hippocrates first delivered medicine from the thraldom of superstition.—dissection of the human body and rise of anatomy.—hippocrates, father of medicine and surgery.—the law.—plato.

hippocrates, the “father of medicine,” was born at cos,384 460 b.c. on his father’s side he was believed to be descended from ?sculapius, and through his mother from hercules. a member of the family of the asclepiad?, of a descent of three hundred years, he had the advantage of studying medicine under his father, heraclides, in the asclepion of cos. herodicus of selymbria taught him medical gymnastics, and democritus of abdera and gorgias of leontini were his masters in literature and philosophy. he travelled widely, and taught and practised at athens, dying at an age variously stated as 85, 90, 104, and 109. fortunate in the opportunities offered by his birth and position, he was still more fortunate in his time—the age of pericles—in which greece reached its noblest development, and the arts and sciences achieved their greatest triumphs. it was the age of socrates, plato, xenophon, euripides, sophocles, ?schylus, pindar, aristophanes, herodotus, thucydides, and phidias. philosophy, poetry, literature, and sculpture found in these great minds their most perfect exponents. medicine, in the person of hippocrates, was to find its first and most distinguished author-physician.

the father of medicine was therefore the worthy product of his remarkable age. the genius which culminated in the works of the golden age of greece could scarcely have left medicine without her hippocrates; the harmony otherwise would have been incomplete.

the following genealogy of hippocrates has been given by tzetzes, but mr. grote says it is wholly mythical:—

?sculapius was the father of podalirius, who was the father of hippolochus, who was the father of sostratus, who was the father of cleomyttades, who was the father of theodorus, who was the father of173 sostratus ii., who was the father of theodorus ii., who was the father of sostratus iii., who was the father of nebrus, who was the father of gnosidicus, who was the father of hippocrates i., who was the father of heraclides, who was the father of hippocrates ii., otherwise called the great hippocrates.

hippocrates was the first physician who delivered medicine from the thraldom of superstition and the sophistries of philosophers, and gave it an independent existence. it was impossible that our science should make progress so long as men believed that disease was caused by an angry demon or an offended divinity, and was only to be cured by expelling the one or propitiating the other. hippocrates, with a discernment and a courage which was marvellous, considering his time, declared that no disease whatever came from the gods, but was in every instance traceable to a natural and intelligible cause. before the asclepiad? there was no medical science; before hippocrates there was no one mind with vision wide enough to take in all that had been done before—to select the precious from the worthless and embody it in a literature which remains to the present time a model of conciseness and condensation, and a practical text-book on all that concerns the art of healing as it was understood in his time. the minuteness of his observations, his rational, and accurate interpretation of all he saw, and his simple, methodical, truthful, and lucid descriptions of everything which he has recorded excite the admiration and compel the praise of all who have studied the works which he has left. nor are his candour, honesty, caution, and experience less to be extolled. he confesses his errors, fully explains the measures adopted to cure his cases, and candidly admits that in one series of forty-two patients whom he attended only seventeen recovered, the others having perished in spite of the means he had proposed to save them. he was probably the first public teacher of the healing-art; his counsels were not whispered in the secret meetings of sacerdotal assemblies. he was the first to disclose the secrets of the art to the world; to strip it of the veil of mystery with which countless generations of magicians, thaumaturgists, and priestly healers had shrouded it, and to stand before his pupils to give oral instruction in anatomy and the other branches of his profession. had he not been the father of medicine, he would have been known as one of the greatest of the philosophers. he first recognised φ?σι?—nature in the treatment of disease. nature, he declared, was all-sufficient for our healing. she knows of herself all that is necessary for us, and so he called her “the just.” he attributed to her a faculty, δ?ναμι?; physicians are but her servants. the governing faculty, δ?ναμι?, nourishes, preserves, and increases all things.

