17-11-42 MFP

11-7-52

LONDON

MEDICAL, adj.

า Lat. medicus, medicina; Fr. medecine. Physical, or relating to the healMedicaing art.

to

-ment is any thing used in that art; a topical application. To medicate, tincture or impregnate with medicine nature. Medicinable

MEDICALLY, adv. MEDICAMENT, N. S. MEDICAMENTAL, adj. MEDICAMENTALLY, adv. MED'ICATE, v. a. MEDICATION, n. s. MEDICINABLE, adj. MEDICINAL, MEDICINALLY, adv. MED'ICINE, n. s. & v. a. or any thing of a medicinal and medicinal, having the power of healing, or of physic; appertaining to physic. Medicine is physic; any remedy prescribed by the faculty: the verb is obsolete, but used by Shakspeare as signifying to operate upon as physic.

A merry heart doeth good like a medicine; but a broken spirit drieth the bones. Prov. xvii. 22.

O, my dear father! restauration, hang Thy medicine on my lips; and let this kiss Repair those violent harms.

Shakspeare. King Lear. Not all the drowsy syrups of the world Shall ever medicine thee to that sweet sleep Which thou owedst yesterday.

Shakspeare.

Come with swords as medicinal as true, Honest as either; to purge him of that humour That presses him from sleep. Id. Winter's Tale. Every medicine is an innovation, and he that will not apply new remedies must expect new evils; for time is the greatest innovator; and if time of course alter things to the worse, and wisdom and counsel shall not alter them to the better, what shall be the end? Lord Bacon.

The watering of the plant with an infusion of the medicine may have more force than the rest, because the medication is oft renewed.

Id.

1. MEDICINE, from Lat. medico, to heal, in its verbal signification, means, as we have seen, the art of curing, mitigating, and preventing disease; as a substantive it signifies the material employed to effect these purposes.

2. In treating of this subject, as a science and an art, we shall first present our readers with an historical account of the successive revolutions which medicine has undergone from the earliest periods; we shall then give a short estimate of its present condition; engage in the consideration of classifying or arranging disease; and finally treat of ailments as they occur in practice, enquiring into their sources remote and immediate, and the methods best adapted to remedy and re. move them.

B

PART 1.

HISTORY OF MEDICINE.

3. To reason from the general course of nature, says an author of whose labors we shall avail ourselves in the present article, it is evident that man, subjected as he is to the influence of a variety of causes which may disorder the action of his organs, must very soon have been obliged to seek for the means of alleviating the pains and of curing the diseases with which he was affected. As he cannot seclude himself entirely from the constant agency of many of those external causes; and as he carries within him several others which are destined to act at particular periods of life, or which may at any time exert their influence; we may with safety affirm that the first trials of particular remedies bear almost as ancient a date as the existence of man himself. Among the most rude and uncultivated tribes, as those of New Holland, and New Zealand, of Lapland, and Greenland, of North America and the interior of Africa, we find traces of the practice of medicine and surgery. The savages in these countries know how to distinguish different diseases, and to apply a more or less suitable method of treatment; and they are acquainted with the use of several remedies which form no part of their daily food. These uncivilised communities present to us the picture of mankind in their infancy, and give us a lively idea of the original state of all nations.

4. From their first existence, men must have had diseases which they naturally sought to cure or alleviate. To attain these objects they tried a variety of methods. But we may presume that their discoveries were in general very slow, and more frequently the offspring of fortunate accidents than the result of rational investigation. Men receiving by tradition a knowledge of the discoveries which had been already made, would soon find themselves obliged to make new observations for themselves, and in this manner their acquisitions would gradually increase. In these early ages all the knowledge of the tribe formed a common stock; and their imperfect arts might be exercised by all those who were endowed with a certain portion of intelligence. Medicine therefore existed before there were any regular physicians. (Cabanis).

5. Whether instinct or actual observation had most to do with the origin of medicinal attempts has been the subject of dispute, but it is most probable that each had a share in the matter; and, although we must receive as fabulous and unworthy of full credence several accounts which have been transmitted to us on the subject of men being taught the virtues of herbs by witnessing the instinct of brutes, it is more than probable that some of these narrations have their foundation in truth.

