116 



MEDICINE 



maxim, to live conformably to nature, Imdily exer- 

 cises. including tin- manipulations of the bath- 

 altendant ( ' manage ' ), and dietetics being his 

 chief remedies. liU immediate follower, Tliemi- 

 00, simplified hix etiology, nnd, ignoring the 

 atom*, insisted on the abnormal condition of tin' 

 pore* a* the one cause of disease, lindi-ig ln<alili in 

 tin- mrt/KxIiii or ' mill. Hi- passage' (as Uaser ex- 

 plains it) <if these channels, and the low of health 

 in their constriction or relaxation, or in the partial 

 coexi-tcm ..... f lioth ronditioiiH. His thera|N'iitic- 

 aimed at inducing; a state op|xixit to that in which 

 the patient was found, ami so relaxation wan 

 treated with astringent.", constipation with laxa- 

 tive*. The Methodic* had the merit of ignoring 

 mere authority, even the Hlppoentb ' humor- 

 ali-in ' still dominant. and studied the patient's 

 general condition as the safest ground of diag- 

 nosis. Despising etiology, even in local affec- 

 tions, their therapeutics Ix-came an unreflecting 

 routine. Itut their skill in dietetics amply ex- 

 plains their acceptance with the Roman world, 

 ensuring the patient fresh air, and a pure and 

 healthy skin, while rejecting all drastic or lowering 



Aulus Cornelius Celsus, an adherent of no 

 school and perhaps not a professional man at all, 

 is yet the higln-t name in the Roman healing art, 

 for hi- treat ie /'. Mi'ilii-iiin. which formed part 

 of hi- encyclopaedia a sort of ' Whole Duty of the 

 Roman I'atrician.' Himself one of the order, he 

 had doubtless to interest himself in the amnla 



che 



iiii, or inlirniaries for slaves attached 

 to every timntrv seat or urban palace. Hi- 

 \|icricnce of siirli hospitals enabled him to test 

 the practice of the profession, and from the 

 knowledge tlm- acquired, c-|>cciallv in dietetics, 

 phannacv, ami surgery, he compiled his elegantly 

 written fxiok. Historically it- \alue is priceless, 

 a* the source from which we have distinct know 

 ledg' 1 of the Alexandrian period. He bases medi 

 'in", with IlippocrateM, on anatomy, physiology, 

 and the cientilic investigation of the causes of di.-- 

 ease, while, without excluding the hypothetical, he 

 allows no hvjmthesi- to inlluence practice. The 

 whole work forms a compendium which, since its 

 re-emerging to light in the Kith century, has held 

 the lii-t juke* in I-atin medical literature. In the 

 next generation to <'el-us. I'liny the Klder deserve* 

 notice for his valuable, though incidental, allusions 

 to medical authors, lint to return to the Methodic-. 

 In I lie reign of Nero. The ulii- of Tralles was their 

 mcmt |Mipuhir lepri-entative ; half a century later 

 .1111- of Kphesiis t'Mik his place in Ro ...... i_- the 



Mont distinguished of the .chool. His masterwork, 

 written in i;-eek. i- "ii ol-stetric-, while in medi- 

 cine pro|M>r his treatise on acute and chronic dis- 

 ease* (lost in it- Ureek original, but pre-erveil to 

 u in the African l.atinit\ of I Vims Aurelianus, 

 who lived alsini the enil of the 4th or beginning of 

 the 5th rcnlnryi exhibits the Methodic practice 

 in its most favotuahle light. This, though with 

 diminishing strength, te-isicd even the inlluem -e 

 of tialpii. till in the middle agi-s it took a fresh 

 start. 



An olV-hoot from the Methodic school had already 

 appeared in tin- l-t ci-ntiiry vi/. the rneiimatic. 

 which nought to iccoiicilc it with the Hip|H -laiie 

 humornli-m. It- originator. Athcn.cu-. derived its 

 .-entral doctrine from a hypothetic pneiima or soul 

 iH-Mading the univer-e : but in practice he com- 

 bined the empiric and methodic therapeutic-. 