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galen states that the greater part of aristotle’s physiology was taken from hippocrates. it has been the custom to make light of his anatomical knowledge, and to say that in face of the difficulty, if not impossibility, of procuring subjects for dissection, he could have had but little exact knowledge of the human body; but it is certain that by some means or other he must have dissected it. in proof of this it is only necessary to mention his treatise on the articulations, especially that part of it which relates to the dislocation of the shoulder joint. dr. adams, in one of his valuable notes on the works of hippocrates,385 says: “the language of our author in this place puts it beyond all doubt that human dissection was practised in his age.” in ashurst’s international encyclop?dia of surgery386 his descriptions of all dislocations are declared to be wonderfully accurate; and the writer adds that it is the greatest error imaginable to suppose, with the common conceit of our day, that all ingenious and useful improvements in surgery belong to the present age. in the treatise on the sacred disease (epilepsy), his description of the brain in man proves that he was acquainted with its dissection.

in the treatise on the heart, again, the construction of that organ in the human body is referred to. other allusions to the internal structure of the human frame in the hippocratic treatises serve to confirm our opinion; and if it be objected that some of these are probably not genuine, they must at least be as old as his period, and it was far more likely that he should have written or inspired them than that they should have emanated from an inferior source. those who argue to the contrary do so on the same grounds as the greek commentators, who say that the iliad and odyssey were not written by homer, but by some other poet of the same name. dr. adams is confident, from his familiarity with the works of hippocrates, that the knowledge of human anatomy exhibited therein had its origin in actual dissection, and he adds that: “i do not at present recollect a single instance of mistake committed by him in any of his anatomical descriptions, if we except that with regard to the sutures of the head, and even in that case i have endeavoured to show that the meaning of the passage is very equivocal.”387 there is no doubt, in fact, that a great deal more human dissection went on than the greek doctors dared to acknowledge for fear of exciting popular prejudice. less than a hundred years after the death of hippocrates there was abundant and open dissection of the human body in the schools of alexandria, and it is incredible that the practice only received popular sanction at that particular time. yet the175 anatomy of hippocrates was very imperfect. the nerves, sinews, and ligaments were confounded together, all being classed as νε?ρον or τ?νο?.

the blood-vessels were supposed to contain both blood and air, and were called φλ?βε?; the trachea was called an “artery.”

the brain was considered as merely a gland which condenses the ascending vapours into mucus. the office of the nerves was to convey the animal spirits throughout the body. we must not forget that the science of anatomy was extremely imperfect even at the beginning of the present century.

“when,” says littré,388 “one searches into the history of medicine and the commencement of the science, the first body of doctrine that one meets with is the collection of writings known under the name of the works of hippocrates. the science mounts up directly to that origin, and there stops. not that it had not been cultivated earlier, and had not given rise to even numerous productions; but everything that had been made before the physician of cos has perished. we have only remaining of them scattered and unconnected fragments. the works of hippocrates have alone escaped destruction; and by a singular circumstance there exists a great gap after them as well as before them. the medical works from hippocrates to the establishment of the school of alexandria, and those of that school itself, are completely lost, except some quotations and passages preserved in the later writers; so that the writings of hippocrates remain alone amongst the ruins of ancient medical literature.”

it is vain to inquire how hippocrates acquired a knowledge which seems to us so far in advance of his age. was greek wisdom derived from the east, or was its philosophy the offspring of the soil of hellas? such questions have often been discussed, but to little purpose. there would seem to be every reason to suppose that greek medicine was indigenous. we have no means of knowing how long philosophy and medicine had been united before the time of hippocrates. the honour of affecting the alliance has been ascribed to pythagoras.

several of the greek philosophers speculated about medicine. we have seen that besides pythagoras, empedocles and democritus did so, although it is not probable that they followed it as a profession. the asclepiad? probably brought medicine to a high state of perfection, but the work these priest-physicians did is a sealed book to us. all was darkness till hippocrates appeared.

in his treatise on ancient medicine, he says that men first learned from experience the science of dietetics; they were compelled to176 ascertain the properties of vegetable productions as articles of food. then they learned that the food which is suitable in health is unsuitable in sickness, and thus they applied themselves to the discovery of the proper rules of diet in disease; and it was the accumulation of the facts bearing on this subject which was the origin of the art of medicine. “the basis of his system was a rational experience, and not a blind empiricism; so that the empirics in after ages had no good grounds for claiming him as belonging to their sect.”389