6. The necessity of medicine from the earliest periods being admitted, says Le Clerc, it may naturally enough be inferred, that both reason and chance might place several remedies in the hands of man; and the most ancient accounts we find extant, respecting the manner in which medicinal virtues were ascertained to exist in certain plants, attribute the discovery of such

virtues to accidental observation. We learn from fabulous history that Glaucus, son of Minos king of Crete, having fallen into a cask of honey, was sought for some time unsuccessfully, until Polydius, a soothsayer, who came from Argos, discovered where he was immured. Minos finding this Polydius to be so cunning a personage, believed that it was in his power, if he were put upon his mettle, to restore the young Glaucus to life, and accordingly ordered him to be shut up in the same cask with the dead body for the purpose of inducing him to make the experiment of re-animation. While thus confined with the corpse, and finding himself without resource, he perceived a serpent approaching him which he immediately killed; soon after another serpent came; and, regarding the dead body of the first, immediately went out, and returned forthwith bearing a certain herb with which he covered the dead body of his fellow, and thereby restored the animal to life. Polydius directly tried the same experiment on the dead body of Glaucus, and with the same effect.

7. This well known story, taken from Hyginus and Apollodorus, Le Clerc follows up by another, which, as having in it a little less of the marvellous, is of course entitled to a little more credit. Melampus while performing the duties of a shepherd, having observed that bis goats were purged while they fed on hellebore, ordered the milk of these goats to be administered to the daughters of Protus, who imagined themselves transformed into cows; the milk proved purgative to thein, and they were cured by it of their hallucination; and hence has been traced the origin of an opinion which came to be general, that hellebore was not merely a cathartic but that it possessed some specific influence upon disorders of the mind.

8. In another part of his history Le Clerc alludes to the story told by Pliny respecting the hippopotamus, or sea-horse, drawing blood from his body by means of a reed, thus relieving himself from a plethora, and thus teaching man the art and benefit of artificial blood-letting; and to the account further of the bird ibis administering enemas to itself with its own bill; and having recorded these with other narratives and intimations, he concludes with the following judicious remarks. Besides that fable is more or less founded on fact, every one knows by his own observation on others that the condition of health is greatly referrible to matters whether of diet or luxury taken out of the ordinary course of things; and, if accidental observation be thus capable of teaching the deleterious qualities of certain substances, the same observation would be likely to lead to the discovery of salubrious substances. Thus mankind would come successively to observe, to reason, and to generalise, and thus would experience and experiment in the art of healing be gradually systematised into a science.

9. We may here incidentally remark, before we proceed with our history, that the simplicity of primeval medicine, and its present condition among savage tribes, have been preferred as arguments against the necessity of its complication; in other words it has been urged that the ancients with their herbs and simples did quite

as well as the moderns who have brought into subserviency the other kingdoms of nature, and have converted medicine from a matter of mere observation and simple inference, into one of extensive reasoning and complicated induction; but objectors of this kind, even if we allow their correctness as to fact, overlook the circumstance of artificial states engendering artificial wants, and that as law, from a simple consideration of right and wrong, branches, eventually out into code, and precepts, and acts, so does the necessity of medicine's complication increase with increasing luxury, and become complicated to meet the complicated demands of artificial existence.

10. As, however, medicine was first cultivated by the patients themselves, or by their friends and relations, it becomes a matter of interesting investigation to trace the successive steps by which it proceeded from general to particular cultivation; and to develope the causes and circumstances which have in the course of ages advanced the science and profession to the rank and importance which they now assume and maintain.

11. It must be recollected, as a matter of importance connected with this enquiry, that in the very earliest ages, and before the physical sciences had made much progress, events were often considered as having received a satisfactory solution, in respect to their rationale, by referring them to divine interpositions; no one, indeed, even in the present day, ought for a moment to question that an interposing providence regulates the affairs of the world, but we do not now talk of the darts of Apollo' when we contemplate the consequences of a heated atmosphere on the Trojan marshes. But, when such was the mode of settling the matter, it is easy enough to conceive that the first men, who came as a distinct order of men to take cognizance of disease and its management, would be those who were the professed media of communication between heaven and earth.

