PATHOLOGY. 
in the mean time, attempting, by his hands, forcibly to 
reduce the bone into its former place. 
He made the diltin&ion into fnnple and compound 
fractures, as it exifts in the prefent day ; and his direc¬ 
tions in the cure of fractured ribs are extremely judicious. 
The different fpecies of hernias are well defcribed by him ; 
and he feems to have pfed a bandage and comprefs after 
the reduction of the bowels, on the fame principle as we 
now ufea trufs. In fome cafes, after the return of in- 
teftitial ruptures, he diminiflied the quantity of loofe 
fkin, and formed a cicatrix, fo as to contract over the 
part, to render it more rigid and capable of relilting. 
He defcribes various dil'eafes of the genital parts, the hy¬ 
drocele or dropfy of the fcrotum, a difficulty of urine, 
and the manner of drawing off the water by a catheter ; 
the figns of ftone in the bladder, and the method of 
founding or feeling for that ftone. Lithotomy was at 
that time performed by introducing two fingers into the 
anus ; the done was then preffed forward to the perinteum, 
and a cut made into the bladder; and by the finger or by 
a fcoop the ftone was extracted. He defcribes the manner 
of performing this operation on both the fexes, of treat¬ 
ing the patient, and the figns of recovery and of danger. 
Celfus gives excellent inltruftions with regard to in¬ 
flammation in general; and mentions fome ufeful topical 
applications in ophthalmia. The operations for the cata¬ 
ract (which confifted in depreffing the cryftalline lens), 
and for fiftula, are likewife defcribed by him ; as alfo the 
mode of performing the operation of paracentefis. The 
external application of arfenic as a cure for cancer origi¬ 
nated with Celfus. In external gangrene, he cut into 
the found flefli; and, when the difeafe, in fpite of every 
effort, fpread, he advifed amputation of the member. 
After cutting to the bone, the fleffi was then feparated 
from it, and drawn bach, in order to fave as much fleffi 
as poffible to cover the extremity of the bone. He de¬ 
fcribes the fymptoms of that dangerous inflammation the 
carbuncle, and direfls immediately to buril or corrode the 
gangrened part. To promote the fuppuration of abfceffes, 
he orders poultices of barley-meal, or of marffimal- 
lows, or the feeds of linfeed and fenugreek. He alfo 
mentions the compofitions of feveral repellent cataplafms. 
In the eryjipelas, he applies cerufe, mixed with the juice 
ofSolanum, or nightlhade. He is very diffufe in thofe 
parts of his works which relate to pharmacy, giving for¬ 
mula for a great many external and internal remedies 
now' defervedly aboliftied. 
Though Celfus followed the praClice of Hippocrates in 
many refpefts, yet he very much differed from him in 
others. He particularly ridiculed his dodtrine of critical 
days, which he attributed to anabfurd application of the 
Pythagorean dodlrine of numbers; and he differed from 
that phyfician in regard alfo to bleeding; for he held it 
dangerous to take much blood from patients at once, and 
rather preferred the abllradlion of it at repeated intervals. 
In regard to abflinence, he feems to have followed 
Afclepiades, enjoining the fick to endure hunger and 
thirft during the firft days of their illnefs, and afterwards 
allowing them plenty of food. He entirely difregarded 
the indications of the pulfe, from having obferved that 
it was accelerated or depreffed by many adventitious cir- 
cumllances, as well as from having found it very different 
in complaints of a fimilar nature. 
The moft confiderable of the Roman pathologifts, and 
the laft of any great eminence, was Galen, who flourilhed 
about a hundred and thirty years after Celfus, and was 
phyfician to the emperor Marcus Aurelius. This great 
man was confidered for many centuries afterwards the 
moft infallible authority in all matters relating to patho¬ 
logy. Impreffed at an early age with the important truths 
contained in the writings of Hippocrates, he viewed with 
contempt and difguft the jargon and obfcurity which en¬ 
veloped them in the fchools of medicine. Accordingly 
he became lrimfelf the expofitor of Hippocrates. He re¬ 
peated and extended his obfervations, prefented his opi- 
Vol. XIX. No. 1283. 
