thigh, which the history of medicine uniformly attributes to Hippocrates, by recording a controversy between him and Ctesias on this subject. 106. Yet even the undisputed works of Hippocrates must be received with some hesitation. The criteria by which they are decided are, we have said, not infallible; for they assume a degree of uniform excellence which perhaps few have possessed. The tract De Aere, Aquis, et Locis, shows the author to have been a European; and various passages, even in the most genuine works, may be adduced to prove that interpolations have crept in. Where then can we draw the line?

107. The style of Hippocrates, says Le Clerc, is very concise, which makes it frequently difficult to comprehend his meaning; to this may be added, that it is grave, and Erotian remarks that there is a similarity between his phrases and

those of Homer.

108. His language seems mainly Ionic. Galen observes that the style of Hippocrates inclines somewhat towards the Attic; and he adds that some have considered him as writing in the old Attic.

109. There were several physicians contemporary with him of considerable note in their ume, but of such inferior importance in history as scarcely to require notice in the present place. We may mention merely the names of Phæon, Euryphon, Philistion, Ariston, Pythocles, Philetas, Acumenus, and Egeineus. The sons of Hippocrates were Thessalus and Draco; Polybus was his son-in-law; the first enjoyed the greatest reputation. Ctesian was also a relation of Hippocrates, and contemporary with Xenophon.

110. Diocles was the first in medicine, subsequently to Hippocrates, to make much noise in the world; and on this account he was called by the Athenians the second Hippocrates. A fragment of his is quoted by Galen, which contains a close description of dyspeptic and hypochondriac disorders; his theory of that affection is, that those who are the subjects of it have a superfluous quantity of heat in the veins, which receive the nourishment from the stomach, and that the blood in these veins is consequently thickened, and that thus nourishment is prevented from being distributed through the body, remaining crude upon the stomach and passing the greatest part of it into the lower belly. It is curious to observe in Diocles, an allusion to stomach disorders similar to what is at this very period (1827) the subject of controversy. He states that some conceive that in these affections there is an inflammation at that orifice of the stomach which is connected with the bowels, and that this inflammation occasions a hindrance to the passage of the aliment, and causes the inflation, heat, and other symptoms characterising the disorder. Now, whether in dyspepsia, after it has some time existed, inflammation of the stomach be or be not present is, as we have said, a controverted point among several physicians of the present day. See the several authors who have lately written on dyspepsia, Wilson Philip, Paris, Johnson, and Uwins.

111. Diocles made considerable progress in anatomy considering the impediments of the

times in which he lived; but the first great promoters and improvers of this important part of medical and physiological science were Erasistratus and Herophilus.

112. There seems some uncertainty respecting the precise period in which Erasistratus lived. Eusebius places it about the 131st Olympiad, which commenced at the year of the world 3714; but several parts of his history present discrepancies with respect to this alleged time of his birth; for instance, he is stated to have been in great reputation during the time of Seleucus Nicator, who died in the 124th Olympiad. Respecting the part of Greece which gave him birth there seems also to be considerable uncertainty; some have stated it to be Cos, the island in which Hippocrates was born; but it would seem more probable that this supposition has been grounded upon the similarity of the name Cos, and Coa; which last, according to Suidas, was the real birth place of this celebrated man.

113. It seems to be pretty certain that, before the time of Erasistratus and Herophilus, human bodies had not been anatomically examined; and it follows of course that these individuals had opportunities presented them by the permission to investigate human anatomy of a far superior kind to any enjoyed by their predecessors.