he assiduously applied himself to the study of the natural history of diseases, especially with the view to determine their tendencies to death or recovery. in every case he asked himself what would be the probable end of the disorder if left to itself. prognosis, then, is one of the chief characteristics of hippocratic medicine. he hated all charlatanism, and was free from all popular superstition. when we reflect on the medicine of the most highly civilized nations which we have considered at length in the preceding pages, and remember how full of absurdities, of magic, amulet lore, and other things calculated to impose on the credulity of the people, were their attempts at healing, we shall be inclined to say, that the most wonderful thing in the history of hippocrates was his complete divorce from the evil traditions of the past. although he forsook philosophy as an ally of medicine, his system was founded in the physical philosophy of the elements which the ancient greeks propounded, and which we have attempted to explain. there was an all-pervading spiritual essence which is ever striving to maintain all things in their natural condition; ever rectifying their derangements; ever restoring them to the original and perfect pattern. he called that spiritual essence nature. “nature is the physician of diseases.”390 here, then, we have the enunciation of the doctrine of the vis medicatrix natur?. in his attempts to aid nature, the physician must regulate his treatment “to do good, or at least, to do no harm”;391 yet he bled, cupped, and scarified. in constipation he prescribed laxative drugs, as mercury (not the mineral, of course, but mercurialis perennis), beet, and cabbage, also elaterium, scammony, and other powerful cathartics. he used white hellebore boldly, and when narcotics were required had recourse to mandragora, henbane, and probably to poppy-juice.

he is said to have been the discoverer of the principles of derivation and revulsion in the treatment of diseases.392

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sydenham called hippocrates “the romulus of medicine, whose heaven was the empyrean of his art. he it is whom we can never duly praise.” he terms him “that divine old man,” and declares that he laid the immovable foundations of the whole superstructure of medicine when he taught that our natures are the physicians of our diseases.393

he was father of surgery as well as of medicine. eight of his seventeen genuine works are strictly surgical. by an ingenious arrangement of apparatus he was enabled to practise extension and counter-extension. he insisted on the most exact co-aptation of fractured bones, declaring that it was disgraceful to allow a patient to recover with a crooked or shortened limb. his splints were probably quite as good as ours, and his bandaging left nothing to be desired. when the ends of the bones projected in cases of compound fractures, they were carefully resected. in fracture of the skull with depressed bone the trepan was used, and in cases where blood or pus had accumulated they were skilfully evacuated. he boldly and freely opened abscesses of the liver and kidneys. the thoracic cavity was explored by percussion and auscultation for detection of fluids, and when they were discovered paracentesis (tapping) was performed. this was also done in cases of abdominal dropsies. the rectum was examined by an appropriate speculum, fistula-in-ano was treated by the ligature, and h?morrhoids were operated upon. stiff leather shoes and an admirable system of bandaging were employed in cases of talipes. the bladder was explored by sounds for the detection of calculi; gangrenous and mangled limbs were amputated; the dead f?tus was extracted from the mother. venesection, scarification, and cupping were all employed.394

he resected bones at the joints. in the treatment of ulcers he used sulphate of copper, sulphate of zinc, verdigris, lead, sulphur, arsenic, alum, etc. he came very near indeed to the antiseptic system in surgery when he made use of “raw tar water” (a crude sort of carbolic acid, in fact) in the treatment of wounds. suppositories were employed.

in dr. adams’ life of hippocrates,395 he says:178 “in surgery he was a bold operator. he fearlessly, and as we would now think, in some cases unnecessarily, perforated the skull with the trepan and the trephine in injuries of the head. he opened the chest also in empyema and hydrothorax. his extensive practice, and no doubt his great familiarity with the accidents occurring at the public games of his country, must have furnished him with ample opportunities of becoming acquainted with dislocations and fractures of all kinds; and how well he had profited by the opportunities which he thus enjoyed, every page of his treatises on fractures and on the articulations abundantly testifies. in fact, until within a very recent period, the modern plan of treatment in such cases was not at all to be compared with his skilful mode of adjusting fractured bones, and of securing them with waxed bandages. in particular, his description of the accidents which occur at the elbow and hip-joints will be allowed, even at the present day, to display a most wonderful acquaintance with the subject. in the treatment of dislocations, when human strength was not sufficient to restore the displacement, he skilfully availed himself of all the mechanical powers which were then known. in his views with regard to the nature of club-foot, it might have been affirmed of him a few years ago that he was twenty-four centuries in advance of his profession, when he stated that in this case there is no dislocation, but merely a declination of the foot; and that in infancy, by means of methodical bandaging, a cure may in most cases be effected without any surgical operation. in a word, until the days of delpech and stromeyer, no one entertained ideas so sound and scientific on the nature of this deformity as hippocrates.”