 Alxillt the name time nro-c the Iv'lcctic-. whose 

 chief repn -ntatiM-s were Rufu- of Kphi-sus and 

 the much aldei \n-t MI- of Cappndix-ia. who, for 

 general riilture. moral worth, and professional 

 skill, to say nothing of the purity of his Ionic 

 Greek, come* next to Hip|ocrate*, 



We have now reached the epoch-making Cab-n, 

 lM>rn at IVrgamus in 131 A. I)., who, after varied 

 -indies in the Hellenic schools of the Levant, came 

 as a i|ualilieil practitioner to Rome in 11H. Hi- 

 rapid success aroused the jealousy of the profes- 

 sion there, and he again travelled in the East, 

 to lie recalled to Koine by the enipenus Lucius 

 Verus and Marcus Anrelius. He found medicine 

 -peaking a lialx'l of tongues while claiming to 

 be a science, and po-ing as a profession. He 

 sought to rehabilitate it by restoring to anatomy 

 and physiology the value withheld from them by 

 Kmpnics and SlethcKlics, and by reinforcing practice 

 with the iliscoveries of the Alexandrian school; in 

 other words, to make diagnosis scientific by basing 

 it on anatomy and physiology, and to reconstruct 

 therapeutics by an unprejudiced clinical experience. 

 His guide was Hippocrates the treatise on Prog- 

 nostics in particular: but unhappily he abandoned 

 the sound Hip|xtcratic method, and tried to unite 

 professional to scientific medicine with a philo- 

 sophic link. This he found in a hyper-ideali-tic 

 Flatonism, from which he evolved a Ideological 

 system which provided qpery question with an 

 answer and every riddle with a solution. Hence 

 aro.se a plausible appearance of infallibility, which 

 kept medicine in chains till the 17th and 18th 

 centuries. Adopting the Hippocratic view of the 

 corporeal element- as consisting of the solid, the 

 liquid, the warm, and the cold, he found them 

 blended emially ill the blood, while in the bile the 

 warm predominated, in the phlegm the cold. His 

 vivifying principle, the JHII m/m. reaches in man its 

 highest development as the ' psychical,' the ' vital, 

 and the 'natural' spirit, and manifests itself in 

 spiritual,' 'pulsating,' and 'natural' force. The 

 processes regulating nutrition and structure he 

 explained by attractive, secretive, propulsive, and 

 expulsive ]Miwers. Recognising, however, that 

 these do not cover all physiological processes, he 

 added to them the (iccult powers of the 'whole 

 -ubstance,' the 'specific qualities' of his later 

 followers; thus opening the sluice-gates to every 

 kind of superstition. 



l>i-ea-e In- ascrilied, til's t, to immediate causes 

 (such as plethora and corruption of the juices); 

 next, to tne disturbance thence arising; next, to 

 the abnormal structural processes started by 

 Mich disturbance : anil finally, to the symptom-. 

 Maladies he distributed according to their ana- 

 tomical substratum : (I) those of the elementary 

 substances ( blood, phlegm, yellow and black bile); 

 I'J) irregularities of homogeneous substances 

 (tissues), which, again, fall into anomalies of 

 the physical condition (strain and atony), and 

 of the primal ([Ualities (warm, cold, \-c. ); (3) 

 ailments of special organs. l-'or the Hippocralic 

 'crudity,' coction,' and 'crisis.' maniicsicd only in 

 acute disease, he substituted the 'beginning,' the 

 1 progress,' the 'culmination,' and the 'decline;' 

 hut retained the doctrine of crises and critical 

 days; and he agreed with Hippocrates that the 

 recuperative principle is nature, working necessarily 

 through the attractive. I lanstoi niing, and expulsive 

 powers. He originated the doctrine of indications' 

 in their Ix-aring on the prevention of disease; on 

 it -character, stage, type, symptoms; on the idiosyn- 

 cra-y of the patient and the nature of the affected 

 organs even on his dreams. Diet, gymnastics, 

 baths, friction, and blood letting formed hi- main 

 therapeutics. Consistently, with his theories he 



classified ineiljeines. according to the prevaleni f 



one or more elements, into simple, compound, and 

 tho-e operating through their ' whole substance ' 

 (emetics, for instance, purgatives, poison- and 

 their antidotes). In his own practice he preferred 

 simplex, and set peculiar value on opium, introduced 

 by the Alexandrian school. It was not till after 