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12. The priests,' says Cabanis, soon seized upon the province of medicine, and found it no difficult matter to combine it with their other instruments of power. Indeed, the medical and the sacerdotal professions have in reality many features of resemblance. Both bring into action the same principles, hope and fear; and, although the objects of these two passions are not the same in the hands of the priest as in the hands of the physician, their effects had, at that time, nearly the same degree of influence in promoting the views of both. Certain it is that medicine, like superstition, exerts on the minds of men an influence proportional to their weakness; and, as the former acts upon more real and palpable objects than the latter, it is found that the most rational and enlightened men can never entirely resist its power. In short, no art penetrates further into the human heart; no profession enables its votaries more easily to obtain possession of the most important family secrets; no species of doctrine (except that, indeed, which relates to the agency of invisible powers) affects so nearly all those fanciful ideas in which the human mind, when it throws off the restraint of reality, is so apt to indulge; and certainly none

furnishes means more independent of all political revolution, to those who impose upon the credulity of the public, and cultivate it, like a fruitful soil, with the utmost care and attention. It was, therefore, natural that the priests should become physicians, as they in fact became; and in most savage tribes the art is still practised by the priests or by mountebanks.

13. Egypt was the cradle of medicine as it appears to have been of every other science; and we hear of Thoth, or Thouth, whom the Greeks have called Hermes, and the Latins Mercury, but about whose actual existence there seems to be some doubt: and the same may be said of Isis and Osiris, which were perhaps rather regal titles and allegorical representations than real existences. At any rate, their history is so mixed up with fable, and one is in such a manner confounded with the other, that very little of satisfaction can be obtained with respect to them as cultivators and promoters of the healing art. Some have attributed the invention of medicine to Horus, son of Isis, who was the Apollo of the Greeks, and about whom the early historians speak as a real person. It is to this Apollo that Ovid alludes in his Metamorphoses, making him call himself the inventor of medicine and the subjector of plants to his power in the following well-known lines :—

Inventum medicina meum est, opiferque per orbem Dicor, et herbarum subjecta potentia nobis, i. 521.

14. Esculapius was called by the Greeks the son of Apollo, and we find a great deal, both in the historians and poets of the early periods, of allegorical and metaphorical matter mixed up with the accounts respecting the circumstances of Esculapius's birth and elevation. Certain it is, that, for a long time, he acquired the ascendancy over medicine and medical rites; and the priests, who were still the physicians of the time, acted in the assumed capacity of priests of Esculapius, and invented charms and effected cures avowedly under this assumption.

15. Temples were erected in different parts of Greece, dedicated to Esculapius, now deified, and from these temples oracles were issued by the officiating priest, as if emanating from the resident and presiding divinity; these oracular emanations were usually conceived and issued in such sort as to establish their prophetic and operative power in the event of success, and to be susceptible of a double signification, so as to elude exposure, or conceal the imposition, in the event of the prediction not being fulfilled. And in spite of the doubts of the philosophers, and the occasional ridicule of the satirical writers of the times, the mass of the people resorted to the Esculapian temples under the full feeling of belief and expectation; and often returned, satisfied and cured, from the very circumstance of their faith keeping pace with their wishes.

16. We are told, moreover, that the air respired in the country, and surrounding the Æsculapian temples, was naturally pure, from the elevation of the soil, and was rendered still more salubrious by the woods which encompassed them. These woods themselves became also the objects of religious veneration; they were preserved with great care; and their sombre shade

contributed much to the awe with which the people naturally beheld the abode of their deities. The temples of Asculapius, in particular, enjoyed all these advantages, which seemed to be more peculiarly appropriated to them; for an unhealthy abode would have been very unsuitable to the god of physic. If his advice did not always restore health, it was at least becoming that the patients should contract no new disorders at the foot of his altars. In consequence of some prudent precautions in this respect many cures must have been accomplished by the diversions which the patients experienced in the course of their journey to the temples; by an exercise to which, perhaps, they had been but little accustomed; by the beneficial consequences of a change of air; by the invigorating effects which an elevated situation produces upon man, and indeed upon the generality of animals; and, lastly, by the still more invigorating effects of hope. Esculapius acted like a certain description of physicians, who possess more cunning than real talent; he established himself in situations the salubrious influence of which left him little or nothing to do; and he maintained his reputation the better, that he had less occasion to labor in order to acquire it.