dr. adams, recapitulating the general results of the investigations as to the genuineness of the hippocratic books, states that a considerable portion of them are not the work of hippocrates himself. the works almost universally admitted to be genuine are: the prognostics, on airs, etc., on regimen in acute diseases, seven of the books of aphorisms, epidemics, i. and iii., on the articulations, on fractures, on the instruments of reduction, the oath.

the following are almost certainly genuine: on ancient medicine, on the surgery, the law, on ulcers, on fistul?, on h?morrhoids, on the sacred disease.396

the law.

1. medicine is of all the arts the most noble; but owing to the ignorance of those who practise it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts. their mistake appears to me to arise principally from this, that in the cities there is no punishment connected with the practice of medicine (and with it alone) except disgrace, and that does not hurt those who179 are familiar with it. such persons are like the figures397 which are introduced in tragedies, for as they have the shape, and dress, and personal appearance of an actor, but are not actors, so also physicians are many in title but very few in quality.

2. whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages: a natural disposition; instruction; a favourable position for the study; early tuition; love of labour; leisure. first of all, a natural talent is required; for when nature opposes, everything else is vain; but when nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place well adapted for instruction. he must also bring to the task a love of labour and perseverance, so that the instruction taking root may bring forth proper and abundant fruits.

3. instruction in medicine is like the culture of the productions of the earth. for our natural disposition is, as it were, the soil; the tenets of our teacher are, as it were, the seed; instruction in youth is like the planting of the seed in the ground at the proper season; the place where the instruction is communicated is like the food imparted to vegetables by the atmosphere; diligent study is like the cultivation of the fields; and it is time which imparts strength to all things and brings them to maturity.

4. having brought all these requisites to the study of medicine, and having acquired a true knowledge of it, we shall then, in travelling through the cities, be esteemed physicians not only in name but in reality. but inexperience is a bad treasure, and a bad friend to those who possess it, whether in opinion or reality, being devoid of self-reliance and contentedness, and the nurse both of timidity and audacity. for timidity betrays a want of power, and audacity a want of skill. there are, indeed, two things, knowledge and opinion, of which the one makes its possessor really to know, the other to be ignorant.

5. those things which are sacred are to be imparted only to sacred persons; and it is not lawful to impart them to the profane until they have been initiated in the mysteries of the science.

the “hippocratic collections” of works which have been attributed to hippocrates, but the greater part of which were neither written by him, nor compiled from notes taken by his students, consists of eighty-seven treatises.

hippocrates believed in the influence of the imagination of pregnant women on the child in the womb. he forbad nurses to eat food of an180 acrid, salt, or acid nature, and observed that infants during the period of dentition were liable to fevers, bowel troubles, and convulsions, especially if there was constipation. he mentions thrush as one of the diseases of dentition (de dent.). he recommends friction for contracting or relaxing the body according as it is applied in a hard or soft manner. very fully he discourses on the evil effects of plethora, and recommends purging, emetics, warm baths, and bleeding, for reducing the system (de dietol., iii. 16 et seq.). he constantly advises gentle purgatives as a means of keeping the body in health. his favourite laxative medicine was the herb mercury. the administration of clysters is recommended; this treatment was evidently derived from the egyptians. what are called errhines or sternutatories—i.e., medicines which, applied to the nose, excite sneezing—were described by hippocrates as medicines which purge the head. though he fully describes the effects of baths, he speaks unfavourably of thermal springs as being hard and heating. he insists that the diet should be full in winter and spare in summer (aphor., i. 18). he disapproves of the habit of eating a full dinner (de vet. med.). he condemns the use of new bread. the nutritious properties of pulse in general are insisted upon. he calls the flesh of fowls one of the lightest kinds of food (de affect., 46), and says that eggs are nutritious, and strengthening, but flatulent. he remarks that the flesh of wild animals is more digestible than that of domesticated. he objects to goat’s flesh as having all the bad qualities of beef, which he calls a strong, astringent, and indigestible article of diet. milk, he says, sometimes causes the formation of stones in the bladder (de ?r. aquis et locis, 24). dr. francis adams says this opinion was adopted by all the ancient physicians. cheese he considers flatulent and indigestible. fishes are light food; sea fish are lighter and better for delicate persons than fresh-water fish (de affect., 46). honey, when eaten with other food, is nutritious, but is injurious when taken alone.