114. It is to Erasistratus that we owe the just intimation of a distinct order of vessels in the mesentery as conveyors of chyle; and he with Herophilus were the first to give any thing like a correct account of the brain and nervous system. It has indeed been asserted that Erasistratus recognised two orders of nerves, the one for sensation, the other for motion; and that he described the first as hollow, and taking their origin from the membranes of the brain, while the others originated in the brain itself; but he afterwards spoke of all the nerves originating from the brain itself. He was the first also, according to Galen, to describe, with any thing like accuracy, the membranes which are found about the orifices of the heart, and he speaks of the veins and the arteries as deriving their origin from the heart; but he considers the latter as channels of air, and he supposes respiration to be the process through which air is supplied to the arteries. Some have attributed to him the knowledge of the circulation, but he does not appear to have even been aware of the reason of a double heart. His notion of digestion was that of attrition, as opposed to the concoction and humoral doctrine of Hippocrates; and he differs from Hippocrates in his explanation of the mode in which the kidneys perform the office of separating urine from the blood. He talks moreover of the division of the veins in the liver for the formation of the bile.

115. In his practise Erasistratus was more partial to fasting and abstinence than to bloodletting and purging; and his opinion of disease generally (or rather of febrile disorders) was, that it was occasioned by such a plenitude of the veins as to cause the blood in them to flow into the arteries, and thus to give rise to inflammatory commotion.

116. Respecting the time at which Herophilus lived there seems to be the same uncertainty as

in reference to Erasistratus, some considering him as the contemporary of this last, some making him his predecessor, and some his successor. 117. It was at Alexandria, the capital of Egypt, and under the sanction of the Ptolemies, that both Erasistratus and Herophilus conducted their dissections.

118. Herophilus was the first to point out the optic foramina and nerves, and he speaks still more satisfactorily than Erasistratus respecting the vessels on the mesentery, as being distinct in their œconomy and office from the general venous system. He pointed out also the retina of the eye, and compared that cavity in the brain which goes at present by the name of the fourth ventricle, to the extremity of a writing pen; and described the union of the sinuses, formed by the dura mater; to this day this junction is called the torcular of Herophilus.

119. This author is said to have been the first who described, with any degree of precision, the pulse; and he was so particular in reference to this point, says Pliny, that he contended for the necessity of a knowledge both of geometry and music, in order properly to appreciate the differena of pulsation produced by age and by disorder. Le Clerc, however, contends that this remark of Pliny was founded upon a vulgar error, which attributed this position to Herophilus, because he was the first to make use of the word ououos in application to the pulse. Indeed the precision and science here spoken of seems, as Le Clerc justly remarks, to be inconsistent with the account that has been given, by Galen, of Herophilus, viz. that, in respect to practice, he was half an empiric. Galen actually ranks him among the empirics.

120. Herophilus objected to the prognostics of Hippocrates, and it is surmised that he did SO on account of very little attention having been comparatively given by Hippocrates to the pulse. He did not expatiate much upon the curative part of medicine; but it is remarkable that he pointed out particularly palsy of the heart as being a malady which often produced sudden death.

121. It was very shortly after the time of Erasistratus and Herophilus that medicine came to be divided into three parts, the dietetic, the pharmaceutic, and the chirurgical; yet it is observable that, even after the division was acknowledged, the same authors treated of each, the proportion of their attention to one or the other branch being regulated by fancy or by incidental circumstance. The Pharmacopolists of the ancients seem to have been a class of men distinguished from the professors of any of the other branches, and the herbalists were a still different and lower branch.

122. Now also arose the sect of physicians called empirics, who particularly opposed themselves to the anatomical schools introduced by Erasistratus, Herophilus, and their followers. Serapion of Alexandria was the first openly to contend that the science of medicine is and ought to be a mere matter of observation, and that anatomical and physiological knowledge is incapable of affording any real aid in the treatment of discase. Philinus indeed, who was from the island of

Cos, is said to be the primary instigator of the empirical creed, and it has even been said that Herophilus was the first to intimate to Philinus the doctrine of experiinental observation as opposed to theoretical reasoning.

123. Of Serapion's followers the most famous was Heraclides of Tarentum, who somewhat deviated, it is said, from his predecessors, since he commented on the works of Galen, and dealt in those compositions which seemed to indicate some kind of à priori reasoning as to their separate and combined effects. This inconsistency is charged upon Heraclides by Caelius Aurelianus, who asks how nature or mere accidental observation could instruct men in the composition of medicaments, which seem in the abstract to have so little of correspondence.

