts with the His opinions.
postulate that the body is composed of the four
elements. From these are formed the four cardinal humours. He thinks that the humours are liable to undergo change; that health consists in their right constitution and proper adjustment as to quantity ; disease, in their impurities and inequalities; that the disordered humours undergo spontaneous changes or coction, a process requiring time,
the explanation of critical days and critical discharges. The primitive disturbance of the humours he attributed to a great variety of causes, chiefly to the influence of physical circumstances, such as heat, cold, air, water. Unlike his contemporaries, he did not impute all the afflictions of man to the anger of the gods. Along with those influences of an external kind, he studied the special peculiarities of the human system, how it is modified by climate and manner of life, exhibiting different predispositions at different seasons of the year. He believed that the innate heat of the body varies with the period of life, being greatest in infancy and least in old age, and that hence morbific agents affect us with greater or less facility at different times. For this reason it is that the physician should attend very closely to the condition of those in whom he is interested as respects their diet and exercise, for thereby he is able not only to regulate their general susceptibility, but also to exert a control over the course of their diseases.
Referring diseases in general to the condition or dis
tribution of the humours, for he regards inflammation as the passing of blood into parts not previously containing it, he considers that so long as those liquids occupy the system in an unnatural or adulterated state, disease continues; but as they ferment or undergo coction, various characteristic symptoms appear, and, when their elaboration is completed, they are discharged by perspiration or other secretions, by alvine dejections, etc. But where such a general relief of the system is not accomplished, the peccant humours may be localized in some particular organ or special portion, and erysipelatous inflammation, mortification, or other such manifestations ensue. It is in aiding this elimination from the system that the physician may signally manifest his skill. His power is displayed much more at this epoch than by the control he can exert over the process of coction. Now may he invoke the virtues of the hellebores, the white and the black, now may he use elaterium. The critical days which answer to the periods of the process of coction are to be watched with anxiety, and the correspondence of the state of the patient with the expected condition which he ought to show at those epochs ascertained. Hence the physician may be able to predict the probable course of the disease during the remainder of its career, and gather true notions as to the practice it would be best for him to pursue to aid Nature in her operations.
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 of his praçnature. 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 assist the natural operation.
When we consider the period at which Hippocrates lived, B.C. 400, and the circumstances under which he had studied medicine, we cannot fail to admire the very great advance he made. His merit is conspicuous in rejecting
the superstitious tendency of his times by teaching his disciples to impute a proper agency to physical causes. He altogether discarded the imaginary influences then in
For the gods he substituted, with singular felicity, Impersonal Nature. It was the interest of those who were connected with the temples of Æsculapius 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 god, 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 substitution 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 noble profession, and taught them not to hesitate in encountering the prejudices and passions of the present for the sake of the truth, and to trust for their reward in the just appreciation of a future age.
With such remarks we may assert that the medical philosophy of Hippocrates is worthy of our highest
admiration, since it exhibits the scientific conis truly
ditions 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 title which has been conferred upon him by his European successors—the Father of Medicine—and perhaps inducing us to excuse the enthusiastic assertion of Galen, that we ought to reverence the words of Hippocrates as the voice of God.
The Hippocratic school of Cos found a rival in the school of Cnidos, which offered not only a different view of the The school of 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, vene
section, 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
Is destroyed until the time of Constantine, when it was by Constandestroyed 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 apothe- Classes of cary's shop at Athens. Aristotle the druggist, physicians. 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 class. 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.
When the Alexandrian Museum was originated by Ptolemy Philadelphus, its studies were arranged in four faculties—literature, mathematics, astronomy, Egyptian memedicine. These divisions are, however, to be dicine. The 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-Stephanus,