hippocrates opposed all hypothesis in medicine, and grounded his opinions on disease on actual observation. he insisted that the essence of fever is heat mixed up with noxious qualities. he was the great master of prognostics. his work prorrhetica and coac?, says dr. francis adams,181 “contains a rich treasure of observations which cannot be too much explored by the student of medicine. his prognostics are founded upon the appearance of the face, eyes, tongue, the voice, hearing, the state of the hypochondriac region, the abdomen, the general system, sleep, respiration, and the excretions. we can do little more, in this place, than express our high sense of the value of the hippocratic treatises on prognostics, and recommend the study of them to all members of the profession who would wish to learn the true inductive system of cultivating medicine.” (the seven books of paulus ?gineta, by francis adams.) the state of the countenance which immediately precedes death is called by physicians the facies hippocratica, because hippocrates described it, calling it πρ?σωποι διαφθορ? (coac. pr?not., 212). the nose is sharp, the eyes hollow, the temples sunk, the ears cold and contracted, and their lobes inverted; the skin about the forehead hard, tense, and dry; the countenance pale, greenish, or dark. in fevers he was greatly attached to the importance of the critical days. galen adopted his list of critical days with little alteration. hippocrates does not seem to have paid much attention to the pulse, or if he did he attached little importance to it; even in describing epidemical fevers he neglects to mention the characteristics of the pulse. galen, however, affirms that he was not altogether ignorant of it. he quite correctly described the characteristics of healthy stools, and pointed out that they should in colour be yellowish, if too yellow there is too much bile, if not yellow at all there was a stoppage of the passage of bile to the intestines. his indications from the state of the urine are not less valuable. how wise are his observations on the treatment of febrile diseases! “to be able to tell what had preceded them; to know the present state and foretell the future; to have two objects in view, either to do good or at least do no harm” (epidem., i. 7). he it was who formulated the rule all physicians have since followed that a fluid diet is proper in all febrile affections. he advised cold sponging in ardent fevers—a method of treatment recently revived and of great value (de rat. vict. acut.). he laid it down that diseases in general may be said to arise either from the food we eat or the air we breathe. in cases of fever he allowed his patients to drink freely of barley-water and cold acidulated drinks. in this he was much in advance of the medical science of the time. he has described cases of “brain fever,” one of the few complaints which novelists permit their heroes to suffer from. they appear to have been cases of remittent fever rather than true inflammation of the brain. we may estimate the wonderful extent of the medical science of hippocrates by the fact that he vigorously opposed the popular belief of the period, that epilepsy was due to demoniacal influence. he explains that the lower animals are subject to the same disorder, and that in them it is often associated with water in the brain. there is really no doubt that the morbus sacer of the ancients and the cases of demoniacal possession of which we read were cases of epilepsy (hippoc. de morbo sacro). concerning apoplexy he says that a slight attack is difficult to cure, and a severe one utterly incurable. the cause of the attack he considered was turgidity of the182 veins. we know it to be often associated with cerebral h?morrhage or sanguineous apoplexy and sometimes with effusion of serum = serous apoplexy. hippocrates therefore came very near the truth. he advised bleeding, which is still recommended but is not often practised in england; and he very justly said that the malady occurs most frequently between the age of forty and sixty (aphoris., ii. 42). in certain forms of ophthalmia he advises free purgation, bleeding, and the use of wine; and this accords with the best modern practice, if for venesection, we substitute vesication. his treatment of nasal polypus by the ligature is not unlike our own; and nothing could be better than his plan for dealing with quinsey and allied complaints, viz., hot fomentations, warm gargles and tinctures, with free purgation. he disapproves of a practice too often followed by surgeons to-day, of scarifying the tonsils when swollen and red. in cases of inflammation of the lungs he advised bleeding, purging, and cooling drinks. la?nnec, the great french physician, who invented the stethoscope, highly praises hippocrates for his knowledge of phthisis, and the diagnostic value of his tests of the nature of the sputa in that disease. in cases of empyema, or the formation and accumulation of pus in the chest, he directs us to make an incision into the pleural cavity—an operation which has been revived in modern times under the name of “paracentesis thoracis.”