124. The question of empiricism and dogmatism is very well discussed by Celsus in his Preliminary Discourse to his Treatise on Medicine, and we recommend its perusal to our young readers, both on account of the fairness and ability with which the investigation is pursued, and the elegant and classical language in which the discussion is clothed.

125. We are now to speak of the introduction of medicine into Rome, or of its transference from Greece to Rome; which, in the infancy of its establishment, was not only indifferent to the reception of the sciences and the fine arts, but was actually jealous of copying the refinements of the Greeks under the apprehension of their eventually leading to effeminacy and weakness. The Romans were said to be nearly 600 years without any medical aid beyond what rude empiricism or blind fanaticism bestowed; and, keeping free from the refinements of their neighbours, they of course did not stand so much in need of the physician's assistance as in after times, when the luxuries of peace took place of the ruggedness of war, and the love of arms ceded to the love of science and art.

126. Rome, says a modern author, formed by the rude tribes of ferocious banditti, wanted for many ages little more than those chirurgical aids which their mode of life rendered indispensable. Epidemic fevers were, however, at times violent and fatal, from the Pontine marshes which were at no great distance from this capital of the world. Yet, for nearly 600 years, they were said to be without medical aid, and their only resources to have apparently been blind empiricism, superstitious charms, or religious ceremonies. Temples seem to have been erected to Febris; and their most destructive enemy, thus raised to the rank of a goddess, was worshipped. In various parts of the city subordinate deities of the same kind were introduced; and no less than three goddesses, Intercidona, Pilumna, and Devirra, were propitiated, by offerings, to confine Sylvanus, who was supposed to be inimical to women in child-bed. In the year 321, ab urbe conditâ, a temple was erected to Apollo for the health and safety of the Roman people; and in 470 Esculapius, or rather his emblem, a snake, was brought to Rome by a solemn embassy, sent for the purpose to Epidau

erected. This fact is of considerable importance in the history of medicine, since it proves that the worship of Esculapius was continued in Greece at that era; and consequently that traces of record from which as a fountain Hippocrates drew a great part of his observations were still preserved. Some of the votive tablets, hung up in the new temple, are preserved by Gruter, and of a date so late as the age of the Antonines; but these are in Greek, and seem to have owed their origin to the gratitude or superstition of some Greeks who, at that time, resided in the

city.

127. It indeed appears singular that while Rome was so little distant from Naples, a Greek city which traced its origin to the Rhodians, among whom Esculapius was worshipped, should have had no traces of medicine, especially as the Pythagorean philosophy was brought from thence, or from the further provinces styled Magna Græcia, to the Roman kings. The testimony of Pliny, however, is positive; nor is it repelled by Dionysius of Halicarnassus, who remarks in two distinct epidemics, viz. of the years 282 and 400 ab urbe conditâ, that the disease was so violent as to baffle the skill of the physicians; for such would be the language, whatever the medical aid might have been. The stern patriotism of Marcus Cato seems to have prevented the increasing influence of the Grecian physic, and from authority or complaisance Pliny fixed the period of 600 (strictly 535) years during which no physicians were to be found in Rome. It must be obvious that this could not be strictly true; but some resources, either ridiculous or superstitious, must have been sought for when disease occurred. The dietetic system, the virtues of cabbage, adopted from the school of Pythagoras, and the superstitious attachment to the Asclepiada, could not have sufficed; but we find little to substitute in their place. The Roman records fail us, and the authority of Cato is supreme. We mean not, in this account, to allude to a law, said to be introduced by Cato, prohibiting the Grecian practice, (for, at the time of the arrival of Archagathus from Greece, he was but fifteen years old); but, to his influence in preventing the increase of the prevailing fashion. The fame of Archagathus quickly faded; for although at first styled Vulnerarius (healer of wounds), he was soon stigmatised by the appellation of Carnifex (executioner). Of the practice of Cato, who wished to supersede the Grecian system, we have hints from Pliny, Plutarch, and his own remaining works. He did not enjoin abstinence, but allowed his patients to eat vegetables. Pliny says cabbage, exclusively, ducks, pigeons, or hares. In fractures and dislocations his remedy was a charm, consisting of hard words without a meaning. The English reader may find some amusement on this subject in the memoirs of Martinus Scriblerus.

