192 INTERNAL MEDICINE 



inward maladies (<ai/pa Kal aS?/Aa voo-^/xara), taught that even for the 

 inner, by careful sight and touch, laborious inspection of excretions, 

 and so forth, many facts are accessible to methodical investigations; 

 yet, as in inner diseases the field for inference is more spacious, the 

 data even of direct observation fell the more readily into the scheme 

 of the four humors, and by this doctrine were so colored that, 

 although observed with a rare clinical insight, they were set in the 

 frame of a fictitious pathology. 



How was it then that the speculative side of the medicine of Hip- 

 pocrates embarrassed him so little? Because the clinical method of 

 the school was soundly based upon the outward maladies, where 

 direct induction was practicable. No sooner indeed does an inward 

 affection - - an empyema for example - - work outwards than the 

 mastery of Hippocrates becomes manifest. What we separate as 

 surgery, surgery which, from Guy to Pare, by clerks, faculties, and 

 humanists was despised as vile, and from Pare to Hunter as illiberal, 

 was in the age of Hippocrates, as in all critical epochs of medicine 

 since that age, its savior. 



If then our admiration of the inner medicine of Hippocrates, great 

 as it is, is a relative admiration, an admiration of the historical sense, 

 of his outer medicine our admiration is instant and unqualified. 

 Little as the fifth century knew of inward anatomy, as compared 

 with Alexandria about two centuries later, yet the marvelous eye and 

 touch of the Greek physician had made an anatomy of palpable 

 parts --a clinical anatomy sufficient to establish a medicine of 

 these parts of the body of which our own generation would not be 

 ashamed. 



In respect of fractures and luxations of the forearm, M. Petre- 

 quin pronounces Hippocrates more complete than Boyer; in respect 

 of congenital luxations richer than Dupuytren. Malgaigne again 

 admires his comparison of the effects of unreduced luxations on the 

 bones, muscles, and functions of the limb in adults, in young children, 

 and before birth, as a wonderful piece of clinics. In Littre's judg- 

 ment, the work of Hippocrates on the joints is a work for all time. 

 On wounds Littre pronounces that the Hippocratic books must be 

 pondered with deep attention; for they are founded on a wide ex- 

 perience, minute and profound observation, and an enlightened and 

 infinitely cautious judgment. Permit me to call your attention, how- 

 ever, to certain of his counsels: That a wound be let bleed, in order 

 to prevent inflammatory consequences; that if in fresh wounds 

 healing by first intention may take place, suppuration or coction is 

 the usual, and in less recent and in contused wounds the normal 

 course; also that wounds should be treated with linseed and other 

 poultices: counsels which, as we shall see presently, were to be as 

 hotly contested in the thirteenth and fourteenth centuries as in the 