13 
nions in new lights, and fupported his dodtrines with all 
the aids which w'ere derivable from fpeculative reafoning 
or the comparifon of fadls. Yet Galen in fome meafure 
fell into the fame error of which he accufed his predecef- 
fors and contemporaries. He obferved the naked faffs 
and fimple truths related almofl without comment by the 
coarle fage. He applied himfelf too much to explain, 
arrange, and fyftematize, a very fmall ftock of informa¬ 
tion ; and, by endeavouring to illullrate a very uncertain 
fcience by means of others not more exadl, he permitted 
his imagination to frame hypothefes in the higheft degree 
gratuitous and aflumptive. Thefe obfervations are fully 
exemplified by the following Iketch of his fyftem. 
He firft begins with eftablilhing four qualities in the ani¬ 
mal body; heat, cold, moifture, and drynefs. The pe¬ 
culiar combinations which thefe qualities undergo, or in 
other words the changes which may be rung on them, pro¬ 
duce eight conftitutions, or temperaments; i. e. hot, 
cold, moilt, and dry ; hot and moift, cold and moift, hot 
and dry, and cold and dry. (See Galen, vol. viii.) 
Idiofyncracy is that temperament which cannot be referred 
to any of thefe qualities, and is therefore fuppofed to arife 
from occult caules. With Hippocrates, Galen admitted 
the operation of Nature ; but to this agent he added three 
other faculties, or, as we thou Id call them, vital properties. 
The firft and molt important, he calls the animal faculty ; 
it has its feat in the brain, .performs the operations of 
mind, and by means of the nerves diftributes the proper¬ 
ties of motion and fenfation to all parts of the body. The 
fecond is called the natural faculty ; it has its feat in the 
liver, and is the principal agent in giow’th, generation, 
and nutrition. The third, denominated the vital facul¬ 
ty, is lodged in the heart, and from thence, by means of 
the arteries, dilleminates heat and vitality through the 
whole fyftem. Thefe three faculties were adled upon by 
Nature as a primum mobile. Their production was fuppo¬ 
fed to be owing to the agency of certain Jpirils, or faille 
vapours, which he likewife divided into three kinds, bear¬ 
ing the names of vital, natural, and animal. Galen ad¬ 
mits the exiftence of the four humours of blood, phlegm, 
yellow, and black bile, firft infilled on by Hippocrates. 
With that phyfician he likewife divides the body into 
three component parts; fpirits, humours, and parts, or, 
as we call them ,folids. The laft-inentioned fubllances he 
divides into organical and fimilar. 
It were ufelels to enter into a detail of the minute diftinc- 
tions of difeafesand their caufes in which Galen has in¬ 
dulged. Suffice it to fay, that the increafe, deficiency, or ir¬ 
regular diftribution,of the different humours,qualities,&c. 
which we have enumerated, was regarded by him as the 
eflential caufe of difeafe ; confequently the abllradlion of 
redundant, the reproduction of deficient, or the correc¬ 
tion of peccant, humours, formed the principal indications 
in his pathology. In anatomy and phyfiology, Galen dil- 
covered or arranged many important fadls. His affiduous 
diffedlions of animals furnifhed him with many ufeful ob¬ 
fervations : he likewife preferved in his writings much of 
the anatomical knowledge of the Alexandrian fchool; 
and has indeed corrected by experiment the errors into 
which that fchool had fallen, particularly in regard to the 
circulation of the blood. Hippocrates had afierted, that 
all the veffels communicated with each other, and that 
the blood underwent a kind of flux and reflux to and 
from the heart, like the ebbing and flowing of the lea; 
and he mentions the throbbing of the temporal arteries, 
as an evidence of this fail. The.anatomifls at Alexandria 
had adopted a different ©pinion ; as they found the ar¬ 
teries empty, and the veins containing blood, in their 
diffedlions, they imagined that the former were tubes for 
the diftribution of air, (and gave them that name which 
they have borne ever fince;) and that the veins were the 
only channels for the blood. The heart of man confid¬ 
ing of two lets of cavities not communicating with each 
other, and its connexion with the lungs, were to them 
delufive circumftances, and feemed to favour their opi- 
E nions. 