128. The bad success of the severer practice of Archagathus soon rendered his successors more gentle in their operations; but some remains of the active Greek surgery continued to prevail, we learn from Plutarch, who informs us that when C. Marius suffered the extirpation of the varices of one leg without a groan, he deVOL. XIV.

clined the attempt on the other, saying that the advantages did not compensate for the sufferings.

129. Numerous works have been written to prove that physicians at Rome were slaves, libe:ti, or foreigners. The opponents of this opinion have been equally voluminous. We must, as usual, give the result of our enquiry without engaging in the controversy. It seems clear that the greater number of practitioners were of the description mentioned, but it is equally certain that many were of a superior character. Archagathus himself was received at first with great ardor, and a house purchased for him; nor on the decline of his credit was he apparently deprived of it. He was also raised to the rank of a Roman citizen, and the Aquilan law declares, that if any physician neglects a slave after any operation he shall be pronounced guilty of a crime. By the same law an action will lie against a physician, who, by the unskilful use of the knife, or of medicine, shall kill a slave, and Ulpian decides that a midwife in the same circumstances shall be pronounced equally guilty. These regulations must relate to free men, and the Aquilan law is confessedly anterior to the age of the Cæsars; for all physicians were by Julius Cæsar raised to the rank of Roman citizens. Varro is also explicit on this subject, when he discusses the question, for what farms it is preferable to have artificers, among whom he reckons medical assistants, occasionally hired, and to what kinds it is better to have slaves attached. In the time of Cato also the Phoenicians had been driven from Sicily by the Romans, and the Macedonians from Greece. The Grecians had therefore recoverea a great share of their former liberty. As their language was fashionable, their manners pleasing, their demeanor obliging, perhaps approaching to servility (Juvenal), it is not surprising that they should flock to Rome, nor that they should be favorably received.

130. We are now called upon in the order of time to mention Asclepiades, who was the founder of a new sect of medicine called the Methodic, and who explained all the laws of life and the phenomena of disease upon the principle of the Epicurean philosophy, or rather of the philosophy of Democritus extended and improved by Epicurus. By means of corpuscles and pores, Asclepiades explained every thing. He astonished the people, and was sometimes successful in effecting a cure. He laughed at the ideas of Hippocrates on critical days; he ridiculed his patience in observing nature in order to aid her, or supply her wants; and termed his system a Meditation upon Death.

131. In some consistency with the philosophy of Asclepiades do we find his medical practice. Gestation, friction, and the employment of wine, constituted the three main items of his curative plans, which were all so many means of opening the external and internal pores of the body, and causing the juices and corpuscles to pass from one part to the other freely, and to make their exit liberally.

132. It should seem that the anatomy of As clepiades was not very correct or extensive, nor was his physiological reasoning entitled to much

C

commendation. We have spoken of him as the founder of the Methodic sect, but this honor is more strictly due to Themison who succeeded him; and whose system though in some measure harmonizing with the corpuscular philosophy, and regulated by the principles of Asclepiades, was rather, if we may so say, fibrous, than porous; for he divided diseases into those of contracted fibres, those of relaxed fibres, and those of a mixed condition of fibre; in the first he directed evacuants, in the second astringents, and in the third a mixture of both, or rather to meet by the one or the other class of medicaments the most dangerous symptoms.

133. Thessalus, who lived under Nero, about fifty years after Themison, further modified the methodic system especially in its practical bearings; to him has been ascribed the introduction of the metasyncrisial method of treatment, and of causing his patients to abstain from aliment during three whole days, in order to effect a thorough change in constitutional conditions. But it seems that Soranus was most esteemed among the methodical physicians, as having brought the principles of the sect into the greatest degree of practical perfection. This Soranus lived under the emperors Trajan and Adrian. His writings are lost, but their substance is retained by Cælius Aurelianus, who avows that his own works are very little more than a translation of those of Soranus-a translation, for Cælius Aurelianus wrote in Latin. He was indeed an African by birth, according to the most common opinion, but the precise time at which he lived is uncertain.