17. The temples of Esculapius, continues the author from whom we are now extracting, were very spacious; and within their walls were convenient lodgings for the priests; but, as the deity did not permit any person to die within them, which certainly would have been very indecorous, those persons who were afflicted with severe disorders, and women in the last stages of pregnancy, were obliged to remove to the neighbourhood; and they often remained in the open fields exposed to all the injuries of the weather. The deity, too, forbade any part of the offerings and victims to be consumed out of the temples. From this prohibition, which was no doubt, very politic, we see that he was both wise and provident; and had the welfare of his ministers no less at heart than his own fame and character.

18. Of the great number of temples dedicated to Esculapius the most celebrated were those of Epidaurus, of Pergamus, of Cos, and of Cnidos. The temple of Cos was burnt in Hippocrates' time. The walls and pillars of it were covered with inscriptions, briefly describing the history of diseases, and giving an account of the remedies which had been successfully employed for their cure according to the advice of the deity. People of affluence had these inscriptions engraved on marble, on metal, or on stone; the poorer sort had them carved on mere tables of wood. However imperfect these descriptions of diseases, and of the methods of cure, may have been, their collection was nevertheless very valuable. They formed, as it were, the first rudiments of the art; and discovered some faint traces of the method of observation and experiment which alone is capable of placing it on a solid basis. 19. In contemplating the circumstances and particulars connected with and characterising ancient medicine, we are disposed to think that the whole was imposition on the part of the agents, and credulity on the part of the people; but it may be questioned whether the Ascula

pian prophets and priests did not act as much under the principle of self-deception as that of deceiving the multitude; and, indeed, when they found crowds of votaries returning from their visits to the temples, with their faith confirmed and their maladies healed, it was natural enough, in these early times of fanaticism and unfounded belief, that they should come to believe themselves what the people supposed them to be, immediate interposers between them and deity. Knavery is often supposed and charged, even in modern times, when the fact has been that the individuals thus impugned have been acting under the influence of somewhat better motives than those supposed to be in operation. The facts connected with the history of our late prophetess, Joanna Southcott, were sufficiently humiliating and extraordinary; but it is far from impossible that even this woman was quite as much a fanatic as an impostor, and that she was worked upon by the faith of her followers, so as to actually suppose herself what her disciples gave her credit for being. In any other point of view than that of fanaticism and delusion, it is difficult to realize the systematic procedure of the priests in ancient times with regard to their profession of miraculous powers.

20. In Egypt then, in the first instance, and subsequently in Greece, medicine was practised alone by the sacerdotal orders; and this was in fact the case among the Israelites; we find in sacred history that the Levites were the persons consulted respecting the management of leprosy and other disorders incident to the age and people, and in the porch of the temple of Jerusalem, a complete formulary of remedies was exhibited, of which Solomon was said to be the author.' The Essenes, a sect celebrated for the pure and mild system of morality which they endeavoured to propagate among a wicked and hypocritical people, cultivated the science of medicine, not only in order to render themselves more respected, but also in order to discover means to improve the minds of their adherents by rendering their bodies more healthy. Zealous apostles of their doctrine they endeavoured to confirm it by the performance of cures; and by these means they were often enabled to brave the jealous furies of the Pharisees, those hypocritical and domineering priests. They went sometimes by the name of Essenes and sometimes by the appellation of JepanενTаι, which signifies healers or physicians.'

21. Chinese pretensions to antiquity always defy any attempts to follow them; but there were some practices among these people of exceedingly ancient date which have been resumed in modern times such as acu-punctuation; and among the Babylonians and Chaldeans a great deal of their medicine was connected with astronomical investigations that characterised these people. Herodotus, however, speaks of the sick at Babylon as being exposed in public places to the inspection of passers by, who were solicited to give them advice and furnish them with means of cure; so that part of the medicine of these ancient people consisted in something more palpable than astrological influence, or mere calculations from planetary positions.