he declares the loss of hair and the diarrh?a of phthisis to be fatal signs, and his description of hydrothorax, or dropsy of the chest, has been highly praised by the greatest authorities. he says that phthisis is most common between the ages of eighteen and thirty-six (see hippoc. de morbis, ii. 45; coac? pr?nat., et alibi). for pleurisy his treatment is practically the same as that followed at the present day. he advised the administration of flour and milk in diarrh?a—an exceedingly useful remedy—and treated the pains of colic by warm injections, warm baths, fomentations, soporifics and purgatives, as the case might require. he was wise enough to know that stone of the bladder was a product of a morbid condition of the urine, and said that when it had fairly formed nothing but an operation for its removal was of any value. he recognised the disease known as hydatids of the liver, and directed that abscesses of that organ should be opened by the cautery. his account of the causes and treatment of dropsy is fairly accurate according to our present knowledge. he approved of paracentesis abdominis (tapping) in cases of ascites, and describes the operation. he recognised the incurability of true cancer. many of his treatises on the disorders of women prove that they were well understood in his day, and on the whole were properly treated. difficult labour was managed not so differently from our modern methods as183 might be supposed. his account of hip-joint disease is remarkably accurate. gout was well understood by our author, and probably his treatment by purgation and careful dieting was on the whole as successful as our own.

hippocrates speaks of leprosy as more a blemish than a disease; it is probable, however, that the works in which he is supposed to allude to it are not genuine. he points out the danger of opening the round tumour on tendons, called a ganglion. in his book called prognostics, he refers to the danger of an erysipelas being translated to an internal part. cold applications, he says, are useful in this disease when there is no ulceration, but prejudicial when ulceration is present. struma or scrofula is described by hippocrates (de glandulis) as being one of the worst diseases of the neck. in the treatise (de ulceribus) on ulcers, he particularly praises wine as a lotion for ulcers, and there is good reason to believe that we might advantageously revert to this treatment. some of the drugs which he recommends for foul ulcers, such as frankincense and myrrh, are excellent, and owe their efficacy to their “newly discovered” antiseptic action. he recommends also arsenic and verdigris. the actual cautery or burning applied freely to the head is recommended in diseases of the eyes and other complaints. he describes water on the brain in the treatise de morbis, ii. 15, and even recommends perforation of the skull or trephining quite in the modern way. opening the temporal veins is advised for obstinate headaches. although no express treatise on bleeding is found amongst the works of hippocrates, he practised venesection freely in various diseases. he forbids the surgeon to interfere with non-ulcerated cancers, adding that if the cancer be healed the patient soon dies, while if let alone he may live a long time (aph., vi. 38). he warns us that the sudden evacuation of the matter of empyema or of the water in dropsy proves fatal. he speaks of evacuating the fluid with an instrument similar to that which we call a trochar. he approves of scarification of the ankles in dropsy of the lower extremities; this is quite modern treatment. in cases of dislocation of the hip-joint from the formation of a collection of humours, he recommends burning so as to dry up the redundant humours. he minutely describes the cure of fistula with the ligature in his work de fistulis, which, even if not a genuine treatise of hippocrates, is extremely ancient, and was considered authentic by galen. h?morrhoids or piles are to be ligatured with very thick thread, or destroyed with red-hot irons. varicose veins are to be treated by small punctures, not freely opened (de ulceribus, 16). hippocrates considered the extraction of weapons to be one of the most important departments of surgery. in his treatise de medico,184 he says that surgery can only be properly learned by attaching one’s self to the army. homer said,—

“the man of medicine can in worth with many warriors vie,

who knows the weapons to excise, and soothing salves apply.”

hippocrates treats of fractures in his books de fracturis (de articulis; de vulner. capit.; officina medici). he insists that no injuries to the head are to be considered as trifling; even wounds of the scalp may prove dangerous if neglected. fissures, contusions, and fractures of the cranium are minutely explained and appropriate treatment suggested. he describes the trephine under the name of τρ?πανον, i.e. the trepan. he says that convulsions are the frequent consequence of head injuries, and that they occur on the opposite side of the body to that in which the brain injury is seated. one of the most valuable legacies of the ancients is this profoundly learned treatise of the father of medicine, and it proves to us how high a point the surgery of ancient greece had reached. he noticed a certain movement of the brain during respiration, a swelling up in expiration and a falling down during inspiration; and although several great authorities of the past denied the accuracy of this observation, it has since been shown to be perfectly correct. (see paulus ?gineta, dr. f. adams’ edit., vol. ii. p. 442.) in cases of fracture of the lower jaw, our author directs that the teeth separated at the broken part are to be fastened together and bound with gold wire. so accurately does he describe this fracture that paulus ?gineta transcribes it almost word for word from the de articulus. his method of treating fracture of the clavicle is admirable; in fracture of the ribs he observes that when the broken ends of the bone are not pushed inwards, it seldom happens that any unpleasant symptoms supervene. in fractures of the arm he minutely and precisely indicates the correct principles on which they are to be treated, and insists strongly on the necessity of having the arm and wrist carefully suspended in a broad soft sling, and that the hand be placed neither too high nor too low. hippocrates could learn very little from our modern surgeons in the treatment of such injuries. in cases of broken thigh he has indicated all the dangers and difficulties attending the management of this accident; his splints and bandages are applied much as we apply them at the present time, and his suggestions for ensuring a well-united bone without deformity of the limb are invaluable. in fractures of the thigh and leg-bones he lays great stress on the attention necessary to the state of the heel. in those of the foot he warns against the danger of attempting to walk too soon. in compound fractures compresses of wine and oil are to be used, and splints are not to be applied till the wound puts on a185 healthy appearance. he is fully aware of the peculiarly dangerous character of such injuries, and his observations read like extracts from a modern text-book of surgery. “no author,” says dr. francis adams, the learned translator of the works of paulus ?gineta, “has given so complete a view of the accidents to which the elbow joint is subject as hippocrates.”

plato (b.c. 427-347) in its philosophical aspect studied medicine, not with any idea of practising the art, but merely as a speculative contemplation. the human soul is an emanation from the absolute intelligence. the world is composed of the four elements. fire consists of pyramidal, earth of cubical, air of octagonal, and water of twenty-sided atoms. besides these is the ?ther. everything in the body has in view the spirit. the heart is the seat of the mind, the lungs cool the heart, the liver serves the lower desires and is useful for divination. the spleen is the abode for the impurities of the blood. the intestines serve to detain the food, so that it might not be necessary to be constantly taking nourishment. the inward pressure of the air accounts for the breathing. the muscles and bones protect the marrow against heat and cold. the marrow consists of triangles, and the brain is the most perfect form of marrow. when the soul is separated from the marrow, death occurs. sight is caused by the union of the light which flows into and out of the eyes, hearing in the shock of air communicated to the brain and the blood. taste is due to a solution of sapid atoms by means of small vessels, which vessels conduct the dissolved atoms to the heart and soul. smell is very transitory, not being founded on any external image. the uterus is a wild beast exciting inordinate desires. disease is caused by a disturbance of the quantity and quality of the fluids. inflammations are due to aberrations of the bile. the various fevers are due to the influence of the elements. mental diseases are the results of bodily maladies and bad education. diseases fly away before appropriate drugs. physicians must be the rulers of the sick in order to cure them, but they must not be money-makers.398

in the republic of plato, book iii., we find that medical aid was largely in request in greece to relieve the indolent and voluptuous from the consequences of self-indulgence. it was thought by socrates disgraceful to compel the clever sons of asclepius to attend to such diseases as flatulence and catarrh; it seemed ridiculous to the philosopher to pay so much attention to regimen and diet as to drag on a miserable existence as an invalid in the doctor’s hands. when a carpenter was ill, he expected his doctor to cure him with an emetic or a purge, the cautery or an operation; if he were ordered a long course of diet, he186 would tell his doctor that he had no time to be ill, and he would go about his business regardless of consequences. ?sculapius, it was maintained, revealed the healing art for the benefit of those whose constitutions were naturally sound; he expelled their disorders by drugs and the use of the knife, without interfering with their usual avocations; but when he found they were hopelessly incurable, he would not attempt to prolong a miserable life by rules and diet, as such persons would be of no use either to themselves or the state. constitutionally diseased persons and the intemperate livers were to be left to be dealt with by nature, so that they might die of their diseases.