134. Our limits will not allow us to engage in a lengthened description of the methodic system as it appears in the writings of Caelius Aurelianus: indeed there is in it altogether so much of fanciful and wild, that we should be occupying our time and pages to very little purpose, by transcribing its principles in detail, and we shall content ourselves with the following quotation from Dr. Parr, in reference to the leading doctrine of the methodic school, as, says this author, the cycles of the methodists are often mentioned in medical works, we shall give a short description of the meaning.

135. The cycles were periods supposed to consist of three days each, or combinations of three, and during these the same plans were continued; but at the end of each cycle the exertions were increased, so as at last to arrive at the most active measures. The resumptive cycle consisted of common foods; the metasyncritic of a more acrid and stimulating diet, with frictions, baths, rubefacients, sternutatories, &c. Themison we have said was the principal inventor of this part of the methodic system of medicine. The cyclus vomitorius was distinguished into two, as the vomits accompanied the sparer diet of the first, or the more stimulating diet of the second. Each cycle consisted of four diatriti, though sometimes prolonged to sixteen days; the additional diatriton containing four days.'

136. The reader will perceive, in the Asclepiadæan or methodic theory, traces of what we shall afterwards speak of as the humoral doctrine propounded by Boerhaave; and of the system of solidism or fibrous pathology advocated at great

length and with much ingenuity by Hoffman, and taught with some modification by the celebrated Cullen.

137. The episynthetic, eclectic, and pneumatic sects of physicians, followed those of the methodic, but their respective peculiarities, as consisting merely in some niceties of bad metaphysics, need not be here dwelt upon; it may suffice to say that the episynthetics affected to reconcile the various discordant opinions of different authors, the eclectics proposed to select from each system the good and practical, and the pneumatics added a governing or spiritual principle to the corporeal or material qualities already recognised; which principle regulated every thing, and occasionally induced disease.

The

138. Arctæus was the most noted writer among the pneumatic sect of physicians; indeed he is the only author of this sect whose works have descended to modern times complete. It seems uncertain at what precise period Arctæus lived, some have supposed him contemporary with Galen from the circumstance of his never mentioning that author, nor that author him. principal clue that we have to the discovery of the time in which Arctæus flourished is the dialect of his writing, which is the Ionic, and the circumstance of his being quoted by Paul Eginetus and Aëtius, which proves that he was prior to them. If indeed Arctæus could be proved a contemporary of Galen that would settle the point; for the time in which this last writer lived is as we shall immediately see well known. The writings of Arctæus appear to us to be among the most valuable of ancient records. We may here remark that there is some uncertainty also with respect to the time at which the celebrated Latin writer Celsus lived, some considering him as having been born under the reign of Augustus, others under that of Tiberius, while others again suppose him to have lived so late as the reign of Nero, or even of Trajan. The purity of his style would be almost sufficient to prove him of the Augustan period, and there are other circumstances which favor this presumption. curious that Celsus, although one of the best writers on medicine that either ancient or modern times have produced, does not appear to have been himself a medical practitioner. He talks indeed of his observations, but it is supposed that he was merely an observer. Some indeed have gone so far as to imagine that the volumes of Celsus, to which the reader will recollect we have already made allusion, are translations of some Greek author whose name has been lost; for this opinion, however, there does not seem any thing like a foundation; indeed the purity of the style, and the general aspect of the writings of Celsus, would be sufficient guarantees for their originality. We must here repeat our recommendation to the medical student to familiarise himself with the works of this classical author, both on account of the information with which they are pregnant, and the pure Latinity in which they are penned.

It is

139. We come now to speak of the famed Galen, who was born in the second century of the Christian era, under the reign of Severus, and who, for the space of 1500 years